저산소성 허혈성 뇌손상을 유발시킨 어린 백서에서 Myeloperoxidase 측정 검사

양혜정(Hae Joung Yang),피대훈(Dae Hun Pee),임지혜(Ji Hye Lim),최병민(Byung Min Choi),이기형(Kee Hyoung Lee),은백린(Baik-Lin Eun) 대한소아신경학회 2002 대한소아신경학회지 Vol.10 No.2

목 적 : 예전에는 뇌경색 부위에서 발견되는 백혈구를 단지 뇌손상에 뒤따르는 생리적인 반응으로만 생각하였으나 최근 10년 사이 재관류 손상에서도 백혈구에 의한 염증 작용이 중요한 역할을 한다고 알려지면서 이들의 역할에 대한 연구가 새롭게 이루어지고 있다. PML의 존재는 세포질내 과립에서 분비되는 MPO를 생화학적으로 측정함으로서 증명할 수 있는데 저자들은 미성숙 뇌에서 저산소성 허혈증에 의한 뇌손상이 발생할 때 백혈구가 침윤되는 과정을 MPO 측정 검사를 통하여 관찰하였고, P와 L-selectin 억제제인 Fucoidin을 투여한 후 MPO의 변화를 확인하였다. 방 법 : 생후 7일된 어린 흰쥐를 사용하여 우측총 경동맥을 전기 응고시켜 자르고 8% 산소에 노출시켰다. 저산소 노출 후 회복 시간에 따라 동물을 희생시키고 뇌를 추출하여 뇌조직 1 g당 10mL의 20 mM potassium Phosphate buffer(pH 7.4)를 첨가하여 50초간 분쇄하였다. 각각의 균질회된 조직 샘플들은 4℃에서 20분 동안 원심 분리하여 상층액을 제거한 후, 침전물은 처음 조직량에 따라 조직 1 g당 10 mL의 0.5% cetylditrimethylethyl ammonium bromide(wt/vol)가 첨가된 50 mM potassium phosphate buffer(pH 6.0)를 첨가하였다. Vortex를 이용하여 buffer와 침전물을 잘 섞고 60℃수조에서 120분 동안 방치하였다. 그 후 각 조직 샘플들을 4 watts에서 음파처리하고 4℃에서 15분 동안 원심 분리를 시행하여 상층액을 새로운 tube에 옮겼다. MPO 측정검사를 위한 MPO reaction buffer는 50 mM potassium phosphate buffer(pH 6.0) 100 mL에 0.53 mM odianisidine edihydrochlorde와 0.0005% HO를 섞어 만들었다. MPO reaction solution 2.9 mL에 각각의 MPO sample 0.1 mL을 첨가하여 460 nm의 파장에서 5분 동안 MPO에 다른 흡광도 차이를 관찰하였다. 결 과 : 조직내 백혈구 침윤의 지표로 측정한 MPO 활성도는 대조군에서는 미미하였으나 총 경동백을 절단한 우측 대뇌군에서는 허혈 및 저산소증 유발 후 8시간째부터 현저히 증가되기 시작하여 24시간 경과 후 발현이 가장 높았으며, Fucoidin 50 mg/kg으로 전처치한 약물 실험군에서는 MPO 활성도가 현저히 감소하였다. 결 론 : 백혈구는 미성숙 뇌의 저산소성 허혈증에 의한 뇌손상에서 중요한 매개체 역할을 하며, 백혈구의 생화학적 활성도를 나타내는 MPO 활성도는 저산소성 허혈성 뇌손상의 정도를 측정하는 지표로 이용될 수 있다고 생각된다. Purpose : Neutrophils found around an infarcted area in the brain was once considered as only the physiologic response following the brain injury, but recent studies have shown that inflammatory responses by neutrophils play an important role in the reperfusion injury. The presence of ploymorphonuclear leukocytes(PML) is proven by biochemical assay of myeloperoxidase(MPO) Secreted in the cytoplasmic granules. We observed the process of PML infiltration on hypoxic-ischemic brain injury of immature rats by the assay of MPO activity and changes of the MPO activity after the administration of fucoidin, inhibitor of P- and L-selectin. Methods : We used a well characterized model of the brains of 7 day-old-rats, which had unilateral hypoxic and ischemic injuries(HI). Those injuries were induced by unilateral carotid artery ligation followed by timed exposure to hypoxic inspiratory gas mixture(8% O). MPO activity was measured in the brain tissue homogenates of HI rats(n=18) at 0, 2, 8, 24 and 48 hrs and in rats that received fucoidin immediately before and again after hypoxia(50 mg/kg, n=6) at 8 and 24 hrs. Controls(n=2) were rats with neither hypoxia nor ischemia. The brain samples were homogenized in 20 mM potassium phosphate buffer(pH 7.4) for 50 secs. The homogenate was centrifuged at 14,000 g at 4℃ for 15 mins and the supernatant was discarded. The tissue was pulverized, weighed, and suspended in 1 mL of 50 mM potassium phosphate buffer solution(pH 6.0) contatining 0.5% cetylditrimethylammonium bromide(wt/vol). The tissue was sonicated and centrifuged at 10,000 g for 15 mins. 200 µL of the supernatant was mixed with 1 mL of 50 mM potassium phosphate buffer solution(pH 6.0) containing 10 μL of 1.325 mM o-dianisidine hydrochloride and 170 µL of 3% hydrogen peroxide(vol/vol). Changes in absorbance at 460 nm were measured for 5 mins by using microplate reader. One unit of MPO activity was defined as that degrading 1 µmol peroxide/min at 25℃, and the result was expressed as units of MPO/100 gm tissue. Results : In HI rats, MPO activity increased at 2 hrs after HI and peaked at 24 hrs in the right hemisphere. In rats with fucoidin treatment immediately before and again after hypoxia, the MPO activity significantly decreased in both hemispheres compared with HI rats(P<0.05). MPO activity in the tissue of control rats was insignificant. Conclusion : The dynamic changes of the MPO activity suggest the important role of PMN on hypoxic-ischemic brain injuries in immature rats. MPO activity could be used as an index of the severity of injuries of hypoxic-ischemic brains.

