『상한론(傷寒論)』 소음병(少陰病) 318조(條)로 진단하여 회역산(回逆散) 투여 후 호전된 뚜렛장애 환자 1례 보고

김창식 ( Chang-sig Kim ),정연일 ( Yeon-il Jeong ),이숭인 ( Soong-in Lee ) 대한상한금궤의학회 2020 대한상한금궤의학회지 Vol.12 No.1

Objective : The purpose of this study is to report the improvement in a patient who had Tourette syndrome treated with Hoeyeoksan based on Shanghanlun provisions. Methods: The symptoms of the patient were checked on days 14, 34, 62, 82, 103, and 119 after administration of Hoeyeoksan. Tourette syndrome was evaluated using Yale Global Tic Severity Scale (YGTSS), and oversleep and constipation were evaluated using visual analog scale (VAS). In addition, new clinical implications for the interpretation of Shanghanlun provision 318 were reviewed. Results: Daily tics occurred ten times a day for 14 days after the initial diagnosis but decreased to eight times a day after 34 days, six times a day after 62 days, five times a day after 82 days, twice a day after 103 days, and once a day after 119 days after administration of Hoeyeoksan. Oversleep and constipation improved together with Tourette syndrome. Conclusions: In this study, we observed that Hoeyeoksan had a therapeutic effect by improving the chief complaint of the patient. Hence, the interpretation of Shanghanlun provision 318 must include a patient's behavioral and sleep patterns as predisposing factors of Tourette syndrome.

패혈증으로 유도된 폐조직손상에 대한 펜톡시필린의 방지효과

김창식(Chang Sig Kim),김상운(Sang Woon Kim),박영복(Young Bok Park),김재황(Jae Hwang Kim),이수정(Soo Jung Lee),김홍진(Hong Jin Kim),심민철(Min Chul Shim),권굉보(Koing Bo Kwun) 대한외과학회 1995 Annals of Surgical Treatment and Research Vol.48 No.5

장폐쇄를 동반한 혈관내피종 1예

허영수(Young Soo Huh),김창식(Chang Sig Kim),최경찬(Kyung Chan Choi),최원희(Won Hee Choi) 대한외과학회 1996 Annals of Surgical Treatment and Research Vol.50 No.6

『傷寒論』 辨病診斷體系에 근거하여 白虎湯 투여 후 호전된 불면증 증례 1례

정연일 ( Yeon-il Jeong ),김창식 ( Chang-sig Kim ),이숭인 ( Soong-in Lee ) 대한상한금궤의학회 2021 대한상한금궤의학회지 Vol.13 No.1

Objective: This study aimed to report the improvement of a patient with chronic insomnia who was treated with Baekho-tang based on the Shanghanlun disease pattern identification diagnostic system (DPIDS). Methods: The patient’s symptoms were checked on days 19, 37, and 52 after taking Baekho-tang. Chronic insomnia was evaluated by the degree of insomnia, hours spent asleep, and the number of times the patient woke up during the night, which were all assessed by a visual analog scale (VAS) with the Leeds Sleep Evaluation Questionnaire. In addition, new clinical implications for the interpretation of the 350th Shanghanlun provision were reviewed. Results: After administering Baekho-tang for 52 days, based on the 350th Shanghanlun provision according to the DPIDS, the VAS score decreased from 10 to 1. Conclusions: The patient recovered from chronic insomnia. This case report suggests that the words “滑,” “厥,” and “裏” in the 350th provision of Shanghanlun mean physical and psychological causes of insomnia. In addition, Baekho-tang had a therapeutic effect in improving the chief complaint of the patient. Therefore, the interpretation of the 350th Shanghanlun provision requires a new definition that includes the patient's lifestyle, family conflict, and past history of the patient as a cause of chronic insomnia.

급성췌장염의 임상적 고찰

고승석(Seung Suck Koh),정기수(Ki Soo Chung),이동훈(Dong Hun Lee),김창식(Chang Sig Kim),이중건(Choong Kyun Lee),이경원(Kyung Won Lee) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.2

