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서혜선 ( Hye Sun Seo ),이내희 ( Nae Hee Lee ) 대한내과학회 2010 대한내과학회지 Vol.78 No.1
The diagnosis and assessment of pulmonary arterial hypertension (PAH) is a rapidly evolving area, with changes occurring in the definition of the disease, screening and diagnostic techniques, and staging and follow-up assessment. After 4th World Symposium on pulmonary hypertension (PH) which took place in Dana Point in early 2008, the definition of PH has been simplified (mean pulmonary artery pressure ≥25 mmHg) based on currently available evidences. The diagnosis of PH involves two stages: detection (determining the cause of a patient`s symptoms, or to detect the presence of PAH in a high-risk patient) and characterization (determining the specific clinical context of the PH, including causal factors, associated diseases or substrates and hemodynamic perturbations). Echocardiography and right heart catheterization have been main diagnostic method in PAH. Also, there has been progress in imaging techniques and biomarkers used to screen patients for the disease and to follow up their response to therapy. Useful tools to predict outcome include functional class, exercise capacity, pulmonary hemodynamics, acute vasoreactivity, right ventricular function, as well as brain natriuretic peptide, endothelin-1, and so on. As new therapies have been developed for PAH, screening, prompt diagnosis, and accurate assessment of disease severity have become increasingly important. A clear definition of PH and the development of a rational approach to diagnostic assessment and follow-up using both conventional and new tools will be essential to advance proper treatment of patients. (Korean J Med 78:5-13, 2010)
증례 : 순환기 ; 급성 심근경색 및 심장 내 혈전증이 동반된 베체트병 1예
허순미 ( Soon Mi Hur ),조윤희 ( Youn Hee Cho ),하태훈 ( Tae Hoon Ha ),서혜선 ( Hye Sun Seo ),전찬홍 ( Chan Hong Jeon ),김동훈 ( Dong Hun Kim ),서존 ( Jon Suh ) 대한내과학회 2012 대한내과학회지 Vol.82 No.3
A 36-year-old man with a history of Behcet`s syndrome and vascular complications visited the emergency room due to sudden chest pain and dyspnea. He had no coronary risk factors. Electrocardiography showed ST elevations in multiple precordial leads. Echocardiography showed akinesia of the anterior wall, interventricular septum, and apex, with a movable round mass measuring 1.4×1.5 cm in the right atrium. Cardiac computed tomography (CT) suggested the presence of a thrombus in the coronary sinus protruding into the right atrium. Coronary angiography revealed total occlusion with thrombi in the proximal left anterior descending coronary artery. Thrombectomy and stent insertion were performed. After the procedure, the patient was prescribed warfarin. Follow-up CT indicated the disappearance of the thrombi originating from the coronary sinus. (Korean J Med 2012;82:347-351)
개회충증에 의하여 유발된 호산구성 심장막염을 동반한 급성 담낭염 1예
추진우 ( Jin Woo Choo ),최현종 ( Hyun Jong Choi ),문종호 ( Jong Ho Moon ),정종호 ( Jong Ho Chung ),박진석 ( Jin Seok Park ),명유식 ( Yu Sik Myung ),서혜선 ( Hye Sun Seo ) 대한내과학회 2013 대한내과학회지 Vol.84 No.6
Toxocariasis is a parasite infection of a human host caused by Toxocara canis. Most human infections occur in persons who eat contaminated food containing embryonated eggs or larvae. Toxocariasis can produce various symptoms associated with eosinophilic infiltration into various internal organs such as the liver, lungs, eyes, or central nervous system. However, a simultaneous onset of cholecystitis and pericarditis has not yet been reported in the literature. A 39-year-old female patient complained of right upper abdominal pain. Several imaging studies revealed acute cholecystitis and pericarditis with pericardial effusion. Marked eosinophilia was observed in her peripheral blood and pericardial fluid. A high titer of antibodies against T. canis was discovered during the search for the cause of the eosinophilia. All clinical features and the eosinophilia improved dramatically after treatment with albendazole. We report a case of simultaneous onset of acute cholecystitis and pericarditis associated with marked eosinophilia caused by T. canis. (Korean J Med 2013;84:836-841)