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.

Ga 함량에 따른 Cu(In<SUB>x</SUB>Ga<SUB>1-x</SUB>)Se₂ 태양전지의 특성분석

김석기(Seok Ki Kim),권세한(Se Han Kwon),이두열(Doo Yeol Lee),이정철(Jeong Churl Lee),강기환(Ki Whan Kang),윤경훈(Kyung Hoon Yoon),안병태(Byung Tae Ahn),송진수(Jinsoo Song) 대한전기학회 1998 대한전기학회 학술대회 논문집 Vol.1998 No.7

췌장암 환자에서 알코올 내장신경 신경파괴블럭 후 발생한 간염

이상은,최석환,김영환,임세훈,이정한,이근무,정순호,최영균,김영재,신치만 인제대학교 2008 仁濟醫學 Vol.29 No.-

Splanchnic neurolytic block(SNB) with alcohol improves the management of pancreatic cancer pain. Adverse effects of alcohol SNB which include regional pain, hypotension, diarrhea, and acute alcohol intoxication are common, but acute hepatitis caused by alcohol neurolytic block is rare. A 63-year-old patient with pancreatic head cancer and liver metastasis had complete pain relief after both retrocrural tansdiscal SNB with 100% alcohol 10 ml. But, 1 day later, liver function test showed a high elevation in the aspartate aminotransferase (AST, 2182 IU/L) and alanine aminotransferase (ALT, 1807 IU/L). The patient had slight jaundice, general weakness, chilling, nausea and vomiting after SNB. Both AST and ALT decreased to 46 and 119 IU/L within 10 days with only supportive therapy. But, 19 days later, the patient died due to pneumonia. Our case illustrates the importance of clinical surveillance especially in patient with hepatic disease after alcohol SNB.

Carbachol에 의한 닭 췌조직내 nitric oxide synthase 활성 및 methylated arginine 함량변화

유세근,남석우,박승희,남태균,서동완,한정환,홍성렬,이향우 성균관대학교 약학연구소 1994 成均藥硏論文集 Vol.6 No.1

The role of nitric oxide (NO) in the regulation of exocrine secretion was investigated in chicken pancreatic tissues. Nitric oxide synthase (NOS) in the pancreatic tissues were Ca^2+-dependent form. Treatment of tissue with L-arginine (10 mM) or carbachol (10^-5 M) showed the increase of pancreatic exocrine secretion, but that of D-arginine (10 mM) did not. ^3H-citrulline formation, cyclic GMP level and methyl arginine contents in the homogenates of pancreatic tissues treated with carbachol were not affected. Although the action mechanism of NO in the pancreatic tissues remains unknown, NO apparently participates significantly in the overall control of pancreatic secretory function.

농산물중의 잔류농약 실태에 관한 연구(Ⅰ) : 고체상 추출에 의한 농산물중 잔류농약 분석에 관한 연구 Analysis of Residual Pesticides in Agricultural Products by Solid-Phase Extraction

허옥순,이재관,이정성,서정혁,주인선,허수정,김세은,김정근,신영희,유미자,김지연,심규창,김성환 식품의약품안전청 1998 식품의약품안전청 연보 Vol.2 No.-

신속 · 정밀하고 효율적인 짠류농약 검출을 위하여 극싱칼럼 (Extrelut-3')을 사옹한 SPE법을 시도하였다. 시료는 채소류체 사용하는 농약중 잔류성이 있고 식품공전상 시험 전처리가 각각 다른 Chlorothalonil등 6종의 농약을 선정하고 그들 표준액에 대한 PPIR수준의 농도로추출용라의 종류 및 용매량 등의 추출조건을 달리하여 회수율 등을 측정한 결과 최적의 분석조건을 얻었다. 1) 추출 용매량은 증가할수록 추출 수율이 높았고,용매 종류에 대한 추출수율은 각 농약별로 다소 차이는 있었으나 극성 정도가 비교적 높은 Ethyl acetate애서 평균 추출수율이 가장 높았다 2) 최대 평균회수율은 Ethyl acetate 60mL를 사웅할 경우로서 93.6%였다. 3)표준액을 시료에 첨가한 시험에서도 역시 Ethyl ace늘to가 푼출수율이 가장 높았으며 불순물 분리제거 효과도 LLE법 보다 월등히 우수하였다. 4) 각 농약별 검출한계는 치소 0.001ppin으로 농산물 중 미량 잔류하는 농약을 검출할 수 있을 것으로 사료된파. 그러므로 SPE법은 LLE법보다 경제적인 방법으로 판명되었으며, 앞으로 농산물 중 잔류농약 분석에서 LEE법을 대치할 쑤 있을 것으로 기대된다. Solid-phase extraction by polar column(Extrelut-3') was attempted to develope the fast and efficient method of detecting pesticide of farm product.5·ix kinds of pesticide used in farming fieldfrequently and different in pretreatment, were chosen from Korea Food Cord. Optfmal analysis condi-tions were determiBed from t31e recovery rate of standard pesticides according to extraction solvent andextraction volurae. Extraction yietd was increased as solvent polarity and extraction volume. Maximumrecovery rate was acquired at 93.6% when 60mL of ethyl acetate was used as eluent. Tllis method wasmore effective than liquid-liquid partition extract·ion method to eliminated the impurity and had 0.001ppm of detection limit. Therefore. solid-phase eEl=raction was expected to be economical substitute fortraditional liquid-liquid extT·action method.

