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강기운,이성규,윤현수,진정연,명진철,김원호,박상현,최유정,정경태,정명호 대한비만학회 2013 The Korean journal of obesity Vol.22 No.4
Background: Previous reports have demonstrated that obese patients may have better clinical outcomes after percutaneous coronary intervention (PCI) than non-obesepatients; however this “obesity paradox” remains still unknown in young patients. Therefore, we investigated the influence of obesity on the outcomes of young patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 541 young patients (≤ 45 year old) with acute STEMI undergoing urgent PCI were enrolled in the Korea Acute Myocardial Infarction Registry betweenJanuary 2008 and Aug 2011. These patients were categorized according to their body mass index (BMI, kg/m2) as non-obese (BMI < 27.5, N = 73), obese (27.5 ≤ BMI < 32.5,N = 183) and morbidly obese (BMI ≥ 32.5, N = 285). At follow-up, the major adverse cardiac events (MACE; defined as death, myocardial infarction, and target vesselrevascularization) were compared among the three groups. Results: The mean duration of follow-up was 384 ± 82 days. Among the three groups, age, sex, cardiovascular risk factors and left ventricular ejection fraction were similar andnumber of infarct-related artery or stenotic coronary artery was also similar. The length of stay in the coronary care unit was shorter among the obese and morbidly obese group compared with that of the non-obese group. In-hospital death and clinical outcomes among the three groups were not significantly different. At follow-up, the one-year MACE-free survival rate of those groups was not significantly different (93% in non-obese, 94% in obese and 95% in morbidly obese). Conclusion: In young patients with STEMI undergoing urgent PCI, influence of obesity on clinical outcomes was not observed as significant in the young Korean patients.
Leptin as a Key Between Obesity and Cardiovascular Disease
강기운,옥민호,이성규 대한비만학회 2020 The Korean journal of obesity Vol.29 No.4
Obesity increases the risk of cardiovascular disease through various influencing factors. Leptin, which is predominantly secreted by adipose tissue, regulates satiety homeostasis and energy balance, and influences cardiovascular functions directly and indirectly. Leptin appears to play a role in heart protection in leptin-deficient and leptin-receptor-deficient rodent model experiments. Hyperleptinemia or leptin resistance in human obesity influences the vascular endothelium, cardiovascular structure and functions, inflammation, and sympathetic activity, which may lead to cardiovascular disease. Leptin is involved in many processes, including signal transduction, vascular endothelial function, and cardiac structural remodeling. However, the dual (positive and negative) regulator effect of leptin and its receptor on cardiovascular disease has not been completely understood. The protective role of leptin signaling in cardiovascular disease could be a promising target for cardiovascular disease prevention in obese patients.
2018 대한부정맥학회 비판막성 심방세동 환자의 동율동 조절 약제 지침
강기운,심재민,안진희,이대인,김준,정보영,최기준 대한내과학회 2018 대한내과학회지 Vol.93 No.2
Rhythm control therapy is the main strategy for restoring and maintaining sinus rhythm in patients with non-valvular atrial fibrillation (NVAF). Sinus rhythm is better restored and maintained with antiarrhythmic drugs than with placebo treatment. In addition, catheter ablation or combination therapy is more effective than antiarrhythmic drugs for treating NVAF. However, in most clinical trials to date, rhythm control therapy has resulted in neutral clinical outcomes compared with rate control therapy. The decision to undergo rhythm control therapy should be based on age, atrial fibrillation (AF)-related symptoms, type of AF, structural heart disease, and underlying comorbidities. For now, rhythm control therapy is indicated to improve symptoms in patients with NVAF who have refractory symptoms after adequate rate control therapy. The Korean Heart Rhythm Society organized the Korean AF Management Guideline Committee and analyzed all available data, including South Korean patients with NVAF. This review article provides general principles and detailed methodology for rhythm control therapy in South Korean patients with NVAF.
