관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

SPORTS 外傷에 關한 調査硏究 : Centering around 88 Olympic with representative player '88서울올림픽男子代表選手를 中心으로

盧日煥,姜忠植,金達永,金興植,朴贊弘,元忠熙,姜信一,金正洙,朴晶來,李哲遠,林鎬根 公州大學校스포츠科學硏究所 1988 스포츠科學硏究所論文集 Vol.- No.2

According to the investigation made by analyzing cause of the detail about sports injury. We make this things an object of all the male representative players 254 out of 286 (88.81%) that took part in the whole event from April 15, 1988 to September 16, 1988 in Seoul Olympic Games. The results are as follows. 1. The representative players in Korea started in the athlete life at age 13.1 on the average. Gymnast early started at age 8.4 and yachtist was later at age 18 in the athlete life. 2. There are about 5.7 cases on the outbreak of the sports trauma per person of player a year. This came into existence near the ankle at the high rate of damage formed 11.90%. 3. A sort of sports injury in analysis muscular bruise broke out at the highest rate of occurrence formed 15.70%. 4. The greater part of representative players themselves the injury of trauma by massage (12.53%). Some of them undergo medical treatment to the specialist hospital once a year on the average. Most of hockey players have had experience in this kind of injury treatment three times one year to per person of players. A few of them showed 0.15 times per person a year. 5. Most of representative players have been periodically to the orthopedist formed 27.59 (732) out of all 2653 cases at the high rate of fact. Especially a sort of injury in analysis, the injury of ankle region showed the percentage 11.86 (704) out of all 5,937 cases at the highest rate. 6. The period of medical treatment of the representative players in Korea came out about 14.7 days. Besides period of the other player's treatment came out mostly from one to five days formed 44.82%(935 cases) 7. Manyof them have been roughly treated with muscular bruise in analysis of sports injury. They were taking pains with muscular bruise formed 15.65% (1003) out of all 6408 case. 8. In major cause of sports injury came into existence during the training with waste of physical stamina formed 35.89% and were beyond their power with practicing the game formed 48.09%. Also, a sort of those were brought about the cause of sports injury with desire of outcome too much during in the game formed 44.20%

除草劑를 利用한 이태리포풀러 苗圃床의 雜草防效果

鄭丞根,金洪殷,李喆求,李明煥 충북대학교 농업과학기술연구소 1989 農業科學硏究 Vol.7 No.2

This experiment was conducted to screen useful herbicides for Populus euramericana Gainer nur-sery at the Chungbuk Forestry Experiment Station in 1988. Soil surface treatment of 11 herbicides was made on May 19 after planting Populus euraneicana G. cuttings. Digitaria sanguinalis(L.) Scopp, Chenopodium album var. centrorubrum Makino, Portulaca oleracea L., Eleusine indica(L.) Gaertner and Echinochloa crusagali (L.) Beauv. var. praticola Ohwi were dominant weeds in the nursery. Among herbicides tested, alachlor G, alachlor+pendimethalin G, Metolachlor+prometryn EC and oxyfluorfen EC were effective to control both grasses and broad-leaf weeds effectively, but the falter two chemicals resulted in severe damage to Populus euramericana. The growth of cuttings measured by basal diameter and height showed no significant difference among treatments and he-rbicides except oxyfluorfen. Significant correlations were observed between weed coverage 2 weeks after herbicide treatment and number of weeds 1 month and 3 months after herbicide treatment. Also, number of weeds after 1 month was significantly correlated with that of 3 months after herbicide treatment.

관동맥 재개통 후 QTc간격분산의 감소 : 정량적으로 측정한 심근 허혈의 호전 정도와의 연관성 Relationships with the Quantitative Degree of Improvement in Myocardial Ischemia

박상선,최기준,남기병,이철환,홍멸기,박성욱,박승정,신중우,문대혁,김유호 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

긴 관동맥병변에서 긴 스텐트삽입에 대한 임상경과 및 재협착율

김영학,박성욱,정상식,박훈기,이상곤,이일수,이철환,김재중,홍명기,박승정 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6

성공적인 경피적 승모판 교련절개술 후 임상 경과와 재협착율

김영학,강덕현,송재관,최기준,이철환,홍명기,김재중,박성욱,박승정 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.2

관동맥연축의 진단을 위한 Ergonovine Echocardiography의 안전성 및 임상적 유용성

송재관,박성욱,강덕현,조구영,나득영,이내희,이철환,홍명기,김재중,박승정 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

Expression of stanniocalcin-1 in culprit coronary plaques of patients with acute myocardial infarction or stable angina

Lee, Cheol Whan,Hwang, Ilseon,Park, Chan-Sik,Lee, Hyangsin,Park, Duk-Woo,Kang, Soo-Jin,Lee, Seung-Whan,Kim, Young-Hak,Park, Seong-Wook,Park, Seung-Jung BMJ Publishing Group Ltd 2013 Journal of clinical pathology Vol.66 No.9

