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RISS 인기검색어
- 검색키워드
- 저자 : 박승정(Seung Jung Park) (검색결과 71 건)
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박승정(Seung Jung Park),심원흠(Won Heum Shim),조승연(Seung Yun Cho),이웅구(Woong Ky Lee),김성순(Sung Soon Kim),탁승재(Seung Jea Tahk),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung) 대한내과학회 1988 대한내과학회지 Vol.35 No.1
N/A Percutaneous mitral balloon valvuloplasty (PMV) using the double-balloon technique was performed in 28 symptomatic patients with mitral stenosis who were candidates for mitral valve commissurotomy. There were 21 women and 7 men with a mean age 38±10 years (range 23 to 57). PMV in 28 patients with moderate to severe mitral stenosis (including 3 with a fluoroscopic calcified valve) resulted in an increase mitral valve area (0.9±0.2 to 2.2±0,7cm, p<0.0001) by Gorlin`s formula, and a decrease in mean diastolic mitral pressure gradient (16.8±5.7 to 6.1±3.9mmHg, p<0.0001), and mean left atrial pressure (23.6±6.7 to 11.7±5.8mmHg, p<0. 0001). And also cardiac output increased (4.8±1.0 to 5. 8±1.5L/min, p<0.005) and mean pulmonary artery pressure decreased (32±12 to 24±9mmHg, p<0.05). Mitral regurgitation developed or increased in severity after PMV in 15 (53.6%) patients, grade 3mitral regurgitation in 2 and no mitral regurgitation in 12 patients. Oxymetric studies performed immediately after PMV demonstrated a small left-to-right shunt (pulmonary-to-systemic blood flow ratios>1.5) through the interatrial communication in 4 patients. Follow up echocardiography showed improvement in mitral valve area by 2-D and Doppler pressure half-time (0.9±0.2 to 1.8±0.5 and 0.8±0.2 to 1.7±0.4 cm, p<0.0001), increase of mitral EF slope (13±7 to 37±17mm/ sec, p<0.0001) and decrease peak E mitral velocity (209±32 to 142±32cm/sec, p<0.0001). Transient cerebral embolic phenomenon just after PMV was observed in 1 patient and cerebral embolic infarction with hemorrhage requiring surgery developed in 1 patient. PMV using the double-balloon technique is safe and effective procedure to relieve mitral valve obstruction and could be an alternative to surgical mitral commissurotomy in selected patients with mitral stenosis.
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급성 심근경색증 환자의 예후인자로서 내원 시 혈당의 유용성
승기배 ( Ki Bae Seung ),조명찬 ( Myeong Chan Cho ),박승정 ( Seung Jung Park ),김은정 ( Eun Jung Kim ),박오장 ( Oh Jang Park ),정명호 ( Myung Ho Jeong ),안영근 ( Young Keun Ahn ),김주한 ( Ju Han Kim ),김영조 ( Young Jo Kim ),채성철 대한내과학회 2010 대한내과학회지 Vol.79 No.1
Background/Aims: It has been suggested that admission hyperglycemia is associated with poor clinical outcomes in patients with acute myocardial infarction (AMI). The aim of this study was to assess the relationship between admission hyperglycemia and short-long term prognosis in patients with AMI. Methods: A total of 6,030 AMI patients without a previous history of diabetes were enrolled between Nov. 2005 and Jan. 2008. The patients were divided into three groups according to the levels of admission glucose levels: group I (<140 mg/dL, n=3,307), group II (140~199 mg/dL, n=1,946), and group III (≥200 mg/dL, n=777). In-hospital and one-year mortality were compared among three the groups. Results: The mean age was 64.3±13.3, 65.9±12.7, and 67.7±13.0 years in group I, II and III, respectively. The proportion of female gender (23.9%, 29.5%, 35.0%; p<0.001), Killip class III-IV (8.9%, 12.3%, 28.3%; p<0.001), ST-segment elevation myocardial infarction (54.6%, 71.5%, 71.7%; p<0.001), and in-hospital mortality (3.5%, 7.5%, 19.7%; p<0.001) increased with higher tertiles of elevated values of initial serum glucose. Hazard ratio (HR) for mortality rate were significantly increased in group II [HR=1.19, 95% confidential interval (Cl) 1.02~1.40, p=0.032], and in group III [HR=1.91, 95% Cl 1.59~2.30, p=0.001], compared with group I. And also significant differences were existed between group II and group III [HR =1.55, 95% Cl 1.27~1.88, p=0.001]. Conclusions: Admission glucose in patients with AMI provides incremental prognostic value, and significantly correlates with in-hospital and one-year mortalities.
