아프리카 食糧生産의 主要 規制要因

王仁槿,權五復 서울大學校 農科大學 1986 서울대농학연구지 Vol.11 No.1

The purpose of this paper is to overally analyze and examine some major derermining factors of the Sub-Saharan Africa's food production as part of a larger study primarily conducted by the second author through literature study approach. Significance of the study may lie in the fact that many latecomer developing countries in the Black African Continent have been seriously suffering from hunger and even famine, that the agricultural food production is the core of the agricultural and rural development in many of these countries, that the agricultural and rural development may be approximated to the national development itself in many countries, and that Africa as the major pocket of serious poverty and un-development of the world today is, manifestly and potentially, significantly concerned with national interests of Korea as an emerging donor firstcomer developing country in international assistance-cum-cooperation, in particular for agricultural and rural development. Five major categories of the determining factors of the food production have been selectively identified, problem- or constraint-wise. They are colonization antecedents, environments and resources, national development policy decision-makings including, of course, those of the agriculural and rural development, land tenure system, and technology and productivity. The relatively long colonization experiences by European powers the African countries had to historically undergo have had such impacts upon the food production as: the divergent use of the African native labor of the productive age bracket in mines and plantations owned and managed by Europeans of the colonizing countries, depriving the rural areas of the agricultural labor needed, plunder of good arable lands by European colonizers that were used to be cultivated for producing staple food grains, implementation of agricultural policies with special emphasis on export crops with the result of a typical monoculture farming skewedly developed, and introduction of the economic dualism. The major physical or natural environments that affect significantly the good production may be: frequent haunting of serious and wide-spread droughts in recent years, and the 'tse-tse fly' damage the extent of which, area-wise, has been estimated at nearly one-thirds of the Black African Content. Population and livestock have been rapidly increasing, resulting in ultimate consequences of deterioration of land fertility and desertification. The irrigation level is the lowest in the world, and agricultural population and economically active population in agriculture have a tendency to increase over the years, which, however, are falling behind the increasing rate of the total population. As a result, agricultural population is decreasing, relatively and absolutely. National development policies of most countries have tended to put priority on urban and industrial sectors, and agricultural policies have been concentrated on export and cash crops, neglecting food production for domestic consumption for a long time. In most cases, agricultural commodity prices have been maintained rather at a lower level, providing small farmers with little or no incentives for increased food production. Marketing functions of agricultural produce and inputs have been in the hands of governments or the public sector to have badly inappropriate performance. Traditional land tenure systems have been of communal type, allowing individuals or families to have only the usufruct, not the right of transaction, transfer or lease of lands. The traditional land tenure system, consequently, has been considered to discourage farmers' incentives for land improvement, investment in land, and flexibility in land management. The badly low level of technologies of food production and agricultural productivity at a very low level, as a result, have been noted, contributing to the lagged food production. The quantity of chemical fertilizers being used and the degree of mechanization have been very low. Damages of food crops by some exogenous crop pests have been increasing as foreign food imports have been on the increase, and the post-harvest loss of food is found high. The demand or consumption aspect of food also impinges upon the production or supply aspect, usually considered as another major derermining factor category. In this regard, however, analysis and examination of this aspect should be beyond the scope of this paper, too important to be dealt with in this paper. Therefore, with a very limited view to complementing the analysis and examination of the major determining factors of food production, the following may be summarized: over the past decade, food demand has been increasing by more than 3 percent on the average while food production by less than 2 percent annually, the most important contributing factor for the increased demand being the population increase; the impact of income may be considered as negligible; but changes in food consumption patterns seem to be a contributing factor. Alleviation or removal of major constraints of food production so far identified, or solution of Africa's food problems, may be duly considered formidable challenges at least in the foreseeably near future as long as the countries' self-generating and indigenous capacity is concerned. They need stepped-up external development assistance and cooperation primarily in the form of the efficient and effective international agricultural and rural development technology transfer.

