이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

비만 여성을 대상으로 한 해조류 추출물의 국부처치와 운동 병행을 통한 지방분해 효과의 임상적 검정

서태수,이인숙,변재철,김규호,박승한,김유영,김상국,김현정,김상기,신동철,성미영,박종석,김종기,박언휘 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.3

This study was carried out to test the body fat breakdown during topical seaweed extract treatment and in combination with the aerobic exercise. Of 20 female obesity subjects, ten treated a cream types of seaweed extract(control group) and ten treated a placebo cream(placebo group). Topical treatment of each sample was designed for 4 weeks, and treated with 2 times a day about 10ml on the abdomen and the thigh, respectively. All subjects were participated aerobic dance half hour a day and four times a week. After 4 weeks of topical treatment and exercise, they were measured body fat, skinfold thickness, body circumference. Then venous blood samples were taken and analyzed blood cells, serum enzymes, and serum lipids. There were reduction of body weight, % of body fat, antebrachium, brachium, chest, waist, thigh circumference and abdomen thickness between pre and post treatment in both group. Especially, body weight and % of body fat significantly reduced in the subjects treating the seaweed extract than those treating the placebo. There were significant decrement in total cholesterol and LDL whereas increment in HDL and TBIL in the control group, but no significant difference in the placebo group. In conclusion, there were 7.6% of body fat reduction during 4 weeks of aerobic exercise and 21% of body fat reducement in combination of topical seaweed treatment and exercise, respectively. These results suggest that the topical treatment of seaweed extract should be very effective for fat breakdown. Especially, the body fat breakdown maximized in the combination with the topical seaweed extracts treatment and the aerobic exercise.

임신부 뇨로부터 정제된 인간 상피세포 증식 인자 유사체의 in vitro bioassay 및 특성

박세철,전재현,남정현,권태종,고인영,유광현 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.4

벤조산흡착, 음이온 교환수지, 단일클론항체을 이용한 immunoaffinity chromatography를 통하여 임신부 뇨로부터 천연의 hEGF를 정제하였다. 정제된 hEGF는 μ Bonda C_18 column을 사용한 HPLC 분석을 통하여 4개의 fraction으로 분리가 가능하였으며 western blot과 double immunodiffusion 실험 결과, 각각의 fraction이 hEGF의 특성을 가진 유사체인 것을 알 수 있었다. 또한 hEGF 표준 물질과의 spiking 및 아미노산 분석 등을 통하여 두 번째 fraction이 nhEGF와 동일한 것으로 확인하였다. nhEGF 및 그 유사체의 생물학적 활성 비교를 위하여 NIH 3T3 세포주에서 5'-Brdu incorporation 측정을 위한 labelling 시간, 혈청 농도의 최적 조건을 결정하였다. NIH 3T3 세포주의 DNA 합성능은 0.2% FCS가 포함된 저혈청 배지에서 hEGF가 0.1~10 ng/ml 농도로 첨가하였을 때 증가하는 경향을 나타냈다. HPLC를 통하여 분리된 두번째 hEGF 유사체가 다른 유사체보다도 생물학적인 활성이 우수하였으며, rhEGF 표준물질과의 spiking 및 아미노산 서열 분석등을 통하여 nhEGF로 밝혀졌다. 임신부의 뇨의 hEGF 유사체 함량중 natural hEGF는 46%이었다. Natural human epidermal growth facto (nhEGF) was purified from pregnant human urine by benzoic acid adsorption, DEAE-Sepharose ion exchange, and immunoaffinity chromatography. The purified nhEGF was further separated into four fractions using Bondapak C_18 HPLC system. Following characterization by Western blot and double immunodiffusion, we found that each fraction corresponds to four derivatives of the nhEGF. For biological analysis of nhEGF, we optimized the labeling time and serum concentration for the incorporation of 5-bromo-2'-deoxy-uridine (BrdU), a non-radioactive alternative for [^3H]-thymidine uptake, into NIH 3T3 cells. The DNA synthesis of NIH 3T3 cells was gradually increased at the nhEGF concentrations between 0.1~10 ng/ml in the Dulbecco's Modified Eagles Medium (DMEM) containing 0.2% Fetal calf serum (FCS). When we assayed the biological activity of four fractions, the activity of the second fraction was superior to that of the others.

