• 건강소식
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• v.36 no.2
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• pp.26-27
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• 2012

매스컴을 통해 유명인의 갑작스러운 죽음에 대한 소식을 접하곤 한다. 교통사고, 자살 등 여러 원인 가운데 급성 심근경색이 원인이 되는 경우도 있다. 최근 인기그룹 2PM의 준수 아버지가 심근경색으로 사망했고 몇해 전 그룹 거북이의 리더 터틀맨 임성훈 씨도 급성 심근경색으로 사망해 팬들을 안타깝게 했다. 급성 심근경색은 현대인 급사의 가장 많은 질환의 하나이다.

• Proceeding of EDISON Challenge
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• 2017.03a
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• pp.656-661
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• 2017

이 연구의 목적은 심근경색의 발생 위치와 그 부피에 따른 심실의 여러 가지 생리학적인 특성들을 분석하는 데에 있다. 우리는 심근경색의 발생 사례를 총 8가지로 분류하여 각 병변의 발생 위치와 부피를 달리 하였으며 대조군으로 정상 상태의 심장을 두어 기준 값으로부터 각 사례 별로 전체 심장 대비 심근경색 부위가 차지하는 비율, 압력-부피 선도, 1회 박출량(SV), 분당 심박출량(CO), ATP 소모율, 박출 효율(EF), 1주기의 1ATP 당 소모한 일의 양(SW/ATP) 등을 조사하였다. 또한 본 연구는 심근경색의 발생 위치와 부피에 따른 이의 심각성을 나타내고자 했기 때문에, 각 사례 별로 압력-부피 선도, 들의 변화율 및 세포가 괴사한 정도에 따른 수치 변화율을 퍼센트(%)로 표시하여 그 정도를 조사하였다. 심근경색을 가진 심장은 그렇지 않은 심장에 비해서, ATP 소모량이나 EF의 경우 각 사례 마다 상이한 결과를 가지기는 하지만, 대체적으로 더 적은 1주기 일량(SW) 및 1회 박출량(SV) 분포를 보였으며 SW/ATP의 값은 거의 일괄적으로 감소하였음을 확인하였는데, 이는 심실의 효율이 정상 심장에 비해서 떨어졌음을 의미한다. 결과적으로, 본 연구는 심근경색의 생리학적 특징들을 재확인함과 동시에 임상적으로 확인할 수 없는 특징들의 수학적인 분석과 더불어 심근경색의 공간 특징적인 현상들을 밝히고 있다.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1077-1082
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• 1997

To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

• 건강소식
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• v.34 no.12
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• pp.34-35
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• 2010

매서운 칼바람이 부는 겨울은 날씨가 추워지는 만큼 건강관리에도 신경을 써야 하는 계절이다. 특히 심근경색은 더더욱 그러하다. 최근 런던열 의과대학 크리시난 바스카란교수의 연구결과에 의하면 기온 1도가 떨어지면 1개월간 심근경색이 발생할 위험이 2% 증가하는 것으로 나타났다. 본격적인 겨울에 들어서는 12월, 심근경색 전선에 이상 징후는 없는지 체크리스트를 통해 점검해보자.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.7 no.6
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• pp.1116-1121
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• 2006

We studied on some techniques which are able to discriminate the difference between normal and infarcted myocardium by consecutive image analysis in B-mode echocardiogram. In order to analyze two-dimensional echocardiogram, we presented inter-frame and intra-frame analysis method throughout the complete heart cycle in closed-chest human and proposed new analysis parameters which are named HGE and LT. The analysis technique using the proposed parameters revealed quantitatively dominant features between normal and infarcted regions. The infarcted areas yield regions of higher intensity throughout the entire cardiac cycle, but normal tissue demonstrates greater variability throughout the entire cardiac cycle. Hence, we could verify that these parameters varying over the entire cardiac cycle are good indicators for the state of myocardium.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.7-12
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• 1998

The study in detection of perioperative myocardial infarction by serial ECGs and the analysis of risk factors involved was carried out from January 1994 to July 1996 on 87 consecutive patients undergoing coronary artery bypass grafting. There were significant differences in the mean CK-MB peaks and frequencies of flipping in LDH1/LDH2 among the 3 groups(group I: new Q-wave, group II: S-T change, group III: no ECG change). The ECG was considered positive for postoperative myocardial infarction if the new Q-waves appeared in the postoperative period or if S-T segment changes persisted for more than 48 hours. The hospital mortality rate was 3.3% and the perioperative infarction rate was 17.2%. The following risk factors of the perioperative MI were found: endarterectomy, decreased ejection fraction($\leq$40%) and prolonged aortic cross clamping time. Left main disease, triple vessel disease, 3 or more graft, unstable angina and hypertension did not correlate with myocardial infarction. This study suggests that serial ECGs could be used as means of detecting the perioperative myocardial infarction after coronary artery bypass grafting.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.19 no.5
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• pp.151-155
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• 2019

