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Radiation exposure in coronary angiography:A comparison of cineangiography and fluorography
황종민,이수용,천민구,이상현,황기원,김정수,박용현,김준홍,전국진 대한심장학회 2015 Korean Circulation Journal Vol.45 No.6
Background and Objectives: Coronary angiography (CAG) is the gold standard for diagnosing coronary artery disease. However,exposure to ionizing radiation delivered during CAG has various negative biological effects on humans. In this study, there was anevaluation of whether fluorography resulted in decreased radiation exposure, as compared with cineangiography. Subjects and Methods: Fifty-five patients were prospectively enrolled and divided into two CAG groups, in accordance with theoperator’s professional discretion: a conventional cineangiography group versus a fluorography group. Fluorography refers to thephotography of fluoroscopic images that are retrospectively stored, e.g., using the “Store fluoro” function of the Siemens cardiacangiography system. The primary outcomes included the air kinetic energy released per unit mass {air kerma (AK) mGy} and the dose(kerma)–area product (DAP; μGy ∙ m2), both measured using built-in software in the Siemens system. The secondary outcomes includedthe total procedure time and amount of contrast agent used with each CAG method. Results: The total AK and DAP were significantly lower in the fluorography group (159.3±64.9 mGy and 1337.9±629.6 μGy ∙ m2,respectively) than in the cineangiography group (326.9±107.5 mGy and 2341.1±849.9 μGy ∙ m2, respectively; p=0.000 for both). The totalprocedure time (cineangiography vs. fluorography, 12.8±4.7 vs. 12.5±2.9 min; p=0.779) and contrast agent amount (136.1±28.3 vs. 126.3±25.7, p=0.214) were comparable between the two groups. Conclusion: Fluorography is a useful method to decrease the radiation exposure in selected patients requiring CAG
김유정,김성만,천민구,지준형,김동준,송여정,김태익 대한내과학회 2011 대한내과학회지 Vol.81 No.5
We report a 44-year-old woman with massive ascites, elevated serum carbohydrate antigen 125 (CA 125) concentrations, pericardial effusion, and junctional bradycardia. Ascites caused by hypothyroidism are rare, and the pathogenesis is unclear. The ascitic fluid showed elevated total protein concentrations and a high serum-ascites albumin gradient. The massive ascites and increased serum, ascitic, and pericardial CA 125 concentrations led us to make an incorrect presumptive diagnosis of an ovarian malignancy with metastasis. However, there was no evidence of malignancy except the elevated CA 125 level. Similar to ascites, also junctional escape rhythm with marked bradycardia is a very rare feature of hypothyroidism. Following thyroid hormone replacement, the ascites and serum CA 125 gradually decreased, and the heart rhythm returned to sinus bradycardia. We report this case with a brief review of the literature. (Korean J Med 2011;81:641-646)
윤지훈,권혁용,김명준,천민구,악설정,박승근,박희욱 대한소화기내시경학회 2011 Clinical Endoscopy Vol.42 No.2
Retrograde jejunogastric intussusception is a rare complication following Billroth ll gastric surgery. It is a segmental invagination of a jejunal loop into the stomach through stoma. Clinical manifestations are epigastric pain, vomiting with bile or blood, and a palpable mass in the epigastrium. Gastroscopy and a upper GI (UGI) series are very helpful in the diagnosis of this disease. Although the management of this disease is usually surgical, when endoscopic reduction has failed, surgery should be immediately done because of the high mortality. We present here a case of jejunogastric intussusception that was diagnosed by gastroscopy in a patient with a history of Billroth ll surgery that had been done 6 years prior due to gastric cancer. 역행성 공장-위 장겹침증은 위아전절제술 후 0.1%에서 나타나는 비교적 드문 합병증으로 증상발현 후 48시간 이내 적절한 치료를 하지 않을 경우 높은 사망률을 보이는 질환으로 알려져 있다. 특히 과거 위아전절제술을 받은 환자가 지속되는 구토, 토혈을 주소로 내원한다면 역행성 공장-위 장겹침증의 가능성을 고려해야 하며, 이는 상부위장관내시경으로 조기진단이 가능하다. 저자들은 6년 전 조기위암으로 위아전절제술을 받은 환자가 상복부 동통을 주소로 내원하여 시행한 상부위장관내시경을 통해 역행성 공장-위 장겹침증을 경험하여 보고한다.
Perforated Mitral Valve Aneurysm in the Posterior Leaflet without Infective Endocarditis
김동준,조경임,전희재,김유정,송여정,지준형,천민구,김성만,이현국,김태익 한국심초음파학회 2012 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.20 No.2
Aneurysm of the mitral valve, although uncommon, occurs most commonly in association with infective endocarditis of the aortic valve and true mitral valve aneurysm is a rare cause of mitral regurgitation. We report a case with perforated mitral valve aneurysm in the posterior leaflet without concurrent infective endocarditis initially mistaken diagnosis of cystic mass, which was confirmed at operation with successful mitral valve annuloplasty.
황종민,박용현,최경운,김정수,황기원,이상현,천민구,이수용,이대성 한국심초음파학회 2016 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.24 No.4
Cardiac metastasis from renal cell carcinoma (RCC) without inferior vena cava (IVC) involvements is extremely rare with few reportedcases. Sarcomatoid RCC with rhabdoid feature is a rare pathologic type of RCC having aggressive behavior due to greatmetastatic potential. Here, we report a case of rapidly growing cardiac metastasis of RCC which brought on right ventricular outflowtract (RVOT) obstruction without IVC and right atrial involvement in a 61-year-old woman. Cardiac arrest occurred duringradical nephrectomy and echocardiography revealed mass nearly obstructing the RVOT which was not recognized by preoperativeechocardiography 1 month ago. Postoperative immunohistochemical evaluation of renal mass revealed sarcomatoid RCCwith rhabdoid feature.
전국진,이상현,이대성,이수용,황종민,천민구,황기원,김정수,박용현,김준홍 대한심장학회 2016 Korean Circulation Journal Vol.46 No.2
Background and Objectives Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients. Subjects and Methods The medical records of all patients who underwent right heart catheterization at our hospital between January 2003 and December 2014 were reviewed retrospectively. Right cardiac catheterizations via the antecubital fossa vein and the femoral vein were compared in terms of demographic data (age, sex, weight, height, and body mass index), indications for right cardiac catheterization, and procedural and outcome data (initial success rate, procedure time, compression to ambulation time, and complications). Results We reviewed 132 cases (antecubital fossa vein approach, n=37; femoral vein approach, n=95). The demographic data, initial success rate (100% vs. 100%) and procedure time (21.6±16.8 min vs. 25.6±12.6 min, p=0.14) were similar in both groups. The antecubital fossa vein group had a shorter mean compression to ambulation time than the femoral vein group (0.0 min vs. 201.2±48.1 min, p<0.01). No complications were observed in either group. Conclusion Our study indicated the ease of performance of right cardiac catheterization via the antecubital fossa vein. Thus, the antecubital fossa vein can be an alternative access site for right cardiac catheterization in Korean patients.