결핵에 의한 급성호흡곤란증후군의 사망률 및 예후 예측인자

김태옥 ( Tae ok Kim ),강현욱 ( Hyun Wook Kang ),지수영 ( Su Young Chi ),반희정 ( Hee Jung Ban ),오인재 ( In Jae Oh ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il Kim ),임성철 ( Sung Chul Lim ),김영철 ( Young Chul Kim ),권용수 ( Yong Soo 대한내과학회 2011 대한내과학회지 Vol.81 No.4

Background/Aims: Acute respiratory distress syndrome (ARDS) due to tuberculosis (TB) is a rare disease, but its mortality is believed to be high. The aim of this study was to evaluate the mortality rate and prognostic factors of ARDS. Methods: We retrospectively reviewed the demographic, clinical, radiologic, and laboratory data of 19 patients with ARDS due to active pulmonary TB at Chonnam National University Hospital between January 2000 and December 2010. Results: The median age of patients was 71.1 (interquartile range [IQR] 51-74) years. None had a history of TB treatment. The most common symptoms were dyspnea (90%), fever (68%), and cough (53%). The overall in-hospital mortality was 73%. The median acute physiologic assessment and chronic health evaluation (APACHE) III score and pneumonia severity index (PSI) were 81.9 (IQR 59.0-92.0) and 111.0 (IQR 77.0-131.0), respectively. The PSI was significantly higher in non-survivors than in survivors (55.0 vs. 122.0; p=0.016). The rate of TB treatment before admission was significantly higher in survivors than in non-survivors (75% vs. 13%; p=0.037). The time from admission to treatment initiation was significantly longer in non-survivors than in survivors (3 vs. 0 days; p=0.049). The median duration of mechanical ventilation was 11 days (IQR 5-16 days). The most common cause of death was a refractory shock (53%). Conclusions: The overall mortality rate of ARDS due to pulmonary TB was high. A high PSI score and delay of TB treatment may be risk factors for a poor outcome of ARDS due to pulmonary TB. (Korean J Med 2011;81:458-463)

Qualitative Analysis of Proteins in Two Snake Venoms, Gloydius Blomhoffii and Agkistrodon Acutus

Su-Jeong Ha,Yeo-Ok Choi,Eun-Bin Kwag,Soo-Dam Kim,Hwa-Seung Yoo,In-Cheol Kang,So-Jung Park 대한약침학회 2022 Journal of pharmacopuncture Vol.25 No.1

Objectives: Snake venom is a complex mixture of various pharmacologically active substances, such as small proteins, peptides, and organic and mineral components. This paper aims to identify and analyse the proteins in common venomous snakes, such as Gloydius blomhoffii (G. blomhoffii) and Agkistrodon acutus (A. acutus), in Korea. Methods: We used mass spectrometry, electrophoresis, N-terminal sequencing and in-gel digestion to analyse the proteins in these two snake venoms. Results: We identified eight proteins in G. blomhoffii venom and four proteins in A. acutus venom. The proteins detected in G. blomhoffii and A. acutus venoms were phospholipase A2, snake venom metalloproteinase and cysteine-rich secretory protein. Snake C-type lectin (snaclec) was unique to A. acutus venom. Conclusion: These data will contribute to the current knowledge of proteins present in the venoms of viper snakes and provide useful information for investigating their therapeutic potential.

[Ca(2+)]-dependent generation of intracellular reactive oxygen species mediates maitotoxin-induced cellular responses in human umbilical vein endothelial cells.

Yi, Sun-Ju,Kim, Kyung Hwan,Choi, Hyun Jung,Yoo, Je Ok,Jung, Hyo-Il,Han, Jeong-A,Kim, Young-Myeong,Suh, In Bum,Ha, Kwon-Soo Korean Society of Molecular Biology 2006 Molecules and cells Vol.21 No.1

