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위암 환자에서 위절제술후 나타나는 담도확장의 임상적 의의: 추적 CT 소견을 중심으로
윤구섭,백승연,이문규,김영환,오용호 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1
A retrospective review of consecutive 35 patients'pre and post operative abdominal computed tomography was performed to determine frequency and degree of bile duct dilatation following Billroth Ⅱ operation for stomach cancer and it's clinical significance. Degree of intrahepatic biliary dilatation was classified as mild, moderate, marked according to the extension into central, middle and peripheral zone of liver, respectively. Three specialists on the abdominal image participated in analysis of those findings without prior information of the patients. Intrahepatic biliary dilatation was seen in 22 patients(63%) analysed by at least one radiologist, in 13 patients(37%) by at least two radiologists. Bile duct dilatation on CT was common finding and not necessarily meant tumor recurrence. Vagotomy and afferent loop resulted form Billroth Ⅱ were one of possible causes of bile duct dilatation. This study showed in the cases of bile duct dilatation without clinical and other radiological evidence of recurrence, no further study are needed and only enough to follow up study.
곽승근,천재민,박남숙,박상은,박수진,윤환중,김삼용,조덕연 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2
Megaloblastic anemias are disorders caused by impaired DNA synthesis and chara-cterized by the presence of megaloblastic cells. Clinical data on these disorders in Korea are limited. The aim of this study was to analyze clinical characteristics of megaloblastic anemias caused by vitamin B12 deficiency. We identified 40 cases who were diagnosed as megaloblastic anemia from January 1993 to December 2002 in a retrospective study on the basis of chart review. We investigated the annual distribution of diagnosed patients, clinical manifestations and response to treatment. 19 cases were complicated with a previous total gastrectomy(gastrectomy group) and 21 cases had no history of surgical operation(non-gastrectomy group). The most common presenting complaint was generalized weakness. The median age at diagnosis was 7(range: 38-79) years in non-gastrectomy group. The mean pos-toperative duration was 7(range: 4-25)years in group of total gastrectomy and mean level of serum vitamin B12 was lower than 100 pg/mL in both group. Peripheral blood revealed thrombocy-topenia, macrocytic anemia and hypersegmented neutrophil in all cases. After treatment of pareliteral vitamin B12, Their clinical symptoms and hematologic findings improved except two patients who had bone marrow with lower cellularity. Cobalamin replacement after total gastrectomy is still missing. Diagnoses are made too late in a population of patients, resulting in irreversible neurological sequale, and we suggest that Pernicious anemia seems not to be very rare in Korea.
이상용,박익근,윤종학,노승남,안형근 한국공작기계학회 2001 한국공작기계학회 춘계학술대회논문집 Vol.2001 No.-
A new flaw detection technique using by SH angle beam method has been discussed. The SH-wave is horizontally polarized shear wave and the surface SH wave has a characteristic of traveling along near surface layer. The surface SH wave technique is valuable for the detection of fatigue cracks at fillet weld heels which cannot be detected by other ultrasonic technique such as angle beam technique and The dispersion curves of it has simple characterization. In this work, using these beneficial chraterization, quality evaluation of spot weld with ultrasonic sound intensity of SH-wave passing through nugget area of spot weld are verified experimentally.
내시경역행성담췌관조영술 후 발생한 종격동기종, 피하공기증, 긴장성 기흉 1예
조용건,이현승,권균홍,김자영,김봉진,김지연,배용목,박선자 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4
However, Endoscopic retrograde cholangiopancreatography (ERCP) is still helpful procedure for the diagonosis of the pancreatobiliary disease and treatment through endoscopic sphinterectomy (EST) is relatively safe, these have possiblity of complications such as hemorrhage, infection, panceatitis, and perforation. ERCP related perforation was rarely reported in 0.3 to 1.1% of previous study, but most serious complication. A report of Pneumomediastinum, Tension Pneumothorax complicating perforation after ERCP and EST is very uncommon. In our hospital, we experienced case of pneumomediastinum, subcutaneous emphysema, and tension pneumothorax after ERCP and EST, and the patient (a 58 years old female with suspicious common bile duct stone) was treated successfully with conservative treatment.
급성 carbamate계 농약 중독환자에 관한 임상적 고찰
이승훈,김동윤,문용 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4
We observed and analysed relating problems concerned to 21 patients of the acute carbamate intoxications, visited the emergency room of cheonju Presbyterian Medical center, from Oct 1993 to July 1996. The results were as follows : 1) Male was more prevalent than female with a ratio of 2:1 in sex distribution and the highest incidence of age group was in third decade and sixth decade of age in male sex 2) The most common drug of intoxication was deltanet in 7 cases, the remainders were bassa in 3 cases, b.p in 3 cases, huradan, qratel and methomyl in 2 cases, each, in order of frequency. 3) Among the exposed carbamate in 13 patients with respiratory failure, detanet was the most common in 6 cases, b.p in 3 cases, methomyl in 2 cases, bassa and huradan each in 1 case. 4) The serum ChE activity of patients were significantly reduced compare to normal. 8 patients were between 20~50% of normal, 8 patients were above 50% of normal, 4 patients were between 10~20% of normal, only 1 patient was below 10% of normal. 5) In 13 patients with respiratory failure, serum ChE activities were below 50% of normal. 6) In all patients with respiratory failure except 1 case time to recovery of the respiratory failure was below 48hrs. 7) Mean dose of atropine administered within first full atropinization and first 24 hours was significantly higher in patients with than patients without respiratory failure in staitistics(29.3 ±23.3mg, 54.5 ±49.5mg VS 7.6 ±3.6mg, 13.6 ±6.9mg). 8) 3 patients among a total of 21 patients expired. So that motality rate was 14.3%. Among the expired cases, 1 patients discontinued treatment due to economic problems and only 2 patients died in hospital during the treatment.
김용철,김남호,김승환,최준호,박은미,이상재,이은미,유남진,윤경호,오석규,정진원 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2
석청에 포함된 grayanotoxin에 의해 독성 작용이 나올 수 있으며, 이러한 독성 작용은 일반적으로 24시간 이내 저절로 회복된다. 최근에 본 저자들은 석청 복용 후 발생한 심실빈맥을 경험하였기에 보고하는 바이다. 49세 남자가 호흡곤란으로 내원하였으며, 내원당시 분당 40회 정도의 동성 서맥이 관찰되었고, 수액을 투여하던 중 심실 빈맥이 발생하였다. 항부정맥제를 투여 후 정상 동율동으로 전환되었으며, 특별한 이상 없이 4일 후 퇴원하였다. Mad-honey intoxication caused by the consumption of honey producted from the nectar of rhododendrons. The grayanotoxins cause the intoxication. The toxic effects of mad-honey poisoning are rarely fatal and generally last for no more than 24 hours. We experienced one case, a 49 years-old man who presented with dyspnea after ingestion of mad-honey. He showed marked sinus bradycardia with < 40 beats per minute on admission. The cardiac rhythm was changed to ventricular tachycardia immediately. These features resolved completely in 24 hours with continuous infusion of amiodarone(600 mg per day) and fluids. We report the case of intoxication of mad-honey as a presentation of fatal cardiac arrhythmia.