과민성 대장증후군에 대한 Trimebutin Maleate ( PolybutineR ) 서방정 및 속방정의 비교 임상연구 (

함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),이종철(Jong Chul Rhee),이상(Sahng Lee),윤석진(Suhk Jeen Yoon) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

N/A The purpose of this paper is to evaluate the clinical effectiveness of Trimebutine maleate in the treatment of patients with irritable bowel syndrome, the total number of subjects was 55 patients (male: 31 cases, female: 24 cases) who had been visited to Hanyang university hospital, Among them, 30 cases were treated with trimebutine maleate(300 mg) twice daily (Drug A) and 25 cases with trimebutine maleate(200mg) three times daily (Drug B). Drug A and drug B were administered randomly to each assigned group, and symptoms were scored before and after the study. The results were as follows: Initial symptorns of patients with drug A were appeared as abdominal distension(92.8%), abdominal pain(92.6%), constipation(90%) and diarrhea(89.5%) ancl 91.3%, 90.0%, 88.9% and 86.4%, respective]y in patients with drug B The effective rate of trimebutine maleate (drug A & B) on each symptoms were 92.8%, 91.3%(abdominal distension), 92.6%, 90.0% (abdominl pain) 90.0%, 86.4% (constipation) 89.5%, 88.9% (diarrhea) and 85.7%, 87.5%(vomiting) respectively, and there are no differences in the effectiveness of subjective symptoms between each groups. The result of evaluation of the overall effectiveness of trimebutine maleate (Drug A & B) were 90.0% & 92.0% and there are no differences of overall effectiveness, between each group. No serious adverse drug reactions were noted with each group. Considering the effectiveness of the two regimens which do not show statistical differences, trimebutine maleate 330mg twice daily is preferable in the treatment of patient, with irritable bowel syndrome in terms of convenience.

간질환환자의 위내용물 배출시간에 관한 연구

함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),박경남(Kyung Nam Park),이민호(Min Ho Lee),이종철(Jong Chul Rhee),기춘석(Choon Suck Kee),유대현(Dae Hyun Yoo) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.2

N/A Gastric emptying time(GET) is influenced by several factors, such as neura), hormonal and composi- tion and physiochemical properties of food. The patients with delayed GET have some upper gastrointestinal symptoms such as recurrent nausea, vomiting, postprandia! Bloating, anorexia, and iveight loss. And also, almost of acute hepatitis and a part of chronic ]iver disease patients have similar symptoms of the patients with delayed GET. Therefore We performed GET measurement in liver disease patients to identify the relationship between nonspecific upper gastrointestinal symp- toms and gastric emptying function. The resu]ts are as followings; 1) Total ]iver disease patients are 28 in number, composed of acute hepatitis 3, chronic hepatitis 18, liver cirrhosis 7. 2) The GET(T1/2) of liver disease patients was delayed significantly than that of the normal volunteers. (Mean+SE;120.8+6.6 vs 89.4+5.9 mins.) 3) The GET of the symptomatic patients (N = 20 ) ivas 128.3+6.8 mins (Mean+SE), and that of the asymptomatic patients (N =8) was 101.8+13.2 mins. The symptomatic patients have delayed GET in 10 patients and asymptomatic patients have delayed GET in 3. 4) The GET of the patients who have elevated serum transaminase level higher than twice of normal is delayed significantly than that of the patients who have serum transaminase level lower than twice of normal. (Mean+SE; 143.4+2.6 vs 110.0+7.4 mins.)

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.

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.

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.

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.

간장 ( 肝腸 ) 및 담도 ( 膽道 ) : 울혈성 위질환 ( Congestive Gastropathy ) 과 만성간질환의 상관관계에 대한 연구 - 표식자로서의 의의 -

함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),이민호(Min Ho Lee),이종철(Jong Chul Rhee),기춘석(Choon Suck Kee),안종훈(Jong Hoon Ahn),박경남(Kung Nam Park),박병권(Byung Kwon Park) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3

N/A The fact that gastric mucosal lesions are frequently seen in portal hypertension is already well known. In recent years, many workers reported that endoscopic features of gastric mucosa with portal hypertension showed minimal inflammation and marked venous ectasia and dilatation. However, the pathogenesis and pathophysiology and the diagnostic value of portal hypertension of these changes have been argued by many authors. Our purpose of the study is concerned about the incidence and the significance of congestive gastropathy on various chronic liver disease. For this aims, First, retrospectively the results of endoscopic features and liver biopsies of the 477 patients with abnormal liver function test were analyzed, investigated the incidence of these changes, and Second, prospectively selected 10 patients with normal liver function test and congestive gastropathy on the proximal part of the stomach, and unresponsive to anti-erosive medication, were under taken liver biopsies. The result was as follows; 1) The incidence of congestive gastropathy was similar in liver cirrhosts and in other types of chronic liver disease (p<0.05). LC 20.3% (38/187), CAH 16.8% (21/125), CPH 15.5%, (9/58), and others 14.3% (12/84). 2) In second study, 7 of the 10 patients undertaken liver biopsy probed to be the chronic liver diseases. 3) The liver function test of the one of the two who had no pathology on liver biopsy to be abnermal during follow-up 4 month in second study. These suggested that congestive gastropathy was found on various chronic liver disease and the possible stigmata even if without any other sign of the chronic liver disease.

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.

혈중 및 뇨중의 펩시노오겐 I 농도에 관한 고찰

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.