관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

급성 중독 환자에 대한 역학적 고찰 : 서울과 지방의 비교

김성중,김인병,최성욱,김경수,이영수,Choi, Jong Moo 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study objective: To compare patients with acute poisoning between urban and rural areas Design: Retrospective chart review of 217 patients with acute poisoning Setting: Two University Hospital EDs Methods: patients were divided into two groups according to hospital. The group A was 109 patients who came to ED of Asan Medical Center and the group B was patients who came to ED of Ajou University Hospital from June 1994 to February 1995. We analysed the age and sex distributions, poisoning substances. causes of poisoning and the past history of psychiatric problems in patients of the two groups. Results: Total number of patients with acute poisoning were 109 in the group A and 108 in the group B. Female was more prevalent than male in the group A and male was more than female in the group B. There was a significant difference in sex distribution between two groups. The mean age of the group A was 27.7 years which was significantly different from the mean age of the group B, 33.7 years. The age incidences in both group were highest in 2nd decade. The accidental poisoning cases were 37% in the group A and 31% in the group B. The rates of committed suicide were 7% in the group A and 22% in the group B. The most common agent of poisoning was therapeutic drug in the group A and agricultural or industrial chemical in the group B. The overall mortality was 5% in the group A and 15% in the group B. Conclusion: There were significant differences in age and sex distributions. poisoning substances, causes of poisoning and the past history of psychiatric problems between two groups.

Decreased Glomerular Filtration Rate is an Independent Predictor of In-Hospital Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Kim, Joon Young,Jeong, Myung Ho,Ahn, Yong Keun,Moon, Jae Hyun,Chae, Shung Chull,Hur, Seung Ho,Hong, Taek Jong,Kim, Young Jo,Seong, In Whan,Chae, In Ho,Cho, Myeong Chan,Kim, Chong Jin,Jang, Yang Soo,Yo The Korean Society of Cardiology 2011 Korean Circulation Journal Vol.41 No.4

<P><B>Background and Objectives</B></P><P>Patients with renal dysfunction (RD) experience worse prognosis after myocardial infarction (MI). The aim of the present study was to investigate the impact of admission estimated glomerular filtration rate (eGFR) on clinical outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation MI (STEMI).</P><P><B>Subjects and Methods</B></P><P>We retrospectively evaluated 4,542 eligible patients from the Korea Acute Myocardial Infarction Registry (KAMIR). Patients were divided into three groups according to eGFR (mL/min/1.73 m<SUP>2</SUP>): normal renal function (RF) group (eGFR ≥60, n=3,515), moderate RD group (eGFR between 30 to 59, n=894) and severe RD group (eGFR <30, n=133). Baseline characteristics, angiographic and procedural results, and in-hospital outcomes between the three groups were compared.</P><P><B>Results</B></P><P>Age, gender, Killip class ≥3, hypertension, diabetes, congestive heart failure, peak creatine kinase-MB, high sensitivity C-reactive protein, B-type natriuretic peptide, left ventricle ejection fraction, multivessel disease, infarct-related artery and rate of successful PCI were significantly different between the 3 groups (p<0.05). With decline in RF, in-hospital complications developed with an increasing frequency (14.1% vs. 31.8% vs. 45.5%, p<0.0001). In-hospital mortality rate was significantly higher in the moderate and severe RD groups as compared to the normal RF group (2.3% vs. 13.9% vs. 25.6%, p<0.0001). Using multivariate logistic regression analysis, adjusted odds ratio for in-hospital mortality was 2.67 {95% confidence interval (CI) 1.44-4.93, p=0.002} in the moderate RD group, and 4.09 (95% CI 1.48-11.28, p=0.006) in the severe RD group as compared to the normal RF group.</P><P><B>Conclusion</B></P><P>Decreased admission eGFR was associated with worse clinical courses and it was an independent predictor of in-hospital mortality in STEMI patients undergoing primary PCI.</P>

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

The Effect of Rosiglitazone on the Cell Proliferation and the Expressions of p27 and Skp2 in<i>Helicobacter pylori</i>Infected Human Gastric Epithelial Cells

Kim, Sung-Soo,Cho, Young-Seok,Kim, Hyung-Keun,Shin, Ok-Ran,Chae, Hiun-Suk,Choi, Myung-Gyu,Chung, In-Sik The Korean Society of Gastroenterology 2010 대한소화기학회지 Vol.55 No.4

