수술 후 국소재발된 직장암의 방사선치료 결과

정현주,신영주,양광모,서현숙,전하정,이명자,Jeong Hyeon Ju,Shin Young Ju,Mo Yang Kwang,Suh Hyun Suk,Chun Hachung,Lee Myung Za 대한방사선종양학회 1999 Radiation Oncology Journal Vol.17 No.1

Purpose : We reviewed the treatment results for the patients with locally recurrent rectal carcinoma. The object was to evaluate the treatment outcome and to identify the prognostic factors influencing the survival. Methods and Materials: Twenty-eight patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1982 to 1996 in the Department of Radiation Oncology at Paik and Hanyang Hospital were reviewed retrospectively Of these, 17 patients had initially abdominoperineal resection, 9 had low anterior resection, and 2 had local excision. No patients had received adjuvant radiation therapy for the primary disease. There were 14 men and 14 women whose ages ranged from 31 to 72 years (median age:54.5). Median time from initial surgery to the start of radiation therapy for local recurrence was 11 months (4~47 months). Radiation therapy was given with total doses ranging from 27 to 64.8 Gy (median=51.2 Gy). Results : The median survival was 16.7 months. The 2-year and 5-year survival rates were 20.1%, 4.1% respectively. Upon multivariate analysis, overall survival was positively correlated with duration of intervals from initial surgery to local recurrence (P=0.039). Relief of pelvic symptoms was achieved in 17 of 28 patients (60.7%). Pain and bleeding responded in 40% and 100% of patients, respectively Conclusions : Patients with locally recurrent rectal carcinoma treated with radiotherapy have benefited symptomatically, and might have increased survivals with a small chance of cure. But, patient were rarely cured (median survival : 10 months, 5-year survival : less than 5%). Overall survival was positively correlated with long intervals from initial surgery to local recurrence. Future efforts should be directed to the use of effective therapy for patients with locally recurrent rectal carcinoma and adjuvant therapy for patients with rectal cancer to reduce the incidence of pelvic recurrence. 서론 : 완치 목적의 절제술을 시행 후 국소재발된 직장암환자에 대한 방사선치료 결과 및 생존율에 미치는 예후인자에 대해 평가하고자 하였다. 대상 및 방법 1982년 7월부터 1996년 5월까지 인제대부속 백병원과 한양대부속병원 방사선종양학과에서 국소재발된 직장암으로 방사선치료를 시행받은 총 28명의 환자를 대상으로 치료결과에 대한 후향적 분석을 시행하였다. 남녀비는 14:14이었고, 연령분포는 31세에서 72세 사이로 나타났다(평균 연령:54.5세). 일차 수술 후 국소 재발까지의 기간은 4개월에서 46개월로 관찰되었다(중앙값:10개월). 방사선치료는 총 27Gy에서 64.8Gy(median; 51.2Gy)가 조사되었다. 50.OGy 이하로 조사된 환자는 모두 11례로 나타났으며, 17례에서 50.OGy 이상이 조사되었다. 결과 : 증상완화는 전체 환자 중 17례(60.7%)에서 관찰되었고, 출혈 및 통증을 호소한 환자의 경우 각기 100%와 40%%에서 증상완화가 관찰되었다. 증상완화정도의 방사선 조사량에 따른 차이는 관찰되지 않았다. 방사선치료 시작 일부터 전체 환자의 중앙생존기간은 16.7개월이고, 2년 및 5년 생존율은 20.1%, 4.1%로 나타났다. 생존율에 대한 예후 인자를 분석해 보았을 때, 단일변량분석에서 일차 수술 후 국소재발까지의 기간이 유일한 예후인자로 나타났다. 그 외 연령, 성별, 임상수행능력정도, 재발부위, 초기병기, 초기 수술방법, 원격전이여부, 방사선조사량 등은 유의한 인자로 관찰되지 않았다. 즉 일차 수술 후 국소재발까지의 기간이 1년 이상인 경우에서 1년 이하에 비해 의미있게 높은 생존율이 관찰되었다(2년 및 5년 생존율:42.0%, 8.4% vs 0.0%)(P<0.05). 다변량분석에서도 생존율과 연관된 예후 인자로는 일차 수술후 국소재발까지의 기간만이 의미있게 관찰되었다. 결론 : 본 연구에서는 방사선치료가 국소재발된 직장암환자에서 병변으로 인한 증상을 완화시키는 데 효과적이며, 일부의 환자에서는 장기간의 생존이 가능함을 알 수 있었다. 그러나, 전체적으로 2년 및 5년 생존율이 저조하게 나타났고, 일차 수술 후 국소재발까지의 기간이 생존율에 영향을 미치는 것으로 관찰되어, 향후 국소 재발된 직장암 환자에서 생존율의 향상을 위한 효과적인 치료법에 대한 연구가 필요하겠고, 더불어 초기 치료 후 국소재발방지를 위해 부가치료에 대한 적극적인 연구가 우선되어야겠다.

