제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

김치 발효중 생체활성 아민 생성에 관한 연구

서일원,류춘선,이주돈,이영환,변광의 순천향대학교 기초과학연구소 1997 순천향자연과학연구 논문집 Vol.3 No.2

Biogenic amines can be formed and degraded either as the result of endogenous amino acid decarboxylase activity in raw materials or by the growth of decarboxylase-positive microorgannisms under conditions favorable to enzyme activity. Three biogenic amines(Tryptamine, Histamine, Tyramine) were intensively investigated by the HPLC during Kimchi fermentation at 5℃. The patterns of microfloral changes in lactic acid bacterial group, Leuconostoc, Streptococcus and Lactobacillus, were similar to the typical low-temperature fermentation. The population of microbial growth were high after 10 days and gradually decreased. The levels of Tyramine were lowered(10mg/kg) during this mid-periods(8∼16 days) but very high in initial-(15mg/kg) and final-periods (30mg/kg), in which the total acidity ranged between 0.2∼0.35% and 0.4∼0.6%, while the acidity in mid-periods revealed 0.35∼0.4% beginning the initial ripening period. Leuconostoc was highly increased in number in mid-period but slightly declined as the acidity increased, whereas Streptococcus was highly distributed in initial-period and Lactobacillus in final-period. The levels of Tryptamine and Histamine were relatively low throughout the whole fermentation period, but the profile of Tryptamine level was very similar to the case of Tyramine. Histamine was maintained at a certain level after mid-period of fermentation.

심도 180m와 230m상당압의 He-O 포화잠수가 수면에 미치는 영향

서유진,박영만,박광박 慶南大學校 附設 基礎科學硏究所 1996 硏究論文集 Vol.9 No.-

심도 180m와 230m의 고압 He-O₂ 환경하에서의 두 종류의 simulated된 잠수 실험에 있어서, 4명의 다이버들에 대해서 각각 표준적인 polysomnograms를 총 188일의 밤에 걸쳐서 기록했다. 두 종류의 잠수 조건에 있어서 해저의 감압하에서는 전체 수면 시간의 단축, 수면 효율의 감소, 수면으로 들어가는 시간의 증가, 중도 각성 회수와 수면 단계 이행 회수의 증가, 1단계 수면의 증가, 더욱이 4단계 수면의 감소를 보였지만, 어느 쪽도 뚜렷한 변화는 보이지 않았다. 230m 잠수에 있어서의 수면은 180m 잠수에 비해서 4단계 수면만 유의한 감소를 보였다. 두가지의 잠수 조건 모두 잠수 기간 중에는 각성하기 쉬운 상황이었고, 기초적인 수면 패턴의 혼란은 없는 것으로 추측 되었다.

유동전동기의 센서리스 속도제어

서영수,차광훈 명지대학교 대학원 1997 대학원논문집 Vol.1 No.-

Speed sensors are required for the vector control of induction motor. However, this sensor reduce the sturdiness the system and make many problems in operation. A sensorless controller of induction motor has several advantage: availability in a harsh environment. Therefore, a drive system without speed sensor is required. In this paper, to overcome these problems caused by the speed sensor speed estimator is using. The flux information is driving from the currents and voltage. And the speed information is driving from the currents and the estimated stator flux.

抽水性 自生水生植物의 종자번식에 관한 연구

서병기,김광두,안영희,최광율 中央大學校 遺傳工學硏究所 1999 遺傳工學硏究論集 Vol.12 No.1

본 실험은 조경가치가 높은 자생수생식물들의 효과적인 실생번식방법을 알아보고자 실시하였다. 각 종자들은 15, 30, 45일간 냉장고(4℃)에서 저온처리를 하여 25℃로 고정된 plant growth chamber와 Incubator에서 실험한 결과 세모고랭이, 큰고랭이, 부들은 대조구에서는 전혀 발아가 되지 않았으나, 세모고랭이의 경우 30일간의 저온처리구에서 45%, 큰고랭이와 달뿌리는 45일간의 저온처리구에서 36.7%, 96.6%, 부들은 15일간의 저온처리구에서 65%가 발아하여 저온처리가 발아촉진에 우수한 효과를 나타내었으며 또한, 光 조건에서 발아가 촉진되는 경향을 나타내었다. In this study, we studied efficiently sexual propagation method of landscaping native aquatic plants. The results of study,-each seeds treated on cold chamber(4℃) during 15, 30, 45 days, and then growth in the plant growth chamber and incubator fixed 25℃- Scirpus triqueter, S. tabernaemontani, Typha orientalis did not germinated in control, but in cold treated for 30 days with Scirpus triqueter is germinated 45℃, cold treated for 45 days with S. tabernaemontani, Phragmites japonica is germinated 36.7%, 96.6%, and cold treated for 15 days with Typha orientalis is germinated 65%. So, cold treatment as showed high efficiency for germination, and activated of germination in light control.

