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이명철(Myung Chul Lee),정준기(June Key Chung),이영우(Young Woo Lee),서정돈(Jung Don Seo),박영배(Young Bae Park),이동수(Dong Soo Lee),김상은(Sang Eun Kim),최창운(Chang Woon Choi),이명묵(Myoung Mook Lee),고창순(Chang Soon Ko),배상균(Sa 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2
N/A Rest gated blood pool scan (Rest GBP scan) and dipyridamole Tc-99m-MIBI SPECT were performed in 34 patients with or suspected coronary artery disease. Both studies were performed within 2∼32 days (mean 8.1 days). A significant correlation was present between left ventricular ejection fraction (r=-0.7356, p〈0.001) and peak ejection rate and peak filling rate in rest GBP scan and perfusion defect in MIBI SPECT. And there were acceptable correlations (0.05〈p〈0.001) between regional ejection fractions and perfusion defects corresponding to the regions. There were 39 segments of fixed (rest) perfusion defects in MIBI SPECT and there was a significant difference in perfusion defect according to the regional wall motion (normal or mild hypokinesia in 23 regions: 26.2±10.8%, severe hypokinesia, akinesia or dyskinesia in 16 regions: 78.2±23.7, p〈0.001). These data indicate there is a significant coupling between the degree of myocardial perfusion and the myocardial functional change in coronary artery disease.
급성 관동맥증후군과 만성 안정형협심증 사이에서 보이는 전환효소와 안지오텐시노젠 유전자 다형성의 차이
이명묵(Myung Mook Lee),오명돈(Myoung Don Oh),최강원(Kang Won Choi),오병희(Byung Hee Oh),김효수(Hyo Soo Kim),김광일(Kwang Il Kim),채인호(In Ho Chae),손대원(Dae Won Sohn),박영배(Young Bae Park),최윤식(Yun Shik Choi),이영우(Young Woo Le 대한내과학회 1999 대한내과학회지 Vol.56 No.5
N/A Objectives : The renin-angiotensin system(RAS) had an important role in the pathogenesis of ischemic heart disease(IHD). Angiotensinogen(ATG), angiotensin-converting enzyme(ACE), and angiotensin II receptor are key components of RAS and reported to have polymorphisms. We studied to investigate the separate and interactive effects of ACE (I/D) and ATG (M235T) gene polymorphisms on the pathogenesis of IHD, and to compare the genetic influences between on the chronic stable angina(CSA) and on the acute coronary syndrome(ACS). Methods : We studied total 468 patients who underwent CAG. Control group comprised 159 patients who did not have a significant coronary lesion. IHD group was subgrouped according to clinical manifestation into CSA group(n=90) and ACS group(n=219). To determine the frequency of ACE and ATG genotype, polymerase chain reaction (PCR) and enzyme digestion was done. Results : 1) In ACS group, genotype frequency of ACE(II:ID:DD) was 0.27:0.48:0.25 and ATG (MM:MT:TT) was 0.31:0.59:0.10, which was significantly different from control group (ACE II:ID:DD =0.38:0.45:0.17 and ATG MM:MT:TT =0.51:0.40:0.09) (p<0.05). 2) There was no significant difference in genotype frequency of ACE, ATG gene between CSA group and control. 3) In multiple logistic regression analysis, sex, age, ATG and ACE genotype were independent risk factors for ACS. The relative risk for ACS in ACE DD compared to II genotype was 3.52 (95% CI: 1.52-8.13) and that in ACE ID compared to ACE II genotype was 1.55 (95% CI: 0.82-2.94), which showed that the risk increased with the number of ACE D-allele. In contrast, sex, age, and DM were independent risk factors for CSA, whereas ATG and ACE genotype were not. 4) In combined analysis including both ACE and ATG gene polymorphism, the relative risk for ACS associated with ATG genotype increased with the number of ACE D-allele. Conclusion : ACE and ATG gene polymorphism are associated with the development of ACS but not CSA, which suggests that ACE and ATG genes may be involved in the plaque unstabilization or thrombosis rather than the chronic progression of coronary atherosclerosis.
우리나라에서 관동맥질환을 진단하는 약물부하 심근관류 SPECT의 비효용과 성능 : 운동부하심전도와 관동맥조영술과 비교
이동수(Dong Soo Lee),강건욱(Keon Wook Kang),장명진(Myung Jin Jang),천기정(Gi Jeong Cheon),이명묵(Myoung Mook Lee),정준기(June Key Chung),이명철(Myung Chul Lee) 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.3
N/A Purpose: Cost-effectiveness of myocardial SPECT f'or the diagniosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. Materials and Methods: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (ΔQALY) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases, Cost/Δ QALY was calculated and compared between four different tactics according to pre-test probability, Results: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective, Conclusion: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system. (Korean J Nucl Med 2000;34:207-21)