뇌졸중 환자의 추후관리가 주간호제공자의 삶의 질에 미치는 영향

정현주(Jeong Hyun-ju),조복희(Cho Bok-hee) 한국재활간호학회 2000 재활간호학회지 Vol.3 No.2

담낭 및 간외담도계 악성종양의 방사선치료결과

정현주(Hyeon Ju Jeong),이현주(Hyun Ju Lee),양광모(Kwang Mo Yang),서현숙(Hyun Suk Suh),김예희(Re Hwe Kim),김성록(Sung Rok Kim),김홍용(Hong Ryong Kim) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.1

배 경 : 담낭 및 간외 담도계 악성종양의 5년 생존율은 10% 이하로 비교적 예후가 불량한 것으로 알려져 있다. 이러한 질환에서 방사선치료가 증상 완화 및 전체 생존율을 향상시키는 것으로 알려져 있어, 본원의 환자를 대상으로 후향적 분석을 시행하여, 방사선치료의 역할을 알아보고자 하였다. 방 법 : 1984년 2월부터 1995년 11월까지 인제대학교 부속 백병원 방사선종양학과에서 담낭 및 간외 담도계 악성종양으로 완치 목적의 방사선 치료를 받은 43명의 환자중 3000cGy 이하의 방사선량을 조사받은 10명을 제외한 총 33명의 환자(담낭 악성 종양은 21명, 간외 담도계 악성종양 12명)를 대상으로 하였다. 남녀 비는 전체 11명대 22명(담낭 악성종양 4:17, 간외 담도계 악성종양7:5)이었고, 연령분포는 35-77세(중앙값 61세)이었다. 병기별로는 Ⅳ기가 19명으로 가장 많았으며, 재발후 방사선치료를 받은 경우가 3명 포함되었다. 방사선치료는 4MV 선형가속기를 사용하여 총 31.44-54.87Gy(중앙값 44.25Gy)가 조사되었고, 3명의 환자에서는 체외조사 전후로 근접치료가 추가되었다. 방사선조사 단독치료는 6명, 수술 후 방사선 치료는 27명에서 시행되었고, 이 중 16명만이 근치적절제술을 시행받았다. 항암화학요법은 17명에서 병행되었으며 이중 11명이 Mitomycin+5-FU+Leucovorin을 사용하였다. 결 과 : 총 추적관찰 기간은 2-97개월(중앙값 8.5개월)이었다. 전체 환자의 2년 생존율은 29.9 %, 5년 생존율은 13.3%로 나타났다. 질환별로는 담낭의 경우 2년 생존율이 34.5%, 간외담도계 악성종양은 27.8%이었다. 수술 후 방사선치료를 시행받은 환자들의 2년 생존율은 30.1%이며, 이 중 근치적 절제술을 시행받은 16명의 2년 생존율은 43.8%로, 부분절제 및 우회수술후 방사선치료를 시행받은 17명의 20.7%보다 높게 나타났으나 통계적 유의성은 없었다(p>0.05). 병기별로는 Ⅰ, Ⅱ기의 2년 생존율이 66.6%, Ⅲ, Ⅳ기는 23.6%로 통계학적으로 유의한 차이를 나타내었다(p<0.05). ECOG에 의한 임상수행능력정도에 따른 2년 생존율은 2급과 3급이 각각 41.9%, 16.7%로 통계학적으로 유의한 차이를 나타내었다(p<0.05). 항암화학요법을 병행한 군의 2년 생존율은 40.5%로 항암화학요법을 병행하지 않은 군의 22.6% 보다 비교적 높게 나타났으나 통계적 유의성은 없었다(p>0.05). 결 론 : 본 연구결과 전체 환자의 2년 생존율과 5년 생존율은 29.9%와 13.3%로 나타났으며, 병기가 낮고, 임상수행능력이 높을수록 생존율이 향상됨을 알 수 있었다. 또한 근치적 절제술후 방사선치료를 받은 환자와 항암화학요법을 병행한 군의 치료성적이 비교적 높은 것으로 볼 때, 담낭 및 간외 담도계 악성종양환자중 일부에서 적극적인 병합치료요법이 생존율의 향상에 도움을 줄 것으로 기대된다. Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5- year survival rates are less than 10%. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4- MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were 29.9% and 13.3 % respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were 34.5% and 27.8% respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation(43.8% vs. 20.7%), albeit statistically insignificant(p >0.05). The 2-year survival rates in Stage Ⅰ and Ⅱ were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were 40.5% and 22.6% respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy. More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.

