중증 화상 환자에서 영양지원

박지영,목혜숙,신현선,노순예,김애심,백금선,김도헌,허준,전욱 대한화상학회 2003 대한화상학회지 Vol.6 No.2

Value of Ventricular Stiffness Index and Ventriculoarterial Interaction in Patients With Nonischemic Dilated Cardiomyopathy

Her, Ae Young,Kim, Jong-Youn,Choi, Eui-Young,Kim, Sung-Ai,Jae, Rhee Sang,Shim, Chi Young,Kang, Seok-Min,Ha, Jong-Won,Chung, Namsik Japanese Circulation Society. 2009 CIRCULATION JOURNAL Vol.73 No.9

<P><B><I>Background:</I></B> Whether echo-Doppler-derived index of ventricular elastance or ventriculoarterial interaction can reliably reflect circulatory efficiency in various conditions was investigated in the present study and whether they can be helpful in predicting exercise capacity in patients with dilated cardiomyopathy (DCM). <B><I>Methods and Results:</I></B> The 25 patients with DCM, 25 age- and gender-matched hypertensive patients, and 25 marathon runners underwent symptom-limited graded supine bicycle exercise echocardiography after resting echo-Doppler evaluation. Echo-Doppler-derived left ventricular (LV) diastolic elastance index (Ed), ventricular-vascular coupling index (10 × Ea/Ees), based on arterial elastance index (Ea) to LV end-systolic elastance index (Ees), and hemodynamic parameters were measured during rest and exercise. DCM patients had lower Ees, higher Ed and Ea/Ees with blunted exercise responses of Ees than the other groups, and the hypertensive patients had lower Ees and ΔEes compared with the marathon runners. Resting Ed, Ea/Ees, and total stiffness index (10 × Ed × Ea/Ees) correlated with exercise duration independent of age and gender. A stiffness index of 0.8 could reliably predict impaired exercise capacity. <B><I>Conclusions:</I></B> Echo-derived elastance is predictive of exercise capacity in patients with DCM. (<I>Circ J</I> 2009; <B>73:</B> 1683-1690)</P>

A Clinical Risk Score to Predict In-hospital Mortality from COVID-19 in South Korea

Her Ae-Young,Bhak Youngjune,Jun Eun Jung,Yuan Song Lin,Garg Scot,Lee Semin,Bhak Jong,Shin Eun-Seok 대한의학회 2021 Journal of Korean medical science Vol.36 No.15

Background: Early identification of patients with coronavirus disease 2019 (COVID-19) who are at high risk of mortality is of vital importance for appropriate clinical decision making and delivering optimal treatment. We aimed to develop and validate a clinical risk score for predicting mortality at the time of admission of patients hospitalized with COVID-19. Methods: Collaborating with the Korea Centers for Disease Control and Prevention (KCDC), we established a prospective consecutive cohort of 5,628 patients with confirmed COVID-19 infection who were admitted to 120 hospitals in Korea between January 20, 2020, and April 30, 2020. The cohort was randomly divided using a 7:3 ratio into a development (n = 3,940) and validation (n = 1,688) set. Clinical information and complete blood count (CBC) detected at admission were investigated using Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to construct a predictive risk score (COVID-Mortality Score). The discriminative power of the risk model was assessed by calculating the area under the curve (AUC) of the receiver operating characteristic curves. Results: The incidence of mortality was 4.3% in both the development and validation set. A COVID-Mortality Score consisting of age, sex, body mass index, combined comorbidity, clinical symptoms, and CBC was developed. AUCs of the scoring system were 0.96 (95% confidence interval [CI], 0.85–0.91) and 0.97 (95% CI, 0.84–0.93) in the development and validation set, respectively. If the model was optimized for > 90% sensitivity, accuracies were 81.0% and 80.2% with sensitivities of 91.7% and 86.1% in the development and validation set, respectively. The optimized scoring system has been applied to the public online risk calculator (https://www.diseaseriskscore.com). Conclusion: This clinically developed and validated COVID-Mortality Score, using clinical data available at the time of admission, will aid clinicians in predicting in-hospital mortality.

