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).

Development of Simultaneous Analytical Method for ImidazolinoneHerbicides from Livestock using LC-MSMS

Hyo-Min Heo,Hyeong-WookJo,Kyu-Won Hwang,Jung-Hun Sun,Joon-Kwan Moon 한국농약과학회 2021 한국농약과학회 학술발표대회 논문집 Vol.2021 No.11

Simultaneous analytical method using LC/MSMS for imidazolinone herbicides from livestock (egg, milk, beef, pork and chicken) for monitoring was developed with QuEChERS preparation. Sample weighing (5g) in a 50mL conical tube, added 0.1 M potassium phosphate dibasic solution (5mL) was shaken for 10min. After 0.5mL 6 NHCl, 10mL acetonitrile were added, it was shaken for 10min. And QuEChERS extraction salt (Original method, 4g MgSO₄, 1g NaCl) were added to the sample in the 50 mL conical tube. The mixture was strongly shaken for 1 min and was centrifuged at 3,000g for 10 min. The acetonitrile layer was purification with dSPE (150mg MgSO₄, 25mg C18) and was centrifuged at 13,000g for 5min. The supernatant was filtered with a membrane filters (pore size: 0.2um) before analysis. ME (%, Matrix effect) for almost analytes range were -6.56 to 5.70%. MLOD (Method LOD) and MLOQ (Method LOQ) was calculated by S/N ratio. MLOQs were 0.01 mg/kg. The linear correlation coefficients (r2) were > 0.99 within the range of 2 ~ 100 ug/kg for all of the 3 imidazolinone herbicides. The percentages (of imidazolinone herbicides) recovers were in the range of 84.1 ~ 110.6% (0.01mg/kg level), 90.8 ~ 97.1% (0.1mg/kg level) and 94.4 ~ 102.1% (0.5mg/kg level) within the validation criteria (recover; 70-120% with RSD < 20%)

자바리, Epinephelus bruneus의 난 발생과 부화에 미치는 수온의 영향

양문호,최영웅,정민민,구학동,오봉세,문태석,이창훈,김경민,한석중,Yang, Moon-Ho,Choi, Young-Ung,Jung, Min-Min,Ku, Hag-Dong,Oh, Bong-Sae,Moon, Tae-Seok,Lee, Chang-Hoon,Kim, Kyong-Min,Han, Seock-Jung 한국발생생물학회 2007 발생과 생식 Vol.11 No.2

This study examined temperature effect in egg development and hatching of longtooth grouper, Epinephelus bruneus. Fertilized embryos was not growth after morula stage at $15^{\circ}C$, at 18, 21, 24 and $27^{\circ}C$, the required time from fertilized embryos to hatching were 70 h. 30 min., 44 h. 10 min., 29 h. 10 min. and 24 h. 30 min., respectively. The hatching rates at $24^{\circ}C$ were higher than the other conditions and the hatching was not occurred at $15^{\circ}C$. These results suggest that the water temperature range of egg development and hatching was $18{\sim}27^{\circ}C$. 이 연구는 실내 사육수조에서 자연산란 후 수정된 난을 대상으로 수온에 따른 난 발생속도와 부화율을 조사하였다. 부화에 이르기까지 각 수온조건에서 소요된 시간은 $15^{\circ}C$에서 상실기 이후 발생이 진행되지 않았고, 18, 21, 24, $27^{\circ}C$에서 각각 70시간 30분, 44시간 10분, 29시간 10분 그리고 24시간 30분이 소요되었다. 부화율은 $15^{\circ}C$에서 0%였고, 18, 21, 24 그리고 $27^{\circ}C$에서 각각 $8.3{\pm}1.2%$, $18.0{\pm}6.2%$, $24.0{\pm}4.0%$ 그리고 $17.0{\pm}7.2%$로 뚜렷한 차이 없이 $24^{\circ}C$에서 다소 높았고 21와 $27^{\circ}C$에서 비슷한 경향이었으며 $18^{\circ}C$에서 가장 낮게 나타났다. 이러한 결과에서 자바리의 난발생 수온범위는 $18{\sim}27^{\circ}C$로 제안된다.

Differential Effects of Pioglitazone in the Hippocampal CA1 Region Following Transient Forebrain Ischemia in Low- and High-Fat Diet-Fed Gerbils.

