본태성고혈압 환자에서의 Doppler 심초음파 소견에 대한 연구

임석아(Seock Ah Im),정혜경(Hye Kyung Jung),정성애(Sung Ae Jung),박정은(Jung En Park),신길자(Gil Ja Shin),이우형(Woo Hyung Lee) 대한내과학회 1995 대한내과학회지 Vol.48 No.1

N/A Objectives: Systemic arterial hypertension causes structural and functional changes of myocardium and coronary circulation, increased tendency to ventricular arrhythmia, ischemic heart disease, and congestive heart failure. In recent years, the echocardiogram has been developed as noninvasive method for the evaluation of left ventricular performance. Estimation of systolic and diastolic function of left ventricle and measurement of left ventricular mass may predict outcome of hypertensive patients. Methods: We measured systolic and diastolic function of left ventricle and left ventricular mass with M-mode, two-dimensional, and Doppler echocardiography in 62 cases of hypertensives and 20 cases of healthy adults from November 1992 to August 1993. Results: 1) Hypertensive group was 62 cases (M:F=33:29), the mean age was 56±13 years. Normotensive group was 20 cases (M:F=8:12), the mean age was 53±10 years. There was no significant differences in age distribution, sex ratio, height, weight, and body mass index. 2) On M-mode echocardiographic measurements, interventricular septum thickness and LV posterior wall thickness were significantly increased in hypertensive group (14.4±2.9㎜, 13.9±2.9㎜) than normotensive group (10.7±1.1㎜, 10.3±1.6㎜) (p<0.01). 3) Ejection fraction was decreased in hypertensive group (55.8±12%) than normotensive group (63.0±6.7%) but within normal range. 4) There was no significant differences of cardiac output and cardiac index between hypertensive group (4.69±1.151/min., 3.20±2.641/min./㎡) and normotensive group (4.88±1.211/min., 3.02±0.791/min./㎡). 5) There was no significant differences of peak E velocity between hypertensive group (72.8±22.4㎝/sec) and normotensive group (77.1±16.3㎝/sec). Peak A velocity was significantly increased in hypertensive group (83.1±22.2㎝/sec) than normotensive group (62.6±15.0㎝/sec) (p<0.01). Peak E/A ratio was significantly decreased in hypertensive group (0.91±0.28) than normotensive group (1.22±0.25) (p<0.01). Mitral valve deceleration time was significantly prolonged in hypertensive group (240.0±48.4msec) than normotensive group (240.0±48.4msec) (p<0.01). Conclusion: Diastolic dysfunction and left ventricular hypertrophy were prominent in hypertensive group but systolic function was relatively saved.

Signet Ring Cell Type 위 선암 69예에 대한 임상적 연구

박정은,임석아,이순남 梨花女子大學校 醫科大學 醫科學硏究所 1993 EMJ (Ewha medical journal) Vol.16 No.3

In the past gastric carcinomas composed predominantly of signet ring cells formed onlya small percentage of gastric malignancies. However. we have had the impression that in recentyears the relative incidence and amount of signet ring cells in biopsy and resection specimensof gastric carcinoma have risen sharply. This report is an analysis of 69 cases of signet ringcell type of gastric adenocarcinoma diagnosed at Ewha Womens University Hospital fromJanuary, 1987 to December, 1991. The results obtained were summerized as follows. 1) The male to female ratio was 1:1.2 2) The peak age incidence was the 6th decade and the 7th decade with 23.9% each other,and the 8th decade with 17.4%, the 5th decade and the 4th decade with 16% each other.Average age of patients was younger than entire gastric adenocarcinoma. 3) The major clinical symptom was epigastric pain. indigestion, vomiting and abdominalfullness in decreasing orders. 4) The macroscopic feature of the signet ring cell type of adenocarcinoma by gastronberscopyshowed Borrmann's type Ⅲ 26 cases(37.6% ). type Ⅳ 21 cases(30.4% ), type Ⅱ 10 cases(14.5%). 5) The location of signet ring cell type was mainly the gastric antrum 39 cases(56.5%),the body 18 cases(26%), and widespread from body to antrum 9 rases(13%). 6) The size of lesion showed above 3cm with 53%, 1.5~3.Ocm with 31.3%, below 1.5cmwith 15.7% in frequency. 7) Thirty out of 39 cases(76.9%) involve to the serosa. 3 cases(7.7%) to the muscle layer,3 cases(7.7%) to the mucosa and the submucosa each other. 8) Distant metastases were relatively frequently occurred in increased CEA group. 9) Five-year survival rate of 49 cases was 62.8%.

