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심승주,이찬우,송기훈,김기호 대한피부과학회 2003 大韓皮膚科學會誌 Vol.41 No.9
Actinic lichen planus is a particular subtype of lichen planus with a distinct photodistribution. This disease has been variously named lichen planus in subtropical countries, such as lichen planus subtropicus annularis, lichen planus tropicus, summertime actinic lichenoid eruption, and lichenoid melanodermatitis. It is a disorder seen most frequently in Africa, the Middle East, and the Indian subcontinent, favoring Asiana. This disease presents in the spring or summer and is frequently quiescent during the winter. A 61-year-old man with unusual lichenoid photosensitive eruption is presented. The lesions developed during the late spring, appearing on both dorsa of hands, wrists, and lower legs. We report a case of actinic lichen planus with a review of the literature. (Korean J Dermatol 2003;41(9) : 1250~1253)
복합용도개발과 가로공간의 상호 관련성에 관한 연구 : 롯데월드 공간구조를 중심으로 On the LOTTE WORLD's spatial configuration
이승주,심재현,김영욱 대한건축학회 2004 대한건축학회논문집 Vol.20 No.2
The purpose of this study is to analyze the circulatory relationship between a mixed-use complex and its adjacent local street. this study is based on the spatial analysis with Space Syntax method and its outcome. The subject of the case study is focused on LOTTE WORLD's and surrounding areas in 'Jamsil-Dong'. According to the analysis of the study, current spatial configuration shows bisected areal discrepancy within the inner arrangement of the space and its use. In tenn of pure academic observation, it has lack of uniformity and causes disorientation of spatial cognition. This study emphasis the continuity and the integration of the space between the mixed-use complex and its external urban streets and areas.
관상동맥 질환을 가진 제 IIa형 과지질단백혈증 환자에 동반된 건 황색종 1예
이찬우,심승주,송기훈,김기호 대한피부과학회 2003 大韓皮膚科學會誌 Vol.41 No.11
We report a case of type IIa hyperlipoproteinemia with xanthoma tendinosum associated with coronary artery disease in a 51 year-old male. Multiple hard nodules appeared firstly on both achilles tendon area 30 years ago and the lesions gradually spread to the dorsa of hands and feet. On past history, he had been diagnosed as unstable angina with atherosclerosis of three vessels in coronary arteries, 2 years ago. His family history revealed nothing contributory. Serum lipid profile including lipoprotein electrophoresis showed an increase in total cholesterol and LDL-cholesterol with increased P-lipoprotein fraction, which suggested type IIa hyperlipoproteinemia. Histopathologic finding of a nodule from the dorsum of right hand showed many foamy histiocytes and cholesterol clefts in the dermis. Most of the xanthoma cells were mononuclear, but many Touton type giant cells were seen also. He died suddenly of heart failure with unstable angina. (Korean J Dermatol 2003;41(11) : 1541-1543)
Sim, Doo Sun,Jeong, Myung Ho,Kim, Hyo Soo,Gwon, Hyeon Cheol,Seung, Ki Bae,Rha, Seung Woon,Chae, Shung Chull,Kim, Chong Jin,Cha, Kwang Soo,Park, Jong Sun,Yoon, Jung Han,Chae, Jei Keon,Joo, Seung Jae,Ch Elsevier 2018 Journal of cardiology Vol.72 No.5
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Dual antiplatelet therapy (DAPT) is recommended in patients receiving drug-eluting stents (DES). However, bleeding risk should be weighed against ischemic risk. Utility of GRACE risk score and ACUITY-HORIZONS bleeding risk score was assessed in patients with acute myocardial infarction (MI) according to use of P2Y12 blocker.</P> <P><B>Methods</B></P> <P>From the Korea Acute Myocardial Infarction Registry-National Institute of Health database, 7791 patients with acute MI receiving DES were divided into ticagrelor (<I>n</I> =1554) and clopidogrel (<I>n</I> =6237) groups. Propensity-matched 12-month mortality and bleeding event rates were compared according to GRACE and ACUITY-HORIZONS scores. Patients who received thrombolysis, prasugrel or anticoagulants, or who discontinued or switched DAPT were excluded.</P> <P><B>Results</B></P> <P>In all patients, high-risk patients more often received clopidogrel. After propensity score matching (<I>n</I> =1553 in each group), 12-month mortality was not different, but TIMI major bleeding rate was higher with ticagrelor (2.8% vs. 1.4%, <I>p</I> =0.007). On subgroup analysis, 12-month mortality was lower with ticagrelor in patients with high (>140) compared to low-to-moderate risk GRACE score (5.1% vs. 7.9%, <I>p</I> =0.04). When combined with ACUITY-HORIZONS bleeding score, 12-month mortality was lower with ticagrelor in patients with high GRACE score but without very high (≥20) ACUITY-HORIZONS score (2.4% vs. 5.3%, <I>p</I> =0.03).</P> <P><B>Conclusions</B></P> <P>In patients with acute MI receiving DES, GRACE and ACUITY-HORIZONS scores may help guide DAPT. In patients with high GRACE score, a more potent P2Y12 blocker may be considered, particularly in the subset not at very high risk of bleeding.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Both ischemic and bleeding risks are correlated with mortality post-percutaneous coronary intervention. </LI> <LI> GRACE and ACUITY-HORIZONS scores may help guide dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (MI). </LI> <LI> The optimal DAPT regimen in Asian patients with acute MI needs to be determined. </LI> </UL> </P>
