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        Dimethylnitrosamine 유발 급성 간 손상 흰쥐에서 ^(99m)Tc-Lactosylated Serum Albumin을 이용한 간 기능의 평가

        정신영,이재태,서명랑,유정아,배진호,안병철,황재석,정재민,하정희,이규보 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.6

        목적: ^(99m)Tc-lactosylated serum albumin (^(99m)Tc-LSA)은 간세포에 특이적으로 결합하는 간수용체 영상용 방사성의약품으로 새로이 합성되었다. 간섬유화를 유발하는 dimethylnitrosamine (DMN)을 투여한 간 손상 휜쥐 모델에서 ^(99m)Tc-LSa의 역동학적인 간섭취를 조사하고 간효소치의 변화와 조직학적 소견을 비교하여, LSA의 간섭취가 간기능의 변화를 반영하는지를 연구하였다. 대상 및 방법: SD계 흰쥐에 DMN를 27 mg/kg으로 복강 내 주사하여 급성 간손상을 유도하고 대조군과 비교하였다. DMN을 주사한 흰쥐를 3일(DMN-3), 8일(DMN-8), 21일(DMN-21)에 ^(99m)Tc=LSA (1,665 mg/kg) 29 MBq를 정맥 주사하여, 30분 동안 동적 영상을 획득하고 간과 신장부위에 관심영역을 설정하여 간과 심장부위의 시간방사능 곡선을 얻었다. 간기능 평가를 위해 시간방사능 곡선을 이용하여 간섭취지수와 혈중제거지수를 구하였고 곡선 최적화를 시행하였다. DMN 투여군과 대조군의 간효소치의 변화와 간조직의 광학현미경 소견을 비교하였다. 결과: 대조군에서는 ^(99m)Tc-LSA가 빠르게 간에 섭취되고 혈중에서 제거되었으나 DMN을 처리한 군에서는 간섭취가 낮았다. 간섭취지수의 비교에서 대조군에 비해 DMN 처리군에서 유의하게 간섭취지수가 낮았다(DMN-3: 0.842, DMN-8: 0.898, DMN-21: 0.91, 대조군: 0.96, p<0.05). 혈중제거지수의 비교에서도 대조군에 비해 DMN 처리군에서 혈중제거지수가 유의하게 높았다(DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, 대조군: 0.473, p<0.05). 비선형 회귀분석에서 R_(2) 값은 0.9이상으로 좋은 일치를 보였고, 대조군에ㅓ K값이 DMN처리군에 비해 크고(DMN-3: 0.28, DMN-8: 0.41, DMN-21: 0.46, 대조군: 0.97, p<0.05), T_(1/2)값은 작았다(DMN-3: 2.5, DMN-8: 1.7, DMN-21: 1.5, 대조군: 0.7, p<0.05). 간효소치의 변화는 DMN-3군에서는 대조군에 비해 상승하였으나 DMN-8, DMN-21군에서는 간효소치의 상승이 관찰되지 않았다. 간조직 소견의 경우 DMN-3군에서 중심정맥 주위에 괴사가 관찰되었으나 DMN-8군, DMN-21군에서는 미약한 정도의 염증세포 침윤만이 관찰되었다. 결론: ^(99m)Tc-LSA 간신티그래피의 간섭취 정도는 간손상과 반비례하였으며 간섭취의 변화는 조직학적 손상이 심한 정도와 간손상후 회복되는 과정을 반영하여 주었다. ^(99m)Tc-LSA 간신티그래피가 간손상을 평가하고 간손상후 회복되는 과정을 추적하는 간수용체 영상용 방사성 의약품으로 사용될 수 있을 것으로 생각된다. Objects: ^(99m)Tc-lactosylated human serum albumin(LSA) is a newly synthesized radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically presented on the hepatocyte membrane. Hepatic uptake and blood clearance of LSA were evaluated in rat with acute hepatic injury induced by dimethylnitrosamine(DMN) and results were compared with corresponding findings of liver enzyme profile and these of histologic changes. Materials and Methods: DMN (27 mg/kg) was injected intraperitoneally in Sprague-Dawley rat to induce acute hepatic injury. At 3(DMN-3), 8(DMN-8), and 21(DMN-21) days after injection of DMN, LSA injected intravenously, and dynamic images of the liver and heart were recorded for 30 minutes. Time-activity curves of the heart and liver were generated from regions of interest drawn over liver and heart area. Degree of hepatic uptake and blood clearance of LSA were evaluated with visual interpretation and semiquantitative analysis using parameters (receptor index : LHL3 and index of blood clearance : HH3), analysis of time-activity curve was also performed with curve fitting using Prism program. Results: Visual assessment of LSA images revealed decreased hepatic uptake in DMN treated rat, compared to control group. In semiquantitative analysis, LHL3 was significantly lower in DMN treated rat group than control rat group (DMN-3:0.842, DMN-8: 0.898, DMN-21: 0.91, Control: 0.96, p<0.05), whereas HH3 was significantly higher than control rat group (DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, Control: 0.473, p<0.05). AST and ALT were significantly higher in DMN-3 group than those of control group. Centrilobular necrosis and infiltration of inflammatory cells were most prominent in DMN-3 group, and were decreased over time. Conclusion: The degree of hepatic uptake of LSA was inversely correlated with liver transaminase and degree of histologic liver injury in rat with acute hepatic injury.

