신종인플루엔자 유행 관리를 위한 수학적 모형과 전략에 관한 고찰

김성순(Seong Sun Kim),이상원(Sang Won Lee),최보율(Bo Youl Choi) 한국역학회 2008 Epidemiology and Health Vol.30 No.2

Despite many countries’ current effort to make mathematical models for pandemic influenza (PI) and predict the impact of an outbreak, natural history of PI is remains incomplete, so that any assumption or model is unable to completely predict the impact. Our objective is to review and summarize previous studies on parameters and models of PI, and to make suggestions for the controls in order to decrease the impact of PI. We searched PubMed to retrieve literature about the PI model systematically . Reference lists and review papers on the topic were searched, as well. We found 35 articles that examined the PI model over the period of May 2003 to August 2008. We reviewed modelling methods that were focused on the PI, and their parameters i.e. latent period, and basic reproductive number (R0). Then, we summarized PI controls: antivirals, vaccines, and social distancing. Recent studies showed with mathematical models that Targeted Antiviral Prophylaxis (TAP) is the best strategy for containing PI at the source. In case of an outbreak, quick measures of social distancing, including therapeutic and prophylatic antiviral for cases and closing contacts school closure, workplace closure, border quarantine, and home isolation were found to be most effective. We reviewed strengths and weaknesses of models that are adaptable in Korea, and summarized their parameters. It is our hope that these strategies with various interventions give important information for future preparation for and response to PI in Korea.

부산지역 유흥업소 종사여성으로부터 분리된 HPV16형의 발암유전자(E6/E7) 돌연변이 유형 분석

민상기(Sang-Kee Min),김성순(Sung Soon Kim),최병선(Byeong-Sun Choi),장대호(Dai-Ho Jang),이미옥(Mee-Ok Lee),최성화(Seung-Hwa Choi),김남호(Nam-Ho Kim),박연경(Yon-Koung Park),정영아(Yeong-A Jeong),김성준(Seong-Joon Kim),빈재훈(Jae-Hun Bi 한국생명과학회 2009 생명과학회지 Vol.19 No.6

HPV-16형의 염기배열 변이는 지역적, 인종적으로 특징적인 차이가 있으며 특히 HPV-16형 E6/E7 유전자의 특정 염기서열변이는 자궁경부암 및 자궁상피내 신생종양물의 발생을 일으키는 고위험 요인으로 알려져 있다. 본 연구는 2007년 부산지역 유흥업소 종사여성으로 분리된 HPV-16형 19건을 대상으로 E6/E7 유전자 영역(nt 34-880)을 표적으로 지역적 염기서열 변이를 조사하였다. nucleotide 수준에서 HPV16형 E6 유전자는 T178G (n=11), T178A (n=1), T350G (n=4), A442C (n=2), A104T, A111G, C116T, G145T, T183G, C335T, G522C 등 11종의 변이주가 발견되었고, E7 유전자는 A647G (n=12), A645C, A777C, G663A, T732C, T760C, A775T, T789C, T795G 등 9종의 변이주가 발견되었다. 아미노산 수준에서는 HPV-16형 E6 단백질의 경우 D25E (n=12), L83V (n=4), E113D (n=2), M1L, Q3R, P5S, Q14H, D25N, I27R, H78Y, C140S 등 11종의 변이주를, HPV16형 E7 단백질의 경우 N29S (n=12), L28F, T72S 등 3종의 변이주를 관찰할 수 있었다. 본 연구 결과, 부산지역의 HPV-16형 E6/E7 우점 돌연변이주는 E6 D25E (75%), E7 N29S (78%)로 각각 나타났다. 앞으로 자궁경부암 환자 및 일반여성을 포함한 더 많은 모집단을 대상으로 HPV-16형 E6/E7의 intratypic variants를 비교 조사하여 실제 HPV-16형 E6/E7 어떤 변이주가 자궁경부암 유발 위험성과의 관련성은 더 많이 연구되어져야 할 것으로 사료된다. Recent studies have reported that the distribution of HPV-16 sequence variation differs geographically, and more specifically that HPV-16 E6/E7 intratypic variants might carry a high risk for development of ICC (invasive cervical cancer) and CIN (cervical intraepithelial neoplasia) in a given population. To investigate the genetic diversities of HPV-16 E6/E7 oncogene by region, we collected nineteen HPV-16 isolates from sexually high-risk women in Busan, and analyzed the HPV-16 E6/E7 coding regions (nt 34 to 880) with HPV-16 E6/E7 specific PCR amplification. At the nucleotide level, eleven variants of the E6 genes and nine variants of the E7 genes were identified as follows: E6 T178G (n=11), E6 T178A (n=1), E6 T350G (n=3), E6 A442C (n=2), E6 A104T, E6 A111G, E6 C116T, E6 G145T, E6 T183G, E6 C335T, E6 G522C and E7 A647G (n=12), E7 A645C, E7 A777C, E7 G663A, E7 T732C, E7 T760C, E7 A775T, E7 T789C and E7 T795G, respectively. At the amino acid level, the isolated HPV-16 E6 and E7 genes showed eleven E6 variants: E6 D25E (n=12), E6 L83V (n=4), E6 E113D (n=2), E6 M1L, E6 Q3R, E6 P5S, E6 Q14H, E6 D25N, E6 I27R, E6 H78Y, E6 C140S and three E7 variants: N29S (n=12), L28F, T72S. HPV16 E6 L83V, the dominant variant in the Caucasian population, showed relatively low frequencies in our study population. We elucidated that the dominant HPV-16 E6/E7 variants were HPV-16 E6 D25E (63.2%) and HPV-16 E7 N29S (63.2%), which were phylogenetically included in Asian lineage. Further study is needed to evaluate the risk of cervical cancer related HPV-16 E6/E7 intratypic variants in the Korean population.