안정형 협심증 환자에서 혈중 C-반응성 단백질의 농도와 관상동맥 조영술상 병변의 중증도와의 상관관계

허애영 ( Ae Young Her ),김용훈 ( Yong Hoon Kim ) 한국지질동맥경화학회(구 한국지질학회) 2009 韓國脂質學會誌 Vol.19 No.2

증례 : 비소세포 폐암과 합병된 Wegener 육아종증 1예

허애영 ( Ae Young Her ),이희영 ( Hui Young Lee ),강구 ( Gu Kang ),송서영 ( Seo Young Song ) 대한내과학회 2007 대한내과학회지 Vol.73 No.3

저자 등은 객혈, 호흡 곤란을 주소로 내원한 70세 여자 환자에서 비소세포 폐암과 합병되어 눈, 코, 부비동, 신장 등을 침범한 Wegener 육아종증 1예를 경험하였고 이에 대한 국내의 보고가 드물기에 문헌고찰과 함께 보고하는 바이다. Vasculitis may be a manifestation of the paraneoplastic syndrome in association with solid and hematological cancers. There are few reports of paraneoplastic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in patients with solid tumors. Wegener`s granulomatosis is a systemic vasculitis characterized by necrotizing granulomatous vasculitis of the upper and lower respiratory tracts together with glomerulonephritis and are ANCA-positive. We experienced a case of Wegener`s granulomatosis complicated by non-small cell lung carcinoma (NSCLC) and we report this case with a brief review of the literature.(Korean J Med 73:336-341, 2007)

Gender differences in risk factors and clinical outcomes in young patients with acute myocardial infarction

Cho, Kyoung Im,Shin, Eun-Seok,Ann, Soe Hee,Garg, Scot,Her, Ae-Young,Kim, Jeong Su,Han, Jun Hee,Jeong, Myung Ho BMJ 2016 Journal of epidemiology & community health Vol.70 No.11

<P>Background There are limited data on the influence of gender on risk factors and clinical outcomes in young patients with acute myocardial infarction (AMI). Methods This prospective study stratified outcomes according to gender in patients of age <= 50 years with a diagnosis of AMI, and who were enrolled in the nationwide registry of the Korea Working Group of Myocardial Infarction. The end point was the incidence of major adverse cardiovascular events (MACEs) defined as the composite of cardiac death, recurrent myocardial infarction (MI), and repeat revascularisation at 30 days and 1 year after admission. Results The registry enrolled 30 001 patients with AMI, of whom 5200 met the study inclusion criteria; 4805 patients were male and 395 were female. Current smoking was significantly higher in men, while hypertension and diabetes mellitus were significantly more common in women. Women underwent less coronary revascularisation, and were less likely to be on optimal medical therapy compared with men despite having a higher Killip class at presentation and higher risk angiographic findings. Although women had higher rates of MACEs (3.8% vs 1.8%, p=0.018 at 30 days and 7.8% vs 4.7%, p=0.004 at 1-year follow-up) compared with men, female gender was not an independent predictor of MACEs after adjusting for propensity score. Conclusions There were significant gender differences in the risk factors for coronary artery disease and the short-term and long-term clinical outcomes of young patients with AMI. Continued preventive strategies should be focused on gender-different risk factor reduction in these young patients.</P>

닭 분변 유래 대장균 및 장구균의 항생제 내성 양상 조사

김애란 ( Ae Ran Kim ),조영미 ( Young Mi Cho ),임숙경 ( Suk Kyoung Lim ),허문 ( Moon Her ),정우석 ( Won Seog Jeong ),정석찬 ( Suk Chan Jung ),권준헌 ( Jun Hun Kown ) 한국수의공중보건학회 2007 예방수의학회지 Vol.31 No.1

닭 분변 유래 Enterococcus faecium의 quinupristin/dalfopristin 항생제 내성 양상 조사

김애란 ( Ae Ran Kim ),조영미 ( Young Mi Cho ),허문 ( Moon Her ),정병열 ( Byeong Yeal Jung ),임숙경 ( Suk Kyung Lim ),정석찬 ( Suk Chan Jung ),송창선 ( Chang Seon Song ),이지연 ( Ji Youn Lee ) 한국예방수의학회(구 한국수의공중보건학회) 2011 예방수의학회지 Vol.35 No.2

