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Park, Duk-Woo,Yun, Sung-Cheol,Lee, Seung-Whan,Kim, Young-Hak,Lee, Cheol Whan,Hong, Myeong-Ki,Kim, Jae-Joong,Choo, Suk Jung,Song, Hyun,Chung, Cheol Hyun,Lee, Jae-Won,Park, Seong-Wook,Park, Seung-Jung Ovid Technologies Wolters Kluwer -American Heart A 2008 CIRCULATION - Vol.117 No.16
<P>BACKGROUND: Although previous studies have compared the treatment effects of percutaneous coronary intervention and coronary artery bypass grafting (CABG), the long-term outcomes beyond 1 year among patients with multivessel coronary artery disease who underwent percutaneous coronary intervention with drug-eluting stents (DES) or CABG have not been evaluated. METHODS AND RESULTS: Between January 2003 and December 2005, 3042 patients with multivessel disease underwent coronary implantation of DES (n=1547) or CABG (n=1495). The primary end point was all-cause mortality. In a crude analysis, the rate of long-term mortality was significantly higher in patients who underwent CABG than in those who underwent DES implantation (3-year unadjusted mortality rate, 7.0% for CABG versus 4.4% for percutaneous coronary intervention; P=0.01). However, after adjustment for baseline differences, the overall risks of death were similar among all patients (hazard ratio, 0.85; 95% confidence interval [CI], 0.56 to 1.30; P=0.45), diabetic patients (hazard ratio, 1.76; 95% CI, 0.82 to 3.78; P=0.15), and patients with compromised ventricular function (hazard ratio, 1.39; 95% CI, 0.41 to 4.65; P=0.60). In the anatomic subgroups, mortality benefit with DES implantation was noted in patients with 2-vessel disease with involvement of the nonproximal left anterior descending artery (hazard ratio, 0.23; 95% CI, 0.01 to 0.78; P=0.016). The rate of revascularization was significantly higher in the DES than in the CABG group (hazard ratio, 2.81; 95% CI, 2.11 to 3.75; P<0.001). CONCLUSIONS: For the treatment of multivessel coronary artery disease, percutaneous coronary intervention with DES implantation showed equivalent long-term mortality as CABG.</P>
Kim, Young-Hak,Park, Duk-Woo,Lee, Seung-Whan,Yun, Sung-Cheol,Lee, Cheol Whan,Hong, Myeong-Ki,Park, Seong-Wook,Seung, Ki Bae,Gwon, Hyeon-Cheol,Jeong, Myung-Ho,Jang, Yangsoo,Kim, Hyo-Soo,Seong, In-Whan Ovid Technologies Wolters Kluwer -American Heart A 2009 CIRCULATION - Vol.120 No.5
<P>BACKGROUND: Limited information is available on long-term outcomes for patients with unprotected left main coronary artery disease who received drug-eluting stents (DES). METHODS AND RESULTS: In the multicenter registry evaluating outcomes among patients with unprotected left main coronary artery stenosis undergoing stenting with either bare metal stents (BMS) or DES, 1217 consecutive patients were divided into 2 groups: 353 who received only BMS and 864 who received at least 1 DES. The 3-year outcomes were compared by use of the adjustment of inverse-probability-of-treatment-weighted method. Patients receiving DES were older and had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and multivessel disease. In the overall population, with the use of DES, the 3-year adjusted risk of death (8.0% versus 9.5%; hazard ratio, 0.71; 95% confidence interval, 0.36 to 1.40; P=0.976) or death or myocardial infarction (14.3% versus 14.9%; hazard ratio, 0.83; 95% confidence interval, 0.49 to 1.40; P=0.479) was similar compared with BMS. However, the risk of target lesion revascularization was significantly lower with the use of DES than BMS (5.4% versus 12.1%; hazard ratio, 0.40; 95% confidence interval, 0.22 to 0.73; P=0.003). When patients were classified according to lesion location, DES was still associated with lower risk of target lesion revascularization in patients with bifurcation (6.9% versus 16.3%; hazard ratio, 0.38; 95% confidence interval, 0.18 to 0.78; P=0.009) or nonbifurcation (3.4% versus 10.3%; hazard ratio, 0.39; 95% confidence interval, 0.17 to 0.88; P=0.024) lesions with a comparable risk of death or myocardial infarction. CONCLUSIONS: Compared with BMS, DES was associated with a reduction in the need for repeat revascularization without increasing the risk of death or myocardial infarction for patients with unprotected left main coronary artery stenosis.</P>
이봉기,Young-Hak Kim,Duk-Woo Park,Sung-Cheol Yun,Jung-Min Ahn,Hae Geun Song,Jong-Young Lee,김원장,강수진,Seung-Whan Lee,Cheol Whan Lee,Jae-Hwan Lee,In Whan Seong,Seong-Wook Park,Seung Jung Park 대한의학회 2012 Journal of Korean medical science Vol.27 No.12
This was designed to assess the outcomes of side branch (SB) stenosis after implantation of three drug-eluting stents (DES). From 2,645 patients in the ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) Trial, 788 patients had 923 bifurcation lesions with SB ≥ 1.5 mm were included. SB was treated in 150 lesions, including 35 (3.8%) receiving SB stenting. Of untreated SB with baseline stenosis < 50%, the incidences of periprocedural SB compromise was similar in the zotarolimus (15.8%), sirolimus (17.2%), and paclitaxel (16.6%) stent groups (P = 0.92). At follow-up angiography, delayed SB compromise occurred in 13.9%, 3.2%, and 9.4% (P = 0.010) of these groups. When classified into four groups (< 50%, 50%-70%, 70%-99%, and 100%), 9.0% of untreated SB were worsened, whereas improvement and stationary were observed in 9.6% and 81.4%. In a multivariable logistic regression model, main branch (MB) stenosis at follow-up (%) was the only independent predictor of SB stenosis worsening (odds ratio, 1.03; 95% confidence interval, 1.01-1.04; P < 0.001). After MB stenting in bifurcation lesions, a minority of SB appears to worsen. DES with strong anti-restenotic efficacy may help maintain SB patency.
