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신동맥하 복부대동맥류의 혈관 내 치료에서 혈관누출 발생에 영향을 미치는 인자
조정선,이호균,정상영,김재규,최수진나 대한혈관외과학회 2013 Vascular Specialist International Vol.29 No.2
Purpose: The purpose of this study is to evaluate the factors affecting the endoleaks of endovascular aneurysm repairs in infrarenal abdominal aortic aneurysms. Methods: On a retrospective basis, we analyzed 122 patients, who underwent endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm between March, 2006 and June, 2011. According to the endoleak, the patients were divided into 2 groups: endoleak group and non-endoleak group. We compared the following variables between the 2 groups: patient clinical characteristics (age, gender, body mass index, history of smoking, hypertension, diabetes mellitus, and coronary artery disease) and anatomical features of the aneurysms. Results: A total of 111 male and 11 female patients were included. Fifty-two patients showed endoleak (42.6%) during follow-up periods (median: 4.6 years). There was no significant difference between endoleak and non-endoleak group according to patient's clinical characteristics and used devices. However, there were significant differences between two groups according to the anatomical features of the aneurysm, such as the morphology, size of the aneurysm, and the size and angle of the neck of the aneurysm. Conclusion: Endoleak indicated high frequency when the aneurysm size is large, and when the neck aneurysm is large, with the neck angle being more than 60 degrees. Thus, patients with more than one of the above three characteristics may need more attentive and cautious procedures as well as a closer follow-up.
조정선,허성호,백주열,박만원,김형두,정명호,안영근,채성철,허승호,홍택종,김영조,성인환,채제건,류재영,채인호,박승정,배장호,나승운,김종진,최동훈,장양수,윤정한,정욱성,조정관,승기배,조명찬 대한의학회 2010 Journal of Korean medical science Vol.25 No.11
The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) with or without glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059). These groups were further subdivided according to the use of LMWH with low dose UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or myocardial infarction during the 30 days after the registration. The primary end point occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor (odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006). Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is more beneficial than UFH.
조정선,윤호중,허성호,박만원,김찬준,박경민,정명호,조재영,안영근,김계훈,박종천,승기배,조명찬,김종진,김영조,한규록,김효수,the Korea Acute Myocardial Infarction Registry Investigators 대한의학회 2015 Journal of Korean medical science Vol.30 No.7
The prognostic value of the left ventricle ejection fraction (LVEF) after acute myocardial infarction (AMI) has been questioned even though it is an accurate marker of left ventricle (LV) systolic dysfunction. This study aimed to examine the prognostic impact of LVEF in patients with AMI with or without high-grade mitral regurgitation (MR). A total of 15,097 patients with AMI who received echocardiography were registered in the Korean Acute Myocardial Infarction Registry (KAMIR) between January 2005 and July 2011. Patients with low-grade MR (grades 0-2) and high-grade MR (grades 3-4) were divided into the following two sub-groups according to LVEF: LVEF ≤ 40% (n = 2,422 and 197, respectively) and LVEF > 40% (n = 12,252 and 226, respectively). The primary endpoints were major adverse cardiac events (MACE), cardiac death, and all-cause death during the first year after registration. Independent predictors of mortality in the multivariate analysis in AMI patients with low-grade MR were age ≥ 75 yr, Killip class ≥ III, N-terminal pro-B-type natriuretic peptide > 4,000 pg/mL, high-sensitivity C-reactive protein ≥ 2.59 mg/L, LVEF ≤ 40%, estimated glomerular filtration rate (eGFR), and percutaneous coronary intervention (PCI). However, PCI was an independent predictor in AMI patients with highgrade MR. No differences in primary endpoints between AMI patients with high-grade MR (grades 3-4) and EF ≤ 40% or EF > 40% were noted. MR is a predictor of a poor outcome regardless of ejection fraction. LVEF is an inadequate method to evaluate contractile function of the ischemic heart in the face of significant MR.
조정선,Ju-Hyung Kang,Jae-Min Shin,Il-Ho Park,이흥만 대한천식알레르기학회 2015 Allergy, Asthma & Immunology Research Vol.7 No.3
Purpose: Nasal polyps are associated with chronic inflammation of the mucous membranes in the nose and paranasal sinuses and involved in extracellular matrix (ECM) accumulation. Delphinidin promotes ECM degradation in hepatitis and cardiac fibrosis. The aims of this study were to examine the inhibitory effect of delphinidin on TGF-β1-induced myofibroblast differentiation and ECM accumulation, and to determine the underlying mechanisms in nasal polyp-derived fibroblasts (NPDFs). Methods: NPDFs were stimulated with TGF-β1, with or without delphinidin, and the expression levels of α-SMA, fibronectin, and collagen type I were determined by RT-PCR, Western blot analysis, and collagen assay. The expression of α-SMA protein was measured by immunocytochemical staining. Mitogen-activated protein kinase and NF-κB activation induced by TGF-β1 were determined by Western blot analysis. The transcriptional activity of NF-κB was measured by luciferase assay. Results: The expression levels of α-SMA, fibronectin, and collagen type I increased in TGF-β1-stimulated NPDFs. In TGF-β1-induced NPDFs, delphinidin inhibited the expression of α-SMA, fibronectin, and collagen. Inhibitors of MAPK and NF-κB blocked the expression of α-SMA, fibronectin, and collagen type I. Delphinidin suppressed the activation of MAPK and NF-κB induced by TGF-β1 stimulation. Conclusions: These results suggest that delphinidin may inhibit TGF- β1-induced myofibroblast differentiation and ECM production through the MAPK/NF-κB signaling pathway in NPDFs.
