말기 신부전 환자에서 투여 경로에 따른 유전자 재조합 인 Erythropoietin(Epokine^(�))의 효과와 안정성에 대한 연구 : 제 4상 연구 A Phase 4 Single Center Study

송현용,윤향숙,강신욱,최규헌,하성규,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

목 적 : 국내 독자적 기술로 첫 개발된 유전자 재조합 인 에리트로포에틴(Epokineⓡ)의 투여방법에 따른 유효성과 안정성을 알아보고자 하였다. 방 법 : Epokineⓡ을 주당 100-150 U/kg, 주 2회, 12주간 피하 주사하여 목표 또는 안정된 혈색소치 유지 후 무작위로 피하 및 정맥 주사군으로 나누어 12주간 혈액투석 및 복막투석 환자13명, 28명에서 유효성, 안정성을 분석하였다. 결 과 : 양군에서 혈색소치와 헤마토크릿은 Epokineⓡ 투여 2주 후부터 증가, 혈색소치가 혈액투석 환자는 투여 전 7.3 g/dL, 투여 12주 9.5 g/dL, 24주 10.6 g/dL로, 복막투석 환자는 6.8g/dL에서 12주 10.2 g/dL, 24주 10.8 g/dL로 증가하였다. 양군에서 교정 망상적혈구수(%)는투여 1주 후부터 전 기간동안 증가하였다. 혈청 내 철분, ferritin치는 양군에서 투여 2주 후부터감소, 총 철분 결합능은 투여 2주 후부터 증가하였다. 12주째 혈액투석 환자에서 많은 Epokineⓡ용량이 필요했으나(142.2±20.5 vs 117.3±33.6 U/kg/wk, p<0.001) 24주 후 양군의 용량차이는 없었다(123.6±41.5 vs 99.2±49.3 U/kg/wk, p>0.05). 혈액투석 환자에서 피하 주사가Epokineⓡ 투여용량이 더 적었으나(97.4±15.4 vs 145.4±2.9 U/kg/wk, p<0.002) 복막투석 환자는 차이가 없었다(93.0±60.2 vs 105.4±9.7 U/kg/wk, p>0.05) 연구기간 중 9명(18.8%)에서혈압강하제 추가가 필요한 혈압상승, 근육통 동반 상기도 감염 유사증상 및 두통 등의 부작용이 있었다. 대부분 자연소실 혹은 대증요법으로 치유되었고 2명이 부작용으로 탈락하였다. 결 론 : 말기 신부전 환자의 빈혈 개선에 사용하는 Epokineⓡ의 효과는 복막투석 환자에서 더 좋았으며 투여 경로는 정맥주사보다 피하주사가 높음을 알 수 있었다. Background : We evaluated the clinical efficacy and safety of recombinant human erythropoietin(Epokine^(ⓡ)). Methods : A comparative prospective study of intravenously and subcutaneously administrated Epokine^(ⓡ) conducted 13 patients performing hemodialysis and 28 patients performing continuous ambulatory peritoneal dialysis with end-stage renal disease. Epokine^(ⓡ) was given initially at a dosage of 100 unit/kg, subcutaneously, two times a week. The patients had achieved stable or more than 10 g/dL of hemoglobin level for 12 weeks and then we randomized switching intravenously or subcutaneously administrated Epokine^(ⓡ) for another 12 weeks. Results : Hemoglobin(g/dL) and hematocrit(%) increased significantly from baseline levels beginning from 2 weeks after Epokine^(ⓡ) administration. In HD patients, hemoglobin increased significantly from 7.3 to 9.5 after 12 weeks and to 10.6 after 24 weeks. In CAPD patients, hemoglobin increased significantly from 6.8 to 10.2 after 12 weeks and then 10.8 after 24 weeks(p<0.05). Corrected reticulocyte count(%) was significantly increased from baseline levels beginning from 1 week after Epokine^(ⓡ) administration and continuously increased during study period in both group. Serum ferritin and serum iron decreased significantly and total iron binding capacity increased significantly after 2 weeks. At 12 weeks, HD patients were significantly needed more dosage of Epokine^(ⓡ) than CAPD patients(142.2±20.5 vs 117.3±33.6 U/kg/wk, p<0.001), but at 24 weeks, the dosage was not different(123.6±41.5 vs 99.2±49.3 U/kg/wk, p> 0.05). In HD patients, intravenously administrated Epokine^(ⓡ) group was more dosage than subcutaneously group(97.4±15.4 vs 145.4±2.9 U/kg/wk, p< 0.002), but CAPD patients were not different by administration method(93.0±60.2 vs 105.4±9.7 U/kg/ wk, p>0.05). The 9 cases(18.8%) were suffered from headache and flu-like syndrome, but these side effects were not severe and disappeared from conventional therapy. Conclusion : Epokine^(ⓡ) administration is safe and effective in treating anemia of ESRD patients and subcutaneously administration is significantly more effective than intravenously. (Korean J Nephrol 2002;21(2):190-198)

