관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

표면근전도와 적외선체열촬영을 이용한 요통의 평가

이강진,최인성,이소영,한재영,이삼규,채홍재,이성과,문재동 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 요통환자에서 요통의 유무와 강도를 평가하고자 표면근전도를 이용하여 근육 활동성의 차이를 검증하였고 적외선체열촬영을 이용하여 제표면 온도의 변화를 측정하였다. 방법 : 요통환자군 16명과 대조군 16명에 대하여 요부에 부착한 표면전극에서 얻은 근전도 신호와 적외선체열촬영 결과를 비교하였다. 교란요인의 영향을 배제하기 위하여 연령과 성별 그리고 비만도에 따라 정상 대조군과 요통환자군을 짝짓기하여 각각 16명씩 선정하였다. 결과 : 정적표면근전도 실시 결과 우측의 경우 중앙값이 요통환자군에서 198.1 ㎶, 정상대조군에서는 161.3 ㎶로 통계적으로 유의한 차이가 있었고(p<0.01), 좌측은 요통환자군에서 194.2 ㎶, 정상대조군에서 180.5 ㎶로 유의한 차이는 없었다. 동적표면근전도 실시 결과 재신전시와 굴곡시 근전위의 비가 우측의 경우 요통환자군에서 중앙값이 1.12였고 정상 대조군은 1.39로서 두 군간에 유의한 차이가 있었고(p=0.027), 좌측의 경우도 요통환자군에서는 1.08이었고 정상 대조군에서는 1.21로 유의한 차이가 있었다(p=0.036). 적외선체열촬영결과 ΔT가 0.5 ℃ 이상의 차이가 있을 때 이상이 있는 것으로 정하면, 요통환자군에서는 16명 모두 이상자로 판정되었고, 정상 대조군에서는 16명중 3명이 이상자로 판정되어 민감도는 100 %, 특이도는 81.3 % 였다. 표면근전도를 이용한 요통의 진단은 민감도가 78.6 %이고 특이도가 72.2 %였으며, 적외선체열촬영은 민감도가 100 %였고 특이도가 87.5 %였다. 결론 : 이러한 결과로 볼 때 표면근전도 검사법과 적외선체열촬영은 요통을 간접적으로 평가하는데 도움이 되는 검사법이며, 적외선체열촬영이 표면근전도검사법에 비하여 보다 정확한 검사법으로 판단된다. Objectives : We studied the efficacy of surface electromyography(SEMG) and digital infrared theimographic imaging (DITI) in the assessment of low back pain both(LBP) Methods : We compared electromygraphic signals from electrodes placed in the lumbar area and the digital theimographic images in 16 LBPpatients and 16 control subjects. The LBP patients and the control subjects were matched for age, gender, and body mass index(BMI) to adjust for any confounding effects Results : In the static analyses of SEMG, median value was 198.1 ㎶ for the controls on the right side, and they were 194.2 ㎶ and 180.5㎶ on left side respectively. There was a statistically significant difference between the two groups on the right side(p<0.01), but not on the left side. In the dynamic analyses of the SEMG, the median values of the extension per flexion ratio of right side were 1.12 for LBP patients and 1.39 for controls. and those on the left side were 1.08 and 1.21 respectively. There were statistically significant differences in both sodes(p<0.05). The sensitivity and specificity were 100% and 81.3% in DITI, 78.6% and 72.2% in SEMG. Conclusions : These results indicate that SEMG and DITI are useful methods for indirect assessments of LBP, and that DITI is more sensitive and specific than SEMG.

