• Molecules and Cells
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• 제43권4호
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• pp.408-418
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• 2020

The sinus node (SN) is located at the apex of the cardiac conduction system, and SN dysfunction (SND)-characterized by electrical remodeling-is generally attributed to idiopathic fibrosis or ischemic injuries in the SN. SND is associated with increased risk of cardiovascular disorders, including syncope, heart failure, and atrial arrhythmias, particularly atrial fibrillation. One of the histological SND hallmarks is degenerative atrial remodeling that is associated with conduction abnormalities and increased right atrial refractoriness. Although SND is frequently accompanied by increased fibrosis in the right atrium (RA), its molecular basis still remains elusive. Therefore, we investigated whether SND can induce significant molecular changes that account for the structural remodeling of RA. Towards this, we employed a rabbit model of experimental SND, and then compared the genome-wide RNA expression profiles in RA between SND-induced rabbits and sham-operated controls to identify the differentially expressed transcripts. The accompanying gene enrichment analysis revealed extensive pro-fibrotic changes within 7 days after the SN ablation, including activation of transforming growth factor-β (TGF-β) signaling and alterations in the levels of extracellular matrix components and their regulators. Importantly, our findings suggest that periostin, a matricellular factor that regulates the development of cardiac tissue, might play a key role in mediating TGF-β-signaling-induced aberrant atrial remodeling. In conclusion, the present study provides valuable information regarding the molecular signatures underlying SND-induced atrial remodeling, and indicates that periostin can be potentially used in the diagnosis of fibroproliferative cardiac dysfunctions.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.1-5
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• 2000

The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

• 한국식품영양학회:학술대회논문집
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• 한국식품영양학회 2003년도 하계 학술 심포지엄
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• pp.82-82
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• 2003

오디는 옛부터 보혈자음(補血滋陰), 생진윤조(生津閏操), 현훈이명(眩最耳鳴), 심계실면(心悸失眠), 수발조백(鬚髮早白) 등을 치료하는 효능을 가진다고 알려져 있다. 상심자(桑 子)라 하여 뽕나무 열매로서 한방에서 상심(桑 ), 상실(桑實), 오심(烏 ), 흑심(黑 ) 등으로 지칭되며, 뽕나무과(Moraceae)에 속하는 뽕나무(Morus alba L)의 성숙한 과실로 취화과(聚花果)에 속하며 작은 수과(瘦果)가 많이 모여 이루어진 장원형으로 길이 1 내지 2 cm, 지름 0.5 내지 0.8 cm이며 황갈색, 갈홍색 또는 암자색을 띠고 짧은 줄기가 있다. 작은 수과(瘦果)는 난원형으로 조금 납작한 편이며, 길이는 약 2 mm, 너비는 약 1 mm 이고 육질의 화편(花片) 4개가 둘러싸고 있다. 그러나 아직까지는 오디에 대하여 자연과학적인 연구방법을 이용하여 구체적으로 연구된 바가 많지 않다. 또한 이의 생리활성 성분에 대해서도 그 작용과 연관지어 보고된 바가 많지 않다. 뇌졸중 가운데 뇌조직으로 가는 혈액 공급의 감소 혹은 차단으로 발생되는 허혈성 뇌졸중(ischemic stroke)은 전체 뇌졸중 환자의 약 80%정도를 차지하고 있으나 아직까지 뇌신경세포 손상기전의 복잡성 등으로 뇌졸중으로 발생하는 뇌신경세포의 손상을 보호해 줄 수 있는 물질이 개발되어 있지 못한 실정이다. 한편, 천연물로부터 뇌허혈 보호작용을 가지는 물질의 도출은 주로 한방에서 처방을 중심으로 이루어지고 있으며, 따라서 처방으로부터 신경보호작용을 가지는 물질의 도출은 그 처방에 함유되어 있는 각종 생약이 갖는 다양한 활성으로 인해 어려운 점이 있으며, 비록 효과가 있다고 하더라도 과학적인 입증자료가 매우 미비한 실정이다. 이에 본 연구에서는 위에 언급된 자료를 토대로 오디추출물이 뇌허혈에 효과가 있을 것이라는 가정하에 in vitro system을 이용하여 오디추출물의 신경보호작용기전을 검색하고자 DPPH radical 의 생성억제효과, PC12 cell line을 이용한 산화적 스트레스에 의한 오디추출물의 방어효과, LSP에 의하여 활성화된 BV-2 cell에 미치는 영향 등을 검색하였다. 오디의 DPPH 소거활성은 단일화랍물인 bacicalein과 유사한 효과를 나타냈으며 PC12 cell line을 이용한 산화적 스트레스에 의한 오디의 방어 효과는 LDH activity를 행한 결과 농도 의존적으로 LDH 유리 량을 감소시켰다. 뇌손상시에 오디추출물의 염증방어 효과를 관찰하기 위하여 microglial cell line인 BV2 세포주를 선택하여 배양한 후 LPS로 자극을 준 후 일차적인 염증지표인 NO양을 측정한 결과 BV2 cell에 LPS 100 ng/ml을 처리하는 경우 nitrite량이 유의적으로 증가하였는데 이때 오디추출물을 1, 5, 10 ug/ml의 용량으로 처리하는 경우 역시 저농도에서 NO생성량을 감소시켰다. 정리해보면 뽕나무과 식물인 오디는 신경보호효과가 있는 것으로 사료되는데 이러한 효과는 아마도 오디의 항산화효과에 기인한 것으로 추정된다.

