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약물요법으로 약물방출 스텐트 시술 후 재협착을 더 줄일 수 있나?
한규록 ( Kyoo Rok Han ) 대한내과학회 2008 대한내과학회지 Vol.74 No.4
Until now restenosis is one of the most important issues after stent implantation. Use of systemic drug therapy to inhibit post-stent restenosis has been largely unsuccessful. Drug-eluting stents (DES) have been shown to significantly reduce restenosis after percutaneous coronary intervention. However we still experience lots of problems associated with restenosis even after DES implantation. Recently some clinical trials have suggested that cilostazol reduces intimal hyperplasia and lowers restenosis after bare metal stents (BMS) implantation. It is uncertain that cilostazol can also reduce restenosis after DES implantation. We need more large clinical trials to elucidate the efficacy of cilostazol on restenosis after DES implantation.(Korean J Med 74:366-367, 2008)
인공삼첨판막의 혈전에 의한 삼첨판막 협착증의 임상상과 치료
한규록(Kyoo Rok Han),송종민(Jong Min Song),최성주(Sung Joo Choi),한기훈(Ki Hoon Han),박선수(Sun Soo Park),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),노정일(Chung Il 대한내과학회 1994 대한내과학회지 Vol.46 No.4
N/A Background: Thrombosis of prosthetic valve occurs more frequently in the mechanical prosthetic valve than tissue valve and more frequently in right-side heart than left-side heart. This study shows the clinical characteristics and treatment of bileaflet prosthetic valve thrombosis in the tricuspid position. Methods: Patients with bileaflet prosthetic valve in tricuspid position were followed till clinically significant tricuspid stenosis due to thrombosis develops. Five patients had clinically significant thrombotic tricuspid stenosis. Diagnosis was based on history taking, physical examaination, echocardiograpy and cinefluoroscopy. Results: Anticoagulation therapy was inadequate in 4 of 5 patients. Prosthetic valve replacement was undertaken in one patient and four patients were treated with thrombolytic therapy using urokinase. Three patients among 4 patients managed with thrombolytic therapy were successfully treated. There was no serious complication. Cinefluoroscopy and echocardiography were useful in diagnosis and evaluation of the thrombolysis. Conclusions: Thrombolytic therapy is useful as an initial treatment of thrombosed tricuspid prosthetic valve stenosis without major complications.
문한국 ( Han Kook Moon ),박대균 ( Dae Gyun Park ),김성은 ( Sung Eun Kim ),윤덕형 ( Duk Hyung Yoon ),이준희 ( Jun Hee Lee ),한규록 ( Kyoo Rok Han ),오동진 ( Dong Jin Oh ) 대한내과학회 2008 대한내과학회지 Vol.74 No.4
전격성 심근염은 급성기에 높은 사망률을 보이나 약물치료나 기계적 순환 보조장치로 회복되기만 하면 급성 심근염 환자에 비해 장기 생존률은 좋은 것으로 알려져 있다. 현재까지 국내에서 기생충 질환에 의한 과민반응에 기인하여 양호한 경과를 보였던 호산구성 심질환은 보고 되었으나 폐 흡충증과 연관되어 호산구수가 증가하고 증상 시작 2일만에 혈압저하, 호흡곤란등 울혈성 심부전 경과를 보이는 급성 호산구성 전격성 심근염을 국내에서는 처음으로 경험하여 문헌고찰과 함께 보고하는 바이다. Fulminant myocarditis is characterized by critical illness at presentation. However, if affected patients recover with pharmacologic therapy and mechanical circulatory support, they may have a better long-term prognosis than patients with other forms of myocarditis. A 31-year-old man was admitted due to chest pain associated with dyspnea. Electrocardiogram showed ST-segment elevation in all leads except for aVR and aVL. Non-sustained ventricular tachycardia developed 12 hours after admission. The echocardiography showed diffuse hypokinesia, concentric edematous thickening of the left ventricular wall, and pericardial effusion. Serum cardiac enzymes and absolute eosinophil count were elevated. Since the ELISA (Enzyme-Linked Immunosorbent Assay) against Paragonimus westermani was positive, the patient was treated with praziquantel for 2 days. Eosinophil count normalized after 10 days, with conversion to negativity on ELISA after 4 weeks. We concluded that his myocarditis was probably caused by allergic reaction secondary to Paragonimus westermani infection.(Korean J Med 74:451-456, 2008)