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채인호,윤창환,박진주,오일영,서정원,조영석,연태진,최동주 대한의학회 2017 Journal of Korean medical science Vol.32 No.6
The combined use of a drug-eluting balloon (DEB) and a bare metal stent (BMS) for the treatment of de novo non-small vessel coronary artery diseases (CAD) remains to be evaluated. We investigated the efficacy of a sequential treatment using a DEB together with a BMS implantation in comparison to a zotarolimus-eluting stent (ZES). This study was a prospective, randomized, open-label study. We designed it to demonstrate the non-inferiority of a sequential treatment using a DEB first followed by a BMS (DEB + BMS) compared with the use of a ZES. The primary endpoint was in-segment late loss (LL) at 9 months measured by quantitative coronary angiography (QCA). A total of 180 patients were enrolled in the study. The 9-month follow-up angiography was performed in 72 patients with DEB + BMS and 74 patients with ZES. When comparing the DEB + BMS results with the ZES ones, LL was 0.50 ± 0.46 mm in DEB + BMS patients vs. 0.21 ± 0.44 mm in ZES patients (P < 0.001). The mean difference of the LL was 0.31 mm, which was larger than the prespecified non-inferiority margin of 0.19 mm, and the 2-sided 95% confidence interval was 0.15–0.48. The clinical outcomes were not significantly different. In conclusion, the DEB + BMS strategy is inferior to the ZES one in terms of the LL result at 9 months. The DEB strategy for de novo coronary artery lesions needs to be improved for it to become an alternative treatment option. This was a clinical trial study and was registered at www.ClinicalTrials.gov (Identifier: NCT01539603; http://www.clinicaltrials.gov/ct2/show/NCT01539603).
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채인호(In Ho Chai),한규록(Kyoo Rok Han),고경수(Kyung Soo Ko),류오열(O Yeol Ryoo),신원석(Won Sock Shin),조명찬(Myung Chan Cho),김철호(Cheol Ho Kim),이명묵(Myoung Mook Lee),최윤식(Yun Shik Choi),서정돈(Jung Don Seo) 대한내과학회 1991 대한내과학회지 Vol.41 No.6
To evaluate the survival and embolic events of idiopathic dilated cardiomyopathy (IDCMP), we followed up 80 patients diagnosed as IDCMP between 1984 and 1989 on the basis of clinical findings and echocardiography. We analyzed the clinical parameters, echocardiographic findings, and outcome. The following results were obtained: 1) Eighty patients, 58 male and 22 female (male: female = 2.6:1), with a mean age of 54±12 years (18 to 79 years) were included in this study. They were followed up for a mean of 30±26 months (ranging from 1 to 111 months). 2) By Kaplan-Meier method, the survival rates for 1, 2, and 5 years were 72%, 65%, and 58%, respectively. During the follow-up period, 27 patients died, and 24 of them (89%) died within 2 years of initial diagnosis. The causes of death were aggravation of congestive heart failure (22 cases, 81% of total deaths), sudden death (4 cases, 15%), and cerebrovascular disease (1 case, 4%). 3) There were significant differences (p<0.05) between the survivors and those who died in left ventricular end systolic dimension (34.7±6. 2 vs 38.8±6.5 mm/m), left ventriclar end diastolic dimension (41.2±616 vs 45.2±7.2 mm/m²), and ejection fraction (39.2±8.4 vs 34.1±7.6%), but age, sex, presence of embolism, clinical features, and electrocardiographic findings did not seem to influence the prognosis. 4) Cerebral embolism was found in 17 patients (21.3%), but including atrial fibrillation, there were no clinical variables predicting embolic events. Our data showed that 1) patients with idiopathic dilated cardiomyopathy had poor prognosis, 2) enlarged left ventricular end systolic dimension and end diastolic dimension, and decreased ejection fraction could be regarded as poor prognostic factors, 3) but there were no significant predictive factors for embolism.
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