• Investigative and Clinical Urology
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• 제59권6호
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• pp.363-370
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• 2018

Purpose: The aim of this study is to describe the technique and to report early results of transperineal magnetic resonance imaging and ultrasonography (MRI-US) fusion biopsy. Materials and Methods: A total of 75 patients underwent MRI-US fusion transperineal biopsy. Targeted biopsy via MRI-US fusion imaging was carried out for cancer-suspicious lesions with additional systematic biopsy. Detection rates for overall and clinically significant prostate cancer (csPCa) were evaluated and compared between systematic and targeted biopsy. In addition, further investigation into the detection rate according to prostate imaging reporting and data system (PI-RADS) score was done. Results of repeat biopsies were also evaluated. Results: Overall cancer detection rate was 61.3% (46 patients) and the detection rate for csPCa was 42.7% (32 patients). Overall detection rates for systematic and targeted biopsy were 41.3% and 57.3% (p<0.05), respectively. Detection rates for csPCa were 26.7% and 41.3%, respectively (p<0.05). The cancer detection rates via MRI fusion target biopsy were 30.8% in PI-RADS 3, 62.1% in PI-RADS 4 and 89.4% in PI-RADS 5. Rates of csPCa missed by targeted biopsy and systematic biopsy were 0.0% and 25.0%, respectively. The cancer detection rate in repeat biopsies was 61.1% (11 among 18 patients) in which 55.5% of cancer suspected lesions were located in the anterior portion. Conclusions: Transperineal MRI-US fusion biopsy is useful for improving overall cancer detection rate and especially detection of csPCa. Transperineal MRI-US targeted biopsy show potential benefits to improve cancer detection rate in patients with high PIRADS score, tumor located at the anterior portion and in repeat biopsies.

• 한국미생물·생명공학회지
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• 제47권3호
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• pp.465-472
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• 2019

Candida albicans는 기회감염을 유발하는 주요한 병원성 진균 중의 하나이다. 캔디다증 치료과정에서 항진균제에 대한 내성이 흔히 발견되는데, 그 이유는 Candida가 바이오필름을 형성할 수 있기 때문이다. 이전의 연구에서 우리는 단삼(Salvia miltiorriza)의 에탄올추출물이 세포막의 투과성을 변화시키고 세포벽 합성을 저해하여 항캔디다 활성을 나타냄을 밝혔다. 본 연구에서는 10개 C. albicans 임상균주가 형성한 초기단계의 바이오필름을 대상으로 XTT 환원분석법으로 대사활성을 측정하니, $78{\mu}g/ml$ 단삼 에탄올추출물에 의해 바이오필름의 대사활성이 평균 51.3% 감소되었다. C. albicans 세포들이 폴리스티렌 표면에 부착하거나 germ tube를 형성하는 과정에서의 단삼 에탄올추출물의 영향을 현미경으로 분석하니, $39{\mu}g/ml$ 단삼 에탄올추출물에 의해 부착된 세포의 밀도는 현저하게 감소하였으나 germ tube 형성은 거의 억제하지 못했다. 단삼 에탄올추출물이 C. albicans SC5314 세포의 균사에 특이적인 유전자 발현에 미치는 영향을 qPCR로 분석한 결과, EAP1은 34.7% (p < 0.001), ALS1은 45.0% (p < 0.001), ALS3는 48.1% (p < 0.001), ECE1은 21.3% (p = 0.006) 억제하였다. 결론적으로 단삼의 에탄올추출물은 초기단계의 C. albicans 바이오필름 발달을 효율적으로 저해하며, 이는 EAP1, ALS1, ALS3 유전자의 발현억제에 따른 세포부착 억제와 관련이 있다. 더불어 단삼 에탄올추출물의 C. albicans 세포막 기능저해와 세포벽 합성억제에 의한 구조변화 또한 세포부착단계에서의 바이오필름 발달억제에 기여할 것으로 추정된다.

