Furosemide에 의한 소디움 운반체 발현의 변화

오윤규 ( Yoon Kyu Oh ),나기영 ( Ki Young Na ),이재욱 ( Jay Wook Lee ),장혜련 ( Hye Ryun Chang ),박영선 ( Young Sun Park ),박정환 ( Jung Hwan Park ),주권욱 ( Kwon Wook Joo ),김근호 ( Gheun Ho Kim ),이정상 ( Jung Sang Lee ),한진석 ( 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.2

배경 : 임상에서 흔히 사용하는 이뇨제 furosemide는 비후상행각에서 Na+-K+-2CI- cotranspoter (NKCC2)를 억제하여 NaCl 재흡수를 차단하여 이뇨작용을 나타낸다. Furosemide를 장기간 투여하면 내성과 대사성 알카리증의 부작용이 발생할 수 있는데, 이는 집합관에 도달하는 소디움 증가와 관련 있을 가능성이 있다. 방법 : 저자들은 furosemide의 내성이나 부작용이 집합관 상피 소디움 통로 (ENaC) 단백발현의 변화와 관련이 있는지를 확인하고자, Sprague-Dawley rat에서 farosemide (12 mg/day)을 7일간 지속적 피하 주입한 후 반정량적 immunoblotting과 면역조직화학법을 이용하여 NKCC2, Na +-CL- cotransporter (NCC), ENaC 단백의 발현을 관찰하였다. 실험기간 동안 수분과 전해질 용액 (0.8% NaCl & 0.1% KCl)을 자유롭게 섭취하도록 하여 체액 감소를 방지하였다. 결과 : 부형약 (vehicle)을 투여한 대조군에 비하여, furosemide를 투여한 군에서 각각 요량과 요 소디움 배설이 증가하였으나, 체중, 혈청 알도스테론치 및 크레아티닌 청소율은 차이가 없었다. Furosemid 투여 후 NKCC2 단백은 피질 (151±10 vs. 100±10%, p<0.05)과 외수질 (122±5 vs. 100±3%, p<0.01)에서 증가해 있었다. ENaC 단백은 세 가지 subunit 모두 furosemide 투여 후 대조군에 비하여 피질 (α:187±25 vs. 100±22%, p<0.05; β:155±8 vs. 100±15%, p<0.05; γ:168±16 vs. 100±9%, p<0.05)과 외수질 (α:171±27 vs. 100±17%, p<0.05; β :986±91 vs. 100±33%, p<0.01; γ :242±24 vs. 100±22%, p<0.01)에서 증 가하였다. 면역조직화학법에서도 furosemide를 투여한 군의 집합관 주세포에서 ENaC β-subunit가 더 강하게 염색되었다. 결론 : 이상에서 장기간 furosemide 투여시 집합관 ENaC 발현이 증가하며, 이러한 원위부네프론의 적응 반응이 이뇨제 내성을 유발하는데 기여할 것으로 생각한다. Background : Furosemide inhibit NaCl absorption in the thick ascending limb and produce an increase in distal delivery of Na+. We carried out semiquantitative immunoblotting and immunohistochemistry of rat kidneys to investigate whether chronic furosemide infusion is associated with compensatory increases in the abundance of Na+ transporters in distal nephron. Methods : Osmotic minipumps were implanted into Sprague-Dawley rats to deliver 12 mg/day of furosemide(n=6) with simultaneous administration of 0.8% NaCl and 0.1% KCl in drinking water for 7days. Results : Compared with vehicle infused controls, urine volume and urine sodium amount were increased. However, there were no differences in body weight, serum aldosterone, and creatinine clearance. The abundance of Na+-K+-2CI - cotransporter after furosemide infusion was increased in cortex (151±10 vs. 100±10%, p<0.05) and outer medulla (122±5 vs. 100±3%, p<0.01). In furosemide infusion group, the abundance of all three subunits of epithelial sodium channel (ENaC) was increased both in cortex (α:187±25 vs. 100±17%, p<0.05; β:155±8 vs. 100±15%, p<0.05; γ :168±16 vs. 100±9%, p<0.05) and outer medulla (α:171±27 vs. 100±17%, p<0.05; β :986±91 vs. 100±33%, p<0.01; γ :242±24 vs. 100±22%, p<0.01). Consistent with these results, ENaC β-subunit immunohistochemistry showed a remarkable increase in immunoreactivity in the principal cells of collecting ducts with furosemide treatment. Conclusion : These increases in the abundance of ENaC protein may account for the generation of diuretic tolerance.

