http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
발작성 상심실성 빈맥환자에 있어서 각종 항부정맥제에 대한 전기생리학적 검사
김성순(Sung Soon Kim),박승정(Seung Jung Park),장양수(Yang Soo Jnag),탁승제(Seung Jea Tahk),심원흠(Won Heum Shim),조승연(Seung Yun Cho),김현승(Hyun Seung Kim) 대한내과학회 1991 대한내과학회지 Vol.40 No.3
N/A Electrophysiologyc studies (EPS) and serial drug testing were performed in 100 consecutive patients with paroxysmal supraventricular tachycardia (PSVT) but without ventricular preexcitation. All patients had a history of electrocardiographically-documented PSVT. Two patients with concealed bypass tract (CBT) had Ebstein's amomally, and 1 patient with atrial reentrant SVT had mitral stenosis. The remaining patients had structurally normal hearts. Ninety-eight patients had inducible sustained PSVT during the control study. Two had only nonsustained PSVT. EPS revealed AV reentrance utilizing concealed bypass tract (CBT) in 63 patients (Group I), A V nodal reentrance in 36 (Group II), and atrial reentrance in 1. The location of the accessory pathway in Group I was left free wall in 45 (72%.), posteroseptal in 12 (19%), right free wall in 4 (6%), and anteroseptal in 2(3%) patients. Eight patients had associated anterograde dual AV nodal pathways. Five of them utilized slow AV nodal pathway for anterograde conduction during AV reentrant SVT. Single and double atrial extrastimulation demonstrated discontinuous AV nodal conduction curve in 28 patients (77%) in Group II, and the remaining 8 had a continuous AV nodal conduction curve. Serial daily SVT induction was attempted after intravenous ad- ministration of procainamide 20 mg/kg, verapamil 0.15 mg/kg, digoxin 0.75 mg, and proplanolol 0.15 mg/kg. In Group I, procainamide showed drug response in 40/49 (82%), flecainide in 24/32 (75%), verapamil in 36/41 (89%), digoxin in 5/20 (25%), and digoxin + propranolol in 9/18 (50%). In Group II, procainamide showed drug response in 21/24 (88%), flecainide in 10/11 (91%), verapamil in 20/28 (95%), digoxin in 12/20 (60%), and digoxin + propranol l in 11/15 (73%) patients. In conclusion, AV reentrant SVT utilizing CBT is the most common mechanism (63%) of PSVT in symptomatic Korean patients. Serial EPS with multiple drugs is very useful to define effective dugs in patients with symptomatic PSVT. Our data on serial drug testing might help us select the drug for those who want to be treated without invasive EPS.
관상동맥동내 전극도자를 이용한 좌측 우회로의 전기적 절제술
김성수(Sung Soon Kim),박승정(Seung Jung Park),탁승제(Seung Jea Tahk),장양수(Yang Soo Jang),심원흠(Won Heum Shim),조승연(Seung Yun Cho),김현승(Hyun Seung Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.4
N/A Background: Surgical treatment has been reserved for treatment of paroxysmal or incessant bypass tract mediated reentrant tachycardia refractory to medical management. During the past decade, catheter ablative techniques have been introduced that replicate the surgical experience without expense and morbility associated with cardiac surgery. Methods: Catheter ablation (CA) of accessory pathway (AP) via the coronary sinus (CS) was performed in 70patients (43male, 27female) with symptomatic supraventricular tachyarrhythmias. Thirty one patients had manifest AP and 39had concealed AP. Sixty one patients had left. free wall AP and 9had posteroseptal AP. Two to 6unipolar D.C shocks (80-100J) were delivered between the electrode (cathode) close to the AP in the CS and a patch electrode (anode) placed on the posterior or lateral chest wall in each patient. Six patients received additional 1 to 2unipolar shocks of 200J via electrically common pair of electrodes {cathode). One to 2additional bipolar shocks (80J) were delivered via two electrodes close to the AP in the CS in the first 5patients. Results: Immediately after the shock was delivered, ventriculoatrial conduction via AP was abolished in all patients and anterograde AP conduction was eliminated in each patient with preexcitation. Two patients had prolonged sinus pause requring pacing for 10min. One who received 1shock of 200J required emergency surgery for a ruptured coronary sinus. One patient who received 3shocks of 100J developed cardiac tamponade requiring needle pericardiocentesis. Other complications were accelerated junctional rhythm in 8patients, nonsustained slow ventricular tachycardia in 2patients and an asymptomtic pericardial effusion in 2patients. Sixteen patients had recurrence within 2months (initial success rate of 77%. 54/70). Five underwent second ablation with successful result in 2, The overall longterm success rate (6-57mos, mean follow-up=24.6±7.4mos) was 80% (56/70), Mean peak CK-MB reached 34.8±23.8 IU/L (control CK-MB 6.0±5.4 IU/L). Conclusions: Although CA carries some life- threatening risk, it may be an effective alternative to surgical ablation of the left-sided AP in a selected group of patients.
