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조경임(Kyoung Im Cho),윤철(Cheol Yoon),이홍기(Hong Gi Lee),김석주(Seok Joo Kim),장윤식(Yeun Sik Jang),이연재(Youn Jae Lee),이상혁(Sang Hyuk Lee),설상영(Sang Young Seol),정정명(Jung Myung Chung),강미선(Mi Seon Kang) 대한소화기학회 2000 대한소화기학회지 Vol.36 No.3
Peripheral cholangiocarcinoma which was originated from the small bile ducts and generally presents an infiltrative growth, intraductal growth in the peripheral large duct tributaries, is very unusual. Mucin-producing cholangiocarcinoma showing intraductal spread has been reported previously, and it is difficult to diagnose this type of cholangiocarcinoma definitely in early stage in spite of jaundice due to mucin impaction in the common bile duct. We experienced a 49-year-old male patient who had hepatic mass observed incidentally without any specific symptom. This patient was diagnosed as having mucin-producing cholangiocarcinoma by abdominal ultrasonography, computed tomography scan and ERCP. He received hepatic resection successfully. It was diagnosed as mucin-producing cholangiocarcinoma, intrahepatic variant. He is expected to have long term survival. We report this case because the case of asymptomatic mucin-producing cholangiocarcinoma diagnosed at such an early stage is rare. (Kor J Gastroenterol 2000;36:431 - 436)
강지현 ( Ji Hyun Kang ),이지현 ( Ji Hyun Lee ),조경임 ( Kyoung Im Cho ),김태익 ( Tae Ik Kim ),권혁용 ( Hyuk Yong Kwon ),김현진 ( Hyeon Jin Kim ),김명준 ( Myoung Joon Kim ),황치성 ( Chi Sung Hwang ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.3
Background: Aberrations of cardiovascular regulation have been reported in patients who suffer with fibromyalgia (FM). Abnormalities of the cardiovascular autonomic regulation, as well as the correlation between coronary heart disease and depression, have been considered to be the causative factors. The clinical features of transient left apical ballooning syndrome with the patients under acute stress have been clearly described, but the effect of chronic stress such as FM on the myocardium is unknown. We investigated the cardiac strain in FM patients by strain imaging with using the 2D grayscale images, and we quantified the regional myocardial deformation properties. Methods: We investigated 30 consecutive postmenopausal women (mean age: 48±8 years) who satisfied the criteria for fibromyalgia with atypical chest pain by performing standard and 2-dimensional strain echocardiography (2DS). Those patients with hypertension, coronary heart disease or diabetes were excluded. The global and segmental longitudinal deformation parameters of the LV from 3 apical views were analyzed, and the patients underwent a manual tender point survey for determining the number of tender points and tender point counts, and the patients completed the fibromyalgia impact questionnaire (FIQ), the brief fatigue inventory (BFI), and Beck depression inventory (BDI). Results: The global longitudinal LV strain was significantly reduced in the FM patients with a high FIQ score (>40) as compared to the patients with a low FIQ score (-18.61%vs.-22.72%). Also, both the global and segmental longitudinal LV strains were negatively associated with fatigue or the tender point counts. However, there was no significant association between depression and the LV strain. Conclusion: This study showed the reduced myocardial longitudinal deformation in FM patients. This suggested that strain imaging is a feasible approach to assess the regional ventricular function in FM patients.
