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    Elucidating influence of chemical structure on reduction rate and defluorination

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ) -- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ๊ณต๊ณผ๋Œ€ํ•™ ๊ฑด์„คํ™˜๊ฒฝ๊ณตํ•™๋ถ€, 2020. 8. ์ตœ์ •๊ถŒ.This study used zeolite supported Rh-based catalyst and hydrogen as a reductant to reduce fluoroarene, which is also a big part of the chemical industry. Rh/zeolite catalyst was applied for the reductive treatment of fluoroarenes with various structures. The experimented fluoroarenes were fluorobenzene, difluorobenzene, (difluoromethyl)benzene, (trifluoromethyl) -benzene, (pentafluoroethyl) benzene, fluorophenol, fluorotoluene, fluorobenzoic acid, and their pseudo-first-order reaction constant and defluorination yield were compared with each other. The reaction rate of fluorobenzene and difluorobenzene decreased in the order of one substituent (fluorobenzene), ortho (1,2-difluorobenzene), meta (1,3-difluorobenzene), and para (1,4-difluorobenzene). It was the same as the results of other papers. However, perfluoroalkyl groups, such as trifluoromethyl and pentafluoroethyl, did not react or the defluorination yield was lower than 30%, so the application of Rh catalyst had a limitation in the perfluorinated alkyl structure. Multiple linear regression analysis was performed to elucidate the effect of structural characteristics of each fluoroarenes on their reaction constants and defluorination yield, except for (trifluoromethyl)benzene, 4-trifluoromethylphenol, (pentafluoroethyl)benzene. To perform multiple linear regression analysis, two or more independent variables were required, and variables capable of representing the structural characteristics of each fluoroarene were selected, such as ฯƒposition, bond dissociation energies (BDE), number of fluorine (No.F), and some chemical properties calculated by SPARC chemical calculator. As a result, the electron affinity, ฯƒposition, and No.F had a significant effect on the reaction rate constant (Log(kobs)), and the electron affinity, ฯƒposition, BDE, boiling point, and No.F was found to have a significant effect on defluorination yield (DeF yield*). The R2 value of each regression model was 0.795 for Log(kobs) and 0.816 for DeF yield*. Thus, the regression model for defluorination yield was better explained than for the reaction rate constant. In other words, the structural and chemical properties of fluoroarene had a greater effect on the final defluorination yield than the reaction rate. It suggested that not only the defluorination reaction but also hydrogenation occurred by Rh/zeolite catalyst, and the structural and chemical properties of fluoroarene can change the ratio of defluorination/hydrogenation reaction. Since there were expected to be various intermediates that can be produced through hydrogenation reaction, some of the expected intermediates were quantified when 1-difluoromethyl-2-fluorobenzene and 1-difluoromethyl-3-fluorobenzene were experimented as starting materials. Difluoromethylbenzene, fluorotoluene, toluene, and methylcyclohexane were selected as the expected intermediates, and the concentration was quantified according to the reaction time. As a result, in both cases, the concentration ratio of dimethylbenzene and fluorotoluene compared to the initial concentration was measured very low, and the generated time was similar. In other words, both fluorine attached to the benzene and fluorine of dimethyl could be rapidly defluorinated, and it was suspected that unknown intermediates, which undergo only hydrogenation, not defluorination, might be generated. This phenomenon occurred when two functional groups were in the meta position, such as 1,3-difluorobenzene, 1-difluoromethyl-3-fluorobenzene, and 3-fluorophenol, except for 3-fluorotoluene.๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ํ™”ํ•™ ์‚ฐ์—…์˜ ํฐ ๋ถ€๋ถ„์„ ์ฐจ์ง€ํ•˜๊ณ  ์žˆ๋Š” ํ”Œ๋ฃจ์˜ค๋กœ์•„๋ Œ (fluoroarene) ์„ Rh ์ด‰๋งค๋ฅผ ์ด์šฉํ•˜์—ฌ ํ™˜์› ์ฒ˜๋ฆฌํ•˜๋Š” ์‹คํ—˜์„ ์ˆ˜ํ–‰ํ•˜์˜€๋‹ค. ๋กœ๋“ ์ด‰๋งค๋Š” C-H ๊ฒฐํ•ฉ์— ๋Œ€ํ•œ C-F ๊ฒฐํ•ฉ์„ ๊ฐ์†Œ์‹œํ‚ฌ ์ˆ˜ ์žˆ์œผ๋ฉฐ, ๋”ฐ๋ผ์„œ Rh/zeolite ์ด‰๋งค๋ฅผ ํ•ฉ์„ฑํ•˜์—ฌ ๋‹ค์–‘ํ•œ ๊ตฌ์กฐ์˜ ํ”Œ๋ฃจ์˜ค๋กœ์•„๋ Œ์„ ๊ฐ์†Œ์‹œ์ผฐ๋‹ค. ์‹คํ—˜ ๋Œ€์ƒ ๋ฌผ์งˆ๋กœ fluorobenzene, difluorobenzene, (difluoromethyl)benzene, (trifluoromethyl)benzene, (pentafluoroethyl)benzene, fluorophenol, fluorotoluene, fluorobenzoic acid ๋ฅผ ์„ ์ •ํ•˜์—ฌ ๋ฌผ์งˆ ๋ณ„ ๋ฐ˜์‘์†๋„์™€ ํƒˆ๋ถˆํ™”์œจ์„ ๋น„๊ตํ•˜์˜€๋‹ค. ๋ฐ˜์‘์†๋„ ์ƒ์ˆ˜ kobs๋Š” log ๋ฅผ ์ทจํ•˜์—ฌ ๋ณ€ํ™˜ํ•˜๊ณ , ํƒˆ๋ถˆํ™”์œจ (defluorination yield; DeF yield) ๋Š” ํ”Œ๋ฃจ์˜ค๋ฆฐ์˜ ์ˆ˜๋กœ ํ‘œ์ค€ํ™” ํ•˜์—ฌ ๊ฐ ๋ฌผ์งˆ๋“ค์˜ ๋ฐ˜์‘์„ฑ๊ณผ ํƒˆ๋ถˆํ™” ์ •๋„๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. fluorobenzene๊ณผ difluorobenzene ๊ณ„์—ด (1,2-difluorobenzene, 1,3-difluorobenzene, 1,4-difluorobenzene) ์—์„œ๋Š” ์ž‘์šฉ๊ธฐ๊ฐ€ 1๊ฐœ์ผ ๋•Œ, 2๊ฐœ์ผ ๋•Œ ortho, meta, para ์ˆœ์„œ๋กœ ๋ฐ˜์‘์†๋„๊ฐ€ ๊ฐ์†Œํ•˜๋Š” ๊ฒฐ๊ณผ๋ฅผ ์–ป์—ˆ๊ณ , ์ด๋Š” ๋‹ค๋ฅธ ๋…ผ๋ฌธ๋“ค์˜ ๊ฒฐ๊ณผ์™€ ์ผ์น˜ํ•˜๋Š” ๊ฒฐ๊ณผ์˜€๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ trifluoromethyl, pentafluoroethyl๊ณผ ๊ฐ™์ด perfluoroalkyl์— ๋Œ€ํ•ด์„œ๋Š” ๋ฐ˜์‘์ด ์ผ์–ด๋‚˜์ง€ ์•Š๊ฑฐ๋‚˜ ํƒˆ๋ถˆํ™”์œจ์ด 30% ์ดํ•˜๋กœ ๋‚ฎ๊ฒŒ ๋‚˜ํƒ€๋‚˜ ๊ณผ๋ถˆํ™” ์•Œํ‚ฌ ๊ตฌ์กฐ์—์„œ๋Š” Rh ์ด‰๋งค ์ ์šฉ์— ํ•œ๊ณ„๊ฐ€ ์žˆ์—ˆ๋‹ค. ๋ฐ˜์‘์ด ์ผ์–ด๋‚˜์ง€ ์•Š๊ฑฐ๋‚˜ ํƒˆ๋ถˆํ™” ๋ฐ˜์‘์ด ์ž˜ ์ผ์–ด๋‚˜์ง€ ์•Š์•˜๋˜ ๋ฌผ์งˆ ((trifluoromethyl)benzene, 4-trifluoromethylphenol, (pentafluoroethyl)-benzene) ์„ ์ œ์™ธํ•œ ํ”Œ๋ฃจ์˜ค๋กœ์•„๋ Œ์— ๋Œ€ํ•˜์—ฌ ์ด๋“ค์˜ ๊ตฌ์กฐ์  ํŠน์ง•์ด ๋ฐ˜์‘์†๋„ ๋ฐ ํƒˆ๋ถˆํ™”์œจ์— ์–ด๋–ค ์˜ํ–ฅ์„ ๋ฏธ์ณค๋Š”์ง€ ์•Œ๊ธฐ ์œ„ํ•ด ๋‹ค์ค‘ํšŒ๊ท€๋ถ„์„์„ ์ˆ˜ํ–‰ํ•˜์˜€๋‹ค. ๋‹ค์ค‘ํšŒ๊ท€๋ถ„์„์„ ์ˆ˜ํ–‰ํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” 2๊ฐœ ์ด์ƒ์˜ ๋…๋ฆฝ๋ณ€์ˆ˜๊ฐ€ ํ•„์š”ํ–ˆ์œผ๋ฉฐ, ๊ฐ ํ”Œ๋ฃจ์˜ค๋กœ์•„๋ Œ์˜ ๊ตฌ์กฐ์  ํŠน์ง•์„ ๋Œ€ํ‘œํ•  ์ˆ˜ ์žˆ๋Š” ๋ณ€์ˆ˜๋ฅผ ์„ ์ •ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ ๋…๋ฆฝ๋ณ€์ˆ˜๋กœ๋Š” ฯƒposition, Bond dissociation energies (BDE), ๋ถˆ์†Œ์˜ ์ˆ˜ (No.F) ๊ทธ๋ฆฌ๊ณ  SPARC๋ฅผ ํ†ตํ•ด ๊ณ„์‚ฐํ•œ ๋ฌผ์งˆ์˜ ํ™”ํ•™์  ํŠน์„ฑ๊ฐ’๋“ค์ด ์„ ์ •๋˜์—ˆ๊ณ , ์ด ๋…๋ฆฝ๋ณ€์ˆ˜๋“ค์„ ์กฐํ•ฉํ•˜์—ฌ ์ ์šฉํ•˜๋ฉด์„œ ๋‹ค์ค‘ํšŒ๊ท€๋ถ„์„์„ ์ˆ˜ํ–‰ํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ๋ฐ˜์‘์†๋„์ƒ์ˆ˜ (Log(kobs)) ์—๋Š” ์ „์ž์นœํ™”๋„ (electron affinity), ฯƒposition, and No.F ๊ฐ€ ์œ ์˜๋ฏธํ•œ ์˜ํ–ฅ์ด ์žˆ์—ˆ๊ณ , ํƒˆ๋ถˆํ™”์œจ (DeF yield*) ์—๋Š” ์ „์ž์นœํ™”๋„, ฯƒposition, BDE, ๋“๋Š”์  (boiling point), No.F ๊ฐ€ ์œ ์˜๋ฏธํ•œ ์˜ํ–ฅ์ด ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๊ฐ๊ฐ์˜ ํšŒ๊ท€๋ชจ๋ธ์˜ R2 ๊ฐ’์€ Log(kobs)์— ๋Œ€ํ•ด 0.795, DeF yield*์— ๋Œ€ํ•ด 0.816 ์ด์—ˆ์œผ๋ฉฐ, ๋ณธ ์—ฐ๊ตฌ์—์„œ ์„ ์ •ํ•œ ๋ณ€์ˆ˜๋“ค๋กœ ํšŒ๊ท€๋ชจ๋ธ์„ ์ ์šฉํ•˜์˜€์„ ๋•Œ ๋ฐ˜์‘์†๋„๋ณด๋‹ค ํƒˆ๋ถˆํ™”์œจ์˜ ๊ฒฝํ–ฅ์„ ๋” ์ž˜ ์„ค๋ช…ํ•  ์ˆ˜ ์žˆ๋‹ค๋Š” ๊ฒฐ๋ก ์„ ์–ป์—ˆ๋‹ค. ์ฆ‰, ํ”Œ๋ฃจ์˜ค๋กœ์•„๋ Œ์˜ ๊ตฌ์กฐ์ , ํ™”ํ•™์  ํŠน์„ฑ์€ ๋ฐ˜์‘์†๋„๋ณด๋‹ค ์ตœ์ข… ํƒˆ๋ถˆํ™”์œจ์— ๋” ํฐ ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค๋Š” ๊ฒƒ์ด๋‹ค. ์ด๋Š” ๋กœ๋“ ์ด‰๋งค์— ์˜ํ•ด ํƒˆ๋ถˆํ™”๋ฐ˜์‘ ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ์ˆ˜์†Œํ™”๋ฐ˜์‘ (hydrogenation) ๋˜ํ•œ ํ•จ๊ป˜ ์ผ์–ด๋‚˜๊ณ  ํ”Œ๋ฃจ์˜ค๋กœ์•„๋ Œ์˜ ๊ตฌ์กฐ์ , ํ™”ํ•™์  ํŠน์„ฑ์ด ํƒˆ๋ถˆํ™”/์ˆ˜์†Œํ™” ๋ฐ˜์‘์˜ ๋น„์œจ์„ ๋ณ€ํ™”์‹œํ‚ฌ ์ˆ˜ ์žˆ์Œ์„ ์‹œ์‚ฌํ•œ๋‹ค. ์ˆ˜์†Œํ™”๋ฐ˜์‘์„ ํ†ตํ•ด ์ƒ์„ฑ๋  ์ˆ˜ ์žˆ๋Š” ์ค‘๊ฐ„์ƒ์„ฑ๋ฌผ์งˆ์˜ ์กฐํ•ฉ์€ ๋งค์šฐ ๋งŽ๊ธฐ ๋•Œ๋ฌธ์— ๋ชจ๋‘ ์ •๋Ÿ‰ํ•  ์ˆ˜๋Š” ์—†์—ˆ์œผ๋‚˜, 1-difluoromethyl-2-fluorobenzene ๊ณผ 1-difluoromethyl-3-fluorobenzene ์„ ์‹œ์ž‘๋ฌผ์งˆ๋กœ ์‹คํ—˜ํ•˜์˜€์„ ๋•Œ ์˜ˆ์ƒ๋˜๋Š” ์ค‘๊ฐ„์ƒ์„ฑ๋ฌผ์งˆ๋กœ difluoromethylbenzene, fluorotoluene, toluene, methylcyclohexane์„ ์„ ์ •ํ•˜์—ฌ ๋ฐ˜์‘ ์‹œ๊ฐ„์— ๋”ฐ๋ผ ๋†๋„๋ฅผ ์ •๋Ÿ‰ํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ๋‘ ๊ฒฝ์šฐ ๋ชจ๋‘ ์ดˆ๊ธฐ ๋†๋„ ๋Œ€๋น„ dimethylbenzene๊ณผ fluorotoluene์˜ ๋†๋„ ๋น„์œจ์ด ๋งค์šฐ ๋‚ฎ๊ฒŒ ์ธก์ •๋˜์—ˆ์œผ๋ฉฐ ์ƒ์„ฑ๋œ ์‹œ๊ฐ„๋„ ๋น„์Šทํ•œ ์ˆ˜์ค€์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ฆ‰, ๋ฒค์  ๊ณ ๋ฆฌ์— ๊ฒฐํ•ฉ๋œ ๋ถˆ์†Œ๋‚˜ dimethyl์˜ ๋ถˆ์†Œ ๋ชจ๋‘ ๋น ๋ฅธ ์†๋„๋กœ ํƒˆ๋ถˆํ™” ๋ฐ˜์‘์ด ์ผ์–ด๋‚  ์ˆ˜ ์žˆ์—ˆ์œผ๋ฉฐ, ์ตœ์ข… ํƒˆ๋ถˆํ™”์œจ์˜ ์ฐจ์ด๋Š” ๋ถˆ์†Œ๊ฐ€ ์ œ๊ฑฐ๋˜์ง€ ์•Š์€ ์ฑ„๋กœ ์ˆ˜์†Œํ™”๋ฐ˜์‘์ด ์ผ์–ด๋‚œ ๋ฌผ์งˆ์ด ์ƒ์„ฑ๋˜์—ˆ์„ ๊ฐ€๋Šฅ์„ฑ์ด ์žˆ๋‹ค. ์ด๋Ÿฌํ•œ ํ˜„์ƒ์€ 1,3-difluorobenzene, 1-difluoromethyl-3-fluorobenzene, and 3-fluorophenol ๊ณผ ๊ฐ™์ด ๋‘ ์ž‘์šฉ๊ธฐ๊ฐ€ meta ์œ„์น˜์— ์žˆ์„ ๋•Œ ๋ฐœ์ƒํ•˜์˜€์œผ๋ฉฐ, 3-fluorotoluene์—์„œ๋Š” ์˜ˆ์™ธ์˜€๋‹ค. ๋”ฐ๋ผ์„œ ๋‹ค์–‘ํ•œ ๊ตฌ์กฐ์˜ Fluoroarene์˜ ๊ฒฝ์šฐ ์ œ๊ฑฐ ์†๋„์™€ ํƒˆ๋ถˆํ™”์œจ์˜ ๊ฒฝํ–ฅ์„ฑ์€ ๊ฐ๊ฐ ๋‹ค๋ฅธ ๋ฐฉ์‹์œผ๋กœ ์ ‘๊ทผํ•˜์—ฌ ์ฒ˜๋ฆฌ ํšจ์œจ์„ ์˜ˆ์ธกํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋ฉฐ, ๊ธฐ์กด์˜ linear chain ๊ตฌ์กฐ๋ฅผ ๊ฐ€์ง„ PFCs์™€๋Š” ๋‹ค๋ฅธ ์ ‘๊ทผ์ด ํ•„์š”ํ•˜๋‹ค.1. Introduction 1 1.1. Background 1 1.2. Research objectives 2 1.3. Research area 3 2. Literature review 4 2.1. Fluoroarene 4 2.2. Rhodium catalyst 6 2.3. Hydrodefluorination 7 2.4. Structure-reactivity relationships 8 2.5. Multiple linear regression analysis 12 3. Materials and methods 13 3.1. Reagents 13 3.2. Catalyst 14 3.3. Batch experiments 16 3.4. Analytical methods 17 3.5. Calculation methods 19 4. Results and discussions 21 4.1. Reaction kinetics and defluorination yield 21 4.1.1. Pseudo-first-order reaction constant 21 4.1.2. Defluorination yield 23 4.2. Effect of structural properties 29 4.2.1. Effect of the number of fluorine and substituent position 29 4.2.2. Effect of substituent type 30 4.3. Structure-reactivity relationships 34 4.3.2. Selection of variables 34 4.3.2. Multiple linear regression analysis 37 5. Conclusions 42 Appendix 44 Bibliography 50 Abstract in Korean 53Maste

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    VATER์ฆํ›„๊ตฐ์—์„œ์˜ ๋งŒ์„ฑ ์‹ ์žฅ ์งˆํ™˜์˜ ์ž„์ƒ์  ๊ฒฝ๊ณผ, ์น˜๋ฃŒ ๋ฐ ๊ฒฐ๊ณผ

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    Dept. of Medicine/์„์‚ฌ[ํ•œ๊ธ€] VATER ์ฆํ›„๊ตฐ์€ ์ฒ™์ถ”๊ฒฐ์†, ์‡„ํ•ญ, ์‹ฌ์žฅ ๊ฒฐ์†, ๊ธฐ๊ด€์‹๋„๋ฃจ, ์‹ ์žฅ ๊ฒฐ์†, ์š”์ธก ์ƒ์ง€ ์ดํ˜•์„ฑ์ฆ ๋“ฑ์˜ ์—ฐ๊ด€ ์งˆํ™˜์ด๋‹ค. VATER์ฆํ›„๊ตฐ์˜ ์•ฝ 60%์—์„œ ์‹ ์žฅ๊ธฐํ˜•์ด ๋ฐœ๊ฒฌ๋˜๋ฉฐ, ์ผ๋ถ€์—์„œ ๋งŒ์„ฑ์‹ ์งˆํ™˜(chronic kidney disease, CKD)์ด ๋™๋ฐ˜๋œ๋‹ค. ์˜ํ•™์  ๋ฐœ์ „์„ ํ†ตํ•ด ์ตœ๊ทผ์—๋Š” ๋งŒ์„ฑ์‹ ์งˆํ™˜์„ ๋™๋ฐ˜ํ•œ VATER์ฆํ›„๊ตฐ ํ™˜์ž์˜ ์ƒ๋‹น์ˆ˜๊ฐ€ ์„ฑ์ธ ์—ฐ๋ น๊นŒ์ง€ ์ƒ์กดํ•˜์ง€๋งŒ, ์ด๋“ค์˜ ์‹ ์žฅ ์งˆํ™˜ ๊ด€๋ฆฌ์— ๊ด€ํ•œ ์ข…๋‹จ์  ๊ด€์ฐฐ ์ž๋ฃŒ๋Š” ์—†๋‹ค. ๋ชฉ์  VATER์ฆํ›„๊ตฐ ํ™˜์ž์˜ ์‹ ์žฅ ์งˆํ™˜ ๊ฒฝ๊ณผ ๋ฐ ์˜ˆํ›„๋ฅผ ๊ธฐ์ˆ ํ•˜๊ณ , ๋น„์Šทํ•œ ์‹ ์žฅ์งˆํ™˜์„ ๋™๋ฐ˜ํ•˜๊ณ  ์žˆ์ง€๋งŒ VATER์ฆํ›„๊ตฐ์ด ์•„๋‹Œ ๋Œ€์กฐ๊ตฐ๊ณผ ์ž„์ƒ์  ํŠน์ง•์„ ๋น„๊ตํ•œ๋‹ค. ๋ฐฉ๋ฒ• 1980๋…„ 1์›”๋ถ€ํ„ฐ 2005๋…„ 12์›”๊นŒ์ง€ University of California San Diego ๋ณ‘์›์—์„œ ์น˜๋ฃŒํ•œ ํ™˜์ž๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค. VATER์ฆํ›„๊ตฐ ํ™˜์ž ์ค‘ ๋งŒ์„ฑ ์‹ ์งˆํ™˜ 2๊ธฐ~5๊ธฐ์— ํ•ด๋‹น๋˜๋Š” ํ™˜์ž๋“ค์˜ ์˜๋ฌด ๊ธฐ๋ก๊ณผ, ๋™๋ฐ˜๋œ ์‹ ์งˆํ™˜ ๋ฐ ์—ฐ๋ น์„ ๊ธฐ์ค€์œผ๋กœ VATER์ฆํ›„๊ตฐ ํ™˜์ž๊ตฐ๊ณผ ์„œ๋กœ ์ ํ•ฉํ•˜๊ฒŒ ์„ ์ •๋œ ๋Œ€์กฐ๊ตฐ๋“ค์˜ ์˜๋ฌด ๊ธฐ๋ก์„ ํ›„ํ–ฅ์ ์œผ๋กœ ๊ฒ€ํ† ํ•œ ํ›„, ๋‘ ํ™˜์ž๊ตฐ์˜ ์ž๋ฃŒ๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. ํ†ต๊ณ„ ๋ถ„์„์€ SPSS v12.0์„ ์ด์šฉํ•˜์—ฌ ์ˆ˜ํ–‰๋˜์—ˆ๋‹ค. ๊ฒฐ๊ณผ ์‹ ์žฅ ๊ฒฐ์†์„ ๊ฐ€์ง„ VATER์ฆํ›„๊ตฐ๊ตฐ์€ 54๋ช…(๋‚จ: ์—ฌ = 15:39)์ด์—ˆ์œผ๋ฉฐ ์ด ์ค‘ 12๋ช…(๋‚จ:์—ฌ = 3:9)์ด ๋งŒ์„ฑ์‹ ์งˆํ™˜์„ ๋™๋ฐ˜ํ•˜์˜€๋‹ค. ๋งŒ์„ฑ์‹ ์งˆํ™˜ ๋™๋ฐ˜ VATER์ฆํ›„๊ตฐ๊ตฐ์˜ ํ‰๊ท  ์ถ”์  ๊ธฐ๊ฐ„์€ 15.0ยฑ1.4๋…„์ด์—ˆ์œผ๋ฉฐ ๋Œ€์กฐ๊ตฐ 12๋ช…์˜ ํ‰๊ท  ์ถ”์  ๊ธฐ๊ฐ„์€ 11.0ยฑ2.1๋…„์ด์—ˆ๋‹ค. VATER์ฆํ›„๊ตฐ์—์„œ๋Š” ์‡„ํ•ญ(91.7%), ์‹ฌ์žฅ ๊ฒฐ์†(66.7%), ์ฒ™์ถ” ๊ฒฐ์†(50%), ๊ธฐ๊ด€์‹๋„๋ฃจ(25%) ๋ฐ ์‚ฌ์ง€ ๊ฒฐ์†(25%) ๋“ฑ์ด ๊ด€์ฐฐ๋˜์—ˆ๋‹ค. VATER์ฆํ›„๊ตฐ๊ตฐ 8๋ช…๊ณผ ๋Œ€์กฐ๊ตฐ 4๋ช…์ด ๋ง๊ธฐ์‹ ์งˆํ™˜์œผ๋กœ ์ง„ํ–‰ํ•˜์˜€๋‹ค(66.7% ๋Œ€ 33.3%). ๋ง๊ธฐ์‹ ์งˆํ™˜์ด ๋ฐœ์ƒํ•œ ํ‰๊ท  ์—ฐ๋ น์€ ๋‘ ๊ตฐ๊ฐ„ ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ์—†์—ˆ๋‹ค(8.5%ยฑ2.5 ๋Œ€ 9.3ยฑ2.7 ๋…„, p>0.5). VATER์ฆํ›„๊ตฐ๊ตฐ ํ™˜์ž์˜ 6๋ช…์ด ์ด์‹์ „ ํˆฌ์„์„ ๋ฐ›์•˜์œผ๋ฉฐ, ์ด ์ค‘ 2๋ช…์€ ํ˜ˆ์•กํˆฌ์„, 4๋ช…์€ ๋ณต๋ง‰ํˆฌ์„์„ ๋ฐ›์•˜๋‹ค. ๋ณต๋ง‰ํˆฌ์„์„ ์‹œ์ž‘ํ•œ 4๋ช… ์ค‘ 3๋ช…์€ ์‹ฌ๊ฐํ•œ ํ•ฉ๋ณ‘์ฆ(ํšก๊ฒฉ๋ง‰๋ˆ„์ถœ, ์‹ฌํ•œ ๋ณต๊ฐ• ์œ ์ฐฉ ๋“ฑ)์œผ๋กœ ์ธํ•ด ํˆฌ์„ ๊ฐœ์‹œ ์ˆ˜๊ฐœ์›” ์ด๋‚ด์— ํ˜ˆ์•กํˆฌ์„์œผ๋กœ ์ „ํ™˜ํ•˜์˜€๋‹ค. ๋Œ€์กฐ๊ตฐ์œผ๋กœ์„œ ํˆฌ์„์„ ์‹ค์‹œํ•œ 3๋ช… ์ค‘, 2๋ช…์€ ๋ณต๋ง‰ ํˆฌ์„์„, 1๋ช…์€ ํ˜ˆ์•ก ํˆฌ์„์„ ๋ฐ›์•˜์œผ๋ฉฐ ๋ชจ๋‘ ์‹ฌ๊ฐํ•œ ํ•ฉ๋ณ‘์ฆ์ด ์—†์—ˆ๋‹ค. VATER์ฆํ›„๊ตฐ๊ตฐ ์ค‘ 7๋ช…๊ณผ ๋Œ€์กฐ๊ตฐ ์ค‘ 4๋ช…์ด ์‹ ์žฅ์„ ์ด์‹๋ฐ›์•˜๋‹ค. ์ด์‹ ํ›„ 2๋…„ ์งธ ํ‰๊ท  ํฌ๋ ˆ์•„ํ‹ฐ๋‹Œ ์ฒญ์†Œ์œจ์€ VATER์ฆํ›„๊ตฐ๊ตฐ์—์„œ 65.8ยฑ6.3 mL/min/1.73m2 ์ด์—ˆ๊ณ , ๋Œ€์กฐ๊ตฐ์—์„œ 87.8ยฑ7.1 mL/min/1.73m2์ด์—ˆ๋‹ค(p=0.07). ํ‰๊ท  ํ‚คํ‘œ์ค€ํŽธ์ฐจ์ ์ˆ˜๋Š” VATER์ฆํ›„๊ตฐ๊ตฐ์—์„œ ๋Œ€์กฐ๊ตฐ์— ๋น„ํ•˜์—ฌ ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜๊ฒŒ ๋” ์ €ํ•˜๋˜์–ด ์žˆ์—ˆ๋‹ค(-2.34ยฑ0.41 ๋Œ€ -1.27ยฑ0.24, p<0.05). ๊ฒฐ๋ก  ๋งŒ์„ฑ์‹ ์งˆํ™˜์„ ๊ฐ€์ง„ VATER์ฆํ›„๊ตฐ๊ตฐ ํ™˜์ž๋“ค์€ ์ฃผ๋กœ ์—ฌ์ž์ด์—ˆ๋ฉฐ, ๋ฐฉ๊ด‘์ด์ƒ์„ ๋ณด์ด๋Š” ๊ฒฝ์šฐ๊ฐ€ ๋งŽ์•˜๋‹ค. ๋Œ€์กฐ๊ตฐ์— ๋น„๊ตํ•˜์—ฌ ๋ง๊ธฐ์‹ ์งˆํ™˜์„ ์ž˜ ์ผ์œผ์ผฐ์œผ๋ฉฐ, ์ฃผ๋กœ ํ˜ˆ์•ก ํˆฌ์„์„ ํ•„์š”๋กœ ํ•˜์˜€๊ณ , ํˆฌ์„ ์ค‘ ๋” ๋งŽ์€ ํ•ฉ๋ณ‘์ฆ์ด ๋ฐœ์ƒํ•˜์˜€์œผ๋ฉฐ, ์ด์‹ ํ›„ 2๋…„์งธ ์‹ ์žฅ ๊ธฐ๋Šฅ์ด ๋‚ฎ์•˜๊ณ , ์‹ฌํ•œ ์„ฑ์žฅ ์žฅ์• ๋ฅผ ๋ณด์˜€๋‹ค. [์˜๋ฌธ] Background: Renal anomalies occur in approximately 60% of VATER (nonrandom association of vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula with atresia, renal defects and radial limb dysplasia) patients. The renal anomalies can be associated with chronic kidney disease (CKD). With improved medical care, a large proportion of these patients are surviving into adulthood. However, longitudinal follow-up data regarding the management of kidney disease in these children do not exist. Objective: To describe the course and outcome of kidney disease in VATER association patients and compare them to control patients with similar renal abnormalities but no VATER association Design/Methods: The records of VATER patients with CKD stage 2-5 and age-matched controls with similar renal anomalies and CKD but no VATER association seen at the University of California San Diego from Jan 1980 to Dec 2005 were retrospectively reviewed. Statistical analysis was performed using SPSS v12.0. Results: Fifty-four VATER (M:F 15:39) patients with renal involvement were identified, among which twelve(M:F 3:9) patients had CKD. The mean follow up period for the VATER patients was 15.0 1.4SE yrs, while the mean follow up period for the 12 controls was 11.9 2.1SE yrs. VATER patients had imperforate anus(91.7%), cardiac anomalies(66.7%), vertebral anomalies(50%), TEF(25%) and limb anomalies (25%). Eight VATER patients progressed to end-stage renal disease(ESRD) compared