• 대한임상검사과학회지
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• 제48권2호
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• pp.49-53
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• 2016

급성 심 질환 환자는 트로포닌(troponin)과 같은 생물학적 표지자(biomarker)가 등장하면서 진단과 치료에 많은 개선이 있었다. 콩팥 질환에서는 많은 치료약제 개발이 꾸준하게 진전해 왔음에도 불구하고 실제 사망률이나 이환률은 별로 개선되지 않았다. 급성 콩팥 손상 환자를 대상으로 응급의료센터에서 측정한 NGAL의 측정치는 NGAL이 증가할수록 Creatinine이 유의하게 증가 하였다. 그러나, AST, ALT, BUN, Na, K, Cl 과의 상관관계는 통계적으로 유의하지 않았다. NAGL kit와 ELISA의 민감도는 ${\geq}300$ (92.2%), ${\geq}200$ (95.6%), ${\geq}100$ (99.6%), 특이도는 ${\geq}300$ (95.1%), ${\geq}200$ (97.3%), ${\geq}100$ (99.4%)로 조사되었으며 양성예측도는 ${\geq}300$ (93.3%), ${\geq}200$ (93.4%), ${\geq}100$ (99.2%), 음성예측도는 ${\geq}300$ (96.7%), ${\geq}200$ (97.7%), ${\geq}100$ (98.1%)로 조사되었으며, 급성 콩팥 손상의 정도를 평가하는 검사로써 조기 진단 및 예후를 예측함에 있어서 환자의 치료의 결정에 유용하게 이용 될 수 있다. 향후 응급의료센터에서 콩팥 질환 환자의 중증도를 평가하고 치료 방향을 결정하며, 예후를 예측하는데 있어서 NGAL kit 검사가 도움이 될 수 있다고 생각한다.

• Molecules and Cells
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• 제19권3호
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• pp.402-407
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• 2005

Bone marrow mesenchymal stem cells (MSCs) have shown potential for cardiac repair following myocardial injury, but this approach is limited by their poor viability after transplantation. To reduce cell loss after transplantation, we introduced the fibroblast growth factor-2 (FGF-2) gene ex vivo before transplantation. The isolated MSCs produced colonies with a fibroblast-like morphology in 2 weeks; over 95% expressed CD71, and 28% expressed the cardiomyocyte-specific transcription factor, Nkx2.5, as well as ${\alpha}$-skeletal actin, Nkx2.5, and GATA4. In hypoxic culture, the FGF-2-transfected MSCs (FGF-2-MSCs) secreted increased levels of FGF-2 and displayed a threefold increase in viability, as well as increased expression of the anti-apoptotic gene, Bcl2, and reduced DNA laddering. They had functional adrenergic receptors, like cardiomyocytes, and exposure to norepinephrine led to phosphorylation of ERK1/2. Viable cells persisted 4 weeks after implantation of $5.0{\times}10^5$ FGF-2-MSCs into infarcted myocardia. Expression of cardiac troponin T (CTn T) and a voltage-gated $Ca^{2+}$ channel (CaV2.1) increased, and new blood vessels formed. These data suggest that genetic modification of MSCs before transplantation could be useful for treating myocardial infarction and end-stage cardiac failure.

• The Journal of Korean Physical Therapy
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• 제14권2호
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• pp.1-15
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• 2002

