• 한국노년학
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• 제29권2호
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• pp.645-656
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• 2009

본 연구는 의료기관 가정간호사업 현황을 총체적으로 파악하여, 의료기관 가정간호사업 활성화와 노인장기요양보험제도 도입 이후 세 가지 유형의 가정방문 간호사업을 효율적으로 기능역할 정립하는데 필요한 기초자료를 생성하기 위함이다. 건강보험심사평가원의 2006년 의료기관 가정간호 급여청구자료를 2차 분석하고, 전국 75개 의료기관 가정간호사업소의 사업현황을 횡단적 조사 분석하였다. 2006년 전체 의료기관 가정간호 이용자 중 65세 이상 노인은 20,343명(전체 대상자의 64.0%), 급여 청구는 98,822건(전체 청구의 70.1%), 방문은 333,889건(전체 방문의 76.8%)이었다. 이용자의 진단명은 뇌졸중 23.6%, 뇌졸중을 제외한 심장 등 순환기질환이 17.7%로 전체 청구 중 41.3%가 뇌졸중을 비롯한 순환기질환에 의한 것이었다. 다음은 당뇨 등 내분비계질환 10.4%, 신생물 9.7% 순이었다. 2006년 일 년간 노인대상 의료기관 가정간호 총 진료비는 13,247,992,290원(전체의 70.5%), 가정간호비용은 6,544,430,760원(전체의 72.2%)이었다. 2006년 일 년간 의료기관 가정간호 서비스 이용 노인 일인당 평균 총 진료비는 646,262원, 가정간호비용은 319,476원, 총 방문건수는 15.3건이었다. 의료기관 가정간호사업은 보건소 방문보건사업과 중재 종류는 유사하나, 보건소 방문보건사업에서는 수행되지 않는 헤마토크릿(16.8%), 혈색소(15.6%), 적혈구 침강속도(5.6%), 경피적산소분압(0.1%) 등 임상검사와 흡입배농 및 배액(0.7%), 약물저류 관장(0.1%) 및 가스관장(0.01%)등 특수처치가 수행되었다. 건강보험 급여한도 월 8회를 초과하여 전액본인부담금으로 의료기관 가정간호를 이용한 노인은 질환별로 욕창 7.0%, 암 5.4%, 당뇨 2.5%, 고혈압 1.1%, 뇌졸중 0.9%였다. 따라서, 이러한 서비스 차이를 반영하여 세 가지 유형의 가정방문 간호사업간 기능역할을 설정하고, 서비스 이용을 활성화하기 위해서 보험급여를 확대할 필요가 있다.

• Journal of Korean Biological Nursing Science
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• 제4권1호
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• pp.41-49
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• 2002

The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, "What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?" The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing sciences. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained : It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient's skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient's current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

• 한국식품영양과학회지
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• 제34권1호
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• pp.66-74
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• 2005

