백서와 기니픽의 대뇌피질에서 Opioid Kappa 수용체의 특성에 관한 연구

김기원(Kee-Won Kim),노혜원(Hye-Won Rho),김형일(Hyoung-Il Kim),은재순(Jae-Soon Eun),소수미(Soo-Mi Soh),조규박(Kyu-Park Cho) 대한약리학회 1994 대한약리학잡지 Vol.30 No.2

In this study, we tested the influences of several κ opioid ligands on the [³H]diprenorphine binding in rat and guinea pig cortex membrane preparations. Using paradigm to block μ and δ opioid receptors with DAMGO(1μM) and DPDPE(1μM), [³H]diprenorphine labeled κ sites. Competition analysis in both rat and guinea pig cortex has shown a single population of [³H]diprenorphine binding site with different Kd values, respectively. There is a significant difference in Ki values of (-) WIN44441 and (+)WIN44441 in both rat and guinea pig cortex. Bremazocine, (-)ethylketocyclazocine, (-)cyclazocine, nor-binaltorphimine effectively inhibited the [³H]diprenorphine binding with different Ki values in rat and guinea pig cortex. U-69,593, U-50,488H and dynorphine-A (1-8) did not inhibit the [³H]diprenorphine binding in rat but in guinea pig cortex. Nor-binaltorphimine was a ligand discriminate the κ₁, and κ₂ receptor most effectively. We, also, examined the influence of Na ion and GTPγS, a nonhydrolyzable guanine nucleotide analog, on the inhibition of [³H]diprenorphine binding by diprenorphine, (-)ethyl-ketocyclazocine, U-69,593 and bremazocine. By the replacement of NaCl with N-methy-D-glucamine or addition of GTPγS, Ki values of diprenorpnine were not changed and that of ethylketocyclazocine were changed significantly in both rat and guinea pig cortex. The Ki value of bremazocine was decreased by removal of Na ion, and increased by GTPγS, however, was not changed by any one of either. These results suggest that there are 2 kinds of subtypes of κ opioid receptor, κ₁, and κ₂, showing different Ki values for various κ opioid ligands, also, bremazocine possess the antagonistic property at κ₂ site which is dominant subtype of K receptor in rat cortex.

혈액투석환자에 발생한 중심정맥 폐쇄증의 치료경험

조원현,김형태 대한혈관외과학회 1998 Vascular Specialist International Vol.14 No.2

As the increasing incidence of the double lumen catheterization (Quinton catheter) for temporal hemodialysis, central vein occlusion, a serious complication which can cause arteriovenous fistula failure, occurred more frequently. Severe arm edema, pain with venous hypertension and insufficient fistula function suggest central vein obstruction and this can be confirmed by color duplex sonography or venography. This kind of occlusion should be treated promptly because it is closely related with arteriovenous fistula function. Division and ligation of fistula is one option but to salvage the fistula is more recommendable. For this purpose, thrombolysis, percutaneous transluminal balloon angioplasty(PTA) with or without stent insertion, direct surgical approach to the obstructed vein, surgical bypass using autogenous vein or artificial graft are performed according to the site and degree of the obstruction. From January 1995 through December 1997, we experienced 9 cases of subclavian vein or innominated vein occlusion which were detected by angiogram in hemodialysis patients. Four cases were treated by PTA with one case of thrombolysis at the same time. Two of them developed recurred symptoms at 3 and 6 months after PTA. The previous fistula were ligated and made a new basilic vein reposition arteriovenous fiatulas were made at opposite arm. Among the remaining 5 cases, surgical bypass was performed between internal jugular vein and subclavian vein in 2 cases, between axillary vein and opposite subclavian vein in 3 cases using 8 mm PTFE graft. One out of 5 surgical bypass group showed recurred occlusion at 16 months and that patient died soon after that occlusion. Another one showed partial occlusion of bypassed graft but the symptoms were mild so we could continue hemodialysis without problems. The remained 3 cases were patent for more than 13 months of their follow up. In summary, to salvage the failed fistula by central vein obstruction, aggressive procedure such as surgical bypass using artificial graft to opposite central vein also be considered with PTA.

