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심방중격 결손중에서 경흉부 및 경식도 심초음파도의 비교
김양수(Yang Soo Kim),김성훈(Sung Hoon Kim),강흥선(Heung Sun Kang),조정휘(Chung Whee Choue),김권삼(Kwon Sam Kim),김명식(Myung Shick Kim),송정상(Jung Sang Song),배종화(Jong Hoa Bae) 대한내과학회 1994 대한내과학회지 Vol.46 No.3
N/A Objectives: Transthoracic two-dimensional echocardiography and conventional Doppler color flow mapping studies have been to used in patients with congenital cardiac defect. However, the transthoracic approach is of limited value in patients with poor acoustic window, Recently transesophageal echocardiography provides high quality images of structure because of close proximity. The purpose of this study is the usefulness of transesophageal echocardiography compared with transthoracic echocardiogrphy in the diagnosis and assessment of the shunt volume in patients with atrial septal defect. Method: 13 patients with atrial septal defect documented at cardiac catheterization or surgery were evaluated. The study group consisted of 7 men and 6 women aged 15 to 59 years. Two-dimensional transthoracic echocardiogrphy with Doppler color flow mapping assessed the morphology and shunt of atrial septum. The size of atrial septal defect and the shunt volume across the defect were estimated by using the tranesophageal echocardiography. Results: 1) Transthoracic echocardiography identified 9 of 13 patients with and atrial septal defect (69%), whereas transesophageal echocardiography identified 13 of 13 patients and the diagnostic sensitivity was 100%. 2) Transesophageal echocardiography identified the site and size of defect correctly compared with operative findings (r=0.73, p<0.05). 3) The shunt flow volume by transesophageal echocardiography was compared with pulmonary to systemic blood flow ratios (Qp/Qs) by cardiac catheterization. The net shunt flow volume by transesophageal echocardiography and shunt flow ratio cardiac catheterization correlatie well (r=0.88, p<0.001). Conclusion: Transesophageal echocardiography was better and more usuful than transthoracic echocardiography in the diagnosis and in the assessment of shunt volume in the patients of atrial septal defect. However further studies with large number of patients and using the biplane or multiplane TEE will be required to determine the exact status of this the technique in assessment of shunt.
심근경색에서 측부순환 유무에 따른 99mTc-MIBI 심근 SPECT 소견
김덕윤(Deog Yoon Kim),양형인(Hyung In Yang),강홍선(Heung Sun Kang),조정휘(Chung Whee Choue),김권삼(Kwon Sam Kim),김명식(Myung Shick Kim),송정상(Jung Sang Song),배종화(Jong Hoa Bae),김재만(Jae Man Kim),나득영(Deug Young Na),박은경(Eun 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1
N/A The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and 99mTc-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The pat#ients #were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3; 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, 99mTc-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with invoivement of right coronary artery (RCA). The callateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I . 3) The presence of good collateral channels was more frequently 99mTc-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences af left ventrieular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of 99mTc-MlBI reversible perfusion defect.
정상 관동맥 조영상을 갖는 급성 심근경색증 환자의 임상적 특징 및 99mTc - MIBI 심근 SPECT 소견
김광원(Kwang Won Kim),김덕윤(Deog Yoon Kim),박명재(Myung Jae Park),최태열(Tae Youl Choi),강홍선(Heung Sun Kang),조정휘(Chung Whee Choue),김권삼(Kwon Sam Kim),김명식(Myung Shick Kim),송정상(Jung Sang Song),배종화(Jong Hoa Bae) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.1
N/A Among 64 patients with acute myocardial infarction who underwent coronary angiogrphy, 7 patients (10.9%)showed normal coronary artery. Six patients were men and 1 patient was female. The mean age of patients were 31.1±3.9 years. Among the risk factors of coronary heart disease, smoking was most probable factor in patients with acute myocardial infarction with normal coronary angiography. Tc-99m-MIBI heart SPECT performed 5 of 7 patients and showed that it could be used in diagnosis, localization, extent of infarct area in patients with acute myocardial infarction with normal coronary angiography. But follow up Tc-99m-MIBI heart SPECT study will be needed to define the ability of myocardial viability in this patients.
