내관지압이 슬관절 전치환술 받은 노인 환자의 오심, 구토 및 통증에 미치는 효과

유제복 ( Je Bog Yoo ),장희정 ( Hee Jung Jang ),나은희 ( Eun Hee Na ),김선영 ( Sun Young Kim ),신동수 ( Dong Soo Shin ) 경희대학교 동서의학연구소 2011 동서간호학연구지 Vol.17 No.2

지압은 수직압, 지속압, 조화압으로 경혈을 찾은 다음 치료하는 사람의 체중을 실어서 위에서 아래로 누르는 방법으로 어깨에 불필요한 힘을 뺀 상태에서 자연스럽게 상체의 체중을 손가락에 집중을 시켜 수직으로 경혈을 보통 3-4초 정도 지속적으로 눌러 주는것을 말한다(East-west nursing research institute, 2000; Kim, 1999). 내관지압의 오심· 구토 경감 효과를 검증한 연구를 살펴보면, Alsaid 등(1997)이 수술 후 오심· 구토 감소에 효과가 있다고 보고하였고, Ming 등(2002)은 기능적 내시경 부비동 수술에 지압이 효과가 있다고 하였으며, Apfel 등(1999)은 항암화학요법을 받는 유방암 환자에게 지압이 오심과 구토에 유의한 차이가 있다고 보고하였다. Kim. 2003). Kim (2003)의 연구결과 내관지압이 항암화학요법을 받는 폐암 환자의 오심· 구토에 미치는 영향을 연구한 결과, 실험군에서 제2일과 3일에 오심 정도를 감소시키는 효과를 검증한 바 있다. 수술 환자의 자가 통증 조절기 사용은 최근 널리 적용되고 있는 통증완화를 위한 방법으로 자가 통증 조절기는 통증 완화를 위한 치료 효과는 높지만 오심· 구토는 대부분의 수술 후 자가 통증 조절기를 사용하는 환자들이 경험하는 심각한 불편감으로, 자가 통증조절기(PCA) 사용을 중단하게 되는 원인이 되기도 한다(Lee, 2006). 수술 후 오심, 구토는 통증보다 더욱 힘든 것으로 보고되고 있어, 이를 경감시켜 주기 위한 다양한 간호중재 전략의 개발이 요구된다Song & Shin, 1988). 본 연구는 슬관절 수술 환자의 자가 통증 조절기 사용 후 오심· 구토의 완화를 위해 내관지압을 적용하여 그 효과를 검증함으로써 비 침습적이고 독자적인 간호중재로서 발전시키기 위해 시도되었다. 본 연구 결과에서 내관지압 제공 후 24시간에 구토영역과 오심·구토 전체 영역에서 유의한 차이가 있었는데, 이는 Lee (2008)의 중이수술 대상자에게 손목밴드 내관지압을 적용한 결과 마취 종료후 24시간에 오심· 구토의 전체영역에서 유의한 차이가 나타났다는 결과와 일치하였다. 그러나 본 연구에서는 오심 영역은 유의미한 차이를 나타내지 못하여 Kim (2003)의 연구에서 항암화학요법주기 제2일 오심불편감이 실험군과 대조군 간에 통계적으로 유의한 차이를 보였다는 결과와 일치하지 않는 결과를 나타내었다. 이는 대상자의 차이에 의한 것으로 수술 환자와 항암요법대상자의 차이에서 비롯된 것으로 본다. Shin (2002)의 연구에서는 지압교육실험군에서 항암화학요법제투여 2일, 3일, 4일, 5일째 오심· 구토 정도가 유의미하게 감소하였다. 본 연구에서는 내관지압 제공 후 12시간에서 유의미하게 구토영역에서 감소를 나타내기 시작하였다. 이는 대상자가 다르기 때문으로 판단되며 항암요법을 실시하고 있는 대상자보다 고관절치환술 후자가통증조절기를 보유하고 있는 대상자의 오심· 구토 정도가 상대적으로 항암 환자보다 낮은 정도이기 때문으로 본다. Lee (2002)의 연구결과 오심 정도는 제3일째는 유의미한 차이가 있었으나 구토정 도에서는 유의미한 차이를 나타내지 않았다. 본 연구결과와는 차이를 나타내었다. 역시 항암요법을 받는 난소암 환자가 대상자이기 때문에 대상자의 차이로 인한 결과라고 본다. 