심질환 환자에서 오메가-3 지방산, 비타민, 킬레이션 요법의 효과

주승재,Joo, Seung-Jae 제주대학교 의과학연구소 2021 The Journal of Medicine and Life Science Vol.18 No.1

Omega-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) may be beneficial for the primary and secondary prevention of cardiovascular events (CVEs), especially in patients with myocardial infarction or heart failure with reduced ejection fraction. For this purpose, one to two seafood meals per week is preferentially recommended. Omega-3 fatty acids with a high-dose EPA formula (4 g/day) may be more effective than EPA+DHA mixed supplements for the secondary prevention of CVE. Krill oil also contains omega-3 fatty acids, but at a much lower dose compared to fish oil. Supplemental vitamins and minerals have not shown the preventive effects on CVE in prospective, and randomized clinical trials, except for one Chinese study showing the stroke prevention effects of folic acid. The clinical benefit of chelation therapy in reducing CVEs is uncertain.

아키히사 히라타 건축의 시스템 구성 원리에 관한 연구

주승재(Joo, Seung-Jae),정태종(Jeong, Tae-Jong) 대한건축학회 2021 대한건축학회 학술발표대회 논문집 Vol.41 No.2

급성심근경색증 환자에서 좌심실 이완기 기능과 심박수 변이성의 연관성

주승재 ( Seung Jae Joo ),김기석 ( Ki Seok Kim ),육동승 ( Dong Seung Yook ),이재우 ( Jae Woo Lee ) 대한내과학회 2005 대한내과학회지 Vol.69 No.2

목적 : 급성심근경색증 후 심박수 변이성(heart rate variability)의 감소는 사망과 치명적인 부정맥 발생의 위험 인자이다. 또한 좌심실 수축기 기능과 이완기 기능은 급성심근경색증 후 예후를 예측할 수 있는 중요한 인자들이며 특히 좌심실 이완기 기능이 제한성장애인 경우 예후가 불량하다. 이 연구에서는 급성심근경색증 후 좌심실 이완기 기능과 심박수 변이성의 지표들 사이의 연관성을 밝히고자 하였다. 방법 : 급성심근경색증 환자 50명을 대상으로 발병 5~7일 사이에 경흉부 심초음파 검사와 24시간 활동 중 심전도 검사를 시행하였다. 심초음파 검사에서 좌심실 구혈률, 국소벽운동지수, 좌심실 유입 혈류의 E/A 비, 감속 시간 등을 구하였고, 감속 시간이 150 msec 이하이거나 E/A 비가 2 이상인 경우 제한성장애로 진단하였다. 24시간 활동 중 심전도 검사에서 standard deviation of all NN intervals (SDNN), coefficients of variance (CV: SDNN/average of all NN intervals), standard deviation of the average of NN intervals in all 5-minute segments of the entire recording (SDANN) 등을 구하였다. 결과 : 감속 시간과 SDNN (r=0.53; p<0.001), CV (r=0.42; p=0.003), SDANN (r=0.59; p<0.001) 사이에 유의한 양의 상관관계가 있었다. 제한성장애가 있는 환자의 SDNN (80±14 vs. 96±25 msec; p=0.044), CV (9.4±1.8 vs. 10.7±2.4%; p=0.012), SDANN (61±11 vs. 79±24 msec; p=0.009) 등이 유의하게 감소되어 있었다. 결론 : 급성심근경색증 후 좌심실 이완기 기능이 제한성 장애인 경우 그렇지 않은 환자에 비해서 심박수 변이성이 감소되어 있었다. Background : Reduced heart rate varaibility (HRV) after acute myocardial infarction (AMI) is an important risk factor for mortality and life-threatening arrhythmias. The correlation between the left ventricular (LV) diastolic function and autonomic balance expressed by HRV in patients with AMI was evaluated in this study. Methods : A 2-dimensional and Doppler echocardiography and a 24-hour Holter monitoring were performed at 5th to 7th day after attack in 50 patients with AMI. The restrictive filling pattern of the LV diastolic function was defined by E/A ratio >2 or deceleration time (DT) of the mitral inflow ≤150 msec. Standard deviation of all NN intervals (SDNN), coefficients of variance (CV: SDNN/average of all NN intervals), standard deviation of the average of NN intervals in all 5-minute segments of the entire recording (SDANN), and other indexes of HRV were assessed using a 24 hour Holter monitoring. Results : DT correlated significantly with SDNN (r=0.53; p<0.001), CV (r=0.42; p=0.003), and SDANN (r=0.59; p<0.001). The patients with the restrictive filling pattern (n=10) had significantly lower SDNN (80±14 vs. 96±25 msec; p=0.044), CV (9.4±1.8 vs. 10.7±2.4%; p=0.012), and SDANN (61±11 vs. 79±24 msec; p=0.009) than those with non-restrictive filling pattern (n=40). Conclusion : Patients with the restrictive LV filling pattern after AMI had more reduced HRV than those with the non-restrictive filling pattern.(Korean J Med 69:167-176, 2005)

