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만성신부전환자에서 혈장 단백 C 및 S 의 임상적 의의
이귀순(Kwi Soon Lee),하성규(Sung Kyu Ha),박종훈(Chong Hoon Park),서정건(Jung Kun Seo),이호영(Ho Yung Lee),한대석(Dae Suk Han),송경순(Kyung Soon Song) 대한내과학회 1997 대한내과학회지 Vol.53 No.2
N/A Objectives: Patients with chronic renal failure have increased hemorrhagic tendency due to an uremic platelet dysfunction and complications from anticoagulants used in hemodialysis. They are also prone to have thrombotic complications in the cerebral vessels, coronary arteries and A-V fistula, due to hypercoagulability from changes in various factors. Recently, deficiencies in plasma protein C and S, which are physiological anticoagulants, have been reported to cause thrombosis. In chronic renal failure, plasma protein C and S activities are known to be decreased. Methods: In the present study, activities and antigen concentrations of plasma protein C and S, as well as AT-III activities were investigated in three groups; the normal control group, the predialysis group of chronic renal failure patients treated conservatively, and the hemodialysis group. The findings were analyzed for their relationship to hypercoagulability. Results: 1) The activities of plasma protein C, S and antithrombin-III were significantly lower in the predialysis chronic renal failure group as compared to the control. Antithrombin-III concentrations in the hemodialysis group assayed immediately prior to dialysis were significantly lower than those of the control group. But, protein C antigen concentrations in the hemodialysis group assayed immediately prior to dialysis were significantly higher than those of the control group. There was no significant difference between these groups in plasma protein C activities, and plasma protein S activities and antigen concentrations. 2) In the hemodialysis group, antithrombin-III activities, antigen concentration and activities of plasma protein C were significantly higher than after dialysis as compared to those before the dialysis. 3) There were no significant difference in plasma protein C, S and antithrombin-III activities and plasma protein C and S antigen concentrations in hemodialysis patients between with and without thrombosis at arterio-venous fistula site. However, plasma protein C and antithrombin-III activities were significantly lower in those with thrombosis as compared to those of the normal control group. There were no significant difference in plasma protein C and S activities and antigen concentrations in those without thrombosis as compared to those of the normal control group. 4) There were no significant diffrences in plasma protein C, protein S and antithrombin-III activities and antigen concentrations in dialysis patients with and without recombinant erythropoietin treatment. 5) There were no significant correlations between serum creatinine and creatinine clearance, and plasma antithrombin-III, protein C and protein S activities and antigen concentrations in predialysis group. Conclusion : These results suggest that the decrease in plasma antithrombin-III, protein C and S could be the factors causing hypercoagulability in chronic renal failure patients, and the decreased activities of these factors may return to normal by dialysis. In the hemodialysis group, there were no significant diffrences in plasma protein C and S and antithrombin-III activities and antigen concentrations between the group which showed clinical thrombosis and the group which did not. However, in those who had thrombosis, plasma protein C and antithrombin-III activities are significantly lower than the control group. Administration of recombinant human erythropoietin does not appear to affect the activities of plasma protein C and S and antithrombin-III. In predialysis chronic renal failure patients, there was no significant relationship between renal function and plasma protein C and S and antithrombin-III.
HBsAg 과 Anti - HBs 가 동시 양성예의 임상적 경과 관찰
박효진(Hyo Jin Park),김경희(Kyung Hee Kim),노형근(Hyung Keun Roh),박종훈(Chong Hoon Park),이관식(Kwan Sik Lee),문영명(Young Mung Moon),강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),송경순(Kyung Soon Song) 대한내과학회 1990 대한내과학회지 Vol.39 No.1
N/A To assess the clinical implication of concomitant HBsAg and anti-HBs in patients with HBV infection, we studied the longitudinal behavior of HBsAg, anti-HBs and their subtypes and the correlation of clinical events in 25 patients with concomitant HBsAg and anti-HBs. The results were as follows: 1) Concurrent markers were persistent in 12 (57.1%) out of 21 patients with chronic liver disease. In two patients, anti-HRs was detected intermittently during the follow-up period. In each, the recurrent antibody was persistently heterotypic, and the appearance, disappearance and reappearance of anti-HBs were not associated with alterations in the clinical course. 2) The mean level of anti-HBs was 16.6±17.7 SN ratrio and 61.9% of the patients were less than 10 SN ratio. 3) In the majority of patients, HBsAg subtype ad was accompanied by anti-y. In addition, in two patients with intermittent concomitance the recurrent amtibody was persistently heterotypic. 4) During the follow-up period, acute exacerbations of the disease occurred in four out of 21 patients with chronic hepatitis. All patients were initially HBsAg subtype ad and remained so during and after exacerbation. Therefore, the possibility of reinfection with HBV of a different subtype was not supported. In conclusion, concomitant HBsAg and anti-HBs are not uncommon in patients with acute and chronic hepatitis B and do not reflect changes in the clinical courses. The concomitance is of no practical or prognostic significance, and therefore, the attention devoted to it may be clinically unnecessary.
