쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화

정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).

태연혈(太淵穴)의 유침 시간에 따른 체온 변화 -적외선체열촬영(赤外線體熱撮影)을 중심으로-

이봉효 ( Bong Hyo Lee ),이경민 ( Kyung Min Lee ),박지하 ( Ji Ha Park ),김민서 ( Min Seo Kim ),김산들 ( San Deul Kim ),박병규 ( Byeong Gyu Park ),양현동 ( Hyun Dong Yang ),예성호 ( Sung Ho Yea ),이호정 ( Ho Jung Lee ),최재원 ( Jae 경락경혈학회 2012 Korean Journal of Acupuncture Vol.29 No.2

Objectives: This study was performed to find the desirable remaining time of needle in the acupuncture treatment. Methods: The 21 volunteers were given acupuncture at LU9 vertically and needles were remained for 2 min, 10 min, 15 min, 30 min, respectively. The thermographic change induced by acupuncture was measured with Digital Infrared Thermographic Image at the following acupoints: LU11, LU10, LU9, LU8, LU5, LU1, and PC7. The statistical significance of thermographi change was evaluated using paired t-test and post hoc Wilcoxon test. Results: The most significant changes after acupuncture were produced when needles were remained for 10 min or 15 min. LU11, LU5, LU1, and PC7 were the point at which all of the remaining time produced significant change commonly. At LU11, the biggest change was produced when needle was remained for 15 min, while at LU5, LU1, and PC7, the biggest change was produced when needle was remained for 30 min, and the smallest change was produced when needle was remained for 10 min at all of acupoints of LU11, LU5, LU1, and PC7. The unbalance between left side and right was decreased the most largely in 15 min group. Conclusions: The results of this study suggest that the desirable remaining time of acupuncture needle might be 15 min.

