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Isoproterenol 정주에 의한 심박수의 변화가 고혈압 환자의 대동맥 경직도에 미치는 영향
이무용 ( Moo Yong Rhee ),권나영 ( Na Young Kwon ),김재덕 ( Jae Deok Kim ),송승호 ( Seung Ho Song ),윤영원 ( Young Won Yoon ),이명용 ( Myoung Yong Lee ),김영권 ( Young Kwon Kim ) 대한내과학회 2003 대한내과학회지 Vol.64 No.1
목적 : 고혈압 환자에서 대동맥 경직도의 증가는 심혈관 질환의 위험도를 반영하는 독립적인 위험인자로, 혈압의 상승이나 교감신경계의 항진은 대동맥의 경직도를 증가시킨다. 그러나 인공심박기에 의한 심박수의 상승은 대동맥의 경직도를 증가시키지 않는 것이 보고되고 있다. 본 연구에서는 고혈압 환자에서 교감신경계 흥분제인 isoproterenol을 투여하여 심박수를 상승시켰을 때 대동맥 경직도의 변화를 연구하였다. 방법 : 고혈압 환자를 대상으로 하였으며, 연구 Background : Increased aortic stiffness (AS) is an independent risk factor of cardiovascular disease in patients with hypertension. Elevation of blood pressure (BP) or sympathetic tone increases AS. It was reported that acute changes in heart rate by arti
김현주,노상철,권호장,백기청,이무용,정재윤,임명호,구미진,김창훈,김혜영,임정훈,김동현,Kim, Hyun-Joo,Roh, Sang-Chul,Kwon, Ho-Jang,Paik, Ki-Chung,Rhee, Moo-Yong,Jeong, Jae-Yun,Lim, Myung-Ho,Koo, Mi-Jin,Kim, Chang-Hoon,Kim, Hae-Young,Lim, Je 대한예방의학회 2008 예방의학회지 Vol.41 No.5
Objectives : We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. Methods : The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. Results : The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% Cl) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% Cl 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% Cl 2.14-11.64) for those highly exposed to fighter noise. Conclusions : The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed people's health.
최락경(Rak Kyeong Choi),이무용(Moo Yong Rhee),전원호(Won Ho Jeon),김인수(In Su Kim),김석연(Seog Yeon Kim),전용덕(Yong Deog Jeon),이홍순(Hong Soon Lee),유수웅(Soo Woong Yoo),이학중(Hak Choong Lee) 대한내과학회 1995 대한내과학회지 Vol.49 No.5
N/A Objectives: The exercise test is commonly used in conjunction with baseline clinical information to estimate the likelihood that a patient has significant coronary diseases. The purpose of this study was to determine if patterns of ST depression or elevation during exercise testing provide reliable information about the location of an underlying coronary lesion. Methods: We reviewed 49patients out of 137patients who performed treadmill test and coronary angiography at National Medical Center from January, 1984 through August, 1993. All the patients underwent modified Bruce protocol treadmill exercise test and coronary angiography. Exercise ST changes were classified as depression or elevation by lead groups involved(V1-V3, V4-6, I AVL, II III AVF), Coronary angiography was done in several oblique projections and results were reviewed by at least two senior angiographers. Results: 1) There were significant stenosis in coronary angiography in 22cases(70.9%) among positive 31cases, 0cases(0%) among borderline positive 4cases, 5cases(10.2%) among negative 49cases. 11cases(47.8%) among nondiagnostic 23cases, and 3cases(25%) among pseudonormalization 12cases in exercise treadmill tests. 2) The sensitivity of treadmill exercise electrocardiography was 61.2%, and specificity was 81.8%. The sensitivity of each coronary artery diseases was 6l.7% in Left anterior descending artery disease, 66.6% in Right coronary artery disease, 38.5% in Left circumflex artery disease, 100% in 2-vessel disease, and 100% in 3-vessel disease. 3) ST depression was not useful in predicting the site of coronary artery narrowing. In contrast, ST elevation was correlated with coronary artery disease. 4) ST depression was most often seen in leads V4-V6 and leads II III AVF without correlation between the diseased coronary artery and the leads in which ST depression occurred. Conclusion: The exercise treadmill induced depression of the ST segment is an significant sign for predicting the presence of coronary artery disease and for the decision to perform coronary angiography. But, site of ST depression during exercise is not a good predictor of anatomic site of coronary artery disease. The other noninvasive test and coronary angiography may be necessary to nondiagnostic group which revealed insufficient exercise load or target heart rate during exercise test because the presence of coronary artery disease can't be ruled out.
