<i>In vitro</i> and <i>in vivo</i> evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Park, Dae Sung,Bae, In-Ho,Jeong, Myung Ho,Lim, Kyung Seob,Sim, Doo Sun,Hong, Young Joon,Lee, So-Youn,Jang, Eun Jae,Shim, Jae-Won,Park, Jun-Kyu,Lim, Han Chul,Kim, Han Byul Elsevier 2018 Materials Science and Engineering C Vol.91 No.-

<P><B>Abstract</B></P> <P>Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO<SUB>2</SUB>) and verify its efficacy by <I>in vitro</I> and <I>in vivo</I> assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO<SUB>2</SUB> stent, everolimus-eluting N-TiO<SUB>2</SUB> (N-TiO<SUB>2</SUB>-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO<SUB>2</SUB> film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO<SUB>2</SUB> deposition (37.0%). The platelet adhesion on the N-TiO<SUB>2</SUB> surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO<SUB>2</SUB>-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO<SUB>2</SUB>-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO<SUB>2</SUB>-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, <I>n</I> = 10, <I>p</I> < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO<SUB>2</SUB> deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> N-TiO<SUB>2</SUB> surfaces can help to reduce the platelet adhesion. </LI> <LI> In porcine model, N-TiO<SUB>2</SUB> everolimus decreased in-stent restenosis and fibrin deposition. </LI> </UL> </P>

성인병에 대한 한방치료법(증치의학과 사상의학)에 관한 연구 : 고혈압에 대한 한방치료법(중치의학과 사상의학)에 관한 연구

박동일,김영균,안창범,이인선,김종원,권정남,장경전,이인선,이성근,장용우,신영민 동의대학교 한의학연구소 1999 동의한의연구 Vol.3 No.-

We had a result of the treatment as below when is devided Korean medicine Tx.. Western medical Tx., Cooperative Tx.. 1) At the improvement of BP control, an average in Korean medicine Tx. (from 170㎜Hg/100㎜Hg to 150㎜Hg/90㎜Hg), an average in Western medical Tr. (from 170㎜Hg/100㎜Hg to 130㎜Hg/80㎜Hg), an average in Cooperative Tx.(from 180㎜Hg/110㎜Hg to 130㎜Hg/90㎜Hg), generally all pars had improvements of BP control. But it is not significant of each case. 2) At the improvement of symptoms by the apologetics, Cooperative Tx. is profitable in cases of 'GanHwa',' DamEum', 'EumYangYangHer', 'EumHer'. Korean medicine Tx. is superior in case of 'GiChe'. 3) At the improvement of symptoms by a questionnaire, Korean medical Tx., Western medical Tx., Cooperative Tx. groups had improvements, but each practice group didn't have specific significance. Only it was somewhat profitable to Korean medical Tx. in the 210㎜Hg/110㎜Hg, Western medical Tx. in the 180㎜Hg/110㎜Hg, Cooperative Tx, in the 170㎜Hg/90㎜ Hg. 4) There are the apparent improvements in patients whose BP are over 200㎜Hg of Korean medical Tx. group, whose BP are over 190㎜Hg of Western medical Tx. group and whose BP are over 170㎜Mg of Cooperative Tx. group. There are the improvement of diastolic BP in 110㎜Mg(Korean medical Tx., Western medical Tx.) and 90㎜Hg(Cooperative Tx.). 5) At the improvement of Pulse pressure, generally Pulse pressure are decreased. There are similar improvements in all of Korean medical Tx., Western medical Tx., and Cooperative Tx.. 6) At the Symptomatic approvement according to ages, Korean medical Tx., Cooperative Tx. are somewhat good for his twentieth, and Western medical Tx. is somewhat good for his forties. 7) the correlation of Obesity-grade and BP, as Obesity-grade is higher as BP is higher, but there are no similarity in the improvement. 8) At the EAV improvements, as examination into correlation with the point of 1~3th, we could get results as below. There are high improvements of DRHTM, DRALM, DLLYM, DLLIM in Cooperative Tx. There are high improvements of DRPASI, DLLARI in the Korean medical Tx. group. There are high improvements of DRFADM in Western medical Tx. group.

