Impact of Chronic Kidney Disease in Patients Undergoing Percutaneous Coronary Intervention: Improved but Not Solved

Jae Kean Ryu,In Hee Lee 대한심장학회 2017 Korean Circulation Journal Vol.47 No.2

심리적 요인이 관상동맥질환에 미치는 영향과 치료적 의의

류재근,이양현 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Although the importance of psychological factors In the development and expression of coronary artery disease(CAD) has been debated, an extensive recent studies provide clear and convincing evidence that psychological factors contributed significantly to the pathogenesis and course of coronary artery disease. The relationship between psychosocial factors and CAD are reviewed on the basis of epidemiology and pathophysiological mechanism with emphasis on the following factors : 1) depression, 2) anxiety, 3) Personality traits, 4) social isolation and lack of social support, 5) chronic and acute life stress. Suggestions to improve the integrations of psychosocial interventions into clinical practice are also described.

파국성 원발성 항인지질 증후군 1예

김재훈,김용진,김창수,최정윤,오동호,김상경,김호각,도준형,현대성,류재근,최병렬 대한내과학회 1999 대한내과학회지 Vol.56 No.2

Catastrophic antiphospholipid syndrome is a rare clinical syndrome characterized by acute multi-organ failure occurring in patients with antiphospholipid antibodies. It is associated with involvement of several end-organs particularly kidneys, lungs, gastrointestinal tracts and adrenal glands and presents catastrophic clinical pictures such as acute renal failure with thrombotic microangiopathy, myocardial failure, adult respiratory distress syndrome, convulsion and disseminated intravascular coagulation. Conventional treatments(e.g. intravenous heparin, steroid, immunosuppressants) were not effective, while plasmapheresis seems to be a useful therapy. We experienced a case of catastrophic primary antiphospholipid syndrome in 41-year-old woman proved by renal biopsy and immuno-serological tests. She developed acute renal failure, multiple esophageal and oral ulcers, adult respiratory distress syndrome, abnormal elevation of hepatic and pancreatic enzymes and signs of disseminated intravascular coagulation. Evidences of any other connective tissue diseases were not found. Renal biopsy revealed features of thrombotic microangiopathic nephropathy and serum antiphospholipid antibody level was elevated(34GPL). In spite of steroid, cyclophosphamide and supportive therapies, her respiratory distress was not improved.

Apnea-hypopnea Index is Correlated with Pulse Rate in Patients with Sleep-related Breathing Disorder without Hypertension, Cardiovascular Disease, or Diabetes Mellitus

Jeonggeun Moon,Jae Hyoung Park,Seo-Eun Cho,Kwang-Pil Ko,Seung-Heon Shin,Ji-Eun Kim,Jae-Kean Ryu,Seung-Gul Kang 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.3

Objective: This study aimed to compare the mean pulse rate (PR) and mean blood pressure (BP) between patients with obstructive sleep apnea (OSA) and those with simple snoring (SS) during a 24-hour period, and to investigate the correlation between apnea-hypopnea index (AHI), PR, and BP in sleep-related breathing disorder (SRBD) patients with and without hypertension, diabetes mellitus (DM), and cardiovascular diseases (CVDs). Methods: Ninety SRBD patients underwent full-night polysomnography, and ambulatory BP and PR were monitored for 24 hours. Participants were classified into OSA (AHI ≥ 5) and control (SS) (AHI < 5) groups, and BP and PR were compared. Participants were also divided into groups with and without hypertension, CVDs, or DM to analyze the correlation between AHI, BP, and PR in each group. Results: Mean PRs during the daytime period and during the whole 24-hour period in the OSA group were significantly higher than those in the SS group after controlling for potential confounders. No significant difference was observed in mean BP between the groups. Partial correlation analysis after controlling for confounders showed significant correlation between AHI and PR during daytime and the 24-hour period in participants without hypertension, DM, or CVDs, but not in participants with these conditions. Conclusion: The significant differences and correlations only in PR (not in BP) found in this study suggest that PR could be an early marker for SRBD in individuals without comorbidities, and that an increased sympathetic tone could be responsible for future occurrence of CVD.

