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.

비소세포폐암에서 Microsatellite Instability

전효성,김정란,손지웅,박선하,박태인,김창호,김인산,정태훈,박재용 경북대학교 병원 2001 경북대학교병원의학연구소논문집 Vol.5 No.1

연구베경:MMR 유전자의 불활성화에 의해 야기되는 뮤전적 불안정성은 발암기전의 한 부류로 인정되고 있다.저자들은 비소세포폐암의 발암과정에서의 MSI의 역할을 규명하기 위해 비소세포폐암에서 MSI의 빈도 및 MSI 유무에 따른 임상상의 차이를 조사하였다. 대상 및 방법:근치적 절제술을 받은 비소세포폐암 20예를 대상으로 하였다.동결된 폐암조직과 환자의 림프구에서 DNA를 추출한 후 3P와 9p의 15개의 marker들을 대상으로 PCR을 시행하고 7% polyacrylamide gel에서 전기영동한 후 silver 염색을 시행하였다. 암조직과 림프구 DNA의 PCR product의 band를 비교하여 MSI와 LOH를 판정하였다. 결과:1)대상환자들은 남자 19예,여자 1예였으며 모두 흡연자였고 평균 흠연력은 47 갑년이었다. 폐암의 조직형은 편평상피암 15예, 선암 4예,대세포암 1예였고, 술 후 병리학적 병기는 Ⅰ기 6예,Ⅱ기 5예, ⅢA기 7예,ⅢB기 2예였다. 2)20예 가운데 8예(40%)에서 MSI가 관찰되었으며 3예는 한 개의 marker에서,5예는 2개 이상의 marker에서 MSI가 관찰되었다. 3)LOH는 10예(50%)에서 있었으며,LOH유무에 따른 병가 및 흡연력의 차이가 없었다. 4)분석한 marker의 10% 이상에서 MSI가 관찰된 MSI-L종양은 5예였으며, 대부분의 marker에서 MSI양성인 MSI-H종양은 없었다.MSS종양과 MSI-L종양은 흡연력, 병기, 폐암 조직형 및 LOH 빈도의 유의한 차이가 없었다. 결론:비소세포폐암에서 MSI는 비교적 흔히 관찰되지만 MMR 유전자의 불활성화에 의한 MMP pathway 는 비소세포폐암의 주요 발생기전은 아닐 것으로 생각된다.향 후 비소세포폐암의 발암과정에 있어서 MMP pathway의 역할을 규명하기 위해서는 보다 많은 예를 대상으로 한 연구가 필요할 것으로 생각되며, MSI 발생기전에 관한 추가적인 연구가 필요할 것으로 생각된다. Purpose: Microsatellite instability(MSI) is frequently used as an indicator of microsatellite mutator phenotype (MMP) tumors.MSI has been observed in a percentage of non-small cell lung cancer(NSCLC).However, its role in tumorigenesis of NSCLC remains unknown.The frequency and partten of MSI in NSCLC were evaluted and clinical parameters of MSI-positive tumors with those of MSS(microsatellite stable) tumors were compared. Materials and Methods: Twenty surgically resected NSCLCs were analyzed for 15 microsatellite markers located at chromosomes 3p and 9p.The peripheral blood lymphocytes of patients were used as the source of the normal DNA. Results:1) of 20 cases, 8(40%) demonstrated MSI. 2) Instability was observed more frequently in tri- and tetra-nucleotide repeats that in dinucleotide repeats. In all cases, instability appeared as a shift of individual allelic bands. 3) LOH was observed in 10(50%) of 20 tumors analyzed. 4) Of 20 cases, MSI-H tumor(showing MSI in the majority of markers) was absent. There were 5 MSI-L tumors( showing MSI in a greater than 10% of markers). 5) No significant difference was observed between MSI-L tumors and MSI negative tumors in terms of clinicopathologic features such as pack-year history of smoking, histologic subtype, and (delete) stage of disease.There was also no significant difference in the incidence of LOH in relation to the status of MSI. Conclusion: These data strongly suggest that MSI plays different roles in lung and colon cancer.MMP pathway appears to be far less important in the tumorigenesis of NSCLC, caused mainly by cigarette smoke, with little familial tendency.(tuberculosis and Respiratory Diseases 2000,48:24-32)

