부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

응급 의료 센터내 사망 환자의 분석

유인술,김준식,진재우,이철주,민영기,조준필 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

We need the constitute of Emergency medical system that connect prehospital care of inhospital care effectively for optimal treatment of emergency patient. The analysis of actual condition of our emergency medical system, through study of mortality case in emergency medical center will be a aid to the constitute. The authors performed a review on the records of 60 cases who died in Ajou university Emergency medical center during management, since June 1994 to september 1995. Among the 60 patient, 72% were male and 28% were female. In nontrauma patient, 6th decade was many, in trauma patients, 3rd and 5th decade was many. Among the 60 patient, 33% were traumatic cases, 66% were nontraumatic cases. Among the traumatic patients, more than half of the cases were due to motor vehicle accidents. The most frequent time interval from onset of emergent situation to arreving at emergency center was more than 2 hours. The most common transfer method was by 119 ambulance. In most cases, prehospital treatments were not taken. In most cases, initial mental status was comatose, and systolic blood pressure was less than 60 mmHg. Most cardiovascular resuscitation was done in 30 min. to an hour. In cases as traffic accident of ischemic heart disease, where rapid transportation of the patient is critical for the patient's survival, however, in most cases it took more than two hours to bring such patients to hospital, and first aid treatment before arrival to hospital was rare. No prehospital treatment was done to nearly all patient. In many cases the patient was already in under coma or shock state. The inhospital care at emergency center was made relatively quickly and adequately. The mean duration of cardiopulmonary resustation was 30min to one hour. From this study, we could notice the poor quality of prehospital care in the region ,near Ajou university hospital, and we came to know that the improvement of quality of prehospital care was the most important factor to reduce the motality of emergency department patient. that is, in the treatment of emergency patients, weak points has been revealed in the pre-hospital treatment, the improvement of which is important factor for the survival of emergency patients.

오렌지 껍질로부터 분리된 프라보노이드의 화학요법 감작효과

최철익,변익건,차윤정,김선필,민영돈,유진철,송재경 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : The overexpression of P-glycoprotein (Pgp) or multidrug resistanceassociated protein (MRP) confers multidrug resistance (MDR) to cancer cells. MDR cells could be sensitized to anticancer drugs when treated concomitantly with a chemosensitizer. In this study, orange peel have been screened for the development of chemosensitizers reversing MDR. Materials and methods : Expression of Pgp in AML-2/WT and AML-2/D100 were determined using western blot analysis and RT-PCR. Candidates for chemosensitizers were isolated, purified from orange peel using sephadex LH-20 column chromatography and silica-gel column chromatography, whose structure was determined using ^1H-NMR, ^13C-NMR, ^1H-^1H-COSY, 13C-NMR, EI-Mass, IR. Chemosensitizing effect of NP-28 on AML-2/DX100 over expressing Pgp and MRP was determined by the MTT assay. Membrane toxicity was evaluated by the RBC hemolysis test. Antioxidant effects were examined by using a fluorescence probe (2’-7’-dichlorofluorescein diacetate). Results : A potent candidate, NP-28, has a flavonoid nucleus with some methoxy moiety. NP-28 is believed to have high therapeutic index, being non-transportable inhibitor and possibly, of inhibiting other efflux pumps such as MRP and antioxidant effects. NP-28 is also unlikely to be a substrate of Pgp. NP-28 did not increase Pgp levels. Conclusion : NP-28 has a Chemosensitizing effect to reverse Pgp-mediated MDR by increasing the intracellular accumulation of drugs. Furthermore, they do not increase expression of Pgp, which can allow a long term use without the concern about Pgp activation. NP-28 is anticipated as an ideal second-generation flavonoid chemosensitizer and/or possibly other therapeutic agents by further investigation.