원발성 하지정맥류에 대한 임상적 고찰

김형태,조원현,박흥수,이상목,정기용,김유사 大韓脈管外科學會 1995 大韓脈管外科學會誌 Vol.11 No.2

골형성부전증 10예의 임상적 특징

이형숙,김현주,조재현,이승원,김현아,최준혁,송영준,김대중,이관우,정윤석 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경 및 방법: 골형성부전증은 비교적 희귀한 유전병으로 교원질 대사 장애로 인한 골의 취약성과 다발성 골절 및 척추측만증 등을 특징으로 한다. 유전방식과 표현형의 발현 정도에 따라 다양한 임상 양상을 보이며, 임상적 중증도에 따라 4가지 형태로 분류된다. 지금까지 국내 보고는 분만과정이나 태아 진찰시 골격이상으로 발견된 증례보고가 주였다. 저자들은 비교적 경미한 임상 양상을 보이는 예를 포함한 다수의 골형성부전증 환자들의 전반적인 임상적 특징에 대해 보고하는 바이다. 결과: 2001년 6월부터 2003년 2월까지 골형성부전증으로 진단받은 6 가계, 10예를 대상으로 하였다. 평균 나이는 27.3(5∼56)세였고 소아가 2예였다. 모두 상염색체 우성으로 유전되었으며, 제 I형이 4예, 제 III형이 4예, 그리고 제 IV형이 2예였다. 전 예에서 다수의 골절 경험이 있었고, 골밀도 저하와 골피질 두께 감소 소견이 관찰되었다. 전신의 평균 골밀도는 0.690(0.421∼1.039) g/cm²였다. 골형성지표로 측정된 sAlk는 소아의 경우만 증가되어 있었고, 골흡수지표로 측정된 uDPD의 평균치는 12.9(4.4∼36.3) nM/mM Cr으로 증가된 소견을 보였다. mobility score는 대부분 3,4단계에 속해 있었다. 중증형일수록 진단 시의 mobility score가 낮은 경향을 보였다. 결론: 한국인 골형성부전증 환자의 임상적 특징을 살펴본 결과 기존의 보고된 II형 외에도 I, III, IV형이 다양하게 존재함을 알 수 있었으며, 모든 예에서 상염색체 우성으로 유전됨을 확인할 수 있었다. 또한 모든 예에서 증가된 골흡수로 인한 골밀도 저하와 골절을 확인할 수 있었다. Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis (J Kor Soc Endocrinol 18:496∼503, 2003).