<P>Maitotoxin (MTX) is known as one of the most potent marine toxins involved in Ciguatera poisoning, but intracellular signaling pathways caused by MTX was not fully understood. Thus, we have investigated whether intracellular reactive oxygen species (ROS) are involved in MTX-induced cellular responses in human umbilical vein endothelial cells. MTX induced a dose-dependent increase of intracellular [Ca(2+)]. MTX stimulated the production of intracellular ROS in a dose- and time-dependent manner, which was suppressed by BAPTA-AM, an intracellular Ca(2+) che-lator. Ionomycin also elevated the ROS production in a dose-dependent manner. MTX elevated transamidation activity in a time-dependent manner and the activation was largely inhibited by transfection of tissue transglutaminase siRNA. The activation of tissue transglutaminase and ERK1/2 by MTX was sup-pressed by BAPTA-AM or ROS scavengers. In addition, MTX-induced cell death was significantly de-layed by BAPTA-AM or a ROS scavenger. These results suggest that [Ca(2+)]-dependent generation of in-tracellular ROS, at least in part, play an important role in MTX-stimulated cellular responses, such as activation of tTGase, ERK phosphorylation, and in-duction of cell death, in human umbilical vein endothelial cells.</P>

중재 시술용 기능성 기관-기관지 팬텀의 유용성

김태형(Tae-Hyung Kim),임청환(Cheong-Hwan Lim),김정구(Jeong-Koo Kim),김명수(Myeong-Soo Kim),최원찬(Won-Chan Choi),임진오(Jin-Oh Lim),이광종(Kwang-Jong Lee),박인애(In-Ae Park),김미옥(Mi-Ok Kim),정은미(Eun-Mi Jung),신령미(Ryung-Mi Shin) 대한방사선과학회(구 대한방사선기술학회) 2003 방사선기술과학 Vol.26 No.4

중재 시술용 기능성 기관-기관지 팬텀을 제작하고, 스텐트 삽입술을 시행하여 그 유용성을 평가하고자 한다. 중재 시술용 기능성 기관-기관지 팬텀은 실리콘으로 제작하였으며, 기관을 통하여 스텐트 삽입술이 가능하도록 삽입구를 제작하였다. 팬텀은 지점토를 이용하여 인체와 동일한 형태로 기관, 기관지 분지부와 양쪽 상부 기관지를 재현하였고, 사각형의 틀에 지점토를 고정시킨 후 액상의 실리콘을 채워 건조시킨 후 지점토를 제거하여 제작하였다. 인체, 동물, 팬텀에서 기관지스텐트 삽입 후 흉부 촬영 필름의 농도와 기관지 분지부의 각도를 측정하여 비교하였다. 기관지스텐트는 세선의 교차가 다른 2가지(X-type, Y-type) 형태를 삽입하였으며, 스텐트 삽입술 후 기관 상부, 기관 분지부, 좌기관지, 우기관지, 스텐트 삽입부의 필름농도를 측정하였다. 필름농도는 기관 상부의 경우, 인체 0.76(±0.011), 동물 0.97(±0.015), 팬텀 0.45(±0.016)이었고, 기관 분지부의 경우는 인체 0.51(±0.006), 동물 0.65(±0.005), 팬텀 0.65(±0.OO8)이었고, 우기관지의 경우는 인체 0.14(±0.OO8), 동물 0.59(±0.014), 팬텀 0.04(±0.007)이었고, 좌기관지의 경우는 인체 0.54(±0.004), 동물 0.54(±O.008)로 팬텀 0.08(±0.OO8)이었고, 스텐트 삽입부의 경우는 인체 0.54(±0.004), 동물 0.59(±0.011), 팬텀 0.04(±0.007)이었다. 기관 분지부가 이루는 각도는 인체의 좌기관지에서 42.6(±2.07)˚, 우기관지에시 32.8(±2.77)˚이었으며, 동물에서 각각 43.4(±2.40)˚, 34.6(±1.94)˚, 팬텀에서 각각 35(±2.00)˚, 50.2(±1.30)˚이었다. 본 연구팀이 제작한 기관-기관지 팬텀은 기관지 스텐트 삽입술의 재현이 가능하여 중재시술의 술기연습용이나 스텐트를 평가하기 위한 체외실험에 사용이 가능할 것으로 사료된다. To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom, respectively. The film density of trachea part were O.76(±O.O11) in human, O.97(±O.015) in animal, O.45(±O.O16) in phantom. The tracheobronchial bifurcation part measured O.51(±O.OO6) in human, O.65(±O.OO5) in animal, O.65(±O.008) in phantom. The right bronchus part measured O.14(±0.008) in human, O.59(±0.014) in animal and O.O4(±O.OO7) in phantom. The left bronchus were O.54(±O.004) in human, O.54 (±0.008) in animal and O.08(±0.008) in phantom. At the stent part were O.54(±O.004) in human, O.59(±0.011) in animal and O.04(±0.007) in phantom, respectively. The tracheobronchial angle of the left bronchus site were 42.6(± 2.07)˚ in human, 43.4(±2.4O)˚ in animal and 35(±2.00)˚ in phantom, respectively. The right bronchus site were 32.8(±2.77)˚ in human, 34.6(±1.94)˚ in animal and 50.2(±1.30)˚ in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce.

