임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

영양표시정착화사업(Ⅱ) : 식품참고량설정에 관한 연구 Study on the Establishement of the Reference Amount in Foods

김대병,장영미,김인복,이혜영,장재희,김보영,이정구,김창민,정해랑 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

본 연구는 영양표시에서 1회분량 및 영양소함량표시의 기준으로 사용되는 "식픔창고량"에 관한 연구를 수행하므로써 합리적이고 일관성있는 영양표시기준 개선을 위한 기초자료로 활용코자 하였다. 이를 위하여 미국 및 캐나다를 중심으로 제외국의 현황 및 식품참고량 설정방법을 조사 ·연구 하으며 제도도입 및 개선 방안을 강구하였파. 또한, 시판 제품의 영양료시현황 및 음료류 둥의 포장단위 등을 피악하여 식품참고량설정을 위한 기초자료로 활용코자 하였다. 앞으로 국민건강 ·영양조사자료의 체계적인 통계분석, 가공식품의 섭취량조사 등을 통하여 우리나라 국민의 1인 1회 섭취량자료의 축적이 선행되어야 할 것이다. The purpose of this ?roject is to study on the reference amounts customarily consumed per eating occasion to improve the nutrition labelling standards. We Performed to study on the methodology to establish the reference amounts on the basis of the review on the advanced counITy's status. And we investigated the packaged unit ofprocessed foods. Further study is needed to establlsh the customarily consumed amount per eating occasionthrough the statistical analysis of nationwide food consumption data. Our results will be helpful information to improve nutrition labelling system in Korea.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

HCV, Alcoholic : PE-096 ; Clinical and histopathological features of acute onset autoimmune hepatitis

( Min Young Rim ),( Soo Yong Park ),( In Ku Yo ),( Min Su Ha ),( Ju Seung Kim ),( Ju Won Lee ),( Young Kul Jung ),( Dong Hae Chung ),( Oh Sang Kwon ),( Yun Soo Kim ),( Duck Joo Choi ),( Ju Hyun Kim1 ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease of unknown etiology that is reported to be a consequence of aberrant autoreactivity. Several studies which reported the acute presentation of AIH have different clinical course and histologic features. In this study, we compared acute presentation of AIH and chronic presentation of AIH. Methods: We retrospectively reviewed the medical records of patients with autoimmune hepatitis from January 2003 to June 2011 at Gachon University, Gil Hospital. A total of 29 patients were enrolled, 7 patients were diagnosed with acute presentation of AIH. Results: There was no difference between two group in age, gender, and score system of AIH. Patients with acute presentation had higher serum levels of total bilirubin, lower serum levels of albumin in clinical feature (p<0.05), and higher frequency of zone 3 necrosis in histologic feature. The cumulative incidental rate of the normalization of serum AST and ALT levels with prednisolone treatment was similar between patients with acute presentation and chronic presentation in clinical course. Conclusions: Higher AST, ALT and, bilirubin were clinical specific feature, and zone 3 necrosis is a histological characteristic of autoimmune hepatitis with acute presentation.

Mild Cognitive Impairment 노인군의 점화효과 특성

박재우,김도관,고선규,고효정,김성환,김재경,서민영,이인수,김지혜 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.3

