관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

Rickettsia tsutsugamushi 단백질 항원에 대한 유전자 클로닝 및 대장균내에서의 단백질 발현 양상

이기영,최인학 인제대학교 1993 仁濟醫學 Vol.14 No.4

쭈쭈가무시병의 원인균인 R. tsutsugamushi의 병원성 연구 및 진단법 개발에 필요한 리켓치아항원을 유전자 재조합 기술을 이용하여 클로닝하였다. 리켓치아 세포 표면 항원인 47-kDa및 120-kDa의 단백질을 발현하는 유전자와 세포질내 단백질인 180-kDa을 발현하는 유전자가 클로닝되었다. 이들 세 유전자는 리켓치아 자체 promotor에 의해 대장균내에서 발현되고 있었으며, 클로닝된 세 항원은 R. tsutsugamushi의 세 혈청형인 Kato, Gilliam, Karp에 모두 공통인 항원 결정기를 가지고 있었다. R. tsutsugamushi is a obligate intracellular parasite, the causative agent of tsutsugamushi disease, whose surface proteins are suspected to involve its pathogenecity. Although large quantities of purified R. tsutsugamushi are required to study rickettsial pathogenecity, it still remains technically and economically unfeasible to get large-scale growth and purification of rickettsia for the isolation of individual antigens. We have expressed the rickettsial protein antigens via recombinant expression vector system and examined their biological characteristics. A genomic library of R. tsutsugamushi Kato strain was constructed using lambda ZAP II vector system. From this gene bank, three genes encoding 63-kDa, 47-kDa, and 120-kDa rickettsial protein antigens were cloned and expressed in E. coli. Expression of cloned proteins were shown to be independent of isopropyl beta-D-thiogalactopyranoside(IPTG) induction, suggesting that the intact rickettsial promoters were operational in all clones. Affinity-purified monospecific antisera against each cloned protein were used to identify the antigens in Western blots of extracted Kato and cloned proteins. Monospecific antisera against the recombinant 63-kDa protein reached with 180-kDa Kato proteins, indicating the pKT 1 has cloned the partial sequence of rickettsial gene expressing 180-kDa protein. And monospecific polysera against the recombinants 47-kDa and 120-kDa protein recognized the protiens of 47-kDa and 120-kDa in Kato strain respectively, suggesting these two clones have expressed the whole sequeces of 47-kDa and 120-kDa rickettsial antigen genes. Three cloned proteins were reactive with serotype specific polysera against R. tsutsugamushi Kato, Gilliam, Karp strains, indicating they have the common antigenic determinants of strains of R. tsutsugamushi.

확률이론을 이용한 공동주택에서의 예비비 산정 연구

이만희,이학기 東亞大學校 建設技術硏究所 2005 硏究論文集 Vol.29 No.1

The most matter for construction manager to carefully consider is to contract based on the contingency which can be estimated by reasonable methods at the early time of construction performance. To do it, it is important to accurately estimate costs and contingency associated with risk factors which are included in the project. To establish the real process, first of all, fisk factors in construction project is classified and qualified according to a standard and then the process model to calculate contingency is suggested. The results of the study are followed; (1) Factors to plus or minus costs and main activities in the apartment are determined. (2) According to input data, the regression model to estimate contingency is structured through variability percentage of construction costs and total costs, regression analysis and sensitiveness analysis. (3) Input data by simulation and process model were suggested. (4) Finally, efficiency of model was tested by appling a real case.

상악동 후비공 용종에서 줄기의 경로에 따른 상악동구 전산화단층촬영 소견

이승훈,박동우,이승로,함창곡,이학수,김용수,박충기 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2

Purpose: We evaluate the pathway of the stalk of antrochoanal polyp on the coronal and axial computed tomography scans (CT), comparing with operative findings. Materials and Methods: Fourteen patients (7∼40 years old, median= 12.5 years old, ratio of male to female: 8/6) with antrochoanal polyp were examined, who took the orbitomeatal unit (OMU) CT including both coronal and axial scans as well as the operation. The CT findings and clinical findings were analyzed for the pathway of the stalk of antrochoanal polyp, comparing with the operative findings. Results: The antrochoanal polyps were mostly located on the left side (12/14, 85.7%) and equally passed through the natural and accessory ostia (7/14, 7/14) in our cases. Those that were passing through the accessory ostium were located more inferiorly and posteriorly, with preserving the natural ostium on CT scans, comparing to those via the natural ostium. However, those passing through the natural ostium had a larger stalk that eroded the uncinate process widely. So each ostium was hardly discriminated on CT scans. Conclusions: The pathway of the stalk of the antrochoanal polyp could be more specifically evaluated on both coronal and axial OMU CT scans. So, it could be more hilpful in the presurgical planning.