환자 분류에 기초하여 입원병동의 적정 간호인력을 산정하는 모델

김경옥,박미정,이인광,박경순,손호선,김경아,서창진,차은종,Kim, Kyoung-Ok,Park, Mi-Jung,Lee, In-Kwang,Park, Kyung-Soon,Shon, Ho-Sun,Kim, Kyung-Ah,Seo, Chang-Jin,Cha, Eun-Jong 대한의용생체공학회 2016 의공학회지 Vol.37 No.2

Nursing staffing is of major interest in hospital management, however, no practical method has been developed. The present study proposed a mathematical model based on the patient classification system for nursing staffing optimization. A few characteristic parameters possibly determined experimentally and/or empirically were introduced followed by systematic calculation of the required number of nurses. An essential concept of the model is the unit work load defined as the amount of nursing work performed on single patient per unit time, where the work load is defined as the number of nursing staffs multiplied by the working hours. The unit work load was considered to vary with the patient classification level as well as the working time during a day, both of which were represented by corresponding parameter values. The number of patients for each class and the number of working hours were multiplied to the unit work load, and added up to obtain the total required work load. As the next step, the averaged number of hours that a nurse could provide per day was formulated considering the degree of nursing practice experience into 3 levels. Finally, the appropriate number of nursing staffs was calculated as the total work load divided by the average working hours per nurse. The present technique has a great advantage that the number of nursing staffs to fulfill the required work load is systematically calculated once the characteristic parameters are appropriately determined, leading to instant and fast evaluation. A practical PC program was also developed to apply the present model to nursing practice.

저층 경계면 연구용 Benthic chamber(BelcI) 개발

이재성,박경수,강범주,김영태,배재현,김성수,박정준,최옥인,Lee, Jae-Seong,Bahk, Kyung-Soo,Khang, Buem-Joo,Kim, Young-Tae,Bae, Jae-Hyun,Kim, Seong-Soo,Park, Jung-Jun,Choi, Ok-In 한국해양학회 2010 바다 Vol.15 No.1

