내경동맥 지배 영역의 급성 허혈성 뇌졸중 환자에서 초 선택적 국소적 Urokinase주입술

김인규,김명규,김재규,조기현,김세종 대한신경과학회 1998 대한신경과학회지 Vol.16 No.5

고형배지의 종류가 수경재배 멜론의 품종별 과실의 생육과 품질에 미치는 영향

전하준,황진규,김인규,손미자 대구대학교 생명과학연구소 2004 생명과학연구 Vol.3 No.1

In order to examine how growth substances influence to fruit growth and its quality, we cultivated 3 different kinds of melons which grown in hydroponic system into 3 different types of growth substances, such as perlite, perlite/rock wool and rock wool/perlite. In this experiment, “Siroi Kagayaki”, showed no significant difference in fruit weight and its diameter in any of growth substances, but higher in plant height in perlite/rock wool than Perlite. In case of “TS-1806”, there were no significant differences in soluble solids, fruit weight and diameter in all the substances. However, it showed longer in fruit length in rock wool / perlite than that in perlite/ rock wool. In addition, the soluble solids in placenta and flesh were higher in perlite than those in rock wool/perlite.

된장이 고지방 및 고콜레스테롤 식이를 급여한 흰쥐의 지질 대사에 미치는 영향

이인규,김종규 대한보건협회 2002 대한보건연구 Vol.28 No.3

OBJECTIVE: This study was performed to investigate the effects of dietary supplementation of Korean traditional soybean paste(doen-jang) on the changes of serum biochemical components and histopathological changes of organs in rats fed a high fat and/or a high cholesterol diet. DESIGN: This was a single open-group prospective clinical intervention. METHODS: A total of one-hundred and twenty eight 3-weeks old male Sprague-Dawley rats were divided into 16 groups by a randomized blocking method. The rats consumed one of the experimental diets, the control diet, a high fat diet(40% of the total calories), a high cholesterol diet(1% of the total weight), and a high fat and high cholesterol diet for 13 consecutive weeks. Each of these diet groups were divided into 4 groups one with no soybean paste added, one with just 0.5% soybean paste added, one with 1% soybean paste added, and one with 5% soybean paste added. These levels were taken from the data of the National Nutrition Survey of Korea from 1994 to 1998. From this data, we know that Koreans on an average eat less than 0.5% soybean paste per person, per day. A Korean traditional soybean paste was used for this study. All of the preparation methods for the soybean paste followed the recommendations of Korea Food Research Institute. After ripening 6 months it was incorporated into the diet. Blood specimens were obtained at the baseline and after 13 weeks of dietary intervention. At the end of the study the organs(liver, heart, and kidney) were excised, and pieces of the organs were taken for histopathological examinatoin. Fool intake, body weight, food efficiency ratio, relative organ weights, and fecal lipid levels were determined at the end of the experiment. RESULTS: The feeding of a high fat and/or a high cholesterol diet resulted in many deleterious effects including increased food intake, increased weight gain, increased organ weights, increased fecal lipid levels,increased serum triglyceride, total lipid, free-cholesterol, easter-cholesterol, total cholesterol, low-density lipoprotein(LDL) cholesterol level, and atherogenic index, and increased lipase, aspartate aminotransferase(AST), alanino aminotransferase(ALT), cholinesterase(ChEase), and lactate dehydrogenase(LDHase) activities, and decreased high-density lipoprotein(HDL) cholesterol level, and most significantly severe fatty changes, in the livers, compared with the control and soybean paste control groups. The feeding of 0.5% soybean paste reduced the adverse effects of the high fat and/or the high cholesterol diet on the food efficiency ratio, weight gain, relative organ weights, fecal lipid levels, and improved serum lipid component levels. Significant decreases(p<0.05) in triglyceride, total lipid, total cholesterol, and LDL-cholesterol were seen. A significant increase was found in the level of HDL-cholesterol(p<0.05). A decrease was observed in atherogenic index. Also it recovered the levels of lipase, AST, ALT, ChEase, and LDHase activities. No significant changes in levels of serum free-cholesterol and easter-cholesterol were observed. It was helpful to reduce the severs histopathological lesions of livers. Although changes in these findings were observed in all of the groups with soybean paste, the most profound inhibitory changes were evident at the 5% level of soybean paste in the results of histological study of livers. In each group, adding soybean paste reduced the adverse effects of a high fat and/or a high cholesterol diet in ratio to the amount of soybean paste added to the diet. CONCLUSIONS: Dietary supplementation of 0.5% soybean paste resulted in reductions in several risk factors for lipid metabolism in rats, fed a high fat and/or a high cholesterol diet especially improved serum lipid component levels and the histopathological lesions of the livers. The feeding of 1% and 5% soybean paste showed even more reduction of risk factors. These results suggest that Korean soybean paste has a protective effect on a high fat and/or a high cholesterol diet. Long-term, placebo-controlled clinical trials are needed to evaluate the effect of soybean paste on the lipid metabolism in the human population.