      • 혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

        임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

        Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

      • 쌍태임신중 일측태아 사망 5 예에 대한 임상적 고찰

        신정옥,심일구,이항재,김희범 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

        Objective : Our purpose of this study was to evaluated the incidence of twin pregnancy with one fetal demise, predisposing factors and the maternal complications and perinatal outcomes. Patients : From January 1993 to December 1997, 5 twin pregnancy with single fetal demise after 28 weeks gestation by gestational age were observed in Soonchunhyang Kumi Hospital. Results : 1. The incidence of one fetal demise was 3.01% in twin pregnancy. 2. Maternal disseminated intravascular coagulation has not been demonstrated. 3. The predisposing factors of twin pregnancy with single fetal demise are umbilical cord torsion (40%), congenital anomaly(20%) and unknown(40%). 4. According to chorionicity, it seems that the perinatal mortality rate of monochorionic group was higher than dichorionic. Conclusion : This study suggests that monochorionic placentation is associated with increased risks of twin pregnancy with single fetal demise. But it may be partially explained due to small numbers of cases in this study.

      • 국소 폐병변에서의 역동적 조용증강 CT의 유용성

        신현준,최영철,전혜정,박정희,김요한 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-

        The blood supply and metabolism of malignant nodules are qualitatively and quantitatively different from those of most benign nodules. We evaluated the efficacy of dynamic CT for differentiation of benign malignant lesions. Thirty-six patients with malignant nodule(n=20), tuberculoma(n=7), and pneumonic consolidation(n=9) were evaluated by thin section dynamic CT. CT numbers of lesion and aorta were measured before enhancement, and 1 minute, and 3 minutes after enhancement. Malignant lesions(maximum, 31.1±10.7 HU) enhanced significantly more than tuberculoma(maximum, 13.5±12.9 HU), but mass/aorta ratios were not so significantly different between malignant lesions(maximum, 0.61±0.27), tuberculoma(maximum, 0.36±0.15), and pneumonic consolidation(maximum,0.49±0.14). Dynamic CT is very useful for differentiation of malignant lesions from tuberculoma.

      • 전방 십자인대의 파열시의 자기공명영상:직접소견의 중요성

        신현준,이창희,최영칠,전혜정,박정희,김동헌 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

        It is Important to know the normal size, shape, and signal intensity of anterior cruciate ligament in the evaluation of knee injury Many studies have reported findings of tear or rupture as well as normal anatomy of these structure, especially with MR images. To our knowledge, there are few studies about normal structures of anterior cruciate ligament in MR images. The purpose of this study is to compare normal finding with tear of anterior cruciate ligament on MRI. Twenty-three cases with rupture of anterior cruciate ligament were evaluated on MRI, measuring the length, thickness, width of anterior cruciate ligament, and angles of anterior and posterior cruciate ligaments. Mean length, thickness, and width of anterior cruciate ligament in patients with rupture were 37.7±4.8mm, 9.0±1.2mm, 8.0±0.8mm, and mean angles of anterior cruciate ligament, and posterior cruciate ligament were 48.1±9.6˚, 118.8±13.1˚. Curvature ratio of posterior cruciate ligament was 0.25±0.09. The results showed significant differences between normal persons and patients with complete or partial rupture, and the mean angle and curvature ratio of posterior cruciate ligament which are known to related with indirect sign in tear of anterior cruciate ligament showed significant differences between ours and that of western countries. These results will be useful in the evaluation of patient wish rupture of anterior cruciate ligament, especially on MRI.

