지단백과 알부민 및 이들의 변형물질이 메산지움세포 증식에 미치는 영향

손일석,이태원,박재경,김희진,조병수,임천규,김명재 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

목 적 : 혈청 지단백과 알부민은 그 자체로써 또는 산화나 당화 과정에 의한 변형을 거쳐 사구체 질환을 진행시킬 수 있는 것으로 알려져 있다. 그 기전은 분명하지는 않으나 메산지움세포 증식과 관련이 있는 것으로 알려져 있다. 저자들은 비교적 간단한 흡광도측정법을 이용하여 지단백과 알부민 및 그들의 변형물질들이 각각 메산지움세포 증식에 미치는 영향을 알아보고자 하였다. 방 법: 정상인의 혈청 지단백을 원심분리 하여 저밀도지단백, 고밀도지단백, 초저밀도지단백을얻고, 산화 저밀도지단백, 당화 저밀도지단백, 그리고 혈청 알부민과 당화 알부민을 각각 농도를 달리하여 배양 중인 인간 메산지움세포에 가한 후 흡광도를 측정함으로써 메산지움세포의 증식정도를 알아보았다. 양성 대조군으로 interleukin-1β를 이용하였다. 결 과: 저밀도지단백은 농도 증가시 50 μg/mL와 100 μg/mL에서 세포의 증식을 보였으며,고밀도지단백과 초저밀도지단백은 농도에 따른 유의한 변화가 없었다. 산화 저밀도지단백은5 μg/mL에서부터 세포의 증식을 초래한 후 10 μg/mL와 25 μg/mL에서도 이를 유지하였다. 당화 저밀도지단백은 농도 증가에 따라 10 μg/mL와 100 μg/mL에서 세포의 증식을 억제하였다. 알부민은 농도 500 μg/mL에서 세포 증식을 억제하다가 고농도(1,000 μg/mL)에서는 영향이 없었으며, 당화 알부민 역시 100 μg/mL의 적은 농도에서는 억제효과를 보였으나 고농도(1,000 μg/mL)에서는 오히려 증식을 일으키는 결과를 보였다. 결 론: 저농도에서 저밀도지단백과 산화 저밀도지단백은 사람 메산지움세포의 증식을 초래하였으며, 당화 저밀도지단백은 증식을 억제하였다. 알부민은 일정농도까지 사람 메산지움세포의 증식을 억제하다가 고농도에서는 영향이 없었으며, 당화 알부민도 일정농도까지 증식 억제 효과가 있다가 고농도에서는 오히려 증식을 초래하는 양상을 보였다. Background : Modified lipoproteins may be involved in nephro- and glomerulosclerosis. Diabetic nephropathy-like lesions have also been induced in a rat model by glycated and glycoxidized albumin. In cultured rat or human mesangial cells, enhanced cell proliferation and production of mesangial matrix in response to lipoproteins and their modified forms have been demonstrated by [3H]-thymidine incorporation and cell counting assays. But these methods are relatively complex and most of them have used only one or two of the lipoprotein, albumin and their modified forms. Methods : We investigated the effects of native and modifed lipoproteins, and albumin on cultured human mesangial cell proliferation using non-radioactive colorimetric method by MTS/PMS assay. Lipoproteins added were low density lipoprotein(LDL), high density lipoprotein(HDL), very low density lipoprotein(VLDL), oxidized LDL(oxidation with copper sulfate in vitro) and glycated LDL and we also used albumin, glycated albumin, and interleukin-1β as a positive control. Results : Interleukin-1β promoted the proliferation of cultured human mesangial cells up to concentration 20 ng/mL. LDL induced the proliferation of mesangial cells in a concentration-dependent manner up to concentration 100 μg/mL. HDL and VLDL had no significant proliferative effect. Oxidized LDL caused the proliferation of mesangial cells at low concentration up to concentration 25 μg/mL. Addition of glycated LDL resulted in a concentrationdependent inhibition of mesangial cells. Albumin and glycated albumin inhibited the proliferation of mesangial cells at low concentration of 100 μg/mL, but cell growth was increased at higher concentrations. Conclusion : We demonstrated the effects of the single and modified proteins on the proliferation of cultured human mesangial cell by relatively simple colorimetric method. Results were almostly identical to those of previous studies obtained by radioactive method or cell counting assay. (Korean J Nephrol 2002;21(2):266-275)