따라서 앞으로 연구 시에는 동일대상자에 대한 반복연구가 필요함을 시사할 뿐 아니라 최초 효과발현 시기에 대해 다양한 대상자별 반복연구가 필요함을 알 수 있었다. 본 연구의 결과에서 내관지압 제공 후 24시간 시점에서 두 군 간의 오심· 구토 전체 점수는 유의미하게 낮았고 특히 구토 횟수, 구토불편감, 구토 양은 통계적으로 낮아 유의한 차이가 있었다. 그러나 Lee (2008)의 연구에서는 마취종료 후 24시간에 오심· 구토 전체 점수에서 유의미하게 차이가 났다는 결과와는 일치하였으나 세부 하위영역에서 유의미한 영역은 차이가 있다. 즉, Lee (2008)는 특히 오심에서 유의미한 차이를 나타내어 본 연구결과와 일치하지는 않았다. 이는 대상자의 수술의 심각성 정도에 따라 차이를 나타낸 것으로 보인다. Shin (2002)의 연구에서 항암화학요법을 받은 위암 환자에게 내관지압이 하위영역 구토 횟수 감소에 유의한 효과를 나타냈다는 결과와는 일치하였으며 Kim 등(2007)의 연구와도 일치하였다. 이는 지압 제공 후 12시간보다는 24시간에 효과가 큰 것은 시간이 지남에 따라 지압의 효과가 축적되어 나타나는 것이라 본다. Kwon(2011)의 결과 갑상선절제술 환자에게 손목밴드를 이용한 내관지압을 적용하였을 때 시간이 경과함에 따라 오심· 구토 점수가 감소하였다는 결과가 있었고 Kim 등(2010)의 결과에서는 시간에 따라 오심감소가 유의미하게 있었으므로 앞으로도 시간이 경과함에 따라오심· 구토의 감소효과를 계속해서 연구할 필요가 있다. Aidah 등(2002)의 연구결과 24-48시간에 구토의 부작용이 가장 심하게 나타난다는 연구결과가 있었는데 이때 지압을 통해 구토영역이 유의미하게 낮은 점수를 나타낸 것은 대조군은 구토의 부작용이 지속되지만 실험군은 지압의 효과로 구토의 부작용을 최소화하였기 때문이라 볼 수 있다. 그래서 본 연구의 실험군에서도 24시간에 가장 구토영역의 유의미하게 낮은 점수를 나타낸 것으로 본다. 본 연구결과는 24시간 시점에서 집중적으로 오심· 구토를 중재할 수 있는 간호 중재의 요구도가 있다는 것을 나타내는 증거라고 본다. 그러므로 앞으로는 내관(P6)지압을 24시간 이후 48시간에도 계속 적용한 후 오심· 구토 정도를 확인하는 반복 연구가 필요하다. 내관지압의 통증감소효과에 대한 가설을 세웠으나 본 연구결과 통증에는 효과가 나타나지 않았음을 보였다. 지압이 통증 감소에 영향을 미친다는 연구결과와 일치하지 않는 것을 보였다. Ju (2010)의 연구결과 경혈지압마사지가 요통 환자의 통증감소에 효과적이었다고 보고하였으나 이는 8주간의 장시간을 두고 효과를 검증한 것이었다. Shin (2004)은 자궁 적출술 환자의 통증 자가조절교육과 함께 내관지압을 실시한 실험군에서 통증감소효과가 있었다고 보고한 것과도 일치하지 않는 결과를 나타내었다. 이는 본 연구에서 이미 대상자 스스로 통증치료를 위해 PCEA를 사용하고 있으므로 통증에 대해서는 스스로 조절을 하는 부분이 더 영향을 미쳤을 것으로 본다. 그러나 앞으로의 연구에서는 PCEA를 착용하고 있으므로 이를 통한 통증약물 사용량을 함께 측정함으로써 통증 정도를 좀 더 정확하고 광범위하게 측정하여 통증 정도의 효과를 검증하는 것이 필요하다고 본다. 이상에서 논의한 바와 같이 본 연구는 수술 후 자가 통증 조절기사용 환자의 오심 및 구토, 통증 완화에 지압을 이용한 간호중재가 부분적으로 오심· 구토 감소에 효과를 나타낸다는 것을 검증하였으므로 임상에서 내관(P6)지압을 간호중재의 하나로서 적극 활용할 것을 제안한다. Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=- 2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

