위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-

위암 환자에서 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김삼용,김영건 충남대학교 암연구소 1991 癌共同硏究所 硏究誌 Vol.1 No.1

We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly decreased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD_(4) positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

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.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

장상피화생과 Helicobactor pylori와의 상관 관계에 관한 연구

이복희,김대수,이현숙,진영주,윤세진,송형근,성노현,정현용,이동호 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

In 1965 Lauren divided advanced gastric carcinoma into two main types-namely, "intestinal" and "diffuse" type carcinoma, which differ not only morphologically but also in their clinical and epidemiological characteristics. Moreover, a different histogenetic process has been postulated by many authors that intestinal type gastric carcinoma might arise from areas with intestinal metaplasia. Since Warren and Marshall reported the presence of Helicobacter pylori in the stomach in 1983, strong evidence has been obtained that there is a close relationship between Helicobacter pylori and chronic gastritis, atrophic gastritis, intestinal metaplasia, and intestinal type gastric carcinoma. To study the relationship between intestinal metaplasia and Helicobacter pylori infection, we performed gastroscopic biopsies and CLO tests taken from patients with epigastric pain. Only 87 patients with macroscopically suspected antral gastritis were included. The prevalence of intestinal metaplasia in gastric antral biopsies increased from 33.3% in the age group<30 years to 63.6% in the age group 60 years. When all patients were divided into two age groups-namely, (i)<50 years(n=41) and (ii)≥ 50 years(n-=46), intestinal metaplasia was found significantly more often in patients ≥ 50 years. ((i) 39.2%, (ii) 54.3%, p<0.0001). The prevalence of Helicobacter pylori in gastric antral biopsies decreased from 66.7% in the age group<30 years to 62.5%, in the age group in the age group 50 to 59 years. When all patients were divided into the same two age groups-namely(i)<50 years and (ii)≥50 years, the prevalence of Helicobacter pylori did not differ between two groups in a statistically significant way. The mean age of intestinal metaplasia positive patients who were also Helicobacter pylori positive was 48±11.0(mean±S.D.)years, whereas the mean age of intestinal metaplasia positive patients who were Helicobacter pylori negative was 52±9.7(mean±S.D.)years. In conclusion. although our data do not prove a causal relationship between Helicobacter pylori infection and the histogenesis of intestinal metaplasia, we suggest that Helicobacter pylori plays an important role in the development of intestinal metaplasia in the gastric mucosa. Whether Helicobacter pylori has to be present at all times during this process or is only necessary as a 'trigger', needs further research.

G-CSF로 체내 증폭된 골수를 이용한 동종 조혈모세포이식

이종욱,김정아,민창기,김희제,엄현석,박수정,서정곤,김동욱,홍영선,민우성,김춘추,김동집 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

