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혈액투석으로 전환하여 성공적으로 치료한 복막투석치료중인 당뇨병성 만성신부전환자에서 발생한 고삼투압성 혼수
구자룡,이형철,김형직,채동완,박규용,노정우,권성희,이준상,전로원,고경식,박경창,윤정이,김근호 대한내과학회 1999 대한내과학회지 Vol.57 No.5
Continuous ambulatory peritoneal dialysis(CAPD) is now the most important and effective therapeutic modality as well as hemodialysis(HD) and renal transplantation in patients with chronic renal failure. It is frequently recommended to diabetic renal failure patients because of poor, athersclerotic vascularity of them. Hyperglycemia and obesity are not uncommon complications of CAPD therapy. But there were only few reports of very severe hyperglycemia or hyperosmolar coma in CRF patients on CAPD therapy, especially with 7% dextrose CAPD dialysate in foreign countries in the past. Moreover, no specific management for hyperosmolar coma is established in those situations yet. In Korea, only three cases of hyperosmolar coma in non diabetic renal failure patient on CAPD therapy have been reported in one case report. And only one case among them whose CAPD therapy was changed to HD survived. Authors also experienced a case of diabetic hyperosmolar coma treated successfully with conversion to HD in chronic renal failure patient on CAPD therapy. So we report this case with a review of literature. Taken together with this case and review of literature, changing CAPD therapy to HD is regarded to be an important part of treatment when hyperosmolar coma develops in chronic renal failure patients. (Korean. J. Med 57:946-949, 1999)
Min, Jeong-Ki,Kim, Young-Myeong,Kim, Sung Wan,Kwon, Min-Chul,Kong, Young-Yun,Hwang, In Koo,Won, Moo Ho,Rho, Jaerang,Kwon, Young-Guen Williams Wilkins 2005 JOURNAL OF IMMUNOLOGY Vol.175 No.1
<P>Inflammation is a basic pathological mechanism leading to a variety of vascular diseases. The inflammatory reaction involves complex interactions between both circulating and resident leukocytes and the vascular endothelium. In this study, we report evidence for a novel action of TNF-related activation-induced cytokine (TRANCE) as an inflammatory mediator and its underlying signaling mechanism in the vascular wall. TRANCE significantly increased endothelial-leukocyte cell interactions, and this effect was associated with increased expression of the cell adhesion molecules, ICAM-1 and VCAM-1, on the endothelial cells. RT-PCR analysis and promoter assays revealed that expression of these cell adhesion molecules was transcriptionally regulated mainly by activation of the inflammatory transcription factor, NF-kappaB. TRANCE induced IkappaB-alpha phosphorylation and NF-kappaB activation via a cascade of reactions involving the TNFR-associated factors, phospholipase C, PI3K, and protein kinase C (PKC-alpha and PKC-zeta). It also led to the production of reactive oxygen species via PKC- and PI3K-dependent activation of NADPH oxidase in the endothelial cells, and antioxidants suppressed the responses to TRANCE. These results demonstrate that TRANCE has an inflammatory action and may play a role in the pathogenesis of inflammation-related diseases.</P>
The WNT antagonist Dickkopf2 promotes angiogenesis in rodent and human endothelial cells.
Min, Jeong-Ki,Park, Hongryeol,Choi, Hyun-Jung,Kim, Yonghak,Pyun, Bo-Jeong,Agrawal, Vijayendra,Song, Byeong-Wook,Jeon, Jongwook,Maeng, Yong-Sun,Rho, Seung-Sik,Shim, Sungbo,Chai, Jin-Ho,Koo, Bon-Kyoung American Society for Clinical Investigation 2011 The Journal of clinical investigation Vol.121 No.5
<P>Neovessel formation is a complex process governed by the orchestrated action of multiple factors that regulate EC specification and dynamics within a growing vascular tree. These factors have been widely exploited to develop therapies for angiogenesis-related diseases such as diabetic retinopathy and tumor growth and metastasis. WNT signaling has been implicated in the regulation and development of the vascular system, but the detailed mechanism of this process remains unclear. Here, we report that Dickkopf1 (DKK1) and Dickkopf2 (DKK2), originally known as WNT antagonists, play opposite functional roles in regulating angiogenesis. DKK2 induced during EC morphogenesis promoted angiogenesis in cultured human endothelial cells and in in vivo assays using mice. Its structural homolog, DKK1, suppressed angiogenesis and was repressed upon induction of morphogenesis. Importantly, local injection of DKK2 protein significantly improved tissue repair, with enhanced neovascularization in animal models of both hind limb ischemia and myocardial infarction. We further showed that DKK2 stimulated filopodial dynamics and angiogenic sprouting of ECs via a signaling cascade involving LRP6-mediated APC/Asef2/Cdc42 activation. Thus, our findings demonstrate the distinct functions of DKK1 and DKK2 in controlling angiogenesis and suggest that DKK2 may be a viable therapeutic target in the treatment of ischemic vascular diseases.</P>
Study of Wrist Motion : Ⅱ. Radial and Ulnar deviation Ⅱ. 요측 및 척측운동
Ahn, Sang-Rho,Lee, Jeong-Koo 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2
완관절의 요척운동시 요척운동의 양과 각 요 수근 관절 및 중수근 관절의 기여도를 규정키 위하여 10예의 정상인의 완관절을 중립위치, 요측 및 척측운동을 최대로 시킨 위치에서 후전면 및 측면 엑스선을 촬영하여 요골-제3중수골간각, 요골-월사골간각 및 월상골-제3중수골간각을 측정하여 요척 운동의 양과 각 요 수근관절 및 중수근 관절의 기여도를 분석하여 다음과 같은 결과를 얻었다. 1. 총 요측 운동양은 28˚이었고, 총 척측 운동양은 40˚였다. 2. 총 28˚의 요측운동시, 7˚(25%)의 운동이 요수근관절에서 발생하였고, 21˚(75%)의 운동이 중수근관절에서 발생하였다. 3. 총 40˚의 척측운동시, 26˚(64)의 운동이 요수근 관절에서 발생하였고, 14˚(35%)의 운동이 중수근관절에서 발생하였다. 4. 총 요척운동양은 68˚였으며, 이중 33˚(48%)의 운동이 요수근 관절에서 발생하였고, 35˚(52%)의 운동이 중수근 관절에서 발생하였다.
