• Title/Summary/Keyword: 외분비 기능부전

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취장 외분비기능 부전에서 합성 단백 분해효소 억제 물질에 대한 취조직 재생 및 기능 변동 연구

  • 김경환
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.84-84
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    • 1993
  • 취장 외분비 기능 부전은 임상적으로 영양결핍, 발육부전, 지방변동을 유발하나 이의 치료로는 결려된 소화효소 보충 등 보존적 요법만 시행될 뿐 근본적인 치료법은 없는 실정이다. 지난해 과제는 합성 단백분해 억제물질인 Camostat이 취장의 비대와 중식을 일으키며 또한 단백분해 효소분비를 증가시킴을 보고한 바 있다. 이를 토대로 최근 보고된 실험적 취장 외분비기능 부전 모델을 이용하여 camostat의 효과를 검색하고자 하였으며 아울러 이를 CCK효과와 비교하였다. 실험동물로는 몸무게 200 g 안팎의 수컷 Sprague-Dawley계 흰쥐를 사용하였으며 취장기능 부전은 oleic acid (25 $\mu$/100 g bw)를 취관내 주입하여 유발하였다. Camostat은 200 mg/kg씩 위내 투여(i.g.)하였으며 CCK(CCK-8)는 5 $\mu\textrm{g}$/kg씩 하루 2회 피하주사하였고 투여기간은 각각 3, 7, 14 일간으로 하였다. 각 약물 투여 후 취장 외분비 기능과 조직학적 검색을 실시하여 다음과 같온 결과를 얻었다. 1. Oleic acid의 취관내 주입으로 흰쥐의 취장 무게, 조직내 효소단백 함량 및 효소분비량이 현저히 감소되었고 조직학적으로 심한 위축과 섬유화를 관찰할 수 있었으며 이는 주입 후 기간이 지남에 따라 계속 진행하였다. 2. 취장기능 부전 유발 흰쥐에서 camostat 처치로 조직내 효소단백 함량 및 효소분비가 증가 되었으며 이는 14일간 처치군에서 뚜렷하였다. 3. 취장 기능부전 유발 횐쥐에서 camostat 처치는 조직학적으로 기능적인 외분비 조직이 유지되었으며 이는 3일군에서 특히 뚜fut하였다. 4. 취장기능부전 유발 횐쥐에서 CCK 처치효과는 camostat 처치효과와 비슷하였다. 이상의 결과로 보아 oleic acid 주입은 취장기능부전 연구에 유용한 실험모델로 생각되며 합성 단백 분해 효소 억제제인 Camostat은 취장외분비 기능 부전의 진행을 억제하고 어느정도 그 기능을 호전시킬 수 있으며 이는 CCK유리에 기인한다고 생각한다.

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PSEUDOHYPOPARATHYROIDISM : CASE REPORT (가성부갑상선 기능저하증 환아의 구강 증상)

  • Kim, Seong-Oh;Hong, Eun-Kyoung;Choi, Hyung-Joon;Lee, Jae-Ho;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.262-266
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    • 2004
  • The parathyroid hormone plays a major role in the metabolism of calcium and phosphorus. In hypoparathyroidism the parathyroid glands are atrophied or absent associated with autoantibodies against parathyroid tissue. Pseudohypoparathyroidism is a metabolic disease caused by the disturbance in peripheral action of parathormone, but parathormone level is normal. In general, patients with pseudohypoparathyroidism have short stature, round face, brachydactylia, obesity, mental retardation, cataracts & ectopic calcifications on soft tissues. Dental manifestations are enamel hypoplasia, delayed eruption, blunting of root apex, hypodontia, pulp calcification, thickened lamina dura, excessive caries & malocclusion. In this case, intraoral examination showed enamel hypoplasia on the erupted permanent teeth & hypermobility on the remaining deciduous teeth. From the radiographic view severe dental anomalies were observed on canines and shortening and blunting of root apex was observed on mandibular incisors. Pathologic root resorption was also observed on deciduous teeth.

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Effects of Glucose Degradation Products on Human Peritoneal Mesothelial Cells (포도당분해산물이 사람 복막중피세포 활성화에 미치는 영향)

  • Song, Jae-Sook;Lee, Kyung-Lim;Ha, Hunjoo
    • Microbiology and Biotechnology Letters
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    • v.33 no.4
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    • pp.308-314
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    • 2005
  • Both high glucose and glucose degradation products (GDP) have been implicated in alterations of peritoneal membrane structure and function during long-term peritoneal dialysis (PD). The present study examined the role of GDP including methylglyoxal (MGO), acetaldehyde, and 3,4-dideoxyglucosone (3,4-DGE) in HPMC activation with respect to membrane hyperpermeability or fibrosis. The role of reactive oxygen species (ROS) and activation of protein kinase C (PKC) in GDP-induced HPMC activation were also examined. Using M199 culture medium as control, growth arrested and synchronized HPMC were continuously stimulated by MGO, acetaldehyde, and 3,4-DGE for 48 hours. Vascular endothelial growth factor (VEGF) was quantified as a marker of peritoneal membrane hyperpermeability and fibronectin and heat shock protein 47 (hsp47) as markers of fibrosis. Involvement of ROS and PKC was examined by the inhibitory effect of N-acetylcystein (NAC) or calphostin C, respectively. MGO significantly increased VEGF (1.9-fold), fibronectin (1.5-fold), and hsp47 (1.3-fold) secretion compared with control M199. NAC and calphostin C effectively inhibited MGO-induced VEGF upregulation. Acetaldehyde stimulated and 3,4-DGE inhibited VEGF secretion. Fibronectin secretion and hsp47 expression in HPMC were not affected by acetaldehyde or 3,4-DGE In conclusion, MGO upregulated VEGF and fibronectin secretion and hsp47 expression in HPMC, and PKC as well as ROS mediate MGO-induced VEGF secretion by HPMC. This implies that PKC activation and ROS generation by GDP may constitute important signals for activation of HPMC leading to progressive membrane hyperpermeability and accumulation of extracellular matrix and eventual peritoneal fibrosis.

Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.