여대생의 비타민 A 영양 상태

나유경,김영남 동아시아식생활학회 1997 동아시아식생활학회지 Vol.7 No.4

The purpose of this study was to diagnose nutritional status of vitamin A in female university students. Total of 59 female students in Korea National University of Education, Home Economics Education department were recruited for this study. Retinol and 4 major carotenoids in serum(β-carotene, α-carotene, lycopene and lutein) were analyzed by HPLC. The isocratic separation was performed in a μ Bondapak™ C_(48), stainless steel column with a solvent system of acetonitrile : methanol= 85 : 15. The results of analysis were as follows: The average retinol concentration of 59 female students was 25.9㎍/100ml. According to biochemical criteria for the assessment of vitamin A status, 18 of them belong to well-nourished and 6 students belong to adequate status. On the other hand, 8 students, 3 freshmen and 5 sophomore, were in critical vitamin A status. Retinol concentrations of junior and senior students were higher than those of freshmen and sophomore(P<0.001). The average concentrations of serum β-carotene, lycopene, and lutein were 1.9, 5.4, and 41.4 ㎍/100ml, respectively. Serum β-carotene concentration of senior was significant, higher than those of freshman, sophomore and junior (p<0.001). Lycopene concentration of freshman was significant. lower than those of the other grades and that of senior was sig, higher than those of the other grades(p<0.05). Lutein concentrations of junior and senior were significant, higher than those of freshman and sophomore(p<0.001). The serum α-carotene concentrations of the students were too low to analyze.

D-Amphetamine이 니코틴성 흥분작용에 의한 카테콜아민 분비작용에 미치는 영향

임건한,서유석,민선영,임지연,김용직,나광문,임동윤 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

본 연구의 목적은 d-arphetamine이 흰쥐의 적출부신 관류모델에서 니코틴 수용체 흥분에 의한 카테콜아민(CA) 유리작용에 미치는 영향을 검색하여 그 작용기전을 규명하고자 하였다. D-amphetamine은 흰쥐 부신정맥내로 60분간 관류시 d-amphetamine자체는 약한 CA 분비작용을 나타내었으나, d-amphetamine (30 μM)을 비롯한 강력한 neuronal nicotine 수용체 작용제인 cytisine (50 μM) 및 epibatidine (30 μM)에 의한 CA 유리작용을 처음 4-10분 동안만 유의하게 증강시켰다. 또한, d-amphetamine (30 μM)은 60분간 부신정맥 내로 관류한 상태에서 dihydropyridine L-형 칼슘통로 개방약물인 Bay-K-8644 (10 μM)과 세포질내 칼슘저장고에서 Ca^(2+) ATPase 억제제인 cyclopiazonic acid (10 μM)의 CA 유리작용을 처음 4분간만 유의하게 증강시켰다. 그러나, 고농도의 d-amphetamine (500 μM)은 상기한 모든 분비촉진제의 CA분비작용을 오히려 억제하였다. 이와 같은 연구결과로 보면, 흰쥐 관류 부신수질에서 d-amphetamine은 낮은 농도에서는 콜린성 니코틴 수용체 흥분에 의한 카테콜아민 분비반응을 증강시키지만, 고농도에서는 오히려 억제적으로 작용함을 시사한다. 따라서, d-amphetamine은 용량에 따라서 흰쥐 적출 관류부신수질의 니코틴 수용체의 작용제 및 길항제로 이중 작용(dual action)을 나타내는 것으로 생각된다. 이러한 d-amphetamine의 작용은 흰쥐 부신수질 크롬친화세포의 dihydropyridine계 L-형 칼슘통로의 활성화 및 세포 내 칼슘저장고로부터 칼슘유리작용과 관련성이 있는 것으로 사료된다. The purpose of the present study was to examine the effect of d-amphetamine on CA release evoked by nocotinic receptor stimulation from the isolated perfused model of the rat adrenal gland, and to establish its mechanism of action. D-amphetamine(30 μM), when perfused into an adrenal vein of the rat adrenal gland for 60 min, enhanced the CA secretory responses evoked by ACh (5.32 mM), nicotine (30 μM), cytisine (50 μM, a selective neuronal nicotinic Nn-receptor agonist) and epibatidine (30 nM, a selective neuronal nicotinic Nn receptor agonist) only for the first period (4~10 min), although it alone has weak effect on CA secretion. Moreover, d-amphetamine (30 μM) in to an adrenal vein for 60 min also augmented the CA release evoked by BAY-K-8644, an activator of the dihydropyridine L-type Ca^(2+) channels, and cyclopiazonic acid, an inhibitor of cytoplasmic Ca^(2+) ATPase only for the first peroid (4 min). However, in the presence rather inhibited the CA secretory responses evoked by the above all of secretagogues. Taken together, these experimental results suggest that d-amphetamine at a low concentration enhances the CA secretion from the rat adrenal medulla evoked by stimulation of cholinergic nicotininc receptors, but at a high concentration it rather inhibits them. It semms that d-amphetamine has dual action acting as both agonist and antagonist at nicotinic receptors of the isolated perfused rat adrenal medulla, which are might be dependent on the concentration. It is also thought that these actions of d-amphetamine are probably relevant to the activation of the dihydropyridine L-type Ca^(2+) channels located on the rat adrenomedullary chromaffin cell membrane and release of Ca^(2+) from the cytoplasmic store.

