관동맥연축의 비침습적 진단에 있어 Ergonovine Echocardiogrpahy의 유용성

송재관,박성욱,김재중,두영철,김원호,박승정,이종구 울산대학교 의과대학 1992 울산의대학술지 Vol.1 No.1

관동맥연축의 비침습적인 진단방법의 확립은 침습적인 관동맥조영술 및 연축유발검사에 비해 반복적용이 가능한 이론적인 장점이 있어 선별검사(screening test)로서의 기능뿐만 아니라 치료로 이용되는 약물의 효과비교 및 추적검사를 통한 관동맥연축의 임상ㄹ활동도 평가등에 손쉽게 이용될 수 있으라라 예상된다. 이에 저자들은 ergonovine 투여시 기록된 좌심실벽운동장애 유무가 갖는 관동맥연축에 의한 심근허혈의 진단적 가치를 평가하기 위해 Beside Ergonovine Echocardiography Test를 시행하였다. 관동맥조영술 및 연축유발검사에서 변이형협심증으로 증명된 30명(남자 27명, 평균연령 54세)과 비특이적인 흉통질환군 20명(여자 12명, 평균연령 55세)을 대상으로 관동맥조영술 다음날 ergonovine test를 시행하였다. 운동부하검사가 음성인 환자들을 대상으로 6시간 공복시킨 뒤 앙와위에서 상지정맥을 통하여 25-50microgram(이하 mcg)을 5뷴 간격으로 투여하여 흉통의 유무, 심전도 및 이면성심초음파를 5분마다 기록하였으며 총투여량이 350mcg에 도달하거나 양성반응을 보이는 경우 nitroglycerin 250mcg 정주 및 설하투여로 종료하였다. 좌심실벽운동의 분석은 side-by-side continuous cine-loop display가 가능한 QUAD screen 방법으로 판별하였다. 가역적인 심전도 변화나 국소적인 심실벽운동장애가 유발되는 경우를 양성으로 판정하였다. Ergonovine Echocardiography의 전체 민감도는 90%, 특이도는 100%로 동시에 기록된 심전도 변화의 민감도(73%)보다 높았으며 특히 흉통이 있으나 심전도 변화가 전혀 없었던 5례 모두에서 좌심실벽운동장애가 관찰되어 본 검사법의 우월성을 확인할 수 있었다. 양성반응을 보인 ergonovine 평균 투여량이 173±95mcg 이었으며 흉통발작의 빈도를 기준으로한 임상활동도가 높은 경우 활동도가 낮은 군에 비해 양성반응을 의한 총 ergonovine 투여량이 적었으며(123±86 vs 213±83mcg, p<0.01) 관동맥협착이 연축에 동반되어 있는 경우 정상 관동맥에 연축이 있는 경우보다 민감도가 더 높았다(100% va 60%, P=0.02). Ergonovine 투여로 혈압은 기저치 보다 약 17%정도 증가되었으나 맥박수는 큰 변화를 나타내지 않아 안전하게 시행될수 있었으며 오심, 두통, 견갑부통증, 심실기외수축, 방실차단 등이 소수례에서 관찰되었으나 검사로 인한 사망례는 없었다. Ergonovine 주입후 기록된 좌심실벽운동동장애는 심전도 변화보다 더 민감하게 관동맥연축에 의한 심근허혈을 진단할 수 있었으며 Ergonovine Echocardiography는 운동부하검사 등으로 심한 관동맥협착이 배제된 선별된 흉통환자들에서 관동맥연축의 진단에 안전하게 시행될 수 있는 민감하고 특이도가 높은 검사방법이며 변이형협심증의 임상활동도와 관동맥협착의 동반유무가 본 검사법의 결과에 영향을 미칠 수 있으리라 사료된다. The purpose of this study was to evaluate the clinical feasibility of bedside intravenous ergonovine test with echocardiography as a noninvasive diagnostic method for coronary vasospasm. Bedside ergonovine test was performed in 50 patients with chest pain one day after coronary angiography with spasm provocation test;30 patients showed positive results of provocation test while in 20 patients there was no evidence of coronary vasospasm. A bolus of ergonovine maleate(.025 or .05mg) was injected at 5 min intervals up to total cumulative dosage of 0.35mg, and 12-leads ECG and 2-D Echo were recorded every 3min after each injection. Left ventricular wall motion was analyzed with a commercially available ' QUAD' system. The positive criteria of beside ergonovine test included reversible ST segment elevation or depression, T wave changes in ECG(ECG criteria) and reversible regional wall motion abnormalities(RWMA) in Echo(Echo criteria). The overall sensitivity and specificity of ECG criteria were 73%(22/30) and 100% respectively ; The sensitivity of Echo criteria increased up to 90%(27/30) without the change of the specificity. Among 22 patients with reversible ECG changes only 73%(16/22) showed typical ST segment elevation while ST depression was recorded in 2 patients(9%) and minor T wave peaking or flattening without ST segment displacement in 4 patients(18%). Concomitant fixed coronary lesion does increase the sensitivity of the test compared to pure coronary vasospasm with ECG criteria(100% vs 60%, p<0.05). Mean does of ergonovine with positive results was 173±95 microgram(mcg) and the amount of does of ergonovine for positive result was significantly larger in patients with low disease activity (chest pain <5times/자) than those with high disease activity(213±83 vs 123±86mcg, p<0.01). There was no procedure related mortality or fatal arrhythmias. Ergonovine echocardiography is a highly sensitive and specific test for coronary vasospasm and is safe in selected patients in whom the exercise test is negative and severe fixed coronary artery disease has been excluded. Presence of concomitant fixed coronary artery disease and the degree of clinical activity of coronary vasospasm may influence the results of this test.

