白鼠胎兒卵巢가 胎兒睾丸分化에 미치는 影響에 關한 硏究

姜重遠 최신의학사 1967 最新醫學 Vol.10 No.1

The "freemartin" phenomenon, the situation in which twin calves are of opposite sex, was first described by Lillie(1916) and by Keller and Tandler(1916). This foundation for generally accepted notion that very early in embryonic development sex glands of the vertebrates secrete sex hormones which are responsible for the differentiation of two sexes from an indeterminate type prevailingin the embryo has received a considerable attention from numerous investigators. However this sex hormone theory of gonadal differentiation from an indeterminate type of gonad was not entirely proved at the mammalian level. Willier(1939) described the early embryonal gonad as a bisexual premordium capable of differentiation to either sex. Male or female potentialities are represented by specific histological elements, medulla and cortex, which have alternative roles in gonadogensis. In his amphibian experiments, Witschi(1934) obtained information that formed a portion of his theory concerning the so-called corticomedullary inductors, cortexin and medullarin, in the sex differentiation of amphibia. The corticomedullary inductor theory was deduced concerning the sex differntiation and was then proven by others. Witschi(1934) concluded that the inductors produce their effects by the release of morphogenic substances called medullarin and cortexin each of which may be the antagonist of the other. The theory was proven by others. Macintyre(1956) and Macintyre et al. (1959) obtained results interrupted as substantiating at the placental mammalian level that portion of the corticomedullary inductor theory of sex differentiation which deals with the secretion of an inductor by the medullary tissue and by the cortical tissue of a developing gonadal anlage. The author has attempted the present experiment in order to study the effect of each inductor(corticomedullary), especially the inductor secreted by the cortical tissue of a developing gonadal anlage, to the opposite gonadal tissue in rats(Placental mammalian level vertebrates). Materials and Methods Both testes and ovaries of the 16- day old rat fetus(post coitem or estimated by the crown-rump length of the albino rat as presented by Kupfer and Koeller(1951) and by Christie(1964)) were obtained from pregnant albino rats. The excised gonads from the fetuses at this stage may be surgically separated from adjacent tubular structures and cleaned by the aid of the stereomicroscope under the magnification of 15 X 1.33 diameters.Grafts of both gonads were made to a subcapsular portion in the kidneys of adult male rat hosts which have been castrated at least 3 weeks prior to their use. The author adopted the transplantation period of three weeks in the kidney site recommended by Macintyre(1956). In the first experimental group, the male and female gonads were transplanted side by side to the subcapsular site of the host. For the control group the fetal testis or ovary of the 16-day old rat fetus, as described above, was transplanted to the subcapsular site of the host kidney in the absence of gonadal tissue of opposite sex. The developed testis or ovary, grown in the site for 3 weeks, was compared with the grown or grafted gonads of the experimental groups. i For the experimental group, A) the male and female gonads were transplanted to the subcapsular site of the host side by side and 15 grafts removed from the hosts were histologically checked. B)one fetal testis and multiple ovaries (4 to 14 ovaries) were, in manual contact, grafted in one subcapsular site of the host kidney before removal. These grafts were tested in the same manner. The grown grafts were removed from the host after 3 weeks, fixed in Bouin's fluid, embedded in paraffin, sectioned serially at 6 u and stained with hematoxylin and eosin. Results Control groups 1. Transplanted testis without ovary: The fetal testis, developed in the subcapsular site of the host kidney for 3 weeks' grew into a large mass measuring about 5 mm. in length. Two or three layers of spermatogonia-like cells were arranged around the growth of senuniferous tubules. The cells showed fairly active proliferation. Relatively well developed interstitial cells, whose cytoplasma was well stained with eosin dye, were found in the stroma. It was evident that the 3 week old grafts of fetal male gonads showed some precocity of growth and differentiation as compaired to normal testis of equivalent age. 2. Transplanted ovary without testis : The fetal ovary of the certain developmental stage grew into a relatively small mass of about 3mm. in length and contained several