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부식제에 의한 상부 소화관 손상에 대한 내시경적 연속추적검사에 관한 고찰
박충기(Choong Kee Park),김학양(Hak Yang Kim),신호균(Ho Kyun shin),정인구(In Goo Jung),전성국(Sung Gook Jun),유재영(Jae Young Yu) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
The ingestion of caustic agents can initiate a progressive and devastating injury to the esophagus and stomach. Since the introduction of concentrated alkaline cleansers in the 1960s, the incidence of seveve injury has increased. If the patient survives the acute effects of caustic ingestion, the reparative response can result in esophageal and gastric stenosis and an increased incidence of esophageal cancer. There are little reports in the case of the strong acid was ingested, and especially no reports about the periodic gastrofiberscopic examination. We have done the periodic gastrofiberscopic examination every a week for four times to whom ingested the caustic agents. The results obtained were as follows: 1) Male to female ratio was 7:6. The mean age was 33.6 years. (range: 18 to 59) 2) Amount of acid ingested was about 30 to 100 cc. 3) The motive of ingestion was accidental in 2 patients, suicidal attempt in 11 patients, and 4 patients of whom was major depression patients. 4) Patients with ulcer had more severe and many symptoms than patients with gastritis and esophagitis. 5) Of the 13 patients, stricture developed in 5 patients, esophageal stricture in 3 patients, and gastric antral stricture in 2 patients. 6) The esophageal injury was more severe than the gastric injury, probably that is due to ingestion of highly concentrated acid. 7) In 3 patients, serial fiberoptic gastroscopy demonstrated nodular regeneration at 2 weeks after ingesting caustics, esophageal or gastric antral stricture 3 or 4 weeks later. 8) In 5 patients with stricture, 4 patients required operation. Remaining patients without stricture were treated conservatively with antacid or H2 antagonist without subsequent complication.9) None of 13 patients expired. 10) 9 patients had followed-up from 3 months to 15 months after ingestion, 8 patients of whom were free of symptoms, only 1 patient persisted anorexia and dysphagia.
박충기(Choong Kee Park),임규성(Kyu Sung Rim),김진민(Jin Min Kim),손희철(Hie Chul Son),주상언(Sang Aun Joo),한덕종(Duck Jong Han),윤대원(Dai Won Yoon) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2
Pancreatic lithiasis occurs in a significant percentage of patients with chronic alcoholic pancreatitis. We report here a case of chronic pancreatitis with pancreatic lithiasis. A 42-year-old woman was admitted to the Hangang Sacred Heart Hospital, Hallym Medical College because of RUQ pain, nausea and vomiting. 3 years before admission, she was diagnosed as acute pancreatitis, D.M. and gallstone at another hospital. She have experienced intermittent colicky abdominal pain after eating meats. There was no diarrhea and steatorrhea. On examination she appeared acutely ill. There was mild tenderness over the RUQ & epigastrium. Simple x-ray films of the abdomen showed multiple calcified stone densities. Abdominal ultrasound and ERCP showed markedly dilated pancreatic duct with multiple stones. 3 stones, about 1.5 x 1.5, 0.6 x 0.8, 0.3 x 0.3 cm, were removed by operation. The patient discharged in good general condition without complcation.
내시경적 역행성 담췌관 조영술 328예에 대한 임상적 고찰
박충기(Choong Kee Park),임규성(Kyu Sung Rim),양재식(Jae Sik Yang),이일준(Il Jun Lee),김우중(Woo Jung Kim),김연근(Yun Geun Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
N/A We reported the clinical results which were obtained from 328 cases of E.R.C.P. that were performed at the Depatment of Internal Medicine, KANGNAM SCARED HEART Hospital, from May 1980 to July 1986. The results were as follows: 1) The distribution of age was from 11 year to 77 year old. Most of the case were in the 6th decades (52%) and there was no difference in the male to female ratio. 2) The most common complaint of patient was abdominal pain (79%). 3) Success rate for visualization of biliary and/or pancreatic duct was 85.4%. The major cause of failure were unsuccessful cannulation due to papilitis with stenosis. 4) The most frequent shape of Ampulla of Vater was the hemisphelical, followed by papillary and flat type in order. 5) The incidence of biliary and pancreatic cancer was 14.6% and the most frequent site was common bile duct. 6) The most frequent diagnosis of E.R.C.P. was bile stone (57.8%) and its frequent location was C.B.D. followed by cancer, pancreatitis, parasite, and choledochal cyst in order.