국내 Fabry disease 환자의 a-Galatosidase A 유전자 돌연변이 검색

박기범,최지혜,강윤성,김선미,정향민,문영준,이광호 中央大學校 基礎科學硏究所 2001 基礎科學硏究所 論文集 Vol.15 No.-

Fabry disease(FD) is an X-linked recessive lysosomal disorder caused by a deficiency of a-galactosidase A(a-Gal A), localized at Xq22. Besides onset of pain and paresthesias in the extremities, FD was diagnosed by absence of a-Gal A activity. In this experiment the a-Gal A activity of Korean FD patients was spectrometrically analysed using an artificial substate, 4-Mrthylumbellifery1-a-D-galactoside. As expected, no a-Gal A activity was detected in lymphocytes and lymphoblastoid cells from FD patients. To screen the mutation in their a-Gal A genes, we performed single strand conformation polymorphism(SSCP) and PCR-direct sequencing form seven a-Gal A exons. The nonsense mutation was identified both in classically affected hemyzygotes and a heterozygote. They showed the C to T transition at nucleotide number 11,002, resulting in a arginine-to-stop(R342X). This result will be applicable for pre- and neonatal detection of FD and to define the genotype/phenotype correlation.

Characterization of Isolated Yeast from Fermented Grains of Chinese Liquor

Hyang-Sik Yoon,So Yoon Lee,Ye-Rin Ju,Hye-Jeong Kang,Hyun-Ju Eom,In Jae Kim,Youngho Kim 한국식품영양과학회 2020 한국식품영양과학회 학술대회발표집 Vol.2020 No.10

Development of analysis method for pyrifluquinazon residues in agricultural commodities

Se Ra Won,Nam Suk Kang,Yoon Jung Kang,Ho Won Chang,Sung Ho Woo,Hyang Min Ahn,Su Jin Kim,Su Zie Choi,Si Woo Bark,Gil Ran Kang,Gyeong Jun Kim,Jae I Kim,Tae Seok Kang,Woo Seong Kim 한국분석과학회 2016 학술대회논문집 Vol.2016 No.11

Dysfunction of Vascular Smooth Muscle and Vascular Remodeling by Simvastatin

Kang, Seojin,Woo, Hyang-Hwa,Kim, Keunyoung,Lim, Kyung-Min,Noh, Ji-Yoon,Lee, Moo-Yeol,Bae, Young Min,Bae, Ok-Nam,Chung, Jin-Ho Oxford University Press 2014 TOXICOLOGICAL SCIENCES Vol.138 No.2

<P>Statins, inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, are widely prescribed for hypercholesterolemia. With the increasing use of statins, numerous reports demonstrated that statins can cause damage to skeletal muscles. However, the toxicities of statins on vascular smooth muscle, which are essential to cardiovascular homeostasis, have not been previously described. Here, we examined the effects of simvastatin on the contractile function and the integrity of vascular smooth muscle in isolated rat thoracic aortic rings, primary cultured vascular smooth muscle cells (VSMCs) <I>in vitro</I> and rats <I>in vivo</I>. In aortic rings, simvastatin suppressed the normal agonist-induced contractile responses in time- and concentration-dependent manners (0.86 g ± 0.11 at 10μM simvastatin for 24 h compared with 1.89 g ± 0.11 at control). The suppression persisted in the endothelium-denuded aortic rings and was irreversible even after wash-out of simvastatin. Simvastatin suppressed the contraction induced by Bay K8644, an activator of voltage-operated Ca<SUP>2+</SUP> channel (VOCC) in rat aortic rings and abolished agonist-induced intracellular Ca<SUP>2+</SUP> increase in VSMCs. The simvastatin-induced contractile dysfunction was reversed by the supplementation of mevalonate and geranylgeranylpyrophosphate, precursors for protein isoprenylation. Consistently, activation of RhoA, a representative isoprenylated protein, was disrupted by simvastatin in VSMCs and RhoA-mediated phosphorylation of MYPT1 and CPI-17, and tonic tension were also suppressed. Notably, prolonged treatment of simvastatin up to 48 h induced apoptosis of vascular smooth muscle in aortic rings. Most importantly, simvastatin treatment <I>in vivo</I> significantly attenuated the agonist-induced vasoconstriction in rats <I>ex vivo</I> and induced a decrease in luminal area of the vascular wall. Collectively, these results demonstrate that simvastatin can impair the normal vascular contractility by disturbing Ca<SUP>2+</SUP> influx and RhoA activity, ultimately leading to apoptosis and structural remodeling.</P>