南北韓 國史敎科書에 登場하는 國王, 王族의 人物 比較

김인식,김선규 한국교육과정학회 2000 교육과정연구 Vol.18 No.2

본 연구는 남북한의 중등학교 국사 교과서에 등장하는 인물 중 국왕·왕족에 대하여 양적인 측면에서는 각 교과서별·시대별 분포와 설명이 있는 인물의 수 및 비율을, 질적인 측면에서는 공통으로 등장하는 인물에 관한 서술을 비교하는 것이었는데, 비교 대상 교과서는 남한의 중학교 및 고등학교 <국사>교과서와 북한의 고등중학교 국사교과서인 <조선력사>였다. 먼저 남북한 국사 교과서에 등장하는 전체 등장 인물의 수 및 비율을 각 교과서별·시대별·유형별로 분류하였다. 이어 남북한 국사교과서에 등장하는 국왕·왕족의 수 및 비율을 각 교과서별·시대별로 양적으로 분석하고, 각 인물의 양적인 비교를 보완하기 위하여 단순 등장 인물과 설명이 있는 인물의 등장 횟수 및 비율도 산출하였다. 아울러 이들 국왕·왕족이 남북한 국사교과서에 공통 및 어느 한쪽에만 등장하는 인물로 분류하여 각 시대별로 나누어 제시하였다. 다음으로 남북한 공통 등장 인물에 대한 질적인 비교는 인물의 '활동 분야·역할'의 측면, 서술 방식·비중'의 측면, 그리고 '인물 평가'의 측면으로 나누어 고찰하되 주로 각 측면별로 남북한이 상이하거나 부분적으로 일치하는 인물의 서술을 중심으로 논의 하였다. 비교의 결과 남북한 국사 교과서의 등장 인물을 양적으로 분석하면 인물의 수는 남한의 <국사>가, 설명이 있는 등장 인물은 북한의 <조선력사>가 더 많았으며, 남북한 공통 등장 인물보다 어느 한쪽에만 등장하는 인물의 수가 더 많았다. 이들 국왕·왕족을 질적으로 비교하면 인물의 '활동 분야·역할'과 같은 사실적 진술보다는, 인물의 '서술 방식·비중' 및 '인물 평가'의 측면에서 상이하거나 부분적으로 일치하는 노력이 요청된다. 하지만 남북한의 국사 교과서에는 이질적인 측면뿐만 아니라 유사하거나 동질적인 부분도 많은 만큼 공통적인 점은 더욱 심화·확대시키고, 차이점에 대해서는 이질성 극복을 위한 보다 적극적인 대처가 필요하다고 본다. The purpose of this study was to analyze the historical characters appearing in national history textbooks of South and North Korea, and to compare their similarities and differences in terms of quantitative dimension and qualitative dimension, In order to achieve these goals, this study overviewed the existing curricular structure and history education of South and north Korea, and analyzed the following three history textbooks ; <Junghak Kooksa> which is the history textbook for middle schools of South Korea, <Kogyo Kooksa> , which is the history textbook for high schools of South Korea, <Josun Ryuksa> which is the history textbook for secondary education of North Korea. As the quantitative approach, this study counted the frequency of all characters appearing in the textbooks, and divided them into a group of commonly appearing characters and a group of characters appearing in one part among three textbooks. Then, the frequency and the rate of all characters' appearance were calculated separatedly and compared with each other. As a result, some quantitative differences were founded in total counts of appearing characters in three textbooks. In total frequency of characters appearing in textbook, the history textbook of South Korea (<Junghak Kooksa> : 393, <Kogyo Koodsa> : 512) contained much more characters than North Korea's (<Josun ryuksa> : 348). And, commonly appearing characters in three comparative textbooks were 133, which amounted to only 18% of total numbers of appearing characters(735). It means that there are lots of differences between south Korea and north Korea in the number of appearing characters. And, as the qualitative approach, this study tried to analyze and discuss the similarities and difference of commonly appearing characters in three textbooks in terms of a character's activity area and role, description and weight of him/her, and historical evaluation of him/her as a whole. As a result, much more similarity was found in character's activity area and role any other aspects. On the other hand, in the aspect of description and weight of a character, difference between three textbooks was much more than similarity, and partially accordant characters were the most in historical evaluation of characters. Nowadays waking to the unification of South and North is faster and faster. So when we compare and study south and north Korean history education and characters in textbooks, we need to study more about 'how same' than 'how different'. Since appearing characters in textbook were deeply connected with their historical background and situation, how to describe a character would greatly influence on the historical interpretation. Therefore, in order to identify the reality of a character, we need a careful analysis on the historical viewpoint of textbook writers. It exceeds. however, the task and the focus of this study. In other word, based on the results of this study, a much more in-depth analysis on types of characters, modes of explaining them, and socio-cultural context should be continued in the future.

