응급실에 내원한 환자에서 어지럼증의 원인과 임상양상의 분석

문원식,정경운,위준선,문정미,전병조,김용권,소정일,류진호,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Recently, The number of patients who have been complaining of the vertigo or dizziness has been increasing due to rapid growth of elderly population and senile disease. The differentiation of dizzy patients is not familiar to most emergency physicians. This study was designed to differentiate true vertigo and to investigate the clinical difference among central vertigo, peripheral vertigo, and other causes of dizziness. Methods: The authors analyzed the cases of 237 dizzy patients who visited the emergency department of Chonnam University Hospital during the recent 2 years. For the base of dizziness, associated past illnesses, severity, nystagmus type, and the causes of central and peripheral vertigo. Results: Female patients were 142(59.9%) and male patients were 95(40.1%). The most common age group was the 6th decade. The origin of dizziness was classified as peripheral cause(25.3%), central cause(32.9%), and others(41.8%). As to nature of the dizziness, the rotatory sense was dominant in peripheral vertigo and the floating sense and blurred vision in central vertigo. Peripheral vertigo was triggered by position change of head and body, and central vertigo by the eye movement. Audiograms I showed that most patients with central vertigo had normal hearing, but 46.7% of thoswith peripheral vertigo had an abnormal hearing disturbance. Nystagmus was more prevalent in peripheral vertigo Conclusion: History taking and physical examination played an important role in the diagnosis of dizzy patients. An important part of the diagnosis of a dizzy patient could be to evaluate the peripheral origin, the central origin and others causes. Because central vertigo may be associated with a significant neurological pathology, spectral radiological studies, including MRI and CT, are mandatory to rule out a devastating brain lesion.

Effects of Stressed and Unstressed Reinforcements on Prestressed Concrete Members with Unbonded Tendons

Moon, Jeong-Ho,Shin, Kyung-Jae,Lim, Jae-Hyung,Lee, Sun-Hwa Korea Concrete Institute 2000 KCI concrete journal Vol.12 No.1

The research purpose of this paper is to investigate the influential Parameters on the unbonded tendon stress. The parameters were the reinforcing ratio, the prestressing ratio, and the loading type. To this end. first, the influence of parameters were examined with twenty eight test results obtained from references. Then, an experimental study was carried out with nine specimens. Test variables were the reinforcing ratio and the prestressing ratio. Specimens were divided equally into three groups and each group had a different level of the reinforcing ratio. Each specimen within a group has a different level of the prestressing ratio. The investigation with previous and current tests revealed the followings; (1) the length of crack distribution zone does not have a close relation with the length of plastic hinge. (2) the prestressing ratio does not affect both the length of crack distribution and the length of plastic hinge, (3) the tendon stress variation is in reverse relation with the ratios of mild steels and tendons, (4) the loading type nay not affect significantly the length of crack distribution zone, (5) AASHTO LRFD Code equation and Moon/Lim's design equation predicted the test results well with some safety margins.

Voice Mismatch Meets Neurolinguistics

Gui-Sun Moon,Sun-Woong Kim,Jeong-Ah Shin,Hae-Kyung Wee,Jong Un Park,Myung-Kwan Park,Wonil Chung 현대문법학회 2018 현대문법연구 Vol.99 No.-

Gui-Sun Moon, Sun-Woong Kim, Jeong-Ah Shin, Hae-Kyung Wee, Jong Un Park, Myung-Kwan Park, and Wonil Chung. 2018. Voice Mismatch Meets Neurolinguistics. Studies in Modern Grammar 99, 85-115. This paper aims to investigate Korean advanced L2 English learners’ strategies for ellipsis resolution during sentence processing. Ellipsis resolution is known to involve several stages of information processing from the initial step of detecting an ellipsis-licensing element by the parser to the final stage of integrating the ellipsis site with the information retrieved from the antecedent of the ellipsis site. In examining these steps, we have manipulated three factors: (i) TP vs. VP-ellipsis; (ii) two types of discourse coherence relations (resemblance(-contrast) vs. cause-effect relations); (iii) voice match vs. mismatch. We found through the ERP recordings that voice mismatch in TP ellipsis elicited N400, followed by P600, irrespective of discourse coherence relations. In contrast, voice mismatch in VP-ellipsis registered N400 only in resemblance(-contrast) relation, but not in cause-effect relation. These findings lead us to conclude that Korean advanced L2 learners of English seem to undergo the full sequence of processing stages required for ellipsis resolution.