조정선,윤호중,허성호,안서희,박만원,최민석,이재범,Jeong U Baeg,박찬석,김미정 한국심초음파학회 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.3
A 56-year-old male presented with resting dyspnea and chest discomfort for several years. During transthoracic and transesophageal echocardiography, a spontaneously healed membranous type ventricular septal defect (VSD) with malaligned interventricular septal wall, aneurysmal changes, a subaortic ridge and a double-chambered right ventricle (DCRV) was observed. When combined with DCRV, VSD with malalignment between the outlet and trabecular septa was associated with tetralogy of Fallot. The subaortic ridge was due to turbulent flow caused by the malalignment-type VSD. The VSD with malaligned interventricular septal wall can be developed after aneurismal changes of a perimembranous VSD. We report here in the unusual case of a 56-year-old patient who had a pathology complex comprising DCRV, subaortic ridge, spontaneously healed membranous type VSD with malaligned interventricular septal wall, and survived with surgical treatment.
조정선,윤호중,조은주,허성호,박만원,이재범,최민석,박찬석 한국심초음파학회 2013 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.21 No.2
Background: This study was to investigate the feasibility of real-time 3-dimensional echocardiography (RT3DE) for the analysis of biventricular ejection fractions and volume measurements in patients with cor pulmonale and the correlations of RT3DE results with 64-slice multi-detector cardiac computed tomography (64-MDCT) results. Methods: This study included a total of 22 patients (59.3 ± 16.6 years of age; 10 males and 12 females) who showed flattening or reverse curvature of the interventricular septum and severe pulmonary hypertension [mean right ventricular (RV) systolic pressure = 66.8 ± 19.7 mmHg] on 2-dimensional transthoracic echocardiography due to cor pulmonale. Biventricular enddiastolic and end-systolic volumes were measured by RT3DE and 64-MDCT. The severity of D-shaped deformation was evaluated by using left ventricular (LV) eccentricity index (ratio of diameters parallel/perpendicular to the interventricular septum on parasternal short axis images of the papillary muscle level). Results: There were moderate correlations between biventricular volumes measured by RT3DE and 64-MDCT except for LV end-systolic volume (59.8 ± 17.1 vs. 73.2 ± 20.2 mL, r = 0.652, p = 0.001 for LV end-diastolic volume; 30.6 ± 9.1 vs. 30.8 ±12.5 mL, r = 0.361, p = 0.099 for LV end-systolic volume; 110.1 ± 42.9 vs. 171.1 ± 55.3 mL, r = 0.545, p = 0.009 for RV enddiastolic volume; and 80.9 ± 35.0 vs. 128.7 ± 45.1 mL, r = 0.549, p = 0.005 for RV end-systolic volume respectively). Conclusion: This study suggests that RT3DE may be a modest method for measuring distorted biventricular end-systolic and end-diastolic volumes in patients with cor pulmonale.
Antiallergic Effects of Trichostatin A in a Murine Model of Allergic Rhinitis
조정선,강주형,한인혜,엄지영,박일호,이상학,이흥만 대한이비인후과학회 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.3
Objectives. Trichostatin A (TSA), an inhibitor of histone deacetylase, has been shown to play an important role in attenuating asthmatic inflammation. However, the effect of TSA in allergic rhinitis is not known. The aims of this study were to investigate the effect of TSA on allergic nasal inflammation and on the induction of regulatory T cells in a murine model of allergic rhinitis. Methods. BALB/c mice were sensitized intraperitoneally with ovalbumin (OVA) and then challenged intranasally with OVA. TSA (1 mg/kg) was given to the treatment group, and multiple parameters of allergic responses were evaluated to determine the effects of TSA on allergic rhinitis. Allergic nasal symptom scores, including frequency of rubbing and sneezing, were checked. Eosinophil infiltrations were stained with Chromotrope 2R, and the expression levels of OVA-specific IgE, T-helper 1 (Th1) cytokine (interferon-gamma [IFN-γ]), Th2 cytokines (interleukin [IL] 4 and IL-5) and Treg (Foxp3, IL-10, and transforming growth factor-beta [TGF-β]) were measured by quantitative reverse transcription-polymerase chain reaction or enzyme-linked immunosorbent assay. Results. TSA reduced the scores of allergic nasal symptoms and the amount of eosinophil infiltration into the nasal mucosa. TSA suppressed OVA-specific IgE levels and reduced expression of the IL-4 and IL-5. However, the expression of IFN-γ was unchanged in the treatment group. The levels of Foxp3, IL-10, and TGF-β were increased in pretreatment with TSA as compared to control group. Conclusion. This study shows that TSA induced antiallergic effects by decreasing eosinophilic infiltration and Th2 cytokines in a murine model of allergic rhinitis via regulation of Tregs. Thus, TSA may be considered a potentially therapeutic agent in treating allergic rhinitis.