혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

경피적 중심 정맥 도관의 임상적 적용에 관한 연구

이희경,김영창,이혜경,박보림 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

신생아실에서의 미숙아 및 선천성 기형의 치료의 발달과 함께 중심 정맥의 필요성이 증가되면서 경피적 중심 정맥 확보인 경피적 정맥 도관(PCVC)을 시행하게 되었으며 현재 널리 이용하계 되었다. 1995년 5월에서부터 1997년 4월까지 본원 신생아실에서 경피적 정맥 도관을 시행받은 78례에 대상으로 후향적으로 성공률의 유무, 도관 유지, 문제점, 합병증등을 알아 보아 향후 치료에 도움을 얻고자 본 연구를 시행하였다. 1. 경피적 정맥 도관을 시행한 78례중 64례(80.8%)에서 시술에 성공하였으며 본 시술만 전담하는 간호사에 의해 시행한 1997년 1월에서 4월까지 성공률은 95.3%였다(p<0.001). 2. 73.1%가 총정맥 영양법을 위해 시행되었고 이중 43.6%가 미숙아로 인한 총정맥 영양법을 위해 본 시술이 필요하였으며 17.9%는 항생제를 포함한 장기간의 약제 사용을 위한 정맥 확보를 위해, 9%에서 고농도의 용액의 사용을 위해 시술되었다. 3. 시술 부위는 주관절 정맥이 59.4%로 가장 많았고 액와 정맥이 35.9%로 많았다. 4. 시술후 도관의 위치는 우심방이 44.9%, 상대 정맥이 12.8%, 액와 정맥이 21.8%, 하대 정맥이 1.3%, 무명정맥이 1.3%로 우심방과 상대 정맥에 위치한 경우와 그이외 말초 부위에 위치한 경우를 비교했을 때 우심방과 상대 정맥에 위치한 경우가 도관의 유지기간이 의의있게 길었다(p<0.001). 5. 도관 제거의 이유는 더 이상 수액 제제가 피료치 않아 계획적으로 제거된 경우가 56.3%, 기계적 폐색등으로 제거된 경우가 21.9%, 도관과 관련된 감염으로 제거된 경우가 3%순이었다. 6. 도관 제거후 배양 검사를 시행한 36례중 9례(25%)에서 균이 배양되었고 staphylococcus epidermidis와 candida albicans가 대부분을 차지하였다. Percutaneous central venous catherization(PCVC) is performed commonly as a vascular access procedure for a various indications in the neonatal intensive care unit (NICU). We evaluated a total of 78 PCVC cases performed in the NICU over 2 years from April, 1995 to April, 1997 in terms of age, success rate, indications, insertion sites, indwelling time and causes of removal of catheters, and associated complications including sepsis retrospectively. The results are described below ; 1. Patient ages and body weights at the time of insertion ranged from 1-120 days (average age, 10.9 days) and from 660-4,100 gm(average weight, 2,119 gm) respectively. 2. The overall success rate of insertions was 80.8%, however, the insertions attempted by highly- trained nurse were successful in 95.3 % from Jan. to April, 1997. 3. The most common indication was total parenteral nutrition (73.1%). 4. The insertion sites were cubital vein(59.4%), axillary vein(35.9%), and external jugular vein(3.1%). 5. The locations of catheter tip were right atrium(44.9%), axillary vein(21.8%), superior vena cava(12.8%), and inferior vena cava(1.3%). 6. The indwelling time ranged from 1-52 days (average, 12.6 days). When the catheter tips were placed in the right atrium or superior vena cava, the catheter was placed in the longer duration compared to those of other sites significantly. 7. The causes of removal of catheter were elective (56.3 %), mechanical obstruction(21.9%) and catheter related infection(3%). 8. The cultures of catheter tip were done after removal in 36 cases, among them cultures were positive in 9 cases(25%) the most common causes were S. epidermidis and Candida albicans.

