제5차 대한간학회 춘계학술대회 초록집 : 경동맥 화학색전술을 시행한 간세포암 환자에서 재발인자분석

금민수 ( Geum Min Su ),탁원영 ( Tag Won Yeong ),권영오 ( Kwon Yeong O ),김성국 ( Kim Seong Gug ),최용환 ( Choe Yong Hwan ),정준모 ( Jeong Jun Mo ) 대한간학회 1999 Clinical and Molecular Hepatology(대한간학회지) Vol.5 No.1(S)

대한간학회지 제2차 춘계학술대회 초록집 : 식도정맥류 출혈시 내시경적 경화요법과 고무밴드 결찰요법의 치료 효과

김영탁 ( Kim Yeong Tag ),금민수 ( Geum Min Su ),이양일 ( Lee Yang Il ),최성곤 ( Choe Seong Gon ),이창형 ( Lee Chang Hyeong ),권영오 ( Kwon Yeong O ),김성국 ( Kim Seong Gug ),최용환 ( Choe Yong Hwan ),정준모 ( Jeong Jun Mo ) 대한간학회 1996 Clinical and Molecular Hepatology(대한간학회지) Vol.2 No.2(S)

향어 담즙에 의한 독성간염

최성곤(Sung Gon Choi),김영탁(Young Tak Kim),금민수(Min Su Geum),이양일(Yang Il Lee),권중구(Joong Gu Kwean),이창형(Chang Hyeong Lee),권영오(Young Oh Kweon),김성국(Sung Kook Kim),최용환(Young Hwan Choi),정준모(Joon Mo Chung) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3

The raw carp bile has been known as having both nephrotoxic and hepatotoxic effects which mechanisms are not well-known. Review of previously reported literature revealed many cases that had clinical evidences of both hepatitis and renal failure but any case of isolated hepatitis without acute renal failure was not found. We experienced a case of acute toxic hepatitis without evidence of renal failure due to ingestion of raw carp bile, so we report this case with review of literature. (Korean J Gastroenterol 1995;28: 421 - 425)

제3차 대한간학회 춘계학술대회 초록집 : 간경변증 환자에서 초발 자발성 세균성 복막염의 빈도 및 예측인자

김대현 ( Kim Dae Hyeon ),이영두 ( Lee Yeong Du ),조창민 ( Jo Chang Min ),금민수 ( Geum Min Su ),박언휘 ( Park Eon Hwi ),권영오 ( Kwon Yeong O ),김성국 ( Kim Seong Gug ),최용환 ( Choe Yong Han ),정준모 ( Jeong Jun Mo ) 대한간학회 1997 Clinical and Molecular Hepatology(대한간학회지) Vol.3 No.2(S)

