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우리 나라 말기심부전 환자에서 적출한 심장에서의 인형 거대세포 바이러스 감염의 빈도
최성준(Seong Choon Choe),김효수(Hyo Soo Kim),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),최현석(Hyun Seok Choi),김용진(Yong Jin Kim),손대원(Dae Won Sohn),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),이영우(Young 대한내과학회 1997 대한내과학회지 Vol.53 No.3
N/A Objective: In order to evaluate the prevalence of cytomegalovirus infection to terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. Methods: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts (N=5) and polymerase chain reactions(PCRs) were done for detection of late gene sequence coded pp150 phosphoprotein. The products were confirmed with electrophoresis on 1% agarose gel. In order to improve the sensitivity of detection in cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. Results : All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing hearts(3 cases/22, 13.5%) and normal hearts(1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/20, RV 5/22, HA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 1/5, RA 2/5). There was no significant change in the presence of cytomegaloviral DNA between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to nested PCR results. Conclusion: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. But cytomegalovirus might have no direct causal relationship in the development of terminal heart failure.
가족성 고콜레스테롤혈증에서 아포지단백 E 유전자 다형성의 빈도분포 및 관동맥질환과의 연관성
한기훈(Ki Hoon Han),최성준(Seong Choon Choe),김석연(Seok Yeon Kim),채인호(In Ho Chae),김효수(Hyo Soo Kim),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),이영우(Young Woo 대한내과학회 1998 대한내과학회지 Vol.55 No.6
N/A Objectives: Apolipoprotein E genetic polymorphism was screened in subjects with FH to determine the genetic effects of Apo E polymorphism on basal cholesterol levels, severity of coronary atherosclerosis and response to lipid lowering therapy using HMG CoA reductase inhibitor. Methods: Total C unrelated patients with FH(M:F=24:21, 48.0/11.5yr.) were included in this study. Apolipoprotein E genetic polymorphism was screened. Clinical parameters were checked. Change of lipid profile to lovastatin; 20mg/d(n=19), 4)mg/d(n=12), and of Achilles tendon thickness were analysed. Results: 1) Genotype frequencies of E2/3, 3/3, 4/3 were 8.9, 60.0, 31.1% respectively, and allele frequencies of ε 2, ε 3, and ε 4 were 0.044, 0.800, and 0.155 respectively. 2) Presence and degree of coronary atherosclerosis, the thickness of Achilles tendon and lipid levels were not significantly different by apolipoprotein E genotype, 3) On multivariate study, age, triglyceride and cholesterol /high density lipoprotein were significantly related to presence of coroanry atherosclerosis. 4) Percent reduction of LDL-cholesterol by lovastatin was significantly low in subjects having E4/3 genotype than those having E3/3 genotype (p=0.05; 40mg/d), and the percent reduction of Achilles tendon thickness was significantly low in subjects having E4/3 genotype than those having E3/3 genotype (p=0.037; 20mg/d). Conclusion: The distribution of apolipoprotein E genotype in patients with familial hypercholesterolemia was not significantly different with that in normal subjects. But apolipoprotein E polymorphism may affect the reduction of LDL-cholesterol and Achilles tendon xanthoma with medication of HMG CoA reductase inhibitor in patients with familial hypercholesterolemia.
우리나라 일부 의학 학술지에 게재된 의약품 광고의 과학적 근거에 대한 평가
안성복,최원,김철준,최성준,이강희,하경수,김현창,Ahn, Song Vogue,Choi, Won,Kim, Chul Joon,Choe, Seong Choon,Lee, Kang Hee,Ha, Kyoungsoo,Kim, Hyeon Chang 한국의료질향상학회 2006 한국의료질향상학회지 Vol.12 No.1
Background : The promotion and advertisement of pharmaceuticals should be based on evidence from clinical trials. We conducted this study to assess whether the pharmaceutical advertisement claims in Korean medical journals had relevant references, and whether the claims were supported by the references. Methods : We reviewed pharmaceutical advertisements in five Korean medical journals issued during the first half of 1999 and during the first half of 2004. Three investigators independently reviewed the advertisements to see whether the studies quoted to endorse the advertising messages supported the corresponding claims. Using multiple logistic regression analyses, we investigated which factors were associated with the quality of the advertisement claims. Results : From the 550 advertisements in the five journals, we identified 157 different advertisements and 475 different promotional claims. Only 149 claims had at least one reference, and 105 claims had references of published article. We could find supporting evidences in the 90 claims. The factors which were associated with the quality of advertisement claims were category of drugs, category of claims, and the manufacturer characteristics. Claims for cardiovascular and endocrine drugs, and claims on efficacy, and claims of multinational company were more evidence-based. Conclusion : Majority of the pharmaceutical advertisement claims in Korea did not have appropriate references. Drug category, claim category, and the manufacturer characteristics were associated with the quality of advertisement claims, and the manufacturer characteristics was the most important determinants.
