• Korean Circulation Journal
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• 제48권12호
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• pp.1148-1156
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• 2018

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

• Korean Circulation Journal
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• 제48권11호
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• pp.989-999
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• 2018

Background and Objectives: We aimed to compare outcomes of complete revascularization (CR) versus culprit-only revascularization for ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) in the $2^{nd}$ generation drug-eluting stent (DES) era. Methods: From 2009 to 2014, patients with STEMI and MVD, who underwent primary percutaneous coronary intervention (PCI) using a $2^{nd}$ generation DES for culprit lesions were enrolled. CR was defined as PCI for a non-infarct-related artery during the index admission. Major adverse cardiovascular event (MACE) was defined as cardiovascular (CV) death, non-fatal myocardial infarction, target lesion revascularization, or heart failure during the follow-up year. Results: In total, 705 MVD patients were suitable for the analysis, of whom 286 (41%) underwent culprit-only PCI and 419 (59%) underwent CR during the index admission. The incidence of MACE was 11.5% in the CR group versus 18.5% in the culprit-only group (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.37-0.86; p<0.01; adjusted HR, 0.64; 95% CI, 0.40-0.99; p=0.04). The CR group revealed a significantly lower incidence of CV death (7.2% vs. 12.9%; HR, 0.51; 95% CI, 0.31-0.86; p=0.01 and adjusted HR, 0.57; 95% CI; 0.32-0.97; p=0.03, respectively). Conclusions: CR was associated with better outcomes including reductions in MACE and CV death at 1 year of follow-up compared with culprit-only PCI in the $2^{nd}$ generation DES era.

• 대한한의학회지
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• 제40권3호
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• pp.1-20
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• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• 한국방사선학회논문지
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• 제14권2호
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• pp.179-191
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• 2020

이 연구는 스텐트 내 재협착 병변에서 약물용출 풍선 확장술을 시행한 환자를 대상으로 주요 심장사건에 영향을 미치는 예측 인자가 무엇인지 알아보고자 하였다. 2012년 10월부터 2017년 1월까지 전남대학교병원 심혈관센터에서 경피적 관상동맥 삽입술 후 스텐트 내 재협착이 발생한 환자 중에서 약물용출 풍선 확장술을 시행 받은 환자 257명 (평균연령 66.1±10.1세, 남자 172명)을 대상으로 그룹 I (주요 심장사건 발생군, n=35명), 그룹 II (주요 심장사건 발생하지 않은 군, n=222명)로 나누어 분류 하였다. 약물용출 풍선 성형술 후 주요 심장사건의 독립적인 예측 인자를 보기 위한 다변량 분석에서 완전 폐쇄병변 형태의 재협착 형태 (HR=4.179, 95% C.I.=1.851-9.437 p= 0.001), 25 mm이상의 긴 병변 (HR=8.773, 95% C.I.=1.898-40.546 p= 0.005), 반복되는 스텐트 내 재협착 (HR=4.693, 95% C.I.=1.259-17.490 p= 0.021)이 독립적인 예측 인자로 판명되었다.

• Korean Journal of Radiology
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• 제24권9호
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• pp.838-848
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• 2023

