대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

Organic Solar Cells: Solution‐Processable Reduced Graphene Oxide as a Novel Alternative to PEDOT:PSS Hole Transport Layers for Highly Efficient and Stable Polymer Solar Cells (Adv. Mater. 42/2011)

Yun, Jin‐,Mun,Yeo, Jun‐,Seok,Kim, Juhwan,Jeong, Hyung‐,Gu,Kim, Dong‐,Yu,Noh, Yong‐,Jin,Kim, Seok‐,Soon,Ku, Bon‐,Cheol,Na, Seok‐,In WILEY‐VCH Verlag 2011 Advanced Materials Vol.23 No.42

<P>Solution‐processable reduced graphene oxide as a hole‐transporting layer for highly efficient and stable organic solar cells is reported on page 4923 by Dong‐Yu Kim, Seok‐In Na, and co‐workers. Introduction of a newly reduced graphene oxide by simple solution processing into solar cells dramatically raises the cell efficiency and cell life‐time. The results will allow full use of chemically reduced graphene and will advance the realization of carbon‐based printable optoelectronic devices. </P>

인체 방광암에서 p33^ING1의 발현 변화

이석영,신관희,한광희,이상철,김용태,김원재 大韓泌尿器科學會 2001 Korean Journal of Urology Vol.42 No.7

설계변경의 경향 및 원인 분석을 통한 설계 품질향상 방안

석성재,김재근,이철우,홍순구,유춘번 한국품질경영학회 2000 품질혁신 Vol.1 No.1

This study is prepared to introduce design quality improvement measures by the trend and cause analysis of design changes which have been made during operations of construction project for power plant. In this study, two types of analysis tool have mainly taken for the use of the improvement measures. One tool is the trend analysis to identify which action should be taken to cut down design changes. This is also useful to monitor whether project participant's endeavour for the action taken is effective or not, to the project performance and design quality improvement. The other is the cause analysis, by using cause and effect diagram, which is useful to identify main causes of the design changes and to establish the measures to reduce recurrence of the design changes.

Canine juvenile cellulites의 진단과 치료 증례

황철용,유종현,강형석,윤화영,한홍율 한국임상수의학회 2002 한국임상수의학회지 Vol.19 No.4

Canine Juvenile cellulitis was diagnosed in 2 puppies hospitalized in Veterinary Medical Teaching Hospital of Seoul National University. Characterized dermatological problems were presents of scale, crust, purlent exudation and alopecia limited on their face. On cytologic examinations of direct impression smears for the lesions, numerous neutrophils and macrophagies were observed. No bacteria and fungus were noted. Treatments with administration of predinisolone and antibiotic orally combined with topical shampoo treatment had good results for the two puppies.

