관동맥 조영술 중에 관찰된 관동맥 기형의 빈도에 관한 연구

김주성(Ju Sung Kim),김명수(Myung Su Kim),정호석(Ho Seuk Jeung),류은상(Eun Sang Ryoo),현민수(Min Su Hyun),김성구(Sung Gu Kim),권영주(Young Joo Kwon) 대한내과학회 2001 대한내과학회지 Vol.60 No.5

N/A Background : Coronary anomalies are found incidentally, in which anatomy is altered but physiology is normal; that is, coronary blood flow is normal. However, certain anomalies are associated with myocardial ischemia or infarction, heart failure, and sudden death. Methods : From February 1988 to February 2000, 3534 cases have been catheterized, among them we experienced 28 cases of coronary anomalies. The incidence of coronary anonalies and clinical characteristic were evaluated. Results : The incidence of coronary anomalies was 0.79% and in 28 cases of coronary anomalies, 5 cases of anomalous origin from the aorta (0.14%), 2 cases of coronary artery aneurysm (0.16%) and 21 cases of coronary arteriovenous fistula (CAVF,0.59%) were found. In 5 cases of anomalous origin from the aorta, 4 cases showed that right coronary artery originated from left coronary sinus of Valsalva, 1 case showed that left circumflex coronary artery originated from right coronary sinus of Valsalva. All of coronary artery aneurysm were found in right coronary artery. In 21 cases of CAVF, 28 sites of fistula were found and 14 sites originated from right coronary artery (50%), 6 sites from left circumflex coronary altery (21.5%), 6 sites from left anterior-descending coronary artery, 2 sites from left main coronary artery (7%). 13 sites of CAVF drained into pulmonary artery (46%), 10 sites into right atrium (36%), 5 sites into right ventricle (18%). In 7 cases which had double CAVF, 4 cases were originated from bilateral coronary artery, 3 cases were originated from single coronary artery. In 10 cases CAVF without other cardiac lesion, 4 cases confirmed ischemic heart disease. Conclusion: In our study, CAVF is most common coronary anomaly and without other cardiac disease CAVF may develope ischemic cardiac disease. (Korean J Med 60:448-455, 2001)

천식 환자에서 고해상 흉부 단층 촬영을 이용한 폐기종의 평가

김용훈(Yong Hoon Kim),류은상(Eun Sang Ryoo),홍기영(Ki Young Hong),이준혁(June Hyuk Lee),이태영(Tae Young Lee),서문정(Moon Jung Seo),주재학(Jae Hak Joo),김도진(Do Jin Kim),문승혁(Sung Heuk Moon),어수택(Soo Teak Uh),박춘식(Choon Sik Pa 대한내과학회 2001 대한내과학회지 Vol.60 No.5

N/A Background : Bronchial asthma is a clinical syndrome characterized by reversiblity of airway obstruction. however, many asthma patients have evidence of residual airway obstruction. It has become evident that the repair of chronic inflammatory process can lead to various irreversible changes. It is generally accepted that the most common cause for change is cigarette smoking but it is controversial whether asthma progresses to emphysema. High resolution computed tomography (HRCT) is more sensitive and more accurate than chest plain films in determining the type and extent of emphysema. This study was carried out to determine whether asthma can be a cause of emphysema without the effect of cigarette smoking and to evaluate clinical characterics in asthma patients with emphysema. Methods : We studied 58 asthmatic patients with reversible airway obstruction and evaluated the presence of emphysema using HRCT and pulmonary function test. According to HRCT findings, they were divided into 2 groups: Asthma patients with and without emphysema. Results : Of the 58 patients, 7 were judged to have emphysema. (1) 6 asthma patients with emphysema were smokers, but one patient was nonsmoker. (2) Highly significant differences between patients with and without emphysema were found in cigarette smoking (p<0.01), smoking consumption (p<0.01). (3) There was no significant differences in the duration of asthma, age or sex between patients with and without emphysema. (4) There was no significant differences in FEV1 (%), FEV1/FVC (%), diffusing capacity for carbon monoxide (DLco) (%), DLco/alveolar volume between patients with and without emphysema (5) Differences between asthma patients without emphysema and those with emphysema were found to be significant in bronchial wall thickening (p<0.05) and in total Ig E (p=0.07). Conclusion : These results indicate that smoking is a main factor to cause emphysema in the patient with asthma.(Korean J Med 60:463-471, 2001)

