전자의료기기산업 현황과 전망

홍장혁,Hong, Jang-Hyeok 한국전자정보통신산업진흥회 1996 電子振興 Vol.16 No.8

COMDEX Fall 2001 참관기

홍장혁,Hong, Jang-Hyeok 한국전자정보통신산업진흥회 2001 電子振興 Vol.21 No.12

부비동염에서 기원한 진균성 동맥류의 치료과정 중 발생한 코일의 이동

장혁(Hyeok Chang),김도희(Do Hee Kim),김정희(Jung Hee Kim),이호진(Ho Jin Lee),홍상덕(Sang Duk Hong),홍창기(Chang Ki Hong) 대한두개저학회 2020 대한두개저학회지 Vol.15 No.1

Invasive sphenoid fungal sinusitis sometimes invades the adjacent structures such as the optic nerve or cavernous sinus. Here, we present the treatment for a primarily embolized mycotic aneurysm that ruptured during endoscopic sinus surgery. This report describes the case of a 72-year-old man with a mycotic aneurysm. Although the patient’s mycotic aneurysm was controlled by coil embolization, the subsequent endoscopic surgery resulted in massive bleeding and dislocation of the embolic coil. The ruptured vessel was stably controlled by internal carotid artery occlusion. This case emphasizes the need for careful consideration when performing endoscopic surgery for sphenoid sinusitis in patients especially with a mycotic aneurysm.

Automated Quantification of Mitral Regurgitation by Three Dimensional Real Time Full Volume Color Doppler Transthoracic Echocardiography: A Validation With Cardiac Magnetic Resonance Imaging and Comparison With Two Dimensional Quantitative Methods

손장원,장혁재,이진경,정희정,송란영,김영진,Saurabh Datta,허란,신상훈,조인정,심지영,홍그루,정남식 한국심초음파학회 2013 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.21 No.2

Background: Accurate assessment of mitral regurgitation (MR) severity is crucial for clinical decision-making and optimizing patient outcomes. Recent advances in real-time three dimensional (3D) echocardiography provide the option of real-time full volume color Doppler echocardiography (FVCD) measurements. This makes it practical to quantify MR by subtracting aortic stroke volume from the volume of mitral inflow in an automated manner. Methods: Thirty-two patients with more than a moderate degree of MR assessed by transthoracic echocardiography (TTE)were consecutively enrolled during this study. MR volume was measured by 1) two dimensional (2D) Doppler TTE, using the proximal isovelocity surface area (PISA) and the volumetric quantification methods (VM). Then, 2) real time 3D-FVCD was subsequently obtained, and dedicated software was used to quantify the MR volume. MR volume was also measured using 3)phase contrast cardiac magnetic resonance imaging (PC-CMR). In each patient, all these measurements were obtained within the same day. Automated MR quantification was feasible in 30 of 32 patients. Results: The mean regurgitant volume quantified by 2D-PISA, 2D-VM, 3D-FVCD, and PC-CMR was 72.1 ± 27.7, 79.9 ±36.9, 69.9 ± 31.5, and 64.2 ± 30.7 mL, respectively (p = 0.304). There was an excellent correlation between the MR volume measured by PC-CMR and 3D-FVCD (r = 0.85, 95% CI 0.70-0.93, p < 0.001). Compared with PC-CMR, Bland-Altman analysis for 3D-FVCD showed a good agreement (2 standard deviations: 34.3 mL) than did 2D-PISA or 2D-VM (60.0 and 62.8mL, respectively). Conclusion: Automated quantification of MR with 3D-FVCD is feasible and accurate. It is a promising tool for the real-time 3D echocardiographic assessment of patients with MR.

요추부 경막외 스테로이드 주사에서 경추궁(經椎弓)법과경추간공(經椎間孔)법의 효과

김희상,홍장혁,안경회,김용걸 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.4

식이를 통한 농약섭취량에 관한 연구 : 두류, 서류, 견과류, 종실류, 채소류, 과실류 및 그 가공품에 대하여 legumes,potatoes,nuts,seeds,vegetables,fruits and their products

원경풍,홍무기,최동미,오창환,박건상,최윤주,안장혁,황인균,정지윤,정선미,박일경,이정복,장선영,홍주연,최영내 식품의약품안전청 1998 식품의약품안전청 연보 Vol.2 No.-

우리가 섭취하는 식품을 수세 , 탈피, 가열 등으로 섭취직전의 상태로 조리하여 잔류농약을 분석하였다. 그 결과 식품 섭처를 통한 농약의 1일 춘정 섭취량(EDI : estimated daily intake)을 파악하고 이를 농약의 1일섭취허용량(ADI : acceptabte daily intake) 및 이론적 최대섭취량(TffDt : theoretical maxiraum daily in늘he)과 비교하여 우리나라 국민이 식품으로부터 섭취하는 농약의 양에 대한 안전성을 평71하였다. 보편성있는 식품수거를 위채 수거대상 지역은 인구가 밀집되어 있는 대도시인 서울, 부산, 대구』 인천 , 대전, 광주, 수원, 전주, 마산과 춘천의 10곳을 선정하였다. 대상식품으로는 두류 및 가공품 11종, 서류 및 가공품 3종.견과류 및 가공품 8종, 기호식물류 1종, 종실류 2총, 과실류 및 가공품 20종, 채소류 21종의 총 50종of었다. 분석대상농약은 동시다셩분 분석채 가능한 농약으로 HPD대상농약 11종 및 ECD대상농약 48종으로 총 59졸이었다. 1995년부터 5개년 계획으로 수행되어 온 본 딴구는 큼년이 4차년도였으며,종전보다 대상식품 및 대상농약을 크게 늘리고 시료 전처리에 있어석 자동화된 고상추출 정제법을 사용하여 시료 처리속도를 창상시켰다. 분쇄된 시료들은 acetonitrile로 추출한 후 정제하여 GC/BCD 및 GC/HPD로 분석하고 검출된 성분들은 GC/MSD로 재확인차였다. 분석 결과 총 660 식품중 9식품(딸기, 복숭아, 풋고추, 고춧가루, 파, 피망, 상추, 시금치 , 깻잎 )에서 4종의 농약(procymidone, EPN, endosulfan, chlorpyrifos)이 검출피었으며, 이들 식품 십취를 통한 농약의 추정 섭취량()801)은 0.01 ~ 1.28rg/person/day 수준으로 극히 미팡이었다. 대상농약중에서 가장 많이 섭취되고 있는 농약은 on(losulfan으로 그 EDI를 ADI와 ㅂ1교한 결과 0.39%에 불과 하였으며, 이론적 최대섭취량(TMDI)과 비교한 결과도 0.49% 수준으로 나타났다. 따라서 본 연구의 대상식품을 섭치할 경우 분석대상 농약으로 인한 안전성에는 문제가 얼는 것으로 려가되었다. In order to rstimate the intake of pesticide residues through foods which is prepared ready to eat, total diet study(TDS) was carried. The foods(legumes, potatees, nuts, seeds, fruits, vegeta-bles a8d their products) were purchased at the retail stores in 10 large cities of Korea, respectively. Thecollected 660 samples(66 foods x10 regions) were pr,etreated in a manBer similar to that used at home(washing, trimming, peeling. boiling and etc ) and followed Uy the automated solid phase extraction.Frem the extracted samples, total 59 pesticides were determined by capillary gas chromatography withECD, NPD and MSD. The levels of pesticide residues were resulted in not detected or orders of magni-tude lower than maximum residve limits for most of samples. However, in 9 samples(strawberrf, peach,green pepper, red pepper powder, scallion, bell pepper, lettuce korean, spinach, wild sesame leaf),4 pesti-cides(procymidone, chlorpyrifos, endosulfan, EPN) were detected with the estimated daily intake(EDE)values of fftl ~l.28rg/person/day. These EBI values were corresponded to <0.01 ~ 1.82% of ADT(for55kg person) and <0.01 ~O.49% of TMDI.

Late Gadolinium Enhancement in Cardiac MRI in Patients with Severe Aortic Stenosis and Preserved Left Ventricular Systolic Function Is Related to Attenuated Improvement of Left Ventricular Geometry and Filling Pressure after Aortic Valve Replacement

박준범,장혁재,최정호,양필성,이상은,허란,신상훈,조인정,김영진,심지영,홍그루,정남식 대한심장학회 2014 Korean Circulation Journal Vol.44 No.5

