쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화

정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).

Pulse Oximetry and Skin Temperature Gradient as Diagnostic Tools of Successful Caudal Block

Duk Kyung Kim,Kyoung Min Lee,Won Kyoung Kwon,Chung Sik Oh,Sung Whan Jang 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6

Background: Though caudal block is a relative simple technique, it has not been widely used in adults because of a high failure rate. We assumed that any tests to quantify the changes of sympathetic tone in the affected areas would be excellent indicators of successful block. We tested the usefulness of two candidates (pulse oximetry plethysmographic waveform amplitude measured at 5th toe and calf minus 5th toe skin temperature gradient) as indicators of successful caudal block. Methods: In 45 adult patients undergoing anal surgery with caudal block, these two variables were simultaneously measured at 2-min intervals for 20 min. A two-fold increase in the plethysmographic waveform amplitude from baseline and skin temperature gradient of 0°C were predefined as test criteria of successful block. Results: While the sensitivity, specificity, positive predictive value, and negative predictive value of the skin temperature gradient test were 45.9%, 100%, 100%, and 9.1%, those of the plethysmographic waveform test were 86.5%, 100%, 100%, and 28.6%. The plethysmographic waveform test showed a significantly higher discriminative capacity than the skin temperature gradient test (94.9% vs. 48.7%, P < 0.05) Conclusions: Unlike the skin temperature gradient test, the plethysmographic waveform test showed a considerably high validity in detecting successful block. Considering its simple and real time monitoring potentials together with a high failure rate of caudal block in adults, we cautiously recommend it as a supplemental diagnostic tool to predict successful block, especially when verbal communication with patient is difficult. (Korean J Anesthesiol 2007; 53: S 19∼25)

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

정상체중군과 과다체중군 산업장 중간관리자의 건강증진 행위에 관한 비교연구

김정남(Kim Chung Nam),박경민(Park Kyung Min),류미경(Ryu Mi Kyung),장희정(Jang Hee Jung) 계명대학교 간호과학연구소 2001 계명간호과학 Vol.5 No.1

The purpose of this study was to identify and compare Health Promoting Behavior and its affecting factors between Normal and Over weight industrial middle manager. The subjects were 163 workers employed in factories in Taegu and Kyung-book were convenient sampling data the period for May 22th-26th, 2000 through self report methodby structured questionnaires. Collected data were analyzed by t, x2, Kendal tau, Pearson correlation, Stepwise Multiple Regression. The results of this study were as follows. 1. There were a significant difference in shift pattern(x2=7.89, P=0.005) and career. (x2=12.99, P=0.005) between normal weight and overweight group. 2. The average score of performance in health promoting behavior among overweight group(2.55) was higher than that of normal weight group(2.46), but not significant. 3. The average score of health status in overweight group(3.07) was lower than that of normal weight group(3.21), but not significant. 4. The average score of self-efficacy in overweight group(3.63) was significant lower than that of normal group(3.71). 5. The average score of the perceived barrier of in overweight group(2.44) was significant higher than that of normal group(2.24). 6. Health promoting behaviors in overweight group was significantly correlated with health status(r=.384, P<.05), health Concept(r= 458, P<.01) self-efficacy ( r=352, P< 01), perceived benefit(r=.386, P< .05), perceived barrier(r= -245, P< .05) Health promoting behavior in normal weight group was significantly correlated with health concept( r= .307, P< .050 and perceived benefit. 7. In consideration of variables that have an influence on Health promoting behavior among Normal weight group, health concept and perceived benefit account for 28.8% of health promoting behavior. In overweight group. The perceived benefit account for 13.7% of health promoting behavior. The suggestions are as follows on the basis of the results of this study. 1. It is required to develop health promoting program to improve health promoting behavior. In addition, there are special demands on developing nursing strategies for health promoting behavior of overweight industrial supervisors. 2. It is necessary to support exercise facility in occupational field for improving supervisor's health promoting behavior.

