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Adventitial Fibroblast Abormality in Thoracic Aortic Aneurysms and Aortic Dissections
Jong Hui Suh,Jeong-Seob Yoon,Hwan Wook Kim,Keon Hyon Jo 대한흉부외과학회 2011 Journal of Chest Surgery (J Chest Surg) Vol.44 No.6
Development of thoracic aortic aneurysms and aortic dissections (TAAD) is attributed to unbearable wall tension superimposed on defective aortic wall integrity and impaired aortic repair mechanisms. Central to this repair mechanisms are well-balanced and adequately functional cellular components of the aortic wall, including endothelial cells, smooth muscle cells (SMCs), inflammatory cells, and adventitial fibroblasts. Adventitial fibroblasts naturally produce aortic extracellular matrix (ECM), and, when aortic wall is injured, they can be transformed into SMCs, which in turn are involved in aortic remodeling. We postulated the hypothesis that adventitial fibroblasts in patients with TAAD may have defects in ECM production and SMC transformation. Materials and Methods: Adventitial fibroblasts were procured from the adventitial layer of fresh aortic tissues of patients with TAAD (Group I) and of multi-organ donors (Group II), and 4-passage cell culture was performed prior to the experiment. To assess ECM production, cells were treated with TNF-α (50 pM) and the expression of MMP-2 / MMP-3 was analyzed using western blot technique. To assess SMC transformation capacity, cells were treated with TGF-β1 and expression of SM α-actin, SM-MHC, Ki-67 and SM calponin was evaluated using western blot technique. Fibroblasts were then treated with TGF-β1 (10 pM) for up to 10 days with TGF-β1 supplementation every 2 days, and the proportion of transformed SMC in the cell line was measured using immunofluorescence assay for fibroblast surface antigen every 2 days. Results: MMP-3 expression was significantly lower in group I than in group II. TGF-β1-stimulated adventitial fibroblasts in group I expressed less SM α-actin, SM-MHC, and Ki-67 than in group II. SM-calponin expression was not different between the two groups. Presence of fibroblast was observed on immunofluorescence assay after more than 6 days of TGF-β1 treatment in group I, while most fibroblasts were transformed to SMC within 4 days in group II. Conclusion: ECM production and SMC transformation are compromised in adventitial fibroblasts from patients with TAAD. This result suggests that functional restoration of adventitial fibroblasts could well be a novel approach for the prevention and treatment of TAAD.
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Antiapoptotic Effect of Paricalcitol in Gentamicin-induced Kidney Injury
Suh, Sang Heon,Lee, Ko Eun,Park, Jeong Woo,Kim, In Jin,Kim, Ok,Kim, Chang Seong,Choi, Joon Seok,Bae, Eun Hui,Ma, Seong Kwon,Lee, Jong Un,Kim, Soo Wan The Korean Society of Pharmacology 2013 The Korean Journal of Physiology & Pharmacology Vol.17 No.5
While the anti-apoptotic effect of paricalcitol has been demonstrated in various animal models, it is not yet clear whether paricalcitol attenuates the apoptosis in gentamicin (GM)-induced kidney injury. We investigated the effect of paricalcitol on apoptotic pathways in rat kidneys damaged by GM. Rats were randomly divided into three groups: 1) Control group (n=8), where only vehicle was delivered, 2) GM group (n=10), where rats were treated with GM (150 mg/kg/day) for 7 days, 3) PARI group (n=10), where rats were co-treated with paricalcitol (0.2 ${\mu}g/kg/day$) and GM for 7 days. Paricalcitol attenuated renal dysfunction by GM administration in biochemical profiles. In terminal deoxynucleotidyl transferase dUTP nick end labeling staining, increased apoptosis was observed in GM group, which was reversed by paricalcitol co-treatment. Immunoblotting using protein samples from rat cortex/outer stripe of outer medulla showed increased Bax/Bcl-2 ratio and cleaved form of caspase-3 in GM group, both of which were reversed by paricalcitol. The phosphorylated Jun-N-terminal kinase (JNK) expression was increase in GM, which was counteracted by paricalcitol. The protein expression of p-Akt and nitro-tyrosine was also enhanced in GM-treated rats compared with control rats, which was reversed by paricalcitol co-treatment. Paricalcitol protects GM-induced renal injury by antiapoptotic mechanisms, including inhibition of intrinsic apoptosis pathway and JNK.
