이형성 협심증의 위험인자에 관한 연구

성인환 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

To determine the risk factors in variant angina, 62 patients with variant angina compared with 50 normal control subjects and 109 patients with fixed angina(over 75% stenosis). The results are as follows: l. The mean age is significantly(P<0.05) lower in variant angina group(53.3±9.7) than fixed angina group(60.6±10.3 years). 2. The proportion of male is significantly higher in variant angina group(85) than normal control group(42%). Only in male, the risk factors were compared with 53 patients with variant angina and 21 normal control subjects and 79 patients with fixed angina. 3. The smoking amount is significantly higher in variant angina group(29.6±13.5) than normal control group(19.4±12.5 pack. years). The proportion of obesity is significantly lower in variant angina group(3.7) than normal control group(28.9%). The age, serum lipid level (cholesterol, triglyceride and HDL) and the proportion of hypertension and diabetes mellitus are no significant differences beween variant angina and normal control group. 4. The mean age and the proportion of obesity and hypertension is significantly lower in variant angina group(53.4±9.7, 3.7, 24.5) than fixed angina group(59.8 ± 10.Oyears, 25.3%, 44.3%). The HDL level is significantly higher in variant angina group(50.3±12.3) than fixed angina group (35.7±12.3mg/dl). 5. The smoking amount is significantly higher in patients with variant angina than normal control group by multivariate logistic regression analysis. Thus we concluded that smoking is the most significant risk factor in variant angina.

관동맥스텐트(coronary stenting)의 재협착률

성인환 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The purpose of this study was to examine the long-term angiograghic restenosis rate after coronary stenting. We analized the results of coronary stenting in 30 patients admitted to Chungnam national university hospital between January 1996 and December 1997. The results were as follows; 1) 30 patients had angiography at 7.8months after coronary stenting after coronary stenting 2) Minimal luminal diameter inceased from 0.62±0.40mm at baseline to 3.00±0.46mm after coronary stenting. At follow-up there was a 1.07±0.76mm late luminal loss with a final minimal luminal diameter at 6months of 1.76±0.76mm. 3) Restenosis rate, defined as >50%diameter stenosis at follow-up, was 26.7% 4) The smaller minimal luminal diameter after stenting was strong predictor of restenosis after coronary stent implantation. I conclude that the restenosis rate after coronary stenting is low.

경피적 승모판막 성형술 전후 측정방법에 따른 승모판구 면적

성인환,이종구,박종훈 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

To assess mitral valve area(MVA) before and after percutaneous mitral ballon valvuloplasty (PMV), MVA was calculated by 2-D and Doppler (pressure half time) echocardiography before and 1 day after PMV. Also the catheterization derived MVA was calculated by modified Gorlin's fomula before and immediately after PMV. Among a total of 63 patients performed successful PMV, 29 patients were female and 24 patients were male. The age of the patients were between 21 and 68 years with the mean age of 42±12 years. On the EKG 34 patients showed a sinus rhythm 29 patients showed an atrial fibrillation. PMV was performed using Inoue balloon in 31 patients and double balloon in 32 patients with mitral stenosis. After PMV MVA by Gorlins formula, 2-D and Doppler echocardiography was increased from 0.84±0.22㎠ to 1.86±0.47, 1.86±0.31 and 1.76±0.34㎠, respectively (p<0.01). Before PMV MVA determined by the Gorlin's formula correlated closely with MVA by 2D and Doppler echocardiography (r=0.66 and r=0.69 respectively). However, after PMV MVA determined by the Gorlin's formula did not correlate well with MVA by 2-D and Dopper echocardiography (r=0.32 and r=0.41) However, after PMV MVA determined by the Gorlin's formula did not correlate well with MVA by 2-D and Doppler echocardiography (r=0.32 and r=0.41 respectively). Then Correlation between the 2-D planimeteral MVA and doppler derived MVA was good (r=0.82) After PMV the discrepancy of correlation may be bue to lack of simultaneous meusurements of MVA by echocardiogrphy and catheterization. Immediately after PMV the dramatic hemodynamic changes by have a disturbing effect of MVA measurement by Gorlin's formula. In conclusion, 2-D and Doppler echocardiography was non-invasive and effective method for assessment of MVA before and after PMV.

허혈성 심질환의 약물요법

성인환 대한가정의학회 1998 Korean Journal of Family Medicine Vol.19 No.5

관동맥성형술 및 스텐트 삽입술 후 재협착이 있는 환자에서 혈중 클라미디아 항체의 의의

성인환,전은석,최성준 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.4

Doppler 심초음파도로 진단된 급성심근경색후의 심실중격결손증 2예

성인환,전은석,박종훈 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

Ventricular septal defect (VDS) has been reconized as a lethal complication of acute mycocardial infaction, and has been diagnosed ventriculography, but these methods are sometimes impossible because of partient's status. Doppler echocardiography has been used as a noninvasive method for detection of ventricular septal defect after acute myocardial infarction. We experienced two cases with ventriculr septal defect following acute myocardial infarction detected by two dimensional and Doppler echocardiography.

