Surgical Outcomes of Cor Triatriatum Sinister: A Single-Center Experience

김동희,권보상,김동희,최은석,윤태진,박천수 대한심장혈관흉부외과학회 2022 Journal of Chest Surgery (J Chest Surg) Vol.55 No.2

Background: We investigated surgical outcomes after the surgical repair of cor triatriatum sinister (CTS). Methods: Thirty-two consecutive patients who underwent surgical repair of CTS from 1993 through 2020 were included in this study. The morphological characteristics, clinical features, and surgical outcomes were described and analyzed. Results: The median age and body weight at operation were 9 months (interquartile range [IQR], 3–238 months) and 7.5 kg (IQR, 5.8–49.6 kg), respectively. There were 16 males (50%). According to the modified Lucas classification, type IA (classical CTS) was most common (n=20, 62.5%). Atrial septal defect was associated in 22 patients (68.8%) and anomalous pulmonary venous return in 8 patients (25%). Pulmonary hypertension was preoperatively suspected with a high probability in 18 patients (56.3%). There was 1 early death (3.1%) after emergent membrane excision and hybrid palliation in a high-risk hypoplastic left heart syndrome patient. There were no late deaths. The overall survival rate was 96.9% at 15 years post-repair. No early survivors required reoperation during follow-up. Most survivors (31 of 32 patients, 96.9%) were in New York Heart Association functional class I at a median follow-up of 74 months (IQR, 39–195 months). At the latest echocardiography performed at a median of 42 months (IQR, 6–112 months) after repair, no residual lesion was observed except in 1 patient who had moderate pulmonary hypertension (mean pulmonary arterial pressure of 36 mm Hg). Conclusion: Surgical repair of cor triatriatum could be performed safely and effectively with an extremely low risk of recurrence.

건강한 달콤함에 빠지다

김동희,한영희(사진) 샘터사 2016 월간 샘터 Vol.555 No.-

일반학교 특수학급 학생의 사회적 지지 지각과학교생활적응 간 관계의 학교 급별 비교

김동희,박승희 이화여자대학교 특수교육연구소 2008 특수교육 Vol.7 No.1

본 연구의 목적은 일반학교 특수학급 학생이 지각한 사회적 지지가 각 학교 급별(초등학교, 중학교, 고등학교)로 유의한 차이를 나타내는지와 특수학급 학생의 사회적 지지 지각과 학교생활적응 간의 상관관계가 각 학교 급별로 어떠한 차이를 나타내는지를 알아보고, 나아가, 사회적 지지의 세 가지 하위요인 중 학교생활적응에 가장 큰 영향을 미치는 요인이 각 학교 급별로 차이가 있는지 알아보는 것이다. 본 연구대상자는 서울, 경기, 인천 지역의 초·중·고등학교 특수학급에 재학 중인 학생 440명이다. 도구는 김명숙(1994)의 사회적지지 지각 척도와 이유선(1996)의 학교생활적응도 검사를 수정한 것이 사용되었다. 본 연구결과는 첫째, 초·중·고등학교 특수학급 학생의 사회적 지지 지각은 각 학교 급별로 유의한 차이를 나타내었다. 둘째, 초·중·고등학교 특수학급 학생의 사회적 지지 지각과 학교생활적응 간에는 각 학교 급별로 모두 유의한 상관관계를 나타내었다. 셋째, 초·중·고등학교 특수학급 학생의 학교생활적응에 영향을 미치는 사회적 지지 지각의 하위요인 중, 초등학교에서는 친구지지, 교사지지 순으로 큰 영향력을 갖고, 중학교에서는 모든 하위요인이 낮은 영향력을 보이며, 고등학교에서는 교사지지, 친구지지 순으로 큰 영향력을 미친다고 나타났다. 본 연구결과는 일반학생을 대상으로 한 연구결과와 비교되면서 논의되고, 통합교육 내실화 시기에 장애학생의 일반 초·중·고등학교에서 학교생활적응의 지원 방안 구상에 있어서 교사 및 친구로부터의 사회적 지지의 중요성을 재차 확인시키며 세 학교 급에 따라서 차별화된 사회적 지지 방안의 필요성이 지적되었다. 특수학급 학생과 장애학생이란 용어는 엄밀하게는 동일하지 않으나, 본 논문에서는 두 용어가 같은 의미로 문맥에 따라서 혼용되었다. In this study, we examined difference in perceived social supports, the correlation between social supports and school adjustment, and difference in the most influential subfactor of social supports for school adjustment among students in special classes at elementary, middle and high schools. 440 students with special education needs, selected by teachers of special classes at each school in Seoul, Gyeonggi and Incheon were participated in this study. Two questionnaires including scale of perceived social supports and scale of school adjustment were employed to generate the data for this study. One-way analysis of variance, pearson's simple product-moment correlation coefficient, and stepwise multiple regression analysis using SPSS were employed to analyze the data of 440 students of three school levels. The results of the present study were followed. First, perceived social supports were significantly different among students in special classes at three levels, especially between middle and high schools. Second, perceived social supports and students' school adjustment were significantly correlated; the order of the correlation intensity was followed by first high schools, then, elementary schools, and middle schools. Third, the most influential subfactor of social supports for students' school adjustment was different in each group. Subfactor called support from friends was identified as the most influential subfactor in elementary students and support from teachers was the most influential subfactor in high school students. However, the factor of social supports was not significantly influential for students' school adjustment in middle schools. These findings were discussed in terms of comparing the difference among students at three school levels and the differences between student with and without disabilities. Finally, limitations of this study and suggestions for future study were provided.

