- Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study.
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Dong Oh Kang, Du Ha Lee, Hyun Seo Kim, Hyun Su Kim, Sung Rok Kim, Jong Seon Park
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Yeungnam Univ J Med. 1999;16(2):309-317. Published online December 31, 1999
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DOI: https://doi.org/10.12701/yujm.1999.16.2.309
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Abstract
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- BACKGROUND
Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function, we performed M-mode and Doppler echocardiopraphic studies before and after hemodialysis. METHODS: The study population consisted of 30 patients(15 patients were male, mean age 45+/-10 years) with CRF on maintenance henodialysis. They have normal left ventricular systolic function(Fractional shortening > 30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction(EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxaion time(IVRT), deceleration time(DT), and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance(IMP) was calculated from each of the Doppler velocity indices. RESULTS: The weight reduction after hemodialysis was 2.1+/-1.0kg(p<0.0001). After hemodialysiss, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant in IVRT and IMP(p<0.05, p<0.0001) were noted. CONCLUSTION: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And and increased IMP suggests that diastolic function may be aggravated after gemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.
- A Case of Extraadrenal Pheochromocytoma Showed a Transient Oral Captopril Test Positive Result.
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In Bum Lee, Du Ha Lee, Tae Hi Oh, Jong Seon Park
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Yeungnam Univ J Med. 1997;14(2):474-482. Published online December 31, 1997
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DOI: https://doi.org/10.12701/yujm.1997.14.2.474
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Abstract
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- There have been some case reports of the coexitence of extraadrenal pheochromocytoma and renal artery stenosis. Some reporters proposed that their coexistence may be associated through a common pathophysiological mechanism mediated by catecholamine secretion. Also some noted that trasient renal artery stenosis due to a spasm was induced by the catecholamines released from pheochromacytoma. We report a case of left paraaortic extraadrenal pheochromacytoma that had a transient oral captopril test positive result. After 5 days alpha-antagonist reduced the vasospastic response of catecholamines. After surgical removal of the tumor, plasma catecholamines and urinary vanillymandelic acid concentrations as well as the blood pressure level, were restored to normal.
- Polycythemia vera combined with coagulation disorder: A case report.
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Jae Hee Ahn, Du Ha Lee, Hyo Jin Chun, Myung Soo Hyun, Hyun Woo Lee, Chung Sook Kim
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Yeungnam Univ J Med. 1989;6(2):247-255. Published online December 31, 1989
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DOI: https://doi.org/10.12701/yujm.1989.6.2.247
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- We report a case of polycythemia vera combined with coagulation disorder. The patient was 54 years old man who complained of continuous bleeding after incision of skin abscess 20days ago. Laboratory tests were revealed prolonged aPTT and slightly prolonged PT. Coagulation factor, I, VIII, IX, XI and fibrinogen decreased, however FDP did not increased. It appears that patient with polycythemia vera have chronic activation of coagulation system, probably initiated by activation of factor XII. Platelet aggregation test to ADP, collagen, epinephrine was also revealed poor response.
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