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함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),신동호(Dong Ho Shin),정선근(Sun Keun Jung) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1
N/A Acid and pepsin are necessary for gastric digestion of protein. The gastric peptic cells are the major source of pepsinogen, the precursor of pepsin, in blood and urine, but it is uncertain whether they enter the circulation through endocrine secretion or release from degenerating cells. Pepsinogen is also found in seminal fluid and amniotic fluid. Pepsinogen concentration in blood or urine is changed when gastrointestinal or renal diseases occur. So pepsinogen concentration in blood and urine can be used as an index of many gastrointestinal diseases and renal diseases. In this investigation, we analyse pepsinogen I concentration in blood and urine in six gastrointestinal diseases. The results are as follows. 1) The pepsinogen I concentration in blood is lowest in chronic atrophic gastritis(36.8 ng/dl) and high in gastric ulcer(131. 3 ng/dl) and duodenal ulcer(118. 7 ng/dl), (p<0.01, p<0.05). 2) The pepsinogen I Concentration in urine is lowest in Chronic atrophic gastritis(236ng/dl) and highest in duodenal ulcer(913.3 ng/dl), (p<0. 01). 3) The pepsinogen I concentration in blood and urine can be used as a diagnostic index of peptic ulcer diseases, chronic atrophic gastritis and recurrence of peptic ulcer after operation.
간경변증에 동반된 비기능항진증의 치료에 있어서 부분적 비동맹색전술의 이용
함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),서흥석(Heung Suk Seo),손주현(Joo Hyun Son),신창록(Chang Rok Shin) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
N/A Since Madison first used splenic embolization in the treatment of hypersplenism in 1973 and Spigos introduced partial splenic embolization (P.S.E.) reducing complications of total splenic embolization in 1979, P. S. E. has been accepted as an alternative therapeutic modality in the treatment of hypersplenism. P.S.E. was performed in 12 cirrohtic patients with hypersplenism. Femoral artery approach was used for splenic artery catheterization with tip of the catheter always well advanced selectively into the splenic artery. As an embolic material, 2x2cm pieces of belfoam were used and suspended in an antibiotic solution of cephalothin immediately before the intraarterial injection. Depending on the spleen size, 20∼40 pieces of Gelfoam were injected, and the extent of infarction was monitored f]uoroscopically and radiographically. The embolization was stopped when approximate 60% of the splenic parenchyma was devasculized. All patients were followed for 48 weeks(up to 1 year in 2 patients). The results were as followings: 1) The platelet counts were increased immedately after P. S. E. in all 12 patients and normalized in the 1st week in most patients. The maximal platelet count was observed at 4 weel after P. S. E. and then platelet counts tended to decrease gradually but maintained within normal limit until 48 weeks after P. S. E. 2) The WBC counts were increased promptly after P. S. E. like platelet counts, maximum at 1 weeks after P. S. E. 3) The hemoglobin level was not increased rapidly after P. S, E. but tended to increase gradually. 4) Abdominal pain, transient pyrexia, ascites & pleurl effusion ensued but were well tolerated, and there were no serious complications. In conclusion, the P. S. E. is thought to be a safe and effective therapeutic modality, alternative to surgical splenectomy for the treatment of hypersplenism in patients with liver cirrhosis.
함준수(Joon Soo Hahm),박경근(Kyung Geun Park),박준용(Joon Yong Park),한동수(Dong Soo Han),이민호(Min Ho Lee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이광수(Kwang Soo Lee),최은아(Eun A Choi),이명규(Myung Kyo Lee),함경수(Kyung So 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1
N/A Background/Aims: Biliary proteins have been suggested to play an important role in nucleation and gallstone formation. However, the exact roles and characteristics have not been completely documented. The aim of the present study is to isolate and characterize the nucleating protein extracted from gallstones. Methods: We tried to extract, isolate and characterize proteins in patients with gallstones. Twenty-two gallstones were obtained(12 cholesterol, 10 pigment) at cholecystec- tomy and extracted with ethanol/ether mixture. Then, isoelectric focusing was performed and gallstone proteins were analysed by SDS-polyacrylamide gel electrophoresis. The amino acids were also analysis by the autoamimo acid analyzer system. Results: The mean amount of gallstone protein was 4.15 mg/(g stone) in cholesterol and 16.15 mg/(g stone) in pigment stone. The proteins from both cholesterol and pigment stones showed major bands at low pH on isoelectric focusing. On SDS-PAGE, low molecular protein bands were noted, mainly below 45KD in both cholesterol and pigment stones. The composition of aspartate and glutamate was 21.6% in cholesterol stones and 22.7% in pigment stones. Conclusions: The proteins in cholesterol and pigment gallstones are low molecular weight acidic proteins, and these acidic proteins seem to play an important role in the pathogenesis of gall stones. However, it remains to be determined whether these proteins differ in functional roles from different gallstones. (Korean J Gastroenterol 1996;28: 92 - 100)
상부위장관 내시경검사 전처치제로 투여한 Rociverine Citrate 의 효과에 관한 관찰
함준수(Joon Soo Hahm),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),이종철(Jong Chul Rhee),윤호주(Ho Ju Yung) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1
N/A A new synthetic smooth muscle-relaxant, Rociverine citrate (Danapen), was tested for spasmolytic action on the smooth musculature of the pyloric sphincter against Hyoscine butylbromide. The total number of subjects was 262 patients and 10 mg of Rociverine citrate were intramuscularly given in 128 cases and 20 mg of Hyoscine butylbrornide were given in the 134 cases. The drug effect were assessed on the degree of opening of the pyloric sphincter and the endoscopists rating of drug performance. The results were as follows; 1) About the pyloric sphincter status, 116 cases (90.6%) of Rociverine citrate premedicated group and 115 cases (85.8%) of Hyoscine butylbromide premedicated group and 115 cases (85.8%) of Hyoscine butylbromide premedicated group showed above than fair response. 2) The ratings of examination procedure by the endoscopist were very good in 76.6%, good in 20.3%, fair in 2.3%, and ineffective in 0.8%, in Rociverine premedicated group and very good in 73.1%, good in 22.4%, fair in 3.7%, and ineffective in 0.8%, in Hyoscine butylbromicle premedicated group. 3) No adverse effects were noted in Rociverine citrate group. Thus, we concluded that the Rociverine citrate is an active drug as a premedication drug for upper endoscopic examination.
