외상성 췌장손실에 대한 임상적 고찰

송옥평,전성진,조무식 대한외상학회 1993 大韓外傷學會誌 Vol.6 No.2

Pancreatic trauma has been reported with increasing frequency due to high speed automobile accidents and other acts of violeuce. The key to treatment is thought to be early and accurate evaluation and proper management according to the degree of injury. A retrospective review of 42 patients suffering injuries to the pancreas between 1983 and 1992 at the surgical department of the Soon Chun Hyang university hospital was undertaken. There were 39 men and 3 women, in the ratio 13: l. Age incidence was the highest in the second and third decades (70%). Most of them (97%) were injured by blunt trauma, 28 out of 41 cases by traffic accident, thirteen by altercation and violation. One case was injured by penetrating trauma. The time interval between the injury and operation was within 12 hours in the majority of pancreatic trauma. The preoperative serum amylase was increased in 32 cases (76%) of pancreatic trauma. The injury site of pancreas was 19 cases in the body, 15 cases in the tail, 7 cases in the head. According to the classification by Lucas, pancreatic injuries of Class I were 7 cases, pancreatic injuries of class II were 14 cases, pancreatic injuries of class III were 18 cases and combined pan$lt;=reaticoduodenal injuries (class IV) were 3 cases. Seven patients with pancreatic injuries were treated by hemostasis and drainage, 31 by distal pancreatectomy and one by Roux-en-Y distal pancreaticojejunostomy. One patient with pancreaticoduodenal injury was treated by duodenal diverticulization. Two patients were performed Whip- ples pancreaticoduodenectomy due to severe combined pancreaticoduodenal injury. The postoperative complications were present in 24 cases (57.1k), pancreatic fistula (13 cases), pleural effusion (11 cases), wound infection (6 cases), intraabdominal abscess (5 cases), pseudocyst (5 cases). The mortality of pancreatic injuries was 19% (8 cases), the causes of death were ARDS (3 cases), sepsis (2 cases), ARF (1 case) and hypovolemic shock(1 case).

高血壓症患者에서의 血淸脂質에 관한 硏究 : HDL-cholesterol과 Apoprotein A-Ⅰ을 中心으로 Serum HDL-cholesterol and apoprotein A-Ⅰ

金箕洪,宋鈺平 한양대학교 의과대학 1983 한양의대 학술지 Vol.3 No.1

The debate of the value of plasma lipids as predictive risk factor for atherogenesis has centered for many years on cholesterol, triglyceride and LDL (low density lipoprotein) Lately, interest has focused on the role of HDL (high density lipoprotein) as an antirisk factor. So, HDL-cholesterol and/or apoprotein A have been estimated as an index of HDL level in clinical laboratory. Recently, a possible role for apoprotein have been emphasized. This study was performed to investigate the relationship between serum lipids and hypertension. Serum lipids such as triglyceride, cholesterol, phospholipid, lipoprtein fraction, HDL-cholesterol, and apoprotein A-I were measured in 87 patients with hypertension. The results obtained were as follows; 1. The mean levels of serum lipids in hypertensive patients were 162.0±114.0 mg/dl for cholesterol, 208.1±74.7 mg/dl for phospholipid, and the lipoprotein fraction revealed 31.9±8.3% of α-lipoprotein, 25.8±10.4% of pre β -lipoprotein and 42.4±8.8% of β-lipoprotein. The levels of serum triglyceride, phospholipid and pre β-lipoprotein were significantly increased in hypertersive patients than in normal control groups. 2. The mean levels of serum HDL-cholesterol and Apoproteins A-I in hypertensive patients were 40.2±12.5 mg/dl, 134.1±41.2 mg/dl, respectively, and both were significantly lower in hypertensive patients than in normal control group, particularily in 6th and 7th decade. 3. Only serum HDL-cholesterol and apoprotein A-I were significantly lower than in hypertensive patients with complication than in hypertensive patients without complication. 4. The level of serum triglyceride was significantly higher in hypertensive patients particularly complicated with diabetes mellitus, congestive heart failure and hepatopathy, while the level of serum phospholipid was significantly lower in hypertensive patient than in normal control, particularly complicated with renal disease and cerebrovascular accidents. 5. The incidence of hyperlipidemia in hypertensive patients was 44.8%, and no significant difference was found between frequency of hyperlipidemia and degree of blood presure. 6. The level of serum HDL-cholesterol, apoprotein A-I and molar ratio of HDL-cholesterol/Apo A-I showed significant lower in hypertrigyceridemia. 7. Apo A-I was highly positively correlated with HDL-cholesterol in hypertensive patients. 8. Serum triglyceride and pre β-lipoprotein showed inverse correlation with HDL-cholesterol and α-lipoprotein showed positive correlation with HDL-cholesterol. 9. Serum α-lipoprotein showed positive correlation with apoprotein A-I and β-lipoprotein showed negative correlation with apoprotein A-I.

