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송우혁,박종재,신상원,김재선,인광호,강경호,유세화 대한내과학회 1992 대한내과학회지 Vol.42 No.3
본 저자들은 34세 여자 환자의 우측 폐에 발생한 해면상 혈관종 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Cavernous hemangioma is a very rare disease among benign tumors of the lung. Recently authors experienced a case of cavernous hemangioma which was developed in 34-year-old woman and sucessfully enucleated. We report a case of cavernous hemangioma with a review of literatures.
치료 전 고혈압 환자에서 일중 혈압의 변화양상과맥파전도속도 및 좌심실 확장기 기능과의 관계
송우혁,안정천,김진원,나승운,박희남,임도선,김영훈,심완주,박창규,서홍석,오동주,노영무 대한심장학회 2004 Korean Circulation Journal Vol.34 No.11
Background and Objectives:An increased pulse wave velocity (PWV) and a non-dipping pattern in hypertensive patients have been shown to be associated with an excess of target organ damage. The relationship between the PWV and circadian variation of blood pressure (BP) (dipper or nondipper) were sought, and also the LV diastolic function between dipper and nondipper patients compared. Subjects and Methods:44 hypertensive subjects, who had never been treated, were enrolled (mean age: 48±12 yrs, men: 29). The following procedures were undertaken. 1) 24 hour ambulatory BP monitoring; 2) echocardiography for LV geometry, LV mass index (LVMI), LV systolic and diastolic functions, including tissue Doppler and aortic PWV. The patients were divided into two groups with respect to their ambulatory BP profiles, i.e., dipper and nondipper. The PWV, LV geometry and diastolic functions were compared between dipper and nondipper patients, and the relationship between the PWV and diastolic function analyzed in all patients. Results:Twenty (45%) were nondipper patients. There were no significant differences in the LV geometry, LVMI and PWV between dipper and nondipper patients (PWV; 8.8±3.1 vs. 8.6±3.3 m/sec, p>0.05). In all patients, the PWV was related to the deceleration time (r=0.34, p=0.03) and the mitral E/A (r=-0.31, p=0.02) and mitral Em/Am ratios obtained by the tissue Doppler echocardiography (r=-0.31, p=0.03). The proportion with diastolic dysfunction was higher in the nondipper than the dipper patients (21 vs. 50%, p<0.01). There was a significant relation between the PWV and Em (r=-0.45, p=0.047) in the nondipper, but not in the dipper. Conclusion:Prolonged exposure to high BP (nondipper) was not related with increased aortic stiffness in never treated hypertensive patients. The PWV was closely related with LV diastolic dysfunction in nondipper patients. 배경 및 목적: 고혈압 환자 중 nondipper에서 목표장기의 손상이 증가하고 심혈관계 질환 발생의 위험성이 높은 것으로 알려져 있다. 맥파전도속도는 지속적으로 고혈압에 노출되는 nondipper에서 dipper 보다 증가되어 있을 것으로 추측되나 아직 이에 대한 연구는 보고된 바 없으며, 맥파전도속도와 좌심실 확장기 기능과의 상관관계 역시 잘 알려져 있지 않다. 이에 저자 등은 치료 전 고혈압 환자에서 일중혈압의 변화양상이 맥파전도속도에 미치는 영향과 맥파전도속도가 좌심실 확장기 기능에 미치는 영향을 평가하고자 하였다. 방 법: 고혈압으로 진단 받았으나 다른 질환의 증거가 없으며 항고혈압제를 복용한 적이 없는 44명의 환자(평균 고혈압 유병기간:7.9±4.7월, 나이:48±12세, 남자:29)를 대상으로 하였다. 대상환자는 24시간 활동혈압검사를 시행하여 dipper(n=24)와 nondipper(n=20)로 구분하였으며, 심장초음파검사로 좌심실 질량지수(left ventricular mass index), 수축기 및 확장기 좌심실 내경, 좌심실두께 등을 측정하였다. 맥파전도속도는 하행대동맥과 복부대동맥에서 foot-to-foot method를 이용하여 측정하였고 좌심실의 확장기 기능은 확장기 승모판 혈류양상(E wave, A wave, E/A ratio) 및 DT(deceleration time), IVRT(isovolumic relaxation time), 조직 도플러(tissue dopper)를 이용해 승모판륜에서의 초기 이완기 속도(Em)와 후기 이완기 속도(Am)등을 측정하였다. 결 과: Dipper 및 nondipper 간 고혈압 유병기간, 나이, 심장초음파 시행 당시의 혈압, 맥박수 등은 유의한 차이가 없었다. 양군간 좌심실 질량이나 맥파전도속도 역시 유의한 차이를 보이지 않았다(맥파전도속도 dipper;8.8±3.1 m/sec vs nondipper;8.6±3.3 m/sec, p>0.05). 하지만 전체에서 맥파전도속도는 DT(r=0.34, p=0.03), mitral E/A ratio(r=-0.31, p=0.02), 그리고 조직 도플러 심장초음파로 측정한 mitral Em/Am ratio(r=-0.31, p=0.03) 등과 유의한 상관관계를 보였다. Nondipper 군에서 dipper 군에 비해 좌심실 확장기 기능부전 환자가 유의하게 많았으며(21% vs 50%, p<0.01) 맥파전도속도는 nondipper 군에서 조직 도플러상 mitral Em (r=-0.45, p=0.047)과 유의한 상관관계를 보였다. 결 론: 치료 전 고혈압 환자에서 일중혈압의 변화정도는 맥파전도속도로 대변되는 대동맥 경직도에 유의한 영향을 미치지는 않으나 nondipper에서 대동맥 경직도와 좌심실 확장기 기능부전과 유의한 관련이 있었다.
이상학,송우혁,정명호,허승호,전동운,정원주,Anselm K Gitt,Martin Horack,Ami Vyas,Dominik Lautsch,Baishali Ambegaonkar,Philippe Brudi,장양수 한국지질동맥경화학회 2019 지질·동맥경화학회지 Vol.8 No.2
Objective: The aim of this study was to evaluate under target rates of low-density lipoproteincholesterol (LDL-C) in Korean patients with stable coronary artery disease (CAD) or an acute coronary syndrome (ACS) in real world practice. Methods: Dyslipidemia International Study II was an international observational study of patients with stable CAD or an ACS. Lipid profiles and use of lipid-lowering therapy (LLT) were documented at enrollment, and for the ACS cohort, 4 months follow-up was recommended. Rates of under target LDL-C as per European guidelines, were evaluated, and multivariate regression was performed to identify predictive factors of patients presenting under the target. Results: A total of 808 patients were enrolled in Korea, 500 with stable CAD and 308 with ACS. Of these, 90.6% and 52.6% were being treated with LLT, respectively. In the stable CAD group, 40.0% were under target LDL-C, while in ACS group, the rate was 23.7%. A higher statin dose was independently associated with under target LDL-C in both groups (OR, 1.03; p=0.046 [stable CAD] and OR, 1.05; p=0.01 [ACS]). The mean statin dosage (atorvastatin equivalent) was 17 mg/day. In the 79 ACS patients who underwent the follow-up examination, the LDL-C under target rate rose to 59.5%. Conclusion: Only a minority of patients with stable CAD or ACS were under their target LDL-C level at enrollment. The statin dose was not sufficient in the majority of patients. These results indicate a considerable LLT gap in Korean patients with established CAD.