학습성과 평가를 위한 측정도구 개발 및 양호성 검증

주영주,한상윤,김나영 이화여자대학교 교과교육연구소 2013 교과교육학연구 Vol.17 No.2

교과목의 학습성과는 교육의 결과로서 프로그램을 결정하고 학습자의 교육목표를 설정하는데 있어 매우 중요하다. 이는 비단 교과교육에 국한되지 않으며, 비교과교육인 평생교육에 있어서도 교육목표를 설정하고 성공적인 교육 실현을 이끌어내는 바탕이 된다. 이에 교육의 성공적인 질 관리를 위해서 학습자의 특성을 반영한 학습성과 측정이 중요하다. 본 연구는 학습성과 평가를 위한 측정도구를 개발하고 그 양호성을 검증하려는 목적으로 실시되었다. 측정도구를 개발하기 위하여 우선 국내외 문헌고찰 및 관련 문항들의 검토를 바탕으로 35문항을 개발하였고 내용타당도 검증 및 문항이해도 검토를 통하여 문항 제거 및 수정, 보완을 거쳐 24문항을 선정하였다. 이에 대한 타당도를 검증하고자 E대학 평생교육원의 교육과정에 참여하고 있는 성인학습자 158명을 대상으로 1차 설문조사를 진행하였고, 탐색적 요인분석을 실시하였다. 탐색적 요인분석 실시 결과 최종 측정 도구는 5개 요인, 22개 문항으로 확정되었다. 그리고 최종 측정도구에 대한 적합도 검증을 위하여 263명을 대상으로 2차 설문조사를 진행하여 확인적 요인분석 및 상관과 신뢰도 분석을 실시하였다. 이를 통하여 본 측정도구는 적합한 도구임이 검증되었다. 본 연구는 학습자의 특성을 반영하여 학습성과를 평가할 수 있는 도구를 개발하고 그 양호성을 검증함으로써 이전보다 명확한 학습성과 평가가 이루어 질 수 있도록 한 데 그 의의가 있고, 더 나아가 이는 우리나라 평생교육의 성공적인 질 관리에 기여할 수 있을 것이다. The purpose of this study was to develop a scale to measure learning outcomes. In addition, this study attempted to verify the validity of the scale. Based on the results of a literature review, 35 items are developed. These 35 items were then reviewed by three experts and five adult learners. As a result of this process, the number of items was reduced from 35 to 24 items. For the revised-item analysis, 158 adult learners who had completed a course in a lifelong learning institute were chosen for the survey. Through Exploratory Factor Analysis(EFA), two items were deleted. Finally, 22 items in 5 categories were developed based on EFA. To verify the validity of the scale, Confirmatory Factor Analysis(CFA) was conducted with the 263 participants. The model fit of the scale was good. In addition, the factors were correlated with each other and their reliability was good. This study therefore suggests that the reliability and validity of the scale was appropriate. This scale can help evaluate the learning outcomes of learners in a lifelong education institute.

장기간 이뇨제 투여에 따른 요 산성화 능력과 집합관 H^(+)-ATPase 발현의 변화

김근호,나기영,한진석,오윤규,이정상,주권욱,엄재호 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

