• 제목/요약/키워드: the six stomach

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당종해(唐宗海)의 의역사상(醫易思想)에 관(關)한 연구(硏究) (The study of Tang Zong Hai's Medica-change thought)

  • 김기욱;박현국
    • 대한한의학원전학회지
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    • 제12권2호
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    • pp.56-71
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    • 1999
  • 1. In the recohnition of cosmos true form, It is compared to the Boundless(無極) the Great Absolute(太極),Yin and Yang(兩儀) throungh the fertilazation process of spermatozoon and ovum. 2. It is explained that principle of unchange through the Form and Action(體 用) relation of the outer appearances and Number (象數) with matching the number of nine and ten to HaDoo(河圖) and RakSye(洛書). 3. Eigth divinations(八卦) being compared to the human body, Care presevation of pregnancy(養胎) is explained that head forms firstly(Gun-I 1乾一), secondly lung(Tae-E 兌二), heart(E-Sam 離三), liver(Jin-Sa 震四), gall bladder(Son-Oo 巽五), kidney(Gam-Yuk 坎六), intestines and stomach(Gan-Chill 艮七), lastly flesh forms(Gon-Pal 坤八). 4. It is explained that process of physiological change of $\ll$Nei Ching The Natural Truth in Ancient Times$\gg$(內經 上古天眞論) by matching boy at the age of 8 to Gan-divination(艮卦), and girl at the age of 7 to Tae-divination(兌卦). 5. The theory of six sons from Gun-Gon(乾坤六子論) is explained by relation of Apriority Eight-divination(先天八卦) obedience and disobedience-left and right. 6. It is explained that form of the human-body and the relationship of the Heart - the Kidney through the Gam(坎) Li(離) - divination 7. The effort of interpretating time and space of the Twelve Horary signs is explanined by season, direction, Five elements(五行), rise and decline, the Three Sum(三合), the Six Sum (六合), the six crash(六衡)'s relation. 8. the process of change from apriority(先天) to postery(後天) in the book of Changes(周易) is explanined by comparing to the phenomenum of nature and the human body. 9. The Energy Satus(氣位) are different from the direction of Eight-divination(八卦) and the properties of the good or bad of herb-drugs are differnt from the place of production. 10. The rightness of realizating the Overlapping-divinations(重卦) are compared to the phenomenum of nature through the Divination Virture(卦德). 11. The dependence-relations of The Twelve Meridians(十二經脈) are explained by-matching January with liver meridian, February with gall bladder meridian, march with heart pericardium meridiam, April with small intestine meridkan, August with lung spleen meridian, jury with stomach meridian, August with lung meridian, September with large intestine meridian, October with urinary bladder meridianm November with kidney meridian. December with triple energizer meridian throng The Twelve Byuk-divination. 12. The process of menstration cycle is explained by The Month symbolizing-divination(月候卦). 13. Through The Trade(交易) prove the reason of feverish sympotoms to use feverish Drug, mill sympotoms to use mill drug of prescription and Heart-Kidneys Consensus(心賢相交) and through The Change(變易), prove the chill and feverish consensus of forechill after feverish, fore feverish after chill and through. The Non-Change(不易) explain the reason of chill sympotoms to use feverish drug, feverish sympotoms to use chill drug of prscription. 14. Ho-divination(互卦) applicate Jxa Sa(佐使) herb drug match of Kun Sin Jwa Sa() theory. 15. According to the Hyo-position(爻位) match the ages, body form and drug by matching Ehight-divination(八卦) to the human body form and function in medicine and the book of Changes(周易) application emphasize the human body Ehight-divination(人身八卦). 16. Throgh the Order-divination(序卦) explain the rightness of Divination Image(卦象) arrangement and all things take shape by cosmo-energy conseusus(宇宙氣交). 17. Throgh the Mixing-divination(難卦) supply the vacancy of medicine and the book of Changes(周易) relationship in the foreword explian the human energy movements, sleep, vomitting, the energy arrival(逮氣), heart pericardium(心包), lung membrane(肺膜) etc.... Like the above sentence medicine and the book of Changes(周易) theory of scholar Tang on the viewpoint of easten-the way Western appliance(東道西器) researching abyss of medicine impart to descendants, so I think that the achievement of medicine and the book of Changes(周易) study is very excellant and I expect that the study Korean Oriental Medicine(韓醫學) theory by means of medicine the book of Changes(周易) reference, will be accelarated.

