급성 중독 환자에 대한 역학적 고찰 : 서울과 지방의 비교

김성중,김인병,최성욱,김경수,이영수,Choi, Jong Moo 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study objective: To compare patients with acute poisoning between urban and rural areas Design: Retrospective chart review of 217 patients with acute poisoning Setting: Two University Hospital EDs Methods: patients were divided into two groups according to hospital. The group A was 109 patients who came to ED of Asan Medical Center and the group B was patients who came to ED of Ajou University Hospital from June 1994 to February 1995. We analysed the age and sex distributions, poisoning substances. causes of poisoning and the past history of psychiatric problems in patients of the two groups. Results: Total number of patients with acute poisoning were 109 in the group A and 108 in the group B. Female was more prevalent than male in the group A and male was more than female in the group B. There was a significant difference in sex distribution between two groups. The mean age of the group A was 27.7 years which was significantly different from the mean age of the group B, 33.7 years. The age incidences in both group were highest in 2nd decade. The accidental poisoning cases were 37% in the group A and 31% in the group B. The rates of committed suicide were 7% in the group A and 22% in the group B. The most common agent of poisoning was therapeutic drug in the group A and agricultural or industrial chemical in the group B. The overall mortality was 5% in the group A and 15% in the group B. Conclusion: There were significant differences in age and sex distributions. poisoning substances, causes of poisoning and the past history of psychiatric problems between two groups.

이상 시 <신경질적으로비만한삼각형>의 해석

성인수(Seong, In-soo) 국어국문학회 2016 국어국문학 Vol.- No.175

이상의 일본어시 중 <이상한 가역반응> 계열시는, 시적 화자(이상)가 ‘밖(외부나 외국)으로 나가려면 더 죄어오는 주변의 압력’에 관한 시들이다. 화자(이상)는 <이상한 가역반응>에서 ‘프랑스 여인을 향한 도피’를, <破片의 景色->에서 ‘프랑스행을 현실적으로 포기함’을, <▽의 遊戱->에서 ‘그래도 프랑스 여인을 잊지 못함’을, <수염->에서는 ‘화자 이상의 현실과 현실적 고뇌’를 표현했다. 시 <브와뜨․브와뜨즈>에서 화자(이상)에 대한 고문의 증거로, 시 <공복ㅡ>은 두 진영 간의 치열한 대립과 싸움을 벗어나고픈 화자(이상)의 갈증이 시작된 ‘좌·우’ 문제로 해석하였다. 필자는 시 <조감도> 연작시는 시적 화자(이상)가 ‘하늘에서 화자 자신의 모습을 내려 보기’를 요청한 시라고 해석했다. 화자는 <이인…1…>에서 자신을 괴롭히는 ‘첫 번째 사람’으로 ‘총독부의 일본인 조선건축회 상사’를 상징시로 고발하였다. 화자는 <이인…2…>에서 자신에게 어려움을 준 ‘두 번째 사람’으로 자신을 회유하려던 ‘조선귀족회 귀족이나 그 대행자’를 상징시로 표출하여 고발했다. 필자는 앞선 시 <破片의 景色->, <▽의 遊戱-> 등에 등장한 ‘▽’의 의미로 시 <神經質的으로肥滿한三角形>을 해석하고자 한다. ‘▽’이 뚱뚱(비만)해져서 ‘○’(원)이 되는 위상기하학적 과정으로 해석하였다. 이 시는 ‘원’이 화자를 둘러쌓아 구속하는 것을 ‘신경질적으로’ 바라보고 있는 시적 화자(이상)의 현실을 증언한 셈이다. 즉, ‘원’(으로 둘러 싼 굴레)이 ‘직선’ (탈출을 꿈꾸는 시적화자 이상)을 구속하고 있다며, 프랑스 여인이 화자 자신을 구속하는 것과, 그 여인에게 매몰되는 화자 자신이 싫다는 발언을 한 것이다. 그렇지만, 화자는 대상(캐러반) 속에 몸을 숨겨서라도 사막을 건너 프랑스로 건너가고 싶은 의욕을 과시했다. The series of poems <Abnormal Reversible Reaction> of Lee, Sang"s Japanese poems depict the surrounding pressure exerted more severely as the narrator(Lee, Sang)struggles to go out(outside or abroad). The poetic narrator(Lee, Sang) expressed his desire to escape to the French woman in <Abnormal Reversible Reaction> and the abandonment of his dream of going to France for practical reasons in <Fragmentary landscapes>, still not forgetting the French woman in <Game playing of ▽->, and his reality and distress in <Beard ->. In <BOITEUX․BOITEUSE>, the evidence of torture inflicted upon the narrator(Lee, Sang) can be read. The poem <Hungerㅡ> is interpreted as the right and the left problems which caused the narrator"s thirst for getting out of the conflict and fight between two opponent parties. The serial poems of <Bird"s eye view> can be interpreted as urging the poetic narrator(Lee, Sang) to look down at himself from the sky. In <Two persons …1…>, the narrator symbolically accused the Japanese superior of Chosun Architectural Association in Japanese Government General of Korea as "the first person" who harassed him in. The narrator named the acting governor as Al Capone, an international criminal, to show the cruelty and violence of Japan"s imperialism. In the poem <Two persons…2…>, the narrator symbolically accused the nobleman of Chosun Nobility Association and his agent who tried to conciliate him as "the second person" who troubled him. This paper aims to interpret the poem <Triangle oversized nervously> in the meaning of ‘▽’ appearing in the previous poems <Fragmentary landscapes>, <Game playing of ▽-> and so on. It is interpreted as the topological process of ‘▽’"s getting oversized and becoming ‘○’(circle). The circle testifies the reality of the poetic narrator(Lee, Sang) who nervously watches the circle surrounding and restraining him. That is, it is stated that "circle" (the bridle surrounded by the circle) is blocking the "straight line" (the poetic narrator dreaming of escape), and that the narrator himself hates his confinement to the French woman and his being absorbed in her. However, the narrator showed the desire to go to France even by hiding himself in the caravan.

