순환기 내과로 자문의뢰된 환자의 임상상

황진용,최지용,손상균,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.4

목적 : 순환기내과 영역은 많은 과로부터 자문의뢰를 받는 영역으로 알려져 있다. 특히 최근 우리나라의 순환기질환의 유형이 변화되고 입원환자가 고령화되면서 동반된 심질환의 유병율도 증가하고있다. 이에 저자들은 타과로 입원하여 순환기내과로 자문의뢰되는 환자의 임상상과 3차병원인 경북대학교병원에서의 순환기내과자문의 유용성 등을 평가하여 향후 순환기질병에 대한 협의진료에 도움을 주고자 본 연구를 시행하였다. 방법 : 1995년 3월부터 순환기내과로 공식자문의뢰된 첫 100명을 대상으로 전향적으로 연령, 의뢰이유, 최종진단명, 수술과의 관련성 여부, 순환기내과의 최종조치, 타과의 순응도 등을 조사하였다. 결과 : 1) 자문을 의뢰한 환자는 평균 58±16(15-89, 중앙치 61)세였고 60세이상의 환자가 57%로 고령의 환자가 많았다. 2) 내과계열 25%, 외과계열 75%로 외과계열의 자문이 많았고 일반외과가 26%로 가장 많았고 내과의 다른 분과가 12%, 신경외과 12%, 정형외과 11%, 흉부외과 11%, 신경과 11% 등의 순이었다. 외과계열중 수술을 시행한 경우는 58례로 이중 응급수술이 13례였다. 술전 위험도 평가를 위한 자문이 38례에서 있었는데 순환기적인 문제로 수술을 받지 못한 경우는 2례(1례는 허혈성 심질환, 1례는 심낭질환)이었다. 이때 응급수술을 제외한 입원일과 술전 자문일파의 간격은 평균 3±7일(입원일-42일)이고 술전 자문일과 수술일과의 간격은 평균 6±4일(1-16일)이었다. 3) 타과의 의뢰이유는 심전도 이상이 36례, 높게 측정된 혈압이 20례, 순환기질환의 과거력 17례, 환자의 증상 때문인 경우가 10례였고 심전도의 이상중에는 부정맥이 18례, 이상 Q파 6례, ST절 이상이 5례, 각차단이 3례의 순이었다. 순환기과거력 중에는 허혈성 심질환이 6례, 현재 혈압은 정상이나 고혈압의 과거력이 있는 경우가 4례 순이었고 환자의 증상은 흉통 6례, 호흡곤란이 3례, 기절이 1례였다. 4) 자문후 최종진단이 가능했던 91례를 진단별(총 97 진단명)로 나누어 보면 고혈압이 28례, 부정맥이 16례, 허혈성 심질환이 14례, 판막질환이 11례, 순환기질환이 아닌경우가 19래였다. 이들중 추적진료가 필요하다고 응답한 경우가 57례였으나 순환기내과 외래에 1번이상 추적진료한 경우는 32례(56%)로 환자의 순응도는 낮았다. 결론 : 순환기내과의 자문의뢰는 고령자에게 많았고 수술과 관련된 경우가 많았으며 심전도의 이상이 의뢰이유로 가장 많았으며 진단별로는 고혈압과 부정맥이 가장 많았다. 그리고 순환기적인문제로 수술을 받지 못한 경우는 드물었고 자문후 지속적인 추적진료를 위해 환자의 교육이 필요하겠다. Objective : Clinical characteristics of the patients with cardiovascular diseases in the general hospital have been changed and prevalance of co-existing cardiovascular disease in the patients who were admitted for non-cardiac diseases has been increased remarkably as the proportion of elderly patients increased rapidly in Korea. We evaluated clinical features of the patients consulted for cardiological evaluation and effectiveness of the consultation in the setting of tertiary general hospital, Kyungpook University Hospital. Method : One hundred patients were studied between January 1995 and January 1996. They were evaluated for the reason of consultation, final diagnosis, final recommendation from cardiologists and its impact on the management of the patients, and compliance of the consulting departments. Results : 1) The ages ranged between 15 and 89 (mean 58±16, median 61) years, 57 patients were male and 43 female. Fifty seven patients were older than 60 years. 2) Consultations from surgical parts were 75 patients. Consultation from general surgery was most frequent (26%), followed by other divisions of internal medicine (12%), neurosurgery (12%) and orthopedic surgery (11%), chest surgery (11%), neurology (11%), obstetrics and gynecology (8%), urology (4%), ophthalmology (2%), dermatology (2%), ENT (1%). Among 75 patients from surgical parts, operation was done on 58 patients, including 13 emergency cases. Preoperative cardiac risk evaluation was the reason of consultation in thirty eight patients, of which operation could not be done in only 2 patients (one had severe ischemic heart disease, the other large pericardial disease). Interval between consultation day and operation day was 6±4 days (1-6 days). 3) Reasons for cardiac consultation were electrocardiographic (ECG) abnormalities in 36 patients, high blood pressure in 20 patients, previous cardiovascular diseases in 17 patients, symptoms of the patients in 10 patients. Among EGG abnormalities, arrhythmias was the reason in 18 patients, abnormal Q waves in 6 patients, ST-T segment abnormalities in 5 patients, bundle branch block in 3 patients. Among previous cardiovascular disease, presence of ischemic heart disease was the reason in 6 patients, previous hypertension in 4 patients. Chest pain was the reason of the consultation in 6 patients, dyspnea in 3 patients, syncope in 1 patient. 4) Definite diagnoses could be made in 91 patients with 96 diagnoses which were hypertension and its complications in 28, arrhythmia with underlying disease in 16, ischemic heart disease in 14. valvular heart disease in 11, non-cardiovascular disease in 19. Cardiological follow up was recommended in 57 patients. However, 25 patients (44%) were lost to follow-up. Conclusion : Cardiological consultation was frequent in the elderly patients. Most frequent reason for consultation was EGG abnormalities. Hypertension or arrhythmia was most common final diagnosis. Inoperability due to cardiovascular problems were rare.

