관상동맥 중재술을 시행 받은 40세 이하의 ST 분절 상승과

박종춘 ( Jong Chun Park ),조정관 ( Jeong Gwan Cho ),김주한 ( Ju Han Kim ),홍영준 ( Young Joon Hong ),안영근 ( Youngkeun Ahn ),강정채 ( Jung Chaee Kang ),김남윤 ( Nam Yoon Kim ),박인혜 ( In Hyae Park ),정명호 ( Myung Ho Jeong ) 대한내과학회 2012 대한내과학회지 Vol.82 No.2

Background/Aims: The prevalence of coronary artery disease has increased in young adults. We evaluated the differences in clinical characteristics and clinical outcomes in young patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Methods: A total of 164 patients with acute myocardial infarction who underwent percutaneous coronary intervention were divided into two groups: the STEMI group (120 patients; mean age, 35.7±3.8 years; 118 males) and the NSTEMII group (44 patients; mean age, 35.7±4.3 years; 43 males). We analyzed clinical and angiographic characteristics and major adverse cardiac events (MACE), including death from any cause, non-fatal myocardial infarction, target lesion revascularization, and coronary artery bypass graft surgery, during a 1-year clinical follow-up of the two groups. Results: During hospitalization, Killip class II acute myocardial infarction (5.8% vs. 15.9%, p=0.041) was observed more frequently in the NSTEMI group. The levels of troponin-I (66.9±103.6 vs. 26.6±38.5 ng/mL, p=0.014) and N-terminal pro-brain natriuretic peptide (733.0±1,018.1 vs. 476.2±374.5 pg/mL, p=0.012) were significantly higher in the STEMI group. One-year MACE did not differ between the two groups. By multiple logistic regression analysis, bare metal stents (odds ratio, 3.360; 95% confidence interval, 1.105-10.217; p=0.033) and high lipoprotein (a) levels (odds ratio, 1.047; 95% confidence interval, 1.020-1.075; p=0.001) were independent predictors of 1-year MACE. Conclusions: Young patients with STEMI and NSTEMI have similar clinical outcomes. Bare metal stents and high serum lipoprotein (a) levels are independent predictors of MACE during 1-year clinical follow-ups in young patients with acute myocardial infarction. (Korean J Med 2012;82:175-184)

원발성 간암에 있어서 혈청 Alphafetoprotein 의 진단적 의의에 관하여

박종춘(Jong Chun Park),김세종(S.J. Kim) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1

N/A An elevated serum alphafetoprotein (AFP) concentration in a nonpregnant adult is the most discriminating laboratory test indicative of malignant disease now available. AFP is found on low concentration in the serum of normal adults, but it appears in high concentration in fetal serum at 12 weeks gestation. Elevations in adults are associated with pregnancy, a variety of nonneoplastic liver diseases, primary hepatocellular carcinoma and teratocarcinoma containing yolk sac elements. Extensive evaluation of the serum AFP concentration as a diagnostic marker for primary hepatocellular carcinoma has been carried out over the last 10 years. The measurement of serum AFP concentration is very useful in the diagnosis of hepatocellular carcinoma. Hepatitis B virus has been linked to hepatocarcinogenesis and recent evidence suggests incorporation of the hepatitis B virus genome into the cancer cell chromosome. Serum AFP was measured quantitatively by radioimmunoassay technique in 296 patients, who visited the out-clinic or were hospitalized at Chonnam University Hospital during the period from June 1981 to July 1983. Those who were tested included 33 cases of normal population as control group, 133, hepatic diseases(46, primary hepatocelluar carcinoma; 11, hepatic metastatic tumor; 76, cirrhosis of liver; 13, acute viral hepatitis; 24, chronic hepatitis), 70 cases of nonhepatic malignant diseases, and 23 cases of the other nonhepatic diseases as the disease group. HBsAg was measured by enzyme immunoassay technique in 35 out of 46 cases of primary hepatocellular carcinoma. The results obtained were as follows; 1) The serum AFP concentration in 33 cases of normal control subjects was 4+-3 ng/ml (Mean+-S.D., Range: 0-12 ng/ml). Upper limit of serum AFP concentration in the normal adult was considered 10 ng/ml, which was derived from mean+-1.96 S.D. 2) In hepatic diseases, the serum AFP concentration was 30+-67 ng/ml(2-248 ng/ml) in acute viral hepatitis, 34+-57 ng/ml(1-260 ng/ml) in chronic active hepatitis, 10+-17 ng/ml (1-35 ng/ml) in chronic persistent hepatitis, 46+-74 ng/ml(0-350 ng/ml) in cirrhosis, 1,590+-2,245 ng/ml(0-8,000 ng/ml) in primary hepatocellular carcinoma and 86+-132 ng/ml(0-360ng/ml) in metastatic tumor of the liver. 3) Serum AFP concentration was exceeded the 400ng/ml only in hepatocellular carcinoma, which was revealed in 26 cases out of 46 cases of primary hepatocellular carcinoma. 4) HBsAg was positive in 21 cases out of 35 cases of primary hepatocellular carcinoma. In 16 out of 21 HBsAg positive cases, AFP was exceeded 400 ng/ml. 5) There were no significant changes of serum AFP concentration in the process of disease. Follow-up examination had been done at 2 to 6 weeks later the initial examination.

