일차성 Streptococcus pneumoniae 균혈증에 동반된 흉부 하행 대동맥염 1예

전민혁,고옥배,정우진,최영준,이정훈,최상호,김미나,김양수,우준희,류지소 대한감염학회 2005 감염과 화학요법 Vol.37 No.5

페렴구균에 의한 대동맥염은 국내에서 1예만 보고될 정도로 매우 드문 감염증이다. 저자들은 원발성의 폐렴구균혈증에 합병된 페렴구균 대동맥염 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Bacterial aortitis is rare and without surgical intervention, it usually leads to uncontrolled sepsis or catastrophic hemorrhage, ultimately, resulting in death. In the postantibiotic era, the dominant infecting organisms are Staphylococcus aureus and Salmonella spp.. In spite of frequent pneumococcal bacteremia, vascular seeding is rare and there is only one published report in Korea. We describe a 77-year-old female with primary pneumococcal bacteremia followed by aortitis of the descending aorta, which was successfully treated by aneurysmectomy, wide excision of periaortic tissue, aortobiiliac bypass via prosthetic graft, and antibiotic therapy.

저강도 초음파 및 레이저를 이용한 장관골 불유합의 치료

전인호,오창욱,김성중,경희수,박일형,박병철,인주철,여준영 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 저강도 초음파는 인체 및 동물 실험에서 골조직에 낮은 미세한 물리적 압력을 가하여 골절의 치유에 유리한 영향을 주고, 레이저 (LASER)는 심부 조직에 혈류를 증가시키고, 세포 내 잠재된 에너지를 증가시키는 것으로 알려져 있다. 이에 저자들은 임상적으로 확진된 장관골 붕류합의 치료에 있어 펄스형 저강도 초음파와 레이저를 적용하고 그 효용성을 알아보고자 하였다. 대상 및 방법: 초음파/레이저의 치료 효과를 비교하기 위하여 장관골 불유합으로 확진된 16예 중 8예는 연구군으로 골이식술 후 저강도 초음파와 레이저 치료를 추가하였고 대조군 8예에 대해선 일반적인 골이식술만 시행하여 조사하였다. 남자가 11예, 여자가 5예, 평균 연령은 41.7세 (19~62세)였고, 불유합 부위는 대퇴골이 10예, 경골이 6예였다. 첫 수상으로 인한 골절 후 초음파/레이저 치료까지 시간(골절 연력)은 평균 502일이었다. 결 과: 8예의 연구군에서는 완전 골유합이 6예에서 이루어졌으며 유합까지의 시간은 평균 141일 (101~202일)로 나타난 반면, 8례ㅢ 대조군에서는 5예에서 골유합이 이루어졌고, 유합까지의 시간은 평균 240일 (183~283일)이었다. 결 론: 저강도 초음파/레이져 골절 치료기가 반복된 수술로 인한 난치성 장관골 불유합의 치료에 있어 골이식술과 함께 사용될 경우 긍정적인 효과가 있었고, 특히 최초 가골 형성에 있어 대조군에 비해 그 시간을 줄일 수 있었따. Purpose: Low-intensity, pulsed ultrasound (LIPUS) has demonstrated a stimulation and acceleration of the normal fracture-repair process in cellular bases as well in animal and human models. In this study, the adjunctive effect of LIPUS and LASER was investigated in established nonunion of the long bones. Materials and Methods: Study group consisted of eight patients to whom conventional bone graft and adjunctive LIPUS and LASER was applied. On the other hands, eight patients in the control group underwent bone graft only. Eleven men and five women were included in this study and the average age of the patients was 41.7 years (range, 19~62 years). Six of the tibias and ten of the femurs met the criteria for established nonunion. The average fracture age, the post-fracture period before the start of LIPUS/LASER treatment, was 502 days. Results: Seven of the ten nonunions who were treated by LIPUS and LASER healed completely in an average treatment time of 141 days (range, 101~202 days) and otherwise, in control group, five of the eight nonunions healed completely, in 240 days (range 183~283 days). Conclusion: This clinical study showed a positive effect of LIPUS and LASER on the rate of osseous repair, especially accelerated time to initial callus cortical bridging compared to that of conventional treatment.

