지속성 외래 복막투석 환자에서 염증 지표와 고해상도 B 모드 경동맥 초음파 소견의 연관성에 관한 연구

송현용,송영수,안철우,강신욱,최규헌,하성규,이현철,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

배 경 : 저알부민혈증 및 C-반응 단백(C-reactive protein, CRP)이 증가된 지속성 외래 복막투석 환자의 사망률이 높은 정확한 이유는 밝혀져 않다. 혈액투석 환자에서처럼 복막투석 환자에서 저알부민혈증 및 염증반응이 심혈관계 질환 위험인자 인지 알아보고자 하였다. 방 법: 비당뇨병성 말기 신부전, 지속성 외래 복막투석 환자 93명의 심혈관계 질환 위험인자들과 복막 투과 특성 및 알부민, CRP 등의 염증지표에 따라 고해상도 초음파를 이용한 경동맥내막-중간막 두께, 내막-중간막 면적, 플라크의 유무 등을 단면적으로 비교하였다. 결 과: 복막 투과 특성은 고투과막군 14명, 중간 고투과막군 38명, 중간 저투과막군 31명, 저투과막군 10명으로 각 군간의 경동맥 내막-중간막 두께, 플라크 유무 및 내막-중간막 면적의 차이는 없었다. 기존 관상동맥 질환 환자는 8예(8.6%)로 내막-중간막 두께는 관상동맥 질환이 없는 환자보다 증가되었고(0.79±0.21 vs 0.60±0.11 mm, p<0.05) 플라크 형성은 더 많이 보이나 통계적 유의성은 없었다(75.0 vs 63.5%, p>0.05). 혈청 알부민치와 경동맥 내막-중간막 면적은 역상관관계를 보였다(r=-0.27, p<0.05). 저알부민혈증 환자(혈청 알부민 <3.5 g/dL)는 정상 알부민혈증 환자보다 내막-중간막 두께가 증가되었고(0.67±0.15 vs 0.61±0.12 mm, p<0.05), 플라크도 유의하게 많았다(68.0 vs 55.8%, p<0.05). 혈청 CRP치와 경동맥 내막-중간막 면적은 양의 상관관계가 있었으며(r=0.21, p<0.05) CRP가 높은 환자(≥0.8 mg/dL, n=18)에서플라크가 많이 관찰되었으나(65.8 vs 50.0%, p<0.05) 경동맥 내막-중간막 두께 및 내막-중간막면적은 양군간에 차이가 없었다. 다변량 회귀 분석상 경동맥 내막-중간막 두께에 영향을 미치는 인자는 고령, 높은 CRP, 기존 심혈관계질환, 낮은 혈청 알부민 순이였다. 결 론 : 복막투석 환자에서 고해상도 초음파를 이용한 경동맥 내막-중간막 두께 측정은 심혈관계 질환 유무 예측의 비침습적 검사가 될 수 있고 저알부민혈증 및 높은 CRP과 같은 만성염증 지속상태가 복막투석 환자에서 죽상 동맥 경화증의 발생을 증가시킨다고 가정할 수 있다. Background : Continuous ambulatory peritoneal dialysis(CAPD) patients with low albumin(LA) and signs of inflammation reflected by increased C-reactive protein(CRP) level have an increased mortality, but the mechanism of this phenomenon is not clear yet. Methods : To answer whether LA and inflammation also enhance cardiovascular risk in CAPD patients, we performed cross sectional study measuring carotid artery intima-media thickness(IMT), calculated intima-media area(cIM area) and the presence of plaque by high-resolution B-mode ultrasonography in 93 non-diabetic CAPD patients. Results : Patients with coronary artery disease (CAD, n=8) had significantly increased IMT(0.79± 0.21 mm vs. 0.60±0.11 mm, p<0.05) and higher prevalence of carotid plaques(75.0% vs. 63.5%) compared to the non-CAD patients. Significant inverse correlation was observed between serum albumin (SA) level and cIM area(r=-0.27, p<0.05). Those patients with LA(SA <3.5 g/dL) had significantly increased IMT compared to non-LA patients(0.67±0.15 mm vs 0.61±0.12 mm, p<0.05). Prevalence of carotid plaques was also significantly higher in LA patients (68.0% vs. 55.8%, p<0.05). CRP level revealed a significant positive correlation with cIM area(r=0.21, p< 0.05). Patients with high CRP(≥0.8 mg/dL, n=18) had higher prevalence of carotid plaques (65.8% vs. 50.0%, p<0.05) compared to those patients with CRP <0.8 mg/dL, but IMT and cIMT area were not different. By multivariate logistic regression analysis, old age, high CRP, history of CAD and low SA were the independent risk factors affecting IMT. Conclusion : Our study strongly suggests that low albumin and chronic inflammatory state of CAPD patients could be associated with increasing atherosclerotic cardiovascular disease. (Korean J Nephrol 2002;21(2):285-294)