Assessment of Cognitive Phenotyping in Inbred, Genetically Modified Mice, and Transgenic Mouse Models of Alzheimer’s Disease

김동희,장윤선,전원경,한정수 한국뇌신경과학회 2019 Experimental Neurobiology Vol.28 No.2

Genetically modified mouse models are being used predominantly to understand brain functions and diseases. Well-designed and controlled behavioral analyses of genetically modified mice have successfully led to the identification of gene functions, understanding of brain diseases, and development of treatments. Recently, complex and higher cognitive functions have been examined in mice with genetic mutations. Therefore, research strategies for cognitive phenotyping should be sophisticated and evolve to convey the exact meaning of the findings and provide robust translational tools for testing hypotheses and developing treatments. This review addresses issues of experimental design and discusses studies that have examined cognitive function using mouse strain differences, genetically modified mice, and transgenic mice for Alzheimer’s disease.

Lysophosphatidic acid increases mesangial cell proliferation in models of diabetic nephropathy via Rac1/MAPK/KLF5 signaling

김동희,Hui Ying Li,이종한,오윤식,전희숙 생화학분자생물학회 2019 Experimental and molecular medicine Vol.51 No.-

Mesangial cell proliferation has been identified as a major factor contributing to glomerulosclerosis, which is a typical symptom of diabetic nephropathy (DN). Lysophosphatidic acid (LPA) levels are increased in the glomerulus of the kidney in diabetic mice. LPA is a critical regulator that induces mesangial cell proliferation; however, its effect and molecular mechanisms remain unknown. The proportion of α-SMA+/PCNA+ cells was increased in the kidney cortex of db/db mice compared with control mice. Treatment with LPA concomitantly increased the proliferation of mouse mesangial cells (SV40 MES13) and the expression of cyclin D1 and CDK4. On the other hand, the expression of p27Kip1 was decreased. The expression of Krüppel-like factor 5 (KLF5) was upregulated in the kidney cortex of db/db mice and LPA-treated SV40 MES13 cells. RNAi-mediated silencing of KLF5 reversed these effects and inhibited the proliferation of LPA-treated cells. Mitogen-activated protein kinases (MAPKs) were activated, and the expression of early growth response 1 (Egr1) was subsequently increased in LPA-treated SV40 MES13 cells and the kidney cortex of db/db mice. Moreover, LPA significantly increased the activity of the Ras-related C3 botulinum toxin substrate (Rac1) GTPase in SV40 MES13 cells, and the dominant-negative form of Rac1 partially inhibited the phosphorylation of p38 and upregulation of Egr1 and KLF5 induced by LPA. LPA-induced hyperproliferation was attenuated by the inhibition of Rac1 activity. Based on these results, the Rac1/MAPK/KLF5 signaling pathway was one of the mechanisms by which LPA induced mesangial cell proliferation in DN models.

