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.

Dipyridamole 부하 심근 SPECT에서 Dipyridamole의 작용과 부작용

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),최창운(Chang Woon Choi),배상균(Sang Kyun Bae),양형인(Hyung In Yang),여정석(Jeong Suk Yeo) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2

N/A Dipyridamole is an agent that may be used to noninvasively evaluate coronary artery disease. The effect of dipyridamole infusion its generally related to its induced peripheral vasodilatory effect. In normal person, heart rate is generally increased slightly while blood pressure decrease, but the achieved double product and related myocardial oxygen consumption have no significant change. The purpose of this study is to examine the effect and side effect of dipyridamole, and to compare different response to dipyridamole among the patients. We evaluated 847 patients who underwent dipyridamole stress myocardial SPECT. 93.6% of them had induced hypotension 0.9% showed no change of blood pressure, 5.5% had increased blood pressure 8.3% had no change of pulse rate more than 10% of basal pulse rate. Among diabetes, 16.9% was not change of pulse rate, 6.7% in non-diabetes. There was no significant correlation between age and rate pressure product rest(RPPr), in patients without perfusion defects on SPECT(y=7.1x+48.4r=0.13 p>0.01). As increasing age, RPPs/RPPr was declined(y=-11.6x+68.9 r=0.17 p〈0.01), similar results were obtained in patients with perfusion defect. The size of perfusion defect on myocardial SPECT have no correlation between RPPr and RPPs/RPPr. The side effects of dipyridamole included chest pain and chest tightness, headache, abdominal pain, dizzness, nausea, and dyspnea. As increasing age, dipyridamole-induced cardiac work at rest was increased, cardiac response to dipyridamole was decreased.

문화 사회에서 기독교의 선교신학적 방향

김창운(Kim, Chang-woon) 한국선교신학회 2010 선교신학 Vol.25 No.-

This study builds on a direction of the missiological spirituality of Christianity in multicultural society . Currently. multiculturalization is a noticeable change of the globalized world . Specifically, Korean society recently experiences such a change. As Christianity has been dynamically transformed to adjust culture change, or context change, for the missiological purpose, Korean Christianity demands a new perspective that can be adapt to the today 's context change. This study is focusing on the contextual need . By employing the biblical and theological discussion , the writer illuminates Christ ian basic idea from the perspective of relation ship-based spirituality . Simply, Christianity is basically relationship-based . From the creation story, God the Father was co- working with the Son and the Spirit in the nature of the Trinity. In the greatest commandment, the on is inviting all creature into God's such a relational friendship. (Mr. 22 :37-4 0) This belief was inherited to the disciples Just as the benediction of Paul in 2Corinthians ( 13: 14 ) presents that blessings are derived from the Trinity of the relational God. Furthermore, Jesus extends the concept of relational friendship, not only close neighbors but also far -off neighbors, that is, not only the members of family and church community, but also st rangers and even enemies. Such a Biblical principle currently direct s the Christ ian perspective to reach to all the neighbors. people from different cultures. with the love of Christ , called relation ship-based spirituality. In order to investigate effect ive methods, this writing suggests SIX main theoretical models. As for the concept of intercultural perspective, the writer brings the notion of Klaus lssler, which can be called the extension of neighbor concept. And for the ideas of cultural diverse and individuals' transformation , th is study employs following models, like experiential transformation (Da vid Kolb ), hidden curriculum (judith and Sherwood Lingenfelter). ecology system (Urie Bronfenbrenner), multiple intelligence (Howard Gardner), storytelling (Tom Steffen ), Th us, the concept of intercultural transformation can be conceptualized as the relation ship-based love of Christians toward all the people from diverse cultures .