산전 초음파로 진단된 선천성 수신증 태아의 경험 1례

강민아,김도균,최석철,양회생,배철성,윤혜원,심재철,하달봉 동국대학교 경주대학 1997 東國論集 Vol.16 No.1

Prenatal ultarsound represents an accurate and reliable method for the detection of intrauterine anomalies, especially urinary tract anomalies. Hydronephrosis is the most common congenital condition detected by prenatal ultrasound. Prenatal ultrasonographic diagnosis allows a good condition and therapeutic assessment of the patients prior to serious impairment of renal function so that in most cases the urological surgeon can opt for a parenchymal conserving procedure. The authors have experienced a case of congenital ureteropelvic obstruction with hydronephrosis diagnosed at 32 weeks of pregnancy and report our experience with a brief review of literature.

보조공학기기 이용실태 및 서비스 희망에 대한 심층면접

정민예,김정란,양노열,유인규,박혜연 대한보조공학기술학회 2009 대한보조공학기술학회지 Vol.1 No.1

목적 : 구직장애인, 장애인공무원과 지원을 많이 받아보지 않은 사업주를 대상으로 심층면접을 통해 보조공학기기 이용실태 및 서비스 희망을 조사하고, 이를 통하여 앞으로 보조공학서비스 서비스 방향을 제안하고자 조사하였다 연구방법 : 심층면접의 대상자는 장애인공무원, 구직장애인, 사업주로 분류하여 반구조화된 가이드라인 설문을 구성하였다. 면접 대상은 설문조사를 위한 모집단 중 무작위로 추출하여 면담 조사에 협조를 약속한 대상자 사업주 7명, 구직장애인 7명, 장애인공무원 5명을 대상으로 총 19명이 응답에 참여하였다. 결과 : 수집된 자료는 질적 분석 절차를 통해 보조공학기기의 사용경험, 보조공학기기 신청경험 또는 개인적 구입경험, 장애유형에 관련된 보조공학기기의 사용경험여부 및 인식조사, 보조공학서비스에 대한 인식정도 및 이용경험과 보조공학서비스 방향과 추가로 제공을 희망하는 서비스 내용 5가지의 주제가 도출되었다. 결론 : 보조공학서비스의 보다 효율적인 운영방식을 고려해야 할 것이며, 보조공학서비스를 할 때 구입이나 사후 관리도 보다 사용자 중심에서 서비스 제공이 필요할 것이다. Objective : The purpose of this study was to provide the information about the actual demand and use of assistive technology among people with disabilities who not received assistive technology service. Methods : In-depth interview subjects were government officials with disable, disabled job seekers, and employers hiring workers with disabilities. We made up the semi-structure guidelines question with group into three classes. We asked for an interview with subjects that choose samples at random. Results : These results show five themes related to use and application experience in assistive technology, the awareness of assistive technology service, and the demand to make of assistive technology service. Conclusion : In conclusion, we suggests that they want to be included assistive technology services target and replied use of those assistive devices will help them to get a job or to improve work efficiency and capacity.

