Role of bicarbonate and volume therapy in the prevention of acute kidney injury in rhabdomyolysis: a retrospective propensity score-matched cohort study

김혜원,Kim Sejoong,Ohn Jung Hun,Kim Nak-Hyun,Lee Jong-chan,김은선,Lim Yejee,Cho Jae Ho,박희선,류지원,Kim Sun-wook 대한신장학회 2022 Kidney Research and Clinical Practice Vol.41 No.3

Background: Although bicarbonate has traditionally been used to treat patients with rhabdomyolysis at high risk of acute kidney injury (AKI), it is unclear whether this is beneficial. This study compared bicarbonate therapy to non-bicarbonate therapy for the prevention of AKI and mortality in rhabdomyolysis patients. Methods: In a propensity score-matched cohort study, patients with a creatine kinase (CK) level of >1,000 U/L during hospitalization were divided into bicarbonate and non-bicarbonate groups. Patients were subgrouped based on low-volume (<3 mL/kg/hr) or high-volume (≥3 mL/kg/hr) fluid resuscitation in the first 72 hours. Logistic regression analyses were used to identify the impacts of bicarbonate use and fluid resuscitation on AKI risk and need for dialysis. The Kaplan-Meier method was used to estimate survival. Volume overload and electrolyte imbalances were assessed. Results: Among 4,077 patients, we assembled a cohort of 887 pairs of patients treated with and without bicarbonate. Bicarbonate group had a higher incidence of AKI, higher rate of dialysis dependency, higher 30-day mortality, and longer hospital stay than the non-bicarbonate group. Further, patients who received high-volume fluid therapy had worse renal outcomes and a higher mortality than those who received low-volume fluids regardless of bicarbonate use. Bicarbonate use, volume overload, and AKI were associated with higher mortality. Volume overload was significantly higher in the bicarbonate group than in the non-bicarbonate group. Conclusion: Bicarbonate or high-volume fluid therapy for patients with rhabdomyolysis did not reduce AKI or improve mortality compared to non-bicarbonate or low-volume fluid therapy. Limited use of bicarbonate and adjustment of fluid volume may improve the short- and long-term outcomes of patients with rhabdomyolysis.

흰쥐에서 Iodine-131-Iododeoxyadenosine 의 생체분포 및 유방암 영상화에 관한 연구

김혜원,원종진,최시성,이현철,김창근,김선구,Yang, David J,이강무,민병철,이종덕,Kim, E Edmund 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.4

Purpose: I-131 labeled (2'-deoxy-2-iodo-β-D-arabinofuranosyl) adenine (IAD) may be involved in DNA synthesis during active proliferation of tumor cells. We conducted this study to find out the biodistribution of IAD and its feasibility for scintigraphic tumor imaging. Materisls and Methods: Tosyl acetyl-adenosine was dissolved in acetonitrile, and I-131-NaI was added and heated to synthesize IAD. Female Fisher 344 rats innoculated with breast tumor cells were injected witb 0.27 MBq of IAD. Rats were sacrificed at 0.5, 1, 2, 4, 24h and the % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy, rats bearing breast cancer were administered with 1.11 MBq of IAD and imaging was perforrned after 2 and 24h. Then, rat body was fixed and rnicrotomized slice was placed on radiographic film for autoradiography, Results: %ID/g of tumor wa.' 0.74 (0.5h), 0.73 (1h), 0.55 (2h), 0.38 (4h), and 0.05 (24h), respectively. At 1h after injection, %ID/g of tumor was higher than that of heart (0.34), liver (0.42), spleen (0.47), kidney (0,69), muscle (0.14), bone (0.33) and intestine (0.51). However, %1D/g of tumor was lower than blood (1.06), lung (0.77), and thyroid (177.71). At 4h, %ID/g of tumor in comparison with other tissue did not change. Tumor contrast expressed by tumor to blood ratio was 0.69 and tumor to muscle ratio was 5.11 at 1h. However, these ratios did not improve through 24h. On autoradiogram and scintigraphy at 2 and 24 hour, the tumor was well visualized. Conclusion: This results suggest that Ial) may have a potential for tumor scintigraphy. However, further work is needed to improve localization in tumor tissue. (Korean J Nucl Med 1998;32:374-81)

'2005국제우수전기제품대전' 유공자 포상식에서

김혜원,Kim hye-won 한국제품안전협회 2005 제품안전 Vol.12 No.-

성인의 아토피 피부염과 식생활평가지수와의 관계: 국민건강영양조사 제7기 (2016-2018년) 자료 이용

김혜원,김지명,Kim, Hye Won,Kim, Ji-Myung 한국영양학회 2022 Journal of Nutrition and Health Vol.55 No.5