Uncoupling Protein 3의 골격근 세포내 과발현이 OLETF 백서 및 배양된 골격근 세포에서 포도당대사에 미치는 영향

한정희,박혜선,고정민,김하영,강호경,이인규,박중열,홍성관,이재담,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:Uncoupling protein(UCP)는 미토콘드리아의 내막에 위치하는 단백질로 세포내의 과다한 에너지를 열로 발산시키는 기능을 가진다. 최근 동물의 갈색지방조직에만 존재하는 UCP와 유사성을 가진 아형들(UCP2,3)이 사람에게도 존재함이 알려져 큰 관심을 끌도 있는데 이중 UCP3는 그 발현이 골격근세포와 갈색지방조직에만 국한된다. 본 연구에서는 UCP3가 체내 인슐린 감수성을 결정하는데 가장 중요한 조직인 골격근에 국한되어 발현되는 점에 착안하여 UCP3를 골격근세포에 과발현시켰을 때 포도당 대사에 어떠한 영향이 나타나는 지를 조사하였다. 방법:25주령의 8마리의 OLETF 백서를 대상으로 하여 4마리는 골격근에 adenovirus 2mL(1×10¹²pfu/mL)를 주사하여 대조군으로 하였고 4마리는 골격근에 재조합법으로 제작된 adenovirus­UCP3 2mL(1×10¹²pfu/mL)를 주사하였다(UCP3 과발현군). UCP3를 투여한 백서에서 먹이섭취가 증가하는 경향이 있어 그 전날 대조군이 먹은 야의 먹이만큼 투여하였다. 골격근에 adenovirus를 주사한 10일 후에 euglycemic hyperinsulinemic clamp를 시행하였다. Adenovirus­UCP를 C2C12 골격근 세포에 transfection시켜 UCP3를 C2C12 골격근 세포에 transfection시켜 UPS3­C2C12를 만들고 C2C12 골격근 세포와 UPS3­C2C12 골격근 세포에서 포도당 수송 및 당원합성을 측정하였다. 결과:UCP3 과발현 OLETF에서 체중이 감소하는 경향을 보였고 인슐린 감수성이 증가하였다. C2C12세포에서 기저상태 포도당 수송은 1.28±0.17μmol/L/min였고 100nM 인슐린으로 2시간 처리한 후 2.67±0.20 μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 포도당 수송이 3.98±0.13μmol/L/min로 증가되었고 인슐린 처리 후 5.74±0.44μmol/L/min로 증가하였다. 인슐린을 처리한 UCP3­C2C12 세포에 P13K 억제제인 wortmannin을 첨가하였을 때 포도당 수송활성이 3.81±0.20μmol/L/min로 감소하였다. 기저상태 당원합성은 C2C12 세포에서 0.25±0.01μmol/L/min였고 인슐린 처리 후 0.45±0.01μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 당원합성이 0.62±0.01μmol/L/min였고 인슐린 처리 후 1.26±454μmol/L/min로 증가하였다. UCP3­C2C12세포에 wortmannin을 첨가하였을 때 당원합성율이 0.80±0.04μmol/L/min로 감소하였다. 결론:UCP3 과발현이 OLETF 백서에서 인슐린 감수성을 증가시켰고 골격근세포에서 포도당 수송 및 당원합성을 증가시켰다. wortmannin을 첨가하였을 때 포도당 수송 및 당원합성이 감소함으로 보아 이 과정이 인슐린 신호전달체계인 P13K에 일부 의존함을 알 수 있었다. Background : UC P3 is a mitochondrial membrane protein expressed selectively in the skeletal muscle and brown adipose tissue. Since the skeletal muscle is the main organ determining insulin sensitivity in the body, it was hypothesized that UCP3 overexpression in skeletal muscle cells would improve glucose metabolism. Methods : An adenovirus-UCP3 was produced by a recombinant DNA method. OLETF rats were divided into 2 groups. Four rats were injected with the adenovirus-UCP3 (UCP3 group) and others were injected with the adenovirus(control group) in the skeletal muscle. The UCP3 group was provided with the same quantity of food as that consumed by the control group on the previous day. Insulin sensitivity was evaluated by the euglycemic hyperinsulinemic clamp method. In a separate experiment, glucose transport and glycogen synthesis we evaluated in C2C212 cells transfected with ether an adenovirus or the adenovirus-UCP3. Results : The insulin sensitivity improved significantly and the body weight decreased in the UCP3 group. The glucose transport and glycogen synthesis were higher in the UCP3-C2C12 skeletal muscle cells at the basal state. After insulin treatment, glucose transport and glycogen synthesis were also higher in the UCP3-C2C12 cells but the increments were reduced after treatment with wortmannin, a PI3K inhibitor. Conclusion : Insulin sensitivity was higher in the UCP3-overexpressed OLETF rats in the in vivo study. UCP3 transfection also increased glucose transport and glycogen synthesis in the cultured skeletal muscle cells by a PI3K dependent mechanism(J Kor Diabetes Asso 25 :460~468, 2001).

Production of Iron-Binding Peptides from Colostral Whey by Enzymatic Hydrolysis

Sang Bum Kim,Myoung Soo Nam,Kwang Seok Ki,Hyeon Shup Kim,Min Jung Ku,Won Mo Cho 한국축산식품학회 2010 한국축산식품학회지 Vol.30 No.6

Colostral whey prepared from colostrum (pooled from first six post-partum milkings) was heated for 10 min at 100oC. Heated colostral whey was incubated with 1% enzymes (protein equivalent basis) for 15, 30, 60, 90, and 120 min at 50oC. Papain, pepsin, trypsin, and alcalase produced different degrees of hydrolysis (DH), 10.66%, 12.42%, 10.83%, and 25.31%, respectively, at an incubation time of 120 min. The SDS-PAGE reveals that significant amounts of bovine serum albumin (BSA), β-lactoglobulin (β-LG), and α-lactalbumin (α-LA) survived papain digestion. In contrast, pepsin completely removed BSA but not β-LG present in heated colostral whey. Alcalase completely eliminated BSA, β-LG, and α-LA. This differential hydrolysis was confirmed by reversed-phase HPLC analysis. Using ion-exchange chromatography, fraction-1 (F-1) was obtained from alcalase hydrolysate at a NaCl gradient concentration of 0.25 M. Reversed-phase HPLC chromatograms of alcalase F-1 showed numerous small peaks, which probably indicate that a variety of new peptides were produced. Iron content of alcalase F-1 was 28.94 ppm, which was the highest among all enzyme fractions, whereas iron content of colostral whey was 36.56 ppm. Main amino acids contained in alcalase F-1 were Thr (15.45%), Glu (14.12%), and Ser (10.39%). Therefore, alcalase can be used to generate good iron-binding peptides in heated colostral whey, and the resulting iron-binding peptides could be suitable as a value-added food ingredient for food supplements.

