결핵에 의한 급성호흡곤란증후군의 사망률 및 예후 예측인자

김태옥 ( Tae ok Kim ),강현욱 ( Hyun Wook Kang ),지수영 ( Su Young Chi ),반희정 ( Hee Jung Ban ),오인재 ( In Jae Oh ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il Kim ),임성철 ( Sung Chul Lim ),김영철 ( Young Chul Kim ),권용수 ( Yong Soo 대한내과학회 2011 대한내과학회지 Vol.81 No.4

Background/Aims: Acute respiratory distress syndrome (ARDS) due to tuberculosis (TB) is a rare disease, but its mortality is believed to be high. The aim of this study was to evaluate the mortality rate and prognostic factors of ARDS. Methods: We retrospectively reviewed the demographic, clinical, radiologic, and laboratory data of 19 patients with ARDS due to active pulmonary TB at Chonnam National University Hospital between January 2000 and December 2010. Results: The median age of patients was 71.1 (interquartile range [IQR] 51-74) years. None had a history of TB treatment. The most common symptoms were dyspnea (90%), fever (68%), and cough (53%). The overall in-hospital mortality was 73%. The median acute physiologic assessment and chronic health evaluation (APACHE) III score and pneumonia severity index (PSI) were 81.9 (IQR 59.0-92.0) and 111.0 (IQR 77.0-131.0), respectively. The PSI was significantly higher in non-survivors than in survivors (55.0 vs. 122.0; p=0.016). The rate of TB treatment before admission was significantly higher in survivors than in non-survivors (75% vs. 13%; p=0.037). The time from admission to treatment initiation was significantly longer in non-survivors than in survivors (3 vs. 0 days; p=0.049). The median duration of mechanical ventilation was 11 days (IQR 5-16 days). The most common cause of death was a refractory shock (53%). Conclusions: The overall mortality rate of ARDS due to pulmonary TB was high. A high PSI score and delay of TB treatment may be risk factors for a poor outcome of ARDS due to pulmonary TB. (Korean J Med 2011;81:458-463)

Qualitative Analysis of Proteins in Two Snake Venoms, Gloydius Blomhoffii and Agkistrodon Acutus

Su-Jeong Ha,Yeo-Ok Choi,Eun-Bin Kwag,Soo-Dam Kim,Hwa-Seung Yoo,In-Cheol Kang,So-Jung Park 대한약침학회 2022 Journal of pharmacopuncture Vol.25 No.1

Objectives: Snake venom is a complex mixture of various pharmacologically active substances, such as small proteins, peptides, and organic and mineral components. This paper aims to identify and analyse the proteins in common venomous snakes, such as Gloydius blomhoffii (G. blomhoffii) and Agkistrodon acutus (A. acutus), in Korea. Methods: We used mass spectrometry, electrophoresis, N-terminal sequencing and in-gel digestion to analyse the proteins in these two snake venoms. Results: We identified eight proteins in G. blomhoffii venom and four proteins in A. acutus venom. The proteins detected in G. blomhoffii and A. acutus venoms were phospholipase A2, snake venom metalloproteinase and cysteine-rich secretory protein. Snake C-type lectin (snaclec) was unique to A. acutus venom. Conclusion: These data will contribute to the current knowledge of proteins present in the venoms of viper snakes and provide useful information for investigating their therapeutic potential.

[Ca(2+)]-dependent generation of intracellular reactive oxygen species mediates maitotoxin-induced cellular responses in human umbilical vein endothelial cells.

Yi, Sun-Ju,Kim, Kyung Hwan,Choi, Hyun Jung,Yoo, Je Ok,Jung, Hyo-Il,Han, Jeong-A,Kim, Young-Myeong,Suh, In Bum,Ha, Kwon-Soo Korean Society of Molecular Biology 2006 Molecules and cells Vol.21 No.1