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비만치료에 대한 이침요법의 효과에 대한 고찰: 체계적 문헌고찰 및 메타분석 (The Effect of Auricular Acupuncture for Obesity: A Systematic Review and Meta-analysis)

  • 박서현;안선주;최성환;강신우;금동호
    • 한방비만학회지
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    • 제20권1호
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    • pp.52-68
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    • 2020
  • Objectives: The purpose of this study is to investigate the weight loss effects of auricular acupuncture in obese patients. Methods: Six databases (Research Information Sharing Service [RISS], Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], PubMed, The Cochrane Library, China National Knowledge Infrastructure [CNKI]) were searched up to May 20, 2020. Eight eligible randomized controlled trials were included the present study. The quality of included studies was assessed by the Cochrane risk of bias tool and a meta-analysis was performed by Review Manager software. A meta-analysis was conducted using a random-effects model and a subgroup analysis was performed to detect the sources of heterogeneity, identify the selection of acupuncture methods and explore its contributions to the weight loss effects. Results: Among 8 trials, 5 trials used auricular acupuncture and 2 trials used auricular acupressure, 1 trial used both types of intervention. Most commonly selected acupoints were Shenmen (TF4) and stomach (CO4). Treatment duration was six to twelve weeks, and total treatment session was six to twelve. Compared to the control groups, auricular acupuncture significantly decreased body weight, body mass index (BMI), high density lipoprotein-cholesterol (HDL) and ghrelin. For the selection of acupuncture methods, both methods performed similarly in most outcome except waist circumference (WC), body fat percentage (BFP), and triglycerides (TG). Conclusions: We found that auricular acupuncture can be effective for weight loss and controlling appetite. However, the findings should be interpreted with caution due to heterogeneity. So further vigorous and well-designed studies should be conducted to strengthen the evidence of the use of auricular acupuncture for obesity.

십이지지(十二地支)의 음양(陰陽) 오행(五行) 육기(六氣) 장부(臟腑)의 배합(配合) 및 상충(相沖) 상합(相合)에 관한(關) 연구(硏究) (A Study on the twelve earthly branches' Yin Yang, Five elements, Six Qi, viscera combination, Mutual collision and Mutual combination.)

