• 대한치과보철학회지
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• 제50권4호
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• pp.279-284
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• 2012

연구 목적: 광중합형 레진에 미리 함침시킨 유리섬유를 이용하여 상악 레진상 총의치를 강화시킨 경우, 강화 부위의 위치가 파절 강도와 의치 파절 시 미치는 효과를 알아보기 위함이다. 연구 재료 및 방법: 본 연구에서는 0.45 mm의 두께를 가지고 광중합형 레진에 미리 함침시킨 유리섬유(SES MESH, INNO Dental Co., Yeoncheon-gun, Korea)를 이용하여 상악 총의치를 강화하였고, 강화재료의 위치 및 유무에 따라 5개의 군(대조군, 의치상을 섬유 망사로 강화하지 않음; A군, 순측 치조정 중앙부 강화; B군, 순측 치조정 하방의 구개 추벽부위 강화; C 군, 구개 중앙부위 강화; D 군, 의치상 전체 강화)으로 나누었으며, 군당6개의 시편을 제작하였다. 파절강도를 Instron test machine (Instron Co., Canton, MA, USA)을 이용해 5.0 mm/min의 크로스헤드 속도를 부여하여 구하였으며, 하중은 20 mm의 지름을 가진 구형 하중체를 통해 의치 중심부에 전달되었다. 파절 강도 시험 후 나타난 의치의 파절 양상을 분석하였다. 파절강도를 일원배치분산분석을 통해 검정하였다(${\alpha}$=.05). 결과: 파절강도에 있어 각 군간 통계적으로 유의한 차이를 보이지 않았다(P>.05). 의치의 파절 양상을 분석한 결과 A군에서는 전후방파절과 후방파절의 양상을 주로 보였고, B군, C군 그리고 대조군에서는 정중국소파절이 주로 관찰되었으며 D군에서는 대부분 후방파절을 보였다. 결론: 파절 강도를 측정하여 분석한 결과 유리 섬유에 의한 강화 유무와 위치에 따른 차이를 보이지 않았다. 의치의 파절 양상을 분석한 결과 유리 섬유에 의한 강화를 통해 균열을 억제하는데 효과를 보인다고 판단된다.

• 구강회복응용과학지
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• 제18권4호
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• pp.235-249
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• 2002

This study was accompolished to analyze and compare the number and area of the occlusal contact points in healthy volunteers and athletes with normal occlusion. Before the study, 89 athletes(sports career:8.6 years, average age 20) at Kyung Hee University were selected, and survey was accomplished for athlete's recognition about sports dentistry. For this study, 15 athletes(13 amles and 2 females with average age 20) and 21 healthy volunteers(14 mles and 7 females with average age 20.09) at Kyung Hee University were selected. The visual display acquired by scanning of occlusal record in maximal intercuspation was converted into 16 gray value image. Then, using computer program(J & Lee Occlusal Analyser), the pixel which was in definite range of the gray value was recognized, and the numbers of recognized pixel were calculated to area. The results were as follows : (1) On the survey about sports dentistry, 28% of 89 athletes didn't agree that human occlusion may be important, and 30% didn't have any idea of the influence of human occlusion during their sports activities. (2) The average numbers of total occlusal contact points were 31.05 in control group, and 34.67 in athlete group. The average area of total occlusal contacts was $100.25mm^2$ in control group, and $127.78mm^2$ in athlete group. (3) In control group, the average numbers of occlusal contact points were revealed in order as follows; the first molar(8.48), the second molar(8.24), the second premolar(4.71), the lateral incisor(2.90), the first premor(2.43), the central incisor(2.19), and the canine(2.1). The least average in canine(2.1) was similar to the average(2.19) in central incisor and (2.09) in lateral incisor. In athlete group, the average numbers of occlusal contact points were revealed in order as follows; the first molar(8.87), the second molar(8.47), the second premolar(5.60), the canine(3.80), the lateral incisor(3.33), the first premolar(2.67), and the central incisor(1.93). (4) In control group, the average areas of occlusal contact surface were revealed in order as follows; the first molar($39.47mm^3$), the second molar($37.54mm^3$), the second premolar($9.54mm^3$) the first premolar($6.18mm^3$), canine($3.49mm^3$), the central incisor($2.76mm^3$), and the lateral incisor($1.28mm^3$). In athlete group, the average areas of occlusal contact surface were revealed in order as follows; the first molar($44.11mm^3$), the second molar($40.69mm^3$), the second premolar($16.50mm^3$), the first premolar($9.39mm^3$), the canine($5.08mm^3$), the lateral incisor($3.7mm^3$), and the central incisor($2.25mm^3$). (5). With aging in both control and athlete group, there was a decreasing tendancy in average number of occlusal contact point, and was an increasing tendancy in average area of occlusal contact surface. In comparison at each age, both the numbers and area of occlusal contact were greater in athlete group than in control group. It was not significant in the numbers of occlusal contact points beween athlete and control group(p>0.1), but significant in the area of occlusal contact surface(p<0.05). (6) In comparision as to the kind of sports(Gymnastics:2, Rugby:3, Soccor:5, Ice hocky:5), the numbers of occlusal contact points were the most in ice hocky, and the area of occlusal contact surface was the greatest in gymnastics. With increasing a career in athlete group, there was a decreasing tendancy in average numbers of occlusal contact points, and was an increasing tendancy in average area of occlusal contact surface.