국내 혈액질환 환자에서 침습성 아스페르길루스증의 구제치료로서 Voriconazole의 효과와 안전성

권재철,김시현,최수미,최재기,이동건,박선희,최정현,유진홍,신완식 대한감염학회 2010 감염과 화학요법 Vol.42 No.1

Background: Invasive aspergillosis (IA) is associated with significant morbidity and mortality in patients with hematologic malignancies. We investigated the efficacy and safety of voriconazole (VCZ) when used as salvage therapy for IA in Korean adults with hematologic malignancies who had not responded to prior antifungal therapy. Materials and Methods: We retrospectively reviewed data, collected from January 2007 to October 2008, from patients with proven or probable cases of IA. All were probable IA cases, except for one proven case. All cases were refractory or intolerant to antifungal therapy prior to administration of VCZ. Efficacy and safety were assessed in patients treated with VCZ for more than 3 days and for more than one dose, respectively. A favorable response [complete (CR) or partial (PR)] was defined by significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results: Fifty patients who met the inclusion criteria were enrolled. There were 27 male and 23 female patients with mean age of 44.4 years (range, 15-65 years). Underlying diseases were acute leukemia (35 cases), chronic myelogenous leukemia (4 cases), myelodysplastic syndrome (3 cases), lymphoma (3 cases) and other hematologic diseases (5 cases). Twenty-two patients had received chemotherapy and 13 patients had undergone hematopoietic stem cell transplantation. The lung was the main infection site (94%) followed by the sinus (6%). Amphotericin B deoxycholate alone was the most frequent previous antifungal therapy. The mean duration of antifungal therapy prior to VCZ therapy was 13.9±8.8 days (2-44 days). The median duration of VCZ therapy was 19 days (interquartile range, 49 days). Sixteen patients (32.0%) showed favorable responses (CR:PR=8:8) at the end of VCZ therapy. The numbers of patients with stable disease, progression and death were, 6 (12%), 6 (12%) and 22 (44%) respectively. Most of those with unfavorable responses had relapsed underlying malignancies or refractory graft versus host diseases. Twelve patients developed drug-related adverse events but only one patient stopped VCZ treatment prematurely. Conclusions: VCZ demonstrated an acceptable level of toxicity in patients with hematologic malignancies but further studies are required to prove its efficacy as salvage therapy.

대형경유차 저공해기술 적용에 따른 나노입자 배출특성

임철수,류정호,엄명도,황진우,김예은 한국대기환경학회 2004 한국대기환경학회지 Vol.20 No.2

Diesel engines which emit a lot of PM and NOx have been known as a main air polluter. Especially, diesel particulate matters (DPM) including black smoke are hazardous air pollutants to human health and environment. The nations retaining advanced engine technologies have reinforced emission regulations. To meet these regulations diesel engine manufacturers have developed low-emission diesel engines, aftertreatment equipments, alternative fuel technologies and so on. In this study, particle number concentrations characteristics according to particle size and engine driving conditions were analyzed when these low-emission technologies were applied. There was a tendency of increasing particle number concentrations from heavy-duty diesel engines with increasing engine rpm and load rate. In the cases of CDPF (Catalytic Diesel Particulate Filter), CNG (Compressed Natural Gas) engine and ULSD (Ultra Low Sulfur Diesel) more than 99% of particle number concentration were removed.

이동 통신 시스템의 가입자 위치 등록기의 구조에 관한 연구

김철원,문유진 호남대학교 정보통신연구소 1997 정보통신연구 Vol.7 No.-

ITU-T권고안에 따르면 이동통신시스템은 하나의 중앙집중적 가입자 홈 위치등록기에 다수의 이동통신교환기가 접속되는 구조로 되어있다. 그러나 급증하는 이동통신 가입자의 증가, 다양한 서비스의 요구 등에 의해 가입자 홈 위치 등록기는 더 강력한 처리능력과 이동통신망 형상변화에 대비한 유연성을 가져야 한다. 본 논문에서는 이러한 방안중의 하나로 단일 형태의 가입자 홈 위치등록기에서 집중화된 기능들을 분산처리하고, HLR기능확장의 용이성을 보장하는 모델을 제시하였다. 그리고 제안한 모델의 완성을 위해 노드시스템에 장착되어 고속 데이터 처리가 가능한 스트림 기반의 디바이스 드라이버 구조를 제안하였다. According to the ITU-T Recommdation in Digital Mobile Communication System, Home Location Register(HLR) stores current mobile subscriber's location information to provide terminal mobility. A number of Visitor Location Registers(VLRs) are connected to the HLR. In this architecture, the transaction capability of HLR affects the whole CMS system performance because HLR provides mobile subscriber's location information to several VLRs. To overcome this situation, the transaction capability of HLR must be enhanced according to the number of subscribers. This paper suggests an expandable and flexible architecture of HLR that uses an internal high-speed optical ring network interface, device driver for network adaptor, and internal/external process communication block are devised in each subsystem. Also, in order to obtain maximal throughput at the device driver, specific read service scheme and several stream related parameters are considered.

