이면성 심초음파도에 의한 관상동맥 우회로술후 좌심실 국소 벽운동의 변화

원수연(Soo Yeon Won),전일문(Il Mun Jeon),박명선(Myoung Seon Park),장명규(Myoung Kyu Jang),유재규(Jae Kyu Ryu),정진원(Jin Won Jeong),박양규(Yang Kyu Park),박옥규(Ock Kyu Park),최종범(Jong Bum Choi) 대한내과학회 1993 대한내과학회지 Vol.45 No.6

N/A Objectives: Studies on the effect of Coronary Artery bypass Graft Surgery (CABG) on segmental left ventricular wall motion have yield conflicting results. So we assessed changes of segmental left ventricular wall motion in patients with coronary artery disease after CABG and advantage of 2dimensional echocardiography on evaluating its effectiveness. Methods: 20patients with coronary artery disease (12unstable angina pectoris, 8 acute myocardial infarction) were studied with 2-dimensional echocardiography before and early 8.3±3.3 (mean±SD) and late 204.5±105.9 days after CABG. The changes in segmental wall motion were assessed quantitatively by assigning a segmental wall motion score recommended by ASE (1: normal, 2: hypokinesia 3: akinesia, 4: dyskinesia, 5: aneurysm) to each of 16echocardiographically defined segments by 45-degree rotating apical 4-plane views (8 in basal, 8 in apical). Results: 1) The mean left ventricular segmental wall motion score did not change significantly (1, 10±0.37, l.25±0.47, 1.12±0.40; befror, early and late after CABG respectively). 2) There was a significant change in septal wall motion at early postoperative study [37 (46%) of the 80septal segments; 1.14±0.41, 1.59±0.59(p<0.001): before and early after CABG respectively], and the worsening segments were nearly normalized at late postoperative study [24(92%) of 26segments]. 3) The segments with normal motion preoperatively remained normal late postoperatively [169(99%) of 171normal segments preoperatively]. 4) Most of the preoperative abnormal segments [23(96%) of 24segments] were in patients with acute MI and a half of them (11segments) were normalized at late postoperative study. 5) While the anterior or anteroseptal preoperative abnormal segments were usually improved postoperatively, the posterior or inferior abnormal segments were not changed significantly. Conclusion: A part of the abnormal segmental left ventricular wall motion in coronary artery disease can be improved after CABG and 2-dimensional echocardiography may be beneficial to assessing not only the changes of segmental left ventricular wall motion motion quantitatively but also the effectiveness of CABG.

건강한 한국인에서의 배변 조영술 소견

유광현(Kwnag Hwon You),김태현(Tae Hyeon Kim),나용호(Yong Ho Nah),장명규(Myoung Kyu Jang),김형언(Hyeong Eon Kim),진경민(Kyung Min) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3

N/A Background/Aims: Defecography is a useful diagnostic method that demonstrates the physiolo- gical, dynamic and anatomic features involved when rectum evacuates semisolid barium contrast media. In Korea, there has recently been increased interest in the use of defecography for the investigation of problems of defecation and pelvic floor dysfunction. Interpretations of abnormal findings, however, are questionable because of the absence of suitable control subjects to define the state of normality. The present study was carried out to determine the normal range of defecographic findings encountered in healthy Koreans. Methods: Fifty healthy volunteers(men:25, women:25) (mean age: 32.6yrs) underwent defecographic examinations. Results: The mean resting centroid anorectal angle was 1l9, decreasing to 108 during squeeze and increasing to l39 on defecation. The mean perineal floor position in the resting state was 6 cm, descending 3 cm in men and 3.5 cm in women during defecation, taking account of the magnification of the X-ray film. All subjects had a closed anal canal in the resting state and the anal canal was widely opened to 2.5 cm during defecation. Loss of the impression of puborectalis sling on the posterior wall of the distal rectum during straining was observed in the all subjects. Conclusions: The anorectal angle increases by 20 on straining and decreases by lO on squeeze from 120 at rest, The anorectal junction lies less than 6 cm below the pubococcygeal line and the descent of pelvic floor during defecation not more than 3 cm in men and 3.5 cm in women below the resting position, wide opening of anal canal(2.5 cm) on evacuation, and loss of impression of puborectalis sling on the posterior wall of distal rectum during defecation. Rectoceles or rectal intussusception may be present in the asymptomatic healthy individuals. But the rectocele is small (less than 4cm in length) and does not have barium trapping. The intussuscepting rectal folds are not thick(less than 0.7 cm in width) and short(less than 4.5 cm in length). (Korean J Gastroenterol 1995;27:309 - 316)