• 재활치료과학
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• 제10권3호
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• pp.97-110
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• 2021

목적 : 본 연구는 Parten의 사회적 놀이의 발달 단계를 바탕으로 학령전기 아동의 사회적 놀이를 측정할 수 있는 평가 문항을 개발하고자 하였다. 연구방법 : 문헌 고찰을 통해 Parten의 사회적 놀이의 발달 단계에 따른 조사 문항을 수집하였다. 이후 아동 작업치료 혹은 놀이와 관련된 치료 경력 7년 이상의 전문가 패널 22명을 대상으로 총 2회의 델파이 조사를 실시하였다. 전문가 패널에게 각 조사 문항에 대한 적절성 여부를 평정하게 한 후 학령전기 아동의 보호자를 대상으로 예비 문항의 내용에 대한 이해도 조사를 실시하였다. 보호자의 예비 문항 이해도 조사 후 전문가 자문 회의를 거쳐 평가 방법을 수립하였다. 결과 : 자료 수집과 델파이 조사를 통해 학령전기 아동의 사회적 놀이는 Parten의 사회적 놀이의 발달 단계인 6개 영역(몰입되지 않은 행동, 방관자적 행동, 혼자 놀이, 평행 놀이, 연합 놀이, 협동 놀이)으로 구성하였고, 몰입되지 않은 행동 12문항, 방관자적 행동 7문항, 혼자 놀이 14문항, 평행 놀이 16문항, 연합 놀이 17문항, 협동 놀이 23문항으로 총 89문항이 도출되었다. 델파이 조사의 평균 내용 타당도 비율은 0.85, 안정도 0.15, 합의도 0.78로 나타났다. 본 연구에서는 연합 놀이 17문항, 협동 놀이 23문항인 총 40문항을 최종 예비 문항으로 구성하였다. 결론 : 학령전기 아동의 사회적 놀이를 측정할 수 있는 평가 문항을 개발하고 내용 타당도를 검증하였다. 향후에는 평가 문항에 대한 타당도를 검증하여 임상에서 평가도구로써 활용되기를 기대한다.

• 생명과학회지
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• 제32권7호
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• pp.550-566
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• 2022

뇌졸중은 세계적으로 사망과 장기간인 신체적, 인지적 장애의 주요 원인들 중 하나이며, 매년 약 1,500만명의 사람들에게 영향을 미친다. 뇌졸중의 병태 생리학적 과정은 다수의 사건들이 관여하는 복잡한 과정으로, 그 중 혈액-뇌 장벽(blood-brain barrier: BBB)의 붕괴는 허혈성 뇌손상의 진행에 크게 기여하는 것으로 알려져 있다. 따라서 BBB 붕괴는 뇌졸중의 특징으로 인식되므로 허혈성 뇌졸중에서 BBB 기능 장애를 보호할 수 있는 새로운 치료 전략을 개발하는 것이 뇌졸중 치료에 매우 중요하다. 전통한약은 천연물로 구성되어 있으며, 이는 뇌졸중 치료약 개발을 위한 유망한 원천이 될 수 있다. 실제로 여러 연구에서 뇌졸중에 대한 한의학의 효능이 밝혀져 허혈성 뇌졸중에 대한 한의학적 치료 가치가 부각되고 있다. 본 리뷰에서는 허혈성 뇌졸중으로 인한 BBB 붕괴에 대한 전통적인 한의학의 처방, 탕약, 약재 및 활성 성분의 개선효과에 관한 현재 정보와 기본 메커니즘을 요약 정리하였다. 이러한 연구가 한의학의 신경보호 효과에 대한 추가 조사를 촉진하고 뇌졸중 환자에 대한 한방유래의 임상시험 시행을 활성화하는데 도움이 되기를 기대한다.

• 대한화상학회지
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• 제22권2호
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• pp.66-70
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• 2019

Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.

• 대한화상학회지
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• 제22권1호
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• pp.10-14
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• 2019

Purpose: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. Methods: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. Results: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. Conclusion: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.