한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

사회적 변화에 따라 정신질환자들의 피해망상 속에 나타난 박해자 유형변화

강승범,황인복,김한석,김승곤,김학렬,박상학,김상훈,황걸 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

Objective: The authors investigated the frequency of persecutors in persecutory delusions of the psychiatric patients who didn't undergo the arrest or traumatic injury, reside in Gwangju Jeonnam area, and were admitted to the hospital after the 5.18 prodemocracy movement in Gwangju in 1980 upward 10 years. Also this study investigated the frequency of the persecutors before and after the prodemocracy movement and in capital and Gwangju Jeonnam area. Subjects and Methods: Among the 896 patients who were admitted to department of psychiatry, Chosun University Hospital from Jan. 1. 1989 to Dec. 31. 1991, we choosed 144 patients with persecutory delusion who had lived in Gwangju Jeonnam area for 10 years after 5.18 prodemocracy movement as subjects. Persecutors were classified into 7 class: unspecified, family, neighbors, communist or spy, police or army or secret agent, impersonal, others. Results: 1) In our study, the frequency of persecutors was family, unspecified, neighbors, police or army or secret agent, impersonal, others, communist or spy in descending order. As compared to previous studies (1956-2003) including our study about frequency of persecutor at capital area and Gwangju Jeonnam area, and before and after 5.18 prodemocracy movement, 2) At capital area, in the early 1980s, police, family, neighbors, unspecified person was frequent in descending order. In the both of early 1970s, 1990s, neighbors, family, unspecified person, police was frequent in descending order. 3) At Gwangju Jeonnam area, in the early 1970s, family, unspecified person, neighbors, police was frequent in descending order. In the early 1990s, unspecified person and family, neighbors, police was frequent in descending order. 4) The police class was most frequent at capital area in the early 1980s. Conclusions: We suppose that class of persecutor in persecutory delusions of psychiatric patients are changing according to social change, and frequency of police class was decreasing in both of capital and Gwangju, Jeonnam area.

하지 절단자 보행의 운동역학적 분석

임규찬,박윤서,배성제,정철수,신인식,김복영 師範大學 體育硏究所 1994 서울大學校 體育硏究所論集 Vol.15 No.2

This study was conducted to investigate the biomechanical characteristics of the gait pattern in an amputee for the purpose of improving the proper gait posture and designing the prosthetic. The subjects were six males amputees and one normal person. The ground reaction force was measured using AMTI force platform. The conclusions were as follows; 1. In case of amputee group, the ground reaction force was revealed in specific figure according to position in which they used the prosthetic, whereas in case of normal person the ground reaction force was revealed in the figure of two humps in regard of vertical axis. 2. In case of amputee group, the ground reaction force in time between fight foot contact and left foot contact was deviated from a figure of rectangle, whereas in case of normal person the ground reaction force was revealed in the figure of rectangle. 3. In case of amputee group, the ground reaction force referred to both feet angle point of view was revealed in irregular figure, whereas in case of normal person the ground reaction force was revealed about 47。

Nelumbinis Semen Reverses a Decrease in $5-HT_{1A}$Receptor Binding Induced by Chronic Mild Stress, a Depression-like Symptom

Jang, Choon-Gon,Kang, Moon-Kyu,Cho, Jae-Han,Lee, Sun-Bok,Kim, Hyun-Taek,Park, Soon-Kwon,Lee, Jin-Woo,Park, Seong-Kyu,Hong, Moo-Chang,Shin, Min-Kyu,Shim, In-Sup,Bae , Hyun-Su The Pharmaceutical Society of Korea 2004 Archives of Pharmacal Research Vol.27 No.10

