Journal of Yeungnam Medical Science

Woong Kim

5 Articles

Enoxaparin Induced Fatal Retroperitoneal Hematoma in Elderly Patient with Acute Coronary Syndrome －Case Report－: Sang-Hee Lee, Jong-Seon Park, Woong Kim, Geu-Ru Hong, Dong-Gu Shin, Young-Jo Kim, Bong-Sub Shim; Yeungnam Univ J Med. 2007;24(2 Suppl):S642-646. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S642

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Anticoagulation and antiplatelet therapy became a cornerstone of the primary treatment strategy in the case of acute coronary syndrome patients which planned to receive medical treatment or percutaneous coronary intervention. The anticoagulation regimen is unfractionated heparins and low molecular weight heparins enoxaparin. Despite of some debates, enoxaparin has replaced unfractionated heparins recently due to its demonstrated advantages. When we encountered acute coronary syndrome patients without contraindication for enoxaparin, it tends to be administered with no hesitation. However, a few patients treated with enoxaparin could be suffered from bleeding complication. Also, in case of bleeding into the retroperitoneal space, the result can be fatal. We report a patient who developed a fatal retroperitoneal hematoma during enoxaparin treatment for acute coronary syndrome.

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Enoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcome
Nikolaos S. Salemis, Ioannis Oikonomakis, Emanuel Lagoudianakis, Georgios Boubousis, Christos Tsakalakis, Sotirios Sourlas, Stavros Gourgiotis
The American Journal of Emergency Medicine.2014; 32(12): 1559.e1. CrossRef

A Case of Glycogen Storage Disease with Hypertrophic Cardiomyopathy.: Dong Hee Kim, Sang Wook Kang, Won Jong Park, Kyoung Ae Jang, Joon Hyuk Choi, Woong Kim, Sang Hee LEE, Geu Ru Hong; Yeungnam Univ J Med. 2006;23(2):252-257. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.252

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Abstract PDF: Glycogen storage diseases are a heterogeneous group of metabolic disorder affecting multiple organ system: liver, skeletal muscle, heart and brain. Clinical features include: short status, hepatomegaly, hypoglycemia, dyslipidemia and rare involvement of the myocardium except in the case of type III, glycogen storage diseases with hypertrophic cardiomyopathy in adult, which is extremely rare. We treated a case of hypertrophic cardiomyopathy with hepatomegaly that was unknown etiology. The patient was diagnosed as having glycogen storage disease. This 46-year old women was transferred with dyspnea on exertion and abnormal LFTs. She was diagnosed with hypertrophic cardiomyopathy by echocardiography but there was no specific cause for hypertrophic cardiomyopathy. A liver biopsy was performed. The result showed glycogen storage disease possible type III, IV or IX. In conclusion, patients with hypertrophic cardiomyopathy of unknown etiology and abnormal LFTs should be evaluated for glycogen storage disease.

P wave dispersion as a predictor of idiopathic paroxysmal atrial fibrillation.: Gue Ru Hong, Woong Kim, Jong Seon Park, Dong Gu Shin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2001;18(2):267-276. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.267

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Abstract PDF: BACKGROUND
P wave dispersion(PWD) is defined as the difference between the maximum and minimal P wave duration in any of the 12 leads of the surface ECG. The prolongation of atrial conduction time and the inhomogeneous propagation of sinus impulse are known electrophysiologic features in patients with paroxysmal atrial fibrillation(PAF). The purpose of this study was to determine the role of P wave dispersion for the prediction of PAF and to evaluate the effectiveness of prophylactic antiarrhythmic therapy. MATERIALS AND METHODS: The study population included 20 patients with a history of idiopathic PAF and 20 age and sex matched healthy control subjects. We measured the maximum P wave duration(P maximum) and P wave dispersion from 12 lead ECG. RESULTS: P maximum and P dispersion in idiopathic PAF were significantly higher than normal control group(97.2+/-12, 48.5+/-9msec vs, 76.5+/-11, 21+/-8msec, respectively p<0.001, <0.001). After 12-month follow up period P maximum and P dispersion were significantly reduced than those of initial state(77.2+/-13, 26.4+/-9msec vs. 97.2+/-12, 48.5+/-9msec, respectively p<0.001,<0.001). CONCLUSION: P dispersion and P maximum were significantly different between patients with idiopathic PAF and healthy control group. Those are easily accessible, non-invasive simple electrocadiographic markers that could be used for the prediction and prognostic factors of idiopathic PAF.