고정성 Resin-bonded bridge를 이용한 상실된 유전치부의 심미 수복 : 증례보고 Case reports

박인천,박성규,위유민,이봉규,김효석,이상호 조선대학교 구강생물학연구소 2002 口腔生物學硏究 Vol.26 No.2

Today's parents are quite conscious of the esthetic and Potential psychological consequences of missing anterior teeth. Premature lobs of Primary incisors usually dose not require the Placement appliances for space maintenance because no mesial movement of the adjacent teeth is normally expected when the canines have already erupted. However, replacement of anterior teeth may be indicated for esthetic purposes or possibly to facilitate normal pronunciation. The treatment options in these cases are removable maintainers of space or fixed partial dentures, the former being most often used. When no cooperation on the part of the patient for their used or when the devices provoke discomfort or atypical glutition, fixed partial dentures may be used, taking into consideration premaxillary growth.

상악골에 발생한 원발성 골내암종

유동수,이영호,최순철,박인우,박태원 大韓口腔顎顔面放射線學會 1997 Imaging Science in Dentistry Vol.27 No.2

The primary intra-osseous carcinoma (PIOC) is a very rare lesion. PIOC is and odontogenic carcinoma defined as a squamous cell carcinoma arisinig within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. The authors diagnosed a 51-year-old female as primary intra-osseous carcinoma after undergoing clinical, radiological and histological examinations. The characteristics were as followed: 1. The patient complained of gingival bleeding on the premolar area in the left maxilla 2. The conventional radiograms showed a relatively well-defined unilocular radiolucent lesion from the mesial aspect of the upper left canine to the mesial aspect of the upper. left 1st molar. The 2nd premolar was separated from the 1st molar and the floor of the maxillary sinus was elevated by the lesion. There was a external root resorption of the upper left canine, the 1st premolar, and the 2nd premolar. 3. On the computed tomograms, the osteolytic bony lesion expanded the cortical plate of the left maxilla and displaced the margin of the left maxillary sinus upwards. But the bony lesion was separated from the maxillary sinus by a bony septum. 4. Bone scintigram with ?Tc demonstrated the increased uptake in the left maxilla. Sonograms in the neck area and chest P-A radiogram didn't show any abnormalities. 5. Histologically, the tumor islands infiltrating into the surrounding bone increased in alveolar pattern, composed of the malignant cells, and there was a necrosis in the center of the tumor islands.

활성탄의 급여가 젖소 송아지의 성장 및 배설물의 Ammonia 함량에 미치는 영향

유선일,박덕섭,명윤아,이인덕,남명수,김용국 충남대학교 농업과학연구소 2007 농업과학연구 Vol.34 No.2

This study was carried out to investigate the influences of feed containing activated charcoal on the performances of calves The daily weight gain, feed intake, feed requirement and the content of ammonia in the excreta were measured. The experiment was conducted with 10 male calves for 30 days. Each were equally divided with treatment group and control group and for the treatment group's animal fed diets containing 1.0% activated charcoal. The daily weight gain of calves were decreased by 1.92% when they were fed activated charcoal(1.02㎏/day) compared to that of control calves(1.04㎏/day) and the daily feed intake of treatment group(2.86㎏/day) was 10.06% lower comparing to the control group(3.18㎏/day). In case of feed requirement, the result showed 8.2% lower in the treatment group(2.80㎏) than control group(3.06㎏). The content of ammonia in excreta was significantly lower for treatment group(0.33ppm) than control group (2.67ppm)(p<0.05), which showed more improvement for reducing ammonia content in the treatment group with 87.6%(p<0.05). 본 연구는 사료에 활성탄을 첨가했을 때 송아지의 일당 증체량, 사료 섭취량, 사료 요구율 및 배설물의 ammonia 함량에 미치는 영향을 규명하기위해 실시하였다. 홀스타인 수송아지 10두를 30일 동안 대조구, 시험구(활성탄 1%첨가)로 각5두 공시하여 시험하였으며, 실험 결과를 요약하면 다음과 같다. 송아지의 일당 증체량은 대조구(1.04kg/일)에 비하여 활성탄을 급여했을 때(l.02kg/일) 1.92% 감소하였고, 일당 사료 섭취량은 시험구(2.86kg/일)가 대조구(3.18kg/일)에 비해서 10.06% 낮았으나, 사료 요구율은 대조구(3.06kg/kg증체)에 비해 시험구(2.80kg/kg증체)에서 8.2% 낮은 결과를 나타내었다. 송아지 배설물의 ammonia 함량은 대조구의 2.67ppm에 비하여 시험구가 0.33ppm으로 87.6% 감소되는 개선효과를 보였다(p<0.05).