<P>Background/Aims: Ligands for peroxisome proliferator-activated receptorgamma (PPARgamma), a member of the ligand-activated nuclear receptor superfamily, exhibit anti-tumoral effects and are associated with de novo synthesis of proteins involved in regulating the cell cycle and cell survival/death. Helicobacter pylori (H. pylori) is an etiologic agent for gastric adenocarcinoma, and raises the cell turnover of gastric epithelium. The aim of this study was to investigate the effect of PPARgamma ligand rosiglitazone on the cell proliferation and the expressions of p27 and Skp2 protein in H. pylori infected gastric epithelial cells. Methods: We examined the expression of PPARgamma by Western blot in H. pylori infected AGS human gastric epithelial cells. The effect of rosiglitazone on the survival of H. pylori infected AGS cells was assessed by cell viability assay. After the treatment of rosiglitazone in H. pylori infected AGS cells, the expressions of p27 and Skp2 were assessed by Western blot. Results: The expression of PPARgamma protein was increased in H. pylori infected AGS cells. Cell growth was inhibited and decreased in dose- and time- dependent manner in H. pylori infected AGS cells treated with rosiglitazone. A decrease in Skp2 expression and a reciprocal increase in p27 expression were found in dose- and time-dependent manner in H. pylori infected AGS cells treated with rosiglitazone. Conclusions: Rosiglitazone inhibited the growth of H. pylori infected AGS cells. Rosiglitazone attenuated Skp2 expression, thereby promoting p27 accumulation in H. pylori infected human gastric epithelial cells. Further studies will be needed to find the effects of accumulation on cell turnover in H. pylori infection and the role in the H. pylori-associated gastric carcinogenesis.</P>

체간미주신경절단술 및 유문성형술, 선택적미주신경절단술 및 유문성형술과 벽세포 미주신경저단술후 Histamine 자극이 위산분비에 미치는 영향에 관한 실험적 연구

김인수,김세민 고려대학교 의과대학 1984 고려대 의대 잡지 Vol.21 No.1

돈지, 들깨유 및 달맞이꽃 종자유의 혼합급이가 흰쥐의 간장, 뇌 및 고환의 지질 성분에 미치는 영향

김성희,김한수,서인숙,정효숙,정승용 慶尙大學校 1992 論文集 Vol.31 No.2

돈지 및 들깨유와 달맞이꽃 종자유등 2종 식물 종자유와의 혼합급이가 흰쥐의 체내 조직의 지질 성분에 미치는 영향을 구명하기 위해 S·D계 숫쥐에게 돈지 2.55및 들깨유와 달맞이꽃 종자유의 혼합비율을 달리하여 4주간 급이 사육한 후 간장,뇌 및 고환의 지질 성분을 분석 검토한 결과는 다음과 같다. 간장의 총콜레스테롤 함량은 D군이 대조군에 비해 유의적으로 낮았으며, 인지질 함량은 각 군간의 유의적인 차이가 없었고, 중성지질 함량은 B및 C군이 대조군에 비해 현저하게 낮았다. 콜레스테롤 급이군의 간장 총콜레스테롤 함량은 대조군에 비해 c,d및 e군이 유의적으로 낮았고, 인지질 및 중성지질의 함량은 b군이 낮게 나타났다. 뇌의 총콜레스테롤 함량은 대조군에 비해 B및 C군이 유의적으로 낮았으며, 인지질 및 중성지질의 함량은 대조군에 비해 전 군이 유의적으로 낮데 나타났다. 콜레스테롤 급이군에 있어 뇌의 총콜레스테롤 함량은 각 군간의 유의적인 차이가 없었고, 인지질 함량은 c군이 중성지질 함량은 e군이 대조군에 비해 낮게 나타났다. 고환의 총콜레스테롤 및 인지질 함량은 각 군간의 유의적인 차이가 없었으나, 중성지질 함량은 대조군에 비해 전 군이 유의적으로 낮았다. 콜레스테롤 급이군은 콜레스테롤 무급이군과 거의 유사한 경향을 나타내었다. In order to observe the effects of the feeds mixed with the lard and two vegetable seed oils, which mixed with 2.5% lard and various level of perilla oil and evening primrose oil were administered to the male rats of Sprague Dawley for 4 weeks on lipid components of liver, brain and testes. In livers , total cholesterol contents were remarkably lower in the D group(2.5% lard+2.5% perilla oil+5.0% evening primrose oil,free cholesterol) than in the control group , and phospholipid contents were not significant difference in each groups. Triglyceride contents were remarkably lower in the B(2.5% lard+7.5% perilla oil+5.0% ,free cholesterol) and C(2.5% lard+5.0% perilla oil+2.5% evening primrose oil,free cholesterol) group than in the control group. In the supplemented cholesterol groups, total cholesterol contents were significantly lower in c(C group+cholesterol diet), d(D group+cholesterol diet) and e(2.5% lard+7.5% evening primrose oil,free cholesterol) group, phhspholipid and triglyceride contents were lower in the b group(B group+cholesterol diet) than in the control groups than in the control group, phospholipid and triglyceride contents in brain were considerably lower in the other groups than in the control group. In the supplemented cholesterol groups, total cholesterol contents were not significant difference in each groups. Phospholipid and triglyceride contents were conspicuously lower in the c and e groups. respectively. In testes, total cholesterol and phospholipid contents were not significant difference in the groups, but triglyceride contents were lower in the all groups except for control group The contents of total cholesterlo, phospholipid and triglyceride were similar between the supplimented cholesterol groups and the nonsupplemented cholesterol groups.

