만성 췌장염 환자의 임상적 고찰

장이찬,오민구,이건욱 대한외과학회 1991 대한외과학회 학술대회 초록집 Vol.1991 No.11

스마트폰을 이용한 질환 홍보

장이찬 대한외과학회 2010 대한외과학회 학술대회 초록집 Vol.2010 No.11

교통사고로 인한 사망 환자의 사인

장이찬 최신의학사 1992 最新醫學 Vol.35 No.5

햄스터에서 제한식이가 담석형성에 미치는 영향

장이찬,박용현,김선희,최재운 대한소화기학회 1995 대한소화기학회지 Vol.27 No.2

Background/Aims: Epidemiologic studies and animal experiments have suggested that high-carbohydrate diet affects the formation of pigment gallstone. Although the mechanism is not clear, recent evidence suggest that high carbohydrate diet may cause poor cholecystokinin(CCK) release. Thus, antiproteinase, which increase cholecystokinin, has been suggested as a candidate for prophylaxis against pigment gallstone. However increased CCK decreases food intake and weight gain. Therefore the present study was undertaken to define the relationship between restricted intake of high carbohydrate diet and pigment gllstone. Methods: Fourty hamsters were divided into 2 groups: Group I was fed high carbohydrate diet ad libitum, and Group II was fed 90% of ad libitum for 8 weeks. Hamsters was sacrificed at the 9th week. Grallbladder was explored to detect whether gallstone was present or not. Grallbladder hile was aspirated. Blood was aspirated by direct cardiac puncture and serum was collected by centrifuge. Bile composition was analysed by Kits, one sample was composed of gallbladder hile from 3 or 4 hamsters. Serum was analysed by automatic analyser, one sample was composed of serum from two hamsters. Results: Gallstones were found in 80%(16/20) of group I and 20%(4/20) of group II(p$lt;0.0001). Gallbladder bile compostion including cholestero1(58.8?4.65 vs 69.2?7.33mg/ dl, p=0.29), phospholipid(652?88.99 vs 480?7l.5mg/dl, p=0.2l), bilirubin(l9.4?9.61 vs l6.8?3.22mg/dl, p=0.40) and bile acid(20.7?4.2 vs 20.4?3.0 mmol/L, p=0.99) were not different between group I and group II. Serum albumin(3.7l? 0.03 vs 3.62?0.04 mg/dl, p=0.2), cholesterol(76.88?3.07 vs 77.6?3.65mg/ dL, p=0.9), triglyceride(182.66?l2.54 vs l66.9?7.63mg/dL, p=0.43) phospholipid(362.1l?23.30 vs 395.6?9.76mg/ dL, p=0.46), calcium level(12.98?0.l4 vs 12.96?0.12mg/dL, p=0.96) and phosporous(8.94?0.15 vs 8.73?0.19mg/dL, p=0.34) were not different hetween group I and group II. Conclusion: Restricted diet inhibits gallstone fortnation in hamsters, but the mechanism was not defined.

담도계 재수술의 임상고찰 : 담석증을 중심으로

장이찬,박용현,김선회,허윤석 대한소화기학회 1993 대한소화기학회지 Vol.25 No.3

Biliary tree has anatomical and pathophysiological features liable to reoperation. The reoperative rate has been reported 4,1% to 25%, which is higher compared to that of Western countries. It has been suggested that the high reoperative rate in our country is related to the high incidence of intrahepatic duct stones, pigment stones and parasites. To investigate clinical features of the reopertive biliary surgery, we reviewed the patients who underwent reoperation on biliary tree for benign diseases especially gallstone disease. The results are as follows; Among the 1,018 biliary operation cases, 130 reoperations (12.8%) were performed from January 1987 to December 1991. The reasons of reoperation were recurrent stone 54.6%, remant stone 32.3% and stricture 4.6%. The mean interval between first operation and reoperation was 7 years and 17 cases received 3 operations, 3 cases 4 operations, 1 case 5 operations. The ratio of reoperation according to the site of the stone in first operation were 9. 1%, 22.9% and 61.7% for GB stone, CRD stone and IHD stone respectively. The patients who underwent reoperative biliary surgery, recieved first biliary operation at younger age, had more female predominance, and higher proportion of pigment and IHD stone, compared to those who did not need reoperation. Reoperative biliary surgery is related to prolonged operativc time, larger amount of transfusion and higher operative morbidity. In conclusion, since reoperative biliary surgery is related to high morbidity, we should try to lower the rate of residual stone and find the measures to prevent recurrent stone and avoid operative injury possibly causing biliary stricture.

담도 장관루

장이찬,한세환,김선희,박용현 大韓消化器病學會 1992 大韓消化器病學會誌 Vol.24 No.4

만성 췌장염 환자의 임상적 고찰

장이찬,오민구,이건욱 大韓消化器病學會 1991 大韓消化器病學會誌 Vol.23 No.4

Intensive Long Distance Running as a Possible Cause of Multiple Splanchnic Arterial Aneurysms: A Case Report

장이찬,박성수 대한혈관외과학회 2016 Vascular Specialist International Vol.32 No.3

This is a case report that suggests the possible association between multiplesplanchnic arterial aneurysms and long-distance running. The clinical featuresof one patient admitted at Chungbuk National University Hospital for treatmentof multiple splanchnic arterial aneurysms were reviewed. A 54-year-old manhad a recurrent, intermittent and epigastric pain for 2 months. There was noabnormality in gastroscopy and colonoscopy. An abdominal computed tomographyangiography documented calcified superior mesenteric artery (SMA) and splenicartery aneurysms. The patient had a history of recreational long-distance runningfor over 10 years. His average running time per week was more than 10 hours. There was no evidence of systemic arteritis, connective tissue disorder or infectiousprocess that may have caused the aneurysms. He did not take any drugs. The SMAaneurysm was opened, and the aneurysmal segment of SMA was replaced with avein graft. The splenic aneurysm was observed. The patient recovered without anysequelae.

[Free Paper] Hospital patient based incidence of acute aortic dissection

장이찬 대한외과학회 2011 대한외과학회 학술대회 초록집 Vol.2011 No.11

치료를 요하는 십이지장 게실에 관한 임상 연구

장이찬,박용현,김선회,허윤석 대한소화기학회 1992 대한소화기학회지 Vol.24 No.4

The most duodenal diverticulum is asymptomatic and incidental finding. Less than 10 percent of demonstrated duodenal diverticula are ever the source of the symptom, and only about 1% require operation due to serious complication of duodenal diverticulum. Elective operation, on the basis of persistent discomfort still remains controversial because of high mortality (8-10%) and recurrence of symptom. Forty cases of duodenal diverticula treated at the Department of Surgery, Seoul National University Hospital for 12 years were reviewed. The most common site of duodenal diverticula was second, medial portion of duodenum. The associated disease were existed in 22 cases. The most common associated disease was gallstone (10 cases). The surgical indications were persistent pain (5 cases), cholangitis symptom (2 cases) and intestinal obstruction symptom (1 cases). In two cases, symptom recurred and in one case, unidentified stomach cancer was cause of symptom. There was one mortality. In conclusion, operation of duodenal diverticulum should be reserved for seriously complicated diverticulum and the surgeon should be aware that duoenal diverticulum may be symptomatic, but other causes should be considered.