급성하벽심근경색에서 전흉부유도 ST절 하강의 의의

정병천,배호상,곽동훈,김영태,배용학,황종현,임현주,류재근,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 급성하벽심근경색증 환자에서 심전도상 흔히 동반되는 전흉부유도 ST절 하강의 의의를 알아보았다. 방법 : 심근경색후 24시간에서 48시간에 얻은 심전도를 기준으로 52명의 급성하벽심근경색증 환자를 전흉부유도에서 ST절의 하강이 있는 군과 없는 군으로 나누었으며 심도자, 관상동맥조영술, 심초음파도 및 방사성 핵종을 이용한 좌심구혈율 측정 등을 시행하였다. 결과 : 1) 좌심실확장기말압은 전흉부유도에서 ST절의 하강이 있는 경우에서 16.9±5.33mmHg로 없는 경우의 11.0±4.02mmHg보다 유의하게 높았다(p<0.05). 그러나 운동량 및 좌심구혈을은 흥부 유도상 ST절의 하강이 있는 경우 7.6±3.0 METs 및 53.9±9.1%로 없는 경우의 9.1±2.7 METs 및 54.6±9.5%보다 낮았으나 통계적 유의성은 없었다(p=0.180, p=0.823). 2) 관상동맥조영술상 전흉부 ST절의 하강이 동반된 군에서는 유의한 좌전하행지나 좌회선지의 협착이 있는 경우가 60.9% 및 57.9%로 ST절의 하강이 없는 군에서의 34.5% 및 7.7%와 비교해 좌관상동맥에 협착이 동반된 경우가 많았다(p=0.050, p=0.001). 3) 관상동맥조영술상 세 혈관질환의 빈도는 흉부유도상 ST절의 하강을 보인 23예에서 10예로 ST절 하강이 없었던 29예중 2예에 비하여 유의하게 많았고(P=0.007), 단 혈관질환의 빈도는 ST절의 하강을 보인 군에서 23예중 5예로 ST절 하강이 없었던 29예중 17예에 비하여 유의하게 적었다(P=0.002). 두 혈관질환의 경우에는 각각 8예와 10예로 양군간에 유의한 차이가 없었다. 4) 흉부유도상 ST절 하강의 빈도는 단 혈관질환 22예 중 5예에서, 두 혈관질환 18예중 8예, 세 혈관질환 12예 중 10예에서 관찰되어 협착이 있는 관상동맥의 수가 많을수록 ST절의 하강이 나타나는 빈도가 많음을 보였다(p=0.00308). 그러나 흉부유도상 나타난 ST절의 하강을 모두 합하여 구한 ST절 하강의 합은 협착이 있는 관상동맥의 수와 통계적인 유의성이 없었다. 5) 심초음파도상 좌심실 하벽의 벽운동은 ST절 하강을 보인 군에서는 akinesia가 83.3%, hypokinesia가 11.1%, 정상 벽운동이 5.6%로, ST절 하강이 없었던 군에서의 dyskinesia가 3.6%, akinesia가 39.3%, hypokinesia가 25.0%, 정상 벽운동이 32.1%와 비교하여 ST절의 하강이 있는 군에서 유의하게 벽운동의 장애가 빈번함을 보였다(p=0.03891). 그러나 좌심실전벽, 측벽 및 중격부위에서는 유의한 벽운동의 차이가 없었다. 결론 : 급성하벽심근경색증 환자의 전흉부유도에서 ST절의 하강이 동반되는 경우 다혈관 질환의 가능성이 높으며 좌심실확장기말압이 상승되었고 운동능력은 감소되어 있었다. 또한 심초음파도상 좌심실하벽의 벽운동장애도 심하였다. 따라서 전흉부 ST절의 하강을 동반한 급성하벽심근경색증 환자는 전흉부유도에 ST절 하강이 없는 경우보다 예후가 불량할 것으로 생각되며, 보다 적극적인 치료가 필요할 것으로 생각된다. The purpose of this study was to determine the significance of precordial ST segment depression appearing during acute inferior myocardial infarction and to assess the correlation of that with angiographic finding. 52 patients were allocated into two groups based on the existence of precordial ST segment depression : 23 patients with ST segment depression and 29 patients without ST segment depression. The extent of coronary artery disease as well as the prevalence of significant stenosis (≥70%) in left anterior descending artery were more frequent in patients showing precordial ST segment depression than in patients not showing them (p=0.050) and the result were similar in cases of left circumplex artery (p=0.001). On echocrdiographic examination of left ventricular (LV) wall motion, it showed more severely decreased inferior LV wall motion in patients showing precordial ST segment depression than in patients not showing them (p=0.03891) even though the other segment of LV wall motion didn't show the statistical difference between both groups. The other cardiac parameters such as LVEDP, exercise amount (METs) and ejection fraction were tend to showing bad profile in patients with precordial ST segment depression. From the above results, we could deduce that patients with precordial ST segment depression have relatively large infarction or concomitant left coronary artery disease, so they need more caution and intensive theraphy.

