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심원흠(Won Heum Shim),박승정(Seung Jung Park),이웅구(Woong Ku Lee),조승연(Seung Yun Cho),김성순(Sung Soon Kim) 대한내과학회 1989 대한내과학회지 Vol.36 No.2
N/A Since Furman and Robinson implanted a transvenous pacemaker (VOO) in 1958, Atricor (Cordis Co.), the first P-wave sensing dual chamber pacemaker (VAT) was introduced in 1963. Subsequently the atrioventricular seqeuential pacemaker (DVI), and universal automatic pacemaker (DDD) followed. Enetrex (Medtronic Co.), a VDD pacemaker, was first implanted after open heart surgery in a patient with a completed heart block in 1983. Sporadic case reports of dual chamber pacemaker implantation have been reported in Korean literature from our laboratory. We reviewed the clinical data of 51 dual pacer implantations in 48 patients performed in our laboratory during the period from September 1983 to November 1987. The following results were obtained: 1. The major indication was complete heart block in 32 cases (64.6%), high degree A-V block in 4(8,3%) and sick sinus syndrome in 11(20.8%) cases. 2. Main clinical symptoms were syncope and presyncope in 26(54.5%) cases. 3. The DDD pacer was most fregucently chosen in 44(86.3%) cases. 4. The route of entry of the leads was most commonly through a subclavian vein by the techique of percutaneous puncture in 44(91.7%)cases, cephalic vein cutdown in 1 cases, and epicardial screw in lead in 3 cases having open heart surgery. 5. The fixation of the atrial leads was the active form in 28 (58.3%) and the passive in 17 (35.4%) cases. The polarity of the leads was unlpolar in 38 (77.1%) and biopolar in 13 (22.9%) cases. 6. The complications wen various. The most fre- quent associated complications were pacemaker mediated tachycardia in 5 (10.9%) cases, infection in 5 (10.9 %), atrial lead displacement in 2, and atrial sensing and pacing problems in 4 cases. However, there were no serious complications such as death or other serious sequelae. In conclusion, dual chamber pacing is a more physilogically priented therapeutic measure for use in patients with symptomatic heart block or sick sinus syndrome and it can be implanted safely.
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.
A Case of Complex Restenosis of Aortoiliac Stent Mimicking Downward Stent Migration
Tae-Hoon Kim,Won-Heum Shim 순천향대학교 순천향의학연구소 2012 Journal of Soonchunhyang Medical Science Vol.18 No.2
We present the case of aortoiliac stent restenosis which was caused by 13 years’ of neointimal progression within and at the edge of the aortoiliac stent at the iliac bifurcation. A 74 year-old man presented with vertigo. We planned 4-vessel cerebral angiography through the right common femoral artery to evaluate his carotid artery but failed due to the catheter jam against the struts of the previously deployed aortoiliac stent. Retrograde sheath angiography through the right femoral artery indicated that the previously implanted stent seemed to have migrated in a downward direction and be embedded in the internal iliac artery. While comparing with the previous angiograms, we found that the implanted stent did not migrate downwardly but was separated from the external iliac artery by newly formed septum of neointimal hyperplasia. We successfully reopened the stenosis using the contralateral approach after widening the struts of the previously deployed T-stents.