중소 기업형 주문 생산을 위한 생산 및 일정계획 지원 시스템 개발

김홍배,양성민,이해경 경성대학교 생산기술연구소 1997 생산기술연구지 Vol.4 No.-

네오스트그민 독성에 대한 디펜히드라민 및 프로메사진의 효과

박은희,양근해,전민정 숙명여자대학교 약학연구소 1998 약학논문집-숙명여자대학교 Vol.14 No.-

This study was designed to examine the effects of diphehydramine and promethazine on the toxic manifestation of neostigmine. It was found that diphenhydramine and promethazine increase acetylcholinesterase activity in liver of mice. When diphenhydramine and promethazine was treated before administration of neostigmine, it significantly extend the onset latency in the signs of toxicities which were characteristically produced by neostigmine and it also prevented lethality in all of the animals.

출혈성 소화성 궤양의 장기 재발률

심기남,정훈용,양석균,홍원선,박의련,박무인,김해련,민영일 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.2

Background/Aims: Bleeding from a peptic ulcer is one of the common and serious complications associated with the rate of reported mortality, which ranges from 5% to 10%. Endoscopic therapy is effective in controlling active bleeding and reducing the emer-gency surgery, the immediate mortality rate and the incidence of early rebleeding. But few recent studies have documented the long-term recurrent bleeding rate after discharge in patients with bleeding peptic ulcers. The aim of this study was to determine the long-term recurrent bleeding rate and factors predisposing to recurrent bleeding. Methods: Eighty-eight patients with bleeding peptic ulcers discharged after medical treatment between Dec. 1990 and Jul. 1992 were included in this study and retrospectively followed up with medical records and telephone interviews. The end point of follow-up was recur-rent hemorrhage, surgery for treatment of ulcer complication, or death. Results: By July 1997, retrospective follow-up was available in 76 patients. Recurrent bleeding occurred in 23 patients (30.3%) with bleeding peptic ulcers and the median follow-up period was 69 months (range, 1 ∼79 months). The estimated cumulative recurrent bleeding rate after 1, 2, 3, 4, 5 and 6 years was 11.8%, 14.5%, 19.9%, 24.2%, 27.2% and 34.2%, respectively. There was no difference between the recurrent bleeding group and the non-recurrent bleed-ing group according to age, sex, prior NSAIDs use, previous history of bleeding or pepticulcer, site of ulcer, stigmata of recent hemorrhage at initial examination, method of treatment and amount of transfusion. Conclusion: Recurrent bleeding occurred in one-third of patients with bleeding peptic ulcers after 6 years of follow-up and one-third of recurrent bleeders rebled within 1 year. The factors predisposing to recurrent bleeding in the long-term follow-up could not be found. Therefore, further studies designed to identify factors predisposing to recurrent bleeding are needed and the evaluation of Helicobacter pylori status in bleeding pepic ulcer is needed because Helicobacter pylori is an important factor of peptic ulcer recurrence.

S-19 : Colonic Intramural Hematoma After Argon Plasma Coagulation

( *hae Min Yang ),( Hyun Woo Park ),( Se Young Jang ),( Sun Young Ahn ),( Hyun Seok Lee ),( Soo Young Park ),( Won Young Tak ),( Young Oh Kweon ),( Sung Kook Kim ),( Chang Min Cho ),( Min Kyu Jung ),( 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Argon plasma coagulation (APC) is a noncontact endoscopic method of hemostasis achieving coagulation without physical contact of APC probe with tissues. APC was first developed for surgical interventions but has been introduced to endoscopic procedures since 1991. It is currently used for the management of bleeding caused by varices, ulcers and vascular ectasias as well as for ablation of Barret`s esophagus, remnant adenomatous tissues after polypectomy and debulking malignant tumors. It is the most preferred method to manage angiodysplasia owing to its ease of application, minimum depth of thermal effects and speedy treatment for wide areas. It is known to be an effective method of hemostasis to treat colonic angiodysplasia and complication rates are also low when it is performed after submucosal injection of saline. The main advantage of APC is the safety owing to minimum depth of the thermal effect but procedure-related complications such as pneumoperitoneum, perforation, subcutaneous emphysema, bleeding, stricture and pain can occur if it is inappropriately used. However, incidence of intramural hematoma is rare. There is only one reported case of intramural hematoma which developed in the stomach after argon plasma coagulation to remove residual tissues after gastric polypectomy. Herein, we report a case of colon intramural hematoma and delayed bleeding after argon plasma coagulation performed to manage bleeding secondary to colonic angiodysplasia in a 57-year old female with liver cirrhosis and end stage renal disease.

