백서 심근에서 plasmid 벡터를 이용한 유전자 전달 및 VEGF 유전자 발현의 특성

정진옥 ( Jin Ok Jeong ),박선진 ( Sun Jin Park ),허정은 ( Jeong Eun Huh ),정은아 ( Eun Ah Jung ),오주현 ( Ju Hyeon Oh ),권현철 ( Hyeon Cheol Gwon ),이영주 ( Young Joo Lee ),김선영 ( Sun Young Kim ),박정의 ( Jeong Euy Park ),이원로 대한내과학회 2001 대한내과학회지 Vol.60 No.1

N/A Background : The purpose of this study was to compare gene expression among newly designed eukaryotic expression vectors, and to characterize the pattern of vascular endothelial growth factor(VEGF) expression using the most potent plasmids DNA vector. Methods : After exposure of a beating rat heart (Sprague-Dawley, 250-300g), 5 different types of plasmid DNA was injected directly into the myocardium. Reporter protein was analyzed by ELISA in the extracted heart. Results : The vector harboring cytomegalovirus (CMV) promoter and enhancer induced the strongest expression of reporter gene (chloramphenicol acetyl transferase; CAT) compared to those of pC3.1, pEF1a, RSV, pActin in the rat heart via direct injection of plasmid DNA into the apex (p<0.001). Using pCN-CAT, gene expression showed a dose-dependent response over a range of 0.3-10 ㎍. CAT expression could be detected up to 30 days after 10 ㎍ of pCN-CAT injection with the maximal expression on day 5. In X-gal staining of injected pCN-lacZ gene, β-galactosidase was found only around the needle track in the apex. The expressed hVEGF121 had biologic activity with vascular permeability assay (Miles assay) in guinea pigs. After injection of pCN-hVEGF121 into the apex of the rat heart, the expression of VEGF protein was dose-dependent over the range of 25 and 500 ㎍. VEGF expression was detected up to 14 days with its peak on day 2 after injection of 250 ㎍ of pCN-hVEGF121. When plasmid was injected into the apex of the rat heart, the expression of VEGF in the heart showed concentration gradient from the apex to the base. However, the expression of CAT was detected only in the apex. Conclusion : Plasmids vector with hCMV IE promoter/enhancer will provide clear advantages over other previously developed plasmids and the information regarding the behaviors of VEGF expression may be useful in angiogenic gene therapy of the heart.(Korean J Med 60:3-15, 2001)

쇼그렌씨 증후군이 동반된 원발성 담즙성 간경변증

송인성(In Sung Song),김정룡(Chung Yong Kim),이효석(Hyo Suk Lee),김용일(Yong Il Kim),김웅(Woong Kim),권현철(Hyeon Cheol Gwon),정현채(Hyun Chai Chung),윤용범(Yong Bum Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2

Primary biliary cirrhosis is a rare disease in Asia. A few case have been reported in Japan and only one case has been reported in Korea so far. The authors have experienced a case of primary biliary cirrhosis with Sjogren's syndrome in 49 year-old female who has suffered from eyeball pain and dry mouth since 4 years ago, and generalized pruritus since 1 month ago. She was treated with D- penicillamine and ursodeoxycholic acid with biochemical improvement. We report the second case of primary biliary cirrhosis in Korea and it is the first case of primary biiiary cirrhosis with Sjogren's syndrome in this country.

대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

Terfenadine 과 Ketoconazole 을 복용한 후 발생한 Torsades de Pointes 2 례

박상준,이상훈,김기현,홍경표,김덕경,박승우,권현철,김준수,이원로,류재춘,박정의,주신배 대한내과학회 1998 대한내과학회지 Vol.54 No.1

Terfenadine is widely used because of nonsedating effect. But it could rarely provoke a potentially lethal ventricular tachyarrhythmia. Recently, we experienced two cases of torsades de pointes(TDP) occurred after combined use of terfenadine and ketoconazole in usual dose. In one case, 31-yr-old female presented palpitation and recurrent syncope of sudden onset after ingestion of terfenadine 60mg and ketoconzole 200mg 5 times. On attack, ECG showed a polymorphic ventricular tachycardia, and after attack, showed prolongation of QT interval and TU wave changes. Her laboratory findings were not contributory. TDP was controlled with MgSO₄ and isoproterenol infusion. Then, QT interval was normalized and no further episode occurred. In the other case, 32-yr-old female presented palpitation and recurrent syncope of sudden onset after ingestion of terfenadine 60mg and ketoconzole 200mg 5 times, ECG showed prolongation of QT interval and TU wave changes. Her laboratory findings were not contributory. TDP was controlled with MgSO₄ and isoproterenol infusion. Then, QT interval was normalized and no further episode occurred.