유지 투석중인 만성 신부전환자에서 허혈성 심질환의진단 지표로서의 심장트로닌-I의 유용성

신병철,강대웅,정지용,류봉관,서영욱,김정인,김범윤,김현리,정종훈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background : Coronary disease is highly prevalent in patient with end stage renal disease (ESRD) and account for much of their observed morbidity and mortality. Troponin-I consistently maintains a high sensitivity and specificity and is most sensitive marker for ischemic heart disease (IHD). Method : We examed 49 hernodialyzed patients (22 male, 27 female) without evidence of acute coronary syndrome (ACS) for 6 months. Biochemical markers were measured in serial predialysis blood samples. For analysis, we used two cardio-specific assays for troponin-T (cTnT) as well as for troponin-I (cTnI) and compared the results with CK-MB (reference value ≤ 4.0 ng/mL) concentration. Results : Myocardial ischemia was observed in 47% (23/49) of patients. cTnT level above 0.1 ng/mL. and cTnI level above 0.5 ng/mL, were observed in 22% (11/49) and 20% (10/49) of patients respectively. cTnI revealed significantly higher positive rate in patients with myocardial ischemia than the patients without myocardial ischemia (43 % vs 30%) (p<0.05). cTnT and CK-MB revealed no difference in positive rate between the patients with and without myocardial ischemia (cTnT : 30% vs 15% and CK-MB : 30% vs 19%). The sensitivity and specificity of cTnI to myocardial ischemia were higher than those of cTnT and CK-MB (sensitivity 43% vs 30% and 30%. specificity 100% vs 85% and 81%). Conclusion: Both cTnT and cTnI are useful in ruling out myocardial injury in chronic renal failure patients. But. cTnI is a more sensitivity and excellent specificity of ischemic heart disease than cTnT and CK-MB in hemodialyzed patients. In patients with ischemic heart disease, the presences of DM and advanced age were higher than those in patients without ischemic heart disease (p<0.05). Among the baseline characteristics old age, elevated LDH and diabeties were significant more frequent in the patients with elevation of cardiac troponin-I (p>0.5 ng/mL) than those with cardiac troponin-I (p<0.5 ng/mL), p=0.038, p=0.049, and p=0.045, respectively. Our results suggest that these cTnI is the potential diagnostic marker for the prediction of IHD in ESRD patients.

