Multiple Sequential Complications After Sirolimus-Eluting Stent Implantation: Very Late Stent Thrombosis, Stent Fracture, In-Stent Restenosis, and Peri-Stent Aneurysm

설상훈,김두일,한양천,김기훈,김동기,김영복,김웅,양태현,김대경,김동수 대한심장학회 2009 Korean Circulation Journal Vol.39 No.10

A 55-year-old male patient presented with an acute myocardial infarction. A sirolimus-eluting stent (SES) was implanted in the proximal left anterior descending artery (LAD). Eight months later, there was a newly developed distal LAD lesion. An additional SES was implanted. Twenty-eight months after the index procedure of primary coronary intervention, the electrocardiogram showed ST elevation in the precordial leads and an emergency coronary angiogram showed diffuse stent thrombosis (ST) in the proximal LAD. Thirty-four months after the index procedure, coronary angiography showed a large peri-stent coronary aneurysm in the proximal LAD and focal in-stent restenosis (ISR) at the proximal edge of the distal LAD stent. On fluoroscopy, a fracture was noted in the middle part of the distal SES. A zotarolimus- eluting stent (ZES) was deployed and overlapped the restenosis and fracture sites. Forty months after the index procedure, there were no changes in the size of the aneurysm or in the other stent complications including the fracture and restenosis. At present, the patient has remained asymptomatic for eight months. A 55-year-old male patient presented with an acute myocardial infarction. A sirolimus-eluting stent (SES) was implanted in the proximal left anterior descending artery (LAD). Eight months later, there was a newly developed distal LAD lesion. An additional SES was implanted. Twenty-eight months after the index procedure of primary coronary intervention, the electrocardiogram showed ST elevation in the precordial leads and an emergency coronary angiogram showed diffuse stent thrombosis (ST) in the proximal LAD. Thirty-four months after the index procedure, coronary angiography showed a large peri-stent coronary aneurysm in the proximal LAD and focal in-stent restenosis (ISR) at the proximal edge of the distal LAD stent. On fluoroscopy, a fracture was noted in the middle part of the distal SES. A zotarolimus- eluting stent (ZES) was deployed and overlapped the restenosis and fracture sites. Forty months after the index procedure, there were no changes in the size of the aneurysm or in the other stent complications including the fracture and restenosis. At present, the patient has remained asymptomatic for eight months.

A Primer on the Methods and Applications for Contrast Echocardiography in Clinical Imaging

설상훈,Jonathan R. Lindner 한국심초음파학회 2014 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.22 No.3

Contrast echocardiography is broadly described as a variety of techniques whereby the blood pool on cardiac ultrasound isenhanced with encapsulated gas-filled microbubbles or other acoustically active nano- or microparticles. The development of thistechnology has occurred primarily in response to the need improve current diagnostic applications of echocardiography such asthe need to better define left ventricular cavity volumes, regional wall motion, or the presence or absence of masses and thrombi. A secondary reason for the development of contrast echocardiography has been to expand the capabilities of echocardiography. These new applications include myocardial perfusion imaging for detection of ischemia and viability, perfusion imaging ofmasses/tumors, and molecular imaging. The ability to fill all of these current and future clinical roles has been predicated on theability to produce robust contrast signal which, in turn, has relied on technical innovation with regards to the microbubblecontrast agents and the ultrasound imaging paradigms. In this review, we will discuss the basics of contrast echocardiographyincluding the composition of microbubble contrast agents, the unique imaging methods used to optimize contrast signal-tonoiseratio, and the clinical applications of contrast echocardiography that have made a clinical impact.