한국 자활사업의 자활효과 영향요인에 관한 연구 : 경제적, 사회적, 정서적 자활효과를 중심으로

이형하,조원탁 한국사회복지정책학회 2004 사회복지정책 Vol.20 No.-

본 연구의 목적은 2000년 국민기초생활보장제도 실시로 근로능력이 있는 수급자의 자활사업 참여를 통해 나타나는 자활효과의 정도와 관련요인을 규명하는데 있다. 자활효과의 측정은 정서적 자활, 사죄적 자활, 경제적 자활의 3가지 차원으로 측정하였다. 연구결과, 첫째, 자활사업 참여 수급자의 정서적 자활은 평균 3.65점(5점만점), 사회적 자활은 평균 3,96점(5점만점)으로 자활사업을 통해 근로태도의 변화보다 사회적 관계망의 변화를 더 긍정적으로 경험하는 것으로 조사되었다. 그러나 경제적 자활은 2.83점(5점만점)으로 보통이하의 결과를 보여 연재의 자활사업은 수급자의 소득증가에는 크게 기여하지 못하는 것으로 나타났다. 둘째, 세 가지 차원의 자활효과 영양요인으로는 근로조건만이 유의한 인과적 영양을 보였다. 즉, 자활사업의 효과에 자활사업의 참여환경(임금, 작업환경, 노동시간, 실무자의 지원과 관심 등)의 중요도를 반영한 결과라 하겠다. 연구의 정책적 대안으로, 첫째, 현행 자활사업의 단계적 발전모델로 자활근로에서 자활공동체의 이행을 설정하고 있는 정책적 실행목표에 있어 소득중점목표를 둘 것인지, 근로중점목표를 설정할 것인지에 대한 이원화된 정책적 목표설정이 시급함을 시사하였다. 둘째, 근로태도의 망상과 사회적 관계망의 긍정적인 변화를 위해 자활후견기관에 사례관리자의 배치가 필요함을 제시하였다. 본 연구의 결과를 통해 수급자의 세 가지 차원의 자활효과가 각기 어느 정도인지 상대적으로 효과가 미약한 자활효과는 어떤 차원의 자활효과인지를 밝힘으로써 향후 자활사업발전에 많은 시사점을 제공해 줄 것으로 기대한다. The purpose of this study is to investigate into the factors that affect the self-sufficiency effect of Workfare among the National Basic Livelihood Security Act recipients. Basing on a field survey, the study measures the self-sufficiency effectiveness at three levels: emotional, social, and economic. The survey was conducted for 391 workers who were being benefited by the Act and working at 8 different Self-Sufficiency Promotion Agencies in Gwangju Metropolitan City Area as of August, 2003. The findings are as follows. First, while the emotional and social self-sufficiency levels appear moderate, their economic self-sufficiency is still lagging behind the average. This means that their participation in the program doesn't guarantee the increase in their income levels. The fact reinforces the necessity of setting up two-tiered policy goals regarding the implementation of self-sufficiency promotion programs. The policies should give more attention to the income of the recipients as well as to their work itself. Second, since the income from the self-support programs covers most of the public income transfer among the recipients, the policies need to be developed or to be supplemented in ways to contribute for the increase of their earned income by adjusting the range of income deduction. Third, for the purposes of improving the recipients' work attitudes and extending their social network, case managers need to be placed in promotion agencies.

중추성 요붕증이 동반된 랑게르한스 세포 조직구증 1예

김진호,문준성,문선중,이지은,최재원,은미정,천경아,조인호,윤지성,원규장,이경희 신덕섭,이형우 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased form 109mOsmol/Kg to 327mOsmol/Kg (300%). Brain MRI showed a thickened pituitary stalk and at hot bone CT.CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes, The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

혈관내초음파로 평가한 스텐트를 삽입한관동맥의 형태학적 특징

정남식,홍범기,임세중,백성일,이문형,장양수,심원흠,조승연,김성순 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.8

Case Report : Improved severe hepatopulmonary syndrome after Liver transplantation in an adolescent with end-stage Liver disease secondary to biliary atresia

( Tae Jun Park ),( Keun Soo Ahn ),( Yong Hoon Kim ),( Hyungseop Kim ),( Ui Jun Park ),( Hyoung Tae Kim ),( Won Hyun Cho1 ),( Woo Hyun Park ),( Koo Jeong Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

Hepatopulmonary syndrome (HPS) is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT) is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient with typical findings of an extracardiac pulmonary arteriovenous shunt on contrast-enhanced transesophageal echocardiography (TEE), and clubbing fingers, who had complete correction of HPS by deceased donor LT. The patient was a 16-year-old female who was born with biliary atresia and underwent porto-enterostomy on the 55th day after birth. She had been suffered from progressive liver failure with dyspnea, clubbing fingers, and cyanosis. Preoperative arterial blood gas analysis revealed severe hypoxia (arterial O2 tension of 54.5 mmHg and O2 saturation of 84.2%). Contrast-enhanced TEE revealed an extracardiac right-to-left shunt, which suggested an intrapulmonary arteriovenous shunt. The patient recovered successfully after LT, not only with respect to physical parameters but also for pychosocial activity, including school performance, during the 30-month follow-up period. (Clin Mol Hepatol 2014;20:76-80)

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

A Case of Successful Recovery form High Dose Intravenous Nicorandil Infusion in Refractory Coronary Vasopasm with Hemodynamic Collapse

Won Jun Koh,Jeong Hyeon Cho,Ji Hyun Lee,Won Sik Kang,Min Kyung Lee,Jun Hyoung Kim,Deok Kyu Cho 영남대학교 의과대학 2012 Yeungnam University Journal of Medicine Vol.29 No.2