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박금수,나흥식,남숙현 고려대학교 의과대학 1991 고려대 의대 잡지 Vol.28 No.1
To determine the cause of genesis of reperfusion arrhythmias, the left anterior descending coronary artery was cannulated and perfused by a carotid-coronary bypass wlth slde branch in 29 open-chest pentobarbital-anesthetized cats . Ischemia was produced by shunt occlusion during 20min. Thereafter the side branch was opened and the ischemic myocardium reperfused with unmodified arterial blood (13 cats). acidlc blood(pH 6.73-7.10, 8 cats), hypocalcemic blood(Ca^(++) 0.13-0.37mM, 3 cats), and venous blood(PO_2, 29.5-47.ImmHg, 3 cats). Each group was evaluated with respect to the incidence of ventricular premature beats, ventricular tachycardia, and ventricular fibrillation and the onset time of first arrhythmia of each arrhythmia in cats. The incidence of ventricular tachycardia was much lower in the acidic reperfusion group (three of 8 cats,38%) than in the unmodilfed reperfusion group(eleven of 13 cats. 85%), (p<0.O5) hypocalcemic reperfuslon group(three of 3 cats. 100%), and hypoxic reperfusion group(three of 3 cats, 100% ). And the incidence of ventricular fibrillation was much lower in the acidic reperfusion group(none of 8 cats, 0%) than in the unmodified reperfusion group(eleven of 13 cats, 85%),(p<0.O5) hypocalcemic reperfusion group(three of 3 cats, 100%), and hypoxic reperfusion group(two of 3 cats, 67%). The onset time of ventricular premature beat and ventricular tachycardia is later in acidic reperfusion group(158.9 ± 117.5sec., 70.8±54.70sec. (mean±S.E) than unmodified reperfusion group(6.78±1.29sec., 24.7±7.5sec. (mean±S.E.)). These results indicate that acidic reperfusion can prevent reperfusion-induced arrhythmias, presumably owing to a reduction of Ca^(++) influx into cells through Na^(++) -Ca^(++) exchange.
박금수,용석중,김원천,최경훈,성낙억 대한내과학회 1987 대한내과학회지 Vol.33 No.2
Left ventricular thrombosis is found in up to 30%. of cases with dilated cardiomyopathy. The main risk consists of unpredictable systemic embolization which is one of the cause of sudden death. The favorite site for lodgement of cardiac emboli is the middle cerebral artery and consequently cardiogenic cerebellar infarction without evidence of cerebral infarction is very rare. Recently we discovered a case of cerebellar infarction and large left ventricular thrombus by two-dimensional echocardiography in a 26 year old male patient who was previously diagnosed as idiopathic dilated cardiomyopathy. We treated the patient with anticoagulant therapy and found significant resolution of left ventricular thrombus by two-dimensional echocardiography about 1 month later. Therefore this case is reported along with a brief review of the literature.