대장수술 후에 발생한 급성신부전의 위험인자

이혜미,황창재,김재황,김흥대,박대팔,서일숙,송선옥,김세연,이덕희,지대림 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

연구 배경 : 급성 신부전은 술 후 발생할 수 있는 합병증 중에서 사망률은 큰 영향을 줄 수 있으므로 이 연구를 통해 위험인자를 알아보려고 한다. 재료 및 방법 : 2004년 1월부터 2006년 12월까지 3년간 영남대학교 의과대학 부속병원에서 대장 수술을 받은 570명의 환자들을 대상으로 하였다. 환자들의 성별과 연령, 미국 마취과학회 신체등급, 동반질환, 수술의 종류, 응급수술의 여부, 수술 시간, 재수술의 여부, 술 중의 투약 상황, 술 후에 자가 통증 조절기에 사용한 약제, 술 중에 저혈압의 유무, 수혈 여부, 술 후 기계적 환기를 시행한 경우를 비교하였다. 결과 : 비교 결과에서 성별과 수술의 종류, 응급 수술의 여부, 개복여부 등에는 유의한 차이를 보이지 않았다. 반면 환자의 나이와 수술 시간, 재수술의 여부, 술중에 이뇨제 등을 사용한 경우, 술 중에 저혈압의 유무, 술 후에 기계적 환기를 시행한 경우 등에는 유의한 차이를 보였다. 결론 : 이상의 결과로 급성신부전의 원인은 어느 한 가지라고 하기 보다는 위험인자에 얼마나 노출되어 있는가가 결정하는 것 같고, 그 원인들이 모여서 상승효과를 내는 것 같다. 그러므로 수술 전부터 많은 위험에 노출된 환자는 술 중 더 적극적인 감시를 시행하여 수술 후의 합병증 발생을 줄이는 노력을 기울여야 하겠다. Background : Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. Materials and Methods : Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. Results : The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). Conclusion : Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

고관절 전치환술 후 비구컵 고정 나사못 돌출에 의한 비구컵 라이너의 해리: 2예 보고

전유선 ( Yoo Sun Jeon ),황득수 ( Deuk Soo Hwang ),강찬 ( Chan Kang ),김필성 ( Pil Sung Kim ),황정모 ( Jung Mo Hwang ),송재황 ( Jae Hwang Song ) 대한고관절학회 2013 Hip and Pelvis Vol.25 No.3

무시멘트형 고관절 전치환술을 받은 환자들 중 비구 고정 나사못 이완에 의한 비구컵 라이너(acetabular liner)의 해리(dissociation) 소견을 보였던 2예의 보고이다. 두 예에서 환자는 수술 후 통증과 관절 잡음의 발생을 주소로 내원하였고 방사선학적 소견상 지주형태 골이식 부위의 붕괴(collapse) 소견을 보이며 비구컵 라이너가 해리된 소견을 보였다. 모든 예에서 재치환술 시 나사못이 비구컵 안쪽으로 돌출(extrusion)되어 있었고 비구컵이 상부로 이동되면서 이로 인하여 비구컵의 라이너가 해리된 것으로 추정되었다. 지금까지 고관절 전치환술 후 나사못의 관절내 돌출에 의한 비구컵 라이너 해리에 대한 증례는 보고되지 않았다. 이에 저자들은 구조성 자가골 이식(structural autogenous bone graft)을 시행한 고관절 전치환술 후 나사못 문제로 인하여 발생한 인공 관절 비구컵 라이너의 해리에 대한 증례보고를 하고자 한다. This is a report of 2 cases that showed dissociation of the acetabular cup liner by acetabular fixation screw among patients who underwent total hip replacement. Screws for fixation of the acetabular cup were used during the primary surgery in both cases. Each patient visited the out patient department complaining of pain and noise from the joint; radiologic finding revealed a collapse of the column shape bone graft area with dissociation of the acetabular cup liner. In both cases, during revision surgery, screw was extruded to the inner side of the acetabular cup, since it migrated superiorly. There has been no report of liner dissociation by extrusion of acetabular cup fixation screw after total hip replacement. Therefore, we report two cases of dissociation of the acetabular cup liner of hip arthroplasty, which occurred due to screw issues after total hip replacement with structural autogenous bone graft.