급성 췌장염의 시대적 변화

김배영(Bai Young Kim),김효종(Hyo Jong Kim),정형근(Hyung Keun Chung),김영관(Young Kwan Kim),동석호(Seok Ho Dong),김병호(Byung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: According to the rapid changes in social environment such as increasing alcohol consumption and the marked improvement in diagnostic technique, we expect that there have been major changes in various aspects of acute pancreatitis during the recent 12 years in Korea. Methods: The medical records of 317 patients with acute pancreatitis diagnosed from 1980 through 1992 were reviewed about clinical, laboratory and radiological findings in the three different time period. Results: 1) There has been an increasing incidence in male sex about three folds. 2) There has been an increasing trends in the duration of hospitalization. 3) A significant increase was observed in the proportion of patients with alcoholic pancreatitis in the three different time period; 26.9%, 45.7%, 50.7% respectively. 4) The complication rates have been slightly increased in the three different time period; 46.3%, 47.1%, 59.1% respectively. But, the type of complications has not been changed. 5) There is increasing severity in non-gallstone group, but no significant differences in gallstone group. There is a declining trends in the number of patients with muld severity index, but increasing trend in the number of patients with moderate severity index in non-gallstone group. 6) There was no significant differences in mortality rate. Conclusions: There has been major changes in the etiology ans severity of acute pancreatitis from 1980 through 1992. Especially, significant increase in the proportion of patients with alcoholic pancreatitis was observed in the three differnt time period. These results might be due to socioeconomic changes.

흰쥐에서 사염화 탄소(CCl4)에 의한 간섬유화의 유도

김병호,이정일,김효종,김영관,장린,동석호,장영운,송일한 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6

Experimental model of hepatic fibrosis is importent contributions to the understanding of cellular and molecular mechanisms underlying excessive accumulation of extracellular matrix in the liver. Carbon tetrachloride (CCl₄) is one of the oldest and most widely used toxin for experimental induction of hepatic fibrosis in laboratory animals. In this study, We intended to induce the hepatic fibrosis in the rat by the intragastric CCl₄/ phenobarbtal treatment once a week for 12 weeks and the administration dosage of CCl₄ in each week was determined by the daily body weight change. Liver function and histologic change were examined just after 12-week treatment in group Ia (9 rats, Phenobarbital treatment only) and II (18 rats, CCl₄/phenobarbital treatment), and liver function and the irreversibility o histologic change were examined 12 weeks after 12-week treatment in group Ib (9 rats, phenobarbital treatment only) and III (18 rats, CCl₄/phenobarbital treatment). 1) Death rate after 12-week treatment was 11% in group Ⅰ, 56% in group Ⅱ and 50% in group Ⅲ. and the highest rate was at 1 week. that is 33 o each in group Ⅱ and Ⅲ. 2) Tatal protein, alkaline phosphatase, alanine aminotransferase and portal venous pressure were significantly increased in group Ⅱ compared with that in group Ⅰa, but it was only portal venous pressure that was increased in group Ⅲ than in group Ⅰb, 3) The gross finding of micronodular change was shown in 88% of group Ⅱ, 71% of group Ⅲ, but none of group Ⅰ. The microscopic finding of hepatic fibrosis was found in all of group Ⅱ and Ⅲ, but none of group Ⅰ. The severe form of hepatic fibrosis suggesting cirrhosis was found in group Ⅱ and Ⅲ, 12% and 29% respectively. In our study, mortality rate was high within 1 week after CCl₄ treatment, which resulted in half survival rate after 12-week treatment. We also experienced the loin rate of severe fibrotic changes in surviving rats. In the future, in order to produce a severe irreversible fibrotic change with low mortality in inducing hepatic fibrosis with CCl₄/phenobarbital treatment in the rat, adequate detemination of the initial dose of CCl₄ and appropriate choice of administration route of CCl₄ were thought to be needed.

