기관지폐 이형성증의 임상 양상: 다기관 연구

성기혜 ( Ki Hye Sung ),김민희 ( Min Hee Kim ),김은령 ( Eun Ryoung Kim ),심재원 ( Jae Won Shim ),이정주 ( Jung Ju Lee ),임재우 ( Jae Woo Im ),진현승 ( Hyun Seung Jin ) 대한주산의학회 2009 Perinatology Vol.20 No.3

목적: 최근 극소 저출생 체중아의 생존율의 개선으로 기관지폐 이형성증(bronchopulmonary dysplasia, BPD)이 늘고 있다. 다기관 연구에 의해 전국적인 BPD의 역학, 임상 양상과 각 병원 간의 차이를 조사하여 향후 우리나라의 BPD 감소와 중증도를 줄이는 것을 목적으로 본 연구를 시행하였다. 방법: 2005년 6월부터 2007년 5월까지 건국대학교병원, 영등포 성애병원, 강북삼성병원, 중앙대학교병원, 건양대학교병원, 강릉아산병원의 신생아 집중 치료실에 입원하였던 신생아 4,476명을 대상으로 하였다. BPD의 진단 기준은 비전형적인 BPD를 포함하여 병인적인 분류를 하고 있는 Ogawa 등의 분류법을 이용하여 신생아 호흡 곤란 증후군(respiratory distress syndrome, RDS)과 전형적 또는 미만성 혼탁의 방사선 소견, 산전 감염의 유무에 따라 6가지 type으로 분류하였다. 또한 전체 신생아의 출생체중 분포와 생존율, 각 출생체중 군별 BPD의 발생률, 병태 비율, 사망률 등을 조사하고, 이 후 재택 산소요법 시행 여부와 미숙아 망막증, 괴사성 장염 등의 합병증 여부를 조사하였다. 결과: 생후 28일째 산소 치료가 필요한 신생아는 89명이었고, 이 중 Ogawa 분류법에 의한 BPD 환아는 70명(1.6%)이었으며, 특히 1,500 g 미만의 환아 237명 중 60명(25.3%)이었다. 생후 28일 이상 생존율은 98.7%이고, 사망 예는 없었으며 평균 재원 기간은 97.8±51.2일(43~405일)이었다. BPD는 900~999 g, 1,000~1,249 g의 체중 군에서 발생률이 각각 15명(21.4%)으로 가장 높았으며, 교정 36주 이후에도 산소투여가 필요한 중증 BPD의 경우 900~999 g의 체중 군에서 7명(23.3%)로 가장 높았다. Ogawa 분류법으로 BPD의 각 병태 비율로는 RDS 이후에 나타나는 I, II형이 각각 전체의 17예(24.3%), 44예(62.9%)로 대다수를 차지하였다. 이외에도 III`형은 2예(2.9%), IV형은 2예(2.9%), V형은 5예(7.1%)이었고, III형, VI형은 없었다. 재택 산소요법은 8예에서 시행되어 전체의 11.4%였으며, 이 중 BPD I형이 7예로 87.5%를 차지하였다. 미숙아 망막증은 35명(50.0%)에서 발생하였으며, 700 g 이하 신생아에서 9예(26.5%)로 가장 많았다. 또한 괴사성 장염은 3명(4.3%)이었다. 결론: 본 연구는 국내에서 처음으로 진행된 BPD의 전국적인 다기관 역학 조사로, 대상 신생아의 Ogawa 분류에 의한 BPD 유병률은 1.6% 이었고 1,500 g 미만 신생아의 25.3%이었으며, 전체 신생아의 BPD 70명 중 Ogawa 분류의 I, II형이 각각 24.3%, 62.9%로 대다수를 차지하였다. Purpose: As the neonatal intensive care advanced, the incidence of neonatal bronchopulmonary dysplasia (BPD) has increased. We conducted a multi-center investigation of the prevalence of BPD in six hospitals to investigate the epidemiology of BPD in Korea. Methods: Retrospective reviews ware performed for survival rate, prevalence of BPD of total 4,476 newborn infants who were admitted to neonatal intensive care unit in Konkuk university hospital, Sung-Ae General hospital, Kangbuk Samsung hospital, Chung-Ang university hospital, Konyang university hospital, and Gangneung Asan hospital between June, 2005 and May, 2007. By Ogawa, BPD was defined as oxygen dependency at 28 days after birth, with respiratory distress symptoms and the change of chest x-ray finding, and classified as 6 subtypes. Classic BPD was defined as oxygen dependency at 36 weeks of postmenstrual age. Results: Survival rate at 28 day after birth was 98.7%. BPD infants by Ogawa classification were 70 (1.6% of overall newborn infants), classic BPD infants were 30 (0.7%). Especially, among 237 preterm infants with birth weight less than 1,500 gram who survived to 28 days of life, 60 (25.3%) had BPD by Ogawa classification and 23 (9.7%) had classic BPD. In Ogawa classification, infants with RDS as type I and II, were 17 infants (24.3%) and 44 infants (62.9%). Home oxygen therapy was performed 8 infants (11.4%). Prevalence of retinopathy of prematurity was 35 infants (50.0%), necrotizing enterocolitis was 3 infants (4.3%), and intraventricular hemorrhage was 6 infants (8.6%). Conclusion: Prevalence of BPD infants was 1.6% of overall newborn, 25.3% of preterm infants with birth weight less than 1,500 gram. Among 70 BPD infants, BPD by Ogawa classification with history of RDS as type I and II were 24.3%, 62.9% as the majority of BPD. This study would be the first report of epidemiology of Korean BPD infants by multi-center study.

