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정장액내 transferrin의 임상적 의의

Title
 정장액내 transferrin의 임상적 의의 
Other Titles
 (The) clinical significance of seminal transferrin 
Issue Date
1992
Publisher
 연세대학교 대학원 
Description
의학과/석사
Abstract
[한글]Sertoli세포 기능을 임상적으로 평가하기 위해서 주로 혈청 난포자극호르몬을 측정하여 왔으나, 난포자극호르몬은 에스트로젠등에 의해 영향을 받으며 병변이 뚜렷하게 진행된 후에야 증가하므로, 조기에 Sertoli세포의 기능을 확인할 수 있는 지표는 없었다. 그러나 최근에 정장액내 transferrin은 대부분이 ertoli세포에서 생성되고, Sertoli세포에서 생성된 단백질의 5%를 차지하며, transferrin mRNA에 반응하는 RNA probe을 이용한 방법을 통해 Sertoli세포가 고환조직에서 transferrin유전자 표현의 유일한 부위임이 밝혀졌 다. 이에 본 연구에서는 정장액내 transferrin의 측정이 Sertoli세포의 기능장애를 조기에 파악할 수 있는 임상적 지표로 이용할 수 있는지를 알아 보고자 61명의 불임환자와 16명의 정상 대조군에서 정장액내 transferrin치을 방사선면역측정법으로 측정하여 다음과 같은 결과를 얻었다. 1. 정장액내 transferrin치는 정상 대조군에서는 45.83±25.00 μg/ml였다. 무정자중에서는 20.57±12.44 μg/m1(p<0.05)였고, 핍정자정자무력증에서는 27.06±16.74 μg/m1(p<0.05)로서 대조군에 비해 감소되어 있었다. 정자수와는 의미있는 상관관계가 있었으나(r= 0.2480, p<0.05), 정자의 형태 및 운동성과는 상관관계가 없었다 (p>0.05). 2. 정관절제술을 시행받은 남성의 정장액내 평균 transferrin치는 16.46±8.39 μg/m1로서 정상 대조군의 약 35%였다. 3. 무정자증중에서 폐쇄성인 경우, 비폐쇄성인 경우, 그리고 정관절제술을 시행받은 남성사이에 정장액내 transferrin치는 통계학적으로 유의한 차이가 없었다(P>0.05). 4. 무정자증 환자군에서 혈청 난포자극호르몬치와 정장액내 transferrin치 사이에는 유의한 상관관계가 없었다(p>0.05). 이상의 결과로서 정장액내 transferrin의 대부분은 고환에서 생성되고 정장액내 transferrin치는 정자수와 상관관계가 있음을 확인하였다. 그러나 무정자증 환자에서 정장액내 transferrin치의 측정만으로는 폐쇄성과 비폐쇄성의 감별하기에는 부족하며, 이를 위해서는 부고환지표와의 복합적인 판정이 필요하다.
[영문]FSH has been used as a clinical marker of Sertoli cell function but its usefullness is limited because it is influenced by estrogens and shows an increased late in the progression of lesions. Recently, several investigations clearly demonstrated that seminal transferrin is produced by the Sertoli cells and this was found to constitute 5% of the total secreted proteins. Furthermore, in situ hybridization using a single-stranded RNA probe complementary to transferrin mRNA was used to show that Sertoli cells were the only anatomical site of the transferrin gene expression in testicular sections. It has been suggested that the concentration of semina1 transferrin may serve as a possible clinical marker of Sertoli cell function, Therefore the concentration of this protein in human seminal plasma from 16 cases of normal contro1s and 61 cases of infertile men has been evaluated using radioimmunoassay in order to identify the relationship between transferrin concentrations, human semen parameters and plasma FSH levels. The following results were obtained; 1. The seminal transferrin concentrations were found to be significantly lower in patient with azoospermia(20.57±12.44 μg/ml) and oligo-asthenospermia(27.06±16.74 μg/ml) as compared with findings for normal controls(45.83±25.OO μg/ml). The levels of significance were p<0.05, respectively, compared with the normal controls. A significant positive correlation was found between sperm count and seminal transferrin levels(r=0.2480, p<0.05). However no significant correlations were obtained to sperm motility and sperm morphology(P>0.05). 2. The seminal transferrin concentration in patients who had had a vasectomy was 16.48±8.39 μg/m1, which was approximatly 35% of the normal controls. 3. No sigificant differences in seminal transferrin concentration were observed in the groups with obstructed azoospermia, nonobstructed azoos permia and men who had had a vasectomy(P>0.05). 4. No significant correlation was found between seminal transferrin and circulating FSH in patients with azoospermia (P>0.05). In conclusion, it is suggested that seminal transferrin originated mainly from the testis and significantly correlated to sperm density. These results, however, do not clarify whether obstructed or nonobstructed azoospermia. So it is thought that a study of patients with azoospermic infertility is necessary to better understand the epididymal marker as a determinant whether there is a difference between obstructive and nonobstructive cases.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/115665
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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