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( Joon Young Kim ),( Myung Ho Jeong ),( Yong Woo Choi ),( Yong Keun Ahn ),( Shung Chull Chae ),( Seung Ho Hur ),( Taek Jong Hong ),( Young Jo Kim ),( In Whan Seong ),( In Ho Chae ),( Myeong Chan Cho ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.6
Background/Aims: Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. Methods: We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. Results: During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow < 3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p < 0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013). Conclusions: The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow < 3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.
Kim, Joon Young,Jeong, Myung Ho,Ahn, Yong Keun,Moon, Jae Hyun,Chae, Shung Chull,Hur, Seung Ho,Hong, Taek Jong,Kim, Young Jo,Seong, In Whan,Chae, In Ho,Cho, Myeong Chan,Kim, Chong Jin,Jang, Yang Soo,Yo The Korean Society of Cardiology 2011 Korean Circulation Journal Vol.41 No.4
<P><B>Background and Objectives</B></P><P>Patients with renal dysfunction (RD) experience worse prognosis after myocardial infarction (MI). The aim of the present study was to investigate the impact of admission estimated glomerular filtration rate (eGFR) on clinical outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation MI (STEMI).</P><P><B>Subjects and Methods</B></P><P>We retrospectively evaluated 4,542 eligible patients from the Korea Acute Myocardial Infarction Registry (KAMIR). Patients were divided into three groups according to eGFR (mL/min/1.73 m<SUP>2</SUP>): normal renal function (RF) group (eGFR ≥60, n=3,515), moderate RD group (eGFR between 30 to 59, n=894) and severe RD group (eGFR <30, n=133). Baseline characteristics, angiographic and procedural results, and in-hospital outcomes between the three groups were compared.</P><P><B>Results</B></P><P>Age, gender, Killip class ≥3, hypertension, diabetes, congestive heart failure, peak creatine kinase-MB, high sensitivity C-reactive protein, B-type natriuretic peptide, left ventricle ejection fraction, multivessel disease, infarct-related artery and rate of successful PCI were significantly different between the 3 groups (p<0.05). With decline in RF, in-hospital complications developed with an increasing frequency (14.1% vs. 31.8% vs. 45.5%, p<0.0001). In-hospital mortality rate was significantly higher in the moderate and severe RD groups as compared to the normal RF group (2.3% vs. 13.9% vs. 25.6%, p<0.0001). Using multivariate logistic regression analysis, adjusted odds ratio for in-hospital mortality was 2.67 {95% confidence interval (CI) 1.44-4.93, p=0.002} in the moderate RD group, and 4.09 (95% CI 1.48-11.28, p=0.006) in the severe RD group as compared to the normal RF group.</P><P><B>Conclusion</B></P><P>Decreased admission eGFR was associated with worse clinical courses and it was an independent predictor of in-hospital mortality in STEMI patients undergoing primary PCI.</P>
Sim, Doo Sun,Jeong, Myung Ho,Ahn, Youngkeun,Kim, Young Jo,Chae, Shung Chull,Hong, Taek Jong,Seong, In Whan,Chae, Jei Keon,Kim, Chong Jin,Cho, Myeong Chan,Seung, Ki Bae,Park, Seung Jung The Korean Academy of Medical Sciences 2011 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.26 No.4
<P>This study compared clinical outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in large coronary arteries in patients with acute myocardial infarction (MI). A total of 985 patients who underwent single-vessel percutaneous coronary intervention (PCI) in large coronary arteries (≥ 3.5 mm) in lesions < 25 mm were divided into DES group (n = 841) and BMS group (n = 144). Clinical outcomes during 12 months were compared. In-hospital outcome was similar between the groups. At six months, death/MI rate was not different. However, DES group had significantly lower rates of target-lesion revascularization (TLR) (1.7% vs 5.6%, <I>P</I> = 0.021), target-vessel revascularization (TVR) (2.2% vs 5.6%, <I>P</I> = 0.032), and total major adverse cardiac events (MACE) (3.4% vs 11.9%, <I>P</I> = 0.025). At 12 months, the rates of TLR and TVR remained lower in the DES group (2.5% vs 5.9%, <I>P</I> = 0.032 and 5.9% vs 3.1%, <I>P</I> = 0.041), but the rates of death/MI and total MACE were not statistically different. The use of DES in large vessels in the setting of acute MI is associated with lower need for repeat revascularization compared to BMS without compromising the overall safety over the course of one-year follow-up.</P>