역류성 식도염 환자에서 증상 발현의 의미

한찬희(Chan Hee Han),이준성(Joon Seong Lee),임희혁(Hee Hyuk Lim),오영수(Young Soo Oh),윤영근(Young Keun Yoon),김상균(Sang Gyune Kim),김명수(Myung Soo Kim),류은상(Eun Sang Ryoo),윤동진(Dong Jin Youn),정인섭(In Seop Jung),고봉민(Bong M 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.2

N/A Background/Aims : The relationship between the symptoms and severity of GERD may be difficult to prove. The intensity and frequency of reflux induced symptoms are poor predictors of the presence or severity of an endoscopic mucosal break. The aim of this study was to determine which factors can be predicted by the presence of GERD symptoms among esophageal sensitivity to acid, abnormal acid reflux, and severity of esophagitis in pateints with reflux esophagitis. Methods : Fourty-four patients who were diagnosed with reflux esophagitis by an endoscopy at a tertiary medical facility, were given a validated questionnaire, and underwent an acid perfusion test, 24 hr ambulatory esophageal pH monitoring, and esophageal manometry. These patients were divided into a symptomatic group and asymptomatic group according to the questionaire. Comparisons between the two groups for each factor were analyzed by Chi-square. Result : Of 44 patients, 26 had symptoms and 18 did not. The positive and equivocal rates of the acid perfusion test were not different between the symptomatic and asymptomatic groups (47% vs. 39%). The abnormal reflux rate (DeMeester score >14.72) from pH monitoring was significantly higher in the symptomatic group than in the asymptomatic group (65% vs. 28%, p <0.05). The severity of esophagitis, presence of a hiatal hernia, and abnormal esophageal manometric findings were not different between the two groups. Conclusion : It would be impossible to predict esophageal sensitivity to acid, severity of the esophagitis grade, and the presence of hiatal hernia with GERD symptoms, but it could be possible to predict abnormal gastroesophageal reflux.

성인 발병성 Still씨 병과 동반된 재발성 간질성 폐렴 1예

김주성,이태영,김현태,배상병,김상균,류은상,문승혁,이국경,홍기영 대한내과학회 1999 대한내과학회지 Vol.57 No.2

Adult onset Still's disease(AOSD) is characterized by a high spiking fever, a transient rash, and arthritis. The clinical features include lymphadenopathy, hepatosplenomegaly, serositis, and sore throat. Leukocytosis is generally marked, but rheumatoid factor and ANA tests are negative. Respiratory system involvement is more common in AOSD than it is in childhood. The most common symptom is pleuritic chest pain with or without effusions. Rare cases of interstitial pneumonitis accompanied by AOSD have been reported. We report a case of AOSD with interstitial pneumonitis, which developed in two consecutive years and was successfully controlled with corticosteroid therapy.

하시모트 갑상선염과 동반된 갑상선 MALT 림프종(MALToma) 1 예

김영선,이태영,한찬희,유명희,김철희,변동원,진소영,남일송,류은상,홍기영,윤석기,서교일 대한내과학회 2001 대한내과학회지 Vol.61 No.3

Primary thyroid lymphomas constitute of up to 5% of all thyroid malignancies. Recently, mucosa-associated lymphoid tissue (MALT) lymphoma are relatively recognized as a B cell subset of non-Hodgkin's lymphoma. MALT-lymphomas are thought to develop from acquired lymphocytic tissue during the course of a chronic inflammatory or autoimmune process. In the thyroid , which is normally devoid of lymphocytic tissue, chronic autoimmune thyroiditis (Hashimoto's disease) has been associated with an increased risk of lymphoma, including MALT type. The clinical presentations include the enlarging of the neck mass, dysphagia, hoarsenes and choking or cold thyroid nodule. We report a case of MALToma of the thyroid accompanied by Hashimoto's thyroiditis with a review of the literature.(Korean J Med 61:281-285, 2001)