소의 뇌 미세혈관 내피세포를 이용한 생체외 혈액뇌관문 모델의 확립

손동섭(Dong-Suep Sohn),김경용(Kyung-Yong Kim),김대진(Dae-Jin Kim),김기정(Ki-Jeong kim),임인자(In-Ja Lim),김성수(Sung-Su Kim),이원복(Won-Bok Lee),김대중(Dae-Joong Kim),방숭규(Seung-Kyu Bang),이희상(Hee-Sang Lee) 대한체질인류학회 2003 대한체질인류학회지 Vol.16 No.4

소의 뇌 겉질에서 미세혈관 내피세포를 분리, 배양하여 영태학적, 기능적 관찰을 통해 생체외 혈액뇌관문 모델을 확립하였다. 배양을 시작한 후 뇌 미세혈관 내피세포는 방추모양으로 자랐으며 배양 후 6-7일 경에 세포들이 소용돌이치는 형태의 특정적인 단층을 형성하였다. 내피세포사이에는 생체내에서와 같이 치밀이음부가 행성되어 있었으며 내피세포 단층의 전기저항은 배양 후 11일 경까지 증가하다가 그 후에 감소하는 양상을 나타냈다. γ GTP 활성도 (1791.5±397.8nmol/min/mg protein)는 높은 연이었다. 형광면역염색에서 anti-vWF, anti-Zo-lanti-vimentin anti-fibronectin 항체에 대한 반응이 있었으나 별아교세포 희소돌기아교세포, 신경세포에 각각 특정적 A로 반응하는 anti-GFAP, anti-GalC, anti-neurofilament l60/200kD 항체에 대한 면역반응은 없었다. 세포간이 동모델약물의 이동도는 mannitol> sucrose> PEG-4000 순이었으며 세포막 이동모델약물인 progesterone 과 propranolol 의 이동도는 10-5cm/sec 대의 높은 이동도를 나타냈다. 이 연구의 결과로서 다공막에 배양된 소의 뇌 미세혈관 내피세포의 단층이 생체외 혈액뇌관문 모델로 충분히 이용될 수 있으며 향후 약물의 개발이나 혈액뇌관문을 통한 약물의 이동 기전을 연구하는데 유용하게 쓰일 수 있 다고 판단된다. The In Vitro blood-brain barrier (BBB) model was established with bovine brain iniciovessel endothelial cells (BBMECs) The charactenstics of BBMECs were identified by morphological and functional studies BBMECs began to grow as spindle shaped cells and distinctly formed the monolayer of whirling appearance by 6 to 7 days after plating Transendothelial electrical resistance (TEER) of the monolayer increased through 11 days and then started to decrease The Y-GTP activity (1791.5±397.8 nmol/min/mg of protein) and alkaline phosphatase activity (15.0±7.8 μmol/mm/mg of piotein) were high BBMECs in culture were characterized by the binding of anti-vWF anti-Z0-1, anti-vimentin, and anti-fibronectin antibodies They failed to react with anti-GFAP, anti-Gaic, and anti-neuiofilament l60/200kD antibodies markers for astrocyte oligodendrocyte and neuron respectively Decreasing older of the permeability through the BBMEC monolayers of paracellular transprt model drugs was mannitol, suciose, and PEG-4000 The permeability of transcellular transport model drugs, progesterone and propranolol was much higher than that of paracellular transpoit model drugs The BBMECs cultured on porous membrane have been qualified as an In Vitro BBB model and also can be used for the BBB transport study m the drug development and for the BBB transport mechanism of drugs

치밀이음부 구조단백질인 Occludin에 대한 활성산소종의 영향

이희상,김대진,손동섭,정봉수,최형택,심규민,이금정,조혜진,김석중,이종찬,정윤희,김성수,이원복,Lee, Hee-Sang,Kim, Dae-Jin,Sohn, Dong-Suep,Jeong, Bong-Su,Choi, Hyung-Taek,Sim, Kyu-Min,Lee, Keum-Jeong,Cho, Hye-Jin,Kim, Suk-Joong,Lee, Jong-Chan,J 한국현미경학회 2004 Applied microscopy Vol.34 No.4