청력장애가 불안 및 우울에 미치는 영향

송상욱,구정완,이원철 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.3

Hearing loss is a very common health problem throughout the world, although the number of hearing impaired individuals varies greatly in the countries. It is generally accepted that hearing impairment inevitably leads to a breakdown in communication and physical and mental health problems consequently. Nevertheless, few community based studies have been undertaken to examine both the mental and more general physical state of the hearing impaired patients. This study was conducted to evaluate the anxiety and depression in hearing impaired patients. Self-administered questionnaires including sociodemographic data were given to 336 subjects over the age of 18 years who visited the Health Management Center, Uijongbu St. Mary's Hospital for the routine health check up from January 1996 to April 1996 and three hundred seventeen samples (male: 197, female: 120) were selected. For the assessment of anxiety and depression we used Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) devised by Zung. And hearing impairment was evaluated using a Beltone Model 110 Audiometer. The results were statistically analyzed by ANOVA test and x²test. The results obtained were as follow: 1. The mean anxiety scores counted by SAS of 0-15dB HL(hearing loss) group(classified by the average loss in the better ear at 500, 1,000, 2,000Hz frequencies), 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 33.1±6.6, 32.2±5.9, 41.6±8.4, 42.8±6.0, respectively. And the mean depression scores counted by SDS of 0-15dB HL group, 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 37.4±7.7, 37.2±7.2, 46.2±8.4, 48.6±8.6, respectively. The more than 30dB HL group showed significant high scores in SAS and SDS than the less than 30dB HL group(p<0.001). 2. The frenquency of clinically significant anxiety disorder(SAS≥50) was 3.4% in less than 30dB HL group and 11.1% in more than 30dB HL group. The difference between two groups was statistically significant(p<0.05). 3. The frequency of clinically significant depression disorder(SDS≥50) was 5.1% in less than 30dB HL group and 39.5% in more than 30dB HL group. The difference between two groups was statistically significant(p<0.05). 4. When several important interaction variables related to anxiety and depression (such as age, sex, marital status, education level, economic status, occupation, religion) were stratified and we compared the groups between the more than 30dB HL and less than 30dB HL, most factors about anxiety and depression showed the significant differences in two groups. 5. Multiple logistic regression analysis revealed that hearing loss(p<0.05) predicted anxiety disorder(SAS≥50) and hearing loss(P<0.01), age(p<0.05) predicted depression disorder(SDS≥50). In conclusion, there was significant difference in anxiety and depression scores between more than 30dB HL (in the better hearing ear) group and less than 30dB HL group. This study suggested that anxiety and depression should be considered as adverse effects of hearing impairment.

마이크로파 용융삽입법을 이용한 생분해성 나노복합체의 제조

하원조,신준식,송승욱,김준호,손세모,박성수 한국환경과학회 2004 한국환경과학회지 Vol.13 No.4

The purpose of this study was to investigate the possibility of application of microwave energy for the fabrication of polymer/clay nanocomposite. APES/Clay nanocomposites were prepared at 130℃ for 30min with various content of clay by melt-intercalation method under classical and microwave heating source. APES/Clay samples were characterized by the means of X-ray diffractometry(XRD), thermal gravimetric analysis(TGA), and rheometric dynamic analysis(RDA). It was found that intercalated or exfoliated state was obtained in the samples according to the condition of organic modification, clay content, and heating source.

