관상동맥 우회로 조성수술후 발생하는 심 방세동의 위험요인 분석

유경종,고영호,임상현,강면식,Yu, Gyeong-Jong,Go, Yeong-Ho,Im, Sang-Hyeon,Gang, Myeon-Sik 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.6

연세대학교심장혈관 센터에서는 1990년 1월 부터 1994년 12월까지 281명의 관상동맥 우회로수술을 시행하였으며 이중 수술전 심방세동이 있던 환자,판막질환 수술 및 심근경색의 합병증의 수술을 병행 하였던 환자 32명을 제외한 249명에 대해 수술전,수술시 및 수술후 심방세동 발생의 위험요인에 대해 분석하였다. 대상환자의 연령은 24세에서 78세 사이로 평균 58.2$\pm$9.)세 였으며,남자가 182명, 여자가 67명 이었 다. 제 1군에 속하는 환자는 38명(15%) 이 었고 제 2군에 속하는 환자는 211명(85%) 이었다. 수술후 심방 세동이 발생한 시간은 환자가 중환자실에 도착한 후 8시간에서 336시간 사이에 발생하여 평균 59.1 $\pm$56. 9 시간 이 었으며(median time : 48 hours), 정상 동 율동으로 돌아온 시간은 심방세동이 발생한 후 1시간 에서 144시간 사이로 평균 26.7 $\pm$33.9시간이었다(median time : 12.5 hours). 퇴원시 심방세동을 보였던 모든 환자는 정상 동율동을 보였다. 심방세동이 발생하기 전과 발생한 직후 측정한 심박출계수는 발생 전 평균 3.9$\pm$ 1.1 L/min/m.에서 발생직후 3.2$\pm$ 1.1 L/min/m'로 통계 학적으로 유의하게 감소하였다(p=0. 001). 분 \ulcorner嘯\ulcorner통계학적인 유의성을 가진 변수는 univariate analysis 에서 수술전 좌심실 박출계수, triglyceride 수치, 수술후 측정한 peak CKMB isoenzyme, 심방 pacing의 여부, 입원기간 및 만기사망이 었 다. 좌심실 박출계수(p=0.025), triglyceride 수치(p=0.006) 및 peak CKMB isoenzyme(p=0.002)은 낮은 경 우에 심방세동의 발생이 증가하였으며,심방 pacing을 찬 경우에 심방세동의 발생이 증가하였다(p=0. 001). 또한 심방세동이 발생한 군에서 입원기간이 길었으며(p=0.001), 만기사망이 많았다(p=0.033). Multivariate analysis 에서 통계학적인 유의성을 보이는 변수는 수술전 체중과 심방 pacing의 여부였다. 체중은 많이 나갈수록 심방세동의 발생 이 .증가하였으며(p=0.011), 심방 pacing을 한 경우에 심방세동의 발생이 증가하였다(p=0.001). Univariate 및 multivariate analysis 에서 환자의 나이는 통계학적인 유의성 을 보이지는 않았지만 나이가 증가할수록 심방세동의 발생이 증가하는 경향을 보여주고 있다(p=0.053, p=0.064). 평균 추적기간은 30.1 $\pm$ 15.4 개월이었으며, 추적율은 98%였다. 이 기간 동안 심방세동을 보일 예는 없었다. 연구결과 수술 \ulcorner발생하는 심방세동은 어느 한가지 요인에 의해서라기 보다는 여러가지 요인이복합 적으로 작용하여 나타나는 것으로 생각된다. 또한 수술후 나타나는 심방세동은 혈동학적 인 장애를 유발 할 뿐만 아니라 입원기간을 증가시키고, 만기사망을 증가시키므로 위험요소가 있거나 위험요소가 발생 시 적극적 인 예방이나 치료가 필요할 것으로 생각된다. A total of 249 patients undergoing isolated coronary revascularization were studied for the occurrence of postoperative atrial fibrillation(AF). Possible associations of this arrhythmia with various preoperative, intraoperative and postoperative factors were studied by univariate and multivariate analysis. The overall incidence of postoperative AF was 15%, with the median time occurence of 48 hours(mean time : 59.1 $\pm$ 56.9 hours) after arrival to the intensive care unit. Cardiac index decreased significantly after occurence of AF(p=0.001). There were no in-hospital complications in those patients with AF. Univariate studies indicated preoperative ejection fract on(EF), triglyceride level, postoperative peak CKMB isoenzpme and atrial pacing to be the dominant factor promoting postoperative AF, with an increasing prevalence in lower EF(p=0.025), triglyceride(p=0.006) and peak CKMB isoenzyme(p=0.002), and in patients with atrial pacing(p=0.001). Hospital stay(p=0.001) and late mortality(p=0.003) were significantly increased in patients with postoperative AF Multivariate analysis showed that body weight and postoperative atrial pacing to be the dominant factor promoting postoperative AF, with an increasing prevalence in over- weight patients(p=0.011) and patients with atrial pacing(p=0.001). Both univariate and multivariate analy- sis showed that the age was not a significant factor but tended to promote postoperative AF respectively (p=0.053, 0.064). After 30.1 $\pm$ 11.4 months gfollow-up, those patients with AF had sinus rhythm. We think that we must try to prevent postoperative AF after ccoronary artery bypass grafting because of its deleterio s hemodynamic effect, prolonged hospital stay, and increased late mortality.