역상 액체 크로마토그래피에서 벤젠류의 머무름 메커니즘

이인호,전선주 大田大學校 環境問題硏究所 1999 환경문제연구소 논문집 Vol.4 No.-

The purpose of this study is to investigate the retention mechanism, which is the key to the prediction of retention and to the systematical optimization for benzenes in reversed-phase liquid-solid chromatography. The retention data, capacity factors(k') of twelve benzenes was measured in the systems containing 75-100% of methanol and acetonitrile as organic modifiers, and PRP-1 column. From the retention data, two extensive approaches are examined in order to elucidate the retention mechanism : 1) the comparison of the retention data of the solutes containing different substituents: 2) the relationship between the thermodynamic values and the retention data, i.e., van't Hoff plots and enthalpy-entropy compensation phenomena. The retention behaviors of benzenes having different substituents, such as normal, iso, and tertiary alkyl groups, are well interpreted in both mobile phases by the liquid-solid adsorption phenomenon, which is closely related with displacement mechanism. The effect of temperature on retention is investigated by van't Hoff plots in the temperature range of 35-55℃. The linearity(R>0.999) means that the retention of solutes is consistent in the above tenperature range. From the observation of enthalpy-entropy compensation phenomenon, some conclusions interpreting the retention mechanism are srawn as follows : 1) the retention mechanism of solutes depends on the type of organic modifier in hydro-organic media : 2) in methanol-water mobile phase, the retention mechanism of benzenes is consistent and identical in the range of 75-100% methanol-water : 3) on the other hand, in the case of acetonitrile-water mobile phase, the retention mechanism depens on the acetonitrile composition. It means that the retention mechanism can not be explained only by a simple mechanism. Consequently, the retention of solutes is controlled by the displacement mechanism in methanol-water mobile phase, while the mixed mechanism involving concurrent adsorption and partition phenomena, must be considered in acetonitrile-water mobile phase.

한국인 건선환자에서 발병하는 질환에 대한 연구 - 다기관 연구

김광호(Kwang Ho Kim),전현진(Hyun Jin Jeon),김광중(Kwang Joong Kim),윤재일(Jai Il Youn),김낙인(Nack In Kim),김태윤(Tae Yoon Kim),최지호(Jee Ho Choi),박기범(Ki Beom Park) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.7

N/A Background: The prevalence of other diseases associated with psoriasis has been investigated in recent years. Objective: This study was performed to see diseases associated with psoriasis in Korea. Methods: From September 1999 to May 2000, a total of 293 patients with psoriasis, who visited the department of dermatology in 6 hospitals, were enrolled in a subject group for the study. We surveyed the incidence rates of associated diseases. Results: In our study, diseases more concomitantly present in patients with psoriasis were dermatophyte infection, seborrhea dermatitis and benign tumor & nevus in skin diseases and obesity, diabetes mellitus, hypertension, gastritis and hepatitis in systemic diseases. Less concomitantly present in-patients with psoriasis were erythroderma, acne, contact dermatitis, atomic dermatitis, bacterial infection, tonsillitis, and internal cancer. Conclusion: Our observations show a distinct pattern of diseases associated with psoriasis in Korea. Further investigation will be mandatory to elucidate concomitant diseases in psoriasis. (Korean J Dermatol 2001;39 (7): 743~748)

금속제 기구 및 용기포장의 유해물질에 관한 조사 연구 : 금속제 주방 기구에서 유해중금속 용출에 관한 연구 Study on Migration of Trace Elements from Metallic Kitchenwares

