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.

유기용제 취급근로자들의 요중대사물질과 말초임파구 자매염색분체교환 발현빈도에 관한 조사연구

김돈균,황인경,류철인,이수일,정갑열,이용환,이충렬,현원일,김석봉,전용덕 大韓産業醫學會 1990 대한직업환경의학회지 Vol.2 No.1

저자들은 유기용제 취급여성근로자 90명을 대상으로 1988년 7월부터 1989년 8월까지 말초혈액임파구에서의 자매염색분체교환의 발현빈도를 조사하고 이들의 업종, 근속연수, 요중마뇨산 농도등이 자매염색분체교환의 발현빈도에 미치는 영향을 조사하였으며 그 결과를 요약하면 다음과 같다. 1. 유기용제 취급근로자들의 말초혈액임파구에서의 자매염색분체교환의 발현빈도는 대조군에 비하여 유의하게 증가되었다. 2. 말초혈액임파구에서의 자매염색분체교환의 발현빈도가 가장 높은 업종은 프라스틱제품 제조업이었다. 3. 근속연수가 말초혈액임파구에서의 자매염색분체교환의 발현빈도에 미치는 영향은 현저하지 않았다. 4. 요중마뇨산농도와 말초혈액임파구에서의 자매염색분체교환의 발현빈도간에는 유의한 상관관계가 있었다. In order to know the possibility of utilizing the sister chromatid exchanges as an index which could evaluate the effect of organic solvents on the health in industrial workers, the authors studied the effects of the inductivity of sister chromatid exchanges in peripheral lymphocytes from 90 female workers expoxed to organic solvents and 20 non-exposed female workers. The results obtained were as follows : 1. The frequency of sister chromatid exchanges in peripheral lymphocytes from 90 female workers exposed to organic solvents was significantly increased in comparison with 20 control subject. 2. The frequency of sister chromatid exchanges was significantly increased in the workers who were employed in the manufacture of plastic materials than the other manufactures. 3. There were no significant differences in the frequency of sister chromatid exchanges by carriers of the exposed workers.

Combination Effects of Self-Volar Gliding Using a Strap and Wrist Distraction on Pain and Wrist Extension Range of Motion in Subjects with Dorsal Wrist Pain

( Ki-song Kim ),( In-cheol Jeon ) 대한물리치료학회 2019 대한물리치료학회지 Vol.31 No.5

Purpose: This study examined the effects of self-volar gliding combined with a strap and wrist distraction on pain and the active and passive wrist extension range of motion (ROM) in subjects with dorsal wrist pain during partial weight bearing of the hand. Methods: Thirty subjects (14 males and 16 females) with dorsal wrist pain during partial weight bearing through the hand participated in this study. The two different self-volar gliding techniques were performed for each group. Self-volar gliding using a strap (SVGS) and SVGS and wrist distraction (SVGSD) were performed five times for one week for each group. The active and passive ROM of wrist extension and the peak pressure pushed by the hand at pain (PPHP) were measured. An independent t-test was used to compare the improvements of these elements between the two different self-volar gliding techniques. The level of statistical significance was at α=0.05. Results: The active and passive ROM of wrist extension and PPHP were greater in both self-volar gliding groups after the one week intervention. On the other hand, these parameters were greater in the SVGSD group than in the SVGS group (p<0.05) Conclusion: SVGSD is recommended to improve the active and passive ROM of wrist extension and PPHP in subjects with dorsal wrist pain during partial weight bearing of the hand.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

불명열 환자에서 진단된 중증 만성 활동성 Epstein-Barr virus 감염증

전경만,김응호,손준성,장현하,정숙인,오원섭,백경란,송재훈,고광철,정철원,고영혜 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

최근 장기적이고 심각한 임상 증상을 유발하는 만성 활동성 EBV 감염증의 개념이 정립되면서 그 증례들이 보고되고 있다. 만성 활동성 EBV 감염증은 소아나 젊은 성인들에게서 주로 발생되며, EBV-VCA IgG, EBV-EA IgG의 수치가 높게 관찰되고, 지속적인 발열, 전신쇠약감, 광범위한 임파선비대증, 간비장비대, 범혈구감소증, 다크론성감마병증을 나타낸다. 이 질환은 환자의 임상소견, 혈액학적 소견, EBV 항체 역가 및 침범 장기의 EBV genome 검출로 확진 되며 치료로 항 바이러스 체제, 항암 치료, 골수이식술 등이 시도되고 있으나 아직 검증되어 있지 않다. 저자들은 불명열을 주소로 내원하여 중증 만성 활동성 EBV 감염증으로 진단된 증례 4례를 경험하였다. 한 례에서는 항 바이러스 제제를 추여 후 임상적, 혈액학적 호전을 보였으나 치료 20일째 발생한 세균성 복막염과 패혈증으로 사망하였고, 두 례에서 총 6회의 CHOP 항암치료와 자가조혈모세포이식을 시행 받은 후 현재까지 증상 없이 추적관찰 중이다. 지속되는 발열을 주소로 내원한 불명열 환자들에게서 EBV에 대한 검사를 시행할 경우 불명열의 원인을 규명하는데 하나의 단서를 제공할 수 있을 것으로 사료된다. Epstein-Barr virus (EBV) is one of eight human herpesvirus. Primary infection with EBV in childhood is generally asymptomatic or mild, however, often causes overt diseases such as infectious mononucleosis (IM) and lymphoproliferative disorder (LPD), the latter occursing in immunologically compromised individuals. Historically, EBV has been considered to be etiologically linked to human malignancies such as EBV genome positive Burkitt's lymphoma and nasopharyngeal carcinoma. Recently, however, another category of EBV-related disease, "chronic active EBV infection", has been made to describe persons without a clearly defined underlying disease. We report 4 cases of patients, presented with episodic fever of unknown origin (FUO), who were diagnosed as severe chronic active EBV infection. A combined application of serology for EBV and in-situ hybridization established the diagnosis of the EBV infection.