to 4 controls (66.7% vs 33.3%). There was no significant difference in mean age at ESRD development (8.5 2.5 vs. 9.3 2.7SE yrs, p>0.5). Six VATER patients were dialyzed pre-transplant; 2 were on hemodialysis(HD) and 4 were begun on peritoneal dialysis (PD), but 3 were switched to HD within a few months due to complications(diaphragmatic leak, severe abdominal adhesions). Three controls were dialyzed without significant complications (2 on PD, 1 on HD). Seven VATER patients underwent renal transplantation compared to 4 controls. Mean creatinine clearance 2 years post-transplant was 65.8 6.3 in VATER patients vs. 87.8 7.1 ml/min/1.73m2 in controls (p=0.07). VATER patients had a significantly lower mean height standard deviation score compared to controls (-2.34 0.41 vs. -1.27 0.24, p<0.05). Conclusions: VATER association patients with CKD are predominantly female, have a high incidence of bladder abnormalities, develop ESRD more frequently, usually require HD as dialysis modality, experience more complications with dialysis, have a worse graft outcome 2 years post-transplant, and have more severe growth failure than controls.ope

    2D-LC Characterization of Branched Polymers

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    ํ‡ด์› ๋…ธ์ธ์˜ ์ฒ˜๋ฐฉ ์•ฝ๋ฌผ ์ดํ–‰๋„์— ๊ด€ํ•œ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :๊ฐ„ํ˜ธํ•™๊ณผ ๊ฐ„ํ˜ธํ•™์ „๊ณต,1999.Maste

    ๋ฏธ์ˆ ๋Œ€ํ•™ ํ•™์ƒ๋“ค์˜ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์˜ ์ƒ๊ด€๊ด€๊ณ„ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ํ˜‘๋™๊ณผ์ •(๋ฏธ์ˆ ๊ต์œก์ „๊ณต), 2013. 2. ๊น€ํ˜•์ˆ™.๋ณธ ๋…ผ๋ฌธ์€ ๋ฏธ์ˆ ๋Œ€ํ•™์˜ ์ง„๋กœ๊ต์œก ํ˜„ํ™ฉ์„ ์•Œ์•„๋ณด๊ณ , ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์ˆ˜์ค€๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ถ„์„ํ•˜๋ฉด์„œ ๋ฏธ์ˆ ๋Œ€ํ•™ ์ง„๋กœ๊ต์œก์˜ ๋ฌธ์ œ์ ๊ณผ ๊ฐœ์„ ์ ์„ ๊ณ ์ฐฐํ•œ ์—ฐ๊ตฌ์ด๋‹ค. ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์„ ๊ฒฐ์ •ํ•˜๋Š” ์›์ธ์œผ๋กœ ์œ ์ „์  ์š”์ธ, ํ™˜๊ฒฝ์  ์š”์ธ, ์„ฑ๊ฒฉ์  ์š”์ธ, ํ–‰๋™์  ์š”์ธ ๋“ฑ ๋‹ค์–‘ํ•œ ์›์ธ๋“ค์ด ์ œ์•ˆ๋˜์—ˆ์œผ๋‚˜, ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰๊ณผ์˜ ๊ด€๋ จ์„ฑ์€ ์•Œ๋ ค์ง„ ๋ฐ”๊ฐ€ ์—†๋‹ค. ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์€ ๊ฐœ์ธ์˜ ์ƒ์• ๋ชฉํ‘œ์— ๋”ฐ๋ผ ์™ธ๋ถ€ํ™˜๊ฒฝ๊ณผ ์ž์‹ ์„ ์กฐ์œจํ•ด ๋‚˜๊ฐ€๋Š” ์ง„๋กœ๊ฐœ๋ฐœ์— ํ•„์š”ํ•œ ์—ญ๋Ÿ‰์œผ๋กœ์„œ, ํƒ€ ์ „๊ณต ๋Œ€ํ•™์ƒ๋“ค์— ๋น„ํ•˜์—ฌ ์ง„๋กœ์— ๊ด€ํ•œ ์ •๋ณด๊ฐ€ ๋งŽ์ง€ ์•Š๊ณ  ํ‰์ƒ์ง์žฅ๋„ ๋“œ๋ฌผ์–ด ์Šค์Šค๋กœ์˜ ๊ฐœ์ฒ™์ด ์š”๊ตฌ๋˜๋Š” ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ์—๊ฒŒ ๊ผญ ํ•„์š”ํ•˜๋‹ค๊ณ  ์ƒ๊ฐ๋œ๋‹ค. ์ด์— ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์„œ์šธ์‹œ ๋‚ด์˜ 4๋…„์ œ ๋ฏธ์ˆ ๋Œ€ํ•™ ์„ธ ๊ณณ์˜ ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ 317๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ์„ค๋ฌธ์กฐ์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์—ฌ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์ˆ˜์ค€๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์„ ํ™•์ธํ•˜๊ณ , ๋‘ ์ˆ˜์ค€ ๊ฐ„์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ฐํž˜์œผ๋กœ์จ ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ๋“ค์˜ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์ด ์ง„๋กœ๊ฒฐ์ •๊ณผ ์ƒ๊ด€์ด ์žˆ๋Š”์ง€ ์•Œ์•„๋ณด์•˜๋‹ค. ๋˜ํ•œ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰ ์ค‘์—์„œ๋„ ํŠน๋ณ„ํžˆ ์ง„๋กœ๊ฒฐ์ •๊ณผ์˜ ์ƒ๊ด€์„ฑ์ด ๋†’์€ ํ•ญ๋ชฉ์„ ์•Œ์•„๋ด„์œผ๋กœ์จ ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ ์ง„๋กœ๊ต์œก์— ์‹œ์‚ฌ์ ์„ ์–ป๊ณ ์ž ํ•˜์˜€์œผ๋ฉฐ, ์ง„๋กœ๊ต์œก๊ฒฝํ—˜ ์—ฌ๋ถ€๋ฅผ ์กฐ์‚ฌํ•จ์œผ๋กœ์จ ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ๋“ค์ด ๋Œ€ํ•™์—์„œ ์ง„๋กœ์™€ ๊ด€๋ จ๋œ ๊ต์œก์˜ ํ˜œํƒ์„ ์–ผ๋งˆ๋‚˜ ๋ฐ›๊ณ  ์žˆ๋Š”์ง€ ํ™•์ธํ•˜๊ณ , ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์ˆ˜์ค€๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์ด ํ˜„์žฌ ๊ต์œก์„ ํ†ตํ•ด์„œ ํ‚ค์›Œ์ง€๊ณ  ์žˆ๋Š”์ง€๋ฅผ ํ™•์ธํ•˜์˜€๋‹ค. ์ด๋ฅผ ํ†ตํ•ด ๋„์ถœํ•œ ์ฃผ์š” ๊ฒฐ๊ณผ๋ฅผ ์š”์•ฝํ•˜๋ฉด ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ฒซ์งธ, ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์ˆ˜์ค€๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์€ ์„ ํ–‰์—ฐ๊ตฌ์™€ ๋น„๊ตํ•˜์˜€์„ ๋•Œ 4๋…„์ œ ์ผ๋ฐ˜ ๋Œ€ํ•™์ƒ๋“ค๊ณผ ๋น„์Šทํ•œ ์ˆ˜์ค€์ด์—ˆ์œผ๋‚˜ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์ˆ˜์ค€์˜ ํ•˜์œ„ํ•ญ๋ชฉ์—์„œ๋Š” ์ฐจ์ด๊ฐ€ ์žˆ์—ˆ๋‹ค. ๋‘˜์งธ, ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์€ ์ƒ๊ด€๊ณ„์ˆ˜ 0.578์˜ ์ •์ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ์žˆ์—ˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ ๋ถ„์„์˜ ๊ธฐ์ค€์œผ๋กœ ์‚ผ์€ Davis(1971)์˜ ๋ถ„์„๋ฐฉ๋ฒ•์—์„œ๋Š” ์ƒ๊ด€๊ณ„์ˆ˜ 0.5 ์ด์ƒ์„ ๋†’์€(strong)์ƒ๊ด€์œผ๋กœ ๊ทœ์ •ํ•˜๋ฏ€๋กœ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์€ ๋†’์€ ์ƒ๊ด€์ด ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋ณผ ์ˆ˜ ์žˆ๋‹ค. ์…‹์งธ, ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์˜ ํ•˜์œ„ ํ•ญ๋ชฉ๋“ค๊ณผ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€๊ณผ์˜ ์ƒ๊ด€๊ด€๊ณ„๋Š” ํ•ญ๋ชฉ๋ณ„๋กœ ์ฐจ์ด๊ฐ€ ์žˆ์—ˆ๋‹ค. ๊ฐ€์žฅ ๋†’์€ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ณด์ธ ํ•ญ๋ชฉ์€ ๋„คํŠธ์›Œํ‚น๋Šฅ๋ ฅ์ด์—ˆ์œผ๋ฉฐ, ๊ฐ€์žฅ ๋‚ฎ์€ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ณด์ธ ํ•ญ๋ชฉ์€ ํ‰์ƒํ•™์Šต๋Šฅ๋ ฅ์ด์—ˆ๋‹ค. ๋˜ํ•œ ๋„คํŠธ์›Œํ‚น ํ•ญ๋ชฉ๊ณผ ๋ณ€ํ™”์— ๋Œ€ํ•œ ์ดํ•ด์™€ ์ˆ˜์šฉ ํ•ญ๋ชฉ์€ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€๊ณผ์˜ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ๋†’์œผ๋ฉด์„œ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์ˆ˜์ค€์ด ๋‚ฎ์€ ๋Œ€ํ‘œ์ ์ธ ํ•ญ๋ชฉ์œผ๋กœ, ์ง„๋กœ๊ต์œก ์ง€์›์ด ํ•„์š”ํ•˜๋‹ค๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ๋„ท์งธ, ์ง„๋กœ๊ต์œก๊ฒฝํ—˜์„ ๋ฐ›์€ ์ ์ด ์žˆ๋Š”์ง€, ์ง„๋กœ๊ต์œก์˜ ์–‘๊ณผ ์งˆ์— ๋งŒ์กฑํ•˜๋Š”์ง€๋Š” ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰, ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€๊ณผ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ์—†์—ˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” 2012๋…„ ํ˜„์žฌ 4๋…„์ œ ๋ฏธ์ˆ ๋Œ€ํ•™ ์ง„๋กœ๊ต์œก ํ˜„ํ™ฉ๊ณผ ๋ฏธ์ˆ ๋Œ€ํ•™ ํ•™์ƒ๋“ค์˜ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰ ๋ฐ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์— ๊ด€ํ•œ ์ž๋ฃŒ๋ฅผ ์ˆ˜์ง‘ํ•˜๊ณ  4๋…„์ œ ๋Œ€ํ•™์ƒ ์ผ๋ฐ˜์„ ๋Œ€์ƒ์œผ๋กœ ํ•œ ์„ ํ–‰์—ฐ๊ตฌ์™€ ๋น„๊ต ๋ถ„์„ํ•จ์œผ๋กœ์จ ๋ฏธ์ˆ ๋Œ€ํ•™์ƒ๋“ค๋งŒ์˜ ํŠน์ˆ˜ํ•œ ํ•„์š”๋ฅผ ์•Œ์•„๋‚ธ ๊ฒƒ์œผ๋กœ์„œ, ๋ฏธ์ˆ ๋Œ€ํ•™์ง„๋กœ๊ฐœ๋ฐœ์ง€์› ์—ฐ๊ตฌ์˜์—ญ์˜ ์ •๋ณด๋ฅผ ์ œ๊ณตํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€๋œ๋‹ค.๊ตญ๋ฌธ์ดˆ๋ก I. ์„œ๋ก  1. ์—ฐ๊ตฌ์˜ ๋ชฉ์  2. ์—ฐ๊ตฌ์˜ ๋‚ด์šฉ ๋ฐ ๋ฐฉ๋ฒ• 3. ์—ฐ๊ตฌ์˜ ์ค‘์š”์„ฑ II. ์ด๋ก ์  ๋ฐฐ๊ฒฝ 1. ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ๊ต์œก ๊ฐ€. ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ๋ฐœ๋‹ฌ๋‹จ๊ณ„ ๋‚˜. ๋Œ€ํ•™์ƒ ์ง„๋กœ๊ต์œก์˜ ํ˜„ํ™ฉ 2. ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰ ๊ฐ€. ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์˜ ๊ฐœ๋… ๋‚˜. ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰ 3. ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€ ๊ฐ€. ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€์˜ ๊ฐœ๋… ๋‚˜. ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€ โ…ข. ์—ฐ๊ตฌ ๋ฐฉ๋ฒ• 1. ์—ฐ๊ตฌ๋Œ€์ƒ 2. ์—ฐ๊ตฌ๋„๊ตฌ ๊ฐ€. ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰ ๋‚˜. ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€ ๋‹ค. ์ง„๋กœ๊ต์œก๊ฒฝํ—˜ 3. ๋ถ„์„๋ฐฉ๋ฒ• IV. ์—ฐ๊ตฌ๊ฒฐ๊ณผ 1. ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰ ๊ฐ€. ์‹ ๋ขฐ๋„ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ ๋‚˜. ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰๊ณผ ํ•˜์œ„ ํ•ญ๋ชฉ ๊ฐ„์˜ ์ƒ๊ด€๋ถ„์„ ๊ฒฐ๊ณผ ๋‹ค. ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ ๋ผ. ๊ธฐ๋ณธ ์ธ์ ์‚ฌํ•ญ์— ๋”ฐ๋ฅธ ์ง„๋กœ๊ฐœ๋ฐœ์—ญ๋Ÿ‰์˜ ์ฐจ์ด 2. ์ง„๋กœ๊ฒฐ์ •์ˆ˜์ค€ 3. ์ง„๋กœ๊ต์œก๊ฒฝํ—˜ 4. ์ƒ๊ด€์„ฑ๋ถ„์„ 5. ์ข…ํ•ฉ๋ถ„์„ ๋ฐ ๋…ผ์˜ V. ๊ฒฐ๋ก  ์ฐธ๊ณ ๋ฌธํ—Œ ๋ถ€๋ก(์„ค๋ฌธ์ง€) ์˜๋ฌธ์ดˆ๋กMaste