B형 간염바이러스 표면항원 검색을 위한 Latex agglutination 법에 대한 고찰
허향숙 ( Hyang Suk Hur ),이경원 ( Kyng Won Lee ),양용석 ( Yong Suk Ryang ),송경순 ( Kyung Soon Song ),이삼열 ( Samuel Y. Lee ) 대한임상검사과학회 1985 대한임상검사과학회지(KJCLS) Vol.17 No.1
The study subjects consisted of positive blood serum samples from 151 patients and negative blood serum samples from 56 patients referred for HBsAg test by ELISA in Yonsei University Yeong Dong Hospital during 5 month period from December, 1984 to April, 1985. HBs Ag was tested by latex agglutination, using the original (LA-A) method and the recently developed, modified (LA-B) method separately as well as RPHA. The results were as follows: 1. Of the 151 HBs Ag positive samples confirmed by ELISA, 140(92.7%) were confirmed positive by RPHA, 134(88.7%) by LA-A and 135(89.4%) by LA-B (P>0.05). 2. Of the 56 HBs Ag negative samples confirmed by ELISA 55(98.2%) were shown negative by RPHA, 53(94.6%) by LA-A and 52(92.9%) by LA-B (P>0.05). 3. Of the 142 moderate to strongly reactive samples (O.D>2.0) confirmed by ELISA, 139(97.9`` %) were confirmed positive by RPHA, 133(93.7%) by LA-B (P>0.05). Of the 9 weakly reactive samples (O.D<2.0) reported by ELISA, 1(1 1. 1%) each was shown positive by RPHA and LA-A and 2(22.2%) by LA-B (P>0.05). 4. Comparison of the original latex agglutination (LA-A) and the modified latex agglutination (LA-B) methods showed their predictability levels were 97.7% by LA-A and 97.1 % by LA-B. There was no significant statistical difference between the LA-A and LA-B methods(P>0.05) and a further advantage of the modified method is its economical use of reagents. On the basis mentioned above, we considered these techniques very useful detection methods because both LA-A and LA-B appear to be equivalent about predictability. Also they can be. applied for mass screening of HBs Ag, and as routine tests for private clinics and emergency testing of HBs Ag in blood banks.
HBsAg 과 Anti - HBs 가 모두 양성인 바이러스성 간질환 환자의 아형에 관한 연구
박효진(Hyo Jin Park),이은경(Eun Kyeong Lee),김경희(Kyung Hee Kim),이상인(Sang In Lee),문영명(Young Myung Moon),강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),송경순(Kyung Soon Song) 대한내과학회 1988 대한내과학회지 Vol.34 No.4
N/A Since the presence of concomitant hepatitis B surface antigen and anti-body has been reported by Koziol et al, in blood donors the concomitancy has been evaluated by means of subtyping of HBsAg and anti-HBs. The subtype of HBsAg and/or anti-HBs was essayed through radioimmunoassay in 46 patients with concomitant hepatitis B surface antigen and antibody, and 19 patients with HBsAg positive but anti-HBs negative. The following results were obtained. 1) The concomitant HBsAg/anti-HBs positivity was seen in 18,9% of HBsAg positive patients. 2) In the most of concomitant cases (16.0%), the pattern was indicative of HBsAg/ad in the presence anti-ay, non-neutralized antibody. 3) The ad subtype of HBsAg in control group and concomitant group were 94.7%, 84.8%, respectively. And among 46 cases of concomitant group, the subtype of anti-HBs was anti-ay in 39 (84.7%). 4) No significant correlation was noted between the subtypes found and severity of the clinical disease. 5) In concomitant subjects. the mean S/N ratio of HBsAg was 73.9±25.3 and positive rate of HBeAg was 71,7%. In patients with HBsAg(+)/anti-HBs (-), the mean S/N ratio of HBsAg as 79.7±10.5 and positive rate of HBsAg was 78.9%, and there was no significant statistical significance between concomitant group and control group. In conclusion, the majority of subtype of HBsAg was ad in Korea and the most common pattern of subtypes in concomitant cases was ad in HBsAg and anti-ay in anti-HBs. In concomitant cases, there were various patterns of clinical entity and serologic profiles and it may provide a clue to lack of complete protection against HBV in some persons after earlier HBV infection.
