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      • 봉독약침이 류마티스 관절염 환자의 관절 통증, 종창 및 급성 염증 반응에 미치는 영향

        이상훈,이현종,백용현,김수영,박재경,홍승재,양형인,김건식,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

        Objective In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender Joint counts, swollen joint counts, Visual analog scale(VAS), morning stiffness, ESR. C-reactive protein(CRP) were analyzed before and after BV therapy. Results The results as follows. 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy(9.0±7.9 vs 15± 11.4, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy(50±61 vs 15±23, p=0.001). 3. VAS in patients after BV therapy was significantly lower than those before BV therapy(608± 17.6 vs 380± 159, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy(119.1± 112.6 min vs 59.0±89.7 min, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed on long-term effect of BV therapy.

      • 한국인에게서 그레이브스병 약물치료의 적정기간

        이형숙,이동훈,정희선,이종우,김정은,신승수,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

        연구배경: 그레이브스병의 치료에는 항갑상선제, 수술 및 방사성 요오드법이 선택되어 사용되고 있다. 이중 항갑상선제는 가장 많이 선호되고 있으나 낮은 관해율과 높은 재발율로 장기간 치료기간이 요구된다. 저자들은 그레이브스병 환자에게서, 선택되는 치료법의 선호도와 각 치료법의 관해율을 조사하고자 본 연구를 시행하였다. 또한 본 연구에서는 항갑선제 치료의 적정기간을 평가하고자 하였다. 방법: 아주대학교병원에 내원한 환자 중 1년 이상 추적관찰이 가능한 205명의 그레이브스병 환자를 대상으로 조사하였다. 항갑상제군, 수술군 및 방사성 요오드군은 각각 170명, 29명 그리고 6명이었다. ROC curve를 이용하여 약물치료의 예후예측인자를 분석하였다. 결과: 1) 그레이브스병 환자의 치료 방법의 선택은 항갑상선제군, 수술군 및 방사성 요오드군 각각 170명(83.0%), 29명(14.1%) 그리고 6명(2.9%)으로 항갑상선제 치료가 가장 선호되었다. 2) 그레이브스병의 관해율은 항갑상선제군, 수술군 및 방사성 요오드군에서 각각 60.0%(102/170명), 96.5%(28/29명) 그리고 83.0%(5/6명)으로 수술군이 가장 높았다. 3) ROC curve의 AUC는 치료기간과 진단시 TBII가 각각 0.709 및 0.648이었고 적절한 약물투여 추적 관찰기간은 26개월이었다. 결론: 그레이브스병의 일차 치료법으로는 항갑상선제가 선호되고 있으나 수술 및 방사성 요오드 치료군에 비해 상대적으로 낮은 관해율을 보였다. 따라서 항갑상선제 치료로 26개월 이상 관해가 되지 않을 경우에는 치료 방법의 변경을 고려하는 것이 관해율을 높이는데 도움이 될 것으로 생각된다. Background: Graves' disease in an organ specific autoimmune disease. Three kinds of therapeutic modalities (antithyroid drugs, ablation with radioactive iodine and subtotal thyroidectomy) are frequently performed for the management of this disease. The most popular therapeutic policy for the disease in Korea is antithyroid treatment. We analysed and compared the remission rates of all three modalities for Graves' disease, and evaluated the antithyroid modality to determine the correct duration of treatment. Subjects & Methods : The medical records of 205 patients with Graves' disease were reviewed. For the evaluation of the antithyroid modality medical treatment, antithyroid drugs were administered for more than 1 year. The prognostic factors associated with remission were analysed by means of an ROC curve. Results: 1) Of the 205 patients, proportions that received medical therapy, subtotal thyroidectomy and radioiodine therapy were 83.0, 14.1 and 2.9%, respectively. 2) The remission rates of the medical therapy, surgery and radioiodine therapy were 60.0, 96.5 and 83.0%, respectively. 3) The remission rate of the medical therapy was associated with the duration of medication and TBII activity. The determined proper duration for the antithyroid treatment was 26 months from the ROC curve analysis. Conclusion: The above results suggest that the proper duration of antithyroid treatment for Graves' disease is 26 months, after which time the subtotal thyroidectomy or radioiodine therapy should be considered if the disease has not remitted (J Kor Soc Endocrinol 18:24∼31, 2003).

