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동기능부전 환자에서 방실전도계의 전기생리학적 특성에 관한 연구
박형욱(Hyung Wook Park),김준우(Joon Woo Kim),김성희(Seong Hee Kim),조장현(Jang Hyun Cho),안영근(Young Keun Ahn),박주형(Joo Hyung Park),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang) 대한내과학회 1998 대한내과학회지 Vol.55 No.3
N/A Background: It is very important to evalute the function of the atrioventricular conduction system in selecting appropriate pacemaker, pacing and sensing mode in sick sinus syndrome. It has been reported that atrioventricular conduction abnormalities were commonly accompanied with sinus node dysfunction (SND). However, there were several long term follow-up studies indicating that incidence of AV conduction abnormalities was as low as below 1% a year in patients with SND implanted pacemaker. This study was performed to evaluate the properties of the AV conduction system in patients with SND. Subjects and Methods: Patients subjected to this study were fifty-eight who underwent electrophysiologic study on suspicion of SND. Sinus node recovery time (SNRT) was defined as the longest time among the times that sinus rhythm reappeared after rapid atrial pacing for 45 seconds with several cycle lengths, and corrected SNRT (cSNRT) was worked out by subtracting sinus cycle length (SCL) from SNRT. Criteria for sinus node dysfunction were 1550 msec or more on SNRT, 550 msec or more on cSNRT and group A (23 cases, 58±13 yrs) was defined as SND not retrieved to normal after intravenous administration of atropine 1-2 mg, group B (21 cases, 52±14 yrs) was retrieved to normal and group C (14 cases, 54±13 yrs) was normal control group. Abnormalities of the AV conduction system were defined as 150 msec or more on AH interval, 500 msec or more on AVblock cycle length (AV-BCL), 4% msec or more on AV nodeeffective refractory period (AVN-ERP). Results: SCI. in group A, B, C was 1197±340 msec, 1215±273 msec, and 898±129 msec, respectively at baseline and 886±218 msec, 798±106 msec, and 722±110 msec respectively after atropine administration, showing a significant prolongation of SCL in group A and B at baseline (p<0.001) and group A after atropine administration (p<0.05). SNRT in group A, B, C was 3520±1817 msec, 3180±2390 msec, and 1282±116, respectively at baseline and 4155±4281 msec, 1237±210 msec, 1020±245 msec, respectively after atropine administration, showing a significant prolongation of SNRT in group A and B at baseline (p<0.001) and group A after atropine administration (p<0.05). AH intervals at baseline and after atropine administration were 107±27 msec and 100±20 msec in group A, 101±21 and 91±14 in group B, and 118±32 and 83±23 in group C, showing no significant difference between 3 groups. AV-BCLs at baseline and after atropine administration were 428±151 msec and 453±301 msec in group A, 525±140 and 370±53 in group B, and 461±120 361±94 in group C, showing no significant difference between 3 groups. AVN-ERP was 315±57 msec in group A, 343±132 msec in group B, 347±132 in group C, showing no significant difference between 3 groups. There was no significant difference in the incidences of cases with abnormal AH interval, AV-BCI AVN-ERP, HV interval between 3 groups. AV block greater than second degree was observed in one patient of group A but none of group B and C. Conclusions: Atrioventricular conduction abnormalities in patients with sinus node dysfunction were not mare common than control subjects, Therefore, atrial pacing rather than ventricular or dual chamber pacing may be safely selected as a permanent pacing mode for sick sinus syndrome with no combined significant AV block.