Health-Related Quality of Life and Its Determinants in Chronic Cough: The Korean Chronic Cough Registry Study

Kang Noeul,Won Ha-Kyeong,Lee Ji-Hyang,Shim Ji-Su,Kang Sung-Yoon,박한기,Jo Eun-Jung,Lee Seung Eun,Kim Min-Hye,Kim Sang-Heon,Kim Sae-Hoon,장윤석,Lee Byung-Jae,Song Woo-Jung,Jo Min-Woo 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.3

Purpose: Chronic cough (CC) is associated with health-related quality of life (HRQoL) impairment. However, the determinants of HRQoL are under-investigated. Methods: Patients aged 19–80 years with CC were prospectively recruited from 10 referral clinics. Comparisons were made with age- and sex-matched controls (1:4 ratio) selected from a Korean general population survey database; 1) a group without current cough (non-cough controls) and 2) another group without major chronic illnesses (healthy controls). HRQoL was assessed using the EuroQoL 5-dimension (EQ-5D) index. In CC patients, cough-specific patient-reported outcomes (PROs) were additionally measured. Cross-sectional analyses were performed to evaluate demographic and clinical parameters associated with the EQ-5D index of CC patients. Results: A total of 200 CC patients (137 newly referred with CC and 63 refractory or unexplained CC [RUCC] patients), 800 non-cough controls, and 799 healthy controls were analyzed. The EQ-5D index of CC patients was significantly lower than that of non-cough controls or healthy controls (0.82 ± 0.14 vs 0.92 ± 0.14/0.96 ± 0.08; P < 0.001, respectively). The index was also associated with older age (≥ 60 years), female sex, and comorbidities such as asthma or depression. Among the patients with CC, the index was significantly lower in patients with RUCC than in those with newly referred CC, being treated with codeine or cough neuromodulators, or with cough-related fatigue. In Spearman analyses, the EQ-5D index correlated with cough-specific quality of life and cough severity scores, not with throat sensation or cough trigger scores. Conclusions: The HRQoL impairment of CC patients was associated with older age, female sex, and comorbidities but it was also affected by cough severity, complications, treatments, and treatment responses. Longitudinal studies are warranted to further understand and improve the HRQoL of CC patients.

Is hyponatremia in peritoneal dialysis patients related to mortality?

( Yoon Jung Choi ),( Seok Hui Kang ),( Jun Young Do ),( Kyu Hyang Cho ),( Jong Won Park ),( Kyung Woo Yoon ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1

Background: There are few reports on the incidence, etiology and mortality of peritoneal dialysis (PD) patients with hyponatremia. Patients and Methods: We identified all the adults who received. Hyponatremia was defined as a serum sodium concentration <135 mmol/L. We enrolled 99 patients who did not show hyponatremic episodes and 297 who showed hyponatremia during follow-up. For evaluating the volume status, all the patients underwent bioelectrical impedance analysis. Results: The incidence of hyponatremia increased as the grade of the Davies risk index increased. The most common cause of hyponatremia was a sodium chloride deficit (39.5%). On the univariate analysis, old age, the presence of hyponatremia during follow-up, hypoalbuminemia, a low residual renal function (RRF) and a high comorbid condition were associated with mortality. On the multivariate analysis, old age, hypoalbuminemia, low RRF and a high comorbid condition were associated with mortality. Conclusion: Accurate evaluation of TBW is important for verifying the etiology of hyponatremia and for treating it. The risk for hyponatremia was associated with higher comorbidity in the PD patients. For the prevention or management of hyponatremia in the PD patients, we would pay more attention to correct any fluid-electrolyte abnormalities and also the underlying comorbidity.

