만성 이황화탄소 중독의 임상 양상

이규백(Kyu Back Lee),변현주(Hyun Ju Byoun),최태승(Tae Seung Choi),김선숙(Sun Sook Kim),조원용(Won Young Cho),김형규(Hyoung Kyu Kim),정태시(Tae See Chung) 대한내과학회 1990 대한내과학회지 Vol.39 No.2

N/A Carbon disulfide (CS2) is a volatile, colorless liquid and has an aromatic odor at room temperature. It has been used as a solvent for the spinning process in viscose rayon plants and also in cellophane and agricultural medicine plants, We experienced 38 workers who possibly suffered from chronic CS2, intoxication. Accordingly, we are reporting our opinions on synthetics and their effects on humanes. The time of exposure to CS2, gas was noted from 2 to 19years/(mean±SD 12±4.5yrs). The age range was from 30 to 64 years. With respect to clinical findings, patiets complained of neuralgia (86.8%), headache (63. 2%), memory disturbance (44.7%), visual dimness (36.8%), decreased sexual libido (29.6%), and hypertension (26.3%). The laboratory findings showed proteinuria in eight patients, azotemia in three patients, anemia in three patients and low HDL-cholesterol level in eight patients. Among the 38 workers, there was polyneuropathy in 13 patients by EMG, sensory neural hearing loss in nine patients, hemorrhage and exudate in eight patients by funduscopy, and cortical dysfunction in six patients by EEG.

Sjogren 증후군을 동반한 전신성 진행성 경화증 1 예

김병수(Byoung Soo Kim),이규백(Kyu Back Lee),이은주(Eun Joo Lee),김해랑(Hae Rang Kim),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim),원남희(Nam Hi Won) 대한내과학회 1989 대한내과학회지 Vol.37 No.5

N/A Progressive systemic sclerosis is an uncommon connective tissue disease marked by increases in fibrotic connecfive tissue with scarring, fibrosis and vascular obliteration of the skin, GI tract, lungs, heart and kid-ney. Therefore, the clinical manifestation is widely varied in extent and severity, and the etiology is not well known although it is suspected to belong to the category of autoimmune disease. For this reason, there is difficulty in the diagnosis of progressive systemic sclerosis. Progressive systemic sclerosis is usually associated with other connective tissue diseases, but progressive systemic sclerosis with Siogren's syndrome is rarely reported in Korea. The occurrence of Siogren's syndrome in progressive systemic sclerosis would further validate its inclusion in the group of autoimmune diseases. We experienced a 50-year-old female who had xerophthalmia, xerostomia, Raynaud's phenomenon and scleroderma with cellulitis on the right lower leg and pneumonia on both lower lung fields. We diagnosed progressive systemic sclerosis based on Raynaud's phenomenon, skin manisfestations and biopsy, and diagnosed Si5grens syndrome based on xerostomia, xerophthalmia, and submaxillary gland biopsy. With supportive care for cellulitis and pneumonia, the patients condition improved and then we controlled the progressive systemic sclerosis and Sidgrens syndrome with symptomatic treatment for xerostomia, xerophthalmia and Raynaud's phenomenon, & prednisone with cytoxan. Therefore, we reported a case of progressive systemic sclerosis with Sjogren's syndrome and briefly reviewed the related literature.

사람의 골수 줄기 세포로부터의 골세포 분화 과정에서 BMP-2가 미치는 영향과 그에 따른 분화 유전자의 발현 비교 연구

김인숙,장옥련,조태형,이규백,박용두,노인섭,황순정,김명진,이종호,Kim, In-Sook,Zhang, Yu-Lian,Cho, Tae-Hyung,Lee, Kyu-Back,Park, Yong-Doo,Rho, In-Sub,Weber, F.,Hwang, Soon-Jung,Kim, Myung-Jin,Lee, Jong-Ho 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.1

