아세틸 콜린 유발 검사시 허혈성 심전도 변화와 흉통의 발생이 내피세포 기능장애에 미치는 영향

최철웅(Cheol Ung Choi),나승운(Seung-Woon Rha),김선원(Sun Won Kim),나진오(Jin Oh Na),임홍의(Hong Euy Lim),김진원(Jin Won Kim),김응주(Eung Ju Kim),한성우(Seong Woo Han),박창규(Chang Gyu Park),서홍석(Hong Seog Seo),오동주(Dong Joo Oh) 대한임상노인의학회 2010 대한임상노인의학회지 Vol.11 No.4

연구배경: 아세틸 콜린 유발 검사시 발생하는 흉통과 허혈성 심전도 변화가 아세틸 콜린에 의해 발생하는 관상동맥의 내피세포 기능에 어떤 영향을 주는지 알아보고자 했다. 방법: 흉통으로 내원하여 관상동맥 조영술과 아세틸 콜린 유발검사를 시행받은 1,085명의 환자를 대상으로 하였다. 아세틸 콜린 유발 검사를 하는 동안 허혈성 심전도 변화 및 흉통의 발생 유무에 따른 관상동맥 내피세포 기능의 특징을 비교하였다. 결과: 539명의 환자에서 아세틸 콜린 검사시 내피세포 기능 장애가 발생 하였다. 허혈성 심전도 변화가 있었던 그룹이 심전도 변화가 없었던 그룹보다 흉통이 더 많았고(78.1% vs. 60.8%, P=0.007), 관상동맥 조영술상 다발성 관상동맥 경련이 빈번하였고(59.4% vs. 40.6%, P=0.004), 관상동맥의 경련 정도도 더 심하였다(64.1% vs. 46.5%, P=0.006). 흉통이 있었던 그룹이 흉통이 없었던 그룹보다 허혈성 심전도 변화의 빈도가 더 높았다(14.7% vs. 7.5%, P=0.007). 또한 흉통이 있었던 그룹이 관상동맥 경련이 다발성으로 발생하는 경우가 많았고 (50.7% vs. 29.5%, P<0.001), 미만성으로 발생하는 경우가 많았고(87.1% vs. 75%, P<0.001), 관상동맥의 경련의 정도도 더 심하였다(51.6% vs. 43.5%, P=0.041). 결론: 아세틸 콜린 유발검사시 발생하는 허혈성 심전도 변화와 흉통은 관상동맥 경련의 정도와 경련이 발생하는 관상동맥 개수와 연관이 있다. Background: ECG changes and chest pain during acetylcholine (Ach) provocation tests may constitute important clinical parameters for Ach-induced endothelial dysfunction. We investigated the association between ischemic ECG changes and chest pain during the Ach-provocation test and angiographic characteristics of Ach-induced endothelial dysfunction. Methods: A total of 1,085 patients with anginal symptoms underwent diagnostic coronary angiography (CAG) and Ach-provocation tests. We compared angiographic characteristics of Ach-induced endothelial dysfunction according to the presence of ECG change and chest pain. Results: A total of 539 patients experienced Ach-induced endothelial dysfunction. Patients who experienced ECG change group suffered more frequent chest pain (78.1% vs. 60.8%, P=0.007), angiographically more frequent multiple coronary artery spasm (59.4% vs. 40.6%, P=0.004), and more severe coronary artery spasm (64.1% vs. 46.5%, P=0.006) than patients without ECG change. However, there was no difference in the length of endothelial dysfunction between the groups. The incidence of ischemic ECG changes in patients with chest pain was higher than in patients without chest pain (14.7% vs. 7.5%, P=0.007). Patients who experienced chest pain more often experienced multiple (50.7% vs. 29.5%, P<0.001), diffuse (87.1% vs. 75%, P<0.001), and severe coronary artery spasm (51.6% vs. 43.5%, P=0.041) than patients without chest pain. Conclusion: Ischemic ECG changes and chest pain during the Ach-provocation test are associated with multi-vessel involvement and severe coronary artery spasm. Chest pain is associated with the length of endothelial dysfunction, but ischemic ECG change is not.

