심실성 조기박동의 장기예후에 관한 연구

최석구(Suck Koo Choi),안정효(Jung Hyo Ahn),김남원(Nam Won Kim),고원섭(Won Sub Ko),노승현(Seoung Hyun Noh),이용석(Young Suk Lee),유원상(Won Sang Yoo) 대한내과학회 1991 대한내과학회지 Vol.40 No.4

N/A Twenty-nine patients who had frequent and/or complex ventricular premature beats on a 24-hour ambulatory ECG test were followed up for an average of 1 year and 7 months, and their prognoses were compared with those of 65 normal controls. Only one out of the 29 patients died of cardiac causes, (3.4%) but none of the normal controls died, This difference was not significant statistically. It did not make any difference, even when the presence of the underlying heart diseases were considered together. In our study of a limited number of patients in a rather short follow-up period, most of the patients who had frequent and/or complex ventricular premature beats had as good a prognosis as the general population.

고혈압 환자의 순응도에 관한 연구 - 의사 개입의 성과 -

유원상(Won Sang Yoo),최석구(Suck Koo Choi),이건주(Kun Joo Rhee),이광재(Kwang Jae Yi),노승현(Seung Hyun Noh) 대한내과학회 1989 대한내과학회지 Vol.36 No.2

N/A Compliances of one hundred patients with essential hypertension treated with usual care were compared with those of another one hundred hypertensives with intervention care simply provided by the physician in charge. The results were as follows: 1) The cumulative dropout rate in the usual care group decreased by 9%, 15% and 13% in 6, 9 and 12 months respectively. 2) The intervention care involved a shorter waiting time, longer consultation time, supportive care with sympathy, educational booklets and positive follow-up by telephone and mails. 3) In the intervention care group 56% of the dropouts were because of the provider, 27% were due to the patient and 17% were because of socioeconomic ceasons. In conclusion, patient compliance will certainly be improved by positive intervention by the physician in charge, escalation of medical insurance and the personal efforts of the patient.

Fenoterol 과 Aminophylline 이 심부정맥 빈도에 미치는 영향에 관한 연구

이정형(Jeong Hyeong Lee),최영호(Yeong Ho Choi),최석구(Suck Koo Choi),김동순(Dong Soon Kim),유원상(Won Sang Yoo) 대한내과학회 1988 대한내과학회지 Vol.35 No.6

N/A Selective beta₂ agonists and theophylline are the most widely used bronchodilators, and combination therapy with both drugs is known to have additive effects. But their effect on cardiac arrhythmia has not been well studied. So we performed a prospective, single-blind controlled study of the arrhythmogenic potential of fenoterol and aminophylline on 24 patients with airway obstruction (11 asthma and 13 COPD). Twenty-four hour Holter monitoring was performed four times on each patient, while the patient received either fenoterol only (B), aminophylline only (A), both drugs (AB), or placebo only (P). Each study period was separated by 5-7 days for wash out of the drugs. During the placebo period, supraventricular premature beat (SVPB) was observed in all patients, and 18 patients (75%) also had ventricular premature beat (VPB). Among them, 2 patients had grade III VPB by Lown classification and 6 patients had grade IV VPB. Mean and maximal heart rates were significantly increased after the combination therapy. However, there was no significant difference in the incidence of SVPB and VPB in each period. The degree of arrhythmia markedly fluctuated even in the same patient. In 6 patients, the complexity of VPB increased after the administration of one or both drugs, but in 2 other patients, a more complicated VPB was found during the placebo period. By the Kruskal-Wallis test, no statistically significant difference was found in the severity of both kinds of arrhythmia during each period. In conclusion, beta₂agonists and theophylline have no effect on the incidence and severity of arrhythmia in stable asthma and COPD patients, but one should be cautious during combination therapy.

매독성 대동맥류 1 예 보고

김예회 ( Re Hwe Kim ),임경호 ( Kyung Ho Lim ),최석구 ( Suck Koo Choi ),김태영 ( Tae Young Kim ) 대한내과학회 1979 대한내과학회지 Vol.22 No.3

고혈압 환자에서 발행할 수 있는 수술중 및 수술후의 심혈관계 변화에 대한 고찰

이성봉(Sung Bong Lee),손영돈(Young Don Son),조병렬(Byung Ryul Cho),최석구(Suck Koo Choi),유원상(Won Sang Yoo),이동철(Dong Chul Lee) 대한내과학회 1991 대한내과학회지 Vol.41 No.5

