지난 2년간의 학회지 "신경정신의학" 심사 평가보고

김찬형,김세주,김도관,김성곤,박원명,송동호,박용천,이영문,오강섭,정영철,이상열,김주한,이동영,이헌정,함병주,김율리,김문두,김정진,이강욱,천근아,김재진,홍진표,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Amitriptyline 과 Desipramine, Paroxetine 은 백서의 Schwann 세포 일차배양에서 산화질소의 생성을 억제한다

김용철,이상철,김선희,임영진,함병문,김현정,정일영,박학수 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.42 No.2

Background : Antidepressants are being used as supplemental therapy in neuropathic and inflammatroy pain. The mechanism of their inhibitory effect on experimental animal inflammation is not clear. Studies during the past few years clearly indicate an important role for nitric oxide (NO) in the inflammation and pain-processing system. We evaluated the effects of amitriptyline, desipramine and paroxetine on NO production in primary Schwann cell cultures. Methods : Primary cultures of the Schwann cell were prepared from dorsal root ganglia of 1-to 3-day old Spraque-Dawley rats. Schwann cells were cultured in the presence or absence of interferon-?? (500 ng/㎖) plus tumor necrosis factor-α (500 ng/㎖), amitriptyline, desipramine or paroxetine. Production of NO was determined in the supernatant of the culture media. Results : Amitriptyline (10 ㎍/㎖), desipramine (10 ㎍/㎖) and paroxetine (10 ㎍/㎖) inhibited NO release by 29.8%, 51.4%, and 66.8%, respectively. No drug had a toxic effect on cultured cells, which was determined by an LDH assay. Conclusions : Inhibition of NO production by Schwann cells may be a mechanism by which some antidepressant medications affect inflammatory and neuropathic pain. (Korean J Anesthesiol 2002; 42: 221~227)

Mirizzi 증후군의 변형된 분류와 치료

김형철,강길호,채만규,김성용,백무준,이문수,박상흠,이문호,김창호,송옥평,조무식,박희주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Purpose : The Mirizzi syndrome is relatively rare and preoperative diagnosis of this disease is difficult. In 1978, Morelli suggested the subclassification of the Mirizzi syndrome into acute or chronic form. We experienced 5 cases of acute form. We analysed clinical features, preoperative radiologic findings and operative findings of 18 cases including acute forms which were diagnosed as Mirizzi syndrome and should suggest the modified classification of Mirizzi syndrome for choice of appropriate treatment. Method : From January 1995 to December 1998, 18 cases, of which 8 cases were diagnosed at Soonchunhyang University Chunan Hospital, and 10 cases were reported in the Korean Journal were retrospectively analysed with regard to clinical features, preoperative radiologic findings and operative findings. According to the clinical features, whole cases were divided into type Ⅰ(acute form) and type Ⅱ(chronic form) and then each type of cases were subclassified according to preoperative radiologic findings and operative findings. Results : Of 18 cases there were 5 cases in type Ⅰ(27.8%), 13 cases in type Ⅱ(72.2%). Type Ⅱb was most common. Type Ⅰa cases were treated only with cholecystectomy. We applied cholecystectomy, T-tube choledochostomy and patch technique in type Ⅰb and thpe Ⅰc cases. Cholectystectomies including removal of gallstones and internal drainage procedures were done in type Ⅱ chronic forms. Conclusion : The acute form(Type Ⅰ) of Mirizzi syndrome was suggested by Morelli might be subclassified into typeⅠa,Ⅰb and Ⅰc following the presence of the necrotic defect in common hepatic duct. Through the modified classification of Mirizzi syndrome based on clinical feature, preoperative radiologic findings and operative findings, we can choice appropriate treatment.

