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.

한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

동종 골수이식 후 만성 이식편대숙주질환과 동반되어 신증후군으로 발현된 IgA 신병증 1예

정철권,김현수,박준성,정성현,조도연,최진혁,남동기,임호영,김명성,신규태,임현이,김효철 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

동종 골수이식 후 발생하는 신기능부전은 원인이 다양하여 감별에 어려움이 있다. 만성 GVHD는 흉선의 기능저하에 따른 면역관용의 실패로 발생되는 자가면역현상에 의해 발생되는 것으로 알려져 있으며 드물게 신장을 침범하여 신증후군을 일으키기도 한다. CaA의 용량을 줄이거나 투약중지 후 발생한 만성 GVHD에 동반된 신증후군의 경우 조기에 신조직검사를 시행하여 감별진단하고 CsA의 용량을 증량하거나 재투약하여 좋은 치료 결과를 보일 것으로 기대된다. 저자들은 문헌고찰을 통해 동종 골수이식 후 발생된 신증후군이 유사한 임상양상을 보이며 발생기전에 만성 GVHD와 자가면역현상이 연관되어 있음을 확인하였으며 동종 골수이식 후 신증후군의 임상양상을 보이는 환자에서 병리조직학적으로 lgA 신병증을 진단하고 이러한 lgA 신병증이 발생기전에 만성 GVHD와 자가 면역현상이 연관되어 있을 가능성을 최초로 확인하였으며 CsA를 이용하여 성공적으로 치료한 경험을 하였기에 보고하는 바이다. Renal insufficiency is occasionally encountered in allogeneic bone marrow transplantation and its cause is difficult to ascertain. Chronic graft-versus-host disease (GVHD) related to thymic dysfunction is immune-mediated and involves autoreactivity of T-lymphocytes derived from donor marrow to recipient's major histocompatibility complex(MHC) minor antigens. The clinical mainifestations of chronic GVHD are similar to those of autoimmune disease but kidney involvement is rare. Few cases of nephrotic syndrome with membranous nephropathy or minimal change nephrotic syndrome have been reported to be associated with chronic GVHD in allogeneic bone marrow transplant recipient especially after cyclosporine A(CsA) withdrawal, and these cases have responded well to CsA. Therefore, it is prudent to differentiate the cause of post-transplant renal insufficiency using renal biopsy and to start CsA in a case of nephrotic syndrome associated with chronic GVHD as early as possible. We report a case who had a massive proteinuria during the post-allogeneic marrow transplantation period. The cause of nephrotic syndrome was diagnosed as IgA nephropathy by renal biopsy. The patient was successfully treated with reintroduction of CsA.

24주간 추적하는 임상 연구에서 한국인 남자 알코올 의존 환자의 비재발률

강철중,김성곤,남궁기,조동환,이병욱,최인근,최용성,박성봉,제영묘,김현경,김성연 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objetives : In order to provide useful data tbr the further clinical studies with Korean alcohol-dependent patients, enrollment and non-relapse rates were investigated while alcohol-dependent patients wcre followed up for 24 weeks. Methods : The subjects of this study were alcohol-dependent male patients who, for the first time, visited a hospital among 3 groups of hospitals, University Hospital, General Hospital or Mental Hospital, or those who needed to be followed up after discharge from those hospitals. After assigning 12 subjects to each hospital, we investigated enrollment and non-relapse rates while cognitive-behavioral therapy and pharmacotherapy were provided. Results : 1) Forty-eight patients were enrolled and the rate of enrollment was 36.4%. The enrollment rate in the University Hospital group was 52.1%, in the General Hospital group 50.0%. and in the Mental Hospital group 10.4%. 2) In 48 patients, non-relapse rate was 27.1% at 12 week and 18.8% at 24 weeks after starting follow-up. It was 24.4% and 20.0% at 12 and 24 weeks, repectively, in the University Hospital group while the General Hospital group showed 33.3% and 16.7%, respectively, and the Mental Hospital Group showed 20.0% at both 12 and 24 weeks. Conclusion : These results provide important data for further clinical studies of Korean alcohol-dependent patients.