관상동맥 중재술을 시술 받은 고령 환자들의 최근 10년간 임상 양상의 변화

박종춘 ( Jong Chun Park ),조정관 ( Jeong Gwan Cho ),안영근 ( Young Keun Ahn ),강정채 ( Jung Chaee Kang ),김주환 ( Ju Han Kim ),김민석 ( Min Suk Kim ),정명호 ( Myung Ho Jeong ),황슨환 ( Seung Hwan Hwang ),고점석 ( Jum Suk Ko ),이 대한내과학회 2010 대한내과학회지 Vol.79 No.6

Background/Aims: The objective of this study was to observe changes in the clinical patterns of Korean patients over 65 years of age who received percutaneous coronary intervention (PCI) in the past 10 years. Methods: In total, 3,209 patients over 65 years of age [male:female; 1,950 (71.4±5.21 years):1,259 (72.5±5.47 years)] who underwent PCI between June 1999 and June 2009 were divided into four groups according to time period. Clinical characteristics, gender differences, coronary angiographic findings, and major adverse cardiac events (MACE) during a 1-year follow-up period were compared among the four groups. Results: The gender ratio was male-dominant and no significant change was observed over the observed time period [male (60.8):female (39.2%)], but the age increased [1999-2001:2002-2004:2005-2007:2008-2009=71.2±5.11:71.4±5.26:71.9±5.25: 72.6±5.57 years; p=0.001]. The prevalence of hypertension increased over time (p=0.028), but smoking decreased (p=0.002). Hypertension was the major risk factor for males, whereas obesity was the major risk factor for female patients. MACE-free 1-year survival increased over the observed period (p=0.014). Males had higher survival rates than females (p=0.007). MACE developed in 105 (3.27%) patients during the 1-year follow-up period and predictive factors for the development of MACE were being female (p=0.001), old age (p=0.008), hypertension (p=0.049), diabetes mellitus (p=0.004), smoking (p=0.009), and low Thrombolysis In Myocardial Infarction (TIMI) flow (p=0.048) by a multivariate analysis. Conclusions: The age of elderly patients undergoing PCI and the prevalence of hypertension increased, whereas smoking decreased over the last 10 years. Predictive factors for patients developing MACE during the one-year follow-up were associated with female gender, hypertension, diabetes mellitus, smoking, old age, and low TIMI flow. (Korean J Med 79:661-672, 2010)

고중성지방혈증과 복부비만이 관상동맥 중재술을 시술받은 급성 심근경색증 환자의 임상경과에 미치는 영향

박종춘 ( Jong Chun Park ),강정채 ( Jung Chaee Kang ),한수경 ( Soo Gyoung Han ),정명호 ( Myung Ho Jeong ),이정애 ( Jung Ae Rhee ),최진수 ( Jin Su Choi ),이기홍 ( Kee Hong Lee ),박근호 ( Keun Ho Park ),심두선 ( Doo Sun Sim ),홍영준 대한내과학회 2014 대한내과학회지 Vol.86 No.2