그레이브스병에서 방사성 요오드 치료에 따른 갑상선 자극 호르몬 수용체 결합억제 면역글로불린(Thyrotropin Binding Inhibitory Immunoglobulin, TBII)의 변화

조영석,권기현,이준철,나소영,이효진,홍우정,이유선,김군순,송민호,김영건,노흥규 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Prediction of thrapeutic response to radioiodine in Graves' disease is poorly understood. Although thyrotropin binding inhibitor immunoglobulin(TBII) level is a strong index for relapse after antithyroid drug medication, conflicting results are reported regarding its prognostic significance in Graves' disease treated with RAI. This study is dengned to evaluate possible relationship between post-treatment hypothyroidism and TBII in Graves' disease treated with RAI. Fourty two patient with Graves' disease after radioiodine treatment were studied retrospectively. The subject were divided into hypothyroid group and euthyroid or hyperthyroid group. We evaluated the association of hypothyroidism and TBII with radioiodine treatment dose. The mean age of hypothyroid group was 48±11 years and euthyroid or hyperthyroid group was 47±12 years. There was no difference in two groups. And there was no significant difference in post- treatment TBII between two groups(49.9±28.5%, 29.9±14.3%, p-value >0.05). The treatment-dose had no influence on post-treatment thyroid state. Euthyroid or hyperthyroid group was done with 13.6±6.9mCi and hypothyroid group was 17.0±10.4mCi(p-value > 0.05). TBII had no prognostic significance on long-term hypothyrodism in Graves' disease treated with radioiodine. And, treatment-dose had no influence on post-treatment thyroid state.

Chitosan/oleamide Nanofluid for Enhancing Gas Utilization Efficiency in C1-gas Bioconversion

Eungsu KANG,Hyunsuk CHOI,Ji Yeong LEE,Min-sik KIM,Jeong Geol NA,Yoo Seong CHOI 한국생물공학회 2021 한국생물공학회 학술대회 Vol.2021 No.10