제 7 부 / Human Development : 소아기의 신체활동과 운동검사 및 처방

김동희 대한스포츠의학회 1999 대한스포츠의학회 WORKSHOP - 임상운동사 ( 처방 ) 연수 - Vol.- No.-

Social Support Mediated by Cognitive and Behavioral Determinants as Predictors of Body Mass Index among Korean Adolescents: A Structural Equation Model

김동희,강인순,김영혜 한국아동간호학회 2007 Child Health Nursing Research Vol.13 No.1

Purpose: This investigation examined a model to predict body mass index in order to prevent later development of obesity among adolescents. The hypothesized model was developed based on the principle of Social Cognitive Theory that social influences predict perceptions of cognition as well as behavior. Method: The 5,770 adolescents, aged 14-18 who participated in this study came from 11 separate school districts in Busan and Kyungnam province of South Korea. The adolescent surveys were administered in a group setting at the participating school. Of the 5770 surveys, adolescents with more than 10 percent missing data in the entire survey were excluded. The final sample contained 4,527 cases. The adolescents were included 2,250 (49.7%) males and 2,277 (50.3%) females. Data was analyzed Pearson correlation coefficients using SPSS 12 program and structural equation model (SEM) using Maximum Likelihood estimation was employed using Amos 5.0. Results: Social support directly affects cognitive determinants. Cognitive determinants directly affect behavior determinants which directly affect BMI. Cognitive and behavioral factors mediated the relationship between social support and BMI (GFI= 0.984, CFI= 0.974, RMSEA=0.031). Conclusion: Social levels should be supportive to help adolescents have healthier behaviors. This support can be accomplished by providing frequent support to establish positive cognitive factors as the foundation of the solution to prevent overweight and obesity.

무통 분만을 위한 경막외 통증자가조절시 Bupivacaine과 혼합한 Fentanyl 혹은 Butorphanol의 효과

김동희,고경심,김석곤 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.2

Background: This study examined the efficacy of patient-controlled epidural analgesia (PCEA) during labor and compared the suitability of fentanyl and butorphanol mixed with bupivacaine. Methods: After establishing effective epidural analgesia with 10 ml of 0.125% bupivacaine mixed with fentanyl 5 ㎍/ml or butorphanol 1 mg/ml, 60 parturients in active labor were randomly assigned to one of two groups: PCEA using 0.0625% bupivacaine with fentanyl 2 ㎍/ml (fentanyl group); PCEA using 0.0625% bupivacaine with butorphanol 20 ㎍/ml (butorphanol group). PCEA pumps were programmed to deliver a 4 ml/hr basal infusion, 4 ml on-demand bolus, 10-min lockout intervals between doses, and a 20 ml hourly limit. Visual analogue pain scores, side effects, parturients' satisfaction scores, duration of labor and Apgar scores were recorded during and after labor. Results: The quality of analgesia, side effects, duration of labor, overall satisfaction and Apgar scores didn't between the two groups. Average hourly infusion rates were 11.8 ± 0.3 ml/hr (fentanyl group) and 13.9 ± 0.4 ml/hr (butorphanol group). Conclusions: PCEA is a safe and effective method for labor analgesia and both solutions, the 0.0625% bupivacaine plus fentanyl 2 ㎍/ml and the 0.0625% bupivacaine plus butorphanol 20 ㎍/ml, appear suitable for PCEA use for labor pain. There is no difference in effectiveness between fentanyl and butorphanol. (Korean J Anesthesiol 1999; 37: 262~267)

A Ruptured Cystic Artery Pseudoaneurysm with Concurrent Cholecystoduodenal Fistula: A Case Report and Literature Review

김동희,김태호,김창환,장재혁,한석원,김재광,이승환,김진아 대한상부위장관ㆍ헬리코박터학회 2018 Korean Journal of Helicobacter Upper Gastrointesti Vol.18 No.2

Pseudoaneurysms of the cystic artery and cholecystoduodenal fistula formation are rare complications of cholecystitis and either may result from an inflammatory process in the abdomen. A 68-year-old man admitted with acute cholecystitis subsequently developed massive upper gastrointestinal (GI) bleeding. Abdominal computed tomography showed acute calculous cholecystitis and hemobilia secondary to bleeding from the cystic artery. Angiography suggested a ruptured pseudoaneurysm of the cystic artery. Upper GI endoscopy showed a deep active ulcer with an opening that was suspected to be that of a fistula at the duodenal bulb. The patient was managed successfully with multimodality treatment that included embolization followed by elective laparoscopic cholecystectomy. Presently, there is no clear consensus regarding the clinical management of this disease. We have been able to confirm various clinical features, diagnoses, and treatments of this disease through a literature review. A multidisciplinary approach through interagency/interdepartmental collaboration is necessary for better management of this disease. (Korean J Helicobacte r Up Gastrointest Res 2018;18:135-140)