There are many researches about the contribution of virginiamycin use in animals to quinupristin/dalfopristin (Q/D) resistance in humans. In this study, the prevalence and mechanisms of streptogramin resistance in Enterococcus faecium from chickens were investigated. A total of 170 E. faecium isolates from 38 chicken farms was tested for antimicrobial susceptibility. Eleven (6.5%) E. faecium isolates were found to be resistant to Q/D. The vatE and ermB genes were detected in 2 (18%) and 6 (55%) of Q/D-resistant E. faecium respectively. By using pulsed-field gel electrophoresis (PFGE), 6 distinct PFGE patterns were identified. These data indicate that Q/D resistance among E. faecium from chickens remains low despite the long history of virginiamycin use. However, we have to concern over antimicrobial resistance in bacteria originated from animals, including the possibility of transfer of resistance genes from animal to human.

말기신부전 환자에서 혈중 Adiponectin과 심혈관 질환

이희영 ( Hui Young Lee ),허애영 ( Ae Young Her ),최동욱 ( Dong Wook Choi ),박명옥 ( Myoung Ok Park ),백현정 ( Hyun Jeong Baek ),정해혁 ( Hae Hyuk Jung ) 대한내과학회 2006 대한내과학회지 Vol.71 No.6

목적: 지방조직에서 유래하는 adiponectin은 인슐린 감수성 및 항염증의 특성이 있고. 심혈관 질환의 발생억제와 연관되어 있는 것으로 알려지고 있다. 그러나 심부전이나 신장질환과 같은 만성소모성 질환이 있는 환자들에서는 그 연관이 뚜렷하지 않고 논란이 있다. 본 연구는 유지 혈액투석 중인 말기신부전 환자에서 adiponectin의 혈청 농도와 심혈관 질환 위험/예측인자들과의 관련성을 알아보고자 하였다. 방법: 유지 혈액투석 중인 48명의 성인 환자를 대상으로 adiponectin과 leptin의 혈청 농도를 측정하였다. 또한 심혈관생화학지표인 B-type natriuretic peptde (BNP), cardiac troponin T (cTnT) 등을 측정하고 심혈관 질환의 병력을 조사하여 지방세포 호르몬과의 관계를 알아보았다. 결과: Adiponectin의 혈청 농도는 HDL-cholesterol (r=0.456, p=0.001), triglyceride (r=-0.528, p<0.001) 및 leptin (r=-0.427, p=0.002)의 혈청 농도와 유의한 상관관계를 보였고, 체질량지수(r=-0.326, p=0.024)와 음의 상관관계를 보였다. 심혈관지표 중 BNP는 adiponectin (r=0372. p=0.009)과 양의 상관관계가 있었고, 체질량지수(r=-0.310, p=0.032)와 음의 상관관계가 있었으며, cTnT는 adiponectin (r=0.276, p=0.058)과 유의하지는 않으나 양의 상관성을 보였다. 과거 심혈관 질환의 병력이 있는 군(n=20)이 없는 군에 비해 체칠량지수 (p=0.026)는 더 낮고 BNP (p=0.017)와 cTnT (p=0.012)가 더 높았으나, adiponectin은 두 군 간에 유의한 차이를 보이지 않았다. 결론: 말기신부전 환자에서 고 adiponectin 혈증은 양호한 혈증 지질 농도와 관련이 있었으나, 심혈관 질환병력과 직접적인 관계가 없었고, 오히려 심혈관 질환의 위험인자였던 BNP의 증가 및 체질량지수의 감소와 연관이 있었다. 따라서 말기신부전 환자에서 adiponectin은 일반인과는 다르게 심혈관 질환 발생에 복잡한 역할을 할 것으로 생각되며 이에 대한 추가 연구가 필요할 것이다. Background: Adiponectin is a fat-based protein that alters the insulin sensitivity, has anti-inflammatory properties, and reduces the incidence of cardiovascular disease (CVD). However, this connection is unclear in patients with chronic wasting disease, such as heart failure or end-stage renal disease (ESRD). Therefore, this study examined the relationship between adiponectin and the cardiovascular risk/predictive factors in ESRD patients. Methods: The serum concentrations of adiponectin and leptin were measured in 48 adult patients on maintenance hemodialysis. In addition, the blood levels of B-type natriuretic peptide (BNP) and cardiac troponin T (cTnT) as cardiovascular biomarkers were measured, and the CVD history was reviewed in order to determine if there was any correlation with adiponectin. Results: There was a significant correlation between the adiponectin levels and the serum concentrations of HDL-cholesterol (r=0.456, p=0.001), triglyceride (r=-0.528, p<0.001), and leptin (r=-0.427, p=0.002) and an inverse correlation with the body mass index (BMI) (r=-0.326, p=0.024). The BNP levels were positively correlated with the adiponectin concentrations (r=-0.372, p=0.009) and negatively correlated with the BMI (r=-0.310, p=0.032), and there was a slight positive correlation between cTnT and adiponectin (r=0.276, p=0.058). Patients with a history of CVD had higher levels of cTnT (p=0.012) and BNP (p=0.017), and a lower BMI (p=0.026) than patients without such a history. There was no significant difference in the adiponectin levels between the two patient groups. Conclusions: A higher adiponectin level is related to a favorable lipid profile. However, adiponectin is not directly associated with a history of CVD, and there was a correlation between a higher adiponectin level and a higher BNP and lower BMI, which are cardiovascular predictive factors, in ESRD patients. However, further research with more patients will be needed to properly determine the complicated relationship between adiponectin and the development of CVD. (Korean J Med 71:646-653, 2006)

