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급성 심근경색 환자에서 심전도상 ST 분절 상호 하강(reciprocal depression)의 임상적 의의 : 심근경색 후 경과시간에 따른 분석
장혁재 ( Hyuk Jae Chang ),박인휘 ( In Whee Park ),김정은 ( Jung Eun Kim ),이종우 ( Jong Woo Lee ),최소연 ( So Yeon Choi ),황교승 ( Gyo Seung Hwang ),윤명호 ( Myeong Ho Yoon ),신준한 ( Joon Han Shin ),탁승제 ( Seung Jea Tahk ),최 대한내과학회 2003 대한내과학회지 Vol.64 No.1
배경 : 급성 심근경색 환자에서 관찰되는 초기 심전도상의 ST 분절 상호 하강의 임상적 의의를 알아보고 특히 심근경색 발생 후 심전도 기록까지 걸린 시간에 따라 ST 분절 상호 하강의 의의가 차이를 보이는지 알아보고자 하였다. 방법 : 1999년 1월에서 2001년 5월 사이 진단받고 심전도상 ST 분절의 상승이 있었으며, 관동맥 조영술을 받은 급성 심근경색 환자 198명을 대상으로 하였다. 이들을 심근경색 부위에 따라 구분하였으며 심전도상 ST 분절 Background : To investigate the clinical significance of reciprocal ST segment depression on the presenting electrocardiogram (ECG) in patients with acute myocardial infarction (MI), in particular, this study focuses whether there is any difference accord
운동부하검사 중 과도한 수축기 혈압상승을 보이는 환자에서 Nitric Oxide/cyclic-GMP경로를 통한 내피세포 기능의 장애
박인휘 ( In Whee Park ),장혁재 ( Hyuk Jae Chang ),정재훈 ( Jae Hoon Chung ),신준한 ( Joon Han Shin ),최태영 ( Tae Young Choi ),최소연 ( So Yeon Choi ),윤명호 ( Myung Ho Yoon ),황교승 ( Gyo Seung Hwang ),탁승제 ( Seung Jae Tahk 대한내과학회 2003 대한내과학회지 Vol.65 No.1
Background : The diagnostic and prognostic implication of exaggerated blood pressure response to exercise has not been well characterized. Endothelial dysfunction has been demonstrated in patients with atherosclerosis or with risk factors for coronary art
심원흠(Won Heum Shim),박승정(Seung Jung Park),탁승제(Seung Jae Tahk),조승연(Seung Yun Cho),김성순(Seung Soon Kim),이웅구(Woong Ku Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.1
N/A Preliminary reports have documented the utility of percutaneous balloon valvuloplasty of the mitral valve in adult patients with mitral stenosis, but the mechanism of successful valve dilation and the effect of mitral valvuloplasty on cardiac performance have not been studied in detail in our country, Accordingly, mitral valvuloplasty was performed in seven adult patients with rheumatic mitral stenosis, using either one (23 mm) or two (18 and 20 mm or 19 ´ 2 bifoil) dilation balloons intraoperatively or percutaneously, and in one in vitro status. Balloon dilation resulted in increased valve orifice area in all cases, secondary to separation of the fused commissures which were posteromedial in 4 cases, anterolateral in 2 and both in 2. Fracture of nodular calcium within the mitral leaflets occurred in one case. There was one ease of liberation of calcium embolic debris. In no case did balloon dilation result in tearing of the valve leaflets or disruption of the mitral ring. 1t is concluded that percutaneous mitral valvuloplasty can be performed in adult patients with mitral stenosis, including patients with calcific disease, and can result in significant improvement in valvular function. The major mechanisms of successful dilation include fused commissural separation and fracture of nodular calcium of the valve leaflets.
