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답차운동부하 검사에서 나타난 위정상화와 관동맥조영술 소견의 비교관찰
임세중(Se Joong Rim),심원흠(Won Heum Shim),양주영(Joo Young Yang),조승연(Seung Yun Cho),김성순(Sung Soon Kim),이웅구(Woong Ku Lee) 대한내과학회 1990 대한내과학회지 Vol.39 No.1
N/A There has been difficulty in interpreting the results of electrocardiographic exercise test in patients with abnormal T waves at rest. To investigate the significance of pseudonormalization of abnormal T waves during the treadmill test, 14 patients with pseudonormalization who underwent coronary angiography were studied. The following results were obtained: 1) The mean age was 57.4±9.6 (mean+SD) years. 2) There was one-vessel disease in eight patients, two-vessel disease in two patients, normal coronary vessels in four patients. 3) When T wave pseudonormalization and coronary angiography were matched to sites of involvement, 33% of T wave pseudonormafization in lead V2 and V5 was associated with significant lesions in the left anterior descending artery, and 71% of T wave normalization in II was associated with significant lesions in the right coronary artery. Overall, 71% of T wave pseudonormalization was associated with significant coronary lesions. 4) Nine out of 10 patients who complained of typical symptoms of angina had significant coronary diseases, but one out of four patients who had no complaints of symptoms had a significant coronary disease. These findings suggest that pseudonormalization of abnormal T waves in the treadmill test is highly predict- able for the presence of coronary arterial disease in patients with a clinical impression of angina.
임세중 ( Se Joong Rim ) 대한내과학회 2007 대한내과학회지 Vol.73 No.1
Although increased intima-media thickness of common carotid artery independently predicts cardiac outcomes, the clinical significance of carotid intima-media thickness in patients with diagnosed coronary artery disease is still controversial. However, the presence of carotid plaques is clearly associated with an increased risk of cardiovascular events in patients with coronary artery disease, and more aggressive medical treatment is required in this occasion. In addition, carotid disease is commonly associated with coronary artery disease, and the detection of asymptomatic significant carotid stenosis in patients with coronary artery disease may modify treatment strategy and reduce the risk of stroke. Therefore, the screening of carotid atherosclerosis using ultrasound can be helpful in patients with coronary artery disease. (Korean J Med 73:1-3, 2007)
이은직(Eun Jig Lee),이현철(Hyun Chul Lee),안광진(Kwang Jin Ahn),임세중(Se Joong Rim),정윤석(Yoon Sok Jung),이관우(Kwan Woo Lee),임승길(Sung Kil Lim),김경래(Kyung Rae Kim),허갑범(Kap Bum Huh),양우익(Woo Ik Yang),박찬일(Chan Il Park),최 대한내과학회 1991 대한내과학회지 Vol.41 No.6
N/A This retrospective study concerns 73 patients with nonfunctioning pituitary adenoma who were operated on during an 9-year period from 1981 to 1989. Among them, 7 men showed positive immunocytochemistry for FSH and negative for other pituitary hormones. Six of them had elevated serum FSH levels, and LH levels were normal. Testosterone levels were low in six patients tested. Their major symptoms were visual impairment, headache, and impotence, which had developed from two months to 2 years before sugery. Primary hypogonadism could be eliminated on clinical grounds (recent onset of hypogonadism, previous fertility, and posttreatment-improvement). Transsphenoidal adenomectomies were performed in all patients, and radiation-therapies were paralleled in 6 of them. Clinical recovery occurred in all patients. One patient who did not received radiation therapy showed regrowth of tumor mass after 18 months. In remaining 6 patients, we haven't found any evidence of tumor recurrence during follow-up period from 10 months to 6.3 years. We conclude that these 7 men had primary gonadotrope adenoma of the pituitary, and present them with a literature review.
감염성 심내막염 환자에서 증상 없이 발견된 뇌동맥류 1예
김희만,임세중,이주용,이꽃실,김준명,홍유선,이규창 대한내과학회 2003 대한내과학회지 Vol.64 No.4
30세 남자 환자로 심내막염 진단 후 발견된 무증상의 감염성 뇌동맥류로 항생제 치료 후 단계적인 수술로 심장판막 대치술과 뇌동맥류 결찰술을 시행하여 심각한 뇌신경학적 후유증이나 합병증이 발생하기 전에 성공적으로 치료한 경험을 하였기에 문헌 고찰과 함께 보고하는 바이다. Cerebral mycotic aneurysm is an uncommon complication of infective endocarditis. In spite of low incidence, mycotic aneurysm is a serious complication because of the high risk of its rupture. Therefore, early diagnosis and management of cerebral mycotic aneurysm are imperative before the rupture. We experienced a case of asymptomatic cerebral mycotic aneurysm in a 30-year old man with infective endocarditis. He was admitted for splenic and renal infarction due to systemic embolization. The echocardiography showed severe mitral regurgitation, mitral valve prolapse and vegetation on the mitral valve. Streptococcus mitis was identified from blood cultures. In the course of antibiotics therapy, brain magnetic resonance image and 4-vessel cerebral angiography were performed, which revealed multiple unruptured cerebral mycotic aneurysms. Considering the high risk of rupture we performed mitral valve replacement with bioprosthesis. On follow-up cerebral angiography after the valve replacement surgery, one of aneurysms was enlarged, and successfully treated by surgical intervention without complication. We report one case of mycotic aneurysm without neurologic symptom in an infective endocarditis patient, who was treated without serious sequelae of the aneurysm. (Korean J Med 64:477-481, 2003)
심방 중격과 승모판 전엽 양쪽에 동시에 부착된 좌심방 점액종 1예
장태익,정재헌,박정탁,이정은,임세중,정남식,임상현 대한내과학회 2004 대한내과학회지 Vol.66 No.6
저자 등은 심계항진을 주소로 내원한 59세 여자 환자에서 심초음파에 의해 진단하여 종양 절제를 성공적으로 시행한 좌심방내 심방 중격과 승모판 전엽 양쪽에 동시에 부착된 점액종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Myxoma is the most common primary cardiac tumor. It usually develops on the interatrial septum, and occurs in the left atrium in more than 75% of cases. Myxoma in the ventricle is much less common and accunts for only 5% of cases. A myxoma arising from mitral valve is exceedingly rare and is normally located on the atrial side of valve, with and eqivalent distribution between the anterior and posterior leaflets. We report a case of myxoma that arose from both the interatrial septum and anterior mital leaflet. which has not been previously reported in the literature.