2009년 인플루엔자 대유행 중 인플루엔자 진료소 방문자의 연령 분포 변화

김백남,곽이경,문치숙,김연숙,김의석,배인규,염준섭,이창섭,허지안 대한감염학회 2010 감염과 화학요법 Vol.42 No.2

The pandemic influenza (H1N1 2009) virus, after being introduced in Korea in April, 2009, spread rapidly nationwide in mid-2009. This study was conducted to characterize trend in age distribution of visitors to Flu-clinics during the pandemic. Demographic, clinical and laboratory data of visitors to flu clinic from Week 36 to 52 (August 30 to December 26) of 2009 were retrieved and collected from electronic databases at 9 hospitals. Visitors 0-6, 7-12, 13-18, 19-29, 30-64, and 65 years or more of age were classified into group I to VI, respectively. A total of 107,467 visitors were seen at Flu-clinics for a 17-week study period. Of those, 32,485 were laboratory-confirmed. Antivirals were prescribed for 62,533 visitors. Numbers of visits, prescriptions of antivirals, and laboratory-confirmed cases of the pandemic influenza (H1N1 2009) peaked at Week 44. A large number of visits by group II and III were followed by those of group I and V, especially around the peak. Numbers of visits by group VI were lowest in all hospitals. In some hospitals, higher number of visits lasted longer in children than in adults while vice versa in other hospitals depending on the location. In summary, the pandemic influenza (H1N1 2009) was presumed to peak in late October and involved majorly children and students in Korea. Unique age distribution of visitors to flu clinic was observed in some hospitals.

