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      • 급성하벽심근경색에서 전흉부유도 ST절 하강의 의의

        정병천,배호상,곽동훈,김영태,배용학,황종현,임현주,류재근,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

        목적 : 급성하벽심근경색증 환자에서 심전도상 흔히 동반되는 전흉부유도 ST절 하강의 의의를 알아보았다. 방법 : 심근경색후 24시간에서 48시간에 얻은 심전도를 기준으로 52명의 급성하벽심근경색증 환자를 전흉부유도에서 ST절의 하강이 있는 군과 없는 군으로 나누었으며 심도자, 관상동맥조영술, 심초음파도 및 방사성 핵종을 이용한 좌심구혈율 측정 등을 시행하였다. 결과 : 1) 좌심실확장기말압은 전흉부유도에서 ST절의 하강이 있는 경우에서 16.9±5.33mmHg로 없는 경우의 11.0±4.02mmHg보다 유의하게 높았다(p<0.05). 그러나 운동량 및 좌심구혈을은 흥부 유도상 ST절의 하강이 있는 경우 7.6±3.0 METs 및 53.9±9.1%로 없는 경우의 9.1±2.7 METs 및 54.6±9.5%보다 낮았으나 통계적 유의성은 없었다(p=0.180, p=0.823). 2) 관상동맥조영술상 전흉부 ST절의 하강이 동반된 군에서는 유의한 좌전하행지나 좌회선지의 협착이 있는 경우가 60.9% 및 57.9%로 ST절의 하강이 없는 군에서의 34.5% 및 7.7%와 비교해 좌관상동맥에 협착이 동반된 경우가 많았다(p=0.050, p=0.001). 3) 관상동맥조영술상 세 혈관질환의 빈도는 흉부유도상 ST절의 하강을 보인 23예에서 10예로 ST절 하강이 없었던 29예중 2예에 비하여 유의하게 많았고(P=0.007), 단 혈관질환의 빈도는 ST절의 하강을 보인 군에서 23예중 5예로 ST절 하강이 없었던 29예중 17예에 비하여 유의하게 적었다(P=0.002). 두 혈관질환의 경우에는 각각 8예와 10예로 양군간에 유의한 차이가 없었다. 4) 흉부유도상 ST절 하강의 빈도는 단 혈관질환 22예 중 5예에서, 두 혈관질환 18예중 8예, 세 혈관질환 12예 중 10예에서 관찰되어 협착이 있는 관상동맥의 수가 많을수록 ST절의 하강이 나타나는 빈도가 많음을 보였다(p=0.00308). 그러나 흉부유도상 나타난 ST절의 하강을 모두 합하여 구한 ST절 하강의 합은 협착이 있는 관상동맥의 수와 통계적인 유의성이 없었다. 5) 심초음파도상 좌심실 하벽의 벽운동은 ST절 하강을 보인 군에서는 akinesia가 83.3%, hypokinesia가 11.1%, 정상 벽운동이 5.6%로, ST절 하강이 없었던 군에서의 dyskinesia가 3.6%, akinesia가 39.3%, hypokinesia가 25.0%, 정상 벽운동이 32.1%와 비교하여 ST절의 하강이 있는 군에서 유의하게 벽운동의 장애가 빈번함을 보였다(p=0.03891). 그러나 좌심실전벽, 측벽 및 중격부위에서는 유의한 벽운동의 차이가 없었다. 결론 : 급성하벽심근경색증 환자의 전흉부유도에서 ST절의 하강이 동반되는 경우 다혈관 질환의 가능성이 높으며 좌심실확장기말압이 상승되었고 운동능력은 감소되어 있었다. 또한 심초음파도상 좌심실하벽의 벽운동장애도 심하였다. 따라서 전흉부 ST절의 하강을 동반한 급성하벽심근경색증 환자는 전흉부유도에 ST절 하강이 없는 경우보다 예후가 불량할 것으로 생각되며, 보다 적극적인 치료가 필요할 것으로 생각된다. The purpose of this study was to determine the significance of precordial ST segment depression appearing during acute inferior myocardial infarction and to assess the correlation of that with angiographic finding. 52 patients were allocated into two groups based on the existence of precordial ST segment depression : 23 patients with ST segment depression and 29 patients without ST segment depression. The extent of coronary artery disease as well as the prevalence of significant stenosis (≥70%) in left anterior descending artery were more frequent in patients showing precordial ST segment depression than in patients not showing them (p=0.050) and the result were similar in cases of left circumplex artery (p=0.001). On echocrdiographic examination of left ventricular (LV) wall motion, it showed more severely decreased inferior LV wall motion in patients showing precordial ST segment depression than in patients not showing them (p=0.03891) even though the other segment of LV wall motion didn't show the statistical difference between both groups. The other cardiac parameters such as LVEDP, exercise amount (METs) and ejection fraction were tend to showing bad profile in patients with precordial ST segment depression. From the above results, we could deduce that patients with precordial ST segment depression have relatively large infarction or concomitant left coronary artery disease, so they need more caution and intensive theraphy.