중학생 예술동아리 자치활동 수혜자들의 프로그램 만족도 및 인성변화 자각도 분석

정현주(Chong, Hyun Ju),정은주(Jeong, Eunju),김경숙(Kim, Kyoung Suk) 학습자중심교과교육학회 2013 학습자중심교과교육연구 Vol.13 No.4

최근 학교현장에서 경험되는 다양한 예술적 경험이 전인적 발달과 성장에 필수적 요건으로 인식되고 있는 가운데, 공교육 안에서 다양한 음악교육 프로그램들이 정책화되고 있다. 중학생 예술동아리 프로그램은 2010년 발표된 교육과학기술부의 ‘초ㆍ중등 예술교육 활성화 방안’에 기초한 인성교육이며, 특히 중학생의 발달적 특성과 자치적 운영이 고려된 예술프로그램이라 할 수 있다. 이에, 본 연구는 지난 2011년 교육과학기술부 학교예술교육 활성화 방안에 따라 선정된 중학생 예술동아리 운영 학교 학생들을 대상으로 예술동아리 자치활동이 청소년의 인성함양에 미치는 영향 을 알아보고자 하였다. 전체 577개 중학생 예술동아리 운영학교 중 30개교를 무작위 추출하여 총 355명의 설문자료를 수집하였으며, 프로그램 만족도 및 인성변화의 자 각에 대한 결과를 도출하였다. 본 연구의 결과는 수혜자들의 높은 프로그램 만족도 및 인성변화 효과를 보여주고 있다. 수혜자들은 장소, 시간, 강사 및 재료 등에서 90%이상의 고른 만족도를 나타내었다. 또한, 수혜자들은 자치적인 예술경험인 예술동아리 활동 결과, 개인적 측면, 관계적 측면, 학교적응 및 동기진로 측면에서 모두 긍정적인 변화가 있었다고 응답하였다. 개인적 측면으로는 자신감(95.5%)이 가장 높은 변화를 보여주었으며, 관계적 측면에서는 공동체인식(98.3%) 및 의사소통(98.1%)에서 변화되었음을 답변하였다. 이밖에 학교적응 태도에서는 학생-교사관계(96%)의 긍정적 변화, 동기진로측면에서는 동기변화(97.2%)에서 변화에 대한 자각도가 높은 것으로 나타났다. 이러한 결과들은 중학생 예술동아리 자치 활동이 청소년기 발달에 필수적인 내적 정서와 사고의 탐색, 긍정적 관계 경험, 소질 및 진로 계발 등 다양한 경험을 제공한 다고 볼 수 있다. 더 나아가 이 결과들은 중학생이라는 교육수혜자들의 자율적 참여를 유도하는 보다 다각적인 예술프로그램의 지원이 활성화되는 기초지표가 될 것으로 사료된다. Arts activities in school settings have drawn attention in that various arts experiences have contributed to development of a well-balanced personality. Recently, the government acknowledges the importance of arts experience in school and has provided music education projects in remote areas of low socio-economic status. Arts group activities are a government-supported program that aid to promoting arts education with an emphasis on developmental characteristics of adolescents. A total of 577 middle school students who participated in arts group activities were recruited from 30 randomly selected public schools that offered arts group activities in 2012. Participants responded to the survey consisting of 20 items asking their program satisfaction and perceived changes in their personality attributes. The results showed a high degree of program satisfaction and perceived changes in their personality attributes. More than 90% of participants were very satisfied or satisfied with the arts group activity and responded that they highly recommend the program to peer students. In terms of the perceived changes in personal attributes, participants showed the most positive changes in self-confidence (95.5%, intra-personal aspect) and awareness of community (98.3%, inter-personal aspect). The arts group activity was also reported to facilitate teacher-student relationship (96%, school adjustment aspect), and to enhance motivation (97.2%, vocational motivation aspects). Overall, the findings indicated that the arts group activities for adolescents fulfil their developmental priorities, such as exploration and expression of inner-self, positive relationship with peers, and initiation of vocational motivation. Current findings provide a firm base for future school-and community-based supports to develop distinguished arts education programs and to spread diverse extracurricular arts group activities in school, fostering well-rounded development of personal traits for adolescents who are in a period of rapid growth and imbalance.

