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우종신,조진만,김수중,김명곤,김종진 대한심장학회 2011 Korean Circulation Journal Vol.41 No.7
Background and Objectives: The prognostic value of biochemical markers and the resolution of ST-segment elevation on electrocardiogram are well established. However, how a combination of these two tools affects the evaluation of risk stratification has not yet been evaluated. Subjects and Methods: Between January 2006 and June 2008, 178 consecutive patients treated with primary percutaneous coronary interventions after ST-segment elevation myocardial infarctions (STEMI) were analyzed at two coronary care units. Patients were divided into the following three groups according to ST-segment resolution: complete (≥70% depression of the elevated ST-segment, n=63), partial (30% to 70%, n=90), and incomplete (<30%, n=25). Demographic data, including history, electrocardiography, biochemical markers, initial ejection fraction, and angiographic findings were also evaluated. Results: There were 7 deaths, 3 repeated myocardial infarctions, and 17 readmissions for worsening heart failure during six months of follow-up. In a multivariate analysis to predict clinical outcomes, ejection fraction {hazard ratio (HR): 0.83 (0.76-0.91), p<0.01}, high-sensitivity C-reactive protein {HR: 1.15 (1.05-1.26), p<0.05}, and the degree of ST-segment resolution {HR: 0.96 (0.93-0.09), p<0.05} were independently associated with clinical outcomes. According to the Cox-proportional hazards model, the addition of ST-segment resolution markedly improved the prognostic utility of the model containing biochemical markers and ejection fraction. Conclusion: Assessment of biomarkers upon admission and ST-segment resolution are strong predictors of clinical outcomes. The combination of these data provides additive information about prognosis at an early point in the disease progression and further improves risk stratification for STEMI.
우종신,주광로,우용식,장재영,장영운,이정일,장린 대한내과학회 2006 The Korean Journal of Internal Medicine Vol.21 No.4
Lung cancer metastases can occur in almost any organ. However, metastasis of small cell lung cancer to the pancreas is r
우종신,하상진,김원 대한심장학회 2010 Korean Circulation Journal Vol.40 No.2
As techniques and device technology have improved, the success rates and long patency of ilio-femoral occlusive disease have also improved. In the case of extensive iliac occlusive disease, however, wire passage and handling remain a challenge due to the relatively weak guiding catheter backup support with the contralateral femoral approach. There has been no report on methods to overcome this problem. We performed a successful percutaneous translunimal angioplasty for long ilio-femoral occlusive disease including the iliac ostium by a dual approach including simultaneous brachial and contralateral femoral arteries for subintimal angioplasty.
우종신 ( Jong Shin Woo ),김명곤 ( Myeong Kon Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.6
Acute coronary syndrome (ACS) represents a broad spectrum of ischemic myocardial events, including unstable angina, non-ST elevation myocardial infarction, and acute ST elevation myocardial infarction, which are associated with high morbidity and mortality. Early diagnosis and risk stratification are essential for initiation of optimal medical and invasive management. Randomized clinical trials over the past decade have revolutionized the care of patients with ACS. Therapeutic measures consist of administration of aggressive antiplatelet, antithrombotic, and antiischemic agents. In addition, patients with high-risk features, notably positive troponin, ST segment changes, and diabetes, benefit from early invasive intervention as compared to conservative strategies. Lifestyle interventions, modification of risk factor profile, and long-term medical treatment are of pivotal importance in reducing the long-term risk of recurrence. (Korean J Med 76:661-676, 2009)