    A Clinical Study of Renal Abscesses in Children

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    Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.ope

    Effect of Inositol hexaphosphate and full spectrum light on tumor growth and liver antioxidative enzyme in nude mice xenotransplanted with HT-29 cells

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์‹ํ’ˆ์˜์–‘ํ•™๊ณผ,2005.Maste

    Metabolomics ๊ธฐ๋ฒ•์„ ์ ์šฉํ•œ ์ฒด์™ธ์ง„๋‹จ๋‹ค์ง€ํ‘œ๋ถ„์„ (IVDMIA)์„ ์ด์šฉํ•œ ํŒจํ˜ˆ์ฆ์—์„œ์˜ ์ƒˆ๋กœ์šด ์กฐ๊ธฐ ๋ฐ”์ด์˜ค๋งˆ์ปค์˜ ๊ฐœ๋ฐœ ๋ฐ ๊ฒ€์ฆ

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    Background: Sepsis is a syndrome that is influenced by pathogens and host factors and is characterized by an aberrant or dysregulated host response and organ dysfunction. Sepsis is the primary cause of death from infection, especially if not recognized and treated promptly. Its recognition mandates urgent attention. However the underlying mechanisms of sepsis are not completely understood. Therefore, a multimarker strategy may be helpful for improving the understanding of the complex pathogenesis of sepsis and its evolution, and especially for facilitating early risk stratification and implementing personalized therapies. The use of emerging metabolomics tools is particularly promising for the diagnosis of complex and heterogeneous conditions such as sepsis and septic shock. Methods: Several different biomarkers are known to aid the diagnosis of sepsis and are used as severity or outcome indexes for patients with sepsis. For the application of metabolomics to sepsis research, we recruited individuals and categorized them in three groups โ€“ normal healthy group, systemic inflammatory response syndrome (SIRS) group, and sepsis group. We assayed the serum levels of amino acids and the respective metabolites using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and analyzed the result to screen promising biomarkers of sepsis. Lastly, an In Vitro Diagnostic Multivariate Index Assay (IVDMIA) was developed by formulating the indexes using the amino acids selected previously. Results: Principle component analysis (PCA) was performed using the results of metabolomics research. Based on the score plot and loading plot, we confirmed that the three aforementioned groups were distinguishable and formed clear clusters. We could also infer that amino acid derangements exist in patients with sepsis, and that these metabolomic derangements could be employed as biomarkers using LC-MS. Based on the PCA results, we selected the candidate amino acids that could be used in IVDMIA. We selected four index amino acids (kynurenine (KYN), tryptophan (TRP), phenylalanine (PHE), and arginine (ARG)) and one ratio (KT ratio). We developed various formulas using the five variables mentioned. After assessing the sensitivity, specificity, accuracy, and area under the ROC curve (AUC) from each formula, the formula with the highest performance was selected for developing the IVDMIA for sepsis. The generated IVDMIA was subjected to validation