부산지역 유흥업소 종사 여성의 HPV 감염 및 유전자형 분포 조사

민상기(Sang-Kee Min),김성순(Sung Soon Kim),최병선(Byeong-Sun Choi),조경순(Kyung-Soon Cho),이주연(Joo-Yun Lee),김성준(Seong-Joon Kim),빈재훈(Jae-Hun Bin),박호국(Ho-Kuk Park) 한국생명과학회 2009 생명과학회지 Vol.19 No.2

부산지역의 유흥업소 종사여성을 대상으로 HPV DNA chip 시험을 통하여 HPV 유병율 및 유전자형 분포를 조사하였다. 총 660건의 자궁경부도찰 검체로부터 258건(양성율 39.1%)이 검출되었으며, 20대에서 가장 높은 유병율을 나타내었다. 양성자의 유전자형 분포는 고위험군 유전자형의 경우 HPV-16 (15.9%), -53 (10.2%), -58 (7.7%), -18 (5.2%)순이었고, 저위험군 유전자형의 경우 HPV-70 (10.4%), -6 (4.1%), -11 (2.0%)순이었다. 특이하게 고위험군 감염여성의 분포비 (62.0%)가 저위험군(14.7%) 및 고/저위험군 혼합감염(12.0%)보다 4배 가까이 높았다. 전체 양성자중 단일유형 감염자는 175건(67.8%)이고 혼합유형 감염자는 83건(32.2%)이었다. 본 연구 결과 밝혀진 부산지역 유흥업소 종사여성에서 많이 발견되는 HPV 유전자형 분포의 다양성은 국내 도입된 자궁경부암 예방백신의 효과 예측 및 국내 특성에 맞는 다가백신 개발의 기초 자료가 될 수 있을 것으로 사료된다. We tried to analyze the HPV prevalence and HPV genotypes of sexually high-risk women living in Busan, the biggest seaport of South Korea. Six hundred sixty women engaging in high-risk occupations participated in this study. The prevalence of HPV infection and HPV genotyping were determined with MyGene<SUP>®</SUP> HPVDNA chip, which consisted of 16 high-risk HPV genotypes (oncogenic genotypes) and 8 low-risk HPV genotypes. The overall prevalence of HPV infection in this study population was 39.1% (258/660) and the 20's showed the highest prevalence of HPV infection (51.5%). The dominant HPV genotypes including single or multiple HPV-infected women were resulted in HPV-16 (15.9%), -53 (10.2%), -58 (7.7%), -18 (5.2%) in case of high-risk HPV genotype and HPV-70 (10.4%), -6 (4.1%), -11 (2.0%) in case of low-risk HPV genotypes. Remarkably, the proportion of women infected with high-risk HPV genotypes (62.0%) was almost four times higher than those of women infected with low-risk HPV genotypes (14.7%) and high/low-risk HPV genotypes (12.0%). Among the 258 HPV-infected women, single infection was 175, double infection 66, triple infection 12, quadruple infection 4, quintuple infection 1, respectively. Our finding suggests that the introduction and development of effective HPV vaccines should consider the current status of HPV genotypic infection in South Korean women.