전국의 대도시, 중소도시, 읍면지역의 주부 100명을 대상으로 구조화된 설문지를 이용하여 전화면접조사를 실시하였다. 식품안전에 대하여 불안을 느끼는 사람이 55.4%, 불안을 느끼지 않는 사람이 34.6%로 식품안전성에 대해 불안을 느끼는 사람의 비율이 1.9배 높은 것으로 나타났다. 식품안전에 대한 불안감에 영향을 미치는 요인은 유아나 초등학생의 자녀여부, 학력, 채소류 구입 장소, 브랜드, 보존료나 착색료 등의 식품첨가물, 원재료의 원산지 등이었다. 불안요인 중 잔류농약은 대상자의 96.0%가, 보존료나 착색료 등 식품첨가물 95.7%, 환경호르몬 93.0%, 식중독균 등 유해 미생물 91.7%, 유전가변형식품은 90.2%가 불안을 느끼는 것으로 나타났다. 그러나 실제로는 잔류농약이나 식품첨가물보다 미생물의 발생으로 인한 식품오염으로 나타날 수 있는 식중독의 경우 더욱 치명적일 수 있으므로 이러한 사실을 일반 소비자들에게 인식시킬 필요가 있다. 불안을 느끼는 식품으로, 도시락은 대상자의 93.3%가, 수입 식품은 92.7%, 패스트푸드 89.9%, 햄과 소시지 등 식육가공식품 88.7%, 외식(패스트푸드 이외의 식품) 81.6%, 통조림과 냉동식품 등 가공식품 83.5%, 컵라면 등 인스턴트식품 82.0%, 쌀 47.4%, 식용유 53.8%, 우유 및 유제품은 56.6%가 불안하다고 느꼈다. 식품의 제조(재배) 및 원료(원산지)를 제시해주는 식품표시에 대하여 신뢰하지 못하고 불안을 느끼는 대상자가 많으므로(75.2%) 표시 제도와 인증제도의 적절한 운용을 통해 식품에 관련한 충분한 정보가 소비자들에게 전달될 수 있는 대책이 강구되어야 하겠다. 신선식품(농축산물)구입시 가장 우려되며 우선적으로 고려하는 사항은 '수입산인지 국내산인지'이었으며 '유통기한', '무농약 및 유기재배 여부', '만질 때 혹은 외관상으로 느껴지는 신선함' 등이 그 다음으로 고려하는 것으로 나타났다. 가공식품 구입시에는 '보존료 및 착색료 등의 식품첨 가물'(93.6%), '유통기한'(92.4%), '원재료가 무농약$.$유기재배인지'(88.8%)에 대하여 염려된다고 응답한 비율이 높았다. 식품안전을 확보하기 위한 식품생산에서 소비단계까지 개선사항으로 '비료, 농약 살포, 수확시 관리 등 생산단계'(59.6%) 및 '물, 토양, 대기 등 자연환경'(43.6%)의 개선이 중요하다는 견해가 많았다. 위의 결과로 볼 때 식품안전성을 확보하기 위해서는 식품위생과 안전성, 식품표시에 대한 홍보와 교육이 지속적으로 이루어져 소비자들의 식품안전에 대한 인식과 신뢰도를 높여야 할 것이다. 농장단계에서 오염원을 줄이는 방안이 최종생산물의 검사에 기반을 둔 식품안전정책보다도 안전성 확보에 훨씬 유효하다는 사고방식이 보편화되고 있으므로 농산물 생산단계에 우수농산물관리 제도(good agricultural practices)를 정착시키고, 나아가 사전예방 원칙을 적용한 HACCP 시스템을 도입하여 식품(특히 축산물)의 안전성을 확보하여야 하겠다. 또 food chain 전반에 관한 이력정보의 부족과 정보의 신뢰성이 문제가 되므로 생산단계부터 가공단계, 유통단계, 그리고 판매 단계 에 이르기까지의 모든 과정을 소비자가 역으로 거슬러 올라가 확인할 수 있는 '이력정보체계 (traceability system)'를 활성화하여야 하겠다.

• 한국식품위생안전성학회지
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• 제20권4호
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• pp.277-283
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• 2005

가소제는 합성수지 재질에 가공성, 유연성 등을 부여하기 위해 첨가되는 물질로, 화학구조에 따라 phthalate류 및 adipate류 가 있으며, 주로 PVC재질에 사용된다. 이러한 가소제는 용기포장으로부터 식품으로 이행될 수 있으며, 이들 중 일부는 내분비계장애추정물질로 분류되는 등 그 안전성에 논란이 있어왔다. 본 연구에서는 시중에 유통되는 용기포장 105품목에 대하여 phthalate류 및 adipate류의 재질 중 잔류량을 모니터링하였다. 분석은 dual-column GC-FID방법을 사용함으로써 검출된 성분의 보다 신속한 확인 및 정량이 가능하였다. 정량을 위한 분석법을 검증한 결과 0.993이상의 직선성, RSD $3.5\%$ 이하의 재현성, 분석대상 가소제 종류에 따라 재질 중 10.4-83.6 ug/g의 검출한계를 확인할 수 있었다. 재질 중 잔류량은 PVC 재질에 대하여는 식품포장용 랩 3품목에서 DEHA가 176.9-198.5mg/g, 병마개 가스킷 40품목에서 DIDP가 157.3-374.7 mg/g, 1품목에서 DINP가 165.6 mg/g 수준으로 검출되었다. 또한 PET, PP, PE, 종이제 등 기타의 재질에서도 일부 가소제가 검출되었으나 검출량은 오염에 기인하는 것으로 판단되는 미미한 수준이었다.