광주광역시 치매의 유병률과 위험인자의 도시-농촌 지역 비교

신일선,김재민,윤진상,김석재,양수진,김웅장,이승현,강순아,곽지영,이형영 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 본 연구의 목적은 광주광역시의 도시 및 농촌 지역에 거주하는 노인에서 치매의 유병률과 위험인자를 조사하고자 하였다. 부가적으로 이 두 지역간에 치매의 유병률과 위험인자를 비교하고자 하였다. 방 법 : 광주광역시의 전형적인 도시와 농촌지역의 65세 이상의 노인(N=1,598)을 대상으로, 2단계의 역학연구를 수행하였다. 1차 선별 단계에서는 38명의 훈련된 연구보조원이 대상노인을 면담하여, 사회인구학적 특징을 조사하고 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination ; MMSE-K)로 평가하였다. 2차 임상 진단 단계에서는 1차 단계에서 MMSE-K 점수가 24점 이하인 노인(N=431)을 대상으로, 전문연구팀의 임상적 평가를 통해 치매를 진단하고 원인질환별로 알쯔하이머병(Alzheimer's disease ; AD), 혈관성 치매(vascular dementia ; VaD) 및 기타 치매로 분류하였다. 대상노인에서 치매의 유병률을 측정한 후, 광주광역시 전체 노인의 연령보정 유병률을 산출하였다. 전체 대상에서 AD의 위험인자를 조사한 후, 도시와 농촌군으로 나누어 분석을 다시 시행하였다. 결 과 : 1차 및 2차 단계의 참가율은 각각 71.0%(N=1,134) 및 83.2%(N=410) 였다. 연구 참여 노인(N=1,134)에서 전체 치매, AD 및 VaD의 유병률은 최소 각각 9.7%, 5.2%, 1.8%였다. 광주광역시 전체 노인의 연령 보정 유병률은 각각 10.7%, 5.7%, 1.9%인 것으로 산출되었다. AD의 독립 위험인자는 고령, 여성, 무학이었다. 도시와 농촌에 따른 유병률의 차이는 파악되지 않았다. 그러나 AD의 위험인자는 지역에 따라 차이가 있었다. 도시 노인에게는 무학만이, 농촌 노인에게는 고령과 여성인 경우가 독립 위험인자였다. 결 론 : 광주광역시 노인에서 치매의 유병률은 높았고, 이는 국내 다른 지역에서 수행된 선행연구 결과와 유사하였다. 알쯔하이머형 치매의 위험인자는 도시와 농촌에 따라 다른 결과를 보였다. 본 연구 결과는 한국에서의 치매의 실태를 반영하며, 치매의 적절한 관리와 예방을 위해서는 지역성 특성이 고려되어야 함을 시사한다. Objectives : The purpose of this study was to investigate the prevalence rate and risk factors of dementia in an urban and a rural sample of older persons in the metropolitan Kwangju area, Republic of Korea. In addition, the prevalence rate and risk factors of dementia between the two samples were compared. Methods : A two-phase epidemiological study of residents aged 65 or over(N=1,598) was conducted in a highly developed, urban and a non-contiguous, poorly developed, rural area of metropolitan Kwangju. In the first(screening) phase, 38 trained research assistants collectively peformed in-home interviews for all participants. Detailed sociodemographic characteristics were gathered and the Korean version of Mini-Mental State Examination (MMSE-K) was administered. In the second (diagnosing) phase, diagnosis of dementia was established for those scoring 24 or less on the MMSE-K in the screening phase(N=431), and etiological types of dementia were classified to Alzheimer's disease(AD), vascular dementia(VaD) or miscellanous type by two teams of experts. Prevalence rate of dementia was determined in the participants, and age-standardized prevalence rate adjusted by age distribution in metropolitan Kwangju was estimated. For AD, the risk factors were investigated in all participants, and analyses were repeated for the urban and rural samples separately. Results : The participating rates in the first and second phases were 71.0%(N=1,134) and 83.2%(N=410), respectively. In the participants, the prevalence rates of dementia(all types), AD and VaD were 9.7%, 5.2% and 1.8%, respectively. The age-standardized prevalence rates were 10.7%, 5.7% and 1.9%, respectively. Aging, female gender and no education(complete lack of formal education) were identified as independent risk factors for AD. No difference between the urban and rural samples was observed in the prevalence rates of dementia(all types), AD and YaD. However, risk factors for AD differed between these areas. In the urban sample, no education was the only significant factor ; whereas, aging and female gender were identified as risk factors in the rural sample. Conclusion : A high prevalence rate of dementia was observed among old persons in metropolitan Kwangju, consistent with previous studies conducted in other Korean areas. The risk factor profi1es for AD differed between urban and rural settings. The results of this study reflect the current status of dementia in Korea and suggests that appropriate management and prevention strategies for dementia should be tailored toward the geographic settings.

말기신부전 환자에서 혈액투석 전후의 QT간격분산 비교

강대웅,정지용,윤나라,안치용,김종오,신병철,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Background: Some cases of QT interval, corrected QT interval (QTc), QT dispersion (QTd) and corrected QT dispersion (QTcd) have been reported in ESRD, but these results are variable and the influence of a hemodialysis is still controversial, In this study, we investigated the effect of hemodialysis on QT and QTc interval and QT and QTc dispersion in patients with ESRD 15 min before and 15 minute after each hemodialysis. Methods: Sixty-seven patients with ESRD (men 33 & women 34) on three-times stable hemodialysis (>3 months) were randomly enrolled. Fifty control subjects with a similar age and normal renal function were enrolled from this hospital. Routine biochemical studies were measured pre- and post dialysis, at the time of the ECG. Plasma Na+, K+, BUN, creatinine, ionized calcium and phosphate were checked. Twelve-lead electrocardiographs were performed at 10㎜/mv and 50㎜/s using a HewIett-Packard Pagewriter 100, before and after a single hemodialysis session.The QT interval was measured from the onset of the QRS complex to the end of the T wave. If the end of the T wave was not clear in a particular lead then it was excluded from analysis. When U waves were present, the end of the T wave was taken as the nadir between the T and U waves. Each QT interval was corrected for heart rate using Bazett's formula (QTc==QT/√(RR)) (ms). The difference between maximal and minimal QT interval duration was defined as QT dispersion (QTd) in each of the 12 leads. Result: This study demonstrates that QT, QTd, QTcd is higher in hemodialysis patients compared with control subjects, and QT and QTd rise postdialysis to levels comparable to those seen acutely following myocardial infarction, when patients are at greatly increased risk of potentially fatal ventricular arrhythmias, Conclusions: QT interval and QT dispersion, markers of risk for arrhythmias and sudden death, are elevated in hemodialysis patients, and rise postdialysis. QT interval and QT dispersion is an easily obtainable, noninvasive, simple, inexpensive, and widely available method of risk stratification in uremic patients receiving chronic dialysis. Additional studies are needed to clarity whether increased postdialysis QT dispersion results in an increased occurrence of arrhythmias.

