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Post-menopausal depression (PMD) is a common psychological disorder accompanied by a cognitive deficit, which is caused by a series of uncontrolled emotional disruptions by strong environmental stressors during menopause. To overcome PMD-induced cognitive deficit, Green tea has been suggested as a dietary supplement because of its ameliorating effect on cognitive dysfunction induced by normal aging or neurodegenerative syndromes; however, its clinical use to improve PMD-accompanied cognitive deficit is still limited due to the controversy for the active ingredients and ambiguous mechanism of its action. Here, we developed modified high-temperature-processed green tea extract (HTP-GTE), which showed lower neuronal toxicity than the conventional green tea extract (GTE). We also demonstrated that HTP-GTE administration prevented the development of learned helplessness (LH) in a rat post-menopausal model. Additionally, HTP-GTE improved LH-induced cognitive impairments simultaneously with rescued the long-term synaptic plasticity. This occurred via the restoration of silent synapse formation by increasing the hippocampal BDNF-tyrosine receptor kinase B pathway in the helpless ovariectomized (OVX) rats. Likewise, we also identified that (−)-gallocatechin gallate was the main contributor of the HTP-GTE effect. Our findings suggested that HTP-GTE has a potential as a preventive nutritional supplement to ameliorate cognitive dysfunctions associated with PMD.

Severe neonatal intraventricular hemorrhage (IVH) patients incur long-term neurologic deficits such as cognitive disabilities. Recently, the intraventricular transplantation of allogeneic human umbilical cord blood-derived mesenchymal stem cells (MSCs) has drawn attention as a therapeutic potential to treat severe IVH. However, its pathological synaptic mechanism is still elusive. We here demonstrated that the integration of the somatosensory input was significantly distorted by suppressing feed-forward inhibition (FFI) at the thalamocortical (TC) inputs in the barrel cortices of neonatal rats with IVH by using BOLD-fMRI signal and brain slice patch-clamp technique. This is induced by the suppression of Hebbian plasticity via an increase in tumor necrosis factor-α expression during the critical period, which can be effectively reversed by the transplantation of MSCs. Furthermore, we showed that MSC transplantation successfully rescued IVH-induced learning deficits in the sensory-guided decision-making in correlation with TC FFI in the layer 4 barrel cortex.

Agmatine suppresses peripheral sympathetic tone by modulating Cav2.2 channels in peripheral sympathetic neurons. However, the detailed cellular signaling mechanism underlying the agmatine-induced Cav2.2 inhibition remains unclear. Therefore, in the present study, we investigated the electrophysiological mechanism for the agmatine-induced inhibition of Cav2.2 current (ICav2.2) in rat celiac ganglion (CG) neurons. Consistent with previous reports, agmatine inhibited ICav2.2 in a VI manner. The agmatine-induced inhibition of the ICav2.2 current was also almost completely hindered by the blockade of the imidazoline I2 receptor (IR2), and an IR2 agonist mimicked the inhibitory effect of agmatine on ICav2.2, implying involvement of IR2. The agmatine-induced ICav2.2 inhibition was significantly hampered by the blockade of G protein or phospholipase C (PLC), but not by the pretreatment with pertussis toxin. In addition, diC8-phosphatidylinositol 4,5-bisphosphate (PIP2) dialysis nearly completely hampered agmatine-induced inhibition, which became irreversible when PIP2 resynthesis was blocked. These results suggest that in rat peripheral sympathetic neurons, agmatine-induced IR2 activation suppresses Cav2.2 channel voltage-independently, and that the PLC-dependent PIP2 hydrolysis is responsible for the agmatine-induced suppression of the Cav2.2 channel.

