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김경아,남혜윤,문제혁,정진숙,임영,정치경 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4
목적 : Rat2 섬유모세포에서 α-quartz에 의해 유도된 NOS의 조절기전을 알아보기 위하여 본 연구가시도 되었다. 방법 : Rat2 세포에 있어서 α-quartz 자극에 의한 NO와 H₂O₂의 분비 및 iNOS의 발현을 관찰하였고, iNOS 억제제인 L-NIL과 H₂O₂ 억제제인Catalase를 전처리하고 마찬가지로 NO와 H₂O₂분비 그리고 iNOS의 단백발현 정도를 western blot-ting을 이용하여 관찰하였다. 결과 : o-quartz는 Rat2 세포에서 iNOS에 의한NO와 H₂O₂의 분비를 유도하였다. L-NIL은 R3t2세포에서 D-quartz에 의한 H₂O₂의 분비와 iNOS발현을 완전히 억제하였다. Catalase로 전처리 하였을 때 o-quartz로 유도된 iNOS에 의하여 생산증가된 H2Oa가 iNOS를 억제하는 autoinhibitorypathway가 차단되어 결과적으로 H₂O₂의 분비와 iNOS의 발현이 증가하였다. 결론 : Rat2 세포에서 α-quartz에 의하여 유도된iNOS는 H₂O₂의 분비를 촉진하고 이 H₂O₂는 iNOS기능을 조절하는 자가조절기전에 중요한 역할을 하는 것으로 생각된다. Objectives : This study was performed in order to investigate the molecular mechanism regulating nitric oxide synthase (NOS) induced by α-quartz in Rat2 fibroblast. Methods : α-quartz-induced nitric Oxide (NO) anti H₂O₂ formation anti α-quarts-induced iNOS protein expression in Rat2 fibroblast were monitored. With iNOS inhibitor (L-N6- (1-iminoethyl) lysine hydrochloride, L-NIL) or antioxidant (catalase), we observed NO and H₂O₂ formation and iNOS protein expression in Rat2 fibroblast stimulated with α-quartz. Results : α-quartz stimulated iNOS-induced NO and H₂O₂ formation in Rat2 fibroblast. L-NIL inhibited H₂O₂ formation and iNOS protein expression by α-quartz in Rat2 fibroblast. Pretreatment with catalase blocked the autoinhibitory pathway of iNOS by iNOS-induced H₂O₂ therefore H₂O₂ and NO production and iNOS protein expression were increased in Rat2 fibrobalst stimulated with α-quartz Conclusion : α-quartz-induced iNOS Stimulated H₂O₂ formation in Rat2 fibroblast. INOS-induced H₂O₂ by α-quartz plays an important role in the autoinhibition pathway for regulating the iNOS function in Rat2 fibroblast
증례 : 급성 심근경색으로 진단된 진성 적혈구 증가증 1예
김지혜 ( Chee Hae Kim ),김혜미 ( Hyue Mee Kim ),이학승 ( Hak Seung Lee ),정지현 ( Ji Hyun Jung ),서정원 ( Jung Won Suh ) 대한내과학회 2015 대한내과학회지 Vol.88 No.2
Traditional risk factors for acute myocardial infarction are hypertension, diabetes, dyslipidemia, smoking, and a family history of coronary heart disease. Most acute myocardial infarction patients have at least one of these risk factors. Polycythemia vera is a rare etiological factor for acute myocardial infarction. Polycythemia vera leads to hyperviscous milieu of the blood and increased platelet activity, which increases the chance of thrombotic occlusion of coronary arteries. In this article we report a rare case of polycythemia vera presenting as an ST-elevation myocardial infarction without any traditional risk factors for cardiovascular disease. (Korean J Med 2015;88:192-196)
증례보고 : 개심술 마취에서 동맥압 파형분석을 이용한 심박출량과 중심정맥 산소포화도
김태엽 ( Tae Yop Kim ),권원경 ( Won Kyoung Kwon ),윤창룡 ( Chang Yong Yoon ),김혜경 ( Hae Kyoung Kim ),김준석 ( Jun Seok Kim ),지현근 ( Hyun Keun Chee ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
The determination of arterial pressure wave-derived cardiac output (APCO) and central venous O2 saturation (ScvO2) has been introduced as a less invasive procedure for monitoring cardiac function and oxygen delivery. We have used an APCO sensor (FloTrac(TM)) and a monitor for ScvO2 (Vigileo(TM)) in two cases of cardiac valve surgery, where placement of pulmonary artery catheter (PAC) was not applicable due to unfavorable cardiac structure (case 1) and was contraindicated due to an unstable cardiac conduction disorder and arrhythmia (case 2). In case 1, monitoring of APCO was started from the beginning of anesthesia induction and a ScvO2 monitoring central venous catheter was inserted just after anesthesia induction. APCO, ScvO2 and other