• Tuberculosis and Respiratory Diseases
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• 제44권2호
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• pp.309-320
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• 1997

연구배경 : 혈중 유산농도를 측정함으로써 결정되는 무산소역치(유산역치)는 관혈적이라는 제한점이 있어, 운동부하시 유산증가에 수반되는 환기적부하에 반응하는 여러환기지표에서 비관혈적으로 무산소역치 (환기성역치)를 측정하는 방법들이 제시되어 있고, 이들에는 환기 당량법, 종말호기 산소분압법, V-경사법, 호흡지수법 등이 알려져 있다. 무산소역치를 반영하는 환기성 역치의 타당도에 관하여 논란이 없는 것은 아니지만, 일관성있는 방법적 신뢰도가 유효하다면 운동능력 평가에 있어서 환기성역치의 유용성이 인정된다는 일반적인 의견이다. 그러나 이미 환기장애가 초래되어 있는 만성기도폐쇄를 보이는 환자에서는 운동증가에 따르는 유산증가에 대처하는 환기반응이 적절하지 못하므로 환기성역치가 무산소역치를 반영하지 못한다는 지적이 었다. 만성기포폐쇄를 보이는 환자에서 상기한 네가지 환기성역치 측정방법들의 역치검출율과 신뢰도를 확인하기 위하여 본 연구를 시행하였다. 방 법 : 12명의 정상대조군과 17명의 만성기도폐쇄 환자군을 대상으로 증상제한적 최대운동부하검사(정상군 : 25 W/min, 만성기도폐쇄군 10 W/min)를 실시한 후 환기당량법, 종말호기산소분압법, V-경사법, 호흡지수법 등에 의해 환기성역치를 구한 후 상관계수를 구하여 유의성을 검증하였다. 결 과 : 각 환기성역치 측정방법에 의한 역치 검출율은 정상대조군에서 호흡지수법이 100%, 환기당량법과 종말호기 산소분압법이 91.7%로 같은 빈도를 보였고, V-경사법은 83.3%의 빈도를 보여 점반적으로 비교적 높은 빈도의 검출율을 보인 반면, 만성기도폐쇄군에서 호흡지수법이 94.1%로 가장 높았으나 환기당량법과 종말호기 산소분압법이 64.7%의 같은 검출빈도로 정상대조군에 비해 현저히 감소되었고, V-경사법은 83.3%로 정상대조군과 검출율에 있으서 같은 빈도를 보였다. 각 환기성역치 측정방법들의 유의성을 검증한 결과 정상대조군에서는 호흡지수법을 제외한 환기당량법과 종말호기 산소분압법, 그리고 V-경사법 등간에 모두 유의한 상관관계를 보인 반면 만성기도폐쇄군애서는 환기당량법과 종말호기 산소분압법사이에서만 상관계수가 0.9860으로 정상대조군에서처럼 매우 높은 일치도를 보였고 나머지 방법들간에는 그 어느 조합도 유의한 상관관계를 확인할 수 없었다. 결 론 : 호흡지수법은 매우 예민하지만 신뢰성이 떨어지는 방법이고, 환기당량법과 종말호기 산소분압법은 거의 유사한 방법이며, 환기능이 정상인 사람에서는 환기성역치 측정이 무산소역치를 반영하는 유용성이 었다고 판단되지만 만성기도폐쇄 환자에서는 그 유용성이 떨어진다고 생각된다.

