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.

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)

십이지장 (十二指腸) 질환의 내시경적 (內視鏡的) 소견과 임상적 (臨床的) 고찰

윤성현(S H Yoon),신현성(H S Shin),이민호(M H Lee),이동후(D H Lee),박경남(K N Park),기춘석(C. S. Kee) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1

N/A The duodenum located at the center of the abdomen, is apparently the most important site for digestion, anatomically, physiologically and in chemical basis and so more abundant and advanced study would be needed. 1, 006 patients with endoscopicallv diagnosed duodenal diseases from 1973 to 1981, were analyzed in various view in this study. The results were as follows; I. The incidence of duodenal ulcer and duodenitis was 6.5% and 8.1% each of total endoscoped patients. 2. Male to female ratio in duodenal ulcer was 4. 3: 1, whereas the ratio in duodenitis was 1.2: 1; The occurrence ratio was highest among thirties in both diseases. 3. The most common type of ducdenal ulcer was round(65.2%), medium sized(63.4%) one that is located at the side of greater curvature(52.8%) within ducdenal bulb. 4. Duodenitis consisted Of nonspecific duodenitis (70. 4%), erosive duodenitis (27. 6%) and hemorrhagic duodenitis(2.0%). 5. In total 274 cases having a concomitant upper gastrointestinal X-ray study, endoscopic and x-ray diagnosis agreed in 69.6% of 136 cases with endoscopically proven duodenal ulcer, wheras only 9.6% of 138 cases with endoscopically proven duodenitis revealed the same result of X-ray. From these points, it is suggested that the initial diagnosis of duodenitis, decision of ulcer activity and detection of bleeding focus would have to be made by endoscopic examination. In bleeding conditions from duodenal pathology, melena to hematemesis ratio was l. 2:1 in duodenal ulcer and 1: 1. 2 in duodenitis. 7. Stormach conditions in 443 ducdenal ulcers were normal(44.6%), gastric ulccr(19.6%), acute erosive gastritis(16.7%) and chronic superficial gastritis(15.8%) in order of frequency.; It is suggested that duodenal ulcer might be related to normal or hyperchlorhydric state of stomach. 8. Stomach conditions associatcd with duodenitis were chronic superficial gastritis(44.2,%), acute erosive gastritis(23.8%), and gastric ulcer(15.3%) in order of frequency, whereas normal stomach states were only 9. 4%. From these findings, it is suggested that duodenitis would be a secondary change reflecting pathology of stomach or other neighboring organs. 9. Other main diseases associated with duodenal pathology were hepatopathy, hypertension, colitis, and chronic obstructive pulmonary diseases in order of frequency. 10. Patients with blood type 0 were 38.1% in duodenal ulcer group and 32.5% in duoden it is, comparing with 29. 0% in generat population in Korea. Ll. Smoker to non-smoker ratio was 1.7: 1 in duodenal ulcer and 1: 2. 7 in ducdenitis; epidemiological study of alcohol, coffee and taste did not show any diffence between duodenal ulcer and duodenitis . More detail study is necessary to know relationship between duodenitis and duodenal ulcer and pathogenesis of duodenitis secondary to pathologic conditions of neighbor organ or gastro intestinal hormones,

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.

위암 (胃癌) 환자 708예에 대한 임상적 (臨床的) 관찰

이민호(M H Lee),이동후(D H Lee),박경남(K N Park),이호채(H C Lee),박찬현(C H Park),손락지(R J Sohn) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1

N/A The incidence of stomach cancer, which was one of the commonest malignancies has been a little decreased recently, but it is still in the first rank in Japan, Finland and Korea. In the respect of portance of stomach cancer, we analysed 708 cases of stomach cancer which were confirmed by endoscopic biopsy from Mlarch 194 to February 1982 in Hanyang University Hospital. The results were as follows: 1. The peak age of stomach cancer was 7th decade(29.2%) and male to female ratio was 2.1: 1 with male preponderance. 2. The patients groups who had under 3 months duration of illness before confirmatory diagnosis was 33.9% and over 12 months was 31.5%. Indigestion was the most common subjective symptom(53.2%) and epigastric pain, weight loss, hunger pain and belching were common symptoms in order of frequency. 3. The most common blood type was type A(36.4%) and O type, B type and AB type in order of frequency. 4. There was no statistically significant difference in incidence not only between smoking group and nonsmoking group(p>0.1), but also between alcohol drinker group and non drinker group(p>0.1). 5. The cases with achlorhydria or hypochlorhydria were 74.7%(162/217). 6. The proportion of patients with anemia(Hb. under 12 gm%) was 59.4%, 7. The most predilection site of stomach cancer was antrum and body(90.6%) and the most common Borrmanns type was type g (47.5%). 8. The most common histological type was adenocarcinoma(74.6%) and positive result rate of biopsy with gastroscope for stomach cancer was 93.4%. 9. The numbers of patients who had got operation were 316cases of 708cases(44.6%)