청계산 청계사의 역사와 위상

황인규(Hwan In-gyu) 보조사상연구원 2013 보조사상 Vol.39 No.-

본고는 의왕시 청계사의 역사와 그 위상을 천착한 연구이다. 청계산 청계사는 고려 원간섭기 역관출신 趙仁規가문의 원당이 되면서 사세가 크게 부각되었다. 조인규 가문 출신의 천태종계 승려들은 과천 청계사와 수원 만의사 일대에서 활동하였을 뿐만 아니라 여말선초 불교계를 주도하게 되는 무학자초와 그의 제자 철호조선이 주지에 재임하였다. 조선초 과천의 資福寺로서 지정되었으며, 圓通菴은 산내 암자였던 듯하다. 乖崖金守溫의 「圓通菴重創記」기문에 의하면 1425년(세종 7) 승려 海幢이 원통암을 세종의 비 昭憲王后의 시주를 받아 1428년(세종 10) 佛殿3칸과 禪僧兩堂등을 중창하였다. 왕후의 8남 永膺大君이 前龍門寺주지 戒眼과 문도들로 하여금 9년간 주재하여 보수 중창되었다. 청계사는 세종말년에서 단종대 초에 태종의 2녀 경정공주와 태종 2남 효령대군, 세종의 장모 삼한국 대부인 안씨 등이 주지 覺頓과 함께 『화엄경』 1,470판으로 인출하여 雜華殿을 짓고 봉안하였다. 이는 고려 대각국사 의천이 가져온 『華嚴經疏鈔』이 유실되어 없어진 것을 청계사에서 개판하였던 것이다. 이렇듯 청계산의 산내암자인 원통암은 세종의 비 소헌왕후와 8남 영응대군의 원당이었으며, 소헌왕후의 5남 광평대군과 7남 평원대군을 비롯하여 1445년(세종 27) 4월 삼한국 대부인 안씨 등과 함께 청계사에 머물며 독경하는 등 왕실의 관심이 컸다. 고려 대각국사 의천이 가져온 『華嚴經疏鈔』가 그 이후 세종대 당시까지 유실되어 찾아볼 수 없었는데, 이를 바로 청계사에서 개판하였던 것이다. 이렇듯 청계사는 산내암자 원통사(암)과 더불어 조선초 왕실의 주목을 받은 원당이었다. 청계사는 연산군대 선교양종의 본산이 폐치되자 명종대 허응보우가 선교양종을 복립할 때까지 선교양종을 아우르는 선종의 본산이었다. 광해군대 세자의 원당이 되었으며, 고승 벽암각성과 고한희언이 주석하며 재를 올리는 등 왕실의 원당이었다. 그런 한편 조인규가문에서도 청계사의 사적비를 짓는 등 조선후기에도 원당으로서의 위상을 지녔으며, 정종의 의해 왕실의 원당이 되었다. 즉, 정조는 잠저시 인근의 화성 용주사에 앞서 청계사를 願堂으로 삼았다. 1789년(정조 13) 아버지 사도세자의 능침인 현융원에 행차시 청계사에 들려 顯隆園祭閣을 세우고 매년 두 차례 제사를 드렸다. 그리고 철종대 근대불교를 중흥하게 되는 경허선사의 출가처가 청계사였다. This paper examines the history and the status of CheonggyesaTempleinUiwang. The temple was highlighted as a votive shrine by the family of Ingyu Cho, an interpreter in the occupation period of Yuan. The tien-tai monks from the family performed their activities at the Gwacheon Cheonggyesa temple and at the Suwon Manuisa temple. Then, Muhakjacho and his discipline, Cheonhojoseon, who led the Buddhism community from the end of the Goryeo to the early Joseon period, became head abbots. The Cheonggyesa temple was designated as a jaboksa; further, the wontongam became a hermitage in the mountains. The Wontongam Jungchanggi, written by Seungae Suwon Kim, stated that the Buddhist monk Haedong received an order from Empress Soheon, wife of King Sejong in 1425 (7th year of King Sejong). Following her order, he built 3 Buddhist sanctums and the Seonseungyangdang in 1428 (10th year of King Sejong). Yeongeungdaegun, the 8th youngest son of the empress, ordered Gyean, the head abbot of the jeonryongmunsa temple, and his disciplines to stay at the temple for 9 years in order to repair and establish the temple. The Cheonggyesa temple was tributed by establishing the japhwajeon from 1,470 sheets of Hwaeomgyeong with Princess Gyeongjeong, the second daughter of King Taejong, Hyoryeongdaegun, the second son of the king and Mrs. Ahn, mother- in-law of King Sejong, by the head abbot Gaksun. This means that the temple re-established the Hwaeomgyeongsocho brought by Daegakguksa Uicheon but lost. The Wontongam, a shrine in Mt. Cheonggye, was avotiveshrine of Empress Soheonand Yeongeungdaegun aswellas that of Gwangpyeongdaegun and Pyeongwondaegun, the 5thand 7thsons of King Sejong.The Cheonggyesa temple became the head abbot of both Buddhismfaiths until Heoeungbou restored the faiths in the era of King Myeongjong after the head abbot of the faiths were closed in the era of Yeonsangun. The temple became a votive shrine for princes in the Gwanghaegun era; it was also the royal votive shrine where prominent Buddhist monks of Byeokamgakseong and Gohanhuieon paid tributes. Meanwhile, the family of Ingyu Cho established a sajeokbi (stele for commemoration), which had the status of a votive shrine; it later became the royal votive shrine by King Jeongjong. During his evacuation, the king designated Cheonggyesa temple as the votive shrine prior to the Yongjusa temple near Hwaseong. In 1789 (13th year of King Jeongjo), the king visited Cheonggyesa temple on the way to Hyeonyungwon, the tomb of his father, and established the Hyeonyungwon Jegak, holding ritual ceremonies twice a year. The Cheonggyesa temple was where Gyeongheoseonsa, who revived modern Buddhism during the era of King Cheoljong, entered Buddhist priesthood.