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

비소세포폐암에서 Microsatellite Instability

전효성,김정란,손지웅,박선하,박태인,김창호,김인산,정태훈,박재용 경북대학교 병원 2001 경북대학교병원의학연구소논문집 Vol.5 No.1

연구베경:MMR 유전자의 불활성화에 의해 야기되는 뮤전적 불안정성은 발암기전의 한 부류로 인정되고 있다.저자들은 비소세포폐암의 발암과정에서의 MSI의 역할을 규명하기 위해 비소세포폐암에서 MSI의 빈도 및 MSI 유무에 따른 임상상의 차이를 조사하였다. 대상 및 방법:근치적 절제술을 받은 비소세포폐암 20예를 대상으로 하였다.동결된 폐암조직과 환자의 림프구에서 DNA를 추출한 후 3P와 9p의 15개의 marker들을 대상으로 PCR을 시행하고 7% polyacrylamide gel에서 전기영동한 후 silver 염색을 시행하였다. 암조직과 림프구 DNA의 PCR product의 band를 비교하여 MSI와 LOH를 판정하였다. 결과:1)대상환자들은 남자 19예,여자 1예였으며 모두 흡연자였고 평균 흠연력은 47 갑년이었다. 폐암의 조직형은 편평상피암 15예, 선암 4예,대세포암 1예였고, 술 후 병리학적 병기는 Ⅰ기 6예,Ⅱ기 5예, ⅢA기 7예,ⅢB기 2예였다. 2)20예 가운데 8예(40%)에서 MSI가 관찰되었으며 3예는 한 개의 marker에서,5예는 2개 이상의 marker에서 MSI가 관찰되었다. 3)LOH는 10예(50%)에서 있었으며,LOH유무에 따른 병가 및 흡연력의 차이가 없었다. 4)분석한 marker의 10% 이상에서 MSI가 관찰된 MSI-L종양은 5예였으며, 대부분의 marker에서 MSI양성인 MSI-H종양은 없었다.MSS종양과 MSI-L종양은 흡연력, 병기, 폐암 조직형 및 LOH 빈도의 유의한 차이가 없었다. 결론:비소세포폐암에서 MSI는 비교적 흔히 관찰되지만 MMR 유전자의 불활성화에 의한 MMP pathway 는 비소세포폐암의 주요 발생기전은 아닐 것으로 생각된다.향 후 비소세포폐암의 발암과정에 있어서 MMP pathway의 역할을 규명하기 위해서는 보다 많은 예를 대상으로 한 연구가 필요할 것으로 생각되며, MSI 발생기전에 관한 추가적인 연구가 필요할 것으로 생각된다. Purpose: Microsatellite instability(MSI) is frequently used as an indicator of microsatellite mutator phenotype (MMP) tumors.MSI has been observed in a percentage of non-small cell lung cancer(NSCLC).However, its role in tumorigenesis of NSCLC remains unknown.The frequency and partten of MSI in NSCLC were evaluted and clinical parameters of MSI-positive tumors with those of MSS(microsatellite stable) tumors were compared. Materials and Methods: Twenty surgically resected NSCLCs were analyzed for 15 microsatellite markers located at chromosomes 3p and 9p.The peripheral blood lymphocytes of patients were used as the source of the normal DNA. Results:1) of 20 cases, 8(40%) demonstrated MSI. 2) Instability was observed more frequently in tri- and tetra-nucleotide repeats that in dinucleotide repeats. In all cases, instability appeared as a shift of individual allelic bands. 3) LOH was observed in 10(50%) of 20 tumors analyzed. 4) Of 20 cases, MSI-H tumor(showing MSI in the majority of markers) was absent. There were 5 MSI-L tumors( showing MSI in a greater than 10% of markers). 5) No significant difference was observed between MSI-L tumors and MSI negative tumors in terms of clinicopathologic features such as pack-year history of smoking, histologic subtype, and (delete) stage of disease.There was also no significant difference in the incidence of LOH in relation to the status of MSI. Conclusion: These data strongly suggest that MSI plays different roles in lung and colon cancer.MMP pathway appears to be far less important in the tumorigenesis of NSCLC, caused mainly by cigarette smoke, with little familial tendency.(tuberculosis and Respiratory Diseases 2000,48:24-32)

관상동맥 질환에서 SDF-1α의 농도

김보영,박용규,박형서,노상필,정승현,이유선,이정우,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

Nelumbinis Semen Reverses a Decrease in $5-HT_{1A}$Receptor Binding Induced by Chronic Mild Stress, a Depression-like Symptom

Jang, Choon-Gon,Kang, Moon-Kyu,Cho, Jae-Han,Lee, Sun-Bok,Kim, Hyun-Taek,Park, Soon-Kwon,Lee, Jin-Woo,Park, Seong-Kyu,Hong, Moo-Chang,Shin, Min-Kyu,Shim, In-Sup,Bae , Hyun-Su The Pharmaceutical Society of Korea 2004 Archives of Pharmacal Research Vol.27 No.10