이광호,권기성,곽인신,전대훈,최병희,유승석,김성욱,이선희 식품의약품안전청 1998 식품의약품안전청 연보 Vol.2 No.-

구이웅즉불판, 스데"1크용 불판, 전골그릇. 솥, 프라이괜, 갬비, 주전자, 밥그릇 및 석쇠 둥 주방용 기구에 사웅되는 황동(3'3총)· 묵쇠 (17종), 알루미늄(10종), 청동(2종), 구리 (2종), 스테인레스(2종) 둥의 금속제에서 Pb, Cd, Ct Zn, Sn등 유괘 중금속의 용출과 기작에 대하여 연구하였다. 촹동을 대표금속으로 선정하여 용출 온도(30, 60, 80,95'c), PH(2.5, 4.3, 6.0, 7.0) 및 시간(30, 90, 180, 3:60븐)에 딱른 금속 용출량 조사에서 온도 및 P 변화체 딱른 시험결과, 95'C, pH 2.5인 조건에서 용출이 가장 많았던 반면, 용출 시간별 시험에서는 180분 이후까지 Pb가 용출된 후 편형 상태를 유지하였다. 위의 실험 결과로 미루어 현행 식품공전 시험법인 30분 조건에 대한 추후 재검토 연구가 필요하다고 잔단되며, 납이 용출되는 기작은 SEM을 통하띨 확인항 수 있었다. 황동의 경우, 재질줄의 Pb 항량곽용 출량과의 관계를 규명하기 위해 Pb 함략별 10종(0, 0.02, 0.09, 0.1, 0.2, 0.5, 0-9, 1.7, 5.4, 9.2%)의 시껼를 제작하여 4% 초산, 95'C, 30분에서 시험한 결과, 용출규격인 중금속이 1.Oppm(납으로서) 이하가 되기 위해서는 재질중 허용 Pb 함량은 0.2% 이하가 되어야 했다. 시중에 운통중인 각 재질별 금속제 기구에서 용출되는 유해중금속의 실태를 파악한결과, 황동제의 경우 주로 주물제품의 구이용 불판(양식 스테이크용 포함)으로 20종중 17종인 식풍 공전의 기준 ·규격인 1.OPPm이상의 Pb가 검출되어 85%의 련적합율을 뽀였다. Pb 용출 함량별 분포를 보면 1~10ppin이 15%, 20~100ppmo1 30%, 100~200ppmo1 20%, foo~300ppmol 10%, 300~400ppmo1 5%, 400~500ppr1 이 5%로 10~100ppm 사이의 용출량을 나타내는 제품이 가장 많이 유통되는 것으로 확인 되었다. 그외 Cu7l 0.37~77.85ppm, Zinc가 2.88~221.Oeppm, Fe이 미량 용출되었으며 Cd는 검출되지 않았다. 무꼭는 요즘 구이용 불판으로 사용되고 있는 솥뚜껑r 스테이크용 불판, 솥, 전골냄티, 프라이팬 등을 대상 겋체로 하였다. Fe이 0.S2~5,058 ppin, Cu, Zn 및 Pb등이 미량 검출 되었으며 Sn, Cd은 용출되지 않아 기준 ·규격에 적합한 것으로 판단.되었다. 알루디늄제는 램비 및 주전짜를 대상 검체로 하였는데 Cu, Zn, Sn, 및 Pb 등이 식품공전의 기준 · 규격의 IPPU내로 미량 검출되엇으며 Cd은 검출되지 않아 역시 기준·규격에 적합하다는 걸론을 얻었다. The migration of trace elements, Pb, Cd, Cu, Zn and Sn from metallie food-contactutensiles was investigated. All samples used in this work were grills, cooking pots, kettles, frying pansand bowls made of brass(20 samples), iron(17 samples) , aluminium(10 samples), copper(2 samples),bronze(2 samples) or stainless(2 samples). The migration of metats from brasses was affected by the iai-gration temperature(30, 60, 80 and 95'c ), the simulant pH (2.5, 4.3, 6.0 and 7.0) and the migration tirae(30,90, 180 and 360mia.). T,he amount of Pb migrati,oB was maximum at 95'c with pH 2.5. This study in-dicated that it could be required to reexamine the m igration time as 30 minutes suggested by the KoreaFood Code because the equilibrium of Pb migration was reached at 180 minutes. The mechanism of Pbmigration was investigated with Scanning Electron :Microscope(SEM) and Electron Probe Micro Analya-er(EPMA ). To correlate the relations between the m igration and the content of Pb in brass samples, tinbrass samples having known eontent of Pb(the quaritities of Fb in brass ; 0, 0.02, 0.09, 0,3,0.2, 0.5,0.9,1.4, 5.4 and 9.2% (w/w) ) were tested in the following conditions,4% acetic acid,95·C and 30 minutes. Theresult re?i?seBts that content of Pb in brass samples must be below 0.2% (w/w) to satis(y the 1.0 ppm(as Pb), of forea Food Code. The study was also coBlducted to estimate the migration of harmful metalsin metallic kitchenware made of brass, iron, alumiBium, copper, bronze and stainless. In the case ofbrass samples, the migration of Pb exceeded the 1.0 ppm in 17 among 20 samples with 85% rejectionrate. The pattern of the distribution for Pb migratioB was as followed; 15% : 1~10ppn1; 30% : fO~100ppm; 20% : 100~200ppm; 10% : 200~300ppm, 5% : 300~400ppm; 5% : 400~500ppm, respectivelr,while the content of otller metals detected as Cu 0.3,7~77.85ppm, Zn 2.88~221.Ooppm, Fe trace. Variousiron kitchenwares including sTilts, cooking pots ancl frying pans were also tested. The migration of themetals showed the following result, Fe . 0.52~s.07 ppm; Cu, Zn, Pb : trace; Sn. Cd : not detected.respectively. Aluminium kitchenwares like kettles were tested. There was no significant migration of trace metals, Cu, Zn, Sn, Fe and Pb, meanwhile the migration of Cd in samples made of the aluminium products could not be detected. The results demonstrated that iron and aluminium kitchenwares were suitable for Korea Food Code, however, brass products could provide harmful effect on human health.