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease presenting diverse manifestation involving multiple organs, such as liver and kidney. Endoplasmic reticulum (ER) stress has been revealed as the one of the contributing factors of lupus pathogenesis. Objectives: The purpose of the present study was to investigate whether ER stress inhibition suppresses organ inflammation including liver and kidney in lupus murine model and the activation of mitogen activated protein kinases (MAPK) and NF-kB. Methods: A murine lupus model was induced through a 4-week treatment with Resiquimod, a toll-like receptor agonist 7. From the 8th week, the mice were treated with phosphate buffered saline, 4-phenylbutyric acid (4-PBA), and dexamethasone for 4 weeks. The increment of body weight, liver weight, inflammation mediator level, and the pathology of hepatitis and nephritis were analyzed at 12 weeks of age. The level of phosphorylated MAPK expression and activation of NF-kb were also evaluated. Results: 4-PBA-treated group showed lower level of body weight increment with liver to body weight ratio compared with vehicle-treated group. 4-PBA group showed decreased inflammatory cell infiltration and fibrosis in the histologic finding of liver and kidney and lower level of inflammatory mediators, including TNF-α and IL-6, compared to vehicle-group. GRP78 and CHOP expression was decreased in the spleen of 4-PBA treated mice compared to vehicle-treated mice and 4-PBA group showed the lower expression level of phosphorylated JNK, ERK, p38 and NF-kB of the spleen. Conclusion: Our results suggest that 4-PBA attenuates the inflammation on liver and kidney of experimental lupus model through suppression of MAPK and NF-kB activation. Thus, inhibition of ER stress could be function as anti-inflammatory therapeutics for SLE. References: [1] Navid F, Colbert RA. Causes and consequences of endoplasmic reticulum stress in rheumatic disease. Nat Rev Rheumatol2017;13:25-40 [2] Hosoi T, Ozawa K. Endoplasmic reticulum stress in disease: mechanisms and therapeutic opportunities. Clin Sci (Lond)2009;118:19-29 Disclosure of Interests: None declared

Ethnophamacological relevance Sam So Eum (SSE), used in traditional Korean medicine, has been prescribed for the treatment of various ailments including emesis, and fever for centuries. SSE is known by several different names (Shen Su Yin in traditional Chinese medicine; Jin So In traditional Japanese Kampo medicine). It is a mixture of medicinal plants including Panax ginseng C. A. Mey., Perilla frutescens (L.) Britton, and Peucedanum praeruptorum Dunn. Studies have revealed that SSE has many pharmacological effects including anti-inflammatory, anti-cancer, and anti-allergic properties, but its toxic effects have not been evaluated in vivo. Recently, the use of traditional medicinal herbs to treat various diseases has increased, owing to increased number of studies supporting their efficacy. However, safety evaluations for toxicity and other adverse effects have not been extensive. It is commonly considered that natural products extracted from traditional medicinal herbs are safer than synthetic drugs, but this lacks a scientific basis. Thus, in this study, we evaluated the toxicity of SSE in male and female rats. Aim of the study To evaluated the safety of SSE in male and female rats. Materials and methods SSE was administered orally for 13 weeks at 1000, 2000, and 4000 mg kg−1·day−1, and then the rats were maintained for 4 weeks without SSE administration (recovery evaluation). Results We observed the animals for changes in clinical signs, including hematological parameters, and food consumption; serum chemistry profiling and urinalysis were also carried out. Creatinine levels in the serum were significantly increased following oral administration of SSE at 2000 and 4000 mg kg−1·day−1 in male and female rats, but returned to the normal levels during the recovery period. In addition, SSE administration does not cause kidney and liver toxicity. Thus, we determined that the no-observed-adverse-effect level of SSE is 4000 mg kg−1·day−1. The no-observed-effect level of SSE was determined to be 1000 mg kg−1·day−1, because serum creatinine was increased by oral administration of SSE at 2000 and 4000 mg kg−1·day−1 in male and female rats. Conclusions SSE administration does not cause toxicity at 4000 mg kg−1·day−1 in male and female rats.

Neuroplasticity is considered essential for recovery from brain injury in developing brains. Recent studies indicate that it is especially effective during early postnatal development and during the critical period. The current study used functional magnetic resonance imaging (fMRI) and local field potential (LFP) electrophysiological recordings in rats that experienced neonatal hypoxic-ischemic (HI) injury during the critical period to demonstrate that physical exercise (PE) can improve cortical plasticity even when performed during adulthood, after the critical period. We investigated to what extent the blood oxygen level-dependent (BOLD)-fMRI responses were increased in the contralesional spared cortex, and how these increases were related to the LFP electrophysiological measurements and the functional outcome. The balance of excitation and inhibition was assessed by measuring excitatory and inhibitory postsynaptic currents in stellate cells in the primary somatosensory (S1) cortex, which was compared with the BOLD-fMRI responses in the contralesional S1 cortex. The ratio of inhibitory postsynaptic current (IPSC) to excitatory postsynaptic current (EPSC) at the thalamocortical (TC) input to the spared S1 cortex was significantly increased by PE, which is consistent with the increased BOLD-fMRI responses and improved functional outcome. Our data clearly demonstrate in an experimental rat model of HI injury during the critical period that PE in adulthood enhances neuroplasticity and suggest that enhanced feed-forward inhibition at the TC input to the S1 cortex might underlie the PE-induced amelioration of the somatosensory deficits caused by the HI injury. In summary, the results of the current study indicate that PE, even if performed beyond the critical period or during adulthood, can be an effective therapy to treat neonatal brain injuries, providing a potential mechanism for the development of a potent rehabilitation strategy to alleviate HI-induced neurological impairments.