류마티스 관절염 환자의 T세포 수용체 Vβ 유전자 레퍼토리 분석

정성수 ( Sung Soo Jung ),황관표 ( Kwan Pyo Hong ),김동욱 ( Dong Yook Kim ),김태환 ( Tae Hwan Kim ),이인홍 ( In Hong Lee ),전재범 ( Jae Bum Jun ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),김성윤 ( Seong Yoon Kim ),이은영 ( 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.1

목적: 류마티스 관절염(rheumatoid arthritis; RA)의 병인에 있어 중추적인 역할을 하는 것으로 알려진 T세포에 관한 연구가 최근에 관심의 초점이 되고 있으나, 현재까지 한국인을 대항으로 시행된 보고는 없다. 한국인 류마티스 관절염 환자의 관절병변부위에서 T세포 수용체(TCR)의 Vβ유전자 사용의 빈도를 검색하여 한국인 류마티스 관절염 환자에서 사용되는 빈도가 높은 유전자계를 찾는데 목적을 두었다. 방법: 이에 저자는 T세포에 관한 연구의 일환으로 류마티스 관절염 환자 3명과 정상인 4명을 대상으로 말초 혈액과 활액 T세포로부터 추출한 RNA를 이용하여 cDNA를 합성한뒤 cDNA를 주형을 Vβ family specific oligonucleotide를 시발체(primer)로하여 반정량적 역전사 연쇄중합반응(semiquantative RT-PCR)을 시행하여 T세포 수용체(T cell receptor; TCR) Vβ 레퍼토리를 분석하여 다음과 같은 결과를 얻었다. 결과: 1. 정상인 4명의 말초혈액에서 T세포 수용체 Vβ유전자 평균사용빈도는 Vβ7(8.68±3.20%), Vβ3(7.83±2.03%), Vβ(6.74±1.43%)의 순서로 빈도가 높았으며, HLA-DR4 양성군(3명)에서는 Vβ8(7.39±1.71%), Vβ2(7.31±2.30%), Vβ1(7.22±1.54%)의 순서로 빈도가 높았고, HLA-DR4 음성(1명)에서는 Vβ3(17.79%), Vβ4(11.41%), Vβ24(9.8%)의 순서로 사용빈도가 높았다. 2. 류마티스 관절염환자 3명의 말초 혈액에서는 Vβ16(6.90±1.81%), Vβ18(6.89±0.80%), Vβ14(6.58±0.65%)의 순서로 빈도가 높았다. HLA-DR4 양성 환자군에서는 Vβ16(7.52±2.06%), Vβ14(6.96±0.04%), Vβ22(6.78±0.18%)의 순서로 빈도가 높았다. 각각 환자의 결과를 보면 첫번째 환자(HLA-DR4 양성)는 Vβ16(8.98%), Vβ14(6.99%), Vβ22(6.91%)의 순서로 빈도가 높았고, 두번째 환자(HLA-DR13 양성)는 Vβ18(7.79%), Vβ20(5.98%), Vβ24(5.90%)의 순서로 빈도가 높았다. 이를 종합해 보면 류마티스 관절염 환자의 말초혈액에서 Vβ16, Vβ20, Vβ14, Vβ18유전자계가 제한되어 사용되었다. 3. 류마티스 관절염환자의 활액의 T세포에서 Vβ유전자 평균발현빈도는 Vβ20(7.39±1.77%), Vβ18(5.60±1.31%), Vβ12(5.56±1.77%)순으로 높았으며, HLA-DR4양성인 환자군에서는 Vβ12(6.56±0.58%), Vβ20(6.44±0.94%), Vβ4(5.30±0.49%)순으로 빈도가 높았으며, HLA-DR4음성 환자에서는 Vβ20(9.29%), Vβ19(7.57%), Vβ18(7.07%)의 순서로 빈도가 높았다. 각각 환자의 결과를 보면 첫번째 환자(HLA-DR4 양성)는 Vβ12(6.15%), Vβ20(5.77%), Vβ7(5.74%)의 순서로 빈도가 높았고, 두번째 환자(HLA-DR4 양성)는 Vβ20(7.10%), Vβ12(6.98%), Vβ24(5.83%)의 순서이었고, 세번째 환자(HLA-DR13 양성)는 Vβ20(9.29%), Vβ19(7.57%), Vβ18(7.06%)의 순서로 빈도가 높았다. 활액 T세포에서는 Vβ20, Vβ12유전자계가 제한되어 사용되었다. 4. 말초 혈액에 비해 활액 T세포에서 TCR Vβ유전자 사용빈도가 1.5배 이상인 경우는 Vβ5.2, Vβ9, Vβ23 이었으나, 이들 유전자계가 활액 T세포 전체에서 차지하는 사용빈도에 있어서는 각각 Vβ5.2는 1.07±1.26%, Vβ9는 2.17±1.42%, Vβ23는 3.84+1.97%로 낮은 수치를 나타내었다. 각각 환자에서 비교했을때에 첫번째 환자(HLA-DR4 양성)는 Vβ23(3.69%:1.12%), Vβ5.1(3.51%:1.40%), Vβ12(6.15%:3.29%), Vβ6(3.35%:2.10%), Vβ2(5.74%:3.73%)의 유전자계에서, 두번째 환자(HLA-DR4 양성)는 Vβ9(3.58%:0.74%), Vβ19(4.67%:1.52%), Vβ5.2(2.52%:0.87%), Vβ10(4.25%:1.75%), Vβ1(5.74%:2.35%)의 유전자계에세, 세번째 환자(HLA-DR13 양성)는 Vβ6(2.68%:0.15%) Vβ9(2.17%:0.73%), Vβ11(2.30%:1.10%), Vβ20(9.29%:5.98%)의 유전자계에서 활액에서 말초혈액보다 1.5배이상 증가되어 사용됨을 볼수 있었다. 즉 활액에서 말초혈액보다 의미 있게 편향되어 사용되는 Vβ 유전자계는 각각 환자마다 다른 결과를 나타내었다. 5. 류마티스 관절염환자의 말초 혈액과 정상인의 말초 혈액의 T세포의 Vβ 유전자 사용빈도를 비교했을때 류마티스 관절염 환자의 말초혈액 T세포에서 Vβ16(6.90±1.81%:3.23±1.21%), Vβ18(6.89±0.80%:2.72±0.70%) 유전자계가 2배 이상으로 빈도가 높았고, HLA-DR4양성군만 비교하였을때도 Vβ16(7.52±2.06%:3.69±1.46%), Vβ18(6.45±0.28%:2.61±0.86%) 유전자계가 2배 이상 사용이 많았다. 