고속액체크로마토그래피를 이용한 혈장중 로바스타틴산의 분석 : 시료전처리로서 단백침전법 및 고상추출법의 비교 Comparison of Protein Precipitation Method and Solid Phase Extraction Method for Sample Pretreatment

송우헌,장정수,박은우,이상길,최영욱 중앙대학교 약학연구소 1997 약학 논총 Vol.11 No.-

Lovastatin(LV), one of the potent cholesterol-lowering agents, is an inactive lactone prodrug which is metabolized to its active open acid (Lovastatin acid. LVA). In order to optimize the assay procedure of LVA by high performance liquid chromatography(HPLC). solid phase extraction(SPE) method and protein precipitation method were employed for the pretreatment of plasma sample containing LV and LVA, and plasma sample was hydrolyzed under alkaline condition to transform all LV to LVA. Following pretreatment of plasma sample. 100ul of sample was injected onto a reversed-phase C_18 column and eluted with a acetonitrile-pH 3.0 phosphate buffer mixture(45:55 v/v) at a flow rate of 2.0ml/min. Ultraviolet detection was carried out at 238nm. It has been shown that all of LV in plasma was converted to LVA in vitro under alkaline condition. On SPE method, elution with acetonitrile-methanol mixture(75:25 v/v) indicated the highest recovery of LVA, but acid treatment of plasma sample before loading on SPE cartridge revealed little effect on recovery of LVA. Compared with two different pretreatment of plasma sample, SPE indicated better sensitivity and recovery.

QLF를 이용한 항우식 제품의 인공우식 재광화 효과에 대한 연구

송주현,김영재,김정욱,장기택,김종철,한세현,이상훈 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

본 연구는 항우식 제품인 저농도의 불소 양치액(500 ppm NaF)과 Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP)를 포함하는 치아 연고,그리고 이 두 제품을 같이 사용했을 경우,인공 우식 병소의 재광화 효과를 알아보고자 하였다. 제3대구치 협면에 인공우식을 유발하였고,시편을 16개씩 4군으로 나누어,28일 동안 매일 2회 다음과 같은 항우식 제품을 시편에 처리하였고,pH 순환 시스템을 적용하였다. 1군: 대조군(무처치) 2군: Tooth Mousse^(ⓡ) (GC Co. Japan) 3군: 치카치카^(ⓡ)(삼일제약. 한국) 4군: 치카치카^(ⓡ)+ Tooth Mousse^(ⓡ) 무기질 소실량(ΔQ)의 장기적인 변화를 Quantitative light-induced fluorescence (QLF)를 이용하여 관찰하여 다음과 같은결과를 얻었다. 1. ΔQ는 1군에서는 28일동안 유의성 있는 차이를 보이지 않았고,2군과 3군에서는 처치전에 비해 14일부터 유의성 있는 증가를 보였으며,4군에서는 7일부터 유의성 있는 증가를 보였다. 2. ΔQ는 1군 < 2군,3군 < 4군 순이었다. 3. ΔQ는 1군과 비교시 2군은 7일,3군과 4군은 3일부터 유의성 있는 증가를 보였고,2군은 3군과 전 기간 동안 유의차가 없었다. 4군은 2군과 3군에 비해 28일에 유의성 있는 증가를 보였다. 4. 모든 군에서 재광화 속도는 점차 감소하였다. The purpose of this in vitro study was to compare the remineralization effect of commercially available anticariogenic products, exactly low level fluoride mouthrinse(500 ppm NaF), tooth cream with Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride mouthhnse plus tooth cream on artificial caries lesion. Artificial caries lesion was induced at the buccal surface of permanent third molar and the specimens were then divided (16 specimens/group) into four group. Twice a day during 28 days specimens of each group were treated with a commercially anticari.ogen.ic product as follows and applied to the pH cycling system. Group 1: control group (No treatment) Group 2: Tooth Mousse^(ⓡ) (GC Co. Japan) Group 3: chikachika^(ⓡ) (Samil Co. Korea) Group 4: chikachika^(ⓡ) + Tooth Mousse^(ⓡ) The long-term change of mineral loss(ΔQ) was evaluated by quantitative 1ight-induced fluorescence(QLF) and the following results were obtained: 1. ΔQ of Group 1 was not noticed statistically significant during 28 days comparing that prior to treatment. There was a statistically significant increase in ΔQ of Group 2 and 3 since 14 days. So was in ΔQ of Group 4 since 7 days. 2. ΔQ was increased as follows: Group 1< Group 2, 3< Group 4. 3. Comparing with Group 1, Group 2 was a statistically significant increase since 7 days and Group 3 and 4 were since 3 days. Comparing Group 2 with 3, there was not noticed statistically significant during whole duration. Group 4 was significantly higher than Group 2 and 3 after 28 days. 4. All groups demonstrated a decrease in the rate of remineraUzation as time goes on.