N/A Hypetension is the most common cause of heart failure and left ventricular hypertrophy. Recently, with advances in operating techniques, equipment and anaesthesiology, elderly patients have had more chances to undergo operation. Therefore, chances for patients with hypertension that comprise 15%-20% of the adult population in Korea to undergo operation has become more frequent. To evaluate the frequency and pragnosis of the cardiovascular changes in patients with hypertension during operation and the perioperative period, the blood pressures of 100 patients who underwent operation at Seoul Paik Hospital from September 1988 to October 1990 were measured proeoperatively, during operation, and postoperatively and analyzed in relevance to cardiovascular complications. The cardiovascular complications were divided into 4 categories: 1) Increase in systolic blood pressure 2) Decrease in systolic blood pressure 3) Marked changes in systolic blood pressure 4) Others (arrythmias, heart failure, chest pain) The results were as follows: 1) Episodes of an increase in the systolic blood pressure more than 50 mmHg compared to the systolic blood pressure at the time of consultation were found in 7 cases (7%) 2) Episodes of a decrease in systolic blood pressure below 100 mmHg were detected in 8 cases (8%) and in most cases, the blood pressure was corrected to normal level simply by the rapid infusion of fluid, except for 1 case that required the use of ephedrine or clacium gluconates. 3) Episodes of changes in systolic blood pressure more than 50 mmHg were found in 42 cases (42%). 4) There were 5 episodes of ventricular premature beat or atrial premature beat, but they were corrected to normal sinus rhythm by intravenous lidocain injection, and there were no more problems postoperatively. 5) There were no coronary events or heart failures clinically. 6) It seemed that there was no correlation between the level of preoperative blood pressure and frequency of cardiovascular complications, In conclusion, most of the patients with hypertension corrected preoperatively or not underwent operation successfully without any cardiovascular complications if the anaesthesiologist monitored the blood pressure and took appropriate therapeutic measures predperatively.

급성심근경색증과 유사한 심전도 변화와 SIADH 를 동반한 급성 간헐성 폴피리아 1 예

김례회 ( Re Hwe Kim ),이오정 ( Oh Jeong Lee ),최석구 ( Suck Koo Choi ) 대한내과학회 1980 대한내과학회지 Vol.23 No.6

관상동맥질환 환자 , 운동선수 및 정상 대조군에서 혈청지질 및 Apolipoproteins 에 대한 연구

박정의(Jeong Euy Park),김우주(Woo Joo Kim),최인석(In Suok Choi),김대원(Dae Won Kim),이갑노(Kap No Lee),김성수(Sung Soo Kim),유원상(Won Sang Yoo),최석구(Suck Koo Choi),이건주(Kun Joo Rhee),서순규(Soon Kyu Suh),이영(Young Lee),고영박(You 대한내과학회 1991 대한내과학회지 Vol.40 No.5

N/A To investigate the usefulness of serum lipids and apolipoproteins as indices of risk factors for coronary artery disease (CAD) and to know the effects of regular exercise on the serum lipids and apolipoproteins, we measured the serum lipids and apolipoproteins in the patients with coronary artery disease, athletes and normal control persons. The study subjects included 67 patients with CAD (57. 8±11.2yr), 22 athletes (21.5±2.1yr) and 62 normal control persons (34.3±11.4yr). 1) In the patients with CAD the serum total cholesterol (TC) was 177. 2±38.5 mg/dl and the HDL-cholesterol (HDL-C) was 39.0±11.2mg/dl. In the normal control persons TC was 162.5±33.5 mg/dl and HDL-C was 42.4±12.6mg/dl, which were not significantly different from the values of CAD patients. 2) The serum apolipopratein A (Apo-A) was significantly lower (201.9±39.6mg/dl, p<0.05), and the apolipoprotein B (Apo-B) was significantly higher (132.3±29.7 mg/dl, p<0.05) in the patients with CAD, compared with normal control persons (age over 40 years; Apo-A: 246.3±39.9 mg/dl, Apo-B: 117.9±26.4 mg/dl). 3) The TC/HDL-C ratio and Apo B/A ratio were significantly higher (4.9±1.6, 0.67±0.17, p<0.005 for TC/HDL-C ratio and p<0.05 for Apo B/A ratio) in the CAD patients compared with normal control persons (age over 40 years; 3.6±1.1, 0.49±0.10). 4) The TC/HDL-C ratio ≥4.0 and Apo B/A ratio ≥0.55 were the good discriminating criteria separating the CAD patients from the normal control persons. 5) In the athletes, the serum triglyceride (TG) was significantly lower (65.7±20.7mg/dl, p<0.001), and the HDL-C was significantly higher (57.8±11.2 mg/dl, p<0.001) compared with normal control persons (age under 30 years; TG; 119.8±94.3 mg/dl, HDL-C: 44.6±11.0mg/dl). The Apo-A, Apo-B, TC/HDL-C ratio and Apo B/A ratio were all significantly lower (p<0.01) compared with those in the normal control persons. 6) Among the athletes, the HDL-C was highest and the TG was lowest in the swimmers compared with fencing players and wrestlers. The Apo B/A ratio and TC/HD1-C ratio were better discriminating indices of risk factors for CAD compared with individual lipids or apolipoprotein values. The Apo-A and Apo-B were considered to be good indices of risks for CAD. The athletes had lowest risks for CAD.