응급실을 내원한 65세 이상 노인 환자의 분석

김진년,김태훈,강양욱,오명,김상철,김성훈,권계형,남홍우,이홍순,유형준 대한노인병학회 2001 대한노인병학회지 Vol.5 No.3

제1형 탈요오드효소 유전자 갑상선호르몬 반응요소에서 T₃자극에 따른 갑상선호르몬 수용체 역동학 모델

이성진,박철영,정인경,홍은경,최철수,김현규,김두만,유재명,임성희,최문기,유형준,박성우,Larsen, P. Reed 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3

연구배경: 제1형 탈요오드효소의 발현에 관여하는 hdiol 유전자는 5 flanking region 내 서로 다른 특성을 가진 두 종류의 갑상선호르몬 반응요소, 즉 TREI과 TRE2를 가지고 있음이 알려져 있다. 사람의 간암세포주인 HepG2 세포에서 T₃를 투여하였을 때 hdiol유전자의 전사작용이 급격하게 증가하는데 hdiol mRNA가 충분히 발현하기 위해서는 두 종류의 갑상선호르몬 반응요소가 모두 필요함이 보고 되어 있으나 T₃ 투여시 갑상선호르몬 반응요소와 결합하는 갑상선호르몬 수용체의 역동학에 대해서는 아직까지 연구된바 없다. 한편 현재까지 보고 된 연구 결과들은 갑상선호르몬 자극이 없더라도 갑상선호르몬 수용체와 갑상선호르몬 반응요소가 서로 지속적으로 상호작용 한다는 전제 조건을 바탕으로 하고 있는데 아직까지 이러한 가정은 간접적으로만 증명되어 있는 상태이다. 이에 저자들은 본 연구에서 사람의 간암세포주인 HepG2세포를 대상으로 염색체 면역침전법과 중합효소연쇄반응을 이용하여 갑상선호르몬 자극 전·후 hdiol 유전자의 갑상선호르몬 반응요소에 결합하는 갑상선호르몬 수용체의 결합양상 변화를 분석함과 동시에 갑상선호르몬 자극 전에도 갑상선호르몬 수용체와 갑상선호르몬 반응요소가 서로 결합된 상태로 존재함을 직접적으로 확인하고자 하였다. 방법: 사람의 간암세포주인 HepG2 세포를 대상으로 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 TRα1, TR 1, TR 2 항체와 IREI, TRE2에 상보적인 시발체를 이용하여 염색체 면역침전법과 고식적 중합효소연쇄반응 및 정량적 중합효소연쇄반응을 시행하였다. 100nM T₃를 투여하기 전과 투여한 후 12시간 뒤 hdiol mRNA 발현량의 변화를 정량적으로 측정하기 위하여 역전사 중합효소연쇄반응을 시행하였다. 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 TR4'1, TR 1, TR 2 단백질의 발현량을 알아보고자Western blot을 시행하였다. 결과: 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 염색체 면역침전법과 TREI 시발체를 이용한 고식적 중합효소연쇄반응을 시행하였을 때 T₃ 투여 전후 TREI 부위에는 TRgl이 결합하였으며 T₃를 투여한 후 TRal 결합이 감소하였다. 정량적 중합효소연쇄반응으로 TR4'1 결합량을 측정하였을 때 T₃ 투여 전3.74에서 T₃ 투여 후 1.97로 감소하여 통계적으로 유의한 차이를 나타내었다(Δ=-47.3%, p<0.05). T₃ 투여 전 ·후 TRβl과 TRβ2의 결합은 관찰되지 않았다. 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 염색체 면역침전법과 TRE2 시발체를 이용한 고식적 중합효소연쇄반응을 시god하였을 때 T₃ 투여 전ㆍ후 TRE2 부위에는 TRα1, TR 1, TR 2가 모두 결합하였으며 T₃를 투여한 후 TRα1과 TR 1의 결합은 감소하였으나 TR 2의 결합은 증가하였다. 정량적 중합효소연쇄반응으로 갑상선호르몬 수용체의 결합량을 측정하였을 때 TRαl은 T₃ 투여 전 10.41에서 T₃ 투여 후 3.01, TRβl은 T₃ 투여 전 12.56에서 T₃ 투여 후 2.93으로 유의하게 감소하였으며 TRβ2는 T₃ 투여 전 9.17에서 T₃ 투여 후 9.84로 증가하는 경향을 보였다(TRα1, Δ=-71.1%, p<0.05; TR 1, Δ=-76.7%, p<0.05; TR2, Δ=+7.3%). 정량적 중합효소연쇄반응으로 측정한 갑상선호르몬 수용체의 전체 결합량은 T₃ 투여 전 32.14에서 T₃ 투여 후 15.78로 감소하여 통계적으로 유의한 차이를 나타내었다(Δ=-50.9%, p.0.05). 갑상선호르몬 수용체 항체를 1.5μL와 4.5μL 첨가한 후TREI과 TRE2에 대하여 염색체 면역침전법 및 정량적 중합효소연쇄반응을 각각 시깡하였을 때 첨가한 갑상선호르몬 수용체 항체의 양에 따른 갑상선호르몬 수용체 결합량의 차이는 없었다. 100 nM T₃를 투여하기전과 투여란 후 12시간 뒤 역전사 중합효소연쇄반응 및 hdiol cDNA 시발체를 이용한 정량적 중합효소연쇄반응을 시행하였을 때 T₃를 투여한 후 hdiol mRNA발현량은 2.03배 증가하였다(p<0.001). 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 Western blot을 시행하였을 때 갑상선호르몬 수용체 발현량은 유의한 차이가 없었다. 결론: 현재까지 갑상선호르몬 수용체의 역동학에 대한 연구가거의 이루어지지 않았던 실정을고려하여볼 때 본 연구는 제한적이나마 일정한 농도의 갑상선호르몬 자극 전 · 후 갑상선호르몬 수용체 결합양상의 변화, 특히 T₃ 자극 전 hdiol 유전자의 TREI 부위에서 TRal이 억제자 (silencer)로서 작용할 가능성 및 T₃자극 전 · 투 TRE2 부위에서 갑상선호르몬 수용체 교대현상을 처음으로 제시하였다는 점에서 의의가 있으며 향후 다른 종류의 세포주 및 체내에서 갑상선호르몬 자극 전 후 갑상선호르몬 수용체 결합양상의 변화 및 유전자 발현에 미치는 영향을 연구할 필요가 있으리라 생각된다. 