hemodyanamic information such as arterial BP, CVP, and data obtained from transesophageal echocardiography (TEE) during the pre-cardiopulmonary bypass (CPB) period were measured. APCO and ScvO2 during the post-CPB period showed a reliable correspondence with continuous cardiac output (CCO) and mixed venous O2 saturation (SvO2) as measured by PAC at the end of CPB. In case 2, APCO and ScvO2 were monitored instead of CCO and SvO2. The values of APCO showed a good correlation to intraoperative COs indirectly calculated by the velocity-time integral of the aortic outflow determined in the TEE examination. We experienced that monitoring APCO and ScvO2 is useful for anesthesia management in cardiac valve surgery and can be an alternative to CCO and SvO2 if the placement of PAC and the thermodilution method are not applicable. (Korean J Anesthesiol 2007; 53: 109~14)
Prevalence and characteristics of isolated nocturnal hypertension in the general population
( Moo-yong Rhee ),( Je Sang Kim ),( Chee Hae Kim ),( Ji-hyun Kim ),( Jung-ha Lee ),( Sun-woong Kim ),( Deuk-young Nah ),( Namyi Gu ),( Eun-joo Cho ),( Ki-chul Sung ),( Kyung-soon Hong ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.5
Background/Aims: Ascertaining the prevalence of isolated nocturnal hypertension (INHT) in the general population and identifying the characteristics of patients with INHT may be important to determine patients who should receive 24- hour ambulatory blood pressure (BP) measurements. This study aimed to evaluate the prevalence and characteristics of INHT in the general population. Methods: Of 1,128 participants (aged 20 to 70 years), we analyzed 823 who had valid 24-hour ambulatory BP measurements and were not on antihypertensive drug treatment. Results: The prevalence of INHT in the study was 22.8%. Individuals with INHT had a higher office, 24-hour, and daytime and nighttime ambulatory systolic and diastolic BPs compared to individuals with sustained day-night normotension. INHT was more prevalent in individuals with masked hypertension (MH) than in those with sustained hypertension (59.8% vs. 15.6%, p < 0.001). Among individuals with INHT, 92.6% had MH. Among individuals with office BP-based prehypertension, 34.5% had both INHT and MH. The prevalence of INHT was highest in individuals with office BP-based prehypertension. INHT was an independent determinant of MH after adjustment for age, sex, body mass index, diabetes, low-density-lipoprotein cholesterol, 24-hour systolic and diastolic BP, systolic and diastolic BP dipping, and systolic and diastolic BP non-dipping. Conclusions: The present study showed that INHT is not uncommon and is a major determinant of MH. Our findings strongly suggest the use of 24-hour ambulatory BP measurement for individuals within the prehypertension range of office BP owing to the high prevalence of INHT and MH in this population.
임세훈,Chee-Mahn Shin,Young-Jae Kim,이근무,이정한,Kwangrae Cho,Myoung-Hun Kim,Shin-Hae Chang 대한마취통증의학회 2012 Anesthesia and pain medicine Vol.7 No.2
Achondroplasia is the most common non-lethal skeletal dysplasia. Underdevelopment and premature ossification of bones result in characteristic craniofacial and spinal abnormalities. Achondroplastic dwarfs have low fertility rates and require delivery by cesarean section due to their cephalo-pelvic disproportion. Controversy exists regarding the ideal anesthesia for an achondroplastic parturient dwarf for urgent cesarean section. Anesthesia, whether general or regional, presents many potential problems during cesarean section. We report the experience of the epidural anesthesia in an achondroplastic dwarf undergoing elective cesarean section.