<P>Maitotoxin (MTX) is known as one of the most potent marine toxins involved in Ciguatera poisoning, but intracellular signaling pathways caused by MTX was not fully understood. Thus, we have investigated whether intracellular reactive oxygen species (ROS) are involved in MTX-induced cellular responses in human umbilical vein endothelial cells. MTX induced a dose-dependent increase of intracellular [Ca(2+)]. MTX stimulated the production of intracellular ROS in a dose- and time-dependent manner, which was suppressed by BAPTA-AM, an intracellular Ca(2+) che-lator. Ionomycin also elevated the ROS production in a dose-dependent manner. MTX elevated transamidation activity in a time-dependent manner and the activation was largely inhibited by transfection of tissue transglutaminase siRNA. The activation of tissue transglutaminase and ERK1/2 by MTX was sup-pressed by BAPTA-AM or ROS scavengers. In addition, MTX-induced cell death was significantly de-layed by BAPTA-AM or a ROS scavenger. These results suggest that [Ca(2+)]-dependent generation of in-tracellular ROS, at least in part, play an important role in MTX-stimulated cellular responses, such as activation of tTGase, ERK phosphorylation, and in-duction of cell death, in human umbilical vein endothelial cells.</P>

중재 시술용 기능성 기관-기관지 팬텀의 유용성

김태형(Tae-Hyung Kim),임청환(Cheong-Hwan Lim),김정구(Jeong-Koo Kim),김명수(Myeong-Soo Kim),최원찬(Won-Chan Choi),임진오(Jin-Oh Lim),이광종(Kwang-Jong Lee),박인애(In-Ae Park),김미옥(Mi-Ok Kim),정은미(Eun-Mi Jung),신령미(Ryung-Mi Shin) 대한방사선과학회(구 대한방사선기술학회) 2003 방사선기술과학 Vol.26 No.4

중재 시술용 기능성 기관-기관지 팬텀을 제작하고, 스텐트 삽입술을 시행하여 그 유용성을 평가하고자 한다. 중재 시술용 기능성 기관-기관지 팬텀은 실리콘으로 제작하였으며, 기관을 통하여 스텐트 삽입술이 가능하도록 삽입구를 제작하였다. 팬텀은 지점토를 이용하여 인체와 동일한 형태로 기관, 기관지 분지부와 양쪽 상부 기관지를 재현하였고, 사각형의 틀에 지점토를 고정시킨 후 액상의 실리콘을 채워 건조시킨 후 지점토를 제거하여 제작하였다. 인체, 동물, 팬텀에서 기관지스텐트 삽입 후 흉부 촬영 필름의 농도와 기관지 분지부의 각도를 측정하여 비교하였다. 기관지스텐트는 세선의 교차가 다른 2가지(X-type, Y-type) 형태를 삽입하였으며, 스텐트 삽입술 후 기관 상부, 기관 분지부, 좌기관지, 우기관지, 스텐트 삽입부의 필름농도를 측정하였다. 필름농도는 기관 상부의 경우, 인체 0.76(±0.011), 동물 0.97(±0.015), 팬텀 0.45(±0.016)이었고, 기관 분지부의 경우는 인체 0.51(±0.006), 동물 0.65(±0.005), 팬텀 0.65(±0.OO8)이었고, 우기관지의 경우는 인체 0.14(±0.OO8), 동물 0.59(±0.014), 팬텀 0.04(±0.007)이었고, 좌기관지의 경우는 인체 0.54(±0.004), 동물 0.54(±O.008)로 팬텀 0.08(±0.OO8)이었고, 스텐트 삽입부의 경우는 인체 0.54(±0.004), 동물 0.59(±0.011), 팬텀 0.04(±0.007)이었다. 기관 분지부가 이루는 각도는 인체의 좌기관지에서 42.6(±2.07)˚, 우기관지에시 32.8(±2.77)˚이었으며, 동물에서 각각 43.4(±2.40)˚, 34.6(±1.94)˚, 팬텀에서 각각 35(±2.00)˚, 50.2(±1.30)˚이었다. 본 연구팀이 제작한 기관-기관지 팬텀은 기관지 스텐트 삽입술의 재현이 가능하여 중재시술의 술기연습용이나 스텐트를 평가하기 위한 체외실험에 사용이 가능할 것으로 사료된다. To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom, respectively. The film density of trachea part were O.76(±O.O11) in human, O.97(±O.015) in animal, O.45(±O.O16) in phantom. The tracheobronchial bifurcation part measured O.51(±O.OO6) in human, O.65(±O.OO5) in animal, O.65(±O.008) in phantom. The right bronchus part measured O.14(±0.008) in human, O.59(±0.014) in animal and O.O4(±O.OO7) in phantom. The left bronchus were O.54(±O.004) in human, O.54 (±0.008) in animal and O.08(±0.008) in phantom. At the stent part were O.54(±O.004) in human, O.59(±0.011) in animal and O.04(±0.007) in phantom, respectively. The tracheobronchial angle of the left bronchus site were 42.6(± 2.07)˚ in human, 43.4(±2.4O)˚ in animal and 35(±2.00)˚ in phantom, respectively. The right bronchus site were 32.8(±2.77)˚ in human, 34.6(±1.94)˚ in animal and 50.2(±1.30)˚ in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce.