Depression is associated with a dysfunctional serotonin (5-hydroxytryptamine; 5-HT) system. More recently, several lines of evidence suggest that an important factor in the development of depression may be a deficit in the function and expression of $5-HT_{1A}$ receptors. The present study assessed if Nelumbinis Semen (N. s.) had an anti-depression effect through reversing a decrease in $5-HT_{1A}$receptor binding in rats with depression-like symptoms induced by chronic mild stress. Using a $5-HT_{1A}$ receptor binding assay, with a specific $5-HT_{1A}$receptor agonist, 8- OH-DPAT (8-hydroxy-2-(di-n-propylamino) tetralin), the mechanism of the anti-depression effect of N. s. on rats was investigated, and the effects compared with two well-known antidepressants, Hyperium Perforatum (St. Johns Wort) and fluoxetine (Prozac). Animals were divided into five groups: the normal (N) group without chronic mild stress (CMS), the control (C) group under CMS for 8 weeks, the Nelumbinis Semen (N. s.) treatment group under CMS for 8 weeks, the Hyperium Perforatum (H. p.) treatment group under CMS for 8 weeks and finally, the fluoxetine (F) treatment group under CMS for 8 weeks. Each treatment was administered to rats during the last 4 weeks of the 8-week CMS. A sucrose intake test was performed to test the anti-depression effect of N. s. The N. s. treatment significantly reversed the decreased sucrose intake under CMS (P<0.05 compared to control group under CMS). In the CA2 and CA3 regions of the hippocampus, both N. s. and H. p. reversed the CMS-induced decrease in $5-HT_{1A}$receptor binding. In the I to II regions of the frontal cortex, N. s. and H. p. also reversed the CMS-induced decrease in$5-HT_{1A}$receptor binding, and even showed a significant increase in $5-HT_{1A}$receptor binding compared to the F treatment group (N. s. vs. P, p<0.05, H. p. vs. P, p<0.05). However, in the hypothalamus, all treatments reversed the CMSinduced decrease in $5-HT_{1A}$receptor binding. This reversal effect of N. s. on the decrease in $5-HT_{1A}$receptor binding in the frontal cortex, hippocampus and hypothalamus of rat brains was very similar to that of H. p, but different from that of F. It is concluded that N. s. presents an anti-depression effect through enhancing $5-HT_{1A}$receptor binding.

Nuclear factor I-C가 치근발생 과정에서 Hertwig's 상피초 형성에 미치는 영향

신인철,박주철,정문진,오현주,박선화,이창섭,김흥중,Shin, In-Cheol,Park, Joo-Cheol,Jeong, Moon-Jin,Oh, Hyun-Ju,Park, Sun-Hwa,Lee, Chang-Seop,Kim, Heung-Joong 대한소아치과학회 2005 大韓小兒齒科學會誌 Vol.32 No.3