충주 지역에서 10년간 급성심근경색의 임상관찰에 대한 연구

박봉안,류하근,이종혁,김인숙,류주성,유재등,이용구,문언수,김형수 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Background: The current treatments of acute myocardial infarct(AMI) Include noninvasive method using thrombolytics and invasive methods such as primary percutaneous transluminal coronary angioplasty(PTCA) and coronary artery bypass graft(CABG)surgery. Although there are many studies comparing the effectiveness of noninvasive and invasive methods, when large clinical centers, 20% of totar hospitals, were excluded, most middle-sized hospitals lacked personnels and facilities for the invasive methods. Thus they opted for the noninvasive methods. Therefore, in this study, the clinical characteristics of AMI patients and the results of thrombolytic & conservative treatment were observed. Method: 137 patients with acute myocardial infarct, who visited KonKuk University Medical Center, ChoongJu Hospital during Sept. 1990 to Sept. 1999 were analysed retrospectively using medical records. Result: The sexual compositions of patients were 63.5% male, and 36.5% female. The mean age for male patients were 56±12.9, and for female patients 68.7±9.6 (p<0.05). The mean age for female patients was significantly older than male patients. The patients in the thrombolytic treatment group had mortality rate of 6.25% which is lower than that of the conservative treatment group at 12% (p>0.05). Conclusion: Although in our study, small number of acute myocardial infarct patients caused the statistical insignificance, rapid revascularization by thrombolytic therapy within 6 hours of onset of symptoms improved mortality rate and early ambulation. And we had good results on AMI with thrombolytic agent in ChungJu including near rural area as primary emergency hospital. Therefore a prospective research with greater number of subjects is needed to develop better treatments for AMI.

LED 광중합기의 조사 mode가 복합레진의 미세경도 및 수축응력에 미치는 영향

박인호,오유향,이난영,이창섭,이상호 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.2

이 연구의 목적은 LED 광중합기(Elipar Freelight 2?, 3M-ESPE, USA)의 조사 mode에 따른 복합레진(Supreme?, Filtek Flow?, 3M-ESPE USA)의 수축응력과 미세경도를 평가하는 것이다. 수축응력을 측정하기 위해 스트레인 게이지가 사용되었다. 표본은 조사 mode와 충전방법에 따라 6개의 군으로 나누어졌다. A군: Filtek Flow?이장, Supreme? 충전, 10초 광중합, B군: Filtek Flow?이장, Supreme? 충전, 15초 광중합, C군: Filtek Flow?이장, Supreme?충전, 15초 soft start 광중합, D군 Supreme? 충전, 10초 광중합, E군: Supreme?충전, 15초 광중합, F군: Supreme?충전, 15초 soft start광중합. 스트레인 게이지를 아크릴릭 링에 부착하고 strain meter에 연결한 후 광중합하고 10분 동안 1초 간격으로 측정하고 기록하였다. 24시간 후에 각각 표본의 미세경도를 측정하였다. 결과는 ANOVA와 Tukey test를 이용해 통계학적으로 분석하였다. 결과는 다음과 같았다. 1. Soft start curing 했을 때 수축응력 이 낮았다(p<0.05). Flow able resin을 이장한 군에서는 효과가 없었다. 2. 10초간 조사한 군은 15초간 조사한 군에 비해 수축응력이 적었다(p<0.05) 3. 미세경도 측정결과 상면과 하면에서 각 군 간에 차이는 없었다(p>0.05). 하지만, 하면의 미세경도가 상면에 비해 80%에 이르지 못했다. The purpose of this study was to evaluate the polymerization contraction and the micro hardness of composite resin(Supreme?, Filtek Flow?, 3M-ESPE, USA) according to irradiation modes of LED curing unit(Elipar Freelight?, 3M-ESPE, USA). The strain guage method was used for determination of polymerization contraction. Sample were divided by 6 groups according to curing modes and filling method. Group A: Supreme?, Filtek Flow? lining, 10seconds curing, Group B: Supreme?, Filtek Flow? lining, 15seconds curing, Group C: Supreme?, Filtek Flow? lining, 15seconds soft start curing, Group D: Supreme? only, 10seconds curing, Group E: Supreme? only, 15seconds curing, Group F: Supreme? only, 15seconds soft start curing Preparations of acrylic molds were followed by filling and curing. Strain guage attached to each sample were connected to a strain meter. Measurements were recorded at each second for the total of 10 minutes including the periods of light application. And micro hardness of each group after 24hours from light irradiation were measured. Obtained data were analyzed statistically using Repeated measures ANOVA and Tukey test. The results of the present study are as follows: 1. In flow able resin liner group, soft start curing group was not found decrease of polymerization contraction. But, In Supreme only filling group, the lowest polymerization contraction was found in soft start curing group. 2. 10 seconds curing group showed statistically significant reduction of polymerization contraction compared with 15 seconds curing group(p<0.05). 3. The micro hardness values of each group not revealed significant difference(p>0.05). But, lower surface micro hardness was not reached 80% of upper surface micro hardness.