• 한국어병학회지
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• 제36권2호
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• pp.239-250
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• 2023

최근 뱀장어 (Anguilla japonica)에서 발생하고 있는 질병을 파악하기 위하여 질병 모니터링을 실시하였다. 2021년 5월부터 2022년 3월까지는 폐사가 발생한 7개의 양만장 유래의 뱀장어를 7회 검사하였다. 모든 양만장에서 JEECV가 검출되었고 양만장마다 1-2종의 세균 (Edwardsiella anguillarum, E. piscisida, Aeromonas sp., Citrobacter freundii, Lactococcus garviae 혹은 Vibrio sp.)이 복합감염이 일어나 있었다. 2022년 3월부터 2023년 10월까지는 전라남도 영광의 한 양식장에서 매달 정기적으로 총 22회 검사를 실시하였다. JEECV가 22회 검사 중 10회 검출되었고 폐사가 발생하지 않는 시기에도 꾸준히 검출되었다. 세균으로는 E. anguillarum, C. freundii, Aeromonas sp.와 Vibrio sp가검출되었으나 E. anguillarum이 분리된 개체만이 간의 농양과 출혈 병소가 일관되게 관찰되었고 다른 세균은 임상증상이 없는 경우가 많았다. 모니터링의 결과를 종합하면 양만장에서의 폐사는 JEECV 단독감염보다는 JEECV가 세균과 복합감염일 경우에 발생하였다. 그러므로 뱀장어의 폐사를 줄이기 위해서는 JEECV와 E. anguillarum의 관리에 중점을 두고 복합감염을 줄이는 것이 중요한 것으로 생각된다.

• Pediatric Infection and Vaccine
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• 제30권3호
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• pp.139-144
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• 2023

농뇨는 가와사키병 환아의 약 30-60%에 동반되는 소견으로, 임상적 증후가 다 나타나지 않은 초기의 가와사키병 또는 불완전 가와사키병에서 요로감염으로 오인할 수 있으나, 불완전 가와사키병 진단에 중요한 검사실 소견 중 하나일 수 있다. 본 연구에서는 한국의 5세 미만 영유아에서 가와사키병 진단 전 요로감염으로 선행 진단 사례의 유병률과 역학적 위험인자를 평가하고자 한다. 건강보험심사평가원에서 제공하고 있는 보건의료 빅데이터 개방시스템 자료를 바탕으로 2007년 11월부터 2019년 10월까지 가와사키병과 요로감염으로 진료, 청구된 대상자에 대해 후향적 단면연구를 시행 하였다. 가와사키병 확정 진단 전 1주일 이내의 요로감염 선행 진단된 환아의 발생률을 계산하였고, 카이제곱 (χ² test) 검정을 실시하였다. 연령, 성별, 지역, 계절별 발생률에 대한 요로감염 선행 진단 여부에 대해 로지스틱 분석 (logistic regression)을 수행하였다. 연구 결과, 총 53,822명의 가와사키병 환자가 포함되었으며 그 중 304명 (0.56%)이 선행 요로감염 진단이 있었다. 12개월 미만에서의 요로감염 선행 진단률이 가장 높았으며 (0.95%), 4세와 비교했을 때 요로 감염 선행진단의 오즈비는 3.12 (2.05-4.77) 였다. 발열을 동반한 농뇨가 있는 영아의 일부에서는 불완전 가와사키병의 감별진단이 필요할 수 있다.

• 한국환경성돌연변이발암원학회:학술대회논문집
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• 한국환경성돌연변이발암원학회 2003년도 추계학술대회
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• pp.34-63
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• 2003