수종의 엔진 구동형 니켈-타이타늄 합금파일의 절삭각에 따른 근관성형 효과에 관한 전자현미경적 연구

전인수,금기연,박성호,윤태철 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.6

The purpose of this in vitro study was to compare the effects of root canal debridement following rotary Ni-Ti instruments with positive versus negative rake angle. Seventy sound, extracted human anterior teeth & premolars were randomly divided into four groups. The used rotary instruments were Ni-Ti HERO642(Micro-Mega in France, 20 specimens), Ni-Ti ProFile(Maillefer, Ballaigues, Switzerland, 20 specimen), stainless steel engine reamer(Mani, Matutani Seisakusho Co.,Japan, 20 specimen) and negative control group(10 specimens) was only extirpated with barbed broach(Mani, Matsutani Seisakusho Co., Japan) Group 1 & 2 teeth were prepared to a #40 at the apex followed by 1 mm using crown-down technique. Group 3 teeth were instrumented from a #15 to a #40 in sequential order. After preparation and final irrigation, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. all root specimens were prepared for SEM investigation & photographed. Separate evaluations were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. the penetration depth of smear layer into dentinal tubules was also estimated in the other halves. the following results were obtained : 1. Smear layer was observed on all the prepared walls with three experimental groups except negative control group 2. Smear layer characteristics1) HERO 642 groups showed snowy & dusty appearance & were observed only few some dentinal tubuli open on the prepared walls, and the penetration depth of it into dential tubules may be 1-2 ㎛ thick. 2) ProFile groups showed shiny & burnished appearance & complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli and penetration depth of it into dentinal tubules may be 1-2㎛ thick. 3) Engine reamer groups showed obviously file's passed tracks on the prepared walls & were observed complete root canal wall covered by a homogenous smear layer with no open dintinal tubuli. The results revealed that a completely clean root canal could not be achieved regardless of positive & negative rake angle, which is in accordance with the majority of studies on root canal cleanliness In conclusion, throughout irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal walls.

남성화를 보이는 여성에서 발견된 난소의 Steroid Cell Tumor 1예

조인호,정대훈,박영미,서영진,손영실,정철회,강영미,정수전,김영남,이경복,성문수,김기태 인제대학교 2006 仁濟醫學 Vol.27 No.-

Steroid cell tumor is a rare ovarian sex cord-stromal tumor which accounts for 0.1% of all ovarian tumors. Until now, only 4 cases have been reported in domestic literatures. Steroid cell tumor often secrets testosterone and presents virilization in adult women or precocious puberty in children. Treatment is often performed by surgical removal, adjuvant chemotherapy and radiation, but completely accepted treatment was not existed. We experienced a case of steroid cell tumor, which was manifested by typical virilization in a 43-year old patient, who was previously performed hysterectomy and unilateral oophorectomy. So, we present with a brief review of the literatures.

頭鍼이 中風患者의 단기간 NIHSS와 MBI에 미치는 영향

류재춘,박인범,김상우,김철홍,서정철,윤현민,장경전,송춘호,안창범 동의대학교 한의학연구소 2002 동의한의연구 Vol.6 No.-

Objective ; The aim of this study was to investigate the effect of Scalp acupuncture on recovery of motor disorders in stroke patients. Methods ; Twenty two patients with poststroke-hemiplegia were randomized into two groups. Ten patients(test group) treated by 2 methods-Scalp acupuncture and body acupuncture. The other twelve patients(control group) treated only by body acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale(NIHSS) and Modified Barthel Index(MBI). The therapy was performed one a day for 2 weeks. Results ; In terms of score of NIHSS, the test group showed statistically meaningful decrease after 2 week treatment, but the control group showed statistically meaningful decrease after 1 week(p<0.05). And in terms of score of MBI, the test group did not show statistically meaningful increase but the control group showed statistically meaningful increase after 1 week(p<O.05). There was no statistically meaningful difference after 1 and 2 week treatment between the groups. Conclusions ; These results support that test group has almost same effectness compared with control group in improvement of the activity of daily living of poststroke-hemiplegic patients.

3D stack package의 구조해석과 모아레 측정법을 이용한 결과 비교

윤형석(Hyung Seok Yoon),최광성(Kwang Seong Choi),배현철(Hyun Cheol Bae),임병옥(Byeong Ok Lim),엄용성(Yong Sung Um),문종태(Jong Tae Moon),전인수(In Su Jeon) 대한기계학회 2010 대한기계학회 춘추학술대회 Vol.2010 No.11

Semiconductor devices become smaller, higher density and performance required is increased interest in this issue is a 3D package technology; Thermo-mechanical reliability was interested in. Coefficient of thermal expansion mismatch between dissimilar materials of the package takes the biggest factors in life are most interested in TSV (through silicon via) and the solder joints were treated with the finite element method. Bump chip thickness, interposer thickness, underfill's material property package of several factors that affect the reliability of CTE of underfill for the study was conducted by the largest change in stress was found to appear. We were aiming to optimize the design, production and real samples by comparing the results of the Moire measuring the reliability of numerical results have been verified.

董氏鍼을 加味한 治療가 中風患者의 NIHSS와 MBI상의 단기간 기능회복에 미치는 영향

조태성,손인석,김철홍,서정철,윤현민,장경전,송춘호,안창범 동의대학교 한의학연구소 2002 동의ㆍ경산 한의학 학술대회 Vol.6 No.-