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민윤주,Young Hwan Choi,Cheol Won Hyeon,Jun Hwan Cho,Kyung Joon Kim,Jee Eun Kwon,김은영,이왕수,이광제,김상욱,김태호,김치정 대한심장학회 2012 Korean Circulation Journal Vol.42 No.11
Background and Objectives: The effects of fenofibrate on C-reactive protein (CRP) are under debate. We investigated the effect of fenofibrate on CRP levels and the variables determining changes. Subjects and Methods: This case-control study enrolled 280 hypertriglyceridemic patients who were managed either with 200 mg of fenofibrate (Fenofibrate group, n=140) or with standard treatment (comparison group, n=140). CRP levels were measured before and after management for 2 months. Results: CRP levels decreased in both the fenofibrate (p=0.003) and comparison (p=0.048) groups. Changes in CRP levels were not significantly different between the two groups (p=0.27) and were negatively associated with baseline CRP levels (r=-0.47, p<0.001). In patients with a baseline CRP level ≥1 mg/L, CRP levels also decreased in both groups (p=0.000 and p=0.001 respectively), however, more in the fenofibrate group than in the comparison group (p=0.025). The reduction of CRP was associated with higher baseline CRP levels (r=-0.29,p=0.001), lower body mass index (BMI, r=0.23, p=0.007), and fenofibrate therapy (r=0.19, p=0.025). CRP levels decreased more in the fenofibrate group than in the comparison group in patients with a BMI ≤26 kg/m2 with borderline significance (-1.21±1.82 mg/L vs. -0.89±1.92 mg/L, p=0.097). In patients with a high density lipoprotein-cholesterol level <40 mg/dL, CRP levels were reduced only in the fenofibrate group (p=0.006). Conclusion: Fenofibrate reduced CRP levels in hypertriglyceridemic patients with high CRP and/or low high density lipoprotein-cholesterol levels and without severe overweight. This finding suggests that fenofibrate may have an anti-inflammatory effect in selected patients.
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고혈압성 관상 동맥 질환 환자에서 상완-발목 맥파 전달 속도(BRACHIAL-ANKLE PULSE WAVE VELOCITY)와 좌심실 이완 기능과의 관계
민윤주,권지은,오민석,이왕수,이광제,김상욱,김태호,김치정,류왕성 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
연구배경 및 목적: 맥파 전달 속도(pulse wave velocity)는 동맥의 경화도를 나타내는 지표이다. 조직 도플러 에서 승모판 초기 유입혈류의 최고속도와 초기 확장기 승모판륜 속도의 비율(E/E`)은 좌심실 충만압의 증가와 좌심실 이완 기능에 가장 정확하고 비침습적인 지표로 보고되고 있다. 하지만 맥파 전달 속도와 좌심실 이완 기능의 연관성에 대하여는 명확하게 연구되지 않았다. 본 연구에서는 고혈압성 관상 동맥질환 환자에서 상완-발목 맥파 전달 속도와 E/E`의 상관관계를 조사하였다 대상 및 방법: 중앙대학교 병원에 내원한 고혈압과 관상 동맥 잘환이 있는 112명의 환자(mean age 66±8 years, 61.6% men)에서 도플러 심초음파로 E/E`을 측정 후 7일 이내에 상완 - 발목 맥파 전달 속도를측정하였다 결과: 평균 상완-발목 맥파 전달 속도는 1841± 410 cm/s이고 평균 E/E’는 14.8±5.9이었고 E/E` 은 상완-발목 맥파 전달 속도와의미 있는 연관 관계를 보였다. (r=0.23, p=0.016). 112명의 환자 중, 10명은 낮은 E/E` (< 9)을 보였고 56명은 중등도의 E/E` (9 to 15)을, 46명은 높은 E/E` (> 15)를 보였다. 이 세 군을 비교했을 때 평균 연령과 성별, 체질량지수, 콜레스테롤, 당뇨병의 유무, 흡연 여부에 대한 유의한차이는 관찰되지 않았으나 평균 상완-발목 맥파 전달 속도는 E/E`의 증가에 따라 순차적으로 증가했다. (1707±270 cm/s vs 1756±377 cm/svs 1974±441 cm/s, respectively; p=0.014). 결론: 결과적으로 E/E`의 점진적인 증가는 상완-발목 맥파 전달 속도의 증가와 연관되어 있다. 동맥의 경화도를 나타내는 상완-발목 맥파 전달 속도는 고혈압성 관상동맥 질환을 가진 환자에서 좌심실 충만압과 이완 기능의 예후인자이다.