급성 심근 경색 환자에서 좌심실 기능 , 좌심방 기능 및 폐정맥 혈류 양상의 변화

김복근(Bok Kun Kim),주승재(Seung Jae Joo),배영환(Young Hwan Bae),박선미(Sun Mi Park),최진(Jin Choi),최휘(Hwi Choi),윤병철(Byung Chul Yoon),오원섭(Won Sub Oh),구양훈(Yang Hwun Koo),홍성준(Sung Jun Hong),김진(Jin Kim),박능화(Neung Hwa 대한내과학회 1997 대한내과학회지 Vol.53 No.6

N/A Objectives: Acute myocardial infarction decreases left ventricular systolic and diastolic function. Left ventricular diastolic function is usually assessed with the left ventricular filling patterns. Abnormal left ventricular tilling patterns after acute myocardial infarction can be classified as relaxation abnormality, pseudonormalization, and restriction, but sometimes the differentiation between pseudonormalization and the normal pattern is difficult. To assess left ventricular systolic and diastolic function, and left atrial function after acute myocardial infarction, M-mode, two-dimensional, pulsed Doppler, and automated border detection echocardiography were performed. To complement the information obtainable from the mitral flow patterns, pulmonary venous flow patterns were also analysed to assess the left ventricular filling patterns. Methods: Twenty six patients (mean age 60 ±10) underwent echocardiographic examination 7 to 14 days after acute myocardial infarction. Twenty healthy persons(mean age 57±12) were served as a control group. Various indexes were obtained with M-mode, two-dimensional, pulsed Doppler, and automated border detection echocardiography Results: 1) Mean age, sex ratio, heart rate, body mass index were not different between patient and control groups. There were five patients with hypertension in patient group. Left ventricular mass index of patient group was greater than that of control group (163±43g/㎡ vs. 109±22g/㎡, P<0.0D1). 2) Patients had decreased cardiac index(2.35±0.53L/min/㎡ vs. 3.02±0.70L/min/㎡, P<0.05) and left ventricular ejection fraction(55±12% vs. 62± 0.4%). There was a negative correlation between left ventricular regional wall motion score and ejection fraction(r=-0.71; P<0.001). 3) In patients, peak mitral flow velocity at atrial contraction(A) was higher(73±11cm/sec vs. 63±13 cm/sec; P<0.01), E/A ratio was lower(0.77±0.28 vs. 1.01±0.25; P<0.01), and left ventricular isovolumic relaxation time was longer(126±34msec vs. 97±21msec; P<0.005). 4) Patients had smaller systolic time-velocity integral(13.0±3.30cm vs. 14.8±2.83cm, P=0.056) and diastolic time--velocity integral(9.18±2.21cm vs. 11.2±2.77cm, P<0.01). 5) Relaxation abnormality of left ventricular filling patterns, which was classified by E/A ratio of less than 1, was more frequently founded in patients than in controls(45%). Four patients had E/A ratio of greater than 1; SV/DV ratio was greater than 1 in two and less than 1 in others. 6) End-diastolic area of left atrium(minimal area) was larger in patients(11±1.9㎠ vs. 9.6+1.4㎠, P<0.01). Therefore, patients showed decreased atrial emptying index and expansion index. Patients had a greater extent of left atrial area decrease resulting from atrial contraction. Conclusion: Patients with acute myocardial infarction showed a decreased left ventricular systolic function and a relaxation abnormality 7 to 14 days after attack, Minimal area of left atrium increased and left atrial function decreased.

운동 부하 심전도 검사에서 하벽부 유도의 진단적 유용성에 관한 고찰

장태일(Tae Il Jang),최종수(Jong Su Choi),박무인(Moo In Park),김지호(Ji Ho Kim),김병립(Byeong Lib Kim),우인기(In Kee Woo),이수정(Soo Jeong Lee),문익흥(Ik Heung Moon),주승재(Seung Jae Joo),이재우(Jae Woo Lee),이덕희(Duk Hee Lee) 대한내과학회 1995 대한내과학회지 Vol.48 No.3

N/A Objectives: Many exercise test trials in patients with angina pectoris have demonstrated that precordial lead V5 is the best single lead as a marker for coronary artery disease. And the diagnostic value of ST segment depressions in the inferior leads is questionable. Methods: 170 patients had a standard exercise test and underwent diagnostic coronary angiography within 1 month of the exercise test. 71 patients had coronary artery disease (stenosis≥50%), whereas 99 patients did not. Sensitivity, specificity, and positive predictive value of each lead and lead groups were calculated to find the reliable leads. And the receiver operating characteristics(ROC) curves were used to compare the reliability between lead II and U5. Results: Multiple lead system had higher sensitivity than that of single lead system, but the specificity is decreased. Comparing the sensitivity and the specificity among each lead, lead V5 is the best single lead. ROC curve analysis also revealed that lead V5 (area=0.725) was markedly superior to lead II(area = 0.635) over multiple cut points(Z = 5.417; p < 0.01). However, the area under the lead II curve(0.635) was greater than 0.5(Z=3.05; p<0.01), suggesting that ST segment depression in lead II is also reliable for the identification of CAD. Conclusion: The precordial lead V5 is the best marker for identification of CAD in exercise test. An exercise - induced ST segment depression in the inferior leads is also valuable.