결론: 이상의 성적으로 미루어 보아 류마티스 관절염 각각 환자마다 다른 Vβ 유전자계의 제한적 사용과 편향됨을 볼 수 있었으나, 공통된 유전자계의 증식은 볼 수 없었다. 이러한 결과는 다른 연구보고와는 다른 결과를 보였고, 이것은 대상 환자의 질병의 유병기간이 다르고, 또 유전적인 배경, 생존 환경, 적용된 방법의 차이로 기인한다고 하는 기존의 보고와 부합된다고 사료되는데 질병의 진행단계에 따라 주로 면역반응을 일으키는 항원의 에피토프가 달라짐에 따라 여기에 대항하는 T세포들의 수용체도 이들 에피토프에 반응할 수 있는 수용체를 가진 코론들이 증식하게 된다는 epitope spreading theory에 부합되며, 이는 아주 초기에 질병을 시작하게 유도하는 항원의 특성을 규명하기 위해서는 환자선택이 연구결과에 결정적인 역할을 할 것으로 사료된다. 또 다른 가능성은 각각 환자마다 다른 Vβ유전자계의 증식된 클론들의 CDR3 연기 서열을 규명하여 비록 유전자 서열이 다를 지라도 항원과 결합하는 같은 성상을 갖는 아미노산 motif를 가질 가능성에 대해서도 연구가 필요하리라 사료된다. Objectives: Polymerase chain reaction (PCR) technology was eamine synovial fluid and peripheral T cells in patients with rheumatoid arthritis (RA) to determine the preferential usage of the T cell receptor(TCR) variable region (V) gene. Methods: Oligonucleotide primers specific for individual TCR Vβ gene families were used to amplify the TCR gene products in a semiquantitative assay of their relative utilization in unselected T cell populations. Results: The result of Vβ utilization was generally heterogenous, similar with previous reports. However, the mean expression of Vβ16 and Vβ18 in RA was more preferentially utilized compared to normal donors. The usage of Vβ in peripheral blood from 3 patients with RA demonstrated restrictions in Vβ16, Vβ20 and Vβ18 genes, respectively. Analyses of synovial fluid resulted in restriction in β12, Vβ20 and Vβ20, respectively. Although there was no significant pattern of skewed Vβ gene mean usage when comparing the synovial fluids with the peripheral blood T cells from RA patients, there were significant biased Vβ genes, Vβ12, Vβl and Vβ20, each 3 patients. As the HLA type is a determining factor in shaping TCR repertoire of peripheral T cells, we compared the Vβ utilization in HLA-DR4 expressing groups that have susceptibility and gene dosage effect in disease progression. It was a little different that comparing the pattern of Vβ usage in peripheral blood and synovial fluid from RA patients between HLA-DR4 positive and negative group. Conclusion: The results were consistent with the conclusion that the increased Vβ family T cells infiltrate synovium and are dependent on each patient and may be involved in inducing and maintaining the synovitis that characterizes RA The different outcome of each patient may be due to the difference in disease duration, genetic background and geographic region. A more important factor may be the stage of disease, because epitope induced immune reaction may change over time. Therefore, selecting patients early in the course of disease may be important and may facilitate the need for more in-depth TCR analysis in the future.