LETTER TO THE EDITOR : Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia with abnormal cortisol secretion mediated by catecholamines

( Harin Rhee ),( Yun Kyung Jeon ),( Sang Soo Kim ),( Yang Ho Kang ),( Seok Man Son ),( Yong Ki Kim ),( In Joo Kim ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.5

Adrenocorticotropic hormone (ACTH)- independent macronodular adrenal hyperplasia (AIMAH) is a rare cause of Cushing syndrome. In AIMAH, cortisol secretion is independent of ACTH, and various hormones and/or cytokines have been thought to stimulate cortisol secretion via the aberrant expression of adrenal receptors or the increased activity of eutopic hormone receptors. Schorr and Ney [1] f irst proposed this concept, and subsequently the ectopic expression of gastric inhibitory peptide (GIP), V2 and V3-vasopressin, β -adrenergic, luteinizing hormone (LH)/human chorionic gonadotropin (hCG), serotonin, and angiotensin receptors, as well as increased activity of a eutopic V1-vasopressin receptor, have been identified in the adrenal gland [1,2]. Several genetic factors, such as Gs α-subunit mutations associated with McCune-Albright syndrome and MC2R (ACTH receptor gene) mutations, have also been postulated as causes of AIMAH. A 50-year-old male was referred and admitted to our hospital due to uncontrolled hypertension. He had suffered from hypertension for 6 years. His blood pressure was originally well controlled for the first 5 years using a calcium channel blocker, but poorly controlled for 1 year before he visited our hospital, despite his regular use of antihypertensive agents. He was initially referred to the Cardiology Department and underwent cardiologic evaluation after complaining of paroxysmal palpitation and dizziness. His 24-hour Holter monitoring and coronary angiographic results were normal, except for several antigen- presenting cells and a minimal coronary arterial obstruction at the middle left anterior descending artery. He had a past history of major depression and had been prescribed an antidepressive agent 18 months before he visited our hospital. On physical examination, he had a moon face, marked central obesity (height, 167 cm; weight, 77.65 kg; body mass index, 27.84 kg/m2), and multiple bruises on his extremities. He also had prominent purple abdominal striae, and all of his morphological features were consistent with Cushing syndrome. Laboratory examinations revealed 145.7 mEq/L serum sodium and 2.86 mEq/L serum potassium. Arterial blood gas analysis revealed metabolic alkalosis (pH 7.519, HCO3, 37.4 mM/L). His hemoglobin A1c level was 5.9%, and his serum fasting blood glucose was 118 mg/dL. The results of basal endocrinological examinations are summarized in Table 1. The circadian variation in serum cortisol production was disrupted, and basal ACTH levels were suppressed. A 24-hour urinary free cortisol test and overnight dexamethasone suppression test (DMST) were both suggestive of Cushing syndrome. Low- and high-dose DMST revealed Cushing syndrome of primary adrenal origin. An abdominal computed tomography scan and magnetic resonance imaging (MRI) revealed bilateral large macronodular adrenal tumors. His pituitary gland was normal on brain MRI scans. We thus diagnosed this patient with Cushing syndrome secondary to AIMAH. To identify aberrant receptors on the adrenal gland, we followed the investigative protocol described by Lacroix et al. [3]. Postural and various provocation tests, including ACTH (250 μg, intravascular), arginine vasopressin (AVP; 10 IU, intramuscular), 5-hydroxy triptamine (5-HT; 10 mg, intravascular), isoproterenol (20 ng/kg/min, intravascular for 30 minutes) and mixed meal tests, were performed. His serum cortisol level showed a positive response to ACTH, AVP, and isoproterenol provocation tests, but a negative response to the postural stimulation test. The results are summarized in Fig. 1A. If the patient had β-adrenergic or AVP receptors on his adrenal gland, then he would have responded to the postural stimulation test; but he did not. We repeated the postural stimulation test, and checked his endogenous antidiuretic hormone (ADH) level. He exhibited an increased ADH level on the postural test, but no cortisol secretion (Fig. 1B). A bilateral adrenalectomy was performed. The subsequent pathological examination of both adrenal glands showed hyperplasia with a multinodular growth pattern: the right and left adrenal glands were sized 14.0 × 5.0 × 3.0 cm and 9.0 × 5.0 × 3.0 cm, respectively, and multiple golden yellow nodules measuring up to 4 cm in diameter were present. Microscopic findings showed that the nodules consisted of variable- sized nests of lipid-laden clear cells similar to those of the normal fasiculata layer (Fig. 2). The final clinical and pathological diagnosis was Cushing syndrome secondary to β-adrenergic agonist-responding AIMAH. After the