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          조직구성림프종에 대한 임상적고찰

          김윤년,송홍석,곽동협 대한내과학회 1986 대한내과학회지 Vol.30 No.2

          A clinical review was done retrospectively on 105 patients with histiocytic lymphoma who visited to the Dong San Medical Center between Jan. 1974 and Aug, 1984, The results of the this study were as follows: JVIale to female ratio was 1.56:1 with male predorminance and the age distribution was between 4 and 82 with mean age of 44,7 years. Palpable neck mass was the most frequent complaint(52cases: 49.5%). Abdominal pain, fever were observed in 14 cases (13.3%) respectively and abdominal mass in 11 cases(10.5%), weight loss in 9 cases(8.6%), throat pain in 9 cases(8.6%) and abdominal swelling in 8 cases(7.6%). Physical findings revealed lymph node enlargement in 74cases (70.5%) with cervical, inguinal, axillary, mesenteric and supraclavicular in order of frequency. Hepatomegaly was observed in 17.1% splenomegaly in 2.5% and abdominal mass in 20cases(19.0%). Extranodal involvement was observed in 71 cases(67.6%) and organs of involvement were as follows: GIT in 18 cases(17.1%), waldeyer`s ring in 17 cases(16.2%), skin in 16 cases(15.2%) liver in 7 cases(6.7%), bone in 6 cases(5.7%), bone marrow in 5 cases(4.8%), retroperitoneum in 5 cases(4.8%), anterior nasal cavity in 4 cases(3.8%), lung and pleura in 2 cases(l.9%) respectively. Laboratory findings revealed anemia in 47.1%, leukocytosis in 27.5%, leukopenia in 14.7% lymphopenia in 43.4%, hypoalbuminemia in 31.5%, azotemia in 10.4%, increased alkaline phosphatase in 13.9% and hypercalcemia in 8.2%. By Ann Arbor staging, stage I was in 23cases (21.9%), stage g in 34cases(32.4%), stage III in 16cases(15.2%), stage g in 32 cases(30.5) and stage B in 20 cases(27.6%). Treatment was performed as follows: Radiotherapy in 20 cases, combination chemotherapy in 18 cases and combined modality therapy in 8 cases. After treatment, 5 year survival rate was 72.2% in adequately treated patients. 2 year survival rate was 83.4% in complete remission group and 58.6% in partial remission group and there was no long-term survival in patients with partial remission.

        • KCI등재후보

          A New Method of ECG Feature Detection Based on Combined Wavelet Transform for u-health Service

          김윤년,김민수,서석태,조영창,손창식 대한의용생체공학회 2011 Biomedical Engineering Letters (BMEL) Vol.1 No.2

          Purpose The analysis of the ECG is required of accuracy for diagnosing many cardiac diseases. In this work, we propose an algorithm using wavelet transform to analyze and classify ECG (electrocardiogram) signal obtained from the developed patch type electrode. This paper presents a new combined wavelet transform artificial neural network (CWTANN) based system for classification and detection of QRS complex, P and T waves. CWTANN provided useful information for detection of cardiac disease or abnormality. Methods In this paper, we proposed a method to detect characteristic waves, such as P, QRS and T wave from abnormal ECG signal. Daubechies, Coiflets and Symlets order 5 wavelet transform were applied to the ECG. The methods have been proven out for detection of normal signal,ventricular tachycardia (VT) and PVC (premature ventricular contraction) in the ECG through subband decomposition and combined wavelet transform. Results From the results, the detection rate achieved was 96.2% for off-line classification, which is indeed a good rate of accuracy for data recognition. Using the simple proposed wavelet scheme, the developed methodology achieves higher detection rates. Conclusions The proposed ECG detection method can be used P, QRS, T wave detection by sum of combined scale using DWT. Thus the clinical use of the methodology is to be beneficial in the analysis of various heart diseases. The new CWTANN method is expected used in monitoring of ECG for mobile home healthcare applications.

