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김새인,이동현,김광현,류동열,김승정,강덕희,최규복,이신아 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.3
Objectives: Metabolic acidosis frequently develops in patients after neobladder reconstruction. However, the incidence of metabolic acidosis in patients with neobladder and the factors associated with the development of metabolic acidosis have not been well elucidated. We aimed to investigate the incidence and the potential predictors for the development of metabolic acidosis after neobladder reconstruction with intestinal segment. Methods: We included patients who underwent neobladder reconstruction using intestinal segment at Ewha Womans University Mokdong Hospital between January 1, 2005 and December 31, 2014. A subgroup of patients according to the time of metabolic acidosis occurrence was further analyzed in order to characterize predictors for metabolic acidosis. Results: Metabolic acidosis was encountered in 79.4% of patients with neobladder during follow up period. When patients were divided into 2 groups according to anion gap (AG), total CO2 (18.9±2.1 mEq/L vs. 20.0±1.3 mEq/L, P=0.001) and chloride (106.6±4.9 mE/L vs. 109.4±3.6 mEq/L, P<0.001) were significant different between groups with AG>12 and AG≤12. Furthermore, when patients were divided into 3 groups; patients with metabolic acidosis at postoperative day (POD) 1; from POD 2 to 14 days; after 14 days, there was significant difference among those subgroups. Conclusion: Our study showed the rate of metabolic acidosis in patients underwent neobladder reconstruction and the difference between patients with metabolic acidosis and those without metabolic acidosis for the first time in Korea. In the future, well designed prospective study will be needed to prevent metabolic acidosis after neobladder reconstruction.
입학전형요소와 학업성취도 사이의 상관관계 : 일개 의학전문대학원을 대상으로 한 연구
류동열,조도상,정순섭,박혜숙,한후재 이화여자대학교 의과대학 2009 EMJ (Ewha medical journal) Vol.32 No.1
This study was performed to provide information on the relationship between admission criteria and medical school performance (MSP). Seventy six medical students admitted to the Ewha School of Medicine in 2007 were enrolled. The admission criteria included the undergraduate grade point average (GPA), medical education eligibility test (MEET), essay, letters of recommendation, and admission interview score. MSP was measured by GPA. Standard tests of bivariate correlation and multivariate regression analysis were used to examine the relationship between multiple factors of admission criteria and MSP for the first two years after admission. Among the admission criteria, scores of undergraduate GPA, essay, and letters of recommendation were significantly correlated with MSP. Admission interview score, however, had no correlation with MSP. Although total MEET score was not related with MSP as well, science reasoning-2 demonstrated significant correlation with MSP. Further studies will be needed to define the clear relationship between various admission criteria and MSP.
류동열,최규복,박정탁,정정화,송은미,노선희,이정민,안혜림,유민아,편욱범,신길자,김승정,강덕희 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.4
Purpose: Cardiac troponin T (cTnT), a useful marker for diagnosing acute myocardial infarction (AMI) in the general population, is significantly higher than the usual cut-off value in many end-stage renal disease (ESRD) patients without clinically apparent evidence of AMI. The aim of this study was to evaluate the clinical usefulness of cTnT in ESRD patients with acute coronary syndrome (ACS). Materials and Methods: Two hundred eighty-four ESRD patients with ACS were enrolled between March 2002 and February 2008. These patients were followed until death or June 2009. Medical records were reviewed retrospectively. The cut-off value of cTnT for AMI was evaluated using a receiver operating characteristic (ROC) curve. We calculated Kaplan-Meier survival curves, and potential outcome predictors were determined by Cox proportional hazard analysis. Results: AMIs were diagnosed in 40 patients (14.1%). The area under the curve was 0.98 in the ROC curve (p<0.001; 95% CI, 0.95-1.00). The summation of sensitivity and specificity was highest at the initial cTnT value of 0.35 ng/mL (sensitivity, 0.95; specificity,0.97). Survival analysis showed a statistically significant difference in all-cause and cardiovascular mortalities for the group with an initial cTnT ≥0.35 ng/mL compared to the other groups. Initial serum cTnT concentration was an independent predictor for mortality. Conclusion: Because ESRD patients with an initial cTnT concentration ≥0.35 ng/mL have a poor prognosis, it is suggested that urgent diagnosis and treatment be indicated in dialysis patients with ACS when the initial cTnT levels are ≥0.35 ng/mL.