1997학년도 신입생 실태조사

채영무,홍기배 충주대학교 학생생활연구소 1997 學生生活硏究 Vol.4 No.-

1997학년도 편입생 실태조사

채영무,홍기배 충주대학교 학생생활연구소 1997 學生生活硏究 Vol.4 No.-

CuGaSe_2 薄膜의 光電氣的 特性에 關한 硏究

김영일,금채,허복희,김유배,이병주 충남대학교 1990 忠南科學硏究誌 Vol.17 No.2

자기베어링 런아웃의 적응제어

김재실,배철용,이재환,안대균,최헌오 창원대학교 산업기술연구소 2001 産技硏論文集 Vol.15 No.-

자기베어링의 회전정밀도에 영향을 미치는 인자로 PWM 전력증폭기, 위치 센서 등과 같은 자기베어링 구성 장치의 동특성 및 정밀도, 시스템의 정확한 모델링, 제어기법, 런아웃 등이 있다. 본 연구에서는 능동 자기베어링을 제어하기 위해 자기베어링의 PWM 전력증폭기와 회전축을 모델링하고 이를 바탕으로 능동 자기베어링 제어를 위한 PID 제어기를 구성하였으며, 변위 센서의 부착위치 및 회전축의 진원도의 영향으로 발생하는 주기적인 런아웃 요소를 첨가하여 런아웃의 영향을 확인하였으며, 런아웃(Runout)에 의해 발생하는 에러(Error)를 효과적으로 제어하여 자기베어링의 제어 정밀도를 향상시키기 위한 방법으로 기본적인 PID 제어기에 최소평균자승(Least Mean Square, LMS) 알고리즘을 적용한 적응 피드포워드 제어기를 구성하여 자기베어링의 능동 제어에서 발생하는 주기적인 런아웃을 효과적으로 제어할 수 있음을 MATLAB을 통한 시뮬레이션을 통해 확인하였다.

일부 도시지역 노인들의 우울과 일상생활능력에 관련된 요인

박원규,이태용,정용준,오장균,이동배,조영채 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

This study was performed to provide the basic data and related factors available for the assessment of the degree of ADL and depression among older persons, manifesting their physical and psychological status. The subjects included the old people aged more than 65 years old who reside in urban areas. The interviews were delivered to 693 individuals in Taejon metropolitan city during the two-month period from June to July, 2000, and Zung Self-Rating Depression Scale and IADL developed by Older American Resources and Services of Duke medical college, were employed for the assessment of depression and IADL, respectively. The collected data were statistically processed by SPSSWIN(ver 10.0) and led to the following results. The degree of depression among 635 subjects showed that 26.6% had mild depression, 8.2% moderate and 0.6% severe while 64.6% were normal. In terms of IADL, 6.9% had impossible IADL when not aided by others, 37.0% needed some help, 56.0% possible IADL, and the higher depression scores, the significantly higher IADL scores. Based on general characteristics, depression scores were significantly higher in the female group, the older, the lower educated, the ones without cohabitants, without a spouse, without making expenses of living on their own, and IADL scores were lower, meaning the lower capability for performing daily activities, in the male group, the older, the higher educated, the group without a spouse, without making expenses of living on their own. Based on daily activities and psychological characteristics, depression scores were higher in the group who don't go out, who don't have recreational or friendly gatherings, who aren't satisfied with the lives of the past or present, who have a sense of isolation, and who don't have the will to live, and IADL scores were lower in the group who don't go out, who don't have recreational or friendly gatherings, who aren't satisfied with the lives of the past or present, who have a sense of isolation. and who don't have the will to live. Multiple regression analysis revealed that the explanatory variable having effects on depression symptoms included, with the explanatory power of 57.5%, the confidence in life, the degree of education, the subjective index of health, the sense of isolation, the exercise, the degree of IADL, the gender, the level of satisfaction with life, whether they eat breakfast or not, the concern about life, the smoking, the going out, the presence of spouse or not. The explanatory variables having effects, with the explanatory power of 28.9%, on IADL scores included the degree of depression symptoms, the age, the presence of friends or not, the frequency of outgoing, the level of education, the degree of obesity, the confidence in life, the level of satisfaction with life, the drinking or not. The study results showed that the higher depression scores had a tendency to be associated with the decreased capabilities of performing daily activities, and that the factors related to depression and/or IADL, included the confidence in life, the level of education, and the level of satisfaction with life. However, the more detailed and decisive results on the factors related to depression and IADL of the older persons are considered to require continuing efforts and comparisons among a variety of the older population.

