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韓國人의 膽石分析에 對한 硏究 : 放射線 回折法에 依하여
黃正雄,睦敦相 고려대학교 의과대학 1980 고려대 의대 잡지 Vol.17 No.1
For the purpose of guiding therapy and diagnosis of gallstone among Korean, author carried out a analysis of the components of gallstone in Korean. The chemical components of 100 cases gallstones, which were collected from 3 major urban hospitals located in Seoul, Korea, during period of one year and eight months starting 1978, had been analyzed by x-ray diffraction method. 1. The prevalence rate of gallstone disease was more prominent in female than in male as 1: 1.8. The average age of gallstone patients was 48.7 year of age. The age of peak incidence was between 50-59 year of age. 2. Forty two percent of gallstones was found in gallbladder and 42% of gallstone was also found in common bile duct. Remaining 16% was found in both gallbladder and common bile duct. 3. The following 9 chemical components were identified, cholesterol (monohydrate, anhydrate and new form cholesterol) in 52%, calcium bilirubinate in 40%, calcium carbonate (calcite, aragonite, vaterite) in 28%, calcium palmitate in 43%, calcium stearate in 1%, and pure pigment in 8%. 4. Single component stones were observed in 46% of cases. The incidence of each single component are as follow: cholesterol in 25%, calcium carbonate in 12%, calcium palmitate in 1%, and pure pigment in 8%. 5. Total crystalline components consisted of cholesterol in 32.7%, calcium bilirubinate in 20.1%, calcium carbonate in 25.1%, calcium palmitate in 21.6% and calcium stearate in 0.5%. 6. Gallbladder gallstones were more prone to have cholesterol (55%) than calcium bilirubinate (24%). On the contrary common bile duct stone contained more calcium bilirubinate and calcium palmitate (71.4%) than cholesterol (40%).
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황정웅,김홍정 대한혈관외과학회 1992 Vascular Specialist International Vol.8 No.1
Since the advent of the management of the peripheral arterial occlusive diseases following various surgeons worldwide since Vetto et. All, the important issue has been the maintenance of graft patency. With new surgical modalities such as the crossover femorofemoral bypass, the graft patency has been increased upto 85% for the duration of 5 years postopertively. However the hemodymanamic changes following the extraanatomic bypass prodeducres have been studied by many researchers intensively without definite results in regard to improve the graft patency. Many preoperatively diagnostic work-ups have been searched and recommended as to make best surgical techniques in order to increase the graft patency. These already known preopertive diagnostic methods are mostly cumbersome and expensive. The authors have tried to come up with simple methods of determining the hemodynamic status before selecting the best surgical techniques for the patients in order to increase the graft patency. The authors have evaluated 15 patients with the unilateral iliac arterial occlusive diseases whom the crossover femorofemoral bypass were done. These patients have been followed over the duration of 5 years at the maximum, and reevaluated the cases of early graft patency failure which the authors have defined as the occlusion of the graft in 3 years postoperatively with associated symptoms. The angiography were evaluated in all cases preoperatively, and postoperatively in selected cases with symptoms and preoperatively, and postoperatively in selected cases with symptoms and signs of the graft failure. Simple geometrical evaluations of the angiography was done and have made correlations to the rate of graft patency failure. Thus the authors have made prediction in regards to the early graft patency failure due to poor selection of the surgical techniques.
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황정웅,서성옥,김세민 대한소화기내시경학회 1993 Clinical Endoscopy Vol.13 No.4
Surgical advance on the general surgical department as minimal access procedure was changed into the laparoscopic cholecystectomy from open cholecystectomy for treatment of cholelithiasis. Laparoscopic cholecystectomy is far less invasive, less painful, less expensive, less complicative, high cosmetic and high conservative procedure, and reduced hospitalization than open surgery. The retrospective study of 176 patients undergoing laparoscopic cholecystectomy during 16 months from September 1991 through December 1992 was conducted. We evaluated the diagnostic tools, previous operation history, associated disorders, operation time, postoperative condition, lyospitalization days, gallbladder pathology, conversion rate to open cholecystectomy and complications. The results were as follows; 1) Of 176 patients who were taken the laparoscopic cholecystectomy, patients' age ranged from 14 to 87 years and female patient were 119 cases(67.8%) and symptomatic cases were 114 cases(65%). 2) Diagnostic tools were abdominal sonogram(100%) in all cases and oral cholecystogram 88 cases(88%), retrograde cholangiopancreaticography 62 cases(38%) and HIDA or abdominal computerized tomography in 4 cases(2%). 3) The most common previous operation history was OB & GY surgery. 4) The common associated disorders were the heart diseases(26.7%), COPD and diabetes(both 16%), and liver cirrhosis(14.7%). 5) Of the 176 gallbladder pathology, 165 cases(93.8%) were contained cholelithiasis, chronic cholecystitis in 139 cases(84.3%), acute cholecystitis in 26 cases(15.7%), GB polyp in 8 cases(4.5%) and cancer in 3 cases(1.7%). 6) Ten cases of the 176 laparoscopic cholecystectomy(5.7%) were required conversion to open cholecystectomy. And average operation time was 65 minutes, total success rate was 94.3%, and there was no death. 7) The complication rate was 6.3%, and wound pain, prolonged ileus and bleeding were noted in decreasing order of frequency. 8) The average postoperative stay was 3.2 days. In conclusion, laparoscopic cholecystectomy which was taken for the symptomatic cholelithiasis will be offered as the most effective therapeutic modality.
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정석인,황정웅,민연기,천영덕,조용걸 대한혈관외과학회 2001 Vascular Specialist International Vol.17 No.1
Purpose: As traffic accidents and invasive vascular procedures are increasing these days so are vascular trauma, either blunt or penetrating. So we investigated the changes of clinical status of vascular trauma for the last 10 years. Method: We retrospectively reviewed the medical records of 121 patients who had admitted and operated at Korea University Hospital due to traumatic arterial injuries from 1990 to 1999. We divided those patients by period into two groups; Era 1 (1990~1994) and Era 2 (1995~1999). The former group included 51 patients, the latter 70. Age distribution, causes of injury, location, degrees of injury, amputation rate, mortality rate, and operation methods between these two groups were compared. Result: The most common cause of arterial injury was blunt trauma by traffic accident in Era 1, injury by broken glasses in Era 2. Iatrogenic injury cases increased (from 3.9% in Era 1 to 10% in Era 2), and so did industrial injuries. Two groups also show similar distribution of degrees and location of injuries. Amputation rate in cases of vascular trauma of lower extremities correlates with combined fracture in both group (p$lt;0.05). Amputation rate was 35.5% in Era 1, and 23.5% in Era 2. The mortality rate was 15.7% in Era 1 and 12.9% in Era 2 (p$gt;0.05). Each group presented statistically significant correlation between location of injury and mortality (p$lt;0.05). Abdominal injury was related to high mortality rate (63.2%). Conclusion: The latter period (Era 2) showed increased iatrogenic injury rate compared to the former. Amputation rate increased when combined with fracture in both groups, but mortality rate didn't significantly change between these two groups.
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