Objective: To quantitatively analyze the cardiac magnetic resonance imaging (CMR) characteristics of chemotherapy-related cardiac dysfunction (CTRCD) and explore their prognostic value for major adverse cardiovascular events (MACE). Materials and Methods: A total of 145 patients (male:female = 76:69, mean age = 63.0 years) with cancer and heart failure who underwent CMR between January 2015 and January 2021 were included. CMR was performed using a 3T scanner (Siemens). Biventricular functions, native T1 T2, extracellular volume fraction (ECV) values, and late gadolinium enhancement (LGE) of the left ventricle (LV) were compared between those with and without CTRCD. These were compared between patients with mild-to-moderate CTRCD and those with severe CTRCD. Cox proportional hazard regression analysis was used to evaluate the association between the CMR parameters and MACE occurrence during follow-up in the CTRCD patients. Results: Among 145 patients, 61 had CTRCD and 84 did not have CTRCD. Native T1, ECV, and T2 were significantly higher in the CTRCD group (1336.9 ms, 32.5%, and 44.7 ms, respectively) than those in the non-CTRCD group (1303.4 ms, 30.5%, and 42.0 ms, respectively; P = 0.013, 0.010, and < 0.001, respectively). They were not significantly different between patients with mild-to-moderate and severe CTRCD. Indexed LV mass was significantly smaller in the CTRCD group (65.0 g/m² vs. 78.9 g/mm²; P < 0.001). According to the multivariable Cox regression analysis, T2 (hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 1.01-1.27; P = 0.028) and quantified LGE (HR: 1.07, 95% CI: 1.01-1.13; P = 0.021) were independently associated with MACE in the CTRCD patients. Conclusion: Quantitative parameters from CMR have the potential to evaluate myocardial changes in CTRCD. Increased T2 with reduced LV mass was demonstrated in CTRCD patients even before the development of severe cardiac dysfunction. T2 and quantified LGE may be independent prognostic factors for MACE in patients with CTRCD.

• 전기화학회지
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• 제16권1호
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• pp.1-8
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• 2013

본 총설에서는 Si 비등방성 식각(anisotropic etching) 공정인 metal-assisted chemical etching(MAC etch 혹은 MACE) 분야 기본 원리, 중요 변수, 그리고 최근 연구 성과들을 정리하였다. 1990년에 최초로 Si 표면에 금속 촉매를 증착한 후 $H_2O_2$/HF 기반 식각을 진행하면 용액 중에서도 비등방성 식각을 통해 다양한 고종횡비(high aspect ratio) 나노구조를 형성할 수 있다는 것이 밝혀 졌다. 고가의 진공기반 장비가 필요한 건식 식각에 비해, 습식 식각을 통해서도 상대적으로 간편하고 경제적으로 종횡비가 큰 Si 마이크로/나노 구조를 만들 수 있게 되었다. 초기 연구들을 통해 MAC etch중 산화제가 촉매에 의해 환원되고, 촉매/Si 계면 근처의 Si 원자들이 선택적으로 식각/용해되어 수직 방향으로 촉매가 Si 기판을 파고 들어가며 비등방성 식각이 발생함이 밝혀졌다. MAC etch에 영향을 미치는 중요 변수로는 금속 촉매의 종류 및 모양, 식각액의 조성, Si기판의 도핑 농도이다. 또한 본 총설은 MAC etch에 의해 형성된 Si 나노 구조를 이용한 태양전지, 수소 연료, 리튬 이온 전지 등의 응용 분야를 다루었다.

• 한국방사선학회논문지
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• 제6권1호
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• pp.5-10
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• 2012

AMI로 SES 혹은 PES 시술을 시행받은 모든 환자에서 4년 이상의 임상추적 기간이 지난 환자를 대상으로 데이터를 분석하여 두 스텐트의 안전성과 유용성을 비교해 보고자 하였다. 2004년 1월 1일부터 2006년 8월 31일까지 본원에서 ST분절 상승 혹은 ST 분절 비상승 급성심근경색증 (STEMI or NSTEMI)로 진단되어 입원 기간 중 관동맥중재술을 시행받은 환자 중 SES 혹은 PES 삽입술이 시행된 환자를 대상으로 후향적 분석을 시행하였다. 그리고 사망, 심장사. 심근경색증, 표적 혈관재관류술, 스텐트 혈전증 발생에 대해 분석하였다. 연구 기간 동안 총 668명의 급성심근경색증 환자가 중 522명만 연구 대상에 포함 사망 ($18.3{\pm}3.0%$ vs. $14.6{\pm}2.2%$, p=0.26), 심장사($11.2{\pm}2.6%$ vs. $6.8{\pm}1.52%$, p=0.39), 심근경색증 ($6.4{\pm}1.8%$ vs. $3.3{\pm}1.1%$, p=0.31), and 스텐트 혈전증 ($5.4{\pm}1.7%$ vs. $3.2{\pm}1.1%$, p=0.53) 표적 혈관재관류술(TVR) ($10.0{\pm}3.0%$ vs. $4.0{\pm}1.2%$, p=0.008) and 심혈관계 임상사건(MACE) ($29.4{\pm}3.5%$ vs. $19.4{\pm}2.5%$, p=0.003) 급성심근경색증의 초기 치료에 약물방출스텐트인 SES와 PES의 4년 장기 임상 성적을 조사한 본 연구를 통해 전체환자를 대상으로 분석하였을 때 두 스텐트의 장기 사망률, 심장사. 심근경색증, 표적 혈관재관류술, 스텐트 혈전증의 발생은 차이가 없었으나 TVR 및 MACE의 발생은 PES 삽입 환자가 SES삽입 환자보다 유의하게 높았다.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.87-92
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• 2010