연구목적 : 이 연구에서는 K-MMSE에서 25점 이하를 받은 50대 이상 노인들을 MCI(Mild Cognitive Impairment) 군으로 보고 이들의 인지 기능 특성을 점화 효과를 중심으로 살펴보고자 하였다. 먼저, 점화 효과가 MCI 노인군에서 있어서도 유지되고 있는지를 알아보고, 인지 기능의 손상 정도에 따라 점화 효과가 유의미하게 변화하는 지를 살펴보고자 하였다. 방 법 : 본 연구에서는 K-NAME 점수 25점 이하의 노인 96명으 대상으로 ADAS-Cog와 일종의 간접 기억 검사 도구인 지각적 파악 과제를 제작하여 점화 효과를 측정하여 인지 기능의 퇴행이 시작된 고연령군이 나타내는 암묵 기억 능력 특성을 알아보았다. 점화효과는 컴퓨터 상에 사전 노출된 자극과 그렇지 않은 자극을 순간 노출시켜 미리 노출된 자극에 대해 반응 시간이 줄어들고 정확 반응이 증가하는 정도로써 측정하였다. 이 때 지능이나 연령, 학력 수준과 같은 변인이 미치는 영향을 통제하기 위해 한국판 웩슬러 지능 검사의 <어휘>, <토막> 소검사를 실시하였고, 인구통계학적 변인에 관한 면접을 실시하였다. 통계적 분석 과정에서는 먼저, 연구에서 측정된 점화효과의 특성을 알아보기 점화 효과 측정치의 기술 통계치를 구하였으며 다른 측정 변인들과의 상관 분석을 실시하였다. 마지막으로 측정된 점화효과가 인지 기능의 퇴행 수준에 비례하는 지의 여부를 파악하기 위해 ADAS-Cog 및 나이, 교육 연한 및 지능 수준을 독립변인으로 회귀분석을 실시하였다. 결 과 : 먼저 기술 통계 분석 결과에 의하면 본 연구에 참여한 피보험자들의 경우 점화효과에 의해 미리 노출된 자극을 평균 3.6개 더 정확히 파악하였으며 평균 59ms 더 빠르게 반응한 것으로 나타나 이들 집단에서도 점화효과가 유지되고 있음을 알 수 있었다. 다음으로 변인들 간의 상관 분석 결과에 따르면, 정확 파악 반응 점수에 따른 점화효과는 전반적인 인지 기능을 평가하는 K-MMSE 및 ADAS-Cog와 정적인 상관이 있는 것으로 나타났으며 반응 속도로 측정한 점화효과의 경우에는 나이와는 정적인 상관이, KWIS의 <어휘> 소검사 점수와는 부적인 상관이 있는 것으로 나타났다. 또한, 본 연구에서 사용된 점화 효과 측정치를 종속 변인으로 ADAS-Cog와 KWIS의 어휘 및 코막 소검사로 측정한 지능 수준, 나이와 교육 연한과 같은 인구 통계학적 변인을 독립 변인으로 회귀 분석을 실시한 결과에 따르면 정화간응 점수로 측정한 점화 효과의 경우 상관 분석 결과에서와 같이 ADAS-Cog 변인만이 유의미한 효과를 갖는 것으로 나타났으며 반응 속도로 측정한 점화 효과의 경우 나이의 효과만 유의미한 것으로 나타났다. 결 론 : 이러한 결과는 경미한 인지 기능의 손상이 진행되고 있는 고연령군의 경우에는 외현 기억 능력은 손상이 시작되지만 점화효과로 측정된 암묵 기억이 전반적으로는 유지되다가 인지 기능의 퇴행이 진행됨에 따라 노출된 자극을 더 정확히 파악하는 능력이 저하되고 점화 효과에 의해 인출 속도가 빨라지는 현상이 연령이 증가함에 따라 함께 증가하는 것으로 나타남을 말해 준다. Objectives : In this study, the cognitive characteristics, especially priming effect, of above 50 years old age group who had less than 25 points in K-MMSE were investigated. Methods : In this study, an implicit memory test measuring priming effect was made and administered ti old age people who had less than 25 points in k-MMSe in screening session. To control the effect of age, educational level and intelligence, demograohic variables were measured, and the subjects of KWIS, vocabulary and block design were administered. Descriptive statistical analysis of the two priming measures and correlational analysis between variables were done. To test the effect of cognitive functioning on priming effect multiple regression analysis was done. Results : Correlational analysis revealed priming score obtained from correct identification response was positively correlated with K-MMSE and ADAS-Cog. And priming score obtained from mean reaction time was positively correlated with age and negatively correlated with vocabulary substest of KWIS. The regression analysis results indicated from correct identification response, whereas age has significant effect on priming score obtained from mean reaction time. Conclusions : The results revealed that as cognitive deterioration progresses priming effect which identify primed stimulus correctly diminish, and as one grow older within age 50 to 70, priming effect which identifies primed stimulus quickly increase.

