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스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석
이두환 ( Doo Hwan Lee ),송종남 ( Jong Nam Song ),박신의 ( Sin Eui Park ),최남길 ( Nam Gil Choi ),한재복 ( Jae Bok Han ),김인수 ( In Soo Kim ) 한국방사선학회 2019 한국방사선학회 논문지 Vol.13 No.3
약물용출 스텐트(drug-eluting stents, DES)는 일반 금속 스텐트에 비하여 재협착을 현저하게 줄였지만, 여전히 관상동맥 스텐트 재협착은 비율이 높다. 2012년 11월부터 2016년 12월까지의 일 대학교병원 심혈관센터에서 경피적 관상동맥 스텐트 삽입술 후 관상동맥 조영술에서 스텐트 재협착 환자 187명 그룹 I (약물코팅 풍선카테터 사용, n=127명), 그룹 II (약물용출 스텐트 사용, n=60명)로 분류하여 치료효과, 주요심장사건, 사망 발생률, 심근경색, 표적병변 재개통술 그리고 스텐트 혈전등을 2년 동안 추적 분석하였다. 임상적 특성는 두 그룹간 차이는 없었고(21.1 ± 5.3 vs. 25.3 ± 9.6 mm, p<0.002), 혈관조영검사에서 약물코팅 풍선카테터 사용 그룹에서 스텐트 재협착 길이가 짧았다. 주요심장사건은 8.7%vs.10.0%, p=0.789, 사망발생률0%vs.0%,p=1.000, 심근경색 1.6%vs.6.7%, p=0.085, 표적병변 재개통술 8.7% vs. 10.0%, p=0.789 그리고 스텐트 혈전증 0% vs. 0%, p=1000에서 양군 간에 차이를 보이지 않았다. 약물코팅 풍선카테터가 약물방출 스텐트와 비교하여 2년 추적 검사 결과 주요심장사건에서 차이가 없었고, 약물코팅 풍선카테터는 스텐트 재협착 병변에서 약물방출 스텐트와 함께 선택할 수 있는 좋은 치료방법이라고 사료된다. Although the development of Drug-eluting stent (DES) improved the ISR significantly more than the Bare metal stent (BMS), the coronary stent restenosis (ISR) treatment still has a high recurrence rate. This study is compared the efficacy of DEB with that of DES implantation in patients with ISR. Among 4,316 patients who underwent coronary stent implantation at the Chonnam National University Hospital between November 2012 and December 2016, 187 patients developed ISR on follow-up coronary angiography (66.3 ± 11.0 years, 123 males) were enrolled and divided into two groups according to revascularization method as group I (DEB group; n= 127) and group II (DES group; n= 60). Primary end point was defined as major adverse cardiac events (MACEs), composite of cardiac death (CD), myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST) during two-year follow-up between the two groups. There were no differences in the baseline characteristics and angiographic findings except that prevalence of device length was shorter (21.1 ± 5.3 vs. 25.3 ± 9.6 mm, p<0.002) in group I.Two-year MACE were not different in the two groups (8.7%vs.10.0%, p=0.789). The incidences of cardiac death (0%vs.0%, p=1.000), MI (1.6%vs.6.7%, p=0.085), TLR(8.7% vs. 10.0%, p=0.789) and ST (0% vs. 0%, p=1000). DEB demonstrated comparable risk reduction for MACEs compared with DES in patients with ISR during two-year follow-up. DEB might be good alternative for the treatment of ISR in patients with ISR
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Floc 내로의 산소확산이 순산소활성슬러지 공정의 운전인자에 미치는 영향
최재환,김영진,김인수 ( Jae Hwan Choi,Young Jin Kim,In S . Kim ) 한국물환경학회 1997 한국물환경학회지 Vol.13 No.2
The effect of oxygen penetration into the microbial floc on the performance of activated sludge process was investigated. Two lab-scale completely mixed biological reactors maintaining dissolved oxygen (DO) concentrations at 2㎎/L and 10㎎/L were run under the same environmental conditions. For high DO level(10㎎/L), about 10% of additional reduced sludge production and slightly improved organic removal efficiency were observed compare to the low DO level(2㎎/L). In order to verify the difference of performance between the two completely mixed biological reactors, the diffusion model for oxygen transfer through bacterial floc was derived by adapting the concept that bacterial floc react as spherical porous catalyst. The data of oxygen uptake rate(SRT variation) used in the model was from the study of Clark et al (1971), and 100㎛ of floc diameter was assumed. The application of diffusion model. to the reactor operational data indicated that complete penetration of oxygen to the center of floc was occurred for the range of 1.0∼13day of SRT in the reactor of high DO level (10㎎/L). However, significant oxygen concentration drop was monitored according to SRT changes in the reactor of low DO level. In the case of low DO level, the concentration of active biomass calculated from the oxygen penetration model was lower than that of high DO level. In order to prove precisely the effect of D0 concentrations on the activated sludge process with diffusion model, it is recommended to measure the floc size and oxygen uptake rate in the future research.
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