Dipyridamole 부하 심근 SPECT에서 Dipyridamole의 작용과 부작용

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),최창운(Chang Woon Choi),배상균(Sang Kyun Bae),양형인(Hyung In Yang),여정석(Jeong Suk Yeo) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2

N/A Dipyridamole is an agent that may be used to noninvasively evaluate coronary artery disease. The effect of dipyridamole infusion its generally related to its induced peripheral vasodilatory effect. In normal person, heart rate is generally increased slightly while blood pressure decrease, but the achieved double product and related myocardial oxygen consumption have no significant change. The purpose of this study is to examine the effect and side effect of dipyridamole, and to compare different response to dipyridamole among the patients. We evaluated 847 patients who underwent dipyridamole stress myocardial SPECT. 93.6% of them had induced hypotension 0.9% showed no change of blood pressure, 5.5% had increased blood pressure 8.3% had no change of pulse rate more than 10% of basal pulse rate. Among diabetes, 16.9% was not change of pulse rate, 6.7% in non-diabetes. There was no significant correlation between age and rate pressure product rest(RPPr), in patients without perfusion defects on SPECT(y=7.1x+48.4r=0.13 p>0.01). As increasing age, RPPs/RPPr was declined(y=-11.6x+68.9 r=0.17 p〈0.01), similar results were obtained in patients with perfusion defect. The size of perfusion defect on myocardial SPECT have no correlation between RPPr and RPPs/RPPr. The side effects of dipyridamole included chest pain and chest tightness, headache, abdominal pain, dizzness, nausea, and dyspnea. As increasing age, dipyridamole-induced cardiac work at rest was increased, cardiac response to dipyridamole was decreased.

In Vitro 고삼투압이 정자 원형질막의 Protein Tyrosine Phosphorylation에 미치는 영향

오영근,장재호,최인호,정노팔,신형철,곽병주 대한의생명과학회 2000 Journal of biomedical laboratory sciences Vol.6 No.4

정자의 원형질막은 삼투압에 의해서 영향을 받는다고 보고되고 있다. 이중 세포막내 분자구조의 변화 특히 막지질 구조의 변화와 동반되는 이온채널의 변화 그리고 Ca2+과 HCO-3의 유동성과도 밀접한 관련이 있는 것으로 보고되고 있다. 지금까지의 연구보고에 의하면, 정자의 첨체반응 (acrosome reaction)이 일어날 경우 protein tyrosine phosphorylation이 증가되는데 이것은 cAMP, protein kinase A 등을 통하여 작용되는 것으로 보고되고 있다. 막의 지질변화를 유도하는 물질로 일종의 sterol acceptor인 BSA가 알려져 있는 바, 실제로 BSA가 막지질 성분에 미치는 영향을 관찰한 결과 cholesterol이 유출되고 이온 등의 유동성 변화가 일어나, 이 유동성 변화가 정자의 adenylyl cyclase를 활성화시켜 cAMP를 증가시키고, PKA가 활성화되어 결과적으로 Protein tyosine phosphorycation이 유도된다고 보는 것이다. 침체반응과 protein tyrosine phosphorylation과는 밀접한 관계가 있는 것으로 사료되고 있다. 본 연구는 정자 원형질막에서 cholesterol이 유출되어 protein tyrosine phosphorylation이 유도될 때, BSA와 같은 sterol acceptor가 작용할 것이라는 전제하에, 고삼투압 하에서 탈수로 인해 원형질막이 위축되더라도 sterol acceptor가 존재한다면 막지질 성분의 구조적 변화가 억제 될 수 있을 것이라는 가설을 설정하였다. 실험결과, 저온 및 고삼투압 하에서 정자운동은 감소되지만 원형질막의 구조적 변화는 없고, 삼투압에 대한 반응정도는 원형질막을 통한 수분이동과 세포용적 변화에 따라 비례적으로 일어난다고 하는 사실을 발견하였다. 이 결과는 정자보존에 있어서 저온변화에 영향을 미치는 여러 인자들 특히 protein fgrosine phosphorylation의 증가와 밀접한 관계가 있음을 시시해 준다. 또한 sterol acceptor로 알려진 BSA는 삼투압이 변화되더라도 역시 중요한 인자로 작용할 수 있음을 알 수 있었으며, 특히 고삼투압으로의 변화는 cAMP와 protein kiname A를 거치는 신호전달과정에 있어서 중요한 요인이라는 사실을 확인할 수 있었다. It has been reported that plasma membrane activity of the spermatozoa may be susceptible to be influenced by extracellular osmolality and such membranous changes involve intracellular molecular changes, special regard to the structure of membranous lipids, and the accompanying ion-channel of which are closely related with their fluidity of Ca2+ and HCO-3. It is of common recognition that a certain kind of sterol acceptor player an important to induce lipid fluctuation of the sperm plasma membrane which have been influenced by BSA administration and came in effect to outflow of cholesterol from the spermatozoa and resulted in changes of ionic fluidity to facilitate adenylyl cyclase, and to induce protein tyrosine phosphorylation by increase of cAMP and activation of PKA. Thus it seems likely that an augmentation of the acrosomal reaction is closely related with protein tyrosine phosphorylation. The following experimental results were obtained in the present study; Under the high osmolality conditions, the spermatozoa motility declined significantly and the structural change of the plasma membrane diminished to confirm that the response degrees to the osmolality depended upon the water transfer volume through the plasma membrane and the changes of cellular volume. Those experimental results suggest that a physiological parameter such as low temperature condition played an important role for presentation of spermatozoa and that inducement of spermatozoa activation for reinforcement of protein tyrosine phosphorylation. On the other hand, it seemed likely that the BSA administration as one of sterol acceptors might represent a key role also under the high osmolality condition and their result also suggests that osmolality change, special regard to high osmolality condition may play an important role also in the processes of signal transmission