Cerebral microvessel endothelial cells that form blood-brain barrier (BBB) have tight junction for maintaining brain homeostasis. Occludin, one of tight junction protein, is crucial for BBB function. $H_2O_2$ induced occludin changes and effects in bovine brain BBB endothelial cells were examined in this study. The decrease of transendothelial electrical resistance (TEER) by $H_2O_2$ was due to disruption of occludin localization. Cytotoxicity test revealed that $H_2O_2$ did not cause cell death below 1 mM $H_2O_2$ within 4 hr. $H_2O_2$ caused intermittent disruption and loss of occludin at tight junctions and occludin disappeared with dose dependent manner from tight junction in confocal laser microscopy. But Western blot revealed that the total amounts of occludin increased by $H_2O_2$ administration. Transmission electron microscopy revealed that the ultrastructure of tight junction was not changed by $H_2O_2$. These data suggest that functional disruption of BBB by $H_2O_2$ was due to the localized loss of occludin in tight junction, but the expression of occludin increased in order to compensate the disrupted function in BBB. 뇌에서 혈액뇌장벽을 형성하는 내피세포는 치밀이음부를 통해 뇌의 항상성을 유지하고 있다. 치밀이음부의 단백질 중의 하나인 occludin은 뇌혈관장벽(BBB)의 기능을 유지하는 중요한 단백질로 인식되고 있다. 본 실험에서는 소의 뇌에서 배양된 BBB 내피세포에서 활성산소종의 하나인 $H_2O_2$에 의해 일어나는 occludin 단백질의 변화를 관찰하였다. $H_2O_2$에 의해 TEER가 감소하는 것은 occludin의 재분포에 의한 것이었다. 세포독성은 4시간내에서는 1mM $H_2O_2$ 이하에서는 나타나지 않았다. Confocal laser microscope으로 관찰한 결과, $H_2O_2$에 의해 occludin은 치밀이음부에서 중간중간이 사라져 감소해 있었고, 이러한 양상은 $H_2O_2$의 용량과 노출시간에 비례하였다. 그러나 Western blot 결과, occludin의 총량은 증가하였다. 투과전자현미경 관찰을 통해 $H_2O_2$가 세포사이의 결합의 구조에 뚜렷한 변화를 미치지 않는 것을 알 수 있었다. 이를 통해 $H_2O_2$에 의한 BBB 기능소실은 occludin이 치밀이음부에서 부분적으로 사라지는 것에 의하지만, 세포는 기능손상을 복구하기위한 방편으로 이 단백질의 생산을 더욱 증가시키는 것으로 생각된다.

악교정수술 후 발생한 종격기종과 기흉: 증례보고

김한림,윤경인,최영준,손동섭,Kim, Han-Lim,Yun, Kyoung-In,Choi, Young-Jun,Sohn, Dong-Suep 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.3

Mediastinal emphysema, also referred to as pneumomediastinum or Hamman's syndrome, is defined as the presence of air or gas within the fascial planes of the mediastinum. Superior extension of air into the cervicofacial subcutaneous space via communications between the mediastinum and cervical fascial planes or spaces occurs occasionally. The mediastinal air may originate from the respiratory tract, the intrathoracic airway, the lung parenchyma, or the gastrointestinal tract. The presence of air in the mediastinum may be spontaneous, iatrogenic or due to penetrating trauma. Pneumothorax is defined as the presence of air or gas within the pleural cavity. A pneumothorax can occur spontaneously. It can also occur as the result of a disease or injury to the lung or due to a puncture to the chest wall. Pneumomediastinum and pneumothorax is a rare complication of head and neck surgery. Nevertheless, when it occurs, it is usually considered to result from direct dissection by the air at the time of injury or of surgery. Most of the cases of pneumomediastinum and pneumothorax that have been described in the oral and maxillofacial surgery literature result from air dissecting down the fascial planes of the neck. The authors report a case with subcutaneous emphysema, pneumomediastinum and pneumothorax after orthognathic surgery.