Oscillometric Method를 이용한 맥파속도 측정: Tonometric Method와의 비교
김영권 ( Young Kwon Kim ),이명용 ( Myoung Yong Lee ),이무용 ( Moo Yong Rhee ) 대한내과학회 2004 대한내과학회지 Vol.67 No.6
목적 : PWV로 측정한 대동맥의 경직도는 심혈관 질환의 독립된 위험 예측인자이다. 통상적으로 PWV는 경동맥과 대퇴동맥에서 tonometric method로 측정한다. 최근 사지에서 oscillometric method로 PWV를 간편하게 측정하는 기구가 이용되게 되었다. 저자들은 hcPWV, hfPWV, baPWV 측정의 재현성을 알아보고, 각 PWV 사이의 관계, 심혈관계 위험 인자 및 관동맥질환과의 관계를 평가하고자 하였다. 방법 : 30~70대 Background : We compared brachial-ankle pulse wave velocity (baPWV) measured by a simple oscillometric method with heart-carotid (hc) and heart-femoral (hf) PWVs measured by a conventional tonometic method. Methods : Using an automatic waveform analyzer,
김인수(In Soo Kim),문석준(Seok Jun Moon),박현진(Hyun Jin Park),김동조(Dong Jo Kim),손행종(Haeng Jong Sohn),이무용(Moo Yong Rhee),박건욱(Keon Uk Park),최락경(Rak Kyeong Choi),유병희(Byung Hee Yu),문성수(Seong Soo Moon) 대한내과학회 1996 대한내과학회지 Vol.50 No.4
N/A Objectives: The construction and maintenance of vascular access are essential in patients with end stage renal disease(ESRD) on chronic hemodialysis. So, the complications of vascular access are significant causes of morbidity and inadequacy of hemodialysis. The current study was undertaken to provide an estimate of the magnitude of the problem of access-related morbidity and to explore the relationship of sex, age, and underlying cause of renal failure as risk factors for vascular complications. Methods: We observed vascular access-related hospitalization, access complications, and sex, age, and underlying cause of renal failure as risk factors on 167 ESRD patients who have received maintenance hemodialysis between January 1983 and June 1993 at the National Medical Center. A univariate survival analysis of time to vascular access-related hospitalization was carried out for each of the risk factors under study, that is, sex, age, and underlying cause of renal failure. Kaplan-Meier survival curves were generated for categorized levels of each variable and compared using the log rank test. Results: 1) The vascular access-related hospitalization occupied 16.5% of all hospital stays and the mean length of hospital stays was 12.4 days. 2) The thrombosis occurred in 82.8% of all access complications. The formation of new vascular access was performed in 69.0% of vascular access-related morbidity. 3) The cumulative 1 year, 2 year, 3 year, 5 year, and 10 year survival rates of vascular access were 89.2%, 83.8%, 75.5%, 67.2%, and 53.2%, respectively, The cumulative survival rate of vascular access in women was lower significantly than in men. It was also lower significantly in diabetics than in other diseases including glomerulonephritis. But, age was not statistically correlated with vascular access survival. Conclusion: The complications of vascular access cause increase in hospitalization among ESRD patients, and women and diabetics apperar to be at particularly high risk. Additional studies on the risk factors for vascular access morbidity are needed to manage vascular access more carefully in ESRD patients on chronic hemodialysis.
물-공기 횡류시 U 자형 튜브 다발에서의 유체탄성불안정
주인철(In-Cheol Chu),정흥준(Heung June Chung),이창희(Chang Hee Lee),윤영중(Young Jung Yun),정한섭(Han-Sub Chung),변형현(Hyung Hyun Byun),김무용(Moo Yong Kim),문효익(Hyo Ik Moon),이희남(Hui Nam Rhee) 대한기계학회 2006 대한기계학회 춘추학술대회 Vol.2006 No.11
In the present study, a series of experiments have been performed to investigate a fluid-elastic instability of an U-tube bundle in air-water two-phase cross-flow. A total of 39 prototypic U-bend tubes are arranged in a rotated square array with a p/d of 1.633, which is identical to U-bend tube bundle of OPR1000 steam generators. The present experimental facility has 2-span U-tubes in contrast to 9-span U-tubes of OPR1000 steam generators. However, modal analysis shows that the major vibration mode and corresponding natural frequencies are almost same to the full 9-span U-tubes. A total of 12 3-axis acceleromters are installed inside U-tubes to monitor a precise vibration motions. The following parameters were obtained throughout a series of experiments: tube vibration responses and critical velocity for fluid-elastic instability, two-phase damping ratio, hydrodynamic mass. Finally, the instability factor (K) of Connors’ relation was evaluated based on the above measured parameters.
