위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-

위암 환자에서 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김삼용,김영건 충남대학교 암연구소 1991 癌共同硏究所 硏究誌 Vol.1 No.1

We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly decreased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD_(4) positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

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.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악소구치에 대한 응력 분석 : 3차원 유한요소법적 연구

이선화,김현철,허복,김광훈,손권,박정길 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.6

이 연구의 목적은 쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악 제2소구치에 대한 응력 분포를 3차원 유한요소법으로 분석하여 평가하기 위한 것이다. 발치된 상악 제2소구치를 이용하여 Micro-CT로 스캔한 후 3D-D0C-TOR로 3차원 유한요소 모형을 제작하였다. 제작된 소구치 모형에 근관 와동을 형성하고 쐐기형 5급 와동과 글래스 아이오노머 기저재의 사용 여부를 구분하여 근관 와동을 혼합형 복합레진으로 충전하였다. 협측 교두 또는 설측 교두에 500 N의 하중을 가하고, ANSYS 8.0 프로그램으로 인장 응력의 분포를 분석하여 평가한 결과 베이스 사용유무에 따른 응력 분포의 차이는 없었다. 협측 교두에 하중이 가해질 때, 하중점과 교합면의 중심구, 구개측 백악법랑경계부에 과도한 인장 응력이 집중되었으며, 5급 와동이 없는 경우보다 5급 와동이 있는 경우에 약간 더 높았다. 설측 교두의 협측 경사면에 하중이 가해질 때, 하중점과 교합면의 중심구, 협측 치경부에 과도한 인장 응력이 집중되었으며, 5급 와동이 있는 경우가 5급 와동이 없는 경우보다 약간 더 낮았다. The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class Ⅴ cavity restored with composite resin using a 3D finite element analysis. The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class Ⅴ cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji Ⅱ LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS. Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class Ⅴ cavity were slightly higher than that of the tooth without class Ⅴ cavity. When the load was applied the palatal cusp, excessive" high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The ten-sile stress values of the tooth without class Ⅴ cavity were slightly higher than that of the tooth with class Ⅴ cavity.

정맥 자가 진통 조절법을 사용하는 유방암 수술환자에서 경구 항구역제 전투약의 효과

이현정,김혜진 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24

Objective: This study was designed to evaluate the effect of premedication of ramosetron orally disintegrating tablet (ODT), a potent 5-HT3 receptor antagonist, for prophylaxis and treatment of postoperative nausea and vomiting (PONY) undergoing breast cancer surgery using patient controlled analgesia (PCA). Material and Method: 130 women classified ASA physical status Ⅰ-Ⅱ, aged 24-60 yr, undergoing elective breast cancer surgery, were randomized. A standard general anesthetic technique and postoperative PCA using fentanyl and ketorolac were used. Patients were assigned to one of three groups; group A (no prophylactic antiemetics were administered), group B (4 mg of ondansetron ODT was administered 30 minutes before induction), and group C (0.1 mg of ramosetron ODT was administered 30 minutes before induction). Episodes of nausea and vomiting, the use of rescue antiemetics, degree of pain, adverse events, and level of satisfaction were checked during 24 hr after the operation. Results: The overall incidence of PONY during the 24 hours after the operation in group B and C were decreased. The incidence of nausea after 6 hours after the operation and the frequency of the use of rescue antiemetics were significantly lower compared with group A and B. The patients in group C were more satisfied with control of PONY than others. Conclusion: This study results suggest ramosetron ODT was an effective way to prevent PONY in breast cancer surgical patients using PCA.

장상피화생과 Helicobactor pylori와의 상관 관계에 관한 연구

이복희,김대수,이현숙,진영주,윤세진,송형근,성노현,정현용,이동호 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

In 1965 Lauren divided advanced gastric carcinoma into two main types-namely, "intestinal" and "diffuse" type carcinoma, which differ not only morphologically but also in their clinical and epidemiological characteristics. Moreover, a different histogenetic process has been postulated by many authors that intestinal type gastric carcinoma might arise from areas with intestinal metaplasia. Since Warren and Marshall reported the presence of Helicobacter pylori in the stomach in 1983, strong evidence has been obtained that there is a close relationship between Helicobacter pylori and chronic gastritis, atrophic gastritis, intestinal metaplasia, and intestinal type gastric carcinoma. To study the relationship between intestinal metaplasia and Helicobacter pylori infection, we performed gastroscopic biopsies and CLO tests taken from patients with epigastric pain. Only 87 patients with macroscopically suspected antral gastritis were included. The prevalence of intestinal metaplasia in gastric antral biopsies increased from 33.3% in the age group<30 years to 63.6% in the age group 60 years. When all patients were divided into two age groups-namely, (i)<50 years(n=41) and (ii)≥ 50 years(n-=46), intestinal metaplasia was found significantly more often in patients ≥ 50 years. ((i) 39.2%, (ii) 54.3%, p<0.0001). The prevalence of Helicobacter pylori in gastric antral biopsies decreased from 66.7% in the age group<30 years to 62.5%, in the age group in the age group 50 to 59 years. When all patients were divided into the same two age groups-namely(i)<50 years and (ii)≥50 years, the prevalence of Helicobacter pylori did not differ between two groups in a statistically significant way. The mean age of intestinal metaplasia positive patients who were also Helicobacter pylori positive was 48±11.0(mean±S.D.)years, whereas the mean age of intestinal metaplasia positive patients who were Helicobacter pylori negative was 52±9.7(mean±S.D.)years. In conclusion. although our data do not prove a causal relationship between Helicobacter pylori infection and the histogenesis of intestinal metaplasia, we suggest that Helicobacter pylori plays an important role in the development of intestinal metaplasia in the gastric mucosa. Whether Helicobacter pylori has to be present at all times during this process or is only necessary as a 'trigger', needs further research.