소형선박에서 운영이 가능한 연안용 benthic chamber(BelcI)를 개발했다. 운영상에 유연성이 큰 BelcI는 연안 저층 경계면 연구에 폭넓게 이용될 수 있을 것으로 판단된다. BelcI는 몸체, 자동채수기, 교반기 및 전자제어부로 구성된다. 운영상에 유연성을 극대화하기 위해 몸체는 사각 셀 단위의 2단 구조로 설계했다. 센서신호의 증폭, 교반기 및 채수장치 제어회로를 초 전력 소모 회로로 구성하여 외부 전원장치를 제거했다. PIV(particle image velocimetry)기법으로 측정한 chamber 내부의 유체유통은 전형적인 radial-flow impeller의 특성을 나타냈다. chamber내 물의 혼합 시간은 약 30초로 추정되었으며, 바닥면에서 shear velocity($u^*$)는 약 $0.32\;cm\;s^{-1}$였다. 산경계층(DBL) 두께는 약 $180{\sim}230\;{\mu}m$였다. 현장에서 측정한 산소소모율은 약 $84\;mmol\;O_2\;m^{-2}\;d_{-1}$로 선상배양결과 보다 2배 이상 컸다. 저층 영양염 플럭스는 "질산+아질산"이 $0.18\;{\pm}\;0.07\;mmol\;m^{-2}\;d^{-1}$, 암모니움이 $2.3\;{\pm}\;0.5\;mmol\;m^{-2}\;d^{-1}$, 인산인이 $0.09\;{\pm}\;0.02\;mmol\;m^{-2}\;d^{-1}$, 규산규소가 $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$로 추정되 었다. We have developed an in-situ benthic chamber (BelcI) for use in coastal studies that can be deployed from a small boat. It is expected that BelcI will be useful in studying the benthic boundary layer because of its flexibility. BelcI is divided into three main areas: 1) frame and body chamber, 2) water sampler, and 3) stirring devices, electric controller, and data acquisition technology. To maximize in-situ use, the frame is constructed from two layers that consist of square cells. All electronic parts (motor controller, pA meter, data acquisition, etc.) are low-power consumers so that the external power supply can be safely removed from the system. The hydrodynamics of BelcI, measured by PIV (particle image velocimetry), show a typical "radial-flow impeller" pattern. Mixing time of water in the chamber is about 30 s, and shear velocity ($u^*$) near the bottom layer was calculated at $0.32\;cm\;s^{-1}$. Measurements of diffusivity boundary layer thickness showed a range of $180-230\;{\mu}m$. Sediment oxygen consumption rate, measured in-situ,was $84\;mmol\;O_2\;m^{-2}\;d_{-1}$, more than two times higher than on-board incubation results. Benthic fluxes assessed from in-situ incubation were estimated as follows: nitrate + nitrite = $0.18\;{\pm}\;0.07\;mmol\;m^{-2}\;d^{-1}$ ammonium $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$ phosphate = $0.09\;{\pm}\;0.02\;mmol\;m^{-2}\;d^{-1}$ and silicate = $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$.

S-470 : A Case of EBV-associated Angioimmunoblastic T-cell Lymphoma Mimicking Drug Hypersensitivity Syndrome

( Sang Heon Suh ),( Yu Na Jeong ),( Mi Ok Jang ),( Seung Ji Kang ),( Hee Chang Jang ),( Sook In Jung ),( Kyung Hwa Park ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

71-year old female patient was referred from an outside hospital to our facility for evaluation of persistent fever with rash in spite of in-hospital care for more than 20 days. Considering her medication history that she had been suffered from intermittent febrile sense and dry cough for about 5 months, for which other medications were prescribed from several general physicians` clinics, and lack of evidence for infection, she was tentatively diagnosed with drug hypersensitivity syndrome (DHS). While starting the treatment with intravenous methylprednisolon 62.5 mg per day, we reviewed the medical history more specifically to find out the culprit that might trigger DHS, although her medication history failed to nominate the culprit drug, because any drugs were not taken long enough to evoke DHS. Seeking for alternative diagnoses, lymphoproliferative diseases were suspected, since marked lymphadenpathies were observed in chest and abdomen computed tomography. After initial stabilization with steroid treatment, excisional biopsy from right axillary lymph nodes was done on hospital day 3. Confirmatory reading available on hospital day 8 demonstrated angioimmunoblastic lymphoma (AITL), although patient expired on hospital day 5 due to refractory hypomia by ventilator-associted pneumonia. Serologic and molecular evaluation indicated the patient`s Ebstein-barr virus (EBV) infection (Table 1). Here, we report a case of EBV-associated AITL with an unusual cutaneous manifestation mimicking DHL.

Overexpression and Inactivation of UGT73B2 Modulate Tolerance to Oxidative Stress in Arabidopsis

In A Kim,Jung-Ok Heo,장광석,이신애,Mi-Hyun Lee,Chae Eun Lim,Jun Lim 한국식물학회 2010 Journal of Plant Biology Vol.53 No.3

Glycosyltransferases (GTs) play an important role in modulating solubility, stability, bioavailability, and bioactivity of secondary metabolites, such as flavonoids. In Arabidopsis thaliana, at least 120 family 1 uridine diphosphate (UDP)-glycosyltransferases (UGTs) have been predicted. However, little is known about their substrates or their physiological roles in planta. To define the role of UGT73B2 in planta, we first characterized its expression pattern using transgenic Arabidopsis plants carrying the ciselements of UGT73B2 fused to the GUS reporter. During vegetative phase, its expression was high in embryonic and postembryonic roots, where it may play a physiological role in the glycosylation of flavonoids. Loss of function of UGT73B2 alone or in conjunction with its closest homologs,UGT73B1 and UGT73B3, confers greater tolerance to oxidative stress, whereas overexpression of UGT73B2increases sensitivity to oxidative stress. In addition, growth phenotypes of mutant and transgenic seedlings correlate well with ROS levels in planta. Our results suggest that the glycosylation of flavonoids by UGT73B2—and/or its closest homologs—modulate the response of plants to oxidative stress.

