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.

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.

氣候適應과 着衣量의 關係에 關한 硏究 : 高等學校 學生을 中心으로 In the Case of High School Students

安必子,崔正和 한국의류학회 1992 한국의류학회지 Vol.16 No.4

To examine the effects of clothes upon human's physiological adaptation to the changes of climatic conditions, clothing weight was examined. The results are as follows; 1. According to the change in temperature, the total, upper and outer clothing weight showed remarked change. Clothing weight change was greatest between the July and October, the change was greater in the coast land and the girl students. 2. The clothing weight tends to be light under outdoor in both regions in all seasons except in July, it is remarked in inland and December. 3. The correlation between Ro¨hrer Index, Body Fat and clothing weight was recognized to be significantly reversed. 4. Positive correlation between health conditions and clothing weight was recognized in December. 5. The correlation between exercise hours and clothing weight was negatively significant in December.

급성 충수돌기염 의증 환자의 진단에서 컴퓨터 단층촬영과 초음파검사의 비교 분석

이정훈,최필조,심민섭,송근정,정연권 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: This study was conducted to compare the accuracy of computered tomography(CT) and sonography(US) in diagnosing acute appendicitis and to analyze the radiologic factors which influence the result. Methods: We retrospectively studied the cases of 53 patients who were suspected of having appendicitis and who were examined by CT and US covered a three-year period. The final diagnosis was determined from the surgico-pathologic diagnosis and clinical follow-up for two months, as well as from the discharge diagnosis. Results: Thirty-eight(38) patients had acute appendicitis; 15 patients did not. In the analysis, CT and US, respectively, revealed sensitivities of 89.5% and 73.7%, specificities of 93.3% and 60.0%, positive predictive values of 97.1% and 82.4%, negative predictive values of 77.8% and 47.4%. Among patients diagnosed with acute appendicitis, 10 patients were discordant in the US and the CT examinations; CT findings were correct in 8 and US findings in 2. Among non-appendicitis patients, 5 patients were discordant in the US and the CT examinations; CT was correct in 5 and US in 0. Nighteen(19) patients had complications such as an abscess or a perforation. Among these patients, the degree and the extent of the complication were accurately evaluated by CT in 15 patients and by US in 5 patients. Conclusion: CT is more accurate than US in diagnosing and excluding acute appendicitis. The use of CT will substantially decrease unnecessary laparotomies and post-operation complications.

'1998 한국인 우울증 선별의 날' 참가자들의 사회인구통계학적 특성과 우울증 선별검사 결과

한상익,이성필,고효진,박원명,장계호,유태열,전태연,채정호,방승규,김광수,최보문,이정태,백인호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 1998년 정신건강의 날 기념 한국인 우울증 선별의 날 행사에 자발적으로 참여한 참가자들의 사회인구 통계학적 특성을 분석하고 우울증 선별검사 결과를 평가하기 위하여 본 연구를 시행하였다. 방 법 : 8개 병원에서 얻어진 619명의 자료를 사용하여 선별검사로 밝혀진 우울증의 유병율과 사회인구통계학적 특성 및 응답자의 정신과적 치료를 포함한 과거력 등을 조사하였다. 결 과 : 우울증 척도 점수는 응답자 전체 평균 57.5±13.8로 경도의 우울 증상이 있는 것에 해당되었다. 전체 응답자의 69.5%(430명)가 최소한 경도 이상의 우울 증상을, 43.1%(267명)가 중등도 이상의 우울 증상을, 18.4%(114명)가 고도의 우울 증상을 보였다. 고도의 우울 증상이 있는 응답자의 56.8%와 중등도의 우울 증상이 있는 응답자의 63.9%가 정신과 치료를 받은 적이 전혀 없었다. 나이가 29세 이하인 것과 전임근무 중인 직업상태는 각각 나이가 60세 이상인 것과 직업이 없는 것에 비교하여 우울증으로부터 보호하는 인자임을 시사하였다. 결 론 : '1998 한국인 우울증 선별의 날' 행사를 통하여 많은 우울증 환자들을 선별해낼 수 있었고, 이들의 우울 증상은 몇몇 사회인구통계학적 특성과 유의한 관계가 있음을 확인하였다. 우울증 선별의 날 행사를 통한 우울증에 대한 교육과 우울증 선별검사는 치료받지 못하고 있는 우울증 환자 및 기존의 치료 중인 환자 모두에게 유용한 프로그램임을 알 수 있었다. Objectives : This study was performed to analyze the sociodemographic characteristics of participants in '1998 Korean Depression Screening Day' and to evaluate the results of the screening test. Methods : By using the survey results of 619 volunteers from 8 hospitals, the authors examined the prevalence of depression detected at the screening test and sociodemographic characteristics and the psychiatric treatment history of respondents. The assessment measure was the Zung Self-Rating Depression Scale. Results : The mean depression score of all participants was 57.5±13.8 and it came under mild depression. Of all participants, 69.5%(N=430) had at least mild depressive symptoms, 43.1%(N=267) had at least moderate symptoms, and 18.4%(N=114) had severe symptoms. Never have 56.8% of respondents in the severely depressed range and 63.9% of those in the moderately depressed range had psychiatric treatment. The results suggest that the age group of 29-year-old or younger(relative to 60-year-old or older group) and full-time employment status(relative to unemployment) are protective factors of depression. Conclusions : By '1998 Korean Depression Screening Day', many depressed patients were detected and their depressive symptoms had statistically significant relationships with some sociodemographic characteristics. The results suggest that the education and screening test programs for depressive illness facilitated by Depression Screening Day are useful to the patients regardless of being under current treatment or not.