• 보건교육건강증진학회지
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• 제20권1호
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• pp.131-145
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• 2003

This study was conducted to estimate the incidence and the degree of cigarette smoking and drinking among working men, and then to investigate the effects on blood pressure, various hematological indices and blood chemistry. The sample consisted of 2,287 male workers who had undertaken a general health check-up during the two-year period from January, 2000 to December, 2001. Such factors as blood pressure, blood glucose, lipid profiles, and liver function tests were determined and then analyzed with respect to the subjects smoking and/or drinking status. The major findings from this study are: 1. The drinking and smoking status have shown that 52.7% of participants were in the habit of both drinking and smoking while 11.6% were not associated with either. On the other hand 25.4% were involved only in drinking and 10.2% only in smoking. In the group smoking over 21 cigarettes per day over 30, the age group occupied the largest proportion at 20.1%. 2. Regarding the relationship between smoking and/or drinking status, and blood pressure, hematology and blood chemistry, the smoking and/or drinking group had significantly higher levels of blood pressure, both systolic and diastolic, Hb & Hct, TG, LDL-C, SGOT, and ${\gamma}$-GTP, than the non-smoking and/or non-drinking group. But HDL-C was significantly lower in the smoking group and significantly higher in the drinking group than the non-smoking/non-drinking group. 3. Regarding amount smoked, a larger number of cigarettes per day was significantly associated with the higher levels of blood pressure, systolic and diatolic, TG, TC, LDL-C, Hb, Hct, and ${\gamma}$-GTP. As for the amount druck, an increasing amount of alcohol intake was associated with rising levels of blood pressure, systolic and diatolic, TG, TC, LDL-C, HDL-C, Hb, SGOT, and ${\gamma}$-GTP. 4. Regarding the correlation among all the variables stated above, the smoking and drinking amount was shown to be in the positive correlation with blood pressure, both systolic and diastolic, TG, TC, Hb, and ${\gamma}$-GTP. On the contrary, LDL-C and HDL-C was in a positive correlation only with the amount drunk amount, and Hct only with the amount smoked. 5. As with systolic and diastolic blood pressure, the odds ratio of the smoking group was 2.35 and 2.58 compared to the non-smoking/drinking group. whereas it was 1.47 and 1.75 in the smoking/drinking group. Concerning serum lipids, the smoking/drinking group had 1.97 times the levels of TG in the non-smoking/non-drinking group, though the smoking group had 1.55 times the levels of HDL-C in the non-smoking/non-drinking group. As with liver function test results, the drinking group had 2.50 times and the smoking/drinking group had 4.41 times the levels of ${\gamma}$-GTP in the non-smoking/drinking group. respectively. The above results revealed that smoking and alcohol intake were effected the results of blood pressure and laboratory tests. Specifically, not only the smoking/drinking group but also those only smoking or only drinking were not as desirable as the non-smoking and non-drinking group to the results of blood pressure and laboratory tests.