강화지역 청소년의 4년간 혈청 지질의 변화와 지속성

이강희,서일,지선하,남정모,김성순,심원흠,하종원,김석일,강형곤,Lee, Kang-Hee,Suh, Il,Jee, Sun-Ha,Nam, Chung-Mo,Kim, Sung-Soon,Shim, Won-Heum,Ha, Jong-Won,Kim, Suk-Il,Kang, Hyung-Gon 대한예방의학회 1997 Journal of Preventive Medicine and Public Health Vol.30 No.1

소아에서부터 청소년기까지 혈청 지질의 지속성(tracking)은 서구에서 행해진 연구들에 의해서 이미 잘 알려져 있으나 국내에서는 이에 관한 연구가 거의 이루어지지 않았다. 본 연구는 우리나라 청소년의 혈청 지질치의 변화를 조사하고 지속성이 있는지를 분석하였다. 연구대상은 경기도 강화군에서 진행하고 있는 강화 아동 혈압 코호트(719명)의 청소년들로 12세, 14세, 16세 세 번에 걸쳐서 공복 후 혈액검사(혈청 총 콜레스테롤, 중성지방, LDL 콜레스테롤, HDL 콜레스테롤을 포함)와 신체계측을 시행하였다. 이 중 3번의 혈액 검사에서 10시간 이상의 공복이 확인된 청소년 309명 (남자 162명, 여자 147명)을 최종 연구대상으로 선정하였다. 연구대상이 된 청소년들과 연구대상에서 제외한 청소년들의 12세때 초기 검사치들을 t 검정을 이용하여 서로 비교한 결과 통계학적으로 유의한 차이는 없었다. 연구방법은 우선 혈청 지질치의 변화양상을 보기 위하여 각 검사 년도간에 반복 측정된 분산분석을 시행하였다. 각 혈청지질의 지속성을 보기 위해서는 첫께, 초기값을 바탕으로 사분위 집단으로 나누어 각 사분위 집단의 혈청지질치가 매 검사 연도마다 어떻게 변하는 지를 그림으로 나타내었다. 둘째, 혈청지질치의 검사 시기사이의 스피어맨 상관계수를 구하였다. 그리고 마지막으로 각 검사 년도의 혈청지질치를 사분위 집단으로 구분하여 초기검사에서 가장 위험도가 큰 집단에 속한 사람들이 지속적으로 위험도가 큰 집단에 속하는 백분율을 계산하였다. 연구결과 남녀 모두 4년간 세 번의 검사에서 혈청 총 콜레스테롤은 남자가 초기검사에서 $160.7{\pm}25.3mg/dl$, 최종 추적검사에서 $150.0{\pm}27.8mg/dl$, 여자가 초기검사에서 $168.8{\pm}29.7mg/dl$, 최종 추적검사에서 $168.8{\pm}29.7mg/dl$, 중성지방은 남자가 $98.0{\pm}45.7mg/dl$에서, $114.1{\pm}67.9/mg/dl$로, 여자가 $109.9\geq37.1mg/dl$에서, $104.9{\pm}47.6mg/dl$로, LDL 콜레스테롤은 남자가 $93.6{\pm}21.2mg/dl$에서, $83.0{\pm}25.0mg/dl$로 여자가 $83.0{\pm}25.0mg/dl$에서, $94.7{\pm}24.4mg/dl$로, HDL 콜레스테롤은 남자가 $47.6{\pm}9.1mg/dl$에서, $44.2{\pm}9.4mg/dl$로, 여자가 $48.8{\pm}10.0mg/dl$에서, $47.8{\pm}11.3mg/dl$ 변화하였다. 반복 측정한 분산분석 결과 남녀 모두 4년 동안 혈청 총 콜레스테롤, LDL 콜레스테롤, HDL콜레스테롤이 통계적으로 유의하게 감소하였다. 특히 남자 LDL 콜레스테롤은 두 번의 추적검사에서 모두 감소한 것으로 나타났다. 중성지방은 남자에서는 지속적으로 증가하였고 여자에서는 변화가 없었다. 같은 연령에서 남녀간의 각 혈청지질치를 비교해보면 중성지방을 제외하고는 모두 여자가 남자보다 더 컸다. 혈청 지질의 초기 검사와 최종 검사간의 스피어맨 상관분석과 각 혈청 지질치의 위험도가 가장 큰 사분위집단에 잔류하는 백분율을 보면 지속성이 존재하였다. 혈청 총 콜레스테롤과 HDL 콜레스테롤에서 각 시기의 검사치들의 상관계수는 남자가 0.6 이상, 여자가 약 0.7 이상이었으며 통계적으로 유의하였다. 첫 번께 검사에서 위험도가 가장 큰 사분위 집단에 속한 사람 중 두 번째 검사에서도 위험도가 가장 큰 사분위 집단에 속한 백분율은 여자의 중성지방(42.9%)을 제외하고는 모두 50%이상이었다. 이들이 세 번째 검사에서도 같은 사분위 집단에 잔류한 백분율은 It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.

