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정인현,Jin Hye Park,Jeong-A Lee,김광실,이혜영,변영섭,김병옥 한국심초음파학회 2020 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.28 No.2
BACKGROUND: A considerable number of patients with dilated cardiomyopathy (DCM) experience left ventricular reverse remodeling (LVRR). LV global longitudinal strain (LV GLS) offers sensitive and reproducible measurement of myocardial dysfunction. The authors sought to evaluate whether LV GLS at the time of diagnosis may predict LVRR in DCM patients with sinus rhythm and investigate its prognostic role in long-term follow-up in this population. METHODS: We enrolled 160 DCM patients with sinus rhythm who had been initially diagnosed, evaluated, and followed at our institute. We analyzed their medical records and echocardiographic data. RESULTS: During the mean follow-up duration of 37.3 ± 21.7 months, LVRR occurred in 28% of patients (n = 45). The initial LV ejection fraction (LVEF) of patients who recovered LV function was 26.1 ± 7.9%, which was not significantly different from the value of 27.1 ± 7.4% (p = 0.49) in those who did not recover. There was a moderate and highly significant correlation between baseline LV GLS (−%) and follow-up LVEF (r = 0.717; p < 0.001). Using multivariate Cox analysis, LV GLS (hazard ratio: 1.474, 95% confidence interval: 1.170-1.856; p = 0.001) was an independent predictor of LVRR. CONCLUSIONS: We demonstrated that LV GLS was an independent predictor for LVRR and the optimal cut-off point of LV GLS for LVRR was −10% in DCM patients with sinus rhythm. There was a significant correlation between baseline LV GLS and follow-up LVEF.
好意同乘에 관한 小考 : centering around Legal Relation and Cases Analysis 法律關係와 判例分析을 中心으로
申鐘澈,鄭寅玄 韓國海洋大學校 人文社會科學大學 1999 韓國海洋大學校 人文社會科學論叢 Vol.- No.6
Abstract In the 21st century. the space and the ocean will be the target to gain more. The ocean. a place that has tons of resources and a place to be challenged. remains very important today in the world. Already the struggling of occupying more on the sea has begun. when the "UN convention on the Law of the Sea". was announced. To a country close to ocean. as they gained more space. they got many other things to do. So they need a new policy paradigm about the EEZ(Exclusive Economic Zone). We have to protect our national interest and to raise our role as a central marine country on the world sea management. Especially the marine industry. as a national main industry is a high value-added science technology and national strategy industry for our country to be advanced country. Our objective is to study. especially the character and strategy of marine country. and to find the right way and character of national policy our country should do. The objective of this research is to provide the way for our country to be 21st century marine advanced country. We have to reconstruct the ocean philosophy which harmony the new ocean time. and strengthen the ocean culture and thought in our country. and to provide a basic theory about efficient way of ocean policy.
선별검사 목적으로 시행된 관상동맥 CT의 석회수치에 따른 임상경과 관찰
정인현 ( In Hyun Jung ),김정순 ( Jeong Soon Kim ),남효정 ( Hyo Jung Nam ),김희성 ( Hee Sung Kim ),김홍규 ( Hong Kyu Kim ),박덕우 ( Duk Woo Park ),이승환 ( Seung Whan Lee ),김영학 ( Young Hak Kim ),이철환 ( Cheol Whan Lee ),김재중 대한내과학회 2010 대한내과학회지 Vol.78 No.4