Lee, Min Goo,Jeong, Myung Ho,Ahn, Youngkeun,Chae, Shung Chull,Hur, Seung Ho,Hong, Taek Jong,Kim, Young Jo,Seong, In Whan,Chae, Jei Keon,Rhew, Jay Young,Chae, In Ho,Cho, Myeong Chan,Bae, Jang Ho,Rha, S The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.10
<P>We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction Registry, a total of 1,990 patients suffered from acute ST-elevation myocardial infarction (STEMI) between November 2005 and December 2006 were categorized according to the National Cholesterol Education Program-Adult Treatment Panel III criteria of MS. Primary study outcomes included major adverse cardiac events (MACE) during one-year follow-up. Patients were grouped based on existence of MS: group I: MS (n=1,182, 777 men, 62.8±12.3 yr); group II: Non-MS (n=808, 675 men, 64.2±13.1 yr). Group I showed lower left ventricular ejection fraction (LVEF) (<I>P</I>=0.005). There were no differences between two groups in the coronary angiographic findings except for multivessel involvement (<I>P</I>=0.01). The incidence of in-hospital death was higher in group I than in group II (<I>P</I>=0.047), but the rates of composite MACE during one-year clinical follow-up showed no significant differences. Multivariate analysis showed that low LVEF, old age, MS, low high density lipoprotein cholesterol and multivessel involvement were associated with high in-hospital death rate. In conclusion, MS is an important predictor for in-hospital death in patients with STEMI.</P>
( Keun Ho Park ),( Young Keun Ahn ),( Myung Ho Jeong ),( Shung Chull Chae ),( Seung Ho Hur ),( Young Jo Kim ),( In Whan Seong ),( Jei Keon Chae ),( Taek Jong Hong ),( Myeong Chan Cho ),( Jang Ho Bae ) 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.2
Background/Aims: The aim of this study was to evaluate the impact of diabetes mellitus (DM) on in-hospital and 1-year mortality in patients who suffered acute myocardial infarction (AMI) and underwent successful percutaneous coronary intervention (PCI). Methods: Among 5,074 consecutive patients from the Korea AMI Registry with successful revascularization between November 2005 and June 2007, 1,412 patients had a history of DM. Results: The DM group had a higher mean age prevalence of history of hypertension, dyslipidemia, ischemic heart disease, high Killip class, and diagnoses as non-ST elevation MI than the non-DM group. Left ventricular ejection fraction (LVEF) and creatinine clearance were lower in the DM group, which also had a significantly higher incidence of in-hospital and 1-year mortality of hospital survivors (4.6% vs. 2.8%, p = 0.002; 5.0% vs. 2.5%, p < 0.001). A multivariate analysis revealed that independent predictors of in-hospital mortality were Killip class IV or III at admission, use of angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers, LVEF, creatinine clearance, and a diagnosis of ST-elevated MI but not DM. However, a multivariate Cox regression analysis showed that DM was an independent predictor of 1-year mortality (hazard ratio, 1.504; 95% confidence interval, 1.032 to 2.191). Conclusions: DM has a higher association with 1-year mortality than in-hospital mortality in patients with AMI who underwent successful PCI. Therefore, even when patients with AMI and DM undergo successful PCI, they may require further intensive treatment and continuous attention.