Cho Jungheum,Kim Youngjune,Lee Seungjae,Min Hooney Daniel,Ko Yousun,Chee Choong Guen,Kim Hae Young,Park Ji Hoon,Lee Kyoung Ho 대한영상의학회 2022 Korean Journal of Radiology Vol.23 No.4
Objective: We compared appendiceal visualization on 2-mSv CT vs. conventional-dose CT (median 7 mSv) in adolescents and young adults and analyzed the undesirable clinical and diagnostic outcomes that followed appendiceal nonvisualization. Materials and Methods: A total of 3074 patients aged 15–44 years (mean ± standard deviation, 28 ± 9 years; 1672 female) from 20 hospitals were randomized to the 2-mSv CT or conventional-dose CT group (1535 vs. 1539) from December 2013 through August 2016. A total of 161 radiologists from 20 institutions prospectively rated appendiceal visualization (grade 0, not identified; grade 1, unsure or partly visualized; and grade 2, clearly and entirely visualized) and the presence of appendicitis in these patients. The final diagnosis was based on CT imaging and surgical, pathologic, and clinical findings. We analyzed undesirable clinical or diagnostic outcomes, such as negative appendectomy, perforated appendicitis, more extensive than simple appendectomy, delay in patient management, or incorrect CT diagnosis, which followed appendiceal nonvisualization (defined as grade 0 or 1) and compared the outcomes between the two groups. Results: In the 2-mSv CT and conventional-dose CT groups, appendiceal visualization was rated as grade 0 in 41 (2.7%) and 18 (1.2%) patients, respectively; grade 1 in 181 (11.8%) and 81 (5.3%) patients, respectively; and grade 2 in 1304 (85.0%) and 1421 (92.3%) patients, respectively (p < 0.001). Overall, undesirable outcomes were rare in both groups. Compared to the conventional-dose CT group, the 2-mSv CT group had slightly higher rates of perforated appendicitis (1.1% [17] vs. 0.5% [7], p = 0.06) and false-negative diagnoses (0.4% [6] vs. 0.0% [0], p = 0.01) following appendiceal nonvisualization. Otherwise, these two groups were comparable. Conclusion: The use of 2-mSv CT instead of conventional-dose CT impairs appendiceal visualization in more patients. However, appendiceal nonvisualization on 2-mSv CT rarely leads to undesirable clinical or diagnostic outcomes.
증례 : 순환기 ; 가성동맥류를 동반한 Haemophilus parainfluenzae 인공판막 심내막염
정지현 ( Ji Hyun Jung ),김학령 ( Hack Lyoung Kim ),김혜미 ( Hyue Mee Kim ),이학승 ( Hak Seung Lee ),김지혜 ( Chee Hae Kim ),최홍미 ( Hong Mi Choi ),조주희 ( Joo Hee Zo ) 대한내과학회 2014 대한내과학회지 Vol.87 No.5
Prosthetic valve endocarditis (PVE) caused by Haemophilus parainfluenzae (H. parainfluenzae) is very rare. Here, we report a case of H. parainfluenzae PVE that developed following the Bentall procedure complicated by a pseudoaneurysm and cerebral emboli. A diagnosis was delayed in this case because of the slow-growing nature of the organism and the unusual clinical presentation. (Korean J Med 2014;87:589-592)
Jinlong Zhang,Doyeon Hwang,Seokhun Yang,Chee Hae Kim,Joo Myung Lee,Chang-Wook Nam,Eun-Seok Shin,Joon-Hyung Doh,Masahiro Hoshino,Rikuta Hamaya,Yoshihisa Kanaji,Tadashi Murai,Jun-Jie Zhang,Fei Ye,Xiaobo 대한심장학회 2022 Korean Circulation Journal Vol.52 No.1
Background and Objectives: The influence of pre-intervention coronary physiologic status on outcomes post percutaneous coronary intervention (PCI) is not well known. We sought to investigate the prognostic implications of pre-PCI fractional flow reserve (FFR) combined with post-PCI FFR. Methods: A total of 1,479 PCI patients with pre-and post-PCI FFR data were analyzed. The patients were classified according to the median values of pre-PCI FFR (0.71) and post-PCI FFR (0.88). The primary outcome was target vessel failure (TVF) at 2 years. Results: The risk of TVF was higher in the low pre-PCI FFR group than in the high pre-PCI FFR group (hazard ratio, 1.82; 95% confidence interval, 1.15–2.87; p=0.011). In 4 group comparisons, the cumulative incidences of TVF at 2 years were 3.8%, 4.1%, 4.8%, and 10.2% in the high pre-/high post-, low pre-/high post-, high pre-/low post-, and low pre-/low post-PCI FFR groups, respectively. The risk of TVF was the highest in the low pre-/low post-PCI FFR group among the groups (p values for comparisons <0.05). In addition, the high pre-/low post-PCI FFR group presented a comparable risk of TVF with the high post-PCI FFR groups (p values for comparison >0.05). When the prognostic value of the post-PCI FFR was evaluated according to the pre-PCI FFR, the risk of TVF significantly decreased with an increase in post-PCI FFR in the low pre-PCI FFR group, but not in the high pre-PCI FFR group. Conclusions: Pre-PCI FFR was associated with clinical outcomes after PCI, and the prognostic value of post-PCI FFR differed according to the pre-PCI FFR.