• 한국직업건강간호학회지
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• 제4권호
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• pp.58-83
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• 1995

The small scale industries which have less than 30 employees occupy 86.5% of total number of industries in Korea. And though they have higher accident rate and lower environmental condition than big industries, it has been not mandatory to appointing health care manager at factory. So, from 1993, government subsidizes to the health care management of small industries. The purpose of this study is to identify the real feature of health care status in small industries, and to evaluate the level of health care management, before and after the subsidiary program. 65 small plating industries which have been managed by the same health care management support institution in 1993 were selected for study. Of the 65 industries, 3 which have not taken both environmental evaluation and health screening in 1994, and 9 which have closed were excluded from study sample. And the remaining 53 were analyzed by using the results of environmental evaluation and health screening, reported to the Ministry of Labor, before and after the subsidiary program, the analysis was done by the comparison of the two year paired data of the same industry. Over-permissible-limit rate, health screening implementation rate, above grade C rate were calculated and compared. The status of health care management ; 1. Of the sample industries, 96.9% provide protective equipment and 80.0% set up ventilating system. Protective gloves (89.2%) and protective clothing (80.0%) are widely provided, but ear plugs (4.6%) are rarely provided. 21.5% of the protective equipment are well put on, and 40.4% of the ventilating systems function well. 2. In 1993, 35 industries, 53.8% of the sample, checked working environment twice. Over-permissible-limit rates of heavy metal (12.2%), suspended particle (11.1%), noise (5.5%) were high. To put on protective equipment and to set up local ventilating system were pointed out by the examiners. 3. General health screening was done at 63.1% of the sample industries and 35.3% of total workers were examined. Specific health screening was done at 93.8% of the sample industries and 75.4% of workers were examined. 15.5% of workers was provided to be above grade C and to have digestive system disease (43.3%), circulatory disease (18.9%), and hematopoietic disease (14.2%), etc. 4. In 1993, the subsidiary program of health care management was provided in forms of health education, health counseling, and rounding check of working field. And 61.5%, 83.0%, 55.4% of sample industries respectively received it. The average visit per industry was 1.8. Comparisons of the level of occupational health before and after the subsidiary program ; 1. Over-permissible-limit rates of hazardous factors of 1993 and that of 1994 were compared. The rates of suspended particle, noise, organic solvent of 1994 (37.5%, 13.4%, 24.2% respectively) were higher than that of 1993 (25.0%, 6.0%, 6.3% respectively). In the case of acid, there was no difference between the rate of 1993 and that of 1994. Only the rate of heavy metal decreased from 12.9% in 1993 to 3.0% in 1994. 2. General health screening was done at 38.7% of the sample industries in 1993 and at 44.6% in 1994. But the implementation rate of specific health screening decreased from 72.4% in 1993 to 64.6% in 1994. 3. The implementation rate of specific health screening was analyzed by some health factors. The rate of suspended particle increased from 61.8% in 1993 to 91.2% in 1994. But the rates of the others-noise, organic solvent, heavy metal, specific chemical substances-decreased. 4. Above grade C rate in health screening increased from 27.8% in 1993 to 35.5% in 1994. But that of endocrine disorders and pulmonary disease decreased.

• 한국보건간호학회지
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• 제14권2호
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• pp.246-259
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• 2000

The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.65-89
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• 2012

Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

• 한국영양학회:학술대회논문집
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• 한국영양학회 1995년도 추계학술대회 초록
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• pp.11-34
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• 1995