Background/Aims: Dyslipidemia and obesity are risk factors for the development of acute myocardial infarction (AMI) that affect the clinical outcomes in patients. Methods: We analyzed 2,751 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) (mean age, 63.7 ± 12.1 years). The patients were divided into four groups based on serum triglyceride levels and central obesity [Group Ia: triglycerides < 200 mg/dL and (-) central obesity; Group Ib: triglyceride < 200 mg/dL and (+) central obesity; Group IIa: triglyceride ≥ 200 mg/dL and (-) central obesity; Group IIb: triglyceride ≥ 200 mg/dL and (+) central obesity]. In-hospital outcome was defined as in-hospital mortality and complications. One-year clinical outcome was compared and defined as the composite of 1-year major adverse cardiac events (MACE), including death, recurrent MI, and target vessel revascularization. Results: Total MACE developed in 502 patients (18.2%), while 303 patients (11.0%) died prior to the 1-year follow-up visit. In-hospital complications and in-hospital mortality were not different among the four groups. One-year clinical outcomes based on triglyceride levels (Group I vs. Group II) were not different. In addition, there were no differences in clinical outcomes in patients with a triglyceride level < 200 mg/dL, regardless of central obesity. One-year MACE rates were not significantly different among the four groups. Conclusions: There was no significant difference in the 1-year MACE rate based on the triglyceride level and presence of central obesity in patients with AMI who underwent PCI. (Korean J Med 2014;86:169-178)

급성 하벽 심근 경색증 환자에서 우흉부 유도 심전도와 관동맥 조영술 소견

박종수(Jong Soo Park),이명곤(Myung Kon Lee),안영근(Young Keun An),박주형(Ju Hyung Park),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang),박옥규(Ock Kyu Park) 대한내과학회 1993 대한내과학회지 Vol.45 No.3

N/A Background: The right ventricular infarction is frequently associated with acute inferior myocardial infarction. It is seldom diagnosed by the conventional 12 lead electrocardiogram (EKG). However, right precordial EKG has been proved highly sensitive and specific in diagnosing the right ventricular infarction. The right ventriculr infarction is said to be associated with proximal right coronary lesions. The present study was performed to evaluate the value of the right precordial EKG in predicting the proximal RCA lesion in acute inferior wall myocardial infarction. Methods: In order to observe the relation of the EKG change and coronary angiographic findings in the RV infarction, 40 patients (men 36, women 4, mean age 57±2.4 years) with an acute inferior myocardial infarction were examined. The right precordial electrocardiogram recorded with 10 hours after the onset of chest pain, and coronary angiogram were analysed. Results: 1) The mean amplitudes of r-waves were 1.4±0.9 mm in V3R and 1.2±0.8 mm in V4R. The mean amplitudes of s-waves were 6.6±3.6mm in V3R, 4.2±1.9 mm in V4R, 2.7±1.4 mm in V5R, 1.7±1.6mm in V6R. The mean r/s ratio in right precordial leads was less than 1. The configuration of T-wave was inverted in 40. 8% of the patients in V3R, 38.6% in V4R, 38.5% in V5R and 35.9% in V6R. 2) Of the 40 studied subjects, 22 were one-vessel disease, 14 two-vessel disease, 3 three-vessel disease and one normal coronary artery. 3) Twenty eight patients had ST segment elevation in V3R, V4R and/or V5R, in which 23 had right proximal coronary stenosis and 5 had right middle or distal coronary stenosis. Among twenty three patients who had proximal right coronary stenosis & ST segment elevation in V3R, V4R and/or V5R, 19 had single proximal right coronary stenosis, 4 had left anterior descending or left circumflex coronary stenosis coincidently, All five patients that had middle or distal right coronary stenosis and ST segment elevation in V3R, V4R and/or V5R had associated left anterior descending or left circumflex stenosis. 4) In the diagnosis of proximal right coronary stenosis, the sensitivity of ST segment elevation in V3R, V4R and/or V5R is 92%, the specificity is 83%, and the predictive accuracy is 82%. Conclusion: Above results suggested that right precordial lead electrocardiogram in acute inferior myocardial infarction is a good predictor of the proximal right coronary arterial stenosis.

