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참깨에서 추출한 Sesamin 섭취가 혈청 지질 농도에 미치는 영향
윤명호,신준한,김한수,탁승제,최병일 아주대학교 1997 아주의학 Vol.2 No.2
Objectives : High serum cholesterol is one of the major risk factors of coronary artery disease. We investigated the lipid-towering property and the side effects of sesamin, an unsaturated fatty add extracted from sesame oil, for the primary prevention of coronary artery disease. Methods : The 37 patients (20 mates and 17 females) with hyperlipidemia, ages ranging from 22 years to 70 years old (48±12), who did not have atherosderotic diseases except essential hypertension were given three capsules of sesamin once daily for 6 weeks. The lipid profile of the patients were examined before and after sesamin treatment, and the patients were grouped according to the presence or abscence of hypertension, smoking habit and obesity. Result : Compared with pretreatment, the total cholesterol level of sesamin treated group decreased significantly (254.2±29.6 versus 241.6 34.0 ㎎/dl, p< 0.05). The level of LDL-cholesterol (162.6±24.3 versus 156.6±32.8 ㎎/dl)HDL- cholesterol (47.5±10.0 versus 47.0±8.7 ㎎/dl) and triglyceride (196.5±95.4 versus 179.3±96.7 ㎎/dl) and the ratio of LDL/HDL- cholesterol (3.6±0.9 versus 3.4±0.9) were not significantly different. The effect of cholesterol lowering property of sesamin was predominant in hypertensive, non- smoking and obese group (P< 0.05 vs pretreatment). The laboratory tests including complete blood cell counts, serum transaminases, total protein, albumin, blood urea nitrogen, creatinine and blood glucose did not change significantly. Conclusion : The lipid lowering effect of sesamin was statistically significant on the total cholesterol particularly with obese, non-smoking and hypertensive patients. There was no significant side effect during sesamin administration. Therefore, three capsules of sesamin as a single daily dose were effective in lowering total cholesterol and safe to administer in patients with hyperlipidemia.
관상동맥 조영술상 정상인 고혈압환자에서 관상동맥 혈류 예비력의 결정인자
고종훈,윤명호,최소연,탁승제 관동대학교 의과대학 의과학연구소 2005 關東醫大學術誌 Vol.9 No.1
Background ; Several studies were reported that reduction of coronary flow reserve(CFR) might lead to myocardial ischemia in the absence of epicardial coronary stenosis. In addition left ventricular hypertrophy might be associated with impairment of coronary flow reserve. The aim of the this study was to assess whether relation exists between CFR and left ventricular mass index(LVMI) and to evaluate the major determinant factors of CFR. Method ; We studied 32 inpatients with hypertension and normal coronary angiogram. Control group consised of 19 subjects(M:F=10:9, mean age 52.6±9.7), group Ⅰ included 14 subjects (LVMI is below 125mg/m2,M:F=6.8 mean age 55.3±14.6) and group Ⅱ consist of 18 subject (LVMI is exceeded 125mg/m2,M:F=5:13 mean age 55.8±9.4). We measured the left ventricular mass(LVM) by M-mode echocardiogram using Devereus and Reichek's method. Left ventricular mass index was calculated as LVM / BSA. We measured average peak velocity at baseline(B) and at adenosine induced hyperemie(H) at the proximal segment of left anteriror descending artery(LAD) using a 0.014 inch 15MHZ doppler wire, CFR was calculated as the hyperemic/baseline(H/B) average peak velocity ratio. Result : 1) There was no significant difference In heart rate, systolic blood pressure or diastolic blood pressure between the two hypertensive groups. 2) The B-APV was significantly increased in hypertensive group compared to the control group(14.4±4.7./21.7.±7.5/23.1±8.1cm/sec p<0.05). 3) CFR was significant reduced in groupⅠand groupⅡ than in the control group (3.2±0.4/2.53±0.6/2.38±0.7 p<0.05). Conclusion ; In hypertensive patients with angiographicaly normal coronary arteries, coronary flow reserve was significantly reduced than normal control group. and CFR was mainly determinant by baseline average peak velocity and not by left ventricular mass index.