Background: D-dimer testing is widely applied as a first step in the diagnostic work-up of pulmonary embolism (PE). Although this is the most sensitive assay for ruling out PE, the prognostic implications of D-dimer testing in patients with normotensive PE are not well known. The aim of this study was to determine if D-dimer testing on admission predicts major adverse cardiac events (MACE) in patients with normotensive PE. Methods: A total of 180 consecutive patients with normotensive PE admitted between January 2003 and June 2009 were included. The group was divided into quartiles on the basis of their D-dimer levels. We compared the frequency of MACE by quartile of D-dimer level and estimated sensitivity, specificity, and predictive values for MACE in the first and fourth quartile. Results: In the 37 (20.6%) patients with MACEs, the median D-dimer level (7.94[IQR:4.03~18.17]${\mu}g/mL$) was higher than in patients with a benign course (5.29[IQR:2.60~11.52]${\mu}g/mL$, p<0.01). The occurrence of MACEs was increased with increasing D-dimer level (p=0.017). In the first quartile (D-Dimer <$2.76{\mu}g/mL$) sensitivity, specificity, and positive and negative predictive values for predicting MACEs were, respectively, 91.9%, 29.4%, 25.2%, and 93.3%. Conclusion: Patients with D-dimer levels below $2.76{\mu}g/mL$ have a low risk of MACEs. Our study suggest that D-dimer level may be used to identify low risk patients with normotensive PE.

• 한국지역사회생활과학회:학술대회논문집
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• 한국지역사회생활과학회 2004년도 제17차 학술대회
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• pp.126-133
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• 2004

우리사회에 이혼률이 급증하고(조이혼률 : 1990년 1.1건$\longrightarrow$2002년 3.0건), 가족생활주기중에 학령기 부부의 결혼만족이 가장 낮다는 연구결과들(서동인ㆍ정현숙, 1994 등)이 제기되면서 어느 때보다 가족관계 또는 부부관계의 질적인 향상에 관한 관심이 증가하고 있다. 실제로 Mace (1979)등은 가족향상에서 가장 중요한 것은 부부중심(couple-focused)이며 행동중심(action- oriented)이라고 하였다.

• 한국지역사회생활과학회:학술대회논문집
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• 한국지역사회생활과학회 2004년도 제17차 학술대회
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• pp.247-252
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• 2004

우리사회에 이혼률이 급증하고(조이혼률 : 1990년 1.1건$\longrightarrow$2002년 3.0건), 가족생활주기 중에 학령기 부부의 결혼만족이 가장 낮다는 연구결과들(서동인ㆍ정현숙, 1994등)이 제기되면서 어느 때보다 가족관계 또는 부부관계의 질적인 향상에 관한 관심이 증가하고 있다. 실제로 Mace(1979) 등은 가족향상에서 가장 중요한 것은 부부중심(couple-focused)이며 해동중심(action-oriented)이라고 하였다. 더 나가가 부부관계를 평가함에 있어서는 자기역할보다는 배우자역할 평가가 중요하다고 보고 (최규련, 1988; 서광희, 1992)되고 있다.