Fixation of Small Osteochondral Fragments with PMMA in Comminuted Intraarticular Fractures
Ahn, Sang-Rho,Lee, Jeong-Koo,Oh, Sun-Tae 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2
심한 관절면 분쇄를 보이는 척골 주두 골절 2례 및 요골두 골절 1례에서 작은 골연골 골편들을 골시멘트를 이용하여 내고정하였다. 골연골 골편들의 고정은 골연골 골편의 양측에 골절면 면적의 30% 이내의 원형의 홈을 판다음 골시멘트를 점유착으로 채운 후 골절편을 해부학적으로 정복하고 골시멘트가 굳을 때까지 눌러 주었다. 관절외 골절은 기존의 방법들을 이용하여 고정하였다. 이방법으로 내고정한 작은 골연골 골편들은 모두 혈관 재생되었고 잘 유합되었다. 동통, 기능, 관절 운동 범위 및 관절면의 유지등에 의하여 판정한 임상적 결과는 모두 양호하였다. 골시멘트 점유착을 이용한 작은 골연골 골절편의 내고정 방법은 심한 분쇄를 가진 관절내 골정의 여러치료 방법중 하나의 좋은 치료방법이 될 것으로 사료된다.
Cyclophosphamide 의 면역독성 검출을 위한 in vitro 시험법의 개발
정태천(Tae Cheon Jeong),(Michael P . Holsapple),차신우(Shin Woo Cha),하창수(Chang Su Ha),한상섭(Sang Seop Han),노정구(Jung Koo Rho) 한국응용약물학회 1994 Biomolecules & Therapeutics(구 응용약물학회지) Vol.2 No.3
A splenocyte culture system supplemented with liver microsomes was developed to detect immunotoxic chemicals which require metabolic activation using cyclophosphamide as a positive standard. When liver microsomes were added to splenocyte cultures isolated from female B6C3F1 mice, the proliferation of splenocytes by lipopolysaccharide (LPS) was increased and the proliferation by concanavalin A (Con A) was decreased. However, when compared with each corresponding control, cyclophophamide was successfully activated to metabolites capable of suppressing lymphoproliferative responses. This suppression was clearly dependent upon the amounts of microsomes added and/or the concentration of cyclophosphamide exposed. In these cultures, the proliferation of splenocytes was suppressed when the cells were exposed to cyclophosphamide on the day of culture initiation. On the other hand, microsome was responsible for the increase in LPS mitogenicity and NADPH was responsible for the decrease in Con A mitogenicity. Finally, our present culture system was compared with the hepatocyte-splenocyte coculture system which we had developed earlier. We found that the hepatocyte-splenocyte coculture was better able to activate cyclophosphamide to metabolites capable of suppressing the antibody response to sheep erythrocytes. Although our present culture system was relatively poor to activate cyclophosphamide in cultures for antibody response, it will be useful as a simple screening method to detect suppression of certain in vitro immunotoxic parameters like LPS mitogenicity by chemicals which require metabolism.
김진철,이정열,구자룡,윤종우,채동완,김근호,전노원,노정우,김형직,노희종,주민하,전만조 대한내과학회 2001 대한내과학회지 Vol.60 No.5
Paraquat, a very potent herbicide, has produced many fatalities through indiscriminate usage and suicides. It is known that with ingestion of more than one mouthful of 20% paraquat, death usually occurs by pulmonary fibrosis. We experienced two cases of successful outcome in patients with paraquat poisoning complicated with pulmonary fibrosis through active, intensive treatment from the early phase after ingestion. They swallowed one to two mouthfuls of the 20% commercial paraquat, and received hemoperfusion within 2-3 hours after ingestion. Then, combination therapy with steroid, vitamin C, D-penicillamine, allopurinol, colchicine was administered from the early phase. They showed moderate to severe hypoxemia and pulmonary fibrosis on chest HRCT during hospital course, but recovered from hypoxemia and remained very well on follow up over 3 months and 12 months after ingestion, respectively. We report these cases with literature review on treatment and prognosis of paraquat poisoning. (Korean J Med 60:490-495, 2001)