국소적으로 진행된 두경부 편평상피세포종양의 방사선-항암화학 병용요법과 방사선단독치료의 비교

정현주(Hyeon Ju Jeong),선현숙(Hyun Suk Suh),김철수(Chul Soo Kim),김예회(Re Hwa Kim),김성록(Sung Rok Kim) 대한방사선종양학회 1996 Radiation Oncology Journal Vol.14 No.1

목적: 국소적으로 진행된 Ⅲ, Ⅳ기 두경부종양의 방사선치료시 항암화학요법을 병행할 경우 방사선에 대한 민감도를 증가시켜 치료효과를 상향시키는 것으로 알려져 있다. 따라서 본연구는 방사선-항암화학 병용요법이 국소제어율 및 생존율에 미치는 영향을 알아보기 위하여 방사선 단독치료군의 치료결과와 후향적으로 비교 분석하였다. 대상 및 방법 : 1983년 11월부터 1994년 3월까지 인제대학교부속 백병원에서 두경부종양으로 진단받고, 추적관찰이 가능했던 Ⅲ, Ⅳ기의 편평상피세포종양 환자 31명(Ⅰ군: 방사선 단독치료 16명, Ⅱ군: 방사선-항암화학병용요법 15명)을 대상으로 하였다. 남녀비는 Ⅰ, Ⅱ군 서 각각 12:4, 15:0 이었고 연령분포는 각각 17-74세(중앙값 64세), 34-71(중앙값 54세)였다. 병기별 분포는 Ⅲ기가 각각 5명, 3명, Ⅳ기가 11명, 12명이었다. 방사선치료는 4MV선형가속기(LINAC)를 사용하였고 총 방사선 조사선량은 Ⅰ군 50-77.6Gy(중앙값 70.2Gy), , Ⅱ군50-75.6Gy(중앙값 70Gy)이었다. 항암화학요법은 cisplatin + 5-FU (7명), methotrexate + leucovorin + 5-FU + cisplatin (혹은 carboplatin)(2명), 방사선민감제로서 cisplatin (6명)이 사용되었다. 결과 : 총 추적관찰기간은 4-134개월(중앙값 16개월)이었다. 전체관해율은 Ⅰ군 66.6%(완전관해 53.3%, 부분관해 13.3%), Ⅱ군 93.3%(완전관해 60%, 부분관해33.3%)였고, 완전관해된 환자에서 2년 종양제어율은 각각 50%, 40%이었다. 국소실패율은 Ⅰ군과 Ⅱ군에서 각각 71.5%, 72.7%이었고, 원격전이율은 14.4%와 9.1%였다. 5년 생존율은 전체 환자에서 21.5%, 72.7%이었고, 원격전이율은 14.4%와 9.1%였다. 5년 생존율은 전체 환자에서 21.5%, Ⅰ군과 Ⅱ군에서 23.4%, 23,5%로 두 군간의 생존율의 차이는 통계학적으로 유의하지 않았다.(P>0.05). 3년 무병생존율 역시 44.5%와 40%로 통계학적으로 유의한 차이를 보이지 않았다.(P>0.5). 치료에 따른 급성 부작용은 피부독성이 Ⅰ군 7/16명(RTOG/EORTC 등급 1; 5명, 2; 1명, 3; 1명), Ⅱ군 5/15명(등급 2; 1명, 3; 4명, 4; 1명), 식도염 및 인두염이 각각 14/16명(등급 1; 7명, 2; 6명, 3이상 1명), 6/15명(등급2; 5명, 3; 1명), 구강점막염은 각각 6/16명(등급 1; 1명, 2; 2명, 3; 2명, 4; 1명), 8/15명(등급 2; 4명, 4; 5명)으로 두 군자의 차이는 없었으나, 혈액학적 독성은 Ⅱ군에서만 8/15(53.3%)가 관찰되었다. 결론 : 본연구에서는 방사선-항암화학 병용요법군이 방사선 단독치료군에 비해 조양의 전채관해율은 높았으나, 5년 생존율 및 3년 무병 생존율에서는 두군간에 통계학적으로 유의한 차이가 없었다(p>0.05). 그러나, 본 연구는 대상 환자의 숫자가 제한되어 있어 항암화학요법의 역할을 규명하기 위해서는 앞으로 더 많은 환자를 대상으로 하여 오랜 기간의 추적관찰이 필요하리라 생각된다. Purpose : The traditional approach with surgery and/or radiotherapy(RT) for advanced head and neck cancer provides anticipated cure rates of 10-65 % depending on stages and sites. Recently, combined modality with chemotherapy have been extensively investigated in attempts to improve survival and local control. We retrospectively analysed our experience of 31 patients with advanced head and neck cancer. Materials and Methods : From November 1983 to October 1994. 