• 한국콘텐츠학회논문지
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• 제9권12호
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• pp.339-347
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• 2009

연구목적: 64 절편 MDCT를 이용한 심장 CT의 진단일치도를 알아보고, 심박동수와 관상동맥 석회화가 진단일치도에 영향을 미치는지 확인하여 심장 CT 검사 시 기초 자료로 활용하고자 함이다. 연구방법: 심장 CT와 관상동맥 조영술을 함께 시행한 178명(남자 84명, 여자 94명)을 대상으로 심장 CT에서 관상동맥 협착과 심박동수, 석회화 수치를 측정하였고, 관상동맥조영술에서 좌전하행동맥, 좌회선동맥, 우관상동맥의 유의한 협착($\geq50%$)이 있는지 확인하였다. 관상동맥 조영술의 결과를 표준으로 심장 CT의 민감도, 특이도, 양성예측도, 음성예측도, kappa index($\kappa$)를 계산하였다. 연구결과: 환자별 협착의 정도를 평가한 결과 심장 CT의 정확도는 96.6%였다. 혈관별로는 LAD, LCX, RCA 각각 86.5%, 84.3%, 92.1%로 높은 진단일치도를 보였다. 체질량지수와 혈압은 심장 CT의 진단일치도에 영향을 미치지 않았다. 심박동수는 60/min 미만에서 정확도 90.1%, $\kappa$값 0.78이었고, 70/min 이상에서는 정확도가 75.8%, $\kappa$값 0.52이었다. 관상동맥 석회화지수 100 미만에서는 정확도가 91.3%, $\kappa$값 0.81이었고, 석회화지수 400 이상에서는 정확도 68.6%, $\kappa$값 0.33으로 떨어졌다. 결론: 64 절편 MDCT를 이용한 심장 CT는 관상동맥 조영술과 거의 비슷한 진단일치도를 나타냈다. 하지만 심박동수 70/min 이상, 관상동맥 석회화지수 400 이상에서는 진단일치도가 저하되었기 때문에 심장 CT 검사 시 심박동수와 관상동맥 석회화지수를 확인하여 검사하여야 하고, 심박동수가 70/min 이상이면 베타차단제를 사용하여 심박동수를 조절하여야 한다.

• Journal of Chest Surgery
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• 제40권8호
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• pp.574-577
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• 2007

심낭에서 발생한 원발성 섬유육종은 매우 드문 질환으로 주로 급격한 혈성 심낭 삼출을 유발한다. 평소에 간헐적인 흉부압박감을 느껴왔던 30세 남자 환자가 내원 하루 전 갑작스런 흉통과 심한 호흡곤란으로 근처 병원에서 협심증 진단 하에 전원되어 심초음파 검사, 흉부 전산화 단층촬영 및 자기공명검사 등 정밀검사를 시행받았고, 그 결과 심낭 기형종 파열에 의한 심낭압전의 진단하에 수술을 받았다. 수술소견 상 혈성 심낭 삼출액이 다량 있었고, 심낭 종괴는 완전 절제하였으나 동결절편검사 상악성종양이 의심되었다. 수술 후 병리조직 검사상 심낭 종괴는 원발성 심낭 섬유육종으로 진단되었고 심낭 삼출액에서 암세포는 발견되지 않았다. 환자는 특별한 합병증 없이 퇴원 후 전원되어 추가적인 방사선치료를 받고 있다. 임상적으로 긴급을 요하는 심낭압전을 동반한 원발성 심낭 섬유육종 1예를 치험하였기에 보고하는 바이다.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1221-1231
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• 2023

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland-Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion: Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

• 혜화의학회지
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• 제8권2호
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• pp.383-397
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• 2000

