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원발성 간암에 있어서의 혈청 Alkaline Phosphatase 활성치
남궁승 ( Seung Namkoong ),이용국 ( Yong Kuk Rhee ),김용태 ( Yong Tai Kim ),이원로 ( Won Ro Lee ) 대한내과학회 1970 대한내과학회지 Vol.13 No.6
A clinical study on the serum alkaline phosphatase activity in 195 cases of hepatoma, confirmed by needle biopsy in Seoul National University Hospital during a period of 12 years and 6 months from January 1955 through June 1967 was made. One hundred and fi
한국인에서 심바스타틴의 효과와 부작용 분석을 위한 다기관 공동 임상 연구
박영배 ( Young-Bae Park ),서정돈 ( Jung-Don Seo ),배종화 ( Jong-Hwa Bae ),노영무 ( Young-Moo Rho ),이원로 ( Won-Ro Lee ),손민수 ( Min Soo Son ),채성철 ( Shung-Chull Chae ),김권삼 ( Kwon-Sam Kim ),김권배 ( Kwon Bae Kim ),안정천 ( J 대한내과학회 1999 대한내과학회지 Vol.57 No.5
The aim of this study was to investigate the efficacy of simvastatin to improved lipid profiles in hypercholesterolemic Korean patients. Methods : From 25 hospitals in Korea, 478 hypercholesterolemic patients were enrolled from November 1996 to April 1998. The inclusion criteria was hypercholesterolemia over 240 mg/dl after diet therapy for 1 month or hypercholesterolemia over 220 mg/dl in patients with definite evidence of ischemic heart disease. Simvastatin 10mg was started and doubled up to 40mg if total cholesterol level remained higher than 200 mg/dl at monthly check. Of 478 subjects, 344 patients in whom study protocol was not violated were analyzed. Results : Male to female ratio was 27:73 and 47% of the subjects were in 6th decade. Hypertension, coronary artery disease, and diabetes mellitus were present in 30, 10, and 4% of the subjects. Baseline lipid profile (mean of total cholesterol-LDL-HDL-triglyceride mg/dl) was 274-185-52-188. The dose of simvastatin for 3 months was 10/10/10mg in 61% of subjects, 10/20/20mg in 21%, 10/10/20mg in 7%, and 10/20/40mg in 12%. The change of total cholesterol level(before-4wk-8wk-12wk-withdrawal 4wk) was 274-209- 205-198-250, and the maximal reduction rate was 27%. The change of LDL-cholesterol was 185-123-116-110-159, with maximal reduction rate 39%. The change of HDL-cholesterol was 52-54-56-55-54, with maximal increase rate 9%. The change of tryglyceride was 188-161- 164-162-189, with maximal reduction rate 15%. The value before/after treatment of ApoA1, ApoB, and Lp(a) was 129/129, 138/83, and 9.3/10.7, respectively. The level of LDL-cholesterol at the end of treatment was below 100mg/dl in 36% of subjects, 100-130 in 45%, 130-160 in 16%, and over 160mg/dl in 4%. The reduction rate of LDL-cholesterol was different between subjects whose LDL decreased below 100 and those whose LDL did not decrease below 130mg/dl, which suggests the existence of the individual difference of responsiveness to simvastatin. There were only 3 subjects (0.9%) who showed increase of liver enzyme over 3 times as the upper normal limit. Conclusion: Simvastatin is effective in improving lipid profiles in hypercholesterolemic Korean patients without serious side effects. (Korean. J. Med 57:906-915, 1999)
64절편 다검출기 CT 관상동맥 조영술을 이용한 관상동맥 질환 진단의 정확도
