아세틸 콜린 유발 검사시 허혈성 심전도 변화와 흉통의 발생이 내피세포 기능장애에 미치는 영향

최철웅(Cheol Ung Choi),나승운(Seung-Woon Rha),김선원(Sun Won Kim),나진오(Jin Oh Na),임홍의(Hong Euy Lim),김진원(Jin Won Kim),김응주(Eung Ju Kim),한성우(Seong Woo Han),박창규(Chang Gyu Park),서홍석(Hong Seog Seo),오동주(Dong Joo Oh) 대한임상노인의학회 2010 대한임상노인의학회지 Vol.11 No.4

연구배경: 아세틸 콜린 유발 검사시 발생하는 흉통과 허혈성 심전도 변화가 아세틸 콜린에 의해 발생하는 관상동맥의 내피세포 기능에 어떤 영향을 주는지 알아보고자 했다. 방법: 흉통으로 내원하여 관상동맥 조영술과 아세틸 콜린 유발검사를 시행받은 1,085명의 환자를 대상으로 하였다. 아세틸 콜린 유발 검사를 하는 동안 허혈성 심전도 변화 및 흉통의 발생 유무에 따른 관상동맥 내피세포 기능의 특징을 비교하였다. 결과: 539명의 환자에서 아세틸 콜린 검사시 내피세포 기능 장애가 발생 하였다. 허혈성 심전도 변화가 있었던 그룹이 심전도 변화가 없었던 그룹보다 흉통이 더 많았고(78.1% vs. 60.8%, P=0.007), 관상동맥 조영술상 다발성 관상동맥 경련이 빈번하였고(59.4% vs. 40.6%, P=0.004), 관상동맥의 경련 정도도 더 심하였다(64.1% vs. 46.5%, P=0.006). 흉통이 있었던 그룹이 흉통이 없었던 그룹보다 허혈성 심전도 변화의 빈도가 더 높았다(14.7% vs. 7.5%, P=0.007). 또한 흉통이 있었던 그룹이 관상동맥 경련이 다발성으로 발생하는 경우가 많았고 (50.7% vs. 29.5%, P<0.001), 미만성으로 발생하는 경우가 많았고(87.1% vs. 75%, P<0.001), 관상동맥의 경련의 정도도 더 심하였다(51.6% vs. 43.5%, P=0.041). 결론: 아세틸 콜린 유발검사시 발생하는 허혈성 심전도 변화와 흉통은 관상동맥 경련의 정도와 경련이 발생하는 관상동맥 개수와 연관이 있다. Background: ECG changes and chest pain during acetylcholine (Ach) provocation tests may constitute important clinical parameters for Ach-induced endothelial dysfunction. We investigated the association between ischemic ECG changes and chest pain during the Ach-provocation test and angiographic characteristics of Ach-induced endothelial dysfunction. Methods: A total of 1,085 patients with anginal symptoms underwent diagnostic coronary angiography (CAG) and Ach-provocation tests. We compared angiographic characteristics of Ach-induced endothelial dysfunction according to the presence of ECG change and chest pain. Results: A total of 539 patients experienced Ach-induced endothelial dysfunction. Patients who experienced ECG change group suffered more frequent chest pain (78.1% vs. 60.8%, P=0.007), angiographically more frequent multiple coronary artery spasm (59.4% vs. 40.6%, P=0.004), and more severe coronary artery spasm (64.1% vs. 46.5%, P=0.006) than patients without ECG change. However, there was no difference in the length of endothelial dysfunction between the groups. The incidence of ischemic ECG changes in patients with chest pain was higher than in patients without chest pain (14.7% vs. 7.5%, P=0.007). Patients who experienced chest pain more often experienced multiple (50.7% vs. 29.5%, P<0.001), diffuse (87.1% vs. 75%, P<0.001), and severe coronary artery spasm (51.6% vs. 43.5%, P=0.041) than patients without chest pain. Conclusion: Ischemic ECG changes and chest pain during the Ach-provocation test are associated with multi-vessel involvement and severe coronary artery spasm. Chest pain is associated with the length of endothelial dysfunction, but ischemic ECG change is not.