치아의 형성은 상피-간엽간의 상호작용을 통해 조절되어지는 복잡한 발생과정이다. 지금까지 치관의 발생에 관여하는 유전자 및 그들의 신호전달경로에 관한 연구는 다수 진행되어 왔지만 치근의 발생을 조절하는 기전에 대해서는 별로 알려진 것이 없다. 최근에 NFI-C knock out 생쥐에서 정상치관에 비정상적인 치근을 가지는 치아가 보고되었다. 본 연구의 목적은 NFI-C가 어떻게 치근의 형태와 상아모세포의 분화에 관여하는지를 규명하는 것이다. NFI-C knock out 생쥐의 치근 발생동안에 HERS의 역할을 연구하고자 cytokeratin 면역조직화학적방법과 치근상아질의 특성을 규명하기 위해 DSPP mRNA in-situ hybrydization법을 수행하였다. 1. NFI-C knock out 생쥐의 치근형성시 HERS의 역할 Wild type과 knock out type 모두에서 cytokeratin은 모든 HERS 세포들과 반응하였고, HERS와 법랑상피 사이의 양성반응세포들의 연속성은 치경부 부위에서 소실되었다. Knock out type에서 치근상아질이 침착된 후, cytokeratin 양성-HERS 세포들은 치경부에서 불규칙한 배열과 극성의 상실을 보였다. 2. NFI-C knock out 생쥐의 치근상아질의 특성 DSPP mRNA의 발현은 wild type에서 치관과 치근상아질의 상아모세포 모두에서 강한 발현을 보인 반면, knock out type에서는 치관부위 상아질의 상아모세포에서만 강한 발현을 보였다. 3. NFI-C knock out 생쥐의 치근 발생과정에서 HERS는 치관으로부터 정상적인 확장을 보인 반면, 치근부위에서의 상아 모세포 분화는 실패하였다. 위의 결과들로 보아 NFI-C는 치근형성 과정에서 상아모세포 분화에 중요한 역할을 하는 것으로 사료된다. Tooth formation is a complex developmental process that is mediated through a series of reciprocal epithelial-mesenchymal interactions. Several signal pathways and transcription factors have been implicated in regulating molar crown development, but relatively little is known about the regulation of root development. It was reported that NFI-C knockout mice showed abnormal root formation with normal crown. The aims of this study are to elucidate how the NFI-C regulate the determine of root shape and odontoblasts differentiation. We carried out immunohistochemistry using cytokeratin to investigate the role of Hertwig's epithelial root sheath and DSPP mRNA in-situ hybridization to conform the nature of root dentin during root development in NFI-C knockout mice. Cytokeratin reacted with all the HERS cells and the continuity of cytokeratin positive cells between the HERS cells and enamel epithelium was lost in the cervical region both wild and K/O types. After root dentin deposition cytokeratin positive-HERS cells showed irregularity and loss of polarity in the cervical region in K/O type. DSPP mRNA was strongly expressed in odontoblasts of crown and root dentin in wild type mice, whereas expression of DSPP mRNA was restricted in odontoblast of crown dentin in the K/O type. During root formation in NFI-C knockout mice, HERS normally grow out of the crown but fail to induce odontoblast differentiation in root portion. These results suggest that NFI-C may play important roles in odontoblast differentiation during root dentin formation.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

Effects of combination therapy of statin and N-acetylcysteine for the prevention of contrast–induced nephropathy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Park, Soo Hwan,Jeong, Myung Ho,Park, In Hyae,Choi, Jin Soo,Rhee, Jung Ae,Kim, In Soo,Kim, Min Cheol,Cho, Jae Yeong,Sim, Doo Sun,Hong, Young Joon,Park, Hyung Wook,Kim, Ju Han,Ahn, Youngkeun,Cho, Jeong Elsevier 2016 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.212 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute myocardial infarction (AMI) is a risk factor for contrast-induced nephropathy (CIN). We investigated whether pretreatment with statin, N-acetylcysteine (NAC) and sodium bicarbonate (NaHCO<SUB>3</SUB>) reduces the risk of CIN.</P> <P><B>Methods</B></P> <P>We conducted a prospective trial and enrolled a total of 334 ST-segment elevation myocardial infarction (STEMI) patients. Patients were divided into four groups: Group I (statin 40mg), Group II (statin 80mg), Group III (statin 80mg plus NAC 1200mg) and Group IV (regimen of group III plus NaHCO<SUB>3</SUB> 154mEq/L). CIN was defined as ≥25% or ≥0.5mg/dL increase in serum creatinine from the baseline within the 72h after PCI.</P> <P><B>Results</B></P> <P>CIN occurred in 72 (21.6%) patients. The incidence of CIN was the lowest in the group III (14.3%), and multivariate analysis showed the lower incidence of CIN in group III compared to Group I [odds ratio (OR) 0.29, 95% confidence interval (CI) 0.13–0.64, p=0.002]. Admission hyperglycemia [(AHG)>198mg/dL] (OR 2.20, 95% Cl 1.20–3.68, p=0.011) and the use of intra-aortic balloon pump (IABP) (OR 4.20, 95% CI 1.38–12.78, p=0.016) were independent predictors for CIN. The CIN (OR 9.00, 95% CI 1.30–62.06, p=0.026) was an independent predictor for in-hospital mortality.</P> <P><B>Conclusions</B></P> <P>Combination of high-dose statin plus NAC was associated with lower incidence of CIN in patients with STEMI who underwent primary PCI compared to statin only.</P>

