http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
유도 괄약근 절개술후의 출혈; 발생 빈도, 위험 인자 및 내시경적 지혈 치료
김홍자 ( Hong Ja Kim ),임병철 ( Byeong Cheol Lim ),유교상 ( Kyo Sang Yoo ),박으택 ( Eun Taek Park ),서동완 ( Dong Wan Seo ),이성구 ( Sung Koo Lee ),김명환 ( Myung Hwan Kim ),민영일 ( Young Il Min ) 대한췌담도학회 1999 대한췌담도학회지 Vol.4 No.1
내시경적 담도 괄약근 절개술에 의한 출혈은 0.5~12%의 빈도로 발생한다고 보고된다. 본 조사에서는 이들 출혈의 위험인자 및 에피네프린과 알코올을 이용한 내시경적 지혈의 치료효과와 합병증에 대해 전향적으로 연구하였다.
임경묵(Kyeong-Muk Im),임병철(Byeong-Cheol Lim),박상흡(Sang-Heup Park) 한국산학기술학회 2015 한국산학기술학회 학술대회 Vol.2015 No.1
그레이팅은 건축, 토목에서 배수의 주 목적으로 하는 구조물이다. 본 연구 에서는 가로형 그레이팅보다 유속에 대한 저항성을 감소시킨 구조인 세로형 그레이팅의 3가지 모델(35.5형, 40형, 43형)을 시뮬레이션하여 응력 분포 및 변형에 대해 연구하고 최적의 격자 간격의 그레이팅을 설계함이 목적이다. 세로형과 가로형 그레이팅에 하중에 대한 최대 응력 및 변형을 비교 분석하여 보다 나은 제품을 확인하였다.
양대현,김나영,이계희,임선희,송찬호,최신은,임병철,이지연,양상석,한윤주,신동혁,노은진 대한소화기학회 2000 대한소화기학회지 Vol.36 No.4
Solitary splenic metastasis of colon cancer is uncommon and usually occurs with wide spread dissemination of the tumor. Only 8 cases of isolated splenic metastasis from colon cancer are reported in the English literature. A 26-year-old male who had received a right hemicolectomy for right colon cancer on May 1996, was hospitalized for increased carcinoembryonic antigen (CEA) level that was identified on regular follow-up. The abdomimal computed tomography (CT) revealed a 5×4×3.5 cm sized low attenuated lesion in posterior portion of spleen. On sono-guided aspiration, metastastic adenocarcinoma was confirmed. Under the diagnosis of solitary splenic metastasis, a splenectomy was performed on July 1998. We report the case with a review of literature.
김명환,이성구,서동완,김홍자,민영일,유교상,박은택,임병철,차재명,최원범,송문희 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.4
Background/Aims : Endoscopic biliary sphincterotomy (EST)-induced hemorrhage occurs in approximately 0.5-12% of procedures. We prospectively investigated the risk factors of EST-induced hemorrhage and evaluated its safety as well as the effectiveness of endoscopic hemostasis. Methods : One thousand three hundred and four patients, who underwent EST between July 1996 and June 1998, were enrolled. As a hemostatic treatment, epinephrine spray was initially used. If bleeding persisted, epinephrine injection was performed consecutively. In patients with exposed vessels, epinephrine injection followed by alcohol injection was given. Results : EST-induced hemorrhage occurred in 136 (10.4%) patients. Types of sphincterotome (needle-knife sphincterotome, p=0.0079) and cutting speed (so-called, zipper cut, p=0.03) were revealed as significant variables for the occurrence of bleeding. Once bleeding occurred, patients with an associated ampullary lesion (impacted stone or cancer) or with coagulopathy were more likely to bleed profusely. Initial hemostasis was achieved in all patients. However, rebleeding occurred in eight patients who were initially classified in the moderate or severe bleeding group. Finally, EST-induced hemorrhage was successfully controlled in all patients after 1-3 treatment sessions (mean: 1.1 sessions). The difference in the incidence of complications between the groups with and without endoscopic hemostasis was not statistically significant. Conclusions : The use of needle-knife sphincterotome and cutting speed were independent risk factors for bleeding occurrence. Once bleeding occurred, its severity was affected by the associated ampullary lesion (impacted stone or cancer) or coagulopathy. Endoscopic hemostasis with epinephrine and/or alcohol was effective and safe in EST-induced hemorrhage.