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오민석,민윤주,권지은,조은정,김정은,이왕수,이광제,김상욱,김태호,김치정,류왕성 대한심장학회 2011 Korean Circulation Journal Vol.41 No.5
Background and Objectives: Ezetimibe alone does not decrease C-reactive protein (CRP) levels in hypercholesterolemic patients. However, several reports have suggested that ezetimibe might potentiate the effect of statin not only on cholesterol but also on CRP when administered together. We investigated the effect of ezetimibe on CRP levels in patients taking statins. Subjects and Methods: Patients who had not achieved recommended low density lipoprotein-cholesterol (LDL-C) goals with statin therapy were divided into two groups, the ezetimibe group (n=60) and the control group (n=60). A third group of hypercholesterolemic patients without statin therapy was treated with statin (n=59). Patients with CRP level 10 mg/L were excluded. Lipid and CRP levels were measured before therapy commenced, and after 2 months of therapy. Results: Ezetimibe decreased cholesterol and LDL-C levels by 20.2% (p=0.000) and 28.1% (p=0.000) respectively. However, ezetimibe did not reduce CRP levels (from 0.83±0.68 to 1.14±1.21 mg/dL, p=0.11). CRP levels remained unchanged in the control group (p= 0.42). In contrast, statin lowered CRP levels (from 0.82±0.73 to 0.65±0.57 mg/dL, p=0.008). In patients taking statins, changes in CRP levels were not associated with changes in LDL-C (r=-0.02, p=0.87), but with baseline CRP levels (r=-0.38, p=0.000). Conclusion: Ezetimibe failed to reduce CRP levels in hypercholesterolemic patients taking statins despite significant reduction of LDL-C. This finding suggests that the anti-inflammatory effect of statin may not be secondary to cholesterol reduction, but via other mechanisms.
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Subarachnoid Hemorrhage Mimicking Leakage of Contrast Media After Coronary Angiography
오민석,권지은,김경준,조준한,민윤주,변준수,김경태,김상욱,김태호 대한심장학회 2012 Korean Circulation Journal Vol.42 No.3
We report a patient who developed subarachnoid hemorrhage (SAH) just after coronary angiography (CAG) with non-ionic contrast media (CM) and minimal dose of heparin. The 55-year-old man had a history of acute ST elevation myocardial infarction that had been treated with primary percutaneous coronary intervention and was admitted for a follow-up CAG. The CAG was performed by the transradial approach,using 1000 U of unfractionated heparin for the luminal coating and 70 mL of iodixanol. At the end of CAG, he complained of nausea and rapidly became stuporous. Brain CT showed a diffusely increased Hounsfield unit (HU) in the cisternal space, similar to leakage of CM. The maximal HU was 65 in the cisternal space. No vascular malformations were detected on cerebral angiography. The patient partially recovered his mental status and motor weakness after 2 days. Two weeks later, subacute SAH was evident on magnetic resonance imaging. The patient was discharged after 28 days.
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Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a Healthy Population
도재혁,최유신,서석원,이승은,오형철,민윤주,강현 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.6
Purpose: To determine the prevalence of and investigate the risk factors for gallbladder (GB) polypoid lesions in a healthy population. Materials and Methods: A total of 23827 subjects who underwent abdominal ultrasonography in conjunction with health screeningexaminations were retrospectively analyzed. The prevalence of risk factors for GB polypoid lesions were evaluated. In addition, risk factors according to the number of polypoid lesions and the presence of stones with polypoid lesions were investigated. To analyze these risk factors, a control group was established with a 1:2 ratio matched for age and sex. Results: The prevalence of GB polypoid lesions was identified as 9.96%. On multivariate analysis, chronic hepatitis B infection (CHB) and the presence of metabolic syndrome (MS) were risk factors for GB polypoid lesions. CHB and MS were also significant independent risk factors for multiple GB polypoid lesions when compared with solitary GB polypoid lesions. In addition, gastric Helicobacter pylori infection and MS were significant risk factors for GB polypoid lesions with stones when compared with GB polypoid lesions without stones. Conclusion: The prevalence of GB polypoid lesions in a healthy Korean population was 9.96%. Patients with CHB and MS need to be carefully examined for such lesions.
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