Papillary Fibroelastoma of Pulmonary Valve Mimicking Infective Endocarditis

윤현주,김수현,조숙희,김계훈,안영권,정명호,조정관,박종춘,강정채 한국심초음파학회 2008 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.16 No.3

In this report, we describe a case of previous undiagnosed masses of the pulmonary valve mimicking infective endocarditis that were incidentally found during the work-up of a 62-year-old woman, who was presented with abdominal discomfort and dyspepsia. The pathologic findings were characteristics of a papillary fibroelastoma. Although benign, papillary fibroelastomas have the potential to cause lethal embolic events such as stroke, myocardial infarction, and pulmonary embolism are reported in some cases. Tumor identification and surgical excision are important to prevent such complications. In this report, we describe a case of previous undiagnosed masses of the pulmonary valve mimicking infective endocarditis that were incidentally found during the work-up of a 62-year-old woman, who was presented with abdominal discomfort and dyspepsia. The pathologic findings were characteristics of a papillary fibroelastoma. Although benign, papillary fibroelastomas have the potential to cause lethal embolic events such as stroke, myocardial infarction, and pulmonary embolism are reported in some cases. Tumor identification and surgical excision are important to prevent such complications.

토론 2

윤현주 한국고등직업교육학회 2015 한국고등직업교육학회 학술대회 논문집 Vol.2015 No.1

The Prognostic Implication of Metabolic Syndrome in Patients with Heart Failure

윤현주,안영근,김계훈,박종춘,최동주,Seongwoo Han,전은석,조명찬,Jae-Joong Kim,Byung-Su Yoo,신미승,성인환,Seok-Min Kang,Yung-Jo Kim,Hyung Seop Kim,채성철,오병희,Myung-Mook Lee,유규형 대한심장학회 2013 Korean Circulation Journal Vol.43 No.2

Background and Objectives: Metabolic syndrome (MetS) increases the risk of heart failure (HF). The purpose of this study was to identi-fy the prevalence of MetS in patients with HF and determine the syndrome’s association with HF in clinical and laboratory parameters. Subjects and Methods: A total of 3200 HF patients (67.6±14.5 years) enrolled in a nationwide prospective Korea HF Registry between Jan. 2005 and Oct. 2009. Patients were divided into two groups according to the presence or absence of MetS at admission: group I (pres-ence, n=1141) and group II (absence, n=2059). Results: The prevalence of MetS was 35.7% across all subjects and was higher in females (56.0%). The levels of white blood cells, platelets,creatinine, glucose, and cholesterol were significantly higher in group I than in group II. Left ventricular dimension and volume was smaller and ejection fraction was higher in group I than in group II. An ischemic cause of HF was more frequent in group I. The rates of valvular and idiopathic cause were lower in group I than in group II. The rate of mortality was lower in group I than in group II (4.9% vs. 8.3%, p<0.001). Conclusion: Despite the increased cardiovascular risks in MetS, MetS was found to be associated with decreased mortality in HF.

Progressive Dilation of the Left Atrium and Ventricle after Acute Myocardial Infarction Is Associated with High Mortality

윤현주,정명호,Yuna Jeong,김계훈,Ji Eun Song,Jae-Yeong Cho,Su Young Jang,Hae Chang Jeong,Ki Hong Lee,Keun Ho Park,심두선,윤남식,홍영준,박형욱,김주한,안영근,조정관,박종춘,강정채 대한심장학회 2013 Korean Circulation Journal Vol.43 No.11

Background and Objectives: The purpose of this study is to identify the prevalence of progressive dilation in patients with acute myocardial infarction (AMI) combined with heart failure (HF) and determine the prognostic significance and associated factors with a geometric change of an infarcted heart. Subjects and Methods: A total of 1310 AMI patients with HF (63.9±12.5 years, 70% male) between November 2005 and April 2011 underwent echocardiography at admission and one year later. Left ventricular (LV) remodeling is defined as 20% progression, and left atria (LA) remodeling is 10% compared with the initial volume index. Results: The prevalence of both LA and LV remodeling was 13.9%; LV only was 9.3%, LA only 22.8% and non-remodeling was 55.1%, respectively. In the non-remodeling group, Killip class II was more frequent (83.9%, p<0.001) whereas in other remodeling groups, Killip class III was more frequent. Initial wall motion score index, ejection fraction, maximal cardiac enzyme, high sensitive C-reactive protein, B type natriuretic peptide, and triglyceride serum levels were significantly associated with heart remodeling. All causes of death occurred in 168cases (12.8%) during the follow-up period. Mortality was the highest in the LV and LA remodeling group (20.9%) and the lowest in the nonremodeling group (11.4%). During the period of follow-up, the cumulative survival rate was significantly lower in the groups of LA and LV remodeling than in others (log rank p=0.006). Conclusion: Total mortality was significantly increased in patients AMI with geometrically progressive LA and LV dilatation.

