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        • KCI등재후보

          관상동맥질환의 독립적 표지자로서의 대동맥 팽창성

          김응주(Eung Ju Kim), 서홍석(Hong Seog Seo), 임성윤(Sung Yoon Lim), 김미나(Mina Kim), 나진오(Jin Oh Na), 최철웅(Cheol Ung Choi), 김진원(Jin Won Kim), 임홍의(Hong Euy Lim), 나승운(Seung-Woon Rha), 박창규(Chang Gyu Park), 오동주(Dong Joo Oh) 대한임상노인의학회 2009 대한임상노인의학회지 Vol.10 No.4

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          연구배경: 대동맥의 탄성은 관상동맥질환 환자에서 비정상인 것으로 알려져 있으나, 대동맥 탄성도의 지표들 중 하나인 대동맥 팽창성이 관상동맥질환과 독립적으로 연관되어 있는 지는 확실치 않다. 방법: 관상동맥 조영술을 받은 일련의 373명 중 급성관동맥 증후군, 과거 심근경색, 중등도 이상의 의미 있는 판막질환, 좌심실 구혈율 40% 미만, 심방세동, 관상동맥 성형술이나 관상동맥 우회술의 병력이 있는 사람들을 제외한 총 305명(관상동맥질환 환자군 107명, 대조군 198명)을 관찰하였다. 심장초음파를 이용하여 대동맥 판막으로부터 3 cm 원위부의 상행대동맥 직경을 측정한 후 2×(대동맥 내경의 변화)/(확장기 대동맥 내경×맥압) 공식으로 대동맥 팽창성(cm²×dyn⁻¹×10⁻⁶)을 구하였다. 결과: 수축기, 확장기 혈압과 맥박수는 양 군간 차이가 없었으나 대동맥 팽창성은 환자군이 유의하게 대조군 보다 낮았다(1.15±0.30 vs. 3.00±0.25, P<0.001). 다변량분석에서 대동맥 팽창성은 나이, 성, 고혈압, 당뇨병, 고지혈증과 흡연을 보정하고도 관상동맥질환과 유의한 상관성(P<0.001)을 보였다. 더욱이 대동맥 팽창성은 1∼3혈관질환으로 표현한 관상동맥질환의 심한 정도와 반비례하는 양상이었다(P<0.001). 결론: 대동맥 팽창성은 관상동맥질환의 독립적 위험 표지자이며 관상동맥질환의 심한 정도와 상관있는 것으로 생각된다. Background: Elastic properties of aorta have been known to be abnormal in patients with coronary artery disease (CAD). However, aortic distensibility (AD), one of the elasticity indexes, has not been ascertained whether it is independently associated with CAD. Methods: We prospectively enrolled 305 subjects (107 patients with CAD and 198 patients without it) among 373 consecutive patients undergoing coronary angiography for the assessment of suspected CAD. Patients with acute coronary syndrome, previous myocardial infarction, valvular heart disease more than mild, left ventricular ejection fraction <40%, atrial fibrillation, and history of coronary intervention or surgery were excluded. Aortic diameters were measured at a level 3 cm above the aortic valve using echocardiography. AD (cm²×dyn⁻¹×10⁻⁶) was calculated from the aortic diameters and brachial artery pressure using the formula: 2×(change in aortic diameter)/(diastolic aortic diameter ×pulse pressure). Results: Systolic, diastolic blood pressure and pulse rate were similar in both CAD and control subjects. AD was significantly lower in patients with CAD than controls (1.15±0.30 vs. 3.00±0.25, P<0.001). In multivariate analysis, AD remained significantly associated with CAD (P<0.001) after adjustment for age, gender, hypertension, diabetes, hyperlipidemia and smoking. Moreover, AD showed significant inverse relationship with the severity of CAD, expressed as one-, two-, and three-vessel disease (P<0.001). Conclusion: Our findings suggest that impaired AD is an independent risk marker for CAD, as well as significantly associated with the severity of CAD.

        • KCI등재

          뇌졸중 환자에서의 Brovincamine의 임상효과

          김준석(Jun Suk Kim), 서홍석(Hong Seog Seo), 오동주(Dong Joo Oh), 임도선(Do Sun Lim) 대한약학회 1993 약학회지 Vol.37 No.1

