The Effect of Topiramate on Hippocampal Neuronal Death and Expression of Glutamate Receptor in Kainate-induced Status Epilepticus Model

박민정,하세운,배혜란,김상호,Park Min-Jeong,Ha Se-Un,Bae Hae-Rahn,Kim Sang-Ho Korean Society of Life Science 2005 생명과학회지 Vol.15 No.3

신경흥분독성과 간질발작발현은 glutamate 수용체활성과 연관이 있다고 알려져 있다. a-amino-3-hydroxy-5-methyl-4-isoxazole-propionate (AMPA), kainate 수용체에 대한 glutamate 활성을 포함하는 다양한 기전을 가진 항전간제인 Topiramate는 신경보호작용을 가진다는 증거가 제시되어 Topiramate가 간질발작 후 해마의 glutamate 수용체 발현에 미치는 효과를 관찰하였다. 흰쥐에 kainate를 복강 내 주사하여 간질중첩증을 유발시킨 후 Topiramate를 1주일 주사하였다 Apop tag in situ detection kit를 이용하여 세포손상을 관찰한 결과 kainate 유발 간질중첩증 1주일 후 해마의 CA1, CA3에서 심각한 세포사를 보였으나, Topiramte 처리 군에서는 세포사가 현저히 감소하였다. 간질중첩증 이후 NMDA 수용체 아형 1,2a, 2b 발현이 현저히 증가했으나 Topiramate 처치에 의해 NMDA수용체의 발현에는 뚜렷한 변화가 없었다. AMPA수용체에서는 GluR1이 간질중첩증 이후 현저히 상향 조정되었고 GluR2는 현저히 하향조정 되었다 Topiramate 1주일 처리 시 간질중첩증으로 인해 변화된 CluR1과 GluR2의 발현이 역전되었다. 결론적으로 Topiramate는 간질중침증에 의한 CluR1/CluR2 발현비의 증가로 유발되는 흥분성 신경세포사를 억제시킴으로써 신경보호작용이 있는 것으로 보인다. Excitotoxicity and epileptogenesis have often been associated with glutamate receptor activation. Accumulating evidences indicates that topiramate (TPM), an antiepileptic drug with multiple mechanisms of action has neuroprotective activity. We explored the neuroprotective effect of TPM on the status epilepticus (SE)-induced hippocampal neuronal death. After development of SE by kainite injection (15 mg/Kg), rats were treated with TPM (10mg/kg) for 1 week. The neuronal death was detected by Apop tag in situ detection kit, and the expression levels of glutamate receptors were semi-quantitatively analyzed by immunoblot. Kainate-induced SE caused a significant neuronal death and cell loss in CAI and CA3 regions of hippocampus at 1 week. However, treatment of TPM for 1 week after SE markedly reduced hippocampal neuronal death. The expression of N-methyl-D-aspartate (NMDA) receptor subunit 1, was increased by SE, but was not affected by 1 week treatment of TPM. The expressions of NMDA receptor subunit 2a and 2b were not changed by either SE or TPM. As for ${\alpha}-amino-3-hydroxy-5-methyl-4-isoxazole-propionate$ (AMPA) glutamate receptors (GluR), kainate-induced SE markedly up-regulated GluR1 expression but down-regulated GluR2 expression, leading to increased formation of $Ca^{2+}$ permeable GluR2- lacking AMPA receptors. TPM administration for 1 week attenuated SE-induced expression of both the up-regulation of GluR1 and down-regulation of GluR2, reversing the ratio of GluR1/GluR2 to the control value. In conclusion, TPM protects neuronal cell death against glutamate induced excitotoxicity in kainate-induced SE model, supporting the potential of TPM as a neuroprotective agent.