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서춘희,이종태,김대환,손병철,이창희,김휘동,안진동 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.3
목적: 산업안전보건법 개정 후 배치전 건강진단의 실시 현황 및 보건관리자의 인식도를 파악하고자 하였다. 방법: 부산과 경남에 위치하는 특수건강진단기관 2개소 에서 2006년 1월 1일에서 2006년 12월 31일까지 배치전 건강진단을 받은 근로자 6,507명을 대상으로 배치전 건 강진단서 판정결과를 검토하였다. 건강관리구분 유소견자 판정을 받은 근로자 330명을 대상으로 전화인터뷰를 시도하여 성공한 185명을 최종 연구 대상으로 하였다. 그리고 동 기관에서 관리하고 있으며 특수건강진단을 실시하는 보건관리대행 사업장 중에서 169개의 사업장 보건 관리자를 대상으로 2007년 5월 1일에서 9월 30일까지 설문조사를 하였다. 결과: 근로자 전화 인터뷰 조사에서 배치전 건강진단 결과 질환 유소견 판정때문에 채용이 거부된 사람은 51명 (27.4%)이었다. 보건관리자를 대상으로 한 설문조사에서 채용시 건강진단의 폐지를 모르는 사업장이 39개(23.1%)였다. 배치전 건강진단을 근로자 채용결정 후 부서배치 전에 실시하는 사업장 73개(43.2%)중에서 그 결과를 부서배치에 활용한다고 응답한 사업장이 63개 (37.3%)였다 질환유소견 판정을 받았을 때 고혈압,당뇨병,고지혈증 등 만성 칠환이 있는 경우 각각 20개(11.8%),21개(12.4%),22개(13.0%) 사업장에서 근로자를 고용하지 않는다고 답했고,업무상 질병과 관련된 청력이상,요추부 방사선 이상소견이 있을 때 각각 76개 (44.4%),75개(43.8%) 사업장에서 근로자를 고용하지 않는다고 답했다. 결론: 채용전 건강진단이 폐지되고 배치전 건강진단에 대한 법 조항이 개정되었음에도 불구하고 사업장에서는 법규에 대한 이해가 불충분하여 여전히 배치전 건강진단이 취업시 불건강자를 가려내는 목적으로 이용되고 있으며,업무 적합성 개념에 대한 이해가 불충분하였다. 따라서 사업주는 배치전 건강진단 실시시기를 준수하고 건강 진단 기관에 배치 예정 업무에 대해 구체적인 정보를 제공하여야 한다. 정부에서는 법규 개정 후 홍보에 힘쓰고,법규 시행 후 적절한 정책 평가도 병행하여야 한다. Objectives: We investigated the status of the preplacement medical examination after the revision of the industrial safety and health law on Oct. 7, 2005 by the Ministry of Labor. Methods: Preplacement medical certificates of 6,507 recruits issued by two hospitals in Busan, Kyeongnam Province from Jan. 1 to Dec. 31,2006 were reviewed. Telephone interviews were performed to the recruits with disease and self-reported questionnaires were administrated to health and safety personnel from May 1 to Sep. 30, 2007. Results: Interviews were conducted with 185(56.1 %) recruits with disease, 51(27.4%) of whom were rejected for employment due to the preplacement medical certificate. The questionnaire survey for the health and safety personnel revealed that 39(22.9%) personnel were unaware of the annulment of the preemployment medical examination. Eighty(48.8%) of the health and safety personnel answered that they performed a preplacement medical examination after employment, and 63(37.3%) made a practical application of the workers' placement. The recruits with chronic conditions were refused employment: 20 (11.8%) due to hypertension, 21 (12.4%) diabetes mellitus and 22(13.0%) hyperlipidemia. The recruits with work-related diseases were also refused employments: 76(44.4%) due to lumbar spine abnormality and 75(43.8%) hearing loss. Conclusions: Despite the annulment of the pre-employment medical examination, a preplacement medical examination was often used to discriminate among healthy and diseased recruits. Employers must respect the law for the point of time of the preplacement medical examination and the payment of cost. The government should publicize the revision of the objectives of the law. We suggest that health professionals elucidate the job fitness through the development of the assessment tools and maintain the confidentiality of recruits.
