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2021 대한부정맥학회 심방세동 전극도자 및 수술적 절제술 지침
임우현,심재민,이지현,정보영 대한내과학회 2022 대한내과학회지 Vol.97 No.1
Rhythm control therapy is used in atrial fibrillation (AF) management to improve AF-related symptoms along with rate control. AF catheter ablation is effective in maintaining sinus rhythm and has an acceptable complication rate. Compared with antiarrhythmic drugs, AF catheter ablation is superior with respect to arrhythmia-free survival and improvement in the quality of life. Therefore, AF ablation is recommended for rhythm control after the failure of antiarrhythmic drugs and is sometimes considered a first-line therapy for AF patients. Radiofrequency and cryoballoon ablation show similar efficacy, with slightly different complication profiles. Surgery for AF is also an effective rhythm control therapy and should be considered in patients undergoing cardiac surgery or in those with failed catheter ablation. For patients undergoing AF catheter ablation, performing ablation under uninterrupted warfarin or non-vitamin K oral anticoagulant treatment is recommended for periprocedural stroke risk management. Here, we review existing data and discuss the general principles of AF catheter and surgical ablation in patients with AF.
임우현,김상현,김학령,김기환,나상훈,이현정,강은규,서재빈,정우영,조주희,홍정애,김광연,김명아 한국심초음파학회 2015 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.23 No.4
A 68-year-old woman visited the emergency department twice with symptoms of acute heart failure including shortness of breath, general weakness, and abdominal distension. Laboratory findings showed extremely low level of serum hemoglobin at 1.4 g/dL. Echocardiographic examination demonstrated dilated left ventricular cavity with systolic dysfunction and moderate amount of pericardial effusion. In this patient, acute heart failure due to severe iron deficiency anemia was caused by inappropriate habitual bloodletting.
임우현,박동호,김동선 해양환경안전학회 2013 해양환경안전학회 학술발표대회 논문집 Vol.2013 No.11
수치모델을 이용하여 한국 동해 용승역의 유동특성에 대해 연구하였다. 용승을 일으키는 주요 인자인 바람, 해류 등을 파악하여 동해 연안역의 시·공간적인 분포와 용승유량을 정량적으로 산정한다. 연구해역인 동해에서 대·소기의 조류는 흐름의 크기가 차이가 났으나 창조류 시 남향하고 낙조류 시 북향하는 흐름을 보였다. 취송류는 연안을 따라 북향하는 흐름을 보이며 표층에서는 외해로 발산하고 저층에서는 연안으로 보상하는 흐름을 나타낸다. 취송류에 의한 용승발생분포는 평균 0.1cm/s정도의 상승류가 동해 전 연안에 걸쳐 넓게 분포하며 표층에서 강하고 저층으로 갈수록 좁게 분포하는 경향을 보였다. 상승류의 최대 유속은 약 1.4cm/s 정도로 영덕, 후포, 구룡포 그리고 기장의 연안에서 나타났다. 또한 본 연구에서는 용승해역에서 용승유량을 정량적으로 산정하여 밝혀낸다.
요양보호사의 직업적 정체성이 이직의도에미치는 영향에 관한 연구 -직무만족의 매개효과-
임우현,이창호,박만원 한국노인복지학회 2013 노인복지연구 Vol.0 No.60
The purpose of this study was to find out how to reduce turnover intention by enhancing occupational identity and job satisfaction through examining the relationship between the occupational identity and the turnover intention through the mediation effect of job satisfaction of case managers in nursing homes. We surveyed 271 case managers in the Gyeong Buk province of south korea. There is positive correlation between occupational identity and job satisfaction while there is negative correlation between occupational identity and turnover intention. Occupational identity of case managers influenced job satisfaction and turnover intention directly. This study proved that job satisfaction has a mediation effect between occupational identity and turnover intention. We suggested educational support, improvement of work environment and Considering the job and organizational environment, provide compensation system for case managers. Promotion of the local community is also critical for case managers. 본 연구는 요양보호사의 직업적 정체성과 이직의도 간의 인과관계와 두 변인 사이에서 직무만족의 매개효과를 살펴봄으로써 직업적 정체성, 직무만족의 강화를 통해 이직의도를 낮출 수 있는 방안을 강구하는데 그 목적이 있다. 이를 위해 경북지역 271명의 요양보호사를 대상으로 설문조사를 하였으며 조사결과를 바탕으로 직업적 정체성과 직무만족과 이직의도와의 관계를 살펴본 결과 직업적 정체성과 직무만족은 정(+)적 상관, 이직의도와는 부(-)적 상관관계가 있는 것으로 나타났다. 또한, 요양보호사의 직업적 정체성이 직무만족과 이직의도에 직접적인 영향을 주었으며 직무만족은 직업적 정체성과 이직의도에 매개효과가 있음이 통계적으로 확인되었다. 이를 바탕으로 요양보호사의 직업적 정체성과 직무만족 강화를 통해 이직의도를 낮출 수 있는 개선방안으로 교육의 지원, 직무 및 조직환경을 고려한 보상체계 마련, 요양보호사의 사회적 역할 및 기능에 대한 지역사회홍보가 필요함을 제안하였다.
임우현,김경희,손대원,황성욱,강시혁,전기현,김형관,조익성 한국심초음파학회 2009 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.17 No.3
In this case report, we describe a 71-year-old woman with right conal coronary artery-to-pulmonary trunk fistula. She visited the outpatient clinic of the nephrology department for long-term management of renal dysfunction. On transthoracic echocardiography (TTE) conducted as a part of cardiac evaluation, an abnormal Doppler color flow taking a course toward echocardiographic probe was incidentally detected outside the main pulmonary trunk, giving an impression of congenital coronary arteriovenous (AV) fistula. Computed tomography coronary angiography confirmed the presence of congenital coronary AV fistula from a conal branch of the right coronary artery to the main pulmonary trunk in the form of a ground cherry. Although the direction of Doppler color flow is not usual (i.e. toward, not away from, echocardiographic probe) in this case, congenital coronary AV fistula should be in the first priority among potential diagnoses when an abnormal Doppler color flow was found near the main pulmonary trunk on TTE.
2018 대한부정맥학회 심방세동 환자의 심박수 조절 지침
임우현,최의근,정보영,최기준 대한내과학회 2018 대한내과학회지 Vol.93 No.2
Atrial fibrillation (AF) is characterized by irregular and relatively rapid heart rate, which occasionally causes symptoms such as palpitations, dyspnea, or reduced exercise capacity. Controlling the ventricular rate is a mainstay for the symptom management of patients with AF. Rate control can be achieved with beta-blockers, non-dihydropyridine calcium channel blockers, digoxin, or combination therapy. Rhythm control is an option for patients in whom appropriate rate control cannot be achieved or who have persistent symptoms despite rate control. The choices of drug and target heart rate are usually specified by international guidelines for AF management. However, pivotal trials included in those guidelines enrolled only a small number of Asian subjects, which limit application of those guidelines to a Korean population. The Korean Heart Rhythm Society organized the Korean AF Management Guideline Committee and analyzed all available studies regarding management of AF including studies with Korean patients. Then, expert consensus or guidelines for optimal management in Korean patients with AF were achieved after systematic review with intensive discussion. This article provides general principles for rate control therapy in Korean patients with AF.