진행된 위암환자에서 CCNU 와 5-FU 를 이용한 화학요법

김관엽 ( Kwan Yop Kim ),김예회 ( Re Hwe Kim ),최석구 ( Suck Koo Choi ),김태영 ( Tae Young Kim ) 대한내과학회 1979 대한내과학회지 Vol.22 No.3

고혈압환자의 휴약에 관한 검토

유원상(Won Sang Yoo),우상준(Sang Joon Woo),성영주(Yong Joo Seong),김준희(Joon Hee Kim),최석구(Suck Koo Choi),전영빈(Young Bin Jeon) 대한내과학회 1991 대한내과학회지 Vol.41 No.2

N/A Thirty four patients with essential hypertension, who could successfully discontinued antihypertensive drug treatment, were analyzed to find out the clinical indices which can be used for the prediction of success and duration of the drug withdrawal. The resnets were as follows: 1) The shorter the time for the normalization of blood pressure after drug administration, the longer the duration of drug withdrawal and the lower the rate of remedication. 2) The duration of withdrawal was inversely proportional to the level of pretreatment mean arterial pressure, the duration from the beginning of drug administration to the withdrawal, and the duration from the time when the blood pressure was normalized to the time when the antihypertensive medicines were withdrawn. 3) There was no correlation between the existence of cardiac complications of hypertension and the duration of successful withdrawal. 4) The rate of remedication of antihypertensive medicines among the patients who had stopped taking the medicines was 53%. In conclusion, among the hypertensive patients, if a persons blood pressure could be normalized within 3 months after the beginning of medication, he would be a good candidate for drug withdrawal. In other cases, if the dosages of antihypertensive medicines could be tapered off at the sixth month and taking the medicines could be stopped at the 12-18th month, the duration of drug withdrawal could be 9-18 months.

Angiotensin Converting Enzyme Inhibitor 가 Capsaicin 유발 기침반사에 미치는 영향

김동순(Dong Soon Kim),권성운(Seong Woon Kwon),김용복(Yong Bok Kim),임창영(Chang Young Lim),유원상(Won Sang Yoo),최석구(Suck Koo Choi) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: Angiotensin converting enzyme(ACE) inhibitors are widely used for the treatment of hypertension and heart failure without serious side effects, but in some patients, they induce intractable cough. The mee-hanism of this cough is not known, but ACE and kininase II are the same enzyme, the derangement in the metabolism of kinines and Substance-P by ACE inhibitors has been proposed as one possibility. So we performed a placebo-controlled, double-blind, randomized crossover study, to find out whether the enalrpril can change the sensitivity to capsaicin which released Substance-P from the nerve ending and its relation to the development of cough after the enalarpril. Method: The subjects were 21 patients (9 men and 12 wemen) with mild to moderate hypertension. Eleven patients developed cough with the Enalarpril (cougher), and 10 pateints didn't have cough (non-cougher) and served as a control group. Baseline PFT, serum IgE level, and blood eosinophil count were done. The patients received either enalarpril 10 mg per day or placebo for one week, and after the washout period of at least one week, another drug(placebo if the patient had enalapril previously and vice versa) was given for a week. Blood pressure, pulmonary function test, and capsaicin challenge test were performed at the end of each period. Capsaicin challenge test was done by inhalation of different concentration of capsaicin via DeVil-bis 646 nebulizer with dosimeter (SCM Co., U.S.A.) and the lowest concentration which induced 2 or more coughs (Th-w) and 5 or more coughs (Th-5) were deter- mined. Result: The age of the two groups were similar (55.5 vs 52 years), but females were predominant in cougher (8 female and 4 male) compared to non-cougher (4 female and 6 male). There was no Significant difference in serum IgE level, eosinophil counts, and pulmonary function between two groups. Cough developed immediately after the inhalation of capsaicin, and the dose-response relationship was fonud between the number of coughs and the concentration of capsaicin. In all patients, Th-2 was 19.7±16.1uM and Th-5 was 78.8±48.6uM. But there was no significant difference in both Th-2 and Th-5 between coughers (21,3 uM and 72.2 uM) and non-coughers (18.0 uM and 81.6 uM). also, no significant change in Th-2 and Th-5 was found during the therapy of enarlapril compared to the placebo period in both groups. Among 11 coughers, 2 patients developed more coughs with capsaicin inhalation after the enarlapril compared to placebo period (responder), and in non-cougher, 3 among 10 patients were responders. Blood pressure was significantly decreased after the Enarlapril, but no significant change in pulmonary function was noted. Conclusion: Our data suggest that Enarlapril does not increase the sensitivity to capsaicin and the cough after the Enarlapril seems to have different mechanism.