Clinical outcome of BK virus nephropathy in renal transplant recipients: Single center experience (초)

( Hae Min Lee ),( Keun Suk Yang ),( Bum Soon Choi ),( Cheol Whee Park ),( Chul Woo Yang ),( Yong Soo Kim ),( Byung Ha Chung ) 대한내과학회 2012 대한내과학회 추계학술대회 Vol.2012 No.1

Poster Session : PS 0777 ; Upper GI Tract : Clinical Usefulness of Scoring Systems of Nonvariceal Upper Gastrointestinal Hemorrhage in Korea: The First Korean Multicenter Prospective Study

( Hae Min Yang ),( Seong Woo Jeon ),( Jin Tae Jung ),( Dong Wook Lee ),( Chang Yoon Ha ),( Kyung Sik Park ),( Si Hyung Lee ),( Chang Heon Yang ),( Youn Sun Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The Glasgow Blatchford score (GBS) and Rockall scores (RS) are widely used to assess patients with upper gastrointestinal hemorrhage (UGIH). We aimed to compare both scoring systems, and evaluate the clinical usefulness of scoring systems in Korea. Methods: Between February 2011 and December 2013, 1584 patients with nonvariceal UGIH were entered in the study. A prospective study was performed to compare the performance of the GBS, pre-RS, full RS in predicting the need for hospital-based intervention (blood transfusion, endoscopic treatment, angioembolization, or surgery), rebleeding and death. We compared the ability of these scores by using receiver-operating characteristic (ROC) curves. We also assessed the usefulness of GBS of 0 in identifying low-risk patients. Results: For prediction of the need for hospital-based intervention, the GBS was similar to the full RS (AUROC 0.705 vs 0.727; p =0.282) and superior to the pre-RS (AUROC 0.705 vs 0.601; p<0.0001). In predicting death, the full RS was superior to the GBS (AUROC 0.758 vs 0.644; p=0.0006) and similar to the pre-RS (AUROC 0.758 vs 0.754; p=0.869). In predicting rebleeding, the full RS was superior to both GBS (AUROC 0.642 vs 0.585; p=0.031) and pre-RS (AUROC 0.642 vs 0.593; p=0.0003). However none of the systems accurately predicted rebleeding with low AUROC. Of 1584 patients, we identifi ed only 13 patients (0.8%) who scored 0 on the GBS. And one patient with GBS score of 0 required endoscopic treatment. Conclusions: The GBS is more useful than Pre-RS for predicting the need for hospital- based intervention. However cut-off value of 0 for low risk who might be suitable for outpatient management is not useful. The full RS is helpful in predicting death. None of the systems accurately predict rebleeding. (Clinical trial: KCT0000514)

HCC : Hepatic Metastases from Gastric Hepatoid Adenocarcinoma Mimicking Hepatocellular Carcinoma

( Hae Min Yang ),( Hyun Woo Park ),( Soo Young Park ),( Won Young Tak ),( Young Oh Kweon ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

Background: Hepatoid adenocarcinoma of the stomach is rare variant of gastric carcinoma with adenocarcinomatous and hepatocellular differentiations, and the production of large amount of AFP. It has an extremely poor prognosis, because of the frequent occurrence of liver and lymph node metastases. It can be misdiagnosed as a hepatocellular carcinoma, because of the production of AFP and early liver metastasis. We present a case of hepatic metastases from hepatoid adenocarcinoma of the stomach mimicking hepatocellular carcinoma in a 38-yearold woman with neurofibromatosis Case: A 38-year-old woman with neurofibromatosis visited local hospital because of abdominal distension for 10 days. Computed tomography of the abdomen revealed multiple hepatic mass lesions, and the serum AFP was markedly increased (>200,000). She was referred to our hospital. We considered these hepatic mass lesions as hepatocellular carcinoma initially. FDG PET scan showed multiple hypermetabolic lesions in both liver lobes and in the stomach, small lymph nodes and ascites with mild FDG uptake. Endoscopy revealed a large ulcerofungating mass at body of great curvature. Biopsy revealed poorly differentiated adenocarcinoma and immunohistochemical stains showed AFP and C-erb B2 positive cells. She was diagnosed with hepatoid adenocarcinoma of the stomach with liver metastasis. Initially, we planned chemotherapy with capecitabine/cisplatin and trastuzumab. But she was transferred to other hospital for supportive care because of poor general condition. Conclusions: Hepatoid adenocarcinoma of the stomach is characterized by gastric adenocarcinoma with high level of AFP. When the patient with hepatic mass has high level of AFP, but patient does not have risk factors of hepatocellular carcinoma such as HBV or HCV infection, possibility of hepatoid adenocarcinoma of stomach should be considered and careful investigation is required including endoscopy and FDG PET.