이석권(Suk Kwon Lee),어완규(Wan Kyu Eo),최철준(Chul Joon Choi),조정휘(Chung Whee Choue),김권삼(Kwon Sam Kim),김명식(Myung Shick Kim),송정상(Jung Sang Song),배종화(Jong Hoa Bae) 대한내과학회 1990 대한내과학회지 Vol.39 No.2
N/A To access the hypothesis that left atrial enlargement as measured by echocardiography is the earliest sign of cardiac dysfunction in patients with systemic hypertension alone, we underwent M-mode echocardiography in 13 normal controls and 31 hypertensive patients who have neither quantitative evidence of left ventricular hypertrophy by noninvasive techniques, nor other causes of left atrial enlargement, such as coronary artery or valvular hart disease. The results were as follows: 1) There were no significant differences in left ventricular end-systolic and end-diastolic dimension, left ventricular mass, ejection fraction, or fractional shortening. 2) The left atrial dimension in the hypertensive patients (1.98±0.51cm) was significantly higher than normal control (3.27±0.46 cm) (p<0.05). 3) The left artial index was also higher in the hyper-tensive patients, 1.99±0.36cm/m² versus 2.42±0.39cm/m² (p<0.05), and the left atrial-to-aortic root dimension ratio was significantly higher in the hypertensive group, 1.10±0.14 versus 1.37±0.39 (p<0.05). The above results suggest that echocardiographic left atrial enlargement may be an early sign of hypertensive heart disease in patients with no other discernible causes of left atrial enlargement.
한국인에서 경동맥 경화와 관상 동맥 질환의 연관 관계에 관한 연구
이상억(Sang Eog Lee),김권삼(Kwon Sam Kim),김병준(Byoung Joon Kim),이효정(Hyo Jung Lee),안우석(U Seouk Ahn),강흥선(Heung Sun Kang),조정휘(Chung Whee Choue),김명식(Myung Shick Kim),송정상(Jung Sang Song),배종화(Jong Hwa Bae) 대한내과학회 1996 대한내과학회지 Vol.51 No.6
N/A Objectives: Along with the recent change in lifestyle in Korea, the incidence of coronary artery disease(CAD) and cerebrovascular disease due to atherosclerosis has increased. B-mode ultrasound of the extracranial carotid arteries offers a valid and repeatable noninvasive method for quantifying the extent of atherosclerosis. The extent of carotid artery atherosclerosis as measured by B-mode ultrasound has been shown to be strongly and independently correlated with the presence or absence of CAD. We investigated the relation between carotid atherosclerosis and the status of CAD in Korean population with a carotid B-mode ultrasound. Methods: One hundred twenty eight patients underwent. B-mode ultrasound of the carotid arteries with 10 MHZ linear array probe. The intima-media thickness(IMT) at two sites in far(posterior) wall of the both common carotid artery and bifurcation were quantified and evaluated for the incidence of softand hard plaques. Coronary angiography was performed by the percutaneous technique using Judkins catheter. The extent of CAD was counted as 0,1,2,3-vessel disease according to the number of major coronary vessels with an obstruction of 50% or greater. Results: The number of coronary artery involved was single-vessel disease in 41, two-vessel disease in 19, three-vessel disease in 25 and no corona atherosclerotic disease in 43. The incidence of plaques was no CAD group in 10(23%) at the bifurcation, whearas CAD group in 18(23%) at the common carotid artery and 68(80%) at the bifurcation. The incidence of plaques at the bifurcation increased progressively in each of 2- and 3-vessel disease group compare with the 1-vessel disease group(89%, 100% vs 64%). The sum of IMT at both common carotid artery and bifurcation was significantly different between no CAD and CAD group(3.17±0.08mm vs 4.26±1.37mm, p<0,05), and increased progressively in each of the groups with increasing numbers of stenosed vessels(2-vessel clisease:4.98±1.28mm, 3-vessel disease: 5.29±1.20mm Conclusion: The results suggest that increased IMT of carotid arteries is closely related to status and extent of CAD Also measurement of IMT may be useful screening method for assessment of CAD and systemic atherosclerosis.
증례 : 순화기 ; 건강한 성인에서 인플루엔자 A (H1N1)에 감염에 의해 발생한 급성 심장막염 1예
오치혁 ( Chi Hyuk Oh ),김진배 ( Jin Bae Kim ),김유진 ( Yu Jin Kim ),이태인 ( Taein Lee ),변종규 ( Jong Kyu Byun ),김권삼 ( Kwon Sam Kim ),김우식 ( Woo Shik Kim ) 대한내과학회 2014 대한내과학회지 Vol.87 No.4
A 21.year.old male with no any other diseases presented with fever, chills, and chest discomfort. A chest radiography scan and transthoracic echocardiogram revealed a large amount of pericardial effusion. An H1N1 viral real.time PCR test confirmed the presence of H1N1 viral infection. Pericardiocentesis was performed to reduce symptoms, and oseltamivir (Tamiflu TM ) was administered. His symptoms improved during the first 4 days, and there was no relapse of the pericardial effusion. The most common manifestation of influenza A infection is respiratory tract infection. Although a cardiovascular manifestation is possible, it is extremely rare. We have reported here a case of acute pericarditis with a large amount of pericardial effusion in a healthy adult infected with influenza A virus (H1N1, swine.origin). (Korean J Med 2014;87:461-465)