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뇌경색증과 심근경색증 환자에서 죽상동맥경화 위험요인의 비교연구
조길우(Keal Woo Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang) 대한내과학회 1991 대한내과학회지 Vol.41 No.4
N/A Thrombotic cerebral infarction (CI) and myocardial infarction (MI) have been considered reliable indicatiors for the presence of atherosclerosis because they are usually caused by atherosclerosis. Atherogenesis and clinical manifestation of atherosclerosis are influenced by several risk factors for atherosclerosis, which have been studied intensively and extensively. However, it is uncertain why atherosclerosis manifests clinically as a variety of disease entities different in their involved anatomic sties such as cerebrum and mycardium in cerebral infarction and myocardial infarction, respectively. This study is aimed at evaluating the relative role of each atherosclerosis risk factor on the clinical manifestation of atherosclerosis as thrombotic cerebral infarction or myocardial infarction. The risk factors for atherosclerosis were examined and compared in thrombotic cerebral infarction (n=154), myocardial infarction (n=135), and normal subjects (n=98) The risk factors showing mare singificantly high values in CI and MI than in the controls were alcohol drinking (p<0.05, p<0.001), smoking (p<0.01, p<0.001), systolic and diadstolie blood pressures(p<0.001, p<0. 001), total-cholesterol(p<0.001, p<0.01), LDL- cholesterol(p<0.01, p<0.01), and ratio of total- cholesterol to HDL-cholesterol(p<0.01, p<0.01). Mean age and triglyceride were higher only in CI than in the control(p<0.05, p<0.01). No difference was found in sex distribution and HDL-cholersterol. 2) Mean age(p < 0.05), systolic and diastolic blood C T prssures(p <0.001), ECG-LVH(p <0.001), triglyceride (p < 0.05), and the proportions of the sedentary worker and female were significantly higher in IC than MI. 3) Smokers, hard workers, and males were more frequently observed in MI than CI. 4) Discrimination accuracies of the selected risk factors such as age(over 65year), sex(male), smoking, diabetes mellitus, hypertension, ECG-LVH, high triglyceride, high LDL-cholesterol, and high total- cholesterol to HDL-cholesterol ratio were 67.6% for CI and 77.9% for MI, and 72.7% for all. 5) Multivariated logistic analysis revealed that hypertension, smoking, and ECG-LVH were the independent risk foactors having a significantly different role in CI and MI, and hypertension and ECG-LVH were more colsely related to Cl than MI (β=0.9348, 0.5698, p=0.001, 0.002, respectively) and smoking to MI than CI (p=0.5800, p=0.001). These results show that some risk factors for atherosclerosis have a different role in the clincial manifestation of atherosclerosis.
최성규,김미정,최기철,김세종,유종선,이숭,윤종만,조길우 대한소화기내시경학회 1990 Clinical Endoscopy Vol.10 No.2
Herpetic esophagitis is a rare diaease and is usually deecribed in autopsied reports. Most of the cases are reported in an immunocompromised host. We report a patient with herpetic esophagitis, following renal transplantation and longstanding steroid therapy due to rejectioh phenomenon. The patient complained of dysphagia and odynophagia. Endoscopic finding revealed multiple scattered or confluent erosions and hemorrhagie tendency, diffusely scattered linear or confluent shallow ulcer covered by a whitish exudate on a elevated margin. Microscopic finding revealed uicerated squamous epithelium of ballooning degeneration, ground glass nuclei, multinuclear giant cell and intranuclear inclusion body. The patient responded dramatically to intravenous acyclovir and leading to syniptomatic and endoscopic improvement.