It is commonly acknowledged that bone morphogenic protein (BMP-2) functions as a potential osteogenic inducer in bone formation. Recently, several papers reported that bone marrow-derived stem cell (BMSC) from human is not responsive to BMP-2 in comparison to high capacity of BMP-2 in the osteoinduction of stromal cell derived from bone marrow of rodent animals such as rat or mouse. In this study, we characterized BMSC derived from 11 years old donor for the responsiveness to rhBMP-2, dexamethasone (Dex) and 1,25-dihydroxyvitamin D (vitamin D), in order to analyze their function in the early osteogenesis. The effect of over mentioned agents was evaluated by means of assessing alkaline phosphatase (ALP) activity/staining, RT-PCR analysis and von Kossa staining. In addition, we analyzed the meaning of expressed several osteoblastic markers such as alkaline phosphatase, collagen typeI, osteopontin, bone sialoprotein and osteocalcin with relation to either differentiation or mineralization. Only in the presence of Dex, human BMSC could commit osteoblastic differentiation and matrix mineralization, and either BMP-2 or vitamin D treatment was not able to induce. But BMP-2 or Vitamin D showed potential synergy effect with Dex. ALP and bone sialoprotein were clearly expressed in response of Dex treatment compared to weak expression of osteopontin in early osteogenesis. Therefore, we expect that this study will contribute partly to elucidiating early osteogenesis mechanism in human, but variations among bone marrow donors must be considered through further study.

쥐의 골수로부터 추출한 줄기세포를 이용한 조골세포로의 분화 유도과정에서 나타난 문제점에 관한 분석 연구

김인숙,조태형,장옥련,이규백,박용두,노인섭,이종호,김명진,황순정,Kim, In-Sook,Cho, Tae-Hyung,Zhang, Yu-Lian,Lee, Kyu-Back,Park, Yong-Doo,Rho, In-Sub,Weber, F.,Lee, Jong-Ho,Kim, Myung-Jin,Hwang, Soon-Jung 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.1

This study was aimed to characterize osteogenic potential of rat bone marrow stromal cells (BMSC) isolated with standard flushing method and investigate the plasticity of transdifferentiation between osteoblastic and adipocytic lineage of cultured BMSC. Unlike aspiration method in human, rat bone marrow was extracted by means of irrigation with culture media that elevates the possibility of co-extraction of committed osteoprogenitor, or preosteoblast or other progenitor cells of several types present inside bone marrow. The cultured stromal cells showed high ALP activity which is representative marker of osteoblast without any treatment. Osteogenic inducers such as Dex and BMP-2 were examined for the evaluation of their effect on osteogenic and adipocytic differentiation of stromal cells, because they function as osteoinductive agent in stromal cells, but simultaneously induce adipogenic differentiation. Osteogenic differentiation was evaluated by measuring alkaline phosphatase activity or mRNA expression of osteoblast markers such as osteopontin, bone sialoprotein, collagen type I and CbfaI, and in vitro matrix mineralization by von Kossa staining. Oil red staining method was used to detect adipocyte and adipocytic marker, aP2 and $PPAR{\gamma}2$ expression was examined using RT-PCR. It can be supposed that irrigation procedure resulted in high portion of already differentiation-committed osteoprogenitor cell showing elevated ALP activity and strong mineralization only under the supplement of $100{\mu}M$ ascorbic 2-phosphate and 10mM ${\beta}$-glycerophosphate without any treatment of osteogenic inducers such as Dex and BMP-2. Dex and BMP-2 seemed to transdifferentiate osteoprogenitor cells having high ALP activity into adipocytes temporarily, but continuous treatment redifferentiated into osteoblast and developed in vitro matrix mineralization. This property must be considered either in tissue engineering for bone regeneration, or in research of characterization of osteogenic differentiation, with rat BMSC isolated by the standard irrigation method.