Depression is associated with a dysfunctional serotonin (5-hydroxytryptamine; 5-HT) system. More recently, several lines of evidence suggest that an important factor in the development of depression may be a deficit in the function and expression of $5-HT_{1A}$ receptors. The present study assessed if Nelumbinis Semen (N. s.) had an anti-depression effect through reversing a decrease in $5-HT_{1A}$receptor binding in rats with depression-like symptoms induced by chronic mild stress. Using a $5-HT_{1A}$ receptor binding assay, with a specific $5-HT_{1A}$receptor agonist, 8- OH-DPAT (8-hydroxy-2-(di-n-propylamino) tetralin), the mechanism of the anti-depression effect of N. s. on rats was investigated, and the effects compared with two well-known antidepressants, Hyperium Perforatum (St. Johns Wort) and fluoxetine (Prozac). Animals were divided into five groups: the normal (N) group without chronic mild stress (CMS), the control (C) group under CMS for 8 weeks, the Nelumbinis Semen (N. s.) treatment group under CMS for 8 weeks, the Hyperium Perforatum (H. p.) treatment group under CMS for 8 weeks and finally, the fluoxetine (F) treatment group under CMS for 8 weeks. Each treatment was administered to rats during the last 4 weeks of the 8-week CMS. A sucrose intake test was performed to test the anti-depression effect of N. s. The N. s. treatment significantly reversed the decreased sucrose intake under CMS (P<0.05 compared to control group under CMS). In the CA2 and CA3 regions of the hippocampus, both N. s. and H. p. reversed the CMS-induced decrease in $5-HT_{1A}$receptor binding. In the I to II regions of the frontal cortex, N. s. and H. p. also reversed the CMS-induced decrease in$5-HT_{1A}$receptor binding, and even showed a significant increase in $5-HT_{1A}$receptor binding compared to the F treatment group (N. s. vs. P, p<0.05, H. p. vs. P, p<0.05). However, in the hypothalamus, all treatments reversed the CMSinduced decrease in $5-HT_{1A}$receptor binding. This reversal effect of N. s. on the decrease in $5-HT_{1A}$receptor binding in the frontal cortex, hippocampus and hypothalamus of rat brains was very similar to that of H. p, but different from that of F. It is concluded that N. s. presents an anti-depression effect through enhancing $5-HT_{1A}$receptor binding.

통조림용 가다랑어육의 식품성분

오광수,김정균,김인수,이응호,김복규 國立統營水産專門大學 附設 水産科學硏究所 1990 수산과학연구소보고 Vol.2 No.-

가다랑어 혈합육을 보다 효율적으로 이용하기 위한 일련의 기초연구로서, 가다랑어 혈합육의 지질성분, 함질소엑스분 및 구성아미노산 등을 보통 육과 함께 분석하여 비교, 검토하였다. 보통육은 혈합육에 비해 수분, 조단백질 함량은 약간 많은 반면, 조지방과 회분 함량은 혈합육이 약간 많았다. 휘발성염기질소량은 보토육이 22.7mg/100g, 혈합육이 46.9mg/100ㅎ으로 혈합육이 보통육에 비해 선도저하가 훨씬 빨랐다. 보통육과 혈합육의 총지질 조성은 각각 중성지질 79.7%, 71.9%, 당지질, 6.8%, 9.5%, 인지질13.5%, 18.6%로 이루어져 있었다. 중성지질의 성분은 free fatty acid ac triglyceride, 인지질은 phosphatidyl ethanolamine, phosphatidyl, 인지질은 phosphatidyl choline이 주성분이었고, lysogud 인지질의축적도 확인되었다. 총지지르 중성, 당 및 인지질의 축적도 확인되었다. 종지질, 중성, 당 및 인지질의 지반산 조성에서 보통육은 16:0 및 18:1을 주체로 한 포화산 및 모노엔산의 조성비가 혈합육보다 높았으며, 혈합육은 폴리엔산, 특히 22:6의 비율이 월등히 높았다. 16:0. 18:0, 18:1, 20:5 및 22:6 등이 주요 구성지방산이었다. 유리아미노산의 조성은 총함량에서 보통육 쪽이 많았고, 보통육에는 histidine, 혈합육에는 tauring의 보통육에서는 680.9mg.100g 정도 전존해 있었으나, 혈합육에서는 IMP의 분해가 급속히 진행되어 73.1mg/100g에 지나지 않았다. TMAO 및 TMA는 보통육에 비해 혈합육에 휠씬 많이 함유되어 있었고, total creatinine은 보통육 쪽이 많았다. 구성아미노산의 조성은 양시료 간에 별차이가 없었고, glutamic acid, aspartic acid, lysine, leucine, alanine, isoleucine 및 arginine 등이 주요 구성아니노산이었다. The lipid components, nitrogenous extracts and amino acids of dark muscle(DM) of skipjack (Katsuwonus pelamis) were analyzed and compared with those of white muscle(WM). WM was higher in moisture and crude protein content, and lower in crude lipid and ash content than those of DM. Contents of volatile basic nitrogen in WM and DM were 22.7mg/100g and 46.9mg/100g. Total lipid(TL) of WM and DM consisted of 79.7%, 71.9% neutral lipid(NL), 6.8%, 9.5% glycolipid(GL), and 13.5%, 18.6% phospholipid(PL), respectively. NL was mainly composed of free fatty acid, triglyceride, and PL was mainly occupied by phosphatidyl ethanolamine, phosphatidyl choline. Also lysophosphatidyl choline and lysophosphatidyl ethanolamine were identified in PL. In fatty acid composition of TL, NL, GL and PL, WM revealed higher contents in saturates and monoenes such as 16 : 0, 18 : 1, while DM showed higher contents in polyenes such as 22 : 6 especially. The major fatty acids of these samples were generally 16 : 0, 18 : 0, 18 : 1, 20 : 5 and 22 : 6. Contents of total free amino acids from WM and DM were 5,982.3mg/100g and 4,450.7mg/100g (dry base). Of free amino acids, Tau concentration was much higher in DM than in WM, Ala, Gly, Met, Arg, Thr were also high in DM. But His was much higher in concentration in WM. Content of inosinic acid(IMP) in WM(680.9mg/100g) was higher than that of DM(73.1mg/100g). The degradations of IMP proceeded very rapidly in DM. DM contained much higher trimethylamine oxide and trimethylamine than those of WM. The profile of combined amino acids in these samples were very similar, and main amino acids were Glu, Asp, Lys, Ala, Ile and Arg.

