심방세동 치료의 최신지견

전국진,Chun, Kook-Jin 한국생명보험의학회 2002 保險醫學會誌 Vol.21 No.-

인간의 입체시 특성을 고려한 입체 카메라의 광축 간격 조절

형세찬(Sae-Chan Hyung),전국진(Kook-Jin Chun),하동환(Dong-Hwan Har) 한국콘텐츠학회 2011 한국콘텐츠학회논문지 Vol.11 No.5

최근 입체영상 콘텐츠를 소비하기 위한 인프라는 급속도로 구축되고 있지만, 이러한 수요를 충족시킬만한 입체영상 제작기반은 부족한 상황이다. 지금의 입체영상 제작환경에서는 기존에 평면영상을 제작하던 것과 같은 방법으로 입체영상을 제작하고 있다. 그로 인해 인간의 사지각과 카메라의 특성이 고려되지 않은 영상이 제작되고, 이것은 업체효과의 저하와 함께 영상 속 피사체의 크기가 현실과 다르게 왜곡되어 나타나는 등의 문제로 이어지고 있다. 본 논문에서는 이러한 문제를 인식하고 더 나은 입체영상 콘텐츠 제작을 위해, 입체영상 관람 시 나타나는 인간의 크기 지각 특성을 고려한 입체 카메라의 광축 간격 조절에 대하여 연구하였다. 우선, 카메라의 광축 간 거리에 따라 영상 속에 나타나는 피사체의 면적 변화와 비율 데이터를 산출하였고, 광축 간격을 변화시키며 실제 입체영상을 촬영, 관람자들을 대상으로 설문을 진행하였다. 그 결과 인간의 입체시는 인간의 두 눈간 거리인 6.5㎝를 기준으로 약60%에서 2,000% 범위인 3.9㎝에서 130㎝ 내에서는 광축 간 거리가 변화하더라도 크기 지각에 왜곡을 느끼지 않는다. 그러므로 입체영상 촬영할 때 광축 간격을 3.9㎝에서 130㎝ 내에서 유지한다면 영상 관람에도 크기 지각에 문제가 발생하지 않고 실제와 동일한 크기로 느껴지는 영상을 제작할 수 있을 것이다. Recently, the infrastructure of stereoscopy is growing fast. Though, the stereoscopy producing capacity is insufficient to meet the demand of the market. Because, at the moment most people who produce the stereoscopy are skilled for the two-dimensional images. So the characteristics of the human stereopsis and stereoscopic cameras are not well considered, it occurs many problems to the viewer. According to this, we studied about the optical axis distance adjustment of stereoscopic camera considering size perception in human stereopsis. First, we measured the area of the object in the image which depends on the optical axis distance. Second, based on the output of first experiment, we conducted a survey and figured out that if we keep the optical axis distance between 3.9㎝ to 130㎝, it wouldn’t occur any size perception and will be possible to produce high quality stereoscopy.

연속파형 Doppler 법에 의한 폐동맥압의 비관혈적 계측

차광수(Kwang Soo Cha),전국진(Kook Jin Chun),신지애(Ji Ae Shin),이동일(Dong Il Lee),이정유(Jung Yoo Lee),이종수(Jong Soo Lee),신영우(Yung Woo Shin),신영기(Yeong Kee Shin),양만석(Man Seok Yang),권형각(Hyong Gak Kwon) 대한내과학회 1991 대한내과학회지 Vol.41 No.5