      • KCI등재

        Anti‑inflammatory effect of Rosa laevigata extract on in vitro and in vivo model of allergic asthma via the suppression of IgE and related cytokines

        Seung‑Hyeon Lee,Seung‑Han Choi,In‑Seung Lee,Yumi Kim,Eun‑Jin An,Hyeung‑Jin Jang 대한독성 유전단백체 학회 2020 Molecular & cellular toxicology Vol.16 No.2

        Backgrounds Exposure to a toxic stress environment leads to excessive inflammatory reactions and induces allergic asthma resulting in airway hyper-responsiveness. We investigated whether Rosa laevigata Michx. (RL) exhibits anti-inflammatory effects related allergic asthma in both an in vitro and in vivo studies. Methods To investigate the preventive effect of RL, A549 cells were pretreated with non-toxic doses of RL (500, 1000 μg/ mL) and induced by epidermal growth factor (EGF) (10 ng/mL). First, we evaluated cytotoxicity via a MTT assay. The inhibitory effects of NF-κB activity and COX-2 expression were confirmed by a western blot assay. In the in vivo study, BALB/c mice were challenged with regard to ovalbumin via an intraperitoneal injection of RL (50, 100 mg/kg) and were killed to collect bronchoalveolar lavage fluid, lung tissues and blood serum. The number of inflammatory cells, the secretion of IgE and related cytokines were monitored by ELISA and multiplex assays. Results RL significantly suppressed NF-κB activity and COX-2 expression levels in EGF-induced A549 cells. In a chronic inflammation mice model, pretreatment of RL attenuated allergic airway inflammation by reducing inflammatory cells, the secretion of IgE and related cytokines in a dose-dependent manner. Conclusions The results of this study present the possibility of RL as a therapeutic agent for allergic asthma patients via the suppression of IgE and related cytokines.

      • 당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

        오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

        연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

      • 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.

      • SCOPUSKCI등재

        위에 발생한 유암종 (Carcinoid Tumor) : 1예 보고

        김남재,김진희,이경태,서광식,정현용,이승민,김석현,이병석,이헌영 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3

        A carcinoid tumor of the stomach is uncommon, has no clinical symptoms, and is regarded as a benign. It is also incidentally found in most cases. 48-year-old woman with gastric carcinoid tumor was admitted. She had suffered from a anorexia and a dry mouth for 4-months. A gastroscopy revealed a polypoid mass on the greater curvature of the mid-body of the stomach which was subsequently thought to be an adenocarcinoma. An endoscopic mucosectomy revealed however, that it was a carcinoid tumor. A case of carcinoid tumor of the stomach is here by presented with a brief literature review.

      • KCI등재

        Thermal cycling 과 시효처리가 Glass-Ionomer수복재의 인장강도에 미치는 영향

        이승익,백병주,김재곤,이승영,김문현 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.4

        본 연구에서는 구강환경과 유사한 액상의 조건하에서의 온도변화가 광중합형 글래스아이오노머계 수복재의 인장강도에 미치는 영향을 평가하기 위해 대조군으로 2종의 재래형 glass ionomer를 선택하고 실험군으로 2종의 광중합형의 resin-modified glass ionomer와 2종의 polyacid-modified resin composite을 선택한 다음 수중에서의 thermal cycling과 시효처리를 행하였으며, 다음과 같은 결론을 얻었다. 1. 글래스아이오노머 수복재의 인장강도를 측정한 결과, polyacid-modified resin composite, resin-modified glass ionomer 그리고 재래형 glass ionomer의 순으로 나타났다. 2. 인장강도는 30일간의 시효처리로 증가되는 경향을 보였다. 3. 재래형 glass ionomer 수복재의 인장강도는 thermal cycling 처리로 증가되는 경향을 보였으며, 37℃의 증류수 중에 1시간 침적한 군과 10,000회의 thermal cycling을 비교한 결과 유의한 차이로서 강도의 증가를 나타냈다(P<0.01). 4. thermal cycling 군의 인장강도는 DR군이 45.4MPa로 최대치를, FL군이 13.4MPa로 최소치를 나타냈으며, 각 군간의 통계적 유의성을 검증한 결과 polyacid-modified resin composite의 인장강도가 나머지 군과 유의한 차이를 보였다(p<0.05). 5. 특성강도는 DR군이 48.6MPa로 가장 높은 강도치를 보였으나, Weibull 계수는 CG군이 8.9로 가장 높은 값을 보여 시험재료 중에서 가장 작은 강도의 분산을 나타냈다. This study was performed to evaluate the effect of aging and thermal cycling on the tensile strength of six commercially available glass-ionomer materials: two chemically set glass-ionomer materials(Fuji Ⅱ, fuji Ⅸ), two resin-modified glass-ionomer materials(Fuji Ⅱ LC, Vitremer), and two polyacid-modified composite resins(Compoglass, Dyract). Rectangular tension test specimens were fabricated in a teflon mold giving 5mm in gauge length and 2mm in thickness. All samples were divided into 3 groups. Group 1 was immersed in a 37℃ distilled water for 1 hour. Group 2 was immersed in a 37℃ distilled water for 30 days. Group 3 was subjected to 10,000 thermal cycles between 5℃ and 55℃, and the immersion time in each bath was 15 seconds per cycle. Tensile testing was carried out at a cross-head speed of 0.5mm/min and fracture surfaces were examined with scanning electron microscope. The results obtained were summarized as follows; 1. The polyacid-modified composite resins were stronger than the resin-modified glass-ionomer materials, which were much stronger than the conventional glass-ionomer materials. 2. Tensile strengths were slightly increased after aging treatments for 30days. 3. Tensile strengths of conventional glass ionomers were significantly increased after thermal cycling treatment(p<0.01). 4. The highest tensile strength value of 45.4MPa was observed in the Dyract group and the lowest value of 13.3MPa was observed in the Fuji Ⅱ LC group after the thermal cycling test, and the strengths of polyacid-modified composite groups were significantly higher than those of other groups. 5. The highest characteristic strength value of 48.6MPa was obtained in the Dyract group, however the highest Weibull modulus value of 8.9MPa was obtained in the Compoglass group after thermal cycling test.