환자 분류에 기초하여 입원병동의 적정 간호인력을 산정하는 모델

김경옥,박미정,이인광,박경순,손호선,김경아,서창진,차은종,Kim, Kyoung-Ok,Park, Mi-Jung,Lee, In-Kwang,Park, Kyung-Soon,Shon, Ho-Sun,Kim, Kyung-Ah,Seo, Chang-Jin,Cha, Eun-Jong 대한의용생체공학회 2016 의공학회지 Vol.37 No.2

Nursing staffing is of major interest in hospital management, however, no practical method has been developed. The present study proposed a mathematical model based on the patient classification system for nursing staffing optimization. A few characteristic parameters possibly determined experimentally and/or empirically were introduced followed by systematic calculation of the required number of nurses. An essential concept of the model is the unit work load defined as the amount of nursing work performed on single patient per unit time, where the work load is defined as the number of nursing staffs multiplied by the working hours. The unit work load was considered to vary with the patient classification level as well as the working time during a day, both of which were represented by corresponding parameter values. The number of patients for each class and the number of working hours were multiplied to the unit work load, and added up to obtain the total required work load. As the next step, the averaged number of hours that a nurse could provide per day was formulated considering the degree of nursing practice experience into 3 levels. Finally, the appropriate number of nursing staffs was calculated as the total work load divided by the average working hours per nurse. The present technique has a great advantage that the number of nursing staffs to fulfill the required work load is systematically calculated once the characteristic parameters are appropriately determined, leading to instant and fast evaluation. A practical PC program was also developed to apply the present model to nursing practice.

저층 경계면 연구용 Benthic chamber(BelcI) 개발

이재성,박경수,강범주,김영태,배재현,김성수,박정준,최옥인,Lee, Jae-Seong,Bahk, Kyung-Soo,Khang, Buem-Joo,Kim, Young-Tae,Bae, Jae-Hyun,Kim, Seong-Soo,Park, Jung-Jun,Choi, Ok-In 한국해양학회 2010 바다 Vol.15 No.1

소형선박에서 운영이 가능한 연안용 benthic chamber(BelcI)를 개발했다. 운영상에 유연성이 큰 BelcI는 연안 저층 경계면 연구에 폭넓게 이용될 수 있을 것으로 판단된다. BelcI는 몸체, 자동채수기, 교반기 및 전자제어부로 구성된다. 운영상에 유연성을 극대화하기 위해 몸체는 사각 셀 단위의 2단 구조로 설계했다. 센서신호의 증폭, 교반기 및 채수장치 제어회로를 초 전력 소모 회로로 구성하여 외부 전원장치를 제거했다. PIV(particle image velocimetry)기법으로 측정한 chamber 내부의 유체유통은 전형적인 radial-flow impeller의 특성을 나타냈다. chamber내 물의 혼합 시간은 약 30초로 추정되었으며, 바닥면에서 shear velocity($u^*$)는 약 $0.32\;cm\;s^{-1}$였다. 산경계층(DBL) 두께는 약 $180{\sim}230\;{\mu}m$였다. 현장에서 측정한 산소소모율은 약 $84\;mmol\;O_2\;m^{-2}\;d_{-1}$로 선상배양결과 보다 2배 이상 컸다. 저층 영양염 플럭스는 "질산+아질산"이 $0.18\;{\pm}\;0.07\;mmol\;m^{-2}\;d^{-1}$, 암모니움이 $2.3\;{\pm}\;0.5\;mmol\;m^{-2}\;d^{-1}$, 인산인이 $0.09\;{\pm}\;0.02\;mmol\;m^{-2}\;d^{-1}$, 규산규소가 $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$로 추정되 었다. We have developed an in-situ benthic chamber (BelcI) for use in coastal studies that can be deployed from a small boat. It is expected that BelcI will be useful in studying the benthic boundary layer because of its flexibility. BelcI is divided into three main areas: 1) frame and body chamber, 2) water sampler, and 3) stirring devices, electric controller, and data acquisition technology. To maximize in-situ use, the frame is constructed from two layers that consist of square cells. All electronic parts (motor controller, pA meter, data acquisition, etc.) are low-power consumers so that the external power supply can be safely removed from the system. The hydrodynamics of BelcI, measured by PIV (particle image velocimetry), show a typical "radial-flow impeller" pattern. Mixing time of water in the chamber is about 30 s, and shear velocity ($u^*$) near the bottom layer was calculated at $0.32\;cm\;s^{-1}$. Measurements of diffusivity boundary layer thickness showed a range of $180-230\;{\mu}m$. Sediment oxygen consumption rate, measured in-situ,was $84\;mmol\;O_2\;m^{-2}\;d_{-1}$, more than two times higher than on-board incubation results. Benthic fluxes assessed from in-situ incubation were estimated as follows: nitrate + nitrite = $0.18\;{\pm}\;0.07\;mmol\;m^{-2}\;d^{-1}$ ammonium $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$ phosphate = $0.09\;{\pm}\;0.02\;mmol\;m^{-2}\;d^{-1}$ and silicate = $23\;{\pm}\;1\;mmol\;m^{-2}\;d^{-1}$.