도장작업시 유해인자들의 노출수준과 작업환경관리실태

이세기,문덕환,이채관,황용식,선병관,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objectives: For the purpose of preparing the fundamental data and assessing the status of exposure level of chemical substances in painting process. Methods and Materials: The author determined the concentration of organic solvents, lead(Pb), Chromium(Cr), and Toluene-2, 4-diisocyanate(TDI) in air of painting process to 90 industries classified by 15 types of manufacturing industry during a period from Jan. 1st 2001 to Dec. 31st 2001. Results: The results were as follows: 1. The geometric mean level of each chemical substance was 0.1706 ppm for exposure index in organic solvents, 0.0019㎎/㎥ for Pb, 0.0024 ㎎/㎥ for Cr, and 0.0004ppm for TDI, respectively. 2. The exposure level of each chemical substances by type of painting was the highest in dipping and brush painting for organic solvent, in spray-painting for TDI, and in spray gun-painting for Pb and Cr, respectively. 3. The exposure level of each chemical substances by type of local ventilation equipment was higher in enclosed and booth type for organic solvents. Cr, and TDI, and in exterior type for Pb, respectively than those of other types. 4. The exposure level of each chemical substances by type of hazardous material arresting media was higher in using water for organic substances, in using bag filter for Pb, TDI, respectively than those of other types. Conclusion: According to above results, this study suggests that the exposure level by type of industry exceeded the exposure level in wooden furniture and metal furniture manufacturing industry for organic solvents and Pb, respectively.

Succinylcholine으로 유발된 Fasciculation과 Myalgia에 대한 Diazepam과 d-tubocurarine 전처치의 비교효과

최세진,길기진,이정은 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

Succinylcholine-induced muscle pain well documented. It is common to use subparalyzing dose of a non-depolarizing muscle relaxant before succinylcholine and accepted in clinical practice forpreventing of succinylcholine-induced fasciculation and it's associated sequalae. But it is needed to give large dose of succinylchcline to offer adeguate relaxation for tracheal intubation in these pretreated cases. This present study was undertaken to compare the effect of diazepam with d-tubocurarine on succinylcholine induced side effects. Sixty cases were studied if four different groups. In 1st group : no pretreatment, 2nd group : diazepam(0.05mg./kg.), 3rd group : diazepam(0.1 mg./kg.), 4th group : d-Tc.(0.05mg./kg.). The following results were obtained : 1. Diazepam pretreatment groups had no significant changes for the prevention of muscle fasciculation following succinylcholine compare to control group, but prevention of muscle fasciculation by d-Tc. pretreatment were significant. 2. Conditions for intubation were excellent in all groups. 3. In the prevention of muscle pain, there was no significant difference between the control and diazepam pretreatment group but significant difference between the control and d-Tc. prtreatment. 4) There was no specific relationship between muscle fasciculation and muscle pain.

비강상악동 미분화암종

김운규,김수관,조세인,윤정훈 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

Sinonasal undifferentiated carcinoma(SNUC) is an uncommon aggressive malignancy of the nasal cavity and paranasal sinuses. Since the initial recognition of SNUC as a distinct clinicopathological entity, treatment regimens have evolved to include the current recommendation of combined radical resection, radio-therapy and chemotherapy. Despite this aggressive therapy, outcomes have remained dismal, with the mean survival time still being less than 1 year after diagnosis. SNUC present with locally advanced disease, with a tendency for the tumor to spread from the paranasal siuses to the orbit and anterior cranial fossa. A case of SNUC occurred in the left maxilla showing an unusual clinical manifestations and a fulminant course of disease, is described with literatures review. A 77-year-old female patient presented with rapidly growing tumor-like bulging of the left maxilla and slight ulceration of the right upper posterior vestibule. At the first biopsy, diagnosis was a radicular cyst, but SNUC was made subsequently by the second biopsy 6 month later. Rapid and wide extension from the maxilla to the orbit and nasal cavity developed with infection. Although the time relationship is not clear, local invasion could be developed from localized disease of SNUC. Despite combined therapy with chemotherapy and radiotherapy, She has been expired 13 months after the first biopsy. Focal positivity of immunohistochemical stain(CK, EMA), which is a specific characteristic of SNUC, may serve as a factor showing unfavorable prognosis.

