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홍명기,원호연,허애영,김병극,김용훈,신동호,김중선,고영국,최동훈,권혁문,장양수 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.2
Purpose: Data comparing the clinical benefits of medical treatment with those of percutaneous coronary intervention (PCI) in an elderly population with angina pectoris are limited. Therefore, we evaluated the efficacy of elective PCI versus optimal medical treatment (OMT) in elderly patients (between 75 and 84 years old) with angina pectoris. Materials and Methods: One hundred seventy-seven patients with significant coronary artery stenosis were randomly assigned to either the PCI group (n=90) or the OMT group (n=87). The primary outcome was a composite of major adverse events in the 1-year follow-up period that included cardiovascular death, non-fatal myocardial infarction, coronary revascularization, and stroke. Results: Major adverse events occurred in 5 patients (5.6%) of the PCI group and in 17 patents (19.5%) of the OMT group (p=0.015). There were no significant differences between the PCI group and the OMT group in cardiac death [hazard ratio (HR) for the PCI group 0.454; 95% confidence interval (CI) 0.041–5.019, p=0.520], myocardial infarction (HR 0.399; 95% CI 0.039–4.050, p=0.437), or stroke (HR 0.919; 95% CI 0.057–14.709, p=0.952). However, the PCI group showed a significant preventive effect of the composite of major adverse events (HR 0.288; 95% CI 0.106–0.785, p=0.015) and against the need for coronary revascularization (HR 0.157; 95% CI 0.035–0.703, p=0.016). Conclusion: Elective PCI reduced major adverse events and was found to be an effective treatment modality in elderly patients with angina pectoris and significant coronary artery stenosis, compared to OMT.
홍명기,김경자,양용준 한국원예학회 2007 Horticulture, Environment, and Biotechnology Vol.48 No.6
Polyphenol oxidase (PPO) caused browning is a major cause of undesirable flavors and nutritional losses in peeled garlic. To screen for antibrowning compounds, PPO was purified from garlic extract by Sephadex G-100 column chromatography. The purified PPO revealed homogeneity of a single protein band on 12% SDS-PAGE. Its molecular weight was estimated to be 30 kDa by SDS-PAGE and confirmed by active staining. Its pH and temperature optima were pH 6.0 and 35℃, respectively. The PPO activity was a little inhibited by Na+ and Fe++ ions, whereas the enzyme activity was increased by Ca++, Mn++, Zn++, and Hg++ ions. It was found by chemical modification reaction that serine residue is involved in active site of PPO. β-glucosidase inhibitor (β-GI) isolated from Bacillus lentimorbus B-6 was found to be an inhibitor for the PPO purified from garlic extract. The kinetic analysis showed that the inhibition of β-GI on the PPO is competitive and reversible. IC50 and the inhibition constant (KI) of β-GI against PPO were determined to be 0.85 mg/ml and 75 μg/ml, respectively.
홍명기,이중희,신동호,김병극,고영국,최동훈,장양수 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.5
Purpose: The effects of short-term intensive lipid-lowering treatment on coronary plaque composition have not yet been sufficientlyevaluated. We investigated the influence of short-term intensive lipid-lowering treatment on quantitative and qualitative changes in plaque components of non-culprit lesions in patients with acute coronary syndrome. Materials and Methods: This was a prospective, randomized, open-label, single-center trial. Seventy patients who underwent both baseline and three-month follow-up virtual histology intravascular ultrasound were randomly assigned to either an intensivelipid-lowering treatment group (ezetimibe/simvastatin 10/40 mg, n=34) or a control statin treatment group (pravastatin 20 mg, n=36). Using virtual histology intravascular ultrasound, plaque was characterized as fibrous, fibro-fatty, dense calcium, or necrotic core. Changes in plaque components during the three-month lipid-lowering treatment were compared between the two groups. Results: Compared with the control statin treatment group, there was a significant reduction in low-density lipoprotein cholesterolin the intensive lipid-lowering treatment group (-20.4±17.1 mg/dL vs. -36.8±17.4 mg/dL, respectively; p<0.001). There were no statistically significant differences in baseline, three-month follow-up, or serial changes of gray-scale intravascular ultrasound parameters between the two groups. The absolute volume of fibro-fatty plaque was significantly reduced in the intensive lipid-loweringtreatment group compared with the control group (-1.5±3.4 mm3 vs. 0.8±4.7 mm3, respectively; p=0.024). A linear correlation was found between changes in low-density lipoprotein cholesterol levels and changes in the absolute volumes of fibro-fatty plaque (p<0.001, R2=0.209). Conclusion: Modification of coronary plaque may be attainable after only three months of intensive lipid-lowering treatment.
홍명기,홍성진,허애영,서용성,원호연,조덕규,조윤형,윤영원,이경훈,강웅철,김용훈,김상욱,신동호,김중선,김병극,고영국,최병욱,최동훈,장양수 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.5
Purpose: To evaluate the ability of coronary computed tomographic angiography (CCTA) to predict the need of coronary revascularizationin symptomatic patients with stable angina who were referred to a cardiac catheterization laboratory for coronary revascularization. Materials and Methods: Pre-angiography CCTA findings were analyzed in 1846 consecutive symptomatic patients with stable angina, who were referred to a cardiac catheterization laboratory at six hospitals and were potential candidates for coronary revascularizationbetween July 2011 and December 2013. The number of patients requiring revascularization was determined based on the severity of coronary stenosis as assessed by CCTA. This was compared to the actual number of revascularization procedures performed in the cardiac catheterization laboratory. Results: Based on CCTA findings, coronary revascularization was indicated in 877 (48%) and not indicated in 969 (52%) patients. Of the 877 patients indicated for revascularization by CCTA, only 600 (68%) underwent the procedure, whereas 285 (29%) of the 969 patients not indicated for revascularization, as assessed by CCTA, underwent the procedure. When the coronary arteries were divided into 15 segments using the American Heart Association coronary tree model, the sensitivity, specificity, positive predictive value, and negative predictive value of CCTA for therapeutic decision making on a per-segment analysis were 42%, 96%, 40%, and 96%, respectively. Conclusion: CCTA-based assessment of coronary stenosis severity does not sufficiently differentiate between coronary segments requiring revascularization versus those not requiring revascularization. Conventional coronary angiography should be consideredto determine the need of revascularization in symptomatic patients with stable angina.