정상 심근과 확장성 심근증 심근에서의 미토콘드리아 DNA 에 대한 분석
최현석(Hyun Seok Choi),김효수(Hyo Soo Kim),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),최성준(Seong Choon Choe),홍석근(Suk Keun Hong),손대원(Dae Won Sohn),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),이영우(Youn 대한내과학회 1997 대한내과학회지 Vol.53 No.3
N/A Objective: The aim of this study is to analyze the mitochondrial DNA in failing and normal hearts. Methods: Genomic DNA was extracted from 18 failing and 4 normal hearts. The DNA was digested with each 50 units of BamH I, Pvu II, Pst I, and hybridized using DNA fragments encoding CO II (cytochrome oxidase II) and CO IU. They were detected using 'Fluorescein Gene Images' system. Results: The light microscopic feature of failing myocardium was compatible with that of primary cardiomyopathy. In southern blot analysis, there was no significant difference in mitochondrial DNA amounts between normal and failing hearts. The amount of mitochondrial DNA in hearts, whether normal or failing, was greater than that in lymphocytes. There were no abnormal bands except 16.6kb-normal band using the enzyme BamH I, Pvu II from failing and normal hearts. After digesting with Pst I, 2.1kb band was found using probe CO II and 14.5kb band using probe CO III. Conclusion : The amount of mitochondrial DNA in hearts, whether normal or failing, was greater than that in lymphocytes, which suggests that the heart is an active organ in the energy metabolism. Abnormal band was not found in southern blot analysis of the mitochondrial DNA from failing and normal hearts. The more sensitive method such as PCR is required to detect the presence of sma11 amount of mutated DNA.
혈전용해술과 비복근 절개술로 치유된 슬와동맥 포획증후군
최성준,배진선,정인목,성인환,전은석 대한혈관외과학회 2000 Vascular Specialist International Vol.16 No.2
Popliteal artery entrapment syndrome (PAES) is rare, but increasingly reported in the literature as a cause of lower limb arterial impairment. Management of a patient with PAES depends on the clinical pictures. Currently, myotomy of the medial head of gastrocnemius muscle with interposition grafting or bypass of diseased popliteal artery has been widely used in cases with a demaged or occluded artery. But, other less extensive therapeutic approaches were also performed instead of it. We present a case of type II popliteal entrapment syndrome in an 36-year-old male. Presenting symptom was exercise- induced pain in his right calf since one month ago. Arteriography showed occlusion in short segment of right popliteal artery and intact distal run-off arteries. After ovemight urokinase thrombolysis, residual focal stenosis and medial deviation of popliteal artery were observed. CT scan showed abnormal structure between right popliteal artery and popliteal vein, so, diagnosis was established. After myotomy of the medial head of gastrocnernius muscle, the symptom resolved completely. Post-operative duplex scan showed normal blood flow, even in active plantar flexion of the foot. In our case, early diagnosis and combined approach of endovascular thrombolytic therapy followed by surgical release of popliteal artery enabled to avoid direct vascular surgery such as bypass or interposition grafting with resolution of ischemic symptoms. This thrombolytic therapy does not obviate surgery but may permit a less extensive procedure to be performed in PAES.
한국인 심부전증 환자 심근에서의 인형 거대 세포 바이러스 감염
이명용,이무용,김영권,한성식,최성준,김효수,이영우,서정돈 단국대학교 1998 論文集 Vol.33 No.-
Objectives: In order to evaluated the prevalence and the site of infection of cytomegalovirus in terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. Methods: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts(N=5) and polymerase cain reactions(PCRs) were done for detection of late gene sequence coding pp150 glycoprotein. The products were confirmed by electrophoresis on the 1% agarose gel. n order to improve the detectability of cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. In situ PCRs also were done with the samples which were confirmed as positive for CMV viral genome by nested PCRs. Results: All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing heart(3 cases/22. 13.5%) and normal hearts( 1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/2, RV 4/22, RA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 2/5, RA 2/5). These was no significant change in positivity of cytomegaloviral DNA genome between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to the nested PCR results. The positivity of cytomegaloviral DNA by n situ PCR was 33.3%(4/12), and the site of positive reaction was the nuclei of the myocardial cells. Conclusion: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. The result of the in situ PCR showed the site of the cytomegaloviral infection was nuclei of the myocardial cells. Cytomegalovirus, however, might have no direct causal relationship in the development of terminal heart failure.