목 적 : 저자들은 임상에서 흔히 사용하면서 대사성 알칼리증을 유발할 수 있는 furosemide와 hydrochlorothiazide를 장기간 투여할 때 발생하는 요 산성화능의 변화를 관찰하고, 이에 동반하여 근위세관 및 헨리고리관의 NHE3와 집합관의 H^(+)-ATPase 단백 발현에 변화가 있는지 조사하고자 하였다. 방 법 : Sprague-Dawley rat에서 수분과 전해질 용액을 자유롭게 섭취시키면서 furosemide12 mg/day/rat 혹은 hydrochlorothiazide 7.5 mg/day/rat을 각각 7일간 지속적 피하 주입시킨 후 신장에서 반정량적 immunoblot 분석을 시행하여 대조군과 비교하였다. 결 과 : Furosemide 투여 후 대조군과 실험군 사이에 체중, 혈청 알도스테론 및 크레아티닌청소율은 차이가 없었다. 요량 및 요 소디움 배설은 furosemide 투여 후 현저하게 증가하였다. 요 pH가 furosemide 투여 후 감소하였고, 요 암모늄 배설은 furosemide 투여 후 증가하였다. 반정량적 immunoblot 분석 결과 furosemide 투여 후 신 피질의 NHE3 발현에 유의한 변화는없었으나, 신 외수질의 NHE3 발현은 실험군(182±25%)에서 대조군(100±25%)에 비해 증가하였다(p<0.05). 또한, H^(+)-ATPase B1 subunit 발현은 furosemide 투여 후 신 피질(대조군100±13%, 실험군 178±11%, p<0.01)과 신 외수질(대조군 100±29%, 실험군 239±24%, p<0.05)에서 모두 증가하였다. Hydrochlorothiazide 투여 실험에서도 요량 및 요 소디움 배설의 증가와 요 pH의 감소를 확인하였다. 신 피질과 외수질의 NHE3 발현은 hydrochlorothiazide투여 후 변화 없었으나, H^(+)-ATPase B1 subunit 발현은 신 피질(대조군 100±24%, 실험군212±27%, p<0.05)과 신 외수질(대조군 100±13%, 실험군 194±13%, p<0.01)에서 모두 증가하였다. 결 론 : 장기간 furosemide 혹은 hydrochlorothiazide 투여에 의해 원위 요 산성화 능력의 항진을 확인하였고, 이는 집합관 H^(+)-ATPase 단백 발현이 증가하여 발생한 결과로 설명할 수 있을 것으로 생각한다. Purpose : Commonly used diuretics such as furosemide and hydrochlorothiazide may cause metabolic alkalosis by increasing proton secretion from distal nephron. We evaluated changes in urinary acidification and abundance of proton-secreting transporters in response to chronic subcutaneous infusion of diuretics. Methods : Osmotic minipumps were implanted into Sprague-Dawley rats to deliver 12 mg/day furoemide or hydrochlorothiazide 7.5 mg/day for 7 days. All animals were offered tap water and a solution containing 0.8% NaCl and 0.1% KCl as drinking fluid. Results : Compared with vehicle-infused controls, diuretic and natriuretic responses were evident from furosemide or hydrochlorothiazide infusion. However, there were no changes in body weight, serum aldosterone and creatinine clearance between diureticinfused( n=6) and control(n=6) rats. In both furosemide- infused and hydrochlorothiazide-infused rats, urine pH was significantly lowered compared with controls. Furosemide-infused rats showed significantly larger excretion of urinary ammonium. Semiquantitative immunoblotting was carried out from rat kidneys to investigate abundance of proximal tubule or medullary thick ascending limb Na^(+)/H^(+) exchanger type 3(NHE3) and collecting duct H^(+)- ATPase using specific polyclonal antibodies to NHE3 and H^(+)-ATPase B1 subunit, respectively. The abundance of NHE3 from cortical homogenates was not changed by either furosemide or hydrochlorothiazide infusion. However, the abundance of NHE3 from outer medullary homogenates was increased by furosemide infusion. The H^(+)-ATPase B1 subunit abundance was increased by furosemide or hydrochlorothiazide infusion in both cortical and outer medullary homogenates. Conculsion : These increases in the abundance of proton-secreting transporters may account for the enhanced distal urinary acidification in response to chronic diuretic administration. (Korean J Nephrol 2002;21(2):222-231)

부산 지하철 2호선 소음 특성 연구

정경원,윤나나,김주인,곽진,김영태 한국환경과학회 2006 한국환경과학회지 Vol.15 No.3

콜리플라워를 이용한 피클제조 최적화

정현아,윤지영,황재선,주나미 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.2

The purpose of this study was to determine the organoleptic characterisitcs of cauliflower pickles made in various compounding ratio according to central conposite design for optimum organoleptic characteristics of the cauliflower pickles. The optimum mixing condition of cauliflower pickles were optimized, using central composite design with 3 variables and 3 levels, by response surface methodology. The various kinds of cauliflower pickle were made in various compounding ratio of vinegar, salt and sucrose - critical ingredients of pickle recipe - and were presented to reliable panels, who graded the subjects in 7 degrees for 4 items : color, lavor, hardness and overall quality. The optimum mixing conditions of cauliflower pickle were 603.50g of vinegar, 80.13g of salt and 251.079 of sucrose in the maximum point of overall quality.

성인 급성 신부전의 원인 및 예후인자 분석

구영선,장윤경,양종오,강민규,황평주,김종학,나기량,이강욱,신영태 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

Acute renal failure is a frequent complication in hospitalized patients and is strongly related to the mortality. The Clinical outcome and prognostic factors of acute renal failure(ARF) have been analyzed by many authors. The present study describes the etiologic and clinical aspects, as well as other factors related to mortality. All the patients suffering from acute renal failure admitted during the period of January 1993 - August 1998 were included in the study. The average age of the patients was 52±17 years and mortality rate was 24%. The causes of acute renal failure were hemorrhagic fever with renal syndrome(HFRS), sepsis, renal hypoperfusion, urinary tract obstruction, acute tubular necrosis, etc. The etiology of ARF was a significant prognostic factor on mortality in ARF. Other significant prognostic factors were oliguria, organ failure, use of vasoconstrictors, hypotension, serum bicarbonate, premorbid conditions, sepsis, neurologic complications, gastrointestinal bleeding. On the other hands, operation, sex, anemia, thrombocytopenia, hypoalbuminemia, BUN, serum creatinine, and hyperkalemia were not significant factors for the mortality. We conclude that major prognostic factors of acute renal failure arc premorbid conditions, sepsis and multiorgan failure, and they are responsible for persistent high mortality of acute renal failure despite of advances of medical care.