응급의학과 전공의가 시행한 흉관 삽입술의 합병증에 대한 고찰

조대윤 ( Dai Yun Cho ),손동섭 ( Dong Suep Sohn ),전영진 ( Young Jin Cheon ),홍기훈 ( Ki Hun Hong ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.2

Purpose: A tube thoracostomy is an invasive procedure that places patients at risk for complications. Tube thoracostomies are frequently performed by emergency medicine residents. Thus, the purpose of the study was to assess both the complication rate for tube thoracostomies performed by emergency medicine residents and the factors associated with these complications. Methods: A retrospective chart review of all patients who had undergone a tube thoracostomy performed by emergency medicine residents between January 2008 and February 2009 was conducted at a university hospital. Complications were divided into major and minor complications and into immediate and delayed complications. Complications requiring corrective surgical intervention, requiring the administration of blood products, or involving situations requiring intravenous antibiotics were defined as major. Complications that were detected within 2 hours were defined as immediate. Results: Tube thoracostomies were performed in 189 patients, and 70 patients(37%) experienced some complications. Most complications were immediate and minor. In multiple logistic regressions, BMI, hypotension and resident seniority were significantly associated with complications. Conclusion: The prevalence of complications was similar to these in previous reports on the complications of a tube thoracostomy. Most complications from tube thoracostomies performed by emergency medicine residents were immediate and minor complications. Thus, emergency medicine residents should be allowed to perform closed tube thoracostomies instead of thoracic surgeons. (J Korean Soc Traumatol 2012;25:37-43)

옛사람뼈 DNA에서 HLA-DRB1 염기서열의 분석

우지영(Ji-Young Woo),김기정(Kijeong Kim),바좌라그촤 문흐체첵(Bazarragchaa Munkhtsetseg),김재현(Jae-Hyun Kim),가와치멛 르학와수렝(Gavaachimed Lkhagvasuren),손동섭(Dong-Suep Sohn),박애자(Ae-Ja Park),이광호(Kwang-Ho Lee),김대진(Dae-Jin Kim),정 대한체질인류학회 2010 해부·생물인류학 (Anat Biol Anthropol) Vol.23 No.2

옛사람 시료의 DNA 분석은 인류학 및 사람 진화 연구에서 최근 세계적으로 널리 이용되고 있는 추세이다. 인류의 유전자 연구에 있어서 사립체 DNA 및 Y 염색체 DNA와 더불어 널리 이용되고 있으나 옛사람으로부터 HLA 분석은 드문 형편이다. 본 연구에서는 고대 사람 시료로부터 HLA 유전자의 염기서열의 분석을 위해 PCR 증폭할 수 있는 방법을 개발하고자 하였다. 연구자들은 염기서열에 기초한 HLA-DRB1 분석을 위한 방법을 개발하였고, 3000년 전부터 500년 전에 해당하는 한국과 몽골 지역에서 출토된 옛사람뼈로부터 HLA-DRB1의 염기서열을 밝혀 대립유전자의 유형을 분석하였다. 유전자형은 HLA database (http://www.ebi.ac.uk/Tools/blast2/nucleotide.html)에서 염기서열을 비교하여 대립유전자형을 결정하였다. 한국인과 몽골인의 HLA-DRB1의 대립유전자는 유형별로 분리하여 구분하였고, 이외에도 몽골의 지형적 분류를 근거로 서부, 중부, 동부, 그리고 북부로 구분하여 각 대립유전자형의 빈도를 나타내었다. 종합하면 옛사람뼈에서 분리 정제한 DNA로부터 성공적으로 HLA-DRB1을 증폭하여 대립유전자의 유형을 분석할 수 있었다. 이 방법은 앞으로 HLA 염기서열 분석을 통해 개인이나 개체군의 유연관계 분석을 위해 이용될 수 있을 것으로 기대한다. The analysis of ancient human DNA is increasingly used recently in the study of anthropology and human evolution. Although mitochondrial DNA and Y chromosomal DNA has commonly been the target in the field of human DNA study, HLA analysis of ancient human DNA is extremely rare. This study aimed to develop the PCR method of ancient human DNA for analyzing the sequence of HLA. Authors established a new method for HLA-DRB1 analysis by sequence-based typing. Alleles of HLA-DRB1 were analyzed and typed by sequencing with DNA of ancient human skeletons from Korea and Mongolia 3000-500 years ago. The types of HLA-DRB1 were determined by comparing the sequences with those of HLA database (http://www. ebi.ac.uk/Tools/blast2/nucleotide.html). The alleles of HLA-DRB1 of ancient human DNA from Korea and Mongolia were classified by types. The frequencies of HLA-DRB1 types of Mongolia were also presented according to the geography such as West, Central, East, and North. In summary, our method was successful in the analyzing the type of HLA-DRB1 from DNA of ancient human bones. Authors anticipate that many researchers could do their research in a better way to get the genetic information for the kinship analysis between individuals or communities from ancient human bones.