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : Changing Pattern Of Digestive And Liver Disease In Korea, 1990-2006 Year; A Single Center Study

( Jung Hyun Kwon ),( Sang Woo Kim ),( In Sik Chung ),( Myung Gyu Choi ),( Kwan Woo Nam ),( Jung Pil Suh ),( Jae Hyuck Chang ),( Won Haing Hur ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: Westernization in many Asian countries have changed lifestyles and diets, so once rare diseases have now become prevalent. The aim of this study is to investigate the changing pattern of digestive and liver disease in Korea, from 1990 to 2006. Methods: We extracted data specific gastrointestina (GI) disease based on the International Classification of Diseases code from the in-patients records at the Kangnam St. Mary`s Hospital in 1990, 1996 and 2006. This hospital is a tertiary-care hospital in Seoul, Korea, which has a capacity of 800 beds. Results: The admission rate for GI disease increased between 1990 and 2006. Overall in-patients were 1,623 persons in 1990, 2,368 persons in 1996 and 4,166 persons in 2006. The mean age of in-patients increased as time went by. A stomach cancer was the most common diagnosis during all periods, but its prevalence has decreased. Colon cancer ranked the 7th in 1990, but markedly increased and now ranks the second. The third was a hepatocellular carcinoma. The bile duct and gallbladder cancer, pancreas and esophageal cancer ranking followed with little interval change. In cases of cancer patients, a regular admission dramatically increased for chemotherapy. The number of patients admitted with pre-malignant neoplasm of stomach and colon increased remarkably with the development of endoscopy. The liver transplant, inflammatory bowel discase, and reflux esophagitis emerged form mid-1990s with greater frequencies, yet much below the levels found in the West. The admission rate for peptic ulcer, especially ulcer bleeding remained relatively stable, despite a decreased rate for ulcer perforation. Liver cirrhosis, hepatitis, cholelithiasis with cholecystitis-cholangitis, appendicitis, hemorrhoid and gastritis all decreased. Conclusions: The stomach cancer is the leading cause of admission, despite a recent decline. Colon cancer showed a marked rise. The liver transplant, inflammatory bowel disease and reflux esophagitis were new diagnosis with an increased tendency.

정상 성인에서 총콜레스테롤의 분별치와 관련 요인 : 전북지역 한 종합병원의 정기검진자를 중심으로

김지식,여영규,홍인선 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 1996 Journal of biomedical laboratory sciences Vol.2 No.2

