http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
강인숙,Wook Bum Pyun 대한심장학회 2016 Korean Circulation Journal Vol.46 No.6
We report the case of a middle aged woman who was previously diagnosed with hypertension. She had been drinking a kelp concentrate solution daily for her hypertension instead of taking the prescribed medicine due to her personal beliefs about the kelp solution. As a consequence, she experienced vasospastic angina complicated by myocardial infarction and cardiogenic syncope resulting from iatrogenic thyrotoxicosis. Complementary medicine is widely used by the general population. However, there is still a lack of evidence regarding their efficacy and safety. This case shows that inadequate use of complementary medicine could have no effect and may even be harmful. In patients with chronic diseases such as hypertension, self-care in the form of life style modification, home blood pressure monitoring and medial adherence are important for disease management.
( In Sook Kang ),( Wook Bum Pyun ),( Gil Ja Shin ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.1
Background/Aims: The CHADS2 score, used to predict the risk of ischemic stroke in atrial fibrillation (AF) patients, has been reported recently to predict ischemic stroke in patients with coronary heart disease, regardless of the presence of AF. However, little data are available regarding the relationship between the CHADS2 score and cardiovascular outcomes. Methods: This was a retrospective study on 104 patients admitted for acute coronary syndrome (ACS) who underwent coronary angiography, carotid ultrasound, and transthoracic echocardiography. Results: The mean age of the subjects was 60.1 ± 12.6 years. The CHADS2 score was as follows: 0 in 46 patients (44.2%), 1 in 31 (29.8%), 2 in 18 (17.3%), and ≥ 3 in 9 patients (8.7%). The left atrial volume index (LAVi) showed a positive correlation with the CHADS2 score (20.8 ± 5.9 for 0; 23.2 ± 6.7 for 1; 26.6 ± 10.8 for 2; and 30.3 ± 8.3 mL/m2 for ≥3; p = 0.001). The average carotid total plaque area was significantly increased with CHADS2 scores ≥ 2 (4.97 ± 7.17 mm2 vs. 15.52 ± 14.61 mm2; p = 0.002). Eight patients experienced cardiovascular or cerebrovascular (CCV) events during a mean evaluation period of 662 days. A CHADS2 score ≥ 3 was related to an increase in the risk of CCV events (hazard ratio, 14.31; 95% confidence interval, 3.53 to 58.06). Furthermore, LAVi and the severity of coronary artery obstructive disease were also associated with an increased risk of CCV events. Conclusions: The CHADS2 score may be a useful prognostic tool for predicting CCV events in ACS patients with documented coronary artery disease.
A case of a single coronary artery originating from the right coronary sinus
( So Yoon Yoon ),( Wook Bum Pyun ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
A single coronary artery is a rare congenital anormaly. Especially the absence of the left coronary artery with the origin of the left coronary system arising from the distal right coronary artery is an extremely unusual instance. We presented the case of R-1 type single coronary artery in a patient with stable angina. The coronary angiography showed the presence of a single coronary artery arising from the right coronary sinus, then three-dimensional heart CT was performed, we could confirm a solitary coronary ostium with left coronary artery system originating from it, and their accurate course and distribution. Visualization of coronary artery anormaly through radiographic imaging methods will be helpful to find out ischemia mechanism accessment for single coronary artery patients. Patient with single coronary artery occasionally developed myocardial ischemia due to atherosclerotic coronary artery disease or vascular compression that aberrant branch is compressed between the great vessels. Especially occlusion of dominant large artery can cause patient to have fetal myocardial ischemia and sudden cardiac death, so detection of coronary artery anomaly and follow up study is important. As a result, it is meaningful that we find coronary artery origin and course by using CT scan. Heart CT may be more useful for understanding of the ischemia mechanism and moreover it has advantage of noninvasive method. Therefore, we expect that it will be helpful to manage elective PCI or surgery when ischemia occurred again in this case.