31 patients with Stage Ⅲand Ⅳ squamous cell head and neck cancer were treated with RT. Sixteen patients were treated with RT alone, and 15 patients were treated with combined RT plus chemotherapy. All patients were treated with 4-MV LINAC and radiation dose ranged from 5000 cGy to 7760 cGy (median 7010 cGy). In combined group. 7 patients were treated with cisplatin plus 5-FU, 2 patients were treated with methotrexate plus leucovorin plus 5-FU plus cisplatin or carboplatin. and 6 patients were treated with cisplatin as a radiosensitizer. Results : Median follow up period was 16 months range 4-134 months). The major responses (CR+PR) were noted in 10 patient (66.6%)of the RT alone group and 14 patient (93.3%) of the chmoradiation group. There was no statistical difference in CR rate between the two groups. The overall survival rates at 5 years were 23.4% in the radiation alone group. 23.5% in the chemoradiation group. Disease-free survival rates at 3 years were 44.5% in the radiation alone group. 40% in the chemoradiation group. There was no statistical differences in overall survival rates and diseasefree survival rates between the tow groups. Local recurrences occurred in 71.5% of the radiation alone group. 72.7% of the chemoradition group and distant metastasis occurred in 14.4% of radiation alone group. 9.1% of the chemoradiation group. The frequencies of complications were comparable in both groups except hematologic toxicity. Conclusion : Total response rates in the combined chemotherapy and radiotherapy was relatively higher than radiotherapy alone. But our result failed to show any survival benefit of the combined chemotherapy and radiotherapy. The accrual of large number of patients and long term follow-up may be necessary to confirm the present result of combined chemotherapy and radiotherapy.

한국인에서 치주질환과 관상동맥질환의 관련성에 대한 염증표지자와 IL-1 유전자 다변성의 영향

정하나,정현주,김옥수,김영준,김주한,고정태,Jeong, Ha-Na,Chung, Hyun-Ju,Kim, Ok-Su,Kim, Young-Joon,Kim, Ju-Han,Koh, Jung-Tae 대한치주과학회 2004 Journal of Periodontal & Implant Science Vol.34 No.3

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

백서 치주 골결손부에 calcium carbonate 이식 및 pulsed Nd:YAG 레이저에 의한 치은상피의 제거 후 접합상피의 치유양상

정철웅,정현주,Jeong, Cheol-Woong,Chung, Hyun-Ju 대한치주과학회 1996 Journal of Periodontal & Implant Science Vol.26 No.1