operation, he took physiological doses of prednisolone and f ludrocortisone. He then lost weight gradually and achieved optimal blood pressure with reduced doses of antihypertensive agents. Kirschner et al. [4] first described AIMAH in 1964. They demonstrated that hypercortisolism was ACTH-independent, and that the resected adrenal glands contained multiple nodules. Since then, a number of cases have been described, and the cause of AIMAH has been characterized more precisely. Previously, steroid production in AIMAH was believed to be autonomous. In the previous study that compared the adrenal glands of patients with AIMAH to those in patients with long-standing Cushing disease, and concluded that prolonged adrenal stimulation by ACTH resulted in adrenal bilateral nodular formation and varying ranges of adrenal autonomy [5]. There were also some cases in which autonomy of the adrenal gland was the result of chronic ACTH stimulation, which eventually resulted in ACTH suppression. However, the rarity of Nelson syndrome following bilateral adrenalectomy in patients with AIMAH strongly argued against the adrenal autonomy hypothesis. In 1971, Schorr and Ney [1] first introduced the concept of aberrant adrenal receptor expression in adrenocortical tissue. They performed in vitro studies, and found that cyclic adenosine monophosphate and corticosterone production in rat adrenocortical carcinoma cells were stimulated by non-ACTH hormones such as catecholamines, thyroid stimulating hormone, follicle stimulating hormone, LH, and prostaglandin E1. This hypothesis was later validated in humans by additional in vitro and in vivo studies. Several ectopic receptors such as GIP, β-adrenergic receptors, vasopressin (V2-V3-vasopressin receptor), serotonin (5-HT7 receptors), and angiotensin II receptors, and increased expression or altered activity of eutopic receptors in- cluding the V1-vasopressin receptors, LH/hCG receptors, serotonin (5-HT4 receptor), and leptin receptors was found [5]. In our patient, the serum cortisol level was increased by ACTH stimulation, exogenous AVP, and isoproterenol. Because exogenous AVP could naturally stimulate ACTH and increase serum cortisol levels, we checked serum ACTH levels during an AVP stimulation test. His serum cortisol level was increased by 82%, and serum ACTH level was increased by 11.5%. We were unable to confirm if AVP itself stimulated the adrenal cortex directly, or whether the induced ACTH caused cortisol secretion. A postural test was performed to screen for the aberrant expression of the AVP, β-adrenergic, or angiotensin II receptors. Interestingly, cortisol secretion was stimulated by exogenous AVP and a β-adrenergic agonist; however, a postural test failed to stimulate cortisol secretion. We repeated the postural test, and also checked the patient`s aldosterone level to verify if the test was accurate and determined serum ADH levels to confirm if endogenous ADH stimulated adrenal cortisol secretion. Because serum aldosterone levels increase in response to postural stimulation, the test itself was working; however, the cortisol response was negative. This suggests that the patient`s β-adrenergic receptor showed a blunted response to the test. Because we did not determine the serum catecholamine levels during postural stimulation, it was unclear whether the postural test induced sufficient endogenous catecholamine. Although a stronger stimulus (such as a treadmill test) would have induced endogenous catecholamine and increased serum cortisol levels, the patient refused because he had ischemic heart disease. In our case, exogenous AVP, but not endogenous ADH, stimulated adrenal cortisol secretion. This suggests that the cortisol response to exogenous pharmacological levels of vasopressin was mediated by AVP-induced catecholamine release [3]. We finally concluded that this patient had ectopic β-adrenergic receptors on the adrenal cortex, and recommended long-term propranolol therapy. However, because he strongly desired to undergo treatment with a rapid response, we consulted the Urological Department who recommended bilateral adrenalectomy. The identification of aberrant adrenal hormone receptors in AIMAH provides novel opportunities for specific pharmacological therapies as alternatives to adrenalectomy. In 1997, Lacroix et al. [3] reported the use of propranolol therapy for ectopic β-adrenergic receptors in adrenal Cushing syndrome in 1997. Some studies have revealed aberrant receptor expression in vitro using reverse transcription polymerase chain reaction. However, a limitation of our study is that we did not confirm aberrant receptor expression using in vitro analyses. In conclusion, we report a rare case of an AIMAH patient. In vivo examinations suggested that altered cortisol regulation due to a β-adrenergic agonist was involved in the pathogenesis of the AIMAH patient.