궤양성 대장염의 임상적 관찰

최희정,박정은,손희정,김금미,변정란,고영엽,김도영,문일환 梨花女子大學校 醫科大學 醫科學硏究所 1993 EMJ (Ewha medical journal) Vol.16 No.3

저자들은 1983년 1월부터 1993년 2월까지 이화여대 부속병원을 내원하여 궤양성 대장염으로 진단받은 환자 36예에 대하여 후향적 방법으로 분석하여 다음과 같은 결과를 얻었다. 1) 발병연령은 20대에서 가장 호발하였으며 남녀비는 1:1.7로 여자에서 더 많았다. 2) 병력기간은 6개월이내가 전체의 63.9%로 대다수를 차지했다. 3) 임상증상은 혈변이 31예(86.1%)로 가장 많았으며 다음으로 복통 27예 (75.0%), 설사 26예(72.2%), 발열 11예(30.6%), 체중감소 10예(27.8%)의순이 었다. 4) 경중도(severity)를 나누어보면 중등도가 52.8%로 가장 많았고 중증이 33.3%, 경증이 13.9%의순이었다. 5) 해부학적 위치에 따른 병변은 pancolitis 36.1%, 직장과 S자상결장이 16.6% , 좌측결장과 직장만침범된 경우가 각각 13.8%, 횡행결장까지가 8.3%,backwash ileitis가 동반된 경우가 11.1%였다. 6) 혈액학적 검사소견은 비특이적이나 빈혈, 백혈구다증, 적혈구 침강속도 상승, 저알부민혈증,전해질장애, 혈청 transaminase 및 alkaline phosphatase상승등을 보였다. 7) 내시경 소견은 점막궤양을 보이는 경우가 27예(77.1%)로 가장 많았고 충혈이 18예(51.4%), 출혈15예(42.5%), 점막의 friability 8예(22.9%), 가성폴립 8예(22.9%), 과립상 7예(20.2%) 등의 소견을보였다. 8) 바륨대장 조영술 소견은 과립상이 18예(62.1%)로 가장 많았고 대장 팽찰부 소실 16예(53.2%), 내강협소 10예(34.5%), 연통모양의 강직 4예(13.8%), 가성폴립 1예(3.4%) 등을 보였고, 정상소견도3예(10.3%)에서 있었다. 9) 조직생검의 병리학적 소견은 염증소견이 30예(83.3%)로 가장 많았고, cryptitis가 20예(55.6%),궤양이 18예(50%), goblet cell 고갈 7예(19.4%),가성폴립 7예(19.4%), 괴상 5예(13.9%), 과립상 3예(8.3%) 등을 보였다. 10) 내과적 치료로 70.8%에서 호전되었고 17.7%에서 재발되었다. 수술은 내과적 치료에 실패한4예를 포함한 6예(16.7%)에서 실시되었으며 장천공 2예의 응급수술이 있었고 4예는 선택적 수술이 었다. Objects : Ulcerative colitis is an waxing and waning inflammatory bowel disease characterizedby rectal bleeding and diarrhea, affecting principally the mucosa of the rectum and colon.Its incidience is being higher in Europe and America and it also seems to be rising increasinglyin our country because diagnostic methods are much developed and Korean life styles arewesternized. So, we investigated its clinical characteristics. Mothods : We analyzed 36 cases of ulcerative colitis which had been treated in the Hospitalof Ewha Womans' University from Jan. 1983 to Feb. 1993. retrospectively. Results : 1) The most prevalent age group was 3rd decade and male to female ratio was 1:1.77. 2) The duration of symptoms was less than 6 months in 63.9%. 3) The most common clinical manifestation was hematochezia(86.1%). abdominal pain(75.0%). diarrhea(72.2%). fever(30.6%), weight loss(27.8%) in the order of frequency. 4) According to the severity. moderate type was shown in 52.8%, severe in 33.3% and mildin 13.9%. 5) According to the anatomical distribution of the lesion pancolitis was shown in 36.1%,the involvement of the rectum and sigmoid colon in 16.6%, the left-sided colon in 13.8%.rectum only in 13.8%, transverse colon in 8.3% and backwash ileitis in 11.1%, respectively. 6) The hematologic laboratory finding was non-specific including anemia. leukocytosis. increased erythrocyte sedimentation rate, bypoalburninemia, electrolyte imbalance, increased serumtransaminase and alkaline phosphatase. 7) Colonoscopy revealed ulceration(77.1%) commonly, including hyperemia(51.4%). bleeding(42.5%), mucosal friability(22.9%), pseudopolyp(22.9%). granularity(20.2%). 8) The Barium enema showed granularity commonly and loss of haustral marking(55.2%),luminal narrowing(34.5%), lead pipe rigidity(13.8%), pseudopolyp(3.4%). Also, normal finding was shown in 10.3%. 9) The most common histopathologic finding was inflammation(83.3%) and ryptitis(55.6%), ulceration(50%), goblet cell depletion(19.4%), pseudopolyp(19.4%). necrosis(13.9%), granolarity(8,3%) were also noted. 10) With the medical treatment 76.5% of the cases showed initial improvement of the symptom, but the recurrence developed in 17.7%. The surgery was performed in 6 cases of patients(16.7%). Emergency operation was performed in 2 cases due to bowel perforation and electiveoperation in 4 cases.