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자가폐동맥판막을 이용한 대동맥근부치환술의 단기 추적관찰 성적
신은석(Eun Sug Shin),홍석근(Suk Keun Hong),황흥곤(Hweung Kon Hwang) 대한내과학회 2001 대한내과학회지 Vol.60 No.4
N/A Background: Ross procedure is the pulmonary valve autograft in the aortic valve disease, and its use trends to increase after introduced by Ross in 1967, firstly. The most import ant point is that it is a permanent valve replacement. It is to be ideal method to the young patient because the graft is a viable tissue to be able to grow, and hemodynamically, most similar to the normal aortic valve, and doesn`t need to do anticoagulation therapy due to not having the thromboembolism, but not popular because it has a lot of technical problem and doesn`t have the long-term follow-up Methods: The patient s were 8 admitted between October 1997 and October 1998, the age from 15 t o 39 ; 6 males and 2 females. The causes of disease were 4 patients of rheumatic disease, 1 of a infective endocarditis with the aortic annular abscess, 1 of recurred severe aortic insufficiency 2 years after replacement. Two patients used the homograft and 6 patients switched a diseased aortic valve with the pulmonary autograft. Results: There were no death and the preoperative dyspnea nearly disappeared (NYHA FC III- IV - > I-II). The diastolic diameter of left ventricle decreased significantly when we compared to the previous echocardiography 1 month after the operation, and we observed the mild aortic valve insufficiency in 3 patients, severe in 4, mild pulmonary valve insufficiency in 4, severe in 1, and mild pulmonary valve stenosis in 4. Conclusion : The operative death rate of Ross procedure in the aortic valve disease was not higher than the artificial valve replacement. Therefore, if we find the appropriate indication of operation, we can expect better results and think that we should have the long- term follow-up furthermore.(Korean J Med 60:368- 372, 2001)
Child-Pugh 분류 A군 간경화에 수반된 간폐증후군
김정선 ( Jung Sun Kim ),김창환 ( Chang Hwan Kim ),김계수 ( Gye Su Kim ),임달수 ( Dal Soo Lim ),황흥곤 ( Hweung Kon Hwang ),노영무 ( Young Moo Ro ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.1
Hepatopulmonary syndrome (HPS) is characterized by a defect in arterial oxygenation that`s induced by pulmonary vascular dilatation in the setting of liver disease. Some studies have shown the relationship between the presence of the HPS and the severity of liver disease, but there are only rare cases of HPS inpatient with Child-Pugh class A liver cirrhosis. We report here on a case of a 58 years-old male who suffered from progressive dyspnea for the previous few years. He was diagnosed with alcoholic liver cirrhosis 5 years previously. There was no significant abnormality on the chest radiograph and transthoracic echocardiography, but the arterial blood gas analysis revealed severe hypoxemia. Contrast-enhanced transesophageal echocardiograpy with agitated saline demonstrated a delayed appearance of microbubbles in the left cardiac chambers. Thus, he was finally diagnosed with HPS. This case suggests that we should consider HPS when a patient with compensated liver cirrhosis has unexplained dyspnea.
Holter 심전도 모니터를 이용한 만성 폐쇄성 폐질환 환자에 있어서의 부정맥에 대한 연구 - 만성 폐쇄성 폐질환에 있어서의 부정맥에 대한 연구
이정균 ( Chung Kyun Lee ),이정희 ( Chung Hee Lee ),박성수 ( Sung Soo Park ),이방헌 ( Bang Hun Lee ),주상언 ( Sang Aun Joo ),김순길 ( Soon Gill Kim ),신승호 ( Seung Ho Shin ),황흥곤 ( Hweung Kon Hwang ),정효철 ( Hyo Chul Chung ) 대한내과학회 1984 대한내과학회지 Vol.27 No.11
관상동맥조영술상 정상인 환자에서 흉통의 원인으로 식도 운동장애에 관한 연구
황흥곤,김경수,김정현,임헌길,이방헌,이정균 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.2
We conducted a prospective study to evaluate the importance of esophageal abnormality as a potential cause of recurrent non-cardiac chest pain in patients with normal or near normal coronary angiography including patients with variant angina, patients with syndrome X and also pateints with sighificant coronary artery disease. Standard esophageal manometry including edrophonium provocation test and acid perfusion test was performed in 50 patients with chest pain. The prevalence of esophageal motility disorder was 73%(8/11) in patients with variant angina, 67%(8/12) in patients with syndrome X, 86%(6/7) in patients with non-cardiac disease respectively. To evaluate the cause of spontaneous chest pain two chnnel ambulatory Holter monitoring, and esophageal motility and pH recording tests were perfromed simultaneously for 24 hours for the 16 patients with daily substernal pain and normal coronary angiography including 5 patients with daily substernal pain and normal coronary angiography including 5 patients with variant angina (group A), 5 patient with syndrome X(group B) and 6 patients with non-cardiac disease (group C). Each patient exeperienced more than one episode of spontaneous chest pain and the number of chest pain episode in each group was 22 in group A, 27 in group B, and 28 in group C respectively. The number of patinets with the chest pain and the frequency of the chest pain associated with gastroesophageal reflux were 4 and 29%(8/28) in group C. And the number of pateints with the abnormal motility were 2 and 14% (3/22) respectively in group A, 1 and 15%(4/27) in group B, and 4 and 29% (8/28) in group C. One patient in group A and two patients in group B experienced chest pain associated wkth gastroesophageal reflux and abnormal motility, but even a sigle episode of chest pain was not associated with gastroesophageal reflux and with abnormal motility simutaneously. So the number of patients with the chest pain and the frequency of the chest pain associated with esophageal desorder were 5 and 78% (17/22) respectively in group A, 3 and 48% (13/27) in group B, and 6 58% (16/28) in group C. On the contrary, the number of patients with the chest pain and the frequency of the chest pain associated with ST change in 24 hours Holter monitoringwere 3 and 18% (4/22) respectively in group A, 1 and 4% (1/27) in group B, and there was none in group C. In conclusion, esophageal disorders frequectly contribute to chest pain in patiects with variant angina, syndrome X and non-cardiac disease, so making a accurate diagnosis of the cause of chest pain may be beneficial to patient, and ambulatory esophageal motility and pH monitoring is useful in evaluation of chest pain.