음경에 발생한 기저세포암 1예

이용주,최혜자,윤석권,김한욱,임철완 대한피부과학회 2004 大韓皮膚科學會誌 Vol.42 No.3

Basal cell carcinoma is the most common malignant skin cancer in Korea. The lesions are most frequently found in the head and neck region. But penile basal cell carcinoma is very rare and there are only 29 other reported cases. We report a rare case of basal cell carcinoma of the penis in a 76-year-old man. He had a well circumscribed 1.3㎝×1.3㎝ thick scaly plaque with central ulcer in right penile root area for 4 years. The lesion was completely excised and no recurrence for four months. (Korean J Dermatol 2004;42(3):350~352)

관상동맥질환에서 운동부하 Tc - 99m Tetrofosmin 심근스캔의 진단적 유용성 : 운동부하심전도검사와의 비교

최지용(Ji Yong Choi),황진용(Jin Yong Hwang),황종현(Jong Hyeon Hwang),임현주(Hyeon Ju Lim),박헌식(Hun Sik Park),조용근(Yong Keun Cho),채성철(Shung Chull Chae),전재은(Jae Eun Jun),박의현(Wee Hyun Park),안병철(Byeong Cheol Ahn),이재태(J 대한내과학회 1997 대한내과학회지 Vol.53 No.6