혈액투석중인 말기신부전 환자에서 Fludrocortisone acetate (FCA) 투여 후 혈청 칼륨 저하 효과

류봉관,강대웅,정지용,윤나라,신병철,박경희,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Background: Hyperkalemia is a commonly encountered problem in dialysis patients with end-stage renal disease. In this study we evaluated the effect of mineralocorticoid therapy (fludrocortisono acetate) on serum potassium level in the serum of hyperkalemic end-stage renal disease patients. Methods: Fourteen patients on hemodialysis receiving fludrocortisone acetate (FCA) 0.1 mg/day were observed for 2 months periods. Consecutive monthly biochemical profiles were compared for the druration of the pre-and post-treatment of FCA. Result: Fourteen patients with mean age (±SE) of 51.5 years (4 males and 10 females) and mean hemodialysis period of 51.9 months were studied. Mean serum potassium levels significantly fell (p<0.05) during the post-FCA period (5.2±0.66 mEq/L) compared with potassium levels during the pre-FCA (5.8±0.43 mEq/L) period. Pre-and post-FCA values were not different for sodium, chloride, protein, albumin, AST/ALT, glucose, blood nitrogen, creatinine, phosphate and calcium. Conclusions: FCA appears to decrease serum potassium value in patients with end-stage renal disease. These results suggested that FCA could be effective to treat hyperkalemia without any adverse effect in patients undergoing hemodialysis.

"한국판 학령전기 기질성격검사[K-psTCI]" 의 신뢰도 및 타당도 검사

박진균,김지웅,기선완,신의진 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : The purpose of this study was to evaluate the reliability and validity of the Korean version of Preschool Temperament and Character Inventory (K-psTCI), a questionnaire based on Cloninger's seven-factor model of personality. Methods : The psTCI was translated into Korean and administered to 266 children aged 2-6 years. α test-retest study of the K-psTCI was conducted across a 4-month interval, Internal consistency was calculated by Cronbach a. Test-retest and reliability was analyzed by Pearson correlation analysis. Factor analyses for the temperament and character dimensions were performed using principal component analysis, rotating factors by varimax. The psTCI scores of Korean and United States preschoolers were compared Results : Cronbach α values for the K-psTCI scales ranged from .62 to .78 for each dimensions. Test-retest correlations (r) ranged from .50 to .77 for each dimensions. Explorative factor analysis with the condition of eigenvalue greater than 2 produced four factors for the temperament items and three factors for the character items like the US original version of psTCI. Through factor analyses, five items in the K-psTCI were categorized differently from the US version of psTCI. Korean preschoolers had higher mean scores on Cooperativeness (CO) in males as compared to a sample of US preschoolers. Conclusion : The results of this study suggests that the Korean preschool TCI is satisfactory in reliability and validity.

Bombyxamycins A and B, Cytotoxic Macrocyclic Lactams from an Intestinal Bacterium of the Silkworm <i>Bombyx mori</i>

Shin, Yern-Hyerk,Beom, Ji Yoon,Chung, Beomkoo,Shin, Yoonho,Byun, Woong Sub,Moon, Kyuho,Bae, Munhyung,Lee, Sang Kook,Oh, Ki-Bong,Shin, Jongheon,Yoon, Yeo Joon,Oh, Dong-Chan American Chemical Society 2019 ORGANIC LETTERS Vol.21 No.6

