정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

人 諸臟器 Alkaline Phosphatase Isoenzyme의 電氣泳動 및 定量

金在植,金京善,金重明,金榮泰,蔣卓仙,李鉉基 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.2

著者들은 家兎와 人體로부터 採取한 血淸과 諸臟器組織을 使用하여 ALPI 電氣泳動像을 觀察하고 生化學的 定量法을 利用하여 ALP의 活性度를 測定試圖하였으며 臟器特異性 沮害因子에 對한 影響을 觀察하였다. 家兎 血淸 및 諸臟器組織 ALPI電氣泳動에서 血淸은 ±의 活性度를 가진 α2와 α2/β分劃을 나타내었으며 肝組纖은 血淸보다 빠른 移動度를 가진 ??의 α_1과 α_2分劃을 나타내었다. 그리고 肝, 骨, 腎 淋巴腺, 脾臟 및 腸組織에서는 顯著하게 높은 活性度를 나타내는 各各 서로 相異한 分劃을 볼 수 있었으며 人體諸 臟器와大體로 類似하였으나 家兎 血淸의 ALP는 사람에서 와는 다르게 肝組織의 分劃과 一致하지 않고 오히려 骨組織과 더 잘 一致되는 것 같았다. ALPI 活性度에 있어서 家兎의 諸臟器는 生化學的 定量法으로 腎 ALP의 活性度가 49.5B.L. units로 다른 臟器組織에 비하여 顯著하게 높았으며, 그 다음은 脾臟, 脊椎骨, 肝, 肺淋巴腺 및 脾 順으로 높은 活性度를 나타내었으며 人體에 있어서는 胎盤, 骨, 小賜, 脾臟, 肝 및 腎臟의 順으로 높았다. 臟器 特異性 沮害因子에 對한 影響에 있어서 胎盤分劃은 特有하게 耐熱性을 나타내었고 보다 urea低抗性이며 肝分劃은 neuraminidase에 對하여 移動度의 遲延을 招來하였다. The studies upon cellulose acetate microzone electrophoretic patterns, quantitative estimation and effects of organspecific inhibitor on ALP isoenzyme of rabbit and human sera and various organ tissues were performed. On electrophoretic pattern the tissue ALP from the liver bone kidney lymph node spleen and intestine showed the characteristic fraction of high activities. The electrophoretic mobility of rabbit serum ALP was not correspond to the liver ALP as observed in human serum and it appeared to be rather corresponded to the bone ALP, which seemed to be the origin of ALP in serum of rabbit. In the quantitative measurement of tissue ALP activity the kidney ALP showed the highest level and the activity of the skeletal muscle ALP was the lowest(1.5 B. L. units), while higher activities were observable in placenta, bone, intestine, spleen, liver and kidney in order. On the effect of organ specific physico chemical agents the placental ALPI was highly stable to the heat and relatively resistant to urea while other organ ALPI were on the contrary. The neuraminidase seemed to effect to the motility of liver fraction.

자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

부산의 한 대학병원에서 분리된 Acinetobacter baumannii의 PER-1 Extended-Spectrum β-Lactamase 생성 현황

김정만,강현경,정석훈,배일권,권수봉,조병규,김둘만,김현주,김아성 대한임상미샐물학회 2004 Annals of clinical microbiology Vol.7 No.1

Inhibition of Cytokine-Mediated Nitric Oxide Synthase Expression in Rat Insulinoma Cells by Scoparone

Kim#, Eun Kyung,Kwon#, Kang Beom,Lee, Ju Hyung,Park, Byung Hyun,Park, Jin Woo,Lee, Hern Koo,Jhee, Eun Chung,Yang, Jeong Yeh Pharmaceutical Society of Japan 2007 Biological & pharmaceutical bulletin Vol.30 No.2

<P>Cytokines produced by immune cells infiltrating pancreatic islets are important mediators of β-cell destruction in insulin-dependent diabetes mellitus. Scoparone (6,7-dimethoxycoumarin) is known to have a wide range of pharmacological properties <I>in vitro</I>. In this study, the effects of scoparone on cytokine-induced β-cell dysfunction were examined. Presence of scoparone significantly protected interleukin-1β (IL-1β) and interferon-γ (IFN-γ)-mediated cytotoxicity of RINm5F, a rat insulinoma cell line, and preserved glucose-stimulated insulin secretion in rat pancreatic islets. Scoparone also resulted in a significant reduction in IL-1β and IFN-γ-induced nitric oxide (NO) production, a finding that correlated well with reduced levels of the inducible form of NO synthase (iNOS) mRNA and protein. The molecular mechanism by which scoparone inhibited iNOS gene expression appeared to involve the inhibition of NF-κB activation. These results revealed the possible therapeutic value of scoparone for the prevention of diabetes mellitus progression.</P>

