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저구연산뇨증에 의한 신결석과 신석회화증을 동반한 원위세관 산증 1 예
채은영(Eun Young Chae),장윤식(Yoon Sik Chang),신동일(Dong Il Shin),태현정(Hyun Jung Tae),박용범(Yong Bum Park),박선희(Sun Hee Park) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.3
Renal stone and nephrocalcinosis are common clinical manifestations of type 1 renal tubular acidosis. In normal state, citrate plays the most critical role in suppressing stone formation as it combines with calcium. In type 1 RTA, increased reabsorption of citrate in proximal tubule results in low citrate excretion, which precipitates renal stone formation. We report a case of type 1 RTA accompanying renal stone and nephrocalcinosis caused by hypocitraturia. A 16-year-old male patient who had renal stone and nephrocalcinosis showed hypocitraturia. Incomplete type 1 RTA was proved as the cause of hypocitraturia by bicarbonate and ammonium loading test in the patient.
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노화가 인체 중간엽 줄기세포로부터 조골세포로의 증식 및 분화에 미치는 영향
백기현,태현정,오기원,이원영,조정기,권순용,강무일,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3
연구배경: 일반적으로 골다공증과 연관된 위험인자로는 연령, 폐경, 약물, 불충분한 칼슘섭취, 만성질환 및 운동부족 등이 있는데, 특히 노화가 진행할수록 골밀도가 감소하는 것은 잘 알려져 있다. 노화와 관련하여 진행되는 골소실은 조골세포 및 전구조골세포의 기능적 결핍에 의한 골형성의 감소가 주요한 요인으로 여겨지고 있다. 그 동안 연령이 조골모 세포의 양과 조골모 세포로부터 성숙조골세포로의 분화 및 증식에 미치는 영향에 대한 일부 보고들이 있었으나 아직 일치된 견해는 없는 형편이다. 방법: 다양한 연령의 사람으로부터 골수를 채취, 중간엽 줄기세포가 포함된 단핵세포를 분리한 후 조골세포로 분화하기 좋은 조건하에서 배양하였다. 대상군은다시 젊은군과 노령군으로 구분하여 다양한 변수를 비교 분석하였다. 일차배양에서는 CFU-F를 계수하여 골수내 중간엽 줄기세포의 수를 추산하였고, 칼슘측정을 통하여 기질의 무기화 정도를 비교하였다. 계대배양후 이차배양에서는 시기별로 알카리성 포스파타제 활성도를 측정하고 오스테오칼신 mRNA의 발현을 관찰하여 젊은군과 노령군 사이의 증식능 차이를 비교하였다. 또한 이차배양 시기별로 MTT 측정을 하여 양군간에 증식능 차이가 있는지 알아보았다. 결과: 1. 일차배양 15일째에 평균 CFU-F의 수는 젊은군에서 유의하게 많았다(젊은군 148.3±28.9, 노령군 54.3±9.1, p=0.02). CFU-F의 평균면적은 젊은군에서 넓은 경향을 보였으나 통계적으로 유의하지는 않았다. 2. 일차배양 17일 경과 후 양군간에 기질 칼슘 침착정도는 유의한 차이를 보이지 않았다(젊은군 103.6±50.6, 노령군: 114.0±56.5, p=NS). 3. 이차배양 10일째에 젊은군에서 알카리성 포스파타제 활성도가 고령군에 비해 유의하게 높았다(젊은군: 935.5±115.0 U/mg, 노령군: 578.4±115.7U/mg,p.0.05). 고령군에서는 시간 경과에 따른 변화가 미약했으며 전반적으로 알카리성 포스파타제의 활성도가 젊은군에 비해 낮았다. 4. 이차배양도중 오스테오칼신 mRNA의 발현은 배양시기별로 젊은군에 비해 고령군에서 더 낮은 경향을 관찰할 수 있었다. 5. 이차배양 10일과 15일에 젊은군에서 노령군보다세포증식이 유의하게 증가된 양상을 보였다(10앓 젊은군 0.73±0.05, 노령군 0.58±0.04, p=0.05, 15일; 젊은군 0.80±0.05, 노령군 0.70±0.03, p=0.05).결론: 이상의 연구에서 저자들은 노령군에서 젊은군보다 골수 내 중간엽줄기세포의 수가 적고, 노령군에서 유래한 전구조골세포의 성숙조골세포로의 증식 및 분화가 젊은군 보다 감소해 있는 것을 관찰할 수 있었다. Background: Osteoblasts originate from osteoprogenitor cells in bone marrow stroma, termed mesenchymal stem cells (MSCs) or bone marrow stromal cells. Each MSC forms colonies (colony forming units-fibroblasts [CFL-Fs]) when cultured ex vivo. There are some reports about the age-related changes of the number and osteogenic potential of osteoprogenitor cells, but any relationship has not been clearly established in humans. In this study, we counted MSCs using CFU-Fs count and examined the proliferative capacity and differentiation potential of osteoprogenitor cells. Finally, we analyzed how these parameters varied with donor age. Methods: Bone marrow was obtained from the iliac crest of young (n=6, 27.2±8.6 years old) and old (n= 10, 57.4k6.7 years old) healthy donors. Mononuclear cells, including MSCs, were isolated and cultured in osteogenic medium. In primary culture, we compared the colony-forming efficiency of MSCs between the two groups and