N/A In order to assess the possibility of noninvasive estimation of pulmonary artery pressure by Doppler echocardiography, pulmonary artery pressures estimated by continuous wave Doppler echocardiography were compared with those measured by cardiac cath-eterization in 10 patients with tricuspid and pulmonary regurgitation. Doppler-determined pressure gradients were estimated from the tricuspid and pulmonary regurgitant flow velocity(V) by means of the simplified Bernoulli equation(ΔP =4v²). The results were as follows: Pressure gradients (PGs) between right ventricle and right atrium at systole measured by Doppler method and catheterization were 58.05±11.67, 59.12±13.78 mmHg, respectively, and correlated well with each other (r=0.95, p<0.01). As for pulmonary arterial systolic pressure (PASP), PGs added by assumed (5 mmHg) right atrial pressure (RAP) and by actual RAP, and catheter-measured PASP were 63.05±11.67, 63.93±11.59, 66.30±12.26mmHg, respectively, and PGs added by assumed RAP and by actual RAP correlated well with catheter-measured PASP, respectively (r=0.97, p<0.01; r=0.98, p<0.01). The PGs between pulmonary artery and right ventricle at end-diastole measured by Doppler method and catheterization were 20.48±4.35, 20.90±4.87, respectively, and correlated well with each other (r=0.97, p<0.01). As for pulmonary arterial diastolic pressure (PADP), the PGs added by assumed (5 mmHg) right ventricular end-diastolic pressure (RVEDP) and by actual RVEDP, and catheter-measured PADP were 25. 48±4.35, 26.38±4.04, 26.80±4.40mmHg, respectively, and PGs added by assumed RVEDP and by actual RVEDP correlated well with catheter-measured PADP, respectively (r=0.96, p<0.01; r=0.96, p<0.01). Doppler-determined PG between the pulmonary artery and right ventricle at early diastole and catheter-measured mean pulmonary arterial pressure were 37.30±6.31, 40.30±5.53mmHg, and correlated well with each other (r=0.81, p<0.01). In conclusion, pulmonary arterial systolic, diastolic pressure and mean pulmonary arterial pressure could be well predicted noninvasively by continuous wave Doppler echocardiography in patients with tricuspid and pulmonary regurgitation,

울혈성 심부전 환자의 치료 경과중 혈청 마그네슘의 동태에 관한 고찰

임종훈(Jong Hoon Lim),전국진(Kook Jin Chun),정준훈(Joon Hoon Jeong),김병진(Byung Jin Kim),오현명(Hyun Myung Oah),박용현(Yong Hyun Park),박융인(Yong Hyun Park),홍택종(Taek Jong Hong),신영우(Yung Woo Shin) 대한내과학회 1997 대한내과학회지 Vol.53 No.6

N/A Objectives: There are many interesting reports suggesting that magnesium(Mg) deficiency is deleterious in patients with congestive heart failure (CHF). It is paradoxical that the most important cause of Mg deficiency in these persons is maybe use of therapeutics including diuretics. Authors investigated the trend of serum and 24 hour urine Mg with other relating electrolytes in Mg homeostasis prospectively, in the management of CHF. And we assessd the effects of medications and many variables in .CHF on serum Mg, and the usefulness of serum Mg representing the body content. Methods: Fifty three patients who were diagnosed as CHF by clinical finding and echocardiogaphy were prescribed conventional doses of diuretics as furosemide 40mg and spironolactone 50mg daily, with or without angiotensin converting enzyme(ACE) inhibitor and digitalis. And then, serial serum and 24 hour urine Mg, sodium, potassium and calcium were obtained at admission, 2nd day, 5th day, and discharge. Results: The patients group with chronic CHF, which was defined as long-term use of diuretics over 6 months, showed higher prevalence of low level of serum Mg concentration than the group with acute one(11 of 28, 39% vs. 2 of 25. 8%, P< 0.01). Of those two groups, the latter showed upward trend of serum Mg from admission to discharge, but the former showed no change. In 24 hour urine Mg excretion, the amount of the patients with CHF was larger than that of control group. In the chronic CHF group, the effect of digitalis on decreasing serum Mg was evident. Serum Mg of acute CHF group correlated with serum BUN(r=0.5609). Whereas, that of chronic group with ejection fraction(r= ?0.4742) and plasma renin activity(r= ? 0.3791), with serum potassium(r=0.4673) and creatinine(0.5846). Serum Mg may be useful indicator of Mg homeostasis, especially in chronic CHF patients. Conclusion: Because patients with chronic CHF were prone to deficiency of Mg in the management, maintaining the adequate serum Mg through long- term replacement seems very important in decreasing the morbidity and mortality of these persons.