연구배경: 이식시 주입되는 골수세포수는 생착 속도 및 생존율과 밀접한 관계가 있으나, 임상적으로 환자의 체중이 공여자에 비해 지나치게 많을 때 단위 체중당 환자에게 주입되는 세포의 양이 적어 문제가 될 수 있다. 방법: 저자들은 가톨릭 조혈모세포이식 센터에서 동종 골수이식을 시행한 환자들 중 환자의 체중이 공여자에 비해 10kg이상 많은 경우 골수 채취 전에 공여자에게 3일간 피하로 G-CSF(10ug/kg/day)를 투여하여 골수를 체내(in vivo) 증폭시킨 후 골수이식을 시행한 25예의 환자를 대상으로 고식적인 방법으로 골수이식을 시행한 위험인자가 일치되는 대조군과 비교하여 이식된 세포수, 혈구의 회복속도 및 이식편대 숙주반응(GVHD)의 발생율, 그리고 생존율 등을 비교 분석하였다. 결과: 단기간의 G-CSF 투여로 증폭된 골수의 총 유핵세포수, 단핵구수는 대조군에 비해 3-5배, CD34 + 세포수는 6배 증폭되었으며, 두 군간에 세포의 면역표현형(CD4, CD5, CD7, CD8, CD20)의 차이는 없었다. 중성 백혈구 수가 0.5×10^(9)/L 이상 회복되는 시기는 두 군간의 차이가 없었으나(15.5일 vs 16일; p=0.131), 혈소판 수가 30×10^(9)/L 이상으로 회복되는 시기는 G-CSF 투여군에서 의의있게 단축되었다(20일 vs 26일; p=0.013). 두 군간 급성 및 만성 GVHD의 발생률과 정도의 차이는 없었으며, 이식 후 재발 및 생존율의 차이도 없었다. 결론: 이식전 공여자에게 단기간 G-CSF를 주사하여 생체내에서 골수 조혈모세포를 증폭시킨 후 이식하는 방법은 공여자와 환자의 심각한 체중 차이로 인해 단위체중당 이식되는 조혈모세포양이 부족한 환자들에게 안전하고 유용한 방법일 뿐만 아니라 GVHD의 증가 없이 빠른 혈구회복을 기대할 수 있는 이식기법이라고 생각한다. 향후 증폭된 골수 조혈모세포의 특성 연구 및 이의 효용성을 확인하기 위한 전향적인 연구가 필요하리라고 생각된다. Background: Sufficient stem cell doses are necessary to overcome engraftment failure in allogeneic bone marrow transplantation(BMT). Cell doses harvested may depend on body weight (BW) difference between donor and recipient. In practice, it is important to achieve large number of stem cells from donor who were lower BW than that of recipient. Methods: We have tried to inject G-CSF(10ug/kg/day) subcutaneously for 3 days to the allogeneic donor with lower BW than recipient before harvest to increase BM inoculum. BM was infused into patients without any manipulation on day 5. A total 25 patients were enrolled; 12 AML, 6 ALL, 5 SAA and 2 CML(expansion group). We compared the expansion group with 25 historical control patients, matched for diagnosis and clinical characteristics, who underwent unprimed BMT. Results: Recipient BW is not different between the expansion and control group. However, allogeneic donors in the control group weigh heavier than those in the expansion group. The yield of TNC, MNC, and CD34^(+) cells from G-CSFprimed BM was significantly higher than that from unprimed BM. There was no difference in immunophenotyping analysis(CD4, CD5, CD7, CD8, CD20) between two groups. The median time reaching to absolute neutrophil count more than 0.5×10^(9)/L was not different(15.5 vs 16 days: p=0.131), but time to platelet recovery more than 30×10^(9)/L was significantly shorter for the patients who received G-CSF-primed BM (20 vs 26 days: p=0.013). There was no difference in the incidence of acute and chronic GVHD, relapse rate and overall survival between the two groups with a median follow-up of 13 months. Conclusion: These data suggest that the short-term administration of G-CSF to an allogeneic donor prior to BM harvest seems to be a feasible method to achieve an adequate number of cell doses for patients who weigh higher than donors. Randomized, prospective study is needed to evaluate the efficacy of allogeneic BMT using in vivo expansion of BM by G-CSF.

