아세틸 콜린 유발 검사시 허혈성 심전도 변화와 흉통의 발생이 내피세포 기능장애에 미치는 영향

최철웅(Cheol Ung Choi),나승운(Seung-Woon Rha),김선원(Sun Won Kim),나진오(Jin Oh Na),임홍의(Hong Euy Lim),김진원(Jin Won Kim),김응주(Eung Ju Kim),한성우(Seong Woo Han),박창규(Chang Gyu Park),서홍석(Hong Seog Seo),오동주(Dong Joo Oh) 대한임상노인의학회 2010 대한임상노인의학회지 Vol.11 No.4

연구배경: 아세틸 콜린 유발 검사시 발생하는 흉통과 허혈성 심전도 변화가 아세틸 콜린에 의해 발생하는 관상동맥의 내피세포 기능에 어떤 영향을 주는지 알아보고자 했다. 방법: 흉통으로 내원하여 관상동맥 조영술과 아세틸 콜린 유발검사를 시행받은 1,085명의 환자를 대상으로 하였다. 아세틸 콜린 유발 검사를 하는 동안 허혈성 심전도 변화 및 흉통의 발생 유무에 따른 관상동맥 내피세포 기능의 특징을 비교하였다. 결과: 539명의 환자에서 아세틸 콜린 검사시 내피세포 기능 장애가 발생 하였다. 허혈성 심전도 변화가 있었던 그룹이 심전도 변화가 없었던 그룹보다 흉통이 더 많았고(78.1% vs. 60.8%, P=0.007), 관상동맥 조영술상 다발성 관상동맥 경련이 빈번하였고(59.4% vs. 40.6%, P=0.004), 관상동맥의 경련 정도도 더 심하였다(64.1% vs. 46.5%, P=0.006). 흉통이 있었던 그룹이 흉통이 없었던 그룹보다 허혈성 심전도 변화의 빈도가 더 높았다(14.7% vs. 7.5%, P=0.007). 또한 흉통이 있었던 그룹이 관상동맥 경련이 다발성으로 발생하는 경우가 많았고 (50.7% vs. 29.5%, P<0.001), 미만성으로 발생하는 경우가 많았고(87.1% vs. 75%, P<0.001), 관상동맥의 경련의 정도도 더 심하였다(51.6% vs. 43.5%, P=0.041). 결론: 아세틸 콜린 유발검사시 발생하는 허혈성 심전도 변화와 흉통은 관상동맥 경련의 정도와 경련이 발생하는 관상동맥 개수와 연관이 있다. Background: ECG changes and chest pain during acetylcholine (Ach) provocation tests may constitute important clinical parameters for Ach-induced endothelial dysfunction. We investigated the association between ischemic ECG changes and chest pain during the Ach-provocation test and angiographic characteristics of Ach-induced endothelial dysfunction. Methods: A total of 1,085 patients with anginal symptoms underwent diagnostic coronary angiography (CAG) and Ach-provocation tests. We compared angiographic characteristics of Ach-induced endothelial dysfunction according to the presence of ECG change and chest pain. Results: A total of 539 patients experienced Ach-induced endothelial dysfunction. Patients who experienced ECG change group suffered more frequent chest pain (78.1% vs. 60.8%, P=0.007), angiographically more frequent multiple coronary artery spasm (59.4% vs. 40.6%, P=0.004), and more severe coronary artery spasm (64.1% vs. 46.5%, P=0.006) than patients without ECG change. However, there was no difference in the length of endothelial dysfunction between the groups. The incidence of ischemic ECG changes in patients with chest pain was higher than in patients without chest pain (14.7% vs. 7.5%, P=0.007). Patients who experienced chest pain more often experienced multiple (50.7% vs. 29.5%, P<0.001), diffuse (87.1% vs. 75%, P<0.001), and severe coronary artery spasm (51.6% vs. 43.5%, P=0.041) than patients without chest pain. Conclusion: Ischemic ECG changes and chest pain during the Ach-provocation test are associated with multi-vessel involvement and severe coronary artery spasm. Chest pain is associated with the length of endothelial dysfunction, but ischemic ECG change is not.