HIV-1 감염에 의한 H9 세포주의 유전자 발현변화 양상 대량 검색

남정구(Jeong-Gu Nam),김경창(Kyung Chang Kim),전수경(Sue Kyong Jeon),김성순(Sung Soon Kim),이선우(Sun Woo Lee),안성환(Sung Whan An),이주실(Joo-Shil Lee) 대한미생물학회 2004 Journal of Bacteriology and Virology Vol.34 No.1

성장기 청소년의 혈압변화와 결정요인

서일,남정모,지선하,김석일,김영옥,김성순,심원흠,김춘배,이강희,하종원,강형곤,오경원,Suh, Il,Nam, Chung-Mo,Jee, Sun-Ha,Kim, Suk-Il,Kim, Young-Ok,Kim, Sung-Soon,Shim, Won-Heum,Kim, Chun-Bae,Lee, Kang-Hee,Ha, Jong-Won,Kang, Hyung-Gon,Oh, Ky 대한예방의학회 1997 예방의학회지 Vol.30 No.2

본 연구는 1992년 당시 경기도 강화군 강화읍내에 거주하는 중학교 1학년에 재학중인 남자 335명과 여자 375명을 대상으로 5년간 혈압수준 및 변화에 대한 분포를 제시하고 혈압수준 및 변화의 결정 요인을 밝히고자 하였다. 혈압의 수준 및 변화와 관련된 요인으로는 신체적 요인, 혈청학적 요인 및 영양소 섭취요인을 조사하였다. 주요 연구결과는 다음과 같다. 1. 12세부터 16세까지 5년간 남자의 수축기혈압의 평균은 108.7mmHg에서 118.1mmHg로, 이완기혈압의 평균은 69.5mmHg에서 73.4mmHg로 증가하였으며 15세에 가장 높은 혈압수준을 보였다. 그러나 동기간 동안 여자의 수축기혈압의 평균은 114.4mmHg에서 113.5mmHg로, 이완기혈압의 평균은 75.2mmHg에서 72.1mmHg로 감소하였으며 13-14세 때에 가장 높은 혈압 수준을 보였다. 2. 남자의 5년간 신장, 체중, 신체비만지수 등은 계속 성장하였으나 여자는 15세를 기점으로 신체적 성장이 둔화되는 경향을 보였다. 한편 연령이 증가할 수록 남자의 혈청 총 콜레스테롤은 감소하고 중성지방은 증가하는 경향을 보였으나 여자에서는 특별한 변화가 없었다. 식이섭취에서는 지질의 섭취가 연령에 따라 약간 증가하는 경향을 보였으나 전반적으로 남녀 모두 에너지의 20% 정도였다. 3. 혈압수준과 체중, 신체비만지수, 피부두께 등은 남녀 모두 각 연령에서 통계학적으로 유의한 관련성이 있었다. 신체비만지수의 영향을 통제하였을 때 혈청 총 콜레스테롤은 남자에서 연령의 증가에 따라 수축기혈압과 음의 관계에서 양의 관계로, 여자의 경우에는 이완기혈압과 15-16세에서 양의 관련성을 보였다. 그리고 중성지방과 크레아티닌은 남자에서는 혈압과 양의 관련성을 보였으나 여자의 경우에는 관련성이 없었다. 한편 영양소 섭취와 혈압과의 관계는 성별-연령별로 일관성 있는 결과가 없었으나 남자의 이완기혈압과 단백질 섭취가 양의 관련성이 있었고 여자의 14세 때 수축기혈압과 비타민 A 섭취가 음의 관련성이 있었다. 4. 혈압변화와 신체비만지수의 변화, 혈청 총 콜레스테롤의 변화는 남녀 모두 양의 관련성을 보였으며 크레아티닌의 변화는 남자에서는 양의 관계를, 여자에서는 음의 관계를 보였다. 또한 남자에서 소디움 섭취가 높은 군이 계속해서 높은 혈압수준을 유지하였으며 여자의 경우에는 에너지에 대한 지질 섭취비율이 높은 군이 계속해서 낮은 혈압수준을 유지하여 성별에 따른 차이를 보였다. 전체적으로 성장기 혈압변화에 가장 큰 영향을 미치는 요인은 남녀 모두 신체비만 지수이었다. Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.

