S-상 심실중격의 임상적 고찰

이동민,장경식,양종태,장대용,김종오,서영욱,고영엽,홍순표 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background: The sigmoid septum described an anatomical variation in the contour of the left ventricular outlet. It is related to degenerative change with aging. We observed clinical significance of sigmoid septum in Korean. Methods: Echocardiographic examination was performed in 434 patients. Sigmoid septum is defined as discrete bulging of the proximal interventricular septum with that thickness is greater than 1.3cm or the thickness is grater 1.5 times than adjacent mid interventricular septum in apical 3 chamber view. Result: The incidence of patient with sigmoid septum(septum patient) is 24.8% (male 8.4%, female 16.3%) . The incidence increases with age and is more common in women. The patients with sigmoid septum were compared with targeted groups, there was no significant difference in blood pressure between them, but in height and weight, the former were lower. (p<001, p<03). In the patients with sigmoid septum, weight and the surface area of a body have an opposite correlation with increase of age (p<03, r=-0.34) (p<04, r=-0.31) , but no decrease of height was found according to age increase (p=0.47, r=-0.11) The main reason patients with sigmoid septum ask echocardiolography and its clinical symptoms were abnormal results of previous electrocardiography and/or usual chest pain. Compared with control group, interventricular septal thickness is larger in septum patients (p<001). The thickness of interventricular septum located in subaortic left ventricular outflow tract is 1.6±0.3cm. There is another web like structure that continued from interventricualr septum to anterior free wall of left ventricle and the width is 1.6±0.4cm. A sign of insignificant obstruction due to left ventricular outflow was observed from three sigmoid septum patients. Conculusion: Septum patient is largely found in older age group and the body weight and body surface area are lower than control group. The body weight and body surface area are opposite correlation with age. So sigmoid septum is considered as structural change by weight reduction with aging. It is assumed that septum patients are related with asymptomatic ischemia because they have more abnormal ECG finding such as T wave inversion on precordial leads or standard leads, nonspecific ST-T change, LBBB etc. Sigmoid septum is not only proximal interventricular septal bludging but also another web like structure continuing to anterior wall of left ventricle.

관상동맥색전증에 의한 급성심근경색증 4예

김민근,주혜원,강경필,최병돈,박민석,변영섭,고충원,이건주,김병옥 인제대학교 2006 仁濟醫學 Vol.27 No.-

Acute myocardial infarction(AMI) due to coronary embolism can occur in patients with normal coronary artery. Coronary embolism is believed to be a cause of acute myocardial infarction when emergent coronary angiography shows perfectly normal coronary trees, except for the finding of coronary artery occlusion. In this report, we describe four patients with AMI due to coronary embolism who were successfully treated using a thrombus aspiration device and anticoagulation, and those patients had intracardial thrombus arising from the left atrium due to chronic atrial fibrillation and valvular heart disease. Patients with chronic or paroxysmal atrial fibrillation can present with AMI due to coronary embolism, and thrombus aspiration with percutaneous aspiration device is a feasible treatment option for these patients along with anticoagulation the rapy.

비수도권 대학생 임대주거 실태 및 요구

박경옥, 송민경, 이종현 충북대학교 생활과학연구소 2013 생활과학연구논총 Vol.17 No.2

The purpose of this study is to propose the renal housing policy direction for undergraduates based on their actual rental housing conditions and needs who reside in non capital area. For the study, questionnaires were answered by 315 undergraduates of 3 universities who reside in rental housings in Cheongju-city. Major findings were as follows: (1) Most of undergraduate rental housings had the size from 12㎡ to 29㎡ and from 29㎡ to 41㎡, were multi-household studio type with room+bath+kitchen, and were typically monthly rent payment. (2) The needs of rental housings were the same as present residence. The possible monthly rent were mostly 300 thousand won, and the most preferred distance was under 10 minute walk from university. The assistance policy that undergraduates need was firstly the central/local governments' refurbished housing supply near university with low rent, and then deposited housing supply for undergraduates by LH corporation.