      • KCI등재
      • 요하지통 환자에서 두 개의 캐눌라를 이용한 박동성 고주파 신경근 응고술의 임상 연구

        김천숙,배재영,배덕구,강규식,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

        Dorsal root ganglion(DRG) block by the local anesthetics and steroids which has done classically in low back pain(LBP) patients with radiculopathy has high incidence of recurrence rate and side effects of steroids. Recently a new technique of pulsed radiofrequency thermocoagulation(P-RFTC) was introduced and substituted for it because of the benefits such as relatively low recurrence rate, low risk of nerve injury and comfort during the procedure. We experienced 15 patients who had LBP with radiculopathy and no or little response to epidural steroid injection. When we performed DR ganglionotomy by P- RFTC under the C-arm guide in these patients, we tried to approach the exact DR ganglion using tow cannulas - the one for obtaining patient's subjective symptoms and injection of contrast dye, the other for making a RF lesioning after identifying the impedance of sensory and motor stimulation. In conclusion, DR ganglionotomy by P- RFTC using two cannulas in LBP patients is an easy and safe procedure with satisfactory results.

      • KCI등재

        SBA-15에 담지된 전이 금속 촉매상에서 p-Xylene의 불균일 액상 산화반응

        김영호,손용배,류재춘,양현수,전기원,박상언 한국공업화학회 2004 공업화학 Vol.15 No.1

        화학적으로 개조된 SBA-15 실리카 위에 활성 전이 금속 종들(Co, Mn, Ni, Fe, or Cu)이 담지된 불균일 촉매를 제조하였다. 제도된 촉매상에서 p-xylene의 불균일 액상 산화반응이 손쉬운 촉매 분리를 위한 불균일 공정의 개발 가능성을 검토하기 위하여 수행되었다. SBA-15 위에 결합된 Co 종(Co-SBA-15)은 다른 전이 금속 종들보다 대응하는 방향족 카르복실산으로의 산화 반응에 가장 효과적인 것으로 나타냈다. 더 나아가 Co-SBA-15 촉매상에서 반응시간(0.5~9 h), 반응온도(130~190 ℃), 전압(10~25 atm) 및 산소 분압(1~9 atm)과 같은 반응 변수의 영향을 연구하였다. 높은 전환율에서 고체 생성물인 terephthalic acid의 형성은 매우 낮고 그때 활성점 위에서 고체 생성물의 쌓임으로 인해 촉매가 쉽게 비활성화 되었을지라도, p-toluic acid로는 고려할만한 선택성이 관찰되었다. p-Toluic acid 및 terephthalic acid를 향한 중간 산화 생성물들의 선택성을 기초로 추정된 반응 경로는 균일 Co/Mn 촉매 반응계에서와 비교하여 거의 같다. 이것은 Co-SBA-15 촉매가 균일 촉매적 행동을 하는 불균일 촉매이고 고체 생성물을 생성하지 않는 탄화수소들의 액상 산화반응을 위하여 잘 적용될 수 있을 것임을 시사한다. Active transition metal species (Co, Mn, Ni, Fe, or Cu) supported on a chemically modified SBA015 silica were prepared as heterogeneous catalysts. The heterogeneous liquid phase oxidation of p-xylene on the prepared catalysts was carried out to investigate the possibility of the development of heterogeneous process for easier catalyst separation.The Co species bound on the SBA-15(Co-SBA-15) was found to be the most effective for the oxidation to corresponding aromatic carboxylic acids than the other transition metal species. In addition, the effects of reaction variables such as reaction time(0.5∼9h), reaction temperature (130∼190℃), total pressure (10∼25 atm) and the partial pressure of oxygen (1-9 atm) were studied on the Co-SBA-15 catalyst. At high levels of conversion, the considerable catalytic activities to p-toluic acid were observed, even though formation of terephthalic acid, an solid product, was very low and then the catalyst was easily deactivated due to build--up of solid products on active sites. The proposed reaction network based on the selectivities of intermediate oxidation products for p-toluic and terephthalic acid was similar to that on the homogeneous Co-Mn catalytic reaction system. This indicates that the Co-SBA-15 catalyst is a heterogeneous catalyst which can behave like a homogeneous catalyst and may be well applied to the liquid phase oridation of hydrocarbons without formation of solid products.

      • KCI등재

        H9c2 심근 세포주에서 외인성 nitric oxide가 허혈에 의한 세포 독성에 미치는 영향

        정성구,장현용,김명천,고영관,정주호,배영미,박원서,김대중,유영민,김성수,임성빈 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

        Background: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. Methods: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-Sdimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. Results: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100,1000μM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. Conclusion: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.

