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- 저자 : Jae Kon Ko(고재곤) (검색결과 15 건)
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이은혜(Eun Hye Lee)ㆍ정민희(Min Hee Jeong)ㆍ고재곤(Jae Kon Ko)ㆍ고태성(Tae-Sung Ko) 대한소아신경학회 2010 대한소아신경학회지 Vol.18 No.1
저자들은 운동에 의해 유발되는 발작이 지속되어수년간 간질로 치료받았던 6년 5개월 남아에서, 특징적으로 심전도에서 QTc 간격이 연장되어 있고,운동 유발 검사에서 다형성 심실 빈맥 소견을 보여QT 연장 증후군으로 진단하고 베타 수용체 차단제로 치료하면서 추적 관찰 중인 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Long QT syndrome(LQTS) is characterized by prolongation of the QT interval, frequent episodes of syncope, and ventricular tachycardia leading to sudden cardiac death in adolescents and young adults. Early diagnosis and prompt treatment to reduce the risk of life-threatening cardiac events is crucial, however sudden onset convulsive syncope may be misdiagnosed as epilepsy and lead to antiepileptic drug therapy for many years. We experienced a case of six-year-old boy who were having seizure triggered by exercise and being treated with antiepileptic drugs. He had normal EEG and brain MRI but his ECG revealed prolonged QT interval(QTc= 477 ms) and treadmill test induced polymorphic ventricular tachycardia. After applying β-blocker, he had no more seizure attacks. We report a case of long QT syndrome misdiagnosed as epilepsy with a brief review of related literatures.
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심계항진을 호소하는 소아에서 경식도 심전도 검사의 유용성
류수정,고재곤,김영휘,박인숙,Ryu, Su-Jeong,Ko, Jae Kon,Kim, Young Hwue,Park, In Sook 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.1
목 적 : 심전도상 빈맥이 확인되지 않은 상태로 심계 항진을 호소하는 소아에서 빈맥의 유무를 확인하고 그 기전을 밝히는데 있어서 경식도 심전도 검사의 유용성을 검토해 보고자 하였다. 방 법 : 1997년 1월 1일부터 2001년 12월 31일까지 심계 항진을 호소하는 소아에서 심실 조기 흥분 증후군이 없고 심장이 정상이면서 경식도 심전도 검사 전까지 심전도상 빈맥이 기록되지 않았던 67명을 대상으로 경식도 심전도 기록을 후향적으로 다시 검토하여 경식도 심방 조율을 통해서 빈맥이 유발되는 정도와 유발된 경우에는 그 기전에 대하여 검토하였다. 결 과 : 심계항진을 호소하는 소아의 70.1%에서 경식도 심방조율을 통해서 빈맥을 유도할 수 있어서 빈맥이 심계항진의 원인임을 알 수 있었다. 빈맥은 대부분 빠른 심방 조율로 유도되었으며 21.3%에서는 isoproterenol을 사용한 후에 빈맥이 유발되었다. 6세 이상에서 보다 6세 미만의 소아에서 빈맥이 유도되는 경우가 유의하게 많았다(P<0.05). 빈맥이 유발된 경우에는 그 기전을 검토해 보았고 빈맥의 기전은 부전도로로 인한 방실 회귀성 빈맥이 53.2%, 방실결절 회귀성 빈맥은 34.0%이었고, 나머지는 특발성 좌심실 빈맥이 12.8%이었다. 이들 중 10명에서 전기 생리 검사가 시행되었는데 빈맥의 기전은 1명을 제외하고 경식도 심전도 검사와 그 기전이 일치하였다. 결 론 : 경식도 심전도 검사는 심계항진을 호소하는 소아에서 빈맥의 유무를 확인하고 그 기전을 밝혀 치료에 대한 방침을 정할 수 있는 침습적이지 않고 간편하고 유용한 검사이다. Purpose : We intended to find out the role of transesophageal atrial pacing in evaluation of infants and children with palpitation of unknown origin. Methods : We tried transesophageal atrial pacing study in 69 infants and children with palpitation, in whom tachycardia wasn't documented in electrocardiogram and reviewed retrospectively the records of transesophageal pacing and medical records of theses patients to find out the induction rate of tachycardia by transesophageal atrial pacing and the possible mechanism of tachycardia if induced. Results : In 70.1% infants and children with palpitation, tachycardia was induced, so we could conclude that tachycaridia was the cause of palpitation in these cases. In most cases, tachycardia was induced by rapid atrial pacing, and in 21% by using isoproterenol. Tachycardia induction rate was higher in <6-year-old children than ${\geq}6$-year-old children(P<0.05). In cases of the induced, we reviewed the mechanism of tachycardia. Of these induced tachycardias, 53.2% is atrioventricular reentry tachycardia, 34.0% were atrioventricular nodal reentry tachycardia, and 12.8% were idiopathic left ventricular tachycardia. Invasive electrophysiologic study was done to 10 patients of those induced. The results of electrophysiologic study and transesophageal pacing and recording were the same except for one patient. Conclusion : Transesophageal atrial pacing and recording is a less invasive, safe and useful method to find out the cause of palpitation and the mechanism of tachycardia in infants and children.