관상동맥 약물 방출 스텐트 삽입 후 스텐트 골절에 대한 임상결과 및 예후

김인수(In Soo Kim),한재복(Jae Bok Han),장성주(Seong Joo Jang) 대한방사선과학회(구 대한방사선기술학회) 2014 방사선기술과학 Vol.37 No.2

본 연구에서는 관상동맥 중재술로 관상동맥 약물방출 스텐트(drug-eluting stent, DES) 삽입 후 스텐트 골절에 대한 임상적 특성, 결과 및 예후에 대하여 연구하였다. 약물방출 스텐트 시술을 받고 추적 관상동맥조영술을 실시한 4,701명 환자에서 스텐트 골절이 발생한 환자는 32명(남:여=19:13, 평균연령 62.44±9.8세, 0.68%)이었다. DES의 종류별 스텐트 골절의 빈도는 SES(sirolimus- eluting stents) 19(59.4%), PES(paclitaxel-eluting stents) 9명(28.1%), BES(biolimus A9-eluting stents) 2명(6.3%), EES(everolimus-eluting stents) 1명(3.1%), EPC(endothelial progenitor cell capture stent) 1명(3.1%), ZES(zotarolimus-eluting stents) 0명(0%) 이었다. 표적 병변은 우관상동맥 13명(40.6%) 좌전하행지 16명(50.0%), 좌회선지 3명(9.4%)이었다. 각 혈관의 병변 형태는 복잡병변인 B2, C형이 25명(69.4%)이었다. 스텐트 골절 환자 중 스텐트 내 협착은 17명(53.1%)이었으며, 스텐트 골절 병변에 대한 치료는 내과적 관찰 16명(50.0%), 동종의 관상동맥 DES 시술 3명(9.4%), 이종의 관상동맥 DES 시술 10명(31.3%), 관상동맥 풍선 확장술 3명(9.4%)이었다. 추적검사에서는 32.9±12.4개월 동안 스텐트 골절로 인한 사망을 포함한 심장사는 발생하지 않았다. 결론적으로 관상동맥 중재술로 관상동맥 DES를 시술받은 추적관찰 대상 환자에서 3.7년 추적관찰 기간동안 스텐트 골절 발생률은 0.68%로 나타났으며, PES보다 SES에서 많은 발생 빈도를 보였다. 좌전하행지와 복잡병변에 대한 시술 후 스텐트 골절이 많이 발생하였다. 또한 스텐트 골절 정도와 협착 병변이 중대한 경우에만 관상동맥 중재술을 실시하였으며, 추적관찰 기간 중 스텐트 골절이 있는 환자는 병용 항혈소판 요법을 지속적으로 투여하였다. 특히 사망을 포함한 주요 심장사건에 관련하여 스텐트 골절과 연관된 심장사의 발생률은 매우 낮은 것으로 나타났다. 본 연구를 통해서 스텐트가 가지고 있는 특성 스텐트 디자인이 폐쇄형(closed cell) 디자인 SES에서 발생 빈도가 높음을 제시함으로써 스텐트 개발에 도움이 될 거라 판단된다. Many studies have suggested that in the era of Drug-Eluting Stents(DES) are one of the causes of In-Stent Restenosis(ISR) of Stent Fracture(SF). The present study sought to evaluate clinical characteristics of patients with stent fracture after successful DES implantation. The 4,701 patients were selected for analysis who underwent a follow-up coronary angiography irre-spective of ischemic symptoms. The overall incidence of SF was 32 patients(male:female=19:13, Av. age 62.44±9.8year, 0.68%). Fractures of Sirolimus-Eluting Stents(SES), Paclitaxel-Eluting Stents(PES), Biolimus A9-Eluting Stents(BES), Everolimus-Eluting Etents(EES), Endothelial Progenitor Cell Capture Stent(EPC) and Zotarolimus-Eluting Stents(ZES) are accounted for 19(59.4%), 9(28.1%),2(6.3%),1(3.1%),1(3.1%)and 0(0%) respectively. SF developed in the left Anterior Dscending(LAD) artery in 16 patients(50%) and in complex(type B2, C) lesions in 25 patients(69.4%). Ten patients were treated with heterogenous DES, the rest being treated with either homogenous DES(3 patients), plain old balloon angioplasty(3 patients), or conservative medical treatment(17 patients). None of the patients with SF suffered from cardiac death dur-ing a follow-up period of 32.9±12.4 months. The overall rate of DES fracture over up to 3.7 years of follow-up was 0.68% with higher incidence in SES than in PES. SF frequently occurred in the LAD artery and in complex lesions. Of the patients with SF, coronary intervention was performed only when the binary restenosis lesion was significant. During the follow-up, patients with SF have continued on combination antiplatelet therapy. There is a very low rate of major adverse cardiac events(post-detection of SF), especially cardiac death associated with SF.

