정상 인체 멜라닌세포에서 endothelin-1 receptor antagonist가 melanin생성에 미치는 영향에 관한 연구

박진우,이종석,황규왕,김정하 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

In the normal skin, melanocytes maintain their constant population and their melanogenic activity in steady state, but respond to several stimulus such as UV radiation and chemical irritation, to accentuate proliferation and differentiation, leading to hyperpigmentation of the skin. Human Keratinocytes produce and secrete endothelin-1, which can be strong mitogens for human melanocytes. The paracrine linkage of endothelin-1 between keratinocytes and melanocytes suggested that endothelin-1 is intrinsic mediators for human melanocytes in UVB-induced pigmentation. The purpose of this study is to investigate the new whitening agent, which improve the hyperpigmentation by inhibiting the ET-1. So, we add ET-1 and five kinds of ETRA into the cultured normal human melanocyte and then three days later, each ETRA on ET-1 was measured melanocyte number and inhibitory effect of melanin synthesis, respectively. In this study, ETRA has a inhibitory effect on ET-1 induced melanocyte proliferation and melanogenesis. ETRA I has a strong inhibitory effect on melanocyte proliferation and ETRA Ⅱ has a strong inhibitory effect melanogenesis. western blotting results shows negative. It may be due to the processing error of protein denaturing or low antigen -antibody affinity. But, we also confirm that ETRA Ⅱ has a inhibitory effect of tyrosinae synthesis by RT-PCR

mucus 분비를 동반한 점막형 간내담관암

최동호 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Peripheral cholangiocarcinoma refers to an adenocarcinoma arising from the bile ducts peripheral to secondary confluence. The growth pattern of the peripheral cholangiocarcinoma may be classified into mass-forming type, infiltrating type, intraductal polypoid type and combined type. Intraductal mucosal spreading mucin secreting intrahepatic cholangiocarcinoma is a rare subtype of peripheral cholangiocarcinoma. Its existence has been neglected due to its paucity. A 59-year old male presented with jaundice was admitted because of recurrent cholangitis. A MRI of the abdomen showed dilated intrahepatic duct without mass lesions Left hepatectomy was done with negative surgical margin. Pathologic diagnosis was intraductal mucinous type cholangiocarcinoma without stromal invasion. Intrahepatic duct stone was found. Postoperative duodenal ulcer bleeding was treated by suture ligation of bleeding vessels of duodenum. Patient discharged 65 days after operation.

진행성 위암과 동반된 후복막 섬유화증 7예의 임상적 고찰

장재영,천영국,최우봉,김진오,조주영,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background/Aims: Retroperitoneal fibrosis is a fibrosing disease process which frequently develops ureteral obstruction. Malignant retroperitoneal fibrosis has been reported that various types of cancer including cancer of the breast, stomach, prostate, lung, cervix, uteri, colon, pancreas, ovary, and even Hodgkin's disease. While the pathogenesis remains obscure, small foci of metastatic neoplasm in the retroperitoneal space can elicit a desmoplastic reaction in secondary form to malignancy. Methods: Recently we experienced 7 cases of retroperitoneal fibrosis with advanced gastric cancer. So, we report 7 cases of retroperitoneal fibrosis with clinical and radiologic characteristics. Results: The most common signs and symptoms were related irreversible renal dysfunction. The urologic finding noted medial deviation of the involved ureters and hydronephrosis Conclusions: Clinical manifestations are abdominal pain, back pain, hydronephrosis, and uremia. When sudden back pain and hydronephrosis develop in advanced malignancy, physicians should be considerd for retroperitoneal fibrosis.