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

In-hospital mortality in patients with STEMI admitted during off hours

( Sung-Soo Kim ),( Myung Ho Jeong ),( Jeong Gwan Cho ),( Young Keun Ahn ),( Jong Hyun Kim ),( Shung Chull Chae ),( Young Jo Kim ),( Seung Ho Hur ),( In Whan Seong ),( Taek Jong Hong ),( Dong-hoon Choi 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Conflicting results exist on the outcome of off hours PCI in ST elevation myocardial infarction (STEMI). However, there were only a few studies that have focused on the clinical characteristics and outcomes of off hours PCI in STEMI. So, we studied the clinical characteristics and hospital mortality in STEMI patients treated with primary PCI during regular hours (weekdays 9:00 AM to 6:00 PM) versus off hours Weekdays 6:01 PM to 8:59 AM, weekends, and holidays) in Korea Acute Myocardial Infarction Registry. We analyzed in hospital and one year mortality among 5,665 consecutive ST segment elevation myocardial infarction patients treated with primary PCI between November 2005 to January 2008. Total 2,848 (50.2%) patients were treated during off hours. Baseline finding were similar, although regular hours patients were older. Median symptom to balloon time (304 min, IQR 175 to 750 vs. 270 min, IQR 145 to 551, p=0.001) were longer for regular hours primary PCI. Median door to balloon time (71min, IQR: 48 to 132 vs. 59 min, IQR 39 to 110 min, p=0.001) were longer for off hours pPCI. Also, Cardiac enzyme such as Max CK-MB (212.1±299.3 vs 194.7±303.4, p=0.031) and max TnI (72.6±239.5 vs. 58.9±94.4, p=0.013) were increased in off hours pPCI. However, unadjusted in hospital (6.0% off hours vs. 6.0% regular hours, p=0.946) and one year cardiac mortality (11.3% off hours vs. 11.7% regular hours, p=0.661) were comparable. In multivariate analysis, off hours primary PCI did not predict an adverse outcome. In conclusion, when primary PCI was performed within an appropriate reperfusion strategy, the clinical effectiveness of either off hours or regular hours pPCI is comparable.

텍스트 ▽, △, 1로 본 李箱의 〈▽의 유희-〉와 소녀 컨텍스트

성인수(Seong, In-soo) 국어국문학회 2013 국어국문학 Vol.- No.163

This paper is intended to reinterpret Lee, Sang‘s Japanese poem, <Game playing of ▽-> released in 1931 and interpret text ▽, △, 1. The poem <Abnormal Reversible Reaction> displays his yearning for Charlotte Perriand, French interior designer, during the Japanese colonial period. He described the situation surrounding him as "Circle" and the effort to overcome the obstacle(circle) as "straight line". The expression, “Does the straight-line kill the Circle?”, questions himself whether he is free from the obstacle. In <Fragmentary Landscapes><破片의 景色->, he (Stick!=스틱크!=李箱!) made a conclusion that “a snowscape which ▽ was finally exhumed and buried in.” Considering he will forget the French woman symbolized as ‘▽’ by covering her with snow, it is interpreted that Lee Sang can not go to France. In <Game playing of ▽->, Lee Sang is looking for a woman of his dream, regretting her disappearance. He confesses that he is waiting for her telegram since the vanished woman (▽) has yet to send a telegram. The “bent line” is a symbolic expression that he gave up going abroad(symbolized as ‘straight line’) because the line couldn"t penetrate ‘circle’(obstacle), so it is bent and confined in ‘circle’ Among text ‘1’, ‘2’ and ‘3’, it is suggested that ‘3’ needs to take the lead and conquer common multiple ‘6’. Why is conquest needed is telling the reason all the text ‘1’, ‘2’ and ‘3’ originated from ‘6’ and Lee Sang blames the situation described as ‘6’ in <Architectural Infinite Hexahedron>(建築無限六面角體). The context of a girl or woman is identified as text ‘1’, ‘▽’ and ‘△’.