본 연구에서는 우리나라 성인 중 AD를 앓고 있는 사람들의 식이 섭취량을 분석하여 이들의 식습관이 AD발병 위험과 관련이 있는지 분석하고자 하였다. 활용한 자료는 제7기 국민건강영양조사 (2016-2018년) 자료로서, 참가자 중 19-64세 성인 10,571명을 AD군 (n = 366)과 non-AD군 (n = 10,205)으로 나누어 영양소 섭취 현황과 식생활평가지수 점수를 비교·분석하였다. 그 결과, AD군의 1일 총 에너지섭취량은 non-AD군보다 많았고, 단백질 에너지섭취비율, 섭취에너지 1,000 kcal 당 단백질, 인, 철, 칼륨 섭취량이 AD군이 non-AD군보다 유의미하게 낮았다. 식생활평가지수 총점을 비교했을 때에는, AD군의 총 채소류, 김치 및 장아찌류를 제외한 채소류, 고기·생선·달걀·콩류 섭취점수가 non-AD군보다 낮았다. 연구대상자의 식생활평가지수와 AD 위험도와의 관계를 분석했을 때, AD 위험도는 총 채소류, 김치 및 장아찌류를 제외한 채소류, 고기·생선·달걀·콩류 섭취 점수가 증가할수록 감소하였다. 결론적으로, 성인 AD환자들은 채소류와 단백질 식품 섭취가 낮았는데, 이들 식품군의 높은 섭취는 낮은 AD 위험과 관련이 있음을 확인한 바, 추후 성인 AD 관리 및 치료 시 채소류와 단백질 식품의 충분한 섭취에 대해 강조해야 할 것이다. Purpose: The purpose of this study was to analyze the dietary intake of Korean adults with atopic dermatitis (AD) to determine whether the risk of developing AD was related to their diet. Methods: Among the participants in the 7th National Health and Nutrition Survey (2016 to 2018), 10,571 adults aged 19-64 were divided into AD (AD group, n = 366) and control groups (non-AD group, n = 10,205) to compare and analyze their nutrient intake status and Korean Healthy Eating Index (KHEI) score. Depending on the prevalence of AD, the nutrient intake, nutrient intake per 1,000 kcal, acceptable macronutrient distribution range, and KHEI score were tested for significance by correcting for age, sex, body mass index, education, marriage, occupation, residence area, physical activity, and energy intake variables that were derived for confounding factors. Results: The acceptable macronutrient distribution range for protein was lower in the AD group than in the non-AD group. Comparing the nutrient intake per 1,000 kcal, the intakes of protein, phosphorus, iron, and potassium of the AD group were significantly lower than those of the non-AD group. In the KHEI, the scores of total vegetables, vegetables excluding kimchi and pickles, meat, fish, eggs, and legumes of the AD group were significantly lower than those of the non-AD group. In addition, as these food intake scores increased, the risk of AD significantly decreased. Conclusion: In conclusion, adult AD patients had low intakes of vegetables, meat, fish, eggs, and legumes, and it was confirmed that high intakes of these foods may be associated with low AD risk. Therefore, we suggest that an adequate intake of vegetables and foods containing protein would be necessary for the management and treatment of AD in adults.

안양지역 어린이급식소에서의 위생관리 모니터링을 위한 adenosine triphosphate(ATP) 분석법 적용

김혜원,피재은,Kim, Hye Won,Pie, Jae Eun 국제문화기술진흥원 2021 The Journal of the Convergence on Culture Technolo Vol.7 No.3

이 연구에서는 어린이급식소에서의 ATP bioluminescence 분석법을 이용한 급식 위생관리 모니터링의 적합성을 확인하고자 하였다. 어린이집과 유치원 두 유형 간을 비교하였을 때, 측정구역별 ATP 측정값, 위생관리 적합률, 획득점수와 측정 횟수별 획득점수에서는 차이가 없었다. 어린이집과 유치원 각각을 비교했을 때는, 어린이집에서의 측정구역별 ATP 측정값은 대부분 1차시보다 2차시에 낮아졌으나, 유치원은 차시 간 차이가 없었으며, 측정구역별 위생관리 적합률은 어린이집과 유치원에서 대부분 1차시보다 2차시에 높아졌다. 또한, 어린이집의 경우 측정 횟수와 평균 획득점수와의 양의 상관관계를 보였다. 결론적으로, ATP bioluminescence 분석법은 어린이급식소에서의 급식 위생관리 모니터링 도구로써 활용 가능할 것으로 보이며, 특히, 어린이집이 유치원보다 더 효과적일 것으로 판단된다. In this study, we identify the suitability of monitoring the hygiene control of meals using ATP bioluminescence assay in children's foodservice facilities. Most ATP measured value by measurement area in childcare centers were lower in the second round than in the first round, and most hygiene control suitable rate by measurement area in childcare centers and kindergartens was higher in the second round. Also, in childcare centers, there was a positive correlation between the number of ATP measurement and the average score. In conclusion, ATP bioluminescence assay could be available as a monitoring tool for meal hygiene control in children's foodservice facilities, especially in childcare centers.

