우리나라 무증상 성인에서의 신장기능 및 성인병의 발현빈도

진동찬(Dong Chan Jin),윤영석(Young Suk Yoon),신영신(Young Shin Shin),송호철(Ho Cheol Song),박철휘(Cheol Whee Park),안석주(Seog Ju Ahn),김석영(Suk Young Kim),최의진(Euy Jin Choi),장윤식(Yoon Sik Chang),방병기(Byung Kee Bang) 대한내과학회 1996 대한내과학회지 Vol.51 No.5

N/A Objectives: This report is the results of mass study on renal functions and prevalence of adult diseases in asympotmatic Korean. Methods: The subjects were 50,000 persons (male 31,633, female 18,367) who were enrolled a regular health check up program, June 1990 to Dec 1994, at Catholic Medical Center, Korea. Results: The mean serum creatinine were 1.073±0.19㎎/dl in male and 0.824±0.13㎎/dl in female. Abnormal creatinine (over mean plus 2 standard deviation) prevalence rate were 0.37% in male (1.6㎎/dl and aver) and 0.65% in female (1.2㎎/dl and over). The prevalence of urine occult blood (one positive) were 3.6% in male, 13.4% in female. The proteinuria were 3.3%, 2.1%, respectively. The differences between age group of serum creatinine were little, but that of blood pressure, cholesterol, body mass index were significant, especially before and after menopause in woman. The prevalence of hypertension were 27.1% in male and 24.2% in female. Hyperlipidemia and obesity (BMI over 25㎏/㎡) were 9.5, 9.3% in male and 28.9, 25.0% in female, respectively. Conclusion: These data were may represent overall Korean normal value and could be useful as reference value in Korea.

제2형 당뇨병 환자에서 당뇨병성 신증과 비당뇨병성 신질환의 임상적 차이

김병수 ( Byung Soo Kim ),장윤경 ( Yoon Kyoung Chang ),송호철 ( Ho Cheol Song ),이소영 ( So Young Lee ),장세나 ( Se Na Jang ),김형욱 ( Hyung Wook Kim ),신영신 ( Young Shin Shin ),최영진 ( Young Jin Choi ),진동찬 ( Dong Chan Jin 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.6

Purpose: It is important to differentiate non-diabetic renal diseases (NDRD) from diabetic nephropathy (DN) in type 2 diabetes. Our study was reviewing the clinical data and treatment strategies from diabetic patients performed renal biopsy to determine the clinical indicators suggestive of NDRD. Methods: We reviewed the medical records of type 2 patients who underwent renal biopsy from Jan. 1995 to Dec. 2007. Results: Seventy four patients were included. Mean age was 52.0±12.5 years and 41 (55%) patients were male suddenly developed. Nephrotic syndrome [34 cases (46%)] was the leading reason for renal biopsy. There were 37 cases (50%) with a pathologic diagnosis of DN, 31 (42%) with NDRD, and 6 (8%) with concurrent DN and NDRD. IgA nephropathy (35%) was the most common lesion found in patients with NDRD. Thirty one patients (84%) with DN and 26 (84%) with NDRD had follow-up periods of more than 6 months. Of 26 patients with NDRD, 12 were treated with immune suppressants and 6 achieved complete remission. Thirteen patients with DN and one with NDRD developed end-stage renal disease. Patients with NDRD tended to show shorter duration of diabetes, lower systolic blood pressure (SBP) and lower serum triglyceride, and had significantly lower incidence of diabetic retinopathy (DR). In the univariate regression analysis, diabetes duration, SBP, triglyceride and DR showed statistically significance. And SBP and DR were identified as independent correlating factors by multivariate regression analysis. Conclusion: In this study, the absence of retinopathy could predict the presence NDRD among NIDDM patients presenting with renal disease. And additional disease-specific therapies may be helpful for the patients with NDRD.