^99mTc-세스타미비 심근관류스캔상 역재분포형부위의 임상적 특성

정병천,류재근,조용근,곽동훈,배호상,배용학,채성철 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.5

정상 남성에서 음주 및 흡연과 혈청 총 콜레스테롤치와의 관계

정의룡(Eui Ryong Cheong),류재근(Jae Kean Ryu),전상중(Sang Joon Jun),채성철(Shung Chull Chae),전재은(Jae Eun Jun),박의현(Wee Hyun Park) 대한내과학회 1996 대한내과학회지 Vol.50 No.4

N/A Objectives : We conducted our study to establish the mean values of total serum cholesterol in healthy Korean male adults and find out the relationship between the cholesterol levels and life styles(eg. smoking and drinking habits). Methods: Eight hundred seventy-nine men involved in a health screening program in May, 1992, in Kyungpook University Hospital, were studied. The total cholesterol levels are determined by enzymatic method. And the life styles of the study groups were examined by answering written questionnaires. Results: The mean value of total cholesterol 189.6±30.6 mg/dl. The total cholesterol levels are higher in the age groups of fourth and fifth decades than in the age groups of second and third decades. The cholesterol levels show the tendency to increase according to age. The cholesterol levels are 189.8±30.7 mg/dl in smokers and 189.0±30.6 mg/dl in nonsmokers. They are not statistically different in either group. But heavy smokers who smoke more than 20 cigarettes per day have higher total cholesterol values than non-smokers. The cholesterol levels are 19431.0 mg/dl in heavy drinkers who drink alcoholic beverages 3-4 times per week and 187.2±31.7 mg/dl in non-drinkers. The group who are both heavy smoker and drinker have significantly higher cholesterol levels than in the group who do not smoke and drink alcoholic beverage. The cholesterol levels in the former and in the latter group are !?0629.0 mg/dl and 18331.2 mg/dl, respectively. Conclusion : The total cholesterol values somewhat related to the age and the life styles such as smoking and alcohol consumption. Generally speaking, the more increased levels of total cholesterol is shown when the person is getting older, the amounts of cigarettes smoked are increased and the frequencies of alcoholic drinks are increased.

S-293 Effect of atrovastatin in endothelial function according to dosage

( Jung Won Park ),( Seung Pyo Hong ),( Young Soo Lee ),( Jin Bae Lee ),( Jae Kean Ryu ),( Ji Yong Choi ),( Kee Sik Kim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Purpose: The aim of this study was to evaluate the effect on endothelial function of statin according to dosage. Methods: We enrolled the 100 patients with hypercholesterolemia between 2014 and 2015. The patients were randomly divided as two groups according to dosage of atorvastatin; 20mg (n= 50, mean age:61years) and 40mg (n= 50, mean age:60years). We measured the aortic pulse wave velocity (PWV) as index of arterial stiffness, intima-media thickness (IMT) of both common carotid artery and laboratory test including of lipid profile, liver profile, renal profile and serum high sensitivity C-reactive protein (hs-CRP) at baseline and 1 year after medication of statin (1year±2 month). Results: The total cholesterol, LDL and CRP level in both groups was significantly decreased 1 year later. However, fasting blood glucose (FBS) and ALT in both groups was significantly increased 1 year later. The IMT in both groups was significantly decreased after 1 year. The PWV in 40mg group was significantly decreased, but not 20mg. In multi-variated analysis, the dosage of atorvastatin was independent associated with PWV. Conclusions: These results suggest that the moderate to high dose of atorvastatin might be more effective in the endothelial function.

