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        • 甲狀腺의 臨床的 硏究

          裴振善 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

          Thyroid gland is the most frequent endocrine organ which requires operation in surgery department. Among 95 patients whe were admitted for operation due to thyroid disease during 3.5years from Jul. 1. 1980 through Dec. 31. 1983 in the Department of Surgery, Chungnam National University Hospital, 18 patients were proven as thyroid cancer. The results about cancer were as follows; 1. The sex ratio of male to female was 1:8. 2. Age distribution in female was 37.5% in 3rd decade and 43.8% in 4th decade. 3. In all patients, mass could be palpable, on the contrary in 78% of patients there w subjective symptom, only 2 patients had easy fatigability, 2 patients palpitation, I patient slight dyspnea. 4. About to the location, the ratio of right to the left was almost equal, in one case it located in the isthmus. 5. Thyroid function test was within normal limit only but one case. 6. 37 year old female patient had follicular cancer in the left lobe and papillary cancer in the right lobe. 7. As to the method of operation, lobectomy was performed in 7 cases, lobectomy and isthmectomy in 7 cases, subtotal thyroidectomy in 3 cases, total thyroidectomy in 1 case. 8. About to the pathological findings, papillary cancer was found in 9 cases, papillary-follicular cancer in 2 cases, follicular cancer in 6 cases. 9. As to the result, in 89% of patients, there was no complication, but one case had hoarseness.

        • 大腸癌의 臨床的 考察

          裵振善 충남대학교 의과대학 지역사회의학연구소 1978 충남의대잡지 Vol.5 No.2

          This paper is a clinical analysis and review of 40 cases of colon and rectal cancer who were admitted to Chungnam National University Hospital from July 1974 to July 1978. The results are as follow: 1. Male outnumbered female by the ratio of 1. 1 : 1 and age incidence was most pre alent in the 6th decades, comprising 45 % of all cases. 2. The duration of symptoms prior to admission was within 7-12 month in 35%. 3. The location of tumor was most frequent in recto-sigmoid colon(62. 5%), cecum (10.0%), transverse colon(10.0%) in this order. 4. Most frequent symptoms were melena (52.5%), followed by bowel habit change (45%) and pain(40%). 5. The tumors were Dukes' type A in 5% of all cases, type B 35%, type C 22.5%, and type D 37%. 6. Colostomy was most frequent operation used(30%), Miles' operation was performed in 22. 5% of all cases and right homicolectomy in 12.5% and biopsy only in 10%. 7. Complication devleoped in 25% of all cases, wound infection being most common (40%). 8. Operative mortality was 2%. 9. Dietary habit of patients seemed to be non-specific.

        • 血淸 CEA値에 關한 臨床的 硏究

          裵振善,尹必逵 충남대학교 의과대학 지역사회의학연구소 1982 충남의대잡지 Vol.9 No.2

          The serum carcinoernbryonic antigen (CEA) values as an indicator of colorectal carcinoma has been accepted, however the CEA value is increased not only in colorectal cancer but in many other conditions, such as chronic pulmonary disease, heavy smoker, inflammatory bowel disease, pancreatitis, liver diseases, biliary tract disease, breast disease, ovarian disease, uterine disease, cervix disease etc. Although it may not be suitable to screening test, nevertheless its serial check is very valuable for early detection of recurrence after removal of tumor by the increase of serum CEA value during postoperative follow-up. Serum CEA values were checked by the patients of peptic ulcer, injury and other non-malignant disease, stomach cancer, breast cancer, and colorectal cancer treated from March 1982 to October 1982 in the Department of General Surgery, Chungnam National University Hospital. The following results were obtained; 1. The level in control was 2.5±1.9 ng/ml. 2. By the patients of stomach cancer, the preoperative level being 39.7±74.1 ng/ml, the postoperative level was 31.4±62.8 ng/ml. 3. By the patients of breast cancer, the preoperative level being 13.3±7.8 ng/ml, the postoperative level was 11.0±8.3 ng/ml. 4. By the patients of colorectal cancer, the preoperative level being 39.0±61.8 ng/ml, whereby the postoperative level was 21.3±35.5 ng/ml.

        • 體外肝灌流法에 依한 肝性昏睡患者治療의 臨床的 考察

          裵振善 충남대학교 의과대학 지역사회의학연구소 1980 충남의대잡지 Vol.7 No.2

          Hepatic coma is caused by functional disturbances of central nervous function in hepatic failure. It accompanies very high mortality, i. e. over 80% with the conventional conservative treatment. Since Eiseman et al. introduced the concept of hepatic assist by ex vivo liver perfusion in 1964, many investigators have tried the technique for the treatment of patients in a state of hepatic coma in order to improve its course and results. However with the pig livers, its effect is not so significant, i. e. of almost same mortality as that of conservative treatment; but with the baboon or human livers, one can achieve survival rate by so far as 40-50%. In the Department of Surgery, Klinikum Steglitz of Free Univerisity in West Berlin, 13 patients of hepatic coma have been treated with 18 times extracorporeal liver perfusion during last 12 years, of whom 7 patients lived longer than 4 days after cessation of the perfusion, and 3 patients were discharged with recovery from coma. Methods of temporary liver replacement are such as; 1. exchange transfusion, 2. homologous or heterologous cross circulation, 3. hemoperfusion with activated charcoal, 4. extracorporeal vital liver perfusion with pig, baboon, or human livers, 5. liver transplantation (definitive treatment). The reasons why one can achieve better results with baboon livers than with pig livers are as followings: 1. It can maintain much longer (as long as 24 hours) than with pig livers (5-6 hours). 2. As to the immunologic problems, because of smaller antigenic disparity between man and baboon than between man and pig; with baboon liver, it causes neither clinical reactions nor antiserum antibody, whereas with pig livers it causes several antipig serum antibodies, such as hemagglutinins, leukoagglutinin, lymphocytotoxic antibody and precipitating antibody. 3. With baboon liver, it causes much less thrombocytopenia, whereas with pig livers it causes decrease of thrombocytes by 80% after 30 minutes of perfusions. 4 With baboon liver, the result is much better than that with pig livers, i. e. in the former, reversal of coma or successful rate is 40-50%, in the latter, it is 20-30% at the best. Ideal indications are endogenous hepatic coma due to acute and potential reversible hepatic necrosis especially by acute viral hepatitis, and. it can be also applied to the treatment of patients with chronic and irreversible liver disease, such as chronic active hepatitis or far advanced liver cirrhosis, in whom there is no likelihood of sufficient regeneration of liver, for the maintenance of life and to be free from infection till the time of liver transplantation.

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