운동부하 검사상 무증상 심근 허혈 환자의 관동맥 병변 소견

조인종(In Jong Cho),서정평(Jung Pyung Suh),류문희(Moon Hee Rheu),이명곤(Myung Kon Lee),박종수(Jong Soo Park),박주형(Joo Hyung Park),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang) 대한내과학회 1994 대한내과학회지 Vol.47 No.5

N/A Objectives: Silent myocardial ischemia is defined as the presence of transient ischemic alterations in absence of angina or its equivalents. In recent reports, silent ischemia comprises about 60-80% of total ischemic events in patients with symptomatic angina and its prognosis is similar to typical painful angina, So, we studied to compare the difference of coronary angiographic features between painful angina and silent angina in patients with positive treadmill exercise test. Method: We studied retrospectively coronary angiographic features of 34 patients; 20 patients with painful treadmill exercise test were grouped in A and 14 patients without pain were grouped in B. Both groups were positive in Thallium corynary perfusion scan. Results: 1) There were no significant differences in sex, age, smoking and hypertension between group A and B but diabetes were more prevalent in group A than in B(p< 0,05) 2) Total exercise duration, ST segment deviation and rate pressure product were not different between two groups in treadmill exercise test. Although treadmill score was significantly low in group A (p<0.05), there was no singificant difference between two groups in case of subtracting treadmill angina index from treadmill score. 3) In dipyridamole Tl scan, defect volume ratio was not different in two groups although defect index was significantly greater in group A(p<0.05). 4) In coronary angiographic findings, there were no sigificant differences in number of stenosed vessels, left ventricular ejection fraction and left ventricular end diastolic pressure, but right coronary artery lesion is more common in group A than group B(p<0,05). 5) The most common clinical diagnosis of studied subject was unstable angina, But there were no statistically difference between two groups. Conclusion: This results suggest that patient with silent myocardial ischemia has similar coronary artery disease to those with painful myocardial ischemia, Early detection and treatment of silent ischemia is essential in the management of ischemic teart disease.

원발성 비후형 심근증에서 심근비후 형태에 따른 임상상의 차이

이명곤(Myung Kon Lee),박종수(Jong Su Park),안영근(Young Keun An),박주형(Ju Hyung Park),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang),박옥규(Ock Kyu Park) 대한내과학회 1993 대한내과학회지 Vol.45 No.4

N/A Background; The idipathic hypertrophic cardiomyopathy(HCM) is characterized by inappropriate myocardial hypertrophy of unknown cause. It may presents a variety of clinical and morphologic features according to the site and extent of the hypertrophy. The widespread application of echocardiography has made it possible to diagnose HCM earlier and easier, even in asymptomatic patients. However, clinical reports on the relationship between the distribution of left ventricular hypertrophy (LVH) and the clinical features are few in Korea. Therefore, the present clinical stu4y was performed to characterize more completely the distribution of LVH and to determine whether different patterns of hypertrophy are of particular clinical significance. Methods: The clinical, electrocardiographic and echocardiographic features were reviewed in 32 patients with idipathic HCM of Chonnam National University Hospital from July 1983 to August 1992. Results: 1) There were 23 males and 9 females. The mean age was 45.4±16.5 ranging from 15 to 74 years. There were no significant difference in age distribution according to the patterns of LUH. 2) Based on M-mode and 2-dimensional echocardiographic findings. The 32 patients were divided into 2 groups; 16 patients in the obstructive HCM group and the other 16 patients in the non-obstructive HCM group. Among the 16 patients with non-obstructive HCM, there were 6 patients with asymmetric septal hypertrophy(septal HCM), 7 patients with apical hypertrophy (apical HCM), 3 patients with symmetric (concentric) hypertrophy (symmetric or concentric HCM). 3) The cardinal clinical symptoms were dyspnea (71.9%), chest pain (59.5%), palpitation(37.5%) and syncope (12.5%). There were no significant difference in the frequency of symptoms according to the patterns of LCH. 4) On chest X-ray examination, the enlargement of cardiac silhoutte (C/T ratiok≥0.55) was observed in 32% of the cases. There wedre 4 patients with C/T ratio ≥0.6, and all had obstructive HCM. 5) In conventional 12 leads electrocardiograms, abnormal electrocardiographic findings were obtained in 94% of the cases. Among them repolarization abnormalities and left ventricular hypertrophy were most common, occuring in 80.6% and 64.5%, respectively. This was followed by abnormal Q waves (37.5%), atrial fibrillation (29.0%) and giant T wave inversion (29.0%). Giant T wave inversion was significantly more common in patients with apical HCM than in any other patients. 6) On the M-mode echocardiograms, the ratio of left ventricular septal thickness to left ventricular posterior wall thickness (IVS/LVPW) was 1.58±0.36 in obstructive HCM, 1.55±0.08 in septal HCM, 1.05±0.14 in apical HCM, and 1.13±0.08 in symmetric HCM. 7) On the 2-dimensional echocardiograms, the ventricular septum and anterolateral free wall were significantly thicker compared to left ventricular posterior wall in patients with obstructive and septal HCM (p<0.001, p<0.01 respectively). The apical wall was significantly thicker compared to the other regions in patients with apical HCM. 8) Mital regurgitation was detected by Doppler echocardiography in 13 (40.6%) of the total 32 cases of HCM and especially in 11 (68.8%) of the 16 cases with obstructive HCM. 9) Continuous wave Doppler echocardiography of left ventricular outflow tract was performed in 10 patients with obstructive HCM and revealed a mean peak pressure gradient of 50.1±39.9mmHg (13~130mmHg) between the left ventricular (LV) mid cavity and the LV outflow tract. Conclusion: Clinical features are very similar in every pattterns of LVH. But the above results suggested that depending on the extent and distribution of LVH, the functional and morphologic features of HCM may differ considerably. It is still questionable whether identifiable patterns of hypertrophy are of clinical significance.