Gymnemic acid의 간장 및 신장의 조직에 미치는 영향에 대한 실험적 연구

박순록,신인철,강주섭,서대규 漢陽大學校 環境科學硏究所 1994 環境科學論文集 Vol.15 No.-

생체에 투여된 물질은 생체내에서 아무 변화없이 체외로 배설되는 경우도 있지만, 대부분은 체내에서 여러가지 생화학적 변화를 거쳐 배설된다. 이런 체내에서의 생화학적 변화는 주로 간장에서 일어나고, 이런 물질과 그 대산사물의 배설은 주로 신장에서 이루어지며, 일부는 다른 경로를 통하기도 한다. 그러므로, 약물의 대사 및 배설장기인 간장과 신장에 이런 물질이 축적되면 그 장기가 손상되는 악순환을 거치게 된다. 이에, 본 실험은 2000여년 전부터 오늘에 이르기까지도 인도지방에서 비만이나 당뇨병에 대한 민간요법제로 이용되어 온 Gymnema sylvestre 잎의 유효성분인 gymnemic acid의 신장과 간장의 조직에 미치는 영향을 검토하고자 실시하였다. 실험동물은 정상 Wistar계 웅성 흰쥐(체중 200gm 내외)를 사용하였고, 실험기간중에 먹이와 물은 자유로이 공급하였다. 실험군은 정상대조군과 동일한 조건하에서 15일동안 gymnema산을 각각 500㎎/㎏, 800㎎/㎏의 용량으로 하루 3회, 즉 오전 7시, 오후 2시, 오후 7시에 각각 경구투여하고, gymnema산 투여 15일째 24시간동안 절식시킨 후 경동맥사혈로 희생시킨 다음 개복하여 간우측 전엽과 우측 신장을 적출하여 일반 육안적 소견과 Hematoxylin 및 eosin 이중염색상의 광학 현미경적 소견을 관찰하여 다음과 같은 결과를 얻었다. 1. 흰쥐 신장의 육안적 소견과 Hematoxylin 및 eosin 이중염색 소견에서는 정상 대조군과 GA투여군에서 특기할 만한 소견이 관찰되지 않았다.(Fig 1-a, 1-b, 1-c). 2. GA(500㎎/㎏)투여군 흰쥐 간장에서 Hematoxylin 및 eosin 이중염색 소견상 간소엽의 중심대와 일부 중간대에서 동양혈관이 확장되었고, 간세포대의 배열이 불규칙해졌으며, 간세포내의 간세포배열이 불규칙해졌고, 공포변성이 초래된 간세포도 관찰도었다(Fig. 3-a,3-b). 3. GA(800㎎/㎏) 투여군 흰쥐 간장에서 Hematoxylin 및 eosin 이중염색 소견상 간소염 전반에 걸쳐 동양혈관이 확장되었고, 간세포대배열이 불규칙해졌으며, 간세포대내의 간세포 배열이 불규칙해졌고, 공포변성이 초래된 간세포도 관찰되었다(Fig. 4-a, 4-b). The majority of the chemicals that enter a living system is taken to elimination by hepatic biotransformation and renal excretion of its metabolites and unchanged form. But, some chemicals are also excreted into feces or through other routes. Therefore, the accumulation of the chemicals in the liver and kidney have damaged the organs. It was more than 3000 yours ago that Gymnema sylvestre. Asclepaidaceae piant indegenous to certain regionss of the tropical and subtropical countries, began to be used a popular folk medicine among native population in India in order to treat obesity and "Madhumeha(DM)" and its use still continues to today in India. Theorefore, this study has the purpose to investigate the effect of gymnemic acid(GA) Which is an effective ingredient of Gymnema sylvestre on the liver and the kidney. In the study, Wistar albino male rats weighing around 200gm were divided into three groups, basic diet group(control), GA(500㎎/㎏)group, GA(800㎎/㎏)group, and administered orally the gymnemic acid for 15 days in dose of 500㎎ and 800㎎ per ㎏ of body weight triple a day. All animals were sacrificed at 15 days after the daministration of gymnemic acid and starved for 24 hours sacrificing them, the specimens and eosin. The specimens have been examined grossly and light microscopically. The results were as follows. 1. In the gross and light microscopic observations of the kidney, the control and all experimental groups were not observed pathologic findings. 2. The gross observations of the liver of the of the control and all experimental groups wrer not observed pathologic findings. 3. The sinusoidal dilation, hepatic cord irregularity and disarrangement of hepatocyte were observed in the central zone and a part of intermediate zone of the hepatic lobule of the 15 days GA(500㎎/㎏) administered group. 4. The sinusoidal dilatation, hepatic cord irregularity, disarrangement of hepatocyte and abnormal shaped hepatocytes were observed in all zonesof the hepatic lobule of the 15 days GA(800㎎/㎏) administered gruop. Consequently, it is suggested that administration of large dose of gymnemic acid in the normal rats induces hepatic cellular damages.