Stents versus coronary-artery bypass grafting for left main coronary artery disease.
Seung, Ki Bae,Park, Duk-Woo,Kim, Young-Hak,Lee, Seung-Whan,Lee, Cheol Whan,Hong, Myeong-Ki,Park, Seong-Wook,Yun, Sung-Cheol,Gwon, Hyeon-Cheol,Jeong, Myung-Ho,Jang, Yangsoo,Kim, Hyo-Soo,Kim, Pum Joon,S Massachusetts Medical Society 2008 The New England journal of medicine Vol.358 No.17
<P>BACKGROUND: Several studies have compared the treatment effects of coronary stenting and coronary-artery bypass grafting (CABG). However, there are limited data regarding the long-term outcomes of these two interventions for patients with unprotected left main coronary artery disease. METHODS: We evaluated 1102 patients with unprotected left main coronary artery disease who underwent stent implantation and 1138 patients who underwent CABG in Korea between January 2000 and June 2006. We compared adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction, or stroke; and target-vessel revascularization) with the use of propensity-score matching in the overall cohort and in separate subgroups according to type of stent. RESULTS: In the overall matched cohort, there was no significant difference between the stenting and CABG groups in the risk of death (hazard ratio for the stenting group, 1.18; 95% confidence interval [CI], 0.77 to 1.80) or the risk of the composite outcome (hazard ratio for the stenting group, 1.10; 95% CI, 0.75 to 1.62). The rates of target-vessel revascularization were significantly higher in the group that received stents than in the group that underwent CABG (hazard ratio, 4.76; 95% CI, 2.80 to 8.11). Comparisons of the group that received bare-metal stents with the group that underwent CABG and of the group that received drug-eluting stents with the group that underwent CABG produced similar results, although there was a trend toward higher rates of death and the composite end point in the group that received drug-eluting stents. CONCLUSIONS: In a cohort of patients with unprotected left main coronary artery disease, we found no significant difference in rates of death or of the composite end point of death, Q-wave myocardial infarction, or stroke between patients receiving stents and those undergoing CABG. However, stenting, even with drug-eluting stents, was associated with higher rates of target-vessel revascularization than was CABG.</P>
Trial of everolimus-eluting stents or bypass surgery for coronary disease.
Park, Seung-Jung,Ahn, Jung-Min,Kim, Young-Hak,Park, Duk-Woo,Yun, Sung-Cheol,Lee, Jong-Young,Kang, Soo-Jin,Lee, Seung-Whan,Lee, Cheol Whan,Park, Seong-Wook,Choo, Suk Jung,Chung, Cheol Hyun,Lee, Jae Won Massachusetts Medical Society 2015 The New England journal of medicine Vol.372 No.13
<P>Most trials comparing percutaneous coronary intervention (PCI) with coronary-artery bypass grafting (CABG) have not made use of second-generation drug-eluting stents.</P>
5남매에 발생한 Familial Dentinogensis Imperfecta 증례
윤철희,신효근,김오환 全北大學校 齒醫學硏究所 1986 전북치대논문집 Vol.4 No.1
Dentinogenesis imperfecta is an autosomal dominant genetic defect which affect one patient in 6000 to 8000, also reported as hereditary opalescent dentin, or Capdepont dysplasia, in France. Clinically, the teeth are described as opalescent and acquire a distinct yellow-brown color shortly after eruption. The enamel chips away and the dentin which is apparently hypomineralized, is soon worn down. Radiographically, the roots appear shorter than usual and constricted to a variable degree in the cervical region and the pulp chambers are seen to be obliterated by the formation of further calcified material. The patient, a 16-year-old girl, was referred to the Dental clinic of the Chon Buk National University Hospital for discoloration of entire teeth and serious dental carious problem. Clinical appearance and radiographic examination revealed the typical abnormilities associated with dentinogenesis imperfecta and her two sisters and two brothers had same abnormalities. We performed extraction on severe cariou, teeth, intra oral sagittal split osteotony due to asymmetry and cross bite, also, rehabilated masticatory systems with fixed crown and bridge. We had a good result.
顎骨 缺遜部의 Hydroxylapatite 및 PCBM(Particulated cancellous bone and marrow)의 混合使用時 治癒過程에 關한 實驗的 硏究
尹哲熙,辛曉根,金晤煥 全北大學校 齒醫學硏究所 1986 전북치대논문집 Vol.4 No.1
By recent studies, HAP implant showed biocompatibility with host tissue, in that no toxic or foreign body reaction was found. HAP was known to have osteophilic property but not osteogenetic ability. This study examined the healing process on histologic basis following implantation with HAP-PCBM mixture on the inferior border of rabbit mandible. The results were as follws: 1. Mild inflammatory response was observed at 1st week, foreign body reaction and inflammatory response were not observed after 2nd week. 2. Osteoclastic, phagocytic activity was observed prominently on the grafted bone at 1st, 2nd week. 3. New bone was bonded with HAP particles directly without intervening tissue after 4th week. 4. At 8th, 12th week, mature bone was observed to have infiltrated between the HAP particles and osteoclastic activities were not noted. 5. Bony bridge between underlying cortical bone and HAP particles was observed after 4th week.