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조인정,장혁재,이상은,심지영,홍그루,정남식 대한심장학회 2017 Korean Circulation Journal Vol.47 No.6
Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17–89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71–11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.
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조인정,홍그루,이승현,이삭,장병철,심지영,장혁재,하종원,정남식 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.2
Purpose: The incidence of prosthesis-patient mismatch (PPM) after mitral valve replacement (MVR) has been reported to vary. The purpose of the current study was to investigate incidence of PPM according to the different methods of calculating effective orifice area (EOA), including the continuity equation (CE), pressure half time (PHT) method and use of reference EOA, and to compare these with various echocardiographic variables. Materials and Methods: We retrospectively reviewed 166 individuals who received isolated MVR due to rheumatic mitral stenosisand had postoperative echocardiography performed between 12 and 60 months after MVR. EOA was determined by CE (EOACE)and PHT using Doppler echocardiography. Reference EOA was determined from the literature or values offered by the manufacturer. Indexed EOA was used to define PPM as present if ≤1.2 cm2/m2. Results: Prevalence of PPM was different depending on the methods used to calculate EOA, ranging from 7% in PHT method to 49% in referred EOA method to 62% in CE methods. The intraclass correlation coefficient was low between the methods. PPM was associated with raised trans-prosthetic pressure, only when calculated by CE (p=0.021). Indexed EOACE was the only predictorof postoperative systolic pulmonary artery (PA) pressure, even after adjusting for age, preoperative systolic PA pressure and postoperative left atrial volume index (p<0.001). Conclusion: Prevalence of mitral PPM varied according to the methods used to calculate EOA in patients with mitral stenosis after MVR. Among the various methods used to define PPM, EOACE was the only predictor of postoperative hemodynamic parameters.
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조인정,김진선,김용진,이상철,최정현,신상훈,심지영,홍그루,하종원,정남식,장혁재 한국심초음파학회 2013 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.21 No.3
Background: Hemorrhagic transformation (HT) of stroke is a disastrous complication in patients with infective endocarditis (IE). In patients with mechanical heart valves complicated by IE, physicians struggle with the appropriateness of anticoagulation administration given the risk of thromboembolism and HT of stroke. In this study, we aimed to define predictive parameters of HT of stroke in patients with prosthetic valve endocarditis (PVE). Methods: This study was a multicenter, retrospective design. We recruited from 7 institutions a total of 111 patients diagnosed with PVE during May, 2011 to April, 2012. Results: Complication of stroke was seen in 26/111 patients (23%), and HT of stroke was seen in 11/111 patients (10%). Most patients with HT (9/11, 82%) had supratherapeutic prothrombin times. However, there were no significant differences in clinical and laboratory values between PVE patients without stroke and those patients who had a stroke and with or without concurrent HT. Furthermore, echocardiographic parameters also did not show significant between-group differences. Conclusion: Even though this was a multicenter study, a limited number of patients was identified and may explain the negative results seen here. However, a large number of PVE patients with stroke also developed HT. Therefore, further studies to define predictive parameters of HT should be implemented in a larger population.
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조인정,편욱범,신길자 대한심장학회 2009 Korean Circulation Journal Vol.39 No.4
Background and Objectives: It is not well understood whether the left ventricular geometry is associated with such diastolic parameters as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry on the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods: 181 patients (mean age: 63±9 years old, 62 males) with hypertension were included for echocardiographic analysis. The hypertensive patients were classified into four groups according to the left ventricular mass index and the relative wall thickness: normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy. We excluded all the individuals with established cardiovascular disease, atrial fibrillation, significant aortic and/ or mitral valve disease, or an ejection fraction <50%. Results: By definition, the left ventricular mass was increased in the patients with eccentric and concentric hypertrophy. Both the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were reduced in the concentric remodeling group, whereas the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were increased in the eccentric and concentric hypertrophy groups. Compared with the patients with normal geometry, the patients with eccentric and concentric hypertrophy demonstrated a significant higher value for the left atrial volume index. The ratio of the transmitral inflow velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Conclusion: This study demonstrates that in a patient population with hypertension and who are without systolic dysfunction, the left atrial volume index and the E/E’ demonstrated a progressive worsening of the left ventricular diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Background and Objectives: It is not well understood whether the left ventricular geometry is associated with such diastolic parameters as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry on the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods: 181 patients (mean age: 63±9 years old, 62 males) with hypertension were included for echocardiographic analysis. The hypertensive patients were classified into four groups according to the left ventricular mass index and the relative wall thickness: normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy. We excluded all the individuals with established cardiovascular disease, atrial fibrillation, significant aortic and/ or mitral valve disease, or an ejection fraction <50%. Results: By definition, the left ventricular mass was increased in the patients with eccentric and concentric hypertrophy. Both the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were reduced in the concentric remodeling group, whereas the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were increased in the eccentric and concentric hypertrophy groups. Compared with the patients with normal geometry, the patients with eccentric and concentric hypertrophy demonstrated a significant higher value for the left atrial volume index. The ratio of the transmitral inflow velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Conclusion: This study demonstrates that in a patient population with hypertension and who are without systolic dysfunction, the left atrial volume index and the E/E’ demonstrated a progressive worsening of the left ventricular diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy.
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논문 : 한국어 교재의 행 바꾸기 -띄어쓰기와 읽기 능력의 계발-
조인정,김단비 국제한국어교육학회 2012 한국어 교육 Vol.23 No.1
In Jung Cho·Danbee Kim, 2012, Examining Line-breaks in Korean Language Textbooks: the Promotion of Word Spacing and Reading Skills, Journal of Korean Language Education 23-1: 77-100, This study investigates issues in relation to text segmenting, in particular, line breaks in Korean language textbooks. Research on L1 and L2 reading has shown that readers process texts by chunking (grouping words into phrases or meaningful syntactic units) and, therefore, phrase-cued texts are helpful for readers whose syntactic knowledge has not yet been fully developed. In other words, it would be important for language textbooks to avoid awkward syntactic divisions at the end of a line, in particular, those textbooks for beginners and intermediate level learners. According to our analysis of a number of major Korean language textbooks for beginner-level learners, however, many textbooks were found to display line-breaks of awkward syntactic division. Moreover, some textbooks displayed frequent instances where a single word (or eojeol in the case of Korean) is split between different lines. This can hamper not only learners` learning of the rules of spaces between eojeols in Korean, but also learners` development in automatic word recognition, which is an essential part of reading processes. Based on the findings of our textbook analysis and of existing research on reading, this study suggests ways to overcome awkward line-breaks in Korean language textbooks.
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