무증상 성인 한국인에서 관상동맥 석회 수치의 연령 및 성별 분포와 특성: 심혈관 질환의 위험요인 및 대사 증후군과의 관계

김동희,최수연,최의근,서정원,이활,김영선,윤대현,정진욱,오병희 대한심장학회 2008 Korean Circulation Journal Vol.38 No.1

배경 및 목적관상동맥 석회수치 (CAC)는 동맥경화반의 총량과 비례하며 향후 허혈성 심장질환 발생의 독립적인 위험인자가 된다. 본 연구는 무증상 성인 한국인의 관상동맥 석회수치의 분포를 알아보고 심혈관 질환 위험인자와 관계를 알아보고자 하였다.방 법2003년 10월부터 2007년 6월까지 서울대학교병원 강남센터에서 건강 검진을 목적으로 MDCT CT로 CAC 수치 검사를 시행한 성인 중 관상동맥 질환을 시사하는 전형적인 증상이나 폐쇄성 관상동맥 질환의 병력이 없는 3,961명 (남자 2,558명 64%, 여자 1,408명, 56±10세)을 대상으로 하였다. 결 과 CAC 유병률 (CAC>0)은 남자 36.2%, 여자 17.0%였고, CAC수치의 평균±표준편차는 남녀 각각 60.5±236.1, 15.1±84.0였다. 석회수치는 연령에 따라 증가하였다 (p<0.001 by ANOVA). 연령과 성별을 통제하고 다변량 분석을 했을 때, 당뇨병은 OR 1.542 (95% CI, 1.252~1.899), 고혈압 OR 1.673 (95% CI, 1.430~1.956), 대사증후군은 OR 1.727 (95% CI, 1.461~2.042; p<0.001), 복부 비만을 의미하는 허리 둘레의 증가 (OR, 1.331; 95% CI, 1.084~1.633; p=0.006)는 CAC의 위험인자였다. 대사 증후군 항목 중에 1) 복부 비만, 2) 중성지방의 상승, 3) 혈압 상승, 4) 공복 혈당의 상승은 석회침착 (CAC>0)의 유의한 위험인자가 되었다. 결 론 이 결과로 한국인의 관상동맥 석회수치를 해석할 수 있는 정보를 제공하고 한국인의 동맥경화의 진행과 위험인자에 대한 이해를 도울 수 있을 것으로 기대한다. Background and Objectives: Coronary artery calcification (CAC) has been used as surrogate marker for coronary atherosclerosis. We developed a setof age-and gender-stratified CAC distribution and risk factors for CAC in a population of asymptomatic Korean subjects. Subjects and Methods: Between 2003 and 2007, 3,961 asymptomatic subjects without a history of ischemic heart disease (male 64%, mean age 56±10 years) were screened for CAC by the use of multi-detector computed tomography. Results: The total CAC score was assigned to a percentile according to age and gender. The prevalence of CAC and mean CAC score increased with age [p<0.001 by analysis of variance (ANOVA)]. The prevalence of CAC (mean CAC score) was 36.2% (60.5±236.1) in males, and 17.0% (15.1±84.0) in females. The age-and sex-adjusted odds ratio for the presence of CAC for subjects with diabetes was 1.542 [95% confidence interval (CI) 1.252-1.899], for subjects with hypertension was 1.673 (95% CI 1.430-1.956), for subjects with metabolic syndrome was 1.727 (95% CI 1.461-2.042), and for subjects with abdominal obesity (abdominal obesity defined as a waist circumference ≥90 cm in males; ≥80 cm in females) was 1.445 (95% CI 1.222-1.709). Conclusion: This study reports the distribution of CAC score by age and gender. It will serve as a reference standard for the clinical interpretation of CAC results in the asymptomatic Korean population. (Korean Circ J 2008;38:29-35)