A Case of Acute Eosinophilic Myopericarditis Presenting with Cardiogenic Shock and Normal Peripheral Eosinophil Count

손일석,박종춘,정재훈,김계훈,안영근,정명호,조정관 대한내과학회 2006 The Korean Journal of Internal Medicine Vol.21 No.2

Eosinophilic myocarditis usually results from myocardial damage as a result of drugs or parasites, and is generally associated with increased peripheral eosinophil count. This form of myocarditis is difficult to diagnose clinically. A 25 year-old previously healthy woman was transferred from a local clinic because of hypotension and dyspnea with sudden cardiogenic shock after a three day history of gastrointestinal illness. Echocardiography revealed concentric left ventricular wall thickening with moderate pericardial effusion. Biopsy of endomyocardial tissue from the right ventricle showed diffuse infiltration of inflammatory cells, mostly eosinophils, even though the patient had a peripheral eosinophil count that was normal at the time of biopsy. The patient was treated with corticosteroids for the symptoms of pericarditis, and she recovered without cardiac sequelae, clinically and echocardiographically. We here report a case of acute eosinophilic myopericarditis, with cardiogenic shock, diagnosed by endomyocardial biopsy with normal peripheral eosinophil count at the time of biopsy, and complete recovery without sequelae.

Cardiac Sarcoidosis: Oldies but Not Goodies

손일석 대한심장학회 2011 Korean Circulation Journal Vol.41 No.6

Real-world evidence on the strategy of olmesartan-based triple single-pill combination in Korean hypertensive patients: a prospective, multicenter, observational study (RESOLVE-PRO)

손일석,임상현,김지희,박상민,홍범기,이창훈,이상현,장대일,주성필,이상찬,이용호,Jeon Dong Woon,정경태,Si Jae Rhee,조윤진,김종진 대한고혈압학회 2022 Clinical Hypertension Vol.28 No.1

In this prospective, multicenter, non-comparative observational study, the effectiveness and safety of the triple single-pill combination (SPC) of olmesartan/amlodipine/hydrochlorothiazide (OM/AML/HCTZ) were evaluated in a real clinical practice setting in Korean patients with essential hypertension.A total of 3752 patients were enrolled and followed for 12 months after administration of OM/AML/HCTZ. Primary endpoint was change from baseline to month 6 in the mean systolic blood pressure (SBP). Secondary endpoints included changes from baseline in the mean SBP at month 3, 9, 12 and the mean diastolic blood pressure (DBP) at month 3, 6, 9, 12; changes in the mean SBP/DBP according to age and underlying risk factors; and blood pressure control rate (%) at different time points. Adherence to and satisfaction with OM/AML/HCTZ treatment among patients and physicians were assessed by medication possession ratio (MPR) and numeric rating scale, respectively, as exploratory endpoints. Safety was evaluated by the incidence and severity of adverse events (AEs) as well as the discontinuation rate due to AEs. OM/AML/HCTZ administration led to significant reductions in the mean SBP/DBP by 11.5/6.6, 12.3/7.0, 12.3/7.2, and 12.8/7.4 mmHg from baseline to month 3, 6, 9 and 12, respectively ( P < 0.0001). The BP reductions were maintained throughout the 1-year observation period in all patients with different age groups and risk factors (diabetes mellitus, cardiovascular disease, and renal disease). The BP control rate (%) of < 140/90 mmHg was 65.9, 67.9, 68.9, and 70.6% at month 3, 6, 9, and 12, respectively. The mean MPR during the observation period was 0.96. The safety results were consistent with the previously reported safety profile of OM/AML/HCTZ. Treatment with the triple SPC of OM/AML/HCTZ demonstrated significant effectiveness in reducing SBP/DBP and achieving target BP control with high adherence over the 1-year observation period in Korean hypertensive patients and was well-tolerated. CRIS, KCT0002196 , Registered 3 May 2016.