김동일,이상수,김명환,이성구,서동완,민영일,유교상,명승재,임병철,박순서,최원범,김승규,배인규 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.2
목적/배경 : 초음파 내시경의 소견을 기초로 하여 담낭용종의 감별진단을 위한 새로운 지침을 제안하였다. 방법 : 92년부터 95년 사이에 초음파 내시경과 담낭절제술을 받은 79예를 대상으로 종양성(선종, 악성종양)과 비종양성 용종으로 나누었다. 용종은 크기에 따라 4그룹(≤5, 5∼10, 10∼15, 그리고 ≥15 ㎜)으로 나누어 분석하였고, 용종의 크기가 5∼15 ㎜인 환자에서 5개의 초음파 내시경적 변수들의 점수의 크기는 판별분석과 대응위험도를 이용하여 계산하였다. 그리고 나서 5가지 변수들의 합계 점수를 96년부터 98년까지 입원한 26예에 적용하였다. 결과 : 92년부터 95년까지의 79예에서 다변량 변량분석을 시행하였을 때 용종의 크기는 가장 의미있는 종양성 용종의 예측인자였으며(p<0.01), 용종의 크기가 5 ㎜ 이하인 모든 용종은 비종양성이었고, 15 ㎜ 이상인 경우 94%가 종양성 용종이었다. 그러나, 용종의 크기가 5∼10 ㎜ 군과 10∼15 ㎜ 군에서의 종양성 용종의 위험도는 통계학적으로 의미있는 차이는 없었으며(p=0.128), 15 ㎜를 초과할 경우 5∼10 ㎜ 군과 10∼15 ㎜ 군과 비교하여 의미있게 종양성 용종의 위험도가 증가하였다. 96년부터 98년까지 입원한 환자에서 용종의 크기가 5∼15 ㎜일 때, 5개 변수들의 합계 점수가 6 이상인 경우 종양성 용종의 위험도는 5 이하와 비교하여 의미있게 증가하였다. 결론: 5㎜ 이하의 용종은 추적관찰, 15㎜ 이상의 용종은 수술적 치료를 시행하고, 5∼15 ㎜ 크기의 경우 초음파 내시경 소견을 바탕으로 수술여부를 결정하는 것이 치료방침에 유용할 것으로 볼 수 있겠다.
Somatostatin Analogue(Octreotide)치료가 유효했던 췌장성 복수 1예
신정현,김명환,정성희,이성구,서동완,민영일,김선영,유교상,박은택,임병철,나비석,표승일 대한소화기학회 2000 대한소화기학회지 Vol.35 No.4
Pancreatic ascites has the characteristics of highly proteinaceous, amylase-rich intraperitoneal fluid. It usually occurs as a result of rupture of a pseudocyst or disruption of main pancreatic duct during the course of acute or chronic pancreatitis. It can be managed by traditional conservative methods including fasting, total parenteral nutrition and ascites tapping or surgical interventions. Recently, several cases of treating pancreatic ascites with somatostatin analogue (octreotide) successfully have been reported. We experienced a patient with chronic pancreatitis and pancreatic ascites, who was successfully treated by somatostatin analogue (octreotide).
췌장의 Intreaductal Papillary Mucinous Tumor:그 아형에 따른 임상적, 방사선학적 및 병리학적 소견의 비교
이영미,김종철,김명환,김경덕,박현주,이성구,서동완,민영일,김정호,유교상,박은택,임병철,이시열 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.6
Backgrounds/Aims: Patients with a branch duct type intraductal papillary mucinous tumor (IPMT) of the pancreas with hyperplasia are suggested to be followed up without resection. The aims of this study were to compare the clinical, radiologic, and pathologic findings among the subtypes of IPMT and to find the factors that could predict a hyperplastic lesion preoperatively. Methods: Twenty two patients with IPMT of the pancreas who underwent surgical resection were investigated. The subtypes of IPMT were classified into the main duct type (7 patients), branch duct type (6 patients), and combined type (9 patients) based on the pathologic findings of the surgical specimens. The clinical, radirologic, and pathoiogic findings of each subtype were analyzed. Results: Asymptomatic patients were more common in the branch duct type of IPMT (p=0.01). The diameter of the main pancreatic duct was $lt;7 mm in most of the branch duet types of IPMT (5/6). Hyperplastic lesions were more likely to be the branch ciuct type (5/6, p=0.01). Conclusions: A hyperplastic lesion can be predicted if a lesion is the branch duct type of IPMT with the diameter of the main pancreatic duct $lt; 7 mm and without symptoms. Therefore, IPMT of the pancreas with these findings can be followed up without an operation.
경피경간담도경검사법을 이용한 간내담석 치료의 장단기 추적 성적
김명환,이성구,서동완,김홍자,민영일,성규보,윤현기,유교상,설상영,명승재,임병철,박은태 대한소화기학회 2000 대한소화기학회지 Vol.35 No.3
Background/Aims: The immediate and long-term results of percutaneous transhepatic cholangioscopic lithotomy for the intrahepatic stones were analyzed according to degree of biliary stricture, severity of cirrhosis, and Tsunoda classification. Methods: We studied retrospectively medical records of 92 patients with hepatolithiasis who received percutaneous transhepatic cholangioscopy (PTCS) treatment from September 1992 to May 1997. Sixty-eight patients were followed up for 24 to 60 months (median 42 months). Results: Complete clearance of the intrahepatic stones was achieved in 74 patients (80%). In group A (Tsunoda class I and II), no recurrence was observed upto 28 months of follow-up. However, in the patients of group B (Tsunoda class Ⅲ and Ⅳ), recurrence rates were increased continuously, and 50% of them had eventually recurrence of stones or cholangitis. Conclusions: PTCS is an effective and safe procedure for management of hepatolithiasis in patients who are not candidates for surgical resection. In cases of severe andultiple strictures, adequate dilatation of bile duct strictures and close follow-up are necessary.