http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
좌심실 수축 기능부전을 가진 급성 심근경색 환자에서 ST 분절 변화가 미치는 영향
설상훈 ( Sang Hoon Seol ),이은주 ( Eun Ju Lee ),박영진 ( Young Jin Park ),조환진 ( Hwan Jin Cho ),양태현 ( Tae Hyun Yang ),김성만 ( Seong Man Kim ),김대경 ( Dae Kyeong Kim ),김두일 ( Doo Il Kim ),김동수 ( Dong Soo Kim ) 대한내과학회 2008 대한내과학회지 Vol.74 No.6
목적: 급성 심근경색 환자에서 ST 분절 상승의 영향에 대해서는 많은 연구가 이루어졌으나 좌심실 수축 기능부전을 동반한 심근경색 환자에서는 연구되지 않았다. 방법: 2004년 1월부터 2006년 6월까지 좌심실 구혈률이 40% 이하의 수축 기능부전을 가진 급성 심근경색 환자 117명을 대상으로 하였다. ST 분절 상승 심근경색 77명과 비 ST 분절 상승 심근경색 환자 40명을 임상적 특징과 관상동맥조영술 결과 및 입원기간 및 1년 주요 심장사건(심장사망, 새로운 비치명적 심근경색, 목표혈관 재관류술, 심부전)을 후향적으로 분석하였다. 결과: ST 분절 상승에 따른 양 군의 기본적인 임상특징의 차이는 없었다. 관상동맥조영술의 TIMI flow 0 grade는 STEMI군에서 많았고(49.4% vs. 15.0%, p<0.01), 다혈관 질환은 NSTEMI군이 많았다(39.0% vs. 65.0%, p=0.01). 하지만 입원 중 심장 사망률과 주요 심장사건은 비슷했다(cardiac death 6.5% vs. 2.5%, p=0.66, MACE 19.5% vs. 22.5%, p=0.81). 1년 심장 사망률과 주요 심장사건에서도 의미있는 차이를 보이지 않았다(cardiac death 14.4% vs. 7.5%, p=0.37, MACE 33.8% vs. 30.0%, p=0.68). 결론: 좌심실 수축기능이 저하된 급성 심근경색 환자에서 ST 분절의 상승은 입원기간과 장기적인 예후에 영향을 미치지 않았다. Background/Aims: Although the impact of ST segment elevation in patients with acute myocardial infarction (MI) has been studied, little information is available on the impact of ST segment elevation in the patients with acute MI and left ventricular systolic dysfunction. Methods: We retrospectively analyzed the baseline clinical and angiographic characteristics and the in-hospital and 1-year clinical outcomes of 117 consecutive patients who were diagnosed with acute MI and who had a left ventricular ejection fraction of less than 40%, and these patients were treated from January 2004 to June 2006 at Busan Paik Hospital. Coronary angiography at the index hospitalization and the major adverse cardiac events (MACEs), including cardiac death, non-fatal reinfarction, target vessel revascularization (TVR), and heart failure, were compared between the 77 patients with ST segment elevation myocardial infarction (STEMI) and the 40 patients with non-ST segment elevation myocardial infarction (NSTEMI). Results: Overall, the baseline clinical characteristics were similar between the two groups. On the coronary angiography, thrombolysis in myocardial infarction 0 flow was more common in the STEMI group as compared to the NSTEMI group (p<0.01) and the NSTEMI group had more frequent multivessel disease compared to the STEMI group (p=0.01). However, the in-hospital cardiac deaths and MACEs were not different on comparison between the two groups (p=0.66, p=0.81, respectively). The one-year cardiac deaths and MACEs were not significantly different on comparison between the two groups (p=0.37, p=0.68, respectively). Conclusions: This study demonstrated that ST segment elevation had no influence on in-hospital and the long term outcomes of patients with acute MI and left ventricular systolic dysfunction.(Korean J Med 74:632-639, 2008)
정정명 ( Jung Myung Chung ),설상훈 ( Sang Hoon Seol ),이상봉 ( Sang Bong Lee ),설상영 ( Sang Young Seol ),윤혜경 ( Hye Kyung Yoon ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.2
Backgrounds/Aims: We aimed to confirm the possibility of the development of stomach cancer by Helicobacter pylori (H. pylori) infection and chronic gastritis with intestinal metaplasia. Methods: The study group consisted of 16 patients with stomach cancer
증례 : 순환기 ; 자연 판막에서 발생한 Staphylococcus Lugdunensis에 의한 감염성 심내막염 1예
조환진 ( Hwan Jin Cho ),설상훈 ( Sang Hoon Seol ),박상율 ( Sang Yool Park ),전현수 ( Hyun Soo Jun ),김동기 ( Dong Kie Kim ),김두일 ( Doo Il Kim ),김동수 ( Dong Soo Kim ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2
S. lugdunensis 감염성 심내막염은 국내에서 거의 보고가 없었고, 매우 드물지만 심한 합병증 및 높은 사망률을 보이는 질환이다. 저자들은 항생제 및 수술적 치료로 완치된 자연 판막에서 발생한 S. lugdunensis 감염성 심내막염 1예를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다. A 37-year-old woman presented to our hospital with a 1-month history of fever. She also complained of lower leg pain. Transthoracic echocardiography showed large vegetations on the mitral valve leaflets. Staphylococcus lugdunensis was isolated from blood cultures. She was diagnosed with infectious endocarditis due to S. lugdunensis and was treated with antibiotics and surgery. Infective endocarditis caused by S. lugdunensis can be invasive and often resembles endocarditis due to Staphylococcus aureus. Thus, whenever this organism is found in patients with endocarditis, early surgical treatment of the infected valve should be considered. (Korean J Med 2011;80:212-215)
