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노영무 ( Young Moo Ro ) 대한내과학회 1971 대한내과학회지 Vol.14 No.1
Although the cerebrovascular accidents is the leading cause of death in Korea, there are still few reports on epidemiology and clinical study of the cerebrovascular accidents. Author reviewed 662 cases of the cerebrovascular accidents who were treated at W
급성심근경색증에서 정맥내 투여 Urokinase 의 혈전용해 효과
노영무(Young Moo Ro),오동주(Dong Joo Oh),심완주(Wan Joo Shim),최석주(Suck Joo Choi),송관규(Gwan Gyu Song),박창규(Chang Kyu Park),유승관(Seung Kwan Ryu),서순규(Soon Kyu Suh) 대한내과학회 1988 대한내과학회지 Vol.34 No.2
N/A To evaluate the thrombolyutic efficacy and safety of Urokinase (UK), an intravenous (IV) bolus of 20,000 units/kg was administered in 15 patients with acute evolving transmural myocardial infarction 6.15(2.5~8.0) hours after the onset of symptoms. Recognition of myocardial reperfusion was based upon the reperfusion scores according to the following indirect clinical criteria; rapid relief of chest pain, rapid resolution of ST segment elevation (∑ST reduction by ? 70%within 90 minutes), ischemic arrhythmia or A-V block and CK wash-out phenomenone, Signs of reperfusion began to occur 30 to 90 minutes after the IV bolus of UK. Of the 15 patients, 8(53.3%) had one or more of the signs of reperfusion and 6 (40%) had reperfusion scores of ?4, which indicates definite reperfusion according to the indirect reperfusion scoring system we employed. Those who received UK within 6 hours after the onset of chest pain, reperfusion was achieved in 71.4% (5 of 7 patients). Transient gum bleeding was the only side effect, which was seen in 1 patient (6.7%). These findings suggest that IV bolus of 20,000 units/ kg UK within 6 hours after the onset of chest pain is an effective and safe method to achieve reperfusion in patients with acute transural myocardial infarction. Since there was no significant complication on 20,000 units/kg of UK, higher dose than 20,000 units/kg can be used to improve reperfusion in acute evolving myocardiaI infarction,
한국인에서 심바스타틴의 효과와 부작용 분석을 위한 다기관 공동 임상 연구
박영배 ( Young-Bae Park ),서정돈 ( Jung-Don Seo ),배종화 ( Jong-Hwa Bae ),노영무 ( Young-Moo Rho ),이원로 ( Won-Ro Lee ),손민수 ( Min Soo Son ),채성철 ( Shung-Chull Chae ),김권삼 ( Kwon-Sam Kim ),김권배 ( Kwon Bae Kim ),안정천 ( J 대한내과학회 1999 대한내과학회지 Vol.57 No.5
The aim of this study was to investigate the efficacy of simvastatin to improved lipid profiles in hypercholesterolemic Korean patients. Methods : From 25 hospitals in Korea, 478 hypercholesterolemic patients were enrolled from November 1996 to April 1998. The inclusion criteria was hypercholesterolemia over 240 mg/dl after diet therapy for 1 month or hypercholesterolemia over 220 mg/dl in patients with definite evidence of ischemic heart disease. Simvastatin 10mg was started and doubled up to 40mg if total cholesterol level remained higher than 200 mg/dl at monthly check. Of 478 subjects, 344 patients in whom study protocol was not violated were analyzed. Results : Male to female ratio was 27:73 and 47% of the subjects were in 6th decade. Hypertension, coronary artery disease, and diabetes mellitus were present in 30, 10, and 4% of the subjects. Baseline lipid profile (mean of total cholesterol-LDL-HDL-triglyceride mg/dl) was 274-185-52-188. The dose of simvastatin for 3 months was 10/10/10mg in 61% of subjects, 10/20/20mg in 21%, 10/10/20mg in 7%, and 10/20/40mg in 12%. The change of total cholesterol level(before-4wk-8wk-12wk-withdrawal 4wk) was 274-209- 205-198-250, and the maximal reduction rate was 27%. The change of LDL-cholesterol was 185-123-116-110-159, with maximal reduction rate 39%. The change of HDL-cholesterol was 52-54-56-55-54, with maximal increase rate 9%. The change of tryglyceride was 188-161- 164-162-189, with maximal reduction rate 15%. The value before/after treatment of ApoA1, ApoB, and Lp(a) was 129/129, 138/83, and 9.3/10.7, respectively. The level of LDL-cholesterol at the end of treatment was below 100mg/dl in 36% of subjects, 100-130 in 45%, 130-160 in 16%, and over 160mg/dl in 4%. The reduction rate of LDL-cholesterol was different between subjects whose LDL decreased below 100 and those whose LDL did not decrease below 130mg/dl, which suggests the existence of the individual difference of responsiveness to simvastatin. There were only 3 subjects (0.9%) who showed increase of liver enzyme over 3 times as the upper normal limit. Conclusion: Simvastatin is effective in improving lipid profiles in hypercholesterolemic Korean patients without serious side effects. (Korean. J. Med 57:906-915, 1999)
ST - 분절의 하강에 R - 파고의 변화를 추가한 운동부하 심전도 검사의 관상동맥 질환에 대한 진단적 가치
박성미(Seong Mi Park),노영무(Young Moo Ro),정성원(Seong Won Jeong),신정호(Jeong Ho Shin),김진석(Jin Seok Kim),이호준(Ho Joon Lee),송우혁(Woo Hyuk Song),박창규(Chang Kyu Park),김영훈(Young Hoon Kim),서홍석(Hong Seog Seo),심완주(Wan Jo 대한내과학회 2002 대한내과학회지 Vol.62 No.2
