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증례 : 순환기 ; 설인신경통과 동반된 실신 환자에서 영구형 인공 심박동기 치료
조상영 ( Sang Young Cho ),김나영 ( Na Young Kim ),박정랑 ( Jeong Rang Park ),황석재 ( Seok Jae Hwang ),박용휘 ( Yongwhi Park ),황진용 ( Jin Yong Hwang ),곽충환 ( Choong Hwan Kwak ) 대한내과학회 2012 대한내과학회지 Vol.82 No.2
설인신경통은 삼킴에 의해 유발되는 극심한 작열통이 설인신경의 지배 영역인 인두, 편도, 후두 부위에 발작적으로 발생하는 드문 질환이다. 설인신경통으로 유발되는 서맥 또는 심장무수축으로 실신이 발생할 수 있고 치명적인 합병증을 초래할 수 있다. 저자들은 설인신경통에 의해 유발되는 심장무수축에 의한 실신으로 영구형 인공 심박동기 치료를 시행한 증례 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Glossopharyngeal neuralgia is a rare disease that is characterized by sharp pain in the posterior pharynx, tonsils, and larynx, triggered by swallowing. Glossopharyngeal neuralgia can trigger bradycardia or asystole, which can induce life-threatening cardiac syncope. A 55-year-old male was admitted with severe paroxysmal pain in his left jaw and ear, followed by asystole and syncope. We report a patient with cardiac syncope associated with glossopharyngeal neuralgia treated with a permanent pacemaker. (Korean J Med 2012;82:217-220)
관상동맥 중재술을 받은 환자에서 실로스타졸 사용 후 동맥경직도의 변화
조상영 ( Sang Young Cho ),김계환 ( Kye Hwan Kim ),안종화 ( Jong Hwa Ahn ),강영란 ( Young Ran Kang ),고진신 ( Jin Sin Koh ),황석재 ( Seok Jae Hwang ),박용휘 ( Yongwhi Park ),정영훈 ( Young Hoon Jeong ),곽충환 ( Choong Hwan Kwak 대한내과학회 2015 대한내과학회지 Vol.89 No.3
Background/Aims: Increased arterial stiffness is a well-known risk factor for cardiovascular disease. Cilostazol, a phosphodiesterase type 3 inhibitor, is a unique antiplatelet agent with vasodilatory and vasoprotective effects. Therefore, we hypothesized that cilostazol may affect arterial stiffness. Methods: We enrolled 161 patients (112 males; mean age, 63 years) who had undergone percutaneous coronary intervention (PCI) for ischemic heart disease. The brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), rAI adjusted for a heart rate of 75 beats/min (rAI75), central systolic blood pressure (cSBP), and central pulse pressure (cPP), were measured at baseline and at the 30-day follow-up. Parameter changes were compared between the cilostazol group (n = 51) and the control group (n = 110). Results: In the cilostazol group, the values for rAI, cSBP, and cPP all improved after 30 days, while the control group displayed no significant interval changes in these parameters. The changes in rAI75 and baPWV did not differ significantly between the two groups. The changes in rAI, cSBP, and cPP were related to brachial systolic blood pressure, brachial diastolic blood pressure, heart rate, and the use of cilostazol and beta-blockers. In a multivariate analysis, the use of cilostazol was identified an independent factor associated with changes in rAI, cSBP, and cPP. Conclusions: The addition of cilostazol to conventional antiplatelet therapy in patients undergoing PCI may be associated with improvements in rAI, cSBP, and cPP, but not in rAI75 or baPWV. Therefore, the effects of cilostazol might be related to an increased heart rate. (Korean J Med 2015;89:295-304)