N/A A c)inical study was performed in 99 cases of acute pancreatitis who were admitted to Seoul Adventist Hospital during the preceding 5 years from Jan. 1978 to Dec. 1982 and following results were obtained. 1) Of total cases with acute pancreatitis, 38 were male and 61 were females. And the ratio of male to female was 1:1.6. 68.8%, of all cases were in 3rd-5th decade of the age groups. 2) The common etiologic conditions were dietary, biliary disease, alcoholic and drug in descending orders. There were no etiologic factors in 35.4%. 3) The cardinal manifestations on admission were abdominal pain, nausea and vomiting, radiating pain, diarrhea and perspiration in descending orders. The physical examination showed abdominal tenderness, abdominal rigidity, diminished peristalsis, fever and abdominal distention in descending orders. 4) On laboratory test, a level of serum amylase more than 300 Somogyi units/100ml were seen in 86.9% Leukocytosis was evident in 73.7%, proteinuria in 45.5% Glycosuria in 29.3% hyperbilirubinemia in 16.1%, and hypocalcemia in 17.2%. 5) The radiologic examination in acute pancreatitis revealed paralytic ileus in 57.0% non- visualization of gall bladder in 33.3% pleural reaction in 12.1%, elevation of diaphragm in 8.1%, and atelectasis in 7.l%. 6) The associated electrocardiographic abnormalities were inverted T wave(6.1%, depre- ssion of ST segment(5.1%), p-mitrale(2.0%), and arrhythmia(3.0%). 7) The major complications were shock, gastrointestinal hemorrhage, psychiatric problem, pancreatic and peripancreatic abscess, and pseudocyst. 8) The mortality rate during the hospitalization was 1.0% and cause of death was septic shock. 9) The causes of readmission which was found in 7 cases were 4 cases of recurrent pancreatitis(2 cases were combined by biliary stone), 2 cases of biliary stone, and 1 case of diabetic coma. Judging from the result so far obtained, we felt deeply the neccessity of detecting and removing the etiologic or combined conditions intensively at first admission to avoid the preventable readmission.

원추각막 환자에서 비구면 RGP 렌즈착용이 각막지형도 및 내피세포에 미치는 효과

신동빈 ( Sin Dong Bin ) , 한남수 ( Han Nam Su ) , 김미금 ( Kim Mi Geum ) , 이재림 ( Lee Jae Lim ) , 김창식 ( Kim Chang Sig ) 대한안과학회 2004 대한안과학회지 Vol.45 No.3

원추각막 환자에서 비구면 RGP 렌즈착용이 각막지형도 및 내피세포에 미치는 효과

신동빈 ( Sin Dong Bin ),한남수 ( Han Nam Su ),김미금 ( Kim Mi Geum ),이재림 ( Lee Jae Lim ),김창식 ( Kim Chang Sig ) 대한안과학회 2004 대한안과학회지 Vol.45 No.3

신생아 선천성 회장 폐쇄증

허영수,신손문,김창식 영남대학교 의과대학 1994 Yeungnam University Journal of Medicine Vol.11 No.1

저자들은 1988년 10월부터 1994년 2월까지 최근 5년 4개월간 영남대학교 의과대학 부속병원 일반외과에 입원하여 수술로서 확진된 선천성 회장 폐쇄증 환자 8명을 대상으로 임상분석하여 다음과 같은 결론을 얻었다. 1. 총 8명중 남아 4명, 여아 4명으로 남녀비가 동일하였으며, 입원시 연령은 생후 3일내가 6례로 75%를 차지하였다. 2. 선천성 회장폐쇄의 원인으로는 Type Ⅲa가 3례(37.5%)로 가장 많았으며, Type Ⅰ 2례, Type Ⅱ 2례, Type Ⅲb 1례 이었으며, Tape Ⅳ는 1례도 없었다. 3. 8명의 환아중 미숙아는 1명으로 저체중아였으며, 나머지 7명은 만삭아였다. 산모의 임신중 병력상 특별한 이상은 없었으며, 형제중 발생순위는 2째 아이에서 4례로 가장 많았다. 4. 주요 임상증상으로는 복부팽만과 구토로 7례에서 나타났고, 구토는 담즙성이었다. 5. 진단은 임상증상과 단순복부 촬영상 팽만된 장관 및 air-fluid level등을 보고 응급수술을 시행하였으며, 다른 질환과의 감별을 위해 2례에서는 대장조영술도 함께 시행 하였다. 6. 8명의 환아중 7명에서 장절제후 단단 문합술을 시행하였으며, 1명에서는 고위쇄항으로 횡행 결장조루술도 함께 시행 하였다. 7. 동반된 기형은 Type Ⅲa 1례에서 고위쇄항, 좌측신 무발육증, 우측 다낭신 및 후복막낭종등을 동반하였다. 8. 수술후 합병증은 8례중 3례(37.5%)에서 패혈증이 발생 하였으며, 술후 사망한 경우도 이들 패혈증을 동반한 3례 이었다. 나머지 5명은 현재까지 특별한 문제없이 건강하게 잘 자라고 있다. Newborns with ileal atresia freqently present with abdominal distension, bilious vomiting, and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprised of 4 males and 4 females, the ratio of male and female was 1:1. 2. Six patients(75%) had been admitted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases: Type Ⅰ in two(25%), Type Ⅱ in two(25%), Type Ⅲa in three(37.5%), Type Ⅲb in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).