Synergistic effects of codecoration of oxide nanoparticles on the gas sensing performance of In₂O₃ nanorods

Park, Sunghoon,Sun, Gun-Joo,Kheel, Hyejoon,Lee, Wan In,Lee, Sangmin,Choi, Seung-Bok,Lee, Chongmu Elsevier 2016 Sensors and actuators. B Chemical Vol.227 No.-

<P><B>Abstract</B></P> <P>n-In<SUB>2</SUB>O<SUB>3</SUB> nanorods codecorated with n-Fe<SUB>2</SUB>O<SUB>3</SUB> and p-Co<SUB>3</SUB>O<SUB>4</SUB> nanoparticles were synthesized by the thermal evaporation of In<SUB>2</SUB>S<SUB>3</SUB> powders in an oxidizing atmosphere followed by the solvothermal deposition of Fe<SUB>2</SUB>O<SUB>3</SUB> and Co<SUB>3</SUB>O<SUB>4</SUB> nanoparticles, and their ethanol gas sensing properties were examined. The p-Co<SUB>3</SUB>O<SUB>4</SUB>-decorated n-In<SUB>2</SUB>O<SUB>3</SUB> nanorods exhibited stronger and faster response to ethanol gas than the n-Fe<SUB>2</SUB>O<SUB>3</SUB>-decorated n-In<SUB>2</SUB>O<SUB>3</SUB> nanorods due to the larger modulation of the conduction channel width and interfacial potential barrier height, and stronger catalytic activity of p-Co<SUB>3</SUB>O<SUB>4</SUB> than n-Fe<SUB>2</SUB>O<SUB>3</SUB>. Furthermore, the codecorated In<SUB>2</SUB>O<SUB>3</SUB> nanorod sensor exhibited significantly stronger and faster response to ethanol gas than its mono-oxide nanoparticle-decorated counterparts under the condition of the same total amount of the decorating nanoparticles. The origin of the synergistic effects of codecoration on the ethanol sensing properties of the In<SUB>2</SUB>O<SUB>3</SUB> nanorod sensor is not the formation of compounds or nanoalloys between the oxides but the formation of a large number of the p–n junctions between the two different types of decorating oxides, i.e., Fe<SUB>2</SUB>O<SUB>3</SUB>–Co<SUB>3</SUB>O<SUB>4</SUB> p–n junctions in addition to the Co<SUB>3</SUB>O<SUB>4</SUB>–In<SUB>2</SUB>O<SUB>3</SUB> p–n junctions.</P>

