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ST분절비상승 급성심근경색증의 초기 진단 및 치료와 예후 관리
박상민,유승기,신미승 대한내과학회 2022 대한내과학회지 Vol.97 No.2
Acute myocardial infarction (MI) is a cardiovascular disease with high mortality. Acute MI is usually divided into ST-segment elevation MI (STEMI) and non ST-segment elevation MI (NSTEMI) based on the electrocardiogram (ECG). NSTEMI is often misdiagnosed in patients presenting to emergency departments with acute chest pain because its clinical course varies and is atypical compared to STEMI. The symptoms can be vague and the ECG is often not diagnostic. In this setting, an early accurate diagnosis and risk stratification could improve the mortality of patients with NSTEMI. Cardiac biomarkers such as high-sensitivity cardiac troponin (hs-cTn) help to diagnose NSTEMI. Serial hs-cTn assays should be considered to differentiate other conditions, especially in an ambiguous clinical situation. If acute MI is strongly suspected based on the symptoms, ECG, and cardiac biomarkers, catheterization laboratory activation should be timely considered to evaluate the coronary arteries and possible revascularization with percutaneous or surgical strategies depending on risk factors. After successful revascularization, antianginal medications, risk factor control, and early recognition of heart failure are essential to improve the cardiovascular prognosis.
KSHF Guidelines for the Management of Acute Heart Failure; Part II: Treatment of Acute Heart Failure
이주희,김민석,유병수,박성지,박진주,신미승,윤종찬,이상은,장세용,최성훈,조현재,강석민,최동주 대한심장학회 2019 Korean Circulation Journal Vol.49 No.1
The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic HF were introduced in March 2016. However, chronic and acute HF represent distinct disease entities. Here, we introduce the Korean guidelines for the management of acute HF with reduced or preserved ejection fraction. Part II of this guideline covers the treatment of acute HF.
한국인 심부전 환자의 임상특성 및 예후인자에 관한 다기관 연구.
한성우,유규형,채성철,양동헌,신미승,이상훈,전은석,오병희,최동주,김재중,신동구,유병수,안영근 대한심장학회 2005 Korean Circulation Journal Vol.35 No.5
Background and Objectives:Congestive heart failure is one of the most frequent problems in cardiovascular pa-tients. The objectives of this study were to evaluate the demographic and clinical characteristics and prognostic Subjects and Methods:Nine university hospitals were involved, and gathered prospective clinical data on patients with heart failure. One thousand eight hundred and sixty four patients, admited betwen Jan.1 198 and Aug. 31 2003, were enroled, and data from 1,759 patients were analyzed. Results:The cumulative survival rates at 6 month, and 1 and 2 years were 90.8, 80.1 and 76.4%, respectively. Ischemic heart disease was the most frequent underlying disease (32.3%). Diabetes melitus (OR: 1.682, 95%CI: 1.234-2.389, p= 0.005), a previous history of myocardial infarction (OR: 2.521, 95%CI: 1.742-4.258, p<0.0001) and cerebrovascular accidents (OR: 2.020, 95%CI: 1.16 -3.101, p= 0.001) were the worst prog-nostic factors. Conclusion:Ischemic heart disease was the major cause of heart failure. The two year survival rate of history of myocardial infarction and cerebrovascular acidents. 배경 및 목적: 울혈성 심부전의 원인 질환 및 자연 경과, 예후인자에 대한 국내의 자료는 드문 실정이다. 본 연구는 국내 울혈성 심부전 환자의 기본적인 역학적 특성과 임상양상에 대한 자료를 파악하기 위하여 9개 의과대학이 참여한 전향적 연구이다. 방 법: 1998년 1월 1일부터 2003년 8월 31일까지 국내 9개 대학병원에 울혈성 심부전으로 입원한 1,864명의 환자를 대상으로 하였다. 생존에 영향을 미칠 수 있는 다른 질환이 동반된 환자를 제외한 1,759명의 자료를 분석하였고 생존률 및 예후인자를 분석하였다. 결 과: 국내 울혈성 심부전 환자의 원인 질환은 허혈성 심장질환이 32.3%로 가장 많았고 확장성 심근증을 포함한 심근질환이 22.7%, 고혈압성 심장질환 16.5%, 심장 판막증이 13.5%였다. 전체환자의 6개월, 1년, 2년 누적생존률은 각각 90.8%, 80.1%, 76.4%였다. 심근경색의 과거력(OR: 2.521, 95%CI: 1.742~4.258, p<0.0001), 당뇨병(OR: 1.682, 95%CI: 1.234~2.389, p=0.005), 뇌혈관사고(OR: 2.020, 95%CI: 1.166~3.101, p=0.001) 등이 불량한 예후인자였다. 결 론:허혈성 심장질환은 국내 울혈성 심부전 환자의 가장 흔한원인 질환이었다. 2년 생존률은 76.4%였고 당뇨병과 심근경색병력, 뇌졸중 등은 국내 울혈성 심부전 환자의 불량한 예 후환자였다.