N/A Objectives: Tetrofosmin is a new Tc-99m labeled myocardial perfusion imaging agent that shows slow clearance from the myocardium and rapid clearance from background organs. The purpose of this study was to assess the ability of exercise Tc-99m tetrofosmin single photon emission computed tomography(SPECT) to identify and localize coronary artery disease. Methods : The study population consists of 49 patients with suspected coronary artery disease who underwent both exercise Tc-99m tetrofosmin SPECT and coronary angiography within 2 weeks. Using the one day imaging protocol, 7-10mCi of Tc-99m tetrofosmin was injected at rest and 4 hours later, 25 mCi of Tc-99m tetrofosmin was injected at peak exercise. Results: The sensitivity and specificity of exercise Tc-99m tetrofosmin SPECT was 94.9% and 60% for detection of coronary artery disease with luminal narrowing more than 50%, and 96.4% and 33.3% for detection of coronary artery disease with luminal narrowing more than 70%. The sensitivity of exercise Tc-99m tetrofosmin SPECT for detection of individual stenosed vessels(≥50% and ≥70% coronary stenosis) was 79.2%, 100% for LAD, 55.6%, 55.6% for LCx and 85.0%, 92.9% for RCA and the specificity was 88.0%, 75.0% for LAD, 100%, 87.5% for LCx, 86.2%, 77.1% for RCA respectively. Conclusion: Exercise Tc-99m tetrofosmin SPECT appears to be an feasible and useful noninvasive test for the diagnosis of coronary artery disease

백서의 하악골 결손부 치유시 골형성단백질 2/4의 발현에 관한 연구

최재용(Jae Yong Choi)이상철(Sang Chull Lee) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.4

Bone morphogenetic protein-2/4 are members of Transforming Growth Factor- β(TGF- β) superfamily and they may induce formation of cartilage and bone in vivo. This study was performed to investigate the cellular target and period of action of BMP-2/4 and understanding of actions of BMP-2/4 at cellular level. The appearance of BMP-2/4 during healing of mandibular and periodontal defect in rat was evaluated immunohistochemically. 40 Sprague-Dawley strain white male rats, each weighing about 300gm were used. Bony defect was performed in the mandible and they were sacrificed at the day of 3rd, 10th, 20th, 30th after operation. The specimens were harvested and examined histologically and immunohistochemically by localization of anti-BMP-2/4. The results were as follows: 1. Woven bone was observed at 10th day and perfect healing of defect with compact bone and periodontal ligment space at 30th day. 2. Osteoprogenitor cells, osteoblastic cells and periosteum were positive reaction to immunohistochemical stain at 10th day. 3. Cells of bone marrow space and surface cells of osteocytes and cementoblasts were positive reaction to immunohistochemical stain at 20th day. 4. Newly formed osteocytes and cementocytes were positive reaction to immunohistochemical stain at 30th day. From the above findings, we could conclude that BMP-2/4 acted significant roles as factors of induction, proliferation and differentiation during bone healing process.

대구 지역에서 발견된 고지혈종 가계에 대한 연구

최명숙,박용복,정남호,채성철 한국지질학회 1993 韓國脂質學會誌 Vol.3 No.2

This study was designed to search potential causes of a hyperlipidemic family found in Taegu area. Members of the family have been found to have an abnormally high content of low density lipoprotein (LDL)-cholesterol and a large size of very low density lipoprotein (VLDL) according to the results from lipid analyses and agarose gel electrophoresis, respectively. It turned out that Lecithin: cholesterol Acyltransferase activity, content of Lp (a) and HDL-cholesterol level of these family members were normal. However, activity of cholesteryl ester transfer protein (CETP, 50∼60% of CE transfer/6 hr) were very high compared to normal persons. In the restriction fragment length polymorphism(RFLP) analyses of CETP gene by Taq I restriction enzyme, 4.6 kb, 3.8 kb and 1.4 kb bands appeared in samples from both normal persons and hyperlipidemic patients. On the other hand, 2.5 kb and 0.8 kb bands which were found only in normal people and ischemic heart disease patients were not shown in the hyperlipidemic family. In the RFLP analyses of apo-E gene by Hha I, there were significant differences in the band patterns between the control groups and the hyperlipidemic subjects. In the RFLP analyses of apo-B gene by Msp I, normal persons showed a consistent 2.2 kb band and a polymorphism at 0.7, 0.5, 0.4 and 0.1 kb, while some of hyperlipidemic family members had 9.4 kb band. In RFLP pattern of EcoR I restriction enzyme digestion, the normal and hyper-lipidemic family groups showed considerably different patterns. In conclusion, blood cholesterol of this family seems to be rapidly transferred from HDL to VLDL or LDL due to the high CETP activity. The transferred cholesterol appears to be improperly cleared from the blood stream presumably by the abnormal apo-B and apo-E.

