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김준수 ( June Soo Kim ) 대한내과학회 2010 대한내과학회지 Vol.78 No.1
Physicians prefer traditional right ventricular apical pacing to right ventricular outflow tract pacing because of easy accessibility, short procedure time, stable lead function and a low incidence of complications. However, right ventricular apical pacing produce an abnormal pattern of ventricular activation compared with right ventricular outflow tract pacing. There is growing evidence that right apical pacing may have long-term detrimental effects on left ventricular function. The report of Kim et al. in this issue showed that ventricular dyssynchrony was commonly seen in patients with permanent pacemaker implantation. They suggested the role of paced QRS duration to predict ventricular dyssynchrony during the follow-up period in patients with permanent pacemaker. However, a large scaled prospective observational study is needed to assess the factors influencing ventricular dyssynchrony in Korean patients with permanent pacemaker. (Korean J Med 78:56-58, 2010)
증례 : 순환기: 위출혈 환자에서 관상동맥중재술 직후 발생한 급성 스텐트혈전증 1예
김준영 ( Jun Young Kim ),김혜인 ( Hye In Kim ),김지원 ( Ji Won Kim ),김진혜 ( Jin Hae Kim ),김영남 ( Young Nam Kim ),송영빈 ( Young Bin Song ),김준수 ( June Soo Kim ) 대한내과학회 2016 대한내과학회지 Vol.90 No.4
급성 위장관출혈 및 흉통으로 내원한 59세 남자 환자에서 수혈 및 내시경지혈술을 시행하였고, 출혈이 멎은 뒤 3일 후 급성 관동맥증후군으로 관상동맥중재술을 시행하였다. 성공적인 중재술 직후 환자는 흉통을 호소하다가 맥박이 소실된 심실세동으로 제세동 및 경피적 심폐순환 보조장치를 삽입 하였다. 이후 시행한 관상동맥조영술에서 급성 스텐트혈전증을 진단하였다. 우리는 급성 관동맥증후군과 출혈이 동시에 발생할 경우 항혈소판제의 균형 있는 사용에 대해 신중한 선택이 필요하다는 것을 본 증례를 통해 확인하였고 이에 문헌고찰과 함께 보고하는 바이다. Stent thrombosis is a rare, but potentially catastrophic complication of stent implantation. Dual antiplatelet therapy with aspirin and a thienopyridine (clopidogrel, prasugrel, or ticagrelor) is essential to minimize the risk of stent thrombosis in patients receiving drug-eluting stents. However, there is an ongoing debate regarding antiplatelet therapy in patients presenting with acute coronary syndrome and bleeding. Here, we report a case of a 59-year-old man with acute stent thrombosis immediately after percutaneous coronary intervention combined with acute coronary syndrome and gastrointestinal bleeding. (Korean J Med 2016;90:322-325)
김정옥 ( Jung Ok Kim ),김은정 ( Eun Jung Kim ),민신영 ( Shin Young Min ),박윤경 ( Yun Gyoung Park ),조아진 ( A Jin Cho,Jun ),전준석 ( Seok Jeon ),김준수 ( June Soo Kim ) 대한내과학회 2011 대한내과학회지 Vol.81 No.2
저자들은 다른 기저 질환이 없는 환자에서 발생한 기침과 동반한 방실전도차단과 관련된 기침 유발성 실신을 영구형심박동기 삽입술로 치료하였던 예를 문헌고찰과 함께 보고 하는 바이다. We report the case of a 52-year-old man who had two syncopal episodes associated with coughing. Other than essential hypertension, he had no organic disease of the heart or lungs. Transient complete atrioventricular block following coughing was detected by electrocardiographic telemonitoring while resting. During that time, the patient experienced near-syncope similar to his previous syncopal episodes. He was treated successfully with permanent pacemaker implantation. (Korean J Med 2011;81:241-244)
섬유혼입 조건과 보강근 유무에 따른 변형 경화형 시멘트 복합체 접합부의 전단거동특성
노태우(Noh, Tae-Woo),류승현(Ryu, Seung-Hyun),김준수(Kim, June-Soo),김성호(Kim, Sung-Ho),이영오(Lee, Young-Oh),윤현도(Yun, Hyun-Do) 한국구조물진단유지관리학회 2011 한국구조물진단학회 학술발표회논문집 Vol.15 No.1
This paper discusses shear behavior of Joint with strain hardening cement-based composite(SHCC). The main variables considered include the type of cement (two kind of SHCC with hybrid fiber) and reinforcement detail. As the result of the tests, for the same reinforcement detail, SFPE-H100 specimen showed better overall behavior(stress, ductile, multiple cracking) than PVAPE-H100. And according to hoop increased shear stress and displacement of SHCC specimens.