소셜 네트워크 분석을 이용한 팬덤 페르소나 디자인

설상훈,성기훈 한국인터넷정보학회 2019 인터넷정보학회논문지 Vol.20 No.5

In this paper, the method of analyzing the unformatted data of consumers accumulated on social networks in the era of the Fourth Industrial Revolution by utilizing data from the service design and social psychology aspects was proposed. First, the fandom phenomenon, which shows subjective and collective behavior in a space on a social network rather than physical space, was defined from a data service perspective. The fandom model has been transformed into a collective level of customer Persona that has been analyzed at a personal level in traditional service design, and social network analysis that analyzes consumers' big data has been presented as an efficient way to pattern and visually analyze it. Consumer data collected through social leasing were pre-processed by column based on correlation, stability, missing, and ID-ness. Based on the above data, the company's brand strategy was divided into active and passive interventions and the effect of this strategic attitude on the growth direction of the consumer's fandom community was analyzed. To this end, the fandom model of consumers was proposed by dividing it into four strategies that the brand strategy had: stand-alone, decentralized, integrated and centralized, and the fandom shape of consumers was proposed as a growth model analysis technique that analyzes changes over time. 본 논문에서는 4차 산업혁명시대에 소셜 네트워크 상에서 축적된 소비자들의 비정형 데이터를 서비스디자인과 사회심리학적 측면에서 데이터를 활용해 분석하는 방법을 제안하였다. 먼저 물리적인 공간보다 소셜 네트워크 상의 공간에서 주관적이며 집단적 행위를 보여주는 팬덤 현상을 데이터서비스의 관점에서 정의하였다. 팬덤 모델은 기존의 서비스디자인에서 개인적인 수준으로 분석하였던 고객의 페르소나를 집단적인 수준으로 변환시켰으며, 소비자의 빅데이터를 분석하는 소셜 네트워크 분석은 이를 패턴화하고시각적으로 분석할 수 있는 효율적인 방법으로 제시하였다. 소셜 리스닝으로 수집한 소비자의 데이터는 연관성, 안정성, 결측정도, 그리고 고유성을 기준으로 Column별 데이터전처리를 진행하였다. 위의 데이터를 기반으로 기업의 브랜드 전략을 적극적 개입형과소극적 개입형으로 나누고 이러한 전략적 태도가 소비자의 팬덤 커뮤니티의 성장방향성에 미치는 영향을 분석하였다. 이를 위해 소비자의 팬덤 모델을 브랜드전략이 가지는 총 4가지 전략인 독립형, 분산형, 통합형, 그리고 중앙집중형으로 나누어서 제안하였고, 소비자의 팬덤 형상을 시간에 따라 변화추이를 분석하는 성장모델분석 기법으로 제안하였다.

만성 B형 간질환 환자에서 라미부딘 1년 치료효과

설상훈,엄수정,이연재,최봉기,박은택,장윤식,이상혁,설상영,정정명 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1

■ Objectives The aim of this study was to evaluate the biochemical and virological responses to one year lamivudine therapy in HBV-associated chronic liver diseases including interferon(IKF) -naive. INF-failed chronic hepatitis and liver cirrhosis. ■ Methods This study was conducted as an one-year trial of lamivudine in 60 patients with HBV-associated liver disease(INF-naive chronic hepatitis 20. INF-failed chronic hepatitis 18. liver cirrhosis 22). We classifed the patients as INF-naive chronic hepatitis(Group A), as INF-failed chronic hepatitis(Group B) and as liver cirrhosis(Group C). ■ Results The mean normalization rate of serum ALT was 71.7%: 65.0% in Group A. 61.1% in Group B and 86.4% in Group C. The negative conversion rate of HBV-DNA was 73.3%: 60.0% in Group A, 83.3% in Group B and 77.3% in Group C. The seroconversion rate of HBeAg was 30.0%: 22.2% in Group A, 35.3% in Group B and 26.3% in Group C. The breakthrough was occurred in 26.7% of patients: 40% in Group A, 16.7% in Group B and 22.7% in Group C. However, they did not deteriorate clinically in spite of ALT elevation and HBV-DNA reappearance. In case of anti-HBe positive chronic liver disease, ALT was normalized and HBV-DNA became undetactable in all 6 patients after 1 year lamivudine treatment. ■ Conclusions One year lamivudine treatment resulted in biochemical and virological improvements in patients with HBV- associated liver disease irrespective of the severity of liver disease and the status of HBeAg/Anti-HBe. Further studies are required to determine the effects of long-term suppressive therapy and optimal duration of therapy in patients with chronic HBV infection.

Bayesian Estimation of Exponentiated Weibull SSPALT Model using Type-I Hybrid Censoring

설상훈,정윤식 한국자료분석학회 2016 Journal of the Korean Data Analysis Society Vol.18 No.1

Based on type-I hybrid censoring, we consider estimation of the exponentiated Weibull (EW) distribution under step-stress partially accelerated life tests (SSPALT) well-known test to obtain information on the lifetime distribution in the life test. A type-I hybrid censoring scheme is a mixture of type-I and type-II censoring schemes. In this paper, we introduce a model in SSPALT and determine likelihood functions in type-I hybrid censoring. Maximum likelihood estimates of the model parameters and an acceleration factor are obtained by Newton Raphson method. Also, we obtain Bayes estimates. The model parameters and an acceleration factor are estimated using Lindley's approximation under a squared error loss (SEL) function. Furthermore, we obtain simulation results of the estimators.