과민성 대장 증후군 환자에서 Colpermin 투여의 임상 효과

금민수,조창민,김대현,이창형,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.1

목적 : 과민성 대장 증후군은 장기능 이상의 증상군으로, 인지할 수 있는 기질적 위장관 병태 생리가 없는 경우로 기능적인 장관의 이상 경축과 가장 밀접한 관련이 있을 것으로 생각된다. 그러나 치료면에서는 아직 뚜렷한 방침이 정립되어 있지 않고 다양한 방법들이 제시되고 있는 실정이다. 저자들은 장용성 캅셀로 조제된 박하유 성분인 Colpermin® 의 임상 효과를 평가하고자 본 연구를 시행하였다. 대상 및 방법 : 1996년 2월부터 1996년 11월까지 경북대학교병원 소화기 내과를 방문하여 과민성대장 증후군으로 진단된 34명의 환자를 대상으로 Colpermin® 을 1회 2캅셀씩, 1일 3회, 경구로 2주간 투여하였다. 결과 : 투여전의 증상의 빈도는 복통 88.2%(30/34) 및 설사 73.5%(25/34)를 호소하는 경우가 가장 많았으며, 그 다음으로 변비 50.0%(17/34), 복부 팽만 47.1%(16/34), 고창 38.2%(13/34)순이었다. 약물 투여후 증상별 개선율은 설사를 보였던 환자들에서 호전 11예와 매우 호전 11예로 88.0%(22/25)의 가장 높은 개선율을 보였고, 그 다음으로 복통 73.3%(22/30), 고창 69.2%(9/13), 변비 64.7%(11/17), 복부 팽만 56.3%(9/16)의 순이었다. 종합적인 증상의 개선도는 현저한 개선이 2예(5.9%), 중등도 개선이 9예(26.5%), 약간 개선이 18예(52.9%), 불변이 4예(11.8%), 악화가 1예(2.9%)였으며, 종합적인 유효율은 85.3%(29/34)였다. 약물의 부작용으로 3예의 환자에서 각각 복부 팽만의 발생, 변비의 악화, 복통의 발생이 있었으나, 그 외의 환자들에서는 아무런 부작용도 관찰되지 않았다. 결론 : 과민성 대장 증후군의 약물치료에 있어서 Colpermin®이 유용한 약제가 될 수 있을 것으로 기대된다. Irritable bowel syndrome (IBS) is a disease characterized by a collection of symptoms of intestinal dysfunctions, without any recognized organic gastrointestinal pathology. This study was performed to evaluate clinical effectiveness of peppermint oil (Colpermin®) in the treatment of patients with IBS. 34 patients (18 males and 16 females) with IBS were treated with peppermint oil 0.4ml (as menthol 176㎎) three times daily for 2 weeks and the efficacy of the treatment was evaluated according to the degree of the improvement. The improvement of symptoms was 88.0% (22/25) in diarrhea, 73.3% (22/30) in abdominal pain, 69.2% (9/13) in flatulence, 64.7% (11/17) in constipation, and 56.3% (9/16) in abdominal distension, respectively. Overall effectiveness of subjective symptoms was 85.3% (29/34). Side effects of the drug were noted in only 3 cases, those were aggravation of constipation, development of abdominal distension and abdominal pain. As a result, Colpermin® might be considered as an effective drug in relieving symptoms of IBS.

기능성 소화불량증환자에서 Winstal® 투여에 관한 임상경험

이창형,김영탁,금민수,권중구,안병철,윤영미,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.3

목적 : 기능성 소화불량증은 소화, 흡수등 장관의 기능적인 이상과 관련되어 있을 것으로 생각되며 복합소화효소제(Winstal®)를 투여하여 그 임상효과를 평가하고자 본 연구를 실시하였다. 대상 및 방법 : 1994년 3월 부터 6월까지 경북대학교병원 내과를 방문한 기능성 소화불량증을 호소하는 환자 20명을 대상으로 Winstal®을 1회 1정씩, 1일 3회 식후 30분내에 경구로 2주간 투여하였다. 결과 : 소화불량증의 증상은 복부불쾌감, 복부팽만감, 식욕부진 및 오심, 복부동통, 공기연하증, 고창 및 구토순이었으며, 증상의 개선은 복부불쾌감이 76.4%(13/17)로 가장 높았으며, 그 다음으로 복부팽만감 및 공기연하증이 66.5%(10/15, 6/9)이었고, 오심 61.5%(8/13), 식욕부진 53.8%(7/13), 복부동통 41.6%(5/12), 고창 37.5%(3/8)이었다. 각 환자별 종합적인 증상의 개선도는 현저한 개선이 2예(10%), 중등도 개선이 3예(15%), 약간개선이 11예(55%), 불변이 4예(20%)이었으며 종합적인 유효율은 80%(16/20)이었다. 부작용은 한 예에서도 관찰되지 않았다. 결론 : 본 제제는 기능성 소화불량증 환자의 증상개선에 추천할 만한 유효한 약제로 생각된다. Dyspepsia is a common symptom in gastroenterologic practice and trigger for numerous consultations with physician. The treatment of chronic functional dyspesia is unsatisfactory. This study was performed to evaluate the efficacy of the digestive compound (Winstal®) on 20 functional dyspepsia patients. On open trial, all patients were given 6 tablets daily for 2 weeks and we evaluated the efficacy of this preparation according to the degree of the improvement. The improvement of symptoms was 76.4%(13/17) in abdominal discomfort, 66.5%(10/15, 6/9) in abdominal distension and aerophagia, 61.5%(8/13) in nausea, 53.8%(7/13) in abdominal pain, and 37.5% (5/12) in flatulence, respectively. Overall effectiveness of subjective symptoms was 80% (16/20) and there were no untoward effects of the preparations during this study. As a result, We think that this preparation is an effective one to relieve symptoms of functional dyspepsia.