Kaon BSMB-parameters using improved staggered fermions fromNf=2+1unquenched QCD

Choi, Benjamin J.,Jang, Yong-Chull,Jung, Chulwoo,Jeong, Hwancheol,Kim, Jangho,Kim, Jongjeong,Kim, Sunghee,Lee, Weonjong,Leem, Jaehoon,Pak, Jeonghwan,Park, Sungwoo,Sharpe, Stephen R.,Yoon, Boram American Physical Society 2016 Physical review. D Vol.93 No.1

<P>We present results for the matrix elements of the additional Delta S = 2 operators that appear in models of physics beyond the Standard Model (BSM), expressed in terms of four BSM B-parameters. Combined with experimental results for Delta M-K and epsilon(K), these constrain the parameters of BSM models. We use improved staggered fermions, with valence hypercubic blocking transfromation (HYP)-smeared quarks and N-f = 2 + 1 flavors of 'asqtad' sea quarks. The configurations have been generated by the MILC Collaboration. The matching between lattice and continuum four-fermion operators and bilinears is done perturbatively at one-loop order. We use three lattice spacings for the continuum extrapolation: a approximate to 0.09, 0.06 and 0.045 fm. Valence light-quark masses range down to approximate to m(s)(phys)/13 while the light sea-quark masses range down to approximate to m(s)(phys)/20. Compared to our previous published work, we have added four additional lattice ensembles, leading to better controlled extrapolations in the lattice spacing and sea-quark masses. We report final results for two renormalization scales, mu = 2 and 3 GeV, and compare them to those obtained by other collaborations. Agreement is found for two of the four BSM B-parameters (B-2 and B-3(SUSY)). The other two (B-4 and B-5) differ significantly from those obtained using regularization independent momentum subtraction (RI-MOM) renormalization as an intermediate scheme, but are in agreement with recent preliminary results obtained by the RBC-UKQCD Collaboration using regularization independent symmetric momentum subtraction (RI-SMOM) intermediate schemes.</P>

A Case of Deep Palmoplantar Wart Occurring on Proximal Nail Fold

Choi, Hye-Ja,Lee, Yong-Ju,Yun, Seok-Kweon,Kim, Hang-Uk,Ihm, Chull-Wan 대한피부과학회 2003 Annals of Dermatology Vol.15 No.4

Deep palmoplantar warts (Myrmecia) are frequently tender papules or plaques caused by HPV-1. Myrmecia are usually misdiagnosed as paronychia or digital mucous cysts. They occur not only on the palms and soles but also on the lateral aspects and tips of the fingers and toes. We report a rare case of deep palmoplantar wart occurring on proximal nail fold, unusual site of right 5th finger in an 11-year-old girl.

白鼠 下顎前齒 拔齒窩에 DMBA 및 Tobacco tar 注入時 拔齒創의 發癌性에 關한 實驗的 硏究

崔津鏞,李相喆 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.1

This study was undertaken to observe the carcinogenesis induced by DMBA injection to extraction wound and the efects of the tobacco-tar on that. In order to carry out this experiment, 40 white rats were used and divided into 3 groups, two experimental(1,2) and one control group. Experimental group 1 was injected into extraction socket of lower incisor tooth with 0.1-0.2m1 DMBA in mineral oil. Experimental group 2 was injected into extraction wound of lower incisor tooth with the fixture of DMBA and 0.5gm of tobacco tar. 4 animals in each experimental group and 2 animals in control group were killed at intervals of 4th, 8th, 10th, and 12th week. At the time of death, the mandible was dissected, fixed in 10% neutral formalin, decalcified with 5% nitric acid, embedded in paraffin and sectioned 4-6 ? in thickness. The sections stained with Hematoxylin-Eosin, PAS, and Masson's trichrome. The results of this study were obtained as follows: 1. In DMBA injection group, extraction socket was undertaken inflammatory reaction and filled with connective tissue at 4th week, but at 8th week, fibrosarcoma initiated and dysplastic enlargement in gingiva and minor salivary glands were observable. At 10th-12th week, growth of fibrosarcoma and carcinoma was prominent 2.1n the mixture of DMBA and tobacco tar injection group, the growth of fibrosarcoma and carcinoma was initiated at 4th week and at 10th week, was prominent. Highly-differentiated squamous cell carcinoma in the gingiva and adenocystic carcinoma in the minor salivary glands were observable. At 12th week, malignancy was more prominent. 3. The growth of fibrosarcoma and carcinoma in the area of extraction wound affected the area of posterior teeth, and carcinoma in the gingiva, hyperplasia of cementum and pulp necrosis were observable. 4. The neuromatic growth in the nerve bundle and the chondromatous growth in the new bone tissue were observable. 5. Carcinogenesis induced by the mixture of DMBA and tobacco tar in the extraction wound was more prominent than DMBA alone injection and had a carcinogenic effect on the all surrounding tissue.

