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증례 : 순환기; 좌심실 후유두근에서 기인한 심장지방종 1예
백용수 ( Yong Soo Baek ),권준 ( Jun Kwan ),이경희 ( Kyung Hee Lee ),신성희 ( Sung Hee Shin ),박상돈 ( Sang Don Park ),정은선 ( Eun Soen Jeong ),민경선 ( Kyung Sun Min ) 대한내과학회 2010 대한내과학회지 Vol.79 No.1
심장 지방종은 매우 드문 원발성 심종양으로 무증상으로 우연히 발견되는 경우가 대부분이다. 저자들은 감염성 대장염으로 입원한 환자에서 우연히 발견된 심장 내 종양의 의심 하에 심초음파와 심장자기공명 촬영 및 관상동맥 다절편 단층 촬영을 이용하여 좌심실내 후유두근에서 기인한 심장지방종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Primary cardiac lipoma is a rare, benign, well-encapsulated tumor that is typically composed of mature fat cells. It can occur in any part of the heart, but is mostly found incidentally. Although cardiac lipoma does not require specific treatment in most cases, physicians should pay attention to this entity, which may cause arrhythmias, embolization, compression of the coronary arteries, or obstruct blood flow within the heart. In this report, we present the case of a 70-year-old woman who was admitted with a complaint of infectious colitis and incidentally found to have a cardiac lipoma in the posterior papillary muscle of the left ventricle on the basis of two-dimensional echocardiography and cardiac MRI. Given the patient`s lack of symptoms and normal cardiac function, we recommended observation without surgical exploration. After six months, the patient was in good health and showed no clinical signs or symptoms of cardiac lipoma. (Korean J Med 79:57-61, 2010)
2018 대한부정맥학회 심방세동 환자에서 NOAC 사용 지침: 처방의 시작과 유지
박진규 ( Jin-kyu Park ),김준 ( Jun Kim ),백용수 ( Yong Soo Baek ),이소령 ( So-ryoung Lee ),황유미 ( You Mi Hwang ),김태훈 ( Tae-hoon Kim ),이대인 ( Dae In Lee ),이기홍 ( Ki Hong Lee ),심재민 ( Jaemin Shim ),정보영 ( Boyoung Joung 대한내과학회 2019 대한내과학회지 Vol.94 No.1
Non-vitamin K antagonist oral anticoagulants (NOACs) are alternatives to vitamin K antagonists to prevent stroke in patients with non-valvular atrial fibrillation (AF) and have emerged as the preferred choice. The use of NOACs is rapidly increasing in Korea after coverage by insurance since 2015. However, the rate of prescribing anticoagulants in Korean patients with AF remains low compared to other countries. Most of the NOAC anticoagulant prescriptions are issued at hospitals. As the prevalence rate of AF in Korea is expected to increase rapidly with the increase in the elderly population, the need to prescribe NOACs in primary care clinics will also increase. Therefore, The Korean Heart Rhythm Society organized the Korean Atrial Fibrillation Management Guideline Committee and analyzed all available studies based on the 2018 European Heart Rhythm Association Practical Guide on the use of NOACs for managing AF, as well as studies on Korean patients. The authors would like to introduce practical guidelines for NOAC prescriptions in Korean patients with AF. (Korean J Med 2019;94:17-39)
2018 대한부정맥학회 심방세동 위험인자와 동반된 심혈관계 질환의 발견과 관리
이소령 ( So-ryoung Lee ),이영수 ( Young Soo Lee ),임우현 ( Woo-hyung Lim ),김태훈 ( Tae-hoon Kim ),차명진 ( Myung-jin Cha ),이지현 ( Ji-hyun Lee ),백용수 ( Yong-soo Baek ),임홍의 ( Hong Euy Lim ),정보영 ( Boyoung Joung ),김준수 ( 대한내과학회 2018 대한내과학회지 Vol.93 No.4
A number of concomitant conditions and cardiovascular diseases are closely related to the development of atrial fibrillation (AF), AF recurrence, and AF-associated complications. Detection, prevention, and treatment of such conditions are essential for the prevention of AF and its disease burden. This article discusses the clinical conditions and concomitant diseases associated with AF including heart failure, hypertension, diabetes, obesity, chronic respiratory diseases, and kidney disease based on the 2016 European Society of Cardiology guidelines for the management of AF and recently updated clinical data, particularly in patients with heart failure. Furthermore, we provide recommendations for the prevention, diagnosis, and management of these conditions.
