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Eun Jung Kwon,Myoung Hoon Kong,Sang Ho Lim,Joon Hyeuk Choi,Mi Kyoung Lee,Suk Min Yoon,Young Seok Choi Korean Society of Critical Care Medicine 1997 Acute and Critical Care Vol.12 No.1
Combination therapy of beta-blocker and a calcium channel blocker is not recommened because their additive effect on the myocardium and the atrioventricular node may precipitate heart block in susceptible patients. We experienced a 68 years old female patient who had paroxysmal supraventricular tachycardia that was treated with verapamil and esmolol. She had been taking verapamil for 2 years because of her paroxysmal supraventricular tachycardia. She was planned for left ureteronephrectomy due to left ureteral tumor. After epidural catheterization for the postoperative pain control, she was anesthetized with isoflurane and vecuronium. During central venous catheterization, SVT (H.R. from 98 beats per minute to 190 BPM) was suddenly developed with hypotension (B.P. from 120/65 mmHg to 75/42 mmHg) when guide wire was introduced. We treated her with combination therapy of verapamil 7.5 mg and esmolol 18 mg under the monitoring of blood pressure, electrocardiogram, end-tidal CO2 tension, central venous pressure and pulse oximeter. After 20 minutes of vigorous treatment, her heart rate and blood pressure returned to a normal range.
이은우,김도현,강동구,강명원,여향순,임연근,김윤아,박혁 대한내과학회 2000 대한내과학회지 Vol.59 No.4
저자들은 심와부 동통을 주소로 내원한 환자에서 담관암을 동반한 신경섬유종증 1형 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Neurofibromatosis is characterized by multiple cutaneous neurofibromas, cafe-au-lait spots and a broad spectrum of clinical, pathologic and radiologic finding. The incidence of malignant neoplasms complicating neurofibromatosis has never been satisfactorily estabilished ; estimates range from 3% to 15%. The malignant tumors are usually derived from neural crest tissue. Gastrointestinal involvement appears to be rare and usually consists of neurofibromas, ganglioneuromas and leiomyomas. Hepatobiliary involvement in neurofibromatosis is rare and mostly located at the periampullary region. Most of theses tumors are carcinoids or less frequently neurofibromas. The authors report a case of peripheral cholangiocarcinoma associated with neurofibromatosis type 1.(Korean J Med 59:463-466, 2000)