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증례 : 항응고요법 중 재발한 신경색증을 동반한 원발성 항인지질증후군 1예
김민희 ( Min Hee Kim ),고충원 ( Choong Won Goh ),김상현 ( Sang Hyun Kim ),한성훈 ( Seong Hoon Han ),장기준 ( Ki Jun Chang ),황진태 ( Jin Tae Hwang ),유성인 ( Sung In Yu ) 대한내과학회 2013 대한내과학회지 Vol.84 No.2
원발성 항인지질증후군은 주로 정맥 혈전증으로 나타나게 되며 동맥 혈전증과 관련된 사례는 드물다. 저자들은 국내에 보고된 바 없는 항응고요법 중 재발한 신경색증으로 진단된 원발성 항인지질증후군을 경험하였다. 이에 문헌고찰과 함께 보고하는 바이다. Anti-phospholipid syndrome is characterized by the occurrence of venous or arterial thrombosis in the presence of anti-phospholipid antibodies and is associated with morbidity during pregnancy. Arterial thromboses are less common than venous thromboses and most frequently manifest with features consistent with ischemia or infarction. Only a few cases of arterial thrombosis with primary anti-phospholipid syndrome have been reported in Korea. We report a 41-year-old man with anti-phospholipid syndrome who had abdominal pain due to a recurrent renal infarction, and we review the literature on anti-phospholipid syndrome. (Korean J Med 2013;84:269-273)
A Knowledge-Based Approach to Arterial Stiffness Estimation Using the Digital Volume Pulse
Dae-Geun Jang,Farooq, U.,Seung-Hun Park,Choong-Won Goh,Minsoo Hahn IEEE 2012 IEEE transactions on biomedical circuits and syste Vol.6 No.4
<P>We have developed a knowledge based approach for arterial stiffness estimation. The proposed new approach reliably estimates arterial stiffness based on the analysis of age and heart rate normalized reflected wave arrival time. The proposed new approach reduces cost, space, technical expertise, specialized equipment, complexity, and increases the usability compared to recently researched noninvasive arterial stiffness estimators. The proposed method consists of two main stages: pulse feature extraction and linear regression analysis. The new approach extracts the pulse features and establishes a linear prediction equation. On evaluating proposed methodology with pulse wave velocity (PWV) based arterial stiffness estimators, the proposed methodology offered the error rate of 8.36% for men and 9.52% for women, respectively. With such low error rates and increased benefits, the proposed approach could be usefully applied as low cost and effective solution for ubiquitous and home healthcare environments.</P>
( Byung Ok Kim ),( Jong Ho Lee ),( Hye Young Lee ),( Young Sub Byun ),( Choong Won Goh ),( Kun Joo Rhee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The usefulness of ST-segment elevation resolution (STR) for predicting epicardial reperfusion is well established. However, it is not known how the ST-segment changes are related with microvascular obstruction. The aim of this study was to evaluate the relationship between the degree of ST segment resolution (STR) and the extent of microcirculatory dysfunction, which was assessed by TIMI myocardial perfusion (TMP) grade and Index of microvasculatory resistance (IMR). Methods: A total of 55 consecutive patients with ST-segment elevation myocardial infarction (STEMI), who underwent successful reperfusion therapy (PPCI), were evaluated. Serial 12-lead electrocardiography (ECG) was performed at baseline and at 90 minutes after reperfusion therapy. Microvascular dysfunction was evaluated according to TIMI myocardial perfusion (TMP) grade and index of microvasculatory resistance (IMR), which was assessed immediately after reperfusion using thermodilution curves obtained during maximal hyperemia by intracoronary adenosine injection with a pressure/ temperature sensor-tipped guide. Results: Mean age of patients was 58 years. History of hypertension and diabetes under treatment was 60% and 24%, respectively. Culprit lesions of IRA include 29 left anterior descending artery (52.7%), 3 left circumflex artery (5.5%), 22 right coronary artery (40%), and 1 ramus intermedius (1.8%). While the magnitude of STR was positively correlated with LVEF(r=0.321, p=0.03), it was correlated neither with TMP (r=0.097, p=0.484) nor with IMR (r=-0.034, p=0.834). There was significant strong positive correlation between IMR and TMP grade (r=0.421, p=0.007). Conclusions: STR reflects the left ventricular dysfunction (EF) after reperfusion rather than the extent of microcirculatory dysfunction (IMR and TMP).