노인의 삼출성 흉막염에 대한 임상적 연구

김희진 ( Hee Jin Kim ),이규백 ( Kyu Back Lee ),인광호 ( Kwang Ho In ),강경호 ( Kyung Ho Kang ),유세화 ( Se Hwa Yoo ) 대한결핵 및 호흡기학회 1990 Tuberculosis and Respiratory Diseases Vol.37 No.3

실험적 허혈성 급성 신부전 모델에 대한 칼슘 길항제의 효과

권영주(Young Joo Kwon),이규백(Kyu Back Lee),권현민(Hyun Min Kyeon),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim),노정우(Chung Woo Noh) 대한내과학회 1989 대한내과학회지 Vol.37 No.4

N/A Recently, much attention has been focused on the role of calcium in mediating or propagating ischemic cell injury. Modifying alterations in cell calcium redistribution or cellular calcium influx with a variety of agents have been beneficial in ameliorating the degree of cell injury in a number of experimental settings. But studies on animal models about ischemic acute renal failure (ARF) produced either by infusion of vasoconstrictors or by interrupting renal artery blood flow have provided conflicting results. The purpose of this study was to evaluate the effect of calcium entry blockers in an ischemic ARF model by the renal artery clamp in rats. Nine cats were anesthetized with pentobarbital sodium (40mg/kg, I.M,) and a tracheostomy, an IV line and a urinary catheter were placed in position. Temperature was maintained at 37.5 degrees C. By an abdominal approach, both renal arteries were isolated. Four cats were used as controls and received saline for 2 hours before bilateral renal artery clamping. Another five cats were treated with verapamil (5㎍/kg/min.) systemically for 2 hours before bilateral renal artery clamping. All nine cats underwent 1 hour of renal artery clamp followed by 3 hours of reperfusion and hydration with saline. Before clamping and after reperfusion, blood and urine were sampled for creatinine, Na and K, and urine volume was measured. The results were as follows: In the control group, the serum creatinine level was 1.28㎍0.33㎎/dl before clamping and increased to 1.63±0.73㎎/dl after clamping; in the experimental group, the serum creatinine level was 1.20±0.33㎎/dl before clamping and increased to 1.75±0.50㎎/dl after clamping. In the control group, the Ccr value was 13.08±9.25ml/min before clamping and decreased to 0.41±0.22ml/min after clamping; in the experimental group, the Ccr value was 6.24±6.18ml/min before clamping and decreased to 0.14±0.09ml/min after clamping. But these results were not significant statistically. Our results suggested that systemic pretreatment with a calcium entry blocker (verapamil) may be ineffective in an ischemic ARF model by renal artery clamping in cats.

한국형 이동식 심폐소생기 개발 보고 II. 응급소생술을 위한 이동식 심폐소생기의 동물 실험 연구

김형묵,이인성,백만종,선경,김광택,이혜원,이규백,장준근,김종원,김학제,Kim, Hyoung-Mook,Lee, In-Sung,Baek, Man-Jong,Sun, Kyung,Kim, Kwang-Taik,Lee, Hye-Won,Lee, Kyu-Back,Chang, Jun-Kuen,Kim, Chong-Won,Kim, Hark-Jei 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.12