식품 위해 요소중점 관리 기준에 대한 서울지역 사업체 급식관리자의 위생관리평가

이헌옥,심재영,김영경,조민호,최호순,엄애선 한국조리과학회 2001 한국식품조리과학회지 Vol.17 No.6

Hazard Analysis Critical Control Point(HACCP) is becoming an important component of food safety worldwide. The aim of this study was to investigate comprehensively the education and knowledge level of food service managers on HACCP as well as applying HACCP system to industrial foodservice. Total 247 foodservice managers participated in the survey and 159 responses were used for analysis. The results were as follows; 1) 89% of foodservice managers were educated about HACCP, and 40.9% felt they did fully understand HACCP and 47.8% did half. 2) The score for the implementation of HACCP was in the order of apparatus and facility sanitation, personal sanitation, and time-temperature/etc. sanitation. 3) Foodservice managers who were taught HACCP kept a deep attention to food and personal sanitation, compared with those without education(p<0.05). However, the education time on HACCP affected conducting safety management. The results suggest that education and understanding of HACCP are positively related, and understanding of HACCP has a positive influence on conducting safety management.

도플러검사법을 이용한 새로운 심기능평가법 : 급성 심근경색증에 의한 심기능장애의 선별진단법으로서 심기능지표의 유용성 The Utility of Cardiac Performance Index in the Screening Test of Cardiac Dysfunction due to Acute Myocardial Infarction

김원,임경수,이영주,최옥경,전정민 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : Because systolic and diastolic dysfunction frequently coexist in acute myocardial infarction (AMI), we hypothesize that a combined measure of ventricular performance using Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic chest pain. Method and Results : Seventy-one patients with AMI (47 male, 59±11 years) and 45 patients with normal coronary artery (29 male, 52±11 years) were included in the study for measurement of cardiac performance index and established parameters of ventricular function using conventional echo-Doppler methods. a new derived index of cardiac performance: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The mean value of the index was significantly different between normal and AMI(p<0.01). The degree of inter-group overlap was smaller for the index compared to other parameters. within functional groups, the value of the index did not appear to be related to heart rate, mean arterial pressure and the degree of mitral regurgitation. Conclusion : cardiac performance index is a conceptually new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it is useful as screening test for patients with cardiac dysfunction due to AMI

경막외 마취시 Clonidine 과 Epinephrine 첨가에 따른 마취연장효과의 비교

최영석,이미경,이일옥,윤석민,임상호,김난숙 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.2

Epidural clonidine is reported to produce analgesia in humans. To investigate the analgesic effect and prolongation of epidural and spinal anesthesia, we mixed 0.2mg epinephrine, 150 mcg clonidine, or 1 cc normal saline with 0.5% bupivacaine and compared the hemodynamie and analgesic effects of each drug. Heart rate and blood pressure were checked before, during and after anesthesia. Sensory level was checked by pin-prick method. The results were as follows; 1) The analgesia onset time and the time to highest level of sensory loss was most rapid in the epinephrine group. 2) The two segment regression time was significantly prolonged in the epinephrine group. 3) The analgesia duration was significantly prolonged in the clonidine and epinephrine group. 4) Although the heart rate gradually decreased over 60 min. After injection of each drug, there was no significant change between the groups. 5) Blood pressure decreased over 20-30 min. After injection of each drug, but there was no significant change between the groups.

신기능과 혈색소의 관계

우학 ( Hak Woo ),신민호 ( Min Ho Shin ),김옥기 ( Ok Ki Kim ),배우균 ( Woo Kyun Bae ),조영욱 ( Young Wook Cho ),이연경 ( Youn Kyoung Lee ),마성권 ( Seong Kwon Ma ),김수완 ( Soo Wan Kim ),김남호 ( Nam Ho Kim ),최기철 ( Ki Chul Choi 대한내과학회 2007 대한내과학회지 Vol.72 No.2