이상의 시 <브와뜨ㆍ브와뜨즈>에서의 ‘十文字’의 해석

성인수(Seong, In-soo) 국어국문학회 2014 국어국문학 Vol.- No.166

This paper is intended to reinterpret Lee Sang’s Japanese poem, <BOITEUXㆍBOITEUSE>, published in 1931. In his first novel, <December 12>, Lee Sang expressed his desire and hope to “rush out once dead or live from home” to see a wider world. Contrary to his initial plan, the novel ends up with the plot “fleeing and returning home”. On December 12, 1929, during a time of social change, Lee Sang went out to meet social reformers, but he was caught by the Japanese police, and misunderstood and tortured. In <BOITEUXㆍBOITEUSE> the word ‘CROSS’ representing a cross can be read as evidence of torture. Lee Sang expresses his resentment of being falsely charged by using “CROSS” which can imply a rack. Arrested and tortured by the Japanese police due to ‘Incident X’ which occurred accidently, Lee Sang stricken with shock seemed to change the novel’s title to <December 12> in haste. He altered the novel’s plot so it now read “fleeing and returning home” and released 28 poems written in Japanese to disguise his story and meaning. Because of this incident Lee Sang expressed his distorted fate under the Japanese colonial era as a “cripple”. The novel symbolizes two facts that he as a cripple was being falsely charged as an arsonist and expelled by the church he believed in. Afterwards the speaker (Lee Sang) devised a plan for revenge against the church for the false charge and his expulsion. However, he was tormented and conflicted due to his desire to reveal the incident, the coercion and lure of the Japanese, and his suppression of himself for the sake of his friends. This is how <BOITEUXㆍBOITEUSE> should be interpreted.

백서 뇌하수체 성장호르몬 종양세포의 Chicken Lysozyme 유전자 갑상선호르몬 반응요소에서 갑상선호르몬 수용체 역동학에 미치는 T₃효과 분석