폐국균종의 임상적 고찰

이상훈 ( Sang Hoon Lee ),이병준 ( Byoung Jun Lee ),정도영 ( Do Young Jung ),김진희 ( Jin Hee Kim ),손동섭 ( Dong Suep Sohn ),신종욱 ( Jong Wook Shin ),김재열 ( Jae Yeol Kim ),박인원 ( In Won Park ),최병휘 ( Byoung Whui Choi ) 대한내과학회 2003 대한내과학회지 Vol.64 No.2

목적: 폐국균종은 만성 폐질환으로 인한 공동성 병소를 가진 환자들에서 대량 객혈과 같은 치명적인 증상을 야기할수도 있는 질환으로, 이에 저자들은 폐국균종으로 진단, 치료받은 36예의 환자들에서 주된 증상, 기저질환, 진단방법, 치료에 대하여 후향적으로 조사하였다. 방법: 1988년 2월부터 2000년 2월까지 중앙대 의료원에서 폐국균종으로 진단되어 치료받은 환자 36예를 대상으로 하였다. 26예는 조직학적으로 확진되었으며 나머지 10예는 흉부방사선학적 Background: Pulmonary aspergilloma usually results from the ingrowth of the colonized Aspergillus in the damaged bronchial tree, pulmonary cyst, or cavities of patients with underlying lung diseases. We analyzed the clinical features, diagnostic methods,

원저 : 폐장의 원발성 악성 섬유성 조직구종 1예

신인철 ( In Cheol Shin ),이선우 ( Sun Woo Lee ),나문준 ( Moon Jun Na ),박인원 ( In Won Park ),최병휘 ( Byoung Whui Choi ),허성호 ( Sung Hh Hue ),김미경 ( Mi Kyoung Kim ),송계용 ( Kye Yong Song ),손동섭 ( Dong Suep Sohn ),양기민 ( 대한결핵 및 호흡기학회 1991 Tuberculosis and Respiratory Diseases Vol.38 No.3