DITI를 통한 불임여성의 체열에 대한 연구

김혜원,김용석,이경섭,Kim, Hye-Won,Kim, Yong-Suk,Lee, Kyung-Sub 대한한방체열의학회 2002 대한한방체열의학회지 Vol.1 No.1

Causes of infertility include a wide range of physical, as well as emotional factors. In Oriental medicine, women's infertility is believed to be caused by the deficiency of the Chung and Ren vessel. Then the Kidney Qi is collapsed and cold. Many infertility women complain the cold hypersensitivity and/or body coldness, especially on the lower abdomen, back and knee. The aim of this study is to examine the interrelationship between infertility and body surface temperature. The 25 infertility women were allocated as infertility group and 25 fertility women (experienced delivery or pregnancy), as control group at the Kangnam Korean Hospital, KyungHee University, Seoul, Korea, from April to December 2000. Thermographic observations for this study were made using the Dorex DITI on 3 different areas's cold hypersensitivity: lower abdomen, back and knee. All data were coded for computer analysis and significances were tested by Mann-Whitney Test. The mean ${\Delta}T$ for abdomen cold hypersensitivity was $0.25{\pm}1.77^{\circ}C$ On control group and $1.00{\pm}0.39^{\circ}C$, infertility group. The mean ${\Delta}T$ for back cold hypersensitivity was $1.75{\pm}0.40^{\circ}C$ on control group and $1.21{\pm}0.58^{\circ}C$, infertility group. The mean ${\Delta}T$ for knee cold hypersensitivity was $0.65{\pm}0.70^{\circ}C$ on control group and $1.32{\pm}0.58^{\circ}C$, infertility group. It was revealed that the cold hypersensitivity on the lower abdomen, back and knee are significantly inter-related to the women infertility. These results do not conflict with the view of Oriental medicine. According to the above results, it is concluded that the body surface temperature, cold hypersensitivity and/or body coldness, have a great effect on women infertility.

수표교(水標橋) 칼럼 - '마포종점' 노랫말에 나오는 당인리발전소를 아십니까

김혜원,Kim, Hye-Won 대한전기협회 2013 전기저널 Vol.- No.443

표준의 패러다임 전환은 기술표준원의 소명

김혜원,Kim, Hye-Won 기술표준원 2005 기술표준 Vol.40 No.-

PET Imaging of Click-engineered PSMA-targeting Immune Cells in Normal Mice

김혜원,Won Chang Lee,In Ho Song,Hyunsoo Park,Sang Eun Kim 대한방사성의약품학회 2022 Journal of radiopharmaceuticals and molecular prob Vol.8 No.2

This study aimed to increase the targeting ability against PSMA in cell therapy using metabolic glycoengineering and biorthogonal chemistry and to visualize cell trafficking using PET imaging. Cellular membranes of THP-1 cells were decorated with azide(-N3) using Ac4ManNAz by metabolic glycoengineering. Engineered THP-1 cells were conjugated with DBCO-bearing fluorophore (ADIBO-Cy5.5) for 1 h at different concentrations and analyzed by confocal fluorescence microscopy and flow cytometry. For PSAM ligand conjugation to THP-1 cells, Ac4ManNAz treated THP-1 cells were incubated with DBCO-PSMA ligand (ADIBO-GUL) at a final concentration with 100 μM for 1 h. To evaluate the effect on cell recognition, PSMA ligand conjugated THP-1 cells(as effectors) were co-cultured with PSMA positive 22RV1 (as target cells) at 3 : 1 a effector-to-target cell (E/T) ratio. The interaction between THP-1 and 22RV1 was monitored by confocal fluorescence microscopy. For preparing the radiolabeled THP-1, the cells were treated at the activity of ~ 740 kBq of [89Zr]Zr(oxinate)4/5 × 106 cells. Radiolabeled cells were analyzed for determination of cell-associated radioactivity by gamma counting and viability using MTS assay. In the cytotoxicity assay, THP-1 cells did not have any cytotoxicity even when the Ac4ManNAz concentration was 100 μM. In confocal microscopy and flow cytometry, THP-1 cells were efficiently labeled ADIBO-Cy5.5 in a dose-dependent manner, and the dose of 100 μM was the optimal concentration for the following experiments. The clusters of PSMA ligand-conjugated THP-1 cells and 22RV1 cells were identified, indicating cell-cell recognition over the cell surface between two types of cells. Cell radiolabeling efficiency was 54.5 ± 17.8%. THP-1 labeled with 0.09 ± 0.03 Bq/cell showed no significant cytotoxicity compared to unlabeled THP-1 up to 7 days. We successfully demonstrated that Ac4ManNAz treated cells were efficiently conjugated with ADIBO-GUL for preparing the PSMA-targeting cells, and [89Zr]Zr(oxinate)4 could be used to label cells without toxicity. It suggested that PSMA-ligand conjugated cell therapy could be improved cell targeting and be monitored by PET imaging.

