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관상동맥 우회로술후 이식편 협착 및 폐쇄를 유발하는 위험인자의 분석
홍준화 ( Joon Hwa Hong ),임홍석 ( Hong Seok Lim ),최진욱 ( Jin Wook Choi ),박인덕 ( In Duk Park ),이철주 ( Cheol Joo Lee ) 대한내과학회 2007 대한내과학회지 Vol.73 No.3
목적: 허혈성심장병의 주된 치료로 알려진 관상동맥우회로술은 1963년 Sabiston에 의해 wjdaorbus을 이용한 최초의 수술이 처음 보고된 이후로 널리 시행되고 있다. 하지만 이식편으로 동맥을 사용하든 정맥을 사용하든 재협착에 의한 다양한 합병증들이 문제가 되어 수술의 큰 제한점으로 대두하고 있다. 따라서 저자들은 관상동맥우회로술후에 이식편의 재협착에 영향을 미치는 인자들을 수술 후의 관상동맥조영술을 분석하여 찾아보고자 하였다. 방법: 1995년부터 2004년사이에 관상동맥우회로술을 시행하였던 348명의 환자군 중 허혈성 심장병의 증세를 보여 관상동맥조영술을 시행하였던 45명의 환자에서 전체 146개의 이식편을 대상으로 분석하였다. 협착을 보였던 27개(S group)과 완전한 개존을 보인 119개(P group)에서 위험인자들을 분석하였다. 결과: S군의 평균연령은 59.44 (±8.549)세이고, P군은 57.99 (±8.676) 세였다. P군의 본래의 관상동맥협착의 정도가 S군에 비해 통계적으로 유의하게 심했다.(80.0±7.2% vs. 68.0±11.9%, p=0.005). S군에서 수술 후의 HDL 수치가 유의하게 낮은 것으로 분석되었다(40.4±15.9 mg/dL vs. 50.5±4.4 mg/dL, p=0.002). 결론: 관상동맥우회로술을 결정할 때는 수술 전의 환자 자신의 관상동맥협착 정도와 수술 후 혈중 HDL을 높게 유지하는 것이 이식편의 장기개통율에 영향을 미치는 것으로 판단된다. Background: Coronary artery bypass graft (CABG) surgery has been a main treatment modality of ischemic heart disease since Sabiston reported the first CABG operation using a saphenous vein graft in 1963. However, graft stenosis that happens after CABG surgery is one of the main limitations of the procedure. We investigated risk factors that are related to graft stenosis and occlusion in patients that needed a coronary angiogram after CABG surgery. Methods: From May 1995 to April 2004, we performed 348 CABG surgeries. Among them, we performed follow up coronary angiogram for 45 patients because of clinical indications, corresponding to 146 graft vessels. According to the angiography findings, patients with 27 graft vessels that showed stenosis or occlusion were defined as group S and patients with 119 graft vessels that showed no stenosis or occlusion were defined as group P. Results: The mean patient age of group S is 59.44 (±8.549) years and the mean patient age of group P is 57.99 (±8.676) years. Group P patients had more stenotic native coronary arteries than group S patients, which is statistically significant (80.0±7.2% vs. 68.0±11.9%, p=0.005). Group S patients had a statistically significant lower postoperative HDL level than the level of the group P patients (40.4±15.9 mg/dL vs. 50.5±4.4 mg/dL, p=0.002). Conclusions: When performing CABG surgery and postoperative patient management, the severity of native coronary artery stenosis and the postoperative HDL level should be considered for better patient outcome.(Korean J Med 73:293-298, 2007)
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朴仁德 淑明女子大學校 亞細亞女性問題硏究所 1977 아시아여성연구 Vol.16 No.-
The purpose of this thesis is to examine Korean wives' expectations of husbands' roles and the degree of their satisfaction with their husbands' roles. The actual sampling has been conducted by the method of purposive sampling and the size of sample is 231 wives. The survey has been made by self-administration using questionaries which are concerned with (I) the husbands' attitude towards sex-life and expression of love, (11) the personality of husbands, (111) the husbands' life-style, (IV) the husbands' role at home and (V) the husbands' attitude towards their wives. Conclusions 1. A majority of wives prefer the husbands who have a strong sense of responsibility for their borne and take care of their children and the health of his family members to .those who make a good marital adjustment, i.e., whose sex life and expression of love are good. The result that the wives who responded, $quot;Not satisfied$quot; to the item, $quot;Your husband does not treat you as an equal human being$quot; account for 4,% is quite unexpected, a fact that needs further research. 2. It has been found from this survey that the higher the level of wives' expectation is, the higher the wives' satisfaction becomes. 3. In general, it is desirable that the trend of the wives' dissatisfaction with husbands' ,roles is relatively low.
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