Recently heart attack is 80% of the sudden death of elderly. The causes of a heart attack are complex and sudden, and it is difficult to predict the onset even if prevention or medical examination is performed. Therefore, early diagnosis and proper treatment are the most important. In this paper, we show the accuracy of normal and abnormal classification with neural network using weighted fuzzy function for accurate and rapid diagnosis of myocardial infarction. The data used in the experiment was data from the UCI Machine Learning Repository, which consists of 14 features and 303 sample data. The algorithm for feature selection uses the average of weight method. Two features were selected and removed. Heart attack was classified into normal and abnormal(1-normal, 2-abnormal) using the average of weight method. The test result for the diagnosis of heart attack using a weighted fuzzy neural network showed 87.66% accuracy.

• The Korean Journal of Nuclear Medicine
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• v.32 no.3
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• pp.259-265
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• 1998

Purpose: We studied early rest/24 hour delay T1-201 perfusion SPECT for prediction of wall motion improvement after reperfusion in patients with acute myocardial infarction. Materials and Methods: Among 17 patients (male/female= 11/6, age: $59{\pm}13$) with acute myocardial infarction, 15 patients were treated with percutaneous transcoronary angioplasty (direct:2, delay: 11) and intravenous urokinase (2). Spontaneous resolution occurred in infarct-related arteries of 2 patients. We confirmed TIMI 3 flow of infarct-related artery after reperfusion in all patients with coronary angiography. We performed rest T1-201 perfusion SPECT less then 6 hours after reperfusion and delay T1-201 perfusion SPECT next day. T1-201 uptake was visually graded as 4 point score from normal (0) to severe defect (3). Rest T1-201 uptake ${\le}2$ or combination of rest T1-201 uptake ${\le}2$ or late reversibility were considered to be viable. Myocardial wall motion was graded as 5 point score from normal (1) to dyskinesia (5). Myocardial wall motion was considered to be improved when a segment showed an improvement ${\ge} 1$ grade in follow up echo compared with the baseline values. Results: Among 98 segments with wall motion abnormality, the severity of myocardial wall motion decrease was as follow: mild hypokinesia: 18/98 (18%), severe hypokinesia: 28/98 (29%), akinesia: 51/98 (52%), dyskinesia: 1/98 (1%). The wall motion improved in 85%. Redistribution (13%), and reverse redistribution (4%) were observed in 24 hour delay SPECT. Positive predictive value (PPV) and negative predictive value (NPV) of combination of late reversibility and rest T1-201 uptake were 99%, and 54%. PPV and NPV of rest T1-201 uptake were 100% and 52% respectively. Predictive values of combination of rest T1-201 uptake and late reversibility were not significantly different compared with predictive values of rest T1-201 uptake only. Conclusion: We conclude that early T1-201 perfusion SPECT predict myocardial wall motion improvement with excellent positive but relatively low negative predictive values in patients with acute myocardial infarction after reperfusion.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.674-680
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• 2006

Background: Acute myocardial infarction (MI) is a life-threatening disease and surgical revascularization plays a major role in selected cases. The purpose of this study is to evaluate the left ventricular contractility improvement by examining the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) in patients who under-went surgical revascularization under diagnosis of acute MI. Material and Method: From January, 2001 to December, 2004, 149 patients who underwent coronary artery bypass surgery within 2 weeks of acute MI were included. We evaluated pre- and postoperative left ventricular contractility by measuring WMSI and LVEF and examined the associating factors. Result: WMSI decreased from $1.54{\pm}4.30\;to\;1.43{\pm}0.40$ (p<0.001) and LVEF increased from $48.1{\pm}12.2%\;to\;49.7{\pm}12.3%$ after surgery (p=0.009). Off-pump technique, non-Q wave, anterior MI, and surgery within 7 days after MI were favorable factors for LVEF improvement (p=0.046, p=0.006, p=0.003, p=0.005, respectively). Conversely, aforementioned factors were irrelevant with WMSI improvement. For triple vessel disease, complete revascularization was favorable factor for WMSI improvement (p<0.001). Conclusion: Coronary artery by-pass surgery can improve WMSI and LVEF in patients with acute MI. In case of anterior MI with non-Q wave, early surgical revascularization within 7 days may be most beneficial in LVEF improvement. Regarding WMSI, complete revascularization may be essential.

• 대한핵의학회:학술대회논문집
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• 1999.11a
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• pp.34.1-34.1
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• 1999