Park, Keun-Ho,Ahn, Youngkeun,Jeong, Myung Ho,Chae, Shung Chull,Hur, Seung Ho,Kim, Young Jo,Seong, In Whan,Chae, Jei Keon,Hong, Taek Jong,Cho, Myeong Chan,Bae, Jang Ho,Rha, Seung Woon,Jang, Yang Soo The Korean Association of Internal Medicine 2012 The Korean Journal of Internal Medicine Vol.27 No.2
<P><B>Background/Aims</B></P><P>The aim of this study was to evaluate the impact of diabetes mellitus (DM) on in-hospital and 1-year mortality in patients who suffered acute myocardial infarction (AMI) and underwent successful percutaneous coronary intervention (PCI).</P><P><B>Methods</B></P><P>Among 5,074 consecutive patients from the Korea AMI Registry with successful revascularization between November 2005 and June 2007, 1,412 patients had a history of DM.</P><P><B>Results</B></P><P>The DM group had a higher mean age prevalence of history of hypertension, dyslipidemia, ischemic heart disease, high Killip class, and diagnoses as non-ST elevation MI than the non-DM group. Left ventricular ejection fraction (LVEF) and creatinine clearance were lower in the DM group, which also had a significantly higher incidence of in-hospital and 1-year mortality of hospital survivors (4.6% vs. 2.8%, <I>p</I> = 0.002; 5.0% vs. 2.5%, <I>p</I> < 0.001). A multivariate analysis revealed that independent predictors of in-hospital mortality were Killip class IV or III at admission, use of angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers, LVEF, creatinine clearance, and a diagnosis of ST-elevated MI but not DM. However, a multivariate Cox regression analysis showed that DM was an independent predictor of 1-year mortality (hazard ratio, 1.504; 95% confidence interval, 1.032 to 2.191).</P><P><B>Conclusions</B></P><P>DM has a higher association with 1-year mortality than in-hospital mortality in patients with AMI who underwent successful PCI. Therefore, even when patients with AMI and DM undergo successful PCI, they may require further intensive treatment and continuous attention.</P>
김태형(Tae-Hyung Kim),임청환(Cheong-Hwan Lim),김정구(Jeong-Koo Kim),김명수(Myeong-Soo Kim),최원찬(Won-Chan Choi),임진오(Jin-Oh Lim),이광종(Kwang-Jong Lee),박인애(In-Ae Park),김미옥(Mi-Ok Kim),정은미(Eun-Mi Jung),신령미(Ryung-Mi Shin) 대한방사선과학회(구 대한방사선기술학회) 2003 방사선기술과학 Vol.26 No.4
중재 시술용 기능성 기관-기관지 팬텀을 제작하고, 스텐트 삽입술을 시행하여 그 유용성을 평가하고자 한다. 중재 시술용 기능성 기관-기관지 팬텀은 실리콘으로 제작하였으며, 기관을 통하여 스텐트 삽입술이 가능하도록 삽입구를 제작하였다. 팬텀은 지점토를 이용하여 인체와 동일한 형태로 기관, 기관지 분지부와 양쪽 상부 기관지를 재현하였고, 사각형의 틀에 지점토를 고정시킨 후 액상의 실리콘을 채워 건조시킨 후 지점토를 제거하여 제작하였다. 인체, 동물, 팬텀에서 기관지스텐트 삽입 후 흉부 촬영 필름의 농도와 기관지 분지부의 각도를 측정하여 비교하였다. 기관지스텐트는 세선의 교차가 다른 2가지(X-type, Y-type) 형태를 삽입하였으며, 스텐트 삽입술 후 기관 상부, 기관 분지부, 좌기관지, 우기관지, 스텐트 삽입부의 필름농도를 측정하였다. 필름농도는 기관 상부의 경우, 인체 0.76(±0.011), 동물 0.97(±0.015), 팬텀 0.45(±0.016)이었고, 기관 분지부의 경우는 인체 0.51(±0.006), 동물 0.65(±0.005), 팬텀 0.65(±0.OO8)이었고, 우기관지의 경우는 인체 0.14(±0.OO8), 동물 0.59(±0.014), 팬텀 0.04(±0.007)이었고, 좌기관지의 경우는 인체 0.54(±0.004), 동물 0.54(±O.008)로 팬텀 0.08(±0.OO8)이었고, 스텐트 삽입부의 경우는 인체 0.54(±0.004), 동물 0.59(±0.011), 팬텀 0.04(±0.007)이었다. 기관 분지부가 이루는 각도는 인체의 좌기관지에서 42.6(±2.07)˚, 우기관지에시 32.8(±2.77)˚이었으며, 동물에서 각각 43.4(±2.40)˚, 34.6(±1.94)˚, 팬텀에서 각각 35(±2.00)˚, 50.2(±1.30)˚이었다. 