생태모사 모델을 융합한 디지털 트랜스포메이션 디자인 전략

설상훈(Sanghun Sul),김정우(Jungwoo Kim),최재붕(Jaeboong Choi) 한국디자인학회 2019 한국디자인학회 학술발표대회 논문집 Vol.2019 No.11

임상화보 : 시멘트 폐색전증

설상훈 ( Sang Hoon Seol ),김웅 ( Woong Kim ),양태현 ( Tae Hyun Yang ),김대경 ( Dae Kyeong Kim ),김두일 ( Doo Il Kim ),김동수 ( Dong Soo Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5

좌심실 수축 기능부전을 가진 급성 심근경색 환자에서 ST 분절 변화가 미치는 영향

설상훈 ( Sang Hoon Seol ),이은주 ( Eun Ju Lee ),박영진 ( Young Jin Park ),조환진 ( Hwan Jin Cho ),양태현 ( Tae Hyun Yang ),김성만 ( Seong Man Kim ),김대경 ( Dae Kyeong Kim ),김두일 ( Doo Il Kim ),김동수 ( Dong Soo Kim ) 대한내과학회 2008 대한내과학회지 Vol.74 No.6

목적: 급성 심근경색 환자에서 ST 분절 상승의 영향에 대해서는 많은 연구가 이루어졌으나 좌심실 수축 기능부전을 동반한 심근경색 환자에서는 연구되지 않았다. 방법: 2004년 1월부터 2006년 6월까지 좌심실 구혈률이 40% 이하의 수축 기능부전을 가진 급성 심근경색 환자 117명을 대상으로 하였다. ST 분절 상승 심근경색 77명과 비 ST 분절 상승 심근경색 환자 40명을 임상적 특징과 관상동맥조영술 결과 및 입원기간 및 1년 주요 심장사건(심장사망, 새로운 비치명적 심근경색, 목표혈관 재관류술, 심부전)을 후향적으로 분석하였다. 결과: ST 분절 상승에 따른 양 군의 기본적인 임상특징의 차이는 없었다. 관상동맥조영술의 TIMI flow 0 grade는 STEMI군에서 많았고(49.4% vs. 15.0%, p<0.01), 다혈관 질환은 NSTEMI군이 많았다(39.0% vs. 65.0%, p=0.01). 하지만 입원 중 심장 사망률과 주요 심장사건은 비슷했다(cardiac death 6.5% vs. 2.5%, p=0.66, MACE 19.5% vs. 22.5%, p=0.81). 1년 심장 사망률과 주요 심장사건에서도 의미있는 차이를 보이지 않았다(cardiac death 14.4% vs. 7.5%, p=0.37, MACE 33.8% vs. 30.0%, p=0.68). 결론: 좌심실 수축기능이 저하된 급성 심근경색 환자에서 ST 분절의 상승은 입원기간과 장기적인 예후에 영향을 미치지 않았다. Background/Aims: Although the impact of ST segment elevation in patients with acute myocardial infarction (MI) has been studied, little information is available on the impact of ST segment elevation in the patients with acute MI and left ventricular systolic dysfunction. Methods: We retrospectively analyzed the baseline clinical and angiographic characteristics and the in-hospital and 1-year clinical outcomes of 117 consecutive patients who were diagnosed with acute MI and who had a left ventricular ejection fraction of less than 40%, and these patients were treated from January 2004 to June 2006 at Busan Paik Hospital. Coronary angiography at the index hospitalization and the major adverse cardiac events (MACEs), including cardiac death, non-fatal reinfarction, target vessel revascularization (TVR), and heart failure, were compared between the 77 patients with ST segment elevation myocardial infarction (STEMI) and the 40 patients with non-ST segment elevation myocardial infarction (NSTEMI). Results: Overall, the baseline clinical characteristics were similar between the two groups. On the coronary angiography, thrombolysis in myocardial infarction 0 flow was more common in the STEMI group as compared to the NSTEMI group (p<0.01) and the NSTEMI group had more frequent multivessel disease compared to the STEMI group (p=0.01). However, the in-hospital cardiac deaths and MACEs were not different on comparison between the two groups (p=0.66, p=0.81, respectively). The one-year cardiac deaths and MACEs were not significantly different on comparison between the two groups (p=0.37, p=0.68, respectively). Conclusions: This study demonstrated that ST segment elevation had no influence on in-hospital and the long term outcomes of patients with acute MI and left ventricular systolic dysfunction.(Korean J Med 74:632-639, 2008)

임상화보 : 카테터 유발 관상동맥 연축

설상훈 ( Sang Hoon Seol ),양태현 ( Tae Hyun Yang ),김성만 ( Seong Man Kim ),김대경 ( Dae Kyeong Kim ),김두일 ( Doo Il Kim ),김동수 ( Dong Soo Kim ) 대한내과학회 2007 대한내과학회지 Vol.73 No.4

Interactive image/video query using object links

Sanghoon Sull(설상훈),Sang Wook Oh(오상욱),Jeong Taek Oh(오정택),Mansuk Yang(양만석),Daniel Berwick,Sang Wook Lee 한국통신학회 1999 한국통신학회 학술대회 및 강연회 Vol.1999 No.4