폐경후 여성에서 1년간의 호르몬대치요법이 Lp(a)와 지질에 미치는 영향(호르몬대치요법과 Lp(a))

김치정 ( Chee Jeong Kim ),이광제 ( Kwang Je Lee ),정유석 ( Yoo Suk Chung ),민용기 ( Young Ki Min ),유왕성 ( Wang Seong Ryu ),유언호 ( Un Ho Ryoo ) 한국지질동맥경화학회(구 한국지질학회) 1996 韓國脂質學會誌 Vol.6 No.1

「폭력행위 등 처벌에 관한 법률」에 대한 비판적 고찰

김치정(Kim, Chee-joung) 강원대학교 비교법학연구소 2018 江原法學 Vol.55 No.-

형사특별법의 문제점으로 형벌불균형, 중형주의, 중복 · 유사 규정 등이 지적되고 있다. 대개의 형사특별법은 그때그때의 국민적 관심을 끄는 범죄문제에 민감하고 과도하게 반응하는 가운데 탄생하였다. 입법필요성에 대한 깊은 성찰은 찾기 어렵고, 정치인인 입법자는 시민의 범죄에 대한 우려를 피상적으로 덮기에 급급한 입법이기 때문에 이 과정에서 형사특별법의 제 · 개정은 용이하다는 인식도 생겨났다. 근거 없는 이런 사고 위에서 양산된 형사특별법은 형법의 과제 수행에 충실할 수 없다. 특별법 제 · 정을 통해 순간적인 경각심을 국민들에게 심어주는 일종의 선전만 부각되었을 뿐이다. 이러한 형사특별법 선호는 형법의 범죄 대처의 효과가 작다는 사고에서 출발한다. 다시 말해 무거운 처벌이 범죄대책에 효과적이라는 이른바 중형주의 사고가 깔려있다. 그러나 범죄자를 가중처벌함으로써 일반예방을 노리고자 하는 식의 사고는 검증되지 않은 허구적 주장에 불과하다. 형법의 규정이 있음에도 그와 균형을 잃은 가중처벌로 대응하는 것은 합리적이지 않다. 강한 억압과 처벌만이 범죄예방의 효과를 극대화 할 수 있다는 것은 개인의 자율성과 가치가 존중되는 자유민주사회에 맞지 않는, 인간의 존엄에 반하는 사고인데다, 범죄예방에도 도움이 되지 않는다. 중형주의 형사정책에도 불구하고 범죄예방효과는 미미한 한편, 현실적으로 특별법에 의하여 선고되는 형량은 그리 높지 않아 특별법의 존재를 의문스럽게 만들었다. 폭처법 제1조(목적)은 반헌법적 규정이며, 제2조(폭행 등)에서 제8조(정당방위등)은 중복, 중형적 입법이고, 제9조(사법경찰관리의 직무유기)와 제10조(사법경찰 관리의 행정적 책임)는 소송법적 규정이며, 실체적 사항의 규정으로 폭처법과는 부적합하게 보인다. 구체적으로 제2조(폭행 등)내지 제6조(미수범) 처벌규정은 폭력행위의 수단 등의 차이에 따라 법정형만 가중되어 있다. 또한 제7조(우범자)는 예비죄의 성격을 가진 조항이다. 단순히 그 물건을 제공하거나 알선한 행위만으로 범죄가 이루어질 우려가 있다는 것은 적절하지 않다고 본다. 제8조(정당방위 등)는 형법 제21조(정당방위)로도 충분히 의율이 가능하다. 제9조(사법경찰괸리의 직무유기)는 형법 제122조(직무유기)의 주체만 바뀐 조항으로 형법의 직무유기죄나 범인은닉죄로 의율 할 수 있는 조항이고, 제10조(사법경찰관리의 행정적 책임)는 검찰청법 제54조와 비슷한 규정이며, 수사절차상의 조항으로 필요하다면 형사소송법에 속하는 규정이라는 것이다. 결과적으로 과잉범죄화만 초래하고, 형법으로 해석하고 적용하는데 충분한 것을 더 난해하고 복잡하게 할 뿐이다. 폭처법은 형법의 규정으로 충분히 의율 할 수 있는 전형적인 중복입법이며, 책임주의와 과잉금지 및 비례원칙에 어긋나는 중형주의 입법의 전형이고, 범죄 규정간의 균형도 깨뜨리는 불균형적인 법률이다. 폭처법을 폐지하고 형법의 적용으로 법을 순화시키고 단순화시키는 당연한 작업이 서둘러 이루어져야 할 것이다. 형법이 명실상부하게 범죄와 형벌에 관한 기본법으로 자리 잡고 적용될 때, 집행의 확실성도 커지고 법에 대한 신뢰도 높아질 것이다. 난해하고 다양한 형사특별법의 제정이 아니라 단순하고 최소한의 법 규정을 합리적인 법적용이나 법해석을 통해서 집행할 때 범죄는 줄어드는 것이다.