Analysis of Fifty Hotspot Mutations of Lung Squamous Cell Carcinoma in Never-smokers

Lee, Ha Youn,Lee, Se-Hoon,Won, Jae-Kyung,Lee, Dong Soo,Kwon, Nak-Jung,Choi, Sun Mi,Lee, Jinwoo,Lee, Chang-Hoon,Lee, Sang-Min,Yim, Jae-Joon,Yoo, Chul-Gyu,Kim, Young Whan,Han, Sung Koo,Park, Young Sik KOREAN ACADEMY OF MEDICAL SCIENCE 2017 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.32 No.3

<P>Smoking is the major risk factor for lung squamous cell carcinoma (SCC), although a small number of lung SCCs occurs in never-smokers. The purpose of this study was to compare 50 hotspot mutations of lung SCCs between never-smokers and smokers. We retrospectively reviewed the medical records of patients newly diagnosed with lung SCC between January 1, 2011 and December 31, 2013 in the Seoul National University Hospital. Formalin-fixed, paraffin-embedded tumor samples were used for analysis of hotspot mutations. Fifty cancer-related genes in never-smokers were compared to those in ever-smokers. Of 379 lung SCC patients, 19 (5.0%) were never-smokers. The median age of these 19 patients was 67 years (interquartile range 57–73 years), and 10 of these patients were women (52.5%). The incidence rates of stage I, II, III, and IV disease in this group were 26.4%, 5.3%, 31.6%, and 36.8%, respectively, and sequencing was performed successfully in 14 cases. In the 26 lung SCC tumor samples (12 from never-smokers and 14 from ever-smokers) sequenced using personal genome machine, the most common mutations were in <I>TP53</I> (75.0%), <I>RAS</I> (66.7%), and <I>STK11</I> (33.3%), but mutations were also found in <I>EGFR</I>, <I>KIT</I>, and <I>PTEN</I>. The distribution of hotspot mutations in never-smokers was similar to that in ever-smokers. There was no significant difference in overall survival between the 2 groups. The 50 hotspot mutations of lung SCC in never-smokers were similar to those of ever-smokers.</P>

Factors predictive of cardiac events and restenosis after sirolimus-eluting stent implantation in small coronary arteries

Lee, Cheol Whan,Suh, Jon,Lee, Se-Whan,Park, Duk-Woo,Lee, Seung-Hwan,Kim, Young-Hak,Hong, Myeong-Ki,Kim, Jae-Joong,Park, Seong-Wook,Park,, Seung-Jung WILEY-LISS 2007 CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS Vol.69 No.6

<B>Objectives:</B><P>Predictors of cardiac events and restenosis after sirolimus-eluting stent (SES) implantation in small coronary arteries were evaluated.</P><B>Background:</B><P>Although SES implantation has markedly reduced the risk of restenosis, small vessel disease remains a major cause of SES failure.</P><B>Methods:</B><P>We prospectively investigated the factors predictive of cardiac events and restenosis in 1,092 consecutive patients who received SES implantation for 1,269 lesions in small coronary arteries (≤2.8 mm). Follow-up angiography at 6 months was performed in 751 patients with 889 lesions (follow-up rate 70.3%).</P><B>Results:</B><P>Restenosis (diameter stenosis ≥ 50%) was angiographically documented in 65 patients with 77 lesions (8.7%): 55 focal (71.4%), 8 diffuse (10.4%), 2 diffuse proliferative (2.6%), and 12 total (15.6%). Lesion length, stent length, reference artery size, and in-stent restenotic lesions were univariate predictors of restenosis. By multivariate analysis, lesion length (OR 1.04; 95% CI 1.02–1.05; P < 0.001) and in-stent restenotic lesions (OR 3.38; 95% CI 1.80–6.35; P < 0.001) were significant independent predictors of restenosis. During follow-up (23.2 ± 7.9 months), there were 17 deaths (5 cardiac and 12 noncardiac), 5 nonfatal Q-wave myocardial infarctions, and 42 target lesion revascularizations. The cumulative probability of survival without major adverse cardiac events (MACE) was (96.6 ± 0.6)% at 1 year and (95.1 ± 0.7)% at 2 years. In multivariate analysis, lesion length (HR 1.04; 95% CI 1.01–1.07; P = 0.004) and in-stent restenotic lesions (HR 3.29; 95% CI 1.58–6.86; P = 0.001) were independently related to MACE.</P><B>Conclusions:</B><P>SES implantation in small coronary arteries is safe and effective, with lesion length having a major impact on restenosis and MACE. © 2006 Wiley-Liss, Inc.</P>