관상동맥죽상경화증 환자에서 식생활요법 후 관상동맥경화증의 변화
정윤석(Yoon Sok Chung),김현만(Hyeon Man Kim),김한수(Han Su Kim),탁승제(Seung Jea Tahk),이웅구(Woong Ku Lee),정익모(Ick Mo Chung),조홍근(Hong Keun Cho),조승연(Seung Yun Cho),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh),백인경(In Kyung Pa 대한내과학회 1995 대한내과학회지 Vol.48 No.2
N/A Objectives: Coronary atherosclerosis is a life-style disease. Recently, Ornish et al. reported regression of coronary atherosclerosis in subjects with coronary artery disease who participated in a strict life-style modification program. We studied the effects of a life-style modification program on Korean patients with coronary atherosclerosis. Methods: Fourteen patients with angiographically documented coronary artery narrowing of over 50% in at least one vessel were studied prospectively. Subjects were divided into two groups. Subjects of group 1 (n=8) had a strict diet program composed of daily intake of less than 15% of fat and less than 100㎎ cholesterol; subjects of group 2 (n=6) had a usual diet program (American Heart Association step 1 diet) with daily intake of less than 30% fat and less than 300㎎ of cholesterol. All subjects were recommended with 200kcal per day exercise and instructed to stop cigarette smoking. Diet, anthropometric parameter, blood pressure measurements, serum lipid levels, and coronary angiography were recorded before and after the life-style modification program. Results: In group 1 (strict program) subjects, whose dietary intake of cholesterol and saturated fatty acid decreased, waist to hip circumference ratio and body fat decreased after the program. In contrast, there was no significant change in waist to hip circumference ratio and body fat of group 2 (usual program) subjects, whose dietary intake of cholesterol and saturated fatty acid did not decrease. In group 1, systolic blood pressure, serum total cholesterol and low density lipoprotein cholesterol levels decreased. There was no significant change in systolic blood pressure, serum total cholesterol, and low density lipoprotein cholesterol levels in group 2. Diameter stenosis of coronary artery regressed from 63.2±3.9% to 56.8±3.6% in group 1. There was no significant change (65.8±4.5% to 66.6±7.7%) in group 2. Conclusion: Coronary atherosclerosis significantly regressed in subjects who followed a strict life-style modification program, but not in subjects who continued their usual life-style program. Therefore, strict life-style change should be advised for coronary atherosclerotic patients.