방아풀, 쑥부쟁이 및 씀바귀 나물의 건조방법에 따른 생리활성 효과
김영민(Young Min Kim),최미승(Mi Seung Choi),배종향(Jong Hyang Bae),유성오(Sung Oh Yu),조자용(Ja Yong Cho),허북구(Buk Gu Heo) (사)한국생물환경조절학회 2009 생물환경조절학회지 Vol.18 No.1
나물로 이용되는 방아풀, 쑥부쟁이 및 씀바귀의 효율적인 건조방법을 구명하고자 건조방법을 달리하여 건조한 후 메탄올을 용매로 한 추출액 1,000㎎ㆍL?¹의 생리 활성을 조사하였다. 총 페놀 함량은 방아풀과 쑥부쟁이는 동결건조 한 것에서 각각 65.1 및 60.2㎎ㆍL?¹로, 씀바귀는 오븐에서 건조한 것에서 51.2mg-L-1로 가장 많았다 총 플라보노이드 함량은 뻗뽑은 오븐건조 처 리구에서 70.6㎎ㆍL?¹로, 쑥부쟁이와 씀바귀는 동결건조 처리구에서 각각 53.9 및 35.8㎎ㆍL?¹로 가장 많았다. 전자 공여능은 방아풀의 경우 동결건조 한 것에서 78.8%로 가장 높았으며, 쑥부쟁이는 89.8~90.9%로 유의성을 나타내지 않았다. 씀바귀 추출물의 전자 공여능은 오븐으로 건조한 것(91.9%), 자연건조 한 것 (91.0%), 동결건조 한 것(90.9%) 순으로 높았다. 아질산염 소거능은 방아풀과 쑥부쟁이는 자연건조 한 것에서 각각 73.3 및 78.2%로 높았으며, 씀바귀는 동결건조 한 것에서 75.1%로 가장 높았다. This study was conducted to investigate into the effective drying method for three greens such as bang-a (Isodon japonicus), aster (Aster yomena) and lettuce greens (Ixeris dentata) Nakai. We have dried three greens using the different drying methods, have made methanol extracts and have also determined the physiological activities in 1,000㎎ㆍL?¹ extracts. Total phenolic compound contents were most increased by 65.1 and 60.2㎎ㆍL?¹ in the extracts of bang-a and aster which were frozen dried, however, that in lettuce greens were oven dried by 51.2㎎ㆍL?¹. Total flavonoid contents were extremely much more in bang-a extracts dried in the oven by 70.6㎎ㆍL?¹, however, aster and lettuce greens extracts frozen dried by 53.9 and 35.8㎎ㆍL?¹. DPPH radical scavenging activity in bang-a extracts were greatly increased by 78.8% when bang-a were frozen and dried, however, that in aster were not significant by 89.8~90.9%. DPPH radical scavenging activities in lettuce greens extracts were became highest in the order of oven drying (91.9%), natural drying (91.0%) and freeze drying methods (90.9%). Nitrite radical scavenging activities in bang-a and aster extracts were most increased in the natural drying treatment by 73.3 and 78.2%, however, that in lettuce greens extracts were highest in freeze drying treatment by 75.1 %.