Influence of Propofol and Fentanyl on Deep Brain Stimulation of the Subthalamic Nucleus

Kim, Wonki,Song, In Ho,Lim, Yong Hoon,Kim, Mi-Ryoung,Kim, Young Eun,Hwang, Jae Ha,Kim, In Keyoung,Song, Sang Woo,Kim, Jin Wook,Lee, Woong-Woo,Kim, Han-Joon,Kim, Cheolyoung,Kim, Hee Chan,Kim, In Young The Korean Academy of Medical Sciences 2014 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.29 No.9

<P>We investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery. We isolated single unit activities from the left and the right side MERs. There was no significant difference in the mean firing rate between the left side MERs (38.7±16.8 spikes/sec, n=78) and the right side MERs (35.5±17.2 spikes/sec, n=66). The bursting pattern of spikes was more frequently observed in the right STN than in the left STN. All the electrode positions were within the STNs on both sides and the off-time Unified Parkinson's Disease Rating Scale part III scores at six months after surgery decreased by 67% of the preoperative level. In this study, a continuous infusion of propofol and fentanyl did not significantly interfere with the MER signals from the STN. The results of this study suggest that propofol and fentanyl can be used for STN DBS in patients with advanced Parkinson's disease improving the overall experience of the patients.</P><P><B>Graphical Abstract</B></P><P/>

Effect of Salinity, Temperature, and Glucose on the Production of Vibrio vulnificus Hemolysin

Kim, Hyun-Soo,Shin, Sung-Heui,Park, Hae-Ryoung,Lee, Shee-Eun,Kim, Choon-Mee,Kim, Soo-Young,Kim, Young-Ran,Lee, Hyun-Chul,Chung, Sun-Sik,Rhee, Joon-Haeng The Korean Society for Microbiology 2002 Journal of Bacteriology and Virology Vol.32 No.4

Among the exotoxins produced by V. vulnificus, hemolysin (HS) has been reported to be the most potent one. To investigate the factors up- or down-regulating HS production in the context of pathogenesis, we observed the effects of salinity or/and temperature shifting, glucose, and acidic pH on the production of HS by V. vulnificus C7184 strain in vitro. Significantly more HS was produced when V. vulnificus was cultured in 0.9% salinity and $37^{\circ}C$ than in 2.5% and $25^{\circ}C$. When the culture condition reflecting natural habitat of V. vulnificus (2.5% salinity and $25^{\circ}C$) was changed into that reflecting human body (0.9% salinity and $37^{\circ}C$), 2.5 fold or more HS was produced than in the V. vulnificus being cultured continuously in 0.9% NaCl at $37^{\circ}C$. This result suggests that V. vulnificus somehow recognizes the shifting in salinity and temperature and stimulate HS production. Glucose addition in the culture medium resulted in a dose-dependent decrease in the HS production. Glucose itself and acidic pH resulting from its metabolism both appeared to inhibit the HS production. Glucose in itself had more dominant role in suppressing the HS production than the lowered pH accompanying the metabolism of glucose. This result suggests that HS production is down-regulated in the presence of glucose and under environmental acidic pH.