각종 간질환에 (肝疾患) 있어서 r - GTP 와 SGOT , SGPT 의 활성에 관한 연구

김세종(Sei Jong Kim),유종선(Jong Sun Rew),양동희(Dong Hi Yang),장건성(Kun Sung Jang),박종춘(Jong Chun Park),이태희(Tae Hi Lee) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1

N/A Of the many hepatic enzymes, only a few are generally used for diagnosis of liver disease. Alkaline phosphatase and aminotransferases are example of two differnet groups of enzymes providing information about pathologic conditions. Aminotransferase reflects hepatic cellular injury with sorbital dehydrogenase and 5-lactic dehydrogenase. Alkaline phosphatase refrects cholestasis and its activity can easily be corrected with that of other enzymes like leucine- aminopepeptidase and 5-nucleotidase. Enzymes indicating alterations of the liver, but not belonging to one of those groups mentioned, include gamma-glutamyl transpeptidase(r-GTP), which was introduced as a test of liver function by Polish authors to indicate chronic hepatitis. A special feature of this enzyme is its increasement with prolonged intake of some drugs or alcohol. This enzyme has been used for differentiating viral hepatitis from obstructive jaundice mainly correlating SGOT or SGPT with r-GTP. Later, r-GTP was not only recommended as an indicator of minor alterations of the liver but also it was introduced as a most sensitive test for alcoholic hepatic cellular injury. The SGOT/SGPT ratio is used as an indicator of minor viral hepatitis and alcoholic induced liver injury. It should be due to the different location in the hepatocyte of the enzyme, as SGPT is present free at cytosol, whereas SGOT is demonstrable at mitochondria and cytosol in hepatocyte. r-GTP in the liver is found in hepatocyte and small bile ductules. The enzyme can be detect by enzyme histochemical methods in hepatocyte and by cytochemical techniques bound to membranes and microsomes. So the observations of SGOT/SGPT, SGOT/r-GTP and r-GTP/SGPT in various hepatic diseases concurrently might be helpful for making the differential diagnosis of the hepatic diseases. So we have observed the ratios of the enzyme activities, SGOT/SGPT, SGOT/r-GTP and r-GTP/SGPT in 20 cases of control group and 130 cases of various hepatic diseases group (Male 107, Female 42), which is including 25 cases of acute viral hepatitis(A.V.H.: Male )9, Female 8 ), 17 cases of chronic active hepatitis(C.A.H.: Male 9, Female 8.), )14cases of chronic persistent hepatitis(C.P.H.: Male 10, Female 4), 14 cases of liver cirrhosis(Male 34, Female 6), 20 cases of primary hepatocellular carcinoma(Male 16, Female 4. ), 8 cases of liver abscess(Male 4, Female 4,) and 12 cases of gall stone(Male 5, Female,7) The results were as follows: 1) In normal control group, the SGOT/SGPT is l.76+- 0.44, SGOT/r-GTP 1.20+-0.67 and r-GTP/SGPT 1, 931+-l. 14 The activity of alkaline phosphatase is 2.6+-0.6 Bessey-Lowry unit 2) In A.V.H. group, the SGOT/SGPT is 0. 78+-0.46, SGOT/r-GTP 3. 46+-2.36 and r-GTP/ SGPT 0.47+-0.91. The ratio af the SGOT/SGPT and r-GPT/SGPT are decreased significantly than the nor mal(p(0.005, p(0.005), but the SGOT/r-GTP is increased significantly, 2.5 times than the normal(p(0.005) It were helpful for differentiating A.V.H. for the other hepatic diseases 3) In C.A.H. group, the SGOT/SGPT is 0. 7+-0.35, SGOT/r-GPT is 1. 63+-1.23 and r-GTP/ SGPT is l.76+-1.38. The each ratio of SGOT/r-GTP and SGPT/SGPT is slightly increased and decreased than the normal(p=0.10, p<0.05) The SGOT/SGPT ratio was markedly decreased. It was helpful for the differentiation of the C.A.H. from the other hepatic diseases. In cirrhosis of liver group, the SGOT/SGPT is 2.05+0.88, SGOT/r-GTP is 1.27+-1.59 and r-GTP/SGPT is 2.97+-2.48. All of the ratios were increased slightly with mild elevation of the alkaline phosphatase activity. It svas also helpful for differential diagnosis of the liver diseases. 5) In primary hepatocellular carcinoma, The SGOT/SGPT is 1.82+-0.97, SGOT/r-GTP is 0.49+-0.29 and r-GTP/SGPT is 5.02+-3.80,The alkaline phosphatase activity was elevated over 2.5 times than the normal as 7.2+-5.2 Bessey-Lowry unit. With the marked elevation of r-GTP/SGPT ratio and alkaline phosphatase activity, the markedly decreased ratio of SGOT/r-GTP were