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관상동맥 조영술을 시행한 환자에서 신동맥 협착의 유병율과 이에 연관된 위험인자 분석
유교상(Kyo Sang Yoo),강재영(Jae Young Kang),장재원(Jae Won Jang),서장원(Jang Won Seo),정영옥(Young Ok Jung),유혜승(He Sung Yoo),박성욱(Seong Wook Park),박승정(Seung Jung Park),박정식(Jung Sik Park) 대한내과학회 1998 대한내과학회지 Vol.54 No.3
N/A Objectives: The distributive pattern of atherosclerotic vascular disease is known to be different among the races. In Caucasian population, renal artery stenosis (RAS) was reported to be a frequent finding in the patients with ischemic heart disease (IHD), ranging from 5% to 29%. We investigated the prevalence of RAS and the risk factors in Korean patients. Methods: Over a 12-month period, 574 patients (M:F, 407:167) with clinical ND underwent cardiac catheterization. Before the procedure, demographic data, medical history, physical findings, and blood chemistries were obtained. During the procedure, selective renal arteriogram was also obtained. The degree of renal artery stenosis was quantitated with automatic edge detection technique, and narrowing of diameter greater than 50% was considered to be significant. Results : RAS was identified in 42 patients (7%), of whom 5 patients (1%) had bilateral disease. Angiographically significant coronary artery disease was present in 473 patients. The prevalence of RAS in patients with single, double and triple vessel disease of coronary artery were 4% (9/235), 13% (20/154), and 12% (10/84), respectively, Among the 101 patients with normal coronary arteries, 3 (3%) had RAS. By univariate analysis, there was significant difference between RAS and non-HAS in age (66±8 yrs vs 59±10 yrs, p<0.0001), duration of hypertension (73±13 yrs vs 3.40.3 yrs, p=0.0002), and the frequency of double or triple ±coronary artery disease (p=0.004). However, no association was found between RAS and serum lipids, lipoprotein(a), creatinine, sex, smoking, diabetes mellitus, or peripheral vascular disease. By multivariate logistic regression analysis, the following parameters were independent risk factors for RAS: age over 65 years (p<0.001), duration of hypertension (p=0.003), and coronary artery disease involving double or triple vessels (p=0.004). Conclusion : The prevalence of RAS in Koreans is somewhat lower than in western population. However, in patients with high degree coronary heart disease, old age over 65 years, or long history of hypertension, the possibility of combined RAS should be considered.