• 한국의학물리학회지:의학물리
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• 제25권4호
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• pp.264-270
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• 2014

본 연구에서는 영상유도 로봇 정위방사선치료장비(Stereotactic Radiation Therapy, SRT) 사이버나이프의 Synchrony 호흡추적장치의 사용에 있어 중요한 요소 중에 하나인 호흡의 안정성을 향상 시키고자 휴대형 호흡연습장치(portable respiratory training device)를 개발하였다. 그래프와 막대 형식의 2가지 디스플레이 중 사용자가 원하는 방식을 선택할 수 있도록 인터페이스를 제작하고, 자신의 호흡주기에 대한 리듬감을 향상 시켜 다음 호흡을 예측할 수 있도록 도와주는 청각시스템을 지원하여 편안한 호흡유도를 제공하였다. 5명의 지원자를 대상으로 자체 프로그램을 통해 검출한 개인고유 호흡주기를 적용하여, '자유호흡(free respiration)'에서 획득한 신호데이터와 시청각시스템을 통해 호흡을 유도하는 '모니터호흡(guide respiration)'의 신호데이터를 획득하고, 호흡주기(period)와 호흡깊이(amplitude)의 편차 평균값을 비교하여 유용성을 평가하였다. 호흡주기의 경우 자유호흡에 비하여 $55.74{\pm}0.14%$로 감소하였고, 호흡깊이의 경우에도 자유호흡의 비해 $28.12{\pm}0.10%$ 감소함으로써 호흡의 규칙성과, 안정성이 향상됨을 확인하였다. 이러한 결과를 바탕으로 개발한 휴대형 호흡연습장치를 이용한 간암, 폐암 등의 체부정위방사선치료에 있어, 호흡 불안정에 의해 발생되는 치료시간의 지연을 줄이고 치료정확도 향상에 도움을 줄 수 있을 것으로 평가되며, 차후 안드로이드(Android)기반의 휴대용단말기를 대상으로 한 호흡연습 어플리케이션 개발에 적용한다면 사용 편의성과 더불어 경제적 효율까지 기대할 수 있을 것으로 판단된다.

• 대한치과교정학회지
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• 제41권5호
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• pp.324-336
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• 2011

전치의 후방 견인 시 적절한 치아 이동 상태 조절은 필수적이다. 설측 장치를 이용한 레버 암 길이의 조절을 통하여 치아 이동에 관한 연구는 있었으나 3차원적인 변위 양상에 대한 연구는 많이 이루어지지 않은 실정이다. 이에 본 연구는 상악 전치부의 레버 암(lever arm)의 길이를 5 mm 단위로 20 mm까지 증가시켰으며 대구치와 TPA (trans palatal arch) 상에 있는 견인 훅(hook)의 위치를 달리 하여 200 gm의 후방 견인력을 가했을 때 나타나는 치아 변위 양상과 응력분포를 3차원적 유한요소분석을 통하여 알아보고자 하였다. 이를 위하여 아시아 성인의 표본조사를 통해 제작된 치아모형(Nissan Dental Product, Kyoto, Japan)을 3차원적으로 스캐닝한 후 상악치아, 치주인대, 치조골에 대한 유한요소 모델을 제작하였다. 각 치아의 절단연과 치근첨의 이동량을 x, y, z 좌표에서 각각 계산하여 치열의 변위 양상을 분석하고 von Mises 응력 분포를 계측하였다. 연구 결과, 정상 교합 모형의 레버 암 길이가 15 mm, 20 mm인 경우 전치 절단연과 치근첨의 설측 변위가 유도되었다. 본 실험의 조건 중 20 mm에서 치근첨의 설측 변위는 최대로 나타났다. 구치부 견인 훅이 치근첨에 있을 때 대구치 치관은 원심 방향으로 변위되었다. 또한 레버 암의 길이가 20 mm인 경우 전치부의 정출은 미약하였고 견치 치관은 협측 방향으로 전위되었다. 이 때 구치부 견인 훅의 위치가 TPA의 구개 중앙 측에 있을 때보다 가장자리 측에 있을 때 견치 치관은 더 많이 전위되었다. 이상의 결과를 토대로 설측 장치를 이용한 상악 6전치의 후방 견인 시 레버 암의 길이가 길고 구치부 견인 훅의 위치가 구개 중앙부에 있을 때 전치부 절단연(incisal edge)의 정출 없이 견치의 측방 전위 및 전치부 절단연과 치근첨의 설측 변위가 공히 나타남을 알 수 있었다.