성인 IgA 신병증의 임상적 고찰

김영학,권용은,허경무,윤채중,김종인,김건영,배학연,정종훈 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

농촌주민의 혈중 납과 카드뮴 농도에 관한 조사연구

정현숙,조영채,이동배 忠南大學校 環境問題硏究所 1991 環境硏究 Vol.9 No.-

The purpose of this study was to find out blood lead and cadmium concentration levels of rural residents. The blood samples were collected from 140 rural residents in 5 nonpolluted regions in Kunbuk-Myun, Kumsan-Gun, Chungnam province from August 31 to September 30, 1990 and analyzed by atomic absorption spectrophotometry. The results were summerized as follow : The mean concentration level(range) of blood lead was 0.240±0.060㎍/ml(0.130-0.390㎍/ml) for males and 0.237±0.056㎍ /ml(0.120-0.370㎍/m) for females. There was no statistically significant difference among age groups and sexes. The distributions were similar to normal distribution in both sexes. The mean concentration level(range) of blood cadmium was 0.066±0.099㎍/ml(0.012-0.582㎍/ ml) for males and 0.060±0.062㎍/ml(0.015-0.392㎍/ml) for females. There was no statistically significant difference among age groups and sexes. The distributions were skewed to the low level ranges in both sexes. The lead concentration level in whole blood did not show statistically sinificant difference among kinds of farming product. But the cadmium level of the rice-ginseng-tobacco farmers was statistically significantly high (p<0.005). The cadmium concentration level in whole blood was 0.040±0.027㎍/ml for the rice-ginseng farmers, 0.076±0.100㎍/ml ofr the rice-tobacco famers, and 0.158±0.171㎍/ ml for the rice-ginseng-to-bacco farmers. There were no statistically significant difference in blood lead and cadmuim concentration levels among groups classified by drinking habit, smoking habit and exposed years to pesticides. The correlation coefficent between the blood lead and cadmium concentration levels was statistically significant(R=0.2054, P<0.05).