단계적 온도 하강법을 이용한 췌도세포 냉동보존법

정인경,오승훈,김병준,양태영,이병완,하창영,노정현,정재훈,민용기,이명식,이문규,김광원 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.1

연구배경:최근 당뇨병의 새로운 치료법으로 시도되고 있는 췌도이식은 충분한 췌도수의 확보와 췌도생존율을 높이기 위한 면역억제제 사용이 제한점이 되고 있다. 본 연구의 목적은 이식 전 충분한 췌도 수의 확보를 위해 분리한 췌도를 냉동보존하는 방법을 확립하고 냉동보존한 백서 췌도세포의 시험관내 그리고 생체내 기능을 조사하였다. 방법:분리한 백서의 췌장소도를 48시간 배양한 후 한 시험관당 췌도세포 1000개씩 나누었다. 냉동보존은 6개의 시험관에 DMSO를 첨가한 후 초 냉각(supercooling), 핵화(nucleation)단계를 거친 후 99% isopropanol과 액체질소가 들어있는 dewer를 이용하여-0.25℃/분의 냉각속도로 -40℃까지 단계적으로 얼린후-70℃ 액체질소 탱크에 보관했다. 해동은 냉동시킨 vial들을 액체 질소 태으에서 꺼내 37℃ 항온조에 담가 급격히 해동시킨 후, 원심분리하여 상층액을 제거하고 각 vial에 0.75M sucrose 용액을 가한 후, 10% fetal calf serum이 함유된 RPMI 1640 media에서 배양하였다 각각 6개의 시험관에서 해동한 췌도들을 광학현미경 및 형광현미경하에서 췌도의 모양과 생존율에 대해 조사하고 인슐린 정적반응을 알아보았다. 또한 분리한 췌도를 냉동보존하지 않고 이식한 경우를 대조군(6마리)과 생체내 기능을 비교하였다. 결과:① 냉동보존후 획득한 췌도의 수와 생존율 해동후 획득한 췌도의 수는 해동시킨 당일날이 902±21, 24시간 배양 후에는 857±16, 72시간 후에는 817±18개로 점차 감소되었다. AO/PI 염색상 각 췌도의 생존율은 냉동 전을 100으로 하였을 때 해동당일, 24시간 후, 72시간 후가 각각 60±5, 80±5, 90±5%로 해동후 3일간 배양하였을 때 냉동전의 수준으로 회복하였다. ② 냉동보존후 췌도의 포도당에 대한 정적 인슐린 분비능:냉동직후 감소된 경향을 보였으나 해동후 3일간 배양한 췌도의 인슐린 분비는 냉동전과 통계적으로 의미있는 차이가 없이 냉동보존 전의 수준으로 회복되었다. ③ 냉동보존후 췌도의 포도당에 대한 동적 인슐린 분비능:냉동보존한 췌도를 해동후 3일째의 인슐린 동적 분비능은 냉동 전과 마찬가지로 자극 인슐린의 반응의 제1기와 2기가 잘 관찰되었다. ④ 냉동보존한 췌도세포 이식 후 혈당 변화:스트렙토조토신으로 유도된 당뇨병 쥐에 췌도이식 후 혈당은 냉동보존한 췌도이식군에서 대조군에 비해 혈당의 조절효과가 더 오래 지속되었다. 결론:소동물에서 단계적 온도 하강법을 이용한 췌도세포 냉동보존법을 확립하였으며 이는 기능, 구조 및 생존율에 큰 이상을 보이지 않았으므로 장차 사람의 췌도세포 동종이식시 부족한 췌도세포수를 극복하고 면역반응을 줄일 수 있는 매우 유용한 방법이 될 것으로 판단된다. Background : Although islet transplantation has been attempted to reverse the state of diabetes, achieving a critical number of islets and modulating the immune response limit the success of islet transplantation. Cryo-preservation of islets offers many important benefits for islet transplantation by collecting islets with a wide variety of HLA phenotypes and islet MHC expression. The aims of this study was to determine the optimal conditions for cryo-preservation by using a controlled cooling method and to evaluate in vitro and in vivo functional properties of the cryo-preserved islets. Methods : Collagenase-isolated, Ficoll-purified islets were cultured for 48 hours. They were aliquoted into freezing tubes (1000 islets per tube), equilibrated with 2M dimethyl sulfoxide (DMSO) in three steps, supercooled, nucleated, and controll-cooled at rate of 0.25℃/min to - 40℃ prior to storage at - 196℃. Rapid thawing and removal of DMSO with 0.75 M sucrose preceded 48 hour of culture and the morphology, viability, glucose-induced insulin secretion, and in vivo function of rats transplanted with cryopreserved islets was reexamined. Results : ① Recovery was 90.2±0.2%, 85.7±0.1% and 81.7±0.1% immendiately after, 24 hours and 72 hours after thawing respectively. The viability was 60±5%, 80±5%, 90±5% immediately after, 24 hours and 72 hours after thawing respectively. ② The glucose-stimulated-insulin secretion (GSIS) tended to decrease immediately after thawing, but GSIS increase to the level of pre-cryopreservation 72 hours after thawing. ③ The in dynamic GSIS, the first and the second phase of insulin secretion were well preserved in islets cultured for 72 hours after thawing. ④ The cryopreserved islets were cultured for 3 days and transplanted into renal sub-capsular space of streptozotocin (STZ) induced diabetic rats. The duration of normoglycemia in the STZ-induced diabetic rats transplanted with cryopreserved islets was significantly longer than of the fresh islets. Conclusion : The optimal condition of cryopreservation using the controlled cooling method was established in rat pancreatic islets. This cryopreservation method can be a feasible approach for human islet transplantation (J Kor Diabetes Asso 26:64~74, 2002).