      • 랫드에서 인체 재조합 적혈구 조혈인자, rHuEPO의 13주 정맥투여 아만성독성에 관한 연구

        김형식,곽승준,천선아,박현선,한하수,임소영,안미영,김원배,김병문,안병옥,홍성렬,이병무 성균관대학교 약학연구소 1998 成均藥硏論文集 Vol.10 No.1

        A recombinant human erythropoietin (rHuEPO) was administered intravenously at dosage levels of 0, 100, 500, and 2500 IU/㎏/day for a period of 13 weeks. There were no observed clinical signs and deaths related to treatment in all groups tested. Decreases in body weight gain and food consumption were observed only in males of 2,500 IU/㎏ group after 2 weeks. In hematological parameters, erythrocyte content, hematocrit values and hemoglobin concentration were dose-dependently increased in rHuEPO treated groups. The ratio between kidney weight and whole body weight was significantly increased in females of 500 and 2,500 IU/㎏ groups. The spleen weight was also increased in both sexes of 500 and 2,500 IU/㎏ groups. However, the absolute weight change of other organs was not observed. In histopathological examinations, the renal tubular basophilia was observed only in males and females of 2,500 IU/㎏ groups. From these results, it is concluded that the no-observed adverse effect level(NOAEL) of rHuEPO is 100 IU/㎏ in rats in the present study.

      • 물리치료사들의 대체의료에 관한 인식도 조사

        김영희,김기열,배주환,김상수,남철현 경산대학교 보건복지연구소 2000 保健福祉硏究 Vol.5 No.-

        This study was conducted to examine physical therapists' awareness of alternative medicine and their treatment. 250 physical therapists who were working in Daegu were selected as subjects of this study. Data were collected from February 21, 2000 to March 31, 2000. The results of this study are summarized as follows. 1. Among 218 respondents, 72.7% of them directly experienced alternative medicine. According to general characteristics of the respondents, 79.0% of them who were in thirties had experiences in alternative medicine. 83.3% of the respondents who had worked for above twenty years experienced alternative medicine and 90.0% of the respondents who were working in Oriental medical clinics had experiences in it. 79.8% of the respondents who had been married experienced alternative medicine and 88.4% of them who were Buddhists had experience in it. 2. The sources of information on alternative medicine were newspapers and broadcast (22.9%), seminars of related associations (22.5%), and Books (20.0%). 3. The respondents experienced alternative medicine for the purpose of treating their chronic diseases (67.0%), improving their energy and quality of life (20.5%), and improving their weak physical constitution (13.4%). 4. According to the respondents' trust in alternative medicine, 40.8% of them trusted chiropractic, while 25.2% of them trusted massage and finger-pressure therapy. 19.7% of them trusted taping therapy and 15.1% of them trusted sports massage. 5. 67.0% of the respondents treated patients by alter native medicine in the hospitals and clinics. In the case of treatment methods by alternative medicine, 35.3% of them gave patients the massage and finger-pressure. 33.0% of them adopted taping therapy and 24.3% of them tried to treat patients by chiropractic. 17.0% of them applied moxacautery, while 15.1% of them gave patients the sports massage. 6. The respondents adopted alternative medicine to treat following diseases: lumbago (57.5%), shoulder pain (51.8%), sciatica (39.9%), arthritis (36.2%), headache (31.1%), hypertension (24.3%), diseases of the peripheral nervous system (22.4%), diseases of digestive organ (14.6%), insomnia (12.3%), obesity (8.7%), stroke (5.5%), allergy and skin diseases (4.1%), cystitis (3.6%). 7. According to their motives of concern about alternative medicine, 59.1% of them were interested in it because they expected additional effect which could be obtained from it in parallel with Western medicine. 16.7% of them were concerned about alternative medicine because they lacked ability to solve patients' clinical problems, while 15.3% of them were interested in it because they acknowledged the effect of it. 8.9% of them had interest in alternative medicine because they were dissatisfied with medical and scientific approach of Western medicine. 8. 73.4% of the respondents thought that alternative medicine needed to be introduced in the college/university curriculum

      • KCI등재

        한국의 수출과 FDI는 보완적인가?

        ( Hyun Bae Chun ),( Hee Cho Jang ),( Jung Hur ) 한국국제경제학회 2013 국제경제연구 Vol.19 No.4

        본 논문은 기업의 수출과 해외직접투자 등 국제화 전략 선택 요인에 관하여 실증 분석한다. 통계청의 ‘기업활동조사’ 자료를 활용하여 우리나라 제조기업의 수출과 해외직접투자의 개별적 선택요인과 동시적 선택요인을 이변량 프로빗 모형을 이용하여 분석하였다. 실증분석결과를 통하여 수출과 해외직접투자는 기업의 국제화 전략적 측면에서 개별적이 아닌 동시적으로 고려 되어야 하며, 두 국제화 전략 사이에는 잠재적인 보완적 관계가 있다는 사실이 확인되었다. 또한 내수기업, 수출기업(단일전략), 해외직접투자기업(단일전략), 복합전략기업의 순으로 생산성 수준을 가진다는 실증분석결과는 기업의 생산성 차이가 국제화 전략의 순위를 결정 한다는 기존의 이론적 가설과 부합함을 보여주었다. This paper conducts empirical analyses on simultaneous choice of two globalization strategies-exports and foreign direct investment (FDI)-using data on the Survey of Business Structure and Activities provided by Statistics Korea. Our estimation results show a possible complementarity between the two strategies and support the theoretical hypothesis of Helpman, Melitz and Yeaple (2004) about globalization strategy according to productivity ordering; domestic firms, exporting firms, FDI firm, and multi-strategies firms.

      • SSCISCOPUSKCI등재

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