      • 이성대상포진의 증상에 따른 안면신경마비의 정도와 예후

        신시옥,송창근,이동욱,최영석,진흥률,신정우,윤희석 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

        연구목적: 이성대상포진에 동반되는 안면신경마비는 Bell's palsy와는 달리 예후가 더 나쁘고 그 마비가 완전히 회복되지 않는 경우가 더 많다.본 연구에서는 이성대상포진에서 발현되는 증상들의 유무가 치료 전 안면신경마비의 정도 및 치료 후 예후와 상관관계가 있는지를 관찰하여 예후의 예측인자에 대해 분석하였다. 재료 및 방법: 지난 1992년 1월부터 1999년 6월까지 이성대상포진으로 진단받고 본원에 입원하여 고용량 부신피질호르몬제와 항바이러스제인 acyclovir의 병합투여로 동일한 치료를 받은 30명의 환자를 대상으로 후향적으로 의무기록을 분석 및 고찰하였으며, 치료 전 안면마비의 정도와 치료 후 마비의 회복 정도를 이통, 이명, 난청, 현훈 등의 증상의 유무와 치료 시작 시기, 그리고 안면신경의 electroneuronography(ENoG) 값에 따라 비교하였다. 결과: 이성대상포진수포가 안면신경마비 보다 먼저 발현된 경우에 안면신경마비의 치료 전 grade가 통계적으로 유의하게 좋았다(p<0.05).이통, 청력손실, 그리고 현훈의 유무에 따른 안면신경마비의 정도는 상관관계가 없었고 예후에도 차이가 없었다.이명의 유무에 따른 치료 전 안면신경마비의 정도는 상관관계가 없었으나 치료 후 완전회복율은 이명이 있었던 군에서 통계적으로 유의하게 높았다(p=0.003<0.05).완전회복군과 불완전회복군 사이의 치료 전 ENoG의 수치는 통계적으로 유의하게 예후와 상관이 있었다(p=0.037<0.05). 결론: 좀더 많은 수의 환자를 연구에 포함하여 증상에 따른 예후의 차이를 연구하는 것이 필 요하며 또한 ENoG 값이 10%에서 40% 사이인 환자들의 치료 방법에 대한 고려와 이성대상포진수포가 안면신경마비보다 먼저 생긴 환자에서 치료 전 마비정도가 경미했던 이유에 대한 연구가 필요할 것으로 생각된다. Purpose: Herpes zoster oticus generally has a poor prognosis, leaving many patients with permanent facial nerve dysfunction, compare to Bell's palsy.Acyclovir and prednisolone have been widely used for the treatment of herpes zoster oticus.This retrospective study was conducted to suggest the prognostic factors according to various symptoms. Materials and Methods : Clinical studies were retrospectively performed on 30 patients with herpes zoster oticus who were treated with acyclovir and prednisolone in the Chungbuk National University Hospital between 1991 and 1999.The authors analyze the pre-treatment grade and prognosis of facial nerve palsy according to symptoms(the existence of otalgia, tinnitus, hearing loss, and vertigo), the treatment onset, and electroneuronography ( ENoG ). Results : Of thirty patients who have been diagnosed as herpes zoster oticus, there is no significant difference in the pre-treatment grade of facial nerve palsy according to the existence of vesicle, otalgia, tinnitus, vertigo, and hearing loss.Of 25 patients who have facial nerve palsy, the recovery from the palsy is complete in 14 patients(56%).There is no significant difference in the pre-treatment grade of facial nerve palsy according to the existence of otalgia, tinnitus, vertigo, and hearing loss.The pre-treatment grade of facial palsy is better when the vesicles precede facial in the group with tinnitus than without tinnitus.A significant difference of the prognosis according to the onset of treatment and other symptoms are not found.ENoG is better in the group that facial nerve palsy is completely recovered than incomplete recovery group. Conclusion : Reliable prognostic factor according to symptoms is not found, ENoG is the only prognostic factor.