follicles showing different stages of the primary follicle, the growing follicle, and the young Graafian follicle. The stroma showed a fairly well-developed picture. The ovary also showed certain precocity of growth and differentiation as compared with the normal one of equivalent age. Experimental group : A. Transplaned testis with ovary in close contact. i In the testis, the growth and differentiation were not different from those of the control group without the ovary. However, the growth and differentiation of the ovary which developed with the testis in close contact was inhibited and depressed to one side probably due to a more rapid growth and differentiation of the testis compared with the ovary as well as to the inhibition of the growth and differentiation of the ovary. In certain instance, the sex cell cord of the ovary developed into a tubular structure which contained degenerating oocytes. In this group the definite effect or an inhibitory action of the testis on the ovary was easily demonstrated by the phenomena of recessive growth and inhibited differentiation of the ovary transplanted with the testis in mutual contact. B. Transplanted testis with multiple ovaries in mutual contact : i) Transplanted testis with 4 to 9 ovaries in close contact : In these 6 hosts the growth and development of the testis was not different from those of the tran tcA control testis without ovary. However, the multiple ovarian grafts grown in close contact with transplanted testis were suppressed in growth and differentiation. These showed degenerating ic-1 ..and the appearances of seminiferous-like tubules in the ovarian medulla and rete ovarii. By these observations, it was evident that the testicular graft not suppressed by multiple ovarian grafts grown in close contact but the latter were depressed by the former. ii) Transplanted testis with 10 to 14 ovaries in close contact : In these 13 hosts, the growth and development of the transplanted testis, grown in multiple ovarian grafts in mutual contact, was somewhat inhibited and most of the seminiferous tubules showed a de-generation characterized by a single layer of spermatogonia-like cells, separation and scattering of the cells, and degenerating spermatogonia-Iike cells. However, the multiple ovarian grafts showed some abortive ovarian structures as the experimental group with transplanted testis and ovary in close contact. These results indicated that the testicular graft was moderately suppressed by multiple ovarian grafts(more than 11 ovaries). Summary and Conclusion The author stuaied the "corticomedullary inductor" of sex dfferentiation presented by Witschi(1934) in respect to the effect of the inductor substance and the possibility of the substance acting as an inhibitor to each other at the mammalian level by the use of heterosexual grafts of the fetal gonads from albino rats in very close proximity to each other. The heterosexual grafts of the 16 day old fetal gonads were performed by the method of Macintyre (1956). The hosts were castrated at least 3 weeks prior to their use and the grafts were allowed to grow in the host's subcapsular renal site. The ovarian explant, grown with testis in close contact. was inhibited and depressed to one side. This was probably due to a more rapid growth and differentiation of the testis as compared with the ovary as well as to a predominant testicular effect upon the nearby ovary by the activity of the diffused inductor substance originating from the testis. The transplanted testis with 4 to 9 ovaries in close contact was not different from those of the transplanted testis without the ovary and was not effected by such numbers of fetal ovaries, probably due to a recessive ovarian effect of the diffused inductor substance originating from the multiple ovaries. The transplanted testis with more than 10 ovaries in mutual contact was somewhat inhibited in growth and development. It showed an abortive growth pattern and a degenerating picture of seminiferous tubules associated with a single layer of spermatogonia-like cells, separation of the sperma togonia-like cell from each other, and scattering of necrotic cells in the tubule. The author presumed a predominant effect of the multiple(more than 10 ovaries) ovarian graft upon the testis to be due to the activity of the diffused inductor substance originating from the multiple ovaries. By these observations the author concluded that the fetal testis suppessed the growth and differentiation of the fetal ovary and vice versa, and proved the existence and biological activity of the "corticomedullary inductor" as indirectly presented by Witschi(1934).