Carotid Intima-Media Thickness, Not Carotid Plaque,is Associated With Large Territory Cerebral Infarction in Patients With Ischemic Stroke

윤현주,정명호,김계훈,안영근,조정관,박종춘,강정채,배장호 대한심장학회 2010 Korean Circulation Journal Vol.40 No.6

Background and Objectives: Carotid intima-media thickness (IMT) has been associated with an increased risk of ischemic stroke. To better understand this association, we evaluated the relationships of vascular risk factors, including carotid IMT and carotid plaque, and large territory cerebral infarction and small vessel stroke. Subjects and Methods: A total of 502 patients with acute ischemic stroke were divided into two groups according to neurologic examinations and imaging studies; 1) a large territory infarction group (group I: n=126, 64.4±11 years,78 males) and 2) a small vessel stroke group (group II: n=376, 62.5±11 years, 242 males). We evaluated associations between (a) territory and non-territory strokes and (b) age, sex, potential vascular risk factors, carotid image and cardiac function (by echocardiography). Results: We did not find significant between group differences of age, sex,diabetes, previous history of ischemic stroke, plaque (presence, site and size of carotid plaque), and velocity of carotid blood flow and left ventricle ejection fraction. However, group I had a higher incidence of hypertension (p=0.006), smoking (p=0.003), and dyslipidemia (p=0.001). Group I had thicker carotid IMT than group II (right carotid: 0.81±0.21 mm vs. 0.76±0.19 mm, p=0.035; left carotid: 0.88±0.23 mm vs. 0.80±0.20 mm, p=0.014)and a higher e/e’ level (12.08 vs. 9.66, p<0.001). Dyslipidemia, thicker carotid IMT and elevated E/E’ ratios were significant independent predictors for large territory infarction in patients with ischemic stroke. Conclusion: Carotid IMT is significantly increased in patients with large territory infarction compared with those with small vessel stroke.

무선 센서 네트워크에서 이동 노드를 활용한 효율적 데이터 수집

윤현주 한국특허학회 2010 특허학연구 : 한국특허학회지 Vol.12 No.1

Dyslipidemia, Low Left Ventricular Ejection Fraction and High Wall Motion Score Index Are Predictors of Progressive Left Ventricular Dilatation After Acute Myocardial Infarction

윤현주,정명호,배장호,김계훈,안영근,조정관,박종춘,강정채 대한심장학회 2011 Korean Circulation Journal Vol.41 No.3

Background and Objectives: Left ventricular (LV) remodeling is a heterogeneous process, involving both infarcted and non-infarcted zones, which affects wall thickness and chamber size, shape and function. Subjects and Methods: A total of 758 consecutive patients (62.8±12.0 years, 539 males) with acute myocardial infarction (AMI), who were examined by echocardiography at admission and after 6 months. An increase in LV end-diastolic volume index >10% was defined as a progressive LV dilation. They were divided into two groups according to the extent of progressive LV dilatation during 6 months. Group I with progressive LV dilatation (n=154, 61.4±11.0 years, 110 males) vs. group II without LV dilatation (n=604, 64.1±12.0 years, 429 males). Results: The age and gender were no significant differences between two groups. The levels of glucose, creatinine, maximal creatine kinase (CK), CK-MB, troponin T and I were significantly increased in group I than in group II (p<0.05). Low ejection fraction (EF) and high wall motion score index (WMSI) were more common in group I than in group II (p<0.05). The presence of dyslipidemia {odds ratio (OR); 1.559, confidence interval (CI); 1.035-2.347, p=0.03}, low EF less than 45% (OR; 3.328, CI 2.099-5.276, p<0.01) and high WMSI above 1.5 (OR; 3.328, CI 2.099-5.276, p<0.01) were sig-nificant independent predictors of progressive LV dilatation by multivariate analysis. Conclusion: Dyslipidemia, decreased systolic function and high WMSI were independent predictors of LV remodeling process in patients with AMI.

