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Bortezomib Induced Tumor Lysis Syndrome in Multiple Myeloma
Shinae Yu,Sung Woo Ryu,Kyoung-Ha Kim,Se-Hyoung Kim,Nam-Su Lee,Sung-Kyu Park,Jong-Ho Won 순천향대학교 순천향의학연구소 2013 Journal of Soonchunhyang Medical Science Vol.19 No.1
The tumor lysis syndrome (TLS) commonly occurs in the lymphoproliferative disorder, either spontaneously or in response to therapy. TLS is uncommon in multiple myeloma. However, with the use of bortezomib in the treatment of multiple myeloma, cases of TLS have been reported. We report here threepatients who presented with TLS after the administration of bortezomib. Two of them presented mild symptoms and recovered with hydration only. However, death of the other patient was associated with TLS. We should monitor patients who had high tumor burden, especially in early phase of bortezomib therapy and appropriate prophylaxis for high risk patient is also needed.
Shinae Yu,Hee Jae Huh,Kyo Won Lee,Jae Berm Park,Sung Joo Kim,Wooseong Huh,Hye Ryoun Jang,Ghee Young Kwon,Hyung Hwan Moon,Eun-Suk Kang 대한진단검사의학회 2020 Annals of Laboratory Medicine Vol.40 No.5
Background: Non-HLA antibodies, anti-angiotensin II type 1 receptor antibodies (anti-AT1R) and anti-endothelial cell antibodies (AECA), are known to play a role in allograft rejection. We evaluated the role of both antibodies in predicting post-transplant outcomes in low-risk living donor kidney transplantation (LDKT) recipients. Methods: In 94 consecutive LDKT recipients who were ABO compatible and negative for pre-transplant HLA donor-specific antibodies, we determined the levels of anti-AT1Rs using an enzyme-linked immunosorbent assay and the presence of AECAs using a flow cytometric endothelial cell crossmatch (ECXM) assay with pre-transplant sera. Hazard ratio (HR) was calculated to predict post-transplant outcomes. Results: Pre-transplant anti-AT1Rs (≥11.5 U/mL) and AECAs were observed in 36 (38.3%) and 22 recipients (23.4%), respectively; 11 recipients had both. Pre-transplant anti-AT1Rs were a significant risk factor for the development of acute rejection (AR) (HR 2.09; P=0.018), while a positive AECA status was associated with AR or microvascular inflammation only (HR 2.47; P=0.004) throughout the follow-up period. In particular, AECA (+) recipients with ≥11.5 U/mL anti-AT1Rs exhibited a significant effect on creatinine and estimated glomerular filtration rate (P<0.001; P=0.028), although the risk of AR was not significant. Conclusions: Pre-transplant anti-AT1Rs and AECAs have independent negative effects on post-transplant outcomes in low-risk LDKT recipients. Assessment of both antibodies would be helpful in stratifying the pre-transplant immunological risk, even in low-risk LDKT recipients.
A Review of HLA Genes in Pharmacogenetics: Risk Assessment of Adverse Drug Reactions
Yu, Shinae Interdisciplinary Society of GeneticGenomic Medici 2021 Journal of interdisciplinary genomics Vol.3 No.1
Adverse drug reactions (ADRs) is a hypersensitivity reactions to specific medications, and remain a common and major problem in healthcare. ADRs suchc as drug-induced liver injury and life-threatening severe cutaneous adverse drug reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug rash with eosinophilia and systemic symptoms can be occurred by uncontrolled expansion of oligoclonal T cells according to genetically predisposing HLA. In this review, I summarized the alleles of HLA genes which have been proposed to have association with ADRs caused by different drugs.
Establishment of Critical Difference for Diagnostic Immunoassays
Shinae Yu,문수영,신경화,이선민,Chul Min Park,Kyung Ran Jun 대한임상검사정도관리협회 2022 Journal of Laboratory Medicine And Quality Assuran Vol.44 No.2
Background: Critical difference (CD) is a significant difference between sequential laboratory results in a patient and is a major parameter for comparative evaluation of quantitative clinical laboratory tests, and how significant the difference is should be set by the laboratory itself. In this study, we established the criteria for CD that can be referenced in each laboratory for diagnostic immunoassays. Methods: We targeted 17 major diagnostic immunoassays as follows: alphafetoprotein (AFP), cancer antigen 125 (CA125), cancer antigen 15-3 (CA15- 3), cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), prostatespecific antigen (PSA), free PSA, tri-iodothyronine (T3), thyroxine (T4), free T4, thyroglobulin, thyroid-stimulating hormone (TSH), estradiol (E2), folliclestimulating hormone (FSH), luteinizing hormone (LH), testosterone, and prolactin. According to Clinical and Laboratory Standards Institute EP31, we investigated acceptance criteria for CD based on clinical outcomes, clinician’s questionnaire, biological variation, published professional recommendations, goals set by accrediting agencies, and general capability in the Korean Association of External Quality Assessment Service. Results: We selected the acceptance criteria for CD as follows: 6.0% for total PSA and TSH based on well-designed clinical study’s outcomes; 20.0% for AFP, CA19-9, CEA, and free PSA, 10.0% for T3, 14.3% for T4, 12.5% for free T4, 16.9% for thyroglobulin, 22.2% for E2, 22.9% for FSH, 20.0% for LH, 10.0% for testosterone, and 25.0% for prolactin based on clinician’s questionnaire; 8.4% for CA125 and 10.2% for CA15-3 based on general capability. Conclusions: Applying the acceptance criteria for CD from this study may help assess the comparability of the quantitative tests in routine laboratory practice.
Lee, Jun Ho,Yu, Shinae,Lee, Ja Young,Kim, Yeon Mee,Lee, Dong Ah,Kim, Sung Eun The Korean Society of Clinical Neurophysiology 2022 Annals of Clinical Neurophysiology Vol.24 No.2
Primary central nervous system lymphoma (PCNSL) is a type of non-Hodgkin lymphoma confined to the central nervous system. Its diagnosis requires a stereotactic biopsy, which is an invasive procedure. Cerebrospinal fluid (CSF) analysis is less invasive and easier to perform than a stereotactic biopsy. We hereby report a PCNSL case diagnosed using CSF analysis and treated with systemic chemotherapy.