봄철 농촌에서 집단발생한 장티푸스의 임상상

김창호,조무식,정재삼,백정선,구영무,송옥평 순천향대학교 1989 논문집 Vol.12 No.3

Chinical observation was made of 202 cases of typhoid fever, whose charts were reviewed at the department of general surgery of Soonchunhyang University, Chunan Hospital from Mar., 1988 to May, 1988. 1) Typhoid fever was occured most frenquetly in those between the age of 0-9 years old. 2) The male-female ratio on admission was 112:90. 3) Symptoms and signs on admission were fever: 87%, abdominal pain: 68%, diarrhea: 52%, headache: 50%, chill: 43%, nausea and vomiting: 38%. 4) In hematologic fidings on admission, the leucocyte count was below 5000/㎣: 33%, between 5000-10000/㎣: 51%, and above 100000/㎣: 16%. 5) The result of Widal test was positive: 69%(above 1:160). 6) Complications of typhoid fever were intestinal bleeding: 29%, hepatitis or decreased liver function and no jaundice: 19%, intestinal perforation: 10%. 7) Intestinal perforation was occured most frequently in those 20-39 years old and the male-female ratio was 7:3. 8) Intestinal hemorrhage(31%) and intestinal perforation(51%) were developed most frequently at 2 to 3 weeks after onset of symptom. 9) Subdiaphragmatic free air in simple X-ray was found in 70% of intestinal perforated cases. 10) The site of intestinal perforation was within 60cm. proximal from ileocecal valve in 65% of the intestinal perforated cases. 11) Intestinal perforation showed multiple perforation(2-5 sites), 55% and single perforation, 45%. 12) In surgical management, primary closure of the perforation site was in 30% of the cases of anastomosis after resection in 70%.

위와 대장에서 병발된 다발성 원발성 악성 종양

김형철,이영준,송옥평 순천향대학교 1994 논문집 Vol.17 No.2

We report 1 case of multiple primary cancer developing in stomach and colon. this case was synchronous multiple cancer and we performed subtotalgastrectomy, gastro jejunostomy and left hemicolectomy on October, 1993. This incidence of multiple primary cancers is now being increased. The colon and stomach are the common site of multiple cancers.Therefore, special diligence in follow up of patient had done or more malignant lesions in warranted. We experienced one case of multiple primary cancer, so we report our experience and review of literature.

췌장암과 췌장염의 전단화단층촬영 소견

김일영,이병호,송옥평 순천향대학교 1987 논문집 Vol.10 No.1

CT is generally considered as the best imaging method for pancreatic disease such as pancreatic cancer and pancreatitis. We reviewed CT films of 15 cases of pancreatic cancer and 10 cases of pancreatitis which were confirmed on clinical or histological base, and the results were as foloows. 1. Most cases of pancreatic cancer showed a focal mass in pancreatic head, while most cases of pancreatitis showed a diffuse enlargement of pancreas. 2. Frequently noted findings of pancreatic cancer were obliteratation of peripancreatic fat plane, dilatation of bile duct, vascular thickening, and enlargement of retroperitoneal lymphnodes. 3. Frequently noted findings of pancreatitis were blurring of surrounding fat density, thickening of Gerota's fascia, peripancreatic fluid collection, pancreatic duct dilatation. 4. Most cases of focal mass in pancreatic cancer showed irregular surface and heterogenous enhancement. 5. Two cases of focal mass in pancreatic cancer showed smooth surface and homogenous enhancement, and could not be differentiated with a case of focal pancreatitis, which showed a focal enlargement of pancreatic head.