탄산음료 유발 법랑질 침식에 대한 항우식 제품의 예방 효과

송주현,김영재,김정욱,장기택,김종철,한세현,이상훈 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

본 연구는 항우식 제품인 Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP)를 포함하는 치아크림, 불소 바니쉬, 저농도 불소 양치액을 치아에 도포하는 것이 단시간 탄산음료에 의한 법랑질의 침식을 예방할 수 있는지 살펴보기 위해 계획되었다. 법랑질 시편에 다음과 같은 항우식 제품을 도포하였고, 인공타액에 24시간 보관한 후, 콜라에 1분 증류수에 1분씩 5회 번갈아 처리하였다. 1군: 대조군(무처치) 2군: CPP-ACP 치아크림군 3군: 불소 바니쉬군(1,000 ppm F) 4군: 저농도 불소 양치액군(227 ppm F) 5군: 불소 바니쉬 + CPP-ACP 치아크림군 6군: 저농도 불소 양치액 + CPP-ACP 치아크림군 미세경도와 침식깊이를 측정하였고, Quantitative light-induced fluorescence(QLF)를 이용하여 안정된 형광 격자에 대한 부피 형광 변화인 ΔQ를 측정하여 무기질 감소량을 평가하였다. 6일 동안 실험을 반복하여 다음과 같은 결과를 얻었다. 1. 미세경도는 1군≤2군≤4군<6군<3군≒5군 순이었다. 2. 평균 침식깊이는 5군≒3군<6군<4군≒2군≒1군 순이었다. 3. ΔQ는 1군≒2군≤4군≤6군≤3군≒5군 순이었다. ΔQ의 감소율은 1군과 2군, 4군과 6군, 3군과 5군이 각각 유사하였다. 4. ΔQ는 미세경도와 강한 양의 상관관계를 나타냈고(r=0.96, p<0.05), 침식깊이와는 강한 음의 상관관계를 보였다(r=-0.96, p<0.05). The aim of this study was to evaluate the preventive effect of commercially available anticariogenic products, specifically, the tooth cream containing Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP), fluoride varnish and low-level fluoride mouthrinse on enamel erosion induced by carbonated beverage in a short period of time. Enamel specimens were treated as follows and were then kept in artificial saliva for 24 hours followed by further processing by alternately soaking them in Cola beverage and in distilled water for 1 minute each five times. Group 1: control group (no treatment) Group 2: tooth cream with CPP-ACP Group 3: fluoride varnish (1,000 ppm F) Group 4: low-level fluoride mouthrinse (227 ppm F) Group 5: fluoride varnish + tooth cream with CPP-ACP Group 6: low-level fluoride mouthrinse + tooth cream with CPP-ACP Microhardness and erosion depth were measured and the mineral loss of each specimen was evaluated by measuring the volumetric fluorescence change(ΔQ) against the stable fluorescent grid using quantitative lightinduced fluorescence(QLF). The experiment lasted for 6 days repeated each day. The results were as follows: 1. The microhardness was increased as follows: Group 1≤2≤4<6<3≒5. 2. The mean erosion depth was increased as follows: Group 5≒3<6<4≒2≒1. 3. The ΔQ was increased as follows: Group 1≒2≤4≤6≤3≒5. The decrement of ΔQ was similar between group 1 and 2, group 4 and 6 and group 3 and 5. 4. The ΔQ showed positive correlation with microhardness (r=0.96, p<0.05), while it was negatively correlated to erosion depth (r=-0.96, p<0.05).

성인 원발성 초점성 사구체 경화증의 예후인자

송영수,최훈영,유태현,강신욱,이중민,정현주,이호영,한대석,최규헌 대한신장학회 2004 대한신장학회잡지 Vol.23 No.1

고출력 레이저를 이용한 인코넬 600 합금의 용접 특성 연구

송성욱,유영태,신호준 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

The laser welding process is one of the most advanced manufacuring technologies owing to its high speed and deep penetration. Welding characteristics of Inconel 600 Alloy using a continuous wave Nd:YAG laser are experimentally investigated. The major process parameters studied in the present laser welding experiment were position of focus, laser power, travel speed. The gap and offset maintained as small as possible. Optical microscope were used to investigate the microstructures of the welded zone. The follow conclusions can be drawn the laser power and travel speed have a pronounced effect the fusion zone size and shape.