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심근경색증 환자에서 간헐파도플러 심초음파검사에 의한 심실확장기능에 관한 연구
조승연(Seung Yun Cho),박승정(Seung Jung Park),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung),박성삼(Sung Sam Park),심원흠(Won Heum Shim),김성순(Sung Sun Kim),이웅구(Woong Ku Lee) 대한내과학회 1988 대한내과학회지 Vol.35 No.4
N/A Inflow characteristics of left and right ventricular filling were assessed in 33 patients with myocardial infarction and 20 normal subjects by pulsed doppler echocardiography. The presence of left and right ventricular diastolic functional change in accordance to the infarct location, serial change of left and right ventricular diastolic function in patients with acute myocardial infarction, and correlation between left ventricular end-diastolic pressure and pulsed doppler echocardiographic incices of left ventricular diastolic function were assessed. Patients with myocardial infarction were subdivided into two groups, the anterior infarct group(20 patients) and the inferior infarct group(13 patients), according to the site of the involved myocardium. Serial doppler echocardiograms were perfarmed three times, within 3 days after onset(lst phase), after about 12 days (2nd phase), and after 4 weeks (3rd phase). 1) Concerning the left ventricular diastolic function, A/E in the anterior infarct group(1.04±0.18) and inferior infarct group(1.07±0.23) was greater than in that of the control group(0.64+0.10)(p<0.05) The corrected isovolumic relaxation time in the anterior infarct group(2.34±0.60 √ms and inferior infarct group(2. 43±0.70 √ms) was longer than in that of the control (1.83±0.31 ms) (p<0.05). The 0.33 area fraction and E area fraction in the anterior infarct group(45±7%, 55±5%, respectively) and inferior infarct group(43+9 53±8%, respectively) were less than in those of the control group(59±9%, 67±5%, respectively) (p< 0.05, p<0.05, respectively) and A area fraction in the anterior infarct group (43±6%) and inferior infarct group(47±8%) was greater than that in the control group(36±7%) (p<0.05). 2) In the right ventricular side, A/E in anterior infarct group(0.86±0.23) and inferior infarct group(1.01±0.16) was greater than in that of contol group(0.62±0.10) (p<0.05), peak A velocity in inferior infarct group(0.44±0.09 m/s) was higher than in those of anterior infarct group(0.36±0.10 m/s) and control group(0,28±0.05 m/s) (p<0.05), 0.33 area fraction and E area fraction in anterior infarct group(43±7%, 52±10%, respectively) and inferior infarct group(42±9%, 50±10%, repectively) were lesser than in those of control group(56±9%, 63±7%) (p<0.05, p<0.05, respectively), and A area fraction in anterior infarct group(48±10%) and inferior infarct group(49±9%) was greater than in that of control group(36±7%) (p<0.05). 3) Serial left ventricular pulsed doppler echocardiogram in 12 patients with acute myocardial infarction showed follwoing results. A/E in phaae 2(0,86±0,17) and phase 3(0.83±0.21) was lesser than in that of phase 1(1.07±0.22) (p<0,05), 0,33 area fraction and E area fraction in phase 2(53±10%, 59±8%, respectively) and phase 3(55±9%, 59±7%, respectively) were greater than in those of phase 1(43±8%, 49±9 respectively) (p<0,05, p<0,05, respectively), A area fraction in phase 2(39±8%) and phase 3(39±8%) was lesser than in phase 1(49±11%) (p<0,05), and these variables were not changed between phase 2 and phase 3. 4) Serial right ventricular pulsed doppler echocardiogram in 12 patients with acute myocardial infarction showed following results, A in phase 2 (0.35±0.10 m/s) and phase 3(0,31+0,06 m/s) was lower than in that of phase 1(0,46±0.09 m/s) (p<0.05), A/E in phase 2(0.92±0.26) and phase 3(0,78±0.18) was lesser than in that of phase 1(1.10±0.16) (p<0.05, p<0.01, respectively), 0,33 area fraction and E area fraction in phase 2(53±10%, 47±9%, respectively) and phase 3(53±8%, 42±9%, respectively) were greater than in those of phase 1(41±10%, 49±8%, respectively) (p<0.05, p<0.05, respectively), and A area fraction in phase 2(47±9%) and phase 3(42±9%) was lesser than in that of phase 1(50±7%) (p<0.05), 5) Left ventricular end diastolic pressure had a signi1icant high correlation with A/E (r=0,76, p=0.01), with 0.08 area fraction (r=0,71, p=0,02), and with E area fraction
