기획특집-LD와 발전방향

배장환,Bae, Jang-Hwan 한국전자정보통신산업진흥회 1991 電子振興 Vol.11 No.7

고혈압 임부에서 24 시간 활동 중 혈압 측정의 임상적 유용성

전현정(Hyeon Jeong Jeon),고병성(Byeong Seong Ko),곽남주(Nam Ju Kawk),김도형(Do Hyeong Kim),배장환(Jang Hwan Bae),김동운(Dong Woon Kim),남기병(Gi Byoung Nam),조명찬(Myeong Chan Cho),정은환(Eun Hawn Jeong) 대한내과학회 1998 대한내과학회지 Vol.55 No.1

N/A Objectives: In the third trimester hypertensive pregnancies, we would like to evaluate effects of white coat hypertension, severity of hypertension and diurnal variation of blood pressure on the fetal outcome by using 24-hour ambulatory blood pressure monitoring. Methods: Hypertensives(n=50) and normotensives (n=14) in the third trimester of the pregnancy underwent 24-hour ambulatory blood pressure monitoring. We excluded hypertensives(n=5) who became pre-eclampsia patients. Hypertensives(n=45) were classified as white coat hypertensives(n=14, mean ambulatory blood pressure <139/87mmHg) and sustained hyprtensives(n=31). Sustained hypertensives(n=31) were divided as moderate to severe hypertensives(n=5, systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥100mmHg ) and mild hypertensives(n=26). Sustained hypertensives were also divided into two grwps which had diurnal variation of blood pressure or not. To exclude effects of hypertension severity, effects of diurnal variation wane evaluated in hypertensives with similar mean arterial blood pressure. Gestational age, body weight, body weight for gestational age were used as parametars of the fetal outcome. Results : 1) The prevalence of white coat hypertension was 28%(14/50). 2) There were no significant differences in the fetal outcome between normotensives(n=14) and white coat hypertensives(n=14). 3) Body weight of fetus and body weight for gestational age in moderate to severe hypertensives(n=5) were less than those of mild hypertensives(n=26), but gestational age was not significantly different between two groups. 4) Body weight of fetus and body weight for gestational age in sustained hypertensives without diurnal variation(n=10) were less than those with diurnal variation(n=8), but gestational age was not significantly different between two groups. 5) All hypertensives who became pre-eclampsia (n=5) were severe hypertensives and had no diurnal variation of blood pressure. Conclusion: White coat hypertension in the third trimester was quite often and did not affect on the fetal outcome. The more severe hypertension and/or absence of diurnal variation of blood sure caused poor fetal outcome. Patients who became pre-eclampsia were severe hypertensives and had no diurnal variation of blood pressure. Ambulatory blood pressure monitoring may have several roles in the antenatal management of hypertenison.

복잡 심혈관 기형을 동반한 DiGeorge 증후군 1 예

김도형,김동운,오태근,배장환,나병규,정상무,조명찬 대한내과학회 1997 대한내과학회지 Vol.53 No.5

DiGeorge syndrome is the developmental anomalies of the third and fourth pharngeal pouches. Recently, damages or abnormal development of the neural crest is suggested as a possible pathogenetic factor, because neural crest cells play a crucial role in development of pharyngeal pouch derivatives, e.g. thymus and parathyroid glands, as well as the aortic arches and conotruncal part of the heat. Most cases have abnormal findings of chromosome 22 and are sporadic, but familial cases have been described. Typical features of DiGeorge syndrome are congenital heart disease, aplasia or hypoplasia of the thymus and parathyroid glands and facial dysmorphism. The main problems and cause of death are severe congestive heart failure due to cardiac anomlies, hypocalcemic complications or immunocompromised conditions. As these results, most cases were expired at infantal period or early childhood. Recently, we have a case of Digeorge syndrome which was associated with complex cardiovascular anomalies(tetralogy of Fallot, atrial septal defect, right aortic arch, left hemitruncus), severe hypocalcemia, aplasia of thymus and facial dysmorphism.