웃음을 이용한 다중음성치료기법(SKMVTT<SUP>®</SUP>)이 성대용종 환자의 음성개선에 미치는 효과

김성태(Seong-Tae Kim),정옥란(Ok-Ran Jeong),안철민(Cheol Min Ahn) 한국음성학회 2008 음성과학 Vol.15 No.2

Vocal polyp is one of the representative chronic diseases of vocal folds, and it can be cured by voice therapy and/or laryngeal microsurgery. However, the existing therapeutic methods about vocal polyp are in great demand. The purpose of this study was to evaluate the effect of vocal improvement between laryngeal microsurgery and SKMVTT<SUP>®</SUP>(Seong-Tae Kim's Multiple Voice Therapy Technique), which was designed by the author. We identified 37 patients, who were diagnosed with unilateral vocal polyp, aged from 21 to 62 years(mean age: 46 years). 21 patients were treated by the SKMVTT<SUP>®</SUP> and the other 16 patients were only treated by the laryngeal microsurgery. All patients who were treated by the SKMVTT<SUP>®</SUP>, received 12 sessions of treatment, and were evaluated before therapy and after finishing the 12th session. The patients who were treated by laryngeal microsurgery, were evaluated prior to and at least 8 weeks after surgery. The results showed that the SKMVTT<SUP>®</SUP> produced better results compared to the laryngeal microsurgery alone. The SKMVTT<SUP>®</SUP> produced better results, especially, at the initial stage of voice therapy compared with those of laryngeal microsurgery. In this study, we can suggest that SKMVTT<SUP>®</SUP> may be useful in improving the voice qualities of vocal polyp patients. However, more data should be collected and evaluated to be widely used in other clinics.

축산분뇨중의 암모니아성 질소 제거

진양오,최성우,김성우,김익성,신남철,박승조 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.2

The purpose of thus study were to investigate the proper conditions of struvite formation in synthetic wastewater and then to apply these conditions to effluent of anaerobic digester of livestock wastewater The conditions of struvite formation had been studied by many researchers. But a little conditions were different among them. Especially, according to suspended solid variation in livestock wastewater was investigated by few researchers. In experiment of synthetic wastewater, the proper conditions of struvite formation were pH 105, l50rpm of mixing rate, 10 minutes of reaction time, and 20 minutes of precipitation time. At same time, the ammonia nitrogen removal rates were about 99.7%, 95.5%, and 96% of synthetic wastewater, raw wastewater, and effluent of anaerobic digester of livestock wastewater at molar ratio of 2(Mg):l(N)2(P) respectively. The larger factor of NH₄/SS constant was, the more effective the removal rate of ammonium nitrogen, SS was, but the less effective COD_(cr), and TOC was. By using XRD analysis, the most certain compound in precipitate of synthetic wastewater was struvite.

진동에 의한 혈관 내 폐 보조장치의 산소전달 특성

김기범,권대규,이삼철,김성종,정인수,오인혁,김기주,변윤섭,정경락 한국화학공학회 2004 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.42 No.2

본 연구는 급성호흡부전환자를 치료하기 위하여 사용되고 있는 혈관 내 폐 보조장치의 기체전달을 향상시키기 위하여 중공사막에 진동기법을 사용하여 기체전달을 향상시키고자 시도하였다. 그리고 혈관 내 폐 보조장치를 정맥에 삽입하기 전, 혈관 내 폐 보조장치의 설계조건을 실험적 모델을 통하여 기체전달을 예측할 수 있는 예측식을 만들고자 하였다. 실험결과, 본 연구에서는 진동기법이 기체전달을 향상시키는데 효과적임을 확인할 수 있었다. 뿐만 아니라, 충진율과 가징 주파수의 함수관계를 이용하여 기체전달을 예측 할 수 있었다. 실험에 의하여 얻어진 결과는 예측식에 의하여 얻어진 결과와 유사한 결과를 얻었다. 그러므로 본 연구에서는 충진율과 가진 주파수의 함수를 이용하여 VIVLAD의 기체전달을 예측할 수 있었다. In this paper, we tried to improve gas exchange of the vibrating intravascular lung assist device(VIVLAD) using vibrating method in the hollow fiber membrane, for the patients suffering from acute respiratory distress syndrome(ARDS). And we tried to formularize prediction equations to make a prediction about gas transfer for designing intravenous artificial lung assist device, and designed modules under various conditions were studied through an experimental modeling before inserted the artificial lung assist device into as venous. As a result, we are convinced that vibration method is very useful for the has transfer increasing. Also, we can estimate the gas transfer as a function of the packing density and excited frequencies. The gas transfer obtained from the experiment was similar to that from the prediction equation, confirming the usefulness prediction equation. Therefore, we can estimate the gas transfer of the VIVLAD as a function of the packing density and excited frequencies.

성공적인 경피적 승모판 교련절개술 후 임상 경과와 재협착율

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

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

로드셀을 이용한 고속 감자 중량계량법

김상철,임종환,김귀식,김성근,양종훈 제주대학교 공과대학 첨단기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.2

Potatos, together with tangerines, are one of the major agricultural products in Jeju, and the production account for more than 30% of the domestic production. Recently some kinds of sorting machine for potatos are available, but they are not extensively used because their performance is not satisfactory and/or they are very expensive. This paper presents a load based high speed weighting method for sorting the potatos. This method is based on the fact that the linear momentum of a potato is proportional to the mass of it. The usefulness of the method is demonstrated with sets of experiments.