남자 고등학생의 흡연행위군별 성격특성

류미경,박경민,김정남,장은진,이충원,김대현,정철호 대한보건협회 2000 대한보건연구 Vol.26 No.2

The purpose of this study is to investigate the differences of personality characteristics using Minnesota Multiphasic Personality Inventory(MMPI) by current-smokers, ex-smokers and non-smokers among male high school students. The subjects for this study were 448 first and second year male students at general and vocational high school in Taegu and Kyung-Buk Province. Data was collected from August 25 to September 15, 1999. The instrument used in this study was the Validity Scale and the Clinical Scale, the Ego Strength Scale and the Personality Disorder Scale of the MMPI. The data was analysed by using the SPSS Program which included frequency, percentage, x^2-test, ANOVA, scheffe test and stepwise discriminant analysis. The results obtained from this study were as follows. (1) There were significant differences by smoking behavior groups in parents who smoke and who did not smoke(p=.044), intimate-friends who smoke and not(p=.000), academic record(p=.000), satisfaction with school life(p=.020), effect of smoking on health(p=.000), drinking experience(p=.000), drug-use experience(p=.007) and experience into No minors district(p=.000). (2) T-scores of subjects in this study were in the range of 40-60. Psychopathic Deviate Scale(Pd), Paranoid Scale(Pa), Psychasthenia Scale(Pt), Schizophrenia Scale(Sc), Histrionic Personality Disorder Scale(HST) and Anti-social Personality Disorder Scale(ANT) showed higher T-scores than other Clinical and Personality Disorder Scale. (3) The results of post-hoc in Validity Scale and Clinical Scale are as follows: T-scores of current-smokers were higher than that of ex-smokers and non-smokers in Hysteria Scale(Hy), Psychopathic Deviate Scale(Pd), Paranoid Scale(Pa), Psychasthenia Scale(Pt), Schizophrenia Scale(Sc) and Hypomania Scale(Ma); T-scores of non-smokers were higher than that of ex-smokers in Depression Scale(D), and T-scores of non-smokers were higher than that of current-smokers and ex-smokers in Social Introversion Scale(Si). (4) In Ego Strength Scale and Personality Disorder Scale, T-scores of ex-smokers were higher than those of current-smokers. In Histrionic Personality Disorder Scale(HST) and Narcissistic Personality Disorder Scale(NAR), T-scores of current smokers and ex-smokers were higher than those of non-smokers. In Borderline Personality Disorder Scale(BDL), Anti-social Personality Disorder Scale(ANT) and Paranoid Personality Disorder Scale(PAR), T-scores of current-smokers were higher than those of ex-smokers and non-smokers. In Schizotypal Personality Disorder Scale(STY), T-scores of current smokers were higher than that of ex-smokers. In Avoidant Personality Disorder Scale(AVD), T-scores of non-smokers were higher than those of current-smokers and ex-smokers. (5) As a result of stepwise discriminant analysis of the MMPI Scale by smoking behavior, a discrimination rate of the F Scale, Hypomania Scale(Ma), Social Introversion Scale(Si) and Psychopathic Deviate Scale(Pd) out of the Validity Scale and Clinical Scale was 51.1%, and that of Anti-social Personality Disorder Scale(ANT) and Avoidant Personality Disorder Scale(AVD) out of the Personality Disorder Scale was 51.6%, both of the rates were statistically significant. The Above results suggested that smoking by high school students is related with personality characteristics as well as external factors like family, school and their social environment. So school health professionals who are in charge of school health, should operate various smoking prevention or prohibition programs, taking into account personality characteristics. It might have an effect on smoking prevention and the reduction of the smoking rate.

말초신경 손상이 실험적으로 유발된 흰쥐의 척수신경절 및 척수등쪽뿔내 신경세포의형태학적 변화에 관한 연구

이원택,손민균,정경승,이홍석,박경아 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.5

오이 추출물에 존재하는 Superoxide Dismutase의 열안정성

김은애(Eun-Ae Kim),김기남(Gi-Nahm Kim),길지은(Ji-Eun Kil),이민경(Min-Kyung Lee),김석환(Suk-Hwan Kim),서정식(Chung-Sik Suh),박인식(Inshik Park) 한국식품영양과학회 1999 한국식품영양과학회지 Vol.27 No.6