Sex-Based Outcomes of P2Y12 Inhibitor Monotherapy After Three Months of Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention

Shin Eun-Seok,Her Ae-Young,Kim Bitna,Hahn Joo-Yong,Song Young Bin,Lee Joo Myung,Park Taek Kyu,Yang Jeong Hoon,Choi Jin-Ho,Choi Seung-Hyuk,Lee Sang Hoon,Gwon Hyeon-Cheol 대한의학회 2023 Journal of Korean medical science Vol.38 No.45

Background: In patients undergoing percutaneous coronary intervention (PCI) in the SMART-CHOICE trial, P2Y12 inhibitor monotherapy after three months of dual antiplatelet therapy (DAPT) achieved clinical outcomes comparable to those of 12 months of DAPT. Nonetheless, the effects of sex on these outcomes remain unknown. Methods: This open-label, non-inferiority, randomized study, conducted in 33 hospitals in South Korea, included 2,993 patients undergoing PCI with drug-eluting stents. Patients were randomly assigned to receive DAPT (aspirin plus a P2Y12 inhibitor) for three months then P2Y12 inhibitor alone for nine months, or DAPT for the entire 12 months. The primary endpoints were major adverse cardiac and cerebrovascular events (a composite of all-cause death, myocardial infarction, or stroke) 12 months after the index procedure. The bleeding endpoints were Bleeding Academic Research Consortium (BARC) bleeding types 2 to 5. Results: Of the patients, 795 (26.6%) were women, who were older and had a higher prevalence of hypertension, diabetes, and dyslipidemia than men. The sexes exhibited comparable primary endpoints (adjusted hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.55–1.55; P = 0.770) and bleeding endpoints (adjusted HR, 1.07; 95% CI, 0.63–1.81; P = 0.811). P2Y12 inhibitor monotherapy vs DAPT was associated with lower risk of BARC type 2 to 5 bleeding in women (adjusted HR, 0.40; 95% CI, 0.16–0.98; P = 0.045) but the difference was not statistically significant when using the Bonferroni correction. The primary endpoints were similar between treatment groups in both sexes. Conclusion: In both sexes undergoing PCI, P2Y12 inhibitor monotherapy after three months of DAPT achieved similar risks of the primary endpoints and the bleeding events compared with prolonged DAPT. Therefore, the benefits of early aspirin withdrawal with ongoing P2Y12 inhibitors may be comparable in women and men.