Pulmonary Aspergilloma : 1 수술 치험례 A Case

신원창,손광현,홍성란 인제대학교 1985 仁濟醫學 Vol.6 No.4

심한 객혈을 동반한 우측 상엽부의 mycetoma 병조를 절제한 후 임상 경과 완쾌되었다. 병리조직학적 검사상 Aspergilloma의 균사 및 아포로 구성된 fungus ball이 증명되었다. Pulmonary aspergilloma with massive hemoptysis is an occasionally fatal condition. A 43 year old house wife has had a severe recurrent hemoptysis for about 3 months. She received various medical treatment including anti-tuberculous measures without improvement. Roentgenographic findings were multicystic and soft patchy appearance at the posterior segment of the right upper lobe by A-P and lateral tomogram and also in computed tomogram. Pre-operatively fungus in the sputum culture was identified at the laboratory. Choice of surgical excision of the involved lobe was decided. Specimen showed beautiful fungus ball in the cavity and bronchiectasis of the communicated bronchi. Pathologic examination showed beautiful aspergillus fumigatus involving the lung parenchyma. Post-operatively hemoptysis was disappeared and 6th months follow up showed good recovery, For the reasons of the complex clinical pictures of the patient, authers report the case with a literature reviews.

세균성·바이러스성 장염

신원창 약업신문사 1996 의약정보 Vol.1996 No.4

비외과적 방법에 의한 치주질환 개선효과에 관한 연구

신원창,김동기 대한구강보건학회 1999 大韓口腔保健學會誌 Vol.23 No.5

가용매분해 펄프화법 ( Solvolysis Pulping Methods - New Process for Biomass Refinery - )

신원창 한국펄프·종이공학회 1983 펄프.종이技術 Vol.15 No.1

양성 식도협착의 내시경적 확장치료에 영향을 미치는 인자

신원창 대한소화기내시경학회 2005 Clinical Endoscopy Vol.30 No.2

Background/Aims: Endoscopic dilatation is an effective therapy for benign esophageal stricture. We analyzed the factors related to the endoscopic dilatation therapy in patients with benign esophageal strictures such as etiology, grade of dysphagia, length of stricture and number of therapeutic sessions. Methods: We retrospectively analyzed the data of 63 patients who received endoscopic esophageal dilatation therapy due to benign esphageal strictures. Results: The grade of dysphagia number was associated with the length of strictures (p=0.012) and therapeutic session (p=0.005). There was a statistically significant correlation between the length of strictures and therapeutic session number (p=0.001). There was no statistical difference in grade of dysphagia or the length of stricture according to the cause of strictures of therapeutic sessions performed. In corrosive stricture, the higher grade of dysphagia, was associated with the in creased number (p=0.028). The length of stricture was longer (p=0.040) and the number of therapeutic sessions were increased (p=0.026) in corrosive stricture than other etiologies. Conclusions: Corrosive esophageal stricture shows long stricture segment and needs increased number of therapeutic session as compared to other etiologies. However, corrosive esophageal stricture can be effectively treated with careful technique and increased number of endoscopic dilatation sessions. 목적: 내시경 확장치료는 대부분의 양성 식도협착 환자에게 가장 좋은 초기 치료법으로 알려져 있다. 본 연구는 양성 식도협착의 원인, 연하장애의 정도, 협착의 길이, 치료 시술의 횟수가 내시경적 확장치료 효과에 어떤 영향을 미치는지 알아보았다. 대상 및 방법: 1995년부터 2002년까지 인제대학교 상계백병원에서 양성 식도협착으로 진단하고 내시경적 풍선 확장술 및 식도 부우지법으로 치료한 63명을 대상으로 후향적으로 분석하였다. 결과: 치료 후 1년 이상 추적이 되었던 환자 47명에서 식도 확장술 전 연하장애가 심할수록 협착의 길이가 길었고(p=0.012), 양호한 치료효과를 나타내는데 필요한 시술 횟수도 많았다(p=0.005). 협착의 길이가 길면 시술 횟수도 많이 필요하였다(p=0.001). 양성 식도협착의 원인에 따른 연하장애의 정도와 식도협착의 길이는 차이가 없었고, 부식성 협착의 경우에만 연하장애의 정도가 심할수록 내시경적 확장술이 더 많이 필요하였다(p=0.028). 또한 부식성 협착은 다른 원인들보다 협착의 길이가 길었고(p=0.040), 양호한 치료효과를 나타내는데 필요한 시술 횟수도 많았다(p=0.026). 내시경적 식도 확장술 중 3명은 천공이 생겼고, 2명은 치료 실패 후 수술을 하였으며, 2명은 치료와 상관없는 사망, 9명은 추적 불가능하였다. 결론: 양성 식도협착의 원인 중 부식성 식도협착은 수술 후 식도협착이나 기타 원인에 의한 식도협착과 비교하여 협착의 길이가 길며, 증상을 호전시키기 위한 확장 시술 횟수가 많이 필요하고, 시술 중 천공이 많이 생겼다. 그러나 부식성 식도 협착도 조심스럽게 치료하고 시술 횟수를 늘려서 확장술을 시행하면 다른 원인에 의한 협착과 마찬가지로 내시경적으로 안전하고 우수한 확장 치료효과가 있을 것이라 생각한다.