흰쥐에서 사염화 탄소(CCl4)에 의한 간섬유화의 유도

김병호,이정일,김효종,김영관,장린,동석호,장영운,송일한 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6

Experimental model of hepatic fibrosis is importent contributions to the understanding of cellular and molecular mechanisms underlying excessive accumulation of extracellular matrix in the liver. Carbon tetrachloride (CCl₄) is one of the oldest and most widely used toxin for experimental induction of hepatic fibrosis in laboratory animals. In this study, We intended to induce the hepatic fibrosis in the rat by the intragastric CCl₄/ phenobarbtal treatment once a week for 12 weeks and the administration dosage of CCl₄ in each week was determined by the daily body weight change. Liver function and histologic change were examined just after 12-week treatment in group Ia (9 rats, Phenobarbital treatment only) and II (18 rats, CCl₄/phenobarbital treatment), and liver function and the irreversibility o histologic change were examined 12 weeks after 12-week treatment in group Ib (9 rats, phenobarbital treatment only) and III (18 rats, CCl₄/phenobarbital treatment). 1) Death rate after 12-week treatment was 11% in group Ⅰ, 56% in group Ⅱ and 50% in group Ⅲ. and the highest rate was at 1 week. that is 33 o each in group Ⅱ and Ⅲ. 2) Tatal protein, alkaline phosphatase, alanine aminotransferase and portal venous pressure were significantly increased in group Ⅱ compared with that in group Ⅰa, but it was only portal venous pressure that was increased in group Ⅲ than in group Ⅰb, 3) The gross finding of micronodular change was shown in 88% of group Ⅱ, 71% of group Ⅲ, but none of group Ⅰ. The microscopic finding of hepatic fibrosis was found in all of group Ⅱ and Ⅲ, but none of group Ⅰ. The severe form of hepatic fibrosis suggesting cirrhosis was found in group Ⅱ and Ⅲ, 12% and 29% respectively. In our study, mortality rate was high within 1 week after CCl₄ treatment, which resulted in half survival rate after 12-week treatment. We also experienced the loin rate of severe fibrotic changes in surviving rats. In the future, in order to produce a severe irreversible fibrotic change with low mortality in inducing hepatic fibrosis with CCl₄/phenobarbital treatment in the rat, adequate detemination of the initial dose of CCl₄ and appropriate choice of administration route of CCl₄ were thought to be needed.

정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

급성 췌장염의 시대적 변화

김배영(Bai Young Kim),김효종(Hyo Jong Kim),정형근(Hyung Keun Chung),김영관(Young Kwan Kim),동석호(Seok Ho Dong),김병호(Byung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: According to the rapid changes in social environment such as increasing alcohol consumption and the marked improvement in diagnostic technique, we expect that there have been major changes in various aspects of acute pancreatitis during the recent 12 years in Korea. Methods: The medical records of 317 patients with acute pancreatitis diagnosed from 1980 through 1992 were reviewed about clinical, laboratory and radiological findings in the three different time period. Results: 1) There has been an increasing incidence in male sex about three folds. 2) There has been an increasing trends in the duration of hospitalization. 3) A significant increase was observed in the proportion of patients with alcoholic pancreatitis in the three different time period; 26.9%, 45.7%, 50.7% respectively. 4) The complication rates have been slightly increased in the three different time period; 46.3%, 47.1%, 59.1% respectively. But, the type of complications has not been changed. 5) There is increasing severity in non-gallstone group, but no significant differences in gallstone group. There is a declining trends in the number of patients with muld severity index, but increasing trend in the number of patients with moderate severity index in non-gallstone group. 6) There was no significant differences in mortality rate. Conclusions: There has been major changes in the etiology ans severity of acute pancreatitis from 1980 through 1992. Especially, significant increase in the proportion of patients with alcoholic pancreatitis was observed in the three differnt time period. These results might be due to socioeconomic changes.