난치성 백반증에 대한 흡입물집을 이용한 비배양 표피세포이식술 20례

배정민 ( Jung Min Bae ),정한미 ( Han Mi Jung ),이한나 ( Han Na Lee ),이로우 ( Ro Woo Lee ),은성혜 ( Sung Hye Eun ),권혁선 ( Hyuck Sun Kwon ),이지혜 ( Ji Hae Lee ),김경문 ( Gyong Moon Kim ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.7

Background: As nonsurgical interventions for vitiligo are not always successful, various surgical modalities have been used in patients with refractory vitiligo. Of these, non-cultured epidermal suspension transplantation (NCES) was recently introduced to treat large recipient sites using cells from small donor tissue. Objective: We assessed the effectiveness and safety of NCES as a surgical treatment for patients with refractory vitiligo. Methods: We retrospectively reviewed 20 cases in 17 patients (11 females; median age 25 years) who underwent NCES from July 2015 through March 2018. Suction blisters (20 mm in diameter) were collected from the patient’s inner thigh at a donor-to-recipient area ratio of 1:5. After the addition of 5 mL recombinant trypsin solution to the suction blisters, followed by incubation at 37°C for 60 min, epidermal cells were manually scraped off the blister surface, and epidermal cell suspension was obtained by centrifugation at 1,500 RPM for 5 min. The suspension was applied to the vitiligo regions after epidermal ablation of those regions. Phototherapy resumed 1 month later. Treatment success was defined as ≥75% repigmentation of the surgical site, and all adverse events were noted. Results: Overall, 85.0% of cases (17/20) exhibited treatment success. Adverse events included hyperpigmentation (20%) and surgical site infection (5%), but the treatment was tolerable in all cases. Conclusion: NCES is a reliable surgical option for patients with vitiligo refractory to nonsurgical treatment. Large areas of vitiligo can be treated by NCES, and use of this technique should be encouraged in Korea. (Korean J Dermatol 2018;56(7):426∼432)

소부혈(少府穴) 자침(刺鍼)이 Kainic Acid로 유도(誘導)된 간질(癎疾) 동물(動物)모델의 해마(海馬) 치상회(齒狀回)에 미치는 영향(影響)

김승태 ( Seung Tae Kim ),정주호 ( Joo Ho Chung ),정우병 ( Wu Byung Jeong ),김장현 ( Jang Hyun Kim ),강민정 ( Min Jung Kang ),홍미숙 ( Mee Sook Hong ),박해정 ( Hae Jeong Park ),김연정 ( Yeon Jung Kim ),박히준 ( Hi Joon Park ),이혜 대한경락경혈학회 2007 Korean Journal of Acupuncture Vol.24 No.4

Objectives: Epilepsy is one of the most common serious brain disorders that affect people of all ages, and it is characterized by recurrent unprovoked seizures. We examined whether acupuncture can reduce both the incidence of seizures and hippocampal cell death in dentate gyrus (DG) using a mouse model of kainic acid (KA)-induced epilepsy. Methods: ICR mice (20~25g) were given acupuncture once a day at acupoint HT8 (sobu) bilaterally during 2 days before KA injection. After an intracerebroventricular injection of 0.1μg of KA, acupuncture treatment was subsequently administered once more (total 3 times), and the degree of seizure was observed for 20 min. Three hours after injection, we confirmed the neural cell death using cresyl violet staining and silver impregnation staining, and determined the expressions of c-Fos and glutamate decarboxylase (GAD)-67 using immunohistochemistry techniques in the DG. Results: KA induced epileptic seizure, neural cell death, increased c-Fos expression and decreased GAD-67 expression in the DG. Acupuncture treatment at HT8 reduced the severity of the epileptic seizure and inhibited neural cell death from KA. In addition, acupuncture normalized the expressions of c-Fos and GAD-67 in the same areas. Conclusions: These results demonstrated that acupuncture treatment at HT8 may reduce the KA-induced epileptic seizure and neural cell death in the DG possibly by normalizing c-Fos expressions and the gamma-aminobutyric acid neurons.