  • 김형주;전윤주;윤창열
    • 혜화의학회지
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    • 제27권1호
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    • pp.9-20
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    • 2018
  • Objectives : Ten heavenly stems(10天干) and Twelve earthly branches(12地支) are symbols exposing change order in heaven and earth, and are a very important sign in studying oriental philosophy and oriental medicine. Especially, 10 heavenly stems(10天干) and 12 earthly branches(12地支) are indispensable for the study of Five Circuits And Six Qi(오운육기), and a deep study is needed. Methods : I have examined Yin Yang combination(음양배합), Five elements combination(오행배합), Six Qi 3Yin 3Yang combination(육기삼음삼양배합), viscera combination(장부배합), Mutual collision(상충), Six combination(육합), Three combination(삼합), etc. of 12 earthly branches(12지지) by referring to books such as "Yellow Emperor Internal Classic" ("黃帝內經") and "Principle of universe change" ("우주변화의 원리"). Results & Conclusions : Zi Yin Chen Wu Shen Xu(子 寅 辰 午 申 戌) become Yang(陽), Chou Mao Si Wei You Hai(丑 卯 巳 未 酉 亥) become Yin(陰), Zi Si Yin Mao Chen Si(子 丑 寅 卯 辰 巳) become Yang, and Wu Wei Shen You Xu Hai(午 未 申 酉 戌 亥) become Yin. Twelve earthly branches can be divided into five movements by its original meaning, where YinMao(인묘) is tree, SiWu(사오) is a fire, ShenYou(신유) is a gold, HaiZi(해자) is water, and ChenXuChouWei(진술축미) mediate in the middle of four movements So they become soil(土). SiHai(巳亥) is JueYin Wind Tree(궐음 풍목), ZiWu(子午) is ShaoYin Monarch Fire(소음 군화), ChouWei(丑未) is TaiYin Humid Soil(태음 습토), YinShen(寅申) is ShaoYang Ministerial Fire(소양 상화), MaoYou(卯酉) is YangMing Dry Gold(양명 조금), and ChenXu(辰戌) is TaiYang Cold Water(태양 한수). Viscera combination(장부배합) combines Zi(子) and Bile(膽), Chou(丑) and Liver(肝), Yin(寅) and Lung(肺), Mao(卯) and Large intestine(大腸), Chen(辰) and Stomach(胃), Si(巳) and Spleen(脾), Wu(午) and Heart(心), Wei(未) and Small intestine(小腸), Shen(申) and Bladder(膀胱), You(酉) and Kidney(腎), Xu(戌) and Pericardium(心包), Hai(亥) and Tri-energizer(三焦), Which means that the function of the viscera and channels is the most active at that time. Twelve earthly branches mutual collisions collide with Zi(子) and Wu(午), Chou(丑) and Wei(未), Yin(寅) and Shen(申), Mao(卯) and You(酉), Chen(辰) and Xu(戌), and Si(巳) and Hai(亥). The two colliding earthly branches are on opposite sides, facing each other and restricting each other by the relation of Yin-Yin and Yang-Yang it rejects each other so a collision occurs. Six Correspondences(六合) coincide with Zi(子) and Chou(丑), Yin(寅) and Hai (亥), Mao(卯) and Xu(戌), Chen(辰) and You(酉) and Si(巳) and Shen(申) Wu(午) and Wei(未). Three combination(三合) is composed of ShenZiChen(申子辰), SiYouChou(巳酉丑), YinWuXu(寅午戌), and HaiMaoWei(亥卯未). Three combination(三合) is composed of ShenZiChen(申子辰), SiYouChou(巳酉丑), YinWuXu(寅午戌), and HaiMaoWei(亥卯未). This is because the time Six Qi(六氣) shifts in these three years are the same.

Cimetidine과 위산도 변화가 $^{99m}Tc-Pertechnetate$의 흰쥐 위벽 집적에 미치는 영향 (Effect of Cimetidine and Gastric Acidity on the Gastric Mucosal Retention of $^{99m}Tc-Pertechnetate$ in Rats)

  • 김성훈;김종우;박용휘
    • 대한핵의학회지
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    • 제23권1호
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    • pp.41-48
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    • 1989
  • $^{99m}Tc-Pertechnetate\;(TcO_4^-)$ is concentrated by the stomach after intravenous injection, allowing the detection of ectopic gastric mucosa. It has been used to develop a noninvasive test of gastric secretion. However the cellular site of concentration is still controversial, that is whether mucin-secreting epithelial cell or acid-secreting parietal cell. This study is planned to investigate the effects of cimetidine and gastric acidity on the retention of $TcO_4^-$ in the gastric wall of the rat. Also we further attempted to clarify the uptake and secreting cell of $TcO_4^-$ in the gastric mucosa. One hundred rats were divided into two groups, preliminary (40 rats) and main examination group (60 rats). Preliminary examination group was composed of fasting group (20 rats) for the detection of the time for reaching stable $TcO_4^-$ retention ratio in gastric wall and post-prandial group (20 rats) for the detection of the time for reaching the maximal gastric acidity. Main examination group was composed of fasting group (30 rats), which was subdivided into control group (10 rats), cimetidine group (10rats), $Mylanta^{(R)}$ group (10 rats) and post?prandial group (30 rats), which was subaivided into 90 min group (10 rats), 90 min cimetidine group (10 rats), and 120 min group (10 rats). Retention ratio (%) of $TcO_4$ in the gastric wall and the pH of the gastric contents were measured in the extracted stomach of the six groups. Gastric wall retention ratio of $TcO_4^-$ was calculated by the gastric wall radioactivity (cpm) divided by total gastric radioactivity (cpm) at 30 mins after intravenous injection of 0.4 mCi of $TcO_4^-$. The results were as follows: 1) The time required for reaching stable $TcO_4$ retention ratio and the lowest gastric PH were 30 min and 90 min, respectively. 2) In the fasting group, the gastric wall retention ratio of $TcO_4^-$ was significantly increased in the cimetidine group, compared with the control group (P < 0.01). However there was no significant difference between the control and $Mylanta^{(R)}$ group 3) The $TcO_4^-$ retention ratios of 90 min and 120 min groups were lower than that of the fasting control group (p < 0.05), either. After administration of cimetidine, the retention ratio was significantly increased in 90 min group (p < 0.01). 4) While $TcO_4^-$ retention ratio and gastric pH were well correlated in the post-prandial 120 min group (r=0.7112, p<0.05), in the post-prandial 90 min and 90 min cimetidine groups correlated poorly. However, there was no correlation in the three fasting groups at all. Referring the above results, we infer that $TcO_4^-$ is secreted into the gastric lumen by both parietal and non-parietal cells, with dominant non-parietal $TcO_4^-$ secretion in the fasting state and dominant parietal $TcO_4^-$ secretion in the stimulated state.