IL-β의 인슐린 분비 자극효과와 그 과정에 관여하는 인자들

정인경,오승훈,강동묵,정재훈,민용기,이명식,이문규,김광원 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경: IL­1β는 용량과 노출시간에 따라 인슐린분비에 대해 상반되는 효과를 가지고 있다. IL­1β의 인슐린 분비 억제효과는 제1혁명 당뇨병의 자가면역 기전과 관련되어 잘 알려져 있으나 인슐린 자극효과에 대해서는 아직 명백히 밝혀지지 않았다. 이에 저자 등은 IL­1β의 다양한 농도에 따라 백서의 췌도세포에서 인슐린 분비에 미치는 영향을 살펴보고, 그 기전으로 인슐린 생합성, iNOS의 발현, 칼슘통로의 활성도 변화여부를 알아보고자 하였다. 방법:200∼300g인 수컷 Sprague­Dawley 백서의 췌도를 변형된 Lacy&Kostianovsky's 방법으로 분리한 후 IL­1β의 다양한 농도(0, 0.5, 5, 50, 500pmol/L)에 2, 6, 24시간 노출시켜 췌도세포의 형태, 생존능을 관찰하고 인슐린 분비능 및 췌도세포내 인슐린 함량을 측정하였으며, 전전구 인슐린 mRNA발현, iNOS mRNA발현을 RT­PCR을 통해 확인하였고, 세포의 칼슘 통로 활성도 변화 여부를 측정하였다. 결과:1) IL­1β에 노출되 췌도의 생존능:2시간 노출시는 대조군과 차이가 없었으나, 6시간 고농도군과 24시간 모든 군에서 생존능이 감소되었다. 2)인슐린 분비능은 IL­1β를 2시간 5poml/L이상의 고농도와 6시간 0.5pmol/L 저농도 처리시 대조군에 비해 의미있게 증가하였으나, 6시간과 24시간 5poml/L이상의 고농도에서는 의미있게 인슐린의 분비가 억제 되었다. 3)췌도내 인슐린양의 변화는 IL­1β의 시간과 농도에 따라 배지내의 인슐린 변화와 비슷한 경향을 보였으나 통계학적으로 의미있는 차이는 없었다. 4)전전구인슐린의 mRNA발현은 2시간 50pmol/L이상 고농도의 IL­1β에서 의미있게 증가하였고, 6시간 처리군에서는 의미있는 차이는 없었으나, 24시간에서 IL­1β의 용량의존적으로 억제되었다. 5)iNOS mRNA는 IL­1β 처리 후 2시간부터 발현되기 시작하여, 6시간에 최고에 달한 후 24시간에는 점차 감소하였다. IL­1β의 처리시간과 무관하게 5poml/L이상의 고농도에서 용량에 따라 발현이 증가하였다. 6)칼슘통로 활성도는 IL­1β의 농도나 시간에 따라 유의한 차이가 없었다. 결론: IL­1β는 단시간 고용량이나 장기간 저용량에서 인슐린 분비와 생합성을 증가시키며, 이런 효과는 iNOS나 칼슘 통로 활성도 변화와는 무관한 것으로 생각된다. Background : The inhibitory effort of IL-1β on the insulin secretion has been validated in pathogenesis of type 1 diabetes, but complex results about the stimulatory effect of IL-1β have been reported. The aims of this study are to clarify the effects of IL-1βon insulin secretion of pancreatic islets and to investigate the mechanisms in terms of preproinsulin synthesis, inducible NOS expression, and calcium channel activity. Method : Islets were isolated from male Sprague-Dawley (SD) rat by modified Lacy-Kostianovsky's method. After islets were treated with different concentrations (0, 0.5, 5, 50, 500 pmol/L) and exposure time (2, 6, 24 hours) of IL-1β, morphology, viability, static stimulation of insulin to glucose, insulin content, preproinsulin mRNA expression, iNOS mRNA expression and calcium channel activity were measured. Results : 1) Viability o islets was reduced in high concentrations of long term exposure of IL-1β. 2) Insulin secretion was stimulated in islets treated with 5, 50, and 500 pmol/L of IL-1β for 2 hours. 3) Insulin content was not significantly different regardless of concentration and exposure time of IL-1β. 4) Preproinsulin mRNA expression increased in islets treated with 50, 500 pmol/L of IL-1β for 2 hours. After 24 hours, it decreased in dose dependent manner. 5) iNOS mRNA expression was detectable after 2 hours in the presence of IL-1β, peaks at 6 hour and decreased after 24 hours. It was increased above 5 pmol/L of IL-1β in dose dependent manner. 6) Activities of the voltage-dependent Ca^2+ channels were not different among groups. Conclusion : IL-1β plays a positive role in terms of insulin secretion and insulin synthesis in high concentration of short term or low concentration of long term. These effects of IL-1β might be neither dependent of iNOS pathway nor Ca^2+ channel activity (J Kor Diabetes Asso 431~443, 2000).