Occupational and environmental exposure to manganese continue to represent a realistic public health problem in both developed and developing countries. Increased utility of MMT as a replacement for lead in gasoline creates a new source of environmental exposure to manganese. It is, therefore, imperative that further attention be directed at molecular neurotoxicology of manganese. A Need for a more complete understanding of manganese functions both in health and disease, and for a better defined role of manganese in iron metabolism is well substantiated. The in-depth studies in this area should provide novel information on the potential public health risk associated with manganese exposure. It will also explore novel mechanism(s) of manganese-induced neurotoxicity from the angle of Mn-Fe interaction at both systemic and cellular levels. More importantly, the result of these studies will offer clues to the etiology of IPD and its associated abnormal iron and energy metabolism. To achieve these goals, however, a number of outstanding questions remain to be resolved. First, one must understand what species of manganese in the biological matrices plays critical role in the induction of neurotoxicity, Mn(II) or Mn(III)? In our own studies with aconitase, Cpx-I, and Cpx-II, manganese was added to the buffers as the divalent salt, i.e., $MnCl_2$. While it is quite reasonable to suggest that the effect on aconitase and/or Cpx-I activites was associated with the divalent species of manganese, the experimental design does not preclude the possibility that a manganese species of higher oxidation state, such as Mn(III), is required for the induction of these effects. The ionic radius of Mn(III) is 65 ppm, which is similar to the ionic size to Fe(III) (65 ppm at the high spin state) in aconitase (Nieboer and Fletcher, 1996; Sneed et al., 1953). Thus it is plausible that the higher oxidation state of manganese optimally fits into the geometric space of aconitase, serving as the active species in this enzymatic reaction. In the current literature, most of the studies on manganese toxicity have used Mn(II) as $MnCl_2$ rather than Mn(III). The obvious advantage of Mn(II) is its good water solubility, which allows effortless preparation in either in vivo or in vitro investigation, whereas almost all of the Mn(III) salt products on the comparison between two valent manganese species nearly infeasible. Thus a more intimate collaboration with physiochemists to develop a better way to study Mn(III) species in biological matrices is pressingly needed. Second, In spite of the special affinity of manganese for mitochondria and its similar chemical properties to iron, there is a sound reason to postulate that manganese may act as an iron surrogate in certain iron-requiring enzymes. It is, therefore, imperative to design the physiochemical studies to determine whether manganese can indeed exchange with iron in proteins, and to understand how manganese interacts with tertiary structure of proteins. The studies on binding properties (such as affinity constant, dissociation parameter, etc.) of manganese and iron to key enzymes associated with iron and energy regulation would add additional information to our knowledge of Mn-Fe neurotoxicity. Third, manganese exposure, either in vivo or in vitro, promotes cellular overload of iron. It is still unclear, however, how exactly manganese interacts with cellular iron regulatory processes and what is the mechanism underlying this cellular iron overload. As discussed above, the binding of IRP-I to TfR mRNA leads to the expression of TfR, thereby increasing cellular iron uptake. The sequence encoding TfR mRNA, in particular IRE fragments, has been well-documented in literature. It is therefore possible to use molecular technique to elaborate whether manganese cytotoxicity influences the mRNA expression of iron regulatory proteins and how manganese exposure alters the binding activity of IPRs to TfR mRNA. Finally, the current manganese investigation has largely focused on the issues ranging from disposition/toxicity study to the characterization of clinical symptoms. Much less has been done regarding the risk assessment of environmenta/occupational exposure. One of the unsolved, pressing puzzles is the lack of reliable biomarker(s) for manganese-induced neurologic lesions in long-term, low-level exposure situation. Lack of such a diagnostic means renders it impossible to assess the human health risk and long-term social impact associated with potentially elevated manganese in environment. The biochemical interaction between manganese and iron, particularly the ensuing subtle changes of certain relevant proteins, provides the opportunity to identify and develop such a specific biomarker for manganese-induced neuronal damage. By learning the molecular mechanism of cytotoxicity, one will be able to find a better way for prediction and treatment of manganese-initiated neurodegenerative diseases.

• 대한한방종양학회지
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• 제2권1호
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• pp.113-160
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• 1996