증례 : Angio-seal(R) 사용 후 발생한 가성 동맥류를 초음파 유도하 트롬빈 주입으로 치료한 1예

황기원 ( Ki Won Hwang ),전국진 ( Kook Jin Chun ),안성규 ( Sung Gyu An ),김경엽 ( Kyung Yup Kim ),김창원 ( Chang Won Kim ),홍택종 ( Taek Jong Hong ),신영우 ( Young Woo Shin ) 대한내과학회 2007 대한내과학회지 Vol.72 No.1S

증례 : 연하 유발성 심방세동 1예

이현국 ( Hyeon Gook Lee ),전국진 ( Kook Jin Chun ),이동완 ( Dong Wan Lee ),이혜정 ( Hye Jeong Lee ),김준홍 ( June Hong Kim ),홍택종 ( Taek Jong Hong ),신영우 ( Yung Woo Shin ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-

저자들은 식사시작과 함께 심계항진을 주소로 내원한 63세 여자 환자에서 국내에서 아직 보고된 바 없는 연하 유발성 심방세동을 진단하였고, 약물치료로 호전되었기에 문헌고찰과 함께 보고하는 바이다. Deglutition tachyarrhythmias are rare. We report a case of atrial fibrillation triggered by swallowing. A 63 year old female presented to our hospital with a 20 day history of paroxysmal palpitations lasting approximately 5 to 10 seconds in duration and precipitated by ingestion of solids but not liquids. Cardiovascular examination, chest radiography, Echocardiography, upper GI endoscopy and thyroid function tests were normal and 24 hour ambulatory monitoring showed sinus rhythm except for numerous episodes of atrial fibrillation with rates of 150 to 200 beats/minute during meals. Most episodes spontaneously reverted to sinus rhythm within few minutes. The patient`s exercise tolerance was good with the achievement of 96% of the age predicted maximum heart rate. Her symptoms were controlled by verapamil. She is currently symptom-free with regular doses of verapamil under clinical follow-up. (Korean J Med 69:S818-S823, 2005)

정상 관상동맥조영술시 cardiac troponin 1 상승의 원인

배우형 ( Woo Hyung Bae ),전국진 ( Kook Jin Chun ),오준혁 ( Jun Hyok Oh ),이동원 ( Dong Won Lee ),안병재 ( Byung Jae Ahn ),김성호 ( Seong Ho Kim ),이준상 ( Joon Sang Lee ),김무영 ( Moo Young Kim ),이현국 ( Hyeon Gook Lee ),고우석 ( 대한내과학회 2005 대한내과학회지 Vol.69 No.5

