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신 이식 후 재발된 국소성 분절성 사구체 경화증 환자에서 Circulating Factor ( s ) 에 관한 연구
황의원(Eui Won Hwang),김승일(Seung Il Kim),김은나(Eun Na Kim),임현진(Hyun Jin Lim),변정득(Jung Duk Byun),박형근(Hyung Kun Park),이은영(Eun Young Lee),양동호(Dong Ho Yang),홍세용(Sae Yong Hong) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.4
Background: Although a significant number of studies were done on focal segmental glomerulosclerosis(FSGS), its pathogenesis has not been sufficiently established yet. Recent studies suggested certain types of circulating factor(s) played an important role in development and recurrence after renal transplantation of FSGS by modifying the glomerular permeability of albumin. The purpose of this study performed on animals and through molecular-biological experiments is to certify the role of circulating factor (s), which cause proteinuria, by manipulating plasma of a FSGS patient who showed massive of proteinuria and wide effacement of glomerular epithelial foot processes in histologic examination after renal transplantation. also, whose massive proteinuria decreased significantly after plasma exchange. Methods - The patient's plasma prior to(plasma A) or post to(plasma B) plasma exchange were injected into tail veins of two groups of male Sprague-Dawley rats, six in each. The ratio of 24 hour urine protein and urine creatinine(Uprt/Ucr) was calculated for each case. The 2D gel electrophoresis was performed in plasma A and plasma B. The pattem of 2D gel electrophoresis of plasma A was compared to those of plasma B and healthy human serum. Results: Compared to control group, there was no significant differences in 24-hour Uprt/Ucr afer injecting 1, 2, 3, 5 mL of plasma A(p>0.05). There was no significant difference in 24-hour UprtAlcr between the injecting groups of plasma A and plasma B(p>0.05). We were not able to observe any new protein which did not appear in plasma B or healthy human serum in 2D gel electrophoresis. Conclusion ; These results suggest that the proteinuria developed in a few hours after renal transplantation and is related to wide effacement of glomerular epithelial foot processes, and that it may be induced by a certain factor which is eliminated by the plasma exchange or restrained by the immunosuppressive agents. However, we were not able to find certain circulating factor(s) which rapidly changes albumin permeability in the patient's plasma with FSGS.
2 , 3 , 7 , 8 - tetrachlorodibenzo - p - dioxin 이 배양 사구체 혈관간세포와 세뇨관 상피세포의 활성화에 미치는 영향
김은나(Eun Na Kim),유미라(Mi Ra Yu),임현진(Hyun Jin Lim),황의원(Eui Won Hwang),하헌주(Hun Joo Ha),이희발(Hi Bahl Lee) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.1
배 경 : 내분비계 장애 물질로 추정되는 Benzo[a]pyrene (BP)과 dioxin (2,3,7,8- tetrachlorodibenzo-p-dioxin : TCDD)은 방향족 탄화수소 수용체(aromatic hydrocarbon receptor : AHR)를 경유하여 작용을 나타낸다. BP가 신독성 물질로 알려진 반면 TCDD가 신장 기능에 미치는 영향은 거의 알려져 있지 않다. 신장의 기능은 신장을 구성하는 다양한 세포들의 특수한 기능에 의하여 유지되는데, 서로 다른 신장세포는 약물 또는 독성물질에 대하여 세포 특이적이고 선택적인 반응을 나타낸다. 본 연구는 이미 신장 각 부위의 성상이 확인된 세포주 - 생쥐의 사구체 혈관간 세포(mouse mesangial cells :MMC), 돼지의 근위세뇨관 세포(LLC- PK1 세포) 및 개의 원위세뇨관 세포(Madin - Darby canine kidney cells :MDCK 세포) 를 이용하여 BP와 TCDD의 영향을 비교하였다. 방 법 : 세포성장이 동일화된 각 세포주를 BP 3과 30 μM이나 T CDD 1- 100 nM로 자극하고 24- 96시간 후의 세포 증식과 생존을 각각 [^3H]thymidine incorporation과 lactate dehydrogenase (LDH) 유리로 측정하였다. 세포외 기질 단백에 미치는 영향을 검색하고자 fibronectin 단백 양을 Western blot 분석과 ELISA로 측정하였다. 결 과 : MMC, LLC- PK1 세포 및 MDCK 세포 사망은 TCDD에 의해서 농도 의존적으로 증가하였다. MMC 증식은 BP 30 μM에 의하여 억제되었고 TCDD에 의해서 증가하였다. LLC- PK1 세포의 증식은 BP에 의하여 영향을 받지 않았지만 TCDD에 의해서는 증가하였다. MDCK 세포의 증식은 BP와 T CDD에 의하여 억제되었다. 즉, TCDD는 원위세뇨관 세포의 증식을 억제하면서 근위세뇨관과 혈관간 세포의 증식을 증가시켰다. 한편, BP와 T CDD는 MMC, LLC- PK1과 MDCK 세포의 fibronectin 단백 분비를 의의 있게 증가시켰다. 결 론 : TCDD는 BP 보다 신장 세포에 대한 독성이 강하고 fibronectin 단백 분비를 증가시킴으로써 신장의 섬유화를 유발할 수 있음을 시사하였다. N/A
윤여일,윤석기,김선규,김용현,남일송,차건영,황의원,김영선 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2
Background: The diabetic patients are at significantly increased risk of developing vascular disease. It's etiology may involve oxidative damage by free radiacals and protection againse such damage can be offered by antioxidants. We investigated that oxidative stress as assessed by measurement of total antioxidant status may play a role in development of diabetes mellitus. Method: We measured total antioxiant status using merchandised kit, glycated hemeglobin(HbA1c) in 46 type 2 diabetes mellitus patients and 50 healthy matched control subjects. Result: The total antioxidant status(TAS