Choi, Sun Young,Won, Jong Yun,Lee, Do Yun,Choi, Donghoon,Shim, Won-Heum,Lee, Kwang-Hun The Korean Society of Radiology 2010 KOREAN JOURNAL OF RADIOLOGY Vol.11 No.1
<P><B>Objective</B></P><P>The purpose of this study was to evaluate the technical feasibility and clinical efficacy of percutaneous transabdominal treatment of endoleaks after endovascular aneurysm repair.</P><P><B>Materials and Methods</B></P><P>Between 2000 and 2007, six patients with type I (n = 4) or II (n = 2) endoleaks were treated by the percutaneous transabdominal approach using embolization with N-butyl cyanoacrylate with or without coils. Five patients underwent a single session and one patient had two sessions of embolization. The median time between aneurysm repair and endoleak treatment was 25.5 months (range: 0-84 months). Follow-up CT images were evaluated for changes in the size and shape of the aneurysm sac and presence or resolution of endoleaks. The median follow-up after endoleak treatment was 16.4 months (range: 0-37 months)</P><P><B>Results</B></P><P>Technical success was achieved in all six patients. Clinical success was achieved in four patients with complete resolution of the endoleak confirmed by follow-up CT. Clinical failure was observed in two patients. One eventually underwent surgical conversion, and the other was lost to follow-up. There were no procedure-related complications.</P><P><B>Conclusion</B></P><P>The percutaneous transabdominal approach for the treatment of type I or II endoleaks, after endovascular aneurysm repair, is an alternative method when conventional endovascular methods have failed.</P>
국내에서 수집된 자두의 품종식별을 위한 SSR Profile 데이터베이스 구축
홍지화(Jee-Hwa Hong),심은조(Eun-Jo Shim),박원흠(Won-Heum Park),소은희(Eun-Hee Soh) 한국육종학회 2015 한국육종학회지 Vol.47 No.2
This study was conducted to construct a DNA marker database for 38 plum varieties collected in Korea using simple sequence repeat (SSR) markers. A set of 61 SSR primer pairs was tested to select polymorphic SSR markers between 8 varieties. Among the 61 primer pairs, 21 showed polymorphism, reproducibility and easy scoring. The genetic relationship between the 21 SSR markers and 38 varieties was analyzed. A total of 210 polymorphic amplified fragments were obtained with the 21 SSR markers. Three to seventeen SSR alleles were detected for each locus, with an average of 10.0 alleles per locus. Average polymorphism information content (PIC) was 0.758, with a range from 0.549 to 0.870. A total of 210 SSR marker loci were used to calculate Jaccard’s distance coefficients for cluster analysis by an unweighted pair-group method with arithmetical average (UPGMA). The genetic distance ranged from 0.06 to 1.00 in 38 varieties. Out of 38 plum varieties, 32 were identified using the 21 SSR markers. Therefore, these SSR markers may be employed to complement distinctness, uniformity, and stability (DUS) tests or as potential tools to solve seed disputes regarding plums.
박승정(Seung Jung Park),심원흠(Won Heum Shim),조승연(Seung Yun Cho),이웅구(Woong Ky Lee),김성순(Sung Soon Kim),탁승재(Seung Jea Tahk),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung) 대한내과학회 1988 대한내과학회지 Vol.35 No.1
N/A Percutaneous mitral balloon valvuloplasty (PMV) using the double-balloon technique was performed in 28 symptomatic patients with mitral stenosis who were candidates for mitral valve commissurotomy. There were 21 women and 7 men with a mean age 38±10 years (range 23 to 57). PMV in 28 patients with moderate to severe mitral stenosis (including 3 with a fluoroscopic calcified valve) resulted in an increase mitral valve area (0.9±0.2 to 2.2±0,7cm, p<0.0001) by Gorlin`s formula, and a decrease in mean diastolic mitral pressure gradient (16.8±5.7 to 6.1±3.9mmHg, p<0.0001), and mean left atrial pressure (23.6±6.7 to 11.7±5.8mmHg, p<0. 0001). And also cardiac output increased (4.8±1.0 to 5. 8±1.5L/min, p<0.005) and mean pulmonary artery pressure decreased (32±12 to 24±9mmHg, p<0.05). Mitral regurgitation developed or increased in severity after PMV in 15 (53.6%) patients, grade 3mitral regurgitation in 2 and no mitral regurgitation in 12 patients. Oxymetric studies performed immediately after PMV demonstrated a small left-to-right shunt (pulmonary-to-systemic blood flow ratios>1.5) through the interatrial communication in 4 patients. Follow up echocardiography showed improvement in mitral valve area by 2-D and Doppler pressure half-time (0.9±0.2 to 1.8±0.5 and 0.8±0.2 to 1.7±0.4 cm, p<0.0001), increase of mitral EF slope (13±7 to 37±17mm/ sec, p<0.0001) and decrease peak E mitral velocity (209±32 to 142±32cm/sec, p<0.0001). Transient cerebral embolic phenomenon just after PMV was observed in 1 patient and cerebral embolic infarction with hemorrhage requiring surgery developed in 1 patient. PMV using the double-balloon technique is safe and effective procedure to relieve mitral valve obstruction and could be an alternative to surgical mitral commissurotomy in selected patients with mitral stenosis.