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고혈압성 심장에서 4 심음과 좌심실 근질량 및 승모판 혈류양상의 관계
정양호(Yang Ho Jung),김경중(Kyeong Joong Kim),허종(Jong Heo),노인환(In Whan Ro),박양규(Yang Kyu Park),정진원(Jin Won Jeong),박옥규(Ock Kyu Park) 대한내과학회 1989 대한내과학회지 Vol.37 No.6
N/A To determine the clinical significance of the fourth heart sound (S.) in hypertensive heart, 31 patients with essential hypertension aged between 32 to 77 years old and 15 normal controls were examined by physical examination, phonocardiography and echocardiography, All hypertensive patients had normal sinus rhythm and no history of coronary artery disease nor COPD and most of them had moderate to severe hypertension. Depending upon the presence of audible S4, hypertensive patients were divided into 3 groups; those without audible S, (group I, 15 cases), those with audible S, (group II, 12 cases) and those with questionably audible S, (group III, 4 cases). M-mode echocardiograms of the left ventricle and pulsed wave Doppler echocardiograms of the mitral valve were performed to determine the left ventricular thickness/dimension ratio (T/D), left ventricular mass index (LVMI) and A/E ratio of mitral flow pattern. T/D and LVMI were significantly increased in both hypertensive group I and group 11 (p<0.01) and T/D of hypertensive group II was more increased than that of hypertensive group I (p<0,05), but there was no significant difference between hypertensive group I and group II in LVMI. In contrast, the A/E ratio of mitral Doppler flow pattern was increased only in hypertensive group II compared to normal controls (p<0.01), and there was a significant difference between hypertensive group I and group II (p<0.01). Audible S, was found in hypertensive patients with an A/E ratio greater than 1.10 and in a normal person with an A/E ratio of 1.27, and all 10 hypertensive patients above an A/E ratio of 1.20 except one had an audible fourth heart sound. In conclusion, audible fourth heart sound is a useful bedside parameter for detecting left ventricular diastolic dysfunction in the hypertensive heart.
이리 및 인접 지역에서 발생한 쭈쭈가무시병 40 예에 대한 임상적 고찰
유웅선(Woong Sun Yu),노인환(In Whan Ro),허종(Jeong Huh),김경중(Kyeong Joong Kim),안태규(Tae Gyoo Ahn),이용구(Yong Goo Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.4
N/A We reviewed 20cases of tsutsugamushi disease who were admitted to WonKwang University Hospital from October to November 1988 and the following clinical results were obtained: 1) Seasonally, the 40cases mainly occurred from Odctober to November. 2) Most of the cases resided in rural areas or were associated with farm work and the age distribution was mainly in the forties. fifties, and sixties. The number of female cases was twice that of male cases. 3) On physical examination, rash, lymphadenopathy and eschar were observed in 38 cases (95%), 28cases (70%) and 17cases (42.5%) respectively. 4) On laboratory findings, leukocytosis (15%) and leukopenia (10%) were observed but anemia was not observed. The degree of elevation of AST and ALT was 2 or 3 times the normal values and elevation of LDH was observed in all cases. 5) On EKG, sinus tachycardia was observed in 6cases (15%). On simple chest X-ray, abnormal X-ray findings (20%) were observed. 6) One case was positive to Weil-Felix reaction. Indirect immunofluorescent antibody test was performed in 26cases of which 3cases (84.6%) were positive. Thirteen cases were positive to indirect immunofluorescent antibody test among 14cases with eschar. 7) Thirty-nine cases were treated with T-C and doxycycline and one case was treated with chloramphenicol. Thirty-eight cases recovered, one case died 3 days after early discharge and the clinical course of one case was not known after early discharge.
호도까기 식도증에서 Diltiazem 투여 전 , 후의 식도내압검사 소견
나용호(Yong Ho Nah),안태규(Tae Gyoo Ahn),허종(Jhong Heo),김경중(Kyeong Joong Kim),유웅선(Wong Soun Yu) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
N/A We studied the effects of oral diltiazem (30 mg TII) alone. And combination with diazepam (1 rng Tll) on esophageal manometric chracteristics in 24 patient, with a nucracker esophagus by baseline maotmetry. A 4-week oral administrationn of diltiazem decreased distal esophageal contraction amplitude (205±35.3 mmHg to 150±30.9 mmHg: p<0.01), but had no effect on lower esophageal sphincter pressure and their was poor correlation with chest pain improvement. After 4-week treat- ment with diltiazem and diazepam, contraction amplitude fell from l50±30.9 mmHg to 101±23.4 mmHg (p<0.01) and the relief of symptom was about 90%. This study suggests that diltiazem is demonstrated to result in a reduction of the peristaltic amplitude in patients with nutcrackcr esophagus, but symptomatic benefit is most marked with combination off diazepam.