교원효소로 유발된 랫드 대뇌 출혈병변의 병리학적 관찰

서일복,소경순,김광호,김영석 世明대학교 한의학연구소 1998 韓醫學硏究所 論文集 Vol.1 No.-

This study was carried out to characterized the hemorrhagic lesion sof the collagenase induced hemorrhagic stroke in rats. Fifty three Sprague-Dawley male rats were divided into two group. Group Ⅰ was served as model animals for hemorrhagic stroke, which were infused with 2㎕ saline containing 0.5unit collagenase(type Ⅶ) into the caudaate nuclei. Group Ⅱ was served as control animals, which were infused with 2㎕ saline only into the caudate nuclei. Six heaks of the rats of group Ⅰ were sacrificed at 30 min, 1, 5, 24 hours, 2, 5, 10 days after the infusion , and 3 heads of rats were sacrificed at 15 days after the infusion. Two heads of the rats of group Ⅱ were sacrificed at 30min, 1,5, 24 hours after the infusion. The brains of the rats were removed and examined grossly and histopathologically. Grossly, pin point sized or linear hemorrhage were occurred at 30minutes and the hemorrhagic lesions extended to 5mm in diameter at 24 hours. After then the hemorrhagic lesions faded gradually. Histopathologically, extended hemorrhage with degeneration of brain parenchyma were observed at 5 hours. Large area of malacia were observed at 24 hours. At 5 days, proliferation of astrocytes, proliferation of newly formed capillaries, and infiltration of lipid laden macrophages were seen at the periphery of the area of malacia. At 15 days, most of the area of malacia were replaced by granulation tissue. These observations may be useful parameters for the screening of therapeutic drugs using collagenase induced hemorrhagic stroke animal model.

심도 20m Nitrox 포화잠수에 있어서 수면의 심리적 영향

서유진,박영만,박광박 慶南大學校 附設 基礎科學硏究所 1996 硏究論文集 Vol.9 No.-

세 종류의 시뮬레이션된 20m Nitrox 포화잠수 상태하에서 수면 구조에 대해 조사했다. 그리고, 장기간의 포화잠수에 대해 12명의 다이버들을 참가시켜서, 연속된 180일간의 밤 동안 분석했다. 3가지 잠수 모두, 감압 전야(前夜)부터 postdive 4일째 밤에 걸쳐서는 전체 수면시간의 단축, 중도 각성 시간의 증가, 입면잠시(入眠潛時)의 연장을 수반한 수면의 혼란함을 조금 보였다. 감압 속도가 빠른 NitroxⅡ에서는, 감압하는 밤부터 postdive 3일째 밤에 걸쳐서 4단계 수면만 조금 감소했다. 20대와 30대에서는 전체 수면 변수에 크게 다른 것은 보이지 않았지만, 50대의 다이버에서는, 해저 생활 후반부터 postdive 3일째 밤에 걸쳐서, 배뇨를 위한 각성 시간이나, 이른 아침의 각성, 입면 잠시의 증가를 보였다. 그리고, 본 연구에서는 이러한 결과를 감압과 폐쇄 환경하에서의 장시간 구속에 의한 심리적 스트레스의 면에 대해서도 고찰했다.

양극성 장애의 우세삽화와 임상양상 간의 연관성 : 예비연구

서호준,우영섭,채정호,전태연,김광수,박원명 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

Objective : This study was performed to fmd clinical implications ofdistinctive pattems in bipolar patients with predominance of depressive episodes or manic episodes and to find possibilities to predict predominant episodes in bipolar disorder. Methods : The recmitment period was between 2002 and 2004, among inpatients who had received psychiatric treatment for bipolar disorder. The data about the number and the polarity of the past episodes were collected through medical records, and Sub-jects were divided into depressive or manic episode predominant groups. The two groups were compared regarding Sociodemo-graphic and clinical variables. Results : 74 patients met the inclusion criteria during the study period. 21 subjects were classified as depressive episode Pre-dominant group (depressive episode group), and 53 subjects as manic episode predominant group (manic episode group). There were no differences in sociodemographic data, the number of total episodes and hypomanic episodes, and onset age. However, 90.5% (n=19) subjects of depressive episode group showed depressive episode as first episode, and 88.7% (n=47) of manicepisode group experienced manic episode as first episode (χ²=42.13, df=1, P<0.00l). Psychotic symptomswere significantly more prominent in the manic episode group (χ²=6.85, df=1, P=0.009), and the number ofsubjects who had suicide attempt experience was higher in the depressive episode group (χ²=7.39, df=1, P=0.007). In the comparison of highest GAF scores during the past year, significant difference was found between the two group (p=0.046), as the mean scores of depressive epi-sode group was 68.337±7.47 and manic episode groupwas 71.51±5.42. Conclusion : The results ofthis study show that there are differences in clinical features according to predominant episodes in bipolar disorder. The type of onset episode appears to be related to predominant episode in this study, and it would be a valid Pa-rameter with therapeutic implication in bipolar patients.