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한국 노인이 겪는 우울감 및 자살사고에 대한 질적 연구 분석
곽희용 ( Hui-yong Kwak ),서효원 ( Hyo-weon Suh ),정선용 ( Sun-yong Chung ),김종우 ( Jong-woo Kim ) 대한한방신경정신과학회 2018 동의신경정신과학회지 Vol.29 No.2
Objectives: To analyze the reports of qualitative research about depressed mood and suicidal ideation of Korean Seniors. Methods: Eleven published qualitative research studies were selected for analysis. We extracted common topics and factors of each stage, Selected factors were paralleled and synthesized to make a flow chart of the phenomena. Results: Depressed mood arousals of Korean seniors are categorized by causation factors, which include economic, psychosomatic, and social factors, and positive-negative coping strategies, which include cognitive-behavioral factors. Suicidal experiences are categorized as ideation, suicidal attempt, and after-suicide stage. In the latter, participants reported three types of lifestyles by their enthusiasm for 'being alive'. Conclusions: Through the qualitative synthesis of research, we could analyze and categorize major factors and coping strategies of participants who exhibited a depressed mood or suicidal ideation.
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급성 심근경색증에 의한 심인성 쇼크 환자의 장기적 예후 예측인자
배은희,임상엽,정명호,박형욱,임지현,박옥영,김한균,홍영준,김원,김주한,안영근,조정관,박종춘,서순팔,안병희,김상형,강정채 대한내과학회 2004 대한내과학회지 Vol.66 No.5
목적 : 급성 심근경색증 후 5~10%에서 심인성 쇼크가 발생하며, 사망률이 감소하고 있으나 여전히 60%에 이르는 것으로 알려져 있다 본 연구는 심인성 쇼크가 발생한 환자들의 임상적 특징 및 시술 관련요인을 비교하여, 이들이 주요 심장사건에 어떠한 영향을 줄 수 있는지 알아보아 사망률을 감소시킬 수 있는 인자를 찾고자 하였다. 방법 : 2000년 7월부터 2002년 6월까지 24개월간 전남 대학교 병원 광주·전남 광역 응급의료센터에 내원한 환자 중 급성 심근경색증으로 확진되었던 환자 1,268명에서 심인성 쇼크가 발생한 환자 255예(연령 66.0±11.0세, 남:여=156:99)를 대상으로, 1년 무사고 생존군 129예(Irns)과 사망 및 주요 심장사건 발생군 126예(Ⅱ)로 나누어 임상적 특징 및 시술 관련요인을 분석하였다. 결과 : I군에 비하여 Ⅱ군이 편균연령이 높았고(64.2±10.6 vs. 68.1±10.0, p=0.004), 진구성 심근경색증의 과거력이 많았다(0% vs. 17.4%, p<0.001). 좌심실 구혈률은 Ⅱ군에서 유의하게 낮았다(49.1±13.0% vs. 39.1±12.9%, p<0.001). 검사실 소견에서 양군에서 CK, CK-MB 및 혈중 지질수치의 유의한 차이는 보이지 않았으나, troponin (Tn)과 CRP가 Ⅱ군에서 유의하게 높았다(Tn -I:29.2±7.7 ng/dL vs. 50.8±5.2 ng/dL, p=0.017, CRP: 3.8±0.5 ㎎/dL vs. 9.9±102 ㎎/dL, p<0.001). 관상동맥 조영술에서 좌주간지의 병변이 Ⅱ군에서 유의하게 높았으며(0.7% vs. 22.0%, p=0.004), I군 108예(83.7%)과 Ⅱ군 31예(24.6%)에서 재관류술을 실시하였다. 재관류술을 시행한 환자들의 사망률이 재관류술ㅇ르 시행하지 않고 내과적 치료만 시행한 환자들에 비해 유의하게 낮았으며(22.3% vs.81.8%, p=0.001), 관상동맥 중재술 후 경색 관련 혈관의 TIMI 3혈류의 도달율이 Ⅱ군에서 유의하게 낮았다. 결론 : 고령, 심근경색의 과거 병력, 높은 트로포닌과 CRP 수치, 낮은 좌심실 구혈을 및 좌주간지 병변 등이 급성 심근 경색으로 인한 심인성 쇼크 환자들의 주요 심장사건과 관련이 있었다. 재관류술 후 TIMI 3 혈류에 도달하였을 때 병원 내 사망률을 줄일 수 있었다. Background : Cardiogenic shock (CS) after acute myocardial infarction (AMI) is developed in 5~10% of patients and associated with high mortality. The aim of this study is to assess the predictive factors of major adverse cardiac events (MACE) in patients with AMI and CS. Methods : Two hundred fifty AMI patients with CS (66.0±11.0 years, M:F=156:99) out of1,268 AMI patients, who admitted at Chonnam National University Hospital between July 2000 and June 2002, were analyzed according to clinical