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진단적 절제 및 절개 생검술을 시행한 경부 종양에 대한 임상적 고찰 (Clinical Analysis of Neck Masses Proved by Diagnostic Excisional and Incisional Biopsies)

  • 권수인;노동영;오승근
    • 대한두경부종양학회지
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    • 제8권2호
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    • pp.112-118
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    • 1992
  • Neck mass as a primary presenting sign is a common problem that physicians and surgeons alike have to face but conclusive diagnosis cna be made only by histopathological examination. During the period of four years from January 1988 to December 1991, three hundred sixteen diagnostic incisional or excisional biopsies of the neck masses were performed at the outpatient department of Surgery, Seoul National University Hospital and tissue diagnoses were confirmed by histopatholotical examination. On which a clinical analysis was performed and its results were compared with the results of one hundred fifteen Fine Needle Aspiration Cytologic examinations on neck masses during the same period. The results were as follows: In the histologic types of neck masses. inflammatory disease was the most common (58.2%), metastatic malignant tumor(22.5%), benign tumor(15.2%). primary malignant tumor(0.4%) in decreasing order. Among the individual lesions. tuberculous lymphadenitis was the most common(29.4%) and nonspecific lymphadenitis was the next. Of overall sexual distribution, female preponderated by a ratio of 1.15:1, but in the primary and metastatic malignancies, male did by a ratio of 1.60:1 and 1.53:1, respectively. The most common age group was third decade(26.8%), and fourth decade was the next(20.9%) but in malignant tumors. sixth decade was the most commom. The duration of symptom between one and three months(33.8%), was the most common and between three and six month was the next but the difference between the individual diseases was not significant. Of the metastatic tumor of seventy one cases, primary site was found in fifty cases(84.2%) and stomach cancer was the most comon primary site. In the result of the Fine Needle Aspiration Cytologic(FNAC) examinations, positive for mlignant cells was the most common(33.1%), following the frequencies with tuberculosis(22.6%), and nonspecific lymphadenitis(16.5%) in decreasing order. Eleven cases of FNAC underwent diagnostic biopsies and the diagnostic accuracy of FNAC was 83.3%. Conclusively, in our study, tuberculous lymphadenitis was the most common histologic type, female was predominant third decade was the most common age group. the duration of symptom between one and three month was the most common and in the metastatic tumors, stomach cancer was the most common primary site.

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재일한국인(在日韓國人)에 對(대)한 사회의학적조사(社會醫學的調査) (Socio-medical Surveys on the Korean Residents in Japan)