Clinical Characteristics of Acute Aortic Syndrome in Korean Patients: From the Korean Multi-Center Registry of Acute Aortic Syndrome

조정래,Sanghoon Shin,Jung-Sun Kim,고영국,홍명기,Yangsoo Jang,승기배,박헌식,Seung-Jea Tahk,임도선,Dong-Wun Jeon,In Ho Chae,김덕경,Junghan Yoon,정명호,최동훈 대한심장학회 2012 Korean Circulation Journal Vol.42 No.8

Background and Objectives: Acute aortic syndrome (AAS) is a heterogeneous group of disorders that often present with severe chest or back pain. It includes acute aortic dissection (AD), intramural hematoma (IMH), dissecting aneurysm, and penetrating aortic ulcer (PAU). The clinical picture of AAS and its prognosis have not been studied in a large number of Korean patients. Therefore, we organized a multi-cen-ter registry to identify the clinical characteristics and treatment patterns, as well as long-term outcomes in Korean patients with AAS. Subjects and Methods: Five-hundred twenty-eight patients, who had been diagnosed with AAS, were enrolled into this registry from 10centers. On a retrospective basis, we collected demographic, laboratory, imaging data, as well as follow-up clinical outcomes by reviewing medical records from individual centers. All the data were collected in core lab and analyzed in detail. Results: The mean patient age was 60.1±14.5 years; the male-to-female ratio was M : F=297 : 231. The prevalent risk factors for AAS in-cluded hypertension (361, 68.4%) and diabetes (52, 11.1%). The components of AAS that are included in this study are acute AD (446, 84.5%),IMH (57, 10.7%), and PAU (11, 2.1%). By type of AAS, patients diagnosed with Stanford A were 45.6% of enrolled patients, whereas those with Stanford B were 54.4% of enrolled patients. Among nearly half of the patients were treated with medicine (55.7%) alone, whereas 40.0%underwent surgery and 4.3% underwent endovascular treatment. Overall, the in-hospital event rate was 21.2% and the in-hospital death rate was 8.1%. The mean follow-up duration was 42.8 months and there showed 22.9% of total event and 10.1% of death during this period. Conclusion: By organizing a multi-center registry of AAS, we could identify the characteristics of AAS in real-world Korean patients. Further,prospective study is warranted with a larger number of patients.