한편 염색체 면역침전법을 통해 HepG2 세포에서 T₃ 자극이 없더라도 갑상선호르몬 수용체와 갑상선호르몬 반응요소 사이에 지속적인 상호작용이 존재할 뿐 아니라 갑상선호르몬 반응요소에 대한 갑상선호르몬 수용체의 결합이 교대로 이루어지고 있음을 직접적으로 확인할 수 있었으며 향후 T₃ 자극 전 · 후 갑상선호르몬 수용체를 통한 유전자 전사조절기전에 관여하는 전사인자와 역동학적 기전을 규명함에 있어서 염색체 면역침전법과 정량적 중합효소연쇄반응이 매우 유용하게 이용될 수 있을 것이다. Background: Type 1 iodothyronine deiodinase (Dl), the product of the hdiol gene, is involved in thyroid hormone activation by the deiodination of thyroxine (T4) to form 3,5,3'-triiodothyronine (T3). Recent studies have identified two thyroid hormone response elements (TREs) in the 5 ' flanking region of the hdiol gene. TRE1, proximal to TRE in the hdiol gene, consists of a direct repeat of thyroid hormone receptor (TR) binding octamers with 10 bp separating the two TR binding sites. The upstream TRE, TRE2, is a classical direct repeat of retinoid X receptor (RXR)/TR binding half-sites with a 4-bp separation. There are few studies clarifying the TR dynamics in the TRE of a specific gene with or without the exposure of activated thyroid hormone. We evaluated TR binding patterns in the proximal and distal TREs of the hdiol gene before and after T₃ stimulation. Methods: We employed chromatin immunoprecipitation (ChIP) technique to investigate the TR- TRE interaction before and after T₃ stimulation in human hepatocellular carcinoma HepG2 cell line. Following cross-linking and sonication of the cells, immunoprecipitation was performed overnight at 4℃ with TRαl, TRβ1 and TRβ2 antibodies. We analyzed the binding patterns and amounts of TRαl, TRβl and TRβ2 to TREl and TRE2 before and after 12 hours stimulation with 100 nM T3 by using conventional and quantitative real-time polymerase chain reactions (RQ-PCR). Reverse transcriptional PCR (RT-PCR) and Western blot with TR 1, TR 1 and TR 2 antibodies were performed to measure the levels of hdiol mRNA and TR 1, TR 1 and TR 2 proteins before and after 12 hours exposure to l00nM T3. Results: In TRE1, TRαl binding was significantly decreased after 12 hours stimulation with l00nM T3 (3.74→97, Δ=-47.3%, p<0.05), but TRβ1 and TRβ2 bindings were not detected by conventional PCR and RQ-PCR. Although all TR isoforms were bound to TRE2, the binding patterns were quite different. While TRα1 and TRβ1 bindings to TRE2 after 12 hours stimulation with 100 nM T3 were significantly decreased (10.41→3.01, Δ=-71.1%, p<0.05; 12.56 →2.93, Δ =-76.7%, p<0.05, respectively), TRβ2 binding was increased but not significantly (9.17 →9.84, Δ =+7.3%). Total TR bindings in TRE2 were significantly decreased after 12 hours stimulation with 1OOnM T₃ (32.14 →15.78, Δ=-50.9%, p<0.05). The TR bindings to TREl and TRE2 were not significantly different by the amounts of TR antibodies used during ChIP assays. The levels of hdiol mRNA were significantly increased, 2.03 times, after 12 hours exposure to l00nM T3 (p<O.001). Western blot showed no significant change of the level of each TR isoform protein before and after 12 hours exposure to 100nM T3. Conclusion: Our results demonstrate the dynamics of TRal at proximal TRE (TRE1) and the switching phenomenon of TR isoforms at distal TRE (TRE2) of the hdiol gene after T3 stimulation. Further investigation, however, is needed to clarify the mechanisms of these observations (J Kor SOC Endocrinol 18:283-295, 2003).