장기 투석 환자에서 발생한 신세포암의 임상적 특성

김영옥 ( Kim Yeong Og ),한창희 ( Han Chang Hui ),신옥란 ( Sin Og Lan ),윤정민 ( Yun Jeong Min ),신석준 ( Sin Seog Jun ),장윤경 ( Jang Yun Gyeong ),윤선애 ( Yun Seon Ae ),양철우 ( Yang Cheol U ),진동찬 ( Jin Dong Chan ),김용수 ( Ki 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.5

배 경 : 장기간 투석을 받고 있는 말기 신부전증 환자에서 신세포암의 발생빈도는 정상인에 비해 매우 높은 것으로 알려져 있다. 그러나 국내에서는 이에 대한 연구가 보고되어 있지 않다. 이에 장기 투석 환자에서 발생하는 신세포암의 임상적 특성을 알아보고자 하였다. 방 법 : 1993년 1월부터 2002년 12월까지 10년 동안 혈액투석 혹은 복막투석을 받고 있는 환자에서 발생한 신세포암을 후향적으로 조사하였다. 투석 전에 신세포암이 발생한 증례는 대상에서 제외 하였다. 결 과 : 총 7예의 신세포암이 발견되었다. 대상 환자의 평균 연령은 46±9세였으며 남자 6명 여자 1명이었다. 원인 신질환은 만성 사구체 신장염과 상염색체 우성 다낭신이 각각 3예였고 고혈압성 신증이 1예였다. 전체 7명의 환자 중 5명이 혈액투석 환자였고 나머지 2명이 복막투석 환자였다. 평균 투석기간은 82±46개월이었다. 신세포암 발견시 주요 증세는 2예에서는 전혀 증세가 없이 우연히 발견되었으며 3예에서는 측복부 동통이었고 2명에서는 복부 종괴의 촉진이었다. 전 환자에서 복부 전산화 단층촬영이 시행되었으며 종양의 크기는 평균 3.1±1.9 ㎝이었으며 상염색체 우성 다낭신 이외의 환자에서도 모두 다수의 낭종이 관찰되었다. 측복부 동통을 호소한 3명 모두는 신낭종의 자연 파열로 인한 신주위 혈종으로 신적출술 후 시행한 조직검사에서 신세포암이 우연히 발견되었다. 3명의 낭종 파열 환자 중 2명은 상염색체 우성 다낭신 환자였다. TNM 분류법에 의한 종양의 병기는 6예가 1기였고 나머지 1예는 폐에 전이된 4기였다. 1기의 6예는 모두 신적출술을 받았으며 평균 45±35개월의 추적기간 동안 1명의 환자에서 신세포암과 무관한 간질환으로 사망하였고 5명의 환자는 재발 없이 투석을 받고 있다. 결 론 : 장기 투석 환자에서 발생하는 신세포암은 대부분이 조기에 발견되었으며 이러한 환자에서는 신적출술의 예후가 양호하였다. 또한 신세포암은 모두 유전성 혹은 후천성 신낭종과 관련 되어 있었으며 평균 투석기간이 82±46개월로 길었다. Background : The incidence of renal cell carcinoma (RCC) in patients receiving long-term hemo-dialysis or peritoneal dialysis patients is 100-fold higher than that in general population. But the clinical study about RCC in dialysis patients is not reported in Korea yet. This study was performed to evaluate the clinical characteristics of RCC in dialysis patients. Methods : We retrospectively investigated medical records of dialysis patients who were diagnosed with RCC between patients January, 1993 and December, 2002. RCC diagnosed before first dialysis was excluded. Diagnosis of RCC was made by both radio-logic and pathologic examinations. Results: A total of 7 patients was diagnosed with RCC. Mean age was 46±9 years. Primary renal disease consisted of chronic glomerulonephritis (n=3), autosomal dominant polycystic kidney disease (n=3), and hypertensive nephropathy (n=l). Five patients were on hemodialysis, 2 were on peritoneal dialysis. Mean duration of dialysis was 82±46 months. The presenting symptoms were asymptomatic in 2 patients, sudden onset of flank pain due to spontaneous renal cyst rupture in 3, palpable abdominal mass in 2. Mean tumor size was 3.1±1.9 cm and multiple renal cysts were noted in all patients. According to the TNM classification for RCC, 6 patients had stage I and 1 patients had stage IV. Six patients with stage I were treated with nephrectomy. With a mean follow-up of 45235 months after the operation, there has been no recurrence. Conclusion : Six patients out of total 7 patients had early stage tumor and all these patients were treated with nephrectomy and the prognosis was good. All RCC were associated with inherited or acquired multiple renal cysts.