정상 성인에서 혈청 총 콜레스테롤의 분별치 및 관련된 제요인을 파악하기 위하여 1995년 3월부터 10월까지 8개월 동안 전주 예수병원에서 의료보험 피보험자와 피부양자를 대상으로한 정기 건강 검진을 받은 대상자 중 성별, 연령별, 혈압, 체중, 기타 생화학적 검사 결과를 분석하였으며, 이들 중 고혈압 등 질병이 없는 건강한 집단으로 1,818명을 분석하였다. 혈청 총 콜레스테롤의 분별치를 산정 하기 위한 75th percentile값을 보면, 21∼30세군에 191 mg/dl, 31∼40군에서 195 mg/dl, 41∼50세군에서 214 mg/dl, 51∼60세군에서 227 mg/dl, 그리고 61세 이상 군에서 222 mg/dl이었다. 90th percentile값을 보면, 21∼30세군에서 214 mg/dl, 31∼40군에서 214 mg/dl, 41∼50세군에서 239 mg/dl, 51∼60세군에서 253mg/dl, 그리고 61세 이상군에서 248 mg/dl 이었다. 혈청 총 콜레스테롤과 각 변수간의 상관관계는 연령과는 남.여 모두 유의한 관계를 보였고(p<0.001), 특히 여자에서 높은 상관성을 보였다. 비만지수인 PIBW, BMI와도 유의한 상관성을 보였고, 수축기혈압과 이완기혈압과도 관련성을 보였다. 대상자들의 흡연 여부와 혈청 총 콜레스테롤과의 관계는 흡연군이 191.6±35.0 mg/dl 이었고, 비흡연군이 194.9±35.9 mg/dl였으며 두 집단간에는 유의한 차이를 보이지 않았다. 음주에 따른 혈청 총 콜레스테롤의 측정치는 비음주군에서는 196.0±36.0 mg/dl 이었고, 음주군에서는 188.9±34.5 mg/dl로 두 군간에는 유의한 차이를 보였다. 운동 습관과 혈청 총 콜레스테롤의 관계는 규칙적으로 운동을 하는 군은 192.1±33.3 mg/dl이었고, 운동을 하지 않는 군은 195.8±37.0 mg/dl였으며 두 군간에는 유의한 차이를 보였다. The cut-off values and related factors for total cholesterol of serum in normal Korean adults were studied from March to October, 1995, based on the data of 1,818 healthy adults of human involved the male and female. The comparisons of the serum total cholesterol levels were analyzed by sex, age, systolic blood pressure, diastolic blood pressure, body weight, height, PIBW, BMI and other biochemical tests. 1. The serum total cholesterol level were 194.4 mg/dl in total group, 186.9 mg/dl for male, and 197.6 mg/dl for female. 2. There was no significant differences by sex among the 21 to 50 ages group, but significantly higher in women than in men over 51 years old. 3. In general, the levels of serum total cholesterol were increased with age, the highest level in men was 192.7 mg/dl in 51 to 60 years old, and 210.5 mg/dl in more than 60 years old in women. 4. The cut-off values of serum total cholesterol for moderate risk were 191 mg/dl in 21 to 30 years group, 195 mg/dl in 31 to 40 years, 214 mg/dl in 41 to 50 years, 227 mg/dl in 51 to 60 years, and 222 mg/dl in more than 61 years. The cut-off values of serum total cholesterol for high risk were 214 mg/dl in 21 to 30 years group, 214 mg/dl in 31 to 40 years, 239 mg/dl in 41 to 50 years, 253 mg/dl in 51 to 60 years, and 248 mg/dl in more than 61 years. 5. The mean values of serum total cholesterol were showed positive correlation with age, PIBW, BMI, systolic blood pressure and diastolic blood pressure. 6. Serum total cholesterol level of drinking group(188.9±34.5mg/dl) was showed lower than those of non-drinking group(196.0±36.0mg/dl). 7. Serum total cholesterol levels of regular excercise group(192. 1±33.3 mg/dl) was significantly lower than those of non regular excercise group(195.8± 37.0 mg/dl).

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

Kim, Jong Hun,Baik, Seung Hee,Chun, Byung Chul,Song, Joon Young,Bae, In-Gyu,Kim, Hyo Youl,Kim, Dong-Min,Choi, Young Hwa,Choi, Won Suk,Jo, Yu Mi,Kwon, Hyun Hee,Jeong, Hye Won,Kim, Yeon-Sook,Kim, Jeong Elsevier 2018 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.74 No.-

<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK).</P> <P><B>Methods</B></P> <P>Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015.</P> <P><B>Results</B></P> <P>A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (<I>p<</I> 0.001). In particular, early death within 7days of hospitalization accounted for 60.6% (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped.</P> <P><B>Conclusions</B></P> <P>This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization of the elderly with the 23-valent polysaccharide vaccine (PPSV23) was implemented in Korea in 2013. </LI> <LI> Overall in-hospital mortality was 34.2% for adult invasive pneumococcal disease (IPD) and 51.0% for patients ≥75 years of age. </LI> <LI> Mortality risks were older age, higher bacteremia score, and immunocompromised status. </LI> <LI> An effective vaccination strategy for those at higher risk of IPD is needed. </LI> </UL> </P>