체간미주신경절단술 및 유문성형술, 선택적미주신경절단술 및 유문성형술과 벽세포 미주신경절단술후 Histamine 자극이 위산분비에 미치는 영향에 관한 실험적 연구

김인수,김세민 고려대학교 의과대학 1984 고려대 의대 잡지 Vol.21 No.1

The goal of the therapy for peptic disease is to reduce the acid-pepsin secretion in ther stomach and the recurrence rate, and the parietal cell vagotomy is believed to be a suitable operation for this purpose. The purpose of this study is to report on the response of the gastric secretion after variable vagotomy procedures and to compare the response rate with the administration of histamine in each vagotomy procedures. The author carried out an experimental study on the gastric secretory response to histamine in total 23 mongrel dogs, 8 control group (gastrostomy), 5 truncal vagotomy with pyloroplasty group; 5 selective vagotomy with pyloroplasty group and 5 parietal cell vagotomy group. Gastric juice analysis was carried out 3 times on a monthly with the administration of histamine. The result are as follows: 1. In group of truncal vagotomy with pyloroplasty, the mean value of free acidity after 1 month, 2 month and 3 month of operation decreased by 70.4% 47.1% and 83.1% respectively in comparison with control group, and mean value of total acidity decreased by 32.1%, 24% and 53.1% respectively. The mean value of histamine-responded free acidity after 1 month, 2 month and 3 month of operation decreased by 24%, 43.7% and 48.3% respectively in comparison with control group and mean value of total acidity decreased by 9.4%, 21.2% and 38.8% respectively. 2. In group of selective vagotomy with pyloroplasty, the mean value of free acidity after 1 month, 2 month and 3 month of operation decreased by 18.5%, 41.3% and 25.9% respectively, in comparison with control group. The mean value of histamine-responded free acidity after 1 month, 2 month and 3 month of operation decreased by 27.1%, 45.4% and 46.5% respectively, in comparison with control group and mean value of total acidity decreased by 24.0%, 18.7% and 8.4% respectively. 3. In group of parietal cell vagotomy, the mean value of free acidity after 1 month, 2 month and 3 month of operation decreased by 40.7%, 70.4% and 57.7% respectively, in comparison with control group and mean value of total acidity decreased by 24.0%, 18.7% and 8.4% respectively. Then mean value of histamine-responded free acidity after 1 month, 2 month and 3 month of operation decreased by 33.7%, 25.1% and 63.8% respectively, in comparison with control group and mean value of total acidity decreased by 24.9%, 21.8% and 28.8% respectively. 4. In summary, average reduction rates of free acidity in truncal vagotomy with pyloroplasty, selective vagotomy with pyloroplasty and parietal cell vagotomy were 66.7%, 29.2% and 56.3% respectively, and average reduction rates of total acidity, 36.4%, +10.1% and 28.4% respectively. Average reduction rates of histamine-responded free acidity were 28.7%, 39.5% and 40.9% respectively, and histamine-responded total acidity, 23.1%, 17% and 25.2% respectively.

Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients

Kim, Eun Jung,Jeong, Myung Ho,Kim, Ju Han,Ahn, Tae Hoon,Seung, Ki Bae,Oh, Dong Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, Shung Chull,Kim, Kwon-Bae,Kim, Young Jo,Cha, Kwa Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.236 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate.</P> <P><B>Methods</B></P> <P>A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status.</P> <P><B>Results</B></P> <P>In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA<SUB>1</SUB>C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, <I>p</I> <0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, <I>p</I> <0.001). Comorbidity including cardiogenic shock (<I>p</I> <0.001), cerebral hemorrhage (<I>p</I> =0.012), decreased Hb≥5g/dL (<I>p</I> =0.013), atrioventricular block (<I>p</I> <0.001) and ventricular tachycardia (<I>p</I> =0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients.</P> <P><B>Conclusions</B></P> <P>These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients.</P>

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.