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홍정표,최선희,조만종,이성주,박종,김기순,김양옥 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.1
The main purpose of this study is to identify and evaluate the depressive states for the patients with chronic pulmonary tuberculosis. A questionnaire(Self-rating Depression Scale, SDS) survey was performed toward 57 pulmonary tuberculosis patients with initial treatment who started chemotherapy and 53 pulmonary tuberculosis patients with retreatment, admitted to one tuberculosis-centered hospital and two general hospital. Fifty three healthy persons as control group were investigated with the same questionnaire for comparison. The survey was performed from July to August 1996. The results are as follws : 1. The patients had significantly high scores in the depression than control and the patient with retreatment showed significantly high scores in the depression than the patient with initia1treatment(P<0.01). 2. The depressive levels of the patients were associated with duration of admission and the expectancy of recovery (P<0.05). 3. The percentage of the subjects with 40 or more scores tentatively classifiable as psychologically depressed was 67.1% of the total subjects, 48.4% of the control groups, 75.0% of the patient with initial treatment and 84.1% of the patient with retreatment. Because patient with pulmonary tuberculosis with initial treatment showed higher depression scores than normal persons, and patients with retreatment due to failure of initial treatment showed higher depression scores than initial treatment, it is necessary to give attention to depression of the patients during treatment of pulmonary tuberculosis.
이용훈,최선희,심원보,강창원,박무정,정수상,양윤식,조만종,정연재 대한내과학회 1996 대한내과학회지 Vol.51 No.1
Primary tumors of the heart are rare, their morbidity is 0.0017-0.25% at autopsy. About seventy five percent of primary cardiac neoplasms are benign. Atrial myxomas are the most commonly encountered benign cardiac neoplasms. The other benign tumors are fibroma, lipomatous tumor, valvular fibroelastic papilloma, and rhabdomyoma, Malignant neoplasms are about twenty-five percent of primary cardiac neoplasms, and the majority are angiosarcoma and rhabdomyosarcoma. Most cardiac osteosarcomas are clinically mistaken for myxoma because of location in the left atrium. They are extremely rare, larger, tend to infiltrate, and very aggressive neoplasms. Histologically a variety of patterns may be encountered in addition to the osteosarcoma and immunohistochemically cardiac osteosarcomas show similar features as noncardiac osteosarcomas. The overall prognosis of patients with these tumors is dismal. But the role of surgical palliation of these lesions remains valid. Therefore, we believe that early diagnosis of cardiac sarcomas using echocardiography, as well as complete surgical excision, may improve survival. Since we have experienced one case of primary osteosaroma of the left atrium, we report this with related references.
Phenothiazine 에 의해 유발된 Torsades de Pointes 1 예
이상호,최선희,홍정표,심원보,박무정,조만종 대한내과학회 1997 대한내과학회지 Vol.52 No.1
Torsades de pointes (TdP) is a form of polymorphic ventricular tachycardia associated with a prolonged QT interval or increased U wave. It may occur either in the congenital(idiopathic) form or in the aquired form. Although aquired TdP could be found in many clinical settings such as various drugs, bradycardia, or electrolyte imbalance, it is most commonly induced by drugs. The underlying mechanism is though to be the triggered activity arising as a consequence of early afterdepolarization. Phenothiazine has many derivatives that can lead to occur the cardiovascular events including hypo- tension, syncope, tachycardia and various ECG changes. Chloropromazine is a propylamine derivative of phenothiazine. We report a case of TdP occurred after chloropromazine usual dosage.
심원보,김미옥,김형권,강남욱,강창원,오성욱,조만종,최겸 대한내과학회 1995 대한내과학회지 Vol.49 No.6
Myotonic dystrophy is a multisystemic disorder inherited as an autosomal dominant trait. The characteristic clinical features include the presence of myotonia, atrophy of the muscles of the face and numerous nonmuscular manifestations such as cataracts, frontal baldness, gonadal dysfunctions and cardiac abnormalities. We experienced one case of myotonic dystrophy with atrial fibrillation, intraventricular conduction defect and mitral valve prolapse in 36-year-old male who was admitted because of dyspnea, palpitation and cyanosis. We present this case with reviewing literatures.
홍정표,최선희,김형권,강남욱,강창원,이은아,양윤식,오성욱,박무정,조만종,정연재 대한내과학회 1996 대한내과학회지 Vol.50 No.1
Subacute necrotizing lymphadenitis(SNL) is first described in 1972 by Kikuchi and Fujimoto independently, which has benign clinical course with characteristic histologic features. The etiology is unknown but clinical and histological features suggest an infectious agent, which has not been identified. The resemblance of lymph node lesions to those of systemic lupus erythematosus has suggested an autoimmune process. We report a case of a 24-year-old woman who presented with cervical lymphadenopathy, fever, cough and pulmonary lesion in chest x-ray. The histopathological features of the lymph nodes showed typical findings consistent with SNL and the chest lesion was diagnosed as pulmonary tuberculosis by positive sputum AFB smear.
신증후군과 말초 신경증으로 발현된 원발성 전신성 유전분증 1예
이상호,김병준,최선희,이성주,배윤상,양윤식,고영재,이능아,이지혁,조만종 대한신장학회 1997 Kidney Research and Clinical Practice Vol.16 No.3
Primary systemic amyloidosis is a progressive disease that is frequently fatal. Nephrotic syndrome is present in almost one-third, congestive heart failure in one-quarter, and peripheral neuropathy in one-sixth of patients at the time of diagnosis. If heart or renal failure are presented, survival rate is poor. We experienced a case of a 66 year-old fernale patient who had complained lower leg edema and paresthesia of extremities for about 5 rnonths. The laboratory findings were consistent with nephrotic syndrome, but the lower leg edema was non-pitting and the cause of paresthesia was unknown. We perforrned kidney and nerve biopsy and confirmed a case of primary systemic arnyloidosis. In this case, presence of postural hypotension, probable cardiac involvement and relatively long spikes along the outside of the glomerular capillary loops on methenamine silver stain is suggestive of poor prognosis. We can predict chronic renal failure and congestive heart failure in the course of this case. We report a case of primary systemic amyloidosis predominantly presenting nephrotic syndrome and peripheral neuropathy with review of related literatures.