백서 뇌하수체 성장호르몬 종양세포의 Chicken Lysozyme 유전자 갑상선호르몬 반응요소에서 갑상선호르몬 수용체 역동학에 미치는 T₃효과 분석

이성진,박철영,정인경,홍은경,최철수,김현규,김두만,유재명,임성희,최문기,유형준,박성우,Larsen, P. Reed 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경: 유전자 전사과정은 증강부위 (enhancer) 또는 억제부위(silencer)의 복합작용을 통하여 조절되며 chicken Iysozyme 유전자의 억제부위는 두 개의독립적인 전사인자 결합부위 (Fl과 F2)를 가지는데 Fl부위는 75~93 kD 크기의 NePl 단백질이 결합하는 위치인 반면 역위회문구조(inverted palindrome, InvPal)의 F2 부위는 갑상선호르몬 수용체가 결합하는 갑상선호르몬 반응요소인 동시에 갑상선호르몬 수용체에 대해 높은 친화력을 가지고 있다. 실험적으로 Fl부위 또는 F2 부위 (이하 F2-TRE 부위)를 각각 다량체화(multimerization) 하였을 때 전사억제효과가 증가하였다는 연구 결과는 Fl 부위와 F2-TRE 부위가 서로 독립적으로 기능하는 구조임을 시사하고 있으며chicken Iysozyme 유전자의 억제부위가 완전한 전사억제효과를 가지기 위해서는 Fl 부위와 F2-TRE 부위가 모두 필요함이 보고 되어 있다. 현재 갑상선호르몬에 의한 chicken Iysozyme 유전자 조절기전을 규명하기 위해 많은 연구가 이루어지고 있으나 73 자극 전 ·후 갑상선호르몬 수용체의 역동학에 대해서는 아직까지 거의 보고된 바 없으며 이와 관련하여 저자들은 치근 사람의 간암세포주인 HepG2 세포에서 T₃ 자극전 ·후 갑상선호르몬 반응요소인 IRE2 부위에 대한 갑상선호르몬 수용체의 결합이 교대로 이루어지고 있음을 염색체 면역침전법 (chromatin immunoprecipitation, ChIP) 및 정량적 중합효소연쇄반응을 이용하여 확인한 바 있다. 이에 저자들은 본 연구에서 F2-lRE 부위를 포함하는 백서 뇌하수체 종양세포주인 GC8 세포를대상으로 염색체 면역침전법과 중합효소연쇄반응을 이용하여 갑상선호르몬 자극 전 후 시간적 순서에 따라 F2-TRE 부위에 결합하는 갑상선호르몬 수용체의 결합양상 변화를 분석함으로써 갑상선호르몬 수용체의 역동학적 모델을 제시하여 보고자 하였다. 방법: thymidine kinase(TK) promoter의 5' 부위에 chicken Iysozyme silencer의 고친화력 갑상선호르몬 반응요소(F2-TRE 부위)가 삽입된 플라스미드,mouse TRα gene이 삽입된 플라스미드, neomycinresistance gene이 삽입된 플라스미드를 백서 뇌하수체성장호르몬 종양세포인 GC 세포에 각각 주입하여 제작한 GC8 세포주를 사용하였다. 100 αM T₃를 투여하기 전과 투여한 후 12시간 뒤 TRαl, TRβl, TRβ2 항체를 이용하여 염색체 면역침전법과 고식적 중합효소연쇄반응 및 정량적 중합효소연쇄반응을 시행하였다. 각 갑상선호르몬 수용체 항체의 양을 1.5μL에서 4.5μL로 바꾸어 첨가한 후 동일한 방법으로 염색체 면역침전법을 반복하여 시행하였다. 100nM T₃를 투여하기전과 투여한 후 20분, 1시간, 2시간, 4시간, 6시간, 8시간, 12시간 뒤 TRαl, TRβl, TRβ2 항체를 이용하여 염색체 면역침전법을 시행하였다. 100nM T₃를 투여하기 전과 투여한 후 12시간 뒤 TRαl, TRβl, TRβ2 단백질의 발현량을 알아보고자 Western blot을 시행하였다. 결과: 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 염색체 면역침전법과 F2-TRE 시발체를 이용한 고식적 중합효소연쇄반응을 시행하였을 때 T₃를 투여한 후 12시간 뒤 TRα1과 TRβ2의 결합은 증가한 반면 TRβl의 결합은 감소하였다. 정량적 중합효소연쇄반응으로 갑상선호르몬 수용체의 결합량을 측정하였을 때TRα1은 T₃ 투여 전 1.01에서 T₃ 투여 후 2.73으로 유의하게 증가하였으며 TBβl은 T₃ 투여 전 4.59에서 T₃투여 후 2.06으로 유의하게 감소하였고 TRβ2는 T₃ 투여 전 2.53에서 T₃ 투여 후 2.98로 증가하는 경향을보였다(TRα1, Δ=+170.3%, p<0.05; TRαl, Δ=-55.1%, p<0.05; TRβ2, Δ=+17.8%). 정량적 중합효소연쇄반응으로 측정한 갑상선호르몬 수용체의 전체 결합량은 T₃ 투여 전 8.13에서 T₃ 투여 후 7.77로 감소하였으나 통계적으로 유의하지 않았다(Δ=-4.4%).100nM T₃ 투여 전 ·후 시간별로 염색체 면역침전법과 정량적 중합효소연쇄반응을 시행하였을 때 TRα1 결합량은 T₃ 투여 후 20분과 6시간 뒤 각각 증가하였으며 TRβ2 결합량은 T₃ 투여 후 20분 뒤 최고치까지 증가하였다가 2시간 뒤부터 감소하였다. 