급성 심근염에 병발한 좌심실내 혈전의 수술적 치료경험 1예

손일석,박종춘,홍서나,임상엽,이상록,김계훈,박형욱,홍영준,김주한,김원,안영근,정명호,조정관,강정채 한국심초음파학회 2005 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.13 No.3

Clinical impact of guideline-based practice and patients’ adherence in uncontrolled hypertension

손일석,김종진,유병수,김병진,최재웅,김두일,Lee Sang-Hak,송우혁,Jeon Dong Woon,차태준,김대경,임성훈,남창욱,신준한,김웅,곽재진,Park Jun-Bean,Cha Jin-Hye,Kim Young-Joo,Choi Jimi,Lee Juneyoung 대한고혈압학회 2022 Clinical Hypertension Vol.28 No.1

Chronic diseases like hypertension need comprehensive lifetime management. This study assessed clinical and patient-reported outcomes and compared them by treatment patterns and adherence at 6 months among uncontrolled hypertensive patients in Korea.This prospective, observational study was conducted at 16 major hospitals where uncontrolled hypertensive patients receiving anti-hypertension medications (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg) were enrolled during 2015 to 2016 and studied for the following 6 months. A review of medical records was performed to collect data on treatment patterns to determine the presence of guideline-based practice (GBP). GBP was defined as: (1) maximize first medication before adding second or (2) add second medication before reaching maximum dose of first medication. Patient self-administered questionnaires were utilized to examine medication adherence, treatment satisfaction and quality of life (QoL). A total of 600 patients were included in the study. Overall, 23% of patients were treated based on GBP at 3 months, and the GBP rate increased to 61.4% at 6 months. At baseline and 6 months, 36.7 and 49.2% of patients, respectively, were medication adherent. The proportion of blood pressure-controlled patients reached 65.5% at 6 months. A higher blood pressure control rate was present in patients who were on GBP and also showed adherence than those on GBP, but not adherent, or non-GBP patients (76.8% vs. 70.9% vs. 54.2%, P < 0.001). The same outcomes were found for treatment satisfaction and QoL ( P < 0.05). This study demonstrated the importance of physicians’ compliance with GBP and patients’ adherence to hypertensive medications. GBP compliance and medication adherence should be taken into account when setting therapeutic strategies for better outcomes in uncontrolled hypertensive patients.

Preliminary Clinical Experience with Waon Therapy in Korea: Safety and Effect

손일석,조진만,김우식,김종진,김권삼,배종화,Chuwa Tei 한국심초음파학회 2010 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.18 No.2

Background: Waon therapy has beneficial effects on chronic heart failure (CHF), peripheral arterial disease, and other various diseases. This was to assess the safety and effect of Waon therapy by echocardiography for the first time in Korea. Methods: Ten patients with CHF were enrolled. The patients with a light gown were placed in a sitting-position in an evenly maintained 60。C dry sauna system for 15 minutes, and then after leaving the sauna, they underwent bed rest with a blanket to keep them warm for an additional 30 minutes. Waon therapy was performed once a day, 5 days a week. Results: Four of the 5 patients who had been treated for more than 2 weeks as protocol noted improvement of heart failure (HF) symptoms and decrease in left ventricular (LV) volume. There were trends in improvement of LV ejection fraction and parameters of diastolic function after the therapy although statistical significance was lack. No one complained of worsening of HF symptoms. In each session, body weight (61.8±10.2 kg vs. 61.6±10.3 kg, p=0.008) and blood pressure (systolic, 119±28 vs. 111±27 mmHg, p=0.005; diastolic, 69±12 mmHg vs. 63±10 mmHg, p=0.005) were significantly decreased, oral temperature (35.9±0.4。C vs. 37.0±0.9。C, p=0.017) was increased by 1.0。C at the end of sauna bathing, but the heart rate (71±10/min vs. 72±8/min, p=0.8) was not changed. Conclusion: We have experienced Waon therapy which was safe and well tolerated and some beneficial effects for patients with CHF. Large scale randomized study is needed to apply Waon therapy as a promising therapy in Korean HF patients.

