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중증 간경화증환자에 (肝硬化症患者) 동반된 난치성 (難治性) 복수의 (腹水) 초여과에 (超濾果) 의한 치료효과
기춘석(Chun Suk Ki),박경남(K N Park),이호채(H C Lee),황흥곤(H C Hwang),정병천(B C Chung),허동헌(D H Hur),박한철(H C Park) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.1
N/A There had been a considerable trouble in the management of refractory acites combined with liver cirrhosis. Such refractory ascites in advanced liver cirrhosis does not respond to conventicnal therapy such as bed rest, salt restriction, massive diuretics and albumin infnsion. And there are also serious corrplications including hepatic encephalopathy, functicnal renal failure and hyponatremia with massive administration of diuretics. So peritoneovenous shunt(Leveen shunt) had been developed in order to promote effective circulatory volume with increased renal function. But relatively large and serious complications such as DIC, fever, infection, pulmonary edema and pulmonary embolism had limited its widespread use in the magement of refractory ascites. So we have experienced intraperitoneal reinfusion of ultrafiltered ascites for 20 patients with intractable ascites combined with liver cirrhosis. We had performed this procedure via ultrafilter which was usually used in hemodialysis and pump. And the following results werc acquired. 1. About 6200 cc of acites was ultrafiltered for average 4. 5 hrs. and loss of body weight was 6.7kg which was more than the amount of filtered ascites. 2, Increasing tendency in serum albumin concentration after ultrafiltration with peak concentration about 0. 5 gm/dl gain at 3rd after this procedure. There were significant increase in the amount of daily urine output but statisitically nonsignificant increase in creatinine clearance. 4, The complications of this procedure were light headache, hearing disturbance, dizziness and there was no more serious complication such as DIC, variceal rupture, pulmonary edema. There was no recurrence of reaccumulation of ascites within 3 months with one time procedure in a certain case. The repeated with average of 4-6 weeks interval had controlled such refractory ascites. In summary, above results supported that intraperitoneal reinfusion of ultrafiltered ascites have beneficial effect in the control of refractory ascites combined with far advanced liver cirrhosis. The advantages of this procedure are the followings. 1.Low cost. 2. Time saving. 3. Ambulatory control. 4 Less complication. 5. Corresponding effect to intravenous albumin infusion (4-5 bottles)
포스터 발표 : 담도,췌장 ; 연령 차이에 따른 담낭 운동성의 비교
조경란 ( K. R. Cho ),함준수 ( J. S. Hahm ),은창수 ( C. S. Eun ),박준용 ( J. Y. Park ),이승환 ( S. H. Lee ),한동수 ( D. S. Han ),이오영 ( O. Y. Lee ),전용철 ( Y. C. Jeon ),윤병철 ( B. C. Yoon ),이민호 ( M. H. Lee ),기춘석 ( C. S. Kee 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
〈배경〉 담석 발생의 증가를 초래하는 원인에는 지역적, 유전적 요인 담즙에서의 콜레스테롤 분비 증가, 담낭 운동성의 저하, 비만, 체중 감소, 고령 등이 알려져 있다. 고령화에 따른 노령 인구의 증가로, 담석 발생 원인 중, 나이의 증가에 의한 담석증 증가에 대한 관심이 늘고 있다. 이러한 노령층의 담석증 증가가 담낭 운동성의 저하로 인한 것인지를 확인하기 위하여 본 연구를 시작하였다. 〈연구 대상, 방법〉 간담도계 질환이 없는, 60세 이상 (평균 7
구연 / 제 2 회의장 / 위장관 44 : Fibroblast Growth Factor - 10 ( FGF - 10 ) 의 장관 염증 조절 기전에 관한 연구
한동수(D . S . Han),조윤주(Y . J . Cho),손영우(Y . W . Sohn),이오영(O . Y . Lee),전용철(Y . C . Jeon),손주현(J . H . Sohn),윤병철(B . C . Yoon),최호순(Ho Soon Choi),함준수(J . S . Hahm),이민호(M . H . Lee),이동후(D . H . Lee),기춘석(C . 대한소화기학회 1999 대한소화기학회 추계학술대회 Vol.1999 No.-
복수를 (腹水) 동반한 간경화증에서 (肝鏡化症) 복수내 (腹水內) Albumin 의 전신혈류로 (全身血流) 환류에 (還流) 관한 연구
기춘석(Chun Suk Ki),박경남(K N Park),함준수(J S Hahm),황흥곤(H K Hwang),이종숙(J C Rhee),조석신(S S Cho) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1
N/A Ascitic ultrafiltration and intraperitoneal reinfusion therapy for intractable ascites in liver cirrhosis removes ascites fluid rapidly and increases urine output, which is thought as a result of increased effective blood volume by inducing gradual backflow of concentrated ascitic albumin into circulation. To demonstrate a net transfer of ascitic albumin to blood by this therapy in cirrhotic intractable ascitic patient, I-181 labeld human serum albumin was administered intraperitoneally after ascitic ultrafiltration, and thereafter blood samples were chawn serially and radioactivity in these sample were measured. The blood levels of I-131-HSA increased gradually over 48 hours with the peak rate of blood uptake achieved at 6 hour and the peak levels is thought to be achieved at 72 hour considering the rate of uptake. At 48 hour, 6.47% of the isotope administered had appeared in the blood when corrections are made for transfer of labeled albumin into ascites and other extracellular space and degradation of labeled albumin, At 72 hour the precentage of ascitic albumin returned to blood appears to be at least 10% By this studies we can provides the therapeutic basis for ascitic ultrafiltration intraperitoneal reinfusion therapy in intractable ascites.
