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Transcatheter Aortic Valve Implantation: Early Experience in Korea
김원장,김영학,Jong-Young Lee,박덕우,강수진,이승환,이철환,김대희,송종민,강덕현,송재관,김준범,정성호,주석중,정철현,이재원,심지연,최인철,박성욱,박승정 대한심장학회 2012 Korean Circulation Journal Vol.42 No.10
Background and Objectives: Transcatheter aortic valve implantation (TAVI) was recently introduced in Korea. The present report describes the experience of early TAVI cases. Subjects and Methods: Between March, 2010 and October, 2011, 48 patients with severe symptomatic aortic stenosis (AS) were screened at the Asan Medical Center to determine their suitability for surgical intervention. Of these, 23 were considered unsuitable and underwent TAVI. Procedural success rates, procedure-related complications, and clinical outcomes were evaluated in the TAVI patients. Results: Transfemoral (n=20) or transapical (n=3) TAVI was performed. The mean age of patients was 75.9±5.4 years and 57% were fe-males. The mean logistic European System for Cardiac Operative Risk Evaluation was 25.6±5.1%. Implantation was successful in 22 pa-tients (19 transfemoral, three transapical). After successful implantation, the mean aortic valve area increased from 0.68±0.14 cm 2 to 1.45±0.33 cm 2 . There were no procedure-related complications or mortality. The patients showed no paravalvular aortic regurgitation with ≥ moderate degree and remained stable without progression during follow-up. During follow-up (interquartile range, 1.1-12.9), all pa-tients were alive without any occurrence of valve failure. Conclusion: TAVI procedure is feasible in patients with inoperative symptomatic AS leading to hemodynamic and clinical improvement. With accumulation of experience, proper patient selection and development of device technologies, TAVI should decrease adverse events and expand the indications in the near future.
김원장,권창희,한승봉,이우석,강준원,안정민,이종영,박덕우,강수진,이승환,김영학,이철환,박성욱,박승정 대한의학회 2016 Journal of Korean medical science Vol.31 No.6
Current guidelines recommend that coronary artery calcium (CAC) screening should only be used for intermediate risk groups (Framingham risk score [FRS] of 10%-20%). The CAC distributions and coronary artery disease (CAD) prevalence in various FRS strata were determined. The benefit to lower risk populations of CAC score-based screening was also assessed. In total, 1,854 participants (aged 40-79 years) without history of CAD, stroke, or diabetes were enrolled. CAC scores of > 0, ≥ 100, and ≥ 300 were present in 33.8%, 8.2%, and 2.9% of the participants, respectively. The CAC scores rose significantly as the FRS grew more severe (P < 0.01). The total CAD prevalence was 6.1%. The occult CAD prevalence in the FRS ≤ 5%, 6%-10%, 11%-20%, and > 20% strata were 3.4%, 6.7%, 9.0%, and 11.6% (P < 0.001). In multivariate logistic regression analysis adjusting, not only the intermediate and high risk groups but also the low risk (FRS 6%-10%) group had significantly increased odds ratio for occult CAD compared to the very low-risk (FRS ≤ 5%) group (1.89 [95% confidence interval, CI, 1.09-3.29] in FRS 6%-10%; 2.48 [95% CI, 1.47-4.20] in FRS 11%-20%; and 3.10 [95% CI, 1.75-5.47] in FRS > 20%; P < 0.05). In conclusion, the yield of screening for significant CAC and occult CAD is low in the very low risk population but it rises in low and intermediate risk populations.
김원장 ( Kim Won Jang ),조국현 ( Jo Guk Hyun ),엄명철 ( Eom Myung Chul ),이광야 ( Lee Kwang Ya ) 한국농공학회 2002 한국농공학회 학술대회초록집 Vol.2002 No.-
By the explosive increase of population and industrialization the security of water resources is required, and water resource pollution problem is emerging as a serious social issue. For the ongoing Saemankeum project, lots of efforts are being put together to manage the water quality of the Saemankeum above a certain level, and it is sure that water quality management problem of main inflows from Mankyung River and Dongjin River is very important. Based upon the water quality data of Mankyung River this report examines its correlative characteristics by water quality sampling point factors and the water pollution resource factors, and subjects to provide elementary data for efficient water quality management of Mankyung River.
김원장 ( Kim Won Jang ),박상현 ( Park Sang Hyun ),이형주 ( Lee Hyung Joo ),이광야 ( Lee Kwang Ya ) 한국농공학회 2002 한국농공학회 학술대회초록집 Vol.2002 No.-
In recent, industrialization increases the level of pollution load in sea areas, and the inflows of pollutants to public sea areas cause sudden and wide-range of influence to the water quality and the ecosystem. To prepare for these kinds of unpredictable water pollution issues, the necessity is emerging to build an automatic water quality monitoring system, which can monitor and alarm the water quality changes of the subject sea areas. For the ongoing installation plan of the automatic water quality monitoring system around the Saemankeum sea area, this report compares and analyzes its installation conditions as well as the physical and chemical characteristics of the in-situ type and the water-sampling type of the automatic water quality monitoring equipments, and subjects to provide elementary data for the system installation in the Saemankeum.