치주인대 세포의 교원질 생성에 대한 Substance P의 효과

전준영,최제용,경희문,성재현 대한치과교정학회 1996 대한치과교정학회지 Vol.26 No.1

Substance P는 교정력이 가해진 치아의 치주인대 중 인장력을 받는 부위에 많이 분포하는 neuropeptide 중의 하나이며, 또한 여러 조직에서 neurogenic inflammation을 야기하는 neuropeptide 중의 하나로도 알려져 있다. 그러나 중요한 세포의 단백기질인 교원질의 생성에 대한 Substance P의 효과는 잘 알려져 있지 않다. 따라서 이 연구의 목적은 배양 치주인대 세포에서 교원질 생성에 대한 Substance P의 효과를 평가하는 것이었다. collagenase-digestion method로 교원질 생성을 평가하였고 mRNA 수준에서 작용효과를 평가하기 위하여 Northern blot hybridization을 시행하였다. 이 연구는 또한 교원질 생성에 대한 prostaglandin과 gelatinase 생성도 포함하였으며 변성된 교원질의 분해를 평가하기 위하여 Zymography를 이용하였다. 비교원성 단백질, 교원성 단백질, 상대교원질에 대한 dose-dependent effect를 보면 Substance P는 비교원성 단백질 합성을 증가시켰으나 교원성 단백질 합성은 감소시켰다. 그리하여 총 단백합성에 대한 상대적인 교원질 생성을 나타내는 상대교원질은 7%에서 3.6%로 감소시켰다. 세포를 indomethacin과 동시에 처리할 때 substance P의 교원질 합성 억제효과는 나타나지 않았다. 이것은 Substance P의 교원질 합성 억제효과가 prostaglandin의 생성 때문이라는 것을 의미한다. Substance P의 교원질 합성 억제효과가 procollagen mRNA의 정상(steady-state)수준에 부합하는가를 평가하기 위하여 northern blot hybridization을 시행한 결과 Substance P는 α1(1) procollagen mRNA의 양적 변동을 일으키지 않았다. Substance P의 교원질 생성 억제효과는 전사이후의 어떤 단계에서 이루어지는 현상임을 나타낸다. 치주인대세포에서 gelatinase 생성에 대한 Substance P의 효과를 알아보기 위하여 zymography를 이용하였다. zymogram을 보면 Substance P는 치주인대세포에서 gelatinase 생성에는 아무 효과도 나타내지 않음을 알 수 있다. Substance P의 교원질 생성 억제효과가 치주인대세포에 대해 선택적인가 아닌가를 알아보기 위하여 MC3T3-E1세포를 이용하였는데 Substance P는 MC3T3-E1세포의 교원질 합성에는 영향을 미치지 않았다. 이상에서 Substance P는 인간의 치주인대세포에서 교원질 합성을 억제하였다. 이 효과는 procollagen mRNA와 gelatinase 생성의 정상(steady-state) 수준의 변화 때문이 아니라 prostaglandin 생성과 연관이 있음을 알았다. Substance P is one of the neuropeptide which presents highly in tension site of periodontal ligament during the orthodontic tooth movement. It has been also known as one of the neuropeptides which cause neurogenic inflammation in various tissues and organs. However, there is no report about the effect of substance P on major extracellualar matrix protein, collagen production. The purpose of this study was to evaluate the collagen production by substance P in human periodontal ligament cell, The collagenase-digestion method was used to evaluate collagen production and also used Northern blot hybridization for the evaluation of collagen mRNA level. This study also included in terms of prostanglandins and gelatinase production with respect to collagen production. For the collagen degradation, zymography was used to estimate denatured collagen degradation. Dose-dependent effect of substance P on noncollagen protein, collagen, and percent collagen was that substance P increased noncollagen protein synthesis, but decreased collagen systnisis. So the percent collagen, which determined by relative collagen production against total protein production, was decreased from 7% to 3.6%. This inhibitory effect of substance P on collagen production was disappeared when cells were treated concomitantly with indomethacin. It means that substance P-induced inhibitory effect on collagen production was due at least in part to the production of prostaglandins. To evaluate whether substance P-induced inhibitory effect on collagen production is correspond to the steady-state levels of procollagen mRNA, Northern blot hybridizartion was performed and it showed that substance P has no effect on the steady-state level of α1(1) procollagen mRNA. It means that the inhibitory effect of substance P on collagen production was due to the change of a certain mechanism after posttranscription. In this context, gelatinase production by substance P in periodontal ligament cells was evaluated by zymography. Zymogram showed that substance P has no effect on gelatinase production in periodontal ligament cells. To explore wheter substance P-induced inhibitory effect on collagen production is selevtive in periodontal ligament cells or not, MC3T3-31 cells which originated from mouse calvaria was used. It showed that substance P has no effect on collagen production in MCDTD-E1 cells. Taken together, substance P inhibits collagen production in human periodontal ligament cells. This effect was not due to the change of the steady-state level of procollagen mRNA and gelatinase production, but due at least in part to the change of prostaglandins production.