Long-term follow-up on MURCS (Müllerian duct, renal, cervical somite dysplasia) association and a review of the literature

Sun Kim,Yeong Seok Lee,Dong Hyun Kim,Aram Yang,Tack Lee,Seun Deuk Hwang,권대규,이지은 대한소아내분비학회 2019 Annals of Pediatirc Endocrinology & Metabolism Vol.24 No.3

Müllerian duct aplasia-renal aplasia-cervicothoracic somite dysplasia (MURCS) association is a unique development disorder with four common types of malformations that include uterine aplasia or hypoplasia, renal ectopy or agenesis, vertebral anomalies, and short stature. The majority of MURCS patients are diagnosed with primary amenorrhea from late-adolescence. However, a few cases with MURCS association are not well diagnosed during childhood and long-term outcomes are not well reported. We report a case of an 8-year-old girl with MURCS association who presented with recurrent urinary tract infections and multiple congenital malformations, and who was followed for 10 years until adulthood. MURCS association should be considered as one of the differential diagnoses when evaluating prepubertal females with vertebral and renal malformations.

Novel dihydrobenzofuro[4,5-b][1,8]naphthyridin-6-one derivative, MHY-449, induces apoptosis and cell cycle arrest in HCT116 human colon cancer cells

HWANG, HYE JUNG,KANG, YONG JUNG,HOSSAIN, MOHAMMAD AKBAR,KIM, DONG HWAN,JANG, JUNG YOON,LEE, SUN HWA,YOON, JEONG-HYUN,MOON, HYUNG RYONG,KIM, HYUNG SIK,CHUNG, HAE YOUNG,KIM, NAM DEUK Spandidos Publications 2012 International journal of oncology Vol.41 No.6

<P>Colorectal cancer (CRC) is the second most frequent cancer in men and the third most common cancer in women in Korea. In spite of the significant advances in conventional therapeutic approaches to CRC, most patients ultimately die of their disease. There is a need to develop novel preventive approaches for this malignancy. This study was carried out to investigate the anticancer effect of the diastereoisomeric compounds, MHY-449 and MHY-450, novel dihydrobenzofuro[4,5-b][1,8]naphthyridin-6-one derivatives, on HCT116 human colon cancer cells. MHY-449 exhibited more potent cytotoxicity than MHY-450, against HCT116 cells. Treatment of cells with MHY-449 resulted in growth inhibition and induction of apoptosis in a concentration-dependent manner, and inhibition of proliferation in a time-dependent manner. The induction of apoptosis was observed by decreased cell viability, DNA fragmentation, activation of protein levels involved in death receptors. Moreover, activation of caspase-3, -8 and -9 and cleavage of poly(ADP-ribose) polymerase and alteration in the ratio of Bax/Bcl-2 protein expression was observed. MHY-449 induced G2/M phase arrest in the cell cycle progression which was observed by flow cytometry analysis, and a decrease in the protein expression of cyclin?B1 and its activating partners Cdc25c and Cdc2. MHY-449 also caused increase in the expression levels of p53, a tumor suppressor gene, and p21WAF1/CIP and p27KIP, G2/M phase inhibitors. These results suggest that MHY-449 may be a useful candidate for chemo-prevention and/or treatment of colon cancer.</P>

Preparation of methoxy and ethoxy nonafluorobutanes

Hwang, Sun Hee,Kim, Ju Ryun,Lee, Sang Deuk,Lee, Hyun Joo,Kim, Hoon Sik,Kim, Hong Gon THE KOREAN SOCIETY OF INDUSTRIAL AND ENGINEERING 2007 JOURNAL OF INDUSTRIAL AND ENGINEERING CHEMISTRY -S Vol.13 No.4

Research Articles : Preparation of Methoxy and Ethoxy Nonafluorobutanes

( Sun Hee Hwang ),( Ju Ryun Kim ),( Sang Deuk Lee ),( Hyun Joo Lee ),( Hoon Sik Kim ),( Hong Gon Kim ) 한국공업화학회 2007 Journal of Industrial and Engineering Chemistry Vol.13 No.4