1990년대 간경변증의 원인, 합병증, 사망원인의 변화에 관한 고찰

김병호,김경진,김효종,장린,이정일,동석호,이동근,한요셉,장영운,백일현 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.3

$quot;목적: 우리나라에서 간경변증의 가장 중요한 원인은 B형 간염이지만 최근 C형 간염에 의한 경우가 늘고 있으며, 알코올성 간경변증은 드문 것으로 알려져 있으나 음주 인구 및 음주량의 증가로 빈도가 증가되었을 것으로 추측된다. 또한 진단 기술의 발달, 정맥류 출혈 치료의 발전, 간세포암의 조기진단 및 치료법의 발달로 간경변의 진단 시기 및 사망원인 등에도 변화가 있을 것으로 생각된다. 이에 연자 등은 C형 간염 진단이 가능하게 된 1991년 이후의 환자를 대상으로 간경변증의 원인, 진단 시기, 합병증 및 사망원인의 변화 등을 조사하여 비교, 분석하였다. 대상과 방법: 1991년부터 1998년까지 경희대학교 병원에 입원하여 간경변증으로 진단된 1157명의 환자를 대상으로 원인, 합병증의 발생빈도, 사망원인에 대하여 병력기록을 후향적으로 분석하였으며, 이들 결과를 전ㆍ후반기로 나누어 비교하였다. 결과: 간경변증 환자 1157명 중 남자가 848명(73.3%)으로 많았으며, 전ㆍ후반기의 차이는 없었다. 환자의 연령은 전반기 51.4±11.1세, 후반기 51.2±11.2세로 차이가 없었으며, B형 간염이나 알코올에 의한 경우도 유사한 양상이었다. 그러나 C형 간염에 의한 경우는 약 10세 높은 연령), 알코올(12.7%, 20.0%), C형 간염(8.5%, 17.5%) 순으로 후반기에 알코올이나 C형 간염에 의한 경우가 증가하였으나 통계학적 차이는 없었다. 사망환자 249명의 원인 분석에서 전ㆍ후반기 모두 간부전(38.7%, 40.2%)이 가장 많았고, 그 이외 전반기는 정맥류 출혈(20.0%), 간암(18.7%), 간신증후군 순(11.3%)이었고 후반기는 간신증후군(19.2%), 정맥류 출혈(16.2%), 간암(11.2%) 순으로 간신증후군은 증가하고 정맥류출혈은 감소하는 경향이었으나 통계학적 차이는 없었다. 결론: 1990년대 간경변증의 원인은 과거와 마찬가지로 B형 바이러스 감염이 가장 많았지만, 알코올성 간경변증의 빈도가 약 30%로 과거에 비하여 증가한 것으로 생각되었다. C형 간염바이러스 감염에 의한 경우는 빈도의 변화 없이 약 10세 높은 연령에서 진단되었다. 간경변증의 진단은 점차 간경변 초기에 진단되는 경우가 증가하였다. 간경변증의 사망원인 중 정맥류 출혈은 점차 감소한 반면 간경변증 말기에 나타나는 간신증후군에 의한 경우가 증가하는 경향을 보였다$quot;. $quot;Background: Alcoholic liver disease has increased. The causes of death in liver cirrhosis have changed. The author tried to categorize the etiology and complications of liver cirrhosis and analyze the causes of death in the 1990s. Method: The author retrospectively reviewed medical records of 1,175 patients diagnosed as having liver cirrhosis at Kyung Hee University Hospital from January 1991 through December 1998. The etiology, complications and the cause of death were compared between the early (1991-1994) and the late (1995-1998) periods. Results: The proportion of male patients (73.3%) was still about 3 times that of female patients. There was no difference in age at the time of diagnosis between early and late periods (51.4 11.1 and 51.2 11.2 years respectively). Hepatitis B virus (HBV) infection was still the most common cause of liver cirrhosis (57.0%) and alcohol was the next (31.1%). The complications of liver cirrhosis at the time of diagnosis were, in order: esophageal varices, ascites, and variceal bleeding. But there was no significant difference between the periods. The proportion of Child grade B was the most common at the time of diagnosis in both periods, but Child grade A increased in the late period. The most common cause of death was liver failure and the next cause was variceal bleeding in the early period. Hepatorenal syndrome was the second most common cause in the late period. Conclusion: There was no change in the etiology between early and late periods. HBV infection was still the most common etiology but the incidence of alcoholic liver cirrhosis might have increased in the 1990s. The proportion of the Child B at initial diagnosis was the highest (around 50%) but that of Child A increased in the late period. Among the causes of death, liver failure and hepatorenal syndrome had a tendency to increase in the late period$quot;.

