백서에서 신 허혈성 손상에 미치는 칼슘 길항제의 효과

문철웅,정종훈,박천국,이승일,배학연,장경식,김만우,정춘해,홍순표,이병래,김호중 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Renal ischemia is one of the most common causes of acute renal failure. Four factors related to the pathogenesis of acute renal failure are vasoconstriction, decreased glomerular filtration rate, tubular back leak of filtrate, and intratubular obstruction. The cellular response to renal ischemic insults include decreased content of adenosine trihosphate, lipid peroxidation induced membrane degradation, alteration in cellular pH, and calcium or phospholipase induced mitochondrial dysfunction. Much attention has been given to the role of increased cellular calcium as a pathogenetic contributor to cell injury during ischemia. Author studied the protective effects of calcium antagonists on cellular injury during renal ischemia in rat. To investigate the protective role of these agents, author measured the amount of malondialdehyde(MDA) and the enzyme activities of free radical scarvengers-superoxide dismutase(SOD), catalase and glutathione peroxidase from non-pretreated group and calcium antagonists pretreated groups in control, ischemia and reflow subgroups. The results were summerized as follows: 1) The amount of MDA in non-pretreated group was higher in the reflow compared with the control(<p<0.01). But, in all pretreated groups, there was no statistically difference in the amount of MDA. 2) The SOD activity in non-pretreated group was lower in both the ischemia and the reflow compared with the control (P<0.05). But, in both verapamil and trifluoperazine-pretreated groups, there was no statistically difference in the SOD activity. 3) Both catalase and glutathione peroxidase activities in non-pretreated group were lower in both the ischemia and the reflow compared with the control (P<0.05). But in all pretreated groups, there was no statically difference in both catalase and glutathione peroxidase activities. These results suggest that free radical mediated ischemic injury by renal artery clamp in rat can be protected by intraperitoneal pretreatment with calcium antagonists. As trifluoperazine has a protective effect in renal ischemia, the calcium activated calmodulin dependent enzyme may play a role in renal ischemic injury.

7개 대학 병원에서 조사한 지역사회 폐렴의 원인균

정문현,김성민,강문원,최희정,정희진,이경원,한성우,송재훈,신형식,김의종,최강원,김민자,박승철,배현주,정윤섭,김준명,백경란,신완식,이규만,김양리 대한감염학회 1997 감염 Vol.29 No.5

