만성 신부전 환자에서 호모시스테인 대사와 고호모시스테인 혈증의 임상적 의의

윤견일(Kyun Il Yoon) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.1

N/A

Heparin 백서 사구체 메산지움 배양세포의 중식에 미치는 영향

강덕희(Duk Hee Kang),윤견일(Kyun Il yoon),강신욱(Shin Wook Kang),최규헌(Kyu Hun Choi),이호영(Ho Yung Lee),한대석(Dae Suk Han) 대한내과학회 1996 대한내과학회지 Vol.51 No.3

N/A Objectives: Glomerular mesangial cells are the main component of human glomerulus, and exist as a quiescent state in normal healthy kidney. It is now apparent that mesangial cells do not act as a mere framework within the glomerular tuft, but that these cells can undergo striking phenotypic transformation after an exposure to a variety of such as platelet derived growth factor(PDGF) and epidermal growth factor(EGF). Proliferation of mesangial cells is a prominant histologic feature of various glomerular diseases in human as well as in experimental animal. Because glomerular mesangial cells have direct relation with glomerular function through their contractility and proliferation, the inhibitory effects on cell proliferation can result in preventing or delaying the progression of renal disease into end stage renal failure. Heparin is a highly sulfated glycosaminoglycan with anticoagulant activity. It has also been shown that heparin exhibits antiproliferative effects in cultured vascular smooth muscle cells and can ameliorate glomerular injury in some animal model. Methods: The present study was undertaken to characterize the inhibitory effects of heparin on PDGF- and EGF-induced proliferation of mesangial cells isolated from male Sprague-Dawley rat in vitro. Also to examine whether this antiproliferative effects of heparin is related with anticoagulant activity, the effect on the PDGF-induced mesangial cell proliferation was assessed using N-desulfated and N-desulfated N-acetylated heparin which showes no anticoagulant effects. Results: 1) PDGF stimulated the DNA synthesis of glomerular mesangial cell assessed by 3H-thymidine uptake in a dose-dependent manner. At a concentration of 10ng/ml, 3H-thymidine uptake was significantly increased compared to the control value (512,0±38.6 vs. 3300.0±432,5cpm, p<0.05) 2) EGF also induced a significant increase of DNA synthesis of cultured mesangial cell, and at the concentrations of 5ng,ml or higher, the increases in DNA synthesis assessed by 3H-thymidine uptake were statistically significant compared to the control value(428.0±50.4 vs. 1618.0±219.7cpm, p<0.05). 3) Intact heparin caused a dose-dependent inhibition of PDGF-induced DNA synthesis of mesangial cells. At a concentration of 1 ㎍/ml of heparin, 36.7% of inhibition in DNA synthesis of mesangial cell was found. At a concentration of 25, 100 and 500㎍ /ml of heparin, PDGF-induced 3H-thymidine uptake of mesangial cell was reduced by 44.4%, 56.2% and 69.8%, respectively. Chondroitin sulfate and N-desulfated N-acetylated heparin also caused a significant inhibition of PDGF-induced DNA synthesis at the concentraion of 25㎍/ml or higher. However, N-desulfated heparin showed no significant inhibitory effects on PDGF-induced proliferation of mesangial cell at all concentrations. 4) Intact heparin, N-desulfated N-acetylated he- parin and chondroitin sulfate caused a significant inhibition of EGF-induced DNA synthesis only at the highest concentration of 500o㎍/ml. 5) Cell count assessment by hemocytometer revealed the similar results with 3H-thymidine uptake. Conclusion : Heparin had an inhibitory effect on the PDGF-induced DNA synthesis and proliferation of mesangial cell. These antiproliferative effects appear to be unrelated to the anticoagulant effects of heparin, and mediated by selective inhibition of protein kinase C-dependent pathway of mesangial cell proliferation. Further studies utilizing in-vivo glomerulonephritis model are warranted to clarify the potential benefit of heparin in the treatment of glomerulonephritis and to document expected effects of heparin in delaying the progression of glomerulonephritis into end stage renal failure.