The Predictors of Cerebral infarction in Mitral Stenosis.: Hyung Jun Kim, Woong Kim, Jong suk Lee, Gue Ru Hong, Jong Seon Park, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2000;17(1):75-81. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.75

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Abstract PDF: BACKGROUND
Systemic embolism especially, cerebral infarction is one of the most important complications in patients with mitral stenosis. The authors analyse the some that could predict the development of cerebral infarction in cases of mitral stenosis and propose preventive therapeutic measures. METHODS: Retrospective study of 127 patients with rheumatic mitral stenosis was performed by analysis their medical records for transthoracic(TTE) or transesophageal echocardiography(TEE) over a 12months period. The patients were divided into two groups according to the presence (Group I: n=26, age: 55+/-13 years) or absence (Group II: n=101, age: 48.5+/-13 years) of cerebral infarction. No significant difference was observed between the two groups with respect to sex and functional class. RESULTS: Patients of group I were older (55.0+/-13 vs 48.5+/-13;p<0.05), had more dilated left atrial size(5.10+/-0.48 vs 4.81+/-0.70;p<0.05) and smaller mitral surface area(1.01+/-0.39 vs 1.21+/-0.45;p<0.05). In Group I, the incidence of atrial fibrillation(22 out of 26 vs 57 out of 101;p<0.05) and spontaneous left intra-atrial contrast phenomenon(22 out of 26 vs 44 out of 101;p<0.05) was more frequently observed. On multivariate analysis, atrial fibrillation and anticoagulant therapy were the independent predictive factors. CONCLUSION: Age, left atrial dilatation, the severity of mitral stenosis, the presence of spontaneous contrast and especially the presence of atrial fibrillation are the main predictive factors of the development of cerebral infarction in mitral stenosis. Patients presenting one or several of these factors may benefit from prophylactic anticoagulant treatment.

The Effect of Early IABP and Reperfusion therapy in Patient of Post MI Cardiogenic shock.: Jong Suk Lee, Min Kyeung Kim, Woong Kim, Hyung Jun Kim, Jun Ho Bae, Jong Seon Park, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2000;17(1):31-38. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.31

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Abstract PDF: BACKGROUND
We sought to examine the use and outcomes with early intraaortic balloon couterpulsation(IABP) combined early reperfusion therapy in patients presenting with cardiogenic shock complicating acute myocardial infarction. The use of IABP in patients with cardiogenic shock is widely accepted. however, there is a paucity of information on the use of this technique in patients with cardiogenic shock who are treated with reperfusion therapy in Korea. MATERIALS AND METHODS: Twenty-eight Patients presented with cardiogenic shock were classified into two groups: the early IABP group (insertion within 12 hours after AMI onset time) and late IABP group (insertion after 12 hours). We compared In-hospital mortality in two group (early IABP group vs late IABP group). RESULTS: Two groups show no significant difference at clinical feature and coronary angiographic results. Among total 28 patients, 7 patients were treated with thrombolytic therapy and 21 patients with PTCA. Insertion site bleeding, fever, thrombocytopenia were reported as some of the complications of IABP insertion. In-hospital mortality of early IABP group and late IABP group were 4 patients(25%) and 8 patients(66%), respectively(p<0.05). Early IABP insertion and early PTCA showed lower hospital mortality rates. There was significant difference in the time to PTCA after AMI onset between the to groups(p<0.05). CONCLUSION: IABP appears to be useful in patients presenting with cardiogenic shock unresponsive medical therapy. Early IABP insertion and early Reperfusion therapy may reduce In-hospital mortality rates in PostMI Cardiogenic shock patients.

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