Background/Aims: Dong-Moo Lee Jae-Ma(1837-1900) confirmed the sasangchaejil theory based on the sasang-medicine. This theory has been the main-stem of oriental medicine during 100 years in Korea. But rarely anyone has tried to prove this theory systemicaly. So we have a trial to clarify any relationship between the sasangchaejil and the laboratory and clinical results of mass screening tests. Methods: We evaluated the laboratory values of 280 people who had taken many clinical and laboratory tests. The laboratory examinations were complete blood count, liver and kidney function test, ultrasonogram of the abdomen and breasts, gastrofiberscope, many tumor markers body mass index, blood pressure, glucose, and electrocardiogram, etc. Results: 1) Among the 280 subjects, 187/66.8% were sowumin, 58/20.7% were taewumin and 35/12.5% were soyangin. 2) Those who reacted positive to HBsAb were 22 subjects(62.8%) in soyangin, 57.2% in sowumin and 55.1% in raewumin. But there were no significant correlations. 3) 45 subjects(72.4%) in taewumin had obesity, fatty liver and hyperlipidemia.(P<0.05) 4) 20.6% in taewumin had abnormal LFT suggesting hepatic disease. It was statistically sigificant.(P<0.05) 5) An anemic state was present in women of soyangin and sowumin mostly. Since an iron deficiency anemia is common in women, there were no significant corelations among sasangchaejil. Also urinary tract infectons were common in women. 6) 6 subjects in taewumin(10.3%) had cardiac problems, while only one case(2.8%) occured in soyangin and 7 cases(3.7%) in sowumin. Taewumin was significantly high.(P<0.05) 7) In the case of gastric disease, there was no distinguishable difference among sasangchaejil.(taewumin 37.9%, soyangin 31.4% and sowumin 35.2% rrespectively) 8) There was no significant difference beteen subjects with different blood types using sasangchaejil. Conclusions: There were some significant relationship between sasangchaejil and diseases prevalent to them by the theory of sasang-medicine. But Lee didn't considered the differences of gender, the change of body status according to the development of culture, and circumstances of their lives. Also he didn't consider the existence of infectious agents. Now more systemic study with larger populations are requied.

• Archives of Pharmacal Research
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• 제29권3호
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• pp.241-248
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• 2006

Angiotensin converting enzyme (ACE) inhibitors have cardioprotective effects in different species including human. This cardioprotective effect is mainly due to the inhibition of bradykinin (BK) degradation rather than inhibition of the conversion of angiotensin I to angiotensir. II. Bradykinin, a nonapeptide, has been considered to be the potential target for various enzymes including ACE, neutral endopeptidase 24.11, carboxypeptidase M, carboxypeptidase N, proline aminopeptidase, endopeptidase 24.15, and meprin. In the present study, the coronary vascular beds of Sprague Dawley rat isolated hearts were perfused (single passage) with Krebs solution alone or with different concentrations of BK i.e. $2.75{\times}10^{-10},\;10^{-7},\;10^{-6}\;and\;10^{-5}M$ solution. Percent degradation of BK was determined by radioimmunoassay. The degradation products of BK after passing through the isolated rat-hearts were determined using RP-HPLC and mass spectroscopy. All the four doses of BK significantly decreased the perfusion pressure during their passage through the hearts. The percentage degradation of all four doses was decreased as the concentration of drug was increased, implying saturation of a fixed number of active sites involved in BK degradation. Bradykinin during a single passage through the hearts degraded to give [1-7]-BK as the major metabolite, and [1-8]-BK as a minor metabolite, detected on HPLC. Mass spectroscopy not only confirmed the presence of these two metabolites but also detected traces of [1-5]-BK and arginine. These findings showed that primarily ACE is the major cardiac enzyme involved in the degradation of bradykinin during a single passage through the coronary vascular of bed the healthy rat heart, while carboxypeptidase M may have a minor role.

• Korean Circulation Journal
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• 제53권9호
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• pp.635-644
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• 2023

Background and Objectives: The History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department. Methods: We modified the HEART pathway by replacing the Korean cut-off of 25 kg/m² with the conventional threshold of 30 kg/m² in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death. Results: Of the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%. Conclusions: When applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.

• 생명과학회지
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• 제34권1호
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• pp.1-8
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• 2024

Brain-type natriuretic peptide (BNP)은 뇌나트륨이뇨펩티드로, 좌심실의 심근세포에서 분비되는 호르몬으로, 심장과 신장에 작용하여 혈관 확장과 나트륨 이뇨 작용 등을 하는 것으로 알려져 있으나, 최근에는 다양한 조직에서 대사 작용을 조절하는 것으로 보고된다. 본 연구에서는 간 조직에서 BNP의 영향을 알기 위해 BNP가 고지방식이에 의해 유도되는 인슐린 저항성을 개선하는지를 조사하였다. BNP을 주입한 쥐와 control로서 saline을 주입한 쥐들 간에는 몸무게, 체지방양(fat mass), 제지방량(lean body mass)의 변화는 없었다. 고인슐린혈증 정상혈당 글루코스 클램프(Hyperinsulinemic Euglycemic Glucose Clam) 동안, BNP를 주입한 고지방 식이 쥐들은 saline을 주입한 고지방식이 쥐에 비해 혈당(blood glucose)은 감소하였으며, 포도당 주입 속도(glucose infusion rate)는 증가하였다. 또한 BNP은 포도당 신생 및 중성지방 합성 관련 유전자들의 발현을 감소시켜, 간에서 포도당 생성과 중성지방의 양을 감소시켰다. BNP는 saline을 주입한 쥐에 비해 간 조직에서 Akt와 AMP-activated protein kinase (AMPK)의 인산화를 증가시켰는데, 이는 BNP을 처리한 AML12 간세포에서도 BNP는Akt와 AMPK 인산화를 증가시켰다. 이상의 결과는 BNP가 간에서 인슐린 저항성을 개선하여 포도당 생성과 중성 지방 생성을 억제함을 알 수 있었다.