승모판막질환에서의 M - mode 심초음파검사소견에 관한 연구

이우형 ( Woo Hyung Lee ),윤견일 ( Kyun Il Yoon ),신길자 ( Gil Ja Shin ),이순남 ( Soon Nam Lee ),길선연 ( Sun Youn Kil ) 대한내과학회 1983 대한내과학회지 Vol.26 No.3

증례 : 위기저부 중복환자에서 빈혈 및 장이상회전증을 동반한 1 예

이우형 ( Woo Hyung Lee ),윤견일 ( Kyun Il Yoon ),신길자 ( Gil Ja Shin ),이순남 ( Soon Nam Lee ),이영규 ( Young Kyu Lee ) 대한내과학회 1983 대한내과학회지 Vol.26 No.3

만성신부전증 환자의 혈중 세로토닌농도에 관한 연구

천은미(Eun Mee Cheon),윤견일(Kyun Il Yoon),강덕희(Duk Hee Kang) 대한내과학회 1995 대한내과학회지 Vol.49 No.3

N/A Objectives: Serotonin (5-hydroxytryptamine) is a vasoactive agent that influence coronary arterial tone during platelet aggregation and deposition, and high levels of serotonin contribute to hypertension in some patients. In addition, serotonin has recently been implicated in the pathogenesis of ischemic heart disease. The serotonin status of patients in chronic renal failure is not clear. Although there were several re- ports about the concentration and role of serotonin in chronic renal failure patients, no concordent data were available only with the results of possible relationship with hypertension and pruritus in these patients. Methods: We studied 55 patients with chronic renal failure (CRF with conservative treatment(n=10), hemodialysis (n=35), continous ambulatory peritoneal dialysis (n=10)), compared to normal healthy groups (n=20) in order to investigate the level of whole blood and serum serotonin according to the different modality of renal replacement therapy and also to know the possible association with the presence of ischemic heart disease and pruritus. Results: 1) The levels of serotonin decreased significantly in hemodialysis patients (serum ; 58±22 ng/ml, whole blood; 5.6±3.6 μg/dl) compared to normal control group (serum ; 151±45ng/ml, whole blood ; 6.8±2.9μpg/dl, p<0.01) and CAPD patients (serum ; 134±26ng/ml, p<0.01). 2) The whole blood serotonin levels in hemodialysis patients showed significant correlation with the peripheral blood platelets count (r=0.3295, p<0.05). 3) In hemodialysis patients, serum serotonin concentration increased significantly with the time of dialysis (p<0.01), although whole blood serotonin concentration showed constant level during dialysis. 4) Whole blood serotonin levels of hemodialysis patients with ischemic heart disease increased significantly compared to the patients without ischemic heart disease (7.1±3.4μg/dl vs. 4.9±2.3μg/dl, p<0.005). 5) There was no statistically significant difference in serotonin concentration in relation to the presence of pruritus. Conclusion. This study suggests that the level of serotonin decreased significantly in hemodialysis patients and serum serotonin concentration increased significantly with the time of hemodialysis.

혈액 투석 환자에서 Recombinant Human Erythropoietin ( rHuEpo ) 치료가 혈중 Lipoprotein ( a ) [ Lp ( a ) ] 를 포함한 지질 농도에 미치는 영향