오이속의 조효소액에 존재하는 Superoxide dismutase(SOD)활성의 pH 안정성은 pH 8.0에서 가장 안정하였고 pH5.0~9.0 사이의 범위에서는 비교적 안정하였다. 최적 온도는 25℃였고 열 안정성은 60℃까지는 안정하였다. 100℃에서 5분간 보관하였을 경우에는 12%만이 남아있었다. 오이에 존재하는 SOD 활성이 섭취 후에도 안정한가를 확인하기 위한 실험에서는 위속의 pH와 동일하도록 오이속의 조효소액의 pH를 2.0으로 변형시킨 후 36.7℃에서 3시간 동안 보관 후에 잔존활성이 10%였고, 장내의 환경인 pH 7.0으로 바꾸어 6시간 동안 둔 후 잔존하는 SOD의 활성은 25%로 활성이 증가되었다. 다양한 열처리 후에 잔존하는 오이의 SOD활성은 오이속은 데치기에서(끓는 물에서 2분) 25%, 껍질은 찌는 동안에(3분) 53%, 그리고 속과 껍질로 분리하지 않은 오이는 데치기에서 27%의 활성잔존률을 보였다. 4℃에서는 20일간 보관한 후에 오이속의 조효소액은 81%활성이 있었고, 30℃에서는 17%의 활성이 남아 있었다. 투석한 결과 SOD의 활성은 변화가 없었으므로 오이속에 존재하는 SOD는 적어도 분자량이 12,000 이상의 물질로 추정된다. The superoxide dismutase(SOD) in peeled pericarp of cucumber was most stable at pH 8.0 and relatively stabe between pH 5.0 and 9.0. The enzyme was stable up to 60℃ and retained 12% by heat treatment at 100℃ for 5 min. At pH 2.0, the peeled pericarp enzyme activity was decreased to 10% by incubation for 3 hrs. However, the enzyme activity was increased above 25% after incubating the enzyme at pH 7.0 for 6 hrs. Retention of SOD activity in cucumber by various heating methods was also measured. The residual SOD activities of peeled pericarp and whole cucumber was estimated to be 25% and 27% after blanching (2 min), respectively. The skin enzyme retained 53% of its activity after steaming (3 min). When the peeled peri carp enzyme was incubated at 4℃ for 20 days, the enzyme activity remained about 81%. However, when the enzyme incubated at 30℃ for 20 days, the peeled pericarp enzyme activity decreased to 17% of its original activity. The enzyme activity of peeled pericarp cucumber was not changed after exhaustive dialysis for 3 days, which indicated that the SOD activity in cucumber seems to have molecular weight above 12,000.

개의 췌도분리에서 췌장의 팽창과 콜라겐 분해요소

이상훈,김성주,박정환,김종성,오승훈,한진수,정인경,양태영,김동준,김광원,이문규,민용기,이명식,정재훈,함종렬 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.2

Backgrounds: One of the main problems conditioning the outcome of islet transplantation is the ability to separate a sufficient number of viable islets with preserved function. Islet purification is critically affected by all of the isolation stages. Thus, it is necessary to set up the standard isolation method that islets are separate well from acinar without compromising islet yield and viability. Methods: Twenty three adult mongrel dogs were used for the experiment of total pancreatectomy with islet isolation. The islets were properly isolated by a modified Recordi method. The obtained islets were further purified by centrifugation on discontinuous gradients using cell separation system (Model 2991, Cobe, Lakewood Colo). We evaluated islet number (islet equivalent number, 150 um equivalents/kg of recipient body weight, IEq/kg), purity, cell volume, viabilty, recovery rate, and comparison of outcome according to the isolation conditions. Results: 1) The mean of islet numbers before purification were 13543±9431Eq/kg, digestion times were 13.8±2.6 min., digestion temperature was 37.4±0.2℃, purity was 59.7?.0%, viability was 90.0±2.1%, cell volume was 4.7±1.1 mL, islet number after purification were 4064±361 IEq/kg, and recovery rate was 29±2.9%. 2) Isolated islet numbers were different according to the degree of pancreas distension with collagenase, digestion temperature, and digestion time. 3) The best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase. 4) According to multiple regression adjusted by variable factors, the degree of pancreas distension with collagenase and digestion time were independently associated factors for successful islet isolation. Conclusions: In this study, we concluded that the degree of pancreas distension with collagenase and digestion time were independent factors for successful islet isolation and the best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase.

