중증 고혈압증의 임상적 관찰

육동민(Dong Min Yook),곽시영(Si Young Kwak),김성식(Seong Sik Kim),이성숙(Seong Sook Lee),홍관표(Kwan Pyo Hong),최창필(Chang Pil Choi),이재우(Jae Woo Lee),이시래(Si Rhae Lee) 대한내과학회 1987 대한내과학회지 Vol.33 No.2

N/A Clinical studies were carried out in the 110 cases of severe hypertension who had been admitted from January 1979 to August 1985 and the following results were obtained: 1) Underlying diseases of severe hypertension were essential hypertension in 67 cases, renal parenchymal hypertension in 36 cases, and renovascular hypertension in 7 cases. 2) Plasma renin activity was the highest in the group of renovascular hypertension which was 22.07±9.20 ng/ ml/hr, and as a whole, the higher diastolic blood pressure, the higher plasma renin activity was. Plasma renin activity in the group of K-W grade IV retinopathy was higher than those of the other groups. 3) The incidence of ventricular hypertrophy fullfilling voltage criteria and with accompanying ST-T changes on electrocardiolgram was 81.5% in the group of essential hypertension and there was no difference in relation to the level of pressure or fundoscopic changes. 4) The serum creatinine level was the highest in the group of renal parenchymal hypertension (7.93±2.98 mg/dl), and in the group of K-W grade IV retinopathy (6.86±3.50mg/dl), but there was no significant difference in relation to the level of diastolic blood pressure, 5) There were no significant difference in cardiothoracic ratio on chest X-ray in relation to underlying diseases, diastolic blood pressure or fundoscopic changes. 6) The major complications were congestive heart failure (49.1%), hypertensive encephalopathy (17.3%), and cerebrovascular accident (8.2%). 7) In the group of essential hypertension blood pressure was controlled by conservative treatment in 81.0% but in 35.7% in the group of renal hypertension. The patients of chronic renal failure who were treated with dialysis blood pressure was controlled in 87.0%. In all 6 cases with renal transplantation, nephrectomy or renal angioplasty blood pressure was well controlled. 8) In cases refractory to triple antihypertensive regimen blood pressure was controlled by minoxidil in 66.7% and by captopril in 75.0%. 9) In 45 cases who were followed up for more than 6 months diastolic blood pressure was controlled under 100mmHg in 77.8% and there were improvement of renal function, fundoscopic findings and electrocardiographic findings in 20.0%, 33.3% and 16.7%, respectively.

철강 산업 관련 근로자에서의 HBsAg 및 Anti - HBs 양성률에 관한 연구

김은영(Eun Young Kim),한재호(Jae Ho Han),성영호(Young Ho Sung),최덕호(Deog Ho Choi),이상도(Sang Do Lee),전종민(Jong Min Jeon),배진호(Jin Ho Bae),최창필(Chang Pil Choi),김중구(Jung Gu Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5

N/A The study for positivities of hepatitis B surface antigen (HBsAg) by RPHA and hepatitis B surface antibody (anti-HBs) by PHA and transaminases (SGOT and SGPT) by kinetic method were performed in the months, from March to October 1992 among the steel related industrial workers who were residents of Pohang city. The results were as follows; The positive rate of HBsAg in all subjects was 7.5%, (1089/14472) and that of anti-HBs was 30.7%, (4439/14472). The positivities of HBsAg and anti-HBs in male subjects (7.6%, 30.8%) Were significantly higher than in females (3.7%, 26.3%) (p<0.01. p<0.05 respectively). The positive rates of HBsAg and anti-HBs were increased with age. In males those were significantly higher in their thirties (8.0%, 31.7%) than in their twenties (6.8%, 28.5%) (p<0.05, p<0.001 respectively). The anti-HBs positive rate of females in their forties (54.2%) was significantly higher than that of females in their thirties (29.2%) (p<0.05). The positivities of HBsAg and anti-HBs arrording to educational background or work type in male had no significant differences in either groups (Table 4, 5, 8, 9). There were no significant differences in the positive rates of HBsAg according to the workfield in either groups. But the positive rate of anti-HBs in blue collar workers (31.2%) was significantly higher than that of white co]lar workers (27.0% ) (p < 0.01). There were significant differences between the positive rates of HBsAg in males.according to the liver function test (LFT: SGOl and SGPT) which were 6.0% with normal LFT and 21.2% with abnormal LFT (p<0.01). In conclusion, the positive rate of HBsAg was largely influenced by sex, age and LFT but not influenced by educational background, work field or work type. The positive rate cf anti-HBs was largely inflnenced by sex, age and work field but practica@1ly unaffected by educational background or work type.