관동맥연축의 비침습적 진단에 있어 Ergonovine Echocardiogrpahy의 유용성

송재관,박성욱,김재중,두영철,김원호,박승정,이종구 울산대학교 의과대학 1992 울산의대학술지 Vol.1 No.1

관동맥연축의 비침습적인 진단방법의 확립은 침습적인 관동맥조영술 및 연축유발검사에 비해 반복적용이 가능한 이론적인 장점이 있어 선별검사(screening test)로서의 기능뿐만 아니라 치료로 이용되는 약물의 효과비교 및 추적검사를 통한 관동맥연축의 임상ㄹ활동도 평가등에 손쉽게 이용될 수 있으라라 예상된다. 이에 저자들은 ergonovine 투여시 기록된 좌심실벽운동장애 유무가 갖는 관동맥연축에 의한 심근허혈의 진단적 가치를 평가하기 위해 Beside Ergonovine Echocardiography Test를 시행하였다. 관동맥조영술 및 연축유발검사에서 변이형협심증으로 증명된 30명(남자 27명, 평균연령 54세)과 비특이적인 흉통질환군 20명(여자 12명, 평균연령 55세)을 대상으로 관동맥조영술 다음날 ergonovine test를 시행하였다. 운동부하검사가 음성인 환자들을 대상으로 6시간 공복시킨 뒤 앙와위에서 상지정맥을 통하여 25-50microgram(이하 mcg)을 5뷴 간격으로 투여하여 흉통의 유무, 심전도 및 이면성심초음파를 5분마다 기록하였으며 총투여량이 350mcg에 도달하거나 양성반응을 보이는 경우 nitroglycerin 250mcg 정주 및 설하투여로 종료하였다. 좌심실벽운동의 분석은 side-by-side continuous cine-loop display가 가능한 QUAD screen 방법으로 판별하였다. 가역적인 심전도 변화나 국소적인 심실벽운동장애가 유발되는 경우를 양성으로 판정하였다. Ergonovine Echocardiography의 전체 민감도는 90%, 특이도는 100%로 동시에 기록된 심전도 변화의 민감도(73%)보다 높았으며 특히 흉통이 있으나 심전도 변화가 전혀 없었던 5례 모두에서 좌심실벽운동장애가 관찰되어 본 검사법의 우월성을 확인할 수 있었다. 양성반응을 보인 ergonovine 평균 투여량이 173±95mcg 이었으며 흉통발작의 빈도를 기준으로한 임상활동도가 높은 경우 활동도가 낮은 군에 비해 양성반응을 의한 총 ergonovine 투여량이 적었으며(123±86 vs 213±83mcg, p<0.01) 관동맥협착이 연축에 동반되어 있는 경우 정상 관동맥에 연축이 있는 경우보다 민감도가 더 높았다(100% va 60%, P=0.02). Ergonovine 투여로 혈압은 기저치 보다 약 17%정도 증가되었으나 맥박수는 큰 변화를 나타내지 않아 안전하게 시행될수 있었으며 오심, 두통, 견갑부통증, 심실기외수축, 방실차단 등이 소수례에서 관찰되었으나 검사로 인한 사망례는 없었다. Ergonovine 주입후 기록된 좌심실벽운동동장애는 심전도 변화보다 더 민감하게 관동맥연축에 의한 심근허혈을 진단할 수 있었으며 Ergonovine Echocardiography는 운동부하검사 등으로 심한 관동맥협착이 배제된 선별된 흉통환자들에서 관동맥연축의 진단에 안전하게 시행될 수 있는 민감하고 특이도가 높은 검사방법이며 변이형협심증의 임상활동도와 관동맥협착의 동반유무가 본 검사법의 결과에 영향을 미칠 수 있으리라 사료된다. The purpose of this study was to evaluate the clinical feasibility of bedside intravenous ergonovine test with echocardiography as a noninvasive diagnostic method for coronary vasospasm. Bedside ergonovine test was performed in 50 patients with chest pain one day after coronary angiography with spasm provocation test;30 patients showed positive results of provocation test while in 20 patients there was no evidence of coronary vasospasm. A bolus of ergonovine maleate(.025 or .05mg) was injected at 5 min intervals up to total cumulative dosage of 0.35mg, and 12-leads ECG and 2-D Echo were recorded every 3min after each injection. Left ventricular wall motion was analyzed with a commercially available ' QUAD' system. The positive criteria of beside ergonovine test included reversible ST segment elevation or depression, T wave changes in ECG(ECG criteria) and reversible regional wall motion abnormalities(RWMA) in Echo(Echo criteria). The overall sensitivity and specificity of ECG criteria were 73%(22/30) and 100% respectively ; The sensitivity of Echo criteria increased up to 90%(27/30) without the change of the specificity. Among 22 patients with reversible ECG changes only 73%(16/22) showed typical ST segment elevation while ST depression was recorded in 2 patients(9%) and minor T wave peaking or flattening without ST segment displacement in 4 patients(18%). Concomitant fixed coronary lesion does increase the sensitivity of the test compared to pure coronary vasospasm with ECG criteria(100% vs 60%, p<0.05). Mean does of ergonovine with positive results was 173±95 microgram(mcg) and the amount of does of ergonovine for positive result was significantly larger in patients with low disease activity (chest pain <5times/자) than those with high disease activity(213±83 vs 123±86mcg, p<0.01). There was no procedure related mortality or fatal arrhythmias. Ergonovine echocardiography is a highly sensitive and specific test for coronary vasospasm and is safe in selected patients in whom the exercise test is negative and severe fixed coronary artery disease has been excluded. Presence of concomitant fixed coronary artery disease and the degree of clinical activity of coronary vasospasm may influence the results of this test.