목적: 빈혈은 만성신질환 환자들에서 좌심실비대 등 건강에 여러 가지 악영향을 미치는 중요한 합병증 중의 하나이다. 기저질환에 관계없이 신기능의 악화에 따른 빈혈의 발생빈도, 혈색소 농도와 적혈구용적률의 변화 및 성별에 따른 차이를 알아보기 위해 이 연구를 시행하였다. 방법: 전남대학교병원 내과에서 치료하고 있는 환자들 중 남성 157명, 여성 132명의 의무기록을 후향적으로 분석하였다. MDRD 등식에 따라 추정 사구체여과율을 측정하고, 사구체여과율(GFR)이 90 mL/min/1.73 m2 이상을 기준(정상)으로 하여, 추정 사구체여과율이 10 mL/min/1.73 m2씩 감소함에 따라 9개 군으로 분류하여 기준과 비교하여 평균 혈색소 농도와 적혈구용적률이 통계학적으로 유의하게 감소하는 신기능의 범위를 찾아서 남성과 여성을 각각 비교하였다. 결과: 모든 대상 환자들은 기준치(추정 사구체여과율≥90 mL/min/1.73 m2)에 비해 추정 사구체여과율 50≤GFR<60 mL/min/1.73 m2에서 평균 혈색소 농도는 0.8 g/dL(p=0.021), 적혈구용적률은 2.6%(p=0.011)가 감소하였고, 신기능이 감소함에 따라 평균 혈색소 농도와 적혈구용적률은 더욱 유의하게 감소하였다(Hgb.: r=0.635, Hct.: r=0.640, p<0.001). 남성은 기준치에 비해 추정 사구체여과율 40≤GFR<50 mL/min/1.73 m2에서 평균 혈색소 농도는 1.7 g/dL(p<0.01), 적혈구용적률은 4.4%(p<0.01)가 감소하였고, 신기능이 감소함에 따라 평균 혈색소 농도와 적혈구용적률은 더욱 유의하게 감소하였다(Hgb.: r=0.69 8, Hct.: r=0.689, p<0.001). 여성은 기준치에 비해 추정 사구체여과율 60≤GFR<70 mL/min/1.73 m2에서 평균 혈색소 농도는 0.9 g/dL(p<0.01), 적혈구용적률은 2.8%(p<0.01)가 감소하였고, 신기능이 감소함에 따라 평균 혈색소 농도와 적혈구용적률은 더욱 유의하게 감소하였다(Hgb.: r=0.672, Hct.: r=0.687, p<0.001). 결론: 만성신질환 환자들에서 혈색소 농도와 적혈구용적률은 신기능이 감소함에 따라 점차 감소하였고 이것은 경증 내지 중등도 신기능 감소부터 관찰되었다. Background: The goal of this study is to define the relationship between the decreased renal function and anemia, and also to determine whether this relationship is different in male and female patients. Methods: We conducted a retrospective study of 289 patients (male:female=157:132) who were followed at the department of internal medicine at Chonnam National University Hospital. General linear models were used to analyze the relationship between the hemoglobin concentration and Modification of Diet in the Renal Disease formula estimated Glomerular Filtration Rate (mL/min/1.73 m2). Results: Among all patients, the mean hemoglobin concentration and hematocrit of the men with a Glomerular Filtration Rate of 50~59 mL/min/1.73 m2 was an absolute change of 0.8 g/dL (p=0.021) and it was 2.6% (p=0.011) lower than those of the patients with a Glomerular Filtration Rate≥90 mL/min/1.73 m2 and continued to decrease further as the Glomerular Filtration Rate decreased, respectively (Hgb.: r=0.635, Hct.: r=0.640, all p<0.001). Among the male patients, the mean hemoglobin concentration and the hematocrit of men with a Glomerular Filtration Rate of 40~49 mL/min/1.73 m2 was an absolute change of 1.7 g/dL (p<0.01) and it was 4.4% (p<0.01) lower than those of the male patients with a Glomerular Filtration Rate≥90 mL/min/1.73 m2 and continued decrease as the Glomerular Filtration Rate decreased, respectively (Hgb.: r=0.698, Hct.: r=0.689, all p<0.001). Among the female patients, the mean hemoglobin concentration with a Glomerular Filtration Rate of 60~69 mL/min/1.73 m2 was an absolute change of 0.9 g/dL (p<0.01) and the mean hematocrit was 2.8% (p<0.01) lower than those of the female patients with a Glomerular Filtration Rate ≥90 mL/min/1.73 m2 and continued to decrease further as the Glomerular Filtration Rate decreased, respectively (Hgb.: r=0.672, Hct.: r=0.687, all p<0.001). Conclusions: A decrease in the hemoglobin concentration was statistically significant in the patients of both genders, along with a moderately decreased Glomerular Filtration Rate (≤60 mL/min/1.73 m2). (Korean J Med 72:191-199, 2007)

Comparison of Pharmacokinetics and Safety of a Fixed-dose Combination of Rosuvastatin and Ezetimibe Versus Separate Tablets in Healthy Subjects

Min, Kyoung Lok,Park, Min Soo,Jung, Jina,Chang, Min Jung,Kim, Choon Ok Elsevier 2017 Clinical therapeutics Vol.39 No.9