2021 대한부정맥학회 심방세동 환자의 새로운 접근법 및 통합적 관리 지침
박준범 ( Junbeom Park ),차명진 ( Myung-jin Cha ),백용수 ( Yong Soo Baek ),조민수 ( Min Soo Cho ),정보영 ( Boyoung Joung ) 대한내과학회 2021 대한내과학회지 Vol.96 No.5
The prevalence of atrial fibrillation (AF) is gradually increasing with the aging of the population, and there is also increasing interest in AF with the development of various single-lead electrocardiography measurement methods for diagnosis. Further, the current diagnosis and treatment policies for AF do not reflect its progression and complexity. In addition, the various factors related to AF diagnosis and treatment are not simple due to the diversification of tools, advances in treatment methods, and complex mechanism of AF. Therefore, there are many challenges to developing a simple AF classification system. To overcome these, there have been a number of attempts to systematically characterize AF according to treatment and prognosis rather than using a uniform classification. Further, as mentioned in the previous AF guidelines, further research is being conducted on an integrated patient-physician approach to AF. Such an approach would be the basis for consistent treatment based on the guidelines, and would help to improve patient outcomes. Further, for the integrated management of AF patients, some changes should be made to the current approach to develop a multidisciplinary approach, including changes to the behavior of team members, patients, their family members, and physicians. The Korean Heart Rhythm will introduce an integrated approach to the classification and structure of AF management, and provide guidelines for its application in clinical practice. (Korean J Med 2021;96:382-389)
증례 : 순환기 ; 약물용출스텐트 삽입 후 스텐트내재협착과 함께 발생한 관상동맥류의 치료 1예
황태현 ( Tae Hyeon Hwang ),박상돈 ( Sang Don Park ),백용수 ( Yong Soo Baek ),김수한 ( Soo Han Kim ),이선영 ( Sun Young Lee ),고규용 ( Gyu Yong Go ),우성일 ( Seong Ill Woo ) 대한내과학회 2014 대한내과학회지 Vol.86 No.5
관상동맥류는 관상동맥 조영술에서 드물게 발견되는 소견이며 이는 관상동맥 중재술 시 발생하는 혈관벽의 기계적 손상과 관련된 것으로 생각된다. 다른 유발 원인으로는 죽상 경화증, 선천성, 결합조직 장애, 혈관염, 감염, 약재 유발성, 외상, 특발성 등이 있다. 관상동맥류의 합병증은 다양하며 드물게 파열되는 경우가 있고 치료에 대한 합의가 아직까지 명확히 이루어지지는 않았다. 저자들은 55세 남자에서 약물 용출스텐트 삽입 후 5년이 지난 뒤에 발생한 거대 관상동맥류와 스텐트 내 재협착을 그래프트스텐트를 이용하여 성공적으로 치료하였기에 이를 보고하는 바이다. Coronary artery aneurysms are detected rarely during coronary angiography, and are associated with injury to the mechanical vessel wall during percutaneous coronary intervention. Potential causes also include atherosclerosis, congenital defects, connective tissue disorders, vasculitis, infection, drug-related injury, and trauma; it can also be idiopathic. The complications of coronary artery aneurysms vary, but they rupture only rarely. However, there is no consensus treatment strategy for coronary artery aneurysm after coronary intervention. We report a case of a 55-year-old male who developed a coronary artery aneurysm and in-stent restenosis after percutaneous coronary intervention with a drug-eluting stent. The aneurysm was treated successfully with the implantation of a graft stent. (Korean J Med 2014;86:608-611)
조재화 ( Jae Hwa Cho ),윤용한 ( Young Han Yoon ),곽승민 ( Seung Min Kwak ),이홍렬 ( Hong Lyeol Lee ),김광호 ( Kwang Ho Kim ),백용수 ( Yong Soo Baek ),류정선 ( Jeong Seon Ryu ),홍성빈 ( Seong Bin Hong ),유성수 ( Sung Soo Yoo ),유 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.6