Continuous wave of obturation technique에서 플러거의 다양한 적용 깊이에 따른 근단부 폐쇄효율 비교

이상진,박정길,허복,김현철 大韓齒科保存學會 2007 Restorative Dentistry & Endodontics Vol.32 No.6

이 연구와 목적은 continuous wave of obturation technique으로 근관 충전을 할 때, 다양한 heat source plugger의 깊이에 따른 근단부 근관 폐쇄능력을 비교하는 것이었다. 직전 형태 발거 소구치를 #35/.06크기까지 니켈티타늄 파일을 사용하여 성형 및 세정하였다. 성형과 세정이 완료된 치아를 heat source plugger의 적용 깊이에 따라 15개씩 5군으로 분류하였다: 3 mm, 4 mm, 5 mm, 6 mm, 7 mm. 양성 대조군을 제외한 모든 근관은 E&Q plus (Meta Biomed Co., Chungju, Korea)를 사용하여 #35/.06 gutta-percha cone으로 충전하였다. 모든 치아의 근첨공 주변 1 mm를 제외하고 nail varnish를 도포하였고 음성 대조군은 근첨공을 포함하여 전체 면을 도포하였다. 모든 시편을 1% 메틸렌블루 용액에 72시간 동안 보관한 다음 치근첨으로부터 1, 2, 3 mm 높이에서 수평으로 절단하였다. 각 단면을 12.5 x 2.5배 현미경하에서 관찰하고 디지털 카메라로 촬영하였다. 염색제 누출 평가를 위해 five-degree scoring system을 사용하였다. 각 절단면에서의 점수를 모두 합하여 한 시편의 점수로 사용하고 통계학적 분석을 하였다. 이 실험 조건하에서, 3 - 7 mm 까지의 heat source plugger의 적용 깊이는 근단부 폐쇄에서 유의한 차이를 나타내지 않았다. 5 - 7 mm의 Buchanan's protocol을 포함한 3 - 7 mm를 모두 임상 적용에서 받아들여질 만하다고 보인다. The purpose of this study was to compare apical sealing ability of continuous wave canal filling technique according to various heat source plugging depths. Eighty one extracted human premolars with straight root were cleaned and shaped to size 35 using .06 taper rotaiy NiTi file. After cleansing and shaping, the teeth were divided into 5 groups following the heat source probing depths from the apex ; 3, 4, 5, 6 and 7 mm. All specimens were filled using E&Q Plus with #35/.06 tapered gutta-percha cone. The positive control teeth were not filled. All teeth were coated with nail varnish except the apical 1 mm around the apical foramen. Negative control teeth were completely sealed include the apical foramen. All specimens were immersed in 1% methylene blue solution for 72 hours. Then the specimens were sectioned horizontally at 1, 2 and 3 mm from the root apex. Each sectioned surface was photographed using a digital camera attached to the stereomicroscope at 12.5 x 2.5 fold magnification. All points at 1, 2 and 3 mm were summed as final score of one specimen. Statistical analysis of the collected data was performed. Under the condition of this study, there was no significant difference between the heat source plugging depths of 3, 4, 5, 6 and 7 mm in apical sealing ability. All of apical heat source plugging depth from 3 to 7 mm including Buchanan's protocol -from 5 to 7 mm- seems to be acceptable in clinical application.

전기도금을 이용한 스테인레스 스틸 각형 선재의 굵기 증가 후 물성 변화

이정석,이기헌,황현식 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.2

본 연구는 전기도금을 이용하여 각형 선재의 굵기를 증가시킨 후 기존의 선재와 물성을 비교함으로서 이의 임상적 적용 가능성을 알아보고자 시행되었다. 한 변의 길이가 0.016 인치인 정사각형 스테인레스 스틸 교정용 선재에 니켈 전기도금을 시행하여 굵기를 0.01 인치 증가시켜 한 변의 길이가 0.017 인치인 정사각형 선재로 만들었고 도금층의 밀착성을 증진시키기 위해 400℃의 전기로 에서 10분간 열처리를 시행하였다. 시편의 물성변화를 알아보기 위하여 전기도금을 이용하여 제작된 15개의 시편을 실험군(016P군)으로, 기존의 0.016인치(016), 0.017 인치(017군) 스테인레스 스틸 교정용 선재를 대조군으로 설정한 후 3점 굴곡 시험과 비틀림 시험을 시행하여 다음과 같은 결과를 얻었다. 1. 3점 굴곡 시험 결과 016P군에 비해 강성과 항복강도, 국한강도 모두 증가하는 경향을 보였으며, 강성과 극한강도는 통계적으로 유의한 차이가 있었다(p<0.05). 2. 3점 굴곡 시험 결과016P군이 017보다 강성과 항복강도, 극한강도 모두 낮은 경향을 보였으며, 강성은 통계적으로 유의한 차이가 있었다(p<0.05). 3. 비틀림 시험 결과 016P군이 016군에 비해 비틀림 모멘트, 최대 비틀림 모멘트 모두 높았으며, 통계적으로 유의한 차이가 있었다(p<0.05). 4. 비틀림 시험 결과 016P군이 017군에 비해 비틀림 강성과 항복 비틀림 모멘트, 최대 비틀림 모멘트 모두 낮은 경향을 보였으며, 이 중 항복 비틀림 모멘트와 최대 비틀림 모멘트에서 통계적으로 유의한 차이가 있었다(p<0.05). 이상의 결과를 요약해 보면 각형 선재에 도금을 시행하여 굵기를 증가시키고 물성이 증가될 수 있음을 알았다. 비록 도금을 시행한 016P군이 기존의 017군보다 강성이 낮았으나 이는 반대로 016P군이 017군보다 탄성이 높음을 나타내며 토크조절이 부족한 경우 브라켓 슬롯에 쉽게 삽입되어 교정력을 발휘할 것으로 기대된다. The purpose of this study was to evaluate clinical applications of electroplating method through investigation of the physical properties of orthodontic rectangular wires according to varying their cross section. For the study, it was accomplished to electroplate the 0.016-inched orthodontic rectangular stainless steel wire. The cross section of stainless steel orthodontic rectangular wire increased from 0.016 x 0.016 inch to 0.017 x 0.017 inch by electroplating. The wire was heat treated to improve an adhesion between the wire and electroplated metal. A three=point bending test and torsion test were conducted in order to compare physical properties among three wire groups; 0.016 X 0.016 wires (group 016), electroplated 0.016 x 0.016 wires (group 016P) and 0.017 x 0.017 wires (group 017). Through the investigation of each wire group, following results were obtained. 1. At three-point bending test, the group 016P showed higher tendency in the degree of stiffness, yield strength and ultimate tensile strength than the group 016. Stiffness and ultimate tensile strength showed statistically significant differences between two groups at three-point bending test (p<0.05). 2. Stiffness, yield strength, and ultimate tensile strength of the group 016P showed lower tendency than those of the group 017. Stiffness showed statistically significant differenced between two groups at three-point bending test (p<0.05). 3. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed higher tendency than those of the group 016. All measurements showed statistically significant differences between two groups after torsion test (p<0.05). 4. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed lower tendency than those of the group 017. Yield torsional moment, and ultimate torsional moment showed statistically significant differences between two groups after torsion test(p<0.05)