Gene Expression Analysis of the Bromobenzene Treated Liver with Non-hepatotoxic Doses in Mice

Lim, Jung-Sun,Jeong, Sun-Young,Hwang, Ji-Yoon,Park, Han-Jin,Cho, Jae-Woo,Song, Chang-Woo,Kim, Yang-Seok,Lee, Wan-Seon,Moon, Jin-Hee,Han, Sang-Seop,Yoon, Seok-Joo The Korean Society of Toxicogenomics and Toxicopro 2005 Molecular & cellular toxicology Vol.1 No.4

Bromobenzene (BB) is well known hepatotoxicant. Also, BB is an industrial solvent that arouses toxicity predominantly in the liver where it causes centrilobular necrosis. BB is subjected to Cytochrome P450 mediated epoxidation followed by either conjugation with glutathione, enzymatic hydrolysis or further oxidation. In this study, we focused on BB-induced gene expression at non-hepatotoxic dose. Mice were exposed to two levels of BB, sampled at 24 h, and hepatic gene expression levels were determined to evaluate dose dependent changes. When examining the toxic dose of BB treated group in other previous studies, genes related to heat shock protein, oxidative stress, and drug metabolism are expressed. Compared to these results, our study, in which non-toxic dose of BB was administrated, showed similar patterns as the toxic conditions above. The purpose of the study was to select genes that showed changes in relation to the differing dose through confirmation of the difference within transcriptomic boundaries, but those that are not detected by the existing classic toxicology tools in non-hepatotoxic dose.

Single Oral Dose Toxicity Evaluation of Leejung-tang, a Korean Traditional Herbal Formula, in Crl:CD (SD) rats

Lim, Hye-Sun,Lee, Mee-Young,Seo, Chang-Seob,Shin, In-Sik,Ha, Hye-Kyung,Huh, Jung-Im,Shin, Hyeun-Kyoo The Society of Korean Medicine 2011 대한한의학회지 Vol.32 No.3

Objective: Leejung-tang (Rechu-to in Japanese) is a traditional Korean herbal formula used for treatment of gastrointestinal disorders such as vomiting, stomach pain, chronic gastritis and gastrointestinal ulceration. The present study was carried out to investigate the potential acute toxicity of Leejung-tang water extract (LJT) by a single oral dose in Crl:CD (SD) rats in compliance with current guidelines. Methods: In the preliminary study, there were no adverse effects such as death, clinical signs, and body weight changes at dose levels of 500, 1000, and 2000 mg/kg/day body weight. Based on the results, a dose of 2000 mg/kg was selected as the toxicological limited dose. LJT was administered once by gavage to male and female rats at dose levels of 0 and 2000 mg/kg bodyweight. During the study period, mortalities, clinical findings, and body weight changes were observed for 14 days following the administration. On day 14 after the treatment, the animals were sacrificed by carbon dioxide overdose and complete gross postmortem examinations were performed. Results: In present study, no treatment-related deaths were observed. There were no adverse effects on clinical signs and body weight changes. In addition, there were no observed gross findings in all groups except for a kidney cyst in the 2000 mg/kg/day female group. Conclusion: The results indicated that LJT did not induce toxic effects at a dose level up to 2000 mg/kg in rats and its median lethal dose ($LD_{50}$) was considered to be over 2000 mg/kg/day body weight for both genders.

소아 IgA 신병증의 장기 추적(평균 10.8년)에 따른 임상 경과 및 병리학적 변화

문창민,김병길,임범진,송지선,정현주,Moon, Chang-Min,Kim, Pyung-Kil,Lim, Beom-Jin,Song, Ji-Sun,Jeong, Hyeon-Joo 대한소아신장학회 2010 Childhood kidney diseases Vol.14 No.2

목 적 : 소아 IgA 신병증의 임상 양상 및 병리학적 분류(Haas 분류)와 임상 경과와의 상관 관계를 조사하여 이들이 예후를 반영할 수 있는지 알아보고자 하였다. 방 법 : 병리학적으로 IgA 신병증으로 진단받고 추적 중이던 환자들 중 추적 신생검을 시행한 20명의 환자를 대상으로 후향적으로 자료를 분석하였다. 결 과 : 최초 신생검시 평균 9.5세였고 남자 16명, 여자 4명이었으며, 최종 조직 검사까지 평균 10.8년이 경과하였다. 안지오텐신 전환효소 억제제 등으로 치료를 지속한 후 정상뇨 소견, 정상 혈압, 정상 크레아티닌 청소율(CCr)을 보이는 임상적 관해 상태의 환자는 10명(50%)이었으며, 비관해 상태의 환자 10명(50%)도 초기와 비교하여 호전된 경과를 보였고, CCr이 중등도 이상 저하되거나 말기 신질환 양상을 보이는 환자는 없었다. 최초 Haas 분류는 임상경과와 상관 관계가 없었다. 초기 고혈압은 5명(25%)에서 보였고 이는 임상 경과(P =0.010) 및 최종 Haas 분류(P =0.007)와 유의성이 있었다. 초기 CCr의 중등도 저하는 Haas 분류와 유의성이 있었으나(P =0.048), 임상 경과와는 상관관계가 없었다. 결 론 : 소아 IgA 신병증의 추적 기간 중 임상 경과는 양호하나 최초 Haas 분류로 임상 경과를 예측할 수는 없었으나 적극적인 조기 진단 및 치료로 말기 신질환으로의 진행을 지연시킬 수 있을 것으로 보인다. 초기 고혈압은 임상 경과 및 최종 Haas 분류와 유의한 상관관계를 보여 적합한 예후인자로 보인다. 최초 병리학적 소견은 임상 경과를 반영하지 못하나, 추적 Haas 분류가 예후를 반영할 수 있을지에 대해서는 보다 많은 추적 관찰 및 추적 신생검을 통한 연구가 있어야 할 것으로 보인다. Purpose : We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN. Methods : From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features. Results : Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P =0.01) and last Haas classification (P =0.007). None of the cases showed progression to CRF or ESRD. Conclusion : During a mean follow-up of $10.8{\pm}3.4$ years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.