吸入 空氣의 濕度가 Diesel cycle의 性能에 미치는 影響에 關한 理論的 考察

장성운 忠州大學校 2007 한국교통대학교 논문집 Vol.42 No.-

For calculating theoretical thermal efficiency of Diesel cycle in internal combustion engine, Theoretical thermal efficiency is decided by compression ratio. Compression ratio of internal combustion engine is calculated by stroke volume and clearance volume. The air of stroke volume is constant to the engine mechanism. Air temperature of clearance volume increases adiabatic compression. The moisture in intake air is evaporating by the temperature of adiabatic compression. Moisture evaporating is increased volume in the clearance volume after adiabatic compression. Clearance volume is the intake air and the steam of moisture evaporating. The result, compression rate is increased and thermal efficiency is changed. For calculating, Absolute humidity of intake air increase 0, 5, 10, 15, 20, 25, 30.% The result were as follows. 1, Increase the absolute humidity of intake air in Diesel cycle, moisture is changed to super heated steam by evaporating and increased the volume in the clearance volume and changed compressing rate after adiabatic compression. 2, Pressure increase after adiabatic compression improves the power of engine. 3, The high compressing rate increases thermal efficiency in Diesel cycle. 4, If the moisture increasing mechanism is applied to the intake air, engine power and thermal efficiency is increased and engine is effected a little big size.

십이지장 결핵 2예의 내시경적 고찰

장린,박충기,민영일,장영운,우정택,방익수,최학림,장주희 대한소화기내시경학회 1985 Clinical Endoscopy Vol.5 No.1

Today, the duodenal tuberculosis is a very rare disease. Final diagnosis of duodenal tuberculosis is difficult due to inconsistent symptoms and nonspecific duodenal lesions. We found 2 cases of duodenal tuberculosis by gastrascopy. In gastroscopic findings, there were undetermined ulcers and irregular nodular mucosal changes.

수술중 각종수액이 혈중의 포도당, 인슈린, 삼투압 및 전해질에 미치는 영향

정정길,장채운 대한마취과학회 1987 Korean Journal of Anesthesiology Vol.20 No.5

Rapid administration of solution containing dextroae results in marked hyperglycemia and osmotic diuresis but a balanced electrolyte solution containing maltese does not increase blood sugar. 30 patients were chosen at random and divided into 3 groups j.e, one group received 5% dextrose in water, the second group received Hartmann solution and the third group, 5% maltose in a balanced electrolyte solution. The Patient's blood was collected in the operating room prior to the start Ⅰ.V. infusion, for the measurement of blood sugar, insulin, osmolarity and electrolrtes in various conditions of N.P.O. Intravenous fluid was administered at a rate of 10 m1/kg/hour while anesthesia was induced and maintained with an endotracheal tube in place. Blood samples were taken one hour. 2 hours and 3 7ours f:on the time 1,V. infusion started, In the of 5% dextrose in water groups, the value of blood sugar and insulin was 88.5±12.1 mg% and 14.60±7.67 un/ml at NPO, 257.7±60.8mg% and 70.75±37.55 un/m1 at 1 hour, 298.8±84.and 143.19±50.32 un/ml at 2 hours and 228.6±75.8% and 127.71±56.98 un/m1 at 3 hours. Although the b1ood sugar and insulin values increased markedly. but potassium and chloride were 4.74±0.55 mEq/l and 101.1±2.9 mEq/l and 4.11±0.31 mEq/l, 107.4±2.3 mEq/l and 3.75±0.41 mEq/l, 176.4±2.7mEq/l and 3.89±0.50mEq/l, 106.3±2.2 mEq/l and shoewed mild decrease, by the way, osmolarity and serum sodium did not changed. In contrast to the 5% dextrose in water groups, there are no changes in the blood glucose. insulin levels, osmolarity or and electrolrtes in the either Hartmann or Elitol (Elitol=5% maltose contained in a balanced electrolyte solution) groups. There was a slight increase in osmolarity with maltose but it was not significant. Accordingly it is concluded that rapid infusion of harmann or 5% maltose contained ina balanced electrolyte solution affects the blood sugar and insulin levels insignificantly compared to the dextrose cont5aining solution which increase the blood sugar and insulin levels markedly