악안면 영역에서의 유리 전완피판술 적용례분석

김욱규,송원욱,황대석,김용덕,신상훈,김종렬,정인교 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

정확한 완충기체효과가 적용된 질량분석원리에 대한 다중입자 분석 전산시늉

이유용,이원욱,오차환,김필수,송석호 한양대학교 자연과학연구소 2001 自然科學論文集 Vol.20 No.-

질량분석기로 사용되는 폴 트랩 내에서 보다 실제적인 이온운동을 예측해내기 위하여 약 2천 개의 다중입자의 궤적에 대한 계산을 실시하였다. 보다 정확한 질량 분석스펙트럼을 얻기 위하여 충돌확률에 대한 보다 정확하고 실질적인 함수 값을 도입하였다. 계산된 전산시늉의 결과들로부터 특히 작은 질량의 영역에 대한 분석을 할 경우 본 논문에서 제시된 바와 같이 매우 정확한 충돌확률이 고려되어야 함을 확인할 수 있었다. To predict the practical characteristics of ion motion in the paul trap as a mass spectrometer, the ion trajectories of the multi-particle(over than 2000 particles) were calculated. In order to expect more practical mass spectrum, the exact expressions for the collision probability was adopted. From the simulation result, we found that the exact collision probability has to be considered to analyze the materials existed in the low mass region.

대뇌 기저핵 신경세포 일차배양에서 망간에 의해 유도된 Appoptosis : 형태학적인 소견

신동훈,김상표,정용욱,배재훈,송대규,백원기 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 본 실험은 대뇌기저핵의 신경세포를 배양하여 망간(MnCl₂)을 투여한 후 망간독성에 의한 신경세포의 apoptosis를 형태학적인 소견으로 관찰하였다. 방법 : 배양된 신경세포에 0.01에서 10μM Mnc12를 48시간동안 처리한 후 TUNEL (TdT-mediated dUTP Nick End Labelling)법 및 투과전자현미경학적으로 관찰하였다. 결과 : TUNEL방법을 이용하여 관찰한 결과 TUNEL반응에 갈색으로 양성반응을 나타내는apoptotic 세포의 수가 대조군에 비해 MnCl₂를 투여한 군에서 유의하게 높게 나타났으며(P〈0.05), 투과전자현미경학적 소견상 대조군의 신경세포들은 핵인(nucleolus)이 두드러지게 특징적으로 보이면서 핵막과 세포질내 소기관들이 잘 보존되어 있으며, 세포질내망(ER)과 사립체(mitochondria)를 특히 많이 가지고 있었다. Mnc12를 48시간 동안 처리한 군에서 이질염색질(heterochromatin)이 핵막으로 이동하면서 응집되어 있었으며, 핵내 불규칙한 형태의 염색질이 나타나 분절이 진행되는 소견을 보였고, Apoptosis의 가장 특징적인 초기 소견인 막으로 둘러싸인 반달모양의 핵내염색질의 분절편(fragment-ed chromatin)과 주위의 상대적으로 정상적인 소기관으로 구성된 apoptotic body를 관찰할 수 있었다. 결론 : 신경세포에서 망간에 의해 apoptosis가 유도됨을 형태학적인 방법으로 확인할 수 있었으며 망간에 의한 세포사망양상에 apoptosis가 하나의 기전이 될 수 있을 것이다. Objectives : Manganese is cytotoxic to the central nervous system including basal gan-glia. Its toxic mechanism is related to oxidative stress, mediated by toxic free radicals but is specultives. In the present study , we have investigated to manifest apoptosis in man-ganese-induced cytotoxicity in primary neuronal cell culture of rat basal ganglia. Methods : To detect apoptotic neuronal cells were stained by the terminal deoxynu-cleotide (TdT) -mediated dUTP nick end-labelling (TUNEL) method and apoptotic changesin nuclei of neurons were observed by electron microscopy. Results : We showed that TUNEL immunostain showed brownish signal in the nuclei of apoptotic cells and the proportions of apoptotic cells in Manganese treatment groups were more higher than controls. On transmission electron microscopy, there were chromatine condensation with margination toward nuclear membrane and condensation of cyto-plasm in the treated with luM MnCl²for 48 hours in a basal ganglia neurons. Apoptotic bodies were found and consisted of semilunar-like condensed nuclei with relatively intact cytoplasmic organelles. Conclusions : Apoptosis appears to be one mechanism in the manganese-induced net-ronal cell death. Manganese intoxication is a convenient model for apoptosis study.

