만성신부전 환자에서 혈청 종양표지자에 관한 연구

하정훈(Jeong Hoon Ha),정유정(Yoo Jeong Chung),이성철(Seong Cheol Lee),김기영(Ki Young Kim),김수완(So Wan Kim),김남호(Nam Ho Kim),최기철(Ki Chul Choi),강영준(Young Joon Kang) 대한내과학회 1997 대한내과학회지 Vol.53 No.2

N/A Objectives: Tumor markers have been clinically used to diagnose and monitor the progression of various tumor or to assess their response to therapy. This study focuses on the evaluation of tumor markers in Chronic renal failure patients, compared with normal controls. Methods : The following 9 kinds of serum tumor markers, such as carcinoembryonic antigen(CEA), squamaus cell carcinoma-related antigen(SCC), CYFRA 21-1, CA(carbohydrate antigen) 125, CA 19-9, α-fetoprotein(AFP), prostate specific antigen(PSA), human chorionic gonadotropin(hCG) and CA 72-4 were measured in 56 persons without chronic renal failure(CRF) as controls, in 132 patients with chronic renal failure(56 patients on conservative management, 41 patients on chronic hemodialysis, and 35 patients on CAPD) who did not present any evidences of neoplasia. Results : 1) The mean level of CEA in CRF patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than that of patients on conservative management(p<0.05). 2) The mean level of SCC in CRF patients was significantly higher than that of controls(p<0.001), and the mean levels of SCC did not differ significantly among three groups of CRF patients. 3) The mean level of CYFRA in CI4F patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than those of patients on conservative management and on CAPD respectively (p<0.05). 4) The mean level of CA 125 in CRF patients was significantly higher than that of controls (p<0.001), and that of CRF patients on CAPD was significantly lower than that of controls(p<0.05). 5) Positive percent for CYFRA 21-1 in all CRF patients was 89.7%, and SCC 82.9%, CEA 60.3%, CA 125 48%, CA 19-9 22.4%, PSA 7.9%, CA 72-4 6.1%, hCG 4.7% and AFV 3.2% respectively. Conclusion : The present study shows that tumor markers such as CEA, SCC, CYFRA 21-1, CA 19-9 and CA 125 are elevated above reference values in a substantial number of patients according to the reference values commonly used in normal persons, making them unreliable for monitoring malignancies in uremic patients. While the other tumor markers such as AFP, PSA, hCG and CA 72-4 are reliable for the same purpose. These results must be taken into account when serum levels of tumor markers are measured in CRF patients

게슈탈트(Gestalt) 이론에 의한 웹 인터페이스 디자인에 관한 연구

정승은(Chung, Seung Eun),정유정(Jeong Yoo Jeong),조진경(Jo, Jin Kyung),장동훈(Chang, Dong Hoon) 한국정보과학회 2001 한국정보과학회 학술발표논문집 Vol.2001 No.2

지속적외래복막투석 환자 250 예의 임상적 고찰

최기철(Ki Chul Choi),유기섭(Ki Sud Yoo),박종욱(Jong Wook Park),하정훈(Jeong Hoon Ha),이제중(Je Jung Lee),염충호(Chung Ho Yeum),정유정(You Jeong Chung),김수완(Soo Wan Kim),김남호(Nam Ho Kim),강영준(Young Joon Kang) 대한내과학회 1996 대한내과학회지 Vol.51 No.3

