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Intracardiac Echocardiography to Guide Biopsy for Two Cases of Intracardiac Masses
박광인,김미주,오진경,이재환,박재형,최시완,정진옥,성인환 대한심장학회 2015 Korean Circulation Journal Vol.45 No.2
Pathologic diagnosis of a cardiac mass is vital in determining the proper treatment modality. Open heart surgery or transesophageal echocardiographyguided biopsy can be feasible methods to confirm the pathology. However, the former is highly invasive and both methodsrequire general anesthesia. The introduction of intracardiac echocardiography (ICE) can provide good anatomic information of heart anddoes not require general anesthesia. In this report, we present two cases of cardiac tumors which were confirmed by percutaneous biopsyunder the guidance of an ICE. The patients underwent cardiac biopsy without any complications.
유방암에서 I123 Estradiol을 이용한 에스트로젠 수용체 스캔의 적용
박광인,노우철,이령아,최창운,방호윤,황대용,최동욱,이종인,백남선,문난모 대한외과학회 2002 Annals of Surgical Treatment and Research(ASRT) Vol.62 No.5
Purpose: We evaluated the feasibility of non-invasive imaging of estrogen receptors (ER) in primary breast cancer with iodine-123-labeled ER specific ligand (17α,20E)-21-[123I] iodo-19-nonpregna-1,3,5-(10), 20-tetraene-3, 17-diol using conventional nuclear medicine technique. Methods: Before they underwent surgical management, planar scintigraphy and single-photon emission computed tomography (SPECT) were performed in 18 patients with proven primary breast cancer, after single IV injection of 5~10 mCi I-123-estradiol. The results were compared with those of immunohistochemical staining against ER of the surgical specimens. Results: Planar and SPECT imaging showed hot uptake in nine of eighteen (50%) breast cancer patients. The results of ER immunohistochemistry were all positive in these patients. In the 9 cases of negative scintigraphy, 8 showed negative staining results but one showed positive staining results. Therefore, the overall concordance rate of ER scintigraphy and ER immunohistochemistry was 94.4% (17/18). Conclusion: ER scintigraphy using I-123-estradiol is a highly predictable in vivo technique to detect ER-positive breast cancer preoperatively. It has potential application as a reliable diagnostic modality and indicator of hormone therapy for breast cancer patients. (J Korean Surg Soc 2002;62: 366-370)
이재환,박재형,박광인,김미주,김준형,안문상,최시완,정진옥,성인환 한국심초음파학회 2014 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.22 No.2
Background: Speckle-tracking echocardiography has been applied to measure right ventricular (RV) systolic function invarious diseases. However, variations in strain measurement by different vendors have limited the application of these techniquesfor assessment of RV function. We sought to compare two methods for the assessment of RV systolic function in patients withacute pulmonary embolism (PE). Methods: From August 2007 to May 2011, all consecutive PE patients were prospectively included in this cohort study. Global longitudinal strains of RV measured with EchoPAC PC software (GLSRV-EchoPAC; GE Medical Systems) and velocityvector imaging (GLSRV-VVI; Siemens Medical Systems) were recorded on the same set of echocardiographic images. Results: We analyzed a total of 50 patients (12 males, 68 ± 14 years) with acute PE in this study. GLSRV-EchoPAC andGLSRV-VVI were correlated (r = 0.793, p < 0.001) and they showed significant correlations with conventional echocardiographicparameters of RV systolic function and Log B-type natriuretic peptide (BNP) level. However, GLSRV-VVI only showedsignificant correlations with cardiac biomarkers as serum creatinine kinase-MB (r = 0.367, p = 0.010) and tropoinin-Iconcentrations (r = 0.294, p = 0.040). Conclusion: GLSRV-VVI and GLSRV-EchoPAC showed significant correlations
김미주,김민수,박재형,박광인,이충식,나명훈,이재환,최시완,정진옥,성인환 한국심초음파학회 2015 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.23 No.1
Although pulmonary artery angiosarcoma is rare, it can be misdiagnosed as pulmonary embolism because of its similar clinicaland diagnostic features. The diagnosis is often delayed and the misdiagnosis brings unnecessary treatment. Because we made awrong diagnosis of pulmonary artery angiosarcoma as an acute pulmonary embolism, we did thrombolytic therapy which couldbe dangerous to the patient. In this case report, we focused on the clinical and echocardiographic features of pulmonary arteryangiosarcoma which can be used in differentiating the diagnosis from pulmonary embolism.