이성진,박철영,정인경,홍은경,최철수,김현규,김두만,유재명,임성희,최문기,유형준,박성우,Larsen, P. Reed 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경: 유전자 전사과정은 증강부위 (enhancer) 또는 억제부위(silencer)의 복합작용을 통하여 조절되며 chicken Iysozyme 유전자의 억제부위는 두 개의독립적인 전사인자 결합부위 (Fl과 F2)를 가지는데 Fl부위는 75~93 kD 크기의 NePl 단백질이 결합하는 위치인 반면 역위회문구조(inverted palindrome, InvPal)의 F2 부위는 갑상선호르몬 수용체가 결합하는 갑상선호르몬 반응요소인 동시에 갑상선호르몬 수용체에 대해 높은 친화력을 가지고 있다. 실험적으로 Fl부위 또는 F2 부위 (이하 F2-TRE 부위)를 각각 다량체화(multimerization) 하였을 때 전사억제효과가 증가하였다는 연구 결과는 Fl 부위와 F2-TRE 부위가 서로 독립적으로 기능하는 구조임을 시사하고 있으며chicken Iysozyme 유전자의 억제부위가 완전한 전사억제효과를 가지기 위해서는 Fl 부위와 F2-TRE 부위가 모두 필요함이 보고 되어 있다. 현재 갑상선호르몬에 의한 chicken Iysozyme 유전자 조절기전을 규명하기 위해 많은 연구가 이루어지고 있으나 73 자극 전 ·후 갑상선호르몬 수용체의 역동학에 대해서는 아직까지 거의 보고된 바 없으며 이와 관련하여 저자들은 치근 사람의 간암세포주인 HepG2 세포에서 T₃ 자극전 ·후 갑상선호르몬 반응요소인 IRE2 부위에 대한 갑상선호르몬 수용체의 결합이 교대로 이루어지고 있음을 염색체 면역침전법 (chromatin immunoprecipitation, ChIP) 및 정량적 중합효소연쇄반응을 이용하여 확인한 바 있다. 이에 저자들은 본 연구에서 F2-lRE 부위를 포함하는 백서 뇌하수체 종양세포주인 GC8 세포를대상으로 염색체 면역침전법과 중합효소연쇄반응을 이용하여 갑상선호르몬 자극 전 후 시간적 순서에 따라 F2-TRE 부위에 결합하는 갑상선호르몬 수용체의 결합양상 변화를 분석함으로써 갑상선호르몬 수용체의 역동학적 모델을 제시하여 보고자 하였다. 방법: thymidine kinase(TK) promoter의 5' 부위에 chicken Iysozyme silencer의 고친화력 갑상선호르몬 반응요소(F2-TRE 부위)가 삽입된 플라스미드,mouse TRα gene이 삽입된 플라스미드, neomycinresistance gene이 삽입된 플라스미드를 백서 뇌하수체성장호르몬 종양세포인 GC 세포에 각각 주입하여 제작한 GC8 세포주를 사용하였다. 100 αM T₃를 투여하기 전과 투여한 후 12시간 뒤 TRαl, TRβl, TRβ2 항체를 이용하여 염색체 면역침전법과 고식적 중합효소연쇄반응 및 정량적 중합효소연쇄반응을 시행하였다. 각 갑상선호르몬 수용체 항체의 양을 1.5μL에서 4.5μL로 바꾸어 첨가한 후 동일한 방법으로 염색체 면역침전법을 반복하여 시행하였다. 100nM T₃를 투여하기전과 투여한 후 20분, 1시간, 2시간, 4시간, 6시간, 8시간, 12시간 뒤 TRαl, TRβl, TRβ2 항체를 이용하여 염색체 면역침전법을 시행하였다. 100nM T₃를 투여하기 전과 투여한 후 12시간 뒤 TRαl, TRβl, TRβ2 단백질의 발현량을 알아보고자 Western blot을 시행하였다. 결과: 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 염색체 면역침전법과 F2-TRE 시발체를 이용한 고식적 중합효소연쇄반응을 시행하였을 때 T₃를 투여한 후 12시간 뒤 TRα1과 TRβ2의 결합은 증가한 반면 TRβl의 결합은 감소하였다. 정량적 중합효소연쇄반응으로 갑상선호르몬 수용체의 결합량을 측정하였을 때TRα1은 T₃ 투여 전 1.01에서 T₃ 투여 후 2.73으로 유의하게 증가하였으며 TBβl은 T₃ 투여 전 4.59에서 T₃투여 후 2.06으로 유의하게 감소하였고 TRβ2는 T₃ 투여 전 2.53에서 T₃ 투여 후 2.98로 증가하는 경향을보였다(TRα1, Δ=+170.3%, p<0.05; TRαl, Δ=-55.1%, p<0.05; TRβ2, Δ=+17.8%). 정량적 중합효소연쇄반응으로 측정한 갑상선호르몬 수용체의 전체 결합량은 T₃ 투여 전 8.13에서 T₃ 투여 후 7.77로 감소하였으나 통계적으로 유의하지 않았다(Δ=-4.4%).100nM T₃ 투여 전 ·후 시간별로 염색체 면역침전법과 정량적 중합효소연쇄반응을 시행하였을 때 TRα1 결합량은 T₃ 투여 후 20분과 6시간 뒤 각각 증가하였으며 TRβ2 결합량은 T₃ 투여 후 20분 뒤 최고치까지 증가하였다가 2시간 뒤부터 감소하였다. 그러나 TRαl 결합량은 T₃ 투여 후 1시간 뒤 최저치까지 감소되었다가 이후 지속적으로 유지되는 경향을 보였다. 100 nM T₃ 투여 전과 투여 후 2시간 뒤 갑상선호르몬 수용체의 결합량을 비교하였을 때 TRα1은 219.8% (1.01→3.23), TRβ2는 9.9% (2.53→2.78) 증가하였으나 TRβ1은 52.9% (4.59-)2.16) 감소하였으며 결합량 변화의 방향은 100 naM T₃ 투여 후 4시간 뒤와 6시간 뒤 갑상선호르몬 수용체 결합량 변화의 방향과 일치하였다(TRα1, 2.89→4.09, Δ =+41.5%; TRβl, 2.33→2.04, Δ=-12.4%; TRβ2, 2.57→2.59, Δ=10.8%). 갑상선호르몬 수용체 항체를 1.5 μL 또는 4.5 μL 투여한 후 F2-TRE부위에 대한 염색체 면역침전법 및 정량적 중합효소연쇄반응을 각각 시행하였을 때 첨가한 갑상선호르몬 수용체 항체의 양에 따른 갑상선호르몬 수용체결합량의 유의한 차이는 없었다. 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 Western blot을 시행하였을 때 갑상선호르몬 수용체 발현량의 유의한 차이는 관찰되지 않았다. 결론: 본 연구에서 관찰된 T₃ 자극 전 · 후 chickenIysozyme 유전자의 F2-TBtE 부위에 대한 갑상선호르몬 수용체 이성체의 교대현상 및 시간적 순서에 따른 갑상선호르몬 수용체 결합양상의 변화가 나타내는 의미에 대하여 추시 연구가 필요함은 물론 추가적으로 다른 유전자 또는 다른 종류의 세포주를 대상으로 T₃자극에 따른 갑상선호르몬 수용체 결합양상의 변화와유전자 발현을 검토하여야 할 것이다. 한편 본 연구 결과만으로는 갑상선호르몬 수용체 역동학에 대한 많은 의문점을 풀 수 없음에도 불구하고 아직까지 국내외적으로 갑상선호르몬 수용체의 역동학에 대한 연구 결과가 거의 없는 현실을 고려하여 볼 때 본 연구는 제한적이나마 일정한 농도의 갑상선호르몬 자극 전ㆍ후chicken Iysozyme 유전자의 F2-TRE 부위에서 갑상선호르몬 수용체의 교대현상을 재확인하였다는 점과 갑상선호르몬 자극 전 · 후 시간적 순서에 따른 갑상선호르몬 수용체의 역동학적 모델을 처음으로 제시하였다는 점에서 의의가 있을 것으로 생각된다. Background: The regulation of gene transcription can be controlled by both positive (enhancer) and negative (silencer) regulatory sequences. Several enhancer and silencer elements have been described in the 5' region of the chicken lysozyme gene. The silencer located at -2.4 kb upstream of the chicken lysozyme gene is