processes, which included performance comparison with preexisting sepsis markers such as White Blood Cell (WBC), C-Reactive Protein (CRP), and procalcitonin (PCT). The selected IVDMIA formula is as follows: ARG (-0.0513) + PHE 0.0642 + KT ratio 27.6591 - 5.4765. We observed that the developed IVDMIA had similar or better potential than procalcitonin as a sepsis marker. Conclusions: This study demonstrated that the amino acid composition of the body in patients with sepsis differs significantly from those in normal individuals or in patients with SIRS. We developed an IVDMIA specific for sepsis and validated it. The IVDMIA developed in this study can be used to diagnose sepsis in patients. Small-scale or point-of-care testing MALDI-TOF can be used instead of LC-MS/MS for amino acid analysis, which improves the applicability of the test. It is expected to be ready for clinical practice in the near future. In addition, the variations in the concentrations of amino acids we assessed improved our understanding of metabolic alterations in sepsis. ๋ฐฐ๊ฒฝ: ํŒจํ˜ˆ์ฆ์€ ๋ฏธ์ƒ๋ฌผ์— ๊ฐ์—ผ๋˜์–ด ์ „์‹ ์— ๊ฑธ์นœ ์—ผ์ฆ ๋ฐ˜์‘์ด ๋‚˜ํƒ€๋‚˜๋Š” ์ƒํƒœ์ด๋ฉฐ, ์ด๋Ÿฌํ•œ ์ƒํƒœ๊ฐ€ ์ง€์†๋˜๊ฑฐ๋‚˜ ์•…ํ™”ํ•˜์—ฌ ๋‹ค๋ฐœ์„ฑ ์žฅ๊ธฐ ๋ถ€์ „์„ ๊ฑฐ์ณ ์‚ฌ๋ง์— ์ด๋ฅผ ์ˆ˜ ์žˆ๋Š” ์ฃผ์š”ํ•œ ์งˆํ™˜์ด๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ํŒจํ˜ˆ์ฆ์˜ ๋ณ‘ํƒœ์ƒ๋ฆฌํ•™์ด๋‚˜ ๋Œ€์‚ฌ ์ž‘์šฉ์— ๋Œ€ํ•ด์„œ๋Š” ์•Œ๋ ค์ง„ ๋ฐ”๊ฐ€ ๋งŽ์ง€ ์•Š๋‹ค. ํŒจํ˜ˆ์ฆ์€ ๋‹ค์–‘ํ•˜๊ณ  ๋ณต์žกํ•œ ํŠน์ง•์„ ์ง€๋‹ˆ๊ธฐ ๋•Œ๋ฌธ์— ๊ฐ ๊ฒฝ์šฐ์— ๋งž๋Š” ์ ์ ˆํ•œ ์ง„๋‹จ๊ณผ ์น˜๋ฃŒ๊ฐ€ ํ•„์š”ํ•˜์ง€๋งŒ, ๋งž์ถค ์˜ํ•™์ด ๋ฐœ์ „ํ•˜๋Š” ์ตœ๊ทผ์—๋„ ์ด๋ฅผ ํŒจํ˜ˆ์ฆ์— ์ ์šฉํ•˜๊ธฐ๋Š” ์‰ฝ์ง€ ์•Š์€ ๊ฒƒ์ด ํ˜„์‹ค์ด๋‹ค. ๋”ฐ๋ผ์„œ ์—ฌ๋Ÿฌ ๊ฐ€์ง€์˜ ๋ฐ”์ด์˜ค๋งˆ์ปค๋ฅผ ๋ณ‘ํ•ฉํ•˜์—ฌ ์ด์šฉํ•˜๋Š” ๋ฐฉ์•ˆ์ธ ์ฒด์™ธ์ง„๋‹จ๋‹ค์ง€ํ‘œ๋ถ„์„ (In Vitro Diagnostic Multivariate Index Assay, IVDMIA)์ด ์ œ๊ธฐ๋˜์—ˆ๊ณ , ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” Metabolomics ๊ธฐ๋ฒ•์„ ๋น„์šฉํ•œ ํŒจํ˜ˆ์ฆ ํ™˜์ž์—์„œ์˜ ์ƒˆ๋กœ์šด ์กฐ๊ธฐ ๋ฐ”์ด์˜ค๋งˆ์ปค์˜ ๊ฐœ๋ฐœ ๋ฐ ๊ฒ€์ฆ์ด ์‹œํ–‰๋˜์—ˆ๋‹ค. ๋ฐฉ๋ฒ•: ์—ฐ๊ตฌ์— ๋™์˜ํ•œ ๊ฑด๊ฐ•๊ฒ€์ง„ ๋Œ€์ƒ์ž, ์ „์‹ ์—ผ์ฆ๋ฐ˜์‘์ฆํ›„๊ตฐ ํ™˜์ž, ํŒจํ˜ˆ์ฆ ํ™˜์ž์˜ ์„ธ ๊ทธ๋ฃน ์ฐธ์—ฌ์ž๋“ค๋กœ๋ถ€ํ„ฐ ๊ฒ€์‚ฌ ํ›„ ์ž”์—ฌ ํ˜ˆ์ฒญ์„ ํš๋“ํ•˜์˜€๋‹ค. ์ด ๊ฒ€์ฒด๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ์•ก์ฒด ํฌ๋กœ๋งˆํ† ๊ทธ๋ž˜ํ”ผ ์งˆ๋Ÿ‰ ๋ถ„๊ด‘๋ฒ•์„ ์ด์šฉํ•ด Metabolomics๋ฅผ ์‹œํ–‰ํ•˜์˜€๊ณ , ๊ทธ ๊ฒฐ๊ณผ๋ฅผ ์ฃผ์„ฑ๋ถ„ ๋ถ„์„ ํ†ต๊ณ„๋ฒ•์œผ๋กœ ๋ถ„์„ํ•˜์˜€๋‹ค. ๋ถ„์„ ๊ฒฐ๊ณผ๋ฅผ ํ†ตํ•ด ํŒจํ˜ˆ์ฆ์—์„œ์˜ ์ฒด์™ธ์ง„๋‹จ๋‹ค์ง€ํ‘œ๋ถ„์„์— ์ด์šฉํ•  ํŒจํ˜ˆ์ฆ ์กฐ๊ธฐ ๋งˆ์ปค๋“ค์„ ์„ ์ •ํ•˜์˜€๊ณ , ์ด๋“ค์„ ์ ์šฉํ•ด ํŒจํ˜ˆ์ฆ ์ง€ํ‘œ๋ฅผ ์ƒ์„ฑํ•˜์˜€๋‹ค. ๊ฒฐ๊ณผ: ์„ธ ๊ทธ๋ฃน์— ๋Œ€ํ•ด ์‹œํ–‰ํ•œ Metabolomics๊ฒฐ๊ณผ ๋ถ„์„์„ ๊ฑฐ์ณ kynurenine, tryptophan, KT ratio, phenylalanine, ๊ทธ๋ฆฌ๊ณ  arginine ๋“ฑ 5๊ฐœ์˜ ์•„๋ฏธ๋…ธ์‚ฐ ๋ฐ ๊ทธ ๊ณ„์‚ฐ์น˜๋ฅผ ํŒจํ˜ˆ์ฆ ๋ฐ”์ด์˜ค๋งˆ์ปค๋กœ ์„ ์ •ํ•˜์˜€๊ณ , ์„ ์ •๋œ ๋ฐ”์ด์˜ค๋งˆ์ปค๋“ค์„ ์ด์šฉํ•ด ํŒจํ˜ˆ์ฆ์—์„œ์˜ ์ฒด์™ธ์ง„๋‹จ ๋‹ค์ง€ํ‘œ๋ถ„์„์„ ๊ฑฐ์ณ ์ž„์ƒ์—์„œ ์‚ฌ์šฉ์ด ์šฉ์ดํ•œ ํŒจํ˜ˆ์ฆ ์ง€ํ‘œ-IVDMIA-๋ฅผ ๋งŒ๋“ค์–ด๋‚ด์—ˆ๋‹ค. ์ƒ์„ฑ๋œ ํŒจํ˜ˆ์ฆ ์ง€ํ‘œ๋Š” ์‹ค์ œ ํ™˜์ž ๊ทธ๋ฃน์— ์ ์šฉ๋˜์–ด ์ง„๋‹จ, ์ค‘์ฆ๋„, ์˜ˆํ›„ ํ‰๊ฐ€ ๋ฐ ์˜ˆ์ธก ๋“ฑ์—์„œ ๊ทธ ์ž„์ƒ์  ์„ฑ๋Šฅ์ด ๊ฒ€์ฆ๋˜์—ˆ๋‹ค. ๊ฒฐ๋ก : ๋ณธ ์—ฐ๊ตฌ๋Š” Metabolomics ๊ธฐ๋ฒ•์„ ํ†ตํ•ด ํŒจํ˜ˆ์ฆ ํ™˜์ž์—์„œ ์•„๋ฏธ๋…ธ์‚ฐ ๊ตฌ์„ฑ์„ ํฌํ•จํ•œ ์‹ ์ง„๋Œ€์‚ฌ๊ฐ€ ์œ ์˜ํ•˜๊ฒŒ ๊ต๋ž€๋จ์„ ์ž…์ฆํ•˜์˜€์œผ๋ฉฐ, ํ˜ˆ์ฒญ์˜ ์•„๋ฏธ๋…ธ์‚ฐ ๋ถ„์„์„ ํ†ตํ•ด ํŒจํ˜ˆ์ฆ์— ์œ ์˜ํ•œ ์•„๋ฏธ๋…ธ์‚ฐ๋“ค์„ ๋ฐœ๊ตดํ•˜์˜€๋‹ค. ์ด๋ฅผ ๊ธฐ๋ฐ˜์œผ๋กœ ํŒจํ˜ˆ์ฆ ์ง€ํ‘œ๊ฐ€ ์ƒ์„ฑ๋˜์—ˆ๊ณ  ๊ทธ ์„ฑ๋Šฅ์ด ๊ฒ€์ฆ๋˜์–ด ์ž„์ƒ์—์„œ ์œ ์šฉํ•˜๊ฒŒ ์“ฐ์ผ ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€๋œ๋‹ค.open๋ฐ•
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