Growth hormone (GH) plays a key role in regulating postnatal growth and can stimulate growth of animals by acting directly on specific receptors on the plasma membrane of tissues or indirectly through stimulating insulin-like growth factor (IGF)-I synthesis and secretion by the liver and other tissues. IGF-I and IGF-Ⅱ are polypeptides with structural similarity with proinsulin that stimulate cell proliferation by endocrine, paracrine and autocrine mechanisms. The initial event in the metabolic action of IGFs on target cells appears to be their binding to specific receptors on the plasma membrane. Current evidence indicates that the mitogenic actions of both IGFs are mediated primarily by binding to the type I IGF receptors, and that IGF action is also mediated by interactions with IGF-binding proteins (IGFBPs). Six distinct IGFBPs have been identified that are characterized by cell-specific interaction, transcriptional and post-translational regulation by many different effectors, and the ability to either potentiate or inhibit IGF actions. Nutritional deficiencies can have their devastating consequence during growth. Although IGF-I is the major mediator of GH's action on somatic growth, nutritional status of an organism is a critical regulator of IGF-I and IGFBPs. Various nutrient deficiencies result in decreased serum IGF-I levels and altered IGFBP levels, but the blood levels of GH are generally unchanged or elevated in malnutrition. Effects of protein, energy, vitamin C and D, and zinc on serum IGF and IGFBP levels and tissue mRNA levels were reviewed in the text. Multiple factors are involved in the regulation of intestinal epithelial cell growth and differentiation. Among these factors the nutritional status of individuals is the most important. The intestinal epithelium is an important site for mitogenic action of the IGFs in vivo, with exogenous IGF-I stimulating mucosal hyperplasia. Therefore, the IGF system appears to provide and important mechanism linking nutrition and the proliferation of intestinal epithelial cells. In order to study the detailed mechanisms by which intestinal mucosa is regulated, we have utilized IEC-6 cells, an intestinal epithelial cell line and Caco-2 cells, a human colon adenocarcinoma cell line. Like intestinal crypt cells analyzed in vivo or freshly isolated intestinal epithelial cells, IEC-6 cells and Caco-2 cells possess abundant quatities of both type Ⅰ and type Ⅱ IGF receptors. Exogenous IGFs stimulate, whereas addition of IGFBP-2 inhibits IEC-6 cell proliferation. To investigate whether endogenously secreted IGFBP-2 inhibit proliferation, IEC-6 cells were transfected with a full-length rat IGFBP-2 cDNA anti-sense expression construct. IEC-6 cells transfected with anti-sense IGFBP-2 protein in medium. These cells grew at a rate faster than the control cells indicating that endogenous IGFBP-2 inhibits proliferation of IEC-6 cells, probably by sequestering IGFs. IEC-6 cells express many characteristics of enterocyte, but do not undergo differentiation. On the other hand, Caco-2 cells undergo a spontaneous enterocyte differentiation. On the other hand, Caco-2 cells undergo a spontaneous enterocyte differentiation after reaching confluency. We have demonstrated that Caco-2 cells produce IGF-Ⅱ, IGFBP-2, IGFBP-3, and an as yet unidentified 31,000 Mr IGFBP, and that both mRNA and peptide secretion of IGFBP-2 and IGFBP-3 increased, but IGFBP-4 mRNA and protein secretion decreased after the cells reached confluency. These changes occurred in parallel to and were coincident with differentiation of the cells, as measured by expression of sucrase-isomaltase. In addition, Caco-2 cell clones forced to overexpress IGFBP-4 by transfection with a rat IGFBP-4 cDNA construct exhibited a significantly slower growth rate under serum-free conditions and had increased expression of sucrase-isomaltase compared with vector control cells. These results indicate that IGFBP-4 inhibits proliferation and stimulates differentiation of Caco-2 cells, probably by inhibiting the mitogenic actions of IGFs.

• Tuberculosis and Respiratory Diseases
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• 제39권6호
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• pp.502-510
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• 1992