종설 : 고콜레스테롤혈증; 새천년 한국에서는 어떤 환자를 어떻게 치료할 것인가?

김치정 ( Chee Jeong Kim ),이광제 ( Kwang Je Lee ) 대한내과학회 2007 대한내과학회지 Vol.72 No.6

Cardioprotective effect and the safety of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) has been established in many large-scaled randomized controlled trials encompassing both primary and secondary prevention. Therefore, the market of statins is growing rapidly. In new millennium, several studies have shown the benefit from further reducing already low concentration of low density lipoprotein-cholesterol in high-risk patients. However, these clinical trials have applied selection criteria to protect the internal validity at the expense of reducing the applicability of the trial`s findings to the wider population of patients seen in routine clinical practice. Treatment guideline for Korean hypercholesterolemic patients followed that of American. However, the death rate by coronary artery diseases is much lower in Korean population than in American population. The efficacy of statins in preventing cardiovascular diseases and the pitfalls in recent randomized controlled trails will be reviewed and the personal opinion for the management of Korean hypercholesterolemic patients will be suggested. (Korean J Med 72:580-592, 2007)

폐경후 여성에서 호르몬 대치요법의 투여기간이 지질과 Lipoprotein ( a ) 에 대한 효과에 미치는 영향

김치정(Chee Jeong Kim),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),이광제(Kwang Je Lee),정유석(Yoo Suk Chung),민용기(Young Ki Min),유왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1997 대한내과학회지 Vol.52 No.6

N/A Objectievs: Hormone replacement therapy(HRT) in postmenopausal women decreases lipoprotein(a) [Lp(a)]. The influences of progesterone on Lp(a) and lipids, administered with estrogen, are controversial. However, previous studies had variable duration of therapy, and there was no report evaluating the effect of the duration of medication. Methods: A total 246 postmenopausal women were divided into 4 groups: group A; 0.625mg conjugated equine estrogen(CEE)(n=90), group B; 0.625mg CEE plus 5mg medroxyprogesterone acetate(MPA)(n=35), group C; 0.625mg CEE plus 10mg MPA(n=43), and group D; 2mg estradiol valerate(E2) plus 0.5mg norgestrel(N)(n=76). Lp(a) and lipids levels were measured before, 2, 6 and 12 months after HRT. Results: In total subjects, Lp(a) was decreased with medication for 2 months by 20.7%(p<0,0001). Compared with levels at 2 months after medication, levels at 6 and 12 months revealed further reduction(p<0.001) by 5.3% and 9.0% respectively. Medication for 2 months increased HDL-C in group A, not changed in group B and C, and decreased in group D. After 12 months, HDL-C levels were increased in Group A, B, and C, and not changed in group D, In total subjects, low density lipoprotein- cholesterol(LDL-C) was decreased by 12.2% after 2 months(p<0.001). Compared with levels at 2 months after medication, LDL-C level was decreased by 3.4% after 6 months(p<0.001) and there was no further reduction after 12 months. Conclusion: The effect of hormone replacement therapy on Lp(a) and lipids were dependent upon the duration of medication. Inconsistent results in previous studies can be partially explained by the difference in this parameter.