Numerical analysis of flow and bed change at a confluence of the Namhan River and the Seom River using a two-dimensional model

Park Moonhyung,Kim Hyung Suk,Baek Chang Hyun 한국수자원학회 2018 한국수자원학회논문집 Vol.51 No.12

본 연구에서는 4대강 살리기 사업 후 퇴적현상이 지배적으로 발생하는 남한강과 섬강 합류부 구간을 대상으로 2차원 수치모형인 CCHE2D 모형을 이용하여 하천의 흐름 및 하상변동에 대한 해석을 수행하였다. 대상지점 합류부는 남한강 본류의 만곡부에 지류 섬강이 유입되는 특성을 갖는다. CCHE2D 모형은 비평형 유사이송을 해석하며 소류사와 부유사 조정거리가 중요한 입력변수로 대상지점에서는 소류사 조정거리가 하상변동에 가장 큰 영향을 주는 것으로 나타났다. 수치모의 결과 유량비(Qr) 변화가 남한강과 섬강 합류부 지점에서 흐름 및 하상변동에 영향을 미쳤으며, Qr≤ 2.5인 경우에는 합류전 본류의 유속이 증가하여 흐름박리구역을 감소시켰으며 이로 인해 합류부 내측의 퇴적이 감소하였다. Qr>2.5이면 합류부 구간에 퇴적이 증가하여 사주가 형성될 가능성이 높은 것으로 나타났다. 수치모의를 통해 2013년에 발생한 유량비 변화에 의해 합류부에 고정사 주가 형성된 것을 알 수 있었다. The flow and bed change were analyzed using the CCHE2D model, which is a two-dimensional numerical model, at a confluence of the Namhan River and Seom River where deposition occurs predominantly after the “Four Major Rivers Restoration Project.” The characteristic of the junction is that the tributary of Seom River joined into the curved channel of the main reach of the Namhan River. The CCHE2D model analyzes the non-equilibrium sediment transport, and the adaptation lengths for the bed load and suspended load are important variables in the model. At the target area, the adaptation length for the bed load showed the greatest influence on the river bed change. Numerical simulation results demonstrated that the discharge ratio (Qr) change affected the flow and bed change in the Namhan River and Seom river junction. When Qr ≤2.5, the flow velocity of the main reach increased before confluence, thereby reducing the flow separation zone and decreasing the deposition inside the junction. When Qr>2.5, there was a high possibility that deposition would be increased, thereby forming sand bar. Numerical simulation showed that a fixed sand bar has been formed at the junction due to the change of discharge ratio, which occurred in 2013.