보조호르몬요법을 받는 여성 유방암 환자의 모발 변화와 치료 실태에 대한 기초 연구

이재경 ( Jae Kyung Lee ),김창현 ( Chang-hyun Kim ),홍동균 ( Dongkyun Hong ),정경은 ( Kyung Eun Jung ),서영준 ( Young-joon Seo ),김창덕 ( Chang-deok Kim ),이진선 ( Jin Sun Lee ),권인선 ( In Sun Kwon ),박상현 ( Sanghyun Park ),이영 대한피부과학회 2021 대한피부과학회지 Vol.59 No.7

Background: Hormone therapy, which includes tamoxifen and aromatase inhibitors, is the most common adjuvant therapy used for breast cancer. However, only a few studies have reported endocrine therapy induced alopecia. Objective: We investigated the effects of long-term adjuvant hormone therapy on hair in patients with breast cancer, in addition to patients’ concerns and current treatment for hair loss. Methods: Patients completed a questionnaire that included information on self-perceived hair changes after each adjuvant therapy session, distress, and current treatment for hair loss. Using a folliscope, we measured hair density and thickness in each patient and in healthy controls. Results: The study included 93 patients with breast cancer (mean age 51.9±9.8 years). The density and hair thickness were 106.36±21.85 hairs/cm2 and 0.07±0.01 mm in the patient group and 147.86±30.67 hairs/cm2 and 0.07±0.01 mm in the control group (n=98, mean age 52.10±8.40 years), respectively. The mean hair density was significantly lower in the patient group than in the control group; however, no statistically significant intergroup difference was observed in hair thickness. Among 76 patients who perceived hair changes after adjuvant therapy, 71.1% (n=54) were distressed with regard to hair changes. However, only 7.8% of the patients, including two who were treated by dermatologists, currently received treatment for hair changes. Conclusion: Dermatologists should be familiar with hair changes in patients with breast cancer and provide appropriate education to encourage patients to consult dermatologists for hair loss and thinning after breast cancer treatment. (Korean J Dermatol 2021;59(7):521∼526)

Clinicopathological study on metastatic skin cancer

( Chang Il Kwon ),( Seo Mi Gon Jeong ),( Young Bin Shin ),( Yun Sun Moon ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Various primary tumors can cause metastatic skin cancer. Metastatic skin lesion should be distinguished from other skin lesion. Objectives: We studied patients with metastatic skin cancer to find out average age, gender distribution, frequency of primary tumor, time interval between manifestation and primary cancer, and their clinical appearance, location and other metastatic sites. Methods: We reviewed the medical records, clinical photographs and histopathologic records of patients who had been diagnosed with metastatic skin cancer. Results: In the comparison according to clinical records, the mean age at the time of diagnosis was 60.6 years. The ratio of men to women was 1.05:1. The most frequent primary tumors were breast cancer (22.0%), lung cancer (17.0%), head and neck cancer (17%), melanoma (17.0%), gastrointestinal cancer (11%), urologic cancer (11%), and gynecologic cancer (6%). Metastatic skin cancers usually presented as discrete, painless, hard nodules, with sudden onset (88%). Conclusion: Based on the results of this study, it is believed that it is important to recognize the metastatic lesion between various skin lesion such as infections and granulomatous changes of other cause due to drugs and reactive changes.