한국 정상 성인에서의 혈청 총 콜레스테롤 및 중성지방치에 관한 연구 - 포항 및 광양거주 직장인을 중심으로 -

성영호(Young Ho Sung),한재호(Jae Ho Han),송준화(Jun Hwa Song),최덕호(Deog Ho Choi),이상도(Sang Do Lee),전종민(Jong Min Jeon),배진호(Jin Ho Bae),최창필(Chang Pil Choi),김중구(Jung Gu Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.3

N/A Background: Among the risk factors associated with coronary artery disease (CAD), hyperlipidemia is one of the most important. In recent years, the incidence of CAD is increasing in Korean population, being attributed to increasing longevity, the changes in diet and economical conditions. The study was designed for establishing normal adult va1ues of serum lipids in Korean workers. Methods: Serum total cholesterol (TC) and triglyceride (TG) were measured by the enzymatic method and their levels were analysed in relation to different working areas and conditioins in 18518 males and 360 females, resident in Pohang (11651 males and 360 females) and Kwangyang (6867 males) city, Korea. The study subjects are all workers who were considered to be clinically healthy. Results: Total cholesterol levels of male and female adults in Pohang were 171.2±31.2mg/dl and 166.5±30.7 mg/dl and levels of males in Kwangyang were 163.0±28.9 mg/dl, respectively. The total cholesterol levels of males in Pohang were significantly higher than those of females (p<0.01), and males (p<0.001) in Kwangyang. The total cholesterol levels gradually increased significantly with age (twenties through forties) in males in both areas. Serum triglyceride levels of males in Pohang were 124.4±70.7mg/dl and also increased significantly with age (twenties through thirties), respectively. Serum total cholesterol and triglyceride levels of male employees above the level of chief clerk were significantly higher than those of employees below the level of chief clerk (p<0.001). Serum total cholesterol and triglyceride levels of male white-collar workers were significantly higher than those of male blue-collar workers (p<0.001, p<0.01). Serum total cholesterol levels of male nonshift workers were significantly higher than those of male shift workers (p<0.001). Serum total cholesterol and triglyceride levels showed a statistically significant elevation with increment of body weight in male (p<0.001). Serum cholesterol levels of male heavy drinkers (1902 cases, 165.7±29.5 mg/dl) were significantly higher than those of light drinkers (4400 cases, 161.8±28.4 mg/dl) (p<0.001). Serum total cholesterol levels of male heavy smokers (252 cases, 169.9±32.0 mg/dl) were significantly higher than those of male non-smokers (2128 cases, 163.4±28.7mg/dl) (p<0.01), or male light smokers (4487 cases, 162.4±28.8 mg/dl) (p<0.001). Serum total cholesterol levels of male heavy drinkers and heavy somkers (115 cases, 170.5±34.1 mg/dl) were significantly higher than those of non-drinkers and non-smokers (358 cases, 161.1±29.2 mg, dl) (p<0.01), or than those of light drinkers and 1ght smokers (2893 cases, 161.1±28.5 mg/dl) (p<0.01). But there were no significant differences in cholesterol levels between all of drinkers and non-drinkers, between all of smokers and non-smokers. Conclusion: In conclusion, total cholesterol and triglyceride levels of our study subjects are largely influenced by age, sex, body weight, a residential district, working conditions, and weakly influenced by alchol drinking and smoking habits.

신장이식 57 예에서의 공여자특이수혈 및 거부억제제 치료법에 따른 이식신의 예후

황영표(Young Pyo Hwang),유홍(Hong Yoo),김영호(Young Ho Kim),표광민(Kwang Min Pyo),이상욱(Sang Uk Lee),주운수(Woon Soo Joo),최창필(Chang Pil Choi),박진석(Jin Seok Park),김홍기(Hong Khee Kim),이시래(Si Rhae Lee) 대한내과학회 1988 대한내과학회지 Vol.35 No.3

N/A 57 cases of renal transplantation from December 1984 to August 1987, of which 10 cases were HLA-identical (HLA-ID), 39 cases were HLA-haploidentical (HLA-HID) and 8 cases were living-unrelated (LUR). The mean age of recipients and donors was 35.3 years and 40.3 years, respectively, Underlying renal diseases of the recipients were mostly chronic glomerulonephritis (52 cases), and the remaining 5 cases were chronic pyelone-phritis, reflux nephropathy, hypertentsive nephrosclerosis, polycystic renal disease and diabetic nephropathy. The post donor specific transfusion (DST) sensitization rate was compared between a group treated by DST alone and a group treated by DST with Azathioprine The effect of Cyclosporine A plus prednisolone (Cs-A+P group) and Azathioprine plus prednisolone (Aza+P group) as immunosuppressive agents on renal allograft function was compared in the HLA-ID, HLA-HID and LUR group. The post-DST sensitization rate was 20.0% in the DST alone group and 4.9% in the DST with Azathio-prine group, however the difference was not statistically significant. Acute rejection after renal transplantation developed in 4 of 19 cases (21.1%) in the Cs-A+P treated HLA-HID group, in 2 of 10 cases (20.0%) in the HLA-ID group and in 7 of 17 cases (41.2%) in the Aza+P treated HLA-HID group. Again, the difference among these groups was not significant. Excluding 4 cases of graft failure due to nonimmunolgical causes, the acturial graft survival for 2 years was 10096 in the HLA-ID group, 88% in the HLA-H1D group and 71.4% in the LUR group. The number of patients with serum creatinine below 2 mg/dl was 19 of 19 cases (100%) in the Cs-A+P treated HLA-HID group during 7.68±5.18 months, and 14 of 17 cases (82.4% ) in the Aza+P treated HLA-HID group during 12.5±7.5 months, and the difference was not statistically significant. The above results suggest that the pretransplant allosensitization by DST was lower in the DST+Aza group than in the DST alone group, and the effect of Cs -A+P on renal allogrsft seemed to be better than that of Aza+P. However, further studies including more cases and longer observation periods are necessary to conclude which posttransplantation regimen is better between Aza+P and Cs-A+P, even after DST.