신이식환자에서 B 형 및 C 형 간염의 유병율과 임상경과

양철우(Chul Woo Yang),신영신(Young Shin Sin),윤선애(Sun Ae Yoon),진동찬(Dong Chang Jin),안석주(Suk Joo Ahn),김용수(Yong Soo Kim),최의진(Euy Jin Choi),장윤식(Yoon Sik Chang),윤영석(Young Suk Yoon),방병기(Byung Kee Bang) 대한내과학회 1994 대한내과학회지 Vol.47 No.5

N/A Objectives: To evaluate the prevalence and clinical course of HBsAg positive and anti-HCV positive renal transplant recipients. Methods: According to serologic result, we divided the patients into HBsAg positive (HBV) and anti-HCV positive (HCV) group, and evaluated the clinical course based on duration and severity of hepatic dysfunction. Mean duration of observation was 3.8 years. Results: 1) HBsAg positivity was 11.3% and anti-HCV positivity was 13.3%, respectively. Before transplantation, in HBV group, HBsAg positivity was observed in 83.5% before renal transplantation, and 16.5% patients acquired HBsAg after renal transplantation, In HCV group, anti-HCV positivity was observed 54% before transplantation and 19.6% acquired anti-HCV after renal ransplantation. 2) The prevalence of chronic hpatitis in HBV and HCV grup was not different (25.7% vs. 25.5%). Among those with chronic hepatitis in HBV group, four cases progressed to fulminant hepatic failure, one case progressed end-stage of liver cirrhosis and one case progressed to hepatocelluar carcinoma. However, in HCV group, no case showed progression of chronic hepatitis. 3) Overall mortality of HBV and HCV group 25.3% and 7.8%, respectively (p=0.001): Among twenty fatal cases in HBV group 9 cases were liver disease-related but no liver disease-related death was observed in HCV group. Conclusion: HCV as well as HBV infection is quite prevalent and implortant cause of posttransplant chronic hepatitis, and clinical course of anti-HCV-posi- tive recipients are less aggressive than HBsAg positive recipients.

복막염을 유발한 쥐의 복막에서 혈관내피 성장인자의 발현

채은영(Eun Young Chae),박주현(Joo Hyun Park),진동찬(Dong Chan Jin),김용수(Yong Soo Kim),장윤식(Yoon Sik Chang),방병기(Byung Kee Bang) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.3

