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Bioimpedance 를 이용한 심박출량의 측정 ; 열희석법과의 비교
박경선(Kyoung Sun Park),노태호(Tai Ho Rho),최재철(Jae Chul Choi),전승석(Seung Sok Chon),김종상(Chong Sang Kim),김재형(Jae Hyung Kim),최규보(Kyu Bo Choi),홍순조(Soon Jo Hong) 대한내과학회 1989 대한내과학회지 Vol.36 No.4
N/A Changes in bioimpedance during the cardiac cycle are inversely related to the volume of blood within the heart and great vessels. Estimating cardiac output from changes in the bioimpedance is a safe, painless, and noninvasive alternative which should be useful for repeated bedside determinations in individual patients. Cardiac output determined by the bioimpedance method using NCCOM3® (noninvasive continuous cardiac output monitor) was compared with that of the thermodilution method in 22 patients who underwent cardiac catheterization. Twenty-two patients, 7 males and 15 females ranging in age from 22 to 56 (mean 41.4), had various cardiac diseases. Coronary heart disease was present in 5 and valvular heart disease in 17. The cardiac rhythm was sinus rhythm in 4 and atrial fibrillation in 18. The results were as follows: 1) Bioimpedance provided a noninvasive, continuous and simple method to monitor cardiac output. 2) Cardiac output measured by bioimpedance and the thermodilution method correlated well (r=0.827 as a whole, r=0.902 in those with sinus rhythm). 3) Bioimpedance can be used in the clinical setting when the thermodilution method is not readily feasible and when continuous monitoring of cardiac output is indicated.
백상홍 ( Baeg Sang Hong ),양종목 ( Yang Jong Mog ),정욱성 ( Jeong Ug Seong ),전승석 ( Jeon Seung Seog ),노태호 ( No Tae Ho ),박인수 ( Park In Su ),김재형 ( Kim Jae Hyeong ),최규보 ( Choe Gyu Bo ),홍순조 ( Hong Sun Jo ) 대한내과학회 1992 대한내과학회지 Vol.42 No.4
발작성 심실상성빈맥 환자에서 전기생리학적 검사를 실시하여 빈맥이 유발된 26명을 대상으로 빈맥의 발생기전에 따른 임상특징 및 빈맥시 심전도 및 전기생리학적 검사소견을 분석하여 다음과 같은 결과를 얻었다. 1) 전기생리학적 검사에서 계획전기자극에 의한 빈맥의 유발율은 76%였다. 2) 발작성 심실상성 빈맥의 발생기전은 불현성 우회로를 이용한 방실회귀가 80%로 가장 흔하였고 방실결절회귀 15%, 자동성 심방빈맥이 5%였다. 3) 환자는 연령 및 빈맥시 심박동수는 빈맥기전에 따라 유의한 차이가 없었으나, 방실회귀성 빈맥군이 비교적 젊은 연령 및 빠른 심박동수를 보였다. 4) 기능적 각차단은 방실회귀에서 4예 관찰되었다. 5) QRS alternans는 방실회귀에서 3예 관찰되었다. 6) 빈맥이 심전도에서 P파 및 QRS군 관계의 분석(RP/RR) 이 회귀성 빈맥기전의 감별에 유용하였다(p<0.05). 7) His속 전기도에서 VA 간격은 방실회귀성 빈맥시 70 msec 이상(103.1±18.9msec), 방실결절회귀 빈맥에서 60 msec 이하 (36.6±25.1 msec)로 빈맥기전 감별에 유용하였다(p<0.05). 8) 방실회귀성 빈맥시 심전도의 유도 I의 P파 모양이 부전도로 위치 추정에 도움이 되었다. In this study, the frequency of mechanisms of supraventricular tachycardia (SVT) were evaluated by analyzing the electrophysiologic findings of 26 patients with SVT without preexicitation between November 1987 and August 1990. The induction of tachycardia by programmed electrical stimulation and the determination of mechanism of SVT were performed by baseline electrophysiologic (EP) study in drug free status. The study group included 14 males and 12 females with ages rangiang from 16 to 54 years (mean±SD; 35.6±12.8). All patients had structurally normal heart except the 7 mitral value prolapse. We also compared the clinical findings, surface EKG during tachycardia and EP study findings according to the mechanism of SVT. The results were as follows: 1) In EP study, programmed stimulation induced sustained SVT was 20 of the 26 patients(induction rate 76 %). 2) Atrioventricular reentrant tachycardia (AVRT) using concealed bypass tract was the most common mechanism of SVT (80%), atrioventricular nodal reentrant tachycardia (AVNRT) was the second (15%) and the remainder was increased automaticity of the atrium (5%). 3) The age of the patients and their heart rates during tachycardia were not significantly different among the mechanism of SVT. 4) Functional bundle branch block during reciprocating tachycardia appeared in the AVRT group (4/16 cases). 5) The alternations of QRS during reciprocating tachycardia appeared in the AVRT group (3/16 cases). 6) The relationship between P wave and QRS complex (RP/RR) during tachycardia was useful in differentiating the mechanism of SVT (p<0.05). 7) The ventriculoatrial interval on His-bundle electrogram was more than 70 msec in the AVRT group, whereas this was less than 60 mesc in the AVNRT group. 8) In the AVRT group. P wave morphology and axis in the lead I was useful to determine the site of accessory pathway.