  • 김병우
    • Journal of Preventive Medicine and Public Health
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    • 제6권1호
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    • pp.101-117
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    • 1973
  • Socio-medical survey was carried out on six hundred and thirty Korean households in the cities of Tokyo, Osaka, Kyoto, and Nagoya in Japan from Nov. 1972 to Dec. 1972, and following results were obtained. 1. Age distribution of households showed the highest occurence in the group of 40 to 49 years of age in the both sexes. Families with five members showed highest occurence, and the average number of familial members was 5.7 persons per one household. 2. More than half of the householders were some independent enterprisers rather than to be the employees and most of the household had one familial member engaged in more or less liberal profession. 3. 19.4% of households moved into these cities from 1941 to 1945. 4. 40.5% of all the households had their own houses. The possession rate of one's own house was higher in the households which had long period of residence in Japan. 5. 83.5% of all households had various medical insurances. And the 6.2% of the household which had no insurance stated that the reason for not being affiliated was 'because to be the foreigner'. Household of shorter dwelling period had less tendency to be affiliated to the various insurances. 6. In 41.3% of all the households, average medical expenditure amounted to 1000-5000 Yen per month. And only 25.6% of household stated that they do not worry about the medical expenditure for the futures. 7. 66.3% of households were consulting to medical doctors for their sickness, such as toothache, severe coughing, profuse sputum, children's fever and stomach pain etc. 8. 59.4% of households were using the facilities of health center services. The health center service was used mainly for individual health service rather than the environmental aspect. And 19.8% of households were not aware of health center activities. 9. It was found that 23.5% of households received the screening test of the tuberculosis and adult diseases. Especially, the rate of screening test of the adult diseases showed as following ; stomach cancer, 8.9% ; hypertension, 7.9% ; diabetes mellitus, 2.1% ; and uterus cancer, 1.6%. 10. Birth control was carried out in 17.3% of households but not in 52.5%. The chief reason of birth control was 'because of poor maternal health' (40.0%) or 'should not be done' (5.4%). 11. Most of them are obtaining the knowledges and informations on family plannings. public nuisance problems and nutritions etc. by means of the mass communications, while those no preventing diseases and the environmental hygiene through the administrative organizations.

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변비(便秘)에 관(關)한 동서의학적(東西醫學的) 고찰(考察) (A Study on Constipation)

  • 류봉하;조남희
    • 대한한방내과학회지
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    • 제21권1호
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    • pp.169-180
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    • 2000
  • Objectives : To satisfy the demand of good treatment of constipation Methods : we investigated the literatures of Oriental Medicine about Constipation. Results: 1. There are three categories of etimological factors of constipation, that is, endogenous, exogenous and non-exo-endogenous factor. The endogenous factor is caused by seven emotions, called depression of Ki and stagnation of Ki. The exogenous factor is six excessive atmospheric influences, for example, wind, cold, dampness, heat and dryness. And the non-exo-endogenous factors are overfatigue, improper diet, stagnated blood and deficiency of Ki and blood that comes from old age, long disease and after delivery. 2. Classification: According to cause of disease it is classified by constipation due to cold, heat, wind, dryness, retention of undigested and phlegm. According to Internal Organs there are constipation due to deficiency syndrome of the stomach, excess syndrome of the stomach, deficiency syndrome of kidney and splenic constipation. And Differentiation of syndromes according to Ki and blood, there are constipation of deficiency type and excess type. There are constipation due to stagnation and deficiency of Ki, deficiency of blood and stagnated blood. 3. Principles and Methods of treatment 1) Herbal Medicine (1) Excess type [1] Constipation due to heat : Seunggitang(承氣湯) and Majainwhan(麻子仁丸) [2] Constipation due to stagnation of Ki : Samatang(四磨湯) and Yukmatang(六磨湯) (2) Deficiency type [1] Constipation due to deficiency of Ki : Whanggitang(黃?湯) [2] Constipation due to deficiency of blood: Yunjangwhan(潤腸丸) [3] Constipation due to cold : Jechunjun(濟川煎) and Banyuwhan(半硫丸) 2) Enema therapy: It is a method to induce defecation by honey or pig's bile juice for weak people. 3) Acupuncture and Moxibustion: Acupoints used to treat constipation are BL25, ST25 and TE6. Moxibustion at CV8, CV6 is good for constipation due to cold. (4) Diet therapy: It is very important that we eat meals regularly and defecate on the same time even if you don't. And we have to eat food like fruits, vegetables and beans. (5) finger pressure: Finger pressing around these points like ST25, SP25, BL25, BL31, BL32, BL33 and BL34 is good for it. (6) Kigong therapy: Abdominal breathing (7) Old man' s constipation: Hip bath or diet therapy is commended. Laxation with lubricant like Supungyunjangwhan(搜風潤腸丸) is used. (8) Women' s constipation: After delivery, we have to administer tonifying prescription Sipjundaebotang(十全大補湯) and enema can be used. Conclusion : We have to examine the cause of disease and bowl movement carefully. After comprehensive analysis of the data gained by the four methods of diagnosis, we diagnose and treat patients on the base of overall of symptoms and signs.