The production of electricity from wind energy is noticed as economic power generation system in the natural resource. Lately, since lots of wind turbine have installed globally, the accidents have increased gradually. In this paper, we classified domestic information for 10 years, information of new energy and industrial technology development organization(NEDO) for 4years and caithness windfarms information forum(CWIF) for 15 years according to part and cause of wind turbine accident . We found that the main causes of accidents are storm, lightening and carelessness. The results of classifying and analyzing the informations, should be used to take measures on the accident prevention of wind turbine. Key Words ：Wind turbine, Natural resource, CWIF, Accident prevention **†정지현(교신저자) : 제주대학교 기계공학전공E-mail : badaro@jejunu.ac.kr, Tel : 064-754-3627 * 김귀식 : 제주대학교 기계공학전공 **†Ji-Hyun Jeong(corresponding author) : Major of Mechanical Engineering, Jeju National University.E-mail : badaro@jejunu.ac.kr, Tel : 064-754-3627* Gui-Shik Kim : Major of Mechanical Engineering, Jeju National University.

Postoperative cognitive dysfunction (POCD) may be driven by transference of the innate immune response to the brain after aseptic surgical damage. Macrophages are key mediators of innate immunity that can display a pro-inflammatory M1 phenotype or an anti-inflammatory M2 phenotype. Erythropoietin (EPO) is a hematopoietic hormone that exerts anti-inflammatory effects by influencing macrophage function. We hypothesized that EPO would prevent POCD by promoting macrophage phenotype switching to the M2 phenotype post-surgery. To evaluate the effects of EPO on POCD and macrophage polarization post-surgery, we administered EPO (5,000 U/kg) with or without an arginase inhibitor (amino-6-boronohexanoic acid, 10 mg/kg) to ICR mice before and after abdominal surgery. Forty-eight hours post-surgery, we assessed memory, synapse function, and macrophage/microglial phenotypes in the spleen and hippocampus. We also investigated M1/M2 phenotypes in RAW264.7 and BV2 cells stimulated with lipopolysaccharide and interferon- (M1 inducers) in the presence or absence of EPO. EPO prevented POCD, decreased surgery-related synaptic dysfunction, and attenuated pro-inflammatory cytokine generation in the hippocampus. Moreover, EPO suppressed M1-related genes expression and promoted M2 genes expression in the spleen and hippocampus post-surgery. Furthermore, EPO decreased the proportions of macrophages/microglia expressing an M1 surface marker (CD40) and increased those expressing an M2 surface marker (CD206). Arginase inhibition abolished the beneficial effects of EPO on POCD. In vitro, EPO treatment promoted switching of RAW264.7 and BV2 cells stimulated with M1 inducers to an M2 phenotype. In conclusion, EPO prevents POCD by promoting macrophage phenotype switching towards the M2 phenotype.

Some patients experience impaired cognitive functioning after surgery, a phenomenon referred to as postoperative cognitive dysfunction (POCD). Signs of POCD are closely associated with the development of systemic or hippocampal inflammation. However, the precise pathophysiological mechanisms of prevention/treatment options for POCD still remain unclear. After injury, the transcriptional factor nuclear factor-kappa B (NF-κB) is thought to regulate or stimulate inflammation amplification. Therefore, we designed a cell-penetrating fusion protein called nt-p65-TMD, which inhibits NF-κB p65 activation by translocating into the nucleus. In the present study, we discovered that nt-p65-TMD exerted effects on surgery-induced cognitive impairment in mice. Specifically, nt-p65-TMD exhibited strong immunoregulatory properties that were able to reduce surgery-induced elevations in cerebrovascular integrity impairment, subsequent peripheral immune-cell recruitment, and inflammation amplification, which ultimately lead to cognitive decline. The nt-p65-TMD has the unique ability to regulate and reduce systemic inflammation and inflammation amplification, suggesting a new strategy for preventing development of cognitive decline that occurs in POCD.