기(氣)수련이 정신건강 프로파일에 미치는 효과

정영자,정현익,이명수,서채문 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

This cross-sectional investigation evaluated the trend of psychological changes by Qi-training using a self-report inventory of emotional distress, Symptom Check List-90-Revision (SCL-90-R). Forty-one normal healthy subjects (mean age: 21.0±5.4) and one hundred-twenty-three Qi-trainees (divided into three groups, primary, middle and high level) participated in this study. Primary level group has received 1-4 months Qi-training (mean age: 22.0±7.8, n = 41); middle level group has 5-12 months Qi-training (mean age: 20.0±7.8, n = 41); and high level group has more than 1 year Qi-training (mean age: 22.7± 6.7, n = 41). Our results show that all of psychologucal symptom scales of Qi-trainees over lyear were significantly lower scores compared to controls. In addition, high level group had lower global indexes scores than control. A significant negative correlation was found between the Qi-training period and all SCL-90-R subscales except phobic anxiety. These results suggest that Qi-training is effective in protection as well as reduction of psychological symptomatology.

쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악소구치에 대한 응력 분석 : 3차원 유한요소법적 연구

이선화,김현철,허복,김광훈,손권,박정길 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.6

이 연구의 목적은 쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악 제2소구치에 대한 응력 분포를 3차원 유한요소법으로 분석하여 평가하기 위한 것이다. 발치된 상악 제2소구치를 이용하여 Micro-CT로 스캔한 후 3D-D0C-TOR로 3차원 유한요소 모형을 제작하였다. 제작된 소구치 모형에 근관 와동을 형성하고 쐐기형 5급 와동과 글래스 아이오노머 기저재의 사용 여부를 구분하여 근관 와동을 혼합형 복합레진으로 충전하였다. 협측 교두 또는 설측 교두에 500 N의 하중을 가하고, ANSYS 8.0 프로그램으로 인장 응력의 분포를 분석하여 평가한 결과 베이스 사용유무에 따른 응력 분포의 차이는 없었다. 협측 교두에 하중이 가해질 때, 하중점과 교합면의 중심구, 구개측 백악법랑경계부에 과도한 인장 응력이 집중되었으며, 5급 와동이 없는 경우보다 5급 와동이 있는 경우에 약간 더 높았다. 설측 교두의 협측 경사면에 하중이 가해질 때, 하중점과 교합면의 중심구, 협측 치경부에 과도한 인장 응력이 집중되었으며, 5급 와동이 있는 경우가 5급 와동이 없는 경우보다 약간 더 낮았다. The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class Ⅴ cavity restored with composite resin using a 3D finite element analysis. The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class Ⅴ cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji Ⅱ LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS. Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class Ⅴ cavity were slightly higher than that of the tooth without class Ⅴ cavity. When the load was applied the palatal cusp, excessive" high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The ten-sile stress values of the tooth without class Ⅴ cavity were slightly higher than that of the tooth with class Ⅴ cavity.