腦卒中 患者 形態에 關한 臨床硏究

윤현민,안창범,송춘호,손인석,장경전 대한침구학회 2003 대한침구의학회지 Vol.20 No.2

Clinical observation was made on 52 cases of Stroke that were confined through brain CT, MRI scan. The Stroke cases wee classified into the following kinds cerebral infarction, cerebral hemorrhage, cerebellar or brain stem infarction, cerebellar or brain stem hemorrhage. and among the 52 cases of Stroke cerbral infarction was noticed in 75.00%, cerebral hemorrhage in 11.54%, cerebellar or brain stem infarction in 9.52%, cerebeller or brain stem hemorrhage in 3.85%. The ratio between males and females was 1.74:1 in the whole groups of Stroke and most cases were over 60 of age. As the time of hospitalization, most patients hospitalized from 1 day after stroke to 7 days after stroke. And as the course of hospitalization, most patients hospitalized first. Among the preceding disease at the onset of Stroke hypertention was noted in 32.69%, and deabetes mellitus or heart problem was noted frequently(15.39%). Electrocardiography findings were as follows: The normal was noted in 53.85%, the abnormal in 46.15%. And as the abnormal, left ventricular hypertrophy was noted in 17.54%. The predisposing factors or conditions at the onset of brain infarction were usually initiated during the time of sleeping and those of brain hemorrhage chiefly during the time of execising like overwork or walking etc. It was noted that smoking a pack of cigarette showed highest disease rate(33.33%) among the average of smoking amount of one day in case of man. Prior to attack, the most chiefly complain was dyspnea or discomfort on chest region. And 30.70% of patients had no previous sign. There were a large number of recurrent cases. The first attack was noted in 71.15%, the 2nd attack in 23.08%, the 3rd attack in 5.77%.

DYNAMIC RESPONSE OF CARBON NANOTUBES DISPERSED IN NEMATIC LIQUID CRYSTAL

YOUNG HEE LEE,SANG YOUN JEON,KYUNG AH PARK,IN-SU BAIK,SEOK JIN JEONG,SEOK HO JEONG,안계혁,SEUNG HEE LEE 성균관대학교(자연과학캠퍼스) 성균나노과학기술원 2007 NANO Vol.2 No.1

The alignment and dynamic response of carbon nanotubes (CNTs) in nematic liquid crystal (NLC) medium induced by strong electric field have been observed through polarizing optical microscope. Density-functional calculations suggest that LC molecule anchors helically to the CNT wall to enhance π-stacking with a binding energy of nearly -2.0 eV due to a considerable amount of charge transfer from LC molecule to CNT, resulting in the formation of excess charges and permanent dipole moment in CNTs. Under strong electric field, the motion of CNTs distorted the director of adjacent LC molecules. Our detailed analysis of dynamics revealed that the four-lobe textures in vertical cell and two vertical stripes in in-plane switching cell were strongly correlated, i.e., the side view of textures by the vertical motion of CNTs in vertical cell was similar to the textures in in-plane switching cell. Interestingly, the magnitude of textures in microscope was strongly dependent on the size of CNTs and theapplied field strength. The statistical size distribution of textures similar to that of CNTs provided information for the degree of dispersion of CNTs.

Low serum bilirubin level predicts the develop-ment of chronic kidney disease in patients with type 2 diabetes mellitus

( Kang Hee Ahn ),( Sang Soo Kim ),( Won Jin Kim ),( Jong Ho Kim ),( Yun Jeong Nam ),( Su Bin Park ),( Yun Kyung Jeon ),( Bo Hyun Kim ),( In Joo Kim ),( Yong Ki Kim ) 대한내과학회 2017 The Korean Journal of Internal Medicine Vol.32 No.5

Background/Aims: We evaluated whether serum bilirubin levels can predict the development of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T₂DM). Methods: This was a retrospective observational longitudinal study of patients presenting at the Pusan National University Hospital. A total of₃₄₉ patients with T₂DM and preserved kidney function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m²) were enrolled. The main outcome was the development of CKD stage 3 or greater. The patients were divided into four groups according to the quartiles of the total serum bilirubin levels at baseline. Results: The group with the lowest range of total serum bilirubin level (Q₁) showed the highest cumulative incidence of CKD stage 3 or greater than that of the other lower quartiles (Q₁ vs. Q₄; hazard ratio [HR], 6.75; 95% confidence in-terval [CI], 1.54 to 29.47; p = 0.011). In multivariate analysis, the risk of developing CKD stage 3 or greater was higher in the second lowest quartile of the serum bili-rubin level than that in the highest quartile of the serum bilirubin level (Q₂ vs. Q₄; HR, 9.36; 95% CI, 1.33 to 65.73; p = 0.024). In the normoalbuminuria subgroup (n = 236), multivariate analysis showed that the risk of developing CKD stage 3 or greater was higher in the lowest quartile of the serum bilirubin level than that in the highest quartile of the serum bilirubin level (Q1 vs. Q4; HR, 7.36; 95% CI, 1.24 to 35.82; p = 0.019). Conclusions: Serum bilirubin might be an early clinical marker for predicting the progression of CKD in patients with T₂DM and preserved renal function.