KF114와 KB108 원료가공업의 연기증 Nicotine 및 Tar 함량의 변화

이철희,임흥빈,신주식,석영선 충북대학교 연초연구소 2004 煙草硏究 Vol.19 No.-

궐련담배 연기 중 Tar와 Nicotine 함량은 대부분의 국가에서 담배 포갑지에 표시하도록 규정하고 있으며 우리나라에서도 2003년부터 시행하고 있다. 그리하여 궐련담배 제품의 설정목표에 따라 엽배합의 방안을 강구하고자 우리나라에서 생산하고 있는 황색종과 버어리종의 주 품종인 KF114와 KB108의 원료 가공엽을 김천원료공장과 남원료공장에서 착엽위치 및 등급별로 채취하여 연기 중 Nicotine, Tar 및 CO 함량을 조사하였으며, 그 결과를 요약하면 다음과 같다. 1. 원료엽 중 니코틴 함량은 황색종 KF114에 비하여 버어리종 KB108이 높고, 본엽과 상엽에서는 등급이 낮을수록 함량이 높고, 중엽과 하엽에서는 등급이 낮을수록 함량이 낮았다. 2. 황색종 KF114는 궐련담배 1개비 당 중량이 본엽, 중엽, 상엽, 하엽 순으로 무거웠고, 엽위별 등급간에는 등급이 높을수록 무거웠다. 연소시간과 흡연회수는 본엽, 상엽, 중엽, 하엽 순으로 길고 많았다. 3. 버어리종 KB108은 궐련담배 1개비 당 중량이 상엽, 본엽, 중엽, 하엽 순으로 무거웠고, 엽위별 등급간에는 등급이 높을수록 무거웠다. 연소시간은 상엽, 본엽, 중엽, 하엽 순으로 길었으며, 중엽과 하엽에서는 등급이 높을수록 본엽과 상엽에서는 등급이 낮을수록 길었다.4. 황색종 KF114 원료 가공엽의 연기 중 니코틴과 타르 함량은 본엽에서는 등급이 낮을수록 높고, 중엽과 하엽에서는 등급이 높을수록 높은 값을 나타냈다. CO 함량은 본엽, 중엽, 상엽, 하엽순으로 많았고, 등급간 차이는 니코틴과 타르 함량에 대한 등급간 차이보다 적었다. 5. 버어리종 KB108 원료 가공엽의 연기 중 니코틴과 타르 함량은 상엽과 본엽에서는 등급이 낮을수록 높고, 중엽과 하엽에서는 등급이 높을수록 높은 값을 나타냈다. CO의 함량은 상엽, 본엽, 중엽, 하엽 순으로 높았고, 엽위 별 등급간에 차이가 없었다. 6. 잎담배 종류 및 가공엽의 등급에 따라 nicotine/tar 및 Co/tar 비율에 차이가 있는 것을 알 수 있으며, 엽위가 낮을수록 비율도 감소하였다. 7. 버어리종 KB108는 흡연회수, 니코틴, 타르및 CO가 각각 정의 상관관계가 인정되었으나, 황색종 KF114에서는 CO와 니코틴, CO와 타르 간에는 상관관계가 없었다. In most countries, nicotine and tar contents of cigarette smoke should be represented on the cigarette pack by law. It has been carrying out in Korea from 2003. In order to control those contents, It was tested the contents of tar, nicotine, carbon monoxide (CO) of smoke components and puff number for blending two major varieties produced in Korea, KF114, a flue-cured, and KB108, a burley. The processed leaf tobacco were taken from Kim-cheon and Ock-cheon leaf tobacco processing factory. The results were summarized as followed ; 1. Nicotine contents of processed leaf tobacco were higher in KB108, a burley, than in KF114, a flue-cured. Nicotine contents of leaf and tips were higher in low-grade leaves than in high-grade leaves, but those of cutters and lugs were lower in low-grade leaves than in high-grade leaves. 2. The weight per cigarette of KF114 was heavier in the order of leaf, cutters, tips and lugs, and was heavier in high-grade leaves than in low-grade leaves. Combustion time was longer and puff number was more in the order of leaf, tips, cutters and lugs. 3. The weight per cigarette of KB108 was heavier in the order of tips, leaf, cutters and lugs, and was heavier in high-grade leaves than in low-grade leaves. Combustion time was longer in the order of tips, leaf, cutters and lugs. The time of cutters and lugs was longer in high-grade leaves than in low-grade leaves, but those of leaf and tips was longer in low-grade leaves than in high-grade leaves. 4. Nicotine and tar contents of the smoke from the processed leaf tobacco of KF114 were higher in low-grade leaf than in high-grade leaf and cutters and lugs were higher in high-grade than in low-grade. CO contents were higher in the order of leaf, cutters, tips and lugs. The difference of CO contents between different grades was lower than that of nicotine and tar contents. 5. In nicotine and tar contents of the smoke from the processed leaf tobacco of KB108, leaf and tips were higher in low-grade than in high-grade and cutters and lugs were higher in high-grade than in low-grade. CO contents were higher in the order of tips, leaf, cutters and lugs. There was no significant difference of CO contents between different grades of the stalk position. 6. Nicotine/Tar and CO/Tar ratios showed significant difference according to tobacco variety and grade of processed leaf tobacco. The ratios were reduced in lower stalk position. 7. There were positive correlations between puff number, nicotine, tar and CO contents in KB108, but there were no correlations between CO and nicotine, or CO and tar in KF114.

질내가검물 및 소변에서 중합효소연쇄반응을 이용한 Chlamydia trachomatis 검사

최철석,성상철,이무주 대한임상병리사협회 1993 대한임상병리사회지 Vol.25 No.1

심장수술이 혈소판 수와 술후 출혈에 미치는 영향에 관한 연구

최석철 최신의학사 1995 最新醫學 Vol.38 No.4

요로결석 환자에서 Pethidine, Nalbuphine, Ketorolac의 진통효과 비교

장석준,박인철,정성필,최성욱,이한식 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Ureter stone cause severe flank and abdominal pain. In emergency room, these patients require rapid pain relief and diagnosis. Therefore, authors have conducted a study on the efficacy of three types of commonly used analgesics including non opioid analgesics; intramuscular ketorolac 30mg and nalbuphine 10mg was compared with pethidine 50mg in 74 patients who visited SEVERANCE hospital emergency care center with complaint of flank colicky pain from Jan1. 1996 to Mar 31. 1996. Pain was assessed before the drug administration, and then at 10min, 20min, 30min time interval after the first dose. Visual analogue scale was used to assess the pain intensity and scale was self drawn by each patient during the time of pain assessment. Additional need of rescue analgesia and adverse effecfs of first-line analgesia was also recorded. Statistical significant was confirmed using ANOVA and Chi square test. The difference in the decrease of pain intensity was not significant among the three analgesics(P=0.65). Rescue anagesia was required in 37.1% of pethidine, 42.8% of nalbuphine, 16.6% of ketorolac and totally 33.8%. The incidence of all types of adverse event of pethidine, nalbuphine and ketorolac were 14.2%, 14.2% and 5.5% in respectively. The results of this study have shown that non opioid analgesics are as effective as opioid analgesia. Therefore, non opioid analgesics can be tried first line of pain relief drug of renal coliky pain with minimal adverse effects.

심부전 백서의 대동맥과 폐동맥에서 보이는 C형 이뇨단백에 대한 이완반응의 이상

김철호,김광일,조영석,조주희,오병희,이명묵,박영배,최윤식,이영우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8