Gender-related Differences in Management of Nonvalvular Atrial Fibrillation in an Asian Population

Lee, Jung Myung,Kim, Tae-Hoon,Cha, Myung-Jin,Park, Junbeom,Park, Jin-Kyu,Kang, Ki-Woon,Shim, Jaemin,Uhm, Jae-Sun,Kim, Jun,Park, Hyung Wook,Lee, Young Soo,Choi, Eue-Keun,Kim, Chang-Soo,Joung, Boyoung,K The Korean Society of Cardiology 2018 Korean Circulation Journal Vol.48 No.6

<P><B>Background and Objectives</B></P><P>Gender-related differences in health care utilization for atrial fibrillation (AF) are increasingly recognized. However, large cohort data for examining gender-related differences in AF are lacking in Asian populations.</P><P><B>Methods</B></P><P>The Registry for Comparison Study of Drugs for Symptom Control and Complication Prevention of AF (CODE-AF Registry) is a prospective observational cohort-study that enrolled participants at 10 tertiary hospitals in South Korea. Baseline characteristics retrieved from the CODE-AF Registry were analyzed.</P><P><B>Results</B></P><P>A total of 6,274 patients were recruited (mean age 67±11 years, mean CHA<SUB>2</SUB>DS<SUB>2</SUB>-VASc score 2.7±1.7, 63% male, 65% paroxysmal AF) from June 2016 to April 2017. Women underwent less electric cardioversion (12.3% vs. 19.6%, p<0.001), less radiofrequency ablation (12.4% vs. 17.9%, p<0.001), and less antiarrhythmic drug therapy (44.7% vs. 49.5%, p<0.001), despite having more severe symptoms (symptom class III or IV, 45.8% vs. 37.5%, p<0.001). Among patients with a CHA<SUB>2</SUB>DS<SUB>2</SUB>-VA score of 2 or more, a slightly higher proportion of women were taking oral anticoagulants than men (85.7% vs. 81.9%, p=0.002), and non-vitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p<0.001). Insufficient NOAC dosing was very common, more so in women than men (61.5% vs. 56.3%, p<0.001).</P><P><B>Conclusions</B></P><P>Female patients with AF were treated more conservatively and rhythm control strategies were used less frequently than in males, even though the female patients with AF had more severe symptoms. While insufficient NOAC dosing was common in both sex, it was significantly more frequent in women.</P>

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

사이버마케팅의 상호작용성에 관한 고찰

차수련,이흥복 동국대학교 경제경영연구원 1997 經濟經營硏究 Vol.21 No.1

Recent radical development of intelligence technology is changing marketing environments so fundamentally that we see a birth of new marketing system, that is, so called Cybermarketing system. Exchange in Cybermarketing system is free from temporal and spacial limits. Moreover time span is enlarged and interactions among existing market participants are much more deepened in this system. For consumers, more objective informations will be available and more control over information flows will be achieved, will overcome the information unbalanced between consumers and marketers. The advent of commercial online services and the far reach of the Internet have, for the first time in mass marketing history, created the potential for a mass interactive dialogue. The traditional marketing paradigm, a system of mass production, mass media, and mass marketing, is being replaced by a totally new paradigm, a one - to - one communication. The one-to-one communication will be characterized by customized product. This article offers a construct to aid markekter charged with maintaining a customer focus in an interactive communication. Utilizing what we call the Seven I's (e.g. Interconnection, Interface, Interactivity, Involvement, Information, Individualism and Integrity) marketers can better analyze and prepare for their transition from the marketplace to the marketspace. Because traditional marketing system has been based on one-way communication, there is no opportunity to exchange is ideas between marketer and consumer, no feedback from consumer to marketer. But Internet is a communication option that can be used to present database information to users and to capture information for into a database. As interactive communication evolves, the entire paradime of database marketing is being turned on its head because database consuming is being born. Database consuming is the result of customers using database technology to target products just as marketers have been using databases to target customers. Database consumers, and a result of the advances in information technology. have access to unprecedented tools that enable them to search out almost instantly vast amounts of information on products and service offered throughout the globe. Cybermarketing has a lot to offer when compared to traditional forms of marketing. It's not about to replace traditional advertising, direct marketing. and face to face selling bus it will extend it and expand traditional marketing in new direction and in way that will benefit both buyers and sellers. Concludly, it will be expected that interactivity of Cybermarketing contributes forward marketing system in various ways.