강덕희(Duk Hee Kang),윤견일(Kyun Il Yoon) 대한내과학회 1996 대한내과학회지 Vol.51 No.5

N/A Objectives: The efficacy of rHuEpo in the correction of renal anemia has been well established resulting in theoretical benefits on cardiac function with the regression of left ventricular dilatation. However, hypertension and thrombogenic complications can be developed with rHuEpo therapy, which impose the deleterious effects on cardiovascular system. Moreover there has been no study into the effects of rHuEpo on uremic dyslipidemia which may also contribute to an increased cardiovascular mortality in dialysis patients. Methods: The present prospective study was undertaken to evaluate the effects of rHuEpo on lipid profiles including Lp (a) in 22 (M:F 12:10) maintenance HD patients. rHuEpo was started at a dose of 2000 unit, given subcutaneously two or three times a week, at the end of each dialysis session. Lp (a) and other lipid profiles including total cholesterol (TC), triglyceride (Tg), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C) were measured before treatment, and at two week intervals during the first eight weeks of rHuEpo. Results: Hct started to increase significantly 4 weeks after rHuEpo therapy. The concentrations of TC, Tg and LDL-cholesterol did not significantly change during rHuEpo. The median value of Lp (a) before rHuEpo therapy was 20.4㎎/dl with a distribution from 1.4 to 113.6㎎/dl. Five out of 22 patients (22.7%) had Lp (a) concentrations above 30㎎/dl, which value has been shown to be a high risk for atherosclerosis. The Lp (a) concentration also showed no statistically significant changes in spite of a tendency to decrease with rHuEpo. However, it was interesting that Lp (a) levels in all of the five patients whose Lp (a) was above 30㎎/dl decreased significantly 8 weeks after rHuEpo therapy (58.8±4.5 vs. 32.5±7.9㎎/dl, p<0.05). Conclusions: rHuEpo may decrease the serum Lp (a) level, especially in the high Lp (a) subjects. Although the exact mechanism of this favorable effect on Lp (a) during rHuEpo administration is uncertain, it may contribute to a decrease in cardiovascular morbidity, independent of the effects of anemia correction itself.

직시하위생검 (直視下胃生檢)

조상호(Sang Ho Cho),최흥재(Heung Jai Choi),문영명(Young Myoung Moon),윤견일(Kyun Il Yoon),윤영남(Young Nam Yoon),박인서(In Suh Park),이유복(Yoo Bock Lee) 대한소화기학회 1972 대한소화기학회지 Vol.4 No.2

N/A The introdaction of fibergastroscope in recent years has f:acilitated the observation on conditions inside the stomach, and diagnostic value of this device in early detection of stomach cancer has advanced markedly. In some cases, however,it is often difficult to give judgement of benignancy or malignancy observed by a fibergastroscope. The most effective diagnostic methcd is to earry out biopsy of the stomach in conjunction vrith fibergastroscope by which the tissue can be sampled directly from the lesion under fiberscopic observation. We performed direct vision biopsy during the period fro'm June, 1970 to September 1971 in 203 cases, who had been suspected to have stomach cancer, benign gastric ulcer or gastritis in X-ray study, with fibergastroscope (Machida FGS-B and Olympus GFB). The results are as following: 1. The X-ray diagnoses before endoscopic examination of 203 cases were gastric cancer in 96 cases, benign gastric ulcer in 42 cases, chronic gastritis in 49 cases, normal in 15 cases, and other in 1 case. 2. The diagnoses by endoscopic examination with direct vision biopsy were gastric cancer in 45 cases, benign gastric ulcer in 28 cases, atypical hyperplasia in 2 cases, pofyp in 2 cases, bezoar in 2 cases, gastritis in 151 cases and normal in 11 cases. 3. Only 43 cases (44. 7%) among 96 of the suspected gastric cancer on X-ray examination were confirmed by the endoscopy and the direct vision biopsy, most of the rest seemed to be pseudo- positive on X-ray examination. The rate of pseudo-negative result for the gastric cancer of X-ray examination vras 1.9%. The compatability of benign ulcer between X-ray and endoscopic diagnosis were only 30.9% and pseudo-negative result of X-ray examination for benign ulcer was 9.3%. Although tne compatability (86. 9%) between X-ray and endoscopic diagnosis in gastritis was high, pseudo-negative result was also high (69%), suggesting unreliability of X-ray diagnosis of gastritis. It was thought to be impossible to diagnose the gastritis in X-ray study.

유지 혈액투석 환자에서 투석중 베타 엔도르핀 ( β - endorphin ) 농도의 변화

이은영(Eun Young Lee),최규복(Kyu Bok Choi),윤견일(Kyun Il Yoon) 대한내과학회 1998 대한내과학회지 Vol.55 No.1