• 치과방사선
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• 제15권1호
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• pp.13-20
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• 1985

The author obtained the oblique lateral trans cranial radiograms from 376 patients (114 of male, and 262 of female) with temporomandibular joint arthrosis. After tracing each film, the author analyzed the dimensional changes of the condylar heads with pain, clicking, mouth opening limitation, and masticatory difficulty respectively, which were the chief complaints of the TMJ arthrosis and compared these data with control group. The results were as follows; 1. There was a great predilection for occurrence of the TMJ arthrosis in female (262 cases) over male (114 cases). But there was no significant difference in ratio between the sexes on each symptom. In male, 60 patients (52.6%) had pain, 28 patients (24.6%) had clicking, 21 patients (18.4%) had mouth opening limitation, and 5 patients (4.4%) had masticatory difficulty. In female, 148 parients (56.5%) had pain, 57 patients (21.8%) had clicking, 47 patients (17.9%) had mouth opening limitation, and 10 patients (3.8%) had masticatory difficulty. 2. Examined controlled group, the author analyzed the dimension of W-W', 0-H, 0-A, 0-B on the right side first, and left side second. In male, the dimension of W-W' was 14.52㎜, 14.13㎜; 0-H was 13.92㎜, 13. 71㎜' 0-A was 8.91㎜, 9.0㎜ and 0-B was 8.67㎜, 8.78㎜. In female, W-W' was 13.77㎜, 13.51㎜; 0-H was 13.42㎜, 13.35㎜; 0-A was 8.92㎜, 9.01㎜; and 0-B was 8.59㎜, 8.80㎜. 3. W-W' and 0-H of the experimental group were distinctly lesser than the controlled group. Male with mouth opening limitation show the least (12.70㎜, 13.00㎜) on W-W', but both sexes with pain show the least on 0-H. There was no significant difference between experimental group with Clicking and controlled group on 0-H, 0-A, and 0-B. And also there was no difference on 0-B in patients with every symptom except masticatory difficulty. The dimensional changes of the condylar heads with those symptoms were as follows; a) In male patients, complaing of pain, W-W' of the right and left was 13.80㎜, 12.80㎜; 0-H was 13.10㎜, 12.90㎜; 0-A was 8.69㎜, 8.18㎜; 0-B was 8.33㎜, 8.42㎜. In female, W-W' was 13.01㎜, 12.90㎜; 0-H was 12.48㎜, 12.80㎜; 0-A was 8.60㎜, 8.49㎜; 0-B was 8.48㎜, 8.50㎜. b) In male patients with clicking, W-W' was 13.70㎜, 13.10㎜; 0-H was 13.90㎜, 13.10㎜; 0-A was 8.81㎜, 8.16㎜ 0-B was 8.34㎜, 8.25㎜. In female, W-W' was 13.10㎜, 13.50㎜; 0-H was 13.30㎜, 12.91㎜; 0-A was 8.95㎜, 8.49㎜; 0-B was 8.23㎜, 8.70㎜. c) In male patients with mouth opening limitation, W-W' was 12.70㎜, 13.00㎜; 0-H was 13.40㎜, 13.40㎜; 0-A was 8.37㎜, 8.48㎜; 0-B was 8.33㎜, 8.62㎜. In female, W-W' was 13.00㎜, 12.50㎜ 0-H was 12.90㎜, 13.10㎜; 0-A was 8.49㎜, 8.09㎜; 0-B was 8.77㎜, 8.01㎜. d) In male patients with masticatory difficulty, W-W' was 13.30㎜, 13.20㎜; 0-H was 13.40㎜, 12.60㎜; 0-A was 8.26㎜, 8.32㎜; 0-B was 7.80㎜, 8.20㎜. In female, W-W' was 12.30㎜, 12.00㎜; 0-H was 13.10㎜, 13.20㎜; 0-A was 8.68㎜, 7.95㎜; 0-B was 7.46㎜, 7.87㎜.