전신성 홍반성 낭창의 임상적 고찰

신영태,김종학,장윤경,양종오,구영선,강민규,황평주,나기량,이강욱,서광선 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The epidemiology, diagnostic criteria, clinical features, symptoms and signs laboratory findings, kidney pathology, and clinicopathologic correlation of systemic lupus erythematosus(SLE) were analyzed. The 63 patients studied were managed at the Department of Internal medicine, CNUH, from January 1983 to December 1997. Kidney biopsy was performed in 53 patients out of 63 patients with SLE. The results were as follows: 1. The ratio of male to female was 1:26. They were 12 to 71 years old and mean age was 32.1 years old. The peak age incidence was 4th decades(30%). 2. The most frequent chief complaint on admission was generalized edema. Most patients complain two or more symptoms. 3. Immunologic and renal disorders were the most frequently observed in the ARA criteria of SLE. And the positive ANA, hematologic disorder, malar rash, and arthritis, were observed in order of frequency. 4. Among the 53 patients with renal biopsy, 30 patients revealed class Ⅳ lupus nephritis(56%), class II in 12 patients(23%), class V in 8 patients(15%) and class III in 2 patients(6%). 5. The cases of lupus nephritis represented as nephrotic syndrome were high in the class IV with 68% and class V with 86%. 6. Of 30 patients who can be followed up, 5 patients resulted in death(17 % of mortality). They "were 14 to 57 years old and mean age was 28 years old. Follow up duration were from 1 month to 6 years and 3 months, and mean duration was 1 year and 1 month, but 3 cases 7. The causes of death were as follows: Two cases were due to seizure and coma resulted from CNS involvement. One was sepsis due to miliary the & pneumonia. One was dilated cardiomyopathy and heart failure due to cardiac ac involvement. And the other one was sepsis and acute renal failure resulted from cellulitis. 8. Prednisolone was used in all patients basically, and methyl-prednisolone pulse therapy, antimalarials and alkylating agents were used in some cases. In the cases of combined therapy, the activity of SLE was well controlled.

폐내 기관지 낭종

이석열,이숭진,박형주,이철세,이길노,김윤정,나주옥 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A 33-year-old female was admitted to our hospital due to removal of lung mass which indicentally detected Chest radiography. Chest computerized tomography revealed lung parenchymal cystic lesion. Open thoracotomy was done for diagnosis and therapy. Cystic lesion was communicated to bronchus and wedge resection including cystic lesion was done. Bronchogenic cyst is congenital disease and mainly locate in mediastinum. It is rare in lung parenchyme. Herein we report a case of intrapulmonary bronchogenic cyst.

Quality Characteristics and Biological Activities of Traditonally Fermented Ginseng Wine

Yoon Ji Yoon,Na Young Kim,Young Kyoung Rhee,Myung Joo Han 한국식품과학회 2007 Food Science and Biotechnology Vol.16 No.2

Quality Characteristics and Biological Activities of Traditionally Fermented Ginseng Wine

Yoon, Yoon-Ji,Kim, Na-Young,Rhee, Young-Kyoung,Han, Myung-Joo Korean Society of Food Science and Technology 2007 Food Science and Biotechnology Vol.16 No.2

The objectives of this study were to determine the quality characteristics, antioxidant activity, and cytotoxicity of fermented ginseng wine at each fermentation step. In the first mash with and without ginseng, viable cell counts (total cell, lactic acid bacteria, and yeast) were maximum between 2 to 4 days of fermentation. At the beginning of fermentation, Brix and ethanol contents, and titratable acidity increased, while pH decreased rapidly. At 3 days of fermentation of the second mash with ginseng, the viable cell counts were similar to those without ginseng and then continually decreased. At the end of fermentation, the pH of the second mash with ginseng was 4.00, lower than the pH of the second mash without ginseng, which was 4.35. Alcohol contents of second mashes with and without ginseng were 12.2 and 11.8%, respectively. In the aging period of ginseng and rice wines, the pH, titratable acidity, Brix, and ethanol contents did not change markedly. The results of sensory evaluation showed that fermented ginseng wine had good flavor and high acceptability. In the 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity assay, fermented ginseng wine ($IC_{50}$: 0.394 mg/mL) showed higher antioxidant activity than fermented rice wine ($IC_{50}$: 0.884 mg/mL). The butanol fraction of fermented ginseng wine exhibited weak cytotoxic activity against P388 and HeLa cell lines.