혈액투석 전후 심초음파를 이용한 심기능 평가 : TEI Index

손일석,강흥선,조진만,조정휘,김권삼,송정상,배종화 한국심초음파학회 2002 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.10 No.1

Interesting Cases of Unusual Left Ventricular Thrombus

손일석,박종춘,조숙희,임상춘,홍서나,임상엽,이상록,김계훈,박형욱,홍영준,김주한,김원,안영근,조정관,정명호,강정채 대한내과학회 2005 대한내과학회 추계학술대회 Vol.69 No.10

Ritodrine-Induced Hypokalemia

손일석,박정환,조진만,김종진 대한심장학회 2009 Korean Circulation Journal Vol.39 No.7

A 31-year-old woman presented with chest discomfort in the 22nd week of pregnancy. She had been treated with an intravenous infusion of ritodrine hydrochloride (0.25 mg/min) for preterm labor the prior day. On physical examination, the body temperature was 36.3℃, the blood pressure was 117/68 mmHg, the pulse was 96 beats/min, and the respiratory rate was 20 breaths/min. Electrocardiography (ECG) showed ST-T changes resembling ischemia in the inferolateral leads (Fig. A) with a heart rate of 98 beats/min. An ECG taken the preceding day revealed no ST-T changes (Fig. B). The ECG in limb lead II showed flattening of the T wave, slight ST depression, and prominent U waves, as in hypokalemia (Fig. C). QT prolongation and a U wave were prominent in the precordial leads (Fig. A). Urgent echocardiography to detect cardiac function and ischemic changes showed normal cardiac function without wall motion abnormalities. After discontinuing the ritodrine infusion, the ECG returned to normal the following day (Fig. D and E) and her chest discomfort resolved. Her serum potassium level, which had been 4.1 mEq/L the previous day, was 3.4 mEq/L, and returned to 4.1 mEq/L after discontinuation of the ritodrine infusion. The serum fasting glucose level was 81 mg/dL, and 80 mg/dL the preceding day. The plasma calcium was 8.8 mg/dL and the magnesium level was 1.9 mg/dL. Ritodrine, a beta 2-selective adrenergic drug, is used as a tocolytic drug for management of preterm labor.1) One of the most common side effects of ritodrine is hypokalemia because of a marked increase in plasma insulin, which results in stimulation of the cellular uptake of potassium.2)3) Ritodrine-induced hypokalemia shows typical ECG changes resembling hypokalemia typical of other causes. As in this case, typical ECG changes associated with a ritodrine infusion may not be compatible with the absolute serum level of potassium. A 31-year-old woman presented with chest discomfort in the 22nd week of pregnancy. She had been treated with an intravenous infusion of ritodrine hydrochloride (0.25 mg/min) for preterm labor the prior day. On physical examination, the body temperature was 36.3℃, the blood pressure was 117/68 mmHg, the pulse was 96 beats/min, and the respiratory rate was 20 breaths/min. Electrocardiography (ECG) showed ST-T changes resembling ischemia in the inferolateral leads (Fig. A) with a heart rate of 98 beats/min. An ECG taken the preceding day revealed no ST-T changes (Fig. B). The ECG in limb lead II showed flattening of the T wave, slight ST depression, and prominent U waves, as in hypokalemia (Fig. C). QT prolongation and a U wave were prominent in the precordial leads (Fig. A). Urgent echocardiography to detect cardiac function and ischemic changes showed normal cardiac function without wall motion abnormalities. After discontinuing the ritodrine infusion, the ECG returned to normal the following day (Fig. D and E) and her chest discomfort resolved. Her serum potassium level, which had been 4.1 mEq/L the previous day, was 3.4 mEq/L, and returned to 4.1 mEq/L after discontinuation of the ritodrine infusion. The serum fasting glucose level was 81 mg/dL, and 80 mg/dL the preceding day. The plasma calcium was 8.8 mg/dL and the magnesium level was 1.9 mg/dL. Ritodrine, a beta 2-selective adrenergic drug, is used as a tocolytic drug for management of preterm labor.1) One of the most common side effects of ritodrine is hypokalemia because of a marked increase in plasma insulin, which results in stimulation of the cellular uptake of potassium.2)3) Ritodrine-induced hypokalemia shows typical ECG changes resembling hypokalemia typical of other causes. As in this case, typical ECG changes associated with a ritodrine infusion may not be compatible with the absolute serum level of potassium.