전기도금을 이용한 스테인레스스틸 각형 선재의 굵기 증가 후 물성 변화

이정석,황현식,최광철,문재동 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.1

The purpose of this study was to evaluate clinical applications of electroplating method through investigation of the physical properties of orthodontic rectangular wires according to varying their cross section. For the study, it was accomplished to electroplate the 0.016-inched orthodontic rectangular stainless steel wire. The cross section of stainless steel orthodontic rectangular wire increased from 0.016 X 0.016 inch to 0.017 X 0.017 inch by electroplating. The wire was heat treated to improve an adhesion between the wire and electroplated metal. A three-point bending test and torsion test were conduced in order to compare physical properties among three wire groups; 0.016 X 0.016 wires(group 016P) and 0.017 X 0.017 wires(group 017). Through the investigations of each wire group, following results were obtained. 1. At three-point bending test, the group 016P showed higher tendency in the degree of stiffness, yield strength and ultimate tensile strength than the group 016. Stiffness and ultimate tensile strength showed statistically significant differences between two groups at three-point bending test(p<0.05). 2. Stiffness, yield strength, and ultimate tensile strength of the group 016P showed lower tendency than those of the group 017. Stiffness showed statistically significant differences between two groups at three-point bending test(p<0.05). 3. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed higher tendency than those of the group 016. All measurements showed statistically significant differences between two groups after torsion test(p<0.05). 4. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed lower tendency than those of the group 017. Yield torsional moment, and ultimate torsional moment showed statistically significant differences between two groups after torsion test(p<0.05). Xylitol is a 5-carbons carbohydrate, which can be replaced with sucrose for preventing caries. The replication of Streptococcus mutans and its formation of artificial plaque were studied in the media containing xylitol. The combined effect of xylitol and other carbohydrates on Streptococcus mutans was also studied. The replication of Streptococcus mutans was inhibited according to the increased concentration of xylitol. Streptococcus mutans replicated at the initial stage of incubation in the media contaning glucose, fructose or lactose, while replication from the beginning of incubation in the media containing fructose as combining with xylitol. The formation of artificial plaque by Streptococcus mutans was significantly reduced in the media containing with xylitol and fructose. These results indicated that the replication of Streptococcus mutans was inhibited according to the increased concentration of xylitol, and the formation of artificial plaque by Streptococcus mutans was significantly inhibited in the media containing xylitol and fructose.

백서에서 치아이동 후 보정기간 동안 교합이 치주조직 섬유의 재형성에 미치는 영향

정권희,이기헌,황현식,이석형 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.2

The purpose of this study was to evaluate the effect of occlusion on the mechanical strength of periodontal fibers during retention periods after experimental tooth movement. In the Sprague-Dawley male rats weighing 200 g or more. The intraoral elastics was inserted into the interproximal space of upper the first and second molars. After 4th day of teeth movement, the left mandibular first, second, and third molars were extracted for differentiating the occlusal side from the non-occlusal side in the experimental groups. The intraoral elastics was removed and then light cured resin was placed in the interproximal space between the bilateral upper first and second molars following undercut was made for retention. From the day beginning retention, 7 rats were sacrified at 0, 4, 8, 12, 16, 20 days respectively. For evaluating of degree on the mechanical strength of periodontal tissue, maximal shear load of the bilateral upper first molars were measured by use of Instron Universal Testing Machine. The results of this study were obtained as follows: 1. In the occlusal side from no retention group to 4-day, 8-day, 12-day, 16-day, and retention 20-day group as time was going maximal shear load was increased and there was statistically difference from retention 12-day group(p<0.05). 2. In the non-occlusal side from no retention group to 4-day, 8-day, 12-day, 16-day, and retention 20-day group as time was going maximal shear load was increased slightly but there was no statistically difference(p>0.05). 3. The result compared with maximal shear load between occlusal and non-occlusal side showed no statistically difference until retention 8-daygroup(p>0.05), and showed statistically difference from retention 12-day to 20-day group(p<0.05). These results show that the occlusion had an effect on mechanical strength of the periodontal fibers during retention periods after experimental tooth movement; therefore, it is suggested that consideration of occlusion is required for the type and length of retention at the time of retention planning.