Single Oral Dose Toxicity Evaluation of Leejung-tang, a Korean Traditional Herbal Formula, in Crl:CD (SD) rats

Hye-Sun Lim,Mee-Young Lee,Chang-Seob Seo,In-Sik Shin,Hye-Kyung Ha,Jung-Im Huh,Hyeun-Kyoo Shin 대한한의학회 2011 대한한의학회지 Vol.32 No.3

제왕절개술을 위한 경막외 마취시 술전 투여 수액이 신생아 혈당치에 미치는 영향

이혜원,김선희,신정순,장성호,임혜자,채병국 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.4

It is common for patient undergoing cesarean section under epidural anesthesia to have lower blood pressure because of not only supine hypotension syndrome but vasodilation due to sympathetic blockade. So it is necessary to give large volume of fluid before perfarming epidural anesthesia to prevent hypotension. When we use the dextrose containing fluid for that purpose, newborn baby could have a high blood glucose at delivery and low blood glucose level due to high insulin level after birth. The authors examined the blood glucose level at delivery and two hours after birth following use of 5% dextrose in lactated Ringers solution(HD group, n=24) or lactated Ringers solution (HS group, n=24) for prevention of hypotension during epidural anesthesia for cesarean section. The results were as follows; 1) The total amount of fluid was 789.6±264.2 ml in HD group and 741.1±253.5 ml in HS group. 2) The glucose level of mother at delivery was 300.9±76.3 mg/dl in HD group and 98.7±24.6 mg/dl in HS group and there wastistical significance(p$lt;0.01). 3) In HD group, the glucose level of newborn baby was 212.2±57.2 mg/dl at delivery and 465.±20.3 mg/dl at 2 hours after birth. The change of amount during 2 hours after birth was highly related to the glucose level at birth. Higher level of glucose at birth, larger amount of change during 2 hours after birth. 4) In HS group, the glucose level of newborn baby was 66.8±10.2 mg/dl at birth and 67.0±12.1 mg/dl at 2 hours after birth. There was no significant change.

국내 육성 포도 "두누리" 품종의 성숙 시기별 과실특성과 포도주 품질특성

장은하 ( Eun Ha Chang ),정성민 ( Sung Min Jeong ),노정호 ( Jung Ho Noh ),박교선 ( Kyo Sun Park ),임병선 ( Byung Sun Lim ) 한국식품저장유통학회(구 한국농산물저장유통학회) 2012 한국식품저장유통학회지 Vol.19 No.6