대퇴골 전자부 골절에서 압박고 나사 고정과 Captured 고나사 고정 및 감마정 고정의 비교

정의섭,최경수,김민기,이종봉 예수병원 1997 예수병원학술지 Vol.18 No.-

肝吸蟲症의 肝癌 誘發 可能性에 對한 發癌物質 3´-methyl-4-dimethylaminoazobenzene의 影響

閔弘基,鄭慶淑 梨花女子大學校 韓國生活科學硏究院 1986 韓國生活科學硏究院 論叢 Vol.37 No.-

原發性 肝癌 특히 膽管癌이 肝吸蟲症을 동반하고 있는 예가 간흡충증이 高率로 만연되고 있는 극동 및 동남아의 여러 지역에서 드물지 않게 발견되어 왔으며 이런 현상은 偶然의 合倂일 것이라고 주장되기도 하였으나 그 동안의 疫學的, 病理組織學的 및 實驗的 觀察로 제시된 결과는 이들 兩者 사이의 밀접한 相關性을 강력하게 시사하고 있다. 간흡충증으로 인하여 惹起되는 담관의 腺腫性 增殖과 담관상피세포의 粘液細胞化生은 動物宿主의 차이에 관계없이 나타나는 특징적인 병리조직학적 공통소견인 동시에 암으로 轉化될 수 있는 前殷階의 변화로 看做되고 있으나 간흡충감염만으로는 실험적으로 암을 유발시키지 못하며 某種의 發癌物質의 介入으로 이루어질 것이라는 의견이 支配的이다. 그러나 발암물질을 사용한 실험적 연구가 우리나라에서는 수행된 바 없었다. 본실험은 간흡충감염으로 유발되는 담관조직의 변화에 관한 根本 性狀을 해명하고 발암물징이 이에 미치는 영향을 규명하려는 노력의 一環으로 진행 되었다. 食品染料로 많이 쓰이고 있는 발암물질이며 axo화합물의 하나인 3‘-MeDAB을 간흡충감염 마우스에 투여함으로써 담관상피세포가 암세포로 轉化되어가는 移行期 所見을 경험할 수 있었으나 간흡충 또는 발암물질 단독투여의 경우에 있어서는 암발생 소견을 발견할 수 없었다. 이러한 결과를 근거로, 간흡충감염은 담관상피세포의 화생을 유발하는 先行的 要因의 役割을 하며 3‘-MeDAB은 화생된 세포를 자극하여 惡性化시키는 促進的 要因으로서 담관암 발생에 있어 相互 協同作用을 나타내는 것으로 고려되었다. The main objective of the present study is to observe the effect of a carcinogen, 3'-methyl-4-dimethylaminoazobenzene(3'-MeDAB), on bile duct epithelial cells in Clonorchis-infected mice. The animals used were 90 male BALB/c albino mice, and divided into 3 groups: group I, treated with 0.03% 3'-MeDAB(Kwasei Ind. Co., Seoul, Korea) alone for 12 weeks; group II, given approximately 200 Clonorchis metacercriae alone, and group III, given 200 metacercariae at the end of the 12 week treatment with 0.03% 3'-MeDAB. From the 16th week when the autopsies have commenced, 3 mice were removed at random from each group and examined grossly and histopathologically at 4 week interval up to the 52nd week from the beginning of the experiment. For histopathological examination, liver tissues were stained with hematoxylin-eosin. The results obtained are summarized as follows; 1. The gross findings and histopathological changes observed were remarkable in groups II and III, particularly in group III. Mild to severe mucinous cell metaplasia and goblet cell metaplasia were demonstrable in epithelial cells of the adenomatous hyperplastic glands and the biliary ductules peripheral to the second-order bile ducts. Whereas, in group I there were no significant tissue changes except the lower degrees of bile duct proliferation. cholangiofibrosis and inflammatory cell infiltration which were transient. 2. Mice in groups I and II did not develop tumors at any stage. On the other hand, there were strong histopathological evidences of neoplastic transformation of epithelial cells of the biliary ductules and hyperplastic glandular tissues in 2 out of 30 mice in Group III throughout the observation period. The cells were identified as those of transitional stages in the development of cholangiocarcinoma. With the overall findings it was clear that a carcinogen, 3'-MeDAB, played a potentiating role as a promotor for the turnover of metaplastic biliary epithelial cells induced due to Clonorchis infection into neoplastic cells in mice