소화성궤양 출혈의 에탄올 경화요법의 효과와 궤양 기저부 형태에 따른 지혈 치료의 필요성

신원창,김관엽 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.1

The peptic ulcer is the most common cause of the upper gastrointestinal bleeding. We evaluated the efficacy of the sclerotherapy by endoscopic injection of ethanol for the bleeding peptic ulcer patients. We also evaluated the need of the sclerotherapy on the bleeding peptic ulcer according to the bleeding stigmata on the ulcer base. We classified the bleeding stigmata on the ulcer base with 4 group: active bleeding(21/345, 6%), visible vessel(122/345, 35%), red spot(97/345, 28%), no stigmata(105/345, 31%). The patients who manifested hernatemesis, melena, or both initially, were diagnosed as benign gastric ulcer(BGU, 179 patients) and duodenal ulcer(BDU, 166 patients). The median age was 57 year-old in the BGU patients and 37 year-old in the BDU patients. The sclerotherapy was performed to the 109 patients(58 BGU and 51 BDU patients), 96 patients(96/109, 89%) show permanent hemostasis. The hemostasis rate was 77% with active bleeding in the BGU patients, 75% with active bleeding in the BDU patients. There was no significant difference between sclerotherapy and observation group with visible vessel and red spot on the ulcer base of the bleeding peptic ulcer patients. Conclusively, the endoscopic sclerotherapy was very useful and effective treatment method for the bleeding peptic ulcer, but we suggested that all the bleeding peptic ulcer patients should not have done the sclerotherapy.

대장내시경 검사중 동맥혈 산소 포화도와 생리적 변화에 관한 연구

신원창,이진호,김관엽 인제대학교 1994 仁濟醫學 Vol.15 No.3

대장내시경 검사중 발생할 수 있는 동맥혈 산소 포화도의 감소와 혈압, 맥박, 호흡수의 변화가 어느정도 심하게 발생하는지, 또한 전처치 약물과의 관계, 검사 시행 도중에 생기는 통증과 대장고리(Loop)의 형성과 어떤 관계가 있는지 조사하기 위해 50명의 환자를 대상으로 연구하였다. We prospectively evaluated multiple physiologic parameters in 50 consecutive unselected patients undergoing elective colonoscopy. Changes observed during colonoscopy were then correlated with premedication, position of the endoscope and presence of looping, existence of comorbid medical conditions. Clinically important changes in oxygen saturation(28%), in blood pressure(22%), pulse rate(42%), and respiratory rate(14%) were noted. These clinically significant changes were associated with endoscopic looping and pain. In the remainder of patients, no obvious factor was associated with the observed alterations in physiologic parameters. There was no relation with presence of comorbid medical conditions, dose of premedication, and/or colon segment reached by the endoscope. Conclusively although there was no apparent morbidity associated with the induced changes in physiologic parameters, these data suggest that certain patients may be at increased risk of procedure -related morbidity and support the need for physiologic monitoring in high-risk patients.

특발성 문맥압항진증 1례 : A Case Report

신원창,박강수,윤진일,정운태,이진호,김관엽,김홍용 인제대학교 1993 仁濟醫學 Vol.14 No.2

저자들은 비장종대와 빈혈을 동반하고, 간문맥압이 항진된 특발성 문맥압항진증 1례를 치험하였기에 문헌 고찰과 함께 보고하는 바이다. Idiopathic portal hypertension is a disease entity characterized by anemia, huge splenomegaly, esophagogastric varix and bleeding with normal or near normal hepatic function. Recently, we experienced a case of idiopathic portal hyperetension in a 25-year-old man associated with incomplete rotation of intestine, which was managed with surgical intervention.

유방 결핵을 병발한 결핵성 복막염 1예

신원창,이희승,전수영,이진호,김관엽,조혜제,고일향 大韓消化器病學會 1993 大韓消化器病學會誌 Vol.25 No.2

소화불량의 치료전략

신원창 대한가정의학회 2000 Korean Journal of Family Medicine Vol.21 No.8