서정주의 시에 나타난 죽음의식 : 「花蛇集」과 「冬天」을 중심으로

이인복 숙명여자대학교 2002 숙명語文論集 Vol.4 No.-

Seo's work can be divided into two periods. The first period centers around the collection of poems called [Hwasajip (Flower Snake)] and the second period centers around the collection [Dongcheon (Winter Sky)]. The most important pieces from [Hwasajip] is "Jahwasang (Self-portrait)" and "Buhwal (Resurrection)." "Jahwasang" shows resistance to his own existence that rebels against and questions the tragedy of his life. Further, it is a piece that challenges the existence of God. It fights against the irrationality of the burden imposed on humans through the original sin. On the other hand, through "Buhwal," Midang Seo Jeongju shows how he overcame his consciousness of death by maturely experiencing the Buddhist concept of reincarnation and nirvana. Thus all of his works since 1936 fall somewhere within the circular repetition of the first poem "Jahwasang" and the last poem "Buhwal" contained in [Hwasajip]. It is true that changes can be observed in his poetic tech nique and that the depth and width of his thoughts are noticeable, but at least in terms of his consciousness of death, there is only the circular reincarnation of "Jahwasang" and "Buhwal." Seo's works of the latter period can be analyzed through the collection [Dongcheon]. We have already seen that Seo's world of poetry has developed into the Buddhist concept of nirvana. In [Dongcheon], he presents himself to us as the spirit of the Shilla people who lived and died more than a thousand years ago. The first poem in [Dongcheon] is "The falling twilight." Your back curved like a shrimp, the twilight falling beneath, over the hill to your daughter's, could you now go to slumber. In this poem, Midang is squarely confronting death and is calmly accepting it. He says that he will receive death as naturally as he is visiting his daughter over the hill. He compares death to slumber. When you sleep, you can dream and through the dream you can live another life. Thus Midang clearly states that death is not something to be afraid of. Without doubt, the true meaning of death can only be understood by overcoming death itself. When one wishes to overcome death, the first thought that comes to mind is the concept of reincarnation. We already understand the circular representation through which death is connected to life. However, humans hope to physically experience this circular structure within one's lifetime. In other words, we wish to live this life and at the same time experience the world of death. It is at this point that Midang caught on the continuum of time that encompasses the structure of reincarnation. We have already discussed how Seo's poems in [hwasajip] is a continual reincarnation of "Jahwasang" and "Buhwal." When this statement is applied to [Dongcheon], "The falling twilight" is the introspective poem that can be compared to "Jahwasang" while the poems that can be compared to "Buhwal" are "My love for you" and "Untitled" through which Midang portrays his emotion. In these poems, Midang becomes the flawless "mind." From the "cloudless sky," he rides the "seven colors of the sun and rests beneath a flower tree." To those of us who love the purity of thought, it is as if he is calling us up on the phone to talk to us. Thus we humbly listen to the poetic mind represented in these poems. Confucius once said that even after reading three hundred poems, when asked to explain a poetry, he could only describe it as the purity of thought. Certainly, Midang now resides everlastingly in the world of nirvana where only the poets with pure thoughts live.

약물용출 스텐트를 이용한 관상동맥중재술 후 재협착의 독립적 예측인자에 관한 연구

김인수(In-Soo Kim)한재복(Jae-Bok Han),장성주(Seong-Joo Jang),장영일(Young-Ill Jang) 대한방사선과학회(구 대한방사선기술학회) 2010 방사선기술과학 Vol.33 No.1