GO-56 : The Role of gastro-intestinal endoscopy as an adjunct preoperative workup in Ovarian cancer patients

( In Ok Lee ),( Yeon Soo Jung ),( Sang Wun Kim ),( Eun Ji Nam ),( Sung Hoon Kim ),( Young Tae Kim ),( Ga Won Yim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

Performing gastro-intestinal (GI) endoscopy as preoperative evaluation in gynecologic cancer has been a controversy. Postulations were published by gastroenterologist; however, reviews from Gynecologic oncologists are very rare. The aim of this study is to investigate the clinical value of endoscopies of GI system, specifically Esophagogastroduodenoscopy (EGD), and Colonoscopy, as preoperative workup in ovarian cancer patients Retrospective record reviews of patients who were treated for primary ovarian cancer at Severance Hospital between Jan. 2006 and Jan. 2011 were done. Routine preoperative evaluation consists of several image work-ups including EGD and Colonoscopy. The detection rate of incidental benign and/or malignant findings on GI endoscopy was measured. Among 430 patients, sage I was 119 (27.7%), stage II was 29 (6.7%), stage III was 199 (46.3%) , and stage IV was 80 (19.3%). 28.8% of patients had undergone GI endoscopy per guideline prior to the baseline study for ovarian cancer. 15 patients who failed to finish colonoscopy, or skipped the procedure were excluded. Malignancy in EGD was detected in 3 patients (0.7%), while benign lesions including gastritis, ulcer were noted in 54 patients (12.5%). Primary colon cancer from colonoscopy was detected in 8 patients (1.9%), while metastatic malignancy from ovary or invasion was noted in 20 patients (4.6%). Benign lesions in colon including tubular adenoma, polyps were noted in 64 patients (14.8%). None of the patients had hereditary disease for colon or ovarian cancer. Although the detection rate of malignancy from preoperative screening GI endoscopies was not high, diagnostic rate of precancerous intestinal lesions such as tubular adenoma were meaningfully detected. Considering the fact that the most of ovarian cancer patients have not undergone routine health checkup prior to diagnosis, performing EGD and colonoscopy as preoperative workup may provide prompt screening of other primary malignancy.

GATA4 negatively regulates osteoblast differentiation by downregulation of Runx2

( In Sun Song ),( Kab Sun Kim ),( Jung Ha Kim ),( Young Kyoung Lee ),( Hyun Jung Jung ),( Hae Ok Byun ),( Gye Soon Yoon ),( Nac Ksung Kim ) 생화학분자생물학회(구 한국생화학분자생물학회) 2014 BMB Reports Vol.47 No.8

Osteoblasts are specialized mesenchymal cells that areresponsible for bone formation. In this study, we examine therole of GATA4 in osteoblast differentiation. GATA4 wasabundantly expressed in preosteoblast cells and graduallydown-regulated during osteoblast differentiation. Overexpressionof GATA4 in osteoblastic cells inhibited alkalinephosphatase activity and nodule formation in osteogenicconditioned cell culture system. In addition, overexpressionof GATA4 attenuated expression of osteogenic marker genes, including Runx2, alkaline phosphatase, bone sialoprotein, and osteocalcin, all of which are important for osteoblastdifferentiation and function. Overexpression of GATA4attenuated Runx2 promoter activity, whereas silencing ofGATA4 increased Runx2 induction. We found that GATA4interacted with Dlx5 and subsequently decreased Dlx5binding activity to Runx2 promoter region. Our data suggestthat GATA4 acts as a negative regulator in osteoblastdifferentiation by downregulation of Runx2.