‘보행친화도시 만들기’ 가로설계·관리 매뉴얼의 기본방향

이창(Chang Yi),유경상(Gyeong Sang Yoo),김영란(Young-Ran Kim),민현석(Hyun-Suk Min),박찬운(Chan-Woon Park),정상미(Sang Mi Jeong),정윤주 서울연구원 2014 서울연구원 정책과제연구보고서 Vol.- No.-

As manifested in various urban policies, the Seoul Metropolitan Government(SMG) has made great efforts to improve the pedestrian environment. The City of Seoul has managed “Car-Free Day” events several times, and has designated pedestrian-only streets in many areas. However, it is not always convenient to walk in Seoul. On the streets, citizens still experience narrow sidewalks, streets cluttered with street furniture, and slanted sidewalk angles which are not safe for the mobility disadvantaged. The SMG still has work remaining to enhance the quality of the walking environment. In pursuing this goal, public officials in the SMG have realized an urgent need to seek guidance from a street design manual. Herein, the existing manuals were reviewed to see if they could be of use in the redesign of Seoul streets. It was found that the manuals were simply not up to the job, presenting many problems. First, in most cases, the national government created the manuals. Thus, they did not reflect the unique characteristics of Seoul’s built environment. Second, the manuals provided only general direction for street design, without specific details to deal with the diverse types of streets found in Seoul. Third, they set the focus on a few elements of street design, while considering various factors in an integrated manner is a key element for desirable street design. For these reasons, the SMG plans to create a Seoul Street Design Manual. As preliminary research for such a manual, this study drew on lessons from other cities in the world. The manuals for various cities abroad all have a common theme: they aim to convert current “Incomplete Streets” that were designed for automobiles to “Complete Streets” that put pedestrians and bicycles on equal footing with cars. Nevertheless, their coverage of design elements, the level of details included in the guidelines, and the contents of the manuals still differ from each other. Throughout the 1980s and 1990s, Seoul experienced rapid growth with the construction of major urban highways such as the Olympic Freeway. It may be evident that Seoul has not treated pedestrians and bicycles with due respect compared to automobiles. Therefore, we suggested that the Seoul Street Design Manual should focus on the design of Complete Streets, for which the design principles are proposed herein. Moreover, for a city like Seoul with various street types, it is important to provide customized design strategies for each street pattern. Readers can also find them in this report. Since physical developments, including buildings and transport infrastructure, have almost been completed, it is crucial to implement the design manual step by step. Although a design scheme such as road diet is a desirable outcome for pedestrians, it would bring about chaos for auto users if executed instantly. Learning from cities abroad(such as the Parklet program in San Francisco), we proposed a method to carry out the design proposal through gradual and acceptable changes. Finally, the creation of a fine street design is a task that should involve a wide variety of fields including transportation, urban design, and environmental engineering. This report also suggested organizing a Task Force(TF) to collect useful ideas from many disciplines. That way, citizens walking on the streets in Seoul could benefit for years to come.

악성종양에서 골수면역신티그라피를 이용한 골수전이의 평가 : 99mTc-MDP 뼈스캔과의 비교

고창순(Chang Soon Koh),김노경(Noe Kyeong Kim),김병국(Byoung Kook Kim),최창운(Chang Woon Choi),정준기(Jun Key Chung),방영주(Yung Jue Bang),이경한(Kyung Han Lee),정홍근(Hong Keun Chung),이명철(Myoung Chul Lee) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

N/A Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, 99mTc labeled anti-granulocyte rnonoclonal antibody (anti-NCA-95 MAb) has been introdueed as a new bone marrow imaging agent. To evaluate the usefulness of 99mTc anti-NCA MAb bone marrow scans for detecting skeietal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan fmdings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the rernaining 50% did not. Most of these non matched lesions were suggested to be nonspecific 1esions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, but metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus 99mTc anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.