Monte Carlo 방법을 이용한 대기오염 배출률 예측의 불확실성 평가

정효준,김은한,서경석,황원태,한문희 한국환경과학회 2006 한국환경과학회지 Vol.15 No.4

모유 수유아와 조제 분유 영양아에서 수유 방법에 따른 아미노산 농도 비교 및 혈청 트립토판 농도와 수면 유도와의 관계

정다운,김은영,양은석,박상기,박영봉,문경래 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Objective: Sleep behavior is modulated by serotonergic neurons within the brain, and the synthesis and release of serotonin by such neurons is thought to be influenced by the availability of tryptophan, the amino acid precursor of serotonin. Formula-feeding infants have depressed plasma tryptophan concentration relative to breast milk-feeding infants. Because tryptophan alters sleep waking patterns in adults, a study was designed to determine the difference of sleep latency relative to differences in plasma tryptophan and tryptophan : large neutral amino acid (LNAA) ratio between formula-feeding infants and breast milk-feeding infants. Method: 45 newborns who were born in Chosun University Hospital from December 2002 to December 2003 were selected. The newborns were divided to three group, 15 newborns were fed breast milk and 15 newborns were fed formula A, and last 15 newborns were fed formula B. At 6 weeks and 12 weeks, infants were sampled for measuring of serum amino acid level and tryptophan, tryptophan : LNAA ratio. And we taught infants' parents to measure sleep latency that means the time after a feeding to the first episode of active REM sleep that persist ≥ 1 min. Result: 1) At 6weeks, Serum α-amino-n-butyric acid, citrulline, tryptophan level was higher in formula A group than breastmilk group (P<0.05) and proline level was lower than breast milk group (P<0.05). In formula B group, serum n-amino-n-buryric acid, citrulline, cystine, hydroxylysine, hydroxyproline, isoleucine, leucine, lysine, methionine, phenylalanine, taurine, threonine, valine levels were higher than breastmilk group (P<0.05). And Serum isoleucine, methionine, proline, valine level were higher in formula B group than formula A group (P<0.05). 2) At 12 weeks, serum glutamic acid, methionine, ornithine levels were higher in formula group A than breast milk group (P<0.05). Serum β-alanine, aspartic acid, α-amino-n-butyric acid, ethanolamine, glutamic acid, threonine level were higher in formula B group than breast milk group (P<0.05). Serum β-alanine, ethanolamine levels were higher and arginine level was lower in formula B group than formula A (P<0.05). 3) At 6 weeks, serum tryptophan concentration and tryptophan: LNAA ratio were higher in formula A group (P<0.05). Sleep latency was 21 minutes in formula group A, 24 minutes in breast milk group, 25 minutes in formula B group but there was no statistically significance (P>0.05). 4) At 12 weeks, serum tryptophan concentration and tryptophan: LNAA ratio, time after feeding to the first episode of active REM sleep were no difference with each other group. Conclusion: There is significant difference of serum amino acids between breast-feeding infants and formula-feeding infants. And serum tryptophan and tryptophan: LNAA ratio differ between brest-feeding infants and formula-feeding infants. But there is no association between serum tryptophan, tryptophan: LNM ratio and sleep latency.

