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유경보 ( Kyung Bo Yoo ),이선화 ( Sun Hwa Lee ),이경석 ( Kyoung Suk Rhee ),이강휴 ( Kang Hyu Lee ),이상록 ( Sang Rok Lee ),채제건 ( Jei Keon Chae ),김원호 ( Won Ho Kim ),고재기 ( Jae Ki Ko ) 전북대학교 의과학연구소 2010 全北醫大論文集 Vol.34 No.2
배경 및 목적: 최근 약물과 관련되어 발생한 서맥성 부정맥의 예후에 대한 재평가가 이루어지고 있다. 본 연구는 약제 유발성 서맥으로 최초 진단받은 환자들의 임상 경과를 분석하여 그 예후를 평가하고자 하였다. 방법: 전북대학교 병원 심장내과에 2000년 1월 이후 약물 유발성 서맥으로 진단 받고 입원치료를 받았던 환자들을 대상으로 하여 의무기록 분석 및 전화상담을 통한 후향적 조사를 하였다 결과: 전체 환자 중 경과 관찰 기간 동안 영구적 심박동기 삽입술을 시행 받은 환자는 28명(26.9%)으로, 동기능 부전 증후군 군과 고도방실차단 군에서 각각 15명(/68, 22.1%)과 13명(/36, 36.1%)이었다 결론: 고전적으로 양호한 임상경과를 취하는 것으로 알려져 왔던 이차성 서맥성 부정맥 환자 상당수에서 유발인자가 없이도 서맥이 점차 진행하여 결국 영구형 인공심박동기 이식시술을 받게 된다. Background and Objectives: Recently, the prognosis of drug-induced bradyarrhythmias has been reported not as benign as previous considerations. We performed the investigations about the patients who had been diagnosed as drug-related bradyarrhythmias presenting it at first. Subjects and Methods: Medical records of those who had been admitted to Chonbuk National University Hospital due to drug-related bradyarrhythmias since January 2000 were investigated retrospectively and clinical follow-up was performed using phone call. Results: One hundred and four patients were enrolled. Mean age was 68±10(34-85) years. Underlying diseases that need relating drugs were hypertension (50, 48.1%), ischemic heart disease, atrial fibrillation, cardiomyopathy, etc. Most common single causative agent was β-blockers (53.0%) and the others were nondihydropyridine calcium channel blockers (18.9%), digoxin (10.6%), antiarrhythmics (9.1%) and herb-medications (3.8%). 68 patients showed sinus node dysfunction (SND, 65.4%) and 36 showed AVB (34.6%). Mean heart rate on admission was 37.0±7.1 beats/minute. Permanent pacemaker implantations were performed in 28 patients (26.9%). Fifteen among them were with SND (15/68, 22.1%), 13 were with AVB (13/36, 36.1%). Conclusion: Unlikely to the general considerations, it would be better to say that drug-related bradyarrhythmias are not drug-induced bradyrrhythmias itself, but unmasked underlying bradyarrythmias in substantial portion of the patients. Very close and cautious clinical monitoring should be performed, especially in patients with AVB.
송민주 ( Min Ju Song ),유경보 ( Kyung Bo Yoo ),정재석 ( Jae Seok Jeong ),국민하 ( Min Ha Kook ),정주영 ( Joo Young Chung ),박성철 ( Sung Chul Park ),임정호 ( Jung Ho Lim ),김원호 ( Won Ho Kim ) 전북대학교 의과학연구소 2010 全北醫大論文集 Vol.34 No.2
We report the case of a 66-year-old man with a past medical history of hypertension who suffered from the first time syncope. Transthoracic echocardiography showed two echogenic material of interatrial septum. And there is dynamic midventricular obstruction with hyperdynamic left ventricular systolic function. Transesophageal echocardiography showed dumbbell-shaped interatrial septum.
중증 재생불량성빈혈 환자에서 발생한 폐렴막대균 췌장농양
임성균 ( Sung Kyun Yim ),이석 ( Seok Lee ),김인제 ( In Jae Kim ),장지원 ( Ji Won Jang ),정재석 ( Jae Seok Jeong ),유경보 ( Kyung Bo Yoo ),양희찬 ( Hee Chan Yang ),김선민 ( Seon Min Kim ),이태환 ( Tae Hwan Lee ),전소연 ( So Yeon J 전북대학교 의과학연구소 2012 全北醫大論文集 Vol.36 No.1
A 76-year-old woman with severe aplastic anemia was admitted because of a fever, chill and low blood pressure. She was diagnosed as aplastic anemia twelve years ago, and had been managed by supportive cares including transfusion. On admission, she complained of a mild fever up to 37.8℃ with a chill, generalized myalgia, and abdominal pain. A computed tomographic (CT) scan of the abdomen and pelvis showed abscesses in the head and tail of the pancreas. Cultures of the aspirated fluid from the tail abscess grew Klebsiella pneumoniae. Owing to the ultrasound-guided percutaneous drainage of the abscesses and aggressive antibiotic therapy, the abscesses were resolved. The present case demonstrated that pancreatic abscess which causes an abdominal pain may develop during sepsis in aplastic anemia, and that the abscess can be resolved by percutaneous drainage and treatment with antibiotics.
미세침 흡인 세포검사 후 발생한 양측 갑상선내 출혈에서 갑상선 절제술을 하지 않고 압박 지혈술로 회복된 증례
백초옥 ( Cho Ok Baek ),장지원 ( Ji Won Jang ),국민하 ( Min Ha Kook ),김인재 ( In Jae Kim ),유경보 ( Kyung Bo Yoo ),조인진 ( In Jin Cho ),임진한 ( Jin Han Lim ),이영선 ( Young Sun Lee ),백홍선 ( Tae Sun Park ),박태선 ( Hong Sun Bae 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.2
Fine needle aspiration (FNA) procedure for thyroid nodule evaluation is considered to be safe and easy to perform, however serious complication such as intrathyroidal hemorrhage causing airway compression can be occurred. Massive hemorrhage compromised airway problem leads to unexpected results including total thyroidectomy. Prior to operation, careful decision for necessity of thyroidectomy and tight compression around bleeding site should be performed. In this case, we present the patient who resolved completely from massive intrathyroidal hemorrhage without thyroidectomy and implicate the importance of manual compression on the bleeding site after FNA before decision of operation.