Kikuchi-Fujimoto Disease Coexistent with Papillary Thyroid Carcinoma in a Single Lymph Node

Jin Ju Park,Yu Bin Seo,Hyun Chang Choi,Jeong Won Kim,Mi Kyung Shin,Dong Jin Lee,Jacob Lee 순천향대학교 순천향의학연구소 2015 Journal of Soonchunhyang Medical Science Vol.21 No.1

Cervical lymphadenopathy can be developed from various causes such as viral infection, bacterial infection, Kikuchi-Fujimoto disease, tuberculosis, malignancy, and reactive changes. In patients who have malignancy, metastatic lymphadenopathy is possible but it is rare that other concomitant diseases are in the same lymph node. We experienced a case of coexistence of Kikuchi necrotizing lymphadenitis and papillary thyroid carcinoma in a single cervical lymph node. A 38-year-old man who was previously diagnosed with papillary thyroid cancer with cervical lymph nodes metastasis presented with cervical lymphadenopathy. The lymph node biopsy showed tuberculous lymphadenitis. After finishing anti-tuberculosis medication, recurrent lymphadenopathy had developed and a surgical biopsy was performed. At that time, the diagnosis was Kikuchi necrotizing lymphadenitis combined with metastatic papillary carcinoma in a single lymph node.

중량물 들고 보행시 잡기유형의 차이에 대한 운동학적 분석

서국웅,윤양진,김용재,이훈식,정미라,이창민,이중숙 한국운동역학회 2000 한국운동역학회지 Vol.9 No.2

The purpose of this study was to examine the kinematic changes of the body according to various weight loads and the holding during carrying object. The experiments were conducted with utilizing image, analyses for five male and five female adults as subjects. The results were as followed. 1. Meaningful differences were shown partially in the angle changes of the subject's wrist joints, elbow joints and coxal articulations, but not in the angle changes of the subject's knee joints, according to the types of holding the objects while subjects carrying 5kg objects. So, carrying a light object of 5kg in workplaces or gyms doesn't have much influence on human joints and muscles. 2. Meaningful differences of angle changes were shown between right holding and vertical holding while subjects carrying 10kg objects. Female subjects had difficulties to hold the angles of their wrist joints and elbow joints, carrying 10kg objects, because the first loads were imposed on their wrists and female has weaker muscles than male. In right holding of 10kg objects, female subjects had backward body centers from their bodies, the angle of their coxal articulation became bigger and they had unstable behaviors. 3. Female subjects had wider angle of their wrist joints and elbow joints while carrying 15kg objects than male subjects. But male subjects had bigger angle of coxal articulation than female subjects. Because female has weaker muscles, female subjects couldn't maintain the angles of their wrist joints and elbow joints. 4. The 20kg objects influenced the angles of the wrist joints, the elbow joints and the coaxal articulations of both sex subjects in any type of holding during their carrying 20 kg objects, but didn't influence their knee joints. 5. in carrying 25kg objects, female subjects had wider angles of their wrist joints, elbow joints and knee joints in each holding type than male subjects and the significant difference were shown according to the holding type. But in the case of coxal articulation, male subjects had the bigger angles and meaningful differences. This comes from the weakness of female's muscle. N\Male subject's upper bodies were drawn back and the objects influenced their wrists more than their arms.

The Relationship between Psychological Factors and Weight Gain

Hye Jin Jang,Byung-Sung Kim,Chang Won Won,김선영,Myung Weon Seo 대한가정의학회 2020 Korean Journal of Family Medicine Vol.41 No.6

Background: This study aimed to investigate stress, depression, sleeping time, physical activity, and dietary patterns as factors causing weight gain and investigate which of these factors have a greater effect on weight gain. Methods: Data were obtained from the seventh Korea National Health and Nutrition Examination Survey, 2016. Among the respondents, 3,163 adults aged 19–64 years were included in the survey, after excluding non-responders and those with diseases that may affect weight change. The t-test and chi-square test were used to analyze the relationship between weight gain and general characteristics. Logistic regression analysis was performed to evaluate weight changes according to stress, depression, sleep time, physical activity, and dietary patterns and evaluate the odds ratios (ORs) for measuring these associations. Results: Participants in the weight gain group were younger and more likely to be obese than those in the control group. Factors that could cause weight gain among women were stress awareness (OR, 1.271; 95% confidence interval [CI], 1.012–1.597), physical inactivity (OR, 1.250; 95% CI, 1.018–1.535), and skipping breakfast (OR, 1.277; 95% CI, 1.028–1.587). Depression was significantly associated with weight gain among women, but not after adjusting for other variables. There were no significant associations with sleeping time. None of these factors in men were significantly associated with weight gain. Conclusion: Stress awareness was significantly associated with weight gain among women, while other psychological factors were not significantly associated with weight gain.