C6 신경아교종 세포주에서 망간에 의한 Inducible Nitric Oxide Synthase 유도

유경임(Gyeong-Im Yu),이동혈(Dong-Hyul Lee),정인성(In-Sung Chung),이미영(Mi-Young Lee),신동훈(Dong-Hoon Shin) 대한직업환경의학회 2009 대한직업환경의학회지 Vol.21 No.3

다수성 점질 고구마 ‘보드레미’

이형운(Hyeong-Un Lee),남상식(Sang-Sik Nam),정미남(Mi-Nam Chung),김재명(Jae-Myung Kim),한선경(Seon-Kyeong Han),유경단(Gyeong-Dan Yu),양정욱(Jung-Wook Yang),강용구(Yong-Ku Kang),황엄지(Eom-Ji Hwang),이임빈(Im-been Lee),박진천 한국육종학회 2022 한국육종학회지 Vol.54 No.2

In 2019, ‘Bodeuremi’ was developed as a high-yielding sweetpotato variety with good palatability. It was derived from a cross between ‘MI2006-58-02’ with high yield and ‘Beniharuka’ (IT309504) with good palatability. The storage roots of ‘Bodeuremi’ have a red skin, light orange flesh, and an ovate shape. When steamed, ‘Bodeuremi’ storage roots exhibit a moist texture and are more tender than those of the check variety ‘Pungwonmi’. The sugar content of steamed ‘Bodeuremi’ storage roots was 33.4 mg/100 g dw, which was 6.0% higher than that of ‘Pungwonmi’. The marketable yield of ‘Bodeuremi’ storage roots was 30.3 MT/ha in the early season culture, which was 4.5% higher than that of ‘Pungwonmi’ with high yield in the early season culture. ‘Bodeuremi’ is resistant to root-knot nematode and moderately resistant to Fusarium wilt. ‘Bodeuremi’ is expected to contribute to increased income of sweetpotato growers as it has high cultivation stability and can be shipped at a time when the market price is high owing to its high yield in the early cultivation.