심승주 ( Sim Seung Joo ),이찬우 ( Lee Chan Woo ),송기훈 ( Song Ki Hoon ),황기백 ( Hwang Gi Baeg ),김기호 ( Kim Ki Ho ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.10
N/A Background : Ambulatory phlebectomy is a cosmetically elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. Tumescent anesthesia is applied in dermatologic surgery and now being expanded for use in phlebectomy. Objective : To evaluate the efficacy and safety as well as advantages of 0.1% tumescent anesthesia with epinephrine in ambulatory phlebectomy. Methods : Twenty-two patients(twenty-seven legs) without reflux at the SFJ were treated with ambulatory phlebectomy using the tumescent(0.1%) technique. In all patients, we monitored blood pressure, heart rate, and O₂ saturation before, during, and after procedure. All patients were asked to rate the pain, both intraoperatively and postoperatively. They visited in hospital to record complications at one day, one week, and various monthly intervals (1, 3, 6, 12 months) following the initial treatment. Results : The volume of anesthetic fluid ranged from 90 to 650ml, with an average of 320.7ml of fluid. Blood pressure, heart rate, and O₂ saturation measured did not significantly change before, during, or after procedure. The average reported intraoperative pain for all interviewees was from 0 to 2. For postoperative pain, patients reported pain rate less than one. During operation, significant surgical blood loss is eliminated. There were minimal hematoma, purpura, and hyperpigmentation after operation. Conclusion : 0.1% Tumescent anesthesia provides a very safe, comfortable technique of anesthetizing patients for ambulatory phlebectomy and may decrease the incidence of complications.(Korean J Dermatol 2003;41(10) : 1311~1317)
Doo Sun Sim,Myung Ho Jeong,Hyo-Soo Kim,Hyeon-Cheol Gwon,Ki-Bae Seung,Seung-Woon Rha,Shung Chull Chae,Chong Jin Kim,Kwang Soo Cha,Jong Seon Park,Jung Han Yoon,Jei Keon Chae,Seung Jae Joo,Dong-Ju Choi,S 대한심장학회 2020 Korean Circulation Journal Vol.50 No.2
Background and Objectives: There is a paucity of data regarding the benefit of clopidogrel monotherapy after dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents (DES). This study compared outcome between clopidogrel versus aspirin as monotherapy after DES for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 1,819 patients treated with DES who were switched to monotherapy with clopidogrel (n=534) or aspirin (n=1,285) after uneventful 12-month DAPT were analyzed. The primary endpoint was net adverse clinical events (NACE), defined as a composite of death from any cause, MI, repeat percutaneous coronary intervention (PCI), stent thrombosis, ischemic stroke, or major bleeding during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received clopidogrel, compared with those treated with aspirin, had a similar incidence of NACE (0.7% and 0.7%; hazard ratio, 1.06; 95% confidence interval, 0.31–3.60; p=0.923). The 2 groups had similar rates of death from any cause (0.1% in each group, p=0.789), MI (0.3% and 0.1%, respectively; p=0.226), repeat PCI (0.1% and 0.3%, respectively; p=0.548), stent thrombosis (0.1% and 0%, respectively; p=0.121), major bleeding (0.2% in each group, p=0.974), and major adverse cardiovascular and cerebrovascular events (0.5% in each group, p=0.924). Conclusions: Monotherapy with clopidogrel, compared to aspirin, after DAPT showed similar clinical outcomes in patients with acute MI treated with DES.
A fatal acute right heart failure with elevated D-dimer in gastric cancer pateint
( Seung Hyun Park ),( Sang Hoon Seol ),( Joo Won Lee ),( Ho Chan Sim ),( Bo Min Park ),( Dong Ki Kim ),( Ki Hoon Kim ),( Doo Il Kim ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
A 46-year-old woman with gastric cancer presented with a 2 week period of progressively worsening shortness of breath. Six months ealier, she had a total gastrectomy. However, the adjuvant chemotherapy was not done because of her refusal. On admission, the physical examination including auscultation was unremarkable. The patient was afebrile patient, with tachycardia of 116/min, a respiratory rate of 28/min and a blood pressure of 100 /60 mmHg. Laboratory findings were remarkable for microcytic anemia and a strong positive D dimer (11.8 ug/mL, normal <0.55). Electrocardiography showed sinus tachycardia. Echocardiography revealed feature of pulmonary hypertension, namely a severely dilated right ventricle with grossly impaired systolic function and an estimated pulmonary artery pressure of 70 mmHg (Fig. 1). Chest CT presented no evidence of pulmonary emboli (Fig. 2). She rapidly developed hypoxemic respiratory failure and desaturated 80% on 10 liters of oxygen. The patient`s condition progressively worsened and took a rapid downhill course, despite aggressive hemodynamic support. Finally, the patient developed an intractable respiratory failure and died 14 hours after hospitalization.