H9c2 심근 세포주에서 외인성 nitric oxide가 허혈에 의한 세포 독성에 미치는 영향

정성구,장현용,김명천,고영관,정주호,배영미,박원서,김대중,유영민,김성수,임성빈 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. Methods: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-Sdimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. Results: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100,1000μM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. Conclusion: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.

활성탄과 제올라이트 13X 충진탑을 사용한 TSA 공정에서 조업조건이 벤젠의 흡착 및 탈착에 미치는 영향

정민영 ( Min-young Jung ),서성섭 ( Sung-sup Suh ) 한국공업화학회 2018 공업화학 Vol.29 No.5

본 연구는 VOC 제거 기술인 TSA 공정에서 제올라이트 13X와 활성탄이 채워진 두 종류의 탑을 사용하여 원료농도, 질소 유량, 수증기 유량, 탑 온도 등 조업조건의 영향을 분석하였다. 본 연구의 TSA 사이클은 흡착단계, 수증기 탈착단계, 건조 및 냉각단계로 구성되었다. 2% 벤젠 농도에서 제올라이트 13X와 활성탄의 사이클 당 전체 흡착량은 각각 4.44 g과 3.65 g으로 활성탄보다 충전밀도가 큰 제올라이트 13X가 더 많은 양의 벤젠을 흡착할 수 있었다. 수증기 탈착의 결과에서 수증기 유량을 증가시키고 탑의 외부 가열로 온도를 높이면 탈착시간이 짧아지고 배출되는 벤젠의 농도가 높아지는 것으로 나타났다. 2% 벤젠 농도에서 수증기 유량을 75 g/hr로 증가시키면 탈착시간이 1 hr에서 최대 33 min까지 단축되어 상대적으로 건조 및 냉각단계의 시간이 늘어나 수증기 제거와 탑 냉각을 충분히 진행할 수 있었다. 탑 온도를 높이면 탈착량이 증가하나 150 ℃ 이상에서는 에너지소비는 증가하는 반면 탈착량은 거의 일정했다. 연속 사이클 조업에서 재생단계 완료 시 잔존하게 되는 벤젠의 비율이 늘어나면 흡착제 working capacity 감소의 원인이 될 수 있다. 제올라이트 13X를 이용해 연속 사이클 공정실험을 수행한 결과 탑 내부에 잔존하는 벤젠의 비율이 4번째 사이클 이후 일정한 값으로 유지되었다. The effects of operating conditions such as benzene concentration, nitrogen flow rate, steam flow rate, and bed temperature on TSA process were experimentally investigated as a potential VOC removal technology using two kinds of beds packed with activated carbon and zeolite 13X. The TSA cycle studied was composed of the adsorption step, steam desorption step, and drying and cooling step. At 2% benzene concentration, the total adsorption amounts of zeolite 13X and activated carbon were 4.44 g and 3.65 g, respectively. Since the zeolite 13X has a larger packing density than that of the activated carbon, the larger benzene amount could be adsorbed in a single cycle. Increasing the water vapor flow rate to 75 g/hr at 2% benzene concentration reduced the desorption time from 1 hr to a maximum of 33 min. If the desorption time is shortened, the drying and cooling step period can be relatively increased. Accordingly, the steam removal and bed cooling could be sufficiently performed. The desorption amounts increased with the increase of the bed temperature. However, the energy consumption increased while the desorption amount was almost constant above 150 ℃. In the continuous cycle process, when the amount of remained benzene at the completion of the regeneration step increased, it might cause a decrease in the working capacity of the adsorbent. The continuous cycle process experiment for zeolite 13X showed that the amount of remained benzene at the end of regeneration step maintained a constant value after the fourth cycle.