증례 : 순환기 ; 경부 종물로 발현된 원발성 경정맥류

김정은 ( Jung Eun Kim ),이왕수 ( Wang Soo Lee ),조은정 ( Eun Jeong Cho ),김상욱 ( Sang Wook Kim ),김치정 ( Chee Jeong Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.1

Venous ectasia, also called phlebectasia or venous aneurysm, is an isolated saccular or fusiform dilatation of a vein. Ectasia of the internal jugular vein was once considered rare, but is increasing in apparent frequency due to the wide use of noninvasive diagnostic modalities. A 57-year-old woman was referred for right neck discomfort that had developed 1 month earlier. She complained of a non-painful right neck swelling, located anteromedial to the sternocleidomastoid muscle. Computed tomography and color Doppler ultrasonography showed a 2×1.7-cm right internal jugular venous ectasia. The size of the jugular venous ectasia decreased after compression with a probe and increased during the Valsalva maneuver. Here, we report the first Korean case of primary internal jugular venous ectasia, which presented as an asymptomatic right neck swelling. (Korean J Med 77:124-127, 2009)

복잡성 심실성 부정맥과 좌심실 비후의 상관관계 및 예후에 관한 연구

이광제(Kwang Je Lee),정유석(Yoo Suk Chung),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),김치정(Chee Jeong Kim),류왕성(Wang Seong Ryoo),유언호(Un Ho Yoo) 대한내과학회 1997 대한내과학회지 Vol.53 No.1

N/A Objectives: Echocardiographically determined left ventricular hypertrophy is associated with increased risk for sudden cardiae death and for complex ventricular arrhythmias in 24-hour ambulatory electrocardiographic monitoring. In subjects with left ventricular hypertrophy, the presence of asymptomatic complex ventricular arrhythmias is associated with higher incidence of sudden cardiac death and higher cardiovascular mortality. However, their accurate relationship and prognostic significances have been remained to be established. The purpose of this study was to evaluate the relationship between complex ventricular arrhythmias, left ventricular hypertrophy, and sudden cardiac death in Korean patients. Methods: Twenty four hour ambulatory electrocardiographic monitoring, echocardiographic data and medical records were reviewed in 360 subjects from 1991 to 1994. We evaluated the relationship between complex ventricular arrhythmias and left ventricular mass index, and the prognostic values of them. Of the 360 subjects, 187 could be followed up for one to four years. The mean follow-up period was 2.8 years. Results: The incidence of complex ventricular arrhythmias was significantly correlated with left ventricular mass index and ejection fraction in all subjects. During the follow-up periods, seven of 187 subjects died from sudden cardiac death. Six of them had complex ventricular arrhythmias with left ventricular hypertrophy. Conclusion - The incidence of complex ventricular arrhythmias was significantly correlated with echocardiographically determined left ventricular hypertrophy and it is suggested that subjects with complex ventricular arrhythmias combined with left ventricular hypertrophy have higher risk for sudden cardiac death.

고혈압의 임상적 고찰

이영우 ( Young Woo Lee ),이명묵 ( Myoung Mook Lee ),오병희 ( Byung Heui Oh ),서봉관 ( Bong Kwan Seo ),김치정 ( Chee Jeong Kim ),김성국 ( Seong Gook Kim ),유왕성 ( Wang Seoung Ryu ) 대한내과학회 1985 대한내과학회지 Vol.29 No.5

확장성심근중 환자에서 Enalapril 치료가 좌심실내경의 순간변화율에 미치는 영향

김철우(Cheol Woo Kim),정유석(Yoo Suk Jung),이광제(Kwang Je Lee),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),김태호(Tae Ho Kim),김치정(Chee Jeong Kim),류왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1997 대한내과학회지 Vol.52 No.5

