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식품과 알레르기: 유전자 재조합 식품의 알레르기 위험성

  • 손대열
    • Proceedings of the Korean Journal of Food and Nutrition Conference
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    • 2000.12a
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    • pp.29-34
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    • 2000
  • 산업 발달에 따라 날로 많은 식품들이 새롭게 개발되어지고 있다. 또한 이와 병행해서 식품으로 인한 알레르기 발생 빈도도 날로 증가하고 있으며 그 증상 또한 점차 심화되고 있는 것이 세계적인 추세이다. 우리나라도 예외는 아니어서 일반 알레르기 환자뿐 아니라 식품으로 인한 알레르기 환자들이 점차 증가됨이 보고되어지고 있다. 농산물 시장의 수입개방이후 우리나라에는 많은 해외 농산물이 수입되어지고 있으며 그 중 작년 한해의 경우 총 수입 농산물의 10%를 넘는 유전자 재조합 농산물이 우리나라에 수입되어진 것으로 통계 보고되어졌다. 이러한 관점에서 알레르기 환자의 증가와 새로운 식품 (특히 유전자 재조합 식품)의 증가에는 서로 관련성이 있을 것으로 추측되어지고 있어 (새로운) 식품에 대한 알레르기성의 예측과 관리가 필요한 실정이다. 이에 몇몇 발표된 유전자 재조합 식품에 관련된 알레르기성 검사 논문들과 실험실에서 이루어진 연구 결과들을 중심으로 유전자 재조합 식품의 알레르기 위험성에 대해 알아보고자 한다. 일반적으로 식품의 단백질이 알레르겐(allergen)으로 작용하기 위해서는 먼저 소화효소에 의해 분해되어지고 장에서 흡수되어져서 immunopotent cell에 의해 process 되어 immune system에 present 되어져야 한다. 따라서 단백질로 인한 알레르기 반응은 그 단백질의 자연적 형태 뿐만이 아니라 소화 효소에 분해된 단편들의 구조 또는 다른 알레르겐 단백질과의 유사 구조로 인한 교차 반응에 의해 발생함을 기억해야 한다. 식품 단백질 중 어떤 단백질이 알레르겐으로 작용하는가에 대한 특이성 조사에 많은 관심이 집중되어지고 있지만 아직까지는 대략 다섯 개 정도의 일반적인 특성으로서 요약되어질 수 있다. 그러나 이러한 대략의 특성에 적용되지 않는 식품 알레르겐도 많음을 잊어서는 안 될 것이다. 알레르겐으로 작용하는 식품 단백질의 일반적 특성 1. 좋은 수용성 2. 식품내에 많은 부분을 차지하는 주 단백질이 주 알레르겐으로 작용 3. 단백질내에 하나 이상의 IgE-binding site 존재 4. 위장액에 대한 저항성 5. 10~70 kDa 크기 유전자 재조합 기술이란 말 그대로 유전자를 인위적으로 새롭게 조합하는 기술로 이전의 기술로는 불가능했던 유전적 변형을 농작물과 동물에 가능하게 했으며 이로 인해 유전적으로 변형된 식용 동식물의 개발이 가능하게 되었다. 새로운 유전인자를 개체에 삽입함으로 새로운 단백질이 발현 될수 있고 그로 인해 1) 해충과 질병에 대한 저항성 증가, 2) 화학 제초제에 대한 새로운 저항성 부여, 3) 식품의 저장성 향상, 4) 식품의 영향적 보충/향상 등의 이점을 얻을 수 있다 (표 1). 세계적으로 유전자 재조합 된 새로운 농산물의 재배는 날로 증가추세에 있으며 그 중에서 가장 많은 부분을 차지하는 농산물로 soybean을 들 수 있으며 (표 2) soybean을 중심으로 그 알레르기성의 변화가 연구 조사된 몇 가지 예를 살펴보고자 한다. (표 3)에 요약된 soybean중 첫 번째 경우는 재초제에 대한 저항성을 높여주기 위해 Agrobacterium에 존재하는 EPSPS라는 단백질을 콩에서 발현하도록 찬 유전자 재조합 된 콩의 경우이다. 이 콩의 경우에는 첫째. 이전된 새로운 단백질 EPSPS가 다른 여러 식물에 이미 존재하고 있는 단백질로서 우리가 이미 이러한 식품을 섭취할 때 이 단백질도 같이 섭취해오고 있었다는 점, 둘째. 이 단백질이 소화액 분해 실험에서 짧은 시간내에 분해가 되었다는 점, 셋째. 재조합 된 콩과 자연 콩이 성분 분석에서 차이를 나타내지 않았다는 점, 네 번째. 쥐를 통한 다양섭취 실험에서 아무런 이상 반응이 없었다는 점등의 결과를 기준으로 알레르기에 대한 개별 검사 없이 안전한 콩으로 결론짓고 있다. 영양성을 높이기 위해 Brazil nut에서 methionine 함량이 풍부한 2s albumine을 콩에서 발현하도록 한 두 번째 유전자 재조합 콩의 경우 이전된 단백질 때문에 Brazil nut에 알레르기 반응을 일으키는 알레르기 환자들을 조사한 결과 역시 재조합 된 콩에도 알레르기 반응을 일으켰다는 보고이다. Brazil nut에서 콩으로 이전된 단백질이 Brazil nut에서의 알레르기성을 그대로 유지한 점을 볼 때 새로운 단백질이 어디에서 유래하는가가 중요함을 잘 보여준 연구이다 세 번째 콩의 경우 역시 영양성을 높여주기 위해 corn에서 10 kDa과 HSZ 단백질을 콩에서 발현하도록 유전자 재조합했는데 이 콩의 경우는 알레르기 환자들이 유전자 재조합 된 콩과 자연 콩에 반응의 차이를 나타내지 않았다는 결과 보고이다. 위의 세 실험 결과들을 종합해 볼 때 무엇보다도 새롭게 발현된 단백질이 원래 어떤 성질을 갖고 있으며 어디에서 유래했는지가 알레르기성 조사에 중요한 역할을 한다 할 수 있겠다. 또한 유전자 재조합된 식품들은 알레르기 환자들을 위해 표기되어져야 할 것인데 이를 위한 알레르기성 검사 실험은 공공단체를 통해 이루어져야 할 것이며 환자들마다 알레르겐으로 작용하는 단백질의 인식부위(epitope)가 다를 수 있기 때문에 적어도 10명 이상의 알레르기 환자들이 조사되어져서 검사가 이루어져야 할 것이다. 환자들의 혈청을 통한 in vitro 실험에서는 ELISA, RAST, immunoblotting과 같은 검사 방법들이 적용될 수 있고, 그 결과가 음성인 경우에 그 다음 단계로 in vivo 실험에서는 직접 환자의 피부반응검사 (skin prick test)나 DBPCFC (double-blind placebo-controlled food challenge) 검사 방법을 통해 확인되어져서 이 모든 경우가 음성인 경우와 하나라도 양성인 경우를 구별하여 식품에 표기함으로 알레르기 환자들의 유전자 재조합 식품에 대한 안전성이 보장되어져야 할 것이다.