N/A Background: Exercise electrocardiogram is the most widely used non-invasive test in those patients suspected of having coronary artery disease. However, sensitivity and specificity of this test are not satisfactory, especially when the exercise induced ST-segment depression is used as a single criterion of myocardial ischemia. Although many investigators have tried to improve diagnostic accuracy with R-wave amplitude change in addition to ST-segment depression, controversy exists whether this new criteria improve the test accuracy for coronary artery disease or not. The purpose of this study is to determine the test accuracy of R-wave amplitude change induced by exercise combined with the conventional ST-segment criterion for myocardial ischemia. Methods: We reviewed our records of patients who visited to Korea University Anam Hospital with chest pain from January, 1998 to July, 1999. We included 130 patients with chest pain who had a tredmill test followed by a coronary angiography within 2 months. Patients with change in ST-segment depression (ΔSTD)≥1.00 mm and ΔSTD≥1.00 mm with R wave amplitude decrease (-ΔR)≥1.00 mm in the same lead in any of 12 leads and ΔSTD≥1.00 mm with R wave amplitude increase (+ΔR)≥1.00 mm in the same lead in any of 12 leads were compared. According to the findings of coronary angiograms, patients were divided into 4 groups ; normal coronary artery group, mild coronary artery stenosis group (≥30% to <50%), moderate coronary artery stenosis group (≥50% to <70%), severe coronary artery stenosis group (≥70%). Results: Fifty three patients (40.7%) had normal coronary angiograms and 77 patients (59.3%) had coronary artery stenosis. There was no significant difference in gender and age. But, patients with coronary artery stenosis had more diabetes mellitus, hyperlipidemia, smoking, previous myocardial infarction history and angina during exercise testing than those without coronary artery stenosis. The sensitivity of exercise EKG is significantly decreased when combined withΔR (ΔSTD, 74.0%, ΔSTD with -ΔR, 45.5%, ΔSTD with +ΔR, 30.0%, p<0.01), but the The test accuracy is ΔSTD; 73.7%, ΔSTD with -ΔR; 61.5%, ΔSTD with +ΔR; 57.7%. Conclusion: When ST-segment depression is combined with R-wave amplitude change as a marker for myocardial ischemia, the specificity is increased, but the test accuracy of exercise EKG is not improved.(Korean J Med 62:165-170, 2002)
배양된 연골세포에서 각종 Cytokine과 성장인자가 β1-integrin 및 ICAM-1의 발현에 미치는 영향
송관규 ( Gwan Gyu Song ),노영무 ( Young Moo Ro ),유대현 ( Dae Hyu Yoo ),김성윤 ( Seong Yoon Kim ) 대한류마티스학회 1995 대한류마티스학회지 Vol.2 No.1
Objective: The cell-cell and cell-extracellular matrix interactions are critical to the embryogenesis, morphogenesis, maintenance of tissue integrity, and function of cells. This interactions are mediated by membrane glycoproteins called adhesion molecules. βl-integrins are heterodimeric transmembrane glycopro-teins which play critical roles in the ability of cells to elaborate and maintain extracellular matrix. ICAM-l is a sialylated glycoprotein and mediates various cell-cell interactions in immunity and inflammation. Articular cartilage consists of chondrocytes embedded in an extensive extracellular matirx. In normal tissue, the chondrocytes actively effect the stable equili-brium between the synthesis and degradation of matrix components, so that a constant concentration of these components is maintained. In osteoarthritis, the stable equilibrium is disrupted and the rate of loss of proteoglycan exceeds the rate of depositon of newly synthesized moleclues. This equilibrium is influenced by cytokines and growth factors such as IL-I, TNF-α, IGF-1 and TGF-β. Integrins and their ligands may mediate some of the interactions of chondrocytes and cellular matrix, and the cytokines and local growth factors may affect the expression of integrins on chondrocytes. ICAM-1 may mediate interactions with other cells in osteoarthritic joint, and also may be modulated by cytokines and growth factors. The effect of IL-I, TNF-α, IGF-1 and TGF-β in the expression of, β1-integrin (CD29) and ICAM-1(CD54) on chondrocytes was investigated. Methods: Cultured chondrocytes(3rd passages) from 2 osteoarthritc patient were used. Cells were incubated for 24hours with and without IL-1β 25U/ml, IL-l 50U/ml, TNF-α 1ng/ml, TNF-α 10ng/ml, IFN-γ 100U/ml, IGF-1 10ng/ml, IGF-1 50ng/ml, IGF-1 100ng/ml, TGF-β 10ng/ml, and TGF-β 30ng/ml. Chondrocytes were stained with monoclonal antibodies against, β1-integrin (CD29) and ICAM-1 (CD54), and positve cells were counted under the light microscpe. Results: 1) Cultured chondrocytes readily expressed, β1-integrin (82.9%). 2) β1-integrin was down-regulated by IL-1β(75.4%), TNF-α(61.2%), and TGF-β (77.0%), and was slightly up-regulated by IFN-γ(85.0%) and IGF-1 (88.9%). 3) ICAM-1 was presented in only 18.0% of cells. 4) Expression of ICAM-1 was readily up-regulated by IL-1β(84.0%) and TNF-α(80.3%), and mildly up-regulated by IFN-γ(33.0%), IGF-1(35.0%), and TGF-β(29.3%). Conclusions: The presence of, 81-integrin and ICAM-1 on chondrocytes and the modulation of their expression by cytokines and local growth factors suggest that they have important roles in the interaction of chondrocytes with cartilage matrix and with other cells of osteoarthritic joints. Their roles should be elucidated by further researches.