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.

급성 심근허혈에 의해 윤발된 승모판 폐쇄부전의 기전에 관한 실험적 연구

강덕현,송현,송재관,김현숙,이재환,임희영,이재원,박성욱,박승정,송명근 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.8

복합 관동맥병변에서의 Rotational Atherectomy : 초기결과

김진우,박성욱,홍명기,이상곤,이일수,이철환,최기준,강덕현,송재관,김재중,박승정 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

동의보감의 활석에 대한 지질학 및 한의약학적 고찰

이재영,서부일,황덕환,이인호,임용수 慶北大學校 師範大學 科學敎育硏究所 1999 科學敎育硏究誌 Vol.23 No.-

Talc has been used as mineral drugs in the oriental medicine to cure catharsis, dysentery, dry breast, poor micturition, chronic indigestion, etc. according to the 'Donguebogam' which had been published by Heo Jun in 1613. In the book there is a description of 'talc from Chungju is of good quality'. To investigate the description geologically and oriental medically, talc from Dongyang Talc Mine in the Chungju area was analysed and compared with that of Oriental Medical Hospital of Kyungsan University, which has MgO 31.65%, CaO 0.73%, SiO_(2) 60.04%, ignition loss 6.4% close to those of pure talc containing MgO 31.7%, SiO_(2) 63.5%, H_(2)O 4.8%. However, talc from Dongyang Mine with MgO 31.8%, CaO 0.51% and SiO_(2) 61.0% is closer to pure talc and contains less impurities (Fe_(2)O_(3) 0.8%). Ca and Fe may add medical effects to talc drug as in the case of actinolite. Formula (3) logα_(Mg)^(2+) = 11.89 - 2pH and (4) logα_(Mg^(2+)/α^(2)_(H)^(+)) = 6.6 - 1.33 logα_(H4SiO4) may be used as basic data to predict and examine soluble contents of talc drug for medical experiments.

대형 소매업태 발전의 국제비교 : focus on the developing process and appearance of Korean, American and Japanse large retailers 한·미·일 대형소매업태의 발전과정을 중심으로

이덕훈,이인표,박재수 韓日經商學會 1998 韓日經商論集 Vol.16 No.-

The study is of analyzing the developing tendency of national large retailer business through the comparition of Korean, American, Japanese ones with the reality of the Korean distributing industry under the process of industralization. Generally speaking, the changes in retailer institutions are made possible by changing the relevant leading positions as to content of the specific innovation in a retailer business is concerned, and the dynamic change of the retailer institution structure can be seen in the process. "Similar process and types" can be expected in the developing process of the retailer businesses in different countries when they fulfill the innovation in the different stages of economic development. However, "common models" do not exist at all. In conclusion, the similarities and differences of the businesses in the three countries can be found out through the comparition of the relevant developing processes. In this point, it is clear to notice the each situation in the department stores, GMS and large discount stores with the luxurious/fashionable and practical/functional tendency as the priority in American. Whereas the Japanese retailer businesses show mixed above characteristics. In other word, the style of retailer businesses can be seen in the mixed state of the luxurious/fashionable and practical/functional tendency of customers who considers who consider the food categories as the first demand. However, in Korea, the competitive advantage is rather weak as the short developing history of the distributing businesses and large retailers. Therefore, the operating states are considerably different although some similarities between the retailor businesses in different countries exist, when the convergence and movement of the population, growth of income, behavior and valuation are considered as the criteria, and when the exterior appearance is taken into account. In the end, in the light of the reality of immaturity in the environmental conditions of the above developing factors in the industrializing process, the developed state of retailer businesses can be seen in the large economical department stores in the Japanese model.

급성 심근경색후 생존심근 진단에서 Dobutamine 심초음파도와 Thallium 심근스캔의 정확성 비교

이근,강덕현,송재관,이철환,최기준,홍명기,김재중,박성욱,박종훈,박승정 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.2

인산염계 내화물의 기계적 물성 및 내부식성에 대한 핵형성제 첨가효과

이덕용,이재춘,최광훈,김병균,신경숙 明知大學校 産業技術硏究所 1995 産業技術硏究所論文集 Vol.14 No.-

The effect of nucleants was studied on the mechanical property and corrosion resistance of phosphate refractories used for high temperature inorganic binder It was found that a mixture of TiO₂ and ZrO₂ nucleants yielded not only the best corresion resistant but the highest strength phosphate refractory. However, the effects of nucleants on the mechanical property of the refractories could not be identified in this study because each sample showed different porosity which was also presumed to affect the fracture strength of the refractory.

법랑라세포종의 면역조직화학적 및 전자현미경적 연구

이두형,조성덕,양문호,장충현,박재훈 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.3

Clinicopathologic analysis of ameloblastoma in 24 cases and their ultrastructural and immunohistochemical studies, especially to cytokeratin expressions according to morphologic classification were performed to clarify the tumor cell differentiation and origin. Reaction with broad spectrum and high molecular weight cytokeratin were generally positive in the stellate cell of the follicular and acanthomatous ameloblastoma, suggesting more squamous differentiation than peripheral basal cell type. Although ultrastructually common origin from oral epithelium was evidenced by presence of tonofilaments and desmosome, variations were prominent among the different histopathologic types of tumor. In granular cell ameloblastoma there were pleomorphic osmiophilic lysosome-like granules.

머리의 위치변화에 따른 파노라마방사선 사진상에서의 상악동 및 인접조직의 평가

이진경,김재덕 大韓口腔顎顔面 放射線學會 1992 Imaging Science in Dentistry Vol.22 No.2

The purpose of this study was to evaluate the utilization of the orthopantomograph as diagnostic aid to observe maxillary sinus and adjacent structures. For achieving this goal, the lead plates were attached to the five walls of the maxillary sinus of a human dry skull. The dry skull was placed in fourteen different positions : standard, 20mm forward, 20mm backward, 10 degree upward, backward & downward & lateral, upward & lateral, downward &lateral position The obtained results were as follows ; 1. The image of the medial wall was observed very differently according to the head position. 2. The image of the anterior wall was observed at medial third to half of the maxillary sinus in each head position. 3. The image of the posterior wall was always observed at lateral third of the maxillary sinus in all head positions and more obviously in the downward-lateral position. 4. The image of the superior wall was observed at the inferior third to half of the orbit in each head position. 5. The image of the inferior wall was always observed at the inferior third of maxillary sinus in all head positions and observed more obviously in the standard and downward-lateral positions. 6. The image of the zygomatic process, zygomatic arch and zyomaticotemporal suture were observed very well in the downward-lateral position.