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Choi, Ki Hong,Han, Seongwook,Lee, Ga Yeon,Choi, Jin-Oh,Jeon, Eun-Seok,Lee, Hae-Young,Lee, Sang Eun,Kim, Jae-Joong,Chae, Shung Chull,Baek, Sang Hong,Kang, Seok-Min,Choi, Dong-Ju,Yoo, Byung-Su,Kim, Kye The Korean Society of Cardiology 2018 Korean Circulation Journal Vol.48 No.11
<P><B>Background and Objectives</B></P><P>The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB.</P><P><B>Methods</B></P><P>Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality.</P><P><B>Results</B></P><P>The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V<SUB>5</SUB>) and was more frequent in the LAD group than in the normal axis group (p<0.001).</P><P><B>Conclusions</B></P><P>Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).</P>
혈액투석 환자의 산욕기 동안 생체전기 임피던스법을 통해 체액조절한 1예
최성한 ( Shung Han Choi ),신동수 ( Dong Su Shin ),최현석 ( Hyun Seok Choi ) 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.1
저자들은 혈액투석을 시작한 환자가 산욕기에 직면했을 때 생체전기 임피던스법을 통하여 적절한 건체중 설정 및 혈액투석을 혈역학적으로 안정한 상태에서 시행한 예를 경험하였다. 본 증례는 출산을 한 혈액투석 환자를 볼 때 참고할 만한 증례이고, 향후 혈액투석 환자의 산욕기에 대한 추가 연구가 더 필요하다. Accurate volume assessment and proper volume management in hemodialysis patients are important, as volume status can affect mortality. There are several available methods of volume assessment. One of these, Bioelectrical Impedance Analysis (BIA), has been shown to provide an precise assessment of volume status. A 32-year-old woman in her fifth pregnancy, who had chronic renal failure, started hemodialysis treatment 10 days before delivery and experienced a severe change in body fluid status in the puerperium. Her volume status was assessed by BIA during the puerperium, and volume management conducted on the basis of these results enabled the patient to be maintained hemodynamically stable throughout this period.
최거승(Geo Seung choi),김수철(Su Chel Kim),한진우(Jin Woo Han),정군석(Koon Seok Shung),조윤현(Yun Hyun Cho) 전력전자학회 2002 전력전자학술대회 논문집 Vol.- No.-
This paper presents the static characteristics of PMLSM considering the slotting effects of the primary core. To estimate the force ripple, PMLSM is analysed by the theoretical analysis and the FEM The simulation values are compared with experimental ones.
( Woo Kyung Chung ),( Shung Han Choi ),( Ji Yoon Sung ),( Eul Sik Jung ),( Dong Su Shin ),( Ji Yong Jung ),( Jae Hyun Chang ),( Hyun Hee Lee ),( Seung Ho Lee ),( Se Joong Kim ) 대한전해질학회 2011 Electrolytes & Blood Pressure Vol.9 No.2
Accurate measurement of the volume status in hemodialysis patients is important as it can affect mortality. However, no studies have been conducted regarding volume management in cases where a sudden change of body fluid occurs, such as during puerperium in hemodialysis patients. This report presents a case in which the patient was monitored for her body composition and her volume status was controlled using a body composition monitor (BCM) during the puerperal period. This case suggests that using a BCM for volume management may help maintain hemodynamic stability in patients with a rapidly changing volume status for a short term period, such as during puerperium.
Lee, Seung Hun,Kim, Ju Han,Jeong, Myung Ho,Park, Hyukjin,Jeong, Yun Ah,Ahn, Youngkeun,Kim, Jong Hyun,Chae, Shung Chull,Kim, Young Jo,Hur, Seung Ho,Seong, In Whan,Hong, Taek Jong,Choi, Donghoon,Cho, My The Korean Society of Cardiology 2015 Korean Circulation Journal Vol.45 No.4
<P><B>Background and Objectives</B></P><P>This study aims to investigate the clinical features, angiographic findings, and outcomes of younger Korean ST-segment elevation myocardial infarction (STEMI) patients.</P><P><B>Subjects and Methods</B></P><P>We analyzed major adverse cardiac events (MACE) in the Korea Acute Myocardial Infarction Registry from November 2005 to October 2010. The registered patients were divided into two groups; young age group (<65 years) and old age group (≥65 years).</P><P><B>Results</B></P><P>The young age group included 5281 patients (age, 53±7.8 years), and the old age group included 4896 patients (age, 74.3±6.5 years). Male gender, smoking, family history, dyslipidemia, and metabolic syndrome were more frequently observed in the young age group than in the old age group (89.5% vs. 59.3%, p<0.001; 77.3% vs. 47.2%, p<0.001; 11% vs. 4.6%, p<0.001; 11.2% vs. 7.7%, p<0.001; 67.6% vs. 62.9%, p<0.001). Most of the young Korean adults with STEMI complained of typical chest pain (89.8%), and they had a shorter symptom-to-door time (12±53.2 hours vs. 17.3±132 hours, p=0.010). The young age group showed a favorable prognosis, which was represented by the MACE, compared with the old age group at one month (1.8% vs. 2.8%, p=0.028), six months (6.8% vs. 8.2%, p<0.001), and twelve months (10.1% vs. 11.9%, p=0.025). However, there was no significant difference in the adjusted MACE rate at one month {hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.60-1.51, p=0.828} and twelve months (HR 0.86, 95% CI 0.68-1.10, p=0.233).</P><P><B>Conclusion</B></P><P>Younger Korean adults with STEMI have clinical outcomes similar to old aged patients, and therefore, they should be treated intensively like the elderly patients.</P>