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최승원(Seung Won Choi),고윤석(Youn Suck Koh),주용선(Yong Sun Ju),최강현(Kang Hyeon Choe),김우성(Woo Sung Kim),김재중(Jae Joong Kim),박성욱(Seong Wook Park),박승정(Seung Jung Park),이종구(Jong Koo Lee),김원동(Won Dong Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.3
N/A Objetive: The measurement of cardiac output by CO2 rebreathing method is noninvasive procedure using indirect Fick equation. In order to compare the result of cardiac output measured by CO2 rebreathing method with that by thermodilution technique, this study was performed. Methods: Simultaneous measurement of cardiac output by CO2 rebreathing method and thermodilution technique was performed in 13 mitral stenosis patients. The subjects were 4 men and 9 women, with mean age of 41.15±11.01 year. The cardiac output (CO) can be calculated from indirect Fick equation using the CO2 rebreathing method, CO=CO2 production/CvCO2-CaCO2. The CO2 production was obtained by collecting expired gas and multiply its volume by CO2 concentration and the arterial PCO2 was estimated from the end tidal PCO2. The mixed venous PCO2 was obtained from rebreathing plateau during O2 and mixture gas breathing through rebreathing bag. Results: 1) The average cardiac output was 3.41±0.45(L/min) by CO2 rebreathing method and 3.45±0.37(L/min) by thermodilution technique. 2) The result of cardiac output measured by CO2 rebreathing method was highly correlated to that by thermodilution technique (r=0.82). 3) The equation relating two measurements was Y =-0.01±0.99X. (Y: CO2 rebreathing method, X: thermodilution technique) Conclusion: This study showed that the result of cardiac output by CO2 rebreathing method was correlated well with that by standard thermodilution technique, so it is thought that CO2 rebreathing method could provide valid estimate of cardiac output for evaluation of cardiac function. It is simple to perform, easily repeatable and essentially risk free. Therefore this method could be very useful for clinical use.
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심원흠(Won Heum Shim),박승정(Seung Jung Park),이웅구(Woong Ku Lee),조승연(Seung Yun Cho),김성순(Sung Soon Kim) 대한내과학회 1989 대한내과학회지 Vol.36 No.2
N/A Since Furman and Robinson implanted a transvenous pacemaker (VOO) in 1958, Atricor (Cordis Co.), the first P-wave sensing dual chamber pacemaker (VAT) was introduced in 1963. Subsequently the atrioventricular seqeuential pacemaker (DVI), and universal automatic pacemaker (DDD) followed. Enetrex (Medtronic Co.), a VDD pacemaker, was first implanted after open heart surgery in a patient with a completed heart block in 1983. Sporadic case reports of dual chamber pacemaker implantation have been reported in Korean literature from our laboratory. We reviewed the clinical data of 51 dual pacer implantations in 48 patients performed in our laboratory during the period from September 1983 to November 1987. The following results were obtained: 1. The major indication was complete heart block in 32 cases (64.6%), high degree A-V block in 4(8,3%) and sick sinus syndrome in 11(20.8%) cases. 2. Main clinical symptoms were syncope and presyncope in 26(54.5%) cases. 3. The DDD pacer was most fregucently chosen in 44(86.3%) cases. 4. The route of entry of the leads was most commonly through a subclavian vein by the techique of percutaneous puncture in 44(91.7%)cases, cephalic vein cutdown in 1 cases, and epicardial screw in lead in 3 cases having open heart surgery. 5. The fixation of the atrial leads was the active form in 28 (58.3%) and the passive in 17 (35.4%) cases. The polarity of the leads was unlpolar in 38 (77.1%) and biopolar in 13 (22.9%) cases. 6. The complications wen various. The most fre- quent associated complications were pacemaker mediated tachycardia in 5 (10.9%) cases, infection in 5 (10.9 %), atrial lead displacement in 2, and atrial sensing and pacing problems in 4 cases. However, there were no serious complications such as death or other serious sequelae. In conclusion, dual chamber pacing is a more physilogically priented therapeutic measure for use in patients with symptomatic heart block or sick sinus syndrome and it can be implanted safely.
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