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.

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

관동맥질환의 진단에 있어서 Exercise Treadmill Score 의 의의

서정평(Jeong Pyeong Seo),조인종(In Jong Cho),류문희(Mun Hee Rheu),박종수(Jong Soo Park),이명곤(Myung Kon Lee),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang) 대한내과학회 1997 대한내과학회지 Vol.52 No.3

N/A Objectives: The treadmill exercise eletrocardiography(ECG) is the most commonly used non- invasive method in the evaluation of patients with chest pain. But the accuracy of treadmill exercise ECG in detecting the coronary artery disease(CAD) is still controversial. To improve the accuracy of the treadmill exercise test, exercise treadmill score(ETS) based on exercise duration, degree of ST deviation, and treadmill anginal index during treadmill exercise ECG has been used. Methods: The authors calculated ETS by simple equation(total exercise duration-5×maximal ST- segment deviation during or after exercise-4×treadmill angina index) and analyzed coronary angiograms of 173 patients(mean age '55.5±8.7, male: female=2.7: 1) who underwent treadmill exercise ECG and coronary angiography in Chonnam University Hospital from January, 1990 through March, 1993. Results. 1) The studied subjects were subdivided into 3groups according to ETS. Group A(high risk, ETS≤11) were composed of 15cases(mean age 60.2±7.4, male: female = 1.2: 1), group B(moderate risk, 5>ETS≥11) 71cases(mean age 60.2±7.4, male: female=3.3:1), group C(low risk, ETS>5) 87cases(mean age 54.8±9.2, male-female =2.5:1). Clinical diagnoses of the studiedsubjects were 63stable angina, 61unstable angina, 3acute myocardial infarction, and 46 old myocardial infarction. On coronary angiographic findings, 61patients had single vessel disesase, 23patients had two vessel disease and 13patients had three vessel disease. 2) The sensitivity of the treadmill exercise ECG in diagnosing coronary artery disease was 88% and the specificity was 46%. 3) One hundred percent of group A patients had CAD and 54% of them had multivessel disease, 75% of group B had CAD and 27% of them had multivessel disease, and 33% of group C had CAD and 10% of them had multivessel disease. 4) There were no significant differences in the siite of stenotic lesion and degree of stenosis according to ETS in the patients with single vessel disease. 5) There were no significant differences in left ventricular ejection fraction and left ventricular end-diastolic pressure among three groups. Conclusion: Exercise treadmill score is useful in predicting the presence and severity of CAD and that low ETS less than -11 may be an indicator of multivessel coronary disease.

Fosinopril(Monopril^(�))의 강압 효과에 관한 임상적 연구

강정채,조인종,류문회,서정평,길광채,박주형,정명호,조정관,박종춘 최신의학사 1995 最新醫學 Vol.38 No.2

초음파진단에 의한 단순 신낭종의 유병율, 그리고 연령 및 고혈압과의 연관성에 관한 연구

박종욱,최기철,이성철,고영일,강영준,조인종,남미영,류도현,강호철 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.6

Simple renal cyst is the most common space- occupying lesion of kidney in adults. However, there were a few systematic Korean reports for the prevalence of simple renal cysts. Our purpose was to estimate the prevalence of simple renal cysts using ultrasonography, and to determine the relations to age and hypertension. The subjects were 504 volunteers(aged over 29 years) of the persons who were enrolled a health check-up program of Naju Hospital, Naju, Korea. Number of male in 504 persons was 334(66.3%) and female 170(33.7%). Mean age was 55 years(range; 30-86). The results were as follows: 1) One or more renal cysts were found in 50 individuals of 504 persons aged over 29 years(9.9%). In 331 persons aged over 49 years, the prevalence of simple renal cysts was 12.1%. The prevalence was significantly increased with age(P<0.001), but the difference between male(9.6%) and female(10.6%) was insignificant. 2) Mean value of cyst diameter was 23mm(5-69 mm) and was not correlated with age. However, the cyst diameter was significantly higher in female than in male, 32.4mm vs 18.0mm(P<0.001). Total number of cysts per person tended to increase with age(P<0.001). 3) The correlation between prevalence of simple renal cysts and blood pressure was statistically insignificant. However, the prevalence of hypertension in persons with cysts was higher than in persons with no cyst(27.9% vs 15.3%, P<0.05). Cyst diameter was not correlated with blood pressure. 4)Urinalysis in persons with cysts, showed microscopic hematuria in 47.4% and proteinuria in 26.3 %, however, grade of microscopic hematuria and proteinuria were not correlated with cyst diameter. The concentrations of blood urea nitrogen, serum creatinine, hemoglobin and hematocrit were not affected by presence or absence of simple renal cysts. By comparison with the recent foreign reports, the prevalence of simple renal cysts in Korean was similar to those in foreigners. Our study ascertained that simple renal cysts are age-dependent and total number of cysts per person also increases with age. In most of persons with simple renal cysts, the renal function is not affected and the related symptoms are trivial. However, we suggested that simple renal cysts may cause hypertension. To elucidate the correlation between simple renal cyst and hypertension, further studies are needed.