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S-224 : The Early Repolarization Pattern EKG in patients with Acute Coronary Syndrome: IVUS study
( Cheol Won Hyeon ),( Young Hwan Choi ),( Jun Hwan Cho ),( Kyung Joon Kim ),( Sharath Kumar ),( Seong Hyeop Hyeon ),( Jee Eun Kwon ),( Eun Young Kim ),( Seung Yong Shin ),( Wang Soo Lee ),( Kwang Je L 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Background: Early repolarization pattern (ERP) has been considered as benign condition in great majority of cases. Recently, the presence of ERP can be an index of poor prognosis in various heart diseases. Method: We analyzed 59 consecutive patients with acute coronary syndrome underwent primary coronary intervention and virtual histology intravascular ultrasonography (VH-IVUS). Thin cap fibroatheroma (TCFA) was defined as necrotic core (NC) >10% of plaque area with a plaque burden of >40% and NC in contact with the lumen for >3 image slices. Positive remodeling was a remodeling index (lesion/reference vessel area) >1.05. The diagnostic criterion of ERP was defined when there is J-point elevation of ≥0.1 mV in two adjacent leads. Results: The presence of ERP was observed in 27 patients (45.8%). Although there was no significant difference in lesion length and remodeling index at minimal lumen area between the 2 groups, reference diameter and minimal luminal area were significantly smaller in patients with ERP (p=0.033, p=0.048, respectively). The lesion characteristics of patients with ERP demonstrated (1) more necrotic core (p<0.001), (2) lesser calcium component (p=0.028). Although the incidence of plaque rupture failed to demonstrate significant differences, TCFA was more frequently observed in patients with ERP (p=0.038). Conclusion: We report, for the first time, that the ERP in ACS might distinguish patients with more vulnerable plaque.
S-211 : Biventricular tachycardia induced by herbal medicine containing ephedra sinica
( Cheol Won Hyeon ),( Young Hwan Choi ),( Jun Hwan Cho ),( Kyung Joon Kim ),( Sharath Kumar ),( Seong Hyeop Hyeon ),( Jee Eun Kwon ),( Eun Young Kim ),( Seung Yong Shin ),( Wang Soo Lee ),( Kwang Je L 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Ephedra is a potent sympathomimetic agent with cardiovascular effects including tachyardia, positive inotropy, arterial vasoconstriction and hypertension. We report 1 case of biventricular tachycardia after taking herbal medicine containing ephedra sinica. A 77-year-old male with a 30-year-history of COPD prsented with acute onset chest discomfort and dyspnea. He was precribed herbal medicines containing ephedra sinica for abdominal discomfort 2 days ago. Initial electrocardiography (ECG, Fig. A) showed hemodynamically unstable monomorphic ventricular tachycardia with RBBB pattern in percordial leads, which was terminated by electrical cardioversion. ECG after cardioversion, atrial fibrillation was observed (Fig. B). About 1 hour later, hemodynamically unstable fast monomorphic ventricular tachycardia with LBBB pattern was spontaneously induced (Fig. C). Because of hemodynamic instability, additional electrical cardioversion was performed and sinus rhythm was restored (Fig.D). Electrolytes and arterial blood gas analyses were normal. To rule out structural heart disease, echocardiography was done and it revealed normal ejection fraction and no significant abnormalities. Coronary angiography showed a 80% stenosis in the proximal circumflex coronary artery and a 70% stenosis in the posterior descending artery. Percutanous coronary intervention was done to left circumflex artery. The patient was discharged on clopidogrel, warfarin, ACE inhibitor, beta-blocker, statin. His follow up was uneventful.
Jeong, Min-Gyo,Ahn, Seong-Hyeop,Kim, Ji-Hong,Bae, Sang-Hyeon,Lee, Wang-Sang IEEE 2018 IEEE transactions on microwave theory and techniqu Vol.66 No.7
<P>In this paper, a near-field ultrahigh-frequency radio frequency identification (RFID) system, which has cm-level 2-D positioning precision, is proposed. The system consists of a grid-shaped microstrip traveling wave antenna (TWA) and four-port switched differential feeding networks. To selectively form tag-read sections, opposite directional currents (ODCs) are used. To introduce a microstrip TWA for cm-level 2-D positioning, the influence of <TEX>$H_{z}$</TEX> fields in microstrip TWAs is theoretically analyzed. In addition, to utilize field reinforcement and achieve precise 2-D localization, a grid-shaped microstrip TWA with four-port selective switched differential feeding networks is proposed and investigated. The proposed antenna and feeding network were fabricated on FR-4 substrates. The simulated and measured results demonstrate that precise 2-D tag positioning is achieved using the proposed system utilizing ODC along two selected adjacent microstrip lines in the TWA.</P>
Five-Year Clinical Outcomes of Copeptin in patient with ST elevation Acute Myocardial I nfarction
( Moon Ki Jung ),( Jee Eun Kwon ),( Seong Hyeop Hyeon ),( Young Kim ),( Hoyoun Won ),( Seung Yong Shin ),( Wang Soo Lee ),( Kwang Je Lee ),( Sang Wook Kim ),( Tae Ho Kim ),( Chee Jeong Kim ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
We collected 111 coronary arterial blood samples at the coronary artery ostium during primary percutaneous coronary intervention(PCI) in STEMI and assessed the clinical outcomes depending on Copeptin. We evaluated cardiac biomarkers[CK, CK-MB, troponin-I, CRP] and additionally measured the recently introduced biomarkers [Copeptin(C-terminal Provasopressin), N-terminal pro-B-type natriuretic peptide(NT-proBNP)]. Intravascular ultrasound (IVUS) imaging was performed before and after stent implantation during primary PCI. Results: Pt age was 59±12 yrs and 86% were male. STEMI pts had a higher copeptin level than normal pts(243.31±169.68 pmol/L in vs 18.14±6.17 pmol/L, p=0.010). NT-proBNP was not correlated with copeptin (r=0.183, p=0.085). IVUS analysis of the culprit lesion showed the ruptured plaque in 47%(40/86 pts). VH-TCFA was identified in 36 patients, however, the mean copeptin level was similar compared to non-VH-TCFA pts(292.62±199.77 pmol/L vs 240.78±189.46 pmol/L, p=0.328). In hospital death occurred in 7 pts who showed higher Copeptin level than survivors. All were due to cardiogenic shock after primary PCI. The level of Copeptin was higher in-hospital death group than survivor(382.7±263 pmol/L vs. 211.3±127 pmol/L, p=0.0001). The clinical outcomes was worse in pts with Copeptin ≥300 pmol/L during five years follow up (p=0.046). Conclusions: Stress stimulated Copeptin might be one of the prognostic marker in long-term outcomes of STEMI. Thepotential role of Copeptin deserves to confirm with a further study.