characteristics, coronary angiographic findings and MACE during admission and 1-year clinical follow-up. Results : Among the enrolled patients, 129 patients survived without MACE (group I, 64.2±10.6 years, M:F=76:53) and 126 aptients had MACE (group Ⅱ, 68.1±10.0 years, M:F=80:46) during admission and 1-year follow-up period. There were significant differences in age (64.2±10.6 vs. 68.1±11.0 years, p=0.004) and previous MI history (0 vs. 17.4%, p<0.001). Left ventricular ejection faction (EF) was lower in group Ⅱ (group I vs. Ⅱ: 49.1±13.0 vs. 39.1±12.9%, p<0.001). The levels of troponin (Tn) I and C-reactive protein (CRP) were higher in Group Ⅱ (group I vs. Ⅱ: 29.2±7.72 vs. 50.8±5.17 ng/dL, p=0.017, 3.8±0.48 vs. 9.9±1.21 mg/dL, p<0.001 respectively). Left main stem lesion(LMSL) was more common in Group Ⅱ than in Group I (0.7% vs. 22.0%, p=0.004). In-hospital death was associated with low Thrombolysis In Myocardial Infarction (TIMI) flow after coronary revascularization. Conclusion : Old age, previous MI history, high Tn and CRP, low EF and LMSL are associated with higher MACE in patients with AMI and CS. Coronary revascularization with TIMT 3 flow lowers in-hospital mortality.
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Antiapoptotic Effect of Paricalcitol in Gentamicin-induced Kidney Injury
Sang Heon Suh,Ko Eun Lee,Jeong Woo Park,In Jin Kim,Ok Kim,Chang Seong Kim,Joon Seok Choi,Eun Hui Bae,Seong Kwon Ma,Jong Un Lee,Soo Wan Kim 대한생리학회-대한약리학회 2013 The Korean Journal of Physiology & Pharmacology Vol.17 No.5
While the anti-apoptotic effect of paricalcitol has been demonstrated in various animal models, it is not yet clear whether paricalcitol attenuates the apoptosis in gentamicin (GM)-induced kidney injury. We investigated the effect of paricalcitol on apoptotic pathways in rat kidneys damaged by GM. Rats were randomly divided into three groups: 1) Control group (n=8), where only vehicle was delivered, 2) GM group (n=10), where rats were treated with GM (150 mg/kg/day) for 7 days, 3) PARI group (n=10), where rats were co-treated with paricalcitol (0.2 Ռg/kg/day) and GM for 7 days. Paricalcitol attenuated renal dysfunction by GM administration in biochemical profiles. In terminal deoxynu-cleotidyl transferase dUTP nick end labeling staining, increased apoptosis was observed in GM group, which was reversed by paricalcitol co-treatment. Immunoblotting using protein samples from rat cortex/outer stripe of outer medulla showed increased Bax/Bcl-2 ratio and cleaved form of caspase-3 in GM group, both of which were reversed by paricalcitol. The phosphorylated Jun-N-terminal kinase (JNK) expression was increase in GM, which was counteracted by paricalcitol. The protein expression of p-Akt and nitro-tyrosine was also enhanced in GM-treated rats compared with control rats, which was reversed by paricalcitol co-treatment. Paricalcitol protects GM-induced renal injury by antiapoptotic mechanisms, including inhibition of intrinsic apoptosis pathway and JNK.
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