간경변증 환자에서 24 시간 심박동수변이를 이용한 자율신경 장애 측정
김철우(Chul Woo Kim),권재구(Jae Goo Kwon),채민수(Min Su Chae),안혜숙(Hye Sook Ahn),조영중(Young Jung Cho),이창원(Chang Won Lee),장덕환(Duk Whan Jang),이무용(Moo Yong Rhee),김학산(Hak San Kim),이홍순(Hong Soon Lee),유수웅(Soo Woong Yo 대한내과학회 1997 대한내과학회지 Vol.53 No.3
N/A Objective: Heart rate variability(HRV) is helpful to diagnosis autonomic disturbance and sympathetic-parasympathetic imbalance in patients with myocardial infarction and diabetes mellitus. Patients with liver cirrhosis demonstrate reduced blood pressure despite increased heart rate and increased cardiac output, indicating a fall in peripheral vascular resistance. Autonomic disturbance may contribute to this phenomenon. The aim of the present study is to evaluate the degree of autonomic disturbance and the circadian rhythm of autonomic nervous system by estimating HRV with 24 hour-Holter recorder, Methods : 24 hour-HRV with Del Mar Avionics 563 Holter recorder and cardiovascular reflex tests were carried out on 32 patients with liver cirrhosis and 20 control subjects. We evaluated the presence of autonomic disturbance, and assessed quantitatively the autonomic disturbance. Results: 1) Among cardiovascular reflex tests, Valsalva test, standing test and deep breathing test were showed a significantly decreased response in liver cirrhosis compared with control groups. 2) The standard deviation of 24hours average R-R intervals were showed a significantly decrease in liver cirrhosis than control groups(P<0.0001). The HRV of low frequency(LF. P<.D.001), high frequency(HF, P<0.0001) and total power spectral density (P<0.0001) in liver cirrhosis were statistically lower than control. 3) The LF/HF ratio of patients with liver cirrhosis was showed higher than control at night Conclusion: Non-invasive assessment of 24 hour-HRV has a few advantages in the diagnosis and degree of autonomic disturbance, evaluation of diurnal variation of autonomic tone.
이창원(Chang Won Lee),장덕환(Duk Whan Jang),백인석(In Seok Baek),김장원(Jang Won Kim),배순철(Soon Chul Bae),김철우(Cheol Woo Kim),권재구(Jae Koo Kweon),최락경(Rak Kyeong Choi),이무용(Moo Yong Rhee),이홍순(Hong Soon Lee),유수웅(Soo Wo 대한내과학회 1997 대한내과학회지 Vol.52 No.4
N/A Objectives: Signal-averaged electrocardiography (SAECG) has been found to be a useful noninvasive technique for identifying patients at risk for life-threatening ventricular tachycardia. Delayed and fragmented activation of abnormal myocardial tissues causes the occurrence of high frequency low amplitude (HFLA) electocardiographic signals or late potentials. Generally, there are two methods in analyzing signal-averaged electrocardiography. Late potentials in the time domain analysis do not provide sufficient diagnostic power with regard to life-threatening Ventricular tachycardia. Buckingham et al. (1989) reported a time-domain sensitivity of 62%, a specificity of 75%. Spectral turbulence analysis (STA) of the signal-averaged ECG is the most recent frequency domain technique to improve the time domain sensitivity and specificity. So, We designed the study to compare the efficacy of Time Domain Analysis and Spectral Turbulence Analysis among five groups (Normal control, QRS widening, Postmyocardial infarction, Frequent VPC's with group beats, Nonsustained ventricular tachycardia). Methods: 88 patients were selected from the patients who had been admitted between January 1994 and October l994, at National Medical Center. Patients were divided into five groups, which were respectively, Group A: Normal control group (n=33), Group B: QRS widening group (n=14), Group C: Postmyocardial infarction group (n=10), Group D: Frequent VPC's with group beats (n=22), Group E: Nonsustained VT group (n=9). We compared Spectral Turbulence Analysis and Time Domain Analysis of Signal-Averaged Electrocardiogram by 24 hours-Holter monitoring. Results: 1) In normal control group(Group A), 9.1%(3 patients) were positive by Time Domain Analysis, but, all were negative by Spectral Turbulence An- alysis. 2) In QRS widening group (Group B), 71.4%(10 patients) were positive by Time Domain Analysis, but, all were negative by Spectral Turbulence Analysis. 3) In postmyocardial infarction group (Group C), 309o were positive by Time Domain Analysis, and 10% were positive by Spectral Turbulence Analysis. 4) In frequent VPC's group (Group D), 22.7% (5 patients) were positive by Time Domain Analysis, and, 4.5%(1 patient) was positive by Spectral Tur-bulence Analysis. 5) In Nonsustained VT group (Group E), 33.3% (3 patients) were positive by Time Domain Analysis, and 11.1% (1 patient) was positive by Spectral Turbulence Analysis. Conclusions: In Time Domain Analysis, abnormal results were presented at Group R (QRS widening group) by 71.4%, which was markedly higher than other groups. But, in Spectral Turbulence Analysis, abnormal results were not presented at Group A and Group B. In Group A and Group B, Spectral Turbulence Analysis shows less false positive results than Time Domain Analysis.