달리 분류되지 않는 자가면역성 췌장염에 동반한 심낭삼출액
장형하 ( Hyung Ha Jang ),강대환 ( Dae Hwan Kang ),김형욱 ( Hyung Wook Kim ),최철웅 ( Choel Woong Choi ),박수범 ( Soo Bum Park ),송병준 ( Byung Jun Song ),김수진 ( Su Jin Kim ) 대한내과학회 2014 대한내과학회지 Vol.86 No.6
자가면역성 췌장염은 자가 면역기전의 이상에 의한 만성 췌장염의 한 형태이다. 자가면역성 췌장염 두 가지 아형으로 나눠진다. 1형 자가면역성 췌장염은 림프형질세포 침윤 경화성 췌장염이라고도 불리며 IgG4 연관 질환의 스펙트럼에 속한다. 2형 자가면역성 췌장염은 특발성 췌관 중심 췌장염이라고도 하며 전신 IgG4 연관 질환의 스펙트럼에 속하지 않는다. 이번 증례는 ‘달리 분류되지 않는 자가면역성 췌장염’과 병발한 심낭 삼출액에 대한 첫 보고이다. 52세 여자환자가 호흡곤란을 주소로 내원하여 시행한 심초음파에 다량의 심낭삼출액이 관찰되었다. 복부 전산화 단층촬영에서 소시지 모양으로 췌장 실질의 종대와 췌장 가장자리에 저음영의 띠가 관찰되었고 내시경 역행성 담췌관조영술에서는 췌장 미부에서 췌관은 더 이상 조영되지 않았다. 혈청 검사에서 항핵항체는 양성이었으며 IgG4 수치는 정상이었다. 내시경 초음파 유도하 총생검술을 통한 병리 소견은 중성구와 림프구의 침윤은 많지 않았으며 섬유화가 두드러진 소견이었다. 환자는 스테로이드로 치료 후 추적 영상 검사에서 췌장의 종대는 호전을 보이고 내시경적 역행성 담체관조영술 소견상 이전에 관찰되지 않던 췌관 미부는 조영되었으며 불규칙한 협착의 소견이 관찰된 증례이다. Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis characterized by an autoimmune inflammatory process. This is the first case report of AIP, not otherwise specified, accompanied by pericardial effusion. A 52-year-old female visited our hospital due to dyspnea. Echocardiography showed a large amount of pericardial thickening. Abdominal computed tomography revealed diffuse enlargement of the pancreas body and tail with a sausage-shaped appearance, surrounded by a thick hypodense rim. Endoscopic retrograde cholangiopancreatography could not identify the tail portion of the pancreas, despite forceful contrast injection. Serology was positive for antinuclear antibody and IgG4 was normal. Endoscopic ultrasound-guided core biopsy of the pancreas was performed. Histologic examination revealed a fibrous connective tissue with inflammatory infiltration. The patient was treated with steroids. In the follow-up images, abnormal findings of pericardial effusion were improved, although an irregular long stricture of the pancreas tail portion remained. (Korean J Med 2014;86:733-738)
Role of <i>Drosophila</i> EDEMs in the degradation of the alpha-1-antitrypsin Z variant
JANG, BO-YUN,RYOO, HYUNG DON,SON, JAEKYOUNG,CHOI, KYUNG-CHUL,SHIN, DONG-MYOUNG,KANG, SANG-WOOK,KANG, MIN-JI UNKNOWN 2015 INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE Vol.35 No.4
<P>The synthesis of proteins in the endoplasmic reticulum (ER) that exceeds the protein folding capacity of this organelle is a frequent cause of cellular dysfunction and disease. An example of such a disease is alpha-1-antitrypsin (A1AT) deficiency, caused by destabilizing mutations in this glycoprotein. It is considered that the mutant proteins are recognized in the ER by lectins and are subsequently degraded through the proteasome, leading to a deficiency in this enzyme in the afflicted patients. We previously established a <I>Drosophila</I> model of this disease by overexpressing the null Hong Kong (NHK) allele of this gene and found that the <I>Drosophila</I> lectin, ER degradation-enhancing α-mannosidase-like protein 2 (EDEM2), can accelerate the degradation of A1AT when overexpressed. NHK is a rare allele, and in this study, we investigated in depth the mechanisms through which <I>Drosophila</I> EDEMs affect the degradation of the Z variant, which is the predominant disease allele. Specifically, we report that the Z allele does not activate ER stress signaling as prominently as the NHK allele, but similarly requires both <I>Drosophila</I> EDEM1 and EDEM2 for the degradation of the protein. We demonstrate that EDEMs are required for their ubiquitination, and without EDEMs, glycosylated A1AT mutants accumulate in cells. These results support the role of the EDEM-mediated ubiquitination of the alpha-1-antitrypsin Z (ATZ) allele, and establish a <I>Drosophila</I> model for the study of this protein and disease.</P>
A Novel Binary Ant Colony Optimization: Application to the Unit Commitment Problem of Power Systems
Jang, Se-Hwan,Roh, Jae-Hyung,Kim, Wook,Sherpa, Tenzi,Kim, Jin-Ho,Park, Jong-Bae The Korean Institute of Electrical Engineers 2011 Journal of Electrical Engineering & Technology Vol.6 No.2
This paper proposes a novel binary ant colony optimization (NBACO) method. The proposed NBACO is based on the concept and principles of ant colony optimization (ACO), and developed to solve the binary and combinatorial optimization problems. The concept of conventional ACO is similar to Heuristic Dynamic Programming. Thereby ACO has the merit that it can consider all possible solution sets, but also has the demerit that it may need a big memory space and a long execution time to solve a large problem. To reduce this demerit, the NBACO adopts the state probability matrix and the pheromone intensity matrix. And the NBACO presents new updating rule for local and global search. The proposed NBACO is applied to test power systems of up to 100-unit along with 24-hour load demands.