• 치과방사선
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• 제28권1호
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• pp.111-126
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• 1998

In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA/sup (R)/ in male and female adults in their 20's on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop. and postop. root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied using panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows: 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the actual maxilla specimen were 2.83 mm, 4.51mm, and 4.l5mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5％ of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography. 3. In cross-sectional view, when the vertical relationship of the maxillary sinus floor and maxillary roots was assessed, in 1st molars, type II (the sinus floor that extends down to the buccolingual furcation area) was predominant, while in 2nd molars, type I (the sinus floor located above the level connecting the buccal and lingual apices) was predominant. In the horizontal relationship, in 1st molars, type II (the lowest floor of the maxillary sinus located in between the buccal and lingual roots) was predominant; in 2nd molars, type I (the lowest floor of the maxillary sinus located on the buccal side of the buccal roots) and type II appeared in similar frequency. In conclusion, the SCANORA/sup (R)/ cross-sectional tomography was more effective than the frequently used panoramic view, in that the relationship of the maxillary molars and maxillary sinus floor can be evaluated more accurately and the buccolingual cross-sectional view can also be observed. And maxillary sinus floor that was close to maxillary 2nd molar had tendency to be located on buccal side than that close to 1st molar. Therefore, cross-sectional tomography is an effective and accurate method to evaluate the position of the teeth in relation to the sinus floor preoperative and can be easily used to diagnose localized periapical lesions. Also, the image quality obtained was quite satisfactory.

• 치과방사선
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• 제28권1호
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• pp.127-143
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• 1998

The author evaluated the effects of taxol, a microtubular inhibitor, as a possible radiation sensitizer and the production of prostaglandins on three human cancer cell lines(KB, RPMI-2650 and SW-13) and one murine cell line(L929). Each cell line was divided into four groups (control, taxol only, radiation only and combination of taxol and radiation). The treatment consisted of a single irradiation of 10Gy and graded doses (5, 50, 100, 200, 300, 500 nM) of taxol for a 24-h period. The cytotoxicity of taxol alone was measured at 1 day after(1-day group) and 4 days after(4-day group) the treatment. The survival ratio of cell was analyzed by MTT (3-(4,5-dimethylthiazol-2-yl) -2,5-dimethyl tetrazolium bromide) test. Prostaglandins(PGE2 and PGI2) were measured in the culture medium by a radioimmunoassay. The results obtained were as follows. 1. There was a significantly increased cytotoxicity of KB cells in 4-day group than those in I-day group. There was a high correlation between doses of taxol and cell viability in both groups(l-day group R=0.82741, 4-day group R=0.84655). 2. There was a significantly increased cytotoxicity of RPMI -2650 cells treated with high concentration of taxol in 4-day group than those in I-day group. Also there was a high correlation between doses of taxol and cell viability in 4-day group(R=0.93917). 3. There was a significantly increased cytotoxicity of SW-13 cells treated with high concentration of taxol in 4-day group than those in 1-day group. However no high correlation was observed between doses of taxol and cell viability in both groups(1-day group R=0.46362, 4-day group R=0.65425). 4. There was a significantly increased cytotoxicity of L929 cells treated with low concentration of taxol in 4-day group than those in 1-day group. At the same time, there was a low correlation between doses of taxol and cell viability in both groups(1-day group R=0.34237, 4-day group R=0.23381). 5. In I-day group of L929 cells, higher cytotoxicities were observed in the groups treated with 500 nM taxol than given 10 Gy radiation alone. L929 cells in I-day group alone showed a radiosensitizing effect by taxol.. 6. In addition to L929 cells, all cancer cells treated with a combination of taxol and radiation in 4-day group appeared to have some fragmented nuclei and to float on the medium. In addition, L929 cells appeared to be more confluent. 7. The level of PGE2 production was the highest in the contol KB cells. This appeared to increase in every experimental group of all three cancer cells except L929 cells. There was a significantly increased production of PGE2 in SW -13 cells treated with a combination taxol and radiation compared to the other experimental groups. 8. The level of PGE2 production in the control group of RPMI-Z650 cells was the highest. This appeared to increase in every experimental group of all cells except in SW-13 cells. This also increased significantly in RPMI-2650 cells treated with a combination of taxol and radiation compared to the other experimental groups.