蛔蟲과 蟲垂炎

姜重遠 中央醫學社 1972 中央醫學 Vol.22 No.3

퇴행성 슬관절염과 비만과의 상관성에 관한 임상 연구

강중원,류성룡,서병관,조미란,조여원,우현수,이상훈,이재동,최도영,김건식,이두익,이윤호 대한침구의학회 2005 대한침구의학회지 Vol.22 No.6

蜂針療法에 對한 考察 -月刊 ≪養蜂界≫의 ‘蜂針療法에 對한 硏究’를 中心으로-

강중원,박동석,이상훈,이재동 대한침구의학회 2009 대한침구의학회지 Vol.26 No.1

Objectives : To survey concept, meaning, and problems of beekeeper’s bee sting therapy by reviewing and summarizing outline, indications, and clinical cases of ‘Research on Bee Sting Therapy’ described in Monthly Yangbonggye. Methods : As a narrative review, literature researches were carried out based on ‘Research on Bee Sting Therapy’ in Monthly Yangbonggye in the aspects of outline, indications, and clinical cases. In the concrete, outline was just summarized and described, and indications were categorized by recent version of international statistical classification of diseases and related health problems (ICD) of WHO (World health organization), and clinical cases were collected and summarized from the viewpoint of acupoints and methods of therapy. Results : 1. Bee sting therapy is to inject venom into skin by stimulating affected lesions or acupoints on meridian with sting of bee alive for therapeutic purposes. It can be divided into two classes (direct stimulation (直針法) and indirect stimulation (拔針法)) by the differences of methods, and is different from bee venom acupuncture therapy in the aspects of the way of extraction and injection. 2. In this material, bee sting therapy has 83 indications classified into 17 of 22 chapters of ICD. Among clinical cases, cases on neoplasm, goitre, lump, and haemorrhoids by direct stimulation were especially outstanding. 3. The therapeutic acupoints selected in bee sting therapy are mainly Ashi points (阿是穴), and partly acupoints on meridian (經穴), Extra points (經外奇穴), and New points (新穴) with careful consideration of patients’ condition. Conclusions : Although bee sting therapy has more or less controversial points of diagnosis, treatment, and management of side effects, it is thought that the accumulated and inherited experiences from old times can be used as meaningful material by further experimental and clinical researches.

五苓散加減方이 3T3-L1 adipocyte의 leptin 및 leptin receptor 함량과 differentiation에 미치는 영향

강중원(Jung-Won Kang),최도영(Do-Young Choi),박동석(Dong-Suk Park),이재동(Jae-Dong Lee) 대한한의학회 2005 대한한의학회지 Vol.26 No.2

한약물을 이용한 혈관신생 촉진에 대한 최근의 연구동향

이송실,강중원,백용현,최도영,박동석,김덕윤,김강일,박상도,양하루,지미영,이제동,Lee, Song-shil,Kang, Jung-won,Back, Yong-hyeon,Choi, Do-young,Park, Dong-seok,Kim, Deog-yoon,Kim, Kang-il,Park, Sang-do,Yang, Ha-ru,Ji, Mi-young,Lee, Jae-do 대한침구의학회 2004 대한침구의학회지 Vol.21 No.3

Background : Angiogenesis is the proliferation of a network of blood vessels emanating from pre-existing vessels, supplying nutrients and oxygen and removing waste products. Angiogenesis occurs in a variety of normal physiologic and pathologic conditions and is regulated by a balance of stimulatory and inhibitory angiogenic factors. Excessive angiogenesis should be suppressed. However, if blood supply is insufficient, it should be encouraged. Hyul-Mek(血脈) or Hyul-Rark(血絡), known as blood vessels in western medicine, is deeply related to Chung-Ki-Hyul(精 氣 血). The goal of this study is to review the effects of herbal medicines on angiogenesis that is involved in wound healing and enhancement of blood supply. Methods : We conducted a systematic and comprehensive literature search for the identification, retrieval, and bibliographic management of independent studies to locate information on the topic. A computerized search of the published literature of Korea(KISS, RISS), China(CNKI), Japan(Kampo medicine, etc), and western countries(MEDLINE) was performed, and further supplemented with manual searches of print sources(1999 to 2003). Results : The herbal medicines with angiogenic activity were mainly found among herbs that carry replenish Shin-Cheng(補腎益精), foster Eum and improve the circulation of blood(養陰活血), or warm and circulate Kyung-Rark(溫經通絡). In particular, herbs with improve the circulation of blood and clear blood(活血化瘀) activity contain a significant amount of tannin, saponin, and pyrazine. Conclusion : Replenish Ki-Hyul(補氣血) and circulate Kyung-Rark(通經絡) could contribute to the induction of angiogenesis because various growth factors and proliferation, differentiation, and migration of vascular endothelial cells are involved in angiogenic activity.