Roll and pitching motions of a vessel can seriously degrade the performance of mechanical systems and the effectiveness of personnel. Many studies on roll stabilization and trimming control system design have focused on stabilizing the vessel through the use of fins, tanks, rudders and flaps. However the ultimate objective of such approaches must be to improve boarding sensitivity. This paper presents an anti-seasickness bed that consists of a rotator and bearing system that does not make use of electric power. The advantages of this system are its simple construction, usefulness, and safe operation. In this study, the rotation angles of the upper plate of a bed according to change weight of the rotator have been calculated to determine the stability. As a result, it can be concluded that proposed stabilizing bed can be of practical use in the field.

This paper deals with the ultraviolet laser aided micro-cell opening (UV LAMO) method for the improvement of sound-absorption of the expended polypropylene (EPP) bead foam. Although the EPP bead foam, which has been used recently as a sound-absorbing material, has light weight, structural strength and durability, its sound-absorbing performance needs to be improved. In this study, we tried to find the optimum conditions for multiplex absorption of sound wave by forming micro channel in the EPP bead foam with a UV laser beam. An EPP bead foam processed by steam-chest molding was used in the experiment. After a UV laser beam was irradiated on the face of the foam, the cell type formed was analyzed by scanning electron microscopy (SEM). The experiment was carried out to verify the effectiveness of the UV LAMO method by analyzing the sound-absorbing characteristics and the types of micro channels of the EPP beam foam to the changes of the expansion ratio of the EPP bead foam.

Roll forming process is one of the most widely used processes in the world for forming metals such as a furniture drawer guide or an up and down slide guide. It can manufacture goods of the uniform cross section on a large scale throughout the continuous processing. In the domestic design and manufacture, roll forming process for production is taking most of the method of 2-point under rail slide. However, this method is vulnerable to the structural strength and stiffness is not suitable for high load conditions. Therefore, through systematic study of high load, low noise 3-point ball type of under rail slide its own design and manufacturing technology is the need to build. In this paper, to make center member of 3-point ball-type under rail slide for the refrigerator doors, the roll forming modeling and simulation are performed. Tensile test is performed about SCP-1 1/2H for determine the mechanical properties of materials. Modeling and simulation of roll forming is used MSC.MARC software of a dedicated analysis program used by rigid plastic finite element method. Interference between the roll and the final shape are predicted from the results of the simulation.

Agmatine, a putative endogenous ligand of imidazoline receptors, suppresses cardiovascular function by inhibiting peripheral sympathetic tone. However, the molecular identity of imidazoline receptor subtypes and its cellular mechanism underlying the agmatine-induced sympathetic suppression remains unknown. Meanwhile, N-type Ca(2+) channels are important for the regulation of NA release in the peripheral sympathetic nervous system. Therefore, it is possible that agmatine suppresses NA release in peripheral sympathetic nerve terminals by inhibiting Ca(2+) influx through N-type Ca(2+) channels. We tested this hypothesis by investigating agmatine effect on electrical field stimulation (EFS)-evoked contraction and NA release in endothelium-denuded rat superior mesenteric arterial strips. We also investigated the effect of agmatine on the N-type Ca(2+) current in superior cervical ganglion (SCG) neurons in rats. Our study demonstrates that agmatine suppresses peripheral sympathetic outflow via the imidazoline I2 receptor in rat mesenteric arteries. In addition, the agmatine-induced suppression of peripheral vascular sympathetic tone is mediated by modulating voltage-dependent N-type Ca(2+) channels in sympathetic nerve terminals. These results suggest a potential cellular mechanism for the agmatine-induced suppression of peripheral sympathetic tone. Furthermore, they provide basic and theoretical information regarding the development of new agents to treat hypertension.

Roasted and retorted (RR) chestnuts develop green pigment spots on their surface during storage. The purpose of this study was to evaluate the cytotoxicity of the green pigment using RAW 264.7, MOLT-4, KATOⅢ and HT-29 cells. The pigment scraped from RR chestnuts (GP), whole RR chestnuts with green pigment spots (GC), whole RR chestnuts without green pigment (WC) and roasted and frozen stored chestnuts (FC) were extracted in 10% DMSO. MOLT-4 cells were less resistant to the cytotoxicity of the chestnut extracts than the RAW 264.7 cells. The GP extracts did not show different responses against H2O2-induced oxidative stress and LPS-induced NO production compared to the other extracts. The chestnut extracts did not have proliferative activity on either of the KATOⅢ or HT-29 cells (p>0.05). Our results from the comparison of the green pigment produced on the surface of the RR chestnuts to chestnuts that do not develop the green pigment suggest that the pigment may not be harmful in terms of either cytotoxicity towards immune cells or proliferation of gastrointestinal cancer cells.