식도 정맥류 출혈에 대한 내시경적 경화요법의 장기적 관찰
이민호(M H Lee),기춘석(Chun Suk Ki),박경남(K N Park),윤인혁(I H Yoon),한덕호(D H Han),이성구(S G Lee),이종철(J C Rhee) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1
Esophageal variceal bleeding due to portal hypertension is very emergency state and needs emergency treatment. Crafoord and Frenckner introduced endoscopic injection sclerotherapy in esophageal variccal bleeding since 1939, its good effects are reported in many institute recently. This is to report the result of EIS of 88 patients with esophageal varix who had been admitted to the Department of Internal Medicine at Hanyang University Hospital. The result are as follows 1) Aiultivariate analysis revealed that grade of ascites, grade of encephalopathy, prothrombin time, bilirubin and GPT were distinguished best between survivors and nonsurvivors during the first 6 months after inclusion in the study. The difference in the 1-year survival rates of Childs group A and B versus Child's C patients was highly significant(p<0.002). 2) In the 88 cases, the survival cases beyond 36 months were noted in 4 cases and most long duration of survival was 42 months. 3) Rebleedings were noted in 19 cases(21.6%) and of these, re-rebleedings were noted in 9 cases(47.4%) but death due to variceal bleeding were only noted in 7 cases7.9%). Incidence of rebleeding were most high within 6 months(11.4%). 4) Major complications of the sclerotherapy were noted in 9 cases10.2%) but no correlations to direct cause of death were found. 5) Death were noted in 34 cases(38.6%) and cause of death were mostly hepatic failure and hepatocellular carcinoma(76.4%). 5) Furthermore EIS has advantages such as simple, safe, inexpensive. Therefore, EIS is proposed as treatment of choice for patients with esophageal variceal bleeding.
원발성 간암에서 혈청동 및 혈장 Fibrinogen 의 진단 및 예후판정의 의의
이동후(D H Lee),기춘석(Chun Suk Ki),박경남(K N Park),이진(J Lee),최영춘(Y C Choi),오기영(K Y Oh),함준수(J S Ham) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
N/A An increased serum copper (Scu) level has been observed in some solid tumor as lymphomas and also in hepatocellular carcinoma, and some studies suggested the usefulness of determination of Scu level in the differential diagnosis between hepatoma and cirrhosis. But there were no studies about the Scu changes after transhepatic arterial embolization (TAE), relationship between Scu and hepatoma size and portal vein thrombosis, and relationship between Scu and a-fetoprotein. To investigate the diagnostic and prognostic value of plasma fibrinogen (PF) as acute phase reactant and Scu in primary hepatocellular carcinomas, We studied 50 cases of hepatoma, 30 cases of liver cirrhosis and 30 cases of normal control. The results are follows: 1) In hepatomas, Scu level was 197.04±70.35 ug/dl (Mean+ SD) (92.0±59.06 ug/dl in cirrhosis: p < 0.0001, 92.15±20.92 ug/dl in normal controls: p<0.0001). 2) In hepatomas, PF level was 387.40±115.34 mg/dl (Mean+ SD) (266.89±59.06 mg/dl in cirrhosis; P < 0.0001, 282.03±74.03 mg/dl in normal control; P < 0.0001). 3) Scu had a relatively good sensitivity (0.64) and a very high specificity (1.00) at a cutoff value of 160 ug/dl. The combination of Scu and PF improved the diagnostic value slightly. 4) In 11 patients Scu levels decreased 2 Months after TAE from 193.81±44.54 ug/dl (Mean±SD) to 11.49± 39 52 ug/dl(p < 0.0001). 5) The Scu level of diffuse infiltrative hepatoma associated with portal vein thrombosis and larger sized hepatoma were more elevated than the one of localized hepatoma without portal vein thrombosis and smaller sized hepatomas, but there was no statistical significance. 6) There was no relationship between Scu level and α-fetoprotein level. 7) There was no relationship between Scu level and total bilirubin, SGOT/SGPT and alkaline phosphatase. In conclusion, these findings suggested that Scu level may be used as a screening test for early detection of neoplastic degeneration from cirrhosis. And it is corelated with the extension of tumor mass and simultaneous check of PF level with Scu level may provide the more diagnostic and prognostic value in hepatoma.