요통에 대한 침치료 무작위대조군임상연구(RCT)의 FEAS 분석을 통한 계통적 분석 연구

남동우,강중원,김은정,김현욱,송호섭,김선웅,김갑성,이건목,최도영,이재동 대한침구의학회 2009 대한침구의학회지 Vol.26 No.3

Objectives : To review RCTs on acupuncture treatment for low back pain in order to establish a standard acupuncture treatment model in treating low back pain. Methods : RCT articles on traditional acupuncture treatment for low back pain were searched through online database. Study quality was assessed using the FEAS. Results : Ten out of the one hundred six articles searched were reviewed. Among the ten articles reviewed, six articles compared acupuncture treatment with no treatment or non-penetrating sham acupuncture. All six articles concluded significantly positive effect of acupuncture compared to the control. Conclusions : The ideal acupuncture treatment model for low back pain was obtained as follows. A sterile disposable stainless steel(0.30mm×40mm) should be inserted to more than six acupuncture points on the BL, GV and GB meridians such as BL23, BL25, BL40, BL60, GV4 and GB30. Sparrow pecking method to obtain ‘de-qi’ is recommended and repeated stimulation during the 20 minute retention time is necessary. Ideal treatment frequency would be more than one a week for about 7 weeks.

당뇨를 동반한 편측 무정위 운동(Hemichorea-Hemiballism) 환자에 대한 사암침법 간정격 치험 1례

박상민,강중원,김동훈,김종덕,인창식,우현수,서동민,이상훈,강성길,이재동,Park, Sang-min,Kang, Jung-won,Kim, Dong-hoon,Kim, Jong-deog,Yin, Chang-shik,Woo, Hyun-su,Seo, Dong-min,Lee, Sang-hoon,Kang, Sung-keel,Lee, Jae-dong 대한침구의학회 2003 대한침구의학회지 Vol.20 No.4

Objective : Hemichorea-Hemiballism is a violent, involuntary movement restricted to one side of the body. It is usually associated with stroke, and infrequently associated with infections, drug usage, metabolic derangement, and hyperglycemia. In this study, we performed to evlauate the effects of Saamchimbeop Ganjeonggyeok on the the 1 case of Hemichorea-Hemiballism with diabetes mellitus. Methods : We performed Saamchimbeop Ganjeongyeok which consists of KI10(陰谷), LR8(曲泉), LU8(經渠), LR4(中封). The effect of Saamchimbeop was assessed by comparing the counts of the movements of ankle and metatarsal joint for 1 minutes before and after acupuncture therapy. Results : The hemiballismic movements was reduced after acupuncture therapy. Conclusions : The Saamchimbeop was effective on the patient of Hemichorea-Hemiballism with diabetes mellitus. And Further studies with more population are necessary.

Meridian Massage Therapy for Treating Constipation in Patients with Stroke: a Systematic Review

이은남,강중원,이명수 대한침구의학회 2010 대한침구의학회지 Vol.27 No.3

목적 : 이 연구의 목적은 중풍 환자의 변비에 대한 증상완화요법으로서의 경락 마사지에 대해 그 임상적인 근거를 평가하기 위함이다. 방법 : 본 연구에서는 언어적인 제한 없이 12가지의 데이터베이스에서 개시부터 2010년 4월까지의 문헌을 검색했다. 변비가 있는 중풍 환자를 경락 마사지로 치료한 모든 형태의 임상 연구를 대상으로 하여, 플라시보 대조군 연구나 약물요법 또는 무처치 대조군 연구의 경우를 본 연구에 포함하였으며, 증례 보고나 사례군 연구는 제외하였다. 모든 임상 연구의 방법론적인 질은 Cochrane의 risk of bias analysis를 이용하여 평가하였다. 결과 : 전체적으로 세 편의 비무작위 배정 대조군 연구와 한 편의 비대조군 관찰 연구가 포함되었다. 모든 연구들은 높은 수준의 risk of bias를 보였다. 세 편의 비무작위 배정 대조군 연구들은 경락 마사지의 효과를 무처치군과 비교하였는데, 중풍 환자의 변비에 대해 경락 마사지의 긍정적인 효과를 나타내었으며, 한 편의 비대조군 관찰 연구 역시 긍정적인 결과를 보였다. 하지만 모든 연구들은 bias에 노출되어 있었다. 결론 : 경락 마사지가 중풍 환자의 변비에 대해 효과적인 치료법이라는 것을 보여주기에는 현재의 근거가 부족하며, 모든 연구들은 높은 수준의 risk of bias를 가지고 있기 때문에 더욱더 엄격한 연구가 요구된다.

당뇨를 동반한 편측 무정위 운동(Hemichorea-Hemiballism) 환자에 대한 사암침법 간정격 치험 1례

박상민,강중원,김동훈,김종덕,인창식,우현수,서동민,이상훈,강성길,이재동 대한침구의학회 2003 대한침구의학회지 Vol.20 No.1