Human adult dental pulp stem cells (hDPSCs) are a unique precursor population isolated from postnatal dental pulp and have the ability to regenerate a reparative dentin-like complex. In this study, we investigated the role of Asporin in hDPSCs, which was identified as a matrix protein in our previous dentin proteomic analysis. We isolated a clonogenic, highly proliferative population of cells from adult human dental pulp. These isolated hDPSCs were confirmed by fluorescence activated cell sorting (FACS) using stem cell-specific markers and have shown multilineage differentiation potential. The localization of Asporin was identified by immunohistochemistry in the globular calcification region in the junction of predentin and dentin. The gene and protein expression levels of Asporin were enhanced at the early stage of and then reduced during the late stage of differentiation of hDPSCs in mineralization media. ASPN knock-down using a lentiviral system suppressed the mineralization of hDPSCs. These results suggest that ASPN plays positive roles in the mineralization of hDPSCs and predentin to dentin.

Signal transducer and activator of transcription 3 (STAT3) is associated with various human diseases, such as cancer, auto-immune disease, and intestinal inflammation. The limited and inadequate effect of standard approaches for treating inflammatory bowel disease (IBD) has prompted to develop alternative anti-colitis agents through inhibition of STAT3. Here, we show that gallic acid (GA), a 3,4,5-trihydroxybenzoic acid, markedly reduced phosphorylation of STAT3. Among the derivatives of benzoic acids, GA showed significant inhibition on STAT3 phosphorylation. In addition, GA ameliorated the dextran sodium sulfate (DSS)-induced acute colitis as determined by the measurement of symptomatic and histological indices. The suppression of DSS-induced acute colitis by GA treatment may be related to the regulation of cytokines and growth factors. Furthermore, GA inhibited phosphorylation of STAT3 in the colon tissue of DSS-treated mice. These findings may be useful in comprehending the molecular action of GA on STAT3 phosphorylation and provide novel insights into the potential application of GA in the treatment of STAT3-related inflammatory disease, such as IBD.

Eupatilin and jaceosidin are bioactive flavones found in the medicinal herbs of the genus Artemisia. These bioactive flavones exhibit various antioxidant, antiinflammatory, antiallergic, and antitumor activities. The inhibitory potentials of eupatilin and jaceosidin on the activities of seven major human cytochrome P450 enzymes in human liver microsomes were investigated using a cocktail probe assay. Eupatilin and jaceosidin potently inhibited CYP1A2-catalyzed phenacetin O-deethylation with 50% inhibitory concentration (IC(50)) values of 9.4 microM and 5.3 microM, respectively, and CYP2C9-catalyzed diclofenac 4-hydroxylation with IC(50) values of 4.1 microM and 10.2 microM, respectively. Eupatilin and jaceosidin were also found to moderately inhibit CYP2C19-catalyzed [S]-mephenytoin 4'-hydroxylation, CYP2D6-catalyzed bufuralol 1'-hydroxylation, and CYP2C8-catalyzed amodiaquine N-deethylation. Kinetic analysis of human liver microsomes showed that eupatilin is a competitive inhibitor of CYP1A2 with a K(i) value of 2.3 microM and a mixed-type inhibitor of CYP2C9 with a K(i) value of 1.6 microM. Jaceosidin was shown to be a competitive inhibitor of CYP1A2 with a K(i) value of 3.8 microM and a mixed-type inhibitor of CYP2C9 with K(i) value of 6.4 microM in human liver microsomes. These in vitro results suggest that eupatilin and jaceosidin should be further examined for potential pharmacokinetic drug interactions in vivo due to inhibition of CYP1A2 and CYP2C9.