The purpose of this study was to evaluate whether removal of gingival epithelium with pulsed Nd :YAG laser could inhibit the downgrowth of junctional epithelium after alloplastic material grafting in periodontal bone defect. The periodontal bone defects were created surgically on the palatal aspect of the upper right and left molar teeth in 30 rats and filled with resorbable calcium carbonate($Biocoral\;450^{(R)}$: Inoteb, France). The control sites(right molar area) was sutured. The test side (left molar area) received controlled deepithelization of the oral and sulcular epithelium with pulsed Nd:YAG laser($Sunrise\;Maste^{(R)}$: Sunrise Technologies, U.S.A.) under the mode of 1.75W, 15Hz, 116mJ/pulse and was sutured. The control and test sites were evaluated clinically and histologically, at 1, 3, 7, 14, and 28 days postoperation. Clinically, the gingiva showed normal color and shape at the 5th day in the control site and at the 10th day in the test sites. Histologically, the junctional epithelium was formed at the 7th day in the control sites and at the 14th day in the test sites, and the long JE attachment were observed at the 28th day in both sites. The attachment of connective tissue to root surface was observed initially at the 7th day in the control sites and at the 14th day in the test sites, and completed at the 28th day in both sites. In summary, these results showed that the removal of oral epithelium using pulsed Nd:YAG Laser could not prevent epithelial downgrowth after alloplastic material implantation in rat periodontal bone defect.

키토산이 백서 태자 두개관세포에 미치는 영향

김정경,정현주,김영준,김옥수,Kim, Jeong-Kyung,Chung, Hyun-Ju,Kim, Young-Joon,Kim, Ok-Su 대한치주과학회 2004 Journal of Periodontal & Implant Science Vol.34 No.4

The effect of chitosan, a carbohydrate biopolymer extracted from chitin, on periodontal regeneration is of particular interest. The purpose of this study was to evaluate the effect of chitosan on primary rat calvarial cells in vitro, with special focus on their proliferative properties by cell activity and the amount of total protein synthesis. The experimental groups were cultured with chitosan in concentration of 0.01, 0.1, 1.0, 2.0 and 5.0 mg/ml for MTT assay. In the experimental groups, cells were cultured with chitosan in concentration of 0.01, 0.1, 1.0 and 2.0 mg/ml. Each group was characterized by examining alkaline phosphatase activity at 3 and 7 days and the ability to produce mineralized nodules of rat calvarial cells at 14 and 21 days. The results were as follows: 1. The cell activity was not reduced in the concentration of $0.01{\sim}1.0$ mg/ml whereas the cell activity was reduced in the concentration of 5.0 mg/ml than the control at day 1 and 3 (p<0.05). 2. Primary rat calvarial cells treated with chitosan in the concentration 0.01 mg/ml and 0.1 mg/ml showed more protein synthesis than the control at day 3 (p<0.01), But primary rat calvarial cells treated with chitosan showed more protein synthesis than in control but they didn't have statistically difference among groups at day 7. 3. At 3 and 7 days, alkaline phosphatase activity was significantly increased in the concentration of 0.01 mg/ml. 0.1 mg/ml and 1.0 mg/ml (p<0.05). 4. The percentage of mineralized bone nodule was more in the concentration of chitosan 0.1 mg/ml and 1.0 mg/ml than the control. These results suggested that chitosan has a positive effect on the bone formation of primary rat calvarial cells in the concentration of 0.1 mg/ml and 1.0 mg/ml.

Lipomyces starkeyi KSM 22 Glucanhydrolase 용액의 치은 섬유아세포에 대한 영향

윤현정,정현주,김옥수,김도만,Yun, Hyun-Jeong,Chung, Hyun-Ju,Kim, Ok-Su,Kim, Do-Man 대한치주과학회 2002 Journal of Periodontal & Implant Science Vol.32 No.3