composed of two separate modules (Fl and F2) that can function as silencers by themselves, but also show synergistic repression after multimerization. The F1 module is bound by a protein termed NePl and F2 module, a F2 thyroid hormone response element (F2-TRE), and can be bound by the thyroid hormone receptor (TR). F2-TRE has an inverted palindromic structure, with high affinity to TR. Although many current reported results have tried to explain the regulatory mechanism of chicken lysozyme gene expression due to the thyroid hormone, there have been few studies that clarify the TR dynamics in the F2-TRE of the chicken lysozyme gene, either with or without exposure of the thyroid hormone. Here, the changes in the TR binding patterns in the F2-TRE of the chicken lysozyme gene are described, both before and after T₃ stimulation over time. Methods: Using the stably transfected rat pituitary somatotroph tumor cell line, GC8 cells, with the F2-TRE inserted 5' to the thymidine kinase (TIC) promoter, together with a mouse TRα - expressing plasmid, a chromatin immunoprecipitation (ChIP) technique was employed to reveal the TR-TRE interaction before and after T₃ stimulation. Following the cross-linking and sonication of the cells, the immunoprecipitation was performed overnight, at 4℃, with TRαl, TRβl and TRβ2 antibodies, respectively. The binding patterns and amounts of TRαl, TRβ1 and TRβ2 to the F2-TRE, before and after 12 hours of 100nM T₃ stimulation, were analyzed using conventional and quantitative real-time polymerase chain reactions (RQ-PCR). The ChIP technique was used to give a basal value for 20 minutes and 1, 2, 4, 6, 8 and 12 hours after the 100nM T₃ stimulation, and RQ-PCR was then performed. Western blot with TRαl, TRβl and TRβ2 antibodies were also performed. Results: After 12 hours of 100 nM T₃ stimulation of the GC8 cells, the TRα1 and TRβ2 binding to the F2-TRE increased, but the TRβ1 binding to the F2-TRE decreased, by conventional PCR. Although all the TR isoforms were bound to the F2-TRE by RQ-PCR, the TRαl binding to the F2-TRE, after 12 hours of l00nM T₃ stimulation, was significantly increased (1.01→2.73, Δ =+170.3%, p<0.05), but the change in the amount of TW2 binding was not significant (2.53→2.98, Δ=+17.8%). The TRβl binding was significantly decreased compared with that of the basal level (4.59→2.06, Δ=-55.1%, p<0.05). The total TR bindings to the F2-TRE had a tendency to decrease after 12 hours of 100 nM T₃ stimulation (8.13→7.77, Δ=-4.4%). The binding patterns and amounts of TRαl, Tβl and Tβ2, both before and after the 100 nM T₃ stimulation, were also identified over time. While the TRβl bindings to the F2-TRE after 1 hour of l00nM T₃ stimulation were acutely reduced, those of the TRαl at 20 minutes and 6 hours were increased. The TRβ2 bindings showed a maximal increase at 20 minutes. The directions of the TR binding patterns, between the before and after 2 hours of 100nM T₃ stimulation, were identical to those for between 4 and 6 hours of T₃ stimulation. There was no significant difference in the TR bindings to the F2-TRE in relation to the amounts (1.5 vs. 4.5μ I) of TR antibodies used during the ChIP assays. The Western blots showed no significant change of the levels of each TR isoform proteins, either before or after 12 hours of exposure to 100nM T₃. Conclusion: These results show the dynamic binding patterns of the TR isoforms to the F2-TRE of the chicken lysozyme gene, both before and after T₃ stimulation, over time. Further investigation, however, will be needed to clarify the mechanisms of our observations. The ChIP technique may then be used to reveal the dynamic models of the cofactors, as well as TR isoforms, in the TR-regulated transcription machinery (J Kor SOC Endocrinol 18:379-391, 2003).