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

알데히드탈수소효소 2(ALDH2) 및 CYP2E1 유전자 다형성에 따른 요중 뮤콘산 농도와 요중 8-hydroxydeoxyguanosine과의 관련성

김용대,강종원,엄상용,장연위,김성훈,김은영,이철호,문재동,김헌 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2

만성 신부전을 동반한 Laurence Moon-Bardet Biedl 증후군 1례

박래경,이동환,문철,김은미,Park Lae Kyong,Lee Dong Hwan,Moon Chul,Kim Eun Mi 대한소아신장학회 1998 Childhood kidney diseases Vol.2 No.2

The Laurence Moon-Bardet Biedl syndrome is characterized by obesity, mental retardation, visual impairment with retinitis pigmentosa, polydactyly, hypogonadism and renal manifestations. We experienced an 11 years old female with Laurence Moon-Baret Biedl syndrome associated chronic renal failure. She was diagnosed to have LMB syndrom according to the clinical manifestations of polydactyly on hands and feet, mental retardation, obesity, retinitis pigmentosa and chronic renal failure. She is on maintenance hemodialysis now.

Meso-Dihydroguaiaretic Acid Isolated from Saururus chinensis Inhibits Cyclooxygenase-2 and 5-Lipoxygenase in Mouse Bone Marrow-Derived Mast Cells

Tae Chul Moon,Chang Seob Seo,Kyungmi Haa,Jin Cheul Kim,Nam Kyung Hwang,Tae Gyun Hong,Jee Hyeun Kim,Do Hun Kim1,손종근,장현욱 대한약학회 2008 Archives of Pharmacal Research Vol.31 No.5

Meso-dihydroguaiaretic acid (MDGA) is a medicinal herbal product isolated from the aerial parts of Saururus chinensis that inhibits the cyclooxygenase-2 (COX-2)-dependent phase of prostaglandin D2 (PGD2) generation in bone marrow-derived mast cells (BMMC) (IC50 9.8 μM). However, this compound did not inhibit COX-2 protein expression in BMMC at concentrations up to 30 μM, indicating that MDGA directly inhibits COX-2 activity. In addition, this compound consistently inhibited the production of leukotriene C4 (IC50 1.3 μM). These results demonstrate that MDGA inhibits both COX-2 and 5-lipoxygenase. Furthermore, this compound strongly inhibited the degranulation reaction in BMMC (IC50 11.4 μM). Therefore, this compound might provide a basis for novel anti-inflammatory drug development.

151종 생약제 추출물이 B형 간염 바이러스 표면 항원(HBsAg)과 항체(HBsAb)의 결합반응 그리고 HBV DNA polymerase 활성에 미치는 효과 : 한국산 각종 생약제를 이용한 B형 간염치료제의 개발

정태호,김정철,김문규,이인선,채성철,김승래,정준모,이인수,김승호,함경수 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3