Endocrine dysfunctions in children with Williams- Beuren syndrome

Yoon-Myung Kim,Ja Hyang Cho,Eungu Kang,Gu-Hwan Kim,Eul-Ju Seo,Beom Hee Lee,Jin-Ho Choi,Han-Wook Yoo 대한소아내분비학회 2016 Annals of Pediatirc Endocrinology & Metabolism Vol.21 No.1

Purpose: Williams-Beuren syndrome (WBS) is caused by a hemizygous microdeletion of chromosome 7q11.23 and is characterized by global cognitive impairment, dysmorphic facial features, and supravalvular aortic stenosis. Endocrine dysfunctions have been reported in patients with WBS. This study was performed to investigate the frequency, clinical features, and outcomes of endocrine dysfunctions in children with WBS. Methods: One hundred two patients were included. The diagnosis was confirmed by chromosome analysis and fluorescent in situ hybridization. Medical charts were reviewed retrospectively to analyze endocrine dysfunctions such as short stature, precocious puberty, thyroid dysfunctions, and hypocalcemia. Results: The age at diagnosis was 3.7±4.4 years (one month to 19 years). Height- and weight-standard deviation score (SDS) were –1.1±1.1 and –1.4±1.4 at presentation, respectively. Short stature was found in 26 patients (28.3%) among those older than 2 years. Body mass index-SDS increased as the patients grew older (P<0.001). Two males and one female (2.9%) were diagnosed with central precocious puberty. Nine patients (8.8%) were diagnosed with primary hypothyroidism at age 4.0±4.3 years (one month to 12.1 years); their serum thyroid stimulating hormone and free T4 levels were 15.2±5.4 μU/mL and 1.2±0.2 ng/dL, respectively. Hypercalcemia was observed in 12 out of 55 patients under age 3 (22%) at the age of 14.3±6.6 months (7 to 28 months) with a mean serum calcium level of 13.1±2.1 mg/dL. Conclusion: Endocrine dysfunctions are not uncommon causes of morbidity in patients with WBS. The severity and outcomes of their endocrine manifestations were heterogeneous. Long-term follow-up is needed to predict the prognosis of endocrine features.

Is hyponatremia in peritoneal dialysis patients related to mortality?

( Yoon Jung Choi ),( Seok Hui Kang ),( Jun Young Do ),( Kyu Hyang Cho ),( Jong Won Park ),( Kyung Woo Yoon ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-

Factors associated with positive consequences of serving as a family caregiver for a terminal cancer patient

Kang, Jina,Shin, Dong Wook,Choi, Ji Eun,Sanjo, Makiko,Yoon, Soo Jin,Kim, Hwan Kyun,Oh, Myoung Suk,Kwen, Hyang Suk,Choi, Hae Young,Yoon, Wook Hee John Wiley Sons, Ltd 2013 PSYCHOONCOLOGY Vol.22 No.3

<P><B>Abstract</B></P><P><B>Background</B></P><P>We examined factors associated with positive consequences for family members who served as caregivers of terminal cancer patients.</P><P><B>Methods</B></P><P>We conducted a nationwide cross‐sectional survey of 501 bereaved family members who served as caregivers for terminal cancer patients. The main outcomes were measured by the previously developed Caregiving Consequences Inventory, which assesses perceived rewards and burdens of caregiving.</P><P><B>Results</B></P><P>Bereaved family caregivers reported high levels of perceived rewards and burden. Among the characteristics of bereaved family members, older age, female gender, and having a religion were associated with some domains of perceived rewards, but being a spouse of a patient was negatively associated with some domains of perceived rewards. Caregiver depression or perceived burden did not affect positive consequences of caregiving. However, receiving bereavement care was significantly associated with positive outcome in all four perceived reward domains (sense of mastery [adjusted odds ratio {aOR} = 1.69; 95% CI, 1.05–2.70]; appreciation for others [aOR = 2.19; 95% CI, 1.27−3.76]; meaning in life [aOR = 1.80; 95% CI, 1.13–2.89]; and reprioritization about his/her life [aOR = 2.02; 95% CI, 1.27–3.19]).</P><P><B>Conclusions</B></P><P>Family caregivers of terminal cancer patients experience burdens, but caregiving also has positive consequences. This study has important implications for the development of bereavement interventions that aim to encourage positive outcomes and reduce negative outcomes for caregivers.</P><P>Copyright © 2012 John Wiley & Sons, Ltd.</P>