문화 사회에서 기독교의 선교신학적 방향

김창운(Kim, Chang-woon) 한국선교신학회 2010 선교신학 Vol.25 No.-

This study builds on a direction of the missiological spirituality of Christianity in multicultural society . Currently. multiculturalization is a noticeable change of the globalized world . Specifically, Korean society recently experiences such a change. As Christianity has been dynamically transformed to adjust culture change, or context change, for the missiological purpose, Korean Christianity demands a new perspective that can be adapt to the today 's context change. This study is focusing on the contextual need . By employing the biblical and theological discussion , the writer illuminates Christ ian basic idea from the perspective of relation ship-based spirituality . Simply, Christianity is basically relationship-based . From the creation story, God the Father was co- working with the Son and the Spirit in the nature of the Trinity. In the greatest commandment, the on is inviting all creature into God's such a relational friendship. (Mr. 22 :37-4 0) This belief was inherited to the disciples Just as the benediction of Paul in 2Corinthians ( 13: 14 ) presents that blessings are derived from the Trinity of the relational God. Furthermore, Jesus extends the concept of relational friendship, not only close neighbors but also far -off neighbors, that is, not only the members of family and church community, but also st rangers and even enemies. Such a Biblical principle currently direct s the Christ ian perspective to reach to all the neighbors. people from different cultures. with the love of Christ , called relation ship-based spirituality. In order to investigate effect ive methods, this writing suggests SIX main theoretical models. As for the concept of intercultural perspective, the writer brings the notion of Klaus lssler, which can be called the extension of neighbor concept. And for the ideas of cultural diverse and individuals' transformation , th is study employs following models, like experiential transformation (Da vid Kolb ), hidden curriculum (judith and Sherwood Lingenfelter). ecology system (Urie Bronfenbrenner), multiple intelligence (Howard Gardner), storytelling (Tom Steffen ), Th us, the concept of intercultural transformation can be conceptualized as the relation ship-based love of Christians toward all the people from diverse cultures .

SV40 T 항원의 온도조건부 변이형 유전자가 포함된 Amphotropic Retrovirus 에 의한 사람 태아 간세포의 불멸화

이정일(Joung Il Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),김병호(Byung Ho Kim),장영운(Young Woon Chang),장린(Rin Chang),성세라(Se Ra Seong),박재경(Jae Kyung Park),김승보(Seung Bo Kim),이상목(Sang Mok Lee) 대한내과학회 1999 대한내과학회지 Vol.57 No.1

N/A Human cells are almost never spontaneously immortalized in vitro. We tried to immortalize human fetal hepatocytes (h-FH) and evaluate the differentiational status and its change. Methods : Hepatocytes were isolated from a liver fragment of 20 week old fetus and infected with amphotropic recombinant retrovirus containing a temperature- sensitive mutant of SV40 large T antigen and neomycin phosphotransferase gene. G418 resistant colonies were cloned and expanded. The cells which were able to divide more than 30 times were used to analyze various functions. Results : The immortalization rate was 3.3 x 10-8 and two cell lines (C11, D21) were established. C11-60, C11-80, D21-30 and D21-60 (suffix number means the cell division counts) were evaluated. D21-30 was thougt to be imcompletely immortalized because a considerable portion of cells died during culture. The morphology was similar to that of epithelial cells except for D21-30 which looked like fibroblast. The cells grew rapidly at 33oC but stopped growing at 39oC. T antigen and p53 was expressed at 33oC but disappeared at 39oC, which suggest that T antigen binds to p53. Chromosomal changes were so marked that it was impossible to discriminate exact number. Albumin was secreted as about 1/10 as that of h-FH, but alpha-fetoprotein secretion stopped after immortalization. Telomerase was activated in both cell lines except for the incompletely immortalized cells D21-30. Telomere was elongated in competely immortalized cell lines, but it was rather shortened in D21-30 compared to that of h-FH. Macroscopic colonies did not develop in soft agar assay. Conclusions : We successfully immortalized human fetal hepatocytes. Although the cells are not likely to have oncogenicity, the functions are not so good, possibly due to marked chromosomal changes which are thought to occur before telomerase is activated during immortalization step.