국내 포도주 가공용 육성 품종인 ``두누리`` 포도의 양조 가능성과 고품질의 포도주 양조를 위한 적정 성숙시기를 검토하고자 성숙 시기별 과실의 품질특성과 적정 성숙시기를 판단하는 여러 가지 지표를 검토하였고, 포도주 양조후 전문가 관능평가를 통해 포도주 품질에 가장 적합한 성숙 시기를 구명하고자 하였다. ``두누리`` 포도의 과실특성을 조사한 결과 °Brix 당함량은 변색기 이후 급격히 증가하였고 성숙완료 시 17 °Brix를 나타내었으며 과숙기에는 약 20 °Brix까지 증가하였다. 산함량은 변색기 이루 급격히 감소하기 시작하여 성숙 완료 시 거의 0.66%까지 감소하였고 이후에도 서서히 감소하여 과숙기에는0.51%까지 감소하였다. 총폴리페놀과 총안토시아닌 함량은 변색기 이후 급격히 증가하는 것으로 나타났다. 특히 산함량이 0.55%정도 되었을 때 총안토시아닌 및 총폴리페놀의 함량이 최고에 도달하지만 포도가 과숙되면 오히려 함량이 감소하는 것으로 나타났다. 총안토시아닌의 축적과 당, pH, 산함량, brix/acid 비율과의 상관관계를 살펴본 결과 0.87~0.95(p<0.05)의 양 또는 음의 높은 상관관계를 나타내었다. 포도의 적정 성숙시기를 판단하는 지표인 brix×pH(2) 값과 brix/acid 비율을 적용해 본 결과 두 지표를 모두 만족시키는 성숙 시기는 산함량이 0.53~0.55 정도, 당함량이 17 °Brix일 때였다. ``두누리`` 포도주의 성숙 시기별 품질특성을 조사한 결과 산함량은 성숙 시기가 늦을수록 감소하였고, 총안토시아닌, 탄닌 함량 및 포도주의 적색도와 색의 포화도를 나타내는 a*와 C*는 증가하다가 포도가 과숙될수록 함량이 오히려 감소하는 것으로 나타났다. ``두누리`` 포도주의 관능평가를 조사한 결과 산함량은 포도 성숙 후 가장 늦게 수확하여 제조한 포도주에서 가장 안정적인 산미를 나타낸다고 평가하였지만 색, 향기, 전체적인 조화에서는 포도주의 산함량이 0.60%(포도의 산함량으로 0.53~0.55%) 정도일 때 가장 좋은 품질을 나타낸다고 평가하였다. 따라서 ``두누리``포도주를 제조할 경우 포도의 산함량이 0.55% 정도 일 대 포도의 당함량, 색 및 폴리페놀의 함량은 최고에 도달하고, 기존의 성숙시기 판단 지표인brix×pH(2) 값과 brix/acid 비율을 만족시키는 것으로 나타났다. This study was conducted to investigate several indicators of fruit maturity, and expert sensory evaluation was done to determine the most appropriate maturity time for the new Korea grape cultivar ``doonuri`` for high quality winemaking. The grape component changed dramatically during ripening, after veraison. Considerable drops in berry firmness (<0.60 kgf/cm2) and titratable acidity (<0.66%) were found at the ripening stage while the soluble solid content significantly increased in the ripening process. Most of the organic acids contained were tartaric and malic acid. The malic acid content was about twice the tartaric acid content in the fruit-growing period but was less than the tartaric acid content in the maturity period. The total anthocyanin and polyphenol contents increased sharply after veraison. In particular, the total anthocyanin and polyphenol contents reached their maximum levels when the acidity was 0.55%, and after that, there was almost no change. Correlations between anthocyanin accumulation and several factors were found in sugar 0.7811 (p<0.05), pH 0.9315 (p<0.05), and Brix/acid ratio 0.9409 (p<0.05). Brix×pH2 and brix/acid ratio were used as indicators of the proper maturation of the grapes when the acidity was 0.53 to 0.55%, and at sugar 17 Brix. When surveyed, the quality characteristics and sensory evaluation of the wine made using the latest harvested grapes showed the most reliable sourness. The color, aroma, and overall harmony of the wine, however, were evaluated to be the best when the wine acidity was about 0.60% or when the grape acidity was below 0.55%

Effect of metal coating in all-fiber acousto-optic tunable filter using torsional wave.

Song, Du-Ri,Jun, Chang Su,Do Lim, Sun,Kim, Byoung Yoon Optical Society of America 2014 Optics express Vol.22 No.25

<P>Torsional mode acousto-optic tunable filter (AOTF) is demonstrated using a metal-coated birefringent optical fiber for an improved robustness. The changes in acoustic and optical properties of a metal-coated birefringent optical fiber induced by the thin metal coating were analyzed experimentally and theoretically. The filter wavelength shift is successfully explained as a result of combined effect of acoustic wavelength change and optical birefringence change. We also demonstrated a small form-factor configuration by coiling the fiber with 6 cm diameter without performance degradation. The center wavelength of the filter can be tuned >35 nm by changing the applied frequency, and the coupling efficiency is higher than 92% with <5 nm 3-dB bandwidth.</P>

경상남도 창녕에서 집단 발생한 피부 탄저병의 임상양상

박찬원,박정래,정종윤,이선희,장철훈,오차재,조병만,임재영,오창근,권경술 대한감염학회 2002 감염 Vol.34 No.4

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.