약물방출 관상동맥 스텐트 시술 후 스텐트 혈전증 발생 환자의 임상경과

김인수(In-Soo Kim),정명호(Myoung-Ho Jeong),한재복(Jae-Bok Han),장영일(Young Ill Jang),장성주(Seong-Joo Jang) 한국콘텐츠학회 2013 한국콘텐츠학회논문지 Vol.13 No.12

약물방출 스텐트 (drug-eluting stents, DES)는 일반금속 스텐트에 비하여 재협착을 현저하게 줄었지만, DES의 구조적인 특성으로 인한 스텐트 혈전증 (stent thrombosis, ST)이 증가한다고 알려져 있다. 혈전증 유형의 정의는 Early ST ; (EST)은 30일 이내, Late ST ; (LST)은 31일 이상에서 1년 이내 그리고 Very late ST ; (VLST)은 1년 이상으로 분류 하였다. 스텐트 세대별 (시장 출시와 스텐트 디자인, Polymer 향상에 따른) ST발생빈도, 임상 양상 및 예후를 알아보았다. 2003년 6월부터 2013년 6월까지의 전남대학교병원 심혈관센터에서 경피적 관상동맥 중재술을 시행 받은 10,273명 중 ST 발생은 134명(1.30%) 이었다. 세대별 발생빈도는 1세대에서 81명 (0.79%)으로 높았으며, 세대별 ST 유형은 1세대에서는 VLST의 발생률이 높았고 (p=0.002), 2세대에서는 EST와 LST의 발생률이 높았지만 (p=0.025), 3세대에서는 유의한 차이가 없었다(p=0.278). ST로 인하여 사망한 14명은 EST 10명 (18.2%), LST 2명(8.3%), VLST 2명 (3.6%)로서 EST에서 사망률이 높았다 (p=0.042). DES 시술 후 발생하는 ST는 1.3%이였고, VLST는 1세대 스텐트에서 많았으며, 입원 중 사망률은 EST에서 높았다. Stent thrombosis after successful drug-eluting stent(DES) implantation has been reported in around 1% of patients in clinical trials. However, the increased risk of ST associated with DES remains a matter of concern. From 1 June 2003 to 30 June 2013, we investigated clinical characteristics, in-hospital outcomes in 10,273 patients who underwent percutaneous coronary intervention in the Heart Center of CNUH. Overall incidence of ST was 1.30% (134 patients). The incidence of ST according to the stent generations and the timing of ST (n= total, early vs. late vs. very late) were 0.79% (n =81, 26 vs. 12 vs. 43) in first-generation, 0.38% (n=39, 21 vs. 9 vs. 9) in second-generation and 0.14% (n=14, 8 vs 3 vs. 3) in third-generation, (p=0.70). The mortality from ST was significantly higher in early ST group compared to the late and very late ST groups (18.2% vs. 8.3% vs. 3.6%, p=0.042). Overall incidence of ST after DES implantation was 1.30% (134 patients). The in-hospital mortality was significantly higher in early ST group compared to the late and very late ST groups.

비만 여성을 대상으로 한 해조류 추출물의 국부처치와 운동 병행을 통한 지방분해 효과의 임상적 검정

서태수,이인숙,변재철,김규호,박승한,김유영,김상국,김현정,김상기,신동철,성미영,박종석,김종기,박언휘 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.3

This study was carried out to test the body fat breakdown during topical seaweed extract treatment and in combination with the aerobic exercise. Of 20 female obesity subjects, ten treated a cream types of seaweed extract(control group) and ten treated a placebo cream(placebo group). Topical treatment of each sample was designed for 4 weeks, and treated with 2 times a day about 10ml on the abdomen and the thigh, respectively. All subjects were participated aerobic dance half hour a day and four times a week. After 4 weeks of topical treatment and exercise, they were measured body fat, skinfold thickness, body circumference. Then venous blood samples were taken and analyzed blood cells, serum enzymes, and serum lipids. There were reduction of body weight, % of body fat, antebrachium, brachium, chest, waist, thigh circumference and abdomen thickness between pre and post treatment in both group. Especially, body weight and % of body fat significantly reduced in the subjects treating the seaweed extract than those treating the placebo. There were significant decrement in total cholesterol and LDL whereas increment in HDL and TBIL in the control group, but no significant difference in the placebo group. In conclusion, there were 7.6% of body fat reduction during 4 weeks of aerobic exercise and 21% of body fat reducement in combination of topical seaweed treatment and exercise, respectively. These results suggest that the topical treatment of seaweed extract should be very effective for fat breakdown. Especially, the body fat breakdown maximized in the combination with the topical seaweed extracts treatment and the aerobic exercise.