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급성 위염 유발 마우스 동물 모델에서 구기자(枸杞子) 에탄올 추출물의 위점막 손상 보호 효과 (Protective Effects of a Lycium chinense Ethanol Extract through Anti-oxidative Stress on Acute gastric lesion mice)

  • 이아름;이주영;김민영;신미래;신성호;서부일;권오준;노성수
    • 대한본초학회지
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    • 제30권6호
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    • pp.63-68
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    • 2015
  • Objectives : Gastric lesions affect many people around the world and their development are results of the imbalance between destructive and protective factors in the gastric mucosa. Lycium chinense has been widely used as a traditional Korean medicine, it was recently reported that they have potent anti-inflammatory effects in chronic hepatitis models. Therefore, this study aimed to investigate the anti-inflammatory activity of Lycium chinense extract (LCE) on HCl-Ethanol induced gastric lesion mice.Methods : The ICR mice were divided randomly into five groups of six animals each. Group A was normal mice, and group B was treated orally with 0.5 ml 150 mM HCl-60% Ethanol. Mice in group C and D were pre-treatment of LCE (100 mg/kg and 200 mg/kg bodyweight, p.o before HCl/ethanol treatment) and group E was orally administered sucralfate (10 mg/kg).Results : 150mM HCl/60% ethanol-induced gastric mucosal injury mice were ameliorated mucosal damage upon histological evaluation by treatment of LCE. Pre-treatment of LCE attenuated reactive oxidative species (ROS) and produces peroxynitrite (ONOO-) in stomach tissues. As results of stomach protein analyses, LCE effectively reduce inflammatory-related factors such as cyclooxygenase-2 (COX-2), tumor necrosis factor alpha (TNF-α), inducible nitric oxide synthase (iNOS) and interleukin-6 (IL-6) in gastric lesion mice. In addition, nuclear factor kappa B (NF-κB) and inhibitor of phosphorylation of nuclear factor kappa B (p-IκB) were down-regulated in LCE-administrated gastric lesion mice.Conclusions : Our discovery supports that the therapeutic activity of LCE ameliorate the development of gastric lesion via suppressing the oxidative stress and gastric partial inflammation induced by 150 mM HCl/60% ethanol.

자라 위 및 십이지장 내분비세포에 관한 전자현미경적 연구 (Electron Microscopic Study on the Endocrine Cells in the Stomach and Duodenum of the Pond Tortoise(Amyda sinensis))

  • 전창진;이재현;이창헌
    • Applied Microscopy
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    • 제16권2호
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    • pp.25-34
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    • 1986
  • 자라의 위 및 십이지장에 출현하는 내분비세포의 형태를 알아보기 위하여 전자현미경으로 관찰을 행하였던 바, 과립의 크기, 형태, 전자밀도 및 세포의 형태 등에 의해 다음과 같이 6종의 세포형으로 구분할 수 있었다. I형 : 직경 $100{\sim}430nm$(평균 290nm)로서 전자밀도가 낮고 많은 수의 다양한 형태의 과립을 가진 것. II형 : 직경 $190{\sim}430nm$(평균 280nm)로서 높은 전자밀도를 나타내며 다양한 형태의 과립을 가진 것, III형 : 직경 $170{\sim}650nm$(평균 430nm)로서 전자밀도가 높고 과립막과 내용물 사이에 넓은 halo를 형성하는 과립을 가진 것. IV형 : 직경 $140{\sim}370nm$(평균 240nm)로서 전자밀도가 대체로 낮고 과립막과 내용물이 밀착된 과립을 가진 깃. V형 : 직경 $300{\sim}600nm$(평균 410nm)로서 전자밀도는 낮거나 중등도이며, 과립은 곽립막과 내용물 사이에 명확한 halo를 형성하고, 세포질내 미세섬유를 가지는 것. VI형 : 직경 $100{\sim}220nm$(평균 160nm)로서 대체로 소형의 과립을 가지며, 전자밀도는 다양하고 과립은 과립막과 내용물 사이에 halo를 형성하는 것, 밀착된 것 또는 내용물이 결정구조를 나타내는 것 등으로 다양하며 세포질내 풍부한 미세섬유를 가지는 것.