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Alterations of Heart Rate Variability upon β3-Adrenergic Receptor Polymorphism and Combined Capsaicin, Sesamin, and L-Carnitine in Humans (복합 캡사이신, 세사인, 그리고 카르니틴과 베타3 유전자 다형에 대한 심박수 변이성의 영향)

  • Shin, Ki-Ok;Kim, Hyun-Jun;Kang, Sung-Hwun
    • Journal of Life Science
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    • v.18 no.3
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    • pp.291-297
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    • 2008
  • We investigated whether 1) the combined capsaicin (75 mg), sesamin (30 mg), and L-carnitine (900 mg) (CCSC) ingestion enhances autonomic nervous system (ANS) activities including thermogenic sympathetic activity as energy metabolic modulator, 2) ${\beta}_3-AR$ polymorphism of each subject influences with ANS activity. Seven healthy males $(22.0{\pm}0.5\;yr)$ volunteered for this study. The cardiac autonomic nervous activities evaluated by means of heart rate variability of power spectral analysis were continuously measured during 5 min every 30 min for total 120 min resting condition with CCSC or placebo oral administration chosen at random. The results indicated that, there are not $Arp/Arg^{64}$ variants of the ${\beta}_3-AR$ genotypes in our subjects. There were not also significant differences in heart rate during rest between both trials. The difference of ANS activity did not reach the statistical significance between both trials. However, the significant improvement showed TOTAL power, HF component, and the indices of SNS and PNS activities before and at 30 min after CCSC ingestion (p<0.05, respectively). In conclusions, although each component of combined CCSC is associated with lipolysis and/or fat oxidation, the combined CCSC consumption is not influenced in stimulation of thermogenic sympathetic activity as modulator of energy metabolism. In rather, our results suggested that CCSC ingestion improves the balance of both SNS and PNS activities. Therefore, it will be considered many combined nutrient components for ergogenic and/or lipolysis effects as well as genetic variants affecting ANS activity in further studies.

Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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The Effects of Mixtures with Ginseng Radix rubra and Paeonia Radix on Endurance Exercise Performance (홍삼과 백작약의 혼합물 투여가 지구성 운동수행능력에 미치는 영향)

  • Kim, Seung-Kyum;Kim, Chang-Ju;Kim, Hong;Lim, Yong-Taek;Yoon, Sung-Jin
    • Journal of Ginseng Research
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    • v.31 no.2
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    • pp.93-101
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    • 2007
  • The purpose of this study is to examine the improvement of endurance exercise performance by taking mixtures of Ginseng Radix rubra and Paeonia Radix. For this purpose, time of exhaustion, $V0_2max$, heart rate, and blood lactate was used as improvement index. The experiments were executed to thirty eight men in their twenties. They were randomly assigned into four groups[CG: control group(n=10), IG: ingestion mixtures group(n=9), TPG: ingestion placebo+training group(n=9), TIG: ingestion mixtures+training group(n=10)]. IG and TIG took mixtures of Ginseng Radix rubra and Paeonia Radix for four weeks, and TPG and TIG exercised once a day, three times a week, exercised for 25 minutes during the first week and added 2 minutes by week during four weeks up to 75% of their maximum heart rate. Time of exhaustion showed statistically significant increase for IG, TPG and TIG. TIG had the longest time of exhaustion and IG the shortest. In case of $VO_2max$, no statistically significant change was found among four groups. However, IG, TPG, TIG showed small increase in $VO_2max$. Similarly, no significant change was found for heart rate in rest even though TIG and TPG appear to have decreasing trend. For maximum heart rate, no significant change was found either, but IG, TPG and TIG showed increase. In case of blood lactate from rest to exercise until 18 minutes, no group had significant decrease. In case of blood lactate in exhaustion, IG, TPG and TIG had significant increase. Blood lactate recovery volume at 5 minutes, 10 minutes, 20 minutes showed no significant results for all four groups, but TIG and TPG had a small increase.

Anti-aging Effects of L-Carnitine on Human Skin (L-카르니틴의 사람피부에 대한 항노화 효과)

  • Lee Bum-Chun;Choe Tae-Boo;Sim Gwan-Sub;Lee Geun-Soo;Park Sung-Min;Lee Chun-Il;Pyo Hyeong-Bae
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.3 s.47
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    • pp.393-397
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    • 2004
  • L-Carnitine $({\beta}-hydroxy-{\gamma}-trimethyl-ammoniumbutyric{\;}acid)$ is a small water-soluble molecule important in mammalian fat metabolism. It is essential for the normal oxidation of fatty acids by the mitochondria, and is involved in the trans-esterification and excretion of acyl-CoA esters. In this paper, to investigate the relationship between aging and L-carnitine, we investigated the effects of in vitro matrix-metalloproteinase (MMP) inhibition and activity and expression of UYA-induced MMPs in human skin fibroblasts. Also, we studied to develop as anti-aging cosmetics with L-carnitine. Fluorometric assays of the proteolytic activities of MMP-1 (collagenase) were performed using fluorescent collagen substrates. ELISA (enzyme linked immune sorbent assay), gelatin-substrate zymography, RT-PCR ELISA techniques were used for the effects of L-carnitine on MMP expression, activity, and MMP mRNA expression in UVA irradiated fibroblast $(5\;J/cm^2)$, respectively. In addition, we performed clinical study with L-carnitine cream. L-carnitine inhibited the activities of MMP-1 in a dose-dependent manner and the $IC_{50}$ values calculated from semi-log plots were 2.45 mM, and L-carnitine showed strong inhibition on MMP-2 (gelatinase) activity in UVA irradiated fibroblast by zymography. Also, UVA induced MMP-1, 2 expression was reduced $43\%,\;53\%$ by treated with L-carnitine at 1.25 mM, and MMP-1 mRNA expression was reduced dose-dependent manner. Therefore L-carnitine was able to significantly inhibit the MMP activity, and regulate MMP expression in protein and mRNA level. The results of clinical study showed that $1.0\%$ L-carnitine treated group reduced wrinkle significantly compared with placebo treated group (P<0.05). All these results suggest that L-carnitine may be useful as new anti-aging cosmetics for protection against UVA induced Mm expression and activity.