연구배경 : Neuron specific enolase (NSE)는 뇌조직의 신경원에서 처음 발견된 당분해 효소이며, APUD 세포 및 신경내분비계에도 존재하는 것으로 알려졌다. 소폐포폐암은 신경내분비세포 및 APUD 세포와 많은 공통점을 가지고 있다. 따라서 NSE 항체를 사용하는 면역조직화학 염색과 혈청내 NSE 농도측정은 신경내분비 분화를 하는 폐종양의 표지자로서 사용될 수 있으며 소세포폐암의 진단에 유용할 수 있다. 방법 : 소세포폐암으로 진단받은 22명과 대조군으로는 비소세포폐암환자 21명을 대상으로 하였으며 생검조직에서 NSE 항체를 이용한 면역조직화학염색을 시행하고 환자의 혈청에서 방사면역측정법으로 NSE 농도를 측정하였다. 결과: 1) NSE 항체를 이용한 면역조직화학염색 NSE 항체를 이용한 면역조직화학영색에서 소세포폐암군 환자는 18명중 9명에서 양성 반응을 보였으며, 비소세포폐암 환자중 면역조직화학염색을 시행한 16명중 5명에서 양성 반응을 보였다. 2) 방사면역 측정법에 의한 혈청 NSE농도 측정 비소세포폐암군의 혈청 NSE평균치는 $11.79{\pm}4.47\;ng/ml$이었으며 소세포폐암군의 혈청 NSE치는 개인차가 심하기는 하였으나(6.01~361.4 ng/ml) 그 평균치는 $59.30{\pm}77.88\;ng/ml$으로 두 군 사이에는 유의한 차이가 있었다. 소세포폐암환자중 limited disease군의 혈청 NSE 평균치는 $20.19{\pm}12.91\;ng/ml$이었으며, extended disease군의 혈청 NSE치는 역시 개인차가 심하기는 하였으나(17.15~361.44 ng/ml) 그 평균치는 $91.9{\pm}94.2\;ng/ml$로 두 군 사이에 유의한 차이를 보였다. 정상인에서의 혈청 NES 농도는 측정하지 않았으나 대조군인 비소세포폐암군환자 평균+2x표준편차인 20 ng/ml을 기준으로 할 때 소세포폐암환자 22명중 16명(73%)에서 증가된 소견을 보였고 이중 limited disease는 50%(5/10), extended disease는 92% (11/12)에서 증가되었으며, 비소세포암 환자중에서는 1명(1/21)만이 증가된 소견을 보였다. NSE 혈청농도와 면역조직화학염색 정도를 비교시 소세포폐암군과 비소세포폐암군 모두에서 유의한 상관관계를 보이지 않았다. 결론 : 혈청 NSE농도측정은 소세포폐암환자에서 암표지자로서 유용한 방법이 될 수 있을 것으로 사료되며 항 NSE 항체를 이용한 생검조직의 면역조직화학염색은 분화가 나빠 고식적인 현미경적 소견만으로는 소세포암과 비소세포암과의 강벌이 어려운 경우 정확한 조직유형 결정과 신경내분비 기원을 뵈이는 폐암의 진단에 도움을 줄 수 있을 것으로 사료된다.

• 한국발생생물학회지:발생과생식
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• 제13권1호
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• pp.1-11
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• 2009

착상은 배아측과 모체측의 내분비적, 측분비적 및 자가분비적 인자들의 상호 작용에 의하여 조절된다. 착상의 적기는 $2{\sim}4$일로서 이 특수한 시간대 안에서 signaling, appositioning, attachment 및 invasion을 통하여 순차적으로 배아의 착상이 이루어지는데, 이는 자궁내막과 배아로부터 여러 사이토카인, 성장인자, 부착인자와 같은 다수의 생화학 인자의 생성과 분비를 포함하며 이로 인하여 수용적인 자궁내막이 형성된다. LIF, CSF-1, IL-1과 같은 사이토카인들은 착상을 이끄는 연속적인 사건에서 중요한 역할을 수행하며 integrin, L-selectin ligands, glycodelin, mucin-1, HB-EGF, pinopodes는 appositioning과 attachment에 관여한다. 배아 또한 사이토카인과 성장인자 및 LIF, CSF-1, IGF, HB-EGF에 대한 수용체들을 분비하여 능동적으로 대처한다. 자궁내막의 수용성을 평가하고 자연주기 또는 보조생식술을 이용한 임신의 예후를 예측하는데, 이와 같은 인자들이 유용한지는 앞으로 더 연구되어야 한다. 현재로서는 내막조직으로부터 채취한 integrins, pinopodes, glycodelin, LIF가, 자궁강내 세척액에서는 glycodelin과 LIF가 유망한 인자로 떠오르고 있다. 혈액내 마커로서는 VEGF, glycodelin, CSF가 약간의 연관성을 보여주고 있다. 이러한 인자들이 보조생식술 전후로 자궁내막의 기능과 임신의 예후를 평가하는 선별검사로 이용될 수 있는지를 증명하기 위해서는 향후 불임 여성과 대조군인 가임 여성을 대상으로 한 대규모의 연구가 필요할 것이다. 인간의 착상에서 이들 인자들의 기능을 충분히 이해해야 치료적 기법으로 연결되어 보조생식술에서도 더 높은 성공률을 이루어 낼 것으로 사료된다.