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박종춘,조정관,강정채 대한내과학회 1990 대한내과학회지 Vol.38 No.4
Percutaneous mitral balloon valvotomy (PMV) introduced by Dr. Inoue in 1984 has been modified and developed in its methodology. PMV is now considered as a therapeutic alternative to surgical mitral commissurotomy in selected cases, but its long-term follow-up data are still needed. In order to evaluate the value of PMV as a therapeutic modality the 26 patients with severe mitral stenosis undergone PMV since October 1988 in Chonnam University Hopsital were analysed and the results were as follows. The procedure was technically successful in relieving mitral stenosis in 21 patients(80.8%), 18 with two monofoil balloon catheters and 3 with one bifoil balloon catheter. They were 13 male and 8 female patients, aging from 25 to 56 years, average 39.8±9.5 years. Immediately after successful PMV, mitral valve area by Gorlin's formula was significantly increased from 0.68±0.23 to 1.68±0.77(p<0.01), mean transmitral pressure gradient significantly decreased from 12.3±6.0 to 4.5±2.2㎜Hg(p<0.01), and cardiac output measured by thermodilution method increased from 3.2±1.6 to 3.7±1.3 L/min but statistically of no significance(p= 0.14). Thirteen(50%) of 26 patients experienced one or more complications. Mitral regurgitation newly developed or increased in its degree of severity in 6 patients, creation of atrial septal defect(Qp/Qs ratio more than 1. 3) 3, atrial perforation 2, significant bleeding from puncture site 2. Less frequent complications were acute myocardial infarction, chordae tendinae rupture, and protracted hypotension, one for each. There was no death and emergency surgery needed. PMV was failed in 5 patients, 4 failures were experienced during first 10 trials of PMV. The above results suggested that PMV could be an alternative to surgical mitral commissurotomy at least in selected cases.
박종춘,임상엽,김계훈,정익주,조정관,박형욱,김원,안영근,손일석,윤경호,조상희,정명호,강정채,홍영준,김주한 대한의학회 2006 Journal of Korean medical science Vol.21 No.3
Primary adrenocortical carcinoma (ACC) is a rare tumor and its usual sites of meta-stasis are the lung (71%), lymph node (68%), liver (42%), and bone (26%). How-ever, intracaval invasion extending into the right atrium is very rare and spontaneous regression of tumor burden in adrenal carcinoma is also rare. We report a case of ACC with direct invasion of the inferior vena cava and right atrium. A 34-yr-old male patient presented with progressive dyspnea, weight loss, and poor oral intake over 3 months. Non-functioning ACC with direct invasion of the inferior vena cava and right atrium was confirmed by imaging, pathologic, and hormonal study. Chemo-radio-therapy was attempted. However, tumor burden was not changed, but rather toxic hepatitis and thrombocytopenia were developed. His subjective symptoms and gen-eral conditions were improved after 1 month of conservative management and the patient was discharged. During clinical follow-up, this tumor showed spontaneous regression.