아리스톨로크산 함유 생약제에 대한 안전성평가연구 : 3개월간 반복투여독성시험을 통한 신장독성평가

황명실,박미선,문지영,이지선,염영나,이효민,신동환,강진석,윤은경,최미나,육미영,장동덕,길광섭,김승희,양기화 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

본 실험에서는 아리스톨로크산을 함운하고 있는 생약제중 하나인 마두령(.4risfoforfioe JTurruf)의 90일 반복투여독성시헌을 실f,」하였다. 마두령에서 아리스톨로크산을 정량분석한 결과 마두령 단일 건조븐말의 경운 2.112mg/g, 잉상에서 처방되고 있는 마든령복방 (마두령외 9가지 생약제 복합처방) 건조분말꼭 경무에는 0.066m9/5으로 각각 검출되었다. 본 실험에서 용량설정은 마두령 처리군 (저용량 군; 21.3m9/k9/day (임상용량), 중용량군; 2t3mgfg/day, 고용량군; 2430mg딘g b.w./day), 마두령복방 처리군 (427mg/kg b.w./da?; 임상용량) 및 positive control (아리스톨로크산) 처리군 (저용량군;0.05mgag/da17, 중용량군; 0.Smg/kg/day, 고용량군; 5mg./kg/dal·1으료 하여 랫드에게 경구투여하였다. 마두령단방 처궈근 및 마두령복방 처리군에서 저용량군과 중응량군에서는 잉상관찰 및 생화학적 분석에서 패조군과 유의적인 차이가 없었다. 그러나 마두령단방 고용량근에서는 간, 신장의 상대적인 무계가 증가되었고, 신장의 유두이행상피증식 및 암종이 관찰되었으며, 위에서는 편평세포암종이 관찰되었다. 하자만 간손상이나 간암은 유발하지는 않는 것으로 판단되었다. 결론끌으로 본 실험의 결과에서는 아리스톨로크산 함유 생약제인 마두령이 임상용량인 저응량 처리군에서는 독성을 나타내지 않았으나, 고용쏭으로 장기 복용시켰을 깅우 설치류의 전위부위 및 신장에서 독성이 있음을 알 수 있었다. Chines herbs nephropathy (CHN) has been described in young women who had taken a slimming pills containing some chines herbs. Aristolochic acid (AA), suspected substance as the causal factor of CHN, is known a carcinogen. The Aristolochiae fructus (fruit of Aristolochia contorta) was used in Korean Traditional Medicine consists of appropriate amounts of mixed natural products. Subchronic toxicity of A. furctus containing aristolochic acid was investigated in SD rats. The body weight and clinical signs were observed after orally administration of A. futctus at doses of 21.2, 213, and 2130 mg/kg/day; mixture (including 9 other herbs) at dose of 427 mg/kg/day; aristolochic aicd (Ⅰ+Ⅱ) at doses of 0.05, 0.5, and 5 mg/kg/day for 3 months. At the end of the treatment, high dose treated animals revealed a deficit in final body weight about 25% compared with that of control. Organ weights of kidney, liver, testis, or ovary were increased with dose dependent manner. No changes considered to be due to the administration of A. furctus, mixture or aristolochic acid were in hematological and clinical study. However, significant changes at histopathological study of kidney and stomach were boserved in high-dose treated groups. In conclusion, for human health safety it needs appropriate regulatory actions regarding the use of natural herbal medicines known or suspected of containing aristolochic acid.

Gintonin-mediated release of astrocytic vascular endothelial growth factor protects cortical astrocytes from hypoxia-induced cell damages

Sun-Hye Choi,Hyeon-Joong Kim,Hee-Jung Cho,Sang-Deuk Park,Na-Eun Lee,Sung-Hee Hwang,Hyewon Rhim,Hyoung-Chun Kim,Ik-Hyun Cho,Seung-Yeol Nah 고려인삼학회 2019 Journal of Ginseng Research Vol.43 No.2