본 연구팀이 제작한 기관-기관지 팬텀은 기관지 스텐트 삽입술의 재현이 가능하여 중재시술의 술기연습용이나 스텐트를 평가하기 위한 체외실험에 사용이 가능할 것으로 사료된다. To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom, respectively. The film density of trachea part were O.76(±O.O11) in human, O.97(±O.015) in animal, O.45(±O.O16) in phantom. The tracheobronchial bifurcation part measured O.51(±O.OO6) in human, O.65(±O.OO5) in animal, O.65(±O.008) in phantom. The right bronchus part measured O.14(±0.008) in human, O.59(±0.014) in animal and O.O4(±O.OO7) in phantom. The left bronchus were O.54(±O.004) in human, O.54 (±0.008) in animal and O.08(±0.008) in phantom. At the stent part were O.54(±O.004) in human, O.59(±0.011) in animal and O.04(±0.007) in phantom, respectively. The tracheobronchial angle of the left bronchus site were 42.6(± 2.07)˚ in human, 43.4(±2.4O)˚ in animal and 35(±2.00)˚ in phantom, respectively. The right bronchus site were 32.8(±2.77)˚ in human, 34.6(±1.94)˚ in animal and 50.2(±1.30)˚ in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce.
Yi, Sun-Ju,Kim, Kyung Hwan,Choi, Hyun Jung,Yoo, Je Ok,Jung, Hyo-Il,Han, Jeong-A,Kim, Young-Myeong,Suh, In Bum,Ha, Kwon-Soo Korean Society of Molecular Biology 2006 Molecules and cells Vol.21 No.1
<P>Maitotoxin (MTX) is known as one of the most potent marine toxins involved in Ciguatera poisoning, but intracellular signaling pathways caused by MTX was not fully understood. Thus, we have investigated whether intracellular reactive oxygen species (ROS) are involved in MTX-induced cellular responses in human umbilical vein endothelial cells. MTX induced a dose-dependent increase of intracellular [Ca(2+)]. MTX stimulated the production of intracellular ROS in a dose- and time-dependent manner, which was suppressed by BAPTA-AM, an intracellular Ca(2+) che-lator. Ionomycin also elevated the ROS production in a dose-dependent manner. MTX elevated transamidation activity in a time-dependent manner and the activation was largely inhibited by transfection of tissue transglutaminase siRNA. The activation of tissue transglutaminase and ERK1/2 by MTX was sup-pressed by BAPTA-AM or ROS scavengers. In addition, MTX-induced cell death was significantly de-layed by BAPTA-AM or a ROS scavenger. These results suggest that [Ca(2+)]-dependent generation of in-tracellular ROS, at least in part, play an important role in MTX-stimulated cellular responses, such as activation of tTGase, ERK phosphorylation, and in-duction of cell death, in human umbilical vein endothelial cells.</P>
소의 시상하부내에서 Vasopressin과 Oxytion분비세포의 분포에 관한 면역조직화학적 연구
유명철,김종중,장인엽,문정석,정주현,김흥중,조사선 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1
This study was done to observe the distributions of Oxytocinergic and Vasopressinergic neurons in the hypothalamus of the cow. For the immunohistochemical staining, sections were reacted with the following sequence of solutions: monoclonal anti-vasopressin and anti-oxytocin, biotinylated anti-mouse IgG, avidin-biotin peroxidase complex, and Ni-DAB. The results observed under light microscope were summarized as follows. Our immunohistochemical investigations reveal both vasopressinergic and oxytocinergic neurons in the supraoptic nucleus(SON), paraventricular nucleus(PVN), accessory supraoptic nucleus (ASN), periventricular nucleus(PN), suprachiasmatic nucleus(SCN), and arcuate nucleus(AN), but these two types of neurons were mainly distributed in the PVN and SON and the ratio of the number of vasopressinergic neurons to that of oxytocinergic neurons was 1:1.30 in the PVN, and 1:1.00 in the SON. These two types of neurons were round, oval and spindle-shaped and cell size was 30-55um.