위 (胃) 내시경 (內視鏡) 검사 (檢査) 14 , 389 예에 대한 임상 (臨床) 연구
함준수(Joon Soo Hahm),박경남(Kyung Nam Park),이민호(Min Ho Lee),이성준(Seong Joon Lee),오수철(Soo Chun Oh),한덕호(Duck Ho Han),이종철(Jong Chul Lee),기춘석(Chun Suhk Kee) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1
N/A Clinical studies were carried out on 14,389 cases who had taken gastrofiberscopic examination, biopsy and X-ray from May, 1969 to May, 1984 in Han-Yang University Hospital. The results obtained were as follows; 1) Of total 14,389 cases, 7,916 were male and 6,473 were female. 55.1%, of the cases were in the 3rd and 4th decade. 2) Of total 14, 389 cases, 13, 615 showed abnormal endoscopic findings. In abnormal cases, male to female ratio was l.2: l.3) The incidence of single organ involved was 84.8% and multiple organs involved was In single organ involved cases, the most common site of disease was stomach and in multiple organ involved cases, the prevalent sites of lesions were stomach and duodenum. 4) The most frequent disease of stomach was gastritis followed by gastric ulcer. In the cases of duodenum, the most common disease was duodenal ulcer and the next was duodenitis. 5) The most prevalent disease was the chronic gastritis, and the frequency of the other upper gastrointestinal diseases was acute gastritis, gastric ulcer, stomach cancer and duodenal ulcer in orders. 6) The most frequent type of chronic gastritis was superficial gastritis. 7) Among the total cases which had been taken blood-typing, the incidence of most upper gastrointestinal diseases was not related to each blood type. But blood group 0 was common in peptic ulcer disease and blood group A in stomach cancer. 8) The clinical symptoms and signs were of no significant aid for the differential diagnosis of the various upper gastrointestinal diseases.
간장및 담도 : 담석 핵화에 있어서의 단백질의 의의에 관한 연구
함준수(Joon Soo Hahm),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),이종철(Jong Chul Lee),한동수(dong Soo Han),양석철(Suck Chul Yang),이광수(Kwang Soo Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
N/A Formation of gallstones depends upon at least 2 processes; first, supersaturation of cholesterol and calcium salts, seond, nucleation of crystals in the bile. Nucleation requires gallbladder mucins, and its main component, glycoprotein, is known to be concentrated in the gallstones. Howere the nature and role of the gallstone proteins is still unknown, and the difference in the compositions of proteins between various gallstones has not been observed. 21 gallstones, 13 cholesterol stones and 8 pigment stones, were obstanined at cholecystectomy, washed, dried and extracted cholesterol, pigment, and bile salts by 0.1 N HCl petrolium ether ethanol solution for an analysis of proteins in gallstones. The compositions of gallstones by infrared sphectophmeter. The gallstone proteins were then quantified by Bensadoun & Weinstein method, and analyzed by SDS-polyacrylamide gel eletrophoresis. The results were as follaws; 1) The amount of gallstones proteins was 2.12 mg% in cholesterol stones and 2.61mg% in pigment stones. 2) SDS-PAGE could isolate low molecular proteins; 13 cases (62%) below 15 KD, 3 cases (14.2%) between 20~40 KD and 5 cases (23.8%) above 45 KD of molecular weight. 3) There was no significant difference in protein quantification between cholesterol and pigment stones. We could suggest that gallstone proteins are mainly acidic proteins with low molecular weight and these proteins could play an important role in nucleation of gallstone formation.