<P><B>Background</B></P><P>Stanniocalcin-1 (STC1) is involved in fundamental biological processes such as angiogenesis, inflammation and wound healing, but little is known about its expression in human coronary atherosclerotic plaques or its relationship to plaque instability.</P><P><B>Objective</B></P><P>STC1 expression was examined in the culprit coronary plaques of 70 patients with acute myocardial infarction (AMI; n=49) or stable angina (n=21) who underwent directional coronary atherectomy.</P><P><B>Methods</B></P><P>The specimens were stained with H&E, STC1-specific antibodies, and endothelial cells, macrophages and smooth muscle cell markers.</P><P><B>Results</B></P><P>The baseline characteristics of the two groups of patients were largely similar. CD31-immunopositive and CD68-immunopositive areas, indicative of the presence of endothelial cells and macrophages, respectively, were proportionately larger while areas immunopositive for α-actin, as a smooth muscle cell marker, were proportionately smaller in the AMI group than in the stable angina group. The proportion of STC1-immunopositive areas was significantly greater in the AMI group than in the stable angina group (20.0% (8.2–29.0%) vs 8.8% (3.9–19.4%), p=0.022). Areas positive for STC1 were independently correlated with those immunopositive for CD31 (r=0.42, p<0.001) and CD68 (r=0.40, p<0.001). STC1 immunoreactivity co-localised with CD31-immunopositive and CD68-immunopositive cells.</P><P><B>Conclusions</B></P><P>STC1 is differentially expressed in the culprit coronary plaques of patients with AMI versus those with stable angina. STC1 may play a role in plaque instability.</P>

Optimal Duration of Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation : A Randomized, Controlled Trial

Lee, Cheol Whan,Ahn, Jung-Min,Park, Duk-Woo,Kang, Soo-Jin,Lee, Seung-Whan,Kim, Young-Hak,Park, Seong-Wook,Han, Seungbong,Lee, Sang-Gon,Seong, In-Whan,Rha, Seung-Woon,Jeong, Myung-Ho,Lim, Do-Sun,Yoon, American Heart Association, Inc. 2014 CIRCULATION - Vol.129 No.3

<P><B>Background—</B></P><P>The risks and benefits of long-term dual antiplatelet therapy remain unclear.</P><P><B>Methods and Results—</B></P><P>This prospective, multicenter, open-label, randomized comparison trial was conducted in 24 clinical centers in Korea. In total, 5045 patients who received drug-eluting stents and were free of major adverse cardiovascular events and major bleeding for at least 12 months after stent placement were enrolled between July 2007 and July 2011. Patients were randomized to receive aspirin alone (n=2514) or clopidogrel plus aspirin (n=2531). The primary end point was a composite of death resulting from cardiac causes, myocardial infarction, or stroke 24 months after randomization. At 24 months, the primary end point occurred in 57 aspirin-alone group patients (2.4%) and 61 dual-therapy group patients (2.6%; hazard ratio, 0.94; 95% confidence interval, 0.66–1.35; <I>P</I>=0.75). The 2 groups did not differ significantly in terms of the individual risks of death resulting from any cause, myocardial infarction, stent thrombosis, or stroke. Major bleeding occurred in 24 (1.1%) and 34 (1.4%) of the aspirin-alone group and dual-therapy group patients, respectively (hazard ratio, 0.71; 95% confidence interval, 0.42–1.20; <I>P</I>=0.20).</P><P><B>Conclusions—</B></P><P>Among patients who were on 12-month dual antiplatelet therapy without complications, an additional 24 months of dual antiplatelet therapy versus aspirin alone did not reduce the risk of the composite end point of death from cardiac causes, myocardial infarction, or stroke.</P><P><B>Clinical Trial Registration—</B></P><P>URL: http://www.clinicaltrials.gov. Unique identifier: NCT01186146.</P>

Factors predictive of cardiac events and restenosis after sirolimus-eluting stent implantation in small coronary arteries

Lee, Cheol Whan,Suh, Jon,Lee, Se-Whan,Park, Duk-Woo,Lee, Seung-Hwan,Kim, Young-Hak,Hong, Myeong-Ki,Kim, Jae-Joong,Park, Seong-Wook,Park,, Seung-Jung WILEY-LISS 2007 CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS Vol.69 No.6

<B>Objectives:</B><P>Predictors of cardiac events and restenosis after sirolimus-eluting stent (SES) implantation in small coronary arteries were evaluated.</P><B>Background:</B><P>Although SES implantation has markedly reduced the risk of restenosis, small vessel disease remains a major cause of SES failure.</P><B>Methods:</B><P>We prospectively investigated the factors predictive of cardiac events and restenosis in 1,092 consecutive patients who received SES implantation for 1,269 lesions in small coronary arteries (≤2.8 mm). Follow-up angiography at 6 months was performed in 751 patients with 889 lesions (follow-up rate 70.3%).</P><B>Results:</B><P>Restenosis (diameter stenosis ≥ 50%) was angiographically documented in 65 patients with 77 lesions (8.7%): 55 focal (71.4%), 8 diffuse (10.4%), 2 diffuse proliferative (2.6%), and 12 total (15.6%). Lesion length, stent length, reference artery size, and in-stent restenotic lesions were univariate predictors of restenosis. By multivariate analysis, lesion length (OR 1.04; 95% CI 1.02–1.05; P < 0.001) and in-stent restenotic lesions (OR 3.38; 95% CI 1.80–6.35; P < 0.001) were significant independent predictors of restenosis. During follow-up (23.2 ± 7.9 months), there were 17 deaths (5 cardiac and 12 noncardiac), 5 nonfatal Q-wave myocardial infarctions, and 42 target lesion revascularizations. The cumulative probability of survival without major adverse cardiac events (MACE) was (96.6 ± 0.6)% at 1 year and (95.1 ± 0.7)% at 2 years. In multivariate analysis, lesion length (HR 1.04; 95% CI 1.01–1.07; P = 0.004) and in-stent restenotic lesions (HR 3.29; 95% CI 1.58–6.86; P = 0.001) were independently related to MACE.</P><B>Conclusions:</B><P>SES implantation in small coronary arteries is safe and effective, with lesion length having a major impact on restenosis and MACE. © 2006 Wiley-Liss, Inc.</P>