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).

유방암종에서 p53, cyclin D1 및 cathersin D 단백발현의 의의

문경래,김환정,이미자,기근홍,서재홍,양정원,조현진 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives: Breast carcinoma is a heterogenous disease. The prognosis of this carcinoma correlates with various prognostic factors. The aim of this study was to assess the prognostic significance of expression of p53, cyclin Dl and cathepsin D protiens in association with various prognostic factors in invasive breast carcinoma. Materials and Methods: The relationship is presented between expression of p53, cyclin D1 and cathepsin D by immunohistochemistry and various established prognostic factors such as tumor size, histologic grade, lymph node status and extensive intraductal component in 55 cases of invasive breast carcinoma. Results: No significant correlations were observed between expression of p53, cyclin Dl and cathepsin D and tumor size. The expression of p53 correlated with high histologic grade. The expression of p53 and cyclin Dl correlated with lymph node metastasis. Conclusion: These results indicate that expression of p53 and cyclin Dl in invasive ductal carcinoma may be an important prognostic factor, closely related to the high histologic grade and lymph node metastasis.

Helicobacter pylori가 만성위염과 위종양에 미치는 영향에 관한 면역조직화학적 밑 초미세구조적 연구

문경래,정순봉,이미숙,이미자,서재홍,김만우,박찬국 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : Helicobacter pylori (H. pylori) is accepted as a principal cause of chronic gastritis and an important factor in the pathogenesis of peptic ulcer and gastric malignancy. The aim of our studies is to investigate relationships between H. pylori and gastric epithelial cells. Materials ðods : One hundred and eighty one H. pylori positive cases of gastric biopsy specimens were studied immunohistochemically and ultrastructurally. Results : p53 positive staining exhibited foveolar epithelial hyperplasia in 1 out of 32 cases, regeneration in 2 out of 12 cases, incomplete intestinal metaplasia in 5 out of 41 cases, complete intestinal metaplasia in 3 out of 18 cases, chronic ulcer in 1 out of 9 cases, tubular adenoma in 2 out of 14 cases and intestinal type of adenocarcinoma in 16 out of 21 cases. Ultrastructurally, H. pylori was observed to be in direct contact with the microvilli of the target cells and was demolishing the surface microvilli. The organisms were in close contact with the uncoated cell membrance. Penetration into the gastric cells by a few organisms was associated with marked cell damage and ultimately to cell disintegration. Conclusion : Our results suggest that H. pylori plays a role in the pathogenesis of gastric cancer, leading a relatively slow, long lasting process that induces chronic active gastritis, intestinal metaplasia, dysplasia, and adenocarcinoma of intestinal type.