Background and Objectives: We investigated echocardiographic predictors: left ventricular (LV) geometric changes following aortic valve replacement (AVR) according to the late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) in patients with severe aortic stenosis (AS) and preserved LV systolic function. Subjects and Methods: We analyzed 41 patients (24 males, 63.1±8.7 years) with preserved LV systolic function who were scheduled to undergo AVR for severe AS. All patients were examined with transthoracic echocardiography (TTE), CMR before and after AVR (in the hospital) and serial TTEs (at 6 and 12 months) were repeated. Results: The group with LGE (LGE+) showed greater wall thickness (septum, 14.3±2.6 mm vs. 11.5±2.0 mm, p=0.001, posterior; 14.3±2.5 mm vs. 11.4±1.6 mm, p<0.001), lower tissue Doppler image (TDIS’, 4.4±1.4 cm/s vs. 5.5±1.2 cm/s, p=0.021; TDI E’, 3.2±0.9 cm/s vs. 4.8±1.4 cm/s, p=0.002), and greater E/e’ (21.8±10.3 vs. 15.4±6.3, p=0.066) than those without LGE (LGE-). Multivariate analysis show that TDI e’ (odds ratio=0.078, 95% confidence interval=0.007–0.888, p=0.040) was an independent determinant of LGE+. In an analysis of the 6- and 12-month follow-up compared with pre-AVR, LGE- showed decreased LV end-diastolic diameter (48.3±5.0 mm vs. 45.8±3.6 mm, p=0.027; 48.3±5.0 mm vs. 46.5±3.4 mm, p=0.019). Moreover, E/e’ (at 12 months) showed further improved LV filling pressure (16.0±6.6 vs. 12.3±4.3, p=0.001) compared with pre-AVR. However, LGE+ showed no significant improvement. Conclusion: The absence of LGE is associated with favorable improvements in LV geometry and filling pressure. TDI E’ is an independent determinant of LGE in patients with severe AS and preserved LV systolic function.

Effect of Triflusal on Primary Vascular Dysregulation Compared with Aspirin: A Double-Blind, Randomized, Crossover Trial

신상훈,장혁재,김광준,조인정,홍그루,장양수,정남식,나영민 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.5

Purpose: Primary vascular dysregulation (PVD) is a condition in which the response to cold temperature or external stimuli is abnormal. We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin. Materials and Methods: Eighty-eight PVD patients (54% female, 56±8 years) were randomly selected to receive either triflusal (300 mg, b.i.d.) or aspirin (150 mg, b.i.d.) for a period of 6 weeks followed by crossover. PVD was defined as both red-blood-cell standstill in video-assisted microscopic capillaroscopy during cold stimulation using carbon dioxide gas and a score of more than 7 points in a validated questionnaire. Efficacy of treatment was assessed by 1) cold intolerance symptom severity (CISS) score, 2) finger Dopplerindices, and 3) indocyanine green perfusion imaging. Results: The use of triflusal resulted in a greater improvement in CISS score (44.5±18.4 vs. 51.9±16.2; p<0.001) and in mean radial peak systolic velocity (69.8±17.2 vs. 66.1±16.4; p=0.011) compared to aspirin. Furthermore, significant differences were also observedin perfusion rates on indocyanine green perfusion imaging between triflusal and aspirin (45.6±25.8 vs. 51.6±26.9; p=0.020). Conclusion: Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.

Echocardiographic Investigation of the Mechanism Underlying Abnormal Interventricular Septal Motion after Open Heart Surgery

강민경,장혁재,조인정,신상훈,심지영,홍그루,유경종,장병철,정남식 한국심초음파학회 2014 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.22 No.1

Background: Abnormal interventricular septal motion (ASM) is frequently observed after open heart surgery (OHS). The aimof this study was to investigate the incidence and temporal change of ASM, and its underlying mechanism in patients whounderwent OHS using transthoracic echocardiography (TTE). Methods: In total, 165 patients [60 ± 13 years, 92 (56%) men] who underwent coronary bypass surgery or heart valvesurgery were consecutively enrolled in a prospective manner. TTE was performed preoperatively, at 3--6-month postoperatively,and at the 1-year follow-up visit. Routine TTE images and strain analysis were performed using velocity vectorimaging. Results: ASM was documented in 121 of 165 patients (73%) immediately after surgery: 26 patients (17%) presentedconcomitant expiratory diastolic flow reversal of the hepatic vein, 11 (7%) had inferior vena cava plethora, and 11 (7%) had both. Only 2 patients (1%) showed clinically discernible constriction. ASM persisted 3--6 months after surgery in 38 patients (25%),but only in 23 (15%) after 1 year. There was no difference in preoperative and postoperative peak systolic strain of all segments ofthe left ventricle (LV) between groups with or without ASM. However, systolic radial velocity (VRad) of the mid anterior-septumand anterior wall of the LV significantly decreased in patients with ASM. Conclusion: Although ASM was common (74%) immediately after OHS, it disappeared over time without causing clinicallydetectable constriction. Furthermore, we consider that ASM might not be caused by myocardial ischemia, but by the decreasedsystolic VRad of the interventricular septum after pericardium incision.

Prognostic Application of Thoracic Aortic Calcium Scoring for Adverse Clinical Outcome Risk in Elderly Patients with Left Ventricular Hypertrophy

조인정,장혁재,이상은,심지영,홍그루,정남식 대한심장학회 2017 Korean Circulation Journal Vol.47 No.6

Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17–89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71–11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.