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순화기; 부산,울산 권역심뇌혈관질환센터 사업의 초기 경험
이동현 ( Dong Hyun Lee ),서정민 ( Jeong Min Seo ),최재혁 ( Jae Hyuk Choi ),조용락 ( Young Rak Cho ),박경일 ( Kyung Il Park ),박태호 ( Tae Ho Park ),김무현 ( Moo Hyun Kim ),김영대 ( Young Dae Kim ),맹수연 ( Su Youn Maeng ),김두영 ( 대한내과학회 2013 대한내과학회지 Vol.85 No.3
Background/Aims: The purpose of this study was to compare changes in primary percutaneous coronary artery intervention (PCI) outcomes after starting the government-directed Busan-Ulsan Regional Cardiocerebrovascular Center Project. Methods: Patients with ST segment elevation myocardial infarction (STEMI) who visited the Busan-Ulsan Regional Cardiocerebrovascular Center from 1 June 2009 to 30 May 2011 were selected. Their medical records were retrospectively reviewed. Clinical and survival outcomes before and after starting the project were compared. Results: A total of 122 patients (mean age, 63 ± 13 years; male, 74%) with STEMI were selected for analysis. There were no significant differences in patients` baseline characteristics. After starting the Busan-Ulsan Regional Cardiocerebrovascular Center Project, the door-to-balloon time decreased from 72 ± 30 to 59 ± 22 minutes (p = 0.011). The door-to-balloon time when the PCI team did not stay in the hospital also decreased from 80 ± 30 to 62 ± 12 minutes (p = 0.005). However, there was no significant change in the total ischemic time (339 ± 293 vs. 304 ± 287 minutes, p = 0.514), survival discharge rate (94% vs. 93%, p = 1.000), or 1-year survival rate (89% vs. 91%, p = 0.996). Conclusions: After starting the government-directed Busan?Ulsan Regional Cardiocerebrovascular Center Project, the door-to-balloon time was significantly reduced. However, the total ischemic time and short-term survival remained unchanged. (Korean J Med 2013;85:275-284)
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정석희 ( Seuk Hee Chung ),문승환 ( Seung Hwan Moon ),백정환 ( Jeung Hoan Paik ),김경태 ( Kyoung Tae Kim ),최세웅 ( Se Woong Choi ),이창재 ( Chang Jae Lee ),조용락 ( Young Rak Cho ),나서희 ( Seo Heui Ra ),안원석 ( Won Suk An ),김 대한내과학회 2006 대한내과학회지 Vol.70 No.6
Background: The manifestation of Membranoproliperative glomerulonephritis (MPGN) is variable from asymptomatic hematuria, nephrotic syndrome to advanced chronic kidney disease. The etiology, pathogenesis, and treatment of MPGN are unclear. The incidence of idiopathic MPGN is also rare in Korea, and the clinical course was rarely studied. So we investigated clinical course of idiopathic MPGN type 1. Methods: From March 1990 to November 2004, renal biopsy was done in about 1500 patients in Dong-A universty hospital. Among them, 16 patients were diagnosed as idiopathic MPGN. Fourteen patients were observed over 6 months. We analyzed clinical data of these patients retrospectively. Results: Male to female ratio of total 16 patients is 2.2:1. Mean age of patients was 37.6 years (14-76years) at the time of diagnosis. Thirteen cases (81%) had nephrotic range proteinuria, 8 cases (50%) had hypertention, 12 cases (75%) had edema, and 4 cases (25%) had decreased renal fuction (serum creatinine>1.2 mg/dL) at the time of diagnosis. Average observation time was 55.7±37.4 (6-122)months. Six cases ended up with progressive renal failure. Three cases achieved complete remission. Renal survival time for 50% of cases was 92 months. In our study, edema and decreased renal fucntion at the time of diagnosis were related with later development of progressive renal failure (p<0.05). Of the total 14 cases, 4 cases ware treated conservatively, 6 cases were treated with anti-platelet agents, and 4 cases were treated with anti-platelet agents and prednisone. In conservative treatment group, 1 case ended up with progressive renal failure and 1 case achieved complete remission. In anti-platelet agents treatment goup, 4 cases ended up progressive renal failure. In combined anti-platelet agents and prednisone treatment group, 1 case ended up progressive renal failure and 2 cases achieved complete remission. However, the effect of each treatment is inconclusive because the number of the patients are too small. Conclusions: We suspect that deceased renal function and edema at the time of diagnosis may be risk factor predicting progressive renal failure in patients with idiopathic MPGN type 1.(Korean J Med 70:663-671, 2006)
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