• Korean Circulation Journal
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• 제52권10호
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• pp.721-736
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• 2022

Aortic stenosis (AS) is one of the most common valvular heart diseases and the number of patients with AS is expected to increase globally as the older population is growing fast. Since the majority of patients are elderly, AS is no longer a simple valvular heart disease of left ventricular outflow obstruction but is accompanied by other cardiac and comorbid conditions. Because of the significant variations of the disease, identifying patients at high risk and even earlier detection of patients with AS before developing symptomatic severe AS is becoming increasingly important. With the proven of efficacy and safety of transcatheter aortic valve replacement (TAVR) in the severe AS population, there is a growing interest in applying TAVR in those with less than severe AS. A medical therapy to reduce or prevent the progression in AS is actively investigated by several randomized control trials. In this review, we will summarize the most recent findings in AS and discuss potential future management strategies of patients with AS.

• 대한방사선기술학회지:방사선기술과학
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• 제27권1호
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• pp.33-36
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• 2004

• Journal of Chest Surgery
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• 제54권3호
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• pp.163-164
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• 2021

• Journal of Cardiovascular Imaging
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• 제31권1호
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• pp.24-25
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• 2023

• Korean Circulation Journal
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• 제54권8호
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• pp.515-517
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• 2024

• 한국임상수의학회지
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• 제27권6호
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• pp.729-734
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• 2010

11살된 암컷 푸들 (체중 2.3 kg)이 지속적인 기침, 호흡곤란, 운동불내성 및 식욕부진으로 내원하였다. 영상진단 검사 및 실험실 검사를 통해, 환자는 ISACHC Ib 단계의 이첨판 패쇄부전증이 합병된 특발성 출혈성 심낭수 유출증으로 진단되었다. 우측 흉벽에서 심낭에 접근하여 투시현미경의 조사 하에 엘리게이터 포셉과 카테터를 이용한 경피하 심낭 부분절개술을 실시하였다. 시술 직후 실시한 ECG 와 심초음파 검사에서 환자의 심장 기능은 크게 개선되었다. 환자는 경도의 이첨판 역류증과 술 후 감염을 관리하기 위해 furosemide (1 mg/kg, bid, PO), enalapril (0.5 mg/kg, bid, PO), cephradine (20 mg/kg, bid, PO)을 처방 받고 퇴원하였다. 2주 후 실시된 검사에서 심낭수는 발견되지 않았으며 임상증상은 크게 개선되어있었다. 현재는 이첨판 패쇄부전증에 대한 처치를 위해 enalapril을 투약 중이고, 주기적으로 환자를 모니터하고 있다.

• Journal of Chest Surgery
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• 제51권4호
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• pp.231-240
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• 2018

Background: Analyses of the efficacy and safety of transcatheter aortic valve replacement (TAVR) in most countries have been based on outcomes obtained in accordance with national practice guidelines and monitoring protocols. The purpose of this study is to share our experience regarding the process for establishing guidelines and monitoring protocols for the use of TAVR in Korea, in the hopes that it may be helpful to others undergoing a similar process in their own country. Methods: The Korean guidelines for TAVR were established on June 1, 2015 in through a tri-party agreement involving the Department of Health and Welfare, the Korean Society of Thoracic and Cardiovascular Surgery and the Korean Society of Cardiology. We agreed to monitor the guidelines transparently and to exchange opinions regarding amendments or continuation of its contents after 3 years of monitoring. Results: The monitoring meetings were not held as regularly as agreed, and monitoring was also made difficult by insufficient and incomplete data. Nevertheless, during the meetings, measures to improve the monitoring process were discussed, and accordingly, an agreement was made to continue the monitoring process, with the aim of completing data collection by 2018. Conclusion: Compliance with guidelines is critical for assessing the efficacy and safety of TAVR. Moreover, the TAVR monitoring process must be properly conducted for an accurate evaluation to be made. Any country planning to introduce TAVR may encounter difficulties with regards to the optimal initiation strategy and subsequent monitoring. Nevertheless, continued efforts should be made to persuade the government and the corresponding medical societies to facilitate the optimal application of TAVR.

• Tuberculosis and Respiratory Diseases
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• 제67권1호
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• pp.52-58
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• 2009

폐동정맥기형은 드문 폐혈관 질환으로 출혈, 뇌농양, 기이 색전증(paradoxical embolism)에 의한 여러 신경학적 합병증의 발생 위험을 증가시켜 치료를 요한다. 과거에는 수술적으로 제거했으나, 최근에는 주로 코일 및 풍선 등의 다양한 색전물질을 이용한 경피적 색전술을 시행하여 치료하는 추세이다. 거대 폐동정맥기형의 경우에는 색전술 시행 과정에서 코일이 전신 순환으로 빠져 나가 장치 색전증 등의 합병증을 일으킬 위험이 높다. 저자들은 호흡곤란을 주소로 내원한 81세 남자 환자에게서, 지속되는 저산소혈증의 원인으로 거대 폐동정맥기형을 진단하고, Amplatzer$^{(R)}$ 혈관폐색장치를 이용한 경피적 색전술로 치료한 1예를 경험하였기에, 문헌 고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1191-1196
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• 2015

Background: Epidermal growth factor-like domain multiple 7 (EGFL7), recently identified as a secreted protein regulated by oxygen exposure, plays a critical role in promoting metastasis of hepatocellular carcinoma (HCC). Transcatheter arterial embolization (TAE) is widely used for treatment of HCC, resulting in hypoxia in tumors and surrounding liver tissues. Accordingly, we proposed the hypothesis that there could be a relationship between expression of EGFL7 and response to TAE. Materials and Methods: We established a rabbit VX2 liver tumor model using percutaneous puncture technique guided by computed tomography. TAE and sham embolization were performed and the results were confirmed by MRI 3 weeks after inoculation. We investigated the EGFL7 expression of the two groups at 6h and 3 days after intervention by means of immunohistochemistry and Western blotting. Results: Immunohistochemical staining demonstrated that the levels of EGFL7 protein significantly increased in the TAE-treated tumors compared with the control group at 6 hours (P=0.031) and 3 days (P=0.020) after intervention. Meanwhile, the relative EGFL7 protein detected in TAE group also up-regulated compared with the control group at 6 hours (P=0.020) and 3 days (P=0.024) after intervention. Conclusions: This study reveals an increase of EGFL7 expression in rabbit VX2 liver tumors after TAE. The role of EGFL7 in HCC, especially its biological behavior after TAE, needs further investigation.

• Journal of Chest Surgery
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• 제39권2호
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• pp.150-153
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• 2006

심방 중격 결손에 대한 경피적 카테타 폐쇄술은 적절한 환자에서 치료적 대안으로 이용되며, 미용적으로 우수하고, 덜 침습적이며, 재원 기간이 짧으나, 응급 수술이 요구되는 치명적인 합병증이 발생할 수 있다. 저자들은 Amplatzer septal occluder에 의한 심방 중격 결손의 경피적 카테터 폐쇄술 시행 후 발생한 대동맥-우심방루를 경험하였다. 시술 2개월 후에 호흡곤란, 심계항진과 용혈에 의한 황달로 발견되어, 대동맥의 무관상동맥동과 우심방 사이의 누공을 일차 봉합하고, 심방 중격 결손은 팻취로 봉합하는 응급수술을 시행하였다. 이 합병증은 우심방 원반(disk)이 대동맥으로 침식(erosion)하여 발생하였다.