난치성 백반증에 대한 흡입물집을 이용한 비배양 표피세포이식술 20례

배정민 ( Jung Min Bae ),정한미 ( Han Mi Jung ),이한나 ( Han Na Lee ),이로우 ( Ro Woo Lee ),은성혜 ( Sung Hye Eun ),권혁선 ( Hyuck Sun Kwon ),이지혜 ( Ji Hae Lee ),김경문 ( Gyong Moon Kim ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.7

Background: As nonsurgical interventions for vitiligo are not always successful, various surgical modalities have been used in patients with refractory vitiligo. Of these, non-cultured epidermal suspension transplantation (NCES) was recently introduced to treat large recipient sites using cells from small donor tissue. Objective: We assessed the effectiveness and safety of NCES as a surgical treatment for patients with refractory vitiligo. Methods: We retrospectively reviewed 20 cases in 17 patients (11 females; median age 25 years) who underwent NCES from July 2015 through March 2018. Suction blisters (20 mm in diameter) were collected from the patient’s inner thigh at a donor-to-recipient area ratio of 1:5. After the addition of 5 mL recombinant trypsin solution to the suction blisters, followed by incubation at 37°C for 60 min, epidermal cells were manually scraped off the blister surface, and epidermal cell suspension was obtained by centrifugation at 1,500 RPM for 5 min. The suspension was applied to the vitiligo regions after epidermal ablation of those regions. Phototherapy resumed 1 month later. Treatment success was defined as ≥75% repigmentation of the surgical site, and all adverse events were noted. Results: Overall, 85.0% of cases (17/20) exhibited treatment success. Adverse events included hyperpigmentation (20%) and surgical site infection (5%), but the treatment was tolerable in all cases. Conclusion: NCES is a reliable surgical option for patients with vitiligo refractory to nonsurgical treatment. Large areas of vitiligo can be treated by NCES, and use of this technique should be encouraged in Korea. (Korean J Dermatol 2018;56(7):426∼432)

주요우울증에 대한 벤라팍신의 효과 및 안전성

이민수,남종원,강성민,연병길,오병훈,이철,정인과,채정민,백인호 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요우울증 환자에서 벤라팍신의 치료 효과와 안정성을 조사하기 위해 다기관 개방연구를 시행하였다. 방 법 : DSM-IV 진단 기준에 의거하여 주요우울증으로 진단된 환자중 벤라팍신 투여에 동의한 환자를 대상으로 하였다. 선택된 환자에서 다른 항우울제를 복용하고 있는 경우 14일 이상의 약물 배설기간을 가진후 벤라팍신을 6주간 투여하였으며, 기준점, 1주, 2주, 4주, 6주 후에 HAM-D, MADRS, 그리고 CGI등을 사용하여 평가하였다. 본 연구기간중 발생된 모든 부작용은 부작용의 발생 및 소설 시기, 심한 정도, 발생 빈도, 벤라팍신과의 관련성, 관련 조치 및 결과에 대하여 증례기록서에 기록하도록 하였다. 결 과 : 총 141명을 대상으로 하였으며, 이중 94명(66.7%)이 6주간의 연구를 완결하였고, 47명(33.3%)이 중도탈락하였다. HAM-D총점수는 벤라팍신 투여 1주후부터 유의한 감소를 나타내었으며, 2주,4주, 6주후에도 지속적인 감소를 보였다. MADRS의 총점수도벤라팍신 투여 1주 후부터 유의한 호전을 나타내었으며, 2주, 4주, 6주 후에도 지속적인 감소를 보였다. CGI에서도 기준점, 1주, 2주, 4주, 6주 후 각각의 시점 사이에 유의한 호전이 보였다. 활력징후, 일반 혈액학, 생화학, 심전도 검사 등에서 유의한 변화는 없었다. 벤라팍신과 관련된 부작용으로 흔히 보고한 증상은 오심(10.6%), 소화불량(9.5%), 변비(8.5%), 현기증(8.5%)등 이었다. 결 론 : 다기관 개방연구를 통해 주요우울증 환자에 대한 벤라팍신의 투여는 우울증상의 호전에 효과적이었으며 안전하였다. Objective : A Multicenter open-label study was conducted to evaluate the clinical efficacy and safety of venlafaxine for the tretment in patients with major depression. Method : The study was done in patients with major depression diagnosed by DSM-IV who accepted venlafaxine medication. In cases of the patients taking other antidepressants, 6 weeks of venlafaxine medication was carried out after 14 days of drug excretion period and evaluation using HAM-D, MADRS, and CGI was done at baseline, and after 1, 2, 4, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, relationship with venlafaxine, managements and results have been putted into the records. Results : A total of 141 patients were enrolled. Among 94 of them finished the 6 weeks of research and 41 of them did not make it through the research. Total HAM-D scores showed significant decrease after 1 week of venlafzxine medication and continous decrease through the study period. Total scores of MADRS also showed significant improvement after 1 week and continuous decrease through the study period. Similarly, CGI showed significant improvement between baseline, 1, 2, 4, and 6 weeks. There were no significant changes in vital sign, CBC, chemistry, and EKG. The commonly reported side effects of venlafaxine were nausea(10.6%), indigestion(9.5%), constipation(8.5%), and dizziness(8.5%). Conclusion : According to the results, venlafaxine was effective and safe in the treatment of patients with major depression.

