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Dipyridamole Thallium - 201 심근주사
우연미(Youn Mee Woo),백영건(Young Keun Baik),김은식(Eun Sik Kim),이홍순(Hong Soon Lee),김종순(Jong Soon Kim),이학중(Hak Choong Lee),정준기(June Key Chung) 대한내과학회 1986 대한내과학회지 Vol.31 No.1
N/A Exercise Tl-20I myocardial imaging is an important technique in the evaluation of coronary disease. However, a standard maximal exercise stress test is not always possible for various reasons, including therapy with β-blockers, unstable anginal symptoms, poor physical condition and peripheral vascular disease. Previous studies have shown that dipyridamole could lead to coronary vasodilatation in nomral vessels, but fixed coronary stenoses prevented or attenuated this response. The coronary flow response to dipyridamole was similar to that during exercise. So we performed dipyridamole T1-201 myocardial scintigraphy on 21 subjects who have angina or myocardial infarction instead of exercise Tl- 201 scan which bas several disadvantages in actual clinical use. The results obtained are as follows: 1) During dipyridamole infusion the mean systolic and diastolic blood pressure decreased from 126±4.3/75±4.9 to 119±4.2/77±3.0mmHg. Immediately after tilt up, both pressure decreased more dramatically to 115±4.3/76±2.8mmHg, and then slowly returned to baseline values. The heart rate increased from 74±2.4/min to 82±2.7/ min during dipyridamole infusion and 86±2.4/ min after tilting up, Double product also increased from 93±4.0 to 99±4.5. 2) Adverse effects of dipyridamole were noted in 10(47.6%) of the subjects, but in 8 of these, the symptoms were mild in severity and subsided spontaneously. 3) Tl-201 scintigraphic findings in 14 patients with angina were as follows; abnormal redistribution was seen in 7cases, perfusion defect with abnormalredistribution in 3 cases and perfusiondefect in 1 case. 4) Tl-201 scintigraphic findings in 6 patients with AMI were as follows; perfusion defect was seen in all cases and in 3 cases of them abnormal redistribution was accompanied. Myocardial portions exhibiting perfusion defect were comparatively consistent with the area of infarction indicated by ECC. 5) In 8 patients who had undergone coronary angiography, perfusion defect or abnormal redistribution were noted in 12 segments and these segments were consistent with coronary artery narrowing of more than 50%. In conclusion, serial tballium-201 myocardial imaging after dipyridamole is a useful test for coronary artery disease that dose not require exercise or patient effort.
재사용 투석막의 투석효과 저산소혈증 및 백혈구 감소에 대한 고찰
김성봉(Sung Bong Kim),백영건(Young Keun Baik),노태영(Tae Young Nho),이홍순(Hong Soon Lee),유병희(Byung Hee Yoo),김열자(Yul Ja Kim),이학중(Hak Choong Lee) 대한내과학회 1986 대한내과학회지 Vol.30 No.6
N/A Dialyzer reuse is an increasingly common practice in the management of end stage renal disease patients on maintenance hemodialysis, but the validity of this form of treatment still remains in question. The performance of dialyzer reuse was studied prospectively in 30 chronic hemodialysis patients using new(n=14) and reused(n=16) membranes. Clearance of solutes, hypoxemia and leukopenia were examined before, during and after hemodialysis. The results were summarized as follows: 1) Membrane clearance of small solutes (urea, creatinine) was maintained over dialyzer reuse. 2) Arterial oxygen tension was significantly lower at 30 minutes after hemodialysis in both new and reused cuprammonium dialyzer, but there was no significant difference between two groups. 3) Leukopenia was noted at 30 minutes after hemodialysis in both new and reused cuprammonium dialyzer group but change in WBC count was significantly lower in reused dialyzer group, 4) Transdialyzer changes in pH, hematocrit and bicarbonate at completion of hemodialysis were similar in both groups.