급성 췌장염의 시대적 변화

김배영(Bai Young Kim),김효종(Hyo Jong Kim),정형근(Hyung Keun Chung),김영관(Young Kwan Kim),동석호(Seok Ho Dong),김병호(Byung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: According to the rapid changes in social environment such as increasing alcohol consumption and the marked improvement in diagnostic technique, we expect that there have been major changes in various aspects of acute pancreatitis during the recent 12 years in Korea. Methods: The medical records of 317 patients with acute pancreatitis diagnosed from 1980 through 1992 were reviewed about clinical, laboratory and radiological findings in the three different time period. Results: 1) There has been an increasing incidence in male sex about three folds. 2) There has been an increasing trends in the duration of hospitalization. 3) A significant increase was observed in the proportion of patients with alcoholic pancreatitis in the three different time period; 26.9%, 45.7%, 50.7% respectively. 4) The complication rates have been slightly increased in the three different time period; 46.3%, 47.1%, 59.1% respectively. But, the type of complications has not been changed. 5) There is increasing severity in non-gallstone group, but no significant differences in gallstone group. There is a declining trends in the number of patients with muld severity index, but increasing trend in the number of patients with moderate severity index in non-gallstone group. 6) There was no significant differences in mortality rate. Conclusions: There has been major changes in the etiology ans severity of acute pancreatitis from 1980 through 1992. Especially, significant increase in the proportion of patients with alcoholic pancreatitis was observed in the three differnt time period. These results might be due to socioeconomic changes.

무증상 갑상선기능저하증 환자에서 Thyroxine 치료에 따른 혈청 지질 및 아포지단백의 변화

조보연,신찬수,김원배,고창순,김성연,박혜영,박건상,이홍규,박형규,김숙경 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.1

Background: Subclinical hypothyroidism(SCH) is a common biochemical abnormality which can be found in routine screening tests of thyroid function. We are increasingly faced with the question of whether its an indication for thyroxine replacement therapy. The effect of thyroxine replacement on lipid profile in SCH has aroused a great interest because of an association of overt hypothyroidism(OVH) with hyperlipidemia and increased risk of coronary artery disease. Method: We prospectively evaluated the changes in lipids and apoproteins before and after thyroxine replacement therapy in 23 patients with SCH and in 37 patients with OVH. We measured serum total cholesterol and triglyceride using autoanalyzer, high density lipoprotein(HDL) chole-sterol by dextran sulfate method, Apo A1 and Apo B by immunonephelometric assay. Results: Thyroxine replacement therapy significantly decreased total cholesterol, low density lipoprotein(LDL) cholesterol and apo B levels, but did not affect the level of triglyceride, HDL cholesterol or apo AI in patients with OVH. In SCH, thyroxine replacement therapy with the doses to normalize serum TSH concentrations also decreased significantly the level of cholesterol and LDL cholesterol albeit apo B levels did not change. Moreover, in most of patients with OVH (11 of 12) and in all of patients with SCH(5 of 5) who had had hyperchlesterolemia before treatment, thyroxine replament normalized their cholesterol and LDL cholesterol levels. Conclusion: In regard to the beneficial changes in blood lipid levels, patients with SCH should be treated, especially in cases who have other risk factors for the development of atherosclerosis. If thyroxine replacement only will reduce the incidence of coronary artery disease in SCH remains to be elucidated by long-term prospective studies(J Kor Soc Endocrinol 11:41-51, 1996).