그러나 TRαl 결합량은 T₃ 투여 후 1시간 뒤 최저치까지 감소되었다가 이후 지속적으로 유지되는 경향을 보였다. 100 nM T₃ 투여 전과 투여 후 2시간 뒤 갑상선호르몬 수용체의 결합량을 비교하였을 때 TRα1은 219.8% (1.01→3.23), TRβ2는 9.9% (2.53→2.78) 증가하였으나 TRβ1은 52.9% (4.59-)2.16) 감소하였으며 결합량 변화의 방향은 100 naM T₃ 투여 후 4시간 뒤와 6시간 뒤 갑상선호르몬 수용체 결합량 변화의 방향과 일치하였다(TRα1, 2.89→4.09, Δ =+41.5%; TRβl, 2.33→2.04, Δ=-12.4%; TRβ2, 2.57→2.59, Δ=10.8%). 갑상선호르몬 수용체 항체를 1.5 μL 또는 4.5 μL 투여한 후 F2-TRE부위에 대한 염색체 면역침전법 및 정량적 중합효소연쇄반응을 각각 시행하였을 때 첨가한 갑상선호르몬 수용체 항체의 양에 따른 갑상선호르몬 수용체결합량의 유의한 차이는 없었다. 100 nM T₃를 투여하기 전과 투여한 후 12시간 뒤 Western blot을 시행하였을 때 갑상선호르몬 수용체 발현량의 유의한 차이는 관찰되지 않았다. 결론: 본 연구에서 관찰된 T₃ 자극 전 · 후 chickenIysozyme 유전자의 F2-TBtE 부위에 대한 갑상선호르몬 수용체 이성체의 교대현상 및 시간적 순서에 따른 갑상선호르몬 수용체 결합양상의 변화가 나타내는 의미에 대하여 추시 연구가 필요함은 물론 추가적으로 다른 유전자 또는 다른 종류의 세포주를 대상으로 T₃자극에 따른 갑상선호르몬 수용체 결합양상의 변화와유전자 발현을 검토하여야 할 것이다. 한편 본 연구 결과만으로는 갑상선호르몬 수용체 역동학에 대한 많은 의문점을 풀 수 없음에도 불구하고 아직까지 국내외적으로 갑상선호르몬 수용체의 역동학에 대한 연구 결과가 거의 없는 현실을 고려하여 볼 때 본 연구는 제한적이나마 일정한 농도의 갑상선호르몬 자극 전ㆍ후chicken Iysozyme 유전자의 F2-TRE 부위에서 갑상선호르몬 수용체의 교대현상을 재확인하였다는 점과 갑상선호르몬 자극 전 · 후 시간적 순서에 따른 갑상선호르몬 수용체의 역동학적 모델을 처음으로 제시하였다는 점에서 의의가 있을 것으로 생각된다. Background: The regulation of gene transcription can be controlled by both positive (enhancer) and negative (silencer) regulatory sequences. Several enhancer and silencer elements have been described in the 5' region of the chicken lysozyme gene. The silencer located at -2.4 kb upstream of the chicken lysozyme gene is composed of two separate modules (Fl and F2) that can function as silencers by themselves, but also show synergistic repression after multimerization. The F1 module is bound by a protein termed NePl and F2 module, a F2 thyroid hormone response element (F2-TRE), and can be bound by the thyroid hormone receptor (TR). F2-TRE has an inverted palindromic structure, with high affinity to TR. Although many current reported results have tried to explain the regulatory mechanism of chicken lysozyme gene expression due to the thyroid hormone, there have been few studies that clarify the TR dynamics in the F2-TRE of the chicken lysozyme gene, either with or without exposure of the thyroid hormone. Here, the changes in the TR binding patterns in the F2-TRE of the chicken lysozyme gene are described, both before and after T₃ stimulation over time. Methods: Using the stably transfected rat pituitary somatotroph tumor cell line, GC8 cells, with the F2-TRE inserted 5' to the thymidine kinase (TIC) promoter, together with a mouse TRα - expressing plasmid, a chromatin immunoprecipitation (ChIP) technique was employed to reveal the TR-TRE interaction before and after T₃ stimulation. Following the cross-linking and sonication of the cells, the