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- 저자 : 이인규(Sung Koo Kim) (검색결과 2 건)
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이성재(Sung Jae Lee),이란(Ran Lee),이인규(Sung Koo Kim),김성구(In Kyu Lee),채종희(Jong Hee Chae),김기중(Ki Joong Kim),황용승(Yong Seung Hwang),김인원(In One Kim) 대한소아신경학회 2000 대한소아신경학회지 Vol.8 No.2
목적 : ADEM은 중추신경계 탈수초성 질환의 하나로 바이러스성 질환이나 예방접종 후에 발병하며 병태생리는 확실하지 않으나 면역기전이 관계되는 것으로 알려져 있다. 현재까지 진단은 임상양상 및 뇌 영상에 의존하나 소견이 이질적이므로 연구자들은 ADEM 환자에서 뇌 자기공명영상상 병변의 분포에 따라 임상 양상 및 경과에 차이가 있는지 비교해 보았다. 방법 : ADEM 환자 24명을 대상으로 하였다. 남녀 비는 여아가 12명 남아가 12명이었고, 발병시 연령은 12개월에서 13세까지로 평균 4넌 5개월이었다. 뇌 자기공덩영상에서 병변의 분포가 백질에 국한된 경우(W군:12례)와 심부 회백질이 포함된 경우(G군: 12례)로 나누어 각각 말병시 신경학적 소견, 임상경과 및 추적관찰시 신경학적 후유증 등을 비교하였다. 결과 : 발병시 의식손상은 W군 9례(75%) 및 G군 7례(58%)에서 있어 통계적으로 유의한 차이는 없었다(P=0.667). 발작은 W군 5례(42%), G군 3례(25%)에서 있었다. 기타 신경학적 증상은 추체로 징후, 운동장애, 시신경증, 운동실조 등이 있었다. 임상경과의 호전은 W군 10례(83%) 및 G군 11례(92%)에서 있었다. 증상 발현부터 호전되기 시작하기까지의 기간은 정중치로 W군에서 29(9-75;평균 33.6)일, G군에서 24(9-39; 평균 25.9)일로 통계적 차이는 없었다(P=0.839). 장기간 추적관찰시 W군은 7례(58.3%)에서 정상화되었고, G군은 9례(75%)에서 정상화되었다. 결론 : 두 군간에 뚜렷한 차이를 발견하지 못하였으나, 임상양상이 매우 다양하고 회복되는 기간이나 정도도 증례마다 차이가 크며, 심부 회백질을 침범한 경우가 50%에 달해 본 연구에 포함된 증례들이 서로 이질적인 질환들이거나 상이한 발병기전에 의할 가능성이 있으므로, 임상적으로 ADEM으로 생각되는 환자의 발병초기 뇌 자기공명영상상병변의 범위 및 부위에 주의를 기울일 필요가 있을 것이다. Purpose: Acute disseminated encephalomyelitis(ADEM) is a demyelinating disease of the central nervous system preceded by viral illnesses or vaccinations. Diagnosis depends on the clinical manifestations and the neuroimaging findings. The authors analyzed the clinical differences according to the extent and distribution of lesions on brain MRI. Methods: We studied 24 ADEM patients diagnosed by clinical and radiologic findings from 1990 to 1999. We classified the MRI findings as follows. W group : Multifocal lesions only in the white matter; G group : Lesions in the deep gray matter with or without in the white matter, Neurologic findings, clinical courses, outcomes were compared between the 2 groups. Results: Nine of 12(75%) and 7 of 12(58%) had altered mentality in W group and G group respectively. Five of 12(42%) and 3 of 12(25%) had seizures in W group and G group respectively. Other neurological manifestations were as follows : Pyramidal tract signs, motor disturbances, facial palsy and ataxia. Ten of 12(83%) and 11 of 12(92%) showed clinical improvement in W group and G group respectively. Median recovery times were 29 days in W group and 24 days in G group. Seven of 12 and 9 of 12 were recovered completely without neurological sequelae. Conclusion: Although there was no statistically significant difference, ADEM may be a group of heterogeneous disorders, since the clinical and radiological manifestations are quite diverse. Caution should be made on the MRI distribution of lesions need to be considered in the diagnosis of the patients who are suspected as having ADEM
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제 2 형 당뇨병 환자의 췌장 소도내 선택적 베타 세포의 소실 및 알파세포의 증가
이광우,이정민,조재형,서선희,손호영,차봉연,이인규,강무일,윤건호,강성구,이종민,안유배,김성래,손현식,고승현 대한당뇨병학회 2001 Diabetes and Metabolism Journal Vol.25 No.2
Background : It has been reported that a decrease in the β-cell mass, may play a major role in the development of type 2 diabetes. Some stimuli that cause β-cell loss can stimulate neogenesis from precursors as well as replication of matured β-cells. In an animal-based studies reported that a-cells can also be produced in the course of β-cell neogenesis, after being treated with streptozotocin. Through this research, we attempted to determine the change of α-cell mass according to the changes in β-cell mass and to characterize the size of the β-cell nucleus observed in type 2 diabetes. Method: To estimate the relative fraction of α- and β-cell mass in the pancreas, we counted β-cells and a-cells by point count method. We also performed a double immunohistochemical staining with glucagon and insulin antibodies to calculate the ratio between these two cells area in the pancreas (A/B ratio). In order to measure the size of the β-cell nucleus, an immunofluorescence staining of the nucleus and insulin was carried out. Data were gathered from type 2 diabetic subjects (n=19) and normal controls (n=8). Results: Although there was no statistical difference, we observed the tendency of decrease of β-cell mass and increase of a-cell mass in the pancreas of type 2 diabetic patients. The ratio of a-to β-cell area in isiet (ApB ratio) increased to 0.81±0.76 in diabetic patients compared to control with 0.26±0.25 (p$lt;0.01). The mean of the A/B ratios of the islets more than 22,000 ㎛² was 1.64±1.10, whereas that of the islets less than 22,000 ㎛² was 0.73±0.67 in type 2 diabetic patients (p$lt;0.01). The size of the β-cell nucleus in both diabetic subjects and normal controls was bigger than that of exocrine cells (p$lt;0.05) and 2.9% of β-cells in type 2 diabetic subjects showed substantially enlarged nuclei more than M+5SD (M and SD means the average and standard deviation of nucleus size of exocrine cells, respectively) whereas this type of nucleus was found in only 0.5% of β-cells in normal controls (p$lt;0.05). Conclusion: The islet pathology in type 2 diabetes could be characterized by an expansion of α-cells associated with the selective loss of β-cells. Some β-cells found in diabetes showed a significant increase in size of the nucleus. Through the results from this study, we postulate that enlarged β-cell nucleus and reverse of A/B ratio in the islets could be a marker of early senescence of β-cells in patients with type 2 diabetes mellitus.
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