Microbial biotransformation using C1-gases (CH₄, CO) is a notable technique for sustainable, carbon-neutral chemical and fuel production. However, the low mass transfer coefficient (KLa) of C1-gases in biological processes has hampered the efficient production of value-added materials, despite efficient, nonnative strains having been recently developed. Here, we constructed a nanofluid material mainly composed of chitosan and oleamide (CS/OA), which was stably suspended with a particle size of 120.7 ± 39.0 ㎚ in aqueous culture media below pH 7.5. The kLa value was enhanced more than 1.5-fold with a reduction of surface tension even in the 0.0001 % (w/v) CS/OA nanofluid. In addition, when the nanofluid was applied into media for seed-cultivation of three C1-gas utilizing strains such as Methylomonas sp. DH-1, M. trichosporium OB3b, and Thermococcus onnurineus NA1 156T, the CS/OA nanoparticles attached to the cell surface, leading to a morphological change in the cell surface at extended lag-phase, and enhanced the specific cell growth rates (μmax), gas utilization efficiency in log-phase. Remarkably, the adapted strains from the seed culture using the CS/OA nanofluid media also had enhanced μmax in a subsequent subculture and the main culture using conventional culture media, resulting in higher C1 gas consumption, cell growth, and metabolite production such as formate and succinate. These results showed that the CS/OA nanofluid could be an effective medium component to enhance the gas utilization efficiency in C1-gas microbial bioconversion.Microbial biotransformation using C1-gases (CH₄, CO) is a notable technique for sustainable, carbon-neutral chemical and fuel production. However, the low mass transfer coefficient (KLa) of C1-gases in biological processes has hampered the efficient production of value-added materials, despite efficient, nonnative strains having been recently developed. Here, we constructed a nanofluid material mainly composed of chitosan and oleamide (CS/OA), which was stably suspended with a particle size of 120.7 ± 39.0 ㎚ in aqueous culture media below pH 7.5. The kLa value was enhanced more than 1.5-fold with a reduction of surface tension even in the 0.0001 % (w/v) CS/OA nanofluid. In addition, when the nanofluid was applied into media for seed-cultivation of three C1-gas utilizing strains such as Methylomonas sp. DH-1, M. trichosporium OB3b, and Thermococcus onnurineus NA1 156T, the CS/OA nanoparticles attached to the cell surface, leading to a morphological change in the cell surface at extended lag-phase, and enhanced the specific cell growth rates (μmax), gas utilization efficiency in log-phase. Remarkably, the adapted strains from the seed culture using the CS/OA nanofluid media also had enhanced μmax in a subsequent subculture and the main culture using conventional culture media, resulting in higher C1 gas consumption, cell growth, and metabolite production such as formate and succinate. These results showed that the CS/OA nanofluid could be an effective medium component to enhance the gas utilization efficiency in C1-gas microbial bioconversion.

GO-44 : Prognostic value of pre-treatment Hb level in patients with early cervical cancer

( Na Ri Shin ),( Yoo Young Lee ),( Kyoung A Lee ),( Seung Hyun Kim ),( Ji Young Kim ),( Chel Hun Choi ),( Tae Joong Kim,),( Jeong Won Lee ),( Duk Soo Bae ),( Byoung Gie Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The purpose of this study is to investigate the prognostic role of pre-treatment anemia in patients with early cervical cancer who underwent radical hysterectomy In this study, we retrospectively enrolled patients with early cervical cancer (FIGO stage IB to IIA) who were treated at Samsung Medical Center, Seoul, Korea, from 1996 to 2007. We retrospectively enrolled 805 patients. Median pre-treatment Hb level was 12.8 g/dL (4.0-16.9) in all patients. 99 out of 805 patients had pre-treatment anemia (12.3%). Pre-treatment anemia was significantly associated with large tumor size, advanced clinical stage, and parametrial invasion. In multivariate analysis, higher pre-treatment Hb entailed better prognostic significance in disease free survival (HR, 0.88; 95% CI, 0.078-0.99) but not in overall survival (HR, 0.94; 95% CI, 0.80-1.10). In conclusion, we found that the negative association between pre-treatment Hb level and tumor size and the impact of anemia before treatment on disease free survival adjusted for other factors including clinical stage and pathological findings in early stage cervical cancer.

Inhibition of Lipopolysaccharide-induced Expression of Cyclooxygenase-2 by Schizandrin via Suppression of Nuclear Factor-K B Activation in RAW 264 .7 Macrophage Cells.

KIM Yeong Shik,KIM Hyun Pyo,BAE KiHwan,HONG Yoo Na,SHIN Eun Myoung,GUO Lianyu 大韓藥學會 2006 大韓藥學會 總會 및 學術大會 Vol.2006 No.1

Effects of Cu,Zn-superoxide dismutase on cell proliferation and neuroblast differentiation in the mouse dentate gyrus.

