췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

유치거리 분석을 통한 도시공원의 적정배치에 관한 연구

류연수,나정화,도후조 慶北大學校農業科學技術硏究所 2002 慶北大農學誌 Vol.20 No.-

The purpose of this study is to analysis of disposition distance of city park for the plan of suitable arrangement of city park based on the date examining Daegu Metropolitan City. The results of this study are as follows. 1) The result of analysis of population density as the case of districts, it appeared highly in city center area which Seo-Gu district and Nam-Gu district besides Jung-Gu district. However, it apperared in a low Buk-Gu district, Dong-Gu district and Salseong-Gun. 2) The result of analysis of population density as the case of regions, it appeared very highly Joukjun-Dong of Dalseo-Gu district(31,554per/㎢), Naedang-Dong of Seo-Gu district(29,922per/㎢). However it appeared in a low YeugaoMaen(85per/㎢) and Gachang-Maen(94per/㎢) of Dalseong-Gun. The regions where the population density is high have very low green space and live a lot of low income layer. 3) The result of analysis of disposition distance, in the case of children park, it appeared an intensive distribution in Dongcheon-Dong and Guam-Dong of Buk-Gu district, Whanggm-Dong and Dusan-Dong of Suseong-Gu district, Sangin-Dong and Yeongasn-Dong and Walsung-Dong of Dalseo-Gu district. however, it appeared in a low in Jung-Gu district. The case of urban park of the neighboring area, it appeared the most in Dalseo-Gu district except 2 parks in Jung-Gu district, the case of urban park of the walking area, it apperared in equality in city. 4) In conclusion, the area have population density and lots of low income layer, is in out of disposition distance should be considered in first for city park plan.

결핵군 55 kDa 항원의 면역학적 분석

김화중,김홍성,임재현,조은경,송창화,박정규 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Identification and characterization of mycobacterial antigens are critical for evaluation of their role in diagnosis, vaccination, and pathogenesis of mycobacterial diseases. An attempt has been made to immunologic characterize the 55 kDa protein antigen of Mycobacterium tuberculosis H37Rv which attracted our interest because it is present in high concentration in 50-80% ammonium sulfate fraction of the culture filtrate. Two monoclonal antibodies (MAbs) directed to 55 kDa antigen were produced. MAbs MT55-1 and MT55-2 reacted with a single 55 kDa protein band. On examination of degree for cross-reactivity with other mycobacterial species by enzymelinked immunosorbent assay (ELISA) and immunoblotting, these antibodies reacted strongly with M. tuberculosis and M. bovis BCG, and reacted weakly with M. marinum and M. smegmatis. To investigated the subcellular distribution of MAbs defined epitopes in the 55 kDa antigen within the mycobacterium, we isolated three major subcellular factions of M. tuberculosis, namely, cell wall, cytoplasmic membrane, and cytosol, by a simple fractionation procedure. MAb MT55-1 reactive cpitope was found in the cytosol when tested by immunoblotting. A sandwich ELISA was initially developed for detecting 55 kDa antigen using MT55-1 MAb in mycobacterial culture filtrate before detecting it in clincal specimens. The minimal detectable concentration was 1.0 ㎍/m1 for M. tuberculosis culture filtrate and 100 ㎍/ml for sonic extracts of M. bovis BCG and M. marinum, respectively. But the 55 kDa antigen was not detected in sonic extracts of other mycobacterial species examined. Although further evaluations are required, this study suggests that the 55 kDa antigen may be of interest as potential diagnostic reagent.