미세혈관 협심증 환자의 임상상 및 지표에 관한 연구

박상호,온영근,김현정,이태훈,길효욱,김현건,박수진,송해정,한대희,방덕원,신원용,이내희,김성구,권영주 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background : Microvascular angina or syndrom X is heterogenous and encompasses different pathogenetic entities. Several studies suggest that microvascular angina have good prognosis and occurs predominantly in postmenopausal women. Lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, CRP and fibrinogen are the independent risk factor of acute coronary syndrome and are the chief underlying cause of atherosclerosis. We investigated clinical characteristics and markers in patients with microvascular angina. Methods : We studies 23 patients diagnosed with microvascular angina and 16 control group with negative treadmill exercise test and no significant coronary angiogram. We investigated clinical characteristics in patients group and evaluated symptom during a follow-up period of 4.2± 2.5 month. Exercise time in treadmill exercise test was compared between patients and control group. We assessed the level of markers, such as lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, CRP and ESR in two groups. Results : There is no difference in age between two groups. Patients group had a tendency to increase in female, hypertension, DM, and smoking history, but there was no statistical significance difference. Exercise duration time was significantly decreased in patients with microvascular angina (p<0,05). Serum lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholestrol, Triglyceride, ESR, Fibrinogen and Homocystein value were no significant difference between microvascular angina and control group. Only CRP was significantly high in patients with microvascular angina (p<0.05). Conclusion : There was no statistical significance difference in age, sex, hypertension, DM and smoking history between two groups but patients group had a tendency to increase the prevalence in hypertension, DM and smoking history, female. Also, Symptom improvement and disappearance in follow-up was presented in 11 patients of 19(57.9%). Exercise tolerance was worse in patients group than control group. CRP value was significantly higher in patients group than control group. There was no statistical significance difference in lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, ESR and Fibrinogen between two groups.

Clinical correlation of metabolic parameters on ¹⁸ F-FDG PET/CT in idiopathic frozen shoulder

Won, Kyoung Sook,Kim, Du Hwan,Sung, Duk Hyun,Song, Bong-Il,Kim, Hae Won,Song, Kwang-Soon,Lee, Si-Wook,Cho, Chul-Hyun Springer Japan 2017 Annals of nuclear medicine Vol.31 No.3

<P><B>Objective</B></P><P>Because positron emission tomography/computed tomography (PET/CT) using fluorine-18-fluorodeoxyglucose (<SUP>18</SUP>F-FDG) can be used to visualize inflammation of the musculoskeletal system, it may help elucidate the pathophysiology of frozen shoulder (FS). The purpose of this study was to characterize the uptake pattern on <SUP>18</SUP>F-FDG PET/CT in patients with idiopathic FS and to determine if there is a correlation between its metabolic parameters and clinical findings.</P><P><B>Methods</B></P><P><SUP>18</SUP>F-FDG PET/CT was conducted to 35 patients with unilateral idiopathic FS. Clinical data including pain, functional scores, and passive range of motion (ROM) were collected. Maximum standardized uptake values (SUVmax) were measured at the four regions of interest (ROIs): rotator interval (RI), anterior joint capsule (AJC), axillary recess (AR), and posterior joint capsule (PJC) from the attenuation-corrected axial images.</P><P><B>Results</B></P><P>Mean SUVmax values for four ROIs of the affected shoulder were significantly higher than those of the unaffected shoulder. Mean SUVmax values of RI and AR were significantly higher than those of AJC and PJC and mean SUVmax of AJC was significantly higher than that of PJC in the affected side. Three recognizable patterns of increased uptake were noted: (1) AR dominant type (15 patients); (2) RI dominant type (9 patients); (3) both RI and AR dominant type (11 patients). The SUVmax of AR showed negative correlation with abduction and forward flexion. The SUVmax of RI showed negative correlation with external rotation and internal rotation. The SUVmax of AJC showed negative correlation with all ROMs. However, there was no significant correlation between the SUVmax of PJC and any ROM.</P><P><B>Conclusion</B></P><P>Our study demonstrates that the anterior–inferior capsular portion, including RI and AR, is the main pathologic site of idiopathic FS and reveals significant correlations between ROM and metabolic parameters on <SUP>18</SUP>F-FDG PET/CT. These results imply that AR and RI lesions are related to elevational limitations and rotational limitations, respectively.</P>

Discovery of candidate genes and pathways regulating oviduct development in chickens.