Yoo, Dae Young,Shin, Bich Na,Kim, In Hye,Kim, Woosuk,Kim, Dae Won,Yoo, Ki-Yeon,Choi, Jung Hoon,Lee, Choong Hyun,Yoon, Yeo Sung,Choi, Soo Young,Won, Moo-Ho,Hwang, In Koo Kluwer Academic/Plenum Publishers 2012 Neurochem Res Vol.37 No.2

<P>Oxidative stress is one of the most important factors in reducing adult hippocampal neurogenesis in the adult brain. In this study, we observed the effects of Cu,Zn-superoxide dismutase (SOD1) on lipid peroxidation, cell proliferation, and neuroblast differentiation in the mouse dentate gyrus using malondialdehyde (MDA), Ki67, and doublecortin (DCX), respectively. We constructed an expression vector, PEP-1, fused PEP-1 with SOD1, and generated PEP-1-SOD1 fusion protein. We administered PEP-1 and 100 or 500 관g PEP-1-SOD1 intraperitoneally once a day for 3 weeks and sacrificed at 30 min after the last administrations. PEP-1 administration did not change the MDA levels compared to those in the vehicle-treated group, while PEP-1-SOD1 treatment significantly reduced MDA levels compared to the vehicle-treated group. In the PEP-1-treated group, the number of Ki67-positive nuclei was similar to that in the vehicle-treated group. In the 100 관g PEP-1-SOD1-treated group, the number of Ki67-positive nuclei was slightly decreased; however, in the 500 관g PEP-1-SOD1-treated group, Ki67-positive nuclei were decreased to 78.5% of the vehicle-treated group. The number of DCX-positive neuroblasts in the PEP-1-treated group was similar to that in the vehicle-treated group. However, the arborization of DCX-positive neuroblasts was significantly decreased in both the 100 and 500 관g PEP-1-SOD1-treated groups compared to that in the vehicle-treated group. The number of DCX-positive neuroblasts with tertiary dendrites was markedly decreased in the 500 관g PEP-1-SOD1-treated group. These results suggest that a SOD1 supplement to healthy mice may not be necessary to modulate cell proliferation and neuroblast differentiation in the dentate gyrus.</P>

Detection of Botulinum Neurotoxin Type A by In Vitro Bioassay Based on Endopeptidase Activity

Kim, Yun-Jeong,Baek, Joung-Hee,Kim, Jeong-Hee,Kim, Bong-Su,Rhie, Gi-eun,Yoo, Cheon-Kwon,Shin, Na-Ri 대한미생물학회 2010 Journal of Bacteriology and Virology Vol.40 No.1

Botulinum neurotoxin type A (BoNT/A) is a metalloprotease that cleaves SNAP-25 (synaptosome-associated protein of 25 kDa), a specific cellular protein essential for neurotransmitter release. As well as mouse bioassay to detect BoNT/A, various assay methods based on its endopeptidase activity have been developed. In this study, we tried to develop a BoNT/A assay system using recombinant SNAP-25 with glutathione S-transferase (GST) tags at both termini as substrate. The recombinant GST-SNAP-25-GST with 70 kDa was expressed and purified in E. coli and synthesized N-terminal 50 kDa and C-terminal 25 kDa fragment after cleavage at the $Gln_197$-$Arg_198$ bond by BoNT/A. To detect both fragments, we obtained rabbit antisera against peptides corresponding to the cleaved ends of each fragment. In the western blotting, the N-terminal fragment was detected by the antibody specifically recognizing the newly exposed C-terminus (corresponding to amino acid residue 191-197). This assay system was able to detect until 3.125 ng of BoNT/A, which corresponded to about 90 fold $LD_50$ in mice. These results suggest that the in vitro endopeptidase assay developed in this study would replace others to detect BoNT/A.

A case of acute necrotizing encephalopathy associated with parainfluenza virus infection

Yoo-Na Kim,유수정 대한소아청소년과학회 2012 Clinical and Experimental Pediatrics (CEP) Vol.55 No.4

Acute necrotizing encephalopathy (ANE) may be suspected when a young child presents with abrupt onset of altered mental status,seizures, or both. Definitive clinical diagnosis is based on magnetic resonance imaging (MRI) results. ANE is associated with influenza virus infections. Preliminary data suggests that up to 25% of ANE patients die, and up to 25% of ANE survivors develop substantial neurologic sequelae. Here, we describe a case of a comatose 22-month-old girl who was admitted to our hospital because of febrile illness and seizures. On day 13 of her illness, she died from ANE associated with infection from parainfluenza virus. Brain MRI results indicated diffuse bilateral symmetric signal changes in both basal ganglia, thalami,periventricular white matter, pons, and cerebral white matter, as well as generalized swelling of the brain.