결핵균 30 kDa 단백항원 자극에 의하여 유도되는 IFN-Y 및 IL-4 mRNA 발현 양상과 세포독성능

백태현,조은경,박재하,박정규,김화중 충남대학교 생물공학연구소 1997 생물공학연구지 Vol.5 No.-

30 kDa protein antigen, a major secreted protein antigen of Mycobacterium tuberculosis, exhibits strong T cell stimulatory activity. In order to better understand the immunologic activities of 30 kDa antigen, lymphocyte proliferation by ^3H-thymidine incorporation, cytokine mRNA expression pattern using reverse transcription-polymerase chain reaction (RT-PCR), and cytotoxicity in response to in vitro stimulation of human peripheral blood mononuclear cells (PBMCs) with 30 kDa antigen were evaluated. Lymphoproliferative responses to 30 kDa and crude protein antigens in PBMCs of normal PPD-negative and positive donors were compared. As expected, PPD negative donors demonstrated no thymidine incorporation in response to 30 kDa and crude protein antigens, while PPD positive donors showed extensive proliferation to both antigens. Freshly isolated PBMCs were stimulated with 30 kDa antigen for 0, 6, 12, 24, 48 hr, 1 wk, and 2 wk and examined for the induction of IFN-γ and IL-4 mRNA using RT-PCR. The expression of IFN-γ mRNA was greatly augmented after 1 wk, and there was also early inductions at 6 and 24 hr, whereas IL-4 mRNA is consistently expressed through 0 to 48 hr and markedly decreased after 1 wk. In contrast, freshly isolated human tonsillar cells failed to express detectable level of IFN-γ mRNA but showed enhanced IL-4 mRNA expression after in vitro stimulation with 30 kDa antigen for 1 wk. Both natural killer (NK) and T cell cytotoxic activities induced by 30 kDa and crude antigens were also evaluated. PBMCs from PPD positive donors stimulated with 30 kDa antigen showed significantly higher NK and T cell cytotoxic activities than those in PPD negative donors. Crude antigen also induced similar level of cytotoxicity with that of 30 kDa antigen. These results suggest that 30 kDa antigen of M. tuberculosis may selectively activate Th1 cells and be a strong inducer of IFN-γ expression. In conclusion, 30 kDa antigen can be used as a standard T cell immunogen.

Vitamin D_(3)가 RAW 세포에 감염된 Mycobacterium marinum의 증식억제에 미치는 기전 연구

박정규,정샛별,이길수,김수영,송창화,박종호,조현구,조은경,김화중 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

The natural resistance-associated macrophage protein 1(Nramp1) has been proposed to directly regulate bactericidal or bacteriostatic activity of the macrophage toward pathogens or participate in macrophage activation that lead to microbial elimination in the host. The relationship between Nramp1 and nitric oxide(NO) as an antimicrobial factor has not been precisely defined to date. To devise an in vitro assay for Nramp1 function, this study introduced a wild type Nramp1^(G169) cDKA transfected RAW264.7 macrophages(A8) which bear a homozygous mutant Nramp1^(D169) allele and are permissive to replication of specific intracellular parasites. RAW264.7 and A8 macrophages did not produce NO, but vitamin D_(3)-activated-Mycobacterium marinum-infected RAW264.7 and A8 macrophages pretreated with vitamin D_(3) leaded to the increase of NO production and growth inhibition of M. marinum. Inhibition of NO production by a NO inhibitor, L-NAME, abolished the above effects. The mRNA expression of iNOS in infected macrophages with costimulated vitamin D_(3) was increased. IFN-γ activated macrophages also showed the same results with vitamin D_(3) activated macrophages. These results suggest that bactericidal or bacteriostatic activity in RAW264.7 and A8 macrophages correlated with the production of NO, although NO might not be the only factor responsible for controlling M. marinum infection. The Nrampl gene is considered to be a cofactor in the controlling the replication of M. marinum infection.

Interleukin-2와 결핵균 30 kDa 항원이 구개편도 및 말초혈액 T 세포 증식에 미치는 상승효과

박정규,박찬권,조은경,김화중,백태현,고필준,김병국,남부현,나기상,박찬일 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1

Widespread use of BCG has not controlled tuberculosis, and more effective vaccines are clearly needed. Although chemotherapy will remain the mainstay of antituberculosis treatment, the use of adjunctive immunotherapeutic modalitites is attractive, particularly in persons with drug-resistant tuberculosis. Administration of IL-2 or IFN-γto tuberculosis patients enhance bacillary elimination. Cell-mediated immunity is the critical protective immune response in tuberculosis. Mycobacterial antigens are recognized by T cells and that elicit production of protective cytokines are potentially important vaccine antigens. The 30 kDa antigen is secreted in large quantities by growing mycobacteria. That antigen elicits greater proliferation in lymphocytes from healthy tuberculin reactors than healthy tuberculin nonreactors. In this study, the T lymphocyte proliferative responses to 30 kDa antigen from Mycobactrium tuberculosis H37Rv were examined by using tonsilar and peripheral blood lymphocytes from PPD(+) and PPD(-) tonsilectomized persons. When cultured with 30 kD antigen, tonsilar mononuclear leukocytes and T cells of PPD(+) demonstrated more ^3H-thymidine incorporation than PPD(-) persons (stimulation index was 2.5 and 1.9, 0.8 and 1.0, repectively). Peripheral blood mononuclear cells (PBMC) and peripheral blood T lymphocytes were shown the similar responses to this antigen. The combination of IL-2 and 30 kDa antigen elicited a significant proliferative responsiveness in tonsilar mononuclear leukocytes and T cells of PPD(+) persons (SI was 20 and 14.1). PBMC and peripheral blood T cells of PPD(+) persons were also shown a significant responsiveness, but PPD(-) persons did not show. These results demonstrate that the 30 kDa antigen and IL-2 have a synergistic stimulatory property in mycobacteria sensitizing lymphocytes.