• Archives of Reconstructive Microsurgery
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• 제4권1호
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• pp.58-64
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• 1995

사지의 연부조직 결손으로 고려대학교 의과대학 정형외과학 교실에서 입원했던 12명의 환자 13례에 대하여 전완부 유리 피판술을 시행 후 최저 3개월에서 최고 37개월간 평균 14.3개월간 추시하여 다음과 같은 결론을 얻었다. 1. 13례 전례에서 연부조직 결손의 치료로 만족할만한 결과를 얻었다. 2. 이식피판의 크기는 평균 $54cm^2$였으며 유리피판의 평균 혈류 차단시간은 74분 이었다. 3. 술후 3례에서 합병증이 발생하였으며 3례중 2례는 동맥 문합부위에 혈전이 발생하였으나 술후 제 2일에 혈전 재거술을 시행하여 해결하였으며, 1례는 이식 정막내의 혈전으로 이식피판의 표층괴사가 발생하여 고식적인 피부이식술로 치료하였다. 4. 체중 부하를 받는 족저부의 재건에는 감각신경을 포함한 전완부 유리피판술이 좋은 방법의 하나이다. 5. 전완부 피판술은 비교적 넓은 연부조직 결손을 치료할 수 있고 이식 혈관의 내경이 커서 문합이 비교적 쉬워 숙련된 미세수술 수기를 익힌 외과의사에게는 성공률이 높은 유리피판술 중의 하나이다.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.407-412
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• 2006

Purpose: Various attempts of reconstruction for pharyngoesophageal defects after ablative surgery have been made to restore the function of the pharyngoesophagus. A fabricated tubed radial forearm free flap or free jejunal free flap was used when the width of remnant pharyngeal wall was less than 50% of the normal width. However there are many disadvantages such as stricture, saliva leakage and fistula formation on tubed radial forearm free flap. The jejunal free flap has the problem such as short pedicle, poor tolerance of ischemic time, wet voice and delayed transit of swallowed food due to the uncoordinated contraction. The authors studied the utility of patch-type radial forearm free flap using the remnant posterior pharyngeal wall of the hypopharynx. Methods: Retrospective reviews in Severance Hospital were made on 25 patients who underwent reconstruction surgery with patched radial forearm free flap because of the hypopharyngeal cancer between 1996 and 2005. The patients of Group I had the narrow posterior pharyngeal wall and its width was less than 3centimeters after the tumor was resected. Those of Group II had the partial pharyngectomy and the width of the remnant pharynx was larger than 3 centimeters. Results: Seven patients belonged to the group I and the flap of this group had 100% survival rate. One case of fistula and no swallowing discomfort due to stricture was reported. The Group II including 18 patients also had the 100% flap survival rate. Neither fistula nor stricture was seen but the lower diet grade was checked. Conclusion: The patch type radial forearm free flap using the remnant pharyngeal wall have the advantage of the radial forearm free flap, and furthermore this flap is the safe reconstructive method even if the width of the remnant pharyngeal wall is less than 30% of that of normal pharynx.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.645-652
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• 2008