Cyclophosphamide의 간헐적 대량 투여로 다발성 단신경염의 호전을 보인 알레르기성 육아종증 1예

최동철,고은미,정만표,김호중,권오정,한용철,김병준,한정호,이종헌,이병재 대한내과학회 1997 대한내과학회지 Vol.53 No.3S

Churg-Strauss syndrome is a rare systemic vasculitis characterized by presence of asthma and eosinophilia. Survival was rare in pre--steroid era. After introduction of steroid, there have been much improvement in overall survival rate and median survival. The vascultic illness usually requires high dose steroid teratment for several weeks and responds well to corticosteroids. But mononeuritis multiplex responds to steroids more gradually and sometimes requires cytotoxic drugs such as azathioprine, hydroxyurea or cyclophophamide We report a 40 year-old asthmatic female with purpuric skin lesions, pain and paresthesia of both hands and feet, left foot drop and eosinophila. Skin and nerve biopsy demonstrated necrotizing vascultis with perivascular infiltration of eosinophils. Nerve conduction studies showed changes compatible with mononeuritis multiplex. Purpuric skin lesion disappeared and both eosinophilia and sedimentation rate decreased into normal range within a week after steroid treatment whereas neurologic symptoms

압절금속판과 비압접성 소형금속판을 이용한 골접합시 골치유과장에 관한 실험적 연구

최진용,류동목,이상철 慶熙大學校 齒科大學 1989 慶熙齒大論文集 Vol.11 No.-

The present study was designed to compare the resultant bone healing of bicortical compression osteosynthesis with that of monocortical noncompression osteosynthesis. In order to carry out this experiment, 4 Korean dogs weighting about 12 Kg were selected. In order to make a fracture with minimal bone defect between fragments and without compound fracture into the oral cavity and damage of the inferior alveolar nerve and vessels, the both sides of mandibular body region between the 4th bicupid and the 1st molar were fractured by making V-shaped groove and 4 holes, and manipulating a lever. At the left side,, fractured site were fixed with autocompression plate and screws and in the right side, fixation was performed with two_ miniplates and screws. Experimental dogs were sacrificed at 4th and 6th week after surgery and the soft tissue were dissected from the mandible. The fracture site was observed grossly and examined under the light macroscopeto observe the bony repair process histopathologicalIy. The results obtained from this study were as follows ; 1. All fractured sites appeared macroscopically to be healed well and any interfragmental morbilitycouldn't be felt at all. 2. Both groups showed external callus. Especially, large excrescences of external callus which were most extensive at the inferior border of the mandible were showed in the group used with miniplate. 3. At 4th week, the group used with compression plate showed bone repair process with new bone formation from theperiosteum in the periphery of the fractured fragments and fibrous callus in the inner side of the gap between the fractured fragments, and at 6th week, the fractured site was almostly healed with new bone with distinct reversal line. 4. At 4th week, the group used withnoncompressive miniplate showed bone repair process with newly-formed connective tissue containing scattered, new bone formation, and at 6th week, bony healing was started from the periphery of the fractured fragments. 5. The group used with compression plate showed better repair process than the group used with noncompressive miniplate.