간장및 담도 : 만성간질환 환자의 상부위장관 증상에 대한 Domperidone 효과에 대한 연구
함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),이민호(Min Ho Lee),이종철(Jong Chul Rhee),기춘석(Choon Suck Kee),이오영(Oh Yong Lee),안종훈(Jong Hoon Ahn),박경남(Kung Nam Park),조석신(Suck Shin Cho) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
N/A The fact that chronic hepatitis patients with dysfunctional upper gastro-intestinal symptoms have delayed gastric empting time was documented in our previous study. Fifteen patients with chronic hepatitis participated in a assessment of the effects of domperidone on gastric empting time and dysfunctional upper gastrointestinal symptoms such as recurrent nausea, vomiting, postprandial bloating, anorexia and meight loss. They were each given domperidone 10 mg t.i.d. for four weeks. The resu1ts are as folIowing; 1) The total patints with chronic hepatitis are 15 in number, composed of chronic active hepatitis 9, chronic persistant hepatitis 6. 2) The GET (T 1/2) OF 15 patients with chronic hepatitis was delayed significantly than that of the normal control. (Mean +- SE; 135.0 +- 6.0 vs 89.4 +- 5.9 mins) (p<0.05). 3) Follow-up GET (T 1/2) of these patients after domperidone treatment were 116.0 +- 5.5 mins but those results were not statistically significant different from initial GET (T 1/2) (135.0 +- 6.0 mins). 4) Domperidone significantly promote dysfunctional gastrointestinal symptoms such as recurrent nausea, vomiting, postprandial bloating, anorexia, and weight loss. (Mean +- SE; 4.3 +- 0.2 vs 0.8 +- 0.2 symptom scores) (p<0.05). 5) The two side effect seen only with domperidone, diarrhea and mild abdominal pain occurred in one patient each and neither was severe enough to require discontinuing the study. No neurologic problems were noted.
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 만성 간염 환자에 있어서의 Ursodeoxycholic Acid ( SGD - FR ) 의 임상 효과
함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),양석철(Suck Chul Yang),김태환(Tae Hwan Kim),이종철(Chong Chul Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.4
N/A Randomized double blind trials have done to determine the effect of ursodeoxycholic acid (SGD-F) to the progress of the chronic hepatitis, 30 patients who had been admitted at the department of internal medicine, Hanyang University Hospital from October 1989 to March 1990 were selected to the study; UDCA was given to 15 patients and placebo was given to the other 15 patients. The results are as follows; 1) Clinical stage showed improvement (14 cases; 93.3%) and serum transaminase was decreased markedly after UDCA (SGD-F) treatment. 2) Serum transaminase (SGOT, SGPT) was more decreased in UDCA treatment group than in placebo treatmelnt group. 3) The UCDA (SGD-F) treatment group showed more clinical improvement than the placebo treatment group. In conclusion, the ursodeoxycholic acid (SGD-F) treatment may be effective for patients with chronic liver disease.
복수의 성상을 감별진단함에 있어서 복수내 지질측정의 의의
함준수(Joon Soo Hahm),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),윤호주(Ho Ju Yun),이재호(Jae Ho Lee),안광무(Kwang Moo Ahn) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.3
N/A To evaluate the diagnostic value of ascitic lipids to differentiate rnalignant from nonmalignant ascites, the authors studies 47 patients with ascites (22 with cirrhosis, 16 with various neoplasms and 9 with both chronic liver disease and malignancy). Ascitic fluid (AF) concentrations of cholesterol, triglycerides, phospholipids and total lipids were compared with other parameters such as AF total protein, AF to serum ratio of total protein, AF lactic dehydrogenase (LDH), AF to serum ratio of LDH, AF carcinoembryonic antigen (CEA) and AF cytology. The results were as follows: 1) The median and mean values of cholesterol, triglycerides, phospholipids and total lipids were significantly higher in malignant ascites compared to cirrhotic ascites (p<0.01). 2) The sensitivity and specificity of AF total protein in the differentiation between cirrhotic and malignant ascites were 0.75 and 0.86 respectively, AF to serum ratio of total protein (0.69 and 0.91), AF LDH (0.56 and 0.91), AF to serum ratio of LDH (0.63 and 0.86), AF CEA (0.56 and 1.00), and AF cytology (0.56 and 1.00). 3) The best discrimination value of cholesterol was 42 mg/dl. AF cholesterol concentration overlapped the least and showed the highest sensitivity (0.88) and specificity (1.00). 4) There was no significant difference between patients with cirrhosis and both chronic liver disease and malignancy in the AF concentration of cholesterol, triglycerides, phospholipids and total lipids. 5) Significantly positive correlations were found between cholesterol/total protein (r=0.83, p<0. 001), cholesterol/phospholipids (r=0.93, p<0.001), cholesterol/triglycerides (r=0,54, p<0.001) and cholesterol/total lipids (r=0.81, p<0.001). In conclusion, AF lipids, especially AF cholesterol concentration, were parameters valuable for the differential diagnosis of ascites.