Purpose: In skin flap surgery, surgeons often encounter distal ischemia of the flap. If a powerful free radical scavenger is used, it may reduce the formation of free radical and improves the survival of flap. Thus, the present study purposed to examine whether the survival of flap can be enhanced by administering melatonin, which is known to be a powerful free radical scavenger a antioxidant molecule. Methods: We divided 40 Sprague-Dawley rats into 4 groups, 10 in each group. For the control group(n=10), we intraperitoneally injected only carrier solution once 30 minutes before the operation, and once a day for 7 days from the day of operation. Among the experimental groups, a group(n=10) was administered with dimethyl sulfoxide(DMSO), in another group(n=10), melatonin was intraperitoneally injected, and in the other(n=10) melatonin was intraperitoneally injected and applied topically(2 cc of 1% melatonin) to the operation site. Caudally based skin flaps measuring $3{\times}10cm^2$ were elevated on the mid-dorsum of the rats. and then repositioned. On the seventh postoperative day, the survival area of the flap was measured and tissues were examined under the light microscope. Results: The control group, the DMSO group, the melatonin administration group and the melatonin administration and application group showed the mean survival rates of $55.26{\pm}9.2%$, $70.29{\pm}7.47%$, $81.45{\pm}4.14%$ and $86.1{\pm}1.52%$, respectively, for $30cm^2$ of flap. Compared to the control group, the experimental groups showed a significantly high increase in survival area at significance level of 95%. Conclusion: In this study, the survival rate of flap was enhanced through the administration of melatonin after flap surgery. This suggests that melatonin not only functions as a powerful free radical scavenger and oxygen radical scavenger but also stabilizes and protects cells, and by doing so, enhances the survival of moderately injured ischemic sites in the distal end of flap.

• 대한한방내과학회지
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• 제21권1호
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• pp.116-125
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• 2000

Objectives : The aim of this study is to investigate that Sunghyangjeongki-San which has been frequently medicated in the early stage of stroke can protect against ischemic damage in rat brain Methods : Extracellular levels of amino acids(glutamate, aspartate, GABA, glycine, taurine, tyrosine, alanine), organic acids(pyruvate, lactate), and cerebral infarction volume were measured at the striatum of rats subjected to permanant focal cerebral ischemia induced by 2 hours of middle cerebral artery occiusion(MCAO). Rats were orally administered with Sunghyangjeongki-San at 30mins before MCAO and the microdialysate was collected by intracerebral microdialysis three times before MCAO and six times after MCAO at 20mins interval and analyzed by HPLC. After a microdialysis study, the brain was sliced and stained with cresyl violet buffer for the measurement of cerebral infarcted area and volume by image analyzer system Results : The concentrations of glutamate, aspartate, and tyrosine known as excitatory neurotransmitters were significantly decreased in Sunghyangjeongki-San group compared with control group, The concentrations of GABA, glycine, taurine and alanine known as inhibitory neurotransmitters were significantly increased in Sunghyangjeongki-San group compared with control group. The concentrations of pyruvate and lactate showed little significant change in Sunghyangjeongki-San group compared with control group. The measurement of cerebral infarcted area and volume by image analyzer system were significantly decreased in Sunghyangjeongki-San group compared with control group. Conclusions : Sunghyangjeongki-San can affect on protecting against cerebral ischemia by regulating extracellular levels of excitatory and inhibitory amino acid neurotransmitters and improve the conditions of the patients in the early stage of stroke.

• 대한한방내과학회지
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• 제21권1호
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• pp.126-134
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• 2000

Objectives : In order to study effects of Dansamyeum on Hyperlipidemia which causes Hypertension, Arteriosclerosis, Cerebral vascular disease and Ischemic heart disease Methods : The changes of serum total lipid, triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, body weight and organ weight were observed after the liquid extracts of Single-dosage Dansamyeum and Double-dosage Dansamyeum were administered p.o to the Hyperlipidemic rats induced by 1% cholesterol diet for 10, 20 and 30 days. Results : The body weight was significantly decreased in Double-dosage Dansamyeum group for 20 and 30 days compared with control group. The contents of total lipid were significantly decreased in Single-dosage Dansamyeum group for 20 days, but Double-dosage Dansamyeum group did not show any significant change compared with control group. The contents of total cholesterol were significantly decreased in Single-dosage Dansamyeum group for 20 days, and Double-dosage Dansamyeum group showed significant changes for 10 and 20 days compared with control group. The contents of triglyceride were significantly decreased in Single-dosage Dansamyeum group for 30 days, and Double-dosage Dansamyeum group showed significant changes for 10 days compared with control group. The contents of HDL-cholesterol were significantly increased in Single-dosage Dansamyeum group and Double-dosage Dansamyeum group for 10 days compared with control group. The contents of LDL-cholesterol were significantly decreased in Single-dosage Dansamyeum group for 10, 20 and 30 days, and Double-dosage Dansamyeum group showed significant changes for 10, 20 and 30 days compared with control group. The liver weight was significantly decreased in Single-dosage Dansamyeum group and Double-dosage Dansamyeum group compared with control group. The kidney and testis weight was significantly decreased in Single-dosage Dansamyeum group compared with control group. The spleen weight was significantly decreased in Double-dosage Dansamyeum group compared with control group. Conclusions : It was thought that Single-dosage Dansamyeum and Double-dosage Dansamyeum could be applied effectively to the Hyperlipidemia.