Endothelial Dysfunction and Increased Carotid Intima-Media Thickness in the Patients with Slow Coronary Flow

윤현주,정명호,조숙희,김계훈,Min Goo Lee,Keun Ho Park,심두선,윤남식,홍영준,김주한,안영근,조정관,박종춘,강정채 대한의학회 2012 Journal of Korean medical science Vol.27 No.6

Flow mediated brachial dilatation (FMD) and carotid intima-media thickness (IMT) have been a surrogate for early atherosclerosis. Slow coronary flow in a normal coronary angiogram is not a rare condition, but its pathogenesis remains unclear. A total of 85patients with angina were evaluated of their brachial artery FMD, carotid IMT and conventional coronary angiography. Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count method. Group I was a control with normal coronary angiography (n = 41, 56.1 ± 8.0 yr) and group II was no significant coronary stenosis with slow flow (n = 44, 56.3 ± 10.0 yr). Diabetes was rare but dyslipidemia and family history were frequent in group II. Heart rate was higher in group II than in group I. White blood cells, especially monocytes and homocysteine were higher in group II. The FMD was significantly lower in group II than in group I. Elevated heart rate,dyslipidemia and low FMD were independently related with slow coronary flow in regression analysis. Therefore, endothelial dysfunction may be an earlier vascular phenomenon than increased carotid IMT in the patients with slow coronary flow.

심혈관 질환에서 안지오텐신 II 수용체 차단제의 최근 논점들

윤현주,김계훈 대한고혈압학회 2012 Clinical Hypertension Vol.18 No.1

To reduce cardio-cerebro-vascular and renal morbidity and mortality, the current guidelines on the treatment of hypertension recommend evaluating and managing total cardiovascular risks of the patient with hypertension, not just focused on reducing blood pressure itself. In this point of view, the angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) are considered to be ideal drugs in the treatment of hypertension, because the angiotensin II plays a pivotal role in every stage of cardiovascular disease continuum. Many studies have shown that the ARBs were not only effective in lowering blood pressure, but also had another role in reducing morbidity and mortality of heart failure, myocardial infarction, stroke, diabetic nephropathy, chronic kidney disease, and the recurrence of atrial fibrillation, so called beyond blood pressure lowering effects or pleiotropic effects. However, these favorable effects of ARBs are counter-balanced by some debating issues, myocardial infarction paradox or cancer risk. Furthermore, the issue whether ARBs could replace the role of ACEIs in the treatment of cardiovascular diseases is not resolved yet. Because there have been no randomized studies proving the ARBs are better than ACEIs in terms of cardiovascular morbidity or mortality, the current status of the role of ARBs are an reasonable alternative of ACEIs. In this review, the current issues and status of ARBs will be discussed.

접촉 유한요소모델을 이용한 미니 임플란트의 초기 응력분포 연구

윤현주,정의원,이종석,김창성,김정문,조규성,김종관,최성호,Yoon, Hyun-Joo,Jung, Ui-Won,Lee, Jong-Suk,Kim, Chang-Sung,Kim, Jung-Moon,Cho, Kyoo-Sung,Kim, Chong-Kwan,Choi, Sung-Ho 대한치주과학회 2007 Journal of Periodontal & Implant Science Vol.37 No.4

Mini implants had been used provisionally for the healing period of implants in the beginning. But it becomes used for the on-going purpose, because it is simple to use, economic and especially suitable for the overdenture. But there is few studies about the stability of mini implants, that is most important factor for the on-going purpose, and particularly the implant parameters affecting the initial stability. The purpose of this study was to evaluate the stress and the strain distribution pattern of immediate-loaded screw type orthodontic mini-implant and the parameters affecting the initial stability of immediate-loaded mini-implant. Two dimensional finite element models were made and contact non-linear finite element analysis was performed. The magnitude and distribution of Von Mises stresses were evaluated. The obtained results were as follows: 1. The stress was concentrated on the thread tip of an implant in the cortical bone. 2. The direction of load is the most important factor for the stress distribution in cortical bone. 3. The diameter of an implant is the most important factor for the stress distribution in the trabecular bone. In conclusion, if the horizontal load vector is successfully controlled, mini-implants, which diameter is under 3mm, can be used for the on-going purpose.