N/A Objectives: CAPD has established itself as an effective therapeutic modality as hemodialysis or renal transplantation in the treatment of patients with end stage renal disease. Although much progress of technology of CAPD has been made, peritonitis or catheter-related complications have been an important problem until now. Therefore, we reviewed our experience with CAPD over 6.5 years. Methods: Retrospectively, we analysed the clinical results of 250 patients on CAPD at Chonnam University Hospital from July 1988 to December 1994. Results: 1) There were l48(59%) male and 102(41%) female patients, aged 10-73 years(mean 43±13 years). 2) Underlying disorders of end stage renal diseases consisted of mainly chronic glomerulonephritis (24.4%), followed by diabetic nephropathy(22.4%) and hypertensive nephrosclerosis(7.2%). 3) The incidence of pertionitis was 0.75 episodes per patient year and peritonitis free interval was 9.0±1.2 months. The isolation rate of microorganisms from patients with peritonitis was 34.7% and the order of frequency of isolated organisms was Staphylococcus(S.) epidermidis, S. aureus, Pseudomonas species, Candida species, Acinetobacter species and E. coli. The results of peritonitis were treatment with only antibiotics(86.0%), catheter removal(13.0%) and death(1.0%). 4) The complications other than peritonitis were exit site infection or tunnel infection, hernia, leakage, failure to drain, hydrothorax, ultrafiltration failure and others. 5) 67 of 250 catheters(26.8%) were removed and the peritonitis was the most common cause of catheter removal. The catheter survival rate was 86%, 75%, 65%, and 52% at one year, two years, four years and five years, respectively. Mean survival time of all catheters was 44.2±1.6 months. 6) The causes of death were most frequently cardiac disorders(31.8%), followed by vascular disorders (19.5%), and infections(14.6%). The patient survival rate was 94%, 83%, 74%, 69% at one year, two years, three years, four years, respectively. Mean survival time of all patients was 59.0±2.0 months. Conclusion: Although CAPD is an effective therapeutic modality in the tgeatment of patients with end stage renal disease, CAPD-induced peritonitis is the most important pitfalls of CAPD. Therefore, we must exert more effort to prevent and treat the CAPD-induced peritonitis.

신이식 환자에서 골밀도에 대한 연구

최기철(Ki Chul Choi),박종욱(Jong Wook Park),유기섭(Ki Sub Yoo),이민수(Min Su Lee),염충호(Chung Ho Yeum),정유정(You Jeong Chung),이제중(Je Jung Lee),김수완(Soo Wan Kim),김남호(Nam Ho Kim),강영준(Young Joon Kang) 대한내과학회 1996 대한내과학회지 Vol.50 No.2

N/A parameters and BMD of renal transplants. Methods: Using dual-energy X-ray absorptiometry (DEXA), we assessed total body and regional (head, arm, trunk, rib, leg, spine, and pelvis) bone mineral density. Results: 1) Total body BMD of renal transplants was significantly decreased compared with that of normal controls. 2) A separate analysis of BMD in both sexes revealed that males presented marked reduction of BMD compared with the normal controls in the majority of skeletal sites except head and pelvis. Especially, at the spine, their BMD was significantly reduced compared with that of the CRF patients on receiving dialysis in addition to the normal controls. Females also presented reduction of BMD compared with the normal controls in many skeletal sites except head and ribs. 3) The correlations between BMD values and time since renal transplantation and cumulative cyclosporine doses were statistically significant (r=0.46, 0.527, respectively, and p<0.01) in nearly all skeletal sites except head and spine. Conclusion: Our results indicate that significant falls in BMD appear to be inherent to the process of renal transplantation although it achieves the rapid correction of some of the biochemical abnormalities associated with renal failure and that therapeutic strategies to prevent or reduce this damages should be established. In addition, the present study emphasizes the need to pay attention to the further evaluation of correlations between bone loss in renal transplants and some drugs, such as glucocorticoids and cyclosporine.

다약제내성 발현 암세포에서 99mTc-sestamibi와 99mTc-tetrofosmin 섭취의 비교

유정아,정신영,서명랑,곽동석,안병철,이규보,이재태 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.3