Background/Aims: It is well-known that patients with chronic liver disease commonly have nutritional deficiency. In the present study, we investigated the differences in malnutrition risk between patients with liver cirrhosis and viral hepatitis carrier. Methods: Patients with chronic liver disease who have been hospitalized at Konyang University Hospital from May 2012 to April 2013 were analyzed retrospectively. The malnutrition risk was divided into three categories (low, intermediate, and high) according to Konyang University Hospital Malnutrition Screening, which include BMI, serum albumin, total lymphocyte count (TLC), hemoglobin, weight change, appetite, and dysphagia, within 24 hours of hospitalization. Results: Among a total of 460 patients, 313 had liver cirrhosis (LC), and 147 were viral hepatitis carriers. Age (p＜0.001), serum albumin level (p＜0.001), TLC (p=0.011), hemoglobin (p＜0.001) and serum cholesterol level (p=0.005) were significant different between the two groups. However, there were no difference in height, weight, and BMI. The malnutrition risk of the patients with viral hepatitis carrier was significantly lower than that of the patients with LC (p＜0.001). In addition, among 313 patients with LC, malnutrition risk of the patients with Child-Pugh class A (n=150) was significantly lower than that of the patients with class B (n=90) or C (n=73) (p＜0.001). Conclusions: Viral hepatitis carrier group had significantly lower malnutrition risk than LC group. The risk of malnutrition in Child-Pugh class A group was significantly lower than that in class B or C group. (Korean J Gastroenterol 2014;64:284-289)

Radiofrequency ablation (RFA) is a relatively safe therapy for patients with hepatocellular carcinoma (HCC); however, complications are not unknown. A hepatocolic fistula is a rare complication after RFA. We report a case of a hepatocolic fistula following a liver abscess after RFA for HCC in a 58-year-old male. The patient was diagnosed with HCC and liver cirrhosis from hepatitis B infection 3 years prior to admission. The HCC was in segment 6 of the liver and was treated with transarterial chemoembolization and RFA. One month after the second RFA, he was diagnosed with a liver abscess, for which he was treated with antibiotics for 2 months, but continued to have intermittent fever and chills. We made a diagnosis of hepatocolic fistula using colonoscopy, fluoroscopy, and liver dynamic computed tomography. The patient underwent a surgical procedure after antibiotic therapy. Although a hepatocolic fistula is a rare complication following RFA, clinicians should be aware of its existence. (Korean JMed 2012;83:480-484)

Background and Objectives Carotid artery intima-media thickness (CIMT) has recently been recommended as a non-invasive tool for primary prevention of cardiovascular events; the association between CIMT and adverse cardiovascular events is well-known. We sought to evaluate the prevalence and significance of carotid artery plaque, especially in patients with coronary atherosclerosis. Subjects and Methods The study population consisted of 1,705 consecutive patients {933 males (54.7%); mean age, 59.7±10.9 years} who underwent coronary angiography and carotid artery scanning using high-resolution ultrasonography. Carotid plaque was defined as a focal structure encroaching into the arterial lumen by at least 50% of the surrounding IMT value or a thickness >1.2 mm. Results Carotid plaque was identified in 30.3% (516/1,705) of the patients. Of patients in whom the plaque location could be evaluated (n=1,027), carotid plaque was located at the common carotid artery {n=64/267 (24.0%)}, carotid bulb {n=194/267 (72.7%)}, and at both sites {n=9/267 (3.4%)}. The prevalence of hypertension (58.5% vs. 45.2%, p

The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is a rare histological subtype characterized by diffuse involvement of one or both thyroid lobes, widespread lymphatic permeation, prominent fibrosis, squamous metaplasia, abundant psammoma body and lymphatic infiltration. This subtype usually occurs in young female, and exhibits a higher frequency of cervical and distant metastasis. DSPTC clinically resembles Hashimoto’s thyroiditis, and often delays the correct diagnosis. We experienced two patients with DSPTC: the one patient presented with a neck mass lasting for a month, and in the other patient, a thyroid lesion was incidentally found during a medical examination. (J Korean Endocr Soc 23:430~437, 2008)