목 적: 복막투석 환자에서 복막염이 발생하면 복막의 투과성이 항진되어 한외여과 장애가 발생하는데 복막염이 발생했을 때 복막의 투과성이 항진되는 기전에 대하여는 아직 자세히 밝혀지지 않고 있다. 본 연구는 쥐에서 복막염을 유발한 후 복막 투과성의 변화, 복막 조직 소견의 변화 및 복막에서 강력하게 혈관 투과성을 항진시키는 성장인자인 혈관내피 성장인자(Vascular endothelial growth factor, VEGF)의 발현을 규명하고자 시행하였다. 방 법 : Sprague-Dawley 쥐를 대상으로 복막 투석 도관을 삽입한 후 복막 평형검사를 시행하고 대조군(7마리)과 복막염군(13마리)으로 분류하여 복막염군에는 Staphylococcus aureus균 을 1×10 exp (9) colony forming unit 복강내로 주입하여 복막염을 유발한 후 5일째 다시 복막 평형 검사를 시행하고 쥐를 희생하여 복막조직을 생검하였다. 복막 평형검사는 쥐의 혈청을 0시간에 (P_0), 투석액 배액을 0시간(D_0)과 2시간(D_2)에 채취하여 포도당(D_2/D_0)과 총 단백질(D_0 /P_0 및 D_2/P_0)의 투과율을 계산하였고 복막 조직은 PAS 염색과 대식세포 및 혈관내피 성장인자에 대한 면역조직염색을 시행하였다. 결 과 : 복막 평형검사 결과 포도당의 투석액내 농도비는(D_2/D_0) 복막염 유발 5일 후 대조군에 비하여 복막염군에서 유의하게 낮았고 총 단백질의 투석액/혈장 농도비(D2/P0)도 복막염 유발 5일 후에는 대조군에 비하여 복막염군에서 유의하게 높아 저분자 물질인 포도당과 고분자 물질인 단백질의 복막 투과율 모두 증가되었다. 복막조직은 복막염군에서 복막 중피세포 하층에 염증세포의 침윤이 증가되고 복막 중피세포 하층이 두꺼워졌으며 중피세포의 탈락현상도 보였다. 대조군은 대식세포의 침윤이 거의 없었으나 복막염군은 복막 중피세포 하층에 대식세포의 침윤이 현저히 증가되었고 혈관내피 성장인자는 대조군에서 복막 중피세포 층에서 약하게 염색되었으나 복막염군에서는 복막 중피세포층에서 강하게 염색되고 복막 중피세포 하층에 침윤된 대식 세포에서도 강하게 염색되었다. 결 론 : 복막염을 유발한 쥐는 복막의 투과율이 유의하게 증가되었고 그 기전에는 복막 중피세포와 복막 중피세포 하층에 침윤된 대식세포에서 혈관내피 성장인자 발현의 증가가 관여할 것으로 생각된다. Background : Ultrafiltration failure resulting from increased peritoneal vascular permeability during peritonitis is a major problem in CAPD patients. However, the mechanism of increased peritoneal permeability during peritonitis has not been clearly determined. We studied changes in the peritoneal permeability and the expression of vascular endothelial growth factor(VEGF), which is known to increase vascular permeability, in the peritoneal tissues of rats with peritonitis. Methods : After implanting peritoneal dialysis catheter to 20 Sprague-Dawley rats and performing peritoneal equilibration test(PET), rats were divided into control group(n=7) and peritonitis group(n=13). One ml of saline or Staphylococcus aureus(1×10 exp (9) colony forming unit/mL) was injected intraperitoneally to control or peritonitis group for five days, and PET was repeated. Peritoneal transport rates of glucose and total protein were measured, and macrophages infiltration and VEGF expression in peritoneal tissues were examined by immunohistochemical stain. Results : Peritoneal transport rates of glucose and total protein were significantly increased in peritonitis group compared with control group, suggesting that peritonitis increased peritoneal transport rates of both low and high molecular weight solutes. The peritoneal tissues of peritonitis rats showed profuse infiltration of macrophages in the submesothelial space, submesothelial widening and denudation of mesothelial cells. While VEGF was slightly expressed in peritoneal mesothelial cells in control rats, it was intensively stained not only in the peritoneal mesothelial cells but also in the infiltrated macrophages in the submesothelial space in peritonitis rats. Conclusion : Peritonitis increases peritoneal vascular permeability and VEGF expression in peritoneal mesothelial cells and infiltrated macrophages in the submesothelial space. These data suggest that VEGF may play a role in the increased peritoneal permeability during peritonitis.

신장질환이 없는 80세 이상 노인에서 초음파로 측정한 신장의 크기

신영신 ( Young Shin Shin ),박수연 ( Soo Yun Park ),진동찬 ( Dong Chan Jin ),김형욱 ( Hyung Wook Kim ),김용수 ( Yong Soo Kim ),장윤식 ( Yoon Sik Chang ),방병기 ( Byung Kee Bang ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.4