We report a case of pulmonary adenocarcinoma complicated by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) following adjuvant chemotherapy. A 51-year-old woman with stage ⅢA adenocarcinoma received left lower lobe lobectomy in July, 2006. And then combination chemotherapy with paclitaxel and cisplatin was given to the patient. In five days after completion of second cycle of the chemotherapy, she visited emergency room because of general weakness and seizure. Her brain MRI was shown to be no evidence of brain metastasis. Serum sodium, urine and plasma osmolarities were 117mEq/L, 589 and 244mOsm/kg, respectively. She was improved with fluid restriction. Although occurrence of SIADH following chemotherapy is rare, physician should give an attention the potential for development of SIADH in the course of chemotherapyin non-small cell lung cancer patient. (Tuberc Respir Dis 2006; 61: 591-594)
김정수,백용수,정문현,이진수,오경선 대한감염학회 2008 감염과 화학요법 Vol.40 No.3
Background : Studies on immunization in Korea mainly focus to the coverage rates in recipients. The attitudes of health-care providers regarding immunization are rarely evaluated. Therefore, to assess the pattern of vaccine administration by health-care personnel, the vaccine consumption in a university hospital was investigated. Materials and Methods : The vaccine consumption in a university hospital during 2 months (September and October) in 2 years (2002 and 2007) was evaluated. September is representative of months when influenza vaccine is not available, whereas October is representative of months when influenza vaccine is available. These monthly data were summarized by departments and vaccines. Results : Vaccine consumption over the 5-year period increased primarily because of the increased use of the influenza and tetanus-diphtheria (Td) vaccines in adults. In 2007, the most frequently administered vaccine during the influenza season was the influenza vaccine, followed by the Td vaccine. In the same year, the Td vaccine was the most frequently administered vaccine during the non-influenza season. Compared to 2002, there was a marked increase in the use of the hepatitis A virus (7-fo1d), Japanese encephalitis (6-fo1d), and pneumococcal polysaccharide (3-fold) Vaccines in 2007; the Td, meningococcal, and pneumococcal protein-conjugated vaccines were not available in 2002. In adults, pneumococcal vaccination was increasingly prescribed concomitant with the increased influenza vaccination: a similar trend was not observed in children. The use of vaccines in most departments was confined to the influenza vaccine, and the majority of Td vaccine was consumed in the emergency department. As compared to the internal medicine and family medicine departments, fewer vaccines were prescribed by the neurology, surgical, and minor specialty departments, especially in the non-influenza season. Conclusion : Although vaccine consumption increased during the 5-year period, the increase was attributed to the increased consumption of the influenza vaccine. Promotion and education regarding the use of non-influenza vaccines are needed. 배경 : 국내에서 백신 사용은 접종을 받은 사람에서만 조사가 되었고, 예방접종 제공자에서 조사가 적었다. 앞으로 백신 접종률을 높이기 위해서는 접종자에 대한 연구도 있어야 하며, 병원 단위에서 백신 사용 양상을 알기 위해 대학병원에서 백신 사용량을 조사하였다. 재료 및 방법 :2002년과 2007년의 9월과 10월에 약제부에서 사용된 백신 양을 조사하였다. 9월은 인플루엔자 백신이 없는 달을 대표하는 달이고 10월은 인플루엔자 예방 접종이 가능한 달을 대표한 것이다. 월별 백신 소모량을 과별, 백신별로 정리를 하였다. 결과 : 2002년에 비해 2007년에는 백신 사용량이 1.6배 증가했으며, 인플루엔자 백신과 Td의 사용 증가가 주요 이유였다. 인플루엔자 백신 접종 시기에는 인플루엔자 백신 사용량이 제일 많았고, 두 번째 많이 사용되는 백신은 2002년에는 B형 간염 백신이었고 2007년에는 Td였다. 성인에 서는 인플루엔자 백신 사용과 함께 폐렴사슬알균 백신 사용량이 늘었지만 소아에서는 이런 경향이 보이지 않았다. 인플루엔자 백신 접종 시기인 10월에는 소아과에서 사용보다 비소아과에서 백신 사용량이 더 많았다. 과별로 보면 대부분 과에서 인플루엔자 백신이 주로 사용되었고, 응급실에서는 Td만이 사용되었다. 신경과와 재활의학과, 외과계열, 소수과에서 사용이 적었다. 결론 : 예방접종이 5년 사이 증가하였으나 인플루엔자 백신에 국한된 양상을 보였다. 인플루엔자 백신과 파상풍-디프테리아 백신뿐만 아니라 다른 백신에 대한 홍보가 필요하다.