3대에 걸쳐 발생한 유전성 구상 적혈구증

장명규,유재규,박명선,이용구,윤귀현,조지현,문영회 大韓血液學會 1994 大韓血液學會誌 Vol.29 No.1

건강한 한국인에서의 배변 조영술 소견

나용호,장명규,김태현,김형언,유광현,진경민 大韓消化器病學會 1995 大韓消化器病學會誌 Vol.27 No.3

불완전 세관형의 식도 중복증 1 예

김학철,송승렬,장명규,강정성,원수연,전일문 대한내과학회 1994 대한내과학회지 Vol.46 No.2

Esophageal duplication is rare congenital malformation of the gastrointestinal tract, and it may occur at any level in the esophagus, but more frequently in the lower third. There are 2 types of it, cystic and tubular, the former is more common than the latter, and some- times its also classified as communicating type or non-communicating type whether the accessory lumen has opening to the esophagus or the adjacent structure or not. The clinical symptoms are variable according to the location, the type of esophageal dulication. We experienced an asymtomatic case considered as partial tubular duplication of esophagus that had two longitudinal folds those were not changed during the degluttination and connected the two orifices in the lower esophagus. So we report one case of partial tubular duplication of esophagus with review of the literatures.

영양실조성 당뇨병 2 예

조정구,박명선,유광현,장명규,손성식,송승렬 대한내과학회 1994 대한내과학회지 Vol.46 No.2

Malnutrition-related diabetes mellitus is a form of diabetes peculiar to developing countries within the tropical belt, which comprises two subgroups, fibrocalculous pancreatic diabetes (FCPD) and protein-deficient pancreatic diabetes (PDPD). FCPD is a form of diabetes secondary to chronic calcific pancreatitis, which is not due to alcohol consumption and tend to affect younger people and characterized by insulin-requiring but ketosis-resistant and coexisting malnutrition or pancreatic duct stone. FCPD is diagnosed by demonstrating calculi and signs of chronic pancreatitis by radiographic or ultra-sound imaging, together with evidence of pancreatic exocrine insufficiency. We recently experienced the two cases of fibrocalculous pancreatic diabetes. MRDM deserves further study not only because it is now recognized as a major form of the disease but also because it may improve our understanding of other forms of diabetes.

원발성 유미 심낭 1 예

박명선,정진원,박양규,최종범,유재규,박옥규,장명규,원수연,전일문 대한내과학회 1994 대한내과학회지 Vol.47 No.1

Chylopericardum is particularly uncommon and usually secondary to intrathoracic operation, chest trauma, primary or metastatic tumors, chronic inflammation and congenital lymphatic anomaly which cause obstruction of the lymphatic drainage. However, primary chylopericardium unrelated to trauma or chylothorax is a rare condition and its etiology remains obscure in most cases. We have experienced a 69-year-old female patient with primary chylopericardium who was treated with repeated pericardiocentesis, pericardiectromy, and thoracic duct ligation. So we report a case of primary chylopericardium with a review of literature.

피부 병변 및 전신임파선증을 동반한 급성 골수성 백혈병 환자 1 예

이용구,송승렬,박명선,유재규,강정성,원수연,전일문,장명규 대한내과학회 1993 대한내과학회지 Vol.45 No.6

We describe a patient with acute myelogenous leukemia who demonstrated striking leukemia infiltration in back and large cervical, axillary and inguinal 1ymphadenopathy, A 62-year-old man had visited to our hospital with complaints of sore throat, cervical lymphadenopathy and multiple nodules on the skin. Skin biopsy specimen showed diffuse dermal, subcutaneous and fat infiltration of abnormal cells that appeared to be leukemic cell in nature. Bone marrow biopsy and aspiration specimen showed findings of acute monocytic leukemia. Treatment was initiated with combination chemotherapy (Thioguanine, Daunorubicin and Cytarabine) and radiation therapy. We report one case of acute monocytic leukemia patient who had multiple leukemia infiltration on the skin and generalzed lymphadenopathy.