일측성 질폐쇄 및 동측 신장 무발생을 동반한 중복자궁 2예

윤일영,여소진,김형문,김정식,김태희,이해혁,남계현,이권해,김준모,김민의 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Uterus didelphys with unilateral obstructed hemivagina and ipsilateral renal agenesis usually presents after menarch with progressive abdominal pain during menses secondary to hematocolpos, and indeed a very rare congenital anomaly due to Mullerian duct malformation. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patient. Pelvic ultrasound, physical examination and pelvic MRI established a diagnosis of hematometracolpos secondary to uterus didelphys with unilateral imperforate hemivagina. An incision in the vaginal septum allowed drainage of the hematocolpos, providing relief of the patients symptoms. We report two case of uterus didelphys with obstructed hemivagina with brief review of the literature.

Bioconversion of ginsenoside Rc into Rd by a novel α-L-arabinofuranosidase, Abf22-3 from Leuconostoc sp. 22-3: cloning, expression, and enzyme characterization.

Liu, Qing-Mei,Jung, Hae-Min,Cui, Chang-Hao,Sung, Bong-Hyun,Kim, Jin-Kwang,Kim, Song-Gun,Lee, Sung-Taik,Kim, Sun-Chang,Im, Wan-Taek N.V. Swets en Zeitlinger 2013 Antonie van Leeuwenhoek Vol.103 No.4

<P>A novel α-L-arabinofuranosidase (Abf22-3) that could biotransform ginsenoside Rc into Rd was obtained from the ginsenoside converting Leuconostoc sp. strain 22-3, isolated from the Korean fermented food kimchi. The gene, termed abf22-3, consisting of 1,527 bp and encoding a protein with a predicted molecular mass of 58,486 Da was cloned into the pMAL-c2x (TEV) vector. A BLAST search using the Abf22-3's amino acid sequence revealed significant homology to that of family 51 glycoside hydrolases. The over-expressed recombinant Abf22-3 in Escherichia coli BL21 (DE3) catalyzed the hydrolysis of the arabinofuranoside moiety attached to the C-20 position of ginsenoside Rc under optimal conditions of pH 6.0 and 30 C. This result indicated that Abf22-3 selectively converts ginsenoside Rc into Rd, but did not catalyze the hydrolysis of glucopyranosyl groups from Rc or other ginsenosides such as Rb1 and Rb2. Over-expressed recombinant enzymes were purified by two steps with amylose-affinity and DEAE-cellulose chromatography and then characterized. The kinetic parameters for α-L-arabinofuranosidase showed apparent Km and Vmax values of 0.95 0.02 μM and 1.2 0.1 μmol min(-1) mg of protein(-1) against p-nitrophenyl-α-L-arabinofuranoside, respectively. Using a purified MBP-Abf22-3 (10 μg/ml), 0.1 % of ginsenoside Rc was completely converted to ginsenoside Rd within 20 min.</P>

로스팅 서리태를 이용한 음료 제조 및 품질 평가

정수옥,김혜연,한정순,김민주,강미숙,김애정,Jeong, Soo-ok,Kim, Hae-yean,Han, Jung-soon,Kim, Min-ju,Kang, Mi-sook,Kim, Ae-Jung 한국식품영양학회 2016 韓國食品營養學會誌 Vol.29 No.4

This study was performed to develop and evaluate beverage prepared with optimally roasted seoritae to maximize the isoflavone content and antioxidant activities of the beverage. Isoflavone content was maximized at the roasting temperature of $110^{\circ}C$ for 20 min. Both DPPH radical scavenging activity and ABTS radical scavenging activity along with total polyphenol content were highest when seoritae was roasted at $110^{\circ}C$ for 20 min. Western blotting was used to determine the level of nuclear factor of activated T-cells 1(NFATc1) involved in controlling osteoclast differentiation. The results showed that NFATc1 had a concentration-dependent inhibitory effect when the RoS110 (roasted seoritae at $110^{\circ}C$ for 20 min) samples were processed at varying concentrations (10, 50, and $100{\mu}g/mL$). Tea samples were prepared from optimally roasted seoritae by varying brewing times (5~90 min) at $65^{\circ}C$, and tea brewed for 60 min had the highest preference with $65^{\circ}C$ as the preferred temperature for drinking.