Excitation-contraction coupling in skeletal muscle is process by which depolarization of the muscle fiber membrane, elicited by a nerve action potential, triggers the release of $Ca^{2+}$ from the sarcoplasmic reticulum(SR). The resulting rise in intracellular $Ca^{2+}$ concentration$([Ca^{2+}]_i)$ activates the troponin complex, thereby initiating the contraction of the muscle. The question remains as to what factors are involved in the inhibition of SR $Ca^{2+}$ release in fatigued muscle. The purpose of this study was determine whether ATP-sensitive $K^+(K_{ATP})$ channels are activated and contribute to decrease in $[Ca^{2+}]_i$ during fatigue development in the mouse skeletal muscle. To elucidate a role of $K_{ATP})$ in relation to ECC, I measured the modulation effects of $K_{ATP})$ channel blocker(glibenclamide) and opener(pinacidil) on $[Ca^{2+}]_i$ after fatiguing electrical field stimulation(FEFS). Intracellular $Ca^{2+}$ signals were recorded by conforcal laser microscopy(LSM 410) and monitored using the fluorescent $Ca^{2+}$-Sensitive indicator Fluo-3 AM. The results of this study were as followed: 1. The relative [Ca2'li after FEFS in the pre-glibenclamide-treated group was higher than the control. And relative $[Ca^{2+}]_i$ after FEFS in the pre-glibenclamide-treated group was lower than the control. 2. The relative $[Ca^{2+}]_i$ after FEFS for 3 min in the control, pre-glibenclamide-treated group and pre-pinacidil-treated group showed a similar pattern; the gradually significant decrease in $[Ca^{2+}]_i$. But, these decreasing pattern was most significant in the control. These findings suggest a tight relationship between $K_{ATP})$ and $Ca^{2+}$ in ECC during fatigue. Therefore, 1 thought that activation of $K_{ATP})$ channels may be one of mechanisms of the fatigue in skeletal muscle.

• Journal of Chest Surgery
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• 제47권3호
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• pp.233-239
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• 2014

Background: As hypertrophied myocardium predisposes the patient to decreased tolerance to ischemia and increased reperfusion injury, myocardial protection is of utmost importance in patients undergoing aortic valve replacement (AVR) for severe aortic valve stenosis (AS). Methods: Consecutive 314 patients (mean age, $62.5{\pm}10.8$ years; 143 females) with severe AS undergoing isolated AVR were included. Postoperative myocardial injury (PMI) was defined as 1) maximum postoperative creatinine kinase isoenzyme MB or troponin-I levels ${\geq}10$ times of reference, 2) postoperative low cardiac output syndrome or episodes of ventricular arrhythmia, or 3) left ventricular ejection fraction of less than 55% and decrease in left ventricle (LV) ejection fraction of more than 20% of the baseline value. Results: There were 90 patients (28.7%) who developed PMI. There were five cases of early death (1.6%), all of whom had PMI. On multivariable analysis, the use of histidine-tryptophan-ketoglutarate (HTK) solution instead of blood cardioplegia (odds ratio [OR], 3.06; 95% confidence interval [CI], 1.63 to 5.77; p=0.001), greater LV mass (OR, 1.04; 95% CI, 1.01 to 1.07; p=0.007), and increased cardiac ischemic time (OR, 1.13; 95% CI, 1.05 to 1.22; p<0.001) were independent predictors for PMI. Patients who had PMI showed significantly inferior long-term survival than those without PMI (p=0.049). Conclusion: PMI occurred in a considerable proportion of patients undergoing AVR for severe AS and was associated with poor long-term survival. HTK cardioplegia, higher LV mass, and longer cardiac ischemic duration were suggested as predictors of myocardial injury.

• 대한응급의학회지
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• 제29권5호
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• pp.509-518
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• 2018