뼈에 발생한 악성 림프종 환자의 치료 효과 판정에서 ^(18)F-FDG Positron Emission Tomography의 유용성

김남돈,박연희,기승석,박용진,김형준,류백렬,김흥태,김성은,천기정,최창운,임상무 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

원발성골림프종은 매우 드문 질환이기는 하나, 복합항암요법이나 방사선 치료등에 높은 반응율을 보이며, 좋은 예후를 가지는 림프절의 비호지킨 림프종의 일종이다. 그러나, 치료 효과 판정에 있어 골병변의 특이성에 의한 모호한 방사선학적 특징으로 어려움이 있어 왔다. 본 증례는 위와 같은 원발성골림프종 환자에서 PET 스캔을 사용하여 민감하게 완전 반응을 평가할 수 있었던 예로, 앞으로 다른 고식적인 방법과 함께 이 질환의 진단과 치료 평가 있어 유용하게 사용 될 수 있을 것으로 전망할 수 있었다. Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose (^(18)FFDG)PET uptake diminished more rapidly following therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT. It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with ymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on ^(18)FFDGPET while CT showed persistent destructive bone lesion. Thus, ^(18)FFDGPET study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.

연립 주택 화재시 유독가스 방출 특성과 Rats를 이용한 독성평가

김홍,강영구,김동현,정기창,이창섭,김운형 한국화재소방학회 2002 한국화재소방학회논문지 Vol.16 No.3

화재에 의한 독성가스의 노출은 인간에게 있어서 화재시 생명에 아주 위험한 요소일 것이다. 다양한 화재에 의한 독성가스의 노출 중 본 논문에서는 경기도 안산시 재개발지구에서 한 연립주택을 이용하여 실제화재와 같은 조건으로 화재 시험을 하였다. 화재시 발생하는 가스 CO, CO_2, O_2, SO_2, NO 및 NO_2등을 측정하였으며, 발생하는 가스를 실험동물인 백서(S.D)에 노출시켜 2분간격으로 혈액을 체취하였다. 독성평가를 위하여 백서의 혈액과 혈청 중 Glucose, AST(GOT), ALT(GPT), CBC Count 및 CO(carboxy)-Hb를 분석하였다. 폭로되는 CO의 농도와 백서의 혈액중 CO-Hb 농도사이에 양-반응 관계(dose-response relationship)를 보였다. It has long been recognized that exposure to fire-induced toxic gases is a fatal hazard confronting people in fires. In this study, an indoor fire experiment was conducted in an unoccupied residential building located in An-san city, Kyoung-gi province, and the composition of effluent gases, which include CO, CO_2, O_2, SO_2, NO and NO_2, were measured by a gas analyzer A group of lab rats were exposed to the toxic gases released from fire, and the blood samples of the rats were gathered every 2 minutes. A toxicity evaluation was conducted by analyzing the concentrations of Glucose, AST(GOT), ALT(GPT), CBC Count and CO(carboxy)-Hb in the blood samples. Shown from the analysis is the does-response relationship between the CO concentration that rats were exposed to and the CO-Hb concentration in rat blood.

TSC 합성보의 제작방법에 따른 구조적 거동에 관한 실험적 연구

이지운,김도훈,김성배,이창남,김상섭,김규석 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

Composite action can be achieved by providing shear connectors between steel top flange and concrete topping. Composite sections have larger stiffness than the summation of the individual stiffness of slab and beam, therefore, can carry larger load or similar loads with appreciably smaller deflection and are less prone to transient vibration. T-type Steel Composite beam(TSC-beam) is developed and tested. To make the part of steel beam, we used the way of welding two steel plates as well as the way of folding one steel plate.