배경:이동식 인공심폐기는 심정지 기간 동안 안정한 혈역학 상태를 유지하여 생존율을 향상시킬 수 있기 때문에 강력하고 효과적인 심폐소생법의 하나로 그의 사용이 증가하고 있다. 본 연구진은 초기모델의 한국형 이동식 심폐소생기를 이용한 심폐소생술과 기존의 개흉식 심폐소생술을 비교하여 혈역학 유지와 소생 여부 및 신체장기들에 미치는 효과를 알아보고자 하였다. 대상 및 방법: 한국산 잡견 8마리(30∼51kg)를 대상으로 개흉식 심폐소생술군과 심폐소생기를 이용한 심폐소생술군으로 각각 4마리 씩 나누었다. 4분 간의 심실세동형 심정지 기간이 지난 후 15분 간의 기본 심폐소생술(basic life support; BLS)을 실시하고 30분 간의 고급 심폐소생술(advanced life support; ALS)을 실시하여 자발순환회복, 혈역학 상태, 혈구성분에 미치는 효과, 혈액 가스 검사, 생화학 검사 및 생존율 등을 알아보았다. 심장압박과 폐환기는 두 군 모두 동일한 조건으로 유지하였으며, 고급 심폐소생술 시작과 동시에 제세동을 하고 에피네프린 및 탄산수소나트륨을 투여하여 자발순환회복을 유도하였다. 측정한 관찰값은 심정지전 관찰값으로부터의 변화율(%)로 환산하여 평균±표준편차로 표시하였다. 결과: 고급 심폐소생술 초기에 평균 체동맥압은 심폐소생기군에서 개흉식 심폐소생술군 보다 높게 유지되었고 (90±19% vs. 71±32%, p<.05), 평균 폐동맥압은 심폐소생기군이 개흉식 심폐소생술군 보다 낮게 유지되었다 (105±24% vs. 146±6%, p<.05). 자발순환회복은 모든 실험견에서 나타났다. 자발순환회복 후 심폐소생기군에서 혈중 헤마토크리트치, 적혈구와 혈소판 수가 유의하게 감소하였고 혈중 유리헤모글로빈치는 유의하게 증가하였다(p<.05). 혈액가스검사와 lactate 및 CK-MB치는 두 군간에 차이가 없었다. 실험 후 조기사망은 심폐소생기군에서 2마리, 개흉식 심폐소생술군에서 3마리에서 있었다(생존기간 228±153 vs. 31±36 시간, p=ns). 나머지는 모두 장기 생존율을 보였다. 결론: 본 연구결과 이동식 심폐소생기를 이용한 심폐소생술은 심정지 기간 동안 안정한 혈역학 상태를 유지하여 자발순환회복 및 장단기 생존율을 향상시킬 수 있다. 추후 이동식 심폐소생기 개선과 임상적용을 위해 초기모델을 수정 보완하는 실험연구가 더 필요하리라 본다. Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.

비드를 이용한 내시경용 연속봉합기구

조문기(Moon Ki Cho),이창양(Chang Yang Lee),홍대희(Daehie Hong),전훈재(Hoon Jai Chun),이규백(Kyu Back Lee) 한국정밀공학회 2004 한국정밀공학회 학술발표대회 논문집 Vol.2004 No.10월

This paper deals with the designing of instrument for achieving surgical operation in the stomach and gullet using endoscope channel. The method used herein was to provide beads to knot suturing thread automatically. Following design rules were applied : 1) that instrument must be designed to enable surgical operator to stitch successively by only simple handling 2) that instrument must be designed to minimize insertion and extraction of endoscope. The main result from the experiment with animal stomach was that the surgical operation time was reduced and successive suture was available. Considering the requirement of operator’s highly trained skills and the discomfort of patient in traditional suture process, the proposed design is expected to markedly improve the endoscopic suturing performance.

한국형 이동식 심폐소생기 개발 보고 I. 실험견을 이용한 개흉식과 폐쇄식 심폐소생술 비교

김형묵,이인성,백만종,선경,김광택,김연수,김맹호,이혜원,이규백,김학제,Kim, Hyoung-Mook,Lee, In-Sung,Baek, Man-Jong,Sun, Kyung,Kim, Kwang-Taik,Kim, Yeon-Soo,Kim, Maeng-Ho,Lee, Hye-Won,Lee, Kyu-Back,Kim, Hark-Jei 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.9