ADP에 의해서 활성화된 인혈관세포의 Prothrombin과 골타액단백 부착에 관여하는 Integrin avβ3, avβ5, a5β1의 특성

주승재,최휘,김성만,차태준,이재우 고신대학교 의학부 2003 高神大學校 醫學部 論文集 Vol.18 No.1

Background : One of the most important features of integrins is that they exist in active and inactive states. Adenosine diphosphate (ADP), which is usually secreted from activated platelets, may activate integrins on vascular on vascular cells. Each integrin has its own activation-dependent ligands that have much higher affinity to active form than inactive one. Integrins that might mediate adhesion of human vascular cells to prothrombin(PT) and bone sialoprotein (BSP) after ADP stimulation were investigated. Methods : PT and BSP were used as activation-dependent ligands in adhesion assay. Adhesions of human umbilical vein endothelial cells (HUVEC) and human aortic smooth muscle cells (HASMC) were measured after stimulating with 100 μM of ADP, using ligand-coated 24-well plate and Fluorescence Multi-Well Plate Reader. Results : ADP activated HUVEC and HASMC to increase adhesions to PT and BSP in a dose-dependent manner. Adhesions of ADP-stimulated HUVEC to PT and BSP were almost completely inhibited by c7E3, a blocking monoclonal Ab to integrin β₃(96% and 92% inhibition, respectively), but not by P5H9, a blocking monoclonal Ab to integrin α_vβ_5. Adhesion of ADP-stimulated HASMC to PT was completely blocked by P5H9 (92% inhibition), but was not affected by c7E3. Adhesion of ADP-stimulated HASMC to BSP was partially inhibited either by P5H9 (46% inhibition) or by JBS5, a blocking monoclonal Ab to integrin inhibition), but was not affected by c7E3. However, it was completely blocked by cRGD (93% inhibition). Conclusion : These results indicate that the adhesion of ADP-stimulated HUVEC to PT or BSP was mediated by integrin α_vβ₃ and several integrins appeared to be involved in the adhesion of ADP-stimulated HASMC. While the adhesion of HASMC to PT was mediated by integrin α_vβ_5, the adhesion to BSP was associated with integrins α_vβ_5 and α_5β₁.

고콜레스테롤혈증 환자에서 활성화된 혈소판 Glycoprotein Ⅱb/Ⅲa의 증가

주승재,이재우,박양생 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.12

자동 경계 탐지(Automated Border Detection)심초음파도를 이용한 좌심방 면적 및 기능의 평가

김현주,주승재,임진형,정효균,이영수,유호대,차태준,이재우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.2

급성 심근 경색 후 좌심실 재구도와 수축기 기능 및 이완기 기능의 변화 : 입원시 Killip분류에 따른 비교 Comparison according to Killip Class at Admission

고철희,주승재,박달수,김지현,편준철,이영수,차태준,이재우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.10

ADP에 의해서 활성화된 혈관평활근 세포의 증식에 관여하는 Integrin의 종류와 신호 전달 경로

박찬복,이지현,류종철,차태준,주승재,이재우 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background: Adenosine diphosphate(ADP), which is usually secreted from activated platelets activates integrin αvβ3. αvβ5, and α5β1 on human vascular smooth muscle cells. Integrins have an important role in the proliferation of vascular smooth muscle cells. ADP may stimulate the proliferation of vascular smooth muscle dells by the activation of integrins. Integrins mediating ADP-stimulate the proliferation of vascular smooth muscle cells and signal transduction pathway of ADP stimulation were investigated in this study. Methods: MTT(3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay was used to evaluate ADP or ATP-stimulated proliferation of human aortic smooth muscle cells (HASMC). In some experiments, HASMC were incubated with U73122, an inhibitor of phospholipase C, or monoclonal antibodies (mAb) to integrins after ADP of ATP stimulation. Results: ADP and ATP increased the proliferation of HASMC in a dose-dependent manner. U73122 inhibited ADP or ATP stimulated proliferation of HASMC ADP-stimulated proliferation of HASMC was inhibited either by c7E3, a blocking mAb to integrin β3 or by LM609, a blocking mAb to integrin αvβ3(37% and 26% inhibition, respectively: p<0.05), but neither by P1F5, a blocking mAb to integrin αvβ5 nor by JBSS, a blocking mAb to integrin α5β1. Conclusion: These results indicate that ADP increases the proliferation of human vascular smooth muscle cells through phospholipase C pathway, and only integrin αvβ3 mediates ADP-stimulated proliferation of human vascular smooth muscle cells.