연구배경: 메티실린 내성 황색포도알균은 의료기관 관련 감염 뿐 아니라 지역사회 감염에서도 나타나 이에 저자들은 한 대학병원 중환자실에 입원한 환자의 비강 도말 배양을 통해 MRSA의 의료기관 관련 감염 및 지역사회 감염의 빈도와 분자 역학 및 항생제 내성을 연구하였다. 방법: 2006년 6월에서 9월까지 건양대학교 병원 중환자실 환자 353명을 대상으로 입실 첫날 비강 도말 배양을 시행하여 MRSA 획득 위험인자에 따라 HA-MRSA와CA-MRSA로 나누어 Pulsed-Field Gel Electrophorosis(PFGE)로 분류하여 각각의 항생제 내성 검사를 시행하였다. 결과: 353명 중 비강 도말 배양에서 동정된 MRSA는 42명(11.9%)이며, 동정된 MRSA 중 HA-MRSA는 33명(78.6%), CA-MRSA는 9명(21.4%)이다. PFGE에서 type A에서 type K까지 11형으로 구분하였고 HA-MRSA는 type A (n=9), B (n=7)가, CA-MRSA는 type A (n=2), B (n=2)가 주로 나타났다. 항생제 내성률은 erythromycin, ciprofloxacin에서 HA-MRSA가 CA-MRSA보다 높게 나타났다. 결론: MRSA의 집락률은 11.9%이며 HA-MRSA의 균주가 CA-MRSA보다 많고, CA-MRSA는 9예로 적은 예지만 PFGE type에서 대부분의 type이 HA-MRSA에서 동정된 type과 같은 경향을 보여 지역사회전파를 시사한다.

1990년대 초부터 형광 기관지 내시경이 임상 진료에 사용되면서 방사선검사에서 나타나지 않는 상피내 폐암이나 미세하게 진행된 조기 폐암의 진단 빈도가 늘어났으며, 이러한 상피내 폐암의 과반수 이상에서 진행성 폐암으로 진행하므로, 근치적 목적의 치료가 더욱 조기에 도입될 수 있어 폐암 치료에서의 중요한 진단 도구가 되었다. 치료적 내시경술의 발달로 기존의 진행된 폐암에서 기도 폐쇄 감소 혹은 출혈 부위의 지혈 등의 완화적 목적뿐 아니라, 조기 폐암이지만 심폐 기능 등 전신 상태의 문제로 수술이 불가능한 환자에서 근치적 치료로도 이용되고 있으며, 특히, 수술의 절제 범위를 축소시키는 효과를 가져올 수 있다. 아르곤 플라스마 응고소작술(argon plasma coagulation, APC)은 레이저와 광역학 치료법(photodynamic therapy, PDT) 등에 비하여 조기 폐암 병변의 치료에서 근치적 치료 및 진행성 폐암에서의 완화요법으로서 효과면에서 동등하고, 특히 침투 범위가 얕으므로 표재성의 병변에서 탁월하며, 경제적 접근성이 용이하다. 저자들은 우측 상엽의 절제 가능한 폐암에 우측 하엽에 상피내 암이 동반된 동시성 원발성 폐암 환자를 우측상엽절제와 APC로써 치료한 증례 1예를 경험하여 보고한다. (Tuberc Respir Dis 2008;65:137-141)

Background: The causes of the pleural effusion are remained unclear in a the substantial number of patients with exudative effusions determined by an examination of the fluid obtained via thoracentesis. Among the various tools for diagnosing exudative pleural effusions, thoracoscopy has a high diagnostic yield for cancer and tuberculosis. Medical thoracoscopy can also be carried out under local anesthesia with mild sedation. The aim of this study was to determine diagnostic accuracy and safety of medical thoracoscopy. Methods: Twenty-five patients with exudative pleural effusions of an unknown cause underwent medical thoracoscopy between October 2005 and September 2006 in Konyang University Hospital. The clinical data such as age, gender, preoperative pulmonary function, amounts of pleural effusion on lateral decubitus radiography were collected. The vital signs were recorded, and arterial blood gas analyses were performed five times during medical thoracoscopy in order to evaluate the cardiopulmonary status and acid-base changes. Results: The mean age of the patients was 56.8 years (range 22-79). The mean depth of the effusion on lateral decubitus radiography (LDR) was 27.49 mm. The medical thoracoscopic pleural biopsy was diagnostic in 24 patients (96.0%), with a diagnosis of tuberculosis pleurisy in 9 patients (36%), malignant effusions in 8 patients (32%), and parapneumonic effusions in 7 patients (28%). Medical thoracoscopy failed to confirm the cause of the pleural effusion in one patient, who was diagnosed with tuberculosis by a pericardial biopsy. There were no significant changes in blood pressure, heart rate, acid-base and no major complications in all cases during medical thoracoscopy (p>0.05). Conclusions: Medical thoracoscopy is a safe method for patients with unknown pleural effusions with a relatively high diagnostic accuracy.