동료교육에 의한 댄스 프로그램이 소외아동의 학교생활태도에 미치는 영향

장경호,정형수 한국유아체육학회 2000 한국유아체육학회지 Vol.1 No.1

이 연구는 여름 캠프에서 친구 교육(peer-teaching)에 의해 진행되는 힙합 댄스 프로그램이 교우들에게 소외당하고 있는 아동의 행동 변화에 미치는 영향을 조사하는 것으로 힙합 댄스의 업락(Up Lock), 풋 워크(Foot Walk), 킥(Kick) 그리고 킥웜(Kick Worm) 및 나이키(Nike) 동작을 가르치는 내용으로 구성되었으며, 교육의 효과는 프로그램의 시행 전과 시행 후의 행동 변화 차이로 검증하였다. K군의 힙합 댄스 프로그램은 친구 간의 이해를 도모하기 위하여 다양한 친교 프로그램이 적용되었다. 휴식 시간과 피자 파티, 그리고 콘서트 관람까지 계획 전의 행동 강화(activity reinforcement)가 시행되었다. 이러한 계획은 Transdisciplinary Team Model 형태(Falvey, 1989)를 시도한 것이다. 특히, K군의 학교 생활에 직접적인 도움을 줄 수 있는 교우들에게 프로그램을 진행하도록 기회를 부여한 점과 힙합 댄스 기술을 한 명의 동료에게 부탁하지 않고 여러 명에게 각각 부탁하여 프로그램을 진행하는 점에서 Transdisciplinary Model의 형태가 적용되었다. 행동 평가표는 예비 조사를 통하여 타당도(validity와 신뢰도(reliability)가 검증되었다. 타당성 조사는 내용 타당도와 비교 타당도로 나뉘어 조사되었다. 내용 타당도 조사에서는 발육 발달을 전공하는 대학 교수, 담임 교사, 학부모 5일, 그리고 17명의 초등학교 6학년생을 대상으로 실시되었다. 이 조사에서는 문항의 난이도와 의미를 정확하게 전달하는가에 관한 조사가 이루어졌다. 이 연구의 결과에서는 힙합 댄스 프로그램에 참여한 후, 급우들이 느끼는 K군의 학급 생활은 크게 변화한 것으로 나타났다. 이러한 결과는 힙합 댄스 프로그램에 참가 이후, K군의 친구 관계와 생활 태도 변화를 의미한다고 볼 수 있다. K군의 학급 내 생활 태도에 관한 급우들의 느낌은 K군의 행동 가운데 긍정적인 부분에 따라 유의한 영향을 받고 있다. K군에 관한 급우들의 이미지에 영향을 미치는 요인들에 관한 회귀 분석의 결과 K군의 학급 내 생활 태도는 K군의 긍정적인 행동에 따라 많은 영향을 받고 있었다(p<0.05). 이 연구에서는 K군의 생활 태도에 관한 이미지는 K군의 긍정적인 행동, 즉, 선량한 이미지를 높일 때 효과적으로 높일 수 있다고 밝히고 있다. This study was conducted to promote a segregated student's positive classroom behaviors. A Hip-Hop dance program that includes training basic skills and performance was constructed. The basic skills were Up-Lock, Foot Walk, Kick-Worm and Nike, while the activity reinforcers include a pizza party, participation in a concert, and performance demonstration. The transdisciplinary-team model and the peer-teaching method were applied. The subject's classroom behaviors were evaluated by 40 classroom mates. Effects of the Hip-Hop dance program were investigated by pre-post test method. To evaluate the subject's behavior, a behavioral checklist was developed with validity and reliability test. Results of this study indicated that the subjects' classroom behavior were significantly changed after complete of the Hip-Hop dance program. However, the subject's personality characteristics were not changed. Scores of the subject's classroom behavior that was evaluated by male students was greater than that of female students (p<0.05). The different results by the gender was considered to that the male students more likes the Hip-Hop dance than the female students. This study also emphasized that promoting useful classroom behaviors, rather than negative one such as aggressiveness screaming and roughing, is important to protect increasing negative images.

Comparison of the Crystallization Behavior of Silica Between Mg and Al‑Phosphate Used in Tension Coatings of Grain‑Oriented Electrical Steel

Hyung‑Ki Park,Min‑Soo Han,Chang‑Hwan Chang,Jong‑Tae Park,박창수,Hyung‑Don Joo 대한금속·재료학회 2020 METALS AND MATERIALS International Vol.26 No.3

The effect of the phosphate component on the thermal stability of tension coatings was investigated with a focus on thecrystallization behavior of amorphous silica in the tension coating. After stress-relief annealing, core loss of samples coatedwith a Mg-phosphate was improved, while that coated with an Al-phosphate was deteriorated. The domain wall spacing ofthe samples coated with Mg- and Al-phosphates was respectively increased and decreased after stress relief annealing. Thismeans that the stress relief annealing did not much diminish the tensile stress for Mg-phosphate coating but much diminishedthe tensile stress for Al-phosphate coating. Based on FTIR and XRD results, we found that the crystallization temperatureof silica with Al-phosphate was lower than that of silica with Mg-phosphate. The crystallization of silica was accompaniedby an abrupt volume change, which formed cracks in the tension coating and deteriorated the tensile stress.

Poster Session : PS 1239 ; Pulmonology : Azathioprine Induced Cholestatic Hepatitis in Patient with Boop