Photoprotection and Anti-inflammatory Effects of Chinese Medical Plants (약용식물추출물의 광보호 효과와 항염증 효과 연구)

  • Jin-Hwa, Kim;Sung-Min, Park;Gwan-Sub, Sim;Bum-Chun , Lee;Hyeong-Bae, Pyo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.227-233
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    • 2004
  • Chronic exposure to solar radiation, particularly ultraviolet (UV) light, causes a variety of adverse reactions on human skin, such as sunburn, photoaging and photocarcinogenesis. Free radicals and reactive oxygen species (ROS) caused by UV exposure or other environmental facts play critical roles in cellular damage. And, repeated-UV irradiation activated the expression of the matrix metalloproteinase (MMP) and induced skin irritation. Therefore, the development of effective and safe photoprotectants that can reduce and improve the skin damage has been required. The purpose of this study was to investigate the photo-protective effect of several chinese medical plants (Juniperus chinensis) on the UV -induced skin cell damages. We tested free radical and superoxide scavenging effect in vitro. Fluorometric assays of the proteolytic activities of MMP-1 (collagenase) were performed using fluorescent collagen substrates. UVA induced MMP-1 synthesis and activity were analyzed by enzyme-linked immunosorbent assay (ELISA) and gelatin-based zymography in skin fibroblasts. We also examined anti-inflammatory effects by the determination test of proinflammatory cytokine, interleukin 6 in HaCaT keratinocytes. Expression of prostaglandin E$_2$ (PGE$_2$) after UVB irradiation was measured by competitive enzyme immunoassay(EIA) using PGE$_2$ monoclonal antibody. In the human skin we tested anti-irritation effect on the SLS-induced damage skin after appling the extract containing emulsion. We found that Juniperus chinensis extract had potent radical scavenging effect by 98% at 100$\mu\textrm{g}$/mL. The extract of Juniperus chinensis showed strong inhibitory effect on MMP-1 activities by 97% at 100 $\mu\textrm{g}$/mL and suppressed the UVA induced expression of MMP-1 by 79% at 25$\mu\textrm{g}$/mL. This extract also showed strong inhibition on MMP-2 activity in UVA irradiated fibroblast by zymography. In the test of proinflammatory cytokines of human keratinocytes Juniperus chinensis extract decreased expression of interleukin 6 about 30%. The amount of PGE$_2$ by HaCaT keratinocytes was significantly increased at the doses of above 10 mJ/$\textrm{cm}^2$ of UVB (p < 0.05). At the concentrations of 3.2-25$\mu\textrm{g}$/mL of this extract, the production of PGE$_2$ by HaCaT keratinocytes (24 h after 10mJ/$\textrm{cm}^2$ UVB irradiation) was significantly inhibited in culture supernatants (p < 0.05). In SLS-induced skin irritation model in vivo, we found to reduce skin erythema and improve barrier recovery after appling Juniperus chinensis extract containing emulsion when compared to irritated non-treated and placebo-treated skin. Our results suggest that Juniperus chinensis extract can be effectively used for the prevention of UV and SLS-induced adverse skin reactions and applied as anti-aging and anti-irritation cosmetics.

The Effects of Water Extract of Polygonatum Odoratum (Mill) Druce on Insulin Resistance in 90% Pancreatectomized Rats (90% 췌장 절제 백서에서 둥굴레뿌리의 물추출물이 인슐린 저항성에 미치는 영향)

  • Park, Sun-Min;Ahn, Seung-Hee;Choi, Mi-Kyung;Choi, Soo-Ran;Choi, Soo-Bong
    • Korean Journal of Food Science and Technology
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    • v.33 no.5
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    • pp.619-625
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    • 2001
  • We determined whether the supplementation of Polygonatum Odoratum (Mill) Druce (POD) extract had a good effect on insulin resistance in peripheral tissues of 90% pancreatectomized (Px) and sham-operated (Sham) male Sprague Dawley rats. Px and Sham rats were divided into two groups; one group daily consumed 0.3 g of POD extracts per 1 ㎏ body weight for two months, and the other group had a placebo. All rats freely consumed a 40% fat diet. At the end of the experiment, a euglycemic hyperinsulinemic (EH) clamp was performed in a fasting, awake, and unstressed state to determine insulin resistance. At EH clamp, body weights were higher in Sham rats than Px rats, and serum glucose levels of baseline were affected by diabetic status and POD administration. Serum insulin concentrations were higher in Sham rats than Px rats, and POD administration decreased them in Sham rats compared to P. Glucose disposal rates in peripheral tissues increased with POD in both Px (n=10) and Sham (n=10) rats. But glycogen deposits in soleus muscle increased with POD administration in Px and Sham rats, and total glycogen synthase activity and fraction velocity were higher in POD groups. Triglyceride contents in quadriceps muscles decreased with POD in Px rats. In conclusions, POD improves insulin resistance by enhancing glucose utilization with increasing glycogen deposit and decreasing triglyceride contents in muscles.