Airway Responsiveness to Inhaled Aspirin is Influenced by Airway Hyperresponsiveness in Asthmatic Patients

( Sung Soo Kim ),( Inseon S. Choi ),( Yeon Joo Kim ),( Chang Seong Kim ),( Eui Ryoung Han ),( Dong Jin Park ),( Dae Eun Kim ) 대한내과학회 2010 The Korean Journal of Internal Medicine Vol.25 No.3

Background/Aims: Many patients with aspirin-induced asthma have severe methacholine airway hyperresponsiveness (AHR), suggesting a relationship between aspirin and methacholine in airway response. This study was performed to determine whether methacholine AHR affects the response of asthmatics to inhaled aspirin. Methods: The clinical records of 207 asthmatic patients who underwent inhalation challenges with both aspirin and methacholine were reviewed retrospectively. An oral aspirin challenge was performed in patients with a negative inhalation response. The bronchial reactivity index (BRindex) was calculated from the percent decrease in lung function divided by the last dose of the stimulus. Results: Forty-one (20.9%) and 14 (7.1%) patients showed a positive response to aspirin following an inhalation and oral challenge, respectively. Only 24.3 and 14.3% of the responders had a history of aspirin intolerance, respectively. The methacholine BRindex was significantly higher in the inhalation responders (1.46±0.02) than in the oral responders (1.36±0.03, p<0.01) and in non-responders (n=141, 1.37±0.01, p<0.001). The aspirin BRindex was significantly correlated with the methacholine BRindex (r=0.270, p<0.001). Three of four patients who received the oral challenge, despite a positive inhalation test, showed negative responses to the oral challenge. Two of these patients had severe AHR. Conclusions: A considerable number of asthmatic patients with no history of aspirin intolerance responded to the inhalation aspirin challenge. The airway response to aspirin was significantly correlated with methacholine-AHR, and a false-positive response to aspirin inhalation test seemed to occur primarily in patients with severe AHR. (Korean J Intern Med 2010;25:309-316)

Mechanism Underlying Shikonin-induced Apoptosis and Cell Cycle Arrest on SCC25 Human Tongue Squamous Cell Carcinoma Cell Line

Sang-Hun Oh,Sung-Jin Park,Su-Bin Yu,Yong-Ho Kim,In-Ryoung Kim,Bong-Soo Park 대한구강생물학회 2015 International Journal of Oral Biology Vol.40 No.1

Shikonin, a major ingredient in the traditional Chinese herbLithospermumerythrorhizon, exhibits multiple biologicalfunctions including antimicrobial, anti-inflammatory, andantitumor effects. It has recently been reported that shikonindisplays antitumor properties in many cancers. This study wasaimed to investigate whether shikonin could inhibit oralsquamous carcinoma cell (OSCC) growth via mechanisms ofapoptosis and cell cycle arrest. The effects of shikonin on theviability and growth of OSCC cell line, SCC25 cells wereassessed by MTT assay and clonogenic assays, respectively. Hoechst staining and DNA electrophoresis indicated that theshikonin-treated SCC25 cells were undergoing apoptosis. Western blotting, immunocytochemistry, confocal microscopy,flow cytometry, MMP activity, and proteasome activity alsosupported the finding that shikonin induces apoptosis. Shikonin treatment of SCC25 cells resulted in a time- anddose-dependent decrease in cell viability, inhibition of cellgrowth, and increase in apoptotic cell death. The treatedSCC25 cells showed several lines of apoptotic manifestationas follows: nuclear condensation; DNA fragmentation;reduced MMP and proteasome activity; decrease in DNAcontents; release of cytochrome c into cytosol; translocation ofAIF and DFF40 (CAD) onto the nuclei; a significant shift inBax/Bcl-2 ratio; and activation of caspase-9, -7, -6, and -3, aswell as PARP, lamin A/C, and DFF45 (ICAD). Shikonintreatment also resulted in down-regulation of the G1 cellcycle-related proteins and up-regulation of p27KIP1. Takentogether, our present findings demonstrate that shikoninstrongly inhibits cell proliferation by modulating theexpression of the G1 cell cycle-related proteins, and that itinduces apoptosis via the proteasome, mitochondria, andcaspase cascades in SCC25 cells.

Induction of Quinone Reductase, an Anticarcinogenic Marker Enzyme, by Extract from Chrysanthemum zawadskii var. latilobum K.

Kim, Ju-Ryoung,Kim, Jung-Hyun,Lim, Hyun-Ae,Jang, Chan-Ho,Kim, Jang-Hoon,Kwon, Chong-Suk,Kim, Young-kyun,Kim, Jong-Sang The Korean Society of Food Science and Nutrition 2005 Preventive Nutrition and Food Science Vol.10 No.4