급성 심근경색 환자에서 심전도상 ST 분절 상호 하강(reciprocal depression)의 임상적 의의 : 심근경색 후 경과시간에 따른 분석
장혁재 ( Hyuk Jae Chang ),박인휘 ( In Whee Park ),김정은 ( Jung Eun Kim ),이종우 ( Jong Woo Lee ),최소연 ( So Yeon Choi ),황교승 ( Gyo Seung Hwang ),윤명호 ( Myeong Ho Yoon ),신준한 ( Joon Han Shin ),탁승제 ( Seung Jea Tahk ),최 대한내과학회 2003 대한내과학회지 Vol.64 No.1
배경 : 급성 심근경색 환자에서 관찰되는 초기 심전도상의 ST 분절 상호 하강의 임상적 의의를 알아보고 특히 심근경색 발생 후 심전도 기록까지 걸린 시간에 따라 ST 분절 상호 하강의 의의가 차이를 보이는지 알아보고자 하였다. 방법 : 1999년 1월에서 2001년 5월 사이 진단받고 심전도상 ST 분절의 상승이 있었으며, 관동맥 조영술을 받은 급성 심근경색 환자 198명을 대상으로 하였다. 이들을 심근경색 부위에 따라 구분하였으며 심전도상 ST 분절 Background : To investigate the clinical significance of reciprocal ST segment depression on the presenting electrocardiogram (ECG) in patients with acute myocardial infarction (MI), in particular, this study focuses whether there is any difference accord
관상동맥 조영술상 정상인 고혈압환자에서 관상동맥 혈류 예비력의 결정인자
고종훈,윤명호,최소연,탁승제 관동대학교 의과대학 의과학연구소 2005 關東醫大學術誌 Vol.9 No.1
Background ; Several studies were reported that reduction of coronary flow reserve(CFR) might lead to myocardial ischemia in the absence of epicardial coronary stenosis. In addition left ventricular hypertrophy might be associated with impairment of coronary flow reserve. The aim of the this study was to assess whether relation exists between CFR and left ventricular mass index(LVMI) and to evaluate the major determinant factors of CFR. Method ; We studied 32 inpatients with hypertension and normal coronary angiogram. Control group consised of 19 subjects(M:F=10:9, mean age 52.6±9.7), group Ⅰ included 14 subjects (LVMI is below 125mg/m2,M:F=6.8 mean age 55.3±14.6) and group Ⅱ consist of 18 subject (LVMI is exceeded 125mg/m2,M:F=5:13 mean age 55.8±9.4). We measured the left ventricular mass(LVM) by M-mode echocardiogram using Devereus and Reichek's method. Left ventricular mass index was calculated as LVM / BSA. We measured average peak velocity at baseline(B) and at adenosine induced hyperemie(H) at the proximal segment of left anteriror descending artery(LAD) using a 0.014 inch 15MHZ doppler wire, CFR was calculated as the hyperemic/baseline(H/B) average peak velocity ratio. Result : 1) There was no significant difference In heart rate, systolic blood pressure or diastolic blood pressure between the two hypertensive groups. 2) The B-APV was significantly increased in hypertensive group compared to the control group(14.4±4.7./21.7.±7.5/23.1±8.1cm/sec p<0.05). 3) CFR was significant reduced in groupⅠand groupⅡ than in the control group (3.2±0.4/2.53±0.6/2.38±0.7 p<0.05). Conclusion ; In hypertensive patients with angiographicaly normal coronary arteries, coronary flow reserve was significantly reduced than normal control group. and CFR was mainly determinant by baseline average peak velocity and not by left ventricular mass index.
참깨에서 추출한 Sesamin 섭취가 혈청 지질 농도에 미치는 영향
윤명호,신준한,김한수,탁승제,최병일 아주대학교 1997 아주의학 Vol.2 No.2
Objectives : High serum cholesterol is one of the major risk factors of coronary artery disease. We investigated the lipid-towering property and the side effects of sesamin, an unsaturated fatty add extracted from sesame oil, for the primary prevention of coronary artery disease. Methods : The 37 patients (20 mates and 17 females) with hyperlipidemia, ages ranging from 22 years to 70 years old (48±12), who did not have atherosderotic diseases except essential hypertension were given three capsules of sesamin once daily for 6 weeks. The lipid profile of the patients were examined before and after sesamin treatment, and the patients were grouped according to the presence or abscence of hypertension, smoking habit and obesity. Result : Compared with pretreatment, the total cholesterol level of sesamin treated group decreased significantly (254.2±29.6 versus 241.6 34.0 ㎎/dl, p< 0.05). The level of LDL-cholesterol (162.6±24.3 versus 156.6±32.8 ㎎/dl)HDL- cholesterol (47.5±10.0 versus 47.0±8.7 ㎎/dl) and triglyceride (196.5±95.4 versus 179.3±96.7 ㎎/dl) and the ratio of LDL/HDL- cholesterol (3.6±0.9 versus 3.4±0.9) were not significantly different. The effect of cholesterol lowering property of sesamin was predominant in hypertensive, non- smoking and obese group (P< 0.05 vs pretreatment). The laboratory tests including complete blood cell counts, serum transaminases, total protein, albumin, blood urea nitrogen, creatinine and blood glucose did not change significantly. Conclusion : The lipid lowering effect of sesamin was statistically significant on the total cholesterol particularly with obese, non-smoking and hypertensive patients. There was no significant side effect during sesamin administration. Therefore, three capsules of sesamin as a single daily dose were effective in lowering total cholesterol and safe to administer in patients with hyperlipidemia.