immunoprecipitation was performed overnight, at 4℃, with TRαl, TRβl and TRβ2 antibodies, respectively. The binding patterns and amounts of TRαl, TRβ1 and TRβ2 to the F2-TRE, before and after 12 hours of 100nM T₃ stimulation, were analyzed using conventional and quantitative real-time polymerase chain reactions (RQ-PCR). The ChIP technique was used to give a basal value for 20 minutes and 1, 2, 4, 6, 8 and 12 hours after the 100nM T₃ stimulation, and RQ-PCR was then performed. Western blot with TRαl, TRβl and TRβ2 antibodies were also performed. Results: After 12 hours of 100 nM T₃ stimulation of the GC8 cells, the TRα1 and TRβ2 binding to the F2-TRE increased, but the TRβ1 binding to the F2-TRE decreased, by conventional PCR. Although all the TR isoforms were bound to the F2-TRE by RQ-PCR, the TRαl binding to the F2-TRE, after 12 hours of l00nM T₃ stimulation, was significantly increased (1.01→2.73, Δ =+170.3%, p<0.05), but the change in the amount of TW2 binding was not significant (2.53→2.98, Δ=+17.8%). The TRβl binding was significantly decreased compared with that of the basal level (4.59→2.06, Δ=-55.1%, p<0.05). The total TR bindings to the F2-TRE had a tendency to decrease after 12 hours of 100 nM T₃ stimulation (8.13→7.77, Δ=-4.4%). The binding patterns and amounts of TRαl, Tβl and Tβ2, both before and after the 100 nM T₃ stimulation, were also identified over time. While the TRβl bindings to the F2-TRE after 1 hour of l00nM T₃ stimulation were acutely reduced, those of the TRαl at 20 minutes and 6 hours were increased. The TRβ2 bindings showed a maximal increase at 20 minutes. The directions of the TR binding patterns, between the before and after 2 hours of 100nM T₃ stimulation, were identical to those for between 4 and 6 hours of T₃ stimulation. There was no significant difference in the TR bindings to the F2-TRE in relation to the amounts (1.5 vs. 4.5μ I) of TR antibodies used during the ChIP assays. The Western blots showed no significant change of the levels of each TR isoform proteins, either before or after 12 hours of exposure to 100nM T₃. Conclusion: These results show the dynamic binding patterns of the TR isoforms to the F2-TRE of the chicken lysozyme gene, both before and after T₃ stimulation, over time. Further investigation, however, will be needed to clarify the mechanisms of our observations. The ChIP technique may then be used to reveal the dynamic models of the cofactors, as well as TR isoforms, in the TR-regulated transcription machinery (J Kor SOC Endocrinol 18:379-391, 2003).