N/A Objective: Angiotensin-converting enzyme inhibitors have been shown to improve survival in patients with congestive heart failure. To evaluate the efficacy of enalapril in patients with dilated cardiomyopathy during concurrent treatment with digoxin and diuretics, the peak rates of left ventricular movement were assessed after 6 months of follow-up by digitized echocardiography. Methods: Using a high quality digitizer, continuous measurement of left ventricular dimension and its rate of change (dD/dt) were obtained throughout the cardiac cycle. Normalized rates of wall movement (dD/dt/D) were used for comparison. Results: 1) Compared with control subjects, patients with dilated cardiomyopathy showed much lower Peak(-) dD/dt and Peak(-) dD/dt/D. 2) Peak(+) dD/dt and Peak(+) dD/dt/D were also depressed in patients. 3) Peak dD/dt improved significantly (p<0.05) in the enalapril group (n=16), but did not change in the conventional treatment group (n=20) after 6 months. Peak dD/dt/D improved approximately (p<0.005) in the enalapril group. 5) There were no deaths in 2 treatment groups during initial 6 months, but 3 patients in the conventional treatment group died suddenly during 1 year of follow-up. Conclusion: The present study has shown that left ventrieular Peak dD/dt and Peak dD/dt/D are significantly depressed in patients with dilated cardiomyopathy. Enalapril appears to provide well-tolerated and effective long-term therapy by improving peak rates of left ventricular movement in patients with dilated cardiomyopathy.

증례 : 순환기 ; 전신적인 발진성, 결절성 황색종을 동반한 제3형 고지단백혈증 1예

김은영 ( Eun Young Kim ),서기우 ( Ki Woo Seo ),김정은 ( Jung Eun Kim ),조은정 ( Eun Jeong Cho ),이왕수 ( Wang Soo Lee ),김치정 ( Chee Jeong Kim ),이갑석 ( Kap Sok Li ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5

저자들은 55세 여자 환자에서 전신적으로 발생한 발진성, 결절성 황색종을 동반한 제3형 고지단백혈증을 경험하였기에 보고하는 바이다. A 55-year-old female presented with extensive yellowish eruptive plaques over both elbows and the buttocks that she had first noticed 2 years earlier. Yellowish orange discoloration of her palmar creases was noted. Her serum cholesterol and triglyceride were markedly elevated. Lipoprotein electrophoresis showed a broad β band. On apolipoprotein E genotyping, the arginine at position 158 had been replaced by cysteine in both alleles (E2/E2). Under a diagnosis of type III hyperlipoproteinemia, combined atorvastatin and fenofibrate therapy for 2 months normalized the serum cholesterol and triglyceride levels. (Korean J Med 77:620-624, 2009)

증례 : 암페타민 남용과 연관되어 발생한 급성 심근경색증 1예

이성호 ( Sung Ho Lee ),이경은 ( Kyung Eun Lee ),이광제 ( Kwang Je Lee ),김상욱 ( Sang Wook Kim ),김태호 ( Tae Ho Kim ),김치정 ( Chee Jeong Kim ),류왕성 ( Wang Seong Ryu ) 대한내과학회 2007 대한내과학회지 Vol.73 No.4

암페타민에 의한 가장 흔한 심혈관계 부작용은 빈맥과 고혈압이며, 급성 심근경색이 이와 연관되어 유발되었다는 보고는 매우 드물다. 저자들은 39세 남자에서 암페타민 남용과 연관되어 발생한 혈전성 급성 심근경색증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Acute myocardial infarction is a rarely reported complication of amphetamine abuse. We report here on a case of a 39-year-old man who presented with cardiac enzyme patterns, a clinical history and an ECG that were all compatible with acute ST elevation myocardial infarction. This was probably the result from self administration of intravenous amphetamine. The initial coronary angiogram (CAG) showed total occlusion of the distal right coronary artery (RCA) with a large thrombus. Because the RCA was tortuous and removal of thrombus was thought not to be easy, he was treated with thrombolytic therapy and intravenous heparin followed by oral warfarin. The follow-up CAGs at 2 weeks and 10 months later showed almost complete resolution of the coronary abnormalities. In this case, the early coronary angiography was thought to be helpful to determine the relative contribution of thrombus and spasm that were associated with amphetamine abuse.(Korean J Med 73:428-431, 2007)