Background: Gintonin is a ginseng-derived exogenous ligand of the G protein-coupled lysophosphatidic acid (LPA) receptor. We previously reported that gintonin stimulates gliotransmitter release in primary cortical astrocytes. Astrocytes play key roles in the functions of neurovascular systems. Although vascular endothelial growth factor (VEGF) is known to influence the normal growth and maintenance of cranial blood vessels and the nervous system, there is little information about the effect of gintonin on VEGF regulation in primary astrocytes, under normal and hypoxic conditions. Methods: Using primary cortical astrocytes of mice, the effects of gintonin on the release, expression, and distribution of VEGF were examined. We further investigated whether the gintonin-mediated VEGF release protects astrocytes from hypoxia. Results: Gintonin administration stimulated the release and expression of VEGF from astrocytes in a concentration- and time-dependent manner. The gintonin-mediated increase in the release of VEGF was inhibited by the LPA1/3 receptor antagonist, Ki16425; phospholipase C inhibitor, U73122; inositol 1,4,5-triphosphate receptor antagonist, 2-APB; and intracellular Ca<SUP>2+</SUP> chelator, BAPTA. Hypoxia further stimulated astrocytic VEGF release. Gintonin treatment stimulated additional VEGF release and restored cell viability that had decreased due to hypoxia, via the VEGF receptor pathway. Altogether, the regulation of VEGF release and expression and astrocytic protection mediated by gintonin under hypoxia are achieved via the LPA receptoreVEGF signaling pathways. Conclusion: The present study shows that the gintonin-mediated regulation of VEGF in cortical astrocytes might be neuroprotective against hypoxic insults and could explain the molecular basis of the beneficial effects of ginseng on the central nervous system.

Prognostic Value of Pretreatment Metabolic Tumor Volume and Total Lesion Glycolysis Using 18F-FDG PET/CT in Patients With Metastatic Renal Cell Carcinoma Treated With Anti–Vascular Endothelial Growth Factor–Targeted Agents

Hwang, Sang Hyun,Cho, Arthur,Yun, Mijin,Choi, Young Deuk,Rha, Sun Young,Kang, Won Jun Wolters Kluwer Health, Inc. All rights reserved. 2017 Clinical nuclear medicine Vol.42 No.5

<P>Conclusions: Metabolic tumor volume and TLG are independent prognostic factors for predicting PFS and OS in patients with metastatic RCC. Furthermore, MTV and TLG could provide additional prognostic information in patients with clinically high-risk metastatic RCC treated with anti-vascular endothelial growth factor-targeted therapies.</P>

Perfluoroacyl halide 알킬화에 의한 Alkoxy nonafluorobutane 의 합성

황선희,이상득,김홍곤,김주련 한국공업화학회 2000 응용화학 Vol.4 No.1

Synthesis of alkoxy nonafluorobutanes (C₄F_9OR, R=CH₃, C₂H_5), which are considered as prospective alternatives for Cl-containing cleaning solvents such as CFC-113, CH₃CCl₃, CCl₂=CCl₂ and HCFC-141b, by alkylation of acyl halides was studied. Effect of selecting a fluorinating agent, an alkylating agent and a solvent, effect of reaction temperatures, and effect of reaction methods on the yield of C₄F_9OR were evaluated. Heptafluorobutyryl chloride (C₃F_7COC1) or heptafluorobutyryl fluoride (C₃F_7COF) was reacted with an alkali metal fluoride in an aprotic polar solvent to produce alkali metal nonafluorobutoxide (C₄F_9O^-M^+) which was later converted to C₄F_9OR by reacting with an alkylating agent. It was revealed that low reaction temperatures were effective for both the first stage reaction producing C₄F_9O^-M^+ and the second stage reaction alkylating C₄F_9O^-M^+ to C₄F_9OR by prohibiting from the excessive decomposition of C₄F_9O^-M^+ to C₃F_7COF. It was also revealed that CsF was more effective than KF for producing C₄F_9O^-M^+, dimethyl formamide was more effective than diglyme as an aprotic polar solvent, and dimethylsulfate was more effective than methyl triflate as a methylating agent. Two-stage reactions with periodical feeding of the reactants, which could easily control the reaction temperature, showed higher yields of C₄F_9OR than one-pot reactions with all of the reactants mixed at once.