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관상동맥 스텐트 삽입술 후 Ultegra rapid platelet function Assay-ASA을 이용한 Aspirin 저항성의 임상적 의의
임지혜 ( Ji Hye Yim ),박성욱 ( Seong Wook Park ),이승환 ( Seung Whan Lee ),최형오 ( Hyung Oh Choi ),이필형 ( Pil Hyung Lee ),선병주 ( Byung Joo Sun ),박덕우 ( Duk Woo Park ),김영학 ( Young Hak Kim ),이철환 ( Cheol Whan Lee ),홍명 대한내과학회 2009 대한내과학회지 Vol.76 No.6
목적: 이전 연구에서 aspirin 저항성은 심근경색, 뇌경색, 경피적 관상동맥 스텐트 삽입술 후 심근괴사 등과 관련 있다고 보고된 바 있다. 그러나 경피적 관상동맥 스텐트 삽입술이 시행된 환자에서 aspirin저항성과 그 임상적 경과에 대해서는 잘 알려져 있지 않다. 방법: 경피적 관상동맥 중재술을 시행받고 항혈소판제재를 복용한 419명을 대상으로 하였다. 100 mg 또는 200 mg aspirin을 복용 중이었으며 스텐트 삽입술 후 48시간에 aspirin 저항성을 RPFA-ASA를 사용해 측정하여 ARU≥550을 기준으로 aspirin 저항성을 판단하였다. 스텐트 삽입 후 9개월간의 임상경과를 관찰하였다. 결과: 전체 aspirin 저항성은 33명(7.9%)이었으며, aspirin 저항성군(n=33)에서 aspirin 감수성군(n=386)에 비해 aspirin용량은 더 적었다(118.18±39.2 mg vs. 147.93±50.0 mg, p=0.001). 양 군 간에 스텐트 삽입술 후 심근괴사의 발생 빈도 역시 통계학적으로 유의한 차이는 없었다(p=0.938). 다변량 분석에서 aspirin 용량(odds ratio 4.714; 95% CI 1.865~11.914, p=0.001), 연령(odds ratio 1.048; 95% CI 1.005~0.092, p=0.029), 혈소판수(odds ratio 1.007; 95% CI 1.001~1.014, p=0.011), 고지혈증(odds ratio 2.937; 95% CI 1.310~6.583, p=0.009)이 aspirin 저항성에 기여함을 알 수 있었다. 스텐트 삽입술 후 9개월간의 외래 경과관찰 기간 중 스텐트 혈전증과 사망은 발생하지 않았으며 심근경색증은 aspirin 감수성군에서 1명 발생하였다. 결론: 관동맥 스텐트 삽입술 후 aspirin 저항성은 사용하는 aspirin 용량, 나이, 혈소판수, 고지혈증과 관계있으며, 시술 후 9개월 경과관찰 중 aspirin 저항성에 따른 임상경과에 차이는 없었다. Background/Aims: Aspirin resistance is reported to be associated with myocardial infarction, stroke, and myonecrosis after percutaneous coronary intervention. However, aspirin resistance and its clinical implications in patients undergoing drug-eluting stent (DES) implantation have not been evaluated sufficiently. Methods: The study enrolled 419 consecutive patients who underwent DES implantation. All of the patients took aspirin 100 mg (228 patients, 54.4%) or 200 mg (191 patients, 45.6%). Aspirin resistance was measured using the Ultegra Rapid Platelet Function Assay-ASA (Accumetrics, San Diego, CA, USA). The results were expressed as aspirin reaction units (ARU). Aspirin resistance was defined as ARU≥550. We followed all patients for 9 months. Results: Aspirin resistance was found in 33 patients (33/419, 7.9%). The aspirin dose (118.18±39.2 vs. 147.93±50.0 mg, p=0.011) was lower in the aspirin-resistant (n=33) versus the aspirin-sensitive (n=386) group. There was no significant difference in the occurrence of myocardial necrosis (15.6% vs. 15.5%, p=0.988). On multivariate analysis, low-dose aspirin (odds ratio (OR) 4.714; 95% confidence interval (CI) 1.865-11.914; p=0.001), age (OR 1.048; 95% CI 1.005-0.092, p=0.029), platelet count (OR 1.007; 95% CI 1.001-1.014, p=0.011), and hypercholesterolemia (OR 2.937; 95% CI 1.310-6.583, p=0.009) were independent predictors of aspirin resistance. Over the 9 months, no stent thrombosis or death occurred; one acute myocardial infarction occurred in the aspirin-sensitive group. Conclusions: Low-dose aspirin, old age, a higher platelet count, and hypercholesterolemia were associated with a high incidence of aspirin resistance in patients who underwent DES implantation. However, no significant differences in clinical outcome were found between the aspirin-resistant and -sensitive groups during a 9-month follow-up. (Korean J Med 76:685-691, 2009)