관상 동맥 질환에서 아포 E 지단백 유전자 다형성과 혈청 지질치와의 관계

곽선영,김성구,정호석,이유경,이광희,김철현,최태명,현민수,권영주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background and aims: The Apolipoprotein E is a ligand of both the protein component LDL receptor as well as the apo E LDL-Receptor related protein (LRP). It modulates the receptor binding of lipoproteins, with the apolipoprotein E found on cell surfaces as its component, thus serving an important role in the lipid metabolism by carrying out the intracellular transport of cholesterol in lipoproteins. The gene for apolipoprotein E is the product of three common genotypes as well as many more rare alleles. The common genotypes are ε2, ε3, and ε4, and are expressed in the three phenotype isoforms of E2, E3, and E4. In the event that E4 is the main component, a rise in the cholesterol level, as the result of down-regulation of the LDL receptor, is observed. Therefore, those samples with E4 genotypes are known to be in much higher risk of coronary artery disease than those with ε3/ε3, while those with ε2 are in low risk (with the exception of hypertiglyceremai Ⅲ). The aim of this study is to analyze in patients with ischemic heart disease the role of aplipoprotein E alleles in order to seek its correlation with coronary artery disease, as well as to seek whether the polymorphism of apo E produces any differences in the severity of coronary artery disease according to plasma lipid levels. Methods: The subjects for study were 273 patients admitted to the Internal Cardiology Division of the Soonchunhyang University Hospital form December 1998 to February 1999. The subjects were divided into the two groups of which one was ischemic heart disease (IHD) experiment group totaling 105 (avg.60.1 years of age, male/female ratio = 69/36) and the control group totaling 168 (avg. 59.7 years of age, male/female = 73:95). The coronary angiogram was given to 127 subjects, and of this total, 94 have developed significant stenosis in the coronary artery. The stages of the analyzing of the apo E phenotype was first, the separation of DNA from the blood samples, subjecting it to the PCR from with 228 base pairs of expanded products were obtained. The band was determined by means of the reverse hybridization principle on the nitrocellulose strip. Results: From the 105 patients the distributions of apo E phenotypes were as follows: ε3/2(5.7%), ε4/2(1.9%), ε3/3(70%), ε4/3(20%), ε4/4(1.9%). The relative frequencies of each allele are as follow: ε2 (0.038), ε3 (0.833), ε4 (0.128). The results show as follows: ⅰ) The IHD experiment group to have a higher occurrence of ε4/3 phenotypes as well as ε4 alleles than the control group. ⅱ) Both the control group and IHD group showed the largest distribution of ε3/3 for phenotypes, and ε4 for alleles. ⅲ) The IHD group showed less ε2/3 phenotypes as well as significantly less allele frequency of ε3 in comparison to the control group. ⅳ) the IHD group showed a much lower level of HDL in comparison to the control group, while the LDL was significantly higher; samples including the apo ε2 showed a significantly higher level of HDL than those without. Among the control group, samples including apo ε2 showed a significantly higher level of TG (triglyceride) than samples without. No significant difference was found between the experiment apo ε4 sample and the control plasma lipid sample. ⅴ) No significant correlation was found between an apo E polynorphism and the number of involved arteries of a coronary angiogram. Conclusion: Between the experiment IHD group and control group were found differences in the frequency of alleles. The polymorphism of apo E alleles may contribute as a risk factor to the development of heart disease by involving itself in the metabolism and modulation of plasma lipids.

만성 화농성 중이염의 세균학적 고찰

조남순,이영훈,강기훈,최제환,송태현,이병돈,장혁순,강주원,김연준 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background and Objectives : Chronic suppurative otitis media is one of the frequent diseases in otolaryngologic field. It is important to choose of antibiotics in the management of infectious disease. But the organisms in infections have been changed and resistance to antibiotics has been grown as the development of antibiotics has been achieved. And so it has been necessary to recognize the changes of organisms and resistance in antibiotics. Our study was performed to identify the pathogens isolated from discharges in chronic otitis media and evaluate the antibiotic agents, to recognize the change of to resistance to·antibiotic agents and to use the appropriate anitiotics. Materials and Methods : Retrospectively, authors reviewed the backeriologic study of 114 cases of chronic suppurative otitis media who visited the Department of Otolaryngology, Soonchunhyang University in Seoul from Nov. 1996 to Oct. 1999 and analyzed 101 strains and its sensitivity test to various antibiotics. Result : In 93 cases in which pathogenic organism was isolated, single infection was 85 cases(91.4%) and mixed infection was 8 cases(8.6%). The most frequent pathogenic organism was Staphylococcus aureus(59.4%), Pseudomonas aeruginosa(13.9%), Providencia(4.8%), Alcaligenes(3.0%) and Streptococcus pneumoniae(2.9%) were the next. Methicilline-Resistance Staphylococcus aureus was 34 cases(57.6%) of Staphylococcus aureus. Staphylococcus aureus was sensitive to Vancomycin(96.7%), Trimethoprim-Sulfamethoxazole (57.6%), Cefuroxime(42.4%) and Ciprofloxacin(40.7%) but resistant to Penicillin(94.9%). Pseudomonas aeruginosa was sentitive Amikacin(100%), Ciprofloxacin(100%) and Gentamicin(67%). Conclusion : As MRSA recently was wide spread in community accquired infection as well as nosocomial infection, we must consider strict control of MRSA.