부신피질 호산성 과립세포종 1예

이성진,이호권,박철영,정인경,홍은경,오기원,김현규,김두만,유재명,임성희,최문기,유형준,박성우 대한내분비학회 2004 Endocrinology and metabolism Vol.19 No.1

저자들은 건강검진에서 시행한 복부 초음파검사상 우연히 좌측 부신 종괴가 발견되어 복부 전산화 단층 촬영검사와 호르몬검사를 시행한 후 부신피질 악성종양과의 감별 진단을 위해 부신절제술과 전자현미경검사를 포함한 병리조직학적 검사를 시행하여 부신피질호산성 과립세포종으로 진단한 증례를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. Oncocytomas are neoplasms, histologically are composed of epithelial cells, with abundant, acidophilic and granular cytoplasm. Electron microscopic studies of oncocytomas have shown that the cytoplasm of oncocytes is packed with mitochondria. The adrenal gland is a very rare anatomical site for oncocytomas, and to the best of our knowledge, only thirty-six cases of adrenal oncocytomas have been described. Herein, a case of a large adrenal mass in a forty-year-old man, which was incidentally detected by abdominal ultrasonography, is presented. This patient demonstrated no clinical manifestation associated with adrenal hyperfunction. Hormonal studies showed no abnormal findings, except for a mild elevation of the 24-hour urinary VMA level. Abdominal computed tomography with enhancement revealed a large, well-defined left adrenal mass, measuring 5.0×4.2 ×3.0 cm. The patient underwent a left adrenalectomy, and a light microscopic examination confirmed an adrenocortical oncocytoma, with characteristic oncocytes and polygonal, abundant, eosinophilic and granular cytoplasm. The tumor cells were positive for cytokeratin and vimentin as well as S-100, but negative for chromogranin on immunohistochemical staining. An electron microscopic examination demonstrated closely packed mitochondria, containing intramitochondrial inclusions. After surgery, there was no evidence of a recurrent or distant metastatic disease at the 5 month follow-up. In summary, an extremely rare case of a man with an adrenocortical oncocytoma is reported, which was confirmed by histological examinations, including electron microscopy (J Kor Soc Endocrinol 19:82∼89, 2004).