풍속이 사과나무의 광합성 특성과 수액이동 및 엽손상에 미치는 영향
임지혜 ( Ji Hye Yim ),최영민 ( Young Min Choi ),최동근 ( Dong Geun Choi ) 한국농림기상학회 2014 한국농림기상학회지 Vol.16 No.2
This study was carried out to determine the effects of wind speed on physiological responses in ‘Fuji’ apple (Malus pumila Miller). Two levels of wind blowing (3 and 5 m·s-1) were produced by large electric fans. Photosynthetic rate was reduced by one-way wind blowing treatment at 5 m·s-1, compared to the mild wind control, and this reduction was more obvious with stronger wind and increasing duration of wind application. The reduction in photosynthesis by the wind treatments was correlated with that in the proportion of opened stomates and stomatal conductance. The one-way wind treatment at 5 m·s-1 caused a leaf browning and leaf fall, and this negative effect became more serious with increasing time of exposure to the wind treatments. The sap flux through stem increased in all wind treatments compared to the natural mild wind.
갑상선여포암과 휘틀세포암에서 수술 전 세침흡인 세포검사 결과
김원구 ( Won Gu Kim ),임지혜 ( Ji Hye Yim ),김의영 ( Eui Young Kim ),김태용 ( Tae Yong Kim ),공경엽 ( Gyungyup Gong ),윤종호 ( Jong Ho Yoon ),홍석준 ( Suck Joon Hong ),김원배 ( Won Bae Kim ),송영기 ( Young Kee Shong ) 대한갑상선학회 2010 International Journal of Thyroidology Vol.3 No.2
Background and Objectives: Follicular thyroid carcinoma (FTC) and hurthle cell carcinoma (HCC) are relatively uncommon in iodine sufficient area, and there were few reports about these tumors. This study aimed to evaluate the preoperative diagnosis of FTC and HCC in Korea. Materials and Methods: This retrospective study enrolled 208 patients with FTC and 46 patients with HCC who underwent initial thyroid surgery between 1995 and 2006 in Asan Medical Center, Seoul, Korea. Results: There was no significant difference between FTC and HCC in basal clinicopathological parameters, except age and lymphovascular invasion (LVI). Patients with HCC were older (p=0.008), and had more LVI (p=0.008). Preoperative fine needle aspiration cytology (FNAC) diagnoses of FTC patients were follicular neoplasm (FN) in 84 cases (40%), hurthle cell neoplasm (HN) in 4 cases (2%), other malignancy in 26 cases (13%), and benign or indeterminate results in 89 cases (43%). FNAC diagnosis of HCC patients were 21 cases (46%) of HN, 8 cases (17%) of FN, 6 cases (13%) of other malignancy, and 11 (24%) cases of benign or indeterminate results. Conclusion: The results of FNAC were somewhat helpful for decision of thyroidectomy for the patients suspected FTC and HCC. However, clinical suspicion is also important for diagnosis of FTC and HCC even if the FANC results of nodules were benign or indeterminate.