A novel glucanhydrolase from a mutant of Lipomyces starkeyi KSM 22 has additional amylase activity besides mutanolytic activity and has been suggested as promising anti-plaque agent. It has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi KSM 22 glucanhydrolase are desirable for its application as a dental plaque control agent. In human experimental gingivitis model and 6 month clinical trial, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase was comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effect was negligible. This study was aimed to evaluate the cytotoxic effect of Lipomyces starkeyi KSM 22 glucanhydrolase on human gingival fibroblasts. Primary culture of human gingival fibroblasts at the 4th to 6th passages were used. Glucanhydrolase solution was made from lyophilized glucanhydrolase powder from a mutant of Lipomyces stakeyi KSM 22 solved in PBS and added to DMEM medium to the final concentration of 0.5, 1, and 2 unit. Cells were exposed to glucanhydrolase solution or 0.1 % chlorhexidine and the cells cultured in DMEM with 10% FBS and 1% antibiotics as control. After exposure, the morphological change, cell attachment, and cell activity by MTT assay were evaluated in 0.5, 1.5, 3, 6, 24 hours after treatment. The cell proliferation and cell activity was also evaluated at 2 and 7 days after 1 minute exposure, twice a day. The cell morphology was similar between the Lipomyces smkeyi KSM 22 glucanhydrolase groups and control group during the incubation periods, while most fibroblasts remained as round cell regardless of incubation time in the chlorhexidine group. The numbers of the attached cells in the glucanhydrolase groups were comparable to that of control and significantly higher than the chlorhexidine group. The numbers of the proliferated cells in the glucanhydrolase groups at 7 days of incubation were comparable to the control group and higher than the chlorhexidine group. The cell activity in glucanhydrolase groups paralleled with the increased cell number by attachment and proliferation. According to these results, Lipomyces starkeyj KSM 22 glucanhydrolase has little harmful effect on attachment and proliferation of human gingival fibroblasts, in contrast to 0.1% chlorhexidine which was cytotoxic to human gingival fibroblasts. Therefore this glucanhydrolase preparation is considered as a safe and promising agent for new mouthwash formula in the near future.

Induction of NADPH oxidases and antioxidant proteins by Porphyromonas gingivalis in KB cells

김민정,정현주,박병주,박해령,이태훈,Kim, Min-Jeong,Chung, Hyun-Ju,Park, Byung-Ju,Park, Hae-Ryoung,Lee, Tae-Hun The Korean Academy of Periodontoloy 2006 Journal of Periodontal & Implant Science Vol.36 No.4

Porphyromonas gingivalis는 치주질환을 야기하는 독성세균으로서, 구강상피세포에 p. gingivalis가 감염되었을 때, 세포형태에 변화를 초래함으로 인해 방어기작이 작동하게 된다. 치주질환과 관련되어 생성된 활성 산소종의 소거에 관여하는 항산화성분은 p. gingivalis 이 감염된 구강상피세포에서 그 분포와 발현수준이 달라지리라 예상된다. 따라서 이번 연구에서는 구강상피세포(KB 세포)에 p. gingivalis가 감염되었을 때 야기되는 활성산소종과 이를 소거하는 역할을 하는 항산화단백들의 역할들을 규명하고자 하였다. 활성산소종 형성을 조절하는 NADPH oxidase 중 NOX4와 Rac1 전사체는 구강상피세포에서 p. gingivalis세균에 의해 증가하였으며 $gp91^{phox}$, Rac2, $p47^{phox}$와 $p67^{phox}$는 세균에 의한 변화가 관찰되지 않았다. 반면에 $p40^{phox}$ 전사체는 감소하는 경향을 보였다. NOX1 전사체는 p. gingivalis 처리 30분 후 감소하였다가 60분 후에는 다시 증가하는 양상을 보였다. 같은 시간에 NOX 활성화 단백인 NOXA1은 감소하고, NOX 구성단백질인 NOXO1은 증가하는 경향을 보였다. p. gingivalis가 감염된 구강상피세포를 방어하는 항산화단백 발현수준을 평가한 결과, SOD1, 2, 3 모두 p. gingivalis 처리시간에 따라 증가하는 양상을 보였다. GPx 발현 양상도 SOD와 유사하게 나타났다. $H_2O_2$를 소거하는 Prx는 감염된 KB 세포에서 Prx4와 Prx5가 4-6배 증가하는 것을 알 수 있었다. 반면 endocytosis 과정 중 $H_2O_2$ 생산은 변화되지 않았다. 이번 연구의 결과, p. gingivalis의 감염은 KB 세포의 NOX4와 Rac1의 NADPH oxidase 발현을 증가시켰으며, NOX1은 NOXA1과 NOXO1의 조절에 의해 영향을 받음을 알 수 있었다. 또한 항산화기작으로는 SOD, GPx, Prx가 증가하였는데, 이것은 Prx4와 Prx5가 중요한 역할을 할 것을 시사하였다.