• 대한의생명과학회지
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• 제18권3호
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• pp.260-267
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• 2012

Obesity is associated with cardiovascular risk factors, such as dyslipidemia, hypertension and diabetes. However the presence of the obesity related deranged metabolic profiles varies widely among obese individuals. These individuals, known as 'metabolically healthy obese phenotype (MHO)', despite having excessive body fatness, display favorable metabolic profiles characterized by insulin sensitivity, no hypertension, as well as less dyslipidemia, less inflammation. The purpose of this study was to compare cardiac characterization and clinical profile of MHO and Non-MHO (nonmetabolically healthy obese) subjects in men. We measured treadmill exercise capacity (METs) and maximum blood pressure (BP) in 210 subjects through a medical checkup at J General Hospital. Metabolic syndrome was defined according to the modified Adult Treatment Panel III definition criteria. Both MHO and Non-MHO subjects showed statistically significant changes in the left ventricular mass index (P<.001, P<.01, respectively), A-velocity (P<.01, P<.001, respectively), E/A ratio (P<.01, P<.001, respectively), E'-velocity (P<.001, P<.001, respectively), HOMA-IR (P<.01, P<.001, respectively) and maximum systolic BP (P<.01, respectively) compared with the MH-NO (metabolically healthy non obese) subjects. In conclusion, MHO participants were at increased risk of cardiovascular disease and partly metabolic disorder.

• 대한간호학회지
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• 제37권4호
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• pp.568-575
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• 2007

Purpoes: The study was done to investigate the effects of an exercise program on body composition, cardiopulmonary function and physical fitness in obese children. Methods: Thirty nine children in grades 4, 5, and 6 in elementary school were employed: experimental group(20) and control group(19). The subjects in the experimental group participated in an exercise program for 8weeks, thirty five minutes per session, four times per week. This data was analyzed by ANCOVA and paired t-test. Result: The Height(F=2.615, p=0.027) of the experimental group was significantly different from the control group. Also, in the experimental group, there were significant differences of height(t=4 79, p=0.000), cardiac rate(t=-6.461, p=0.000), body mass index(t=-2.13 p=0.046), muscle strength(t=3.48, p=0.003), and muscle endurance(t=3.20, p=0.005). Otherwise, in the control group, there were significant differences of weight(t=2.27, p=0.036), waist-hip ratio(t=3.16, p=0.005), and muscle endurance(t=-2.38, p=0.030). Conclusion: Jumping rope improved the body composition, cardiopulmonary function, and physical fitness for obese children.

• 대한약침학회지
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• 제10권3호
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• pp.143-147
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• 2007

Objective To derive further studies evaluating the effectiveness of Cultured Wild Ginseng Pharmacopuncture (CWGP) Therapy on squamous cell carcinoma as a first line. Methods Three cycles (4 weeks/cycle) of CWGP were administered as a dosage of 10 ml per day. Patient was diagnosed with stage IIIB squamous cell carcinoma and refused all therapy of conventional medicine because of old age and cardiac invasion of tumor. Intensive treatment of CWGP for 3 cycles was done on the patient. Computed Topography (CT) was performed to evaluate the therapeutic efficacy. Results After the intravenous infusion of 2 cycles of CWGP, chest CT revealed the mass size and pleural invasion sustained stable disease. After the point injection of 1 cycle of CWGP, chest CT revealed progressive disease. The disease free survival rate was 1 month. Conclusion This case may provide us the possibility that CWGP offers potential benefits for patients with squamous cell lung carcinoma. But this is a single case study and further case-series research should be compensated.