스포츠 에어로빅스 Cossack Jump 동작의 운동학적 분석

이수재,우철호,김차남 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

This study serves the purpose of understanding about correct motion through Kinematical Analysis of Sports Aerobic's Cossack Jump Motion. And further more that make good assistance for coaches effective guidance through an offer basic data and correct diagnosis, evaluate of motions. It was picture-taked by two-video camera for Cossack Jump Motions. Camera speeds are 60 frame/sec. There are Kinematical Variation elements for analysis, each left and right angle of shoulder joint, hip joint, knee joint and the right angle of ankle joint. Every each person accomplished severely 5 times and we have acquired this conclusion. The conclusions were as follows; 1. Angle The angle of the shoulder joint was shown the highest in the 2nd phase, I consider because of elevation to upward through swing of upper limbs to the higher jump. The angle of hip joint was shown the most flexion in the 3rd phase, because this can to large the motion of right lower limbs have to most closely stick lower limbs to body. Therefore, maximum flexion will be acquired higher points. The angle of right knee joint showed maximal extension(172.43°) in the 3rd phase, it is important that the angle of right knee joint is to extent as closely as possible to 180° and the angle of ankle joint is to flex to 180° toward plantar. 2. Angular Velocity In case of shoulder joint, it showed extremely difference of angular velocity of the left and right shoulder joint in the 3rd phase. I consider that this phenomenon occurred in compensation movement of right shoulder joint for elevation to forward-upward the right lower limbs. In case of hip joint, generally angular velocity of right hip joint has changed rapidly. I consider that this phenomenon occurred many movement of right lower limbs consisted of core Cossack Jump motion. In case of knee joint, expecially it showed extremely difference of angular velocity of the left and right knee joint in the 4th phase. I considered that right knee joint is rapidly dropping downward for the landing with being at dropping point of time from the top to compare with left knee joint. In case of right ankle joint, it was showed extremely to the variation of angular velocity in the 4th phase. I considered that right ankle joint is occurred rapidly dorsal flexion downward for the landing in the processing to starting downward moving with being at dropping point of time after extended at the top.

불소 함유 양성고분자의 분리와 특성

차미선,소원욱,박인준,이수복 한국공업화학회 2004 응용화학 Vol.8 No.1

We describe the synthesis and characterization of amphoteric poly(acrylate), consisting of the F-marcromer and a 2-(dimethyl amino)ethyl methacrylate (2-DMAEMS) The amphoteric polymer were prepared by marcromonomer technique and radical copolymerization. After copolymerization, the resultant rection solution was purified by silica column. In this study, separation of resultant reaction sloution was purified by silica column. In this study, separation of amphoteric poly(acrylate)s and characterization by InfraRed Spectroscopy, Gel Permeation Charomatography. The IR traces showed that the amphoteric poly(acrylate) was separated successfully polymr of p(2-DMAEMA). The amphoteric poly(acrylate) have number average molecular weights(Mw) about 38,000 by GPC.

Estrogen 및 Testosterone이 가토(家兎) 유주혈액세포에 미치는 영향에 관한 실험적연구

李且秀 慶北大學校 1969 論文集 Vol.13 No.-

This experiment was conducted on the responses of the peripheral blood, bone marrow and uterus of rabbits (normal young and adult rabbits) injected intramuscularly with large doses of Estradiol benzoate and Testosterone propionate. The results obtained were as follows: Leukocytosis was observed in rabbits (female) injected with Estradiol benzoate, and this change was more remarkable in young rabbits than in adult ones. Mild changes in the cellular elements of the bone marrow and hemorrhages in the uterus were appeared. There were no significant changes in rabbits (male) injected with Testosterone propionate.