좌심실비후 환자에서 베타차단제의 급중단이 임상증상 및 좌심기능에 미치는 영향

황종현,김영태,배용학,임현주,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.1

목적 : 베타 차단제와 칼슘 길항제의 장기투여로 안정상태에 있는 비후형 심근증이나 고혈압성좌심실비후 환자에서 이들 약제를 갑자기 중단하였을 때 혈역학, 심기능 및 임상상에 미치는 영향을 알아보기 위하여 본 연구를 시행하였다. 대상 및 방법 : 경북대학교 병원 순환기내과에서 통원치료중인 비후형 심근중 환자 5명과 심한좌심실비후를 동반한 고혈압 환자 6명(남자 6명, 여자 5명)을 대상으로 장기투여 중이던 베타 차단제와 칼슘 길항제를 최소 5일 중단한 후 임상증상, 혈압 및 심박수의 변동, 그리고 투약중지 전후에 도플러 심초음파도를 기록하여 좌심실내경, 벽두께, 좌심실근량, 구혈율 및 승모판혈류속도곡선의 변화를 관찰하였다. 결과 : 1) 약물치료 중단 후, 베타차단제의 경우 9명 중 6명에서, 그리고 칼슘길항제 및 디소피라미드를 복용하던 각 1명, 도합 7명의 환자에서 심계항진, 호흡곤란의 악화, 흉통이 관찰되었고, 심계항진을 호소한 1예에서는 심방세동이 재발되었다. 2) 혈압, 심박수, 확장말기 및 수축말기 좌심실내경, 심실중격 및 심실후벽 두께, 좌심실근량 및 구혈을 모두는 치료약물 중단 전후에 다소 변화하였으나 유의하지 않았다. 3) E파 최고속도와 E파 시간속도적분은 약물투여 중단 전후에 유의한 변화는 없었으나, A파 최고속도와 A파 시간속도적분은 중단 후에 각각 유의하게 증가하였으며(both P<0.01), E/A 최고속도비와 E/A 시간속도적분비는 각각 유의하게 감소하였다(both P<0.01). 한편, E파 감속시간, 등용이완시간 그리고 A-Ar 간격[A파의 최고점에서 A reversal(Ar)파의 최저점간의 시간] 모두는 중단 후 유의한 변화가 없었다. 1 결론 : 비후형 심근증 이나 고혈압성 좌심실비후 환자에서 장기투여중이던 베타 차단제와 칼슘길항제를 일시적으로 중단하였을 때 임상중상의 악화와 더불어 확장기 기능의 변화를 초래하였다. 따라서 약물치료로 비록 임상적으로 안정상태에 있더라도 치료를 갑자기 중단할 때는 주의해야 할 것으로 생각된다. Objectives : This study was done to evaluate the changes in clinical findings, hemodynamics and cardiac function after abrupt withdrawal of longterm beta-blockers and/or calcium channel blockers in hemodynamically stable patients with hypertrophic cardiomyopathy and left ventricular(LV) hypertrophy associated with hypertension. Methods : Eleven patients with hypertrophic cardiomyopathy(n=5) and LV hypertrophy associated with hypertension(n=6) were studied. Symptom assessment, blood pressure, electrocardiography and echocardiography including pulsed Doppler examination were obtained before and at least 5 days after abrupt cessation of beta-blockers and calcium antagonists. Results : 1) Deterioration in symptoms(i.e. palpitation, aggravation of dyspnea and chest pain) was observed in seven patients after abrupt withdrawal. 2) There were no significant changes in blood pressure, heart rate, end-systolic and end-diastolic LV dimensions, interventricular septal thickness, LV posterior wall thickness, LV mass, and ejection fraction before and after drug withdrawal. 3) Doppler time intervals and E wave peak-velocity and time velocity integral(TVI) were not significantly changed before and after drug withdrawal. But A wave peak-velocity and TVI after abrupt withdrawal were significantly increased(both p<0.01), and E/A peak-velocity ratio and TVI ratio were significantly decreased(both p<0.01). Conclusions : These findings suggest that temporary omission of beta blockers and calcium channel blockers develops deterioration in symptoms and LV diastolic dysfunction in hypertrophic cardiomyopathy and LV hypertrophy associated with hypertension. Physicians should avoid abrupt withdrawal of longterm beta blockers in LV hypertrophy.

카드뮴 장기간 투여에 따른 흰쥐의 신장내 카드뮴 축적량과 뇨중 배설량의 변화

송인순,조영채,김수영,박암,손경선,이태용,이동배 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.1

This study was performed to compare the cadmium accumulation levels in kidney with urinary cadmium excretion levels according to the duration of cadmium exposure in rats. Total 120 male rats, 6 weeks of age, were administered 0.5 mg/day of Cd to subcutaneously, intraperitoneally and orally 6 times per week for 12 weeks. The animals were sacrificed in the 1st day of 2nd, 4th, 6th, 8th, 10th and 12th week after beginning of cadmium administrations. Body weight, hematologic values, enzyme activities, renal Cd levels, urinary Cd and proteins were calculated and each value was compared according to the Cd administration routes. The Cd accumulation levels in the kidney of rats increased remarkably for 6-8th weeks which were experimented and urinary Cd excretion levels and urinary protein levels showed the tendency of increasing with the Cd accumulations in kidneys, especially in the subcutaneous injected rats. On the other hand, there was a significant positive correlation among the total Cd administration, the Cd accumulation in the kidneys, the urinary Cd excretion and protein.