자연산 영지버섯(Ganoderma lucidum)의 재복용에 의해 재생불량성빈혈이 재발된 1례

이상도,최덕호,김덕희,박경식,최창필,이경희,현명수 大韓血液學會 1995 大韓血液學會誌 Vol.30 No.1

고칼슘혈증 및 골용해성 병변을 동반한 급성 골수성 백혈병 1 예

박경식,이상도,최덕호,현명수,최창필,김덕희,전진종 대한내과학회 1996 대한내과학회지 Vol.50 No.1

A case of hypercalcemia and osteolytic bone lesions complicating acute myelogenous leukemia, is described with review of literature. The patient was admitted with a 15-day history of nausea, vomiting, and multiple joint pain. On admission, laboratory studies revealed Hb 10.6g/dL, Hct 31.7%, WBC 2,100/mm³, Platelet 93,000/mm³, BUN 32.6㎎/dL, Creatinine 2.8㎎/dL, serum calcium 13.3mg/dL, serum phosphate 3.1mg/dL, serum radioimmuno reactive parathyroid hormone 0.17ng/dL. Bone marrow study showed blast as much as 84%. Simple X-ray showed multiple scattered osteolytic bone lesions on skull and pelvis. The patient was treated with Daunorubicin 45㎎/M² to 3 day, Cytarabine 100㎎/ M² to 7 day as remission induction chemotherapy, and achieved normal range of serum calcium and renal function with complete remission hematologically, and received 3 times of consolidation chemotherapy thereafter. The patient was re-adimitted with headache, nausea, intermittent seizure, and loss of consciousness during follow-up. With CNS involvement of the leukemic cell by cerebrospinal fluid(CSF) study, laboratory studies showed recurrence of the AML and hypercalcemia. He was treated with emergency radiotherapy(total 2,400cGy) and chemotherapy. He was improved symptomatically and hypercalcemia was disappeared, but the bone marrow aspiration revealed incomplete remission (blast 10%). The patient with his family refused further therapy, and discharged. He died about 1 month after discharge.

간경변증에서의 복수 형성에 따른 Renin-Aldosterone 계 및 DISIDA Scintigraphy 에 의한 간혈류의 변화에 대한 연구

박병채,김인영,이재준,양상호,구자영,최창필 대한내과학회 1986 대한내과학회지 Vol.31 No.5

Clinical states with ascites in cirrhotic patients are frequently associated with increased plasma renin activity(PRA) and aldosterone(PA). We measured PRA, PA, 24 hr urine Na+, serum albu min and BUN, and ratio of hepatic arterial and portal venous blood flow(A/P ratio) in patients with liver cirrhosis without ascites(group K, 14 cases) and liver cirrhosis with ascites(group g, 18 cases). Fourteen normal persons were involved as control(group I ). 1) PRA and PA in group II (4.48±1.22 ng/ml/hr and 220.00±33.00 pg/ml) were significantly (p$lt;0.05 and p$lt;0.005) elevated as compared to control group (2.11±0.54 and 91.40±11.70), but no statistical differences were observed in comparison between group II and III (6.98±1.74 and 306.9±41.6) 2) 24 hr urine sodium, serum albumin, and A/P ratio in group II (110.8±13.6 mEq/L, 3.97±0.09 gm/dl and 0.262±0.050) showed significant differences(p$lt;0.005, p$lt;0.0005, and p$lt;0.005) as compared with group III (60.6±13.1, 3.07±0.16, and 0.777±0.134), but such differences were not observed in comparison between group II and I (154.1±22.9, 3.78±0.10 and 0.306±0.054). These findings may indicate that PRA and PA may be less important determinants than hypoa1buminemia and abnormal liver perfusion in the initiation of ascites formation in cirrhotic patients.