• 대한한방내과학회지
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• 제19권1호
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• pp.301-317
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• 1998

A clinical analysis was carried out for 32 patients who were treated in Dept. of Dong-shin Oriental Medicine Hospital from 10st January to 16st May in 1998 and ruled out as dememtia. The results were summarized as follows. 1. In the distribution of sex, female was more than male. And the age of seventies(17 cases, 53.125%) was highest in the frequency of age. 2. In the distribution of having history of drinking and smoking were each 4 cases(12.5%) and 7 cases(21.875%). 3. In the distribution of seasons, the ratio of spring and winter were each 16 cases(50.0%), 15 cases(46.875%), that of summer and fall were comparatively low. 4. In the period from onset to admission, the period within a week had 20 cases(62.5%) as top, and the most period of treatment was 2 and 3 weeks(28.125%). 5. The number of cases that had preceding disease was 35 cases(71.875%), a major portion of preceding diseases were hypertension, diabetes mellitus, stroke. 6. The most common symptom was disorientation(78.125%), and the next common symptom was motor desability(71.875%), and memory disturbance, verbal disturbance was each 59.375 and 47.1%. 7. In the distribution of the CT scan films, 15 cases(46.875%) showed cerebral infarction and that of another 5cases (15.625%) showed cerebral hemorrhage, that of another 2 cases(6.25%) showed brain atrophy. 8. In the lipid density of blood, T-Cholesterol, TG, HDL-Cholesterol, LDL- Cholesterol was within normal limit. 9. In the MMSE-K, the most score was from 16 point to 20 point, and second only was from 11 point to 15 point, and the next was from 6 point to 10 point. 10. In the Ischemic score, 20 cases(62.5%) was diagnosed as brain vascular type dementia, and mixed type dementia was 9 cases(28.125%), Alzheimer type dementia was 3 cases(9.375%). 11. The most used recipes were a sort of recipes to activate of flow the vital energy and the blood, to remove the phlegm(41 cases 33.9%), especially DODAMHOALHEL TANG (12 cases, 9.9%), ANSINCHUNGNOITANG (8 case, 6.6%) was the most used recipe. 12. In the judgement of efficacy, 17 cases(53.125%) showed excellent efficacy, 10 cases(31.25%) showed good efficacy, 5 cases(15.625%) showed no change and that according to MMSE-K, 4 case(18.18%) showed excellent efficacy, 15 cases(68.18%) showed good efficacy, 15 cases(68.18%) showed no change.

• Journal of Chest Surgery
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• 제37권2호
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• pp.146-153
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• 2004

관상동맥우회술의 경험이 축적됨에 따라 관상동맥우회술의 재수술은 증가하는 추세이나 아직까지 국내 보고는 미흡한 수준이다. 저자들은 관상동맥 재수술의 사망률, 유병률 등의 임상경험을 정리하고 분석하였다. 대상 및 방법: 1994년 1월부터 2002년 12월까지 관상동맥우회술의 재수술을 시행 받은 14명의 환자를 대상으로 하였다. 최초 수술 후 재수술까지의 기간은 평균 66$\pm$56 (3∼157)개월이었고 재수술 시 평균연령은 62.8$\pm$8.7 (51∼78)세였다. 2003년 6월 30일을 추적관찰 종료시점으로 하여 평균추적관찰 기간은 43$\pm$29 (8∼105)개월이었다. 재수술의 적응증은 이식편의 협착 또는 완전폐쇄가 11예(78.6%), 관상동맥질환의 진행이 1예, 그리고 두 가지 병리가 혼재한 경우가 2예였다. 결과: 입원기간 중 사망은 2예(14.3%)가 발생하였고 사망원인은 저심박출증이었다. 술 후 합병증은 총 7명(50.0%)의 환자에서 8예가 발생하였는데, 수술 전후 심근경색이 2예(14.3%), 종격동염이 1예(7.2%), 십이지장 궤양천공 1예, 허혈성 하지괴사 1예, 장간막경색에 따른 위장관 천공 1예, 지연 뇌경색 1예, 비장출혈 1예 등이었다. 조기사망 2예를 제외한 12명의 환자를 추적 관찰한 결과 만기사망은 1예가 발생하였고 추적관찰 종료시점에서 협심증을 호소하는 환자는 없었으며 모든 환자가 Canadian협심증분류 1급 또는 2급의 양호한 경과를 보였다. 결론: 관상동맥 재수술은 비교적 높은 유병률과 사망률을 보였으나 퇴원 후 환자상태는 양호하였으며 향후 경험의 축적과 노력이 요망된다.