IgG GM₁ 항체와 Campylobacter jejuni 항체와 관련된 급성 운동축삭형 신경병증

홍경훈,김승현,이영배,이영주,김희태,김주한,김명호 대한신경과학회 1997 대한신경과학회지 Vol.15 No.5

항암제 처리한 백혈병 세포주에서의 Apoptosis 발현

김삼용,윤소현,김현수,김종숙,윤환중,김진경,조덕연 충남대학교 암연구소 1998 癌共同硏究所 硏究誌 Vol.2 No.1

The bcl-2 proto-oncogene encodes a 26 kD protein that promotes cell survival by blocking apoptosis. The bax protein is a member of the bcl-2 familly, now known to form heterodimers with the bcl-2 protein. The ratio of bax to bcl-2 is be critical in determining the fate of the cell in response to stimuli that can induce apoptosis. Extract of Pulsatilla Koreana (SB-31) showed promising antitumor activity in vitro with Topo I inhibitory action. In the present study, the relationship between apoptosis and the apoptosis related proteins, bcl-2 and bax were investigated in human leukemic cell lines HL-60, U-937 and CEM-CM3. All anticancer drugs(adriamycin, etoposide, camptothecin, SB-31) induced extensive apoptosis in HL-60, U-937 cells and CEM-CM3 cells. The expression of bcl-2 and bax protein were determined in cell lines by western blotting before and after incubation with anticancer drugs at different time points. 1) In HL-60 or U-937 cell lines, down regulation of bcl-2 and up-regulation of bax were found after incubation with ADR, VP-16 or camptothecin. 2) In HL-60 or U-937 cell lines, no significant change in bcl-2 or bax protein expression resulted after incubation with SB-31. 3) In CEM-CM3 cells, virtually no change was noted in bcl-2/bax expression after incubation with ADR, VP-16, camptothecin or SB-31. It is suggested that different leukemic cell lines use different pathways of apoptosis activation and a given cell may utilize different pathways of apoptosis activation in response to different cytotoxic agents.

Associations of serotonergic genes with poststroke emotional incontinence

Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

<P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>

경찰관의 운동참여에 따른 직무 Stress와 직무만족에 관한 연구

김종달, 남덕현, 이한경, 반종진 용인대학교 체육과학연구소 2000 體育科學硏究論叢 Vol.10 No.1

This study is for the purpose of examining effects related to duty stress & duty satisfaction due to Police of officers' Physical exercise participation, helping more efficient duty Performance, and positive self-formation. Furthermore, providing basic data that can be helpful to the improvement of police duty. The objects of the study were police officers who were taking part in education program in Police Comprehensive Academy, and the number of police officers who answered the questionnaire is 356 police officers, but data used for real analyzation consist of 300 police officers. The tools for the study were based on Ivancevich's duty stress model in order to measure stress. And also questionnaire used on Kim yoon hee, Kim mae ja, Jo kyung soon, Lee hart kyung's study was used as a complementary tool. The instrument for measuring duty satisfaction rate was developed by Paula. And I used the instrument based on questionnaire that was used by Ko hee soon, Park ki hyung, Kim bum sik, Lee jong kil, Lim bun jang, Jo young chang, Hackeman, Lawlar and Oldham's study. Data analysis is Processed statistically with SPSS/PC+, I Performed T-verification, ANOVA-verification in accordance with the purpose of study after getting the percentage and the real number in case of general characteristics of the objects, and examine an average and standard variation in case of duty satisfaction and duty stress rate. And I set an err rate to 0.5. I verificated co-relation between stress and duty satisfaction with Pearson Correlation Coefficient. The result of the study is as follows, The first, among sociological characteristic and external factor of duty satisfaction, The married is more significant statistically(p< .01, p<.05) compared to the unmarried in terms of compensation system and working condition , which are subfactor of duty satisfaction . In terms of the length of one's service, the longer service term one has the higher significance level one shows in compensation system, working condition, safety, and external factor which are sub-factors of duty satisfaction In terms of an academic background, one who graduated from a high school shows significance statistically only in working condition which is a subfactor of duty satisfaction compared to other people (p<0.5) The second, among sociological characteristic and internal factor of duty satisfaction, the married is more significant statistically(P<.05) compared to the unmarried in terms of achievement which is a subfactor of duty satisfaction. In terms of age the older one shows higher significance level in stability which is a subfactor of duty satisfaction compared to younker one(p<.05) In terms of the length of one's service the longer service term one has ,the higher significance level one shows(p<.01, p<.05). The third, in terms of duty stress due to sociological variable, the married is more significant statistically(p<.05) in case of stress stems from police duty than the unmarried Interms of age, welfare and duty stress are significant statistically(P<.05) Interms of the length of one's service, police's work is significant statistically(P<.05). One who graduated from junior college is significant statistically in police's work, welfare, stress and gets a lot of stress in personal relations(p<.05). The forth, groups participating in exercise are more significant statistically in stability(p<.001), feeling of stability(P<.001), achievement(p<.001), internal factor(p<.01), external factor(p<.05) than croups not Participating in exercise. The fifth, groups participating in exercise are more significant statistically only in personal management than groups not participating in. The sixth co-relation between duty satisfaction and duty stress is r=-0.3814, (P<.001) ,which shows opposite co-relation. so, a result the more stress one has, the lower duty satisfaction he gets.