증례 : 순환기 ; 심정지를 수반한 다중 관상동맥 연축 1예
김동수 ( Dong Soo Kim ),김두일 ( Doo Il Kim ),김웅 ( Ung Kim ),김용복 ( Young Bok Kim ),김동기 ( Dong Kie Kim ),양태현 ( Tae Hyun Yang ),설상훈 ( Sang Hoon Seol ) 대한내과학회 2010 대한내과학회지 Vol.79 No.5
변이협심증 환자가 가슴통증으로 내원 후 발생한 심정지로, 심폐소생술 및 관상동맥조영술을 시행하여 세 관상동맥 모두의 전반적 연축을 발견하였고, 관상동맥 내 nitroglycerin 투여로 호전되었다. 재연축을 방지하기 위해 지속적인 정맥내 질산염제제를 투여하였으나, 두 차례의 ST분절 상승을 포함한 심전도 변화와 심정지가 있었고, 설하 nifedipine으로 혈압과 심전도의 이상을 교정할 수 있었다. 환자의 급성 심정지에 관련된 요인으로 다혈관 연축 즉, 3개의 관상동맥 모두의 협착과 약물의 일시 중단이 중요한 인자라고 생각된다. 이와 같이 급사와 관련된 불량 예후가 예측되는 환자에서 보다 장기적으로 지속적이고 충분한 약물치료 및 철저한 교육이 필요하겠다. A 51-year-old female patient was referred to the emergency department with a 5-h history of resting chest pain. The patient, who had been diagnosed with variant angina six months previously, had not used her medications within two days of presentation. Electrocardiography (ECG) revealed a T wave inversion on lead I, AVL, and all precordial leads. Two hours later, the patient`s chest pain was suddenly aggravated with an ST segment elevation noted from leads V2-6, leading to shock. Emergency management, including cardiopulmonary resuscitation (CPR), was initiated. Coronary angiography showed diffuse multifocal narrowing of three vessels; however, the vessels recovered following the intracoronary injection of nitroglycerin. The patient went into cardiac arrest two more times during continuous nitroglycerin infusion. The attacks were managed using CPR and sublingual nifedipine. Here, we describe a rare case of life-threatening three-vessel coronary vasospasm and its successful management with calcium channel blockers. (Korean J Med 79:559-562, 2010)
김두일 ( Doo Il Kim ),이주원 ( Joo Won Lee ),김동기 ( Dong Kie Kim ),박승현 ( Seung Hyun Park ),김기훈 ( Ki Hun Kim ),설상훈 ( Sang Hoon Seol ),박보민 ( Bo Min Park ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Acute myocarditis can be caused by viral, bacterial, or protozoal infection, or drug toxicity. Fulminant myocarditis progresses rapidly and frequently leads to cardiogenic shock, so patients should be supported by extracorporeal membrane oxygenation (ECMO), an intra-aortic balloon pump (IABP), mechanical ventilation, or a temporary pacemaker to maintain hemodynamic status. Most patients recover with supportive therapy. However, a few patients have persistent atrioventricular (AV) block. We report the case of a 34-year-old male with persistent complete atrioventricular block after the regression of acute myocarditis. Ultimately, a permanent pacemaker was implanted. (Korean J Med 2012;83:629-632)
설상훈,엄수정,이연재,최봉기,박은택,장윤식,이상혁,설상영,정정명 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1
■ Objectives The aim of this study was to evaluate the biochemical and virological responses to one year lamivudine therapy in HBV-associated chronic liver diseases including interferon(IKF) -naive. INF-failed chronic hepatitis and liver cirrhosis. ■ Methods This study was conducted as an one-year trial of lamivudine in 60 patients with HBV-associated liver disease(INF-naive chronic hepatitis 20. INF-failed chronic hepatitis 18. liver cirrhosis 22). We classifed the patients as INF-naive chronic hepatitis(Group A), as INF-failed chronic hepatitis(Group B) and as liver cirrhosis(Group C). ■ Results The mean normalization rate of serum ALT was 71.7%: 65.0% in Group A. 61.1% in Group B and 86.4% in Group C. The negative conversion rate of HBV-DNA was 73.3%: 60.0% in Group A, 83.3% in Group B and 77.3% in Group C. The seroconversion rate of HBeAg was 30.0%: 22.2% in Group A, 35.3% in Group B and 26.3% in Group C. The breakthrough was occurred in 26.7% of patients: 40% in Group A, 16.7% in Group B and 22.7% in Group C. However, they did not deteriorate clinically in spite of ALT elevation and HBV-DNA reappearance. In case of anti-HBe positive chronic liver disease, ALT was normalized and HBV-DNA became undetactable in all 6 patients after 1 year lamivudine treatment. ■ Conclusions One year lamivudine treatment resulted in biochemical and virological improvements in patients with HBV- associated liver disease irrespective of the severity of liver disease and the status of HBeAg/Anti-HBe. Further studies are required to determine the effects of long-term suppressive therapy and optimal duration of therapy in patients with chronic HBV infection.