운동부하검사 시 혈압 및 심박수의 상승과 좌심방 용적지수 및 맥파전달속도의 연관성
박재호,진선아,이영달,성석우,이현석,김미주,박광인,오진경,박수진,안계택,김준형,박재형,이재환,최시완,성인환,정진옥 대한고혈압학회 2013 Clinical Hypertension Vol.19 No.2
Background: Exaggerated blood pressure (BP) response to exercise can be an independent risk factor for cardiovascular mortality and morbidity. The purpose of this study was to define the factor that effect on early systolic BP response to exercise. Methods: We examined echocardiographic data, BP, heart rate from graded exercise test and brachial ankle pulse wave velocity (PWV) of 205 patients (137 men and 68 women; mean age 58 ± 11 years; range, 19 to 83 years). Graded exercise test was conducted in BRUCE protocol. We define delta systolic blood pressure (SBP) as systolic BRUCE stage “n” BP minus baseline BP. Results: Resting BP (127 ± 16 mm Hg) was elevated to 171 ± 26 mm Hg after peak graded exercise test. Resting heart rate (80 ± 15 bpm) was increased to 146 ± 27 bpm after peak graded exercise test. Stepwise regression test between baseline SBP, delta SBP, maximal SBP and left atrial volume index (LAVI) was done. Supine SBP,delta SBP, maximal SBP was not associated with LAVI (p > 0.5). But increased LAVI was significantly associated with delta SBP1 in woman (R2 = 0.192, p = 0.002). PWV was significantly associated with base line (R2 = 0.311, p < 0.01) and maximal SBP (R2 = 0.051, p < 0.01). However, PWV was not associated with delta SBP. Conclusions: LAVI and PWV were not associated with early SBP response to exercise. But in women, elevation of early SBP during exercise is associated with LAVI.
당뇨병전기 환자에서 대사증후군의 예측인자로 허리/신장비의 효용성
김지민,백민경,주상현,신민영,김미주,박연희,박광인,정경혜,김현진,구본정 대한비만학회 2015 The Korean journal of obesity Vol.24 No.1
Background: Metabolic syndrome is associated with type 2 diabetes and cardiovascular disease in patients with prediabetes. The aim of thisstudy was to investigate and compare WHtR (Waist-to-Height Ratio) as a predictor of metabolic syndrome with other anthropometric indicesas in Body Mass Index (BMI), Waist Circumference (WC) and Waist to Hip Ratio (WHR) in prediabetes. Methods: A total of 816 subjects withprediabetes were recruited from a community based Cohort Study. Receiver operating characteristic (ROC) curve was performed to find theoptimal cutoff value of WHtR. Area under the curve (AUC) was calculated for each anthropometric index and correlation coefficient betweenWHtR and various dermographic and clinical factors was calculated. Results: WHtR had a significant correlation with metabolic parametersexcept for fasting glucose and increased with increasing number of risk factors for metabolic syndrome. AUC of WHtR was significantly higherthan that of other anthropometric indices. The optimal cutoff value of WHtR was 0.53 for metabolic syndrome in prediabetes. Conclusion:WHtR may be the simple and effective anthropometric index for predicting metabolic syndrome in prediabetic patients 배경: 당뇨병전기 환자에게서 대사증후군 동반 시 당뇨병 및 심혈관질환이 증가하는 것으로 알려져 있으나 대사증후군을 예측하는 지표로 명확하게 제시된 것은 없다. 본 연구에서는 체질량지수 및 다른임상적 지표와 허리/신장비를 비교하여 대사증후군의 예측 지표로써허리/신장비의 유용성에 대해 알아보고자 하였다. 방법: 2005년 12월부터 2006년 2월까지 지역사회 코호트 사업을 위해 참여한 충청남도 금산군 주민 중 당뇨병 전기에 해당하는 총 816명을 대상으로 하였다. 곡선하 면적(area under curve, AUC)값을 통해허리/신장비와 다른 지표들의 대사증후군에 대한 진단력을 비교하였으며 허리/신장비와 여러 임상요소들 사이의 상관관계를 분석하였다. 결과: 공복 혈당을 제외한 대사증후군 각각의 위험 요소는 허리/신장비와 유의한 상관관계를 보였으며, 대사증후군의 진단 기준에 많이해당될수록 허리/신장비 또한 증가를 보였다 (P<0.001). AUC 값을이용하여 대사증후군의 진단력을 비교 시 허리/신장비가 다른 지표들에 비해 우수하였다. 대사증후군의 예측에 있어서 허리/신장비의적정 절단값은 0.53으로 나타났다. 결론: 당뇨병전기 환자에서 대사증후군의 간단하고 유용한 예측 지표로써 허리/신장비를 이용할 수 있겠다.