비만인에서 체중 감소가 당질 및 지질 대사에 미치는 영향

허갑범 ( Heo Gab Beom ),정윤석 ( Jeong Yun Seog ),박석원 ( Park Seog Won ),이현철 ( Lee Hyeon Cheol ),임승길 ( Im Seung Gil ),이영해 ( Lee Yeong Hae ),이종호 ( Lee Jong Ho ),백인경 ( Baeg In Gyeong ),박유경 ( Park Yu Gyeong ),이 대한내과학회 1993 대한내과학회지 Vol.44 No.4

Background: The purpose of obesity treatment is to attain optimal body weight and to maintain weight loss. We determined the effects of weight loss with a program including dietary education, exercise and behavioral modification of lifestyle on obese subjects. Methods: Middle-aged obese women (n=30) and men (n=9) participated in a 6-month weight-management program. Anthropometric parameters and visceral and subcutaneous fat areas at the umbilical level were determined before and after weight loss. Serum levels of lipids and response areas of glucose, C-peptide, insulin and free fatty acid(FFA) during oral glucose tolerance test were determined. Results: Body weight fell and average of 3.9 kg(6.3) in women and 4.1 kg (5.4%) in men. Modest weight loss showed a 23 to 48% decrease in the levels of serum LDL and total colesteorl and a 50 to 130% increase in the ratio of HDL to total cholesterol in all subjects. Although intraabdominal total fat area of females before weight loss was not different from males, females showed subcutaneous-type obesity and males visceral-type obesity. Compared with females, males before weight loss showed and increase in the levels of triglyceride, FFA and insulin. Although weight loss caused a decrease in intraabdominal total fat area in all subjects, a significant decrease in visceral fat area was only shown in men. Decreased visceral fat in males lowered FFA level and decreased FFA level lowered serum triglyceride level (49%) and response area of insulin (56%) in men. Conclusion: The results suggest that modest weight reduction through a weight management program can be viable approach to help normalize plasma lipids and lipoproteins in obese individuals. Modest and gradual weight loss can also help obese individuals succeed in the difficult task of losing weight and maintaining this substantial weight loss.

한국 중년여성에서 내장지방 축적이 당질 대사에 미치는 영향

허갑범 ( Heo Gab Beom ),안광진 ( An Gwang Jin ),이현철 ( Lee Hyeon Cheol ),임승길 ( Im Seung Gil ),이영해 ( Lee Yeong Hae ),이종호 ( Lee Jong Ho ),김명중 ( Kim Myeong Jung ),백인경 ( Baeg In Gyeong ),박유경 ( Park Yu Gyeong ),이 대한내과학회 1993 대한내과학회지 Vol.44 No.5

Backgrounds: Although Koreans are generally leaner than people in America, they have a tendency to central adipose tissue distribution. Central obesity with visceral fat accumulation, measured by computed tomography, can cause metabolic complications. We determined the relation between obesity and glucose metabolism in 55 Korean middle-aged women. Methods: Anthropometric parameters and visceral and subcutaneous fat areas at the umbilical level were determined as indices of obesity. Nutrient intake, serum levles of lipids and response areas of glucose, C-peptide, insulin, and free fatty acid (FFA) during oral glucose tolerance test were determineds. Results: Visceral fat area correlated the most significantly with biochemical parameters among obese indices. The triglyceride level and the response area of FFA, glucose, insulin and C-peptide were all higher in the group of visceral-type obesity (n=20, visceral fat area>10000 mm²), than in the group of subcutaneous-type obesity (n=18, visceral fat area<7400 mm²), though percent ideal body weight was not different between two groups. Thirty five percents in the group of visceral-type obesity showed impaired glucose tolerance (IGT) and non-insulin-dependent diabeyts mellitus (NIDDM). Body weight, subcutaneous fat area and the response areas of insulin and C-peptide were lower and the response areas of FFA and glucose were higher in visceral-type obese patients with IGT and NIDDM thatn in visceral-type obese subjects with normal glucose tolerance. Conclusions: Our results indicate that increased visceral fat area can be associated with the development of NIDDM because of the severe insulin resistance, even when small amonunt of insulin secretion in decreased. Increased calorie intake and decrease physical activity could partly explain visceral fat accumulation in the intraabdominal cabity.