Song, Gwonhwa,Seo, Hee Won,Choi, Jin Won,Rengaraj, Deivendran,Kim, Tae Min,Lee, Bo Ram,Kim, Young Min,Yun, Tae Won,Jeong, Jae-Wook,Han, Jae Yong Society for the Study of Reproduction [etc.] 2011 BIOLOGY OF REPRODUCTION Vol.85 No.2

<P>Estrogen is a key regulator in the development of the female reproductive system. It also stimulates oviduct development in immature chicks. We identified candidate genes and pathways associated with the development of chicken oviducts. A pellet containing the synthetic estrogen analog diethylstilbestrol (DES) was implanted subcutaneously in 1-wk-old female chicks for 10 days. The pellet was removed from half the group for 10 days, and an additional dose was given for a further 10 days. Total RNA was extracted from the oviducts of DES-treated and untreated chicks and subjected to an Affymetrix chicken GeneChip analysis. We found differential expression of 2290 and 1745 transcripts from the oviducts that were treated with DES once and twice, respectively. We also found a twofold or greater change in the expression of 77 and 390 transcripts between the two control and DES-treated time points, respectively, while we found a change in the expression of 10 transcripts that were common to all groups. Analyses of real-time PCR and in situ hybridization of selected genes confirmed the validity of the gene expression patterns observed in the microarray analysis. In particular, CCRN4L, FAM26F, HAS2, NELF, and NTM were up-regulated in the DES-treated chicken oviducts. High-throughput analysis revealed that the differentially expressed genes were related to tubular formation, epithelial differentiation, hormone interactions, nerve development, and tissue remodeling in the chicken oviduct. This study provides novel insights into candidate genes regulating oviduct development and differentiation via estrogen. The identified genes may serve as biomarkers of reproductive tract development in chicks.</P>

Integrin-Linked Kinase Is Required in Hypoxic Mesenchymal Stem Cells for Strengthening Cell Adhesion to Ischemic Myocardium

Song, Suk-Won,Chang, Woochul,Song, Byeong-Wook,Song, Heesang,Lim, Soyeon,Kim, Hye-Jung,Cha, Min-Ji,Choi, Eunju,Im, Sin-Hyeog,Chang, Byung-Chul,Chung, Namsik,Jang, Yangsoo,Hwang, Ki-Chul Wiley (John WileySons) 2009 Stem Cells Vol.27 No.6

<P>Mesenchymal stem cells (MSCs) therapy has limitations due to the poor viability of MSCs after cell transplantation. Integrin-mediated adhesion is a prerequisite for cell survival. As a novel anti-death strategy to improve cell survival in the infarcted heart, MSCs were genetically modified to overexpress integrin-linked kinase (ILK). The survival rate of ILK-transfected MSCs (ILK-MSCs) was augmented by about 1.5-fold and the phosphorylation of ERK1/2 and Akt in ILK-MSCs were increased by about three and twofold, respectively. ILK-MSCs demonstrated an increase of twofold in the ratio of Bcl-2/Bax and inhibited caspase-3 activation, compared with hypoxic MSCs. The adhesion rate of ILK-MSCs also had a 32.2% increase on the cardiac fibroblast-derived three-dimensional matrix and ILK-MSCs showed higher retention by about fourfold compared to unmodified MSCs. Six animals per group were used for the in vivo experiments analyzed at 1 week after occlusion of the left coronary artery. ILK-MSC transplanted rats had a 12.0% +/- 3.1% smaller infarct size than MSC-treated rats after ligation of left anterior descending coronary artery. Transplantation of ILK-MSCs not only led to a 16.0% +/- 0.4% decrease in the fibrotic heart area, but also significantly reduced the apoptotic positive index by two-thirds when compared with ligation only. The mean microvessel count per field in the infarcted myocardium of ILK-MSCs group was increased relative to the sham group and MSCs group. In conclusion, the ILK gene transduction of MSCs further assisted cell survival and adhesion, and improved myocardial damage when compared with MSC only after transplantation.</P>