식도정맥류 (食道靜脈瘤) 근절에 (根絶) 대한 내시경적 (內視鏡的) 경화요법과 (硬化療法) Propranolol 의 병합요법 (倂合療法)

이민호 ( M H Lee ),박경남 ( K N Park ),이동후 ( D H Lee ),기춘석 ( Chun Suk Ki ),정효철 ( H C Jung ),함준수 ( J S Hahm ),정태준 ( T J Chung ) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1

N/A Esophageal Variceal bleeding due to portal hypertension is very emergency state and difficult for management. In spite of many kinds of treatment in esophageal variceal bleeding such as medical and surgical method, but can't be expected of good results especially in Childs B & C groups. Crafoord and Frenckner introduced Endoscopic Injection Sclerotherapy in esophageal varical bleeding since 1939, its good effect are reported in many institute recently. Lebrec and Fleishman reported that propranolol is significantly decreased portal venous pressure in 1980. In order to prevent for rebleeding of esophageal varices and eradication of esophageal varices, we tried that combined therapy of endoscopic injection sclerotherapy and propranolol for over 6 months in 7 patients of Esophageal varices bleeding. Endoscopic Injection Sclertherapy is performed every week for 6 months and propranolol is 80-120 mg/day over 6 months per oral route. So, we have possibility that above combined therapy prevents rebleeding & eradicates esophageal varices.

식도 (食道) 정맥류 (靜脈瘤) 출혈에 있어서 내시경적 (內視鏡的) 경화요법의 (硬化療法) 치료효과

신현성(H S Shin),이동후(D H Lee),기춘석(Chun Suk Ki),박경남(K N Park),황흥곤(H C Hwang),주상언(S U Joo),최일영(I Y Choi) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.1

N/A Bleeding from esophageal varices is the most, severe complication in patients with cinhosis of the liver and portal hyrpertension. There has never been a uniform concept of emergency management of variceal bleeding because of pitfalls in the medical as well as the surgical therapeutic technics. Endoscopic injection sclerotherapy of esophageal varices is being reevaluated by many physicians because of increasing dissatisfaction with shunting procedures. This is to report the result of the EIS of 12 patients with esophageal varix. Who have been admitted to the department of internal medicine at Han Yang Universitv Hospital. The results are as follows: 1. 12 patients with liver cirrhosis who were proven to have esophaveal varices by esophagoscope were treated by EIS. There were 10 males and 2 females in the age range of 37 to 58 years. 2, Severity of liver cirrhosis was classified by Child method revealed cases in grade II and 7 cases in grade III, The varices were classified by the Sesoko method, revealed cases in moderate (B) and 8 cases in severe (C). Intravenous vasopressin was injected within 10 to 12 hours before EIS and b!ood transfusion was performed, if needed. 5.Solution of 5% sodium morrhuate was iniected into varices and Bovine thrombin was spraid around varices. 11 patients with active bleeding had control of their hemorrhage: 7 cases with first shooting, 3cases with second shooting, 1 case with third shooting. In the one patient without bleeding, esophageal varix was significantly decreased in size after EIS. 7. EIS has advantages such as simple, safe, inexpensive, low complication. 8. EIS is proposed as the emergency treatment of choice for patients with proven bleeding Esophageal varices who do not stop bleeding on conservative treatment.

Cryptogenic Multifocal Ulcerous Stenosing Enteritis(CMUSE)

박경남 ( K . N . Park ),박준용 ( J . Y . Park ),한동수 ( D . S . Han ),손주현 ( J . H . Son ),조윤주 ( Y . J . Jo ),김용수 ( Y.S KIM ),백홍규 ( H.K Paik ),전규영 ( K.Y Jun ),장세진 ( S.J Jang ) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

RP - HPLC 를 이용한 유전자 재조합 E . coli 내의 Interferon -α 내포체의 직접 정량화

김윤하,이은규,안상점,박경남 ( Y . H . Kim,E . K . Lee,S . J . Ahn,K . N . Park ) 한국화학공학회 1995 화학공학의이론과응용 Vol.1 No.2

DBM을 활용한 EMR 기반의 스트로크환자의 재활프로토콜 추천 시스템

이선우(S. W. Lee),박경남(K. N. Park),김세진(S. J. Kim),원인수(I. S. Won),권장우(J. W. Kwon) 한국재활복지공학회 2017 한국재활복지공학회 학술대회논문집 Vol.2017 No.4

Most existing stroke rehabilitation training systems were determined by empirical treatment methods of doctors. Standard treatment guidelines for stroke rehabilitation have been introduced to address these problems. However, these guidelines are determined by the doctor"s objective judgment, and sometimes the doctor suggests different treatments for the same patient. In addition, there are cases where only the patient"s exercise function is presented and the individual"s risk management factor is missing during rehabilitation treatment. To solve these problems, this paper proposes a training method suitable for the patient using DBN (Deep Belief Network). In this method, a part of the patient"s EMR(Electronic Medical Records) data and a risk management factor are inputted and a method of presenting a suitable exercise to the patient is derived.