목 적 : 폐렴은 많이 발생하면서 사망률이 크게 줄지 않는 질환이며, 이를 적절히 치료하기 위해서는 원인균의 상대적 빈도, 기저 질환에 따른 변화, 항균제 내성률, 사망에 관련된 인자들을 알아야 한다. 원인균의 빈도는 지역마다 차이가 있고 국내에서는 항균제 내성률이 높아 지역사회에서 발생한 폐렴을 치료하기 위한 경험적 항균제 선택에 도움이 되기 위해 서울 소재 6개 대학 병원과 천안의 1개 대학 병원이 참여하여 위의 사항들에 대해 조사를 하였다. 방 법 : 1995년에 내과에 입원했던 16세 이상 환자를 대상으로 했다. 퇴원 진단명이 폐렴 또는 폐결핵인 병록지을 찾았고, 이중에서 병원 감염을 제외하였다. 특이도를 높이기 위해, 이들 중에서 호흡기 증상이 있고 발열이나 저체온이 있으면서 흉부 X-선에서 이상 음영이 있는 환자만을 대상으로 했다. 폐결핵은 위의 기준에 입원 초기에 항균제 치료를 하고 입원 7일 이후에야 항결핵제가 투여된 경우만을 폐렴의 원인균으로 하였다. 혈액 배양에서 양성, 객담에서 항상균이나 M. tuberculosis가 증명된 경우, 혈청학적으로 항체가가 4배 이상 증가된 경우, 조직에서 원인균이 진단된 경우는 확정(definitive) 원인균으로 하였고, 객담에서 배양된 균이 그람 도말과 일치할때, 항결액제에 대한 반응으로 진단한 폐결핵, 단일 항체가 양성이고 이에 대해 항균제를 사용했을 때는 가능(probable) 원인균으로 정의하였다. 다세균 감염균은 각각 다 른 원인균으로 처리하였다. 임상 조사와 함께 임상병리과에서 S. pneumoniae, H. influenzae, M. catarrhalis, mycoplasma, 항상균에 대해 검사 의뢰 건수, 배양 양성수, 항균제 감수성 결과를 조사하였다. 결 과 : 폐렴의 증례 정의에 부합하지 않은 135명과 폐결핵의 정의에 해당하지 않는 230명을 제외하고 남은 246명의 평균 나이는 58.2세이고 남성이 142명(58.2%) 이었고, 71%의 환자에서 기저 질환이 있었다. 진단 방법의 시행 횟수는 혈액 배양 77.6%, 혈청 검사 18.3%, 기관지경 검사는 4.1%였고, 세균의 항원 검사를 한 예는 없었다. 원인균이 밝혀진 예는 77명(31.3%)이었다. 다세균 감염이 4명에서 있었고, 원인균의 상대적 빈도는 결핵 20명(확정 17, 가능 3: 6개 병원 자료), 폐렴구균 18(확정8 가능 10)명과 폐렴구균이 아닌 Streptococcus 3명 (모두 확정), H. influenzae 11명(모두 가능), 그람음성간균 11명(확정 7, 가능 4) (K. pneumoniae 8건), Mycoplasma 5명(확정 1, 가능 4), S. aureus 4명(확정 2, 가능 2), mucormycosis 1명(확정)이었다. 평균 입원 기간은 19일이고, 중환자실 입원률과 인공 호흡기 사용율은 각각 18%와 9.3%였다. 사망률은 13.8%였고 사망까지 평균 기간은 14.6일 이었다. 다변량 분석에서 사망을 예측할 수 있는 인자는 저체온과 빈호흡이었다. 임상병리과에서 배양되었던 모든 폐렴구균의 Penicillin 내성률은 서울 3개 병원에서 82-88%, 천안에서 72%였다. 폐렴 환자의 혈액에서 배양된 7주는 모두 Penicillin에 감수성이 있었다. K. pneumoniae 8주 모두 cefotaxime과 gentamicin에 감수성을 보였다. 결 론 : 후향적 조사이고 병원마다 원인균 진단에 차이가 있지만, 원인이 밝혀진 경우에는 결핵과 폐렴균이 흔하였고, 무균 부위에서 배양된 폐렴구균의 항균제 내성률은 낮았다. 원인이 밝혀지지 않은 경우가 많고, 혈청검사로 진단되는 원인균이 드물며, 분리균주가 적어 항균제 내성 정도를 추정하기 어려워, 이를 밝히기 위한 전향적 조사가 필요하다. Background : Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, but its management is still challenging. The limitation of diagnostic methods to identify etiologic agents rapidly make it necessary to use empiric antibiotics in almost all patients, and furthermore the discovery of new respiratory pathogens and the emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric regimen. To clarify the factors necessary for the optimal choice of empirical antibiotics, such as the frequency of etiologic agents, the attributable rates to death and antimicrobial resistance rates in the community, six university hospitals in Seoul and one university hospital in Cheonan were participating in this study. Methods : medical records of adults (>15 years of age) hospitalized for CAP or pulmonary tuberculosis between April 1995 and March 1996, were reviewed. Patients who satisfied all of the following criteria were included in the study: (1) fever or hypothermia; (2) respiratory symptoms; and (3) pulmonary infiltrates on chest roentgenogram. To exclude cases of pulmonary tuberculosis whose roentgenographic features were so typical that it could be easily differentiated from conventional pneumonia, two additional criteria were required for inclusion: antibiotic treatment during the first week of hospital admission and initiation of anti-tuberculosis medications thereafter. Organisms isolated from sterile body sites, acid-fast bacilli or Mycobacterium tuberculosis isolated from sputum, pathogens diagnosed by a 4-fold rising titer of antibodies to “atypical”pathogens, or pathogens revealed by histopathology were defined as definitive cause of pneumonia; isolates from sputum withcompatible Gram stain, pathogens diagnosed by a single diagnostic titer plus use of a specific antimicrobial agent, or tuberculosis diagnosed by clinucal response to anti- tuberculosis medications were considered probable cause of pneumonia. The records of the clinical microbiology were reviewed for isolates of S. pneumoniae, H. influenzae, M. catarrhalis, Mycobacterium or acid-fast bacilli, and Mycoplasma. Then the frequency of these agents, antimicrobial resistance rates of resiratory pathogens from all body sites, and their clinical significance were evaluated. Results: After excluding 365 patients (230 with pulmonary tuberculosis and 135 with CAP) who were screened for inclusion but did not meet the inclusion criteria,246 persons were enrolled in this study. Their mean age was 58.2 years old with slight male predominance (58.2%), and 171(71%) patients had underlying illnesses. Blood cultures were performed on 191 (77.6%) patients and serologic tests on 44(18.3%) patients. The etiologic agents were identified in 31.3%, and the list of individual agents, in decreasing order, was pulmonary tuberculosis (17 definite and 3 probable: data of six hospitals), S. pneumoniae (8 definite and 10 probable), non-pneumococci (3 definite), aerobic gram-negative bacilli (7 definite and 4 probable), Haemophilus spp. (11 probable), mycoplasma (1 definite and 4 probable), polymicrobial infections (2 definite and 2 probable: E. coli and S. agalactiae, M. tuberculosis and S. aureus, S. pneumoniae and H. influenzae and A. baumannii and K. pneumonias), S. aureus (2 definite and 2 probable) , and mucormycosis (1 definite). Among gram-negative bacilli, K. pneumoniae was the most common agent (8isolates). therates of admission to the intensive care unitand of using assisted ventilation were 18% and 9.3%, respectively. The mortality was 13.8% and logistic regression analysis showed that hypothermia and tachypnea were associated with death. Hospital stay averaged 19 days. Susceptible rates of S. pneumoniae isolated from all body sites to penicillin ranged from 8% to 28% but seven isolated from blood of patients with pneumonia were susceptible to penicillin. Also all 8 isolated of k> pneumoniae from patients with pneumonia were susceptible to cefotaxime and gentamicin. Conclusion: In Korea, in addition to S. pneumoniae, M. tuberculosis is an important agent causing community-acquired pneumonia. The low incidence of etiologic diagnosis is probably related to infrequent requesting of test "atypical" pathogens and does not represent the true incidence of infections by "atypical" pathogens, which well be answered by a prospective study. The antimicrobial resistance rates of major respiratory pathogens from sterile body sites are low, however, because of a small number of the isolates this result needs confirmation by a nationwide surveillance of antimicrobial resistance.

열안정형 카테콜-O-메틸전이효소 유전자의 클로닝

홍경만,최용복,정갑용,지은정,장현신,박현,백문기 圓光大學校 醫科學硏究所 1998 圓光醫科學 Vol.14 No.2

Catechol-O-methyltransferase (COMT; EC 2.1.1.6) is the enzyme which catalyzes the transfer of methyl group to the catecholamine neurotransmitters from its methyl donor S-adenosyl-L-methionine. Partially purified COMT from rat liver has been used to measure the concentration of catecholamines in the blood through solvent extraction and thin layer chromatography after converting ^3H-methyl derivatives of catecholamines. To improve this inconvenient and fluctuating method, an attempt was made to use COMT gene for the measurement of catecholamines. Specific primers, COMT5P (5'-TGC TCA GAG GTG CTT TGA AG-3') and COMT3P (5'-GGA GCC GCA GAA GGT CA G-3'), were used to amplify COMT gene from human placenta cDNA library. The amplified COMT gene through 35 cycles of polymerase chain reaction was cloned into T-vector and the nucleotide sequences are determined by automatic sequencer. Human COMT has two common variants, a thermostable high activity form which has valine at amino acid 158 and a thermolabile low activity form which Has methionine at the same position. The cloned COMT gene in this study has both variants. Clone 4 and 5 have valine at amino acid 158 (guanine at nucleotide 472) and clone 1-3 have methionine at this site (adenine at nucleotide 472). In addition to this, there are other DNA polymorphisms in COMT gene at nucleotide 101, 102 (amino acid 34, a structural mutation cysteine/serine) and nucleotide 186 (a silent mutation). All of the clones have cysteine at amino acid 34 (guanine and adenine at nucleotides 101 and 102) and cytosine at nucleotide 186 except clone 3 which has thymine at this nucleotide. Clone 4 and 5 are thermostable high activity variants, suggesting being more useful for the measurement of catecholamines after expressing the gene.

