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우기현,유기동,김일규,김현호,김동휘,김지희 대한응급의학회 2013 大韓應急醫學會誌 Vol.24 No.5
A 48-year-old woman visited the emergency department,complaining of syncope and chest pain. Her initial vital signs were unstable and her blood pressure was manually uncheckable. Despite inotropics and fluid replacement, the patient collapsed and required cardiopulmonary resuscitation (CPR). During the first CPR, emergent echocardiography revealed severe right ventricular dysfunction. Under clinical suspicion of massive pulmonary thromboembolism (PTE), heparin was administered and extracorporeal membrane oxygenation (ECMO) implanted by the femoral vessels during resuscitation. ECMO was removed on the third hospital day and the patient was discharged under a tolerable state. We report the survival of a patient from massive PTE by treatment with heparin therapy and ECMO.
좌관상동맥 주간부와 우관상동에서 기원하는 이중 좌전하행동맥
김동휘,문건웅,김은희,우기현,신진경,장지연,하성은,이주영 영남대학교 의과대학 2014 Yeungnam University Journal of Medicine Vol.31 No.1
Congenital abnormalities of the coronary arteries are found in 0.6% to 1.3% of patients in coronary angiography. Dual left anterior descending coronary artery (LAD) is a rare coronary anomaly and is incidentally detected during coronary angiography. We report a case of a 65-year-old female with a rare coronary anomaly who was diagnosed with dual LAD via coronary computed tomography and coronary angiography. The imaging studies revealed dual LAD originating from the left main stem and right coronary sinus. These angiographic findings were considered to be consistent with the type IV variety of dual LAD by Spindola-Franco classification. Recognition of dual LAD is important to prevent errors of interpretation of the coronary angiogram and for optimal surgery.
정은,백주열,정한희,박성일,장지혜,유현아,우기현,윤호중 대한심장학회 2014 Korean Circulation Journal Vol.44 No.4
A 66-year-old man presented with exertional dyspnea. He was found to have an unruptured aneurysm of the right sinus of Valsalva caus-ing significant right ventricular outflow obstruction. This aneurysm was diagnosed by transthoracic two-dimensional echocardiogra phy,transthoracic three-dimensional echocardiography, transesophageal echocardiography, contrast echocardiography and 64-slice multide-tector cardiac computed tomography. Because unruptured aneurysms of the sinus of Valsalva are rarely symptomatic, they can be difficultto detect. However, the unruptured aneurysm of the right sinus of Valsalva in this case caused significant right ventricular outflow tractobstruction, resulting in exertional dyspnea.
정한희,백주열,이원익,장지혜,정민영,우기현,박성일,김일규 영남대학교 의과대학 2014 Yeungnam University Journal of Medicine Vol.31 No.2
A pulmonary artery sling is a very rare congenital abnormality in which the left pulmonary artery rises from the posterior surface of the right pulmonary artery and then passes between the trachea and the esophagus, causing tracheal compression. It is associated with tracheo-bronchial abnormalities (50%) and cardiovascular abnormalities (30%). It may produce respiratory symptoms through the airway compression of the abnormal left pulmonary artery and congenital abnormalities associated with it. Because most (90%) pulmonary artery sling patients present symptoms during infancy, their condition is often diagnosed in the first year of life. However, a pulmonary artery sling is occasionally found in adults. It is usually asymptomatic and found incidentally. This is a very rare case of an asymptomatic pulmonary artery sling in an adult. A 38-year-old man presented symptoms of mild exertional dyspnea. His spiral computed tomography showed a pulmonary artery sling. He was discharged without specific treatment because his symptoms improved without specific treatment and might not have been associated with a pulmonary artery sling. We report an adult case of an asymptomatic pulmonary artery sling diagnosed via spiral computed tomography, accompanied by a literature review.
박윤경,정희찬,김신영,김민영,조관훈,김세영,강보라미,우기현,최현주,위성헌 대한감염학회 2014 Infection and Chemotherapy Vol.46 No.3
Spontaneous pneumothorax occurs in up to 35% of patients with Pneumocystis jirovecii pneumonia. However, spontaneouspneumomediastinum and pneumopericardium are uncommon complications in patients infected with human immunodeficiencyvirus, with no reported incidence rates, even among patients with acquired immunodeficiency syndrome (AIDS) andP. jirovecii pneumonia. We report a case of spontaneous pneumomediastinum, pneumopericardium, and pneumothorax withrespiratory failure during treatment of P. jirovecii pneumonia in a patient with AIDS; the P. jirovecii infection was confirmed byperforming methenamine silver staining of bronchoalveolar lavage specimens. This case suggests that spontaneous pneumomediastinumand pneumopericardium should be considered in patients with AIDS and P. jirovecii pneumonia.