Cancer is one of the most important cause of death. So recently, investigation of cancer progress prosperously all over the world. Cancer in the present medicine correspond to You-Am, Sin-Am, Young-Soon, Sel-Gyun, Sil-Young, Young-Lyoo, Seg-Je, Seg-Young, Seg-Ha, Jerk-Chui(積聚), Jing-Ha, Oel-Gyek, Ban-Oui, Bi-Gi, Bok-Lyang, Jang-Dan, Hyen-Bek in the oriental medicine. Among these, generally Jerk-Chui(積聚) is expressed to cancer. So to develop of new drugs of cancer in the present medicine, bibliographic investigation of mass-prescriptions was studied in the oriental medicine-books. According to the bibliographic study of Jerk-Chui-prescriptions, the results run as follows. 1. According to the analyses of three hundred sixty eight Jerk-Chui-prescriptions in the twenty-seven kinds of literature, the frequency number of the used drugs were Pericarpium Citri Nobilis Viride 140 times, Pericarpium Citri Reticulatae 135 times, Rhizoma Scirpi 124 times, Radix Aucklandie 115 times, Rhizoma Zedoariae 114 times, Cortex Magnoliae Officinalis 111 times, Radix Glycyrrhizae 106 times, Rhizoma Zingiberis 100 times, Rhizoma Coptidis 94 times, Radix Ginseng 93 times, Poria 86 times, Rhizoma Pinelliae 85 times, Semen Arecae 83 times, Rhizoma Cyperi 82 times, Radix Angelicae Sinensis 80 times, Rhizoma Atractylodis 74 times, Massa Fermentata Medisinalis 67 times, Radix Et Rhizoma Rhei 66 times, Fructus Aurantii 62 times, Fructus Hordei Genninatus 55 times, Conex Cinnamomi 54 times, Fructus Evodiae 51 times, Fructus Aurantii Immaturus 49 times, Fructus Crataegi 49 times, Rhizoma Cnidii 46 times, Radix Platycodi 44 times, Semen Tiglii 44 times, Radix Aconiti 43 times, Fructus Amoni 38 times, Semen Raphani 37 times, Radix Aconiti Praeparata 36 times, Radix Scutellariae 35 times, Pericarpium Zanthoxyli 35 times, Rhizoma Corydalis 33 times, Rhizoma Acori Graminei 31 times, Carapax Amydae 31 times, Fructus Foeniculi 31 times, Semen Persicae 30 times, Radix Bupleuri 30 times. 2. The frequency number of the most imponant used drugs in the Jerk-Chui-prescriptions were Rhizoma Coplidis 41 times, Rhizoma Scirpi 35 times, Radix Et Rhizoma Rhei 31 times, Pericarpium Citri Reticuiatae 30 times, Rhizoma Zedoariae 27 times, Rhizoma Cyperi 22 times, Cortex Magnoliae Officinalis 22 times, Rhizoma Atraclylodis 22 times, Pericarpium Citri Nobilis Viride 21 times, Rhizoma Pinelliae 20 times, Semen Arecae 20 times, Fructus Crataegi 18 times, Rhizoma Zingiberis 17 times, Carapax Amydae 16 times, Semen Pharbitidis 13 times, Poria 12 times, Radix Angelicae Sinensis 10 times, Semen Persicae 10 times, Fructus Evodiae 10 times, Radix Aeoniti 10 times, Radix Glycyrrhizae 9 times, Massa Fennenlata Medisinalis 9 times, Fructus Aurantii 9 times, Fructus Hordei Genninatus 8 times, Radix Aueklandie 8 times, Rhizoma Atractylodis 8 times, Radix Bupleuri 8 times, Radix Ginseng 7 times, Semen Raphani 7 times, Radix Astragali 7 times, Cortex Cinnamomi 6 times, Fructus Aurantii Immaturus 6 times, Rhizoma Cnidii 6 times, Radix Aconiti Praeparata 5 times, Fructus Foeniculi 5 times, Lacca Sinica Exsiccata 5 times, Radix Aconiti 5 times, Rhizoma Zingiberis 5 times. 3. The clinical-botanic classifications of the used drugs in the Jerk-Chui-prescriptions were regulating the flow of Qi drugs, warm-heating drugs, promoting blood circulation drugs, killing mass drugs, resolving drugs, purgative drugs, Qi and blood tonics drugs, heat clearing drugs, removing dampness by promoting diures is drugs, phlegm eliminating drugs, allaying pain drugs. 4. According to the nature and taste in the drugs, warm and heating recipes were used most, heatclearing recipes were used a few times assistantly. 5. The Jerk-Chui-prescription used frequently was Bun-Don-Tang, which was used 13 times ; Bok-Oyang-Hoan 12 times, Bi-Gi-Hoan(肥氣丸) 12 times, Sik-Boon-Hoan 12 times, A-Uie-Hoan 12 times, Bi-Gi-Hoan 12 times, Dai-Cil-Gi-Tang 8 times, San-Cuie-Tang 8 times, Guye-Gyen-Tang 6 times, On-Baig-Won 5 times, So-Jek-Jeng-Ouen-San 5 times, Jin-In-Hoa-Cel-Tang 5 times, Byel-Gab-San 5 times, Sng-Hong-Hoan 5 times, Ji-Sil-San 4 times, So-A-Oie-Hoan 4 times, Hyang-Rng-Hoan 4 times.