한국인 원인미상의 급, 만성 간질환 환자와 건강 대조군에서 Transfusion-transmitted Virus 감염률 - PCR 시발체에 따른 검출률의 차이 -
박상훈 ( Sang Hoon Park ),변관수 ( Kwan Soo Byun ),송진원 ( Jin Won Song ),연종은 ( Jong En Yeon ),박충기 ( Choong Kee Park ),이창홍 ( Chang Hong Lee ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.2
Background/Aims: The pathogenic role of transfusion-transmitted virus (TTV) isolated from a cryptogenic posttransfusion hepatitis patient remains unclear. Thus, we evaluated the prevalence and the clinical impact of TTV infection in Korean patients with a
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 심한 재발성 간염을 일으킨 만성 B형 간염 환자에서의 인터페론의 치료효과
유재영(Jae Young Yoo),박충기(Choong Kee Park),김학양(Hak Yang Kim),임규성(Kyu Sung Lim),송숙희(Sook Hee Song),김규태(Kyu Tae Kim),박승욱(Seung Wook Park),조호준(Ho Jun Cho),김종혁(Jong Hyeok Kim),박신성(Shin Sung Park),김동준(Dong Ju 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
N/A We treated nine patients with chronic hepatitis B with recombinant interferon alpha who showed severe exacerbation of hepatitis activity. All had HBsAg for at least 5 years, and had multiple episodes of elevated serum transaminase levels. They were all men, ages 26~55 (mean 41) years. The range of serum AST was 131~885 (mean 326) U/L, the ALT 62~610 (mean 303) U/L, the bilirubin 1.3~37.3 (mean 12.0) mg/dl, total protein 4.4~8.7 (mean 6.6) g/dl, and the albumin 2.4~4.4 (mean 3, 1) g/dl. Seven patients had ascites by ultrasonogram and three showed clinical evidence of grade I hepatic encephalopathy. The needle biopsy of the liver was avalilable in 6 patients, and showed severe chronic active hepatitis with established macronodular cirrhosis. Interferon was administered in a dose of three million units subcutaneously every other day for 6 months and followed up for 12 to 24 months. The results were as follows: 1) Serum transaminases: The serum transaminases became normal in 8 patients during therapy but incresed again during the follow-up in two. One patient, whose transaminses decreased temporalily with therapy, died at the 45th days of therapy due to hepatic failure. 2) Serum bilirubin: In 7 patients with hyperbilirubinemia (2.4~37.3mg/dl), the bilirubin became normal in 5 during therapy, but incresed again in 2 during the follow up-period. In one dead case, the elevated bilirubin decreased transiently but increased again during treatment. 3) Serum albumin: In 4 patients with hypoalbuminemia, the serum albumin became normal in two, and in one became transiently elevated but decreased again during treatment. 4) Prothrombin time: In 6 patients whose prothrornbin time was prolonged, it became normal in 5 except in one patient who died. 5) Ascites: In 7 patients with ascites, the ascites disappeared in 3 during the treatment and in 3 during the follow-up period. But the ascites developed again in 2 of 6 patients. There was no change of ascites in an expired case. 6) Serum HBeAg and HBV-DNA: In 7 patients with serum HBeAg and HBV-DNA, these markers became negative in 5 during treatment, but positive again in one patient during the follow-up period. 7) Symptoms of hepatic encephalopathy: Among 3 patients who developed hepatic encephalopathy (Grade 1) before therapy, 2 patients were improved during therapy. In conclusion, this study, although not adequately controlled, suggested that alpha intreferon therapy may be effective and safe in patients with chronic hepatitis B who showed severe exacerbation of disease activity. A prospective controlled study is needed to assess the role of interferon in these patients.
간장 및 담도 : 만성 B형 간질환 환자에서 각종 바이러스 증식 표지자의 출현동태
유재영(Jae Young Yoo),박충기(Choong Kee Park),김우중(Woo Joong Kim),김태빈(Tae Bin Kim),고순희(Soon Hee Koh),계세협(Sea Hyub Kae),신효균(Ho Kyun Shin),김연근(Yeon Keun Kim),임규성(Kyu Sung Lim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1
N/A We studied several viral replication markers of hepatitis B virus in patients with chronic hepatitis B and hepatocellular carcinoma to evaluate the clinical significance of thesemarkers in serum. The patients comprised of 43 males and 8 females, and ages from 17 to 64 (mean: 34) years. All patients were sero-positive for hepatitis B surface antigen (HBsAg). Histologically, 36 patients showed chronic active hepatitis and 15 showed hepatocellular carcinoma. The viral replication markers tested were hepatitis B e antigen (HBeAg), antibody to hepatitis B e antigen (anti-HBe), Immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc), DNA polymerase and hepatitis B virus deoxyribonucleic acid (HBV-DNA). The results were summerized as follows. 1) The younger the patients, the higher was the positive rate of HBeAg; the older the patients, the higher was the positive rate of anti-HBe. 2) There was a reverse correlation between the age and the level of serum alanine aminotransferase (ALT); the younger the patients, the higher was the titer. But no correlation was noted between age and the level of serum aspartate aminotransferase (AST). 3) The histologic findings of the liver tended to be more severe in older patients. The patients with hepatocellular carcinoma were the oldest group. 4) The positive rate of HBeAg was higher in patients with chronic hepatitis than in patients with hepatocellular carcinoma. but there was no difference between these two groups in the positive rate of IgM anti-HBc. 5) The positive rate of HBV-DNA and DNA polymerase was 63% and 35%, respectively, and their titers were significantly low. 6) There was no significant correlation between the positive rate of HBeAg, IgM anti-HBc, HBV-DNA, and DNA polymtrase. On the basis of these findings, it is suggested that the natural history of chronic hepatitis B of Koreans might be different from that of Caucasians; the positive rate and the titers of the viral replication markers were lower in Koreans.