소아에서 유전성 구상 적혈구증의 비장 적출술

하정옥,도병수,김창식,서보양,허영수 영남대학교 의과대학 1994 Yeungnam University Journal of Medicine Vol.11 No.1

저자들은 1987년 12월부터 1993년 8월까지 영남대학교 의과대학 부속병원에 입원하여 유전성 구상 적혈구증으로 진단받고 비장적출술을 시행한 9례를 대상으로 임상분석하여 다음과 같은 결론을 얻었다. 1. 총 9명중 남아 5명, 여아 4명으로 남녀비가 비슷하였으며, 6세에서 10세 사이가 9례중 5례로 전체의 반이상을 차지하였다. 2. 가족력을 나타낸 경우는 9례중 4례(44.4%)이었다. 3. 주요임상 증상으로는 빈혈, 황달 및 비장종대가 주증상이었으며, 담석증 및 총담관결석을 동반하였던 2례에서는 우상복부 동통을 나타내었다. 4. 검사실 소견으로는 말초혈액 도말검사상 구상 적혈구를 발견할 수 있었으며, 혈색소 8.1 ±2.4 gm/dl, 헤마토크리트 23.4 ±10.2%, 망상적혈구 15.9 ±11.7%이었으며, 삼투압 취약성은 모두에서 증가되어 있었다. 혈청 전 빌리루빈 8.6 ±10.9 gm/dl, LDH 370.1 ±169.1 IU/L으로 증가되었다. Coombs 검사상 9례 모두 음성반응을 보였다. 5. 9례 모두 비장적출술을 시행하였으며 이들중 담석증을 동반한 1례에서는 담낭절제술, 총담관 결석제거술 및 T-tube 담관조루술을 동시에 시행하였다. 수술 소견상 비장의 무게는 350(150-600)gm이었고, 9례중 3례에서 부비장(accessory spleen)이 관찰되었다. 6. 비장 적출후 유전성 구상 적혈구증 9례에서 수술전 혈색소 8.1 ±2.4 gm/dl, 헤마토크리트 23.4 ±10.2%, 수술후 혈색소 12.3 ±1.2 gm/dl, 헤마토크리트 37.0 ±5.3%로 증가되어 술후 빈혈이 교정되었음을 관찰할 수 있었다. 수술후에 수혈의 필요성은 없었으며, 술후 특별한 합병증없이 9명 모두 현재까지 건강하게 잘 자라고 있다. Among the erythrocyte membrane defects, hereditary spherocytosis is the most common. The erythrocyte membrane defect results from a deficiency of spectrin, the most important structural protein in red cell. Hereditary spherocytosis often presents with hemolytic anemia, jaundice, moderate splenomegaly. Diagnosis is established by the presence of spherocytes in the peripheral blood, reticulocytosis, an increased osmotic fragility, and a negative Coombs test. In children, splenectomy is usually performed after age 6 years but can be done at a younger age if warranted by the severity of the anemia and the need for frequent transfusions. In the period December 1987 to August 1993, 9 patients with hereditary spherocytosis underwent splenectomy and the following results were obtained. 1. Nine patients were comprised of five males and four females. 2. Five patients(55.6%) had been admitted to our hospital during age 6-10 years. 3. Four of the nine patients had autosomal dominant inheritance with variable expression. The other five patients had no known inheritance. 4. The diagnosis of the spherocytosis was based on the increased osmotic fragility and increased autohemolysis of the erythrocytes, as well as on the appearance of spherocytes in the peripheral blood smear. 5. In all cases splenectomy was performed. Two patients had concomitant gall stones and choledocholithiasis, respectively. One patient with concomitant gall stones underwent simultaneous cholecystectomy and splenectomy. The other patient associated with choledocholithiasis underwent splenectomy, cholecystectomy, choledocholithotomy, and T-tube drainage. 6. Complete hematologic recovery was obtained by the splenectomy in all cases. 7. Postoperative complication was not occurred.