Overview of recent progress in 3D field physics in KSTAR

Park Gunyoung,In Yongkyoon,Park Jong-Kyu,Ko Won-Ha,Lee Jaehyun,Kim Minwoo,Shin Giwook,Hahn Sang-Hee,Kim SangKyeun,Yang Seong Moo,Hu Qiming,Rhee Tongnyeol,Choi Minjun J.,Kim Kimin,Lee Hyung-Ho,Jeon You 한국물리학회 2022 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.80 No.8

Various 3D field physics challenges of magnetically confined plasmas arise when the driving source comes from either externally applied non-axisymmetric 3D magnetic perturbations or plasma instabilities inside the plasma. Recently, several key outstanding topics of 3D field physics have been extensively studied in the Korean Superconducting Tokamak Advanced Research (KSTAR), such as edge-localized-mode (ELM) control by resonant magnetic perturbation (RMP), error field (EF) control, 3D field effects on rotation and transport, and RMP-induced alteration of divertor heat flux and detachment. KSTAR has a few physically unique features (i.e., high rotation and long-pulse plasmas with a low intrinsic EF) and machine/diagnostic capabilities (i.e., 3-row in-vessel control coil and state-of-the-art 2D/3D imaging diagnostics), which have been taken advantage of until now to address critical 3D field physics issues relevant to ITER and K-DEMO. Among many remarkable achievements are the robust access to and control of n = 1 RMP ELM suppression, along with a development of its physics basis tools, parameter expansion, optimization, and long-pulse control techniques. Nonetheless, a series of unresolved 3D physics themes, as well as limited coverage of 3D field operating regimes, have also been identified as future works for the 3D field research in KSTAR. In this paper, we provide an overview about the recent progress of KSTAR 3D field physics and present future plans of KSTAR 3D research toward a future fusion reactor.

고등학생들의 에이즈(후천성 면역 결핍증)에 대한 지식과 태도에 관한 연구 : K시 일부 고등학생 대상

박인혜,윤현숙,한유정 韓國學校保建學會 1996 韓國學校保健學會誌 Vol.9 No.2

This descriptive study was done to investigate the degree of knowledge and attitudes, the need of health education, and the relationship between knowledge and attitudes concerning AIDS in senior high school students. The data was collected from 386 senior high school students(200 boys, 180 girls) in K city. The data was gathered by a self reporting questionnaire, from Nov. 22nd to the 30th, 1995. Data was analyzed using the descriptive statistics methods: t-test, F-test, Pearson-Correlation Coefficient, GLM with the statistical computer package, SAS. The Result of this study were as follows : 1. The mean score of knowledge about AIDS was 42.70 from a total score of 58, showing significant differences between boys and girls (p< 0.0001). 2. The mean score of attitudes about AIDS was 29.95 from a total score of 40, showing no significant differences between boys and girls. 3. The selected contents that the students want to learn were prevention, etiology, transmission, symptoms, and treatment of AIDS in that order. 4. The relationship between knowledge and attitude about AIDS show a positive correlation and is statistically significant(r=0.27, p< 0.0001). The information obtained from this study will provi a useful data to develop a practical health education program about AIDS for senior high school students.