퇴행성 슬관절염에 대한 제통단의 안정성과 효능 임상연구

서병관,류성룡,강중원,안경애,이상훈,최도영,김건식,이두익,이윤호,이재동 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo-controlled randomized clinical trial of patients with osteoarthriotis of the knee was undertaken. Methods : Data were obtained from 80 patients with OA of the knee. After the enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transminase (ALT) level, blood urea mitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results : The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by Jetongdan. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions : Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

제통단이 퇴행성 슬관절염 환자의 삶의 질에 미치는 영향

서병관,류성룡,강중원,우현수,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : to evaluate the effects of Jetongdan, the newly developed herbal medicine, on the quality of life in patients with osteoarthritis of knee Methods : Placebo-controlled, randomized clinical trial on the 80 patients with osteoarthritis of the knee was fulfilled. After enrollment, they took medication as they enrolled. And they were asked to answer the questionnaires (Korean Health Assessment Questionnaire (KHAQ), Lequesne's functional index (LF1), visual analogue scale (VAS)) and analysed with the erythrocyte sedimentation rate (ESR) at baseline, after 4 weeks and 8 weeks of medication. Results : Total KHAQ score, some categories of KHAQ like hygiene, activities were significantly improved after 8 weeks of medication. And the change of the KHAQ score was significantly correlated with the change of VAS. But LFI, VAS, ESR level was not significantly improved, and it was considered because of the short medication period and small size of study population. Conclusion : In conclusion, Jetongdan could improve the health-related quality of life in patients with osteoarthritis of knee. Further study in the large population, in long period were recommended.

퇴행성 슬관절염 환자의 증상 중증도 지표와 DITI의 상관성 연구

서병관,류성룡,강중원,안경애,이재동,최도영,김건식,이두익,이윤호,이상훈 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index, Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ,, VAS were not correlated with the thermal differences of each region. Conclusion : Further study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

KAL기 추락에 의한 대량재해의 개인식별

강신몽,이원태,고영창,최상규,김윤희,이홍석,서재관,윤중진,이혜경,최득린,김종열,윤창육,변명식,이장홍 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

Individual identification is an important part in medicolegal field especially in mass disaster. At July, 27, 1989, KAL KE-803 was crashed on landing at Tripoli International Airport, Liba. The plane was caught in fire and sixty eight Koreans were sacrified. The majority of victims were severely charred and injured. The authors examed all dead bodies and successfully identified all the cases through visual, anthropological, odontological, radiological and pathological methods including fingerprint and blood typing.

공원묘지 유실에 의한 대량재해의 개인식별

강신몽,이한영,윤중진,이원태,김종열,이영석,서재관,최득린,서지석,이혜경 大韓法醫學會 1992 대한법의학회지 Vol.16 No.1

Individual identification of severely decomposed or skeletonized bodies is an important part in medicolegal field. 142 bodies were torn up and carried away by flood in a park cemetry, Kwang-Ju, Kyunggi province, Korea at Sept., 10, 1990. The authors examed the 56 bodies, which were gained, through medical, anthropological, odontological, radiological methods, and superimposition for individual identification. Among them, 41 cases were successfully identified, and remaining 15 cases were not identified because of sever destruction and no adequate information.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

퇴행성 슬관절염 환자 평가 설문도구의 내적 신뢰도, 상관성에 관한 연구

류성룡,안경애,서병관,강중원,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The aim of this study is to evaluate internal reliability and correlation among assessment instruments of knee OA. Methods : Data were obtained from 85 patients with knee OA. They were asked to answer VAS pain scale, two disease-specific questionnaires (WOMAC and LFI) and one instrument about health-related quality(KHAQ). Reliability was assessed using cronbach's alpha. Correlation was assessed by examining the pearson's correlation coefficients. Results : Cronbach's alpha of all Index except WOMAC stiffness subscale(.6679) exceeded the value of 0.70. A good correlation was obtained between WOMAC Subscale (especially Pain Subscale) and LFI (.726<cronbach's alpha<.791). Also, Correlation between KHAQ and two disease-specific questionnaires (WOMAC and LFI) was good(.612<cronbach's alpha<.662). Conclusions : All used instruments have good internal reliability. also, There are good correlation among them. The treatment of knee OA must be focused on health related quality. For this, we should use proper assessment instruments.

복합 관동맥병변에서의 Rotational Atherectomy : 초기결과

김진우,박성욱,홍명기,이상곤,이일수,이철환,최기준,강덕현,송재관,김재중,박승정 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9