( Hyung Woo Kim ),( Joo Han Song ),( Kyung Soo Chung ),( Song Yee Kim ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae Kang ),( Young Sam Kim ),( Se Kyu Kim ),( Joon Chang ),( Moo Suk Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Azathioprine is widely used as an immunosuppressive drug in infiammatory bowel disease, many autoimmune disease and after organ transplantation to avoid rejection. Azathioprine has adverse reactions like hepatotoxicity. We report a case of azathioprine induced cholestatic hepatitis in patient with bronchiolitis obliterans organizing pneumonia(BOOP). A-37-year old woman was admitted because of pruritus and jaundice. She took transbronchial lung biopsy, bronchoalveolar lavage for cough, dyspnea and GGO patterns on chest computed tomography(CT) scan before she admitted. And it was revealed that she had BOOP. So she had been followed and treated for BOOP with prednisolone from 23th Nov 2012 and azathioprine from 8th Jan 2013. 42 days after taking Azathioprine, routine blood test was taken. Serum bilirubin, alkaline phosphatase(ALP), aspartate transaminase(AST), and alanine aminotransferase(ALT) was elevated(Bilirubin 4.4mg/dL, AST 75IU/L, ALT 104IU/L) and. Other laboratory test, including prothrombin time, serum albumin, and serum protein were within normal range. There was no history of alcohol abuse or herbal medication intake at this period. To exclude other reasons for hepatotoxicity, serological test was performed. The patient tested to negative for Hepatitis A, B, and C as well as for other markers of autoimmune hepatitis. CT scan showed hepatomegaly with lymph node enlargement and there was no evidence of bile duct obstruction. And TPMT(thiopurine methyltransferase) genotyping was done and revealed to be wild type. Azathioprine was stopped and she was monitored for laboratory changes. Because it was regarded as azathioprine induced cholestatic hepatitis and jaundice, we considered not to do liver biopsy. Day 55 after starting azathioprine therapy, total bilirubin reached peak (12.3mg/ dL). The patient was discharged on day 63 with cholestatic parameters of 115U/L(ALP), 36U/L(γ-GT), and 11.5mg/dL(total bilirubin). After 2 months, total bilirubin was decreased to normal(0.8mg/dL). Treatment of BOOP has been continued only with oral steroid.

Differences in Resumption of Orthopedic Surgery According to Characteristics of Surgery during COVID-19 Pandemic: National Registry Data

Hyung Jun Park,Moon Jong Chang,Tae Woo Kim,Chong Bum Chang,Seung-Baik Kang 대한정형외과학회 2023 Clinics in Orthopedic Surgery Vol.15 No.2

Background: Healthcare services have been restricted after the coronavirus disease 2019 (COVID-19) outbreak. With the pandemic still ongoing, the patterns of orthopedic surgery might have changed. The purpose of this study was to determine whether the reduced volumes of orthopedic surgery were recovered over time. Among the trauma and elective surgery, which accounted for most orthopedic surgical procedures, we also sought to elucidate whether the changes in the volumes of orthopedic surgery differed according to the type of surgery. Methods: The volumes of orthopedic surgery were analyzed using the Health Insurance Review and Assessment Service of Korea databases. The surgical procedure codes were categorized depending on the characteristics of the procedures. The actual volumes of surgery were compared with the expected volumes to elucidate the effect of COVID-19 on surgical volumes. The expected volumes of surgery were estimated using Poisson regression models. Results: The reducing effect of COVID-19 on the volumes of orthopedic surgery weakened as COVID-19 continued. Although the total volumes of orthopedic surgery decreased by 8.5%–10.1% in the first wave, those recovered to a 2.2%–2.8% decrease from the expected volumes during the second and third waves. Among the trauma and elective surgery, open reduction and internal fixation and cruciate ligament reconstruction decreased as COVID-19 continued, while total knee arthroplasty recovered. However, the volumes of hemiarthroplasty of the hip did not decrease through the year. Conclusions: The number of orthopedic surgeries, which had decreased due to COVID-19, tended to recover over time, although the pandemic was still ongoing. However, the degree of resumption differed according to the characteristics of surgery. The findings of our study will be helpful to estimate the burden of orthopedic surgery in the era of persistent COVID-19.

Sarcoidosis Presenting with Multiple Lung Parenchymal Nodules

Hyung-Jun Kim,Jimyung Park,Jee Min Kim,Ye Jin Lee,Hye-Rin Kang,Chang-Hoon Lee 이화여자대학교 의과학연구소 2016 EMJ (Ewha medical journal) Vol.39 No.2

Sarcoidosis is a multi-organ disease with various clinical manifestations. The lung is the most common site of manifestation; however, unusual findings may delay the correct diagnosis of sarcoidosis. Here we report a case of 32-year-old man with 4-month history of neck mass. Radiological findings revealed multiple pulmonary parenchymal nodules, with initial biopsy results of his neck lymph node showing chronic granuloma with focal necrosis. The patient was treated with anti-tuberculosis medications, but the size of the nodules did not change. Biopsy was performed from one of his pulmonary nodules, which revealed chronic granuloma without necrosis. Therefore, the patient was diagnosed with sarcoidosis. We present a case of sarcoidosis with multiple lung parenchymal nodules that is uncommon in Korea, with an aim to alert physicians of such unusual presentations.