레일 체결장치 종류에 따른 체결장치의 종방향 마찰거동

백진호(Jin-Ho Baek),배현웅(Hyun-Ung Bae),박상준(Sang-Jun Park),김성순(Seong-Sun Kim),이진옥,임남형(Nam-Hyoung Lim) 한국철도학회 2015 한국철도학회 학술발표대회논문집 Vol.2015 No.10

현재 국내에서는 궤도-교량 상호작용에 의해 발생되는 각종 물리적인 현상을 해석하고 제한하기 위해서 유럽의 설계기준인 UIC774-3R과 독일의 설계기준인 DS804를 적용하여 KR C-08080(궤도-교량 종방향 상호작용해석)과 KR C-08090(교량 단부 콘크리트궤도 사용성 검토)을 규정하고 운영하고 있다. 그러나 아직 국제적인 기준으로 정립되어있지 않기 때문에 국내 철도에 적용하기 위해서는 실제 사용되는 체결장치의 성능 특성 등을 반영하여 검토가 필요하다. 본 논문에서는 국내 콘크리트 궤도에 적용되는 체결장치의 종방향 저항력 실험을 수행하여 한가지 거동으로 규명(현 국내규정)될 수 없는 변동성을 갖는 특성을 파악하였으며, 레일 체결장치의 종류에 따른 종방향 마찰거동 분석을통해 변동성을 고려하기 위한 확률 통계적 접근을 수립하고자 하였다. When the interactions between railway track and bridge are analyzed for assessing safety of ballasted track on bridge, nonlinear behavior should be considered. And several design specifications and standards such as European design standard UIC774-3R, German standard DS 804, KR C-08080 (trackbridge species and regulations and operating direction interaction analysis) and KR C-08090 (bridge concrete track ends usability review) are applied to design the track and bridge considering track-bridge interaction. However, these design specifications were not established as international standards. Therefore, reflecting the characteristics of fasteners used currently in the domestic track is essential to rationally consider the interactions between railway track and bridge. In this paper, we investigate in one motion by performing a longitudinal resistance experiment of the fastening system to be applied to domestic concrete track (the current national standard) had grasp the characteristics of which can not be volatility, longitudinal frictional behavior according to the type of rail fastening system the probability of the statistical approach to account for variability the analysis was to establish.

Hyperkinetic Heart Syndome 에 대한 임상적 고찰

강진경 ( Jin Kyung Kang ),차홍도 ( Hong Do Cha ),노원식 ( Won Shick Loh ),신계철 ( Kye Chul Shin ),이상인 ( Sang In Lee ),김성순 ( Sung Sun Kim ) 대한내과학회 1978 대한내과학회지 Vol.21 No.7

심근경색증 환자에서 간헐파도플러 심초음파검사에 의한 심실확장기능에 관한 연구

조승연(Seung Yun Cho),박승정(Seung Jung Park),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung),박성삼(Sung Sam Park),심원흠(Won Heum Shim),김성순(Sung Sun Kim),이웅구(Woong Ku Lee) 대한내과학회 1988 대한내과학회지 Vol.35 No.4