determined the matrix calcification. When primary culture showed near confluence, the cells were subcultured. Alkaline phosphatase activity, osteocalcin expression by RT-PCR and proliferative potential by MTT assay were examined by the time course of secondary culture. Results: At the 15th day of primary culture, the mean number of CFU-Fs was significantly higher in the younger donors (young: 148.3±28.9, old: 54.3±9.1, p=0.02) and the mean size of CFL-Fs was also larger in the younger donors than the older donors. However, matrix calcification was not different between the two groups (young: 103.6±50.6, old: 114.0±56.5, p=NS). In secondary culture, alkaline phosphatase activities were significantly lower in the older donors. The younger donors showed peak alkaline phosphatase activity at day 10, while the older donors didn't showed a remarkable peak (young: 935.5±115.OU/mg, old: 578.4±115.7U/mg, p<0.05). Total cell number as a proliferative index increased progressively during the secondary culture and a significantly greater cell number was noted in the younger donors. Osteocalcin expression was generally upregulated in the younger donors, but this was not statistically significant. Conclusion: Our study shows that the number of osteoprogenitor cells is decreased during aging and that the proliferative capacity and differentiation potential of osteoprogenitor cells seem to be reduced during aging (J Kor SOC Endocrinol 18:296-305, 2003).
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박선희,최규용,정인식,김성수,이강문,김명철,선희식,이창돈,안창혁,채현석,장정원,방춘상,태현정 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.3
Phytobezoars are the most common type of bezoars composed of nondigestible food material. They are usually formed in stomach and do not migrate to the other intestinal tract. Recently, we experienced two cases of small bowel phytobezoars resulting in obstruction. The first case is a 72-year-old male patient who had no previous history of surgery. He had poor dentition, and the history of eating dry persimmons 20 days before the onset of symptoms. The phytobezoar (4x3cm) obstructed the terminal ileum. Colonoscopic removal was performed successfully. The second case is a 45-year-old male patient undergone previous vagotomy and pyloroplasty for duodenal ulcer perforation. He had a huge phytobezoar (10 X 6 cm) in stornach, which was treated by endoscopic removal. After incomplete endoscopic treatment, it moved into the proximal jejunum and obstructed the lumen. It was removed by operation.
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대장 내시경을 위한 장 세척 과정 중 발생한 Mallory-Weiss 증후군 2 예
최규용,정인식,이강문,최황,선희식,이창돈,한석원,김성수,송호진,채현석,방춘상,태현정,이보인,고경근 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.2
Polyethylene glycol solutions have been usually available for clinical use since 1980 and been considered a standard method of bowel preparations for colonoscopy. There have been many reports about minor complications such as nausea and bloating associated with their use, which are frequently occurred. After ingestion of polyethylene glycol, vomiting occurrs less frequently but it can make major complication such as Mallory-Weiss syndrome and aspiration pneumonia. We have reported here two cases of Mallory-Weiss syndrome, which were occurred after ingestion of polyethylene glycol solution for colonoscopy.
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