S-470 : A Case of EBV-associated Angioimmunoblastic T-cell Lymphoma Mimicking Drug Hypersensitivity Syndrome

( Sang Heon Suh ),( Yu Na Jeong ),( Mi Ok Jang ),( Seung Ji Kang ),( Hee Chang Jang ),( Sook In Jung ),( Kyung Hwa Park ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

71-year old female patient was referred from an outside hospital to our facility for evaluation of persistent fever with rash in spite of in-hospital care for more than 20 days. Considering her medication history that she had been suffered from intermittent febrile sense and dry cough for about 5 months, for which other medications were prescribed from several general physicians` clinics, and lack of evidence for infection, she was tentatively diagnosed with drug hypersensitivity syndrome (DHS). While starting the treatment with intravenous methylprednisolon 62.5 mg per day, we reviewed the medical history more specifically to find out the culprit that might trigger DHS, although her medication history failed to nominate the culprit drug, because any drugs were not taken long enough to evoke DHS. Seeking for alternative diagnoses, lymphoproliferative diseases were suspected, since marked lymphadenpathies were observed in chest and abdomen computed tomography. After initial stabilization with steroid treatment, excisional biopsy from right axillary lymph nodes was done on hospital day 3. Confirmatory reading available on hospital day 8 demonstrated angioimmunoblastic lymphoma (AITL), although patient expired on hospital day 5 due to refractory hypomia by ventilator-associted pneumonia. Serologic and molecular evaluation indicated the patient`s Ebstein-barr virus (EBV) infection (Table 1). Here, we report a case of EBV-associated AITL with an unusual cutaneous manifestation mimicking DHL.

An analysis of the number of liver and kidney transplantations during COVID-19 pandemic in Korea

Jung-Ja Hong,Shin Hwang,Deog-Bok Moon,Young Hoon Kim,Sung Shin,In-Ok Kim,Sae-Rom Lee,Ah-Young Lee,Jiwon Woo 대한이식학회 2021 Korean Journal of Transplantation Vol.35 No.4