      • 콩나물의 품종, 뿌리발생 및 재배일수에 따른 asparagine 함량 변이

        정연신,박희준,Krishna Hari Dhakal,이정동,이인중,황영현 경북대학교 농업과학기술연구소 2008 慶北大農學誌 Vol.26 No.-

        숙취해독에 탁월한 효과를 지니는 asparagine 함량의 콩나물 계통간 차이와 뿌리 발생량에 따른 차이 및 콩나물 재배기간에 따른 차이를 구명하여 고 asparagine을 가지는 기능성 콩나물 생산과 품종육성을 위하여 국내재래 콩나물 계통의 asparagine함량을 분석한 결과를 요약하면 다음과 같다. 1. 공시된 나물콩 174품종 및 계통의 콩나물에서의 sparagine 함량의 범위 및 평균은 0.38-1.67%, 0.99%(생체수준)로 각각 나타나 다양한 변이를 보였다. 2. 공시된 장려품종과 재래계통의 asparagine함량은 각각 1.29, 0.96% (생체수준)로 재래계통보다 장려 품종에서 높게 나타났다. 3. 백립중별 asparagine함량은 8.1~10.0g범위에서 1.02%(생체수준)로 가장 높은 경향이었으나 유의적인 차이는 인정되지 않았다. 4. 종피색별 asparagine 함량은 갈색종피종이 1.15%(생제수준)로 가장 높았으며 다른 종피종들은 비슷한 경향으로 나타났다. 5. 공시된 장려품종의 asparagine 함량의 범위는 4.08~6.24%(건물수준)로 나타났고, 다원콩(6.24%), 소백나물콩(6.21%), 소원콩(5.95%), 소명콩(5.85%) 순이 었다. 6. 콩나물의 재배일수를 10일로 한 경우 asparagine함량과 관계가 깊은 뿌리발생량이 크게 증가하였다. 7. 재배일수에 따른 asparagine함량은 5일재배와 10일재배에서 각각 0,68%, 1.21%(생제수준)로 나타나 재배 일수간 asparagine 함량에는 고도의 유의적인 차이가 인정되었다. 8. 콩나물의 하배측 부위에서 재배일수가 증가할수록 asparagine 함량도 증가하여 2일 재배시 2.91%(건물수준)이던 것이 14일 재배시에는 15.68%까지 증가하였다. The varietel difference, effect of root amounts and cultivation duration on the asparagine content of soybean sprouts, which is known to have the excellent detoxifying effect of ethanol, were investigated for developed varieties and indigenous sprout lines to establish cultivation methods of increasing the asparagine content and to develop soybean varieties having high asparagine content. Some of the research results obtained are summarized as follows; 1. Range and mean of asparagine content of 174 germplasm were 0.38~1.67% and 0.99%, respectively, on fresh weight basis. 2. Developed sprout-soybean varieties showed somewhat higher asparagine content of 1.29% than that of indigenous sprout lines of 0.96% on fresh weight basis. 3. No significant difference in asparagine content among the seed size groups was recognized though the highest asparagine content, 1.02% on fresh weight basis was observed in the seed size of 8.1~10.0g/100 seeds. 4. Among the seed coat color groups, soybean of brown seed coat color showed the highest asparagine content (1.15%) on fresh weight basis. No difference was observed among other groups of seed coat color. 5. Range of asparagine content of 174 varieties was 4.08~6.24% on dry weight basis. Soybean varieties that showed high asparagine content were Dawonkong, Sobacknamulkong, Sowonkong, and Somyungkong, with the contents of 6.24%, 6.21%, 5.95%, and 5.85%, respectively. 6. Amount of roots which have the highest asparagine content out of sprout parts was greatly increased up to 10 days of sprout cultivation. 7. Highly significant difference in asparagne content of sprout was recognized between those grown for five and ten days, with the asparagine content of 0.68% and 1.21%, respectively, on fresh weight basis. 8. Asparagine content of hypocotyle part was also highly proportional to days to cultivation; it increased from 2.91% at 2 days of cultivation to 15.68% on fresh weight basis at 14 days of cultivation.

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