김치용 간절임 배추의 저장에 관한 연구 : Ⅱ. 젖산, Calcium Chloride, 저장온도가 저장중 간절임 배추의 품질에 미치는 영향

김윤숙,김중만,백승화,문정옥,황호선,김인숙 圓光大學校 1987 論文集 Vol.21 No.2

배추를 다듬기 하는데 발생한 폐기량은 7.5∼14% (w/w)이었고 10±2℃에서 30일간 방치한 경우 약 17∼25% 발생하였다. 간절임 배추의 pH값은 저장온도가 낮을수록, 염도가 높을수록 높았으나 calcium chloride 첨가가 절임배추의 pH값의 변화에는 영향을 주지 않았다. 유리당의 함량변화는 최소 약 4% 수준에서 산의 함량과는 반비례적으로 변화하여 저장 90일에는 소금농도가 낮고 저장온도가 높은 경우 적게 감소되었다. 균수변화에서 세균과 효모는 전 기간을 통해 증가한 반면, 곰팡이는 감소하였다. 한편 산의 첨가와 CaCl? 첨가시 소금으로만 절인 경우보다 세균과 효모는 낮은 속도로 증가했다. 저장중 경도는 온도가 낮고 염도가 높으며 젖산을 첨가한 경우 다소 높게 유지됐고, CaCl? 첨가의 경우 잎과 줄기에서 월등히 높았다. 휘발산과 불휘발산의 함량변화에서 온도가 낮고 염도가 높은경우 불휘발산의 함량이 낮았는데 특히 젖산 첨가시 불휘발산의 증가를 억제하는 것으로 나타났다. flavor score 는 저온과 고염도 젖산첨가시 유리하였다. This study was to investigate the effects of storage temperature, lactic acid and calcium chloride addition about the pH values, sugar content, firmness, volatile and nonvolatile acidity, microbial counts and flavor of the salted chinese cabbages during storage (90 days), and trim loss of chinese cabbages during the trimming of raw and storaged (30 days) chinese cabbages. The waste rate was in the course of trimming of raw chinese, cabbages was 7.5-14(w/w). The proportion of trim loss was highly correlated to sunshine duration, temperature, humidity and handling for the storage. Free sugar was decreased fast and much in the case of high temperature and low level sodium chloride in comp rison of low temperature and high sodium chloride, but ?? and lactic acid did not affect its changes. Time to reach the lowest pH values were fast in the case of high temperature and low salt content. Lactic acid affected inital pH value (4.38-4.57) and constant pH value in each case was increased at low salt content, at high temperature, and then the pH values were slowly increased when volatile acidity was increased. Firmness was high in the case of addition of lactic acid and calcium chloride, low temperature, high sodium chloride concentration. Especially, calcium chloride addition remarkably showed high firmness. Flavor score was high in the case of low storage temperature, high yeast counts were slowly increased in spite of low temperature and high salt content, but mold counts were slightly increased during all period Lactic acid, low temperature and high sodium chloride were effective to inhibit the growth of microorganisms. Volatile and nonvolatile acidity was increased during all storage period ; however, lactic acid and low temperature storage inhibited their increase. To conclude, quality of salted chinese cabbages was effective at low temperature storage, lactic acid and calcium chloride addition, and high salt concentration.

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.

Associations of neurofunctional, morphometric and metabolic abnormalities with clinical symptom severity and recognition deficit in obsessive–compulsive disorder