스트레스 유발성 심근증 환자들의 원내 사망과 좌심실 기능 회복의 예측인자
김소연 ( So Yeon Kim ),김장영 ( Jang Young Kim ),박용현 ( Yong Hyun Park ),홍경순 ( Kyung Soon Hong ),조경임 ( Kyoung Im Cho ),조현수 ( Hyun Su Jo ),홍그루 ( Gue Ru Hong ),손창우 ( Chang Woo Sohn ),손장원 ( Jang Won Sohn ),윤준철 대한내과학회 2011 대한내과학회지 Vol.81 No.1
Background/Aims: The reported frequency of stress-induced cardiomyopathy (SCMP, Takotsubo cardiomyopathy) is increasing; however, there are no data regarding predictors of in-hospital mortality and the recovery of left ventricular (LV) systolic function in patients with SCMP. Therefore, in this study, we sought to identify clinical predictors of in-hospital mortality and of the recovery of LV dysfunction in Korean patients with SCMP. Methods: From November 2004 to November 2010, 155 patients who fulfilled the clinical diagnostic criteria of the Mayo clinic for SCMP were enrolled retrospectively from eight medical centers in Korea. We checked in-hospital deaths and compared the LVejection fraction (LVEF) and wall-motion score index (WMSI) upon enrollment for each patient with that after 1 week using echocardiograms. A total of 55 continuous variables and 52 nominal variables were analyzed to find variables associated with in-hospital mortality and the recovery of LV dysfunction. All significant variables were entered into a logistic regression analysis. Results: The mean age of the patients was 64±15 years; 118 (76.1%) patients were female. The in-hospital mortality rate was 5.2% (n=8). An elevated initial platelet count was identified as a predictor of in-hospital mortality (odds ratio [95% CI]: 0.99 [0.99-1.00]). There were no predictors of the recovery of LVEF. Predictors of the recovery of WMSI were an absence of arrhythmic events (odds ratio [95% CI]: 22.89 [1.98-265.34]) and an elevated initial LV end-systolic diameter (odds ratio [95% CI]: 0.86 [0.74-1.00]). Conclusions: An initial absence of arrhythmic events and elevated LV end-diastolic pressure in patients with SCMP may be predictors of the timely recovery of LV dysfunction. (Korean J Med 2011;81:64-72)
증례 : 심근교 환자에서 관상동맥 중재술 후 이면성 긴장의 변화를 보인 1예
김석훈 ( Seok Hoon Kim ),박정호 ( Jeong Ho Park ),안정명 ( Jeong Myung Ahn ),김산 ( San Kim ),이정남 ( Jeong Nam Lee ),조경임 ( Kyoung Im Cho ),김태익 ( Tae Ik Kim ) 대한내과학회 2006 대한내과학회지 Vol.71 No.6
급성 심근경색증과 같은 심각한 경우를 제외하면 심근교 환자에서 스텐트를 이용한 관상동맥 중재술은 흔한 알은 아니다. 특히 심근교 환자에서 관상동맥 중재술 전후에 심초음파를 이용한 이면성 긴장을 측정하여 그 변화를 관찰한 보고는 없었다. 이에 저자들은 베타 차단제와 칼슘 길항제 등의 약물 치료에도 빈번한 협심증 증상을 호소한 중증의 심근교 환자에서 관상동맥 중재술 전 감소되어 있던 이면성 긴장의 횡 이동 정도와 방사형 긴장이 관상동맥 중재술 후 정상적인 양상으로 회복되는 변화를 관찰하였기에 문헌고찰과 함께 국내에서는 최초로 보고하는 바이다. The myocardial bridge of the coronary arteries is observed by coronary angiography at a rate of <5% and ordinarily dues not constitute a hazard. Occasionally, the compression of a coronary artery by a myocardial bridge can be associated with the clinical manifestations of myocardial ischemia during strenuous physical activity and might even result in a myocardial infarction or initiate malignant ventricular arrhythmias. A few cases of percutaneous coronary intervention for a myocardial bridge have been reported. However, there are few reports of the changes in the 2-dirnensional strain in the myocardial bridge. We encountered a case of a myocardial bridge in a 48-year-old male patient who had refractory angina despite continuous medication with a beta-blocker and calcium channel blocker. The 2-dimensional strain of the patient changed after percutaneous coronary intervention with stents. We report the first case in Korea with a review of the relevant literature. (Korean J Med 71:673-677, 2006)
이상봉,설상훈,강석우,조환진,조경임,이원식,주영돈,손창학,고원규 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1
Hookworm infection is one of the major parasitic diseases in warm moist climates, but its prevalence in Korea is very rare nowadays. Authors examined a case of iron deficiency anemia (IDA) associated with hookworm infection in a 46-year-old male. The peripheral blood examination showed markedly increased number of eosinophils, a low level of hemoglobin and decreased MCV. The iron study revealed that serum ferritin was 10.4 ng/ml, serum iron was 30㎍/dl. and total iron-binding capacity was 423㎍/dl. A large number of hookworm ova (7,925/g) were found in the stool sample. The G-I studies were all normal findings. We propose that we have to consider hookworm infection as one of the causes in a case of unknown IDA origin.
다량의 전기 충격을 시행한 급성 심근 경색 환자의 임상 경과 1예
심현진,권영일,오혜주,최윤석,김수형,김병수,조경임,김동수 인제대학교 백병원 2003 仁濟醫學 Vol.24 No.1
Electrical shock is most effective management in patients with hemodynamically unstable serious arrhythmias. But clinical course of survived patients resuscitated by large number and amount of electrical shock because of various situations was a little known. We report a case of myocardial infarction complicating ventricular fibrillation, successfully resuscitated by large number and amount of electrical shock, 35 times, cumulative amount of 7920J.