Vinyl acetate의 低溫radical重合

李學沂,金祐植 慶北大學校 1975 論文集 Vol.20 No.-

Vinyl acetate was polymerized to low conversion at 0℃ with tri-n-butylborane-oxygen as initiators. The poly(vinyl acetate) prepared was saponified to poly (vinyl alcohol), and the poly(vinyl alcohol) was acetylated. The reacetylated poly(vinyl acetate) was characterized by viscosity and molecular weight. From the data, the polymer was known to be a linear molecule. The fact suggests that the reaction of transfer to main chain does not occur at 0℃ and linear PVAc can be prepared by polymerization at 0℃ without carrying out reacetylation.

폴리프로필렌 纖維用 Carbene染料의 開發에 關한 硏究

李學沂,林龍進,민경은 慶北大學校 1982 論文集 Vol.33 No.-

Reactive dyes, which reaction center is carbene, were prepared and the dyeability of polypropylene fiber by those dyestuffs was investigated. Furthermore, a new say of dyeing and an applied technique for pretreating polypropylene with carbenic precursor were studied to improve dyeability. In this experiment, ketones were used as starting materials because these are mostly common functional group in dyes and dyestuff intermediates. Ketones could be changed to tosylhydrazone derivatives by tosylhydrazine in methanol at 0℃ in the presence of aqueous hydrochloric acid. Reactive carbenic dyes were prepared by the reaction of n-butyllithium and these hydrazone derivatives in ethly ether solvent. Dyed polypropylene showed excellent endurance to the light and preserverance to laundry, which were confirmed by means of blue and gray scales. The fact that polypropylene was bonded covalently to dyestuff molecules was confirmed by extraction and reprecipitation. Using the aldehyde as the starting material, carbenic precursor was also prepared analogous route to the dyestuff. After pretreating polypropylene fiber with this precursor, dyeing pattern of fiber in acidic media with butyl orange showed similar adsorption curve which is the typical results of acidic dyeing process. It means that polypropylene could be dyed easily in acidic media if it had pretreated by carbenic precursor.

NMR 스펙트라에 依한α, β-不飽和 히드라존 類의 形態 및 配列에 關한 硏究

沈相喆,李學沂 慶北大學校 1977 論文集 Vol.23 No.-

In order to investigate the conformations and configurations of N-N and N-C single bond of α·β-unsaturated hydrazones, i, e acetaldehyde phenylhydrazone, acetaldehyde methylhydrazone, cinnamic aldehyde methlhydrazone and cinnamic aldehyde phenylhydrazone were synthesized. The raction of αβ-unsaturated hydrazones, whose structures were determined by the anisotropic effect of benzene as N-H π-complex and spin-spin coupling constants of each proton. Both the experimental results and calculations showed that N-phenyl group in the molecule does not almost give the anisotropic effect to each proton.

NMR에 依한 trans-2-Butene-dial dioxime의 立體構造에 關한 硏究

李學沂,沈相喆,嚴在國 慶北大學校 1976 論文集 Vol.21 No.-

The structure of trans-2-butene-dial dioxime was investigated by means of NMR spectroscopy. Its conformer was found to have the planar structure conjugated with the double-bonds from the vicinal spin-spin coupling constants. The configurations of two oxime group were investigated from the solvent effects and assigned as the perfect symmetric structures, mixture of "syn-syn" and "anti-anti" forms.

불포화 에스테르기를 함유하는 중합체의 합성

李學沂,金鴻洛 慶北大學校 1986 論文集 Vol.42 No.-

Functionalized resins have found numerous applications recently as supports in organic synthesis. Active functional groups may be incorporated into polymer chains by direct polymerization and copolymerization of monomers containing the desired functional groups. Furan derivatives undergo ring opening with nitric-acetic acid oxidation. Polymer bound furan as studied as a successful and convenient reagent for the synthesis of unsaturated ester.

Imidazole-Azo유도체의 Spectra

李學沂,林龍進 慶北大學校 1976 論文集 Vol.21 No.-

In order to investigate the possibility as a dyestuff, the spectra of imidazole azo derivatives were studied in comparison with phenyl azo ones. The λmax of imidazole azo derivatives was 17-23 nm longer wave region than that of phenyl derivatives and it means that imidazole azo dyes have more bathochromic effect than phenly azo dyes. The spectra of substituted 2'-oxyphenyl azo imidazole showed isosbestic points in accordance with the variation of pH range in the methanol-water solution. It will be due to the protonation and deprotonation of dyes in acid-alkali solution. The authors discussed these imidazole azo dervatives on the possibility as a disperse azo dye.