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김윤정(Yoon Jeong Kim),고재곤(Jae Kon Ko),박인숙(In Sook Park),고태성(Tae Sung Ko) 대한소아신경학회 1999 대한소아신경학회지 Vol.6 No.2
저자들은 선천성으로 청각 장애가 있으며 반복되는 간질 발작을 주소로 서울중앙병원에 입원하여 시행한 신경학적 검사와 뇌파 검사, 영상 진단이 모두 정상이었으나 특징적으로 실신이 유발되는 과정과 심전도상 QTc 간격이 연장되어 있어 QT 간격 연장 증후군으로 진단 받고 베타 수용체 차단제로 추적 관찰 중인 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다 "Idiopathic Kong QT Syndrome" is characterized by prolongation of the QT interval due to unusual electrocardiographic repolarization abnormality and associated with variable clinical manifestations from no specific symptoms in lifetime to syncope or even sudden death. The prognosis of this syndrome is very grave and motality is approximately 50% within 10 years among untreated symptomatic patients after the initial syncope. But this sudden onset syncope may be misdiagnosed as epilepsy, being teated with antiepileptic drug for many years. However, this high mortality has been significantly reduced to less than 5% by the effective therapy. Therefore, it is crucial to make an early and accurate dianosis. We experienced a case of 34 months old male who presented with recurrent syncopal attacks. He had no specific neurological abnomal finding except congenital deafness. He had normal EEG and brain MRI findings but ECG showed prolonged QT interval(QTc=0.5), findings of which were compatible with long QT syndrome. He is currently being followed at OPD, but the pateint is still experiencing syncopal attack despite of treatment with β-blocker, atenolol. Therefore, we are considering an insertion of pacemaker of performing thoracic sympathectomy.
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우측 대동맥궁과 Kommerell 게실에 의한 기관지 폐색 1 례
최옥자(Ok Ja Choi),홍수종(Soo Jong Hong),김봉성(Bong Seong Kim),김영휘(Young Hwee Kim),고재곤(Jae Kon Ko),박인숙(In Sook Park),서등만(Dong Man Seo) 대한소아알레르기호흡기학회 1999 소아알레르기 및 호흡기학회지 Vol.9 No.3
The vascular rings comprise less than 1% of congenital cardiovascular malformations and can be overlooked because they are rare diseases and show nonspecific respiratory symptoms such as wheezing or airway obstruction or apnea. This case is a 2-months old infant who had been repaired patch closure due to ventricular septal defect, but failed to wean from ventilator. Chest CT showed right main stem bronchus lying between right pulmonary arery and right descending aorta, bronchoscopy showed right main bronchus was compressed by extrinsic pulsating mass which were descending aorta and Kommerell`s diverticulum . After aortopexy and transfer of subclavian artery, this patient was able to be extubated and is now free of respiratory symptoms. When there is failure to weaning of ventilator and persistent bronchial obstruction and emphysema, we should have more vigorous effort to seek the cause of bronchial obstruction, using bronchoscope and chest CT.
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소아에서 연령에 따른 Signal Averaged ECG의 Time Domain 변수들에 대한 연구
박성종,고재곤 울산대학교 의과대학 1996 울산의대학술지 Vol.5 No.1
Signal averaged electrocardiography (SAECG) is a computerized processing technique that greatly enhances the resolution of the surface electrogram so thats low amplitude cardiac potentials can be recorded from body surface. Ventricular late potential is low amplitude high frequency signal located at the end of the QRS complex and can be detected on the surface using SAECG. The purpose of this study is to examine age - related differences of SAECG parameters in children. SAECGs were obtained in 59 children with normal hearts on physical examinations, 12-lead ECGs, and chest roentgenograms. They were divided into 4 groups depending on age (group 1: 1day to < 1year; group 2: 1year to < 6years; group 3: 6years to < 10years; group 4: 10years to < 15years). The root mean square voltage (RMS), the filtered QRS duration and the duration of the low amplitude signal (LAS) were measured using 40 Hz filters. The results showed that filtered QRS duration correlated wish original QRS duration and was lowest in infancy and increased thereafter with age. RMS inversely correlated with filtered QRS duration and was higher in infancy compared with older age group (p<0.05). RMS was not significantly different in group 2 and 3, but RMS of group 4 was significantly lower compared with younger group (p<0.01). The age related normative data of RMS could not be determined due to wide variation of raw data. LAS showed increasing tendency with age but was not statistically significant between groups. The age-related difference of each parameter on SAECG should be considered for ventricular late potentials and normative data for all variables of SAECG should be determined in larger number of children.
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