Objective: The evidence that hyperbaric oxygen (HBO) therapy is more effective for improving the acute neuropsychological status (ANS) of carbon monoxide poisoning than normobaric oxygen (NBO) therapy is not convincing. This is because the levels of carboxyhemoglobin (COHb) do not correlate with the clinical severity of carbon monoxide poisoning and there is no universally accepted severity scale of carbon monoxide poisoning. This paper suggests a new scale for the clinical and neurological severity of carbon monoxide poisoning, called the ANS, and assesses the effect of HBO therapy for each level of ANS compared to NBO therapy. Methods: A total of 217 patients who had been hospitalized because of carbon monoxide poisoning from January 2009 to July 2013 were studied. ANS was suggested as a new severity scale of carbon monoxide poisoning considered in the Glasgow Coma Scale, acute neuro-psychologic signs and symptoms, or cardiac ischemia on the initial medical contact. HBO therapy is indicated in those who have a loss of consciousness, seizure, coma, abnormal findings on a neurological examination, pregnancy, persistent cardiac ischemia, level of COHb >25%, or severe metabolic acidosis (pH <7.2). The end point is the day of discharge, and recovery is defined as a normal neuro-psychological status without any sequelae. Results: The levels of troponin T and creatinine increased significantly with increasing ANS score. In the moderate to severe group (ANS 2 and 3), the recovery rate was significantly higher when treated with HBO therapy than with NBO therapy (P=0.030). On the other hand, the development of delayed neuro-psychological sequelae (DNS) did not correlate with any level of ANS, type of oxygen therapy, or recovery on discharge. Conclusion: In the moderate to severe poisoned group, HBO therapy is more effective for improving the ANS from carbon monoxide poisoning than NBO therapy. On the other hand, the development of DNS of HBO therapy is no more preventable than with NBO therapy. Although the level of ANS is low, the patient needs to be provided with sufficient information and a follow-up visit is recommended for any abnormal symptoms because the ANS does not correlate with the development and degree of DNS.

• 현장농수산연구지
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• 제23권1호
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• pp.117-128
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• 2021

한우의 성장단계별 부위 근육발달을 이해하는 것은 도체율 개선에 따른 소득증대와 증체율 증가에 따른 생산효율 향상에 긍정적인 영향을 미친다. 본 연구에서는 한우의 등심과 사태 유래 근육위성세포를 분리 후 세포단위의 발달 및 분화를 비교하여 transcriptome 단위의 작용기전을 제시하였다. 한우의 부위별 근육 유래 근육위성세포의 근섬유의 양은 4일에 가장 높게 나타났고 이후 감소하였다. 한우의 근육위성세포의 발달 단계에 따라 발현되는 총 전사체 유전자의 종류는 사태근육 위성세포에서 높게 나타났다. 등심과 사태 근육 유래 위성세포의 발달단계에 따라 유의적인 차등 유전자 453개를 찾아냈고 이를 이용한 기능유 전체 분석이 필요하다. 등심과 사태유래 근육위성세포를 이용한 동일조건 분화 비교에서 사태유래 근육 위성세포의 분화 시 myosin complex, skeletal muscle contraction, troponin complex, skeletal muscle tissue development 와 같은 근섬유 형성관련 유전자의 발현이 높게 나타나는 것으로 보아 같은 개체의 근육조직에서도 부위별로 차등 발달이 되고 있다는 것을 알 수 있다. 기존 연구에서는 근육의 성장에 대한 이해를 위해 사양과 영양관련 시험이 많이 이루어졌다. 향후 세포단위의 연구들이 많이 이루어져 작용기작에 대한 생물정보 자료를 추가로 적용한다면 한우의 정밀사양을 적용할수 있는 바탕이 마련될 것이다. 또한 근육위성세포의 연구는 추후 동물실험 윤리제도 강화에 따른 비동물 전임상 screening 시험 활용과 대체단백질 산업의 주요 이슈인 배양육 소재 개발 연구와 같이 축산시험연구의 지속적인 확장성에 많은 영향을 미칠 것으로 생각된다.

• Journal of Ginseng Research
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• 제47권1호
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• pp.106-116
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• 2023