Slipped Capital Femoral Epiphysis 를 동반한 Kallmann`s Syndrome 1예

김도형,고병성,전현정,배장환,오태근,강승백 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.3

The Kallmann's syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or -palate, unilateral renal agenesis, nerve deafness), cryptorchidism and skeletal abnormalities. The slipped capital fernoral epiphysis is the condition in which the femoral head slips downward and backward on the femoral neck at the epiphyseal plate. The clinical association between slipped capital femoral epiphysis and endocrine disorder. We experienced a case of the slipped capital femoral epiphyis associated with Kallmanns syndrome in a 17 years old male(J Kor Soc Endocrinol 11:318-323, 1996).

우중엽 증후군의 임상적 양상

신형식,최기원,최강현,이상도,배장환,이기형 충북대학교 의과대학 충북대학교 의학연구소 1997 忠北醫大學術誌 Vol.7 No.2

우중엽 증후군은 우중엽 기관지 주변의 병변으로 우중엽의 허탈을 유발하는 질환 군이다. 본 연구에서는 1992년 8월부터 1997년 6월까지 충북대학교병원을 방문한 우중엽 증후군 환자를 대상으로 임상적인 고찰을 하였다. 우중엽 증후군 환자는 총 27명이었고, 남자 12명, 여자 15명이었으며 이들의 평균연령은 60세이었다. 주요 증상은 객담을 동반한 기침이었고, 호흡곤란 및 흉통 등의 증상이 있었다. 이학적 소견으로는 국소적 수포음이 가장 많았고 호흡음의 감소, 천명음 등이 있었다. 원인 질환은 기관지 결핵이 9예로 가장 많았고 폐암 7예, 폐렴 6예, 기관지확장증 및 원인 미상의 만성 염증이 각각 2예, 기관지결석 1예의 순이었다. 기관지경 검사상 우중엽기관지가 폐쇄된 경우가 11예로 가장 많았으나 좁아진 경우 5예, 좁아지거나 폐쇄되지 않은 경우도 7예가 있었다. 흥부 전산화단층촬영으로 악성과 양성 질환을 비교적 잘 감별할 수 있었다. Right middle lobe syndrome is a syndrome in which right middle lobe is collapsed due to any disease. Because the clinical features were rarely studied in Korea, we evaluated the clinical features of 27 patients with RML syndrome from August 1992 to June 1997. There were 12 male patients and 15 female patients, with mean age 60 years old. The most common symptom was productive cough and the most common physical finding was localized crackle. The underlying diseases were 9 cases of endobronchial tuberculosis, 7 cases of bronchogenic carcinoma, 6 cases of pneumonia, 2 cases of bronchiectasis, 2 cases of chronic inflammation of unknown etiology and 1 case of broncholithiasis. RML bronchi were obstructed in 11 cases, narrowed in 5 cases and patent in 7 cases on bronchoscopy. Chest CT scans relatively well discriminated between benign and malignant lesion.

장기축회전형 만성위축염전증 1예

박선미,윤세진,김도형,고병성,전현정,배장환,서정철 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.5

Gastric volvulus is a rotation of the stomach of at least 180 associated with a closed loop obstruction. Pare described the first case of gastric volvulus m 1579. Laxity of the gastric ligament, a congenital or acquired diaphragmatic defect, increased abdominal pressure, and a genetic component contributing to gastric volvulus. Gastric volvulus has been classified clinically as acute and chronic gastric volvulus, and can be classified anatomically as organoaxial, mesenteroaxial or a mixed type. Gastric volvulus occurs in children usually before 1 year of age or elderly patients. In acute gastric volvulus, and be patients complain of sudden abdominal or chest pain. The chest pain, which can radiate to the arms and neck accompanied by dyspnea, may initially lead to consideration of ischemic heart disease. Chronic gastric volvulus is difficult to diagnose because it may be associated with mild and nonspecific symptoms such as epigastric discomfort, fullness or heartburn. We experienced a case of 83 year old male with an organoaxial type of chronic gastric volvulus, iagnosed by upper gastrointestinal series, and treated with conservative rnanagement.