Moon, Seung Myung,Choi, Goang-Min,Yoo, Dae Young,Jung, Hyo Young,Yim, Hee Sun,Kim, Dae Won,Hwang, In Koo,Cho, Byung Moon,Chang, In Bok,Cho, Sung-Min,Won, Moo-Ho Kluwer Academic/Plenum Publishers 2015 Neurochem Res Vol.40 No.5

<P>In the present study, we investigated the effects of pioglitazone (PGZ) in the hippocampal CA1 region of low- or high-fat diet (LFD or HFD) fed gerbils after transient forebrain ischemia. After 8 weeks of LFD or HFD feeding, PGZ (30 mg/kg) was intraperitoneally administered to the gerbils, following which ischemia was induced by occlusion of the bilateral common carotid arteries for 5 min. Administration of PGZ significantly reduced the ischemia-induced hyperactivity 1 day after ischemia/reperfusion in both LFD- and HFD-fed gerbils. At 4 days after ischemia/reperfusion, the neurons were significantly reduced and microglial activation was observed in the hippocampal CA1 region in LFD- and HFD-fed gerbils. The microglial activation was more prominent in the HFD-fed gerbils compared to the LFD-fed gerbils. Administration of PGZ ameliorated ischemia-induced neuronal death and microglial activation in the hippocampal CA1 region 4 days after ischemia/reperfusion in the LFD-fed gerbils, but not in the HFD-gerbils. At 6 h after ischemia/reperfusion, tumor necrosis factor-α (TNF-α) and interlukin-1β (IL-1β) levels were significantly increased in the hippocampal homogenates of LFD-fed group compared to control group, and HFD feeding further increased TNF-α and IL-1β levels. PGZ treatment significantly ameliorated the increase of TNF-α and IL-1β levels in LFD-fed gerbils, not in the HFD-fed gerbils. At 12 h after ischemia/reperfusion, superoxide dismutase (SOD) and malondialdehyde (MDA) levels in hippocampal homogenates were significantly increased in the LFD-fed group compared to the control group, and HFD feeding significantly showed relatively reduction in SOD activity and increase in MDA level. PGZ administration significantly reduced the increase in MDA levels 12 h after ischemia/reperfusion in the LFD-fed gerbils, but not in the HFD-fed gerbils. These results suggest that PGZ ameliorates the neuronal damage induced by ischemia by maintaining the TNF-α, IL-1β, SOD and MDA levels in LFD-fed gerbils. In addition, HFD feeding affects the modulation of these parameters in the hippocampus after transient forebrain ischemia.</P>

난치성 백반증에 대한 흡입물집을 이용한 비배양 표피세포이식술 20례

배정민 ( Jung Min Bae ),정한미 ( Han Mi Jung ),이한나 ( Han Na Lee ),이로우 ( Ro Woo Lee ),은성혜 ( Sung Hye Eun ),권혁선 ( Hyuck Sun Kwon ),이지혜 ( Ji Hae Lee ),김경문 ( Gyong Moon Kim ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.7

Background: As nonsurgical interventions for vitiligo are not always successful, various surgical modalities have been used in patients with refractory vitiligo. Of these, non-cultured epidermal suspension transplantation (NCES) was recently introduced to treat large recipient sites using cells from small donor tissue. Objective: We assessed the effectiveness and safety of NCES as a surgical treatment for patients with refractory vitiligo. Methods: We retrospectively reviewed 20 cases in 17 patients (11 females; median age 25 years) who underwent NCES from July 2015 through March 2018. Suction blisters (20 mm in diameter) were collected from the patient’s inner thigh at a donor-to-recipient area ratio of 1:5. After the addition of 5 mL recombinant trypsin solution to the suction blisters, followed by incubation at 37°C for 60 min, epidermal cells were manually scraped off the blister surface, and epidermal cell suspension was obtained by centrifugation at 1,500 RPM for 5 min. The suspension was applied to the vitiligo regions after epidermal ablation of those regions. Phototherapy resumed 1 month later. Treatment success was defined as ≥75% repigmentation of the surgical site, and all adverse events were noted. Results: Overall, 85.0% of cases (17/20) exhibited treatment success. Adverse events included hyperpigmentation (20%) and surgical site infection (5%), but the treatment was tolerable in all cases. Conclusion: NCES is a reliable surgical option for patients with vitiligo refractory to nonsurgical treatment. Large areas of vitiligo can be treated by NCES, and use of this technique should be encouraged in Korea. (Korean J Dermatol 2018;56(7):426∼432)

물리ㆍ화학적 처리에 의한 멸균 초콜릿 우유 오염균의 생육억제 효과

최문경(Moon-Kyoung Choi),윤소영(So-Young Yoon),이소영(So-Young Lee),김꽃봉우리(Koth-Bong-Woo-Ri Kim),이청조(Chung-Jo Lee),정지연(Ji-Yeon Jung),곽지희(Ji-Hee Kwak),김민지(Min-Ji Kim),김동현(Dong-Hyun Kim),선우찬(Chan Sunwoo),이주운(Ju-W 한국식품영양과학회 2011 한국식품영양과학회지 Vol.40 No.8