증례 : 신장 ; 트라넥사민산에 의해 유발된 급성 신피질 괴사 1예
성지윤 ( Ji Yoon Sung ),정을식 ( Eul Sik Jung ),최성한 ( Shung Han Choi ),신동수 ( Dong Su Shin ),이현희 ( Hyun Hee Lee ),정우경 ( Woo Kyung Chung ),장제현 ( Jae Hyun Chang ) 대한내과학회 2012 대한내과학회지 Vol.82 No.4
Kidney cortex necrosis is a relatively rare cause of acute kidney injury and is characterized by complete or partial destruction of the renal cortex, but sparing of the medulla. Tranexamic acid has antifibrinolytic activity and is used to reduce bleeding. We report a rare case of kidney cortex necrosis caused by tranexamic acid. A 49-year-old woman complained of coughing up blood-tinged sputum. She had a history of bronchiectasis and was treated with tranexamic acid for 3 days. Four days after admission, she developed anuria and azotemia. Computerized tomography showed enhancement of the renal medulla, but not the bilateral renal cortex. The patient was treated with hemodialysis, and has since been maintained on hemodialysis for 6 months. Due to the development of kidney cortex necrosis in patients treated with tranexamic acid, all its potential complications should be considered. (Korean J Med 2012;82:503-506)
NADH-Methemoglobin Reductace 결핍에 의한 선천성 Methemoglobin 혈중 1 예
김영재,김건영,이춘희,김문중,한기욱,장봉열,최정매,신성혜 대한내과학회 1991 대한내과학회지 Vol.40 No.4
The authaos experienced a case of hereditary methemoglobinemia due to NADH-met-Hb-reductase deficiency. The patient, a 47-year-old female, had intermittent cyanosis, general weakness, and mild dyspnea for the last 15 years. During her admission to PMC (Presbyterian Medical Center) no cardiopulmonary problems were detected, and the level of met-Hb was elevated to 50% of Hb. We analyzed the level of NADH-met-Hb-reductase of the patient and her family by Hegesh's and Scott's method. Her and her sisters NADH-met-Hb reductase level decreased to one-third of the normal (3.6+1.8 ?/g, 2SD), and two son's met-Hb level were abnormally elevated(Table 1). The patient's symptoms and cyanosis were well controlled by methylene blue. Since being discharged from PMC, she has tolerated the administration of methylene blue (P.0.) and Vitamin-C relatively well. Thus, we concluded that her dissase was a hereditary methemoglobinemia due to NADH-met-Hb-reductase deficiency, and report this case with some reviews of hereditary methemoglobinemia.
Doo Sun Sim,Myung Ho Jeong,Hyo-Soo Kim,Hyeon-Cheol Gwon,Ki-Bae Seung,Seung-Woon Rha,Shung Chull Chae,Chong Jin Kim,Kwang Soo Cha,Jong Seon Park,Jung Han Yoon,Jei Keon Chae,Seung Jae Joo,Dong-Ju Choi,S 대한심장학회 2020 Korean Circulation Journal Vol.50 No.2
Background and Objectives: There is a paucity of data regarding the benefit of clopidogrel monotherapy after dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents (DES). This study compared outcome between clopidogrel versus aspirin as monotherapy after DES for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 1,819 patients treated with DES who were switched to monotherapy with clopidogrel (n=534) or aspirin (n=1,285) after uneventful 12-month DAPT were analyzed. The primary endpoint was net adverse clinical events (NACE), defined as a composite of death from any cause, MI, repeat percutaneous coronary intervention (PCI), stent thrombosis, ischemic stroke, or major bleeding during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received clopidogrel, compared with those treated with aspirin, had a similar incidence of NACE (0.7% and 0.7%; hazard ratio, 1.06; 95% confidence interval, 0.31–3.60; p=0.923). The 2 groups had similar rates of death from any cause (0.1% in each group, p=0.789), MI (0.3% and 0.1%, respectively; p=0.226), repeat PCI (0.1% and 0.3%, respectively; p=0.548), stent thrombosis (0.1% and 0%, respectively; p=0.121), major bleeding (0.2% in each group, p=0.974), and major adverse cardiovascular and cerebrovascular events (0.5% in each group, p=0.924). Conclusions: Monotherapy with clopidogrel, compared to aspirin, after DAPT showed similar clinical outcomes in patients with acute MI treated with DES.
정석후 ( Seok Hu Jeong ),오경용 ( Kyong Yong Oh ),신동수 ( Dong Su Shin ),최성한 ( Shung Han Choi ),정을식 ( Eul Sik Jung ),박진선 ( Jin Sun Park ),나선영 ( Sun Young Na ),성지윤 ( Ji Yoon Sung ),정지용 ( Ji Yong Jung ),김세중 ( S 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Kaposi`s sarcoma (KS) is an unusual multifocal neoplasm of vascular endothelial cell origin. The trunk, arms, head, and neck are the most common sites. It is common in men and has four distinct variants: classic, Africa-endemic, immunosuppressive drug-associated, and acquired immunodeficiency syndromeassociated KS. KS appears to develop immunosuppressed patients, but is uncommon in patients on dialysis. A 79-year-old man on hemodialysis for 2 months presented with pruritus over the entire body and multiple, discrete, variable-sized, dark blue papulonodules (papuloplaques, maculopapules) on the left arm and shoulder. A biopsy specimen form the left arm showed spindle cells with slit-like spaces and extravasated red blood cells. The specimen was positive for CD 34 antigen, and human herpesvirus 8 was detected. We report a case of KS that occurred in a 79-year-old patient on hemodialysis.