Galactosamine에 의한 간상해에 내독소가 미치는 영향

허용진,신현호,이경호,서인수 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.4

GalN은 aminosulfate의 하나로 실험동물에 특징적 간독성을 나타낸다. 본 연구는 GalN의 간독성 발휘에 장관 유래 내독소의 관여 여부를 알아보기 위해 시행하였다. 실험방법을 흰쥐를 세군으로 나누어 GalN 단독 투여군, neomycin투여 후 GalN 투여군, neomycin 투여 후 GalN와 내독소 동시 투여군으로 하고 GalN투여 후 1, 4, 10, 24 및 48시간 후에 도살하여 광학 및 전자현미경으로 관찰하였고 그 성적을 요약하면 다음과 같다. GalN 투여는 간조직에 국소적 간세포 괴사, 지방변성, 염증세포 침윤등 간염을 일으키고, 미세형태학적으로 괴사를 일으키지 않은 간세포에서 mitochondria의 변형, 지방적의 증가, rER과 Golgi등 소기관의 감소등을 일으키고 유동은 Kupffer세포의 증식, 내피세포의 종창과 혈소판 응집등으로 폐색을 보였다. 이와 같은 변화는 초기에는 경미하였으나 차츰 심해져서 10시간째부터 간세포의 괴사를 보였고, 48시간째에 괴사가 가장 심하였다. 초기의 침윤세포는 호중구로 GalN 투여 4시간 후 부터 나타나 24시간까지 증가하였다가 48시간째에는 주로 단핵 탐식구가 많았다. Neomycin 사전 투여는 GalN의한 간독성을 상당히 경감시켜 개개의 간세포의 변화도 경하였고 괴사도 훨씬 적게 일어났으며 염증세포 침윤도 적었다. Neomycin을 사전 투여하더라도 GalN와 내독소를 동시에 투여한 동물들에서는 GalN에 의한 간독성의 정도가 GalN 단독 투여군과 비슷하였다. 이상의 성적으로 보아 GalN에 의한 간독성에 장관유래의 내독소가 관여하며 이것은 Kupffer세포나 침윤한 염증세포에 의해 매개될 것으로 생각한다. D-galactosamine is an amino sugar with unique hepatotoxicity in animals. The mechanism of liver injury by galactosamine is not fully understood, but a role for bacterial endotoxin has been suggested. In this study, the role of enterogenous endotoxin on the galactosamine induced hepatotoxicity. Was persued Sprague-Dawley rats were divided in three groups: Group 1; animals received 500㎎/㎏ of body weight of galactoxamine, Group 2; neomycin pretreated prior to galactoxamine injection, Group 3; galactosamine and E. coli endotoxin were injected simultaneously after neomycin pretreatment. Animals were sacrificed 1, 4, 10, 24 and 48 hours after galactosamine injection. The results were summarized as follow: Galactosmine injection induced hepatitis-like lesion, characterized by fatty changes, liver cell necrosis and inflammatory infiltrates. Electron microscopy showed distortion of were obliterated by swollen endothelial and Kupffer cells and platelet aggregates. These changes were milder in early stage but progressively severe in later time. Liver cell necrosis could be seen after 10 hours. Neutrophils were aggregated from 4 hours and increased in number until 24 hours, after then decreased. After 48 hours, the main infilrates were consisted of mononuclear cell. Neomycin pretreatment markedly reduced hepatotoxicity. Individual liver cells seemed less affected and infiltrates were also reduced in number. But simultaneous injection of endotoxin on these animals intensified toxic effect of galactosamine. The results suggested the participation enterogenous endotoxin in galactoxamine hepatotoxicity, which may be mediated by Kupffer cells and/or macrophages.

양성질환 및 악성종양에서 혈청 CA19 - 9 와 CEA 의 비교

허용진(Yong Jin Huh),장덕기(Duck Key Jang),이상팔(Sang Pal Lee),최재철(Jae Chul Choi),김호균(Ho Kyun Kim),서동룡(Dong Ryong Seo) 대한내과학회 1989 대한내과학회지 Vol.36 No.5

N/A To analyze the sensitivity and specificity of CA19-9 and carcinoembryonic antigen (CEA) in benign and malignant disease, we performed a study to measure the concentration of both tumor markers among the patients admitted in Maryknoll Hospital between October 1987 and October 1988. The results were as follows: 1) The concentrations of serum CA19-9 and CEA were significantly higher in malignant tumor than benign disease. 2) At a cutoff of CA19-9 37 U/ml and CEA 5 ng/ml, CA19-9 had higher sensitivity than CEA in stomach cancer, hepatocellular carcinoma, colon cancer, especially in pancreatic carcinoma and cholangiocarcinoma. 3) There were no significant differences in concentration of CA19-9 and CEA among the stages of stomach cancer. 4) Pancreatic carcinoma with hepatic metastasis had higher concentrations of CA19-9 and CEA than without hepatic metastasis. In conclusion, CA19-9 is not specific for certain malignant tumors, but is more sensitive than CEA in gastrointestinal cancers.