ACE 길항제의 장기복용에 따른 기침의 발생빈도

박헌식,김진년,정의룡,류재근,이봉렬,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1995 慶北醫大誌 Vol.36 No.4

목적 : 근래에 와서 ACE 길항제가 고혈압 및 심부전 환자들에게 널리 사용되면서 임상에서 기침 때문에 사용이 제한되는 경우를 흔히 접하게 된다. 따라서 ACE 길항제의 주요 부작용인 기침에 관한 연구를 시행하였다. 대상 및 방법 : 대상은 1990년 1월부터 1994년 6월까지 경북대학교병원 순환기내과에서captopril과 enalapril을 복용하고 있는 남자 45례, 여자 63례로 모두 108례였고 이들의 평균연령은 57±11.2세였으며 63례에서 captopril을 복용하였고 45례에서 enalapril을 복용하였다. 이들에서 기침의 발생과 환자의 임상적 경과는 병력지에서 관찰하였고 대상환자중에 호흡기질환이 있는 경우는 제외하였다. 결과 : 1) ACE 길항제를 사용한 108례의 환자중 27례에서 기침이 발생하였으며(25%) 그 중captopril을 사용한 환자에서는 28.5%이고 enalapril을 사용한 환자에서는 20%였으나 양군간에 통계학적으로 유의한 차이는 없었다. 2) 투약후 기침이 발생한 때까지의 기간은 평균 225±256.7일이었고 투약후 대개 6개월이내에 기침이 발생하였으며 1년이 지나서도 5명에게서 기침이 발생하였다. 3) 기침의 발생빈도는 심부전환자군이 34.4%, 고혈압환자군에서 20.5%였다. 4) 기침의 발생빈도는 여자에서 28.5%, 남자에서 20%이였으나 통계학적으로 유의한 차이는 없었다. 5) 연령에 따른 기침발생율은 차이가 없었다. 6) 흡연여부에 따른 기침발생율은 차이가 없었다. 결론 : 기침은 ACE 길항제의 흔한 부작용이며 고혈압이나 심부전 환자에서 ACE 길항제를 사용할 때에는 기침의 발생에 적절한 주의가 필요하다. Background : Angiotensin converting enzyme inhibitors(ACEI) are increasingly being used to treat hypertension and congestive heart failure. In general, these durgs are well tolerated, but an unexpected and troublesome cough has been reported in patients taking captopril or enalapril. We studied the incidence and characteristics of ACEI induced cough. Method I Medical records of patients who were treated for hypertension and congestive heart failure in division of cardiology were reviewed retrospectively. Excluding patients with respiratory disease, 108 patients on either captopril(n = 63) or enalapril(n = 45) were selected(45 males and 63 females). Their mean age was 57±11.2 years. Seventy three cases used ACEI for hypertension and thirty five for congestive heart failure. Results : Twenty-five percent of 108 patients(n = 27) developed a cough(cough group) after the ACEI medication(28.5% for captopril vs 20% for enalapril : not significant). Mean duration of therapy until the cough developed was 225 days. The incidence of the cough was 34.4% in patients with congestive heart failure and 20.5% in patients with hypertension (not significant). There was no difference in age between the cough group and the non-cough group(56±9.5 years vs 57±12.4 years). The cough did not appear to be related to the dosage of medications and smoking habits. Conclusion : A cough is not an uncommon side effect in patients taking ACEI. Optimal clinical application of ACEI in the treatment of hypertension and congestive heart failure will require increased awareness of the cough.

급성심근경색 및 당뇨병환자에서 혈청지질분획 및 Apolipoproteins

김신우,황종현,임현주,정의룡,류재근,채성철,전재은,박의현 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.3