췌장 가성낭종에 대한 재고

김일영,이병호,김표년,송옥평 순천향대학교 1988 논문집 Vol.11 No.3

Pancreatic pseudocyst is a relatively rare disease, but early diagnosis and adequate treatment is essential for the management of patient with pancreatic pseudocyst. If early diagnosis and adequate treatment is failed, serious complications such as infection and hemorrhage cause a high mortality. The authors reviewed the charts and X-Ray films of 13 cases of pancreatic pseudocysts which were diagnosed in Chun-An Soonchunhyang hospital, and got following results.: 1. Almost all pancreatic pseudocysts developed after 40 years old age. The most frequent clinical symptoms and signs are abdominal pain and palpable mass, and about half of patients had elevated serum amylase levels. 2. Significant number of conventional X-Ray films showed paralytic ileus, left hemidiaphra gmatic elevation, left pleural effusion, infiltration in left lung base, and compression effects on UGI series. 3. Almost all pseudocysts showed well defined unilocular cystic mass on US or CT scans, but some cases showed multilocular cystic mass or internal debris. 4. Almost all pseudocysts were oval shaped, ranged from 1.9-6.7 cm in diameter, and located near pancreas. The majority of pseudocysts were a single cyst, but some cases had multiple cysts in single patient. 5. We found that pancreatic pseudocysts had a dynamic course on follow up US study, and thought that US study was very necessary for decision of management method.

末端廻腸狹窄症을 隨伴한 大腸形成不全 1例

宋鈺平(O.P. Song),李玟爀(M.H. Lee),盧時憲(S.H. Rho),郭鎭榮(J.Y. Kwak) 대한외과학회 1976 Annals of Surgical Treatment and Research Vol.18 No.11

실도로 주행을 반영한 자동차 온실가스 배출 특성 연구

이정기,용기중,김자륭,엄성복,Lee, Jung-Ki,Yong, Geejoong,Kim, Cha-Ryung,Eom, Seong-Bok 한국자동차안전학회 2018 자동차안전학회지 Vol.10 No.3

Greenhouse gas is the big issue of the whole world. So foreign countries, EU, USA, Japan, China and Korea made the policy for reducing greenhouse gas. For calculation of reduction, it is necessary to know the quantity of current greenhouse emission per year in Korea. It is not reflected real driving condition for measuring the Fuel economy and greenhouse gas. The subject of this study is to figure out the characteristics which influence on greenhouse gas in real driving condition. And final goal is applying the policy greenhouse emission reduction.

Fournier 씨 증후군 -1예 보고-

송옥평,조무식 순천향대학교 1988 논문집 Vol.11 No.1

Fournier's gangrene is a specific form of synergistic gangrene involving the scrotum and perineum. Described by Fournier as an idiopathic condition, it must be recognized as a synergistic gangrene secondary, in most cases, to a focus of perianal infection. One case illustrating the salient features of this disease is presented, together with a review of the literature.

회장에 발생한 아니사키스증 1예

송옥평,조무식,김창진 순천향대학교 1993 논문집 Vol.16 No.4

Human anisakiais is a helminthic disease caused by opportunistic infestation of the third stage larval nematodes of the family Anisakidae and encountered in people who eat inadequately prepared raw salt-water fish or squid. Within a few hours of ingestion, larvae invade the wall of stomach or intestine and cause clinical gastrointestinal symptoms. Though the gastric anisakiasis can be easily diagnosed endoscopically, the intestinal anisakiasis is hard to be found not only due to its rarity but also its inconspicuous clinical symptoms and radiologic pictures. The diagnosis is made by the presence of the helminth in the tissue with its characteristics of a thick multilayered cuticle, well developed musculature beneath the hypodermis, two Y-shaped lateral chords, and large esophagus at center. The authors report a case of human anisakiasis involving the distal ileum in 32 yer-old man and briefly review the literatures.