만성 임파구성 백혈병 1례

장덕기,이상팔,허용진,김호균,옥종환,서동룡 大韓血液學會 1988 大韓血液學會誌 Vol.23 No.2

만성 임파구성 백혈병 예

장덕기,이상팔,허용진,김호균,옥종환,서동룡 임상약학사 1992 臨床藥學 Vol.12 No.2

위의 평활근아세포증 1예

이상팔,정영기,서동룡,장덕기,허용진,원대식,박두복 대한소화기내시경학회 1988 Clinical Endoscopy Vol.8 No.2

In 1960 Martin and his associates described another type of tumor of the stomach derived from the smooth muscle, which they named myoid tumor in a study of six patients. In 1962 Stout applied the term "lelomyoblastoma" to this interesting entity in a report of a collected series of 69 patients. Tumor cells are round or polygonal epithelioid cells, which contain perinuclear vacuole or clear zone. A 58 year-old female was admitted to this hospital because of epigastric discomfort for three months. At Upper gastrointestinal series and gastrofiberscope, a round hemispherical submucosal tumor was noted at posterior wall near the lesser curvature of gastric antrum. After subtotal gastrectomy, the submucosal tumor was diagnosed as leiomyoblastoma. Because leiomyoblastoma are rare and easily misdiagnosed as leiomyoma or leiomyosarcoma, careful histologic study is recommended.

CAPD 중 복막염의 역학

박성배,김기현,이태원,김현철,김형규,이시래,한대석,이영규,김성권,강성구,한진석,이호영,이상운,김경진,이정상,이인수,고광욱,최용,정해일,홍관수,방병기,이희발,임천규,고행일,최의진,원대식,황승덕,임중규,김규순,오형석,최창필,허용진,표석주,전성주,최두혁,김민철,정석호,전건웅,강종명,박한철,김명재,박민선 대한신장학회 1987 Kidney Research and Clinical Practice Vol.6 No.2

This retrospective multicenter cooperative study analyses clinical data from 1,106 CAPD patients treated at22 dialysis centers over the past 6 years and 4 months' period between March 1981 and July 1987. This represents above 90% of all CAPD patients estimated from 81.5% of all centers known to have offered CAPD in Korea during the study period. At the end of the study period 57.7% were still on CAPD, 11.9% were tansferred to hemodialysis, 10.9% died while on CAPD and 3.6% discontinued CAPD and lost to followup. Of 171 patients who were transferred to hemodialysis or lost to followup after discontinuing CAPD, 117 patients or 68.4% did so because of peritonitis. During 1,343.3 patient-years of CAPD, 2,419 episodes of peritonitis developed at the rate of 1.80 episodes per patient-year. The first episode of peritonitis occurred within one week of beginning CAPD in 15.8%, whithin 4 wks in 35.6%, within 6 months in 79.7% and within 1 year in 94.4% of those who experienced peritonitis. Gram-positive organisms were responsible for 66.4% of all peritonitis episodes: Coagulase-negative Staphylococci (31.3%) being the most common organisms. The rate of positive culture was unacceptably low at 25.3%. Female sex, use of Peritosol and Tenckhoff single cuff catheter appeared to be risk factors for peritonits. Age and underlying diseases did not appear to be risk factors. The results of this study suggest that more efforts are needed to reduce peritonitis rates. Associated risk factors for peritonitis should be identificed and Y-connector andi'or measures to strengthen systemic and peritoneal defense mechanisms should be evaluated in the future prospective studies.

당뇨병환자의 CAPD현황과 환자 및 기술생존율

박성배,김기현,김영호,김현철,김형규,이시래,한대석,이영규,강성구,이호영,정석호,홍관수,방병기,이희발,고행일,박한철,최의진,원대식,강종명,황승덕,전건웅,최창필,허용진 대한신장학회 1987 Kidney Research and Clinical Practice Vol.6 No.2

The Korean Society of Nephrology reports the Multicenter Study on CAPD in diabetics with ESRD. This report based on the analysis of the questionairs distributed to fourteen centers throughout the nation. The results were as follows; 1) As of September, 1987, 626 patients are on CAPD in Korea. Of these, 14.1 per cent of the patients are comprised of diabetics. 2) Diabetics with ESRD were older than non diabetic patients with ESRD, and it was most prevalent in the fifties. 3) Most of the centers considered CAPD as the treat- ment of choice for the diabetics with ESRD. 4) It takes 14.6 years on average for diabetics to get in end stage renal failure. 5) Most centers tend to start diabetics on dialysis earlier than in nondiabetics, that is, when their serum creatinine reach 9.83 mg/dl on average. 6) Blood sugar levels were reduced after 24 months of CAPD compared to pre CAPD level, but it was not statistically significant. 7) Various hematologic and biochemical indexes such as hemoglobin level, serum albumin level, Ca and phosphorus levels were improved after starting CAPD. 8) Peritonitis is still a major complication. Each patient experiences 1.9 episodes of peritonitis on average per year. 9) Sizable number of the patients suffered from gastrointestinal complications, particularly nausea and vomiting and cardiovascular complications. 10) 43 patients succumbed to death while on CAPD. Main cause of death were peritonitis and cardiovascular complications. 11) 26 patients stopped peritoneal dialsysis for various reasons other than death or lost to follow-up, and the major reason was peritonitis comprising of 15 patients. 12) Diabetics with ESRD are not doing well in terms of the rehabilitation. This is partly attributable to old age and to cardiovascular complications. 13) The actuarial survival rate were 95.4%, 90.2%, 79. 2% and 61.0% at 3 months, 6 months, 12 months and 24 months respectively. This is lower than that in non diabetics with ESRD. We conclude that continuous ambulatory peritoneal dialysis is a good alternative treatment for diabetics with end-stage renal disease.