강기운,김옥순,진정연,김원호,박상현,최유정,신종호,정경태,임도선,이성규 대한내분비학회 2015 Endocrinology and metabolism Vol.30 No.4
Background: Obesity is well-known as a risk factor for heart failure, including diastolic dysfunction. However, this mechanism in high-fat diet (HFD)-induced obese rats remain controversial. The purpose of this study was to investigate whether cardiac dysfunction develops when rats are fed with a HFD for 10 weeks; additionally, we sought to investigate the association between mitochondrial abnormalities, adenosine triphosphate (ATP) levels and cardiac dysfunction. Methods: We examined myocardia in Wistar rats after 10 weeks of HFD (45 kcal% fat, n=6) or standard diet (SD, n=6). Echocardiography, histomorphologic analysis, and electron microscopy were performed. The expression levels of mitochondrial oxidative phosphorylation (OXPHOS) subunit genes, peroxisome-proliferator-activated receptor γ co-activator-1α (PGC1α) and anti-oxidant enzymes were assessed. Markers of oxidative stress damage, mitochondrial DNA copy number and myocardial ATP level were also examined. Results: After 10 weeks, the body weight of the HFD group (349.6±22.7 g) was significantly higher than that of the SD group (286.8±14.9 g), and the perigonadal and epicardial fat weights of the HFD group were significantly higher than that of the SD group. Histomorphologic and electron microscopic images were similar between the two groups. However, in the myocardium of the HFD group, the expression levels of OXPHOS subunit NDUFB5 in complex I and PGC1α, and the mitochondrial DNA copy number were decreased and the oxidative stress damage marker 8-hydroxydeoxyguanosine was increased, accompanied by reduced ATP levels. Conclusion: Diastolic dysfunction was accompanied by the mitochondrial abnormality and reduced ATP levels in the myocardium of 10 weeks-HFD-induced rats.
강기운,Kim Wonho 고신대학교(의대) 고신대학교 의과대학 학술지 2023 고신대학교 의과대학 학술지 Vol.38 No.3
Scrub typhus is known as one of the most common seasonal infections in endemic rural areas, but life-threatening cardiac complications in cases of scrub typhus are very infrequent. In addition, scrub typhus infection has been rarely reported among workers assembling pallets using manufactured wood in metropolitan areas. Herein, we present two cases involving myocarditis and cardiac tamponade as complications of scrub typhus. One patient died and the other patient survived. These cases indicate that scrub typhus infection could be an environmental hazard in metropolitan areas, especially in locations with poor hygiene, and highlight the need for timely diagnosis and proper management of severe scrub typhus infections. Therefore, we present these two informative fatal cases of scrub typhus infection presenting with myocarditis and cardiac tamponade as an environmental hazard in metropolitan areas.
소고기 생식후 발생한 Yarrowia Lipolytica 혈증 1예
강기운 ( Ki Woon Kang ),윤희정 ( Hee Jung Yoon ),정성희 ( Sung Hee Jung ),조성훈 ( Soung Hoon Cho ),김호용 ( Ho Yong Kim ),유영욱 ( Young Wook Yoo ) 대한내과학회 2008 대한내과학회지 Vol.74 No.5
Yarrowia lipolytica는 Candida lipolytica라고도 불려지며 세균학적으로 현재 Barnett 분류법에서 Yarrowia 속으로 분류하고 있다. 이 균주는 1976년 외상성 안구 진균증 환자에게서 처음으로 동정되었고, 국내에서는 2000년에 5예의 소아환자에서 처음으로 보고되었으며 2001년에 급성 골수성 백혈병을 갖고 있는 환자에서 1예가 보고된 이후 현재까지 보고가 없는 매우 드문 기회 균주이다. 이에 저자들은 소고기를 생식한 과거력이 있는 환자에서 장기간의 항생제 투여후 Y. lipolytica가 혈액에서 배양되었기에 문헌고찰과 함께 보고하는 바이다. Candida lipolytica is also called Yarrowia lipolytica, and this is now microbiologically classified as a member of the Yarrowia genus. Y. lipolytica is a rare opportunistic pathogen that was first isolated in 1976 from a patient with traumatic ocular candidiasis. Five cases of infant patients were reported in 2000 in Korea for the first time, and then in 2001 a case was reported from an AML patient. No more cases have been reported since then. The authors experienced the case of a patient with blood culture positivity for Y. lipolytica and this patient had a previous history of raw beef ingestion and long term antibiotics therapy. Thus, we report on this case along with a review of the literature.(Korean J Med 74:566-569, 2008)
강기운 ( Ki Woon Kang ),이재우 ( Jae Woo Yi ),이봉재 ( Bong Jae Lee ) 경희대학교 경희의료원 2015 慶熙醫學 Vol.30 No.1
Hypersensitivity reactions remain a major problem in the perioperative period. These reactions are rapid onset and start within seconds to minutes of exposure to the allergen. Symptoms progress rapidly and can affect most organ systems. Anesthesiologists use a variety of drugs during provision of an anesthetic and may be involved in risk of hyperseneitivity reactions. We report a case of anaphylaxis which is developed in discectomy during general anesthesia. Anaphylaxis is a potentially life-threating reaction the requires immediate treatment including epinephrine as a first choice vasopressor.