G-CSF로 체내 증폭된 골수를 이용한 동종 조혈모세포이식

이종욱,김정아,민창기,김희제,엄현석,박수정,서정곤,김동욱,홍영선,민우성,김춘추,김동집 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

연구배경: 이식시 주입되는 골수세포수는 생착 속도 및 생존율과 밀접한 관계가 있으나, 임상적으로 환자의 체중이 공여자에 비해 지나치게 많을 때 단위 체중당 환자에게 주입되는 세포의 양이 적어 문제가 될 수 있다. 방법: 저자들은 가톨릭 조혈모세포이식 센터에서 동종 골수이식을 시행한 환자들 중 환자의 체중이 공여자에 비해 10kg이상 많은 경우 골수 채취 전에 공여자에게 3일간 피하로 G-CSF(10ug/kg/day)를 투여하여 골수를 체내(in vivo) 증폭시킨 후 골수이식을 시행한 25예의 환자를 대상으로 고식적인 방법으로 골수이식을 시행한 위험인자가 일치되는 대조군과 비교하여 이식된 세포수, 혈구의 회복속도 및 이식편대 숙주반응(GVHD)의 발생율, 그리고 생존율 등을 비교 분석하였다. 결과: 단기간의 G-CSF 투여로 증폭된 골수의 총 유핵세포수, 단핵구수는 대조군에 비해 3-5배, CD34 + 세포수는 6배 증폭되었으며, 두 군간에 세포의 면역표현형(CD4, CD5, CD7, CD8, CD20)의 차이는 없었다. 중성 백혈구 수가 0.5×10^(9)/L 이상 회복되는 시기는 두 군간의 차이가 없었으나(15.5일 vs 16일; p=0.131), 혈소판 수가 30×10^(9)/L 이상으로 회복되는 시기는 G-CSF 투여군에서 의의있게 단축되었다(20일 vs 26일; p=0.013). 두 군간 급성 및 만성 GVHD의 발생률과 정도의 차이는 없었으며, 이식 후 재발 및 생존율의 차이도 없었다. 결론: 이식전 공여자에게 단기간 G-CSF를 주사하여 생체내에서 골수 조혈모세포를 증폭시킨 후 이식하는 방법은 공여자와 환자의 심각한 체중 차이로 인해 단위체중당 이식되는 조혈모세포양이 부족한 환자들에게 안전하고 유용한 방법일 뿐만 아니라 GVHD의 증가 없이 빠른 혈구회복을 기대할 수 있는 이식기법이라고 생각한다. 향후 증폭된 골수 조혈모세포의 특성 연구 및 이의 효용성을 확인하기 위한 전향적인 연구가 필요하리라고 생각된다. Background: Sufficient stem cell doses are necessary to overcome engraftment failure in allogeneic bone marrow transplantation(BMT). Cell doses harvested may depend on body weight (BW) difference between donor and recipient. In practice, it is important to achieve large number of stem cells from donor who were lower BW than that of recipient. Methods: We have tried to inject G-CSF(10ug/kg/day) subcutaneously for 3 days to the allogeneic donor with lower BW than recipient before harvest to increase BM inoculum. BM was infused into patients without any manipulation on day 5. A total 25 patients were enrolled; 12 AML, 6 ALL, 5 SAA and 2 CML(expansion group). We compared the expansion group with 25 historical control patients, matched for diagnosis and clinical characteristics, who underwent unprimed BMT. Results: Recipient BW is not different between the expansion and control group. However, allogeneic donors in the control group weigh heavier than those in the expansion group. The yield of TNC, MNC, and CD34^(+) cells from G-CSFprimed BM was significantly higher than that from unprimed BM. There was no difference in immunophenotyping analysis(CD4, CD5, CD7, CD8, CD20) between two groups. The median time reaching to absolute neutrophil count more than 0.5×10^(9)/L was not different(15.5 vs 16 days: p=0.131), but time to platelet recovery more than 30×10^(9)/L was significantly shorter for the patients who received G-CSF-primed BM (20 vs 26 days: p=0.013). There was no difference in the incidence of acute and chronic GVHD, relapse rate and overall survival between the two groups with a median follow-up of 13 months. Conclusion: These data suggest that the short-term administration of G-CSF to an allogeneic donor prior to BM harvest seems to be a feasible method to achieve an adequate number of cell doses for patients who weigh higher than donors. Randomized, prospective study is needed to evaluate the efficacy of allogeneic BMT using in vivo expansion of BM by G-CSF.