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차성태,선한경,고광현,홍성표,황성규,박필원,임규성,권창일 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.2
We report a rare case of a massive fatal embolism that occurred in the middle of endoscopic retrograde cholangiopancreatography (ERCP) and retrospectively examine the significant causes of the event. The patient was a 50-year old female with an uncertain history of previous abdominal surgery for multiple biliary stones 20 years prior. The patient presented with acute right upper quadrant pain. An abdominal computed tomographic (CT) scan revealed the presence of multiple stones in the common bile duct (CBD) and intra-hepatic duct (IHD) with biliary obstruction, multifocal liver abscesses, and air-biliarygram. Emergency ERCP showed a wide and straight opening of choledochoduodenostomy, which may have been created during a previous surgery, and multiple filling defects in the CBD. With the use of a forward endoscope, mud stones were extracted through the opening of the choledochoduodenostomy. Cardiac arrest suddenly developed during the procedure, and despite immediate resuscitation, the patient died due to a massive systemic air embolism. We reviewed previously reported fatal cases and accessed factors facilitating air embolisms in this case.
A Case of the Coronary Artery Aneurysm afterSirolimus-Eluting Stent Implantation
박경선,차성태,성정훈,김인재,임상욱,차동훈 대한심장학회 2007 Korean Circulation Journal Vol.37 No.3
This report describes the case of a 26-year-old male diagnosed with angina on exertion. A diagnostic coronaryangiography revealed significant luminal narrowing at the middle third of the left anterior descending artery andproximal circumflex artery. The patient underwent implantation of sirolimus-eluting stents. Eight months afterimplantation of the stents, a follow-up coronary angiography showed intrastent coronary artery aneurysms. Wesuggest that the implantation of the sirolimus-eluting stent caused late formation of a coronary artery aneurysm.(Korean Circulation J 2007;37:127-129)
만성폐쇄성폐질환 급성 악화로 입원한 환자의 세균성 원인
주세경 ( Sae Kyung Joo ),구승원 ( Seung Won Koo ),김미애 ( Mi Ae Kim ),조양현 ( Yang Hyun Cho ),차성태 ( Sung Tae Cha ),홍기연 ( Gi Youn Hong ),김은경 ( Eun Kyung Kim ),이지현 ( Ji Hyun Lee ),홍성근 ( Seong Geun Hong ),정혜철 ( Hy 대한내과학회 2009 대한내과학회지 Vol.77 No.3
Background/Aims: Bacterial infections play an important role in acute exacerbations of chronic obstructive pulmonary disease (AECOPD). While critically ill patients requiring admission need proper antibiotic treatment for the causative pathogen, little is known about the bacterial etiology of AECOPD in Korea. We therefore studied the bacterial etiology of hospitalized patients with COPD in our institution. Methods: The study enrolled 149 patients who were admitted to the hospital in Sungnam with the diagnosis of AECOPD between July 1, 2004 and June 1, 2007. We retrospectively reviewed the clinical data and results of sputum cultures. Results: Of the 149 subjects with sputum collected, 51% (76 cases) had positive bacterial cultures [age 70.7±9.2 years (mean±SD); 116 males] of sputum. Pseudomonas aeruginosa (24 cases, 30.4%) was the organism cultured in sputum most commonly, followed by Streptococcus pneumonia (15 cases, 18.9%), Acinetobacter sp. (9 cases, 11.4%), and Klebsiella pneumonia (7 cases, 8.9%). Patients whose FEV1 was <50% of the predicted value had a greater chance of showing positive growth of P. aeruginosa than patients having a FEV1 >50% (17/96 vs. 4/53, respectively, p=0.002). Patients taking systemic steroids also had a higher rate of sputum culture of P. aeruginosa (85.7%). Conclusions: P. aeruginosa was the pathogen most commonly isolated in hospitalized patients with COPD. This species should be considered when physicians select empirical antibiotics to treat patients with AECOPD. (Korean J Med 77:309-314, 2009)