목 적 : 침습성 눈물막파괴시간(TBUT, invasive tear break-up time)과 비침습성 눈물막파괴시간 (NIBUT, noninvasive tear break-up time) 검사법의 정확도를 비교하고자 하였다. 방 법 : 안질환이 없으며 굴절교정수술을 받지 않은 20대 대학생 56명(112안)을 대상으로 TBUT는 Fluorescein strip을 사용하여 측정하였고, NIBUT는 Keratograph 5M(K5M), Wavefront Analyzer (KR-1W), Auto refractor keratometer(KR-8100P)을 사용하여 측정하였다. 건성안 감별(screening) 기준 은 OSDI(ocular surface disease index) 설문지를 사용하였다. 각 측정값의 일치도 분석은 Bland & Altman Plot을 사용하여 확인하였고, 검사값의 정확도는 ROC(receiver operating characteristic) curve를 이용하여 민감도(sensitivity) 및 특이도(specificity), AUC(area under the curve), cut-off 값을 비교하여 분석하였다. 결 과 : TBUT는 NIBUT보다 유의하게 짧았고(p<0.05), KR-1W, KR-8100P, K5M으로 측정한 NIBUT 값들은 서로 유의한 차이가 없었다(F=2.69, p=0.06). NIBUT 검사값은 서로 중등도의 상관성을 보였지만 (r=0.36,0.44,0.35), TBUT는 K5M로 측정한 NIBUT와 상관성이 있었다. 검사법 상호간의 일치도 분석에서 TBUT와 NIBUT는 차이가 있었고, NIBUT 값들은 상호간 차이가 없었다. 건성안 유무 감별에 대한 민감도와 특이도는 각각 TBUT 검사법에서 25%, 80%, KR-1W 검사법에서 50%, 69%, KR-8100P 검사법에서 86%, 34%, K5M 검사법에서 31%, 82%로, 민감도는 KR-8100P 검사법이 가장 높았고, 특이도는 K5M 검사법이 가장 높았다. 결 론 : NIBUT 검사법은 TBUT 검사법보다 정확도가 높고, 검사법 상호간의 일치도가 우수하며, 건성안 감별에 KR-8100P 측정값이 유용하게 사용될 수 있을 것으로 사료된다.

Calcium exerts antiproliferative effects on cellular targets through the promotion of differentiation and apoptosis. We investigated the influence of calcium on the formation of colonic aberrant crypt foci (ACFs), which were induced by exposure to azoxymethane (AOM) followed by dextran sodium sulfate (DSS), in ICR mice. Six-week-old ICR mice received 3 (weeks 0–2) intraperitoneal injections of AOM (10 mg/kg BW), followed by treatment with 2% DSS via drinking water for a week to induce preneoplastic lesions. The mice were then divided into 3 groups: the control (AOM/DSS), AOM/DSS + 1.0% Ca, and AOM/DSS + 2.0% Ca groups. Calcium (1.0 or 2.0%) was administered via drinking water for 12 weeks. After sacrificing the mice, the total numbers of aberrant crypts (ACs) and ACFs were measured in the colonic mucosa after methylene blue staining. The control group displayed 11.58 ± 2.43 ACFs/colon, which were composed of a total of 30.42 ± 5.18 ACs/colon. The number of ACFs with more than 3 ACs, which are likely to progress to colon cancer, was 2.37 ± 0.68. Compared to the control, 1.0% or 2.0% calcium treatment significantly decreased the number of total ACFs and ACs in a concentration-dependent manner. The decrease in ACFs or ACs after calcium treatment was associated with decreases in cell proliferation and β-catenin expression and an increase in apoptosis in colonic mucosal cells. These results suggest that calcium may exert a protective effect against colon cancer by inhibiting the development of ACFs/ACs in ICR mice.