목적 : 동맥경화발생과 고지혈증과의 관계에 관한 연구로 최근에는 혈청지질의 분석외에 apolipoproteins에 관심이 증가되고 있지만 우리나라에서는 이 방면에 관한 연구가 별로 없는 상태이어서 본 연구를 하였다. 재료 및 방법 : 급성심근경색환자 31례와 성인병당뇨병환자 37례에서 몇가지 혈청지질과 apolipoprptein A1 및 B를 측정하여 건강인 36례의 성적과 비교, 검토하였다. 결과 : 1) 총 cholesterol, triglycerides, LDL-cholesterol 및 apolipoprptein B는 대조군에 비해 급성심근경색환자 및 당뇨병환자에서 유의하게 높았다. 2) HDL-cholesterol/총 cholesterol비 와 LDL-cholesterol/HDL-cholesterol비는 급성심근경색환자군에서만 각각 유의하게 감소 및 증가하였다. 총 cholesterol/Apo-B비와 Apo-A1/Apo-B비는 급성심근경색 및 당뇨병환자군 모두에서 대조군에 비해 유의하게 낮았다. 3) Apolipoprptein B는 총 cholesterol, triglycerides, LDL-cholesterol과 유의한 양의 상관이 있었으나 apolipoprptein A1은 그러하지 않았다. 4) 총 cholesterol이 200㎎/㎗미만인 급성심근경색환자에서는 대조군에 비해 여러지질치 가운데 apolipoprptein B만 유의하게 높았다. 결론 : 이상의 성적으로 보아 apolipoprptein B는 혈청지질중 특히 총 cholesterol, LDL-cholesterol과 유의한 상관이 있었으며 급성심근경색 및 당뇨병환자 모두에서 유의하게 높았다. In recent years, the studies of the relationship between coronary atherosclerosis and hyperlipidemia were focused upon analysis of apolipoproteins including serum lipids. However there were a few reports regarding to this field in Korea. We measered the levels of serum lipids and apolipoprotein A1 and B in 31 patients with acute myocardial infarction and 37 diabetics and compared the results with those in 36 healthy controls. The results were as follows'. Compared with the healthy controls, serum concentrations of total cholesterol, triglycerides, LDL-cholesterol and apolipoprotein B were significantly higher in patients with acute myocardial infarction and diabetics. Ratio of HDL-cholesterol/total cholesterol was significantly lower in pateints with acute myocardial infaction. Ratio of LDL-cholesterol/total cholesterol was significantly higher in patients with acute myocardial infarction. Patients with acute myocardial infarction and diabetics had a lower ratio of total cholesterol/Apo-B and Apo-A1/Apo-B. Level of apolipoprotein B was significantly higher in patients with acute myocardial infarction whose total cholesterol value were under 200 ㎎/㎗ than in controls. Apolipoprotein B was correlated significantly with LDL-cholesterol, total cholesterol and triglycerides but apolipoprotein A1 was not.

Effectiveness and Safety of Zotarolimus-Eluting Stent (Resolute™ Integrity) in Patients with Diffuse Long Coronary Artery Disease

Youngkeun Ahn,Keun-Ho Park,Young-Youp Koh,Young-Jae Ki,Sung Soo Kim,Hyun Kuk Kim,Dong-Hyun Choi,Young Joon Hong,Jin-Yong Hwang,Do Hoi Kim,Jay-Young Rhew,Jae Kean Ryu,Jong-Seon Park,Tae Ho Park,Tae-Hyu 대한심장학회 2019 Korean Circulation Journal Vol.49 No.8

Background and Objectives: Diffuse long coronary artery disease (DLCAD) still has unfavorable clinical outcomes after successful percutaneous coronary intervention (PCI). Therefore, we aimed to evaluate the effectiveness and safety of Resolute™ zotarolimus-eluting stent (R-ZES; Resolute™ Integrity) for patients with DLCAD. Methods: From December 2011 to December 2014, 1,011 patients who underwent PCI using R-ZES for CAD with longer than 25 mm lesion were prospectively enrolled from 21 hospitals in Korea. We assessed the clinical outcome of major adverse cardiac events (MACE) defined as the composite of cardiac death, non-fatal myocardial infarction (MI), and clinically-driven target vessel revascularization at 12 months. Results: Mean age was 63.8±10.8 years, 701 (69.3%) patients were male, 572 (87.0%) patients had hypertension, 339 (33.8%) patients had diabetes, 549 (54.3%) patients diagnosed with acute MI and 545 (53.9%) patients had multi-vessel disease (MVD). A total of 1,697 stents were implanted into a total of 1,472 lesions. The mean diameter was 3.07±0.38 mm and the length was 28.27±6.97 mm. Multiple overlapping stents were performed in 205 (13.8%) lesions. A 12-month clinical follow-up was available in 1,004 patients (99.3%). The incidences of MACE and definite stent thrombosis at 12-month were 3.0% and 0.3% respectively. On multivariate Cox-regression analysis, multiple overlapping stents implantation, previous congestive heart failure, MVD, and age ≥75 years were independent predictors of one-year MACE. Conclusions: Our study shows that R-ZES has an excellent 1-year clinical outcome in Korean patients with DLCAD.