Moon, Chung-Man,Jeong, Gwang-Woo Elsevier 2018 Journal of affective disorders Vol.227 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Obsessive–compulsive disorder (OCD) causes neural dysfunction associated with cognitive deficit and emotional dysregulation. This study assessed the associations of the neurofunctional changes, gray matter (GM) and white matter (WM) volume alterations in conjunction with in vivo metabolic changes on the working memory tasks in patients with OCD.</P> <P><B>Methods</B></P> <P>Eighteen patients with OCD and 18 healthy controls matched for age, sex, and educational levels underwent high-resolution T1-weighted magnetic resonance imaging (MRI), event-related functional MRI (fMRI), and proton magnetic resonance spectroscopy (<SUP>1</SUP>H-MRS) at 3T.</P> <P><B>Results</B></P> <P>In fMRI, patients with OCD showed lower activities in the cerebellum, inferior temporal gyrus, orbitofrontal gyrus, dorsolateral prefrontal cortex and calcarine gyrus compared to the controls. In VBM, the patients showed significantly reduced GM volumes, especially in the cerebellum, hippocampus, and superior temporal gyrus, together with significantly reduced WM volumes in the retrolenticular part of the internal capsule, dorsolateral prefrontal cortex (DLPFC) and orbitofrontal gyrus. In <SUP>1</SUP>H-MRS, the ratios of <I>N</I>-acetylaspartate/creatine and choline/creatine were significantly lower in the DLPFC of the patients than in the controls, whereas the ratio of β∙γ-glutamine-glutamate/creatine was significantly higher in the patients than in the controls.</P> <P><B>Limitations</B></P> <P>This study examined small numbers of subjects in each one of the groups.</P> <P><B>Conclusions</B></P> <P>The findings will be helpful to aid us in understanding of neurocognitive impairment in OCD, and thus, enhancing the diagnostic accuracy for OCD by additional information on the associated brain functional deficit, cerebral volume change and metabolic abnormality.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The BOLD signal change and Cho/Cr ratio in the DLPFC were positively correlated with the accuracy. </LI> <LI> The WM volume of the DLPFC was positively correlated with NAA/Cr ratio. </LI> <LI> The WM volume of the DLPFC was negatively correlated with β∙γ-Glx/Cr ratio. </LI> <LI> BOLD signal and WM volume changes in the DLPFC were negatively correlated with Y-BOCS scores. </LI> </UL> </P>

Whole-brain gray matter volume abnormalities in patients with generalized anxiety disorder: voxel-based morphometry

Moon, Chung-Man,Kim, Gwang-Won,Jeong, Gwang-Woo Wolters Kluwer Health | Lippincott Williams Wilkin 2014 NEUROREPORT - Vol.25 No.3

Patients with generalized anxiety disorder (GAD) experience psychological distress because of excessive and uncontrollable anxiety in everyday life. Only a few morphological studies have so far focused on specific brain regions of interest as well as the gray matter volume changes in GAD patients. This study evaluated gray matter volume alterations in whole-brain areas between GAD patients and healthy controls, and sex differences between the specific brain areas with significant volume changes in GAD patients using voxel-based morphometry. Twenty-two patients with GAD (13 men and nine women), who were diagnosed using the DSM-IV-TR, and 22 age-matched healthy controls (13 men and nine women) participated in this study. The high-resolution MRI data were processed using voxel-based morphometry analysis on the basis of diffeomorphic anatomical registration through an exponentiated Lie algebra algorithm in Statistical Parametric Mapping 8. There was no significant difference in the total intracranial volume between GAD patients and controls, but a significant difference was observed between sexes (P<0.05). Patients with GAD showed significant volume reductions in the hippocampus, midbrain, thalamus, insula, and superior temporal gyrus compared with the controls. As for the sex comparison, female patients showed a significant increase in the volume of the dorsolateral prefrontal cortex relative to male patients. Also, the volume of the dorsolateral prefrontal cortex in female patients was correlated positively with the Hamilton Anxiety Rating Scale score (&ggr;=0.68, P=0.04). The specific morphological variations in patient with GAD will be helpful to understand the neural mechanism associated with a symptom of GAD. Furthermore, the findings would be valuable for the diagnostic accuracy of GAD using morphometric MRI analysis.

Functional and morphological alterations associated with working memory dysfunction in patients with generalized anxiety disorder

Moon, Chung-Man,Jeong, Gwang-Woo Acta Radiologica 2017 Acta radiologica Vol.58 No.3

Proceedings of Korea-Japan Special Symposium on Technology and R&D Trends on Inorganic Waste Recycling : Effect of waste paper addition on thermophilic and dry methane fermentation of food waste

( Chung Man Moon ),( Yasumasa Tojo ),( Takayuki Matsuo ),( Nobutoshi Tanaka ),( Toshihiko Matsuto ) 한국폐기물자원순환학회(구 한국폐기물학회) 2005 한국폐기물자원순환학회 심포지움 Vol.2005 No.1

Abnormalities in gray and white matter volumes associated with explicit memory dysfunction in patients with generalized anxiety disorder

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