목적: 최근 많은 연구에서 MDCT가 관상동맥 질환을 진단하는데 있어서 비교적 민감도와 특이도가 우수하고, 높은 음성예측도를 가진 검사로 보고되고 있다. 그러나 무증상 환자군에서 MDCT상 유의한 협착이 보일 때 어떤 환자군에서 경피적 관동맥 성형술이나 관동맥 우회로 수술을 받는가에 대한 임상경과를 관찰한 연구는 아직 없다. 이에 저자들은 선별 검사 목적으로 MDCT를 시행한 무증상 환자의 관상동맥 석회수치에 따른 임상경과를 보고자 하였으며, 선별 검사 목적의 MDCT의 무분별한 사용을 줄이기 위해 NCEP-ATP III 지침에 따라 10년 관상동맥 질환 위험도를 구분한 각 집단 중 어떤 집단에서 MDCT상 유의한 협착이 많이 관찰되는지 알아보고자 하였다. 방법: 건강검진을 목적으로 서울아산병원 건강증진센터에 방문한 845명의 의무기록과 MDCT를 후향적으로 분석하였다. MDCT상 유의한 협착은 관상동맥 내경이 50% 이상 좁아진 경우로 정의하였고, 관상동맥 질환 위험도는 NCEP-ATP III 지침에 의해 계산된 10-year risk assessment tool(http://hp2010.nhlbihin.net/atp3/riskcalc.htm)을 사용하였다. 침습적 관상동맥 조영술은 심근부하 검사가 양성이거나 심근부하 검사가 음성이라도 MDCT상 주관상동맥의 근위부에 유의한 병변이 있을 때 시행하였고, 관상동맥 재개통술 여부는 관상동맥 조영술 후 주치의의 판단에 의해 결정되었다. 결과: 총 332명(39.3%)에서 동맥경화반이 관찰되었으며 이들 가운데 60명(7.1%)은 관상동맥의 유의한 협착을 보였다. MDCT상 유의한 협착을 갖는 환자의 유병률은 NCEP-ATP III 지침에 따른 위험도에 따라 구분하였을 때, 10년 심혈관계 합병증의 위험도가 10% 이상인 군에서 의미있게 높았다. 유의한 협착을 보인 환자들 중 28명이 관상동맥 조영검사를 받았으며, 17명은 경피적 관동맥 성형술을 받았고, 3명은 관상동맥 우회로 수술을 받았다. ROC 곡선을 이용하여 MDCT상 유의한 협착을 가진 환자에서 관상동맥 재개통술(revascularization)을 시행받은 환자에 대한 CACS의 cutoff 값은 111.0 (AUC=0.87, 95% confidence interval; 0.76~0.97, sensitivity 80.0%, specificity 92.1%)이었다. 결론: 현재 선별 검사 목적의 MDCT 시행에 대하여 논란의 여지가 많은 상황에서 NCEP-ATP III 지침에 따른 위험도가 10% 미만인 군에 대하여는 관상동맥 질환에 대한 선별검사 목적으로 MDCT를 사용하는 것은 가급적 제한하는 것이 바람직할 것으로 생각된다. 또한 선별 검사 목적으로 시행된 MDCT상 유의한 협착이 관찰되고 CACS가 110 이상일 경우 경피적 관동맥 성형술이나 관상동맥 우회수술과 같은 관상동맥 재개통술을 받게 될 가능성이 의미있게 높았다. Background/Aims: In general, multidetector computed tomography (MDCT) is not recommended as a screening tool for asymptomatic individuals. However, the programs for general health evaluation at several hospitals in Korea include MDCT to detect cardiac disease. The objectives of this study were to evaluate the clinical outcomes of asymptomatic individuals according to the coronary artery calcium score (CACS) obtained from screening MDCT and to assess the eligibility of risk stratification in the NCEP-ATP III guidelines for predicting a significant stenosis on MDCT. Methods: We reviewed the medical records of 845 asymptomatic subjects (age 53±9 years, 67% men) who underwent MDCT as part of a general health evaluation at Asan Medical Center, Seoul, Korea, from January to December 2008. Results: Atherosclerotic plaques were identified in 332 (39.3%) subjects. Sixty (7.1%) individuals had significant stenosis (≥50% diameter stenosis). The prevalence of significant stenosis was higher in the group that had more than a 10% risk of coronary heart disease (CHD) at 10 years (p<0.05). Among the patients with occult coronary artery disease (CAD), 28 received coronary angiography, which resulted in 20 revascularizations (17 percutaneous interventions and three bypass surgeries) and eight medical treatments. In patients with significant narrowing, the CACS cutoff value for predicting coronary revascularization was 111.0 (AUC=0.87, 95% confidence interval; 0.76~0.97; sensitivity 80.0%, specificity 92.1%). Conclusions: According to the NCEP-ATP III guidelines, the prevalence of occult CAD on MDCT was significantly higher in the group with a 10% or higher risk for CHD at 10 years. A CACS≥110 was associated with a significantly higher rate of coronary revascularization in asymptomatic patients with significant stenosis on MDCT. (Korean J Med 78:466-476, 2010)
현정인,바니크라메키 한국목재공학회 1980 목재공학 Vol.8 No.1
Quantitative assessment of edge blunting of saw-teeth was carried out by TALYSURF. 1. Using the following equation, the real shape of a saw-tooth can be traced on the graph of TALYSURF. Δh/h = VΔχ/Vχ {Δh : vertical distance of stylus h : vertical distance in chart VΔχ : velocity of stylus Vχ : velocity of chart 2. As shown on Fig 2, the error from stylus itself can be calculated by following equation. i) 13.8μ≤χ$lt;20.4μ y= -0.2246χ+ 4.59μ ii) 0≤χ$lt;13.8μ y= -√(18μ)²-χ²-1.42χ+32.7μ 3. The relationship between profile of saw-tooth and error from stylus itself can be calculated by following equation. E(%)=f(x)×r/18μ/f(R)×R/18.5μ-f(r)×r/18μe7100 E(%) = error of stylus / dullness of saw tooth × 100 r : radius of stylus tip R : radius of tip which is drawn in graph of talysurf f(r) : error of stylus f(R) : dullness of tip which is drawn in graph of talysurf 4. The graph of maximum error and profile of saw-tooth was parabola.