김치경,정진용,곽문섭,김세화,이홍균,홍순조,Kim, Chi-Kyung,Jeong, Jin-Yong,Kwack, Moon-Sup,Kim, Se-Wha,Lee, Hong-Kyun,Hong, Sun-Jo 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.6
Supraventricular tachyarrhythmias are readily characterized and understood, but the surgical procedures for their correction are complex and not easily mastered. Conversely, ventricular tachyarrhythmias are frequently difficult to characterize and localize electrophysiologically and their basic mechanisms are poorly understood. The role of the surgeon in the treatment of cardiac arrhythmia has changed dramatically during the past decade. This report is a case of 26 years old male with supraventricular tachyarrhythmia. The result of endocardial electrophysiologic study demonstrated accessory pathway connecting left atrium to left ventricle which located at left atrial free wall about 4 cm apart from the coronary sinus orifice. The accessory bundle interruption has been successfully accomplished utilizing the internal open heart technique. The operation consisted of dissection of the atrioventricular fat pad and division of all the superficial fibers going from the ventricle to the annulus. Following this, cryoablation made with cryoprobe at - 60$^\circ{C}$ for 90 seconds. The accessory pathway was successfully ablated without specific problems.
흰쥐의 실험적 심근경색증에서 Captopril 및 Propranolol의 장기간 투여가 좌심실 형태학적 변형에 미치는 효과
김철민 ( Kim Cheol Min ),정욱성 ( Jeong Ug Seong ),백상홍 ( Baeg Sang Hong ),전승석 ( Jeon Seung Seog ),김종상 ( Kim Jong Sang ),김재형 ( Kim Jae Hyeong ),최규보 ( Choe Gyu Bo ),홍순조 ( Hong Sun Jo ) 대한내과학회 1992 대한내과학회지 Vol.42 No.6
저자들은 흰쥐에서 심근경색을 유발시킨 후 7일부터 42일까지 captopril및 propranolol을 투여한 후 나타나는 좌심실의 형태학적 변형을 알아보기 위해 경색의 크기, 경색확대율, 좌심실 반경, 심실중격의 두께 등을 측정하여 다음과 같은 곁과를 얻었다. 1) waterf의 좌심실 반경, 경색확대율, 심내막 둘레는 가상대조군에 비해 현저히 증가하였다. 2) captopril군의 좌심실 반경, 심실중격 두께는 Water군에 비해 현저히 감소하였다. 3) propranolol군의 좌심실 반경은 water군에 비해 감소 경향을 보였으나, 심실 중격의 두께의 차이는 보이지 않았다. 이상의 결과 휜쥐의 실험적 심근 경색증후 captopril의 장기 투여는 좌심실의 형태학적 변형에서 좌심실 화대와 대상성 심실비대를 약화시켰으며, propranolol의 장기투여는 좌심실 확대를 약화시켰으나 대상성 심실비대에는 영향을 주지 못하였다. To determine the effects of long-term therapy with captopril or propranolol on left ventricular remodeling, we studied 101 Sprague-Dawley rats with experimental myocardial infarction. The animals were randomized to recieve captopril (2000 ㎎/L) or propranolol (750 ㎎/L) in their drinking water, or water alone for 42 days. Cross sections of the left ventricle were prepared for morphometric measurements of infarct size, infarct expension rate, left ventricular radius, and septal thickeness. The results were as follows: 1) In untreated rats with experimental myocardial infarction, left ventricular remodeling was revealed (total water group). The left ventricular radius (3.1+0.4㎜) and infarct expantion rate (37.8+6.4%) was larger than those of the sham operated rats (p<0.005, p<0.01). 2) The septal thickness of the total captopril group (1.58+0.20㎜) was smaller than that of the total water group (1.89±0.35㎜)(p<0.05), and the septal thickness of the captopril group with moderate myocardial infarction (1.62±0.13 ㎜) was also smaller than that of the propranolol group with moderate myocardial infarction (1.84±0.13 ㎜)(p<0.05). The left ventricular radius of the captopril group with moderate myocardial infarction (2.6k0.3 mm) was smaller than that of the propranolol group (3.0±0.3 ㎜)(p < 0.05). 3) There was no significant difference in the septal thickness between the total propranolol group and total water group. The left ventricular radius of total pro-pranolol group was smaller than that of water group insignificantly. It was concluded that long-term therapy of captopril had effects in rats with infarct, resulting in significant blunting of left ventricular dilation and septal hypertrophy, and long-term therapy of propranolol had effects, resulting in blunting of left ventricular dilation but no decreasing of septa1 hypertrophy.
김미경 ( Kim Mi Gyeong ),김명석 ( Kim Myeong Seog ),김현성 ( Kim Hyeon Seong ),정승은 ( Jeong Seung Eun ),윤호중 ( Yun Ho Jung ),정욱성 ( Jeong Ug Seong ),홍순조 ( Hong Sun Jo ) 대한내과학회 2003 대한내과학회지 증례 특집호 65-5 부록3 Vol.0 No.-
Congenital left ventricular aneurysm is rare, poorly understood, and potentially lethal. Also, congenital coronary artery fistula is rare but hemodynamically, it induces myocardial ischemia due to coronary steal syndrome and diastolic volume overload from
이승우 ( Lee Seung U ),고명범 ( Go Myeong Beom ),허원행 ( Heo Won Haeng ),김주상 ( Kim Ju Sang ),윤호중 ( Yun Ho Jung ),정욱성 ( Jeong Ug Seong ),홍순조 ( Hong Sun Jo ) 대한내과학회 2003 대한내과학회지 증례 특집호 65-5 부록3 Vol.0 No.-
Isolated noncompaction of ventricular myocardium, sometimes referred to as spongy myocardium, is a rare congenital cardiomyopathy. Spongy myocardium results from an arrest in normal endomyocardial embryogenesis. The clinical symptoms and electrocardiograp