Background: Pirarubicin (THP) is an anthracycline antibiotic used to treat various malignancies in humans. The clinical usefulness of THP is unfortunately limited by its dose-related cardiotoxicity. Ginsenoside F1 (GF1) is a metabolite formed when the ginsenosides Re and Rg1 are hydrolyzed. However, the protective effects and underlying mechanisms of GF1 on THP-induced cardiotoxicity remain unclear. Methods: We investigated the anti-apoptotic and anti-oxidative stress effects of GF1 on an in vitro model, using H9c2 cells stimulated by THP, plus trigonelline or AKT inhibitor imidazoquinoxaline (IMQ), as well as an in vivo model using THP-induced cardiotoxicity in rats. Using an enzyme-linked immunosorbent test, the levels of malondialdehyde (MDA), brain natriuretic peptide (BNP), creatine kinase (CK-MB), cardiac troponin (c-TnT), lactate dehydrogenase (LDH), superoxide dismutase (SOD) and glutathione (GSH) were determined. Nuclear factor (erythroid-derived2)-like 2 (Nrf2) and the expression of Nrf2 target genes, including heme oxygenase-1 (HO-1), glutathione-S-transferase (Gst), glutamate-cysteine ligase modifier subunit (GCLM), and expression levels of AKT/Bcl-2 signaling pathway proteins were detected using Western blot analysis. Results: THP-induced myocardial histopathological damage, electrocardiogram (ECG) abnormalities, and cardiac dysfunction were reduced in vivo by GF1. GF1 also decreased MDA, BNP, CK-MB, c-TnT, and LDH levels in the serum, while raising SOD and GSH levels. GF1 boosted Nrf2 nuclear translocation and Nrf2 target gene expression, including HO-1, Gst, and GCLM. Furthermore, GF1 regulated apoptosis by activating AKT/Bcl-2 signaling pathways. Employing Nrf2 inhibitor trigonelline and AKT inhibitor IMQ revealed that GF1 lacked antioxidant and anti-apoptotic effects. Conclusion: In conclusion, GF1 was found to alleviate THP-induced cardiotoxicity via modulating Nrf2 and AKT/Bcl-2 signaling pathways, ultimately alleviating myocardial oxidative stress and apoptosis.

• 한국임상수의학회지
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• 제40권2호
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• pp.130-134
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• 2023

A 12-year-old Standard Poodle presented with intermittent weakness and occasional dyspnea at the Veterinary Medicine Teaching Hospital of Kangwon National University. A grade of 4 out of 6 systolic murmur with an irregular tachycardic rhythm was auscultated on both sides of the chest. Systolic blood pressure was 140 mmHg. Panting was noticed in the hospital, but there was no crackle sound. Blood analysis revealed mild increases in liver panel levels (alanine aminotransferase 149 [reference interval, 19-70] U/L; and alkaline phosphatase, 185 [reference interval, 15-127] U/L) and severe increases in cardiac biomarker levels (n-terminal pro-brain natriuretic peptide, 4169 [reference interval, 50-900] pmol/L; and cardiac troponin I, 0.22 [reference interval, 0.03-0.12] ng/mL). On electrocardiography, irregularly irregular supraventricular tachycardic rhythm with an f-wave and no distinct p-wave was observed. Generalized cardiomegaly with an enlarged right atrium and left ventricle was confirmed on thoracic radiography. Moreover, hepatomegaly and an enlarged caudal vena cava were observed. Echocardiographic evaluation revealed a fibromuscular diaphragm in the right ventricle. Because of the obstructive lesion in the right ventricle, the right atrium and ventricle were enlarged (right atrial area index, 38.82 cm²/m² [reference interval, 4.2-10.2 cm²/m²]; right ventricle end-diastolic area index, 14.152 cm²/m² [reference interval, 4.9-10.92 cm²/m²]). Accordingly, the patient was diagnosed with double-chambered right ventricle (DCRV). Pimobendan, furosemide, enalapril, diltiazem, and S-adenosylmethionine (SAMe) were prescribed, and all symptoms were relieved. DCRV is a right-sided congenital heart defect resembling pulmonic valve stenosis. If symptoms are not severe, medical therapy can be facilitated without surgery or the balloon dilation.

• Journal of Chest Surgery
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• 제32권2호
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• pp.130-137
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• 1999