HL-60 세포주를 이용한 결핵균항원의 세포성면역반응의 분석

박정규,강윤중,김운옥,임재현,송창화,조은경,김화중 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Most persons who become infected with M. tuberculosis mount a protective immune response and remain clinically well, the only evidence of infection being development of a positive tuberculin skin test. Five to 10% develop tuberculosis disease within the first 2 years after infection (primary tuberculosis) or thereafter (reactivation tuberculosis). Acquired resistance against tuberculosis paradigmatically rests on cell-mediated immunity, with the major factors being mononuclear phagocytes and T Lymphocytes. While the former cells act as the principal effectors, the latter ones serve as the predominant inducers of protection. The usefulness of the single dose of BCG routinely given in childhood in many developing countries in preventing far more commonly occurring tuberculosis in adults is in doubt. An effective and safe vaccine against tuberculosis is sorely needed. A subunit vaccine are capable of inducing protective immunity and could have substantial advantages over BCG or other whole-bacterium vaccines. The human promyelocytic cell line HL-60 adopted characteristic macrophage-like properties, including adherence and CD14 expression after a period of continuous culture at high ambient CO_(2) concentration. When HL-60 cells were cultured with 1,25-dihydroxyvitamin D_(3) for 4 days, the cells acquired the activity to potentiate T cell proliferation by the 30 kDa or 38 kDa antigen of Mycobacterium tuberculosis H37Rv Therefore, vitamin D-treated HL-60 cells showed the function of the antigen presenting cells.

결핵균 30 kDa 항원과 Triton X-100 Solubilized Protein 항원에 의한 대장암 주변 림프절 단핵구의 활성화

박정규,김광호,조은경,임재현,민들레,송영자,김화중,백태현 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

Tumor-draining lymph node mononuclear (TDLMN) cells are specifically sensitized to the growing tumor but such cells are deficient for mediating an antitumor response. In this study, we examined the feasibility of using mycobacterial 30 kDa or Triton X-100 solubilized protein (TSP) antigen to stimulate mononuclear cells of colon cancer-draining lymph node for the generation of cell mediated immune effector cells. The proliferative response of TDLMN cells stimulated with mycobacterial 30 kDa or TSP antigen was determined by ^(3)H-thymidine incorporation assay. The proliferation of TDLMN cells to mycobacterial 30 kDa or TSP antigen was significantly increased in PPD (+) patients, but a poor response to the 30 kDa or TSP antigen was observed in PPD (-). The expression on γδ T cells to mycobacterial 30 kDa or TSP antigen was assessed by flow cytometry. The γδ T cells from PPD ( + ) patient responded only to 30 kDa antigen but to TSP antigen. An investigation of cytokine mRNA expression was undertaken using reverse transcription-polymerase chain reaction (RT-PCR) to follow TDLMN cells stimulated with the 30 kDa or TSP antigens for 5 days. The IFN-γ and TNF-α mRNA expression was only induced in TDLMN cells of PPD ( + ) patient in response to the 30 kDa or TSP antigen. The IL-2 mRNA expression was induced in both PPD (+) and PPD (-) in response to the 30 kDa or TSP antigen. But the IL-4 mRNA expression was not induced in response to the 30 kDa or TSP antigen. These results suggest that the 30 kDa and TSP antigens may serve as biologic response modifier for the generation of cell mediated immune effector cells.

결핵균 30 kDa항원과 Interleukin-2 혹은 Anti-CD28의 병합이 건강인 말초혈액 림프구와 단핵구 증식에 미치는 영향

박정규,윤상호,조은경,김화중,백태현 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Cell-mediated immunity is necessary for protection against Mycobacterium tuberculosis. T lymphocytes are thought to play a central role in cell-mediated immune response. And in vitro stimulation of leukocytes with mycobactria or their products induces synthesis and release of several cytokines, including IL-2. To study the T lymphocyte proliferative response to purified 30 kDa antigen from Mycobacterium tuberculosis H37Rv, IL-2 or their combination, peripheral blood lymphocytes and mononuclear cells isolated from healthy subjects were stimulated with the 30 kDa antigen, IL-2 or both. The proliferations of lymphocytes and molnonuclear cells to 30 kDa or 30/32 kDa antigen were significantly increased in PPD(+) group when compared to those in PPD(-) group. It is confirmed here that have shown synergy between 30 kDa antigen and IL-2(250U) in the induction of lymphocytes and mononuclear cells proliferation in PPD(+) group. The proliferative response reflects synergy between two separate activation stimuli. And macrophage-like cells existed in peripheral blood mononuclear cells were shown to help the synergy of the proliferative response to mycobacterial antigen and IL-2. The proliferative responses of lymphocytes and mononuclear cells to 30 kDa antigen were more increased than those to 30/32 kDa antigen. So it was suggested that 30 kDa antigen was the more immunogenic antigen than 30/32 kDa antigen.