N/A Objective : β -endorphin, most potent endogenous opioid peptide, is known to play an important role in many homeostatic systems such as the maintenance of blood pressure, regulation of body temperature and the control of pituitary hormone secretion. Previous reports of plasma levels of β -endorphin in patients with chronic renal failure have mostly shown elevated levels. Rut the effect of hemodialysis on the plasma levels of β -endorphin in patients with maintenance hemodialysis is controversial. The aim of this study was to evaluate the effect of a hemodialysis session on the plasma concentrations of β -endorphin in patients with end-stage renal disease and also to investigate changes of hemodynamic response according to the changes of plasma levels of β -endarphin. Methods: We study group comprised 36 patients who had received regular hemodialysis. Blood for analysis of β -endorphin was sampled before and immediately after hemodialysis and measured by immunoradiometric assay. Extracellular fluid / total body water (ECF/TBW) was measured before and after the hemodialysis session by multifrequency bioimpedance analyzer (InBody 2.0®, Biospace Co., Ltd., Seoul, Korea). Systolic and diastolic blood pressure were measured by Centrysystem 3 BP monitor every 30 minutes. Results: 1) As a whole, the predialysis β -endorphin did not differ significantly from postdialysis levels. Blood pressure increased significantly during dialysis. The postdialysis value of ECF/TBW was significantly decreased(0.37±0.02 vs. 0.34±0.02, p<0.01). 2) The patients were divided into 2 groups according to the pre-, and post-dialysis β -endorphin levels(Group 1, predialysis β -endorphin > postdialysis β -endor- phin(n=23); group 2, predialysis β -endorphin ≤ postdialysis β -endorphin(n=13)). 3) During dialysis, the systolic and diastolic blood pressure increased significantly in group 1(p<0.05), but not in group 2. 4) The postdialysis value of ECF/TBW was significantly decreased from baseline value to reference range (0.34±0.01) in group 1, but to above the reference range in group 2. 5) The plasma concentrations of β -endorphin did not change by administration of recombinant human erythropoietin. Conclusion : In conclusion, the elevation in plasma β -endorphin concentrations probably occur to balance the changes in vasocnnstrictive substances. An increase in vasoconstrictive substances is mainly secondary to the decrease in plasma volume during hemodialysis. The data also suggest that certain vasoactive substances might participate in the hemodynamic response to hemodialysis although their exact roles remain to be further elucidated.

다낭종신의 임상적 고찰

이상용 ( Sang Yong Lee ),박정호 ( Jung Ho Park ),김창규 ( Chang Kyu Kim ),선우일남 ( Il Nam Sunwoo ),윤견일 ( Kyun Il Yoon ) 대한내과학회 1974 대한내과학회지 Vol.17 No.7

Desferrioxamine이 사람 간암 세포주의 DNA 합성에 미치는 영향

강진경(Jin Kyung Kang),김원호(Won Ho Kim),송시영(Si Young Song),김도영(Doe Young Kim),문일환(Il Hwan Moon),윤견일(Kyun Il Yoon) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

N/A Desferrioxamine (DFO), an iron chelator, has been sbown to have antiproliferative activity in a variety of malignant cells including hepatocellular carcinoma. The antiproliferative effect of DFO's known to be caused by decreased activity of ribonucleotide reductase, a key enzyme in DNA synthesis. This study was conducted to investigate the effect Of DFO on the DNA synthesis of cultured hepatoma cells. The proliferation of hepatocellular carcinoma (Hep 3B) as well as hepatoblastoma (Hep G2) cells was measured by trypan blue dye exclusion method and the DNA synthesis was measured by [3H] thymidine incorporation. The results obtained were as follows: The proliferation of hepatoma cells was slightly inhibited by 2 ug/ml and markedly inhibited by 6 ug/ml of DFO. This antiproliferative effect was not enhanced any more by higher dose of DFO. The percent viability of Hep 3B and Hep G2 cells was above 90%. after 96 hours of incubation with 60 ug/ml of DFO and that of Hep 3B and Hep G2 cells was 88.0% and 89.6% respectively after l6 hours of culture with 120 ug/ml of DFO. DNA synthesis of hepatoma ceils was decreased by DFO in a dose dependent manner up to 20 ug/ ml. The decrease of DNA synthesis was not enhanced any more by higher dose of DFO. In conclusion, the antiproliferative effect of DFO on cultured human hepatoma cell lines was caused by the inhibition of DNA synthesis rather than by direct cytocidal effect.