남궁준 ( June Namgung ),최현민 ( Hyun Min Choe ),권성욱 ( Sung Uk Kwon ),도준형 ( Joon Hyung Doh ),이성윤 ( Sung Yun Lee ),허감 ( Gham Hur ),이원로 ( Won Ro Lee ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1
목적: 관상동맥 질환의 진단에 있어서 현재까지 가장 정확한 방법은 고식적 관상동맥 조영술(conventional coronary angiography)이었다. 다검출기 CT (multidetector computed tomography, MDCT) 관상동맥 조영술은 1999년에 처음 등장한 이래로 빠른 기술적 진보를 보여 최근에 임상에 도입된 64절편 MDCT는 공간 및 시간해상도를 더욱 향상시켜 비관혈적으로 관상동맥 영상을 보다 정확히 규명하기에 이르렀다. 이에 본 연구에서는 64절편 MDCT를 사용하여 MDCT 관상동맥 조영술의 진단 정확도를 확인하여 기존의 관혈적 관상동맥 조영술을 대치할 수 있는지 판정하였다. 방법: 고식적 관상동맥 조영술이 예정된 101명(남자 63명, 여자 38명; 평균연령 63.7±10.5세)을 대상으로 MDCT와 고식적 관상동맥 조영술을 7일 이내에 시행하였다. 관상동맥 각 분절의 유의한 협착은 관상동맥 내경의 50% 이상 협착으로 정의하여 고식적 관상동맥 조영술의 영상과 비교하여 MDCT의 진단적 정확도를 측정하였다. 관상동맥의 유의한 협착정도를 각각 관상동맥의 분절별, 혈관별, 환자별로 구분하여 판정하였다. 결과: 총 1,440개의 관상동맥분절 중 1,348개의 분절(94%)이 MDCT로 분석 가능한 영상을 얻을 수 있었고 이중 고식적 관상동맥 조영술에서 209개의 관상동맥 분절의 유의한 협착이 있었다. MDCT의 진단정확도는 민감도, 특이도 양성예측도, 음성예측도가 분절별 평가에서 각각 96%, 97%, 85%, 99%, 혈관별 평가에서 각각 99%, 95%, 88%, 99%, 환자별 평가에서 각각 100%, 94%, 97%, 100%였다. 위양성이 37분절에서 있었고 관상동맥 석회화(26분절)가 위양성의 주요 원인이었다. 결론: 본 연구에서 64절편 MDCT 관상동맥 조영술은 높은 진단정확도를 보였다. 따라서 선택적인 환자에서 불필요한 관혈적 관상동맥 조영술의 시행을 줄이고 이를 대치할 수 있는 유용한 검사로 판단된다. Background/Aims: Invasive coronary angiography remains the gold standard in the diagnosis of coronary artery disease. However, multidetector CT (MDCT) coronary angiography is an emerging technique that is available for the non-invasive detection of coronary artery stenoses. While the diagnostic accuracy of first generation MDCT is limited, recently released 64-slice MDCT has yielded promising results due to increased temporal and spatial resolution. The objective of this study was to investigate the diagnostic accuracy of non-invasive 64-slice MDCT for coronary artery disease. Methods: One hundred one patients (63 males and 38 females; mean age, 63.7±10.5 years) undergoing conventional coronary angiography were included in this study. All coronary arteries, including the distal segments and side branches, were analyzed for the presence of significant stenosis (≥50% diameter stenosis) and compared with of the quantitative coronary angiographic findings. Results: Of the 1,440 coronary artery segments studied, 1,348 segments were assessed quantitatively by both MDCT and conventional coronary angiography (94%). Two hundred nine significant stenoses were detected by conventional coronary angiography. On a segment-based analysis, the senisitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. On a vessel-based analysis, the sensitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. The corresponding values obtained on a patient-based analysis were 100, 94, 97, and 100%, respectively. Coronary calcification was the major cause of false-positive findings. Conclusions: This study demonstrated that 64-slice MDCT coronary angiography is of similar accuracy as conventional coronary angiography for the detection of coronary artery disease. In selected groups of patients, 64-slice MDCT may replace the more invasive coronary angiography. (Korean J Med 75:42-53, 2008)