S-187 Prognostic value of Neutrophil to Lymphocyte Ratio in Patients with STEMI
( Moon-seung Soh ),( Jin-sun Park ),( Kyoung-woo Seo ),( Hyoung-mo Yang ),( Hong-seok Lim ),( Byoung-joo Choi ),( So-yeon Choi ),( Myeong-ho Yoon ),( Gyo-seung Hwang ),( Seung-jea Tahk ),( Joon-han Sh 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Background:?The ratio between the absolute number of neutrophils and the number of lymphocytes (NLR) has recently emerged as a potential new biomarker predicting worse clinical conditions ranging from infectious disease to cardiovascular disease. Prognostic significance of NLR in patients with ST-elevation myocardial infarction (STEMI) is not established. This study aimed to investigate prognostic impact of NLR in patients with STEMI.?Methods:?We analyzed the data and clinical outcomes of 30-day survivors with STEMI who received successful coronary intervention from 2003 to 2005. NLR was computed from the absolute values of neutrophils and lymphocytes from the complete blood count at admission. Occurrence of major adverse cardiovascular events (MACE; death, recurrent MI, target vessel revascularization (TVR)) within 10 years was evaluated.?Results:?We enrolled 326 patients and mean follow-up duration was 68±36 months. The mean NLR was 4.7±5.2. Among all patients, all-cause mortality occurred in 46 patients (14%). Initial NLR was higher in patients who experienced all-cause mortality (6.39±8.9 vs. 4.2±3.1, p=0.004) In a multivariate regression model, the higher NLR was independently associated with increased risk for all-cause mortality (OR, 1.085; 95% CI, 1.002-1.174, p=0.044, Table 1).?Conclusions:?Increased NLR was associated increased rate of all-cause mortality in 30-day survivors after index STEMI, who received successful coronary intervention.
박승정(Seung Jung Park),심원흠(Won Heum Shim),조승연(Seung Yun Cho),이웅구(Woong Ky Lee),김성순(Sung Soon Kim),탁승재(Seung Jea Tahk),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung) 대한내과학회 1988 대한내과학회지 Vol.35 No.1
N/A Percutaneous mitral balloon valvuloplasty (PMV) using the double-balloon technique was performed in 28 symptomatic patients with mitral stenosis who were candidates for mitral valve commissurotomy. There were 21 women and 7 men with a mean age 38±10 years (range 23 to 57). PMV in 28 patients with moderate to severe mitral stenosis (including 3 with a fluoroscopic calcified valve) resulted in an increase mitral valve area (0.9±0.2 to 2.2±0,7cm, p<0.0001) by Gorlin`s formula, and a decrease in mean diastolic mitral pressure gradient (16.8±5.7 to 6.1±3.9mmHg, p<0.0001), and mean left atrial pressure (23.6±6.7 to 11.7±5.8mmHg, p<0. 0001). And also cardiac output increased (4.8±1.0 to 5. 8±1.5L/min, p<0.005) and mean pulmonary artery pressure decreased (32±12 to 24±9mmHg, p<0.05). Mitral regurgitation developed or increased in severity after PMV in 15 (53.6%) patients, grade 3mitral regurgitation in 2 and no mitral regurgitation in 12 patients. Oxymetric studies performed immediately after PMV demonstrated a small left-to-right shunt (pulmonary-to-systemic blood flow ratios>1.5) through the interatrial communication in 4 patients. Follow up echocardiography showed improvement in mitral valve area by 2-D and Doppler pressure half-time (0.9±0.2 to 1.8±0.5 and 0.8±0.2 to 1.7±0.4 cm, p<0.0001), increase of mitral EF slope (13±7 to 37±17mm/ sec, p<0.0001) and decrease peak E mitral velocity (209±32 to 142±32cm/sec, p<0.0001). Transient cerebral embolic phenomenon just after PMV was observed in 1 patient and cerebral embolic infarction with hemorrhage requiring surgery developed in 1 patient. PMV using the double-balloon technique is safe and effective procedure to relieve mitral valve obstruction and could be an alternative to surgical mitral commissurotomy in selected patients with mitral stenosis.