본 연구에서는 약물용출성 스텐트 삽입 후 재협착에 관한 독립적 인자를 확인하고 MDCT로 측정된 calcium score가 재협착 발생의 예측인자로써 가능성을 알아보고자 하였다. 2006년 5월부터 2009년 5월까지 전남대학교병원에서 MDCT상 관상동맥 협착이 발견되어 약물 용출 스텐트를 삽입 받은 환자 1,131명 중 추적검사로 관상동맥조영술을 시행되었던 178명(남자 159명, 여자 19명, 평균 연령 61.7, 연령분포 51~71세), 190개소 병변을 대상으로 하였으며 재협착 여부에 따라 두 군(비협착군 133병변, 재협착군 57병변)으로 나누어 비교 ․ 분석하였다. 그 결과 임상진단명은 진구성 심근경색이 비협착군 3예(2.3%), 재협착군 5예(8.8%)로 유의한 차이가 있었으며(p = 0.040), 급성 심근경색증, 불안정 협심증, 안정 협심증의 유병률은 차이가 없었다. 관상동맥 조영술 소견에서 병변 혈관의 위치는 재협착군에서 좌주간지 병변이 더 많았다(0.8% vs. 5.3%, p = 0.047). 스텐트 직경은 재협착군에서 유의하게 작았으며(3.3±0.4 mm vs. 3.1±0.3 mm, p = 0.004), 스텐트 길이는 양군 간에 차이가 없었다. 관상동맥 조영술 상 혈관의 초기 협착 정도는 재협착군에서 더 심했으며(86.1±11.4% vs. 91.5±9.2%, p = 0.001), 복잡 병변(B2/C형)은 양 군간에 차이가 없었다. 연령은 재협착군에서 더 높았고(60.2±9.9세 vs. 65.8±9.0세, p = 0.0001), 흡연력과 고지혈증은 비협착군에서(42.1% vs. 19.3%, p = 0.003, 23.3% vs. 8.8%, p = 0.019), 그리고 당뇨병은 재협착군에서 많았다(21.8% vs. 52.6%, p = 0.0001). 심초음파로 측정한 좌심실 구혈률은 양 군 간에 유의한 차이는 없었다. 전체 MDCT coronary artery calcium scoring는 비협착군 371.2±500.8, 재협착군 389.3±458.3로 차이가 없었고, 목표혈관과 좌주간지, 좌전하행지, 좌회선지 및 우관상동맥 각각의 calcium score 역시 양군 간 차이가 없었다. 다 변량 로지스틱 회귀분석에서 좌주간지병변(OR = 168.0, 95% CI = 7.83-3,604.3, p = 0.001), 남성(OR = 36.5, 95% CI = 5.89-2,226.9, p = 0.0001), 당뇨병의 존재(OR = 2.62, 95% CI = 1.071~6.450, p = 0.035)가 약물용출성 스텐트 삽입 후 재협착 발생에 대한 독립적인 예측인자이었다. 따라서 관상동맥 협착에 대해 약물용출 스텐트를 삽입 받은 환자에서 스텐트 내 재협착의 발생은 좌주간지병변, 남성, 당뇨병의 존재와 관련이 있었으나, MDCT로 측정된 calcium score는 재협착 발생에 대한 독립적인 예측인자로써 기능은 없었다. We sought to confirm an independent factor about in-stent restenosis (ISR) in the patients who underwent drug-eluting stent (DES) and know a possibility as a predictor of measured coronary artery calcium score by MDCT. A total of 178 patients (159 men, 61.7±10.0 years of age) with 190 coronary artery lesions were included in this study out of 1,131 patients who underwent percutaneous coronary intervention (PCI) with DES implantation for significant stenosis on MDCT at Chonnam National University Hospital between May 2006 and May 2009. All lesions were divided into two groups with the presence of ISR : group I (re ISR, N = 57) and group II (no ISR, N = 133). Compared to group II, group I was more likely to be older (65.8±9.0 vs. 60.2±9.9 years, p = 0.0001), diabetic (21.8% vs. 52.6%, p = 0.0001), have old myocardial infarction (8.8% vs. 2.3%, p = 0.040), left main stem disease (5.3% vs. 0.8%, p = 0.047), and smaller stent size (3.1±0.3 mm vs. 3.3±0.4 mm, p = 0.004). Group II was more likely to be smokers (19.3% vs. 42.1%, p = 0.003), have dyslipidemia (8.8% vs. 23.3%, p = 0.019). Left ventricular ejection fraction, lesion complexity, and stent length were not different between the two groups. Total CAC score was 389.3±458.3 in group I and 371.2±500.8 in group II (p = 0.185). No statistical difference was observed between the groups in CAC score in the culprit vessel, left main stem, left anterior descending artery, left circumflex artery, and right coronary artery. On multivariate logistic regression analysis, left main stem disease (OR = 168.0, 95% CI = 7.83-3,604.3, p = 0.001), male sex (OR = 36.5, 95% CI = 5.89-2,226.9, p = 0.0001), and the presence of diabetes (OR = 2.62, 95% CI = 1.071-6.450, p = 0.035) were independent predictors of ISR after DES implantation. In patients who underwent DES implantation for significant coronary stenosis on MDCT, ISR was associated with left main stem disease, male sex, and the presence of diabetes. However, CAC score by MDCT was not a predictor of ISR in this study population.