혈액투석중인 만성신부전 환자에서 골대사 지표로써의 Osteocalcin치

송치운,이진홍,안미애,윤환중,윤상임,성기양,이강현,송민호,이강욱,신영태,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Background : Serum osteocalcin is synthesized by osteoblast and has been shown to be sensitive indicator of bone turnover inpatients with various metabolic bone disease. In renal osteodystrophy, serum osteocalcin is elevated due to decreased renal clearance and elevated level of PTH. This study was done to evaluate the usefulness of serum osteocalcin as a marker of bone metabolism and the correlation with other biochemical markers of bone metabolism. Methods : We measured serum osteocalcin, calcium, phosphorus, ALP(alkaline phosphatase) and PTH(parathyroid hormone) in 37 patients with end stage renal disease on hemodialysis. Osteocalcin was determined by radioimmunoassay and PTH was determined by radioimmunometric assay. Results : 1) The mean level of serum osteocalcin in ESRD patients was 233.8± 218.2ng/ml which was significantly higher than that of controls(p<0.0001). 2) The mean level of serum PTH in ESRD patients was 40.5± 43.8pg/ml was significantly higher than that of controls(p<0.005). 3) There was a significant positive correlation between the level of serum PTH, ALP and the level of serum osteocalcin in ESRD patients. 4) By using multiple regression, PTH is most reliable factor that affect to elevated level of serum osteocalcin ( beta coefficient = 0.687, Sig T<0.05). Conclusion : Serum osteocalcin as a marker of bone metabolism in ESRD patients is more useful than other biochemical marker such as serum calcium, phosphorus, ALP and PTH is a most reliable factor that affect to elevated level of serum osteocalin.

고주파용 칩인덕터 유리소재 개발

김영호,송민석,윤영진,박찬욱,이재열 嶺南大學校 工業技術硏究所 2003 工業技術硏究所論文集 Vol.31 No.1

The glass systems of SiO_2-Al_2O_3-B_2O_3-K_2O were fabricated with the composition of SiO_2 65∼76wt%, B_2O_3 20∼30wt%, Al_2O_3 0.3∼4.5wt%, and K_2O 0.5∼2.5wt% for mother glass of high frequency chip inductor. The glasses were prepared by quenching the melt from 1500℃ and analyzed by X-ray diffraction. The specimens were prepared with composites of ball milled glasses powder mixed with 0∼50wt% of alumina powder. After heat treating at 850℃∼950℃, sintering behaviors were observed by measuring the density of specimens as a function of temperature and the amount of alumina. Dielectric constants and dissipation factors were evaluated with HP-4192A as well as other crucial properties such as strength, softening point and thermal expansion. The density, dielectric constant and dissipation factor of specimen were 2.61g/㎟, 5.9∼6.2 and 0.0013∼0.0016 at 1㎒, respectively.

관동맥풍선시술중 혈전동반 병변에 대한 구조치료(Rescue Utilization)로서의 Abciximab(ReoPro^(�)의 효과

두영철,채경수,최종형,허필석,송관욱,홍경순,박대균,한규록,오동진,유규형,임종윤,고영박,이광학,이영 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.12