조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

총 경정맥 영양 요법(TPN)중에 발생한 Wernicke-Korsakoff syndrome 1 예

이문수,김태윤,김성용,백무준,김창호,조무식 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Total parenteral nutrition is commonly known as a safe and convenient method of nutritional supplemantation for malnourished patients. Several metabolic complications have been adquately studied and reported their diagnosis and management. There was, however, no precisional data and studies of vitamin B1 deficiecy induced Wernicke's encephalopathy. And Wernicke's encephalopathy may be difficult to recognize, expecially if it is in the early stage and if all manifestation s are not yet present, and because a patients with Wernicke's encephalopathy may become comatose and die if the disorder is not diagnosed and vitamin B1 not given promptly. Therefore Wernicke's encephalopathy is emergent. We report a case of Wernicke-Korsakoff encephalopathy that was caused by vitamin B1 deficiency

자궁 경부 질환에서 p53과 bcl-2 발현 양상

안상묵,김대중,양승하,김의한 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background: The function of p53 protein was known to accelerate the apoptosis while bcl-2 protein was known to suppress the apoptosis. The patterns of expression of mutant p53 and bcl-2 protein has been reported in various malignant tumors. Although the mechanisms of the p53 and bcl-2 protein in tumorgenesis has not been completely proved, the bcl-2 positive tumors appeared to have good prognosis than tumors with mutant p53 expression. The authors analyzed immunohistochemical expression of mutant p53 and bcl-2 protein in epithelial lesions of uterine cervix. Method: Nine cases of squamous metaplasia, 9 cases of mild dysplasia(CIN Ⅰ), 11 cases of moderate dysplasia(CIN Ⅱ), 16 cases of carcinoina in situ(CIS) and 13 cases invasive squamous cell carcinoma(SCC) were immunohistochemically stained with p53 and bcl-2 monoclonal antibodies. Result: 1. The p53 was weakly positive in 3 out of 9 cases(33%) of squamous metaplasia, and the positive cells were observed only in the basal layer. 3 out of 9 cases(33%) in mild dysplasia and 4 out of 11 cases(36%) in moderate dysplasia showed weakly positive reaction. 2. The p53 showed weakly positive reaction in 7 out of 16(44%) CIS cases and in 9 out of 23(38%) cases the invasive SCC and the positive cells were observed in the tumor cells. 3. The bcl-2 protein showed positive reaction of the reserve cells and along the basal layer of the uterine cervix. However, the positive reactions disappeared in reserve cells and basal cells in 3 out of 9 cases(33%) in squamous metaplasia, 3 out of 9 cases in mild dysplasia(33%), 5 out of 9 cases(56%) in moderate dysplasia, 9 out of 16 cases(56%) in CIS and 14 out of 23 cases(54%) in invasive SCC. This meaned that the positive rate of the bcl-2 protein appeared to decrease according to the progression of the lesion. Above result suggested that the expression of the mutant p53 in the epithelial lesions uterine cervix could be different from those of the other organs in view of tumorgenesis and prognosis; the expression of p53 in the epithelial lesion of the uterine cervix have no significant meaning in progression and prognosis of the lesions. The disappearance of the bcl-2 of the basal cells and reserve cells in the epithelial lesions of uterine cervix suggested a relationship with the prognosis of the lesios, however, not statistically significant.

소뇌에 단독으로 발생한 이소성 신경집종 : 증례 보고 case report

조성진,장재철 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Intracerebellar schwannomas of the contral nervous system are extremely rare. The author report on a 27-year-old woman with a schwannoma of the cerebellar hemisphere who presented with headache and dizziness. The tumor was demonstrated low-intensity signals on T1WI and high-intensity signals on T2WI. Preoperative diagnosis was a pilocytic astrocytoma with nural nodule. The tumor was removed via suboccpital approach. The pathological findings with immunochemical staining in samples obtained after resection disclosed as a feature of schwannoma.

중족골 단축증 일단계 신연술 : 증례 보고 A Case Report

민경대,권혁룡 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Congenital shortening of the matatarsal bone has both functional and cosmetic problems. The most widely used surgical correction techniques are either one-stage lengthening with intercalary bone graft or gradual lengthening by callotasis using external fixator. Authors present the case of 21-year-old female patient with brachymetatarsia who treated by one stage lengthening without bone graft or external fixator.