세계인구 43억명 중 B형 간염 바이러스 보균자는 2억 1천 5백만명이며 이중 78%인 1억 6천만명 이상이 아시아 대륙에 집중되어 있다. 한국도 B형 바이러스 간염의 침윤지대이다. 본 연구는 B형 바이러스 보균자 혹은 만성간염을 치료할 수 있는 생약제를 탐색할 목적의 일환으로 한국에서 시판하는 생약제 151종을 구입하여 증류수로 추출하고 여과한 후 냉동건조하여 HBs 항원에 대한 결합능, HBV DNA polymerase억제능, tumor necrosis factor(TNF) 유리에 미치는 영향, 그리고 galactosamine 유발 간염에 대한간장보호 작용을 조사하였다. 151종의 생약제중 0.16㎍/㎖ 농도에서 간염 vaccine 내에 함유된 HBs 항원과 결합하는 생약제는 지유, 가자, 복분자, 대황, 정향, 빈량, 산수유, 소목, 마황, 쇄양, 후박, 목과, 양강, 오약, 산사, 목단피 등 16종이었다. 이들 생약제중 대황(Rheum palmatum L. 大黃), 가자(Terminalia chebula R. 訶子), 지유(Sanguisorba officinalis L. 地楡), 복분자(Rubus coreanus M. 覆盆子)는 HBV DNA polymerase 활성도를 비교적 강하게 억제하였으며 빈량(Areca catechu L. 빈랑), 정향(Eugenia caryophyllata T. 丁香), 목과(Chaenomeles japonica L. 木瓜), 산수유(Cornus officinalis S. 山茱萸)는 약하게나마 HBV DNA polymerase 활성을 억제하였다. 또한 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 대상으로 TNF 유리에 미치는 영향을 조사한 결과 소목을 제외한 8종의 생약제 모두가 대식세포를 자극하여 TNF를 유리시켰다. 그리고 장차 임상에 사용함을 전제로 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 galactosamine 유발 간염(백서)에 투여하여 간기능 검사에 미치는 효과를 조사하였으나 간기능 검사상으로는 특별한 보호작용을 나타내지 못하였으며 생약제 단독 투여로서는 간기능에 대하여 나쁜 영향을 주지 않았다. Hepatitis B virus infection is major cause of acute and chrome hepatitis, cirrhosis of liver, and hepatocellular carcinoma. There are over 200 million carriers of hepatitis B virus in the world, nearly 80 % of whom live in the South East Asia, Korea is also highly endemic area of hepatitis B virus infection. This study was performed to evaluate the effect of extracts of traditional Korean herbal medicines on hepatitis B virus. 151 traditional herbs were extracted, filtered and lyophilized. Using 151 herbal extracts we tested binding capability to the HBs Ag, inhibition of HBV DNA polymerase, release of tumor necrosis factor (TNF), and protection against galactosamine induced liver damage. Among 151 herbs, 16 herbs (Sanguisorba officinalis L., Terminalia chebula R., rubus coreanus M., Rheum palmatum L., Eugenia caryophyllata T., Areca catechu L., Cornus officinalis S., Caesalpinia sappan L, Ephedra sinica S., Cynomorium songaricum R., Machilus thunbergii S., Chaenomeles japonica L., Alpinia officinarum H., Lindera strychnifolia V., Crataegus pinnatifida B., Paeonia suffruticasa A. ) had binding capability to HBs Ag which contained in the commercial hepatitis vaccine, at 16 ug/㎖ of concentratioa Among the above 16 herbs, Rheum palmatum L., Terminalia chebula R., Sanguisorba officinalis L., Rubus coreanus M. significantly inhibited the HBV DNA polymerase activity, and Areca catechu L., Eugenia caryophyllata T., Ephedra sinica S., Caesalpinia sappan L., Chaenomeles Japonica L., Cornus officinalis S. also inibited the HBV DNA polymerase activity but less effective. All of the herbs, except Caesalpinia sappan L., which inhibited the HBV DNA polymerase activity, actively stimulated the mononuclear cells to release tumor necrosis factor(TNF) in whole blood culture system. The herbs which inhibited the HBV DNA polymerase activity, did not show any protective effect in galactosamine-induced hepatitis in rats, but there was no direct toxic effect when herbs were administered alone.

慶南地域의 人工授精實態調査

金基元,文点東,金哲旭 진주산업대학교 1983 論文集 Vol.21 No.-

The status of artificial insemination of Korean cattle, Dairy cattle and Pig was surveyed at Animal farms located Gyeongnam ares during 2 years from Jan. 1981 to Dec. 1982 and The results obtained were summarized as follows: 1. No. head of A. I. by breeds were high in the order of Korean cattle. Dairy cattle and Pig. 2. No. head of A. I. by months were higher than the other months with 42.44% of Korean cattle at 7­9 months 29.0% Dairy cattle at 10­12 months and each 29.7 and 27.28%, Pig at 4­6 and 10­12 months. 3. No. head of A. I. by years were gradually increased as the year passed and these of Korean cattle were incrased with 1.2 times and Dairy cattle 1.1 times, but Pig decreased 4. The conception rate of Korean cattle was 78.46%, Pig 78.38% and Dairy cattle 72.71 and Korean cattle was superior to the others. 5. All the conception rates of the animal surveyed were superior at 4­6 and 10­12 months, but 7­9 months was lower than the other months.