목적 : 다약제내성이 유발된 암세포에서 ^99mTc-sestamibi와 ^99mTc-tetrofosmin의 암세포 내 섭취정도를 비교하고 다약제내성 극복제로 잘 알려진 verapamil 과 cyclosporin A 처리에 의한 두 방사성 의약품의 암세포 내 섭취정도를 비교해 보았다. 재료 및 방법 : Doxorubicin으로 다약제내성이 유발된 HCT15/CL02 대장암 세포와 doxorubicin과 vincristine으로 다약제내성을 유발시킨 K562(Adr)과 K562(Vcr) 백혈병 세포를 사용하였다. 다약제내성의 발현은 RT-PCR로 증명하였으며, vetapamil은 1, 10, 50, 100, 200 ㎛의 농도로, cyclosporin A는 0.1, 1, 10, 50, 100 ㎛의 농도로 각각 사용하였다. MIBI와 tetrofosmin의 암세포내 섭취는 37℃에서 1 × 10_6 cell/㎖ 농도의 단일세포 부유상태에서 1, 15, 30, 45, 60분 간격으로 배양하여 각 시간대별로 상층액과 침전물을 분리하여 각각의 방사능을 감마 계수기로 측정하였다. 결과 : 다약제내성이 발현된 암세포에서는 모세포에 비하여 MIBI와 tetrofosmin의 섭취가 감소되었다. 두 방사성약품의 섭취정도는 HCT15/CL02세포와 K562(Adr)세포에서는 유의한 차이가 없었으나, K562(Vcr)세포에서는 MIBI가 tetrofosmin보다 다소 높았다. Verapamil과 cyclosporin A를 처리하였을 때 MIBI와 tetrofosmin의 섭취율은 기저치보다 모두 증가하였고, verapamil에 의한 MIBI와 tetrofosmin의 섭취율(30분)을 기저치(30분)와 비교해 본 결과 HCT15/CL02세포에서 (100㎛)는 각각 11.9배와 6.8배, K562(Adr)세포에서(50 ㎛)는 각각 14.3배와 8배, K562(Vcr)세포에서(10㎛)는 각각 7배와 5.7배 증가하였다. Cyclosporin A에 의한 MIBI와 tetrofosmin의 섭취율(30분)을 기저치(30분)와 비교해 본 결과 HCT15/CL02세포에서(50 ㎛)는 각각 10배와 2.4배, K562(Adr)세포에서(50 ㎛)는 각각 44배와 13배, K562(Vcr)세포에서(10㎛)는 각각 18.8배와 11.8배 증가하여, MIBI의 섭취율이 tetrofosmin보다 1.2배에서 4배정도 높게 나타났다. 결론 : 이러한 결과로 보아 MIBI와 tetrofosmin은 다약제내성의 발현을 평가할 수 있는 방사성의약품으로 판단되며, 다약제내성 극복제의 효능평가에는 MIBI가 tetrofosmin보다 더 우수할 것으로 사료되나, 세포주에 따른 차이가 있을 수 있으므로 보다 많은 세포주에서의 추가적인 연구가 필요할 것이다. Purpose : Cellular uptakes of ^99mTc-sestamibi(MIBI) and ^99mTc-tetrofosmin into cancer cell lines expressing multidrug resistance(MDR) were investigated and compared. The effects of verapamil and cyclosporin A, well-known multidrug resistant reversing agents, on cellular uptake of both tracers were also compared. Materials and Methods : Doxorubicin-resistant HCT15/CL02 human colorectal cell and doxorubicin-resistant K562(Adr) and vincristine-resistant K562(Vcr) human leukemic cells were studied. RT-PCR analysis was used for the detection of mdr1 mRNA expression. MDR-reversal effects with verapamil and cyclosporine A were evaluated at different drug concentrations after incubation with MIBI and tetrofosmin for 1, 15, 30, 45 and 60 min, using single-cell suspensions at 1×10_6 cell/㎖ incubated at 37℃. Radioactivity in supernatants and pellets were measured with gamma well counter. Results : The cellular uptakes of MIBI and tetrofosmin in K562(Adr) and K562(Vcr) were lower than those of parental J562 cell. In HCT15/CL02 cells and K562(Adr) cells, there were no significant difference in cellular uptakes of both tracers, but cellular uptake of MIBI was higher than that of tefrofosmin in K562(Vcr) cells. Coincubation with verapamil resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Verapamil increased cellular uptakes of MIBI and tetrofosmin by HCT15/CL02 cell by 11.9- and 6.8-fold, by K562(Adr) cell by 14.3- and 8-fold and by K562(Vcr) cell by 7- and 5.7-fold in maximum, respectively. Cyclosporin A increased cellular uptakes of MIVi and tetrofosmin by HCT15/CL02 cell by 11.9- and 6.8-fold, by K562(Adr) cell by 14.3- and 8-fold and by K562(Vcr) cell by 7- and 4.7-fold in maximum, respectively. Cyclosporin A increased cellular uptakes of MIBI and tetrofosmin by HCT15/CL02 cell by 10- and 2.4-fold, by K562(Adr) cell 44- and 13-fold and by K562(Vcr) cell by 18.8- and 11.8-fold in maximum, respectively. Conclusion : Taking together, MIBI and tetrofosmin are considered as suitable radiopharmaceuticals for detecting multidrug resistance. However, MIBI seems to be a better tracer than tetrofosmin for evaluation MDR reversal effect of the modulators. Since cellular uptakes of both tracers might differ in different cell types, further experiments regarding differences in cellular uptakes between cell types should be explored.