      • KCI등재

        백서 두개관세포에서 Ipriflavone이 골조직 개조에 미치는 영향

        이용승,김영준,이기헌,황현식 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.4

        본 연구는 ipriflavone (isopropoxyisoflavone)의 투여가 백서 두개관세포의 증식과 골조직 개조에 미치는 영향을 알아보고자 시도되었다. 태령 20-21일째의 백서 두개관세포를 분리 배양한 후, 10^(-9) M부터 10^(-5) M까지 농도의 ipriflavone을 투여하고 1일째와 3일째에 MTT 분석을 시행하여 흡광도를 평가한 결과, 모든 농도에서 백서 두개관세포의 증식을 보이지 않았다. 한편 골조직 개조에 미치는 영향을 알아보기 위하여 14일째에 alizarin red염색을 시행하여, 형성된 석회화 결절 면적을 측정하였을 때, 10^(-8) M, 10^(-7) M, 10^(-6) M 농도를 투여한 경우 석회화 결절 형성이 유의하게 증가하였다. 골아세포의 분화에 미치는 영향을 알아보기 위하여 ipriflavone을 투여하고 7일째와 14일째에 추출한 RNA를 역전사 중합효소 연쇄반응(RT-PCR)을 시켜 bone sialoprotein (BSP), type 1 collagen (COL I), osteocalcin (OCN) 유전자 발현을 관찰한 결과 BSP와 COL I 유전자는 배양 7일째 높은 발현을 보였고, OCN 유전자는 배양 14일째 높은 발현을 보였다. 이상의 연구결과 ipriflavone이 백서 두개관세포에서 석회화를 촉진시키고 골아세포의 분화에 관여하는 BSP, COL I 및 OCN 유전자 발현을 증가시켜 골조직의 개조를 빠르게 할 수 있음을 시사하였다. lpriflavone (isoprofoxyisoflavone), a synthetic derivative from soy isoflavone diazein, has been shown to inhibit bone resorption and perhaps stimulate bone formation. This study was performed to examine the effects of ipriflavone on the proliferation and bone remodeling in rat calvarial cells in vitro. The rat calvarial cells were isolated from fetus aged 20 to 21 days and cultured in BGJb media. The graded concentration of ipriflavone (10^(-9)-10^(-5) M) was administered into cultured cells. When the cell proliferation was estimated through the measurement of MTT assay, there was no increase in cellular proliferation of the rat calvarial cell at any ipriflavone concentration. The cellular activity was evaluated through the formation of mineralized nodules stained by alizarin red. The formation of mineralized nodules significantly increased at concentrations of 10^(-8) M, 10^(-7) M and 10^(-6) M ipriflavone. Reverse transcription-polymerase chain reaction analyses (RT-PCR) were done at 7 and 14 days after culture to detect the expression of Bone Sialoprotein (BSP), Type I collagen (COL I) and Osteocalcin (OCN). As a result, the expressions of BSP and COL I increased of the 7th day of culture and the expression of OCN increased on the 14th day of culture. These results indicate that ipriflavone facilitates the bone remodeling process by promoting rat calvarial cell differentiation and stimulating mineralization through increased expression of extracellular matrix genes, such as BSP, COL I and OCN.

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