척수압박으로 발현된 급성 골수성 백혈병에 동반된 과립구성 육종 1 례

윤상준,김영곤,김희종,박유환,정춘해,김양수,김태균,박영진,전호종 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

저자들은 척수압박으로 하지마비를 보인 환자에서 수술 후에 급성 백혈병에 동반된 과립구성 육종으로 진단된 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Granulocytic sarcoma(GS) is an uncommon tumor composed of immature cells of the granulocytic series. Most case of GS occur in the course of acute leukemia and the blast crisis of chronic leukemia, Rarely, however, it may present before leukemia becomes clinically apparent. It may also occur in patients with myeloproliferative disoders. GS has been reported that it occurs in 3% to 9% of patients with acute myelogenous leukemia(AML) and the incidence of GS is reported to be higher in patients with t(8;21). GS occurs relatively commonly in africa and has been reported to affect 10-25% of black children presenting with AML. This is very rare case of granulocytic sarcoma with AML(FAB M5) presented with spinal cord compression which was supported by decompression laminectomy.

한국산 감잎의 Polyphenol 화합물의 생리활성물질의 화학구조 및 효소저해효과

안봉전,최희진,손준호,우희섭,한호석,박정혜,손규목,최청 한국식생활문화학회 2003 韓國食生活文化學會誌 Vol.18 No.5

The lyophilization of the solution extracted from 60 percent of acetone applied to persimmon leaves, the compounding process in accordance with the solution's concentration, and the gel filteration through Sephadex G-50 of biologically activated substances obstructing enzyme activity, such as tyrosinase, xanthine oxidase, and angiotesin converting enzyme (ACE) led to the assumption that polyphenol was the compound serving as biologically activated substances obstructing enzyme activity. Xanthine oxidase involved in pruine metabolism oxidizes hypoxanthine to xanthine and xanthine to uric acid. In the continuous study for natural compound, nine flavan-3-ois have been isolated from the persimmon leaves. The structures of (+)-catechin, (+)-gallocatechin, procyanidin B-1, pyrocyanidin C-1, prodelphinidin B-3, gallocatechin-(4α→8)-catechin, procyanidin B-7-3-O-gallate, procyanidin C-1-3'-3''-3'''-O-trigallate and (-)-epigallocatechin-(4β→8)-epigallocatechin-(4β→8)-catechin were established by NMR and their inhibitory effect on xanthine oxidase activity was investigated. Procyanidin C-1-3'-3''-3'''-O-trigallate showed 94%, 90.69%, 80.90% inhibition at 100(μ)M and inhibited on the angiotension converting enzyme respectively. Procyanidin B-7-3-O-gallate and procyanidin 1-3'-3''-3'''-O-trigallate showed 66%, 63% inhibition at 100(μ)M and inhibited on the xanthine oxidase competitively. Procyanidin C-1-3'-3''-3'''-O-trigallate showed 70% inhibition at 100(μ)M inhibited on the thyrosinase competitively.

당뇨병에 합병한 고지혈증에 대한 Acipimox(Olbetam)의 효과

김영건,김진희,전준식,송치운,송민호 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Multiple abnormalities of lipoprotein metabolism exist in patients with diabetes mellitus that could contribute to their enhanced susceptibility to atherosclerosis. Acipimox(5-methyl-pyrazine carboxylic acid 4-oxide, Farmitala Carlo Erba, Milano Italy) is a new potent and long acting(8h) antilipolytic agent, which has been derived from nicotinic acid. By lowering plasma and possibly skeletal muscle concentrations of non-esterified fatty acid, Acipimox may have a potential beneficial effect on glucose metabolism in patients with non-insulin dependent diabetes mellitus. The aim of this study was to evaluate the acute effect of Acipimox on hyperlipidemia associated with non-insulin dependent diabetes mellitus. 18 patients with non-insulin dependent diabetes mellitus were in the study. They had fasting plasma triglyceride concentrations above 250 mg/dl and cholesterol concentrations above 240 mg/dl. The level of triglyceride, cholesterol and glycated hemoglobin were significantly reduced after 8 weeks treatment of Acipimox. Adverse effects were noted in 3 patients, but it was transient with the course of administration. Acipimox is an effective and safe drug for the management of hyperlipidemia associated with non-insulin dependent diabetes mellitus.