중합연쇄반응 제한효소 단편 장다형을 이용한 듀센형 근이영양증 산전 진단
차동현(Dong Hyun Cha),이국(Kook Lee),최종락(Jong Rak Choi),송경순(Kyung Soon Song) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.6
목적 : 듀센형 근이영양증(이하 DMD)은 X-염색체 열성으로 유전되며, 디스트로핀 유전자의 변이로부터 발생한다. DMD의 산전진단에 있어서 중합 연쇄반응 제한효소 단편 장다형의 효율성을 보고자 한다. 연구 방법 : DMD 가계원의 혈액과 태아의 양막세포로부터 DNA를 추출하였고, 5개의 RFLP probe를 이용하여 중합 연쇄반응 제한효소 단편 장다형을 시행하였다. 결과 : 가계 A는 다양한 엑손 결실(6, 8, 12, 13, 17)이 관찰된 가계로서 산모는 pERT84에 이형접합을 보였고, 태아는 DMD 환자와 같은 대립형질을 나타내었고, 유전자형(genotype) 검사상 역시 같은 엑손 결실을 나타내어, 18주에 임신 종결하였다. B 가계의 산모는 pERT84와 pERT87-15에서 이형접합을 보였고, 보인자로 생각되며, 태아는 DMD 환자와 다른 대립형질을 가져 재조합이 없다면 정상으로 생각되었다. C 가계의 산모는 pERT84에서 이형접합을 보였으며, 태아는 역시 환자와 다른 대립형질을 가져 정상으로 생각되었다. 두 가계의 태아는 현재 분만되었고, 정상적으로 생활하고 있으며 추적 관찰 중이다. 결론 : DMD의 예방에는 산전진단이 무엇보다도 중요하다. 중합 연쇄반응 제한효소 단편 장다형은 DMD를 진단하는데 있어서 매우 신속하고 정확한 검사법으로서, 특히 임신 초에 진단이 가능하여 산전진단에 유용하리라 생각된다. Objective : Duchenne muscular dystrophy(DMD) is a X-linked recessive disease and results from mutation in the dystrophin gene. In this study, we evaluate the efficacy of polymerase chain reaction-restriction fragment length polymorphism in prenatal genetic diagnosis of DMD.Methods : DNA was isolated from DMD family's blood and fetal amniocyte and used to perform PCR-RFLP. In DMD family(3 cases), linkage analysis was tried with 5 RFLP probes.Results : DMDs of the family A had mutiple exon deletions(6, 8, 12, 13, 17). The mother was a heterozygote of pERT84;MaeIII. The male fetus had a same allele and also same exon deletions with the affected males. The pregnancy was terminated at IUP 18 gestational weeks. Pregnant woman of the family B was heterozygote of both pERT84;MaeIII and pERT87-15;BamHI, and pregnant woman of the family C was of pERT84;MaeIII. The both male fetuses , as compared with the affected male of each family, had a different allele. Thus, the fetuses were probably not affected with a confidence level of 95%. Conclusion : Prenatal diagnosis in prevention of DMD is most important. PCR-RFLP analysis in DMD family is rapid and useful diagnostic tool.