배경: 심장 수술시 저온 요법은 심근 보호에 있어서 가장 기본적인 요소로 인식되었고 널리 사용되어 왔으나 여러 가지 장점에도 불구하고 효소기능, 세포막 안정성, 조직의 산소이용, ATP 생성과 이용, 심근세포 보존에 해를 끼치는 등 단점이 있다. 1989년 이러한 단점을 없앤 심장의 전기 기계적 정지, 연속적인 온혈 심정지액의 관류에 의한 정온 호기 상태의 심정지에 기초를 둔 새로운 심근 보호법이 개발되었다. 이러한 연속 온혈 심정지액의 사용에 있어서 적절한 관상정맥동의 주입속도, 압력, 연속 심정지액의 사용시 중단 가능한 시간, 심정지액의 온도 등에 대한 논쟁이 계속되어 왔으며 심정지액의 온도를 37$^{\circ}C$, 34$^{\circ}C$, 33$^{\circ}C$ 및 29$^{\circ}C$ 등의 변화를 주어 각각에 대한 연구 보고가 있어 왔다. 대상 및 방법: 저자들은 1994년 10월부터 1995년 2월까지 연속 온혈 심정지액을 사용하여 판막수술을 받은 18명의 환자와 1996년 5월부터 1997년 7월까지 연속 미온혈 심정지액을 사용하여 판막수술을 받은 17명의 환자를 임상적으로 비교 분석하였다. 결과: 저자들의 결과는 심폐기 가동시간, 대동맥 차단시간, 대동맥 차단 해제부터 심폐기 이탈시간, 체외순환중 혈중 최고치 칼륨 농도, 술후 인공호흡기 이탈시간, 술후 1시간 및 12시간 심근 효소 검사, 술후 심근 수축제 및 혈관 확장제의 사용 등에서 양군간에 차이가 없었으나, 술중 소변 배출량 및 술후 12시간 동안의 소변량은 연속 온혈 심정지액을 사용한 군에서 많이 배출되었고, 대동맥 차단 해제후 자연 심박 재개율은 연속 온혈 심정지액군에서 높았다. 결론: 이상과 같은 결과들을 통해서 본 교실에서는 성인 심장 판막수술시 연속 미온혈 심정지액을 이용한 방법은 적어도 연속 온혈 심정지액의 심근보호 효과만큼은 얻을 수 있었다.

• 한국어류학회지
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• 제23권1호
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• pp.1-9
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• 2011

ACP (annealing control primer)를 사용하여 DDRT (differential display reverse transcription)-PCR 방법으로 볼락의 성장단계에 따라 발현량 차이를 나타내는 DEG (differentially expressed gene)를 확보하였다. ACP 120개를 분석하여 18개월령 근육조직에서보다 6개월령 근육조직에서 발현량이 많은 DEG 16개와 6개월령 근육조직에서보다 18개월령 근육조직에서 발현량이 더 많은 DEG22개의 염기서열을 분석하였다. DEG 염기서열을 BLAST 검색한 결과, parvalbumin (PVALB) 등 18개의 유전자(PVALB, NDKB, TPM, TnI, GAPDH, CKM2, factor 2 SERF2, AMPD, TRICA, ARHGAP15, ESD, hsp70, COL1A2, GST, Midllip1, MYL1, SERCA1B, FTH1)와 69~95%의 상동성을 나타냈다. Real time PCR 분석법으로 6개월령 근육조직에서 발현량이 많은 DEG14와 PVALB 유전자의 성장단계별 발현양상을 조사한 결과, 볼락이 성장함에 따라 발현량이 감소하였으며, 특히 PVALB 유전자는 6개월령 이후에는 발현량이 극히 적었다. 6개월령 근육조직에서보다 18 개월령 근육조직에서 발현량에서 많았던 CKM2 유전자는 성장함에 따라 발현량이 계속 증가하였고, 4세 이후에는 발현량이 감소하였다. DEG의 조직특이적 발현양상을 분석한 결과, DEG14는 근육, 간, 신장, 및 비장조직에서 발현되었으며, PVALB 유전자는 근육과 신장조직에서 발현되었고, 간과 비장조직에서는 발현되지 않았다. CKM2 유전자는 근육, 신장 및 비장조직에서 발현되었고, 간 조직에서는 발현되지 않았다. PVALB 유전자의 mRNA 크기는 659 bp 이며, 110개의 아미노산으로 구성되어 있다. Parvalbumin과 CKM2 유전자는 성장속도가 빠른 어류 선발에 이용할 수 있는 분자마커 개발에 활용하고자한다.