2 Cases of a Benign Pulmonary Metastasizing Leiomyoma

Lee, Eun Joo,Jeong, Hye Cheol,Lee, Sung Yong,Kim, Je Hyeong,Lee, Sang Yeub,Shin, Chol,Shim, Jae Jeong,In, Kwang Ho,Kang, Kyung Ho,Yoo, Se Hwa,Lee, Sang Hoon,Kim, Han-Kyeom,Oh, Yu Whan The Korean Academy of Tuberculosis and Respiratory 2009 Tuberculosis and Respiratory Diseases Vol.67 No.6

A benign pulmonary metastasizing leiomyoma is a recognized clinical entity that has been infrequently reported in the medical literature. We report two cases of a benign pulmonary metastasizing leiomyoma. A 35-year-old woman who underwent myomectomy and a cesarean section approximately 6 years earlier visited our hospital for further evaluation of incidentally revealed multiple lung nodules. A diagnostic percutaneuous biopsy was performed. Finally she was diagnosed with a benign metastasizing leiomyoma. The patient then received LH-RH and has been followed up since. The other 44-year-old woman presented after an initial radiology evaluation revealed the presence of multiple, small-sized lung nodules. She underwent a right middle lung wedge resection to confirm the diagnosis. Finally she diagnosed with a benign metastasizing leiomyoma. The multiple lung nodules have been followed up closely.

Risk factors and prognostic impact of venous thromboembolism in Asian patients with non-small cell lung cancer.

Lee, Yun-Gyoo,Kim, Inho,Lee, Eunyoung,Bang, Soo-Mee,Kang, Chang Hyun,Kim, Young Tae,Kim, Hak Jae,Wu, Hong-Gyun,Kim, Young Whan,Kim, Tae Min,Lee, Keun-Wook,Lee, Se-Hoon,Kim, Dong-Wan,Heo, Dae Seog F. K. Schattauer 2014 Thrombosis and Haemostasis Vol.111 No.6

<P>Although the overall risk of venous thromboembolism (VTE) is high in patients with non-small cell lung cancer (NSCLC), risk identification is limited. The goal of this study was to estimate the incidence, risk factors and prognostic implications of VTE, and to evaluate a genetic link between oncogenes and the risk of VTE in Asian patients with NSCLC. A total of 1,998 consecutive patients with NSCLC were enrolled and analysed retrospectively. Since the effects of therapeutics on VTE development were modified by stage, stratified analyses were performed. When comparing overall survival in terms of VTE development, a propensity score-matching method was adopted to minimise potential confounding. The six-month and two-year cumulative incidences of VTE were 4.2% and 6.4%, respectively. The risk of VTE increased 2.45-fold with each advancing stage in NSCLC (p<0.001). The independent predictors of VTE were advanced age, pneumonectomy and palliative radiotherapy in localised NSCLC and ineligibility for surgery and palliative radiotherapy in locally advanced NSCLC. Adenocarcinoma histology (vs squamous cell) and former/current smoking status were significant predictors of VTE in metastatic NSCLC. A significant association between VTE and decreased survival was observed only among patients with localised NSCLC. EGFR mutations (p=0.170) and ALK rearrangements (p=0.159) were not associated with VTE development in lung adenocarcinoma. In conclusion, the two-year cumulative incidence of VTE is 6.4% in Asian patient with NSCLC. The significant predictors of VTE are different across stages of NSCLC. The prognostic impact of VTE on poor survival was limited to localised NSCLC.</P>

이세연·송완범·정유경, 술로 풀어보는 일본사, 이상미디어

이세연 ( Lee Se Yeon ),송완범 ( Song Whan Bhum ),정유경 ( Jung Yu Kyung ) 동아시아비교문화연구회 2017 東硏(동연) Vol.1 No.-