http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
원인 불명의 실신 환자의 진단에 있어서 Head - up tilt Test 의 유용성과 혈관미주신경성 실신 환자의 임상적 특징
윤호중(Ho Joong Youn),정욱성(Wook Sung Chung),백상홍(Sang Hong Baek),김철민(Chul Min Kim),박인수(In Soo Park),김재형(Jae Hyung Kim),최규보(Kyu Bo Choi),홍순조(Soon Jo Hong) 대한내과학회 1994 대한내과학회지 Vol.47 No.2
N/A Background: Syncope, defined as a transient loss of consciousness, is a frequently encountered symptom, but despite thorough clinical and invasive diagnostic investigation, the cause of syncope remains unexplained. In recent years, head-up tilt test has been of increasing interest as a diagnostic aids in patients with unexplained syncope. We studied to define the usefulness of various diagnostic test in the evaluation of patients with recurrent syncope, to assess the usefulness of head-up tilt test in the working of syncope of unknown origin and to evaluate the clinical characteristics of subgroups of patients with syncope induced by head-up tilt test. Methods: Between June, 1991 and November, 1992 at St. Mary`s hospital, 21 patients with history of syncope and 24 control subjects without history of syncope underwent 60° head-up tild test for 60 min. Results: 1) The definite cause for recurrent syncope were diagnosed in 10 of patients (47,6%) after clinical and invasive tests. 2) During head-up tilt test, vasovagal responses were provoked in 5 of 21 patients (23.8%) with recurrent syncope and 1 of 24 patients (4.2%) without syncope (p<0,05). 3) The head-up tilt test induced symptomatic bradycardia or hypotension in 3 of 10 patients (30%.) with negative electrophysiologic results. 4) During tilt induced vasovagal response, a) mean heart rate decreased to 42±24 beat/min from supine control of 70±12 beat/min (p<0. 05), b) mean systolic blood pressure decreased to 95±12 mmHg from supine control of 120±S mmHg (p<0,05), c) mean diastolic blood pressure decreased to 60±21mmHg from supine control of 72±13 mmHg (p<0.05), d) the time interval to onset of vasovagal response was 22±12 min. Conclusions: 1) In a large proportion of patients with recurrent syncope, the diagnosis remains unexplained despite a neurologic and cardiologic investigation including an electrophysiologic study. 2) Vasovagal responses are frequent cause in patients with recurrent unexplained syncope. 3) The head-up tilt test may be a simple, safe and highly yielding provocative test in the investigation of syncope of unknown origin.
완전 방실차단에서 His 속 전기도로 확인한 전도장애의 위치
노태호(Tai Ho Rho),이숙영(Sook Young Lee),백상홍(Sang Hong Paek),김종진(Chong Jin Kim),김철민(Chul Min Kim),김종상(Chong Jin Kim),김재형(Jae Hyung Kim),최규보(Kyu Bo Choi),홍순조(Soon Jo Hong) 대한내과학회 1992 대한내과학회지 Vol.43 No.4
N/A Background: The His bundle recording has proved useful in determining the sites of AV conduction disturbances not discernable in the standard ECG. And the clinical behaviour of patients with conduction disturbance may be partially related to the site of block. Methods: In 27patients with complete AV block, electrophysiologic studies were done to delineate the sites of conduction block. Three multipolar electrodes were located to record the simultaneous electrograms from the right atrium, the His bundle and the right ventricle. Results & Conclusion: lnfraHis location was the most frequent site, accounting for 52% of total cases. When QRS complexes were narrower than 100msec, the localizations of block were divided between supraHis (45%) and infraHis (36%). But complete AV blcok with wider QRS complexes most often corresponded to infraHis block (75%), Mean ages of patients with supra-, intra- and infra- His block were 58, 65 and 55 respectively. All those with intrahis block were female. Definite causes of conduction disturbance were not certain in 24among 27patients. In the remaining three patients, underlying causes were acute myocardia1 infarction in two and dilated cardiomyopathy in one.
Bioimpedance 를 이용한 심박출량의 측정 ; 열희석법과의 비교
박경선(Kyoung Sun Park),노태호(Tai Ho Rho),최재철(Jae Chul Choi),전승석(Seung Sok Chon),김종상(Chong Sang Kim),김재형(Jae Hyung Kim),최규보(Kyu Bo Choi),홍순조(Soon Jo Hong) 대한내과학회 1989 대한내과학회지 Vol.36 No.4
N/A Changes in bioimpedance during the cardiac cycle are inversely related to the volume of blood within the heart and great vessels. Estimating cardiac output from changes in the bioimpedance is a safe, painless, and noninvasive alternative which should be useful for repeated bedside determinations in individual patients. Cardiac output determined by the bioimpedance method using NCCOM3® (noninvasive continuous cardiac output monitor) was compared with that of the thermodilution method in 22 patients who underwent cardiac catheterization. Twenty-two patients, 7 males and 15 females ranging in age from 22 to 56 (mean 41.4), had various cardiac diseases. Coronary heart disease was present in 5 and valvular heart disease in 17. The cardiac rhythm was sinus rhythm in 4 and atrial fibrillation in 18. The results were as follows: 1) Bioimpedance provided a noninvasive, continuous and simple method to monitor cardiac output. 2) Cardiac output measured by bioimpedance and the thermodilution method correlated well (r=0.827 as a whole, r=0.902 in those with sinus rhythm). 3) Bioimpedance can be used in the clinical setting when the thermodilution method is not readily feasible and when continuous monitoring of cardiac output is indicated.