심원흠(Won Heum Shim),김성순(Sung Soon Kim),탁승제(Seung Jae Tahk),박승정(Seung Jung Park),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung),조승연(Seung Yun Cho),이웅구(Woong Ku Lee) 대한내과학회 1988 대한내과학회지 Vol.35 No.6
N/A In 1962, Sakakibara and Konno reported doing endomyocardial biopsies in patients using a cartheter inserted into the right ventricle from a systemic vein. The right ventricular aspect of the ventricular septum was the portion of heart of heart biopsied, Although biopsy is not yet applicable in all cases of myocardial disease, many investigators have found this procedure valuable in specific circumstances, including cardiac allograft rejection, adriamycin-induced cardiomypathy and myocarditis. With this technique diagnoses can be made for various disorders including cardiac amyloidosis, sarcoidosis, hemochromatosis and endomyocardial fibrosis. Endomyocardial biopsy was done in 16 cases which consisted of dilated cardiomyopathy in 9(56.3%) cases, unexplained heart failure in 3(18.8%) cases, ventricular tachycardia in 3 cases and angina with normal coronary angiogram with thallium defects in 1 case. The route of entry of the biopsy porceps was through the right internal jugular vein in 12(75%) cases and right femoral vein in 4(25%) cases. There were no cases of left heart biopsy. There were no serious complications. The number of biopsy samples per patient was 2-7 pieces and these samples were examined by light microscope or electromicroscope or were used for special purposes such as culture or biochemical study. The biopsy yields were 100% and the material was satisfactory for pathologic study. A modified King's bioptome was selected for use in all cases. In conclusion, although of limited value from a diagnostic standpoint, the biopsy is safe and is likely to provide the most asistance as a research tool in the biochemical study of cardiomyopathy.
급성심근경색에서 Troponin T 와 경색의 크기와의 상관관계
서창희(Chang Hee Suh),김한수(Han Soo Kim),강한걸(Han Geol Kang),신준한(Joon Han Shin),탁승제(Seung Jae Tahk),이승호(Seong Ho Lee),최병일(Byung Il William Choi) 대한내과학회 1997 대한내과학회지 Vol.52 No.1
N/A Objectives: The estimation of infarct size has been important in evaluation of prognosis of the patients who had acute myocardial infarction. The infarct size estimated by the thallium-201 SPECT has been known to correlate with the prognosis of patient. The enzymatic estimation by the total release of creatine kinase isoenzyme MB(CK-MB) has been widely used in estimating infarct size clinically, but inconvienent and not cardiospecific. Recently, serum troponin T, cardiospecific myofibrillar protein, has been used in the diagnosis of acute myocardial infarction, and used in the estimation of reperfusion following myocardial infarction. To assess the role of the late troponin T peak concentration on the estimation of infarct size, this prospective study was carried out. Methods: The patients with acute myocardial infarction who were admitted, within 48hours after the onset of chest pain, to Ajou University Hospital between April 1995 and August 1995 were evaluated. All patients were divided into anterior and inferior infarct and checked serum troponin T and CK-MB serially, and underwent stress Thallium-201 SPECT 1 week after infarction, In each group, we assessed the correlation of the late toponin T peak concentration, the total release of CK-MB, and the infarct size estimated by thallium-201 single photon emission computed tomography(SPECT). Results: 1) The eligible subjects consisted of 22 patients (17 men and 5 women), and age ranged from 29 to 77 years(mean 57.8±12.5 years). 2) The mean arrival time to the hospital after the onset of chest pain was 15.5±13.2 hours. The 19 patients had at least one risk factor for coronaryartery disease. 3) The late troponin T peak concentration and the total release of CK-MB in patients with anterior infarction were not different from those with inferior infarction. The infarct size estimated by the thallium-201 SPECT in patients with anterior infarction was larger than patients with inferior infarction The left ventricular ejection fraction in anterio infarction was lower than inferior infarction. 4) The late troponin T peak concentration ha: positive correlation with the infarct size estimated by the thallium-201 SPECT in the total patients, and both patients with anterior infarction and inferio infarction. 5) The total release of CK-MB correlated with the infarct size estimated by the thallium-20 SPECT in the total patients, and the patients of inferior infarction. Conclusion: The late troponin T peak concentration was more accurate than the total release o CK-MB in the estimation of infarct size. Therefore, when the patient arrived to the hospital less than 48hr after the onset of chest pain, the late troponin T peak concentration is useful in the decision and evaluation of therapeutic intervention and in the prediction of prognosis.
조승연,심원흠,박승정,김성순,이웅구,정익모,탁승제 대한내과학회 1988 대한내과학회지 Vol.35 No.4
Percutaneous aortic balloon valvuloplasty (PAV) has recently been proposed as a palliative procedure for treating nonsurgical candidates or high risk patients with calcific aortic stenosis. PAV vas carrried out with a 15×2 bifoil balloon in a 63-year-old woman suffering from syncope, angina and heart failure. The transvalvular systolic pressue gradient (peak to peak 40 mmHg) had almost completely disappeared at the end of the procedure without complications. The aortic valve area increased from 0.6 to 1.6cm² by Gorlin's formula and an increased valve opening was confirmed by angiography and echocardigraphy. PAV is recommended as a simple pailiative proccdure to aortic vale replacement in symptomatic adult aortic stenosis patients.