급성 심장외상의 치료

손동섭,조대윤,양기민 중앙대부설한국의과학연구소 1987 한국의과학 Vol.19 No.3

악성 흉막삼출 환자에서 활석분무 흉막유착술의 방사선학적 평가

김양수,손동섭 중앙대학교 의과대학 의과학연구소 1997 中央醫大誌 Vol.22 No.4

악성 흉막삼출환자에서 활석분무 흉막유착술의 효과와 그 효과에 영향을 미치는 요인들에 대해 알아보고, 방사선학적 소견의 분석으로 그 효과 예측과 대상선정에 도움을 줄 수 있나 알아보기 위하여 악성 흉막삼출로 활석 분무 흉막 유착술을 시행한 10명의 환자를 대상으로 시술 전후와 마지막 추적 단순 흉부촬영에서 흉막 삼출의 정도를 평가하였고 8명의 흉부 CT소견을 분석하였다. 시술과 마지막 추적 검사간의 기간은 평균 113(25-233)일 이었고 시술의 효과는 재발된 늑막삼출의 정도에 따라 4등급(우수, 양호, 일부반응, 무반응)으로 나누어 분석할 결과, 시술 직후 추적흉부 촬영상 10명의 환자들 중 8례에서 우수한 효과, 1례에서 양호 및 1례에서 무반응을 보였고 마지막 추적촬영에서는 5례에서 우수한 효과(폐 이외 장기암에서의 전이성 흉막삼출 3례와 2례의 폐암), 3례에서는 양호한 효과 그리고 2례에서는 무반응을 보였다. CT상 흉막에 조영증강이 없는 증례에서는 모두 우수(2례) 또는 양호(2례)한 효과를 보였고 흉막에 조영증강 병소가 있는 경우에는 무반응(2례), 양호(1례), 및 우수(1례)한 효과를 보였다. 결론적으로 활석 분무 흉막유착술은 악성 흉막삼출시 호흡곤란을 경감시키는데 좋은 효과를 보였으나, 폐포획증후군(trapped lung syndrome)의 경우에는 효과가 없었고, CT로 흉막의 조영증강을 관찰함으로써 흉막유착술의 효과예측에 도움을 줄 수 있으나, 흉막유착술에 효과가 없는 폐포획증후군을 예측할 수는 없었다. We evaluated the effect and influcening factors to the effect of Talc insufflation pleurodesis in 10 patients with malignant pleural effusion and to clarify that radiologic evaluation can help to predict the effect and to select the candidate. We retrospectively analysed simple chest X-rays just before and after pleurodesis and the last follow-up X-rays in each patients and also analysed chest CT in 8 available cases. The mean interval between the procedure and the last follow-up was 114 days(range: 25-233 days). The effects of pleurodesis were classified with 4 grades(exellent, good, partial, response, no response by extent of recurred pleural effusion). On initial(post-procedure) follow-up chest films, 7 of 10 cases showed excellent effect, 2 cases showed good effect and 1 showed no response who had trapped lung syndrome. On last follow-up, 5 cases showed excellent effect(3 cases from extrapulmonary origin and 2 lung cancers), 3 cases showed good effect and 2 cases showed no response. Cases with no pleural enhancement on CT showed excellect(2) or good effect(2), and cases with pleural enhancement showed no respond(2) and good effect(1), and excellent effect(1) on last follow-up check. In conclusion, we think Takc insufflation pleurodesis is an effective procedure for the relief of dyspnea from malignant pleural effusion, but has limitation in trapped lung syndrome. CT can help to predict the effect of pleurodesis by identification of pleural enhancement, but cannot predict trapped lung syndrome.

흉강경 수술시 이산화탄소 주입이 경정맥구혈 산소포화도에 미치는 영향

우영철,손동섭 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.2

Backgrounds : Carbon Dioxide(CO2) insufflation during thoracoscopy may result in adverse hemodynamic consequences such as increase in central venous pressure, decrease in cardiac output and increase in arterial carbon dioxide pressure. But the cerebral effects of CO2 insufflation during thoracoscopy are not known yet. To evaluate the cerebral effect of CO2 insufflation during thoracoscopy, jugular bulb venous blood oxygen saturation and pressure were measured. Methods : Nine patients were underwent thoracic surgery by thoracoscopy and one lung ventilation. After operation, CO2 was insufflated and hemodynamic parameters, arterial blood pressure, heart rate, central venous pressure, jugular bulb pressure, arterial blood gases and jugular bulb venous blood gases were measured at intrathoracic pressure 5 mmHg, 10 mmHg and 15 mmHg respectively. Results : Central venous pressure was increased with insufflation of CO2 of 10 mmHg and 15 mmHg. Jugular bulb pressure was increased with insufflationof of CO2 of 5mmHg, 10 mmHg and 15 mmHg. Arterial PCO2, jugular bulb venous PO2 and jugular bulb venous blood oxygen saturation were increased with insufflation of CO2 of 5 mmHg, 10 mmHg and 15 mmHg. Conclusion : CO2 insufflation pressure of 5 mmHg or greater resulted in significant increase in jugular bulb venous blood oxygen saturation and pressure. (Korean J Anesthesiol 1997; 33: 330∼335)