전기경련치료(ECT)시 뇌파의 비선형 분석 : 단일증례 연구 A Single Case Study

강웅구,이운철,정선주,윤세창,조맹제,이상훈,김용식 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 비선형 분석을 통해 전기경련 치료(ECT)의 적절성 및 효과를 판정할 수 있는 새로운 변인을 추출해 낼 가능성을 탐색하기 위하여 한 여성 우울증 환자에서 ECT중 기록한 뇌파의 단일증례 분석을 하였다. 방 법 : 1주일 간격을 둔 두 ECT 회기에서 치료전 안정상태, 마취후-경련전상태, 경련상태, 경련후 뇌파억제상태, 치료후 안정상태의 다섯 상태에 따른 뇌파를 디지털 기록한 데이터를 분석하였다. 결 과 : 분석의 결과 1) 뇌파가 10차원 이하 저차원의 결정론적 성질을 가지고있으며 2) 뇌파는 비정상적(non-stationary)이지만 비선형 지수들이 각 상태 뇌파를 안정적으로 구분해 줄 수 있고 3) ECT 회기의 진행에 따라 경련중 뇌파의 결정론적 성질이 증가하며 4) ECT 회기의 진행에 따라 치료전후 안정상태 뇌파의 최대발산지수(PLE) 및 상관차원이 증가한다는 사실을 관찰할 수 있었다. 결 론 : 단일증례에 대한 다양한 비선형 분석의 결과는 ECT의 치료효과를 정량화할 수 있는 변인으로서 PLE, 상관차원 등 비선형 변수들이 사용될 수 있을 가능성을 제시한다. Objectives : In order to search for new parameters for the evaluation of the adequacy of electroconvulsive therapy(ECT), the authors performed a non-linear analysis of electroencephalogram(EEG) recorded during the course of electroconvulsive therapy(ECT) in a single female patient with depression. Methods : Digitized EEG recordings from two ECT sessions spaced one week were analyzed at five different stages ; pretreatment stable, postanesthetic-preictal, ictal, postical suppression and posttreatment stable stages. Results : Our analysis showed that 1) EEG signals had low dimensional(below 10 dimensions) deterministic characteristics 2) although EEG was nonstationary signal, non-linear parameters could reliably differentiate between various stages we examined. 3) the deterministic property of ictal EEG increased according to the progression of sessions and 4) the primary Lyapunov exponent(PLE) and correlation dimension of pre- and post-treatment stable stage EEG increased according to the progression of sessions. Conclusion : In this single case study, results of various non-linear analyses suggested that non-linear variables extracted from EEG recordings during ECT may have utilities as tools for the quantitative evaluation of ECT.

마취중 체온변화에 관한 연구

손수창,이정은,김익수,최세진 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

To study the temperature change and the degree of heat loss during general anesthesia, skin temperature, tympanic temperature and rectal temperature were measured in 21 patients. Mean skin temperature was calculated from four probes situated on the lateral aspect of the mid-calf, the ventral surface of the mid-thigh, the nipple and the lateral aspect of the upper arm, using the formula of Ramanathan, and the heat loss can be calculated by Burton's formula. the result are as follows. 1. Mean skin temperature increased higher than control value at 20 minute, not significantly. thereafter remained high. 2. Tympanic temperature decreased significantly at 20 minute (p<0.005), esophageal temperature decreased at 60minute, and rectal temperature decreased at 90 minute significantly (p<0.05). 3. There was continuous loss of total body heat during general anesthesia. 4. In the recovery room, the aural temperature increased progressively.

Vecuronium에 의한 기관내 삽관시 안압 및 심맥관계에 미치는 영향

신용섭,이정은,최세진 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.1

The effects of muscle relaxants(vecuronium, pancuronium, d-tubocurarine, and succinylcholine) for endotracheal intubation on intraocular pressure, blood pressure, heart rate, and arrhythmia were studied in 60 patients undergoing general anesthesia, The patients were divided into 4 groups : vecuronium group (0. 1 mg/kg), pancuronium group (0.08 mg/kg), d-tubocurarine group(0.4 mg/kg), and succinylcholine group(1 mg/kg) according to be administrated. Before induction of anesthesia, initial measurement of intraocular pressure (control value) was taken with Schiotz tonometer after instilling of a 0. 5% pontocaine on conjunctival sac. Subsequent measurement were undertaken as soon as the lid reflex was lost after thiopental sodium injection and then at 75-100% depression of first twitch height of train-of-four after intravenous administration of muscle relaxants. It was measured at 1, 3, 5, 10 minutes after endotracheal intubation too. Blood pressure (systolic and diastolic), heart rate, and ECG abnormalities were observed in all cases. The results were as follows; 1. After thiopental sodium injection, intraocular pressure(IOP) decreased than the control value. 2. At 70-100% depression of first twitch height, IOP decreaeed significantly in vecuronium, pancuronium and d-tubocurarine group, but increased significantly in succinylcholine group than the control value. 3. After 1 minute of endotracheal intubation, IOP increased in all groups. There was no stastistical significance in vecuronium group compared with the control value. 4. After 3 minutes of endotracheal intubation, IOP decreased in all groups. 5. The changes of systolic and diastolic blood pressure and heart rate in vecuronium group were the smallest value among all groups. 6. There was no arrythmia in vecurouium group.