Subacute Combined Degeneration의 임상적 및 전기생리학적 특징

배희준,이한보,이광우 대한신경과학회 1997 대한신경과학회지 Vol.15 No.5

황사 기간 동안에 어린이, 성인, 노인에서의 자각증상과 예방행동에 대한 조사연구

이보은,하은희,박혜숙,권지숙,신경림 韓國學校保健學會 2005 韓國學校保健學會誌 Vol.18 No.1

Purpose: Recently there are scientific evidences for the health effects of Asian dust-storms. Particularly in 2002, the daily average of PM_(10) exceeded 600 and 700 ㎍/㎥ in March and April respectively. We examined the effects of Asian dust-storms on perceived symptoms and preventive behaviors among children, adults, and elders. Method: The subjects of this study were 425 children, 444 adults and 60 elders. A questionnaire survey was carried out on the children and the adults by teachers and on the elders by interviewers to obtain information on demographic variables, perceived symptoms and preventive behaviors, previous respiratory disease, environmental tobacco smoke, and proximity between the house and the road during Asian dust-storms. We analyzed using descriptive statistics, X_(2) test and multiple logistic regression models. After adjustment for potential confounders, we estimated the odds ratios and 95% confidence intervals of the children and the elders for perceived symptoms and preventive behaviors. Result: The elders had a significantly higher prevalence of respiratory symptoms than the other groups. The children had a significantly higher prevalence than the adults in getting URI (1.51), coughing (1.68), rhinorrhea (1.46), fever (2.39) and medication for allergy or asthma (1.90). The children had better behaviors than the elders in closing windows (3.57), taking less outdoor recreational activity (2.59) and staying home (2.60).

岩石의 剪斷破壞擧動에 關하여 : size effect의 影響을 中心으로

李喜寶 全北大學校 1984 論文集 Vol.26 No.-

선택적 신동맥 색전술을 이용한 신절석술 후의 신출혈 치료 1례

이중화,이보배,윤능수,임승수,박청희 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

A patient with uncontrollable postoperative renal hemorrhage was successfully treated by selective injection of gelfoam into the anterior inferior segmental branch of right renal artery. Follow up arteriography was done 16 days later. It revealed persistent occlusion of the bleeding vessels. This method is a simple effective procedure in cases of renal hemorrhage to diverse etiology without responsive management.

만성 B형 간염 환자의 급성 악화 후 발생한 피부 결절 다발동맥염과 류마티스관절염

이주현,김민,이준성,장선희,윤보영,이윤우 인제대학교 2009 仁濟醫學 Vol.30 No.-

Cutaneous polyarteritis nodosa(CPAN) is a rare vascular disorder that affects small and medium-sized arteries in the reticular dermis and subcutaneous tissue. It has been described as a distinct clinical entity with benign and a chronic prolonged course without systemic involvement. Hepatitis B virus-related polyarteritis nodosa (HBV-related PAN) is typical form of classic PAN. Its pathogenesis is not well known, but considered an immune complex-mediated disease. The patients with HBV-related PAN often present with malignant hypertension, orchitis, and vascular nephropathy. But, HBV-related CPAN has been rarely reported. Rheumatoid vasculitis is a complication of rheumatoid arthritis that can be lead to variety of clinically significant skin and systemic conditions, It has been reported before or at the time of rheumatoid arthritis diagnosis but is usually seen an average of 10 to 14 years after arthritis onset. The histological features of cutaneous vasculitis in rheumatoid arthritis overlapped both the characteristics of cutaneous necrotizing venulitis and cutaneous polyarteritis nodosa. But polyarteritis nodosa-like rheumatoid vasculitis has rarely been reported. We report a case of rheumatoid arthritis and cutaneous polyarteritis nodosa in a chronic hepatitis B with acute exacerbation.

심인성 색전 요인이 없는 뇌경색 환자에서 경식도 심초음파와 Acoustic Quantification을 이용한 대동맥 탄성의 평가

이종민,윤호중,임효영,박지원,김휘열,전희경,문건웅,정욱성,채장성,김재형,최규보,홍순조 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

사료용 옥수수 연구 N. 조사료용 CNU 육성 교잡종 옥수수의 수량관련 주요특성

이희봉,정재영,김용일,박보영,지희정,문현귀 충남대학교 농업과학연구소 2006 농업과학연구 Vol.33 No.1

This study was carried out to compare a yield performance about CNU maize hybrids developed at the Maize Genetics and Breeding Lab, in Chungnam National University. Among the hybrids incorporated in the test, CNU 3 and 1 showed higher dry matter per 10a and lower kernel yield per 10a than check hybrid, Kwanganok. Hongchon 5 and Suwon169 showed higher kernel yield than Kwanganok. The average yield of CNU 3 hybrid in dry matter and CNU 4 in kernel yield were 2,106kg/10a and 854kg/10a in regional adaptability test, which were increased 33% and 8% compared with a check hybrid, respectively. Also, these hybrids had better stay green characteristics than check hybrid and showed moderately resistance to corn borer and leaf spot.