선덕재(Duk Jae Shun),박충기(Choong Kee Park),임규성(Kyu Sung Rim),박명석(Myoung Suk Park),김진민(Jin Min Kim),주상언(Sang On Ju) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2
Gastric tuberculosis is a rare disease, and it is very difficult to diagnose correctly in early phase. We experienced a case of gastric tuberculosis which was developed at 14 months after subtotal gastrectomy for stomach cancer in 55 years old male patient.
박광혁 ( Kwang Hyuk Park ),유교상 ( Kyo Sang Yoo ),정용우 ( Yong Woo Chung ),김경오 ( Kyoung Oh Kim ),박철희 ( Cheol Hee Park ),김종혁 ( Jong Hyeok Kim ),박충기 ( Choong Kee Park ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.3
Groove pancreatitis is a rare form of chronic pancreatitis in which scarring is found mainly in the groove between the head of the pancreas, duodenum, and common bile duct. The pathogenesis of groove pancreatitis is still unclear but seems to be caused by the disturbance of pancreatic outflow through Santorini duct. It is often difficult to differentiate preoperatively between groove pancreatitis and pancreatic head carcinoma. Whereas conservative management is effective, some patients with duodenal obstruction may undergo Whipple`s operation. A few case of groove pancreatitis have been reported in Korea, and they were diagnosed only by clinical and radiological features. We experienced a case of groove pancreatitis who needed a surgical management because of severe duodenal obstruction. We report the case with a review of its characteristic pathologic findings. (Korean J Gastroenterol 2007;49:187-191)
간장 및 담도 : 간경변증 환자의 난치성 복수의 치료에 있어서 체외 복강정맥 단락 ( External peritoneovenous shunt ) 의 사용 경험
장린 ( Rin Chang ),박충기 ( Choong Kee Park ),민영일 ( Young Il Min ),장영운 ( Young Woon Chang ),주영실 ( Yeong Shil Ju ),방익수 ( Ik Soo Bang ),조정휘 ( Jeong Whee cho ) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1
N/A In order to evaluate the effectiveness of the external peritoneovenous shunt in controlling the ascites, we have performed the procedure in three patients with intractable ascites. The bedside external peritoneovenous shunt had several advantages over the LeVeen shunt. The summary of the results were as follows; 1) A surgeon and operating room are not required. 2) Peritoneal dialysis catheter can be easily inserted and removed. 3) The abdominal binder is not required. 4) The infusion of the ascitic fluid is under precise control. 5) Definitive short-term therapy. Conclusively, the external peritoneovenous shunt is a very easy procedure to perform and its trial is of value in the medical treatment of intractable ascites.
간장 및 담도 : 복수의 감별진단으로서 혈청과 복수의 알부민 농도차의 진단적 가치
민영일(Young Il Min),박충기(Choong Kee Park),방익수(Ik Soo Bang),장린(Rin Chang),장영운(Young Woon Chang),김양학(Hak yang Kim),박종은(Jong Eun Park) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1
N/A Serum-ascites albumin concentration gradient, a parameter of oncotic pressure gradient reflecting presence of portal hypertension, was compared with the usual parameters of ascitic fluid analysis in the differential diagnosis of ascites. We evaluated 29 ascitic patients with liver disease and 21 patients with malignant neoplasm. 1) The group with malignant neoplasm showed higher ascitic fluid total protein level (2.72+-1.10 vs l.39+-0.87 gm/dl), ascites to serum ratio of total protein level(0.83%+-0.17%,0.23%+-0.13%), ascitic fluid LDH level(124.3+-118.2 vs 80.1+-67.OU/L), ascites to serum ratio of LDH level(0.33+-0.19vs0.26+-0.11) and lower serum-ascites albumia gradient(1.42+-0.41 vs2.56+-0.49) (p<0. 005). 2) The serumascites albumin gradient was less frequently overlapped between the two groups than the other 4 parameters. 3) The predictive value of the serum-ascites albumin gradient was significantly higher than the other parameters. we conclude that the serum-ascites albumin gradient offers the best diagnostic discrimination between ascites caused by liver disease and ascites caused by a neoplasm.