Effect of a Phospholamban Peptide on the Skeletal Sarcoplasmic Reticulum $Ca^{2+}$ Transport

김혜원,이희란,Kim, Hae-Won,Lee, Hee-Ran The Korean Society of Pharmacology 1994 대한약리학잡지 Vol.30 No.1

Phospholamban은 심근 근장그물 $Ca^{2+}-ATPase$ 조절단백이다. 조절작용기전은 탈인산화된 phospholamban에 의해 $Ca^{2+}-ATPase$가 억제됨으로 나타나며, 이 phospholamban이 인산화됨으로 $Ca^{2+}-ATPase$에 대한 억제가 반전됨을 보인다. 최근에 phospholamban의 cytoplasmic domain만으로 $Ca^{2+}-ATPase$를 억제하기에는 불충분하다는 보고가 있어 본 실험을 계획하였다. $Ca^{2+}-ATPase$의 활성을 억제하는 phospholamban domain을 밝히기 위하여 합성한 phospholamban 펩타이드(아미노산 1-25)의 $Ca^{2+}$ uptake에 대한 효과를 살펴보았다. 골격근 근장그물에서 $Ca^{2+}-ATPase$를 분리한 후 phosphatidylcholine이나 phosphatidylcholine과 phosphatidylserine을 포함한 liposome에 재조합시켰다. Phospholamban 펩타이드는 phosphatidylcholine을 이용하여 재조합된 vesicles의 초기 $Ca^{2+}$ uptake rate를 억제하고, cAMP 의존성 protein kinase의 catalytic subunit로 인산화시킨 phospholamban 펩타이드는 이 억제를 반전시킴을 보여 주었다. Phosphatidylcholine과 phosphatidylserine을 포함한 제조합 vesicles에서도 같은 양상을 보였다. 이상의 결과로 미루어 볼 때 인산화 sites를 포함하고 있는 phospholamban의 cytoplasmic domain은 그 자체만으로도 근장그물 칼슘펌프를 억제하기에 충분하다고 결론지을 수 있다. Phospholamban is the regulator of $Ca^{2+}-ATPase$ in cardiac sarcoplasmic reticulum(SR). The mechanism of regulation appears to involve inhibition by dephosphorylated phospholamban. Phosphorylation of phospholamban relieves this inhibition. Recently, there has been a report that the cytoplasmic domain (amino acids 1-25) of phospholamban is insufficient to inhibit the $Ca^{2+}$ pump. To explore the domains of phospholamban responsible for $Ca^{2+}-ATPase$ inhibitory activity, we examined the effect of a synthetic phospholamban peptide consisting of amino acid residues 1-25 on $Ca^{2+}$ uptake by reconstituted skeletal SR $Ca^{2+}-ATPase$. The $Ca^{2+}-ATPase$ of skeletal SR was purified and reconstituted in proteoliposomes containing phosphatidylcholine (PC) or phosphatidylcholine: phosphatidylserine (PC:PS). Inclusion of a phospholamban peptide in PC proteoliposomes was associated with significant inhibition of the initial rates of $Ca^{2+}$ uptake at pCa 6.0, and phosphorylation of this peptide by the catalytic subunit of cAMP-dependent protein kinase reversed the inhibitory effect on the $Ca^{2+}$ pump. Similar effects of phospholamban peptide were also observed using PC:PS proteoliposomes. Based on these results, we could conclude that the cytoplasmic domain of phospholamban, containing the phosphorylation sites, by itself is sufficient to inhibit the $Ca^{2+}$ pump of SR.