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김방순,윤재일,최윤식 ( Bang Soon Kim,Jai Il Youn,Yun Shik Choi ) 대한피부과학회 1991 대한피부과학회지 Vol.29 No.5
Amiodarone hydrochloride is currently used in the treatment of recurrent ventricular tachycardia or ventricular fibrillation. Previous reports indicate that amiodarone occasionally causes a cutaneous photosensitivity reaction that may be associated with a peculiar blue-gray discoloration of the skin. We report a case of amiodarone photosensitivity developing in a patient about 30 months after amiodarone therapy. Symptomes included itching and stinging of the skin, with pinhead sized erythematous papules that developed 2-3 hours after sun exposure. Phototest showed that minimal erythema dose(MED) for UVA was decreased. Symptomes were subsided after the use of sun screen and topical steroid.
원발성 폐 고혈압 환자의 생존율과 예후에 영향을 미치는 인자
송종민(Jong Min Song),최윤식(Yun Shik Choi),채인호(In Ho Chae),김효수(Hyo Soo Kim),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),이영우(Young Woo Lee),전국진(Kook Jin Chun),홍택종(Taek Jong 대한내과학회 2000 대한내과학회지 Vol.59 No.3
Background : Mucosa-associated lymphoid tissue(MALT) lymphoma has an indolent natural course. However, extra-gastric MALT lymphoma has been reported to have more frequent relapses and shorter time to progress than gastric MALT lymphoma. We performed this study to analyze clinical features of extra-gastric MALT lymphoma. Methods : We retrospectively reviewed the medical records of the patients who were diagnosed as extra-gastric MALT lymphoma at the Samsung Medical Center from March 1995 to January 1999. The survival was analyzed by Kaplan-Meier method. Results : During the study period, extra-gastric MALT lymphoma was diagnosed in 50 patients. The median age was 51(28-87)yaers. The male to female ratio was 22:28. Commonly involved sites were conjunctiva (25/50, 50%), lung (6/50, 12%) and intestine(6/50, 12%). Histopathologically, low to high grade ratio of extra-gastric MALT lymphoma was 47:3. Among 41 patients who were staged, 32 patients(78%) had stage I or II and 9 patients(22%)had stage IV. B symptoms were seen in only 3 patients. Bone marrow involvement was observed in 4 patients. The duration of median follow up was 22 months. The 1-year and 2-year survival rates were 95.1% and 91.4% retrospectively. Conclusion : Majoity of our cases with extra-gastric MALT lymphoma had low grade, early stage, good treatement reponse and good prognosis.(Korean J Med 59:261-267, 2000)
최기준(Kee Joon Choi),조주희(Joo Hee Zo),한경일(Kyung Il Han),김영권(Young Kwon Kim),조명찬(Myeong Chan Cho),손대원(Dae Won Sohn),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),이영우(Young 대한내과학회 1990 대한내과학회지 Vol.39 No.5
N/A To observe the clinical features of Takayasu's arteritis and evaluate the incidence and sites of coronary arterial involvement in Takayasu's arteritis, clinical observations were made in 99 patients who were diagnosed as Takayasu's arteritis by clinical features and aortographic findings in Seoul National University Hospital from August 1971 to July 1989 Coronary arteriographies were performed prospectively in 30 patients with Takayasu's arteritis since March 1987. The results were as follows: 1) In 99 cases of Takayasu's arteritis, 15 were male and 84 were female. The male to female ratio was 1:5.7, the mean age was 29.5, and 63% of those studied were under the age of 30. 2) The following were the presenting clinical symptoms and signs in decreasing order of frequency: headache(69%), weak or nonpalpable pulse(68%), carotid or abdominal bruit(55%), Dyspnea on exertion(51%), hypertention(48%), and dizziness(43%). 3) Aorta or arterial involvement in decreasing order of frequency: left subclavian artery(62%), abdominal aorta(58%), right subclavian artery(38%), descending thoracic aorta(37%) and left renal artery(35%). 4) Using Ueno's classification, 29(29%) were Type I, 22(22g) were Type II, and 48(48%) were Type III. Type IV or pulmonary arterial involvements were seen in 11(33%) out of 33 patients. 5) In a prospective study using coronary arteriography, 8(27%) out of 30 patients of Takayasu's ateritis showed coronary involvement. Among the 13 lesions of coronary arterial narrowings in 8 patients with coronary involvements, there were 3 ostial lesions, 5 proximal and 5 middle or distal lesions. 6) Frequently there were no cardiac symptom in patients with Takayasu's arteritis who had coronary arterial lesions, and a myocadial infarction or congestive heart failure may be the first sign of the coronary arterial narrowing.