Background: The severity of the coronavirus disease 2019 (COVID-19) pandemic has discouraged organ donation. However, the prevalence of COVID-19 in Korea was much lower in comparison to Western countries. With this, the authors decided to determine the real-world impact of COVID-19 on organ donation and transplantation in Korea. Methods: The number of kidney transplantations (KTs) and liver transplantations (LTs) performed in 2020 were compared with those in 2019 using the Korean Network for Organ Sharing database and Asan Medical Center (AMC) database. Results: The annual number of deceased donors (DDs) was 450 in 2019 compared to 478 in 2020. Monthly DD number was 37.5±5.9 in 2019 and 39.8±4.4 in 2020 (P=0.284). Annual number of DD kidney transplant (DDKT) was 794 in 2019 and 848 in 2020, and monthly number was 66.1±10.4 in 2019 and 70.7±9.8 in 2020 (P=0.285). The annual number of DDLT was 391 in 2019 and 395 in 2020, and the monthly number was 32.6±5.7, 2019 and 32.9±4.7 in 2020 (P=0.877). The annual number of living donor (LD) KT was 2,293 in 2019 and 1,432 in 2020, and the monthly number was 191.1±19.5 in 2019 and 119.3±11.7 in 2020 (P<0.001). Annual number of living donor LDLT was 1,577 in 2019 and 1,146 in 2020, and monthly number was 131.4±18.1 in 2019 and 95.5±8.0 in 2020 (P<0.001). In the AMC, not all types of KT and LT changed significantly. Conclusions: The results of this study indicate that the number of DD organ transplantations remained stable in Korea in 2020, but the number of LD organ transplantations was significantly reduced. However, the number of organ transplantations did not change in the AMC.

Effects of repeated restraint stress on platelet endothelial cell adhesion molecule-1 immunoreactivity and protein levels in the gerbil hippocampus after transient cerebral ischemia

Ok Kyu Park,Choong Hyun Lee,In Koo Hwang,Ki-Yeon Yoo,Jung Hoon Choi,Moo-Ho Won 대한해부학회 2010 Anatomy & Cell Biology Vol.43 No.1

Stress has long been known to be a causative factor of various disease states. In this study, we investigated the effects of repeated restraint stress on platelet endothelial cell adhesion molecule-1 (PECAM-1), a very important mediator in inflammation, immunoreactivity and protein levels as well as neuronal damage, in the gerbil hippocampus after 5 minutes of transient cerebral ischemia. Transient ischemia-induced neuronal death was shown in CA1 pyramidal cells 4 days after ischemia/reperfusion. However, repeated restraint stress protected neuronal death induced by ischemic damage. In the ischemia-group, PECAM-1 immunoreactivity and its protein levels were significantly increased in all the hippocampal subregions 4 days after ischemia/reperfusion. However, PECAM-1 immunoreactivity and its protein levels did not change significantly in the hippocampus of the stress-ischemia-group compared to the sham-groups. These results indicate that repeated restraint stress protects neuronal damage induced by transient cerebral ischemia, and this may be associated with maintenance of PECAM-1levels.

Fluorescent image guided surgical staging: Pelvic and para-aortic lymphatic system directly visualized with fluorescent image in single-port laparoscopy

( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Jae Hoon Kim ),( Sang Wun Kim ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: Demonstrate a new instrument, technique or procedure. 방법: The aim of this video is to demonstrate fluorescent image guided sentinel lymph node detection and systematic whole pelvic and para-aortic lymphadenectomy during single port laparoscopic surgical staging in endometrial cancer patients. Fluorescent image guided single-port laparoscopic sentinel lymph node dissection and whole pelvic and para-aortic lymphadenectomy using PINPOINT endoscopic fluorescent imaging system (NOVADAQ’s) will be introduced. First, sentinel lymph node and pelvic lymphatic flow system will be visualized using PINPOINT endoscopic fluorescent imaging system (NOVADAQ’s) after injecting 2ml of indocyanine green (ICG; 1.25mg/ml) on the bilateral cervix (3 and 9 O’clock, superficial 1ml, deep 1ml on each side). The pelvic lymph nodes and lymphatic channels from the uterus will be directly visualized. Also the secondary lymph nodes will be shown and fluorescent image guided whole pelvic lymphadenectomy in the aspect of gynecologic cancer surgical staging will be demonstrated. Second, the para-aortic lymph nodes will be visualized after ICG injection on the uterine fundus and the possibility of para-aortic sentinel lymph node detection will be demonstrated. Then fluorescent image guided para-aortic lymphadnectomy will be shown. 결과: Single-port laparoscopic surgical staging as well as single-port laparoscopic sentinel lymph node dissection were successfully performed in endometrial cancer patients with the guide of fluorescent imaging system. 결론: With developments on laparoscopic instruments and surgical tools, pelvic and para-aortic lymphatic flows could be visualized and systematic lymphadenectomy could be performed under the guidance of fluorescent image not only in robotic surgery but also in laparoscopic surgery. These techniques will further facilitate single-port laparoscopic endometrial cancer surgical staging.