Induction of NAD(P)H:(quinone-acceptor) oxidoreductase (QR) which promotes obligatory two electron reduction of quinones and prevents their participation in oxidative cycling and thereby the depletion of intracellular glutathione, has been used as a marker for chemopreventive agents. Induction of phase II enzyme is considered to be an important mechanism of cancer prevention. In our previous study, we assessed the quinone reductase QR-inducing activities of 216 kinds of medicinal herb extracts in cultured murine hepatoma cells, BPRc1 and hepalc1c7 cells. Among the 216 herbal extracts tested in that study, extracts from Chrysanthemum zawadskii showed significant induction of QR. In this study, we examined QR-inducing activity of solvent fractions of the herbal extract. The dichloromethane fraction of the herb showed the highest QR induction among the samples fractionated with four kinds of solvents with different polarity. The fraction also significantly induced the activity of glutathione S-transferase (GST), one of the major detoxifying enzymes, at $4{\mu}g/mL\;and\;2{\mu}g/mL$ in hepalc1c7 and BPRc1 cells, respectively. In conclusion, dichloromethane-soluble fraction of Chrysanthemum zawadskii which showed relatively strong induction of detoxifying enzymes merits further study to identify active components and evaluate their potential as cancer preventive agents.

Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study

Kim Chul,Sung Jidong,Han Jae-Young,Jee Sungju,Lee Jang Woo,Lee Jong Hwa,Kim Won-Seok,Bang Heui Je,Baek Sora,Joa Kyung Lim,Kim Ae Ryoung,Lee So Young,Kim Jihee,Kim Chung Reen,Kwon Oh Pum 대한의학회 2022 Journal of Korean medical science Vol.37 No.14

Background: In Korea, the actual distribution of cardiac rehabilitation (CR) to the clinical field is insufficient due to the many barriers for cardiovascular patients to participate in CR. Community-based CR is a useful alternative to overcome these obstacles. Through a nationwide survey, we investigated the possibility of regional medical and public health management institutes which can be in charge of community-based CR in Korea. Methods: The questionnaires on recognition of CR and current available resources in health-related institutions were developed with reference to the CR evaluation tools of York University and the International Council of Cardiovascular Prevention and Rehabilitation. The questionnaires were sent to regional public and private medical institutions and public health management institutions. Results: In total, 2,267 questionnaires were sent to 1,186 institutions. There were 241 and 242 responses from 173 and 179 regional private and public medical institutions, respectively. And a total of 244 responses were gathered from 180 public health management institutions. Although many institutions were equipped with the necessary facilities for exercise training, there were few patient-monitoring systems during exercise. Most institutions were aware of the need for CR, but were burdened with the cost of establishing personnel and facilities to operate CR. Conclusion: Most regional medical, and public health management institutions in Korea are unprepared for the implementation of community-based CR programs. To encourage the utilization of such, there should be efforts to establish a national consensus.

Effect of Co-Culture with Mammalian Spermatozoa on Maturation in vitro of Porcine Cumulus-Free Germinal Vesicle Oocytes

Kim, Byung-Ki,Kang, Sung-Ryoung,Yim, Cha-Ok,Han, Chang-Hee,Lee, Bok-Kyu,Lee, Kwang-Sun Korean Society of Life Science 2003 생명과학회지 Vol.13 No.5

본 연구는 난구세포가 제거된 돼지 미성숙 난자와 포유동물 정자의 공배양이 체외핵성숙에 미치는 영향을 조사하기 위하여 실시하였다. 난구세포가 부착된 미성숙난자를 직경 3-5 mm난포로부터 채취하여 난구세포를 제거한 후 정자가 첨가된 tissue culture medium 199에서 배양하였다. 배양 후 48시간에 난자의 핵성숙을 핵막붕괴, 제일차 감수분열 중기, 제일차 감수분열 후기-말기, 제이차감수분열 중기로 판정하였다. 배양 후 제이차감수분열 중기로 성숙한 난자의 비율이 무첨가구에 비하여 정자가 첨가된 배양액에서 성숙시킨 미성숙난자에서 유의적인(P<0.01) 증가가 있었다$(31.9\pm1.8%\; vs\; 14.9\pm1.0%)$. 난자의 성숙 단계에 따른 정자의 노출시간과 정자가 유래한 종에 따라서는 차이가 없었다. 그러나 정자의 첨가농도에 따라 유의적인 차이가 인정되었다. 본 연구는 포유동물의 정자는 미성숙난자의 체외성숙을 촉진하는 물질을 갖고 있으며, 촉진 효과는 농도에 의존하는 것으로 암시하고 있다. The purpose of this study was to determine if the addition of spermatozoa into the culture medium could influence the nuclear maturation of denuded porcine germinal vesicle (GV) oocytes in vitro. Cumulus-oocyte complexes were collected from follicles of 3 to 5 mm in diameter, The cumulus and corona cells were removed from oocytes. Porcine denuded oocytes were cultured in tissue culture medium containing spermatozoa. After 48 h culture, oocytes were examined for the evidence of GV breakdown, metaphase I, anaphase-telophase I, and metaphase II (M II). The proportion of oocytes reaching M II stage was significantly (P<0.01) increased in the oocytes cultured in media containing spermatozoa compared to those in media without spermatozoa $(31.9\pm1.8%\; vs\; 14.9\pm1.0%)$.No differences in the rates of M II were observed among the different period of spermatozoa exposure nor among the spermatozoa from different species. The proportion of oocytes reaching M II stage was significantly different between high and low concentrations of spermatozoa. The present study suggests that mammalian spermatozoa contain a substance(s) that improves nuclear maturation in vitro of GV oocytes. Enhancing effect of spermatozoa for oocytes maturation in vitro is a highly dose-dependent.