이산화탄소 농도 및 온도 상승에 따른 소나무와 상수리나무의 생리생태적 반응

서동진 ( Dong Jin Seo ),오창영 ( Chang Young Oh ),김기우 ( Ki Woo Kim ),한심희 ( Jae Cheon Lee ),이재천 ( Sim Hee Han ) 한국임학회 2014 산림과학 공동학술대회 논문집 Vol.2014 No.-

온실가스 증가에 의한 기온 상승 등 미래 환경에 적응력이 높은 수종을 육성하기 위하여, 이산화탄소 농도 및 온도 상승에 따른 소나무와 상수리나무의 생리생태적 반응을 알아보고자 본 연구를 수행하였다. 실험은 지름 10m, 높이 7m 크기의 원형 상부개방형 온실을 이용하다. 실험구는 이산화탄소 처리 농도에 따라 외부(대조구), 대기 농도의 1.0배, 1.4배, 1.8배로 배치하였다. 또한, 생육 온도 상승은 온실효과에 의하여 부가적으로 나타났으며, 외부 대비 상부개방형 온실은 2℃ 가량 높게 나타났다. 개엽 시기를 조사한 결과, 온도 상승에 의하여 소나무는 6일, 상수리나무의 경우 11일 대조구에 비하여 빨리 나타났다. 또한, 이산화탄소 농도가 증가함에 따라서 그 시기가 더 빠르게 나타나 1.8배 처리구에서 대조구에 비하여 소나무 14일, 상수리나무 12일 빠르게 나타났다. 낙엽 시기의 경우에는 온도 및 이산화탄소농도 상승에 따라 늦어진 것으로 나타났다. 온도 상승에 의한 광합성 활성은 두 수종 모두 증가하였지만, 이산화탄소 농도가 증가함에 따라서 수종간 차이가 나타났다. 소나무의 경우 이산화탄소 농도가 증가한 상황에서도 대조구에 비하여 높은 활성을 나타냈다. 하지만 상수리나무의 경우에는 이산화탄소 농도가 증가함에 따라서 광합성 활성과 탄소고정효율이 감소한 것으로 나타났다. 엽록체 내 전분 축적 변화를 조사한 결과, 소나무의 경우에는 대조구와 처리구간 뚜렷한 차이가 나타나지 않았지만 상수리나무의 경우 이산화탄소 농도 증가에 따라서 축적되는 전분의 양이 증가하는 것으로 나타났다. This study was conducted to investigate the ecophysiological characters of Pinus densiflora and Quercus acutissima in response to elevated CO2 concentration and air temperature for breeding tree species adaptive to climate change. Experiment was conducted in open-top chamber(OTC, W10m×H7m), and CO2 treatment concentrations were set as outside(control) and outside concentration ×1.0, ×1.4, ×1.8. Air temperature was elevated by green house effect, about 2℃ in OTC. Leaf unfolding was advanced by air temperature increasing for 6 days in P. densiflora, for 11 days in Q. acutissima. As CO2 concentration increased, leaf unfolding was advanced for 14 days in P. densiflora, 12 days in Q. acutissima in ×1.8 treatment OTC. Photosynthetic activity was increased by increased air temperature for both species, but it was differed by CO2 concentration increase. P. densiflora showed higher photosynthetic activity under higher CO2 concentration treatment, but Q. acutissima responded as decreasing in photosynthetic activity and carbon fixation efficiency as increasing of CO2 concentration. There were no differences in starch accumulation in chloroplast for control and all CO2 treatments in P. densiflora. On the other hand starch accumulation in Q. acutissima was more increased as CO2 concentration increased.