        • KCI등재후보

          고주파 전극도자 절제술의 임상적 경험

          김윤년,허승호,김기식,한성욱,배장호,신경목,김권배 대한내과학회 1997 대한내과학회지 Vol.52 No.1

          Objectives : Among the current therapeutic options for paroxysmal supraventricular tachycardias, only surgery and ablative techniques are curative. However, surgery is associated with substantial cost, morbidity, and rarely death. Recently, catheter ablation techniques have been developed to treat paroxysmal supraventricular tachycardias. These techniques are effective and low-risk curative treatment for supraventricular tachycardias. This article shall describe our clinical experiences in radiofrequency catheter ablation for supraventricular tachycardias and review the literature. Methods: The study population consisted of 154 patients with supraventricular tachycardias from January 1993 to August 1995. Eighty one patients were men and seventy three patients were women, and their mean age was 41.29±15.41 years. Radio-frequency currents(mean) were applied through a catheter electrode positioned against the mitral or tricuspid annulus or a branch of the coronary sinus or atrioventricular node. Results: Among 154 patients, the mechanisms for paroxysmal supraventricular tachycardias were found to be atrioventricular reentrant tachycardia involving a concealed accessory pathway in 51(33.1%), Wolff-Parkinson-White syndrome in 57(37%), and atrioventricular nodal reentrant tachycardia in 46 (29.9%). Successful outcomes were achieved in 46 of 46 patients(100%) with atrioventricular nodal reentrant tachycardia, 7 of 8 patients(87.5%) with double accessory pathways, 69 of 72 patients(95.8%) with left-sided accessory pathway, and 19 of 28 patients (67.9%) with right-sided accessory pathway. Total 141 of 154 patients(91.6%) with supraventricular had a successful outcome with radio- frequency current application(mean). Conclusions: Radiofrequency catheter ablation techniques are highly effective in ablating accessory pathways or modifying atrioventricular node, with low morbidity and no mortality.

        • KCI등재후보

          심근교(Myocardial bridge)의 임상적 의의

          김윤년,김기식,김권배,한성욱,허승호,현대우 대한내과학회 1998 대한내과학회지 Vol.54 No.6

          Objective: A myocardial bridge is an anatomic arrangement in which an epicardial coronary artery becomes engulfed for a limited segment by myocardial fibers from birth. It is recognized angiographyically by systolic compression of coronary artery. A large discrepancy exist between pathological series, in which the incidence has varied from 15% to 85%, and angiographic seires, in which it is reported as being between 0.51% and 2.5%. A myocardial bridge has been associated with myocardial ischemia, infarction and sudden death, but its clinical significance is controversial, The aim of this study was to assess the clinical characteristics and significance of myocardial bridge based on our exerience. Method: We reviewed the consecutive 1554 cinean-giograms performed in the cardiac laboratory of the Keimyung University Hospital from Nov, 1992 to May 1996. Two groups were constituted according to percentage of systolic reduction of the arterial lumen assessed visually or by computerized digital caliper. We differentiated them between below 50% and above 50% in the systolic reduction. Comparison between variables in two groups were made. Results: 1) Myocardial bridges were present in 36 patients (2.3%). 2) Among these patients, 21 had angina (58.3%), 8 had myocardial infarction (22.2%), 6 had hypertension (16.7%) and 4 had hypertrophic cardiomyopthy, primary pulmonary hypertension, mitral regurgitation and aortic regurgitation, respectively. 3) The highest prevalance was found in the mid-left anterior descending (LAD) artery (80.5%), next in the distal LAD artery (11.1%). Two cases had myocardial bridges in two sites. 4) Isolated myocardial bridges which excludes those associated with concomitant cardiovascular diseases were present in 19 patients (1.22%). Initiol symptoms in patients with myocardial bridge are exercise induced angina in 10, atypical chest pain in 3, resting onset chest pain in 3 and palpitation in 1 at admission. Two patients had no specific symptoms except electrocardiographic abnormality. 5) Clinical diagnosis of patients with isolated myocardial bridges were anginal pectaris in 13, myocardial infarction in 2 and nonspecific in 4. Myocardial infarction was present in the group of above 50% of systolic reduction. Conclusion: A myocardial bridge may induce myocardial ischemia and myocardial infarction, but prognosis may be good if patients should avoid precipitating factors i,e. condition induce tachycardia or administered β-blocker etc.

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