멸균 초콜릿 우유로부터 분리한 내열성 균주에 대해 열, pH, 전해수, 오존처리, microwave 및 감마선 처리를 하여 균주의 사멸효과에 대해 알아보았다. 균주의 지방산 분석과 API kit를 통하여 균주를 동정한 결과, Bacillus lentus로 동정되었으며, 잠정적으로 Bacillus lentus M1으로 명명하였다. B. lentus M1에 110℃, 15분간 열처리하였을 경우 생육이 억제되었으며, pH 처리 시 pH 5 이하, 10 이상에서 생육이 억제된 것으로 나타났다. B. lentus M1에 대한 전해수의 항균활성을 paper disc법으로 측정한 결과, 높은 생육억제를 보였으며, 오존 처리의 경우 초기 균수가 10² CFU가량의 균을 10분 동안, 10³ CFU가량의 균을 30분 동안 처리 시 균의 생육이 억제되는 것으로 나타났다. Microwave를 1분간 처리 시 B. lentus M1이 모두 사멸한 것으로 나타났다. 감마선 조사의 경우, 1 kGy 조사 시 생균수가 1.61×10³ CFU로 초기 균수에 비해 4 log cycle 가량 균수가 감소하였으며 7 kGy에서 완전히 사멸하였다. 이상의 결과를 통해 열, pH, 전해수, 오존 처리 및 방사선 처리 방법이 멸균 초콜릿 우유의 생존 오염균인 B. lentus M1을 효과적으로 사멸시킬 수 있을 것으로 사료된다. This study was conducted to investigate the cause of microbiological contaminants in aseptic chocolate milk and evaluate the effect of a physicochemical treatment on the growth inhibition of isolated bacterial strains. The bacterium isolated from aseptic chocolate milk was identified as Bacillus lentus and was named B. lentus M1. In the heat and pH treatment, the growth of B. lentus was inhibited at 110℃ for >15 min and at pH’s <5 and >10. An electrolyzed water treatment against B. lentus M1, revealed 5 ㎜ growth past the inhibition zone. The effect of ozone gas on B. lentus M1 growth was evaluated using viable cell counts. When the initial number of B. lentus M1 was 10² and 10³ CFU, the bacteria were completely suppressed by ozone gas treatment for 10 and 30 min, respectively. In a microwave treatment, B. lentus M1 was sterilized following microwave treatment for 1 min. As the result of γ-irradiation against B. lentus M1, numbers decreased as the γ-irradiation dosage increased. These results show the growth inhibition effects against contaminants in aseptic chocolate milk using physicochemical treatments.

Biliary Self-Expandable Metal Stent Could Be Recommended as a First Treatment Modality for Immediate Refractory Post-Endoscopic Retrograde Cholangiopancreatography Bleeding

Sun Young Moon,Jun Heo,Min Kyu Jung,Chang Min Cho 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1

Background/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaininghemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. Wecompared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding. Methods: Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediateERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding,change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis. Results: A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusionswere needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued byangioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9–491) min. Conclusions: Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMSinsertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has arole as rescue therapy when SEMS does not work effectively.

크론병에 대한 CoPPLX의 방어효과에 대한 연구

이호학,김유림,문창기,이재일,양병윤,김종수,이정민,정재혁,안석진,박상준,김윤권,김소연,김영중,조민구,최영자,장성조 圓光大學校 醫科學硏究所 2005 圓光醫科學 Vol.20 No.1

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.

괴사성 장염 환아의 금식기간 결정을 위한 Iohexol의 유용성 : Iohexol의 위장과 투여 후 채취한 소변을 전산화단층촬영법을 이용

정유진,홍성완,류민현,정철주,문경래 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Background: Necrotizing enterocolitis is the most common gastrointestinal emergency in the neonates and its course is often fulminating with progressive lethargy. The purpose of this study is to determine the period of NP0(non per os) treatment in the patients with neonatal necrotizing enterocolitis. Matenal and methods: For determining the normal range of CT(Computerized tomography) attenuation coefficients of urine from normal neonates, 60 normal neonates participated in this study. And urine specimens from 16 patients with stage IIB necrotizing enerocolitis were obtained 8-12 hours after the instillation of iohexol enterally. The attenuation coefficients of each urine specimen were determined with CT. Periodic examinations were performed at an interval of two days. As soon as the values of attenuation coefficients reached the normal range, we discontinued NPO treatment. Results: The mean period of NPO treatment of 16 patients with stage IIB necrotizing enterocolitis was 11.1 days. The NPO period of 6 patients were 8 days, two were 10 days, four were 12 days, one was 14 days and three were 16 days. Conclusion: By means of this study, we were able to determine the period of NPO treatment on a case by case basis. The authors think that CT examination of the obtained urine after the instillation of iohexol may be a good method to determine the period of NPO treatment.