목적: 신장의 크기가 9 cm 미만인 경우 비가역적인 신장질환을 시사한다고 알려졌고, 한국 정상 성인의 초음파촬영술로 측정한 신장의 크기는 8.76 cm와 12.36 cm가 정상 하한치와 상한치로 제시되었다. 그러나 나이에 따른 신장 기능의 변화는 다른 장기와 마찬가지로 성장이 끝난 이후 차츰 감소하는 것으로 나타나고 있어 80세 이상의 고령에서 적용 여부는 논란이 될 수 있다. 이에 본 연구자들은 신장질환이 없는 80세 이상 고령 노인에서의 신장크기 및 신기능의 지표인 혈청 크레아티닌 (Scr)와 신기능 평가에 이용되는 Cockcroft-Gault (C-G)공식 및 Modification of Diet in Renal Disease (MDRD) 공식과 신장크기와의 상관여부를 알아보고자 하였다. 방법: 대상은 복부 초음파촬영술을 실시한 80세 이상의 노인 150명 중 Scr이 1.3 이하이고, 계산된 사구체 여과율이 60 mL/min/1.73m2 이상이면서 당뇨병과 단백뇨 및 요로 감염이 없는 106명이었다. 평균나이는 83±0.3세 (남자 82±0.4세, 여자 84±0.5세)였다. 결과: 1) 신장크기는 9.9±0.07 cm (최소 7.7 cm, 최대 11.3 cm)였고, 남자에서 더 컸다. 2) 신장크기는 90세 이후가 80대 초반보다 작았다. 3) 신장크기는 연령과 의미 있는 음의 상관관계, Scr과는 통계적 의미는 없으나 음의 상관관계였다. 신체계수는 체표면적이 관련 있었다. 4) 계산에 의한 사구체 여과율 (GFR) 중, C-G 공식은 양측신장의 표면적과 MDRD 공식은 양측신장의 평균값과 관련 있었다. 5) Scr과 C-G 및 MDRD 공식에 의한 GFR은 음의 상관관계였으며, MDRD 공식이 통계적으로 의미 있게 나타났다. 결론: 이상의 결과에서 80세 이상의 노인에서 신장크기는 현재 알려진 정상 성인보다 작을 수 있고, 단순 길이뿐 아니라 단면적, 그리고 체표면적을 포함한 신체 인자도 측정하여야 그 환자에서의 신장크기의 정상 여부를 알 수 있을 것이며, 추후 노인에서 정확한 GFR 측정 방법과 일반 성인과 다른 정상 및 비정상 상태에 대한 더 많은 연구가 필요하리라 여겨진다. Purpose: Kidney size (KS) is used to diagnose the patients with renal disease. When the length of a kidney is measured under 9 cm, it is considered to indicate an irreversible disease. Because glomerular filtration rate (GFR) decreases with age, the normal range of KS in the elderly is indefinite. Therefore, we measured KS in adults older than 80 years old and investigated correlated factors. Methods: One hundreds six adults (51 men, 55 women: mean age 83±0.3) without renal disease were included. Their serum creatinine (Scr) levels did not exceed 1.3 mg/dL, and the calculated GFR were over 60 mL/min/1.73m2. Abdominal ultrasonography were performed to all of them and their body indexes (BI) were measured. Results: 1) The mean length of kidney was 9.9±0.07 cm. 2) KS in the early eighties was larger than that of adults over ninety. 3) KS showed negative correlations with age and Scr, but a positive correlation with body surface area. 4) The calculated GFR showed correlations with the surface areas of both kidney (BK) by C-G equation and with the size of BK by MDRD equation. 4) The GFR calculated by MDRD and C-G equation presented inverse correlations with Scr, but only MDRD equation showed a statistic significance. Conclusion: In the elderly, KS may be smaller than that of younger adults. Other factors such as either surface area or volume of BK and BI should be considered to estimate the individual KS to decide whether the size is within normal range.

HBs Ag 양성 및 음성 간질환에서 혈청 ABS/ALT비의 의의

한남익,진동찬,조현미,최상욱,정진우,이창돈,박두호,김부성 대한내과학회 1990 대한내과학회지 Vol.38 No.1

The ratio of AST/ALT is often used as a clue to the etiology of the underlying liver disease. This ratio is usually more than 2.0 in alcoholic liver disease and less than 1.0 in patients with viral hepatitis. But recently we noted that the AST/ALT ratio can change during the course of chronic viral hepatitis usually rising more than 1.0 if the patient develops cirrhosis. We analyzed retrospectively AST/ALT ratio in 234 patients with vaious histologic types of nonalcoholic liver disease and correlated this ratio with hematologic, biochemical and immunological parameters of disease. The AST/ALT ratio increased as progressing the liver disease histologically in both HBsAg positive and negative groups. Furthermore the AST/ALT ratio in HBsAg positive groups was sighificantly correlated with several biochemical(alkaline phosphatase, prothrombin time, r-GTP, albumin) and immunological(alpha-fetoprotein) parameters that suggest chronicity (r>-0.035, p<0. 001). In conclusion, AST/ALT ratio will be indirectly useful parameter evaluating the severity of nonalcoholic type B liver disease.