경간동맥화학색전술을 시행한 간세포암 환자에서 재발인자 및 예후 분석

김성국,정준모,김대현,최용환,권영오,금민수,탁원영 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.1

Background/Aims : Hepatocellular carcinoma (HCC) is a malignant tumor with very poor prognosis if left untreated after diagnosis. However, recent advances in digital subtraction imaging techniques and superselective catheterization seem to have somewhat increased the survival rate in patients with HCC after transarterial chemoembolization (TACE). This study analyzed the relationship between prognostic factors and recurrence after TACE, an aspect which has not attracted much attention. Methods : This investigation included 258 cases of HCC with 100% lipiodol uptake who received TACE for a duration of 13 years from 1985 to 1997. Clinical characteristics, biochemical factors, tumoral factors, angiographic characteristics, embolization technique, degree of lipiodol uptake, response, and recurrence factors were analyzed retrospectively. Results : Significant differences in survival were noted among 3 groups according to cancer-free interval (p$lt;0.01). The different factors between early recurrence group (within 6 months) and late recurrence group (after 18 months) were initial tumor size (8.8±4.1/6.1±3.7cm, p$lt;0.01), tumor type (multinodular,massive/single nodule, p$lt;0.01), ill-defined margin (51.4/22.0%, p$lt;0.01), response after TACE (NC/CR,PR, p$lt;0.01), ALP level (196.1±124.5/144.4±72.0 IU/L, p$lt;0.05), absence of encapsulation (42.3/25.0%, p$lt;0.05), portal vein thrombosis (64.3/14.3%, p$lt;0.05), nonsegmental embolization (46.6/25.0%, p$lt;0.05), post-TACE AFP level (180.5±252.1/76.6±329.8 ng/mL, p$lt;0.05), and recurrence pattern (revascularization of initial lesion/single nodule, p$lt;0.05). Conclusions : Recurrence factors were significant in the survival of patients with HCC after TACE. Therefore, an understanding of the relationship between prognostic factors and recurrence is very important for early detection of recurrence and the timely provision of further TACE treatment. (Korean J Hepatol 2000;6:111-123)

독성 간염 및 상부 소화관 출혈을 동반한 Piroxicam에 의한 독성표피융해 1예

김성국,조재현,정준모,김대현,권영오,이창형,금민수,권삼,최용한 대한소화기학회 1998 대한소화기학회지 Vol.31 No.1

Drug-induced toxic epidermal necrolysis (TEN) is one of the most severe mucocutaneous diseases characterized by progressive epidermal detachment with the involvement of multiple internal organs and poor prognosis. There are few reports of drug-induced toxic epidermal necrolysis with upper gastrointestinal bleeding and toxic hepatitis simultaneously. We experienced a case of piroxicam-induced TEN with upper gastrointestinal bleeding and toxic hepatitis in a previously healthy 61 year-old woman. The patient was admitted with nausea, vomiting and a high transaminase level on liver function test after two weeks of medication with piroxicam, and showed progressive erythematous rnaculopapular, vesiculobullous skin lesions on the face at first and the lesions spread to the neck and the trunk consecutively. Four.days after admission, hematemesis and melena developed. Upper gastrointestinal endoscopy showed diffuse mucosal erosions and shallow ulcerations in the esophagus, stomach and diffuse mucosal nodularity in the duodenum. Liver biopsy showed mild lymphocytic infiltration in the portal area and an entrapped bile plug in the sinusoidal space which was consistent with drug-induced cholestatic hepatitis. The patient was treated with antibiotics, corticosteroids and other supportive managements and then recovered completely. We report this case with a review of the literatures.