박작성 심실상성빈맥의 감별진단에 있어서 빈맥시 P 파의 유용성에 대한 연구
송종민(Jong Min Song),최윤식(Yun Shik Choi),채인호(In Ho Chae),김효수(Hyo Soo Kim),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),이영우(Young Woo Lee) 대한내과학회 2000 대한내과학회지 Vol.59 No.3
Background : Retrograde P wave can be found not only in atrioventricular reentrant tachycardia (AVRT) but also in atrioventricular nodal reentrant tachycardia (AVNRT), especially of posterior-type. This study evaluated the usefulness of retrograde P wave for differentiating AVNRT from concealed AVRT and for localization of accessory pathway(AP).Methods : Twelve lead ECGs were analyzed in patients with AVNRT (n=41) and concealed AVRT (n=53) who have taken successful ablation. Presence of pseudo r' in V1, pseudo S in II, III, aVF, and configuration and polarity of presumed retrograde P waves were evaluated. RP was obtained by subtracting RP interval in III from that in V1.Results : In anterior-type AVNRTs (n=38), there were no retrograde P wave in 53% and the pseudo r' and/or S in 47%. Retrograde P waves in V1 were positive in 67% (2/3 cases) of posterior-type AVNRTs and 97.4% (37/38 cases) of AVRTs with left free wall AP, but negative in 83.3% (5/6 cases) of AVRTs with right free wall AP. Retrograde P waves in II, III, aVF were negative in all of posterior-type AVNRTs, all with left and right posteroseptal AP, right posterior AP, and 90% (9/10 cases) with left posterior AP. All with left anterior and right anteroseptal AP showed positive P wave in III. RP of posterior-type AVNRT was significantly larger than those with left posteroseptal or left posterior AP (p<0.01). Sensitivity of newly developed stepwise algorithm was 50-100%.Conclusion : Retrograde P wave during tachycardia on standard ECG is very useful for differentiation of AVNRT from concealed AVRT and also for localization of APs. (Korean J Med 59:268-276, 2000)
정상 심근과 확장성 심근증 심근에서의 미토콘드리아 DNA 에 대한 분석
최현석(Hyun Seok Choi),김효수(Hyo Soo Kim),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),최성준(Seong Choon Choe),홍석근(Suk Keun Hong),손대원(Dae Won Sohn),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),이영우(Youn 대한내과학회 1997 대한내과학회지 Vol.53 No.3
N/A Objective: The aim of this study is to analyze the mitochondrial DNA in failing and normal hearts. Methods: Genomic DNA was extracted from 18 failing and 4 normal hearts. The DNA was digested with each 50 units of BamH I, Pvu II, Pst I, and hybridized using DNA fragments encoding CO II (cytochrome oxidase II) and CO IU. They were detected using 'Fluorescein Gene Images' system. Results: The light microscopic feature of failing myocardium was compatible with that of primary cardiomyopathy. In southern blot analysis, there was no significant difference in mitochondrial DNA amounts between normal and failing hearts. The amount of mitochondrial DNA in hearts, whether normal or failing, was greater than that in lymphocytes. There were no abnormal bands except 16.6kb-normal band using the enzyme BamH I, Pvu II from failing and normal hearts. After digesting with Pst I, 2.1kb band was found using probe CO II and 14.5kb band using probe CO III. Conclusion : The amount of mitochondrial DNA in hearts, whether normal or failing, was greater than that in lymphocytes, which suggests that the heart is an active organ in the energy metabolism. Abnormal band was not found in southern blot analysis of the mitochondrial DNA from failing and normal hearts. The more sensitive method such as PCR is required to detect the presence of sma11 amount of mutated DNA.
고혈압 환자에서 내피의존성 혈관반응에 대한 칼슘길항제와 비타민 C 의 효과에 대한 요구
온영근(Young Yeun On),최진호(Jin Ho Choi),채인호(In Ho Chae),김철호(Cheol Ho Kim),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi) 대한내과학회 2001 대한내과학회지 Vol.61 No.5
N/A Background: The effect s of antihypertensive agents on endothelial function have not been fully evaluated in human hypertension and data on the forearm circulation of humans are controversial. The aim of this study was 1) to evaluate the endothelial function in hypertensive patients 2) to investigate whether vitamin C administration has any benefit on the endothelial function and 3) to determine whether treatment with calcium ant agonist improves endothelial dysfunction in hypertensive patients. Methods: The endothelial function was estimated using venous occlusion plethysmography (VOP) in 8 hyper tensive patients and 8 healthy volunteer s. The patients in the hypertension group were treated with amlodipine, then examined again. The change of forearm blood flow (FBF) was measured wit hacetylcholine infusion through brachial artery and also with intra-ar terial vitamin C. Results: Forearm blood flow response to acetylcholine was significantly enhanced with intra- arterial infusion of vitamin C in hypertensive group before antihypertensive treatment. Co- infusion of L- NMMA, an inhibit or of nitric oxide synthase, blunted forearm blood flow response toacetylcholine. After treatment with amlodipine for 2 months in hypertensive group, endothelium-dependent vasorelaxation to acetylcholine was significantly improved comparedt opretreatment, and vitamin C did not affect the improved endothelial function by amlodipine treatment. Conclusion: Vitamin C (acutely) and amlodipine (chronically) improved endothelial function inhypertensive patients. These results suggest that increased oxidative stress, at least in part , maybe involved in the decreased endothelial function in hypertension.(Korean J Med 61:518- 526, 2001)