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          Brovincamine is a selective cerebral vasodilator that was apparently produced via a slow calcium blockade. Brovincamine has been shown to increase ATP production and glucose and oxygen consumption in brain, improving energy metabolism. Also brovincamine inhibited platelet aggregation induced by ADP and collagen in vivo and in vitro via an increase of cAMP concentration, promoting therapeutic effects on cerebral circulatory disorders. So we investigated and represented the clinical effects and safety of brovincamine in patients with cerebral stroke. Thirty patients of cerebral stroke that was older than 2 months, who were 22 cases of cerebral infarction, 6 of cerebral embolism that originated from cerebral infarction, 6 of cerebral embolism that originated from cardiac diseases, and 2 of cerebral embolism that originated from cardiac diseases, and 2 of cerebral hemorrhage, were administered of 20 mg of oral brovincamine three times daily for 8 weeks. Improvement rates of each symptom after 8 week administration were 30.8% for subjective symptoms, 76% for psychiatric symptoms and 65.6% for neurologic symptoms. In final global improvement rates, much improvement was 10%, improvement was 23.3% slight improvement is 36.7%, and no change was 30%. So global improvement rate including slight improvement was 70%. As for side effects, there were 3 cases of mild gastrointestinal symptoms, but there were no other subjective side effects and significant fluctuation in laboratory examination. Conclusively throughout the present study, brovincamine is judged to be well tolerated and effective in patients with cerebral stroke.

        • KCI등재후보

          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

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          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.

        • 黃金比例가 繪畵作品 構圖에 미치는 影響

          徐弘錫 圓光大學校大學院 1982 學位論叢 Vol.8-3 No.-

          It is the problem of composition that an artist encounters first of all through the whole processes to represent or deliver his philosophy or emotion. For there is no other method that he is capable of materializing his inner attributes on the campus. H. N. Rusmusen, as a simple method of solving this principal problem, has suggested that the plastic elements-shape, texture, color, line, form, light, etc, and the composing elements-contrast, change, emphasis, balance, rhythm harmony, repetition. etc. have to be operated as a whole on the campus with balance, rationality and adeguacy. However, before approaching to the main point of this theory, a pre-requisite that needs a preferential right has to be solved before hand, that is, the problem of composition, for which exerts itself to unit these complicated elements. I, in this thesis, insis that a direct application of the best composition methcd and its practical use by introducing the Golden Section Theory, that is, the connection between the uppe space and the lower, of the nearer and the farther, and of the various lateral spaces more or less on the campus must be done. The reason why the composition in the artistic works is often' compared to the main structure of a house or the skeleton in the organs is really here.

        • Verapamil 전처치 개흉견에서 급성관상동맥 결찰과 심근 재관류시 좌심실 기능의 변화

          서홍석,노영무 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.1

          Although reperfusion following brief coronary artery occlusion limits or even prevents myocardial cell necrosis, recovery of left ventricular systolic and diastolic function is delayed for hours or even days( ''stunned'' myocardium or postischemic myocardial dysfunction), depending on the degree, extent and duration of myocardial ischemia, and reperfusion, and drug treatment. To investigate the effect of reperfusion on the left ventricular function in verapamil treated dogs, left anterior descending coronary artery was occluded by silk snare just distal to the first diagonal branch for 20 minutes and was followed by reperfusion for 40 minutes in 10 verapamil pretreated open-chest dogs. Cessation of myocardial perfusion caused by coronary occlusion was confirmed by hydrogen peroxide contrast echocardiography before dogs were sacrificed. Verapamil was infused continuously in doses that decreased heart rate by 20% and was maintained at that rate throuth the experiment. Verapamil caused the fall in arterial pressure from 120±22mmHg to 85±20mmHg in systole and 72±19mmHg to 36±17mmHg in diastole (mean ±S. D., p<0.0l), decreased heart rate from 153±13/min to 122±9/min(p<0.01), and slightly increased pulmonary artery wedge pressure from 8.4±2.3mmHg to 10.8±3.1 mmHg(NS). Cardiac output measured by thermodilution method was not changed by verapamil infusion. Coronary occlusion slightly decreased cardiac output from 2.61±1.26L/min to 2.19±1.20L/min(NS) and fractional shortening from 32.1±0.5% to 19.3±0.7%(p<0.01). The velocity and time-velocity integral of early peak filling wave and those of late peak wave measured by Doppler echocardiography tended to decrease by cororany occlusion; velocity of early and late peak filling waves from 72.5±14.9 to 59.81: 14.7(NS) and from 43.0±13.3 to 37.1±l0.l(NS), respectively, time-velocity integral of early and late peak filling waves from 5.97±1.59 to 4.43±1.19(NS), and from 2.80±0.94 to 2.45±0.58(NS), respectively. However, the ratios of parameters of early peak waves to those of late peak waves were not reversed during coronary occlusion. Reperfusion caused recovery of cardiac output from 2.15±1. 20 L/min to 2.86±1.10 /min in 1 minute and fractional shortening from 19.3±0.7% to 31.5±0.9% (p<0.0l) in 1 minute. The velocity and the time-velocity integral of early and late peak filling waves were recovered within 1 minute after reperfusion. These findings suggest that in open- chest dogs pretreated with verapamil, coronary occlusion causes little impairment of diastolic function and the rate of diastolic filling during rapid filling period is maintained during coronary occlusion, and the recovery of systolic and diastolic function of left ventricle is immediate on reperfusion. Verapamil may be beneficial in the protection of diastolic function during transient myocardial ischemia and may ablate dysfunction of postischemic myocardium.

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