승모판 협착증에서 치료 방법에 따른 임상 및 심초음파 소견의 변화

조인종(In Jong Cho),김원(Woen Kim),김계훈(Kye Hun Kim),강경태(Kyung Tae Kang),안영근(Young Keun Ahn),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang),안병희(Byoung Hee Ahn),김상형(Sang Hyu 대한내과학회 2001 대한내과학회지 Vol.60 No.6

N/A Background : Although rheumatic mitral stenosis is still a prevalent and clinically significant valvular heart disease in Korea, the natural history of rheumatic mitral stenosis has not been clearly determined yet. The present study aimed to evaluate the clinical and echocardiographic changes in patients with rheumatic mitral stenosis according to different therapeutic modalities. Methods : A total of 91 patients (66 women; mean age, 50.9±12 years) with dominant rheumatic mitral stenosis and mitral valve area of less than 1.5 cm2 who were followed for more than 3 years (mean: 5.1 years) were included in this study. The subjects were divided into 3 groups according to the therapeutic modalities for mitral stenosis (A: medical therapy (n=31), B: percutaneous mitral valvuloplasty (n=30), C: mitral valve replacement (n=30)). Clinical and echocardiographic follow-up was performed before and immediately after therapeutic intervention such as percutaneous mitral valvuloplasty (PMV) and mitral valve replacement (MVR) and every year thereafter. Clinical symptoms and echocardiographic findings were compared between 3 groups. Results : The patients of group B consisted of less females and more younger (p=NS). Clinical symptom of dyspnea was more severe in group B and C initially (A: 1.8±0.8, B: 2.5±0.8, C: 2.9±0.7; A vs. B, A vs. C, p<0.05) but more improved in group B and C (A: 1.6±0.5, B: 1.3±1.0, C: 1.6±0.5; A vs B, A vs. C, p<0.05) during the follow-up. The prevalence of atrial fibrillation did not change significantly during follow-up. Mitral valve area decreased significantly in A group from 1.1±0.4 to 0.9±0.3 cm2 (p<0.05), but, no significant change was observed in group B and C. No significant changes were observed in the left ventricular end-diastolic, end-systolic dimensions, and ejection fraction during the follow-up period. No clinically significant aggravations of associated valvular

뇌 결핵종 1 예

김세종 ( Sei Jong Kim ),유주용 ( Joo Yong Yoo ),이진형 ( Chin Hyung Lee ),박종춘 ( Jong Chun Park ),정희성 ( Hi Sung Jung ) 대한내과학회 1982 대한내과학회지 Vol.25 No.9