배경: 고려대학교 흉부외과학교실에서는 심폐소생술에서 인공심 사용이 기존의 표준 심폐소생술에 비해 나은 결과를 보인다는 점에 착안하여 한국형 이동식 심폐소생기를 개발하고자 하였다. 1997년 1월부터 8월까지 한국형 이동식 심폐소생기 개발의 전단계로 심폐정지 모델 결정 및 표준 폐쇄식/ 개흉식 심폐소생술의 비교와 관찰지표 설정을 위한 준비실험을 실시하였다. 대상 및 방법: 실험은 한국산 잡견 9마리(28-35kg)를 대상으로 폐쇄식 심폐소생술군 4마리와 개흉식 심폐소생술군 5마리로 나누어, 4분 간의 심정지 및 15분간의 일차 심폐소생술(basic life support; BLS)과 30분간의 이차 심폐소생술(advanced life support; ALS)을 실시하였다. 심장압박은 폐쇄식군의 경우 흉부에 압박을 가하였고 개흉식군에서는 직접 심장을 맛사지하였다. 소생술기간에 양군 모두 동일한 조건의 폐환기 상태를 유지하였으며, 자발성 순환회복은 이차심폐소생술 기간 초기부터 재세동과 에피네프린 및 탄산수소 나트륨을 투여하여 유도하였다. 결과: 심폐소생술 기간안에 평균 체동맥압은 BLS 동안 폐쇄식군이 33$\pm$11 mmHg인데 비해 개흉식군은 45$\pm$15 mmHg로 높게 유지되었으며, ALS 동안에도 폐쇄식군 44$\pm$15 mmHg에 비해 개흉식군이 83$\pm$36 mmHg로 높게 유지 되었으나 통계상의 유의성은 없었다. 한편 평균 폐동맥압은 BLS 동안 폐쇄식군에서 32$\pm$10 mmHg로 평균 체동 맥압과 비슷한 정도로 증가하였으나 개흉식군은 22$\pm$4 mmHg로 평균 체동맥압의 약 50%정도까지만 증가하였고, ALS 동안에도 폐쇄식군은 32$\pm$15 mmHg로 개흉식군의 24$\pm$10 mmHg보다 높게 유지되었으나 통계처리상 유의성 은 없었다. 자발성 순환회복(restoration of spontaneous circulation; ROSC) 및 심폐소생 성공 여부에서 폐 쇄식군은 4마리 모두 사망하였으나 개흉식군은 5마리중 4마리가 생존하였고 생존기간은 384$\pm$705시간이였다 (p<.05). 결론: 본 연구 결과 개흉식 심폐소생술은 폐쇄식 소생술에 비해 비록 통계학상의 차이는 없었으나 소생술 기간 동안 비교해서 안정된 혈역학 상태를 유지하여서 자발성 순환회복 및 장단기 생존율을 향상시킬 수 있었다고 판단된다. Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

세포외기질 단백질로 미세패턴화된 표면에서 성체 간엽 줄기세포의 형태변화와 세포점착차이에 관한 연구

김지연 ( Ji Youn Kim ),박용두 ( Yong Doo Park ),박정호 ( Jung Ho James Pak ),이규백 ( Kyu Back Lee ),선경 ( Kyung Sun ) 한국조직공학과 재생의학회 2004 조직공학과 재생의학 Vol.1 No.2

Patterning of surface using soft lithography is useful tools for regulating cellular morphology as well as function. Microcontact printing technology was used for patterning extracellular matrix (ECM) protein in this study. This pattern was used for controlling cellular adhesion as well as morphology of human mesenchymal stem cell. Polydimethylsiloxane (PDMS) molds was designed for controlling cellular adhesion by varying stripe width from 5 to 50 μm and fixing spacer to 20 μm. Glass surface was coated with extracellular matrix proteins such as fibronectin and vitronectin with different PDMS molds. Human mesenchymal stem cells were cultured on the patterned surfaces. Cells were aligned on the surfaces by changing cellular morphology. Actin filaments were aligned according to the protein stripe on the surfaces. The length of the actin fiber is longer as the stripe width is thinner. Proteins for focal contact such as vinculin, paxillin, and FAK were localized only on the ECM patterned surfaces. Especially, paxillin and FAK playing key role for focal adhesion were colocalized on the patterned surfaces. This study provides the controlling localization of focal adhesion proteins as well as morphology of human MSCs on the patterned surfaces. For further study, the effects of the localization of focal contacts proteins of MSCs to the stemness and differentiation will be investigated.