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Relationship between Stratum Corneum Carbonylated Protein (SCCP) and Skin Biophysical Parameters (Stratum Corneum Carbonylated Protein (SCCP)의 피부 생물학적 파라미터와의 관계)

  • Lee, Yongjik;Nam, Gaewon
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.45 no.2
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    • pp.131-138
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    • 2019
  • Carbonylated proteins (CPs) are synthesized by the chemical reaction of basic amino acid residues in proteins with aldehyde compounds yielded by lipid peroxidation. CPs are excited by a range of light from UVA to blue light, and resulted in the generation of superoxide anion radicals ($^{\cdot}O_2{^-}$) by photosensitizing reaction. Then, they CPs induce new protein carbonylation in stratum corneum through ROS generation. Furthermore, the superoxide anion radicals produce CPs in the stratum corneum (SC) through lipid peroxidation and finally affects skin conditions including color and moisture functions. The purpose of this study was to investigate the relationship between the production of stratum corneum carbonylated protein (SCCP) and the skin elasticity. 46 healthy female Koream at the ages of 30 ~ 50 years old were participated in this study for 8 weeks. The skin test was experiment conducted into two groups; placebo group (N = 23) used cream that did not contain active ingredients, and the other group (N = 23) used cream containing the elasticity improving ingredients. Test areas were the crow 's feet and the cheek. Various non-invasive methods were carried out to measure biophysical parameters on human skin indicating that dermis density and skin wrinkle were measured by using DUB scanner and Primos premium, respectively. Skin elasticity were measured using dermal torque meter (DTM310) and balistometer (BLS780). SCCP was assessed in a simple and non-invasive method using skin surface biopsy on the cheek of the subject. The amount of SCCP was determined using image analysis. All measurements were taken at 0, 4 and 8 8week. Results revealed that the amount of CP in SC was reduced when the skin wrinkle and skin elasticity related parameters were improved. This indicates that the correlation between the elasticity improvement and the amount of CP can be used as a anti-aging indicator and applicable to the skin clinical test for the measurement of skin aging in the future.

Aspects of Emotional Customs by the N-po Generation (N포세대의 감정 풍속도)

  • Seo, Yeon-Ju
    • Journal of Popular Narrative
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    • v.25 no.1
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    • pp.55-85
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    • 2019
  • In this article, we examine the real meaning behind the stories in which the N-po Generation (Millennial Generation) is depicted, through the observation of entertainment programs, TV series, and movies. This could be an opportunity to investigate the aspects of emotional customs of our era, which have been described by television media as portraying the complex and multifaceted reality in the most mundane and popular manner while influencing the public. Problems with youth unemployment, the polarization of life, and instability are not only global issues but situations that specifically occur in South Korea. It is thus vital to pay attention to the inner side of the N-po Generation who enjoy Sohwakhaeng (small but certain happiness) by eating alone as the placebo effect of this tough reality. This is an agenda that should be viewed as a problem in the fundamental design of South Korean society. The consciousness of the problem shown in the TV series has been drawing attention. The TV series Because depicts a love narrative that concentrates on emotions in a relationship that started between housemates due to poverty and housing problems, leading to marriage. Thus, the TV series persuasively dramatized 'confluent love' in the N-po Generation. In the movie , Miso can be regarded as a symbol that represents the emergence of a new generation of cultural sensitivity. There is a suggestion in the sequence of that identifies the pursuit of taste with the discovery of identity. The TV series is a growth narrative that deals heavily with youth unemployment, temporary workers, fragmented families, and dating violence. The housemates in find emotional stability through interaction with each other, and courageously approach their individual problems. In the process, images of women, who are empathetic towards others and are willing to jointly solve their problems, are calmly depicted to reveal a story of growth revolving around a ground emotional community. The current problem that South Korean society should contemplate is how to be fully human beyond mere survival, and how to further seek the conditions of human existence. In that sense, what we should pursue is a notion of 'publicness', which can put several generations together. Because of the reality that confliction between generations must be triggered, in order to make a passage of sympathizing, mass media's sensitivity training becomes more important. This may be the duty of mass media.

A Prospective Randomized Comparative Clinical Trial Comparing the Efficacy between Ondansetron and Metoclopramide for Prevention of Nausea and Vomiting in Patients Undergoing Fractionated Radiotherapy to the Abdominal Region (복부 방사선치료를 받는 환자에서 발생하는 오심 및 구토에 대한 온단세트론과 메토클로프라미드의 효과 : 제 3상 전향적 무작위 비교임상시험)

  • Park Hee Chul;Suh Chang Ok;Seong Jinsil;Cho Jae Ho;Lim John Jihoon;Park Won;Song Jae Seok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.127-135
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    • 2001
  • Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

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