2018 대한부정맥학회 심방세동 환자의 통합적 관리 지침
박준범 ( Junbeom Park ),정보영 ( Boyoung Joung ),김준 ( Jun Kim ),김진배 ( Jin-bae Kim ),박형욱 ( Hyung Wook Park ),박예민 ( Yae Min Park ),엄재선 ( Jae-sun Uhm ),안진희 ( Jinhee Ahn ),이대인 ( Dae In Lee ),김준수 ( June Soo Kim 대한내과학회 2018 대한내과학회지 Vol.93 No.4
Atrial fibrillation (AF) is the most common form of sustained arrhythmia in elderly patients. However, AF is often detected during health screening, or accidentally during testing for other diseases; some patients lack clinical symptoms. Nevertheless, AF increases the incidence of ischemic stroke and other thrombotic events, and compromises cardiovascular prognosis in terms of heart failure, dementia, and hospitalization. Therefore, initial AF management should be performed at the point of primary care, not only in specialized medical centers. We wish to propose a five-step management protocol for AF. We review the evidence supporting integrated management by primary care physicians new to AF, and by specialized physicians who often diagnose and manage AF. Further, we also outline a structured goal-based follow-up protocol; this is an important part of integrated management. (Korean J Med 2018;93:336-343)
Q 파 심근경색과 비 - Q 파 심근경색의 임상경과 및 관동맥조영술 소견의 비교
정기영(Ki Young Chung),홍석근(Suk Keun Hong),이명룡(Myung Yong Lee),조주희(Joo Hee Zo),김준수(June Soo Kim),김치정(Chee Jeong Kim),조명찬(Myeong Chan Cho),박영배(Young Bae Park),이명묵(Myoung Mook Lee),최윤식(Yun Shik Choi),서정돈(Ju 대한내과학회 1991 대한내과학회지 Vol.40 No.1
N/A Despite of having smaller infarct size and better left ventricular function, patients with non-Q wave myocardial infarction has been reported to have an high late cardiac event rate, and long term prognosis is ultimately comparable to that of patients with Q wave myocardial infarction. This is because there is more viable tissue in the perfusion zone of infarct-related artery rendering myocardium more prone to reinfarction. To compare the prognosis and clinical characteristics of Q wave myocardial infarction with those of non-Q wave myocardial infarction, 390 patients with acute myocardial infarction were reviewed and analyzed retrospectively. Patients were classified according to electrographic results into Q wave infarction (n=336) and non-Q wave infarction (n=54). Predischarge coronary angiography, gated blood pool scan, end treadmill exercise test were performed. There was no significant difference in sex, age, angina history, previous myocardial infarction, location of infarction, and severity of coronary disease; Q wave myocardial infarction did have higher peak CK (1733.9±1432.6 vs. 511.1±588.8 IU; P<0.01) and CK-MB fraction level (334.2±371.5 vs. 78.7±128.5; P<0.01). Predischarge treadmill exercise test showed no significant difference in the exercise duration, ST segment change, and chest pain. In gated blood pool scan, ejection fraction of left ventricle did not show significant difference, but proportion of normal left ventricular wall motion was significantly higher in non-Q wave infarction. (21/257 vs. 19/42; P<0.01). The extent of coronary artery disease and degree of coronary artery stenosis was not different between two groups, but high degree obstruction (>90%) of infarct related artery was more frequent in Q wave myocardial infarction (134/187 vs. 19/35; P<0.05). During follow-up, in-hospital mortality was significantly higher in Q wave myocardial infarction (13% vs. 2%, p<0.01). But postdischarge mortality and the rate of reinfarction did not different between two groups. Further prospective studies should be performed to clarify the clinical behaviors and long-term prognosis in patients with non-Q wave myocardial infarction.
박승우(Seung Woo Park),박대균(Dai Gyun Park),최기준(Kee Joon Choi),권현철(Hyeon Cheol Kwon),조명찬(Myeong Chan Cho),김준수(June Soo Kim),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),이영우 대한내과학회 1990 대한내과학회지 Vol.39 No.6
N/A 26 cases(12.0%) showed angiographically normal coronary artery. Among 217 cases of acute myocardial infarction(AMI), the patients with normal coronary arteriograms were younger than those with abnormal coronary arteriograms (p<0.05). There were no differences between the two groups in risk factors and tread- mill test. The incidence of non-Q wave infarction significantly increased in the group of patients with normal coronary arteriograms (p<0.005). Ejection fraction in gated blood pool scan and hemodynamic findings including cardiac index and left ventricular end diastolic pressure (LVEDP) were similar in both groups. Normal wall motion in the left ventriculogram was noticed more frequently in patients with normal coronary arteriogram (p<0.005). The incidence of postinfarct complication and symptomatic recurrence rate of ischemic heart disease after AMI showed no differences between the two groups. In conclusion, the incidence of AMI with normal coronary arteriogram was higher than that of other western studies. The reason for this difference is unclear, although it might be explained partially by a reported high incidence of vasospasm in our country. More data are needed especially in the aspect of prognosis, in order to establish the clinical significance of normal coronary angiogram in patients with AMI.