관상동맥 질환에서 SDF-1α의 농도

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

Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

Risk of lymphadenopathy from SARS-CoV-2 vaccination in Korea: a self-controlled case series analysis

Mi-Sook Kim(Mi-Sook Kim),Bongyoung Kim(Bongyoung Kim),Jeong Pil Choi(Jeong Pil Choi),Nam-Kyong Choi(Nam-Kyong Choi),Jung Yeon Heo(Jung Yeon Heo),Jun Yong Choi(Jun Yong Choi),Joongyub Lee(Joongyub Lee) 한국역학회 2023 Epidemiology and Health Vol.45 No.-

OBJECTIVES: To assess the risk of lymphadenopathy following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. METHODS: A self-controlled case series design was used to determine whether the risk of lymphadenopathy was higher in the 1-day to 42-day risk interval after coronavirus disease 2019 (COVID-19) vaccination compared to the control period. In addition, subgroup analyses were conducted according to baseline characteristics, time since vaccination, and sensitivity analyses adjusted for the length of the risk interval. RESULTS: The risk of developing lymphadenopathy in the risk interval (1-42 days) after COVID-19 vaccination compared to the control period was significantly increased, with a relative incidence (RI) of 1.17 (95% confidence interval [CI], 1.17 to 1.18) when the first, second, and third doses were combined. The RI was greater on the day of vaccination (1.47; 95% CI, 1.44 to 1.50). In subgroup analyses by baseline characteristics, a significantly increased risk or trend toward increased risk was observed in most subgroups except for those aged 70 years and older, with a significant increase in risk in younger individuals, those with a Charlson’s comorbidity index <5, and those who received mRNA vaccines (mRNA-1273>BNT162b2). Within the 1-day to 42-day post-dose risk period, the relative risk was highest during the 1-day to 7-day post-dose period (1.59; 95% CI, 1.57 to 1.60) compared to the control period, and then the risk declined. In the sensitivity analysis, we found that the longer the risk window, the smaller the RI. CONCLUSIONS: SARS-CoV-2 vaccination is associated with a statistically significant increase in the risk of lymphadenopathy, and this risk was observed only with mRNA vaccines.

Saponins from the Roots of Platycodon grandiflorum Suppresses TGFβ1-Induced Epithelial-Mesenchymal Transition Via Repression of PI3K/Akt, ERK1/2 and Smad2/3 Pathway in Human Lung Carcinoma A549 Cells

Choi, Jae Ho,Hwang, Yong Pil,Kim, Hyung Gyun,Khanal, Tilak,Do, Minh Truong,Jin, Sun Woo,Han, Hwa Jeong,Lee, Hyun Sun,Lee, Young Chun,Chung, Young Chul,Jeong, Tae Cheon,Jeong, Hye Gwang Taylor Francis 2014 Nutrition and cancer Vol.66 No.1

Monitoring canopy phenology in a deciduous broadleaf forest using the Phenological Eyes Network (PEN)[Author's correction]

Choi, Jeong-Pil,Kang, Sin-Kyu,Choi, Gwang-Yong,Nasahara, Kenlo Nishda,Motohka, Takeshi,Lim, Jong-Hwan The Ecological Society of Korea 2012 Journal of Ecology and Environment Vol.35 No.1

Monitoring canopy phenology in a deciduous broadleaf forest using the Phenological Eyes Network (PEN)

Choi, Jeong-Pil,Kang, Sin-Kyu,Choi, Gwang-Yong,Nasahara, Kenlo Nishda,Motohka, Takeshi,Lim, Jong-Hwan The Ecological Society of Korea 2011 Journal of Ecology and Environment Vol.34 No.2

Phenological variables derived from remote sensing are useful in determining the seasonal cycles of ecosystems in a changing climate. Satellite remote sensing imagery is useful for the spatial continuous monitoring of vegetation phenology across broad regions; however, its applications are substantially constrained by atmospheric disturbances such as clouds, dusts, and aerosols. By way of contrast, a tower-based ground remote sensing approach at the canopy level can provide continuous information on canopy phenology at finer spatial and temporal scales, regardless of atmospheric conditions. In this study, a tower-based ground remote sensing system, called the "Phenological Eyes Network (PEN)", which was installed at the Gwangneung Deciduous KoFlux (GDK) flux tower site in Korea was introduced, and daily phenological progressions at the canopy level were assessed using ratios of red, green, and blue (RGB) spectral reflectances obtained by the PEN system. The PEN system at the GDK site consists of an automatic-capturing digital fisheye camera and a hemi-spherical spectroradiometer, and monitors stand canopy phenology on an hourly basis. RGB data analyses conducted between late March and early December in 2009 revealed that the 2G_RB (i.e., 2G - R - B) index was lower than the G/R (i.e., G divided by R) index during the off-growing season, owing to the effects of surface reflectance, including soil and snow effects. The results of comparisons between the daily PEN-obtained RGB ratios and daily moderate-resolution imaging spectroradiometer (MODIS)-driven vegetation indices demonstrate that ground remote sensing data, including the PEN data, can help to improve cloud-contaminated satellite remote sensing imagery.