급성 심근 경색중 후 추적 관찰에 관한 연구

박영배,이영우,오동진,고창순,서정돈,서봉관,오병회 대한내과학회 1986 대한내과학회지 Vol.31 No.5

To assess the change in left ventricular function after hospital discharge, 57 patients with acute myocardial infarction were studied before discharge and 26 of them after discharge as well with either or both of treadmill test and radionuclide ventriculography(RNV). Follow-up study patients were 2g men with mean age of 53.1. Their infarct locations were anterior in 16 cases, inferior in 8 cases and anterior and inferior in 2 cases; 21 cases were in Killip class I, 3 cases in II, and 2 cases in III. Follow-up study was performed 2~19 months(mean 7.3 months) after acute myocardial infarction. The results were as follows: 1) Predischarge study showed that a relationship is present between regional wall motion abnormality, Killip class, peak serum CK and left ventricular ejection fraction(LVEF). 2) Predischarge and follow-up treadmill tests showed no significant change. 3) Follow-up RNV showed worsening of regional wall motion only in 1 case: Other cases showed either improvement or no change in regional wall motion. 4) Overall patients showed a significant increase in LVEF on follow-up. By location, only anterior infarction showed a significant increase in LVEF. 5) Killip class I patients showed a significant increase in LVEF on follow-up. 6) Most cases in this study were uncomplicated myocardial infarction and they showed improved LV function(suggested by RNV) on follow-up. Treadmill test also seems to be valuable for evaluationg improvement in exercise capacity on follow-up. So it is recomended that treadmill test or RNV be performed after discharge to evaluate change in LV function objectively.

Finding key vulnerable areas by a climate change vulnerability assessment

Kim, Ho Gul,Lee, Dong Kun,Jung, Huicheul,Kil, Sung-Ho,Park, Jin Han,Park, Chan,Tanaka, Riwako,Seo, Changwan,Kim, Ho,Kong, Wooseok,Oh, Kyusik,Choi, Jinyong,Oh, Young-Ju,Hwang, Gangseok,Song, Chang-Keun Springer Netherlands 2016 Natural hazards Vol.81 No.3

<P>Extreme climate events such as typhoons, heat waves, and floods have increased in frequency with climate change. Many municipalities within the Republic of Korea (ROK) have experienced damage from these events, necessitating countermeasures. Vulnerability assessment has been suggested in the implementation of a national plan for reducing damage resulting from climate change. Thus, in this study, we assess the vulnerability of the ROK and identify key vulnerable municipalities in support of the national adaptation plan. We create a framework for assessing the vulnerability of all 232 municipalities of the ROK with respect to 32 items in 7 fields. The framework regards decision makers' comprehension and availability of data as important factors. We assess the vulnerability index of each municipality by using variables of climate exposure, sensitivity, and adaptation capacity. The weights of variables are determined by the Delphi method. We used the representative concentration pathways 8.5 climate scenario to reflect future climate exposure for the vulnerability assessment. From the analysis, vulnerability maps are prepared for the 32 items of 7 fields, and key vulnerable municipalities are identified by aggregating the maps. The distribution of vulnerable municipalities changes with the future climate conditions. These maps provide a scientific and objective basis for the ROK government to establish adaptation plans and allocate resources. The ROK government can utilize the results to identify the characteristics of highly vulnerable areas, and municipalities can use the results as a basis for requesting support from the national government.</P>

갑상선암에 의한 림프절 전이의 CT 진단

주지선,김형진,조영국,임명관,서창해,Ju, Ji-Seon,Kim, Hyeong-Jin,Jo, Yeong-Guk,Im, Myeong-Gwan,Seo, Chang-Hae 대한영상의학회 2001 대한영상의학회지 Vol.45 No.6

