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Koh, Jin-Sin,Park, Yongwhi,Ahn, Jong-Hwa,Kang, Min Gyu,Kim, Kye-Hwan,Bae, Jae Seok,Park, Hyun Woong,Jang, Jeong Yoon,Park, Jeong Rang,Hwang, Seok-Jae,Kwak, Choong Hwan,Hwang, Jin-Yong,Tantry, Udaya,Gu Georg Thieme Verlag KG 2019 Thrombosis and Haemostasis Vol.119 No.2
<B>Abstract</B><P>Amlodipine has a potential to reduce clopidogrel bioactivation through the cytochrome P450 3A4 enzyme in vivo, but the clinical impact of this interaction remains controversial. This randomized, open-label, two-period, crossover study was performed to evaluate the influence of amlodipine on the haemostatic profiles of high-risk patients during clopidogrel treatment. We recruited 40 Asian patients (Male/Female: n = 36/4) receiving clopidogrel (75 mg/day), aspirin (100 mg/day) and rosuvastatin for at least 6 months following percutaneous coronary intervention. Patients were randomly assigned to receive either 5 mg daily amlodipine or not for 2 weeks, and then were crossed over to the other treatment for 2 weeks. Haemostatic measurements were conducted with the VerifyNow assay and thromboelastography (TEG). Primary endpoint was P2Y12 Reaction Units (PRU) during on- versus off-amlodipine treatment. The on-amlodipine strategy showed higher level of PRU compared with the off-amlodipine strategy (176.8 ± 75.4 vs. 150.7 ± 65.5 PRU; ∆mean: 26.1 PRU; ∆95% confidence interval [CI]: 4.5-47.7 PRU; p = 0.019). Platelet-fibrin clot strength measured by TEG was lower during on- versus off-amlodipine treatment (7,712 ± 1,889 vs. 8,559 ± 2,174 dyne/cm2; ∆mean: -847 dyne/cm2; ∆95% CI: -1,632 to -62 dyne/cm2; p = 0.035). After amlodipine discontinuation, 27 patients (67.5%) showed a decrease in PRU, which was associated with ‘PRU ≥ 160 on-amlodipine’ in multivariate analysis (odds ratio: 62.014; 95% CI: 2.302-1670.328; p = 0.014). In conclusion, amlodipine increases platelet reactivity and decreases platelet-fibrin clot strength during clopidogrel treatment. In addition, the effect of amlodipine discontinuation on clopidogrel responsiveness is associated with on-amlodipine platelet reactivity.</P>
Leukocytosis 가 동맥혈 산소 분압에 미치는 영향
김진호,심재선,고신옥,오흥근,강신범 대한마취과학회 1990 Korean Journal of Anesthesiology Vol.23 No.4
Arterial blood gas analysis has become an integral part of the clinical evaluation of the patient with known or suspected pulmonary disease. However, when the results of the measurements show arterial hypoxemia which is out of proportion to the clinical and X-ray evidence of lung disease, we may consider potential errors in measurement involving the blood gas analyzer or methods of blood sample storage. We experienced spurious hypoxemia in a patient with extreme leukocytosis (220.0 x 10³/mm³) secondary to leukemia. The degree of PaO₂ decay was blunted by placing the blood on ice.
김진수,이기남,이종현,문준일,고석신 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.1
Several methods for the management of intractable pain for various conditions including malignant disorders, herpes zoster, and low back pain and/or sciatica in 80 patients were described and analyzed. Neurolytic blodks of celiac plexus were given to the patienta suffering from intra-abdominal pain from malignant origin or chronic pancreatitis. Herpes zoster was treated mainly by chemical sympathectomy via paravertebral route and occassionaly corticosteroid was administered epidurally with the local anesthetic, bupivacaine. All the patients with low back pain and/or sciatica were given epidural corticosteroid one to three times. Other peripheral verve blocks and regional corticosteroid therapy were given to the rest of the patients. Fair to excellent result was obtained in 71% of the patients but the response was poor in the remaining 28% of the patients. It seems that the earlier the patients were referred to the pain clinic, the better the results were.