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불완전 절제된 위암의 방사선 치료 (Radiotherapy in Incompletely Resected Gastric Cancers)

  • 김종훈;최은경;조정길;김병식;오성태;김동관;장혜숙
    • Radiation Oncology Journal
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    • 제16권1호
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    • pp.17-25
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    • 1998
  • 목적 : 위암치료에 있어 완전절제수술후 임상적 국소재발이 $30-40\%$에 이르는 것으로 보고되고 있으나 수술 후 항암화학요법이나 방사선 치료의 시행은 아직 그 역할이 분명치 않다. 반면 완전절제가 이루어지지 않은 위암에서는 원발병소 부위의 국소발소 위험성이 매우 높아 추가적인 국소치료의 필요성이 제기되고 있으나 이에 대한 구체적인 연구는 아직 미미한 실정이다. 이에 저자 등은 불완전 절제된 위암에서 수술후 방사선치료가 국소재발을 줄일 수 있는지, 또한 생존율향상을 얻을 수 있는지 알기 위하여 본 연구를 시행하였다. 대상 및 방법 : 1991년 7월부터 1996년 8월까지 울산의대 서울중앙병원에서 위암 진단하에 근치적 절제수술을 시행하였으나 불완전 절제된 25명의 환자에서 수술후 방사선 치료를 시행하였다. 전체 25명의 환자 중 선세포암이 23명, 평활근육종이 2명이었고, 수술은 위전절제수술(Total gastrectomy) 5명, 위부분절제술(Subtotal gastrectomy) 20명이었다. 병기별로는 I B 1명, II 2명, III A 11명, III B 10명, IV 1댕이었으며 불완전 절제부위는 원위절제면(dlstal resection margin) 17명, 근위절제면(proxlmal resection margin) 5명, 간 절제면 1명 및 기타 장기 절제면 2명이었다. 방사선 치료는 총 6회의 FP 항암화학요법중 회차와 동시에 시작되는 것을 원칙으로 하였으며 조사선량은 44.6Gy-59.4Gy 범위였고 중앙선량은 55.8Gy였다. 결과 : 1명을 제외한 모든 환자가 정해진 양의 방사선 치료를 마칠 수 있었으며, 3명의 환자에서 $15\%$ 이상의 체중감소가 있었고 중증도 3 이상의 혈액학적 독성은 5명에서 관찰되었다. 최소 추적관찰기간은 12개월이었다. 전체 25명중 12명에서 재발이 있었으며 조사야내 국소재발은 7명에서 발생하였고 이들은 문합부위재발 3명, 인접조직 3명, 임파절 1명이었다. 반면 원격전이는 10명에서 발생하였고 이들은 복막전이 6명, 간 전이 2명, 쇄골상임파절 및 대동맥 임파절등 원위임파절 전이가 3명이었다. 환자의 현 상태는 무병생존 11명, 위암과 관련 없는 사망 2명, 위암으로 인한 사망 10명, 재발상태의 생존 2명 등이다. 4년 무병생존율과 질병관련생존율(disease specific survival)은 각각 $48\%$$40\%$였으며 중앙생존값은 35개월, 중앙무병생존값은 26개월이었다. 원발병소 위치, T-stage, N-stage, Stage, 방사선량 등은 생존율에 별다른 영향을 미치지 못하였다. 결론 : 수술후 방사선치료와 항암화학요법은 큰 부작용 없이 시행되었으며 치료후 실패양상은 원격전이가 가장 많았고 국소재발은 7명($28\%$)에서 발생하여 문헌상 관찰된 완전절제수술후 국소재발수치과 비슷하거나 낮은 것으로 나타났다 추적관찰 기간이 짧고 환자 수가 적어 단정짓기는 어렵지만 불완전 절제수술 후 원발병소 부위에 잔류암세포가 존재하는 상태인 점을 고려할 때, 불완전 절제된 위암에서 방사선치료가 국소재발을 억제에 기여했을 가능성이 크다고 생각된다.

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