목적: 갑상선암의 일차 및 이차 림프절 전이에 대한 CT의 진단적 가치를 평가하고, 갑상선암에 의한 림프절 전이의 다양한 CT 소견을 알아보고자 하였다. 대상과 방법: 갑상선암으로 갑상선절제술 및 경부청소술이 시행된 환자 중 수술 전 CT를 시행한 59명을 대상으로 하였다. 59명 모두에서 일차 림프절 (Level VI)을 제거하는 중앙부청소술이 시행되었고, 21명에서는 총 136 level의 이차 림프절 (Level II-V)을 제거하는 측부청소술이 병행되었다. CT상 기준치 이상의 크기, 균질하고 높은 조영증강, 석회화, 낭성 또는 괴사성변화를 보이는 경우 림프절 전이가 있는 것으로 판정하였다. 이와 같이 분석한 CT 소견을 조직학적 소견과 비교하여 일차 및 이차 림프절 전이에 있어서 CT의 진단능을 평가하였고, 림프절 전이의 진단에 유용한 CT 소견을 알아보았다. 결과: 59명의 갑상선암 환자 중 조직학적으로 경부 림프절 전이는 31명 (53%)에서 진단되었으며 이 중 일차 림프절은 59명 중 30명, 이차 림프절은 136 level 중 44 level에서 전이가 관찰되었다. 일차와 이차 림프절 전이에 대한 CT의 민감도, 특이도, 양성예측도, 음성예측도 및 정확도는 각각 27%와 93%, 100%와 93%, 100%와 87%, 57%와 97%, 그리고 63%와 93%이었다. CT상 기준치 이상의 크기 (n=19), 낭성 또는 괴사성 변화 (n=14), 석회화 (n=8)의 소견 중 한 개 이상의 소견을 보이는 이차 림프절에서는 조직검사상 모두 전이가 발견되었으나, CT상 조영증강만을 보인 25 level의 이차 림프절 중 6 level (24%)에서는 조직학적 전이소견 없이 반응성 림프절로 진단되었다. 결론: 갑상선암의 경부 림프절 전이의 평가에 있어서 CT의 민감도는 일차 림프절에서는 매우 낮았으나 이차 림프절에서는 비교적 높았다. 기준치 이상의 크기, 석회화 및 낭성변화는 갑상선암의 림프절 전이를 예측하는데 매우 유용한 지표로 생각된다. Purpose: To determine the usefulness of CT for diagnosing metastases to primary and secondary echelon lymph nodes (LNs) and to investigate various CT findings of metastatic LNs in thyroid carcinomas. Materials and Methods: We retrospectively reviewed the CT and histologic findings in 59 patients with thyroid carcinomas who had undergone thyroidectomy and neck dissection. Primary echelon LNs (Level VI) were removed by central neck dissection in all patients, and in 21, a total of 136 levels of secondary echelon LNs (Level II-V) were excised away by lateral neck dissection. CT criteria of metastatic LNs included large size, significant homogeneous enhancement, calcification, and cystic change. We evaluated the ability of CT to detect primary and secondary echelon LN metastasis and tried to determine which CT features were useful for the diagnosis of LN metastasis. Results: Histologically, LN metastasis was found in 31 (53%) of 59 patients, including 30 with metastasis to primary echelon LNs. Of the 136 levels of secondary echelon LNs resected in 21 patients, 44 were found at histology to harbor metastatic foci. The sensitivities, specificities, positive and negative predictive values, and accuracies of CT in the diagnosis of metastasis to primary and secondary echelon LNs, respectively, were 27% and 93%, 100% and 93%, 100% and 87%, 57% and 97%, and 63% and 93%. While all secondary echelon LNs with at least one of the following CT criteria-large size (n=19), cystic or necrotic change (n=14), or calcifications(n=8)-were histologically proven to be metastatic, six (24%) of 25 such LNs with a sole sign of significant enhancement at CT were found to be due to reactive lymphadenopathy. Conclusion: Although CT was unable to detect metastasis to primary echelon LNs, it was useful in the detection of secondary echelon LN involvement. Large size, cystic change, and calcification are considered highly reliable signs of metastatic LNs.