경피적 관상동맥 확장술 전후의 QT 간격분산 ( QT dispersion ) 비교
한혁준(Hyeok Jun Han),노태호(Tai Ho Rho),이만영(Man Young Lee),김희열(Hee Yeol Kim),윤호중(Ho Joong Youn),김종진(Jong Jin Kim),김재형(Jae Hyung Kim),최규보(Kyu Bo Choi),홍순조(Soon Jo Hong) 대한내과학회 1997 대한내과학회지 Vol.52 No.6
N/A Objectives: QT dispersion(QTd) is defined as the difference between the maximum and minimum average QT interval in any of the 12 leads of the surface ECG. QTd has been shown to reflect regional variations in ventricular repolarization. It was reported previously that QTd was dependent on the degree of reperfusion in myocardial infarction. The purpose of this study is to investigate the effects of percutaneous transluminal coronary angioplasty(PTCA) on QTd. Methods: We studied in 21 patients(15 men and 6 women: mean age, 53±7.5 years: 14 acute myocardial infaction, 4 angina pectoris and 3 unstable angina). All standard 12-lead ECGs were recorded at a paper speed of 25mm/sec and examined retrospectively by single observer. QT interval was measured from 11.3±1.1 leads using a computerized program interfaced with digitizer. QTd corrected for heart rate(QTcd) was calculated by Bazett`s formula. Each cases were divided to 2 stages, before and after PTCA(mean obsevation duration, 16.8±9.7 days vs. 22.5±21.9 hours). The difference of QT dispersions was assessed by comparing by paired t-test. Results: There were significant difference in QTd (mean 110.2±37.4 vs. 90.4±37.6 msec, p<0.05). Results did not change when Bazett`s QTc was substituted for QT(QTcd: mean 125.5±38.3 vs. 97.9±29.8 msec, p<0.05). Conclusion: Successful PTCA is associated with less QTd after PTGA. The results are equally significant when either QT or QTc is used for analysis. In our limited study, measurement of QT dispersion, an easily accessible, resonably accurate, noninvasive method, may be a valuable tool in assessment of patients before and after PTCA. However, this study must be confirmed in prospective trial.
개에서 인공 심조율로 조성된 상실성 빈맥의 혈역학적 변화
조은주(Eun Ju Cho),김재형(Jae Hyung Kim),노태호(Tai Ho Rho),진승원(Seung Won Jin),김희열(Hee Yeol Kim),이만영(Man Young Lee),김종진(Chong Jin Kim),채장성(Jang Seong Chae),홍순조(Soon Jo Hong),최규보(Kyu Bo Choi) 대한내과학회 2002 대한내과학회지 Vol.62 No.1
N/A Background: Tachyarrhythmias have various clinical features according to their tachycardia rates, systolic function of the left ventricle, the origin site and the mechanisms. Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) might cause different hemodynamic changes due to their different mechanisms. Methods: To evaluate the hemodynamic differences of supraventricular tachycardias, atrial tachycardia (atrial pacing with AOO mode, 180/min, group I), AVRT (VA pacing interval 80 msec with DOO mode, 180/min, group II) and AVNRT (VA pacing interval 0 msec, 25 msec with DOO mode, 180/ min, group III) were simulated in eleven dogs. Hemodynamic parameters were systemic arterial pressure including systolic, mean and diastolic arterial pressure (SAP, MAP, DAP respectively), mean pulmonary arterial wedge pressure (MPAWP) and cardiac output (CO). Results: The MAP was highest in group I (87.0±20.4mmHg) and decreased with decreasing VA interval of no significance. The SAP was higher in group II (109.8±22.6mmHg) than in group III (95.3±27.1mmHg) (p <0.05). The level of MPAWP had no significant differences among three groups and showed no peculiar pattern with changes of VA interval. The CO was higher in group I (1.18 ±0.32 L/ min) than in other two groups with significant difference (p <0.01) and decreased with shortening of VA interval without significance. Conclusion: Above result s suggested that the AVRT and AVNRT have different effects on hemodynamic changes, those from different timing of atrial contraction, especially on SAP and CO. So hemodynamic compromise during tachycardia could be more severe in AVNRT than in AVRT inspite of their similar QRS morphology and tachycardia rate.(Korean J Med 62:35- 41, 2002)