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혈역학적으로 안정된 폐색전증 환자에서의 임상적 악화를 예측하는 전산화 단층촬영상 소견
정상구 ( Sang Ku Jung ),김원영 ( Won Young Kim ),이충욱 ( Choong Wook Lee ),서동우 ( Dong Woo Seo ),이윤선 ( Youn Sun Lee ),이재호 ( Jae Ho Lee ),오범진 ( Bum Jin Oh ),김원 ( Won Kim ),임경수 ( Kyoung Soo Lim ),홍상범 ( Sang Bum 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.3
Background: The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE). Methods: Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE). Results: There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis (36.4±8.0 vs. 41.7±7.4, p<0.01; 45.7±9.4 vs. 41.5±7.6, p<0.01), superior vena cava diameter (19.2±3.4 vs. 18.0±3.4, p=0.02), azygos vein diameter (10.0±2.2 vs. 9.2±2.3, p=0.02), septal displacement (19 vs. 18, p<0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE (1.34±0.48 vs. 1.03±0.28, p<0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62∼0.79). Conclusion: RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.
정상혈압 폐색전증에서 위험도 평가도구로서의 D-dimer의 역할
윤재철 ( Jae Chol Yoon ),김원영 ( Won Young Kim ),최상식 ( Sang Sik Choi ),정상구 ( Sang Ku Jung ),손창환 ( Chang Hwan Sohn ),김원 ( Won Kim ),임경수 ( Kyoung Soo Lim ),정태오 ( Tae O Jeong ),진영호 ( Young Ho Jin ),이재백 ( Jae 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.2
Background: D-dimer testing is widely applied as a first step in the diagnostic work-up of pulmonary embolism (PE). Although this is the most sensitive assay for ruling out PE, the prognostic implications of D-dimer testing in patients with normotensive PE are not well known. The aim of this study was to determine if D-dimer testing on admission predicts major adverse cardiac events (MACE) in patients with normotensive PE. Methods: A total of 180 consecutive patients with normotensive PE admitted between January 2003 and June 2009 were included. The group was divided into quartiles on the basis of their D-dimer levels. We compared the frequency of MACE by quartile of D-dimer level and estimated sensitivity, specificity, and predictive values for MACE in the first and fourth quartile. Results: In the 37 (20.6%) patients with MACEs, the median D-dimer level (7.94 [IQR: 4.03∼18.17] μg/mL) was higher than in patients with a benign course (5.29 [IQR: 2.60∼11.52] μg/mL, p<0.01). The occurrence of MACEs was increased with increasing D-dimer level (p=0.017). In the first quartile (D-Dimer <2.76 μg/mL) sensitivity, specificity, and positive and negative predictive values for predicting MACEs were, respectively, 91.9%, 29.4%, 25.2%, and 93.3%. Conclusion: Patients with D-dimer levels below 2.76 μg/mL have a low risk of MACEs. Our study suggest that D-dimer level may be used to identify low risk patients with normotensive PE.
강희동 ( Hui Dong Kang ),오세현 ( Se Hyun Oh ),정상구 ( Sang Ku Jung ) 대한스포츠의학회 2017 대한스포츠의학회지 Vol.35 No.3
Immersion pulmonary edema (IPE) is a form of pulmonary edema that can occur in divers or swimmers. IPE is a rare condition, but can be life-threatening and recurrent condition. The pathophysiology of IPE is still incompletely understood. We present a case of scuba diving induced pulmonary edema in a 46-year-old woman diving in cold seawater. After 20 minutes of diving at 18 m, she felt difficulty of breathing. Symptoms on surfacing were dyspnea, cough, and frothy sputum. Chest X-ray showed pulmonary edema and she was treated with an intravenous diuretic and supplemental oxygen. The patient showed rapid resolution of symptoms and was discharged on the same day. Sport physician should be aware of this potentially life-threatening recurrent condition.
고연령 안와파열 골절 환자의 수상 원인과 컴퓨터 단층촬영 소견 및 동반 골절의 연령별 비교
서동우 ( Dong Woo Seo ),손창환 ( Chang Hwan Sohn ),정상구 ( Sang Ku Jung ),안신 ( Shin Ahn ),김원영 ( Won Young Kim ),김원 ( Won Kim ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.1
Purpose: The purpose of this study was to evaluate the causes of blow-out fractures, the computed tomography findings, and the associated facial bone fractures in aged patients. Methods: This study was performed by conducting a chart review. From January 2004 to December 2007, the patients who visited the emergency room of Asan Medical Center and were diagnosed as having a blow-out fracture were included in the study population. Patients 60 years of age or older were grouped as the aged group while patients younger than 60 years of age were grouped as the control group. Results: Between the aged group and the control group, there was a difference in the causes of blow-out fractures. The most common cause of blow-out fracture was a slip down in the aged group and violence in the control group (p<0.05). There were no differences in associated symptoms. Extraocular muscle herniation was the only statistically different computed tomography findings. In associated facial bone fractures, the most common fractures were the zygoma in the aged group and the nasal bone in the control group (p<0.05). Conclusion: In patients 60 years of age or older, the most common cause of blow-out fracture was a slip down, and the most common associated facial bone fracture was a zygomatic fracture. (J Korean Soc Traumatol 2009;22:44-50)