간경병증 환자에서 복수천자가 폐기능에 미치는 영향

김성국,정준모,최용환,김영탁,권영오,이창형,최성곤,금민수 대한간학회 1997 Clinical and Molecular Hepatology(대한간학회지) Vol.3 No.1

Background/Aims : Paracentesis is an acceptable therapeutic modality for the symptomatic relief of dyspnea or abdominal fullness due to tense ascites in patients with cirrhosis. Whereas studies about the effects of paracentesis focused on the changes about hemodynamics, electrolytes and renal function in great detail, the effects of paracentesis on the changes about respiratory system have undergone limited investigations which are defined large-volume paracentesis. Methods .' We performed pulmonary function tests with arterial blood gas analysis just before and 24 hr after paracentesis. The paracentesis of average 2,300ml was carried out in ten liver cirrhosis patients with tense ascites who were free from underlying cardiopulmonary impairment. Results '. 1. The results of pulmonary function test just before paracentesis were as followings; FVC( functional vital capacity), FEV1(forced expiratory volume in 1 sec), FEF25 75(forced expiratory effort 25% 75%) and TLC(total lung capacity) were decreased as 78%, 79%, 62.3% and 89% of normal control value respectively, whereas RV(residual volume) was not decreased. DLCO(lung diffusion capacity of carbon monoxide)was decreased as 61.6%. 2. The results of pulmona function test 24 hr after paracentesis were as followings,' The symptomatic relief of dyspnea was achieved in all participated ten patients. Among lung volume parameters, FVC and VC were increased significantly(p=0.003, p=0.004). Whereas TLC was increased without statistical significance(p=0.228), and RV and FRC(functional residual capacity) showed no change. FEV1 was increased significantly(p=0.039), but FEF25 75 and the ratio of FEF1/FVC showed no change. DLCO was not increased. PaOy(partial pressure of oxygen in arterial blood) was impr'oved without statistical significance. Conclusions .' These results suggest that the patients of liver cirrhosis with ascites have restrictive ventilatory impairment with additional obstructive ventilatory impairment. After paracentesis, the restrictive ventilatop impairment is improved by the relief of diaphragmatic motion limitation caused by ascites. Also, paracentesis of(not large volume, like 5000ml, but) relatively small volume, of 2000 3000ml can achieve objective improvement of dyspnea due to tense ascites.

간경변증에서 근경련의 임상 양상 및 관련인자

김성국,조재현,정준모,최용환,최정일,권영오,금민수,탁원영 대한소화기학회 1999 대한소화기학회지 Vol.34 No.1

Background/Aims: Muscle cramps are observed frequently in the course of liver cirrhosis. We studied the prevalance and clinical features and associated factors of muscle cramps in cirrhotic patients. Methods: We performed a cross-sectional survey for 65 cirrhotic patients with a standardized questionnaire and laboratory tests. Results: The prevalence of muscle cramps in the patients with cirrhosis was 46% (30/65). Muscle cramps occurred frequently during sleep (60%) and involved calves (70.0%), hands (63.3%), thighs (43.3%) and feet (33.3%). There were no significant differences in sex, age, etiology of cirrhosis, alcohol intake and diuretics use between cirrhotic patients with and without cramps. However, the group with cramps have more tense ascites, lower serum albumin level, higher serum total bilirubin level and higher Child's score. They also have higher blood pH level, lower mean arterial pressure, lower serum sodium level and lower total calcium level. However, ionized calcium level was similar in both group. Conclusions: The prevalence of muscle cramps in cirrhotic patients is 46%. Muscle cramps in cirrhotic patients may not be related to diuretics or alcohol intake. The deranged metabolism due to impairment of hepatic function and decreased effective plasma volume can be related to muscle cramps multifactorially.