Prostaglandin E 유사체(Misoprostol)의 장기 투여가 신이식 환자의 혈압, Cyclosporine 용량 및 신기능에 미치는 영향

신영신,김용수,장윤식,김석영,방병기,최의진,박철휘,양철우,진동찬 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.3

Prostaglandin(PG) E has been shown to affect renal function by influencing renal blood flow and perfusion pressure and to have immunosuppressive properties. Positive effects of PG-E on kidney allograft hemodynamics and function have previously been, but not without controversy. This study was therfore designed to evaluate the long-term effect of misoprostol on blood pressure, CsA level, graft survival, renal function and histological change in first-time renal transplant recipients treated with cyclosporine. Eighty kidney transplant(KT) recipients were randomly se parated into three groups according to the duration of misoprostol treatment. Group C(n=50) was control; group M1(n=13) recieved misoprostol for less than 6 months and group M2(n=17) for more than 6 months after KT. The results were as follows. 1)Serum CsA levels at 24 months after KT were not significantly different among the three groups [groupC 167±58ng/ml; group M 163±75ng/ml (group M1 171±70ng/ml, group M2 155±81ng/ml)]. Group M2 requiredher dosage of CsA than group C or M1 to maintain the proper serum levels (group M2 4.27±1.07mg/kg/day vs. group C 4.04±0.90mg/ kg/day or group M1 4.08±1.03mg/kg/day). But these results were not statistically significant. 2) Mean arterial pressures at 24 months after KT were not different among the groups[group C 101±11 mmHg; group M 103±10mmHg(group M1 108±11 mmHg, group M2 100±7mmHg)]. 3) Incidence of acute rejection was no different between group C(10 cases; 20%) and group M(12 cases; 40%). 4) Serum creatinine levels at 24 months after KT were not significantly different among the groups [group C 1.30±0.37mg/dl; group M 1.43±0.41mg/dl (group M1 1.51±0.47mg/dl, group M2 1.36±0.37mg/ dl)]. 5) Routine biopsy of transplanted kidney performed at 2 weeks after KT showed more abnormal findings in group C(9 cases; 49%) than group M(4 cases; 28.5%), but there was no statistical significance. In conclusion, long-term misoprostol treatment in renal transplant recipients was not effective in preventing thection, maintaining the renal fucntion, and decreasing blood pressure. Still, studies in patients receiving CsA are needed to determine the effect of misoprostol in CsA bioavaility and the histologic change of graft kidney.

만성 요독증 흰쥐에서 수면장애와 시상하부의 c-fos Protein 발현 양상과의 관계

김용수,김영옥,장윤식,김석영,송호철,윤선애,방병기,최의진,박철휘,진동찬 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.4

The activation of c-fos protein(FOS) in ventrolateral preoptic neuron(VLPO) induces sleep(Science 271; 216-219, 1996). Although sleep disturbance are very common in patients with chronic renal failure, its mechahanism of sleep disturbance is not clear. The purpose of this study was to evaluate sleep dissturbance and expression of FOS in VLPO of chronic uremic rats. Chronic uremic rats were induced by 5/6 nephrectomized rnodel. After 4 weeks, blood urea nitrogen and serum creatinine in uremic rats(n=14 were higher than in control(n=17) (blood urea nitrogen; 73.6±24.8mg/dl vs. 23.3±2.9 mg/dl, P$lt;0.001 serum creatinine', 1.49±0.42mg/dl vs. 0.66±0.12mg/dl, P$lt;0.001). General activity was counted with infrared during day time(08:00-20:00) and night time(20:00-08:00). Rats were killed at 10:00 or 16:00 during day time(uremic rats 7, control 9) and at 22:00 during night time(uremic rats 7, control 7). The expression of FOS in VLPO was examined with immunohistochernical method. The number of day tirne general activity in uremic rats was significantly higher than in control (458±185 vs. 222±41, P$lt;0.001), and the number of night time general activity in uremic rats was lower than in control(949±430 vs. 1618±261, P$lt;0.001). During day time, the number of FOS immunoreactive cell in uremic rats was lower than in control (18.4±5.3 vs. 42.8±6.3, P$lt;0.001), but there was no difference between 2 groups at night time(10.8±8.4 vs 12.5±5.1, P=0.62). There was strong negative correlation between the number of activity and the number of FOS immunoreactive cell in control(r= -0.93, P$lt;0.001), but there was no correlation in uremic rats. This study shows that sleep disturbance in chronic uremic rats might be related to decrease of expression of FOS in VLPO.

사람 신장의 근위세뇨관상피세포에서 Monocyte Chemoattractant Protein-1의 발현에 대한 Endothelin-1의 효과

김형욱,이명자,김소양,신영신,양철우,진동찬,김용수,장윤식,방병기 대한신장학회 2003 대한신장학회잡지 Vol.22 No.6