Combined effect of bisphosphonate and recombinant human bone morphogenetic protein 2 on bone healing of rat calvarial defects

Kim, Ho-Chul,Song, Jae-Min,Kim, Chang-Joo,Yoon, Sang-Yong,Kim, In-Ryoung,Park, Bong-Soo,Shin, Sang-Hun Korean Association of Maxillofacial Plastic and Re 2015 Maxillofacial Plastic Reconstructive Surgery Vol.37 No.-

Background: This study aimed to investigate new bone formation using recombinant human bone morphogenetic protein 2 (rhBMP-2) and locally applied bisphosphonate in rat calvarial defects. Methods: Thirty-six rats were studied. Two circular 5 mm diameter bony defect were formed in the calvaria using a trephine bur. The bony defect were grafted with $Bio-Oss^{(R)}$ only (group 1, n = 9), $Bio-Oss^{(R)}$ wetted with rhBMP-2 (group 2, n = 9), $Bio-Oss^{(R)}$ wetted with rhBMP-2 and 1 mM alendronate (group 3, n = 9) and $Bio-Oss^{(R)}$ wetted with rhBMP-2 and 10 mM alendronate (group 4, n = 9). In each group, three animals were euthanized at 2, 4 and 8 weeks after surgery, respectively. The specimens were then analyzed by histology, histomorphometry and immunohistochemistry analysis. Results: There were significant decrease of bone formation area (p < 0.05) between group 4 and group 2, 3. Group 3 showed increase of new bone formation compared to group 2. In immunohistochemistry, collagen type I and osteoprotegerin (OPG) didn't show any difference. However, receptor activator of nuclear factor ${\kappa}B$ ligand (RANKL) decreased with time dependent except group 4. Conclusion: Low concentration bisphosphonate and rhBMP-2 have synergic effect on bone regeneration and this is result from the decreased activity of RANKL of osteoblast.

Improvement of the performance of inverted polymer solar cells with a fluorine-doped tin oxide electrode

Kim, Jae-Ryoung,Cho, Jung Min,Lee, A-Rum,Chae, Eun Ah,Park, Jin-Uk,Byun, Won-Bae,Lee, Sang Kyu,Lee, Jong-Cheol,So, Won-Wook,Yoo, Seunghyup,Moon, Sang-Jin,Shin, Won Suk Elsevier 2011 CURRENT APPLIED PHYSICS Vol.11 No.1

<P><B>Abstract</B></P><P>We prepared the inverted polymer solar cells (PSCs) with a fluorine-doped tin oxide (FTO) as a transparent electrode and with TiO<SUB>2</SUB>, WO<SUB>3</SUB> and WO<SUB><I>x</I></SUB> as selective charge transport layers. An adequately thick TiO<SUB>2</SUB> nanoparticles layer was employed for covering a very rough FTO surface. Using a solution-based WO<SUB><I>x</I></SUB> film instead of a vacuum deposited WO<SUB>3</SUB> layer in inverted polymer solar cells showed comparable device performance. A self-assembled molecular (SAM) layer of PCBA and N719 on top of TiO<SUB>2</SUB> improves the device performance by reducing the series resistance at the interface between the active layer and the TiO<SUB>2</SUB> film. The power conversion efficiency (PCE) was improved by 16%, especially in the case of [6,6]-phenyl-C<SUB>61</SUB>-butyric acid (PCBA).</P> <P><B>Highlights</B></P><P>► Inverted polymer solar cells on FTO electrode with various buffer and SAM layers. ► TiO<SUB>2</SUB>, WO<SUB>3</SUB>, and WO<SUB>x</SUB> films were used as selective charge transport layers. ► WO<SUB>x</SUB> film is good for low cost, easy fabrication and large area solar cells. ► The self-assembled molecular layer of PCBA and N719 on top of TiO<SUB>2</SUB> improves the PCE.</P>