N/A Inflow characteristics of left and right ventricular filling were assessed in 33 patients with myocardial infarction and 20 normal subjects by pulsed doppler echocardiography. The presence of left and right ventricular diastolic functional change in accordance to the infarct location, serial change of left and right ventricular diastolic function in patients with acute myocardial infarction, and correlation between left ventricular end-diastolic pressure and pulsed doppler echocardiographic incices of left ventricular diastolic function were assessed. Patients with myocardial infarction were subdivided into two groups, the anterior infarct group(20 patients) and the inferior infarct group(13 patients), according to the site of the involved myocardium. Serial doppler echocardiograms were perfarmed three times, within 3 days after onset(lst phase), after about 12 days (2nd phase), and after 4 weeks (3rd phase). 1) Concerning the left ventricular diastolic function, A/E in the anterior infarct group(1.04±0.18) and inferior infarct group(1.07±0.23) was greater than in that of the control group(0.64+0.10)(p<0.05) The corrected isovolumic relaxation time in the anterior infarct group(2.34±0.60 √ms and inferior infarct group(2. 43±0.70 √ms) was longer than in that of the control (1.83±0.31 ms) (p<0.05). The 0.33 area fraction and E area fraction in the anterior infarct group(45±7%, 55±5%, respectively) and inferior infarct group(43+9 53±8%, respectively) were less than in those of the control group(59±9%, 67±5%, respectively) (p< 0.05, p<0.05, respectively) and A area fraction in the anterior infarct group (43±6%) and inferior infarct group(47±8%) was greater than that in the control group(36±7%) (p<0.05). 2) In the right ventricular side, A/E in anterior infarct group(0.86±0.23) and inferior infarct group(1.01±0.16) was greater than in that of contol group(0.62±0.10) (p<0.05), peak A velocity in inferior infarct group(0.44±0.09 m/s) was higher than in those of anterior infarct group(0.36±0.10 m/s) and control group(0,28±0.05 m/s) (p<0.05), 0.33 area fraction and E area fraction in anterior infarct group(43±7%, 52±10%, respectively) and inferior infarct group(42±9%, 50±10%, repectively) were lesser than in those of control group(56±9%, 63±7%) (p<0.05, p<0.05, respectively), and A area fraction in anterior infarct group(48±10%) and inferior infarct group(49±9%) was greater than in that of control group(36±7%) (p<0.05). 3) Serial left ventricular pulsed doppler echocardiogram in 12 patients with acute myocardial infarction showed follwoing results. A/E in phaae 2(0,86±0,17) and phase 3(0.83±0.21) was lesser than in that of phase 1(1.07±0.22) (p<0,05), 0,33 area fraction and E area fraction in phase 2(53±10%, 59±8%, respectively) and phase 3(55±9%, 59±7%, respectively) were greater than in those of phase 1(43±8%, 49±9 respectively) (p<0,05, p<0,05, respectively), A area fraction in phase 2(39±8%) and phase 3(39±8%) was lesser than in phase 1(49±11%) (p<0,05), and these variables were not changed between phase 2 and phase 3. 4) Serial right ventricular pulsed doppler echocardiogram in 12 patients with acute myocardial infarction showed following results, A in phase 2 (0.35±0.10 m/s) and phase 3(0,31+0,06 m/s) was lower than in that of phase 1(0,46±0.09 m/s) (p<0.05), A/E in phase 2(0.92±0.26) and phase 3(0,78±0.18) was lesser than in that of phase 1(1.10±0.16) (p<0.05, p<0.01, respectively), 0,33 area fraction and E area fraction in phase 2(53±10%, 47±9%, respectively) and phase 3(53±8%, 42±9%, respectively) were greater than in those of phase 1(41±10%, 49±8%, respectively) (p<0.05, p<0.05, respectively), and A area fraction in phase 2(47±9%) and phase 3(42±9%) was lesser than in that of phase 1(50±7%) (p<0.05), 5) Left ventricular end diastolic pressure had a signi1icant high correlation with A/E (r=0,76, p=0.01), with 0.08 area fraction (r=0,71, p=0,02), and with E area fraction

급성 심근경색증에 대한 임상적 고찰

최흥재 ( Heung Jai Choi ),차홍도 ( Hong Do Cha ),이웅구 ( Woong Ku Lee ),정우제 ( Woo Je Chung ),김성순 ( Sung Sun Kim ),심원흠 ( Won Heum Sim ) 대한내과학회 1978 대한내과학회지 Vol.21 No.9