전반사 장애를 이용한 멀티터치 시스템의 구현

차수정,이구연 江原大學校 産業技術硏究所 2010 産業技術硏究 Vol.30 No.A

In this paper, we implement a multi-touch system using FIDR. The implementation consists of hardware manufacture and development of image processing system. In the hardware system, touch screen, infrared LED placements and infrared camera are made. The image processing procedure is to extract each pointer's coordinates from image data and includes binary-coding, noise-elimination, labeling and calculation of mass center. From the implementation, we are able to make a multi-touch system with considerably lower cost than the existing ones.

정확한 완충기체효과가 적용된 질량분석원리에 대한 다중입자 분석 전산시늉

이유용,이원욱,오차환,김필수,송석호 한양대학교 자연과학연구소 2001 自然科學論文集 Vol.20 No.-

질량분석기로 사용되는 폴 트랩 내에서 보다 실제적인 이온운동을 예측해내기 위하여 약 2천 개의 다중입자의 궤적에 대한 계산을 실시하였다. 보다 정확한 질량 분석스펙트럼을 얻기 위하여 충돌확률에 대한 보다 정확하고 실질적인 함수 값을 도입하였다. 계산된 전산시늉의 결과들로부터 특히 작은 질량의 영역에 대한 분석을 할 경우 본 논문에서 제시된 바와 같이 매우 정확한 충돌확률이 고려되어야 함을 확인할 수 있었다. To predict the practical characteristics of ion motion in the paul trap as a mass spectrometer, the ion trajectories of the multi-particle(over than 2000 particles) were calculated. In order to expect more practical mass spectrum, the exact expressions for the collision probability was adopted. From the simulation result, we found that the exact collision probability has to be considered to analyze the materials existed in the low mass region.

외부광궤환에 의한 레이저 다이오드의 출력특성

이세영,오차환,김필수,황의중 漢陽大學校 自然科學硏究所 1997 自然科學論文集 Vol.16 No.-

외부 광궤환 반도체 레이저의 출력 특성을 비율방정식의 수치해를 이용하여 분석하였다. 출력의 세기와 위상과 전자밀도를 시간에 대한 함수로 알아보았다. 또한 bifurcation diagram과 phase diagram을 통하여 궤환비율 k에 따른 레이저의 동작 특성을 조사하였다. 궤환광이 없을때는 이완발진이 감쇄한 후 안정한 출력특성이 나타나지만 되먹임 비율이 증가하면서 안정한 해의 갯수가 증가하다가 ??????이상의 매우 강한 광궤환에서는 출력특성이 극도로 불규칙해지고 무수히 많은 해를 갖는 혼돈현상이 나타남을 알 수 있었다. The output characteristics of a laser diode with external optical feedback were analyzed by numerical solutions of rate equations. The output power, phase and carrier density were plotted as a function of time. Dynamics of external cavity laser were investigated by the bifurcation diagram and the phase diagram with respect to the feedback rate k. If there was no feedback, relaxation oscillation reduced and laser showed stable output. For increasing feed back level, the number of stable state was increased. In very strong feedback rate above ??????, laser output showed extremely unstable and chaotic behavior.

불소함유 지문방지제 합성

차미선,범정철,하종욱,박인준,소원욱,이수복 한국공업화학회 2004 응용화학 Vol.8 No.2

The anti-fingerprint coating agents, consist of a fluorinated macromer(F-macromer) were prepared by marcromonomer technique and hydrosilation reaction. The products were characterized by ¹H-NMR, differential scanning calorimetry. The surface properties of the anti-fingerprint coating agents were investigated by the contact and sliding angle measurement. The modified surface with the anti-fingerprint coating agents showed the extremely low surface free energy of a 10.09 dyn/cm and the sliding angle was smaller than that of commercial products. That is, The synthesised coating agents can be the good candidate for the water and oil repellent, soil release and anti -fingerprint application coating agent.