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Hyun-Jin Kim,Kyung-Hee Kim,Jae-Sung Choi,Jun-Sung Kim,Myung-A Kim,Joo-Hee Zo 한국심초음파학회 2012 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.20 No.1
Preservation of the subvalvular apparatus has the merits of postoperative outcomes during mitral valve replacement for mitral regurgitation. We performed mitral valve replacement with anterior and posterior leaflet chordal preservation in a 65-year-old woman. On the 2nd postoperative day, routine postoperative trans-thoracic echocardiography showed an unknown aortic subvalvular mobile mass. We report a case of a remnant mitral subvalvular apparatus detected by echocardiography after chordal preserving mitral valve replacement which was confused with postoperative aortic valve vegetation.
김학령,Jae-Bin Seo,정우영,Joo-Hee Zo,김명아,김상현 대한심장학회 2013 Korean Circulation Journal Vol.43 No.11
Although atrial fibrillation is the most frequent cause of embolic stroke, coronary embolism from atrial fibrillation is a very rare cause of acute myocardial infarction. Therefore, simultaneously presented acute ischemic stroke and acute myocardial infarction due to atrial fibrillation in the same patient has not been documented. The present report describes the case of a 58-year-old man with paroxysmal atrial fibrillation who initially presented with a large cerebral infarction due to embolic occlusion of the left middle cerebral artery. Four hours after the diagnosis of cerebral embolism, he was subsequently diagnosed with acute myocardial infarction due to concurrent coronary embolism. He underwent successful coronary revascularization with a drug-eluting stent. The possibility of combined coronary embolism as a rare etiology should be kept in mind when a patient with acute embolic stroke presents, especially when there is evidence of acute myocardial infarction.
최기준(Kee Joon Choi),조주희(Joo Hee Zo),한경일(Kyung Il Han),김영권(Young Kwon Kim),조명찬(Myeong Chan Cho),손대원(Dae Won Sohn),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),이영우(Young 대한내과학회 1990 대한내과학회지 Vol.39 No.5
N/A To observe the clinical features of Takayasu's arteritis and evaluate the incidence and sites of coronary arterial involvement in Takayasu's arteritis, clinical observations were made in 99 patients who were diagnosed as Takayasu's arteritis by clinical features and aortographic findings in Seoul National University Hospital from August 1971 to July 1989 Coronary arteriographies were performed prospectively in 30 patients with Takayasu's arteritis since March 1987. The results were as follows: 1) In 99 cases of Takayasu's arteritis, 15 were male and 84 were female. The male to female ratio was 1:5.7, the mean age was 29.5, and 63% of those studied were under the age of 30. 2) The following were the presenting clinical symptoms and signs in decreasing order of frequency: headache(69%), weak or nonpalpable pulse(68%), carotid or abdominal bruit(55%), Dyspnea on exertion(51%), hypertention(48%), and dizziness(43%). 3) Aorta or arterial involvement in decreasing order of frequency: left subclavian artery(62%), abdominal aorta(58%), right subclavian artery(38%), descending thoracic aorta(37%) and left renal artery(35%). 4) Using Ueno's classification, 29(29%) were Type I, 22(22g) were Type II, and 48(48%) were Type III. Type IV or pulmonary arterial involvements were seen in 11(33%) out of 33 patients. 5) In a prospective study using coronary arteriography, 8(27%) out of 30 patients of Takayasu's ateritis showed coronary involvement. Among the 13 lesions of coronary arterial narrowings in 8 patients with coronary involvements, there were 3 ostial lesions, 5 proximal and 5 middle or distal lesions. 6) Frequently there were no cardiac symptom in patients with Takayasu's arteritis who had coronary arterial lesions, and a myocadial infarction or congestive heart failure may be the first sign of the coronary arterial narrowing.
(Jae Ho Lee),(Dong Ho Lee),(Joo Hee Zo),(Tae Ho Kim),(Kook Lae Lee),(Hee Soon Chung),(Cheol Ho Kim),(Sung Ku Han),(Young Soo Sim),(Hyo Suk Lee),(Yong Bum Yoon),(In Sung Song),(Chung Yong Kim) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.2
N/A Background : Hepatopulmonary syndrome (HPS) refers to the association of hypoxemia, intrapulmonary shunting and chronic liver disease. But there is no clear data about the prevalence of HPS in postnecrotic liver cirrhosis by hepatitis B virus(HBV), the most common cause of liver disease in Korea. The aim of this study was to investigate the prevalence of HPS in poorly compensated postnecrotic liver cirrhosis by HBV, and the correlation of the hepatopulmonary syndrome with clinical aspects of postnecrotic liver cirrhosis by HBV. Methods : Thirty-five patients underwent pulmonary function test, arterial blood gas analysis and contrast-enhanced echocadiography. All patients were diagnosed as HBV-induced Child class C liver cirrhosis and had no evidence of intrinsic cardiopulmonary disease. Results : Intrapulmonary shunt was detected in 6/35 (17.1%) by contrast- enhanced echocariography. Two of six patients with intrahepatic shunts had significant hypoxemia (PaO2 < 70 mmHg) and four showed increased alveolar- arterial oxygen gradient over 20 mmHg. Only cyanosis could reliably distinguish between shunt positive and negative patients. Conclusions : The prevalence of intrapulmonary shunt in poorly compensated postnecrotic liver cirrhosis by HBV was 17.1% and the frequency of hepatopulmonary syndrome was relatively low (5.7%). ‘Subclinical’ hepatopulmonary syndrome (echocardiographically postive intrapulmonary shunt but without profound hypoxemia) exists in 11.4% of cases with poorly compensated postnecrotic liver cirrhosis by HBV. Cyanosis is the only reliable clinical indicator of HPS of HBV- induced poorly compensated liver cirrhosis. Further studies are required to determine if the prevalence and clinical manifestations of HPS varies with etiology or with geographical and racial differences.