목적 : Cardiac troponin I (cTnI)는 심근 조직에 절대적으로 높은 예민도와 특이도를 보인다. 그러나 심근 손상을 의미하는 cTnI 증가가 항상 관상동맥질환으로 인한 심근경색이나 허혈을 의미한다고 볼 수는 없다. 이에 저자들은 cTnI가 증가되어 있으면서, 관상동맥조영술에서 정상이거나 미소병변을 보이는 경우 그 유발 원인을 알아보고자 하였다. 방법 : 2002년 3월부터 2004년 2월까지 부산대학교병원을 내원한, cTnI가 상승하였으나 관상동맥조영술에서 정상소견 또는 복잡 병변이나 혈전이 관찰되지 않고 50% 미만의 협착소견인 미소병변을 보이는 33명의 환자들을 대상으로 후향적 추적조사를 시행하였다. 결과 : 유발 원인으로는 중증 심부전이 7명, 변이형 협심증이 7명, 심근염이 5명이었다. 빈맥이 유발 원인인 경우가 4명이었는데, 각각 동성 빈맥, 상심실성 빈맥, 발작성 심방세동 그리고 지속성 심실빈맥이었으며, 이들 중 2명에서 혈역학적 장애를 보였다. 그 외에 심외막염이 1명, 중증 심근교가 1명, 횡문근융해증이 1명 그리고 뇌경색이 1명이었다. 대상 환자들을 42±34주 동안 추적관찰 하였는데, 급성 심근경색증이 발생한 경우는 없었다. 결론 : cTnI가 심근손상의 매우 예민하고 특이적인 지표이지만, cTnI 상승은 심근경색이나 허혈 이외의 다른 원인에 의해 일어날 수 있고, 관상동맥조영술에서 특이소견 없이 발생할 수 있으므로 이에 대한 고려가 필요하리라 사료된다. Background : Cardiac troponin I (cTnI) is most recently described and has nearly absolute myocardial tissue specificity, as well as high sensitivity. But an increased value for cTnI that indicates myocardial injury is not always synonym of myocardial infarction or ischemia due to coronary artery disease. Methods : Retrospective follow-up study for whom underwent coronary angiography for suspected coronary artery disease was done if they had an elevated cTnI value and angiographically normal or minimal disease. Results : 33 patients were qualified. Cut-off value for elevated cTnI was 0.06ng/mL. Increased cTnI values were attributed to severe congestive heart failure in 7 patients, variant angina in 7 patients, myocarditis in 5 patients, pericarditis in 1 patient, severe myocardial bridge in 1 patient, rhabdomyolysis in 1 patient and cerebral infarction in 1 patient. Tachycardia was precipitating cause in 4 patients (sinus tachycardia, paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation and sustained ventricular tachycardia for each), two of whom had hemodynamic compromise. 2 of 33 patients had no identifiable cause for a rise in cTnI value. There was no acute myocardial infarction at 42±34 weeks follow-up. Conclusions : Although cTnI is a sensitive and specific marker of myocardial injury, an elevation of cTnI value may have a cause other than myocardial infarction or ischemia and may occur without significant angiographic coronary artery disease.(Korean J Med 69:487-492, 2005)

심부전 환자의 이뇨제 사용, 증상의 중증도 및 신체활동능력과 영양소 섭취 상태와의 관련성

장준희(Jun Hee Jang),이해정(Haejung Lee),박영주(Youngjoo Park),전국진(Kook Jin Chun),김종현(Jong Hyun Kim) 대한지역사회영양학회 2016 대한지역사회영양학회지 Vol.21 No.2

임상화보 : 심내막염에 합병된 상장간막동맥 진균성동맥류

신선혜(Sun Hye Shin),이선희(Sun Hee Lee),전국진(Kook Jin Chun),김창원(Chang Won Kim) 대한내과학회 2002 대한내과학회지 Vol.63 No.3

심부전 환자의 우울 수준에 따른 자가간호행위

이해정(Lee, Haejung),장준희(Jang, Jun Hee),이성화(Lee, Sung Hwa),전국진(Chun, Kook Jin),김종현(Kim, Jong Hyun) 기본간호학회 2015 기본간호학회지 Vol.22 No.1

Purpose: The purpose of this study was to examine levels of self-care behavior according to levels of depression among patients with heart failure (HF). Methods: Participants in this descriptive research were 169 outpatients with HF who being seen in three university hospitals and one general hospital located in B, Y, and D cities. Data were collected using the Korean version of the Center for Epidemiologic Depression Scale and European Heart Failure Self-care Behavior Scale. Data collection period was from April 25, 2012 to September 26, 2013. Data were analyzed using Chi-square tests and ANOVAs with SPSS WIN 21.0. Results: A higher proportion of patients who were female, without a spouse, with lower household income, not employed, and having lower functional status with serious symptoms of HF tended to be clinically depressed. HF patients with depression tended not to report symptom changes to their health care providers. Conclusion: The findings of this study indicate the need to screen for depression in patients with HF and to develop strategies to improve self-care behaviors in these patients in order to promote reporting of symptom changes to health care providers.