Hyuk Joo Lee,Cheolkyung Sin,Hyeyeong Kim,Hyeon-Su Im,Jae-Cheol Jo,Yoo Jin Lee,Youjin Kim,Junseok Ahn,Soyoung Yoo,Su-Jin Koh,Seockhoon Chung 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.12
Objective The aim of the present study was to explore whether or not cancer patients’ viral anxiety and depression during the coronavirus-2019 (COVID-19) pandemic were associated with a fear of cancer progression. We also assessed whether coping strategies affected the relationship.Methods The present cross-sectional survey included cancer patients who visited Ulsan University Hospital in Ulsan, Korea. The participants’ demographic information and responses to the following symptoms rating scales were collected: Stress and Anxiety to Viral Epidemic–6; Patient Health Questionnaire–9; Cognitive Emotion Regulation Questionnaire-short version; or Fear of Progression Questionnaire-short version.Results Of the 558 cancer patients surveyed, 25 (4.5%) reported that their treatment schedule was delayed during the COVID-19 pandemic. The patients’ fear of progression was found to be related to age (β=-0.08; p=0.011), viral anxiety (β=0.40; p<0.001), depression (β=0.26; p<0.001), and catastrophizing coping strategies (β=0.15; p=0.004), for an overall adjusted R<sup>2</sup> of 0.46 (F=66.8; p<0.001). Mediation analysis showed that viral anxiety and depression were directly associated with fear of progression, while catastrophizing mediated this relationship.Conclusion Fear of progression in cancer patients was associated with viral anxiety, depression, and maladaptive coping techniques, such as catastrophizing, during the COVID-19 pandemic.
Park, Yongwhi,Tantry, Udaya,Koh, Jin-Sin,Ahn, Jong-Hwa,Kang, Min,Kim, Kye,Jang, Jeong,Park, Hyun,Park, Jeong-Rang,Hwang, Seok-Jae,Park, Ki-Soo,Kwak, Choong,Hwang, Jin-Yong,Gurbel, Paul,Jeong, Young-Ho Thieme 2017 Thrombosis and Haemostasis Vol.117 No.5
<B>Summary</B><P>The role of platelet-leukocyte interaction in the infarct myocardium still remains unveiled. We aimed to determine the linkage of platelet activation to post-infarct left ventricular remodelling (LVR) process. REMODELING was a prospective, observational, cohort trial including patients (n = 150) with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Patients were given aspirin plus clopidogrel therapy (600 mg loading and 75 mg daily). Platelet reactivity (PRU: P2Y12 Reaction Units) was assessed with VerifyNow P2Y12 assay on admission. Transthoracic echocardiography was performed on admission and at one-month follow-up. The primary endpoint was the incidence of LVR according to PRU-based quartile distribution. LVR was defined as a relative ≥ 20 % increase in LV end-diastolic volume (LVEDV) between measurements. Adverse LVR was observed in 36 patients (24.0 %). According to PRU quartile, LVR rate was 10.8 % in the first, 23.1 % in the second, 27.0 % in the third, and 35.1 % in the fourth (p = 0.015): the optimal cut-off of PRU was ≥ 248 (area under curve: 0.643; 95 % confidence interval: 0.543 to 0.744; p = 0.010). LVR rate also increased proportionally according to the level of high sensitivity-C reactive protein (hs-CRP) (p = 0.012). In multivariate analysis, the combination of PRU (≥ 248) and hs-CRP (≥ 1.4 mg/l) significantly increased the predictive value for LVR occurrence by about 21-fold. In conclusion, enhanced levels of platelet activation and inflammation determined the incidence of adverse LVR after STEMI. Combining the measurements of these risk factors increased risk discrimination of LVR. The role of intensified antiplatelet or anti-inflammatory therapy in post-infarct LVR process deserves further study.</P>
김신진,김영모,고광식,Kim, Sin-Jin,Kim, Young-Mo,Koh, Kwang-Sik 한국정보처리학회 2002 정보처리학회논문지B Vol.9 No.1
영상의 점진적 전송 방식은 데이터의 전송이 진행되는 동안 수신측에서 낮은 해상도의 영상에서부터 점진적으로 더 높은 해상도의 영상으로 해상도를 향상시켜나가는 방법이다. 이것은 데이터 전송의 초기에 영상의 가치를 판단하여 나머지 부분의 전송을 진행하거나 취소할 수 있어 제한된 전송 대역을 효과적으로 이용할 수 있다. 본 논문에서는 효율적인 영상의 점진적 전송을 실현하기 위하여 영상을 비트플래인으로 분리한 후 각 플래인을 상보 쿼드트리 구조로 재구성하였다. 그리고 상보 쿼드트리의 각 레벨과 각 비트플래인의 데이터를 적절한 순서로 전송하여 전송의 초기에 보다 적은 데이터로 영상의 내용을 대체적으로 파악할 수 있도록 하였다. Progressive image transmission involves a progressive increase in the image resolution at the receiver from a lower to a higher resolution during the transmission of data. This is an effective way of using a limited transmission channel, because, after estimating the value of the data in the early transmission period, a decision can be made whether or not to proceed with the transmission of the remaining part. To realize more effective progressive image transmission, the current thesis divides an image into bit planes and then re-organizes each plane into a complementary quadtree structure. As a result, by transmitting the data on each bit plane and each level of the complementary quadtree in the appropriate order, the basic image contents can be understood with less data in the early period of transmission.