철광석 Brand 별 수소환원 반응속도

김영홍,이광학,김영진,서도수,이재운,김흥식 울산대학교 1999 공학연구논문집 Vol.30 No.2

반응온도가 증가할수록 Brand별 철광석의 환원율은 증가하였으며 일정반응온도에서 원광석형태인 Romeral 보다 펠렛형태인 CVRD,IOC 및 ALG 시편의 환원율이 더 높음을 알수 있었고 펠레시편 중 IOC가 타 시편에 비해 환원율이 가장 큼을 알 수 있었다. 수소가스에 의한 원광석 및 펠렛시편의 환원반응에서 전반응속도는 계면화학반응에 의해 율속됨을 알 수 있었으며, 활성화에너지값은 Romeral, CVRD, IOC 및 ALG의 경우 각각 약 4.8, 7.7, 4.5 및 5.3kcal/mol이었다. 이들 활성화에너지값으로부터 수소가스에 의한 환원반응은 펠렛형인 IOC가 가장 우수함을 알 수 있었다. In order to get an fundamental data to select a suitable ore brand for hydrogen reduction, the reaction kinetics of hydrogen for ore brands was investigated. Four kinds of ore brands such as Romeral ore, CVRD, IOC,ALG pellet were selected for this experiment. It was observed that the reduction ratio of pellets was higher than ore and IOC pellet showed the highest in comparing with other pellets. The kinetics data was fitted to [1-(1-R)1/3] = kt for surface reaction control. The activation energy for the reduction of Romeral, CVRD, IOC and ALG were 4.8, 7.7, 4.5 and 5.3 kcal/mol respectively. It was shown that the overall reduction rate was controlled by surface reaction. And also, we can get result that IOC was the most suitable ore for the reduction with hydrogen gas among the specimens

자발적 초점성분절성사구체경화증 Mouse 모델에서 TGF-β및 MCP-1 유전자발현에 미치는 Renin Angiotensin System 의 영향에 관한 연구

신영태,서광선,이강욱 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

The role of angiotensin Ⅱ in the pathogenesis of the progressive renal injury process has been studied in many human renal diseases and animal renal injury models. The inhibition of angiotensin Ⅱ also has been reported to be effective to attenuate renal injury process in many human renal diseases and animal models. The activation of TGF-β and MCP-1 gene is thought to be related with renal injury process. A mutant strain FGS/Nga/Kist mouse is reported to develop focal and segmental glomerulosis, spontaneously. In order to evaluate renal pathology, MCP-1 and TGF-β gene expressions and the effect of renin-angiotensin system inhibition, 8 FGS/Nga/Kist mice were treated by angiotensin converting enzyme inhibitor, enalapril (150 mg/L in drinking water) for 12 weeks. Another non-treated, agematched 8 FGS/Nga/Kist mice and 6 nomal CBA/Nga mice were also included in this study. The urinary protein excrtion, magnitude of glomerular sclerosis, and renal express of MCP-1 and TGF-β were evaluated by uristick, light microscopic examination and competitive RT-PCR, respectively. CBA/Nga mice did not show significant proteinuria. However, urinary protein scores of enalapril-treated FgS/Nga/Kist mice was significantly lower than that of non-treated FGS/Nga/Kist mice (2.0±0.3, 4.1±0.5, respectively, p <0.05). Focal and segmental glomerular scierosis index of enalapril treated FGS/Nga/Kist mice was significantly lower than that of non-treated FGS/Nga/Kist mice (120±13, 189±15, respectively, p < 0.05). The level of renal TGF-β gene expression of enalapril treated FGS/Nga/Kist was significantly higher than that of CBA/Nga mice (4.7±1.3, 1.0±0.3, respentively, p< 0.05). But, enalapril treated FGs/Nga/Kist mice showed significantly lower level of TGF-β expression than that of non-treated FGS/Nga/Kist mice(p<0.05). MCP-1 gene expression of untreated FGS/Nga/Kist mice was significantly lower than that of CBA/Nga mice. However, enalapril treated FGS/Nga/Kist mice showed markedly increased level of MCP-1 gene expression compared to the untreated FGS/Nga/Kist mice(9.8±1.8, 3.6±1.2, respectively, p<0.05). With the above result, we speculate that angiotensin converting enzyme ingibition attenuates the renal injury process in this model and the regulation pathway of MCP-1 by renin-angiotensin system may be different from other animal renal injury models.