Pyridostigmine과 Neostigmine의 골격근이완계 길항 효과에 관한 연구

우현제,신용섭,김태관,이정은,최세진 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

This present study was undertaken to observe the effects of pyridostigmine and neostigmine of heart rate and it's antagonistic effect on pancuronium in 62 patients during general anesthesia. We obserived the effect of pyridostigmine and neostigmine with atropine and glycopyrrolate of heart rate, appearance of arrhythmia, time required for returning of spontaneous breath an sustained tetanic response and effect on the amount of secretion in oral cavity and trachea. The result are as follows: 1. The incidence of bradycardia was the highest in the group of atropine and neostigmine i. v. administration together, and the lowest in the group of glycopyrrolate and pyridostigmine i. v. administration together. 2. The incidence of tachycardia was the highest in the group of atropine and pyridostigmine i. v. adminstration together, and the least in the group of glycopyrrolate and pyridostigmine i. v. administration together. 3. Among the experimental cases, only one showed arrhythmia which is PVD. 4. The time required for returning of spontaneous respiration was 4.6-6.1 minutes range in all groups. 5. The group of glycopyrrolate administrated showed the greates antisialogue effect.

Halothane 마취중 Vecuronium과 Pancuronium 투여가 심혈관계 및 회복시간에 미치는 영향

길기진,김종열,이정은,김혜자,최세진 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

This study was taken to abserve the effect on cardiovascular response and recovery time with pancuronium and vecuronium. The patients was composed of 20 healthly both sex adults who belong to class I of ASA physical status. Vecuronium 0.1mg/kg(N=10) and pancuronium 0.1mg/kg(N=10) was injected independently at 20 minutes after intubation by succinylcholine 1mg/kg and thiopental sodium. The results were as follow. 1. There were not a significant difference in arterial blood pressure and pulse rate before and after vecuronium injection. 2. After pancuronium administration, arterial blood pressure was not significant change but pulse rate showed significant increasing. 3. In the recovery time when T_1 was recovered to 25% after administration of muscle relaxants respectively, there were 26±7.2 min, vecuronium and 67±11.2 min, in pancuronium. 3. EKG was not change before and after vecuronium.

Two Stage 발효에 의한 고산도 식초 생산

이영철,이금용,김형찬,박기범,유익제,안평욱,최춘언,손세형 한국산업미생물학회 1992 한국미생물·생명공학회지 Vol.20 No.6

산업적으로 산도 17.0% 이상의 고산도 식초를 생산하기 위하여 반연속식인 1st stage와 유가식인 2nd stage로 구성된 two stage 초산 발효를 온도 30 ℃, 교반속도 600 rpm, 통기량 0.1 vvm에서 실시하였다. 1st stage에서 초기 에탄올 농도를 50.0 g/ℓ, 잔류 에탄올 농도를 5.0 g/ℓ로 정하여 반연속적으로 초산발효를 하고, 2nd stage 에서 발효시간의 경과에 따라 에탄올을 유가식으로 첨가하여 초산발효액내의 에탄올 농도를 5.0 g/ℓ에서 10.0 g/ℓ로 유지했을 때 산도가 17.6%인 고산도 식초를 생산할 수 있었으며, 또한 이 ??의 최대 초산 생산성은 3.3 g/ℓ·hr였다. The production of vinegar containing 16.0 ∼18.0% of acetic acid was examined in two stage fermentation consisting of semi-continuous and fed-batch type. The optimum conditions were obtained when the fermentation was carried out at agitation of 600 rpm, aeration of 0.1 vvm and temperature of 30℃. The initial and residual ethanol concentration in 1st stage were 50.0 g/ℓ and 5.0 g/ℓ, respectively, and the ethanol concentration in 2nd stage was maintained from 5.0 to 10.0 g/ℓ. The maximum productivity was 3.3 g/ℓ-hr and the acidity was 17.6% after the two days of acetic acid fermentation.