• Tuberculosis and Respiratory Diseases
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• 제42권6호
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• pp.838-845
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• 1995

연구배경: 현재 국내에서 ADA의 활성치의 측정은 adenosine 기질에서 ADA에 의한 탈아미노작용시 발생하는 암모니아를 Berthelot's 반응을 이용하여 측정하는 Giusti 등에 의한 비색법이 많이 이용되고 있다. 그러나 이 방법은 자동화가 어려워 쉽게 사용하기 어려우며 기기내의 내인성 암모니아 등에 의한 오염의 가능성이 있다. 1993년 Oosthuizen 등은 nucleoside phosphorylase(NP)와 Xanthine oxidase(XOD)을 이용하여 ADA 활성치 측정을 자동화 하였다. 저자들이 측정한 ADA 활성치와 기존의 ADA 활성치 측정결과에 대한 보고를 비교함으로써 Oosthuizen 등에 의한 ADA 활성치 측정의 자동화의 융통성을 알아보고자 하였다. 방법: 1994년 5월부터 1995년 7월까지 연세대학교 원주의과대학부속 원주기독병원에 흉막액으로 입원하여 그 원인이 확진된 162명의 환자를 각각의 원인 질환에 따라서 5개 군(I: 결핵성 흉막액, II: 악성 흉막액, III: 폐렴성 흉막액, V: 여출성 흉막액)으로 나누었으며 Oosthuizen 등에 의한 ADA 활성치 측정법을 Hitachi 747 자동화학분석기에 적용하여 각 군에서 흉막액의 ADA 활성치와 및 흉막액과 혈청에서 ADA 활성치의 비를 측정하였다. 결과: 1) 결핵성 흉막액의 ADA 활성치는 $52.53{\pm}16.43\;U/L$로서 나머지 군에 비하여 통계학적으로 의의있게 높았으며(II, IV, V 군은 p값이 0.001 미만, III 군은 p값이 0.05 미만) 흉막액에서 ADA의 활성치를 30 U/L로 기준하였을 때 결핵성 흉막액과 악성 흉막액의 감별은 민감도(sensitivity) 96%, 특이도(specificity) 93%로 결핵성 흉막염을 진단할 수 있었으며 이는 기존의 보고와 차이가 없었다. 2) 흉막액과 혈청 ADA 치의 비는 결핵성 흉막액에서 $2.29{\pm}0.96$으로 농흉을 제외한 나머지 군에 의해서 통계학적으로 의의있게 높았다(p<0.001). 흉막액과 혈청 ADA 활성치 비를 1.5로 기준하였을 때 결핵성 흉막액과 악성 흉막액의 감별은 민감도 80%, 특이도 88%로 결핵성 흉막액을 진단할 수 있었으며, 이는 기존의 연구 결과와 차이가 없었다. 3) Oosthuizen 동에 의한 ADA 활성치 측정법을 Hitachi 747 자동화학분석기에 적용한 새로운 방법은 r값이 0.971로 Giuisti 등에 의한 기존의 방법과 높은 상관관계를 보였다. 결론: ADA 활성치 측정에 Oosthuizen 등에 제안한 새로운 방법은 현재 사용되는 Giusti 등의 비색법에 의한 ADA 활성치 측정과 차이가 없었으며, 일반 검사실에서도 쉽게 사용될 수 있는 장점이 있었다.