에탄올이 위배출시간에 미치는 영향(抄)

성인환,윤세진,노흥국,이복희 임상약학사 1991 臨床藥學 Vol.11 No.2

경피적 경혈관 관상동맥 확장술의 초기결과 및 재협착

성인환 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

To evaluate the success rate, complication and restenosis rate of percutaneous transluminal coronary angioplasty (PTCA), we analized the result of PTCA for 153 lesions in 109 patients admitted to TaeJeon Eul Ji hospital between March 1993 and December 1994. The results were as follows ; 1) The PTCA was successful in 147 of 153 lesions, the success rate was 96%. The success rate was significantly higher in subgroups with type A (98%) than type B lesion (87%). 2) The PTCA was failed in 6 of 153 lesions (4%). The causes of PTCA failure included guidewire passage failure in 4, balloon passage failure in 1 and acute closure in 1 lesion. 3) The PTCA complications were death in 1 (0.9%), acute myocardial infarction in 1, ventricular tarchycardia in 2, cardiac tamponade in 1 and bleeding in 2 patients. 4) The follow up coronary angiography was performed in 83 of 153 (54%) for a mean follow up duration 7.1 months. The restenosis was observed 37 of 83 lesions, the restenosis rate was 45%. The angiographically restenosis rate was significantly higher in subgroup with over 60 years old (60%), male (50%), diabetes (67%), type B leion (59%), and over 10% residual stenosis (57%). I conclude that the PTCA is an effective and safe revascularization therapy that has a high success rate and low incidence of complications in selected patients with the coronary artery disease. The limitation of PTCA is the restenosis, so I should make a study of reducing the restenosis after PTCA.

Prostacyclin synthase 유전자의 C1117A 다형성과 이형협심증과의 관련성

성인환,임대승,김정희,이재환,최시완,정진옥 대한내과학회 2004 대한내과학회지 Vol.66 No.4

목적 : Thromboxan A2의 혀관수축반응을 저해하는 prostacylin synthase exon 8 C117A의 변이가 관동맥 연축과 관련성이 있는지를 알아보고자 하였다. 방법 : 1998년 1월 1일부터 2000년 12월 31일까지 충남대학교병원 순환기내과에서 관동맥조형술과정맥내 에르고노빈 유발검사를 시행하여 관동맥 연축이 확진된 이형협심증 환자군(45예)과 정상 대조군(59예)을 대상으로 중합효소 연쇄반응법 및 restriction fragment length polymorphism을 이용하여 분석하였다. 결과 : Prostacyclin synthase exon 8 C117A 유전자형의 빈도는 대조군에서 A/A : A/C : C/C =3.4% : 30.5% : 66.1%, 이형협심증 환자군에서 A/A : A/C : C/C = 8.9% : 42.4% : 48.9%로 두 군간에 유의한 차이가 없었다. 대조군에 비해 변이형 협심증 환자군에서 남자의 비율과 흡연률이 높았지만, prostacyclin synthase exon 8 C117A 유전자형에 따른 군에서 당뇨병, 고혈압, 흡연, 고지혈증, 비만 등의 유의한 차이는 없었다. 결론 : 한국인에서 prostacyclin synthase exon 8 C117A 유전자 다형성과 관동맥 연축이 있는 이형협심증과의 유의한 연관성은 발견할 수 없었다. Backround : Coronary artery spasm plays an important role in the pathogenesis of variant angina(VA). Prostacyclin is one of the endothelium derived relaxing factors. The association between the novel single nucleotide polymorphism in the prostacyclin synthase gene and VA is not known. Therefore, we investigated the association between VA and the polymorphysm in the prostacyclin synthase gene. Methods : We compared 45 variant angina patients who had positive intravenous ergonovine test by coronary angiography with 59 control subjects who had negative intravenouis ergonovine test and normal coronary angiogram. Using the polymerase chain reaction-single-strand conformation polymorphism analysis, we identified a single nucleotide polymorphism, C117A, in exon 8. This nucleotide change did not cause an amino acid change in codon 373. Results : There was no significant difference in characteristics between the control group and the VA group, and there was no significant difference in the genotype distributions between the control group and the VA group. Conclusion : The C117A polymorphism in exon 8 of the prostacyclin synthase gene is not associated with variant angina.

인슐린비의존형 당뇨병에 합병된 관상동맥질환의 임상소견과 관상동맥 조영 소견에 대한 고찰

성인환,전은석,김영건,송민호,노흥규,구본정,안봉수,정진옥 대한당뇨병학회 1997 Diabetes and Metabolism Journal Vol.21 No.3