<P>Bombyxamycins A and B (<B>1</B> and <B>2</B>) were discovered from a silkworm gut <I>Streptomyces</I> bacterium. Spectroscopic analysis and multiple-step chemical derivatization identified them as 26-membered cyclic lactams with polyene features. Bombyxamycin A showed significant antibacterial and antiproliferative effects. The bombyxamycin biosynthetic gene cluster was identified by genetic analysis. Gene deletion experiments confirmed that the cytochrome P450 BomK is responsible for the generation of <B>2</B>, which unprecedentedly bears tetrahydrofuran in its macrocyclic ring.</P> [FIG OMISSION]</BR>

Yttrium-doped and Conductive Polymer-Coated High Nickel Layered Cathode Material with Enhanced Structural Stability

Shin, Ji-Woong,Lee, Seon-Jin,Nam, Yun-Chae,Son, Jong-Tae The Korean Electrochemical Society 2021 Journal of electrochemical science and technology Vol.12 No.2

In this study, high nickel layered LiNi_0.8Co_0.1Mn_0.1O₂ cathode materials for lithium-ion batteries were modified by yttrium doping and poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) coating. The effects of yttrium doping and PEDOT:PSS coating on the structural and electrochemical properties of the LiNi_0.8Co_0.1Mn_0.1O₂ cathode material were investigated and compared. The substitution of nickel with an electrochemically inert yttrium was confirmed to be successful in stabilizing the layered structure framework. Moreover, coating the surfaces of the LiNi_0.8Co_0.1Mn_0.1O₂ particles with a conductive polymer, PEDOT:PSS, improved the capacity retention, thermal stability, and impedance of the cathode material by increasing its ionic and electric conductivities.

Designing of a Novel Core-Shell-Structured Co-free Cathode Material with Enhanced Thermal and Structural Stability for Lithium Ion Batteries

Shin, Ji-Woong,Nam, Yun-Chae,Son, Jong-Tae The Korean Electrochemical Society 2019 한국전기화학회지 Vol.22 No.4

The first commercialized cathode material, $LiCoO_2$, suffers from disadvantages such as high cost and toxicity and also possesses safety problems. The nickel-rich $LiNi_{0.9}Mn_{0.1}O_2$ cathode material, used as an alternative to $LiCoO_2$, has highly reversible capacity and high energy density. So, the nickel-rich $LiNi_{0.9}Mn_{0.1}O_2$ cathode material is widely used as an alternative to $LiCoO_2$ due to its highly reversible capacity and high energy density. However, $LiNi_{0.9}Mn_{0.1}O_2$ has several disadvantages as well, such as poor cycle performance and poor thermal instability. To address these problems, we synthesized a new material, $LiNi_{0.5}Mn_{0.5}O_2$, as a shell on the surface of a core to suppress the surface degradation. The new material showed high structural and thermal stabilities and could also maintain a high capacity. The capacity retention of the core-shell cathode (87.7%) was better than that of the core cathode (76.9%) after 50 cycles. Analysis using differential scanning calorimetry revealed that the heat generation in the core-shell cathode ($65.9Jg^{-1}$) was lower than that in the core cathode ($559.7Jg^{-1}$).

Novel Bispecific Human Antibody Platform Specifically Targeting a Fully Open Spike Conformation Potently Neutralizes Multiple SARS-CoV-2 Variants

Ji Woong KIM,Kyun HEO,Hyun Jung KIM,Youngki YOO,Hyun-Soo CHO,Hui Jeong JANG,Ho-Young LEE,In Young KO,Ju Rang WOO,Yea Bin CHO,Ji Hyun LEE,Ha Rim YANG,Ha Gyeong SHIN,Hye Lim CHOI,Kyusang HWANG,Sokho KIM 한국생물공학회 2023 한국생물공학회 학술대회 Vol.2023 No.4

Long-Term Clinical Outcomes of Iliac Artery Endovascular Therapy in the Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry

Ji Woong Roh,Sanghoon Shin,Young-Guk Ko,Nak-Hoon Son,Chul-Min Ahn,Pil-Ki Min,Jae-Hwan Lee,Chang-Hwan Yoon,Cheol Woong Yu,Seung Whan Lee,Sang-Rok Lee,Seung Hyuk Choi,In-Ho Chae,Donghoon Choi 대한심장학회 2022 Korean Circulation Journal Vol.52 No.7

Background and Objectives: Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications. Methods: We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival. Results: TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12–2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03–8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26–2.83; p=0.002), previous bypass surgery (HR, 3.04; 95% CI, 1.28–7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19–7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25–3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07–3.24; p=0.028) were predictors for TLR. Conclusions: Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.