Dry etching of polydimethylsiloxane using microwave plasma

Hwang, Sung Jin,Oh, Dong Joon,Jung, Phill Gu,Lee, Sang Min,Go, Jeung Sang,Kim, Joon-Ho,Hwang, Kyu-Youn,Ko, Jong Soo IOP 2009 JOURNAL OF MICROMECHANICS AND MICROENGINEERING - Vol.19 No.9

<P>This paper presents a new polydimethylsiloxane (PDMS) dry-etching method that uses microwave plasma. The applicability of the method for fabricating microstructures and removing residual PDMS is also verified. The etch rate of PDMS was dominantly influenced by the gas flux ratio of CF<SUB>4</SUB>/O<SUB>2</SUB> and the microwave power. While the PDMS etch rate increased as the flux ratio of CF<SUB>4</SUB> was increased, the etch rate decreased as the flux ratio of O<SUB>2</SUB> was increased. The maximum etch rate of 4.31 µm min<SUP>−1</SUP> was achieved when mixing oxygen (O<SUB>2</SUB>) and tetrafluoromethane (CF<SUB>4</SUB>) at a 1:2 ratio at 800 W power. The PDMS etch rate almost linearly increased with the microwave power. The ratio of the vertical etch rate to the lateral etch rate was in a range of 1.14–1.64 and varied with the gas fluxes. In consideration of potential applications of the proposed PDMS etching method, array-type PDMS microwells and network-type microprotrusion structures were fabricated. The contact angle was dramatically increased from 104° (non-etched PDMS surface) to 148° (etched PDMS surface) and the surface was thereby modified to be superhydrophobic. In addition, a thin PDMS skin that blocked holes and PDMS residues affixed in nickel microstructures was successively removed.</P>

개의 췌도분리에서 췌장의 팽창과 콜라겐 분해요소

이상훈,김성주,박정환,김종성,오승훈,한진수,정인경,양태영,김동준,김광원,이문규,민용기,이명식,정재훈,함종렬 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.2

Backgrounds: One of the main problems conditioning the outcome of islet transplantation is the ability to separate a sufficient number of viable islets with preserved function. Islet purification is critically affected by all of the isolation stages. Thus, it is necessary to set up the standard isolation method that islets are separate well from acinar without compromising islet yield and viability. Methods: Twenty three adult mongrel dogs were used for the experiment of total pancreatectomy with islet isolation. The islets were properly isolated by a modified Recordi method. The obtained islets were further purified by centrifugation on discontinuous gradients using cell separation system (Model 2991, Cobe, Lakewood Colo). We evaluated islet number (islet equivalent number, 150 um equivalents/kg of recipient body weight, IEq/kg), purity, cell volume, viabilty, recovery rate, and comparison of outcome according to the isolation conditions. Results: 1) The mean of islet numbers before purification were 13543±9431Eq/kg, digestion times were 13.8±2.6 min., digestion temperature was 37.4±0.2℃, purity was 59.7?.0%, viability was 90.0±2.1%, cell volume was 4.7±1.1 mL, islet number after purification were 4064±361 IEq/kg, and recovery rate was 29±2.9%. 2) Isolated islet numbers were different according to the degree of pancreas distension with collagenase, digestion temperature, and digestion time. 3) The best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase. 4) According to multiple regression adjusted by variable factors, the degree of pancreas distension with collagenase and digestion time were independently associated factors for successful islet isolation. Conclusions: In this study, we concluded that the degree of pancreas distension with collagenase and digestion time were independent factors for successful islet isolation and the best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase.