관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

THI에 의한 서울시 지하철 역사 근로자의 신체 및 심리적 증상에 관한 연구

손종렬,김선철,변상훈,문경환,김영환 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.2

This paper reports an investigaion for the health status of subway workers in the 67 subway stations in the Seoul area during from September 15th to Nobimber 15th, 2002 . Prevalence of subuective complaints was surveyed of 400 subway workers applied by a general health questionnaire-the Todai Health index(THI). The basic tool employed in this present study was the THI which is modified Comell Medical Index(CMI) and was developed by Tokyo University Research Team in Japan, and had been used to evaluate manufacturing workers, iron workers and other workers by Kim(1979), Chung(1982), Lym(1987), Lee(1996) in Korea. The results were summarized as follows; 1. The physical and psychological complaints were much higher in the 20~29 age group than other age groups. 2. The physical and psychological complaints showed a high tendency of increased incidence in all items as length of service decreased, and the 3~5 years group was higher than less 1 year group with regard to the symptoms of Digestive(C), Aggressiveness(F), Nervousness(E). 3. The physical and psychological complaints showed much higher tendency in the station staff(S?S) group than other groups. 4. The physical and psychological complaints showed much higher tendency in the under station(Un.S) and upper station (Un.S) groups than other groups. 5. The responses of physical and psychological complaints by monthly pay showed much higher tendency in he income of 10.1~1.50 millions won group than other groups. 6. The responses of physical and psychological complaints by smoker or non-smoker showed much higher tendency in the smoker group than non-smoker group. Therefore, it can be concluded that the worker of subway studied was perceived as acceptable the importance of health status, and suggested that the goverment of related subway need to be effort to control the health of subway workers in environment of indoor.

항암화학요법을 받는 암 환자에 대한 Nucare^R의 영양지지효과

조덕연,김현수,곽상혁,강정현,김철희,배광봉,김종숙,박상준,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Purpose : The purpose of this study was to evaluate the effect of nutritional support with enteral liquid supplement in cancer patients receving chemotherapy for possible benefit in nutritional, immunologic and golbal function of patients. Patients and Methods : From October 1995 to February 1997, 30 advanced cancer patients receving chemotherapy were divided two roups. The Nycare group, in addition to normal diet, Nucare^R enteral supplement was given for 1week right after chemotherapy for the duration of 2 chemotherapy cycles. Control group received only normal diet without parenteral fluid supplement for 2 chemotherapy cycles. Results : Median ages were 53 end 56 years for Nucare group and Contrl group respectively. Performance scores was less than 2 by ECOG scale. All patients were stage Ⅲ or Ⅳ. The physical parameters, such as weight, arm muscle circumference(AMC) and triceps skin fold(TSF) were decreased in both groups after 2 cycles of anticancer therapy. but it was less severe in Nucare group(p<0.05). Serum transferrin was maintained in mild deficit state in Nucare group, whereas it aggravated form mild to moderate deficit in Control group(p<0.05). Serum albumin level increased in Nucare group without statistical significance. but it decreased from normal to mild deficit in Control group. Serum total protein did not change significantly in Nucare group. but in Control group, serum total protein was decreased from 7.24±0.9 to 6.52±0.5(P<0.05). Total lymphocyte count did not change significantly in both groups. Conclusion : This study shows that the nutritional support with Nucare^R was effective in the prevention of nutritional deficit status in patients receving a nticancer chemotherapy.

발효조를 이용한 Monascus anka의 적색소와 황색소의 생산

강성국,임종환,정순택,김선재 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.6

Monascus anka를 이용하여 천연식용색소를 대량생산하기 위한 방법을 개발하기 위하여 발효조를 이용하여 적색소와 황색소의 색소생산의 최적 배양 조건과 생산된 색소의 색깔 특성을 조사하였다. Monascus anka 적색소와 황색소를 생산하였는데, 이들 색소는 균체내색소와 균체외 색소로 구분되었다. 균체의 적색소(ERP)는 494nm에서, 균체외 황색소(EYP)는 380nm에서, 균체내 적색소(IRP)는 506nm에서 그리고 균체내 황색소(IYP)는 388nm에서 최대 흡광도를 나타냈다. 적색소와 황색소 생산, 색조의 특성 및 균체증식력을 배양 온도, pH, 쌀가루 농도, peptone 농도, magnesium sulfate 농도, 통기량 및 교반속도에 대하여 조사한 결과 적색소 생산력은 30℃, 초기 pH 6.0, 쌀가루 농도 3~5%, peptone 농도 0.05%, magnesium sulfate 농도 0.25%, 통기량 0.1vvm 교반속도 300rpm의 조건에서 최대치를 보였으며, 이때 ERP, EYP, IRP 및 IYP는 각각 A_494nm 0.84, A_380 nm 0.71, A_506 nm 1.18, A_388 nm 1.10, L값은 각각 29.40, 6.44, 34,98, 8.94, a값은 각각 5.76, -1.08, 11.83, -1.55, b값은 각각 18-19, 3.41 27.26, 6.16 그리고 균체량은 7.4 g/l을 보였다. 또한 황색소 생산력은 온도의 경우 적색소 생산을 위한 최적온도 보다 높은 35℃ 부근에서 우수하였으며 초기 pH와 쌀가루 농도는 적색소 생산을 위한 최적조건과 같았고, 질소원과 무기염의 농도가 높을수록 그리고 통기량이 많을수록 황색소 생산력이 우수하였다. 적색소와 황색소 생산을 위한 발효조의 교반속도는 100~300 rpm이 적합하였다. Production of Red and Yellow Pigments from Monascus anda in a Jar Fermenter, Seong-Gook Kang, Jong-Whan Rhim, Soon-Teck Jung^* and Sun-Jae Kim. Department of Food Engineering. Mokpo National University Chonnam, 534-729, Korea - In order to develop the method for mass production of natural food colorant from Monascus anka, optimum cultivation conditions for producing red and yellow pigments by cultivating the mold in a jar fermenter and their color characteristics were investigated. The mold produced red and yellow pigments both intracellularly and extracellularly. These pigments showed unique light absorption characteristics with maximum absorption of 494, 380, 506, and 388 nm for extracellular red pigment (ERP), extracellular yellow pigment (EYP), intracellular red pigment (IRP), and intracellular yellow pigment (IYP), respectively. Optimum conditions for producing red pigments were found to be temperature 30℃, initial pH 6.0, rice powder 3~5%, peptone 0.05%, magnesium sulfate 0.25%, aeration rate 0.1vvm. Optimum temperature for producing yellow pigments was around 35℃ which is higher than that of producing red pigments. The initial pH rice powder concentration for producing yellow pigments were the same as those of producing red pigments. The higher concentration of nitrogen source and inorganic salt, aeration rate, the more the yellow pigments were produced. Them optimum agitation speed was 100~300 rpm for pigment production.

La, Mg 이온교환 ZSM-5 촉매의 제조와 촉매 산강도에 따른 MTO 반응 활성의 검토

김한일,황종현,정태환,정석진 경희대학교 산학협력기술연구원 1997 산학협력기술연구논문집 Vol.3 No.-

The MTO(methanol to olefin) process that aims at the production of olefins from methanol has attracted research interest because of its possiblity as another source of raw material in petrochemical industries. However its reaction path is not only ceased at the point of olefin production but also much amount of by products such as paraffins and aromatics that accelerate carbon deposit are produced. Thus the catalyst deactivation is rapidly progressed. In order to maximize the selectivity from methanol to olefin, alkylation and aromatization should be excluded from reaction path through catalyst and process variables. In this viewpoint, as a solution of the former problem, various metals were substituted on HZSM-5 which is used in commercial MTO process. With NH_3 TPD and activity test, the correlation between reaction products and possibility in control of Bro¨nsted acid site which is reported as the reaction active site was investigated. In this study, ethylene and propylene are the target products because of their wide applicating field.

방풍림의 효용과 조성

김종성,손요환 고려대학교 자연자원연구소 2000 自然資源科學硏究 Vol.8 No.-

PCR을 이용한 Rat 기관지 세척액에서의 Pneumocystis carinii DNA의 검출 : 기초실험 A pilot study

김주옥,홍석철,한표성,이종진,김선영,이영하,신대환 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.1

Background: Pneumocystis carinii (PC) is a opportunistic pathogen causing serious pneumonia (Pneumocystis carinii pneumonia : PCP) in immunosuppressed patients including AIDS. Laboratory diagnosis of PCP is dependent on microscopic demonstration of the PC by using cytochemical staining or by immunocytochemical staining with monoclonal antibodies. However, these staining methods are not highly sensitive. The development of the polymerase chain reaction (PCR) has made it possible to detect very small numbers of pathogens in clinical specimens. To establish the usefulness of PCR for detection of PC DNA, We performed PCR as a pilot study. Methods: PCP was induced on Spraque-Dawley rats with prednisolone 5mg IM twice a week. Bronchial lavages, impression smears, and permanent sections were performed from the 3rd week to 7th week of cortisonized rats. PC DNA was extracted with bead beater / 10% CTAB method. Results: Impression smears showed PC cyst after the 4th week (100%, 28/28 rats), and permanent sections showed 27/28 rats. Control rats showed some PC cysts (2/7). PCR result was positive only one case among the 6th week rats (1/7), But positive 6 cases at the 7th week rats, (6/7). Among control rats. 2 cases were positive (2/7). ??This data is a pilot study for the PC DNA detection using a PCR. PCP were successfully cortisonized rats. If adequate bronchial washing technique will be used, PCR can be a sensitive for PC DNA detection.

Retinoic acid에 의해 유발된 흰쥐의 구개열에서 Transforming Growth Factor-beta 1, 2, 3의 발현의 변화

김종환,박진혁,신선호,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : Craniofacial malformations are among the most frequent congenital birth defects in humans : cleft palate, that is inadequate fusion of the palatal shelves. Retinoic acid is teratogenic in many species, producing multiple malformations, including cleft palate. Also it plays an important role in embryogenesis, by regulating morphogenesis, cell proliferation, differentiation, and deposition of the extracellular matrix. The effects of retinoic acid which leads to cleft palate vary depending on the stage of development exposed. After exposure of embryonic mice to retinoic acid on gestational day(GD) 10, abnormally small palatal shelves form. And the elevation of palatal shelves is delayed. The growth and differentiation factor, transforming growth factor-beta(TGFβ) family is thought to play important roles in multiple developmental processes, especially, the development of the embryonic palate. The expression of the TGFβ family in embryonic palate suggests a functional role for these molecules. In this study, author has determined the tissue distributions of TGFβ family in murine embryonic palate, and compared them in terms of developmental stage and locations in normal and retinoic acid-induced cleft palate. Methods and Material : Retinoic acid was administered orally at gestational day(GD) 10 to ICR mice. The pregnant mice were sacrifeced on GD 12, 13. 14, 15 to obtain the fetuses and immunohistochemistry was performed. And using the scanning electron microscope, morphology of normal palate and cleft palate was studied. Results : In the retinoic acid-treated fetuses, palatal shelves did not elevate and cleft palate was induced. On GD 13 in the palates of the retinoic acid-treated fetuses, expression of the TGFβ1, 3 decreased dramatically, but that of TGFβ2, did not change. The expression of the TGFβ1, 3 in the palates of the retinoic acid-treated fetuses, increased on GD 14, 15, Significant differences in TGFβ family expression were observed with areas of the palate. Conclusion : These results suggest that retinoic acid inhibits the expression of TGFβ 1, 3, which is critical in the developing palate, and elevation of palatal shelves is delayed and impaired, therefore cleft palate is induced. These data demonstrate a role for retinoic acid and retinoic aicd-induced TGFβ family in the regulation of palatal development and suggest a role for TGFβ in retinoic acid-induced cleft palate.

측정방법별 실내공기 중 폼알데하이드 농도 비교

김영환,손종렬,문경환 高麗大學校 倂設 保健大學 保健科學硏究所 1999 保健科學論集 Vol.25 No.1

This study was conducted to identify suitable methods for measurement of formaldehyde in ambient air at sub-ppm levels. Experiments were designed to compare four different analysis procedures including NIOSH Method No. 3500, NIOSH Method No.2541, EPA Method No. 67 and passive tube method under favorable conditions(laboratory exposure chamber) and in ambient air of the household furniture shops. The results were as follows : 1. Absolute bias by each method were less than 26.8% at the theoretical exposure concentration of 0.21ppm and all methods except the passive method produced precise results at this levels. Use of the NIOSH Method No. 3500 indicated accuracy was approximately 1.5-2.8 times higher than those determined by NIOSH Method No. 2541 and EPA Method No. 67. 2. EPA Method No. 67 had the best precision and accuracy at 0.12ppm level similar to the current regulatory limit for the formaldehyde in ambient air. 3. The amounts of released formaldehyde for household furniture shops were 0.040ppm by NIOSH Method No. 3500. 0.051ppm by NIOSH Method No.2541. 0.054ppm by EPA Method No. 67 and 0.096ppm by passive tube method, respectively. The concentrations indicated by passive tube method were consistently higher than those measured by the other methods. No statistically significant differences of formaldehyde concentrations among ambient air except the passive tube method were found (p<0.05),

북한이탈주민의 외상 후 스트레스 장애와 자연살해세포 활성

김병창,정성훈,임효덕,최종혁,전정희,전양환 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.5

Objectives : The objective of this study was to evaluate an association between posttraumatic stress disorder (PTSD) and altered immunity m North Korean defectors who were more likely to develop medical conditions and other stress-related psychiatric disorders. Methods : Twenty-four North Korean defectors with PTSD and twenty-two controls without PTSD were recruited from the resettlement and training center for North Korean defectors in South Korea. Peripheral T lymphocyte subsets, natural killer(NK) cells, NK cell activity and plasma hormones (ACTH and cortisol) were obtained from all subjects. We also applied the Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) for all subjects. Results : We found NK cell activity was relatively lower than number of NK cells in North Korean defectors with PTSD. Subjects with PTSD had higher HAM-D and HAM-A scores than controls. However, there were no statistical differences in ACTH. cortisol, CD3, CD4, CD8, CD4/CD8 ratio, CD19 and CD56 between the two groups. Conclusion : These findings suggest North Korean defectors with PTSD show higher levels of depression, anxiety and impaired or weak immune function in NK cells.