<P><B>Abstract</B></P> <P><B>Purpose</B></P> <P>Rosuvastatin and ezetimibe are concomitantly used for dyslipidemia treatment. Compared with separate tablets, fixed-dose combination (FDC) tablets of rosuvastatin/ezetimibe could increase patient compliance. The aim of this study was to compare the pharmacokinetic (PK) profiles of an FDC tablet of rosuvastatin/ezetimibe and co-administration of rosuvastatin and ezetimibe as separate tablets in healthy Korean volunteers.</P> <P><B>Methods</B></P> <P>This trial was a randomized, open-label, single-dose, 2-way crossover study. The healthy subjects received an FDC tablet of rosuvastatin 20 mg/ezetimibe 10 mg (test) or co-administration of rosuvastatin 20 mg and ezetimibe 10 mg (reference) in each period (periods 1 and 2), with a 14-day washout period. The blood samples for PK analysis were collected predose and up to 96 hours after administration, and safety was assessed throughout the study.</P> <P><B>Findings</B></P> <P>Sixty-four healthy Korean subjects were enrolled, and 57 subjects completed the study. All subjects were men and mean age was 28.52 ± 5.93. The geometric least squares mean ratios (test/reference) and 90% CIs of C<SUB>max</SUB> and AUC<SUB>0–last</SUB> were 101.54% (94.03–109.65) and 97.71% (91.86–103.93) for rosuvastatin, 108.93% (98.55–120.40) and 102.90% (96.72–109.47) for free ezetimibe, and 106.74% (98.18–116.05) and 104.24 % (99.53–109.17) for total ezetimibe. Twenty-four adverse events (AEs) were reported in 22 subjects. Three cases were related to the study drugs; 2 cases were mild, and 1 case was severe. However, all AEs were resolved without any sequelae. In addition, there were no serious AEs throughout the study.</P> <P><B>Implications</B></P> <P>The FDC tablet of rosuvastatin/ezetimibe was well tolerated and resulted in comparable systemic exposure with co-administration of rosuvastatin and ezetimibe. ClinicalTrials.gov identifier: NCT02941848.</P>

Original Article : Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis

( Kyoung Min Moon ),( Ga Eun Kim ),( Soon Koo Baik ),( Eun Hee Choi ),( Moon Young Kim ),( Hyoun A Kim ),( Mee Yon Cho ),( Seung Yong Shin ),( Jung Min Kim ),( Hong Jun Park ),( Sang Ok Kwon ),( Young 대한간학회 2013 Clinical and Molecular Hepatology(대한간학회지) Vol.19 No.4

Background/Aims: We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis. Methods: Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0.F4) were evaluated. Results: The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0.F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4. Conclusions: The results indicate that this USSS has comparable effi cacy to LSM in the diagnosis of cirrhosis.

Clinical Significance of Non-Mass-Like Enhancement of Preoperative Magnetic Resonance Imaging in Breast Cancer Considering Breast-Conserving Surgery

Min-Ji Park,Min-Young Park,Jin-Ok Kwon,Kyoung Sik Park,Yeong-Beom Yu,Jung-Hyun Yang,Soo-Min Jung 한국유방암학회 2018 Journal of Breast Disease Vol.6 No.1

Purpose: The purpose of this study was to investigate the significance of non-mass enhancement (NME) findings on preoperative breast magnetic resonance imaging (MRI) when invasive breast cancer patients with single lesions underwent breast-conserving surgery (BCS). Methods: We reviewed the preoperative MRI findings of 252 patients who underwent BCS from January 2014 to September 2016. Based on the MRI findings, we divided the patients into two groups, those who did and did not have NME, and we retrospectively analyzed the clinical outcomes of the two groups. Results: The NME group had 57 patients, and the no-NME group had 195 patients. The incidence of in situ lesions was higher in the NME group than in the no-NME group (p<0.001). Additionally, the positive resection margin rate on frozen biopsy was higher in the NME group than in the no-NME group (p=0.002). Conclusion: When preoperative MRI had NME findings, in situ lesions were more likely to accompany invasive breast cancer lesions, and the positive resection margin rate for frozen biopsy during BCS was high. Therefore, in these cases, the lesion should be excised more widely when BCS is performed, or frozen biopsy for resection margin during BCS should be performed if possible.