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증례 : 순환기 ; 임시형 심박조율기 삽입 후 발생한 조율 허용성 다형 심실빈맥 1예
박재영 ( Jae Young Park ),곽성동 ( Seong Dong Kwak ),임주견 ( Ju Kyeon Yim ),정재식 ( Jae Shik Jeong ),천재홍 ( Jae Hong Chun ),최성열 ( Sung Yeol Choi ),정준훈 ( Joon Hoon Jeong ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
저자들은 하벽의 급성 심근경색증 환자에서 VVI 방식의 임시형 심박조율기를 삽입한 후 심박조율기 오작동으로 인한 조율 허용성 다형 심실빈맥을 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. A 74-year-old man was admitted with sudden-onset chest pain. Electrocardiography showed ST segment elevation in leads II, III, and aVF; in addition, the levels of several cardiac enzymes were elevated. The patient received a VVI temporary pacemaker due to bradycardia (45 beats/min) and was subjected to primary percutaneous coronary intervention. After percutaneous coronary intervention for the RCA infarction, the patient was admitted to the coronary care unit. Six hours later, polymorphic ventricular tachycardia occurred following a short-long-short sequence. This is the first case of temporary pacemaker-permitted ventricular tachycardia in Korea. Here we present a case of pacemaker-permitted polymorphic ventricular tachycardia in a patient with inferior acute myocardial infarction. (Korean J Med 77:S1157-S1161, 2009)
복막투석 환자에서 발생한 후두부 가역적 뇌병증 증후군 1예
최성열 ( Sung Yeol Choi ),박재영 ( Jae Young Park ),곽성동 ( Seong Dong Kwak ),임주견 ( Ju Kyeon Yim ),천재홍 ( Jae Hong Chun ),김태우 ( Tae Woo Kim ),서보정 ( Bo Jung Seo ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
Posterior reversible encephalopathy syndrome (PRES) is a clinical radiologic syndrome which is characterized by reversible neurological and radiological findings. It is associated with an abrupt and severe increase in blood pressure, eclampsia, chronic kidney disease with hypertension and using various immunosupressive drugs. Patient with chronic kidney disease could be especially vulnerable to this syndrome because they are frequently exposed to several possible causes as uremia, hypertension, or electrolyte imbalance. We report a case of posterior reversible encephalopathy syndrome in a patient having continuous ambulatory peritoneal dialysis.
복막 투석 환자에서 Brevundimonas vesicularis에 의한 복막염 1예
곽성동 ( Seong Dong Kwak ),최성열 ( Sung Yeol Choi ),박재영 ( Jae Young Park ),임주견 ( Ju Kyeon Yim ),천재홍 ( Jae Hong Chun ),김태우 ( Tae Woo Kim ),서보정 ( Bo Jung Seo ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.4
A 53-year-old male was hospitalized with abdominal pain and turbid peritoneal fluid. He was diagnosed with hypertension, diabetic nephropathy and started continuous ambulatory peritoneal dialysis (CAPD) 4 years ago. Initial peritoneal fluid analysis demonstrated CAPD peritonitis. As initial antibiotic therapy, ceftazidime/vancomycin were injected intraperitoneally. But drug sensitivity test revealed these regimens were ineffective. On sixth hospital day, Brevundimonas vesicularis (B. vesicularis) was cultured from peritoneal fluid, this strain was susceptible to imipenem, piperacillin and resistant to ceftazidime. Accordingly we changed the antibiotics to imipenem, which was administered for 14 days, but analysis of peritoneal fluid was seldom improved. Finally, CAPD catheter was removed, and hemodialysis was started. After CAPD catheter removal, peritonitis improved rapidly. B. vesicularis is a rare opportunistic organism in CAPD peritonitis. Because this peritonitis may not improve in spite of medical treatment with susceptible antibiotics, CAPD catheter must be removed finally.