발작성 상심실성 빈맥환자에 있어서 각종 항부정맥제에 대한 전기생리학적 검사
김성순(Sung Soon Kim),박승정(Seung Jung Park),장양수(Yang Soo Jnag),탁승제(Seung Jea Tahk),심원흠(Won Heum Shim),조승연(Seung Yun Cho),김현승(Hyun Seung Kim) 대한내과학회 1991 대한내과학회지 Vol.40 No.3
N/A Electrophysiologyc studies (EPS) and serial drug testing were performed in 100 consecutive patients with paroxysmal supraventricular tachycardia (PSVT) but without ventricular preexcitation. All patients had a history of electrocardiographically-documented PSVT. Two patients with concealed bypass tract (CBT) had Ebstein's amomally, and 1 patient with atrial reentrant SVT had mitral stenosis. The remaining patients had structurally normal hearts. Ninety-eight patients had inducible sustained PSVT during the control study. Two had only nonsustained PSVT. EPS revealed AV reentrance utilizing concealed bypass tract (CBT) in 63 patients (Group I), A V nodal reentrance in 36 (Group II), and atrial reentrance in 1. The location of the accessory pathway in Group I was left free wall in 45 (72%.), posteroseptal in 12 (19%), right free wall in 4 (6%), and anteroseptal in 2(3%) patients. Eight patients had associated anterograde dual AV nodal pathways. Five of them utilized slow AV nodal pathway for anterograde conduction during AV reentrant SVT. Single and double atrial extrastimulation demonstrated discontinuous AV nodal conduction curve in 28 patients (77%) in Group II, and the remaining 8 had a continuous AV nodal conduction curve. Serial daily SVT induction was attempted after intravenous ad- ministration of procainamide 20 mg/kg, verapamil 0.15 mg/kg, digoxin 0.75 mg, and proplanolol 0.15 mg/kg. In Group I, procainamide showed drug response in 40/49 (82%), flecainide in 24/32 (75%), verapamil in 36/41 (89%), digoxin in 5/20 (25%), and digoxin + propranolol in 9/18 (50%). In Group II, procainamide showed drug response in 21/24 (88%), flecainide in 10/11 (91%), verapamil in 20/28 (95%), digoxin in 12/20 (60%), and digoxin + propranol l in 11/15 (73%) patients. In conclusion, AV reentrant SVT utilizing CBT is the most common mechanism (63%) of PSVT in symptomatic Korean patients. Serial EPS with multiple drugs is very useful to define effective dugs in patients with symptomatic PSVT. Our data on serial drug testing might help us select the drug for those who want to be treated without invasive EPS.
관상동맥동내 전극도자를 이용한 좌측 우회로의 전기적 절제술
김성수(Sung Soon Kim),박승정(Seung Jung Park),탁승제(Seung Jea Tahk),장양수(Yang Soo Jang),심원흠(Won Heum Shim),조승연(Seung Yun Cho),김현승(Hyun Seung Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.4
N/A Background: Surgical treatment has been reserved for treatment of paroxysmal or incessant bypass tract mediated reentrant tachycardia refractory to medical management. During the past decade, catheter ablative techniques have been introduced that replicate the surgical experience without expense and morbility associated with cardiac surgery. Methods: Catheter ablation (CA) of accessory pathway (AP) via the coronary sinus (CS) was performed in 70patients (43male, 27female) with symptomatic supraventricular tachyarrhythmias. Thirty one patients had manifest AP and 39had concealed AP. Sixty one patients had left. free wall AP and 9had posteroseptal AP. Two to 6unipolar D.C shocks (80-100J) were delivered between the electrode (cathode) close to the AP in the CS and a patch electrode (anode) placed on the posterior or lateral chest wall in each patient. Six patients received additional 1 to 2unipolar shocks of 200J via electrically common pair of electrodes {cathode). One to 2additional bipolar shocks (80J) were delivered via two electrodes close to the AP in the CS in the first 5patients. Results: Immediately after the shock was delivered, ventriculoatrial conduction via AP was abolished in all patients and anterograde AP conduction was eliminated in each patient with preexcitation. Two patients had prolonged sinus pause requring pacing for 10min. One who received 1shock of 200J required emergency surgery for a ruptured coronary sinus. One patient who received 3shocks of 100J developed cardiac tamponade requiring needle pericardiocentesis. Other complications were accelerated junctional rhythm in 8patients, nonsustained slow ventricular tachycardia in 2patients and an asymptomtic pericardial effusion in 2patients. Sixteen patients had recurrence within 2months (initial success rate of 77%. 54/70). Five underwent second ablation with successful result in 2, The overall longterm success rate (6-57mos, mean follow-up=24.6±7.4mos) was 80% (56/70), Mean peak CK-MB reached 34.8±23.8 IU/L (control CK-MB 6.0±5.4 IU/L). Conclusions: Although CA carries some life- threatening risk, it may be an effective alternative to surgical ablation of the left-sided AP in a selected group of patients.