경식도 심초음파도의 Direct Planimetry를 이용하여 측정한 대동맥판 면적의 심박출량 및 좌심실 구출율의 변화에 따른 정확도

진승원,김종진,김희열,박지원,전두수,윤호중,박준철,노태호,채장성,김재형,홍순조,최규보 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

Serratia liquefaciens AL-11이 생산하는 Alkaline Lipase의 특성 및 작용양상

최청,김태완,안봉전,김영활,손준호,김성,최희준 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.1

본 효소의 최적 반응온도는 약 45℃이고, 최적 pH는 10.0 정도였고, pH 7.0~10.0 범위와 30~50℃의 범위에서 안정하였다. 금속이온중 Mn^2+, Ca^2+ 등에 의하여 활성이 증대되었으나 Fe^2+, Pb^2+와 Zn^2+ 등에 의해서는 효소 활성이 저해되었고, 효소활성 저해제 중 ethylenediaminetetraacetic acid(EDTA)에 의해 강한 저해작용을 나타내어 본 효소는 효소분자 중 금속이온이 관여하는 것으로 추정되었다. 효소반응 처리한 olive oil 가수분해물을 박충크로마토그래피 분석한 결과 Serratia liquefaciens AL-11이 생산하는 지방분해효소는 기질특이성이 비특이적이었으며, sodium cholate, sodium edoxychol-ate, sodium taurocholate 등의 담즙산염에 의해 효소활성이 증대되었다. The optimum temperature and pH for the enzyme activity were 45℃ and 10.0, respectively. The enzyme was stable in a pH range of 5 to 10, and 62% of its activity was lost on heat treatment at 60℃ for 20 min. The activity of the purified enzyme was inhibited by Fe^2+, Zm^2+ and Pb^2+, and slightly activated by Mn^2+ and Ca^2+. γ-Chloromercuribenzoic acid, 2,4-dinitrophenol and H_2O_2 did not show inhibitory effect on the lipolytic activity of the alkaline lipase but ethylenediaminetetraacetic acid inhibited the enzyme activity. This suggested that the enzyme have metal group in its active site. Sodium salts of bile acids stimulated the enzyme activity. Analysis of hydrolyzates of olive oil after the lipase reaction revealed that Serratia liquefaciens AL-11 produced non-specific lipolytic enzyme.

한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

Dosimetric evaluation of magnetic resonance imaging-guided adaptive radiation therapy in pancreatic cancer by extent of re-contouring of organs-at-risk

Jun Yeong Song(Jun Yeong Song),Eui Kyu Chie(Eui Kyu Chie),Seong-Hee Kang(Seong-Hee Kang),Yeon-Jun Jeon(Yeon-Jun Jeon),Yoon-Ah Ko(Yoon-Ah Ko),Dong-Yun Kim(Dong-Yun Kim),Hyun-Cheol Kang(Hyun-Cheol Kang) 대한방사선종양학회 2022 Radiation Oncology Journal Vol.40 No.4

Purpose: The safety of online contouring and planning for adaptive radiotherapy is unknown. This study aimed to evaluate the dosimetric difference of the organ-at-risk (OAR) according to the extent of contouring in stereotactic magnetic resonance image-guided adaptive RT (SMART) for pancreatic cancer. Materials and Methods: We reviewed the treatment plan data used for SMART in patients with pancreatic cancer. For the online contouring and planning, OARs within 2 cm from the planning target volume (PTV) in the craniocaudal direction were re-controlled daily at the attending physician's discretion. The entire OARs were re-contoured retrospectively for data analysis. We termed the two contouring methods the Rough OAR and the Full OAR, respectively. The proportion of dose constraint violation and other dosimetric parameters was analyzed. Results: Nineteen patients with 94 fractions of SMART were included in the analysis. The dose constraint was violated in 10.6% and 43.6% of the fractions in Rough OAR and Full OAR methods, respectively (p = 0.075). Patients with a large tumor, a short distance from gross tumor volume (GTV) to OAR, and a tumor in the body or tail were associated with more occult dose constraint violations—large tumor (p = 0.027), short distance from GTV to OAR (p = 0.061), tumor in body or tail (p = 0.054). No dose constraint violation occurred outside 2 cm from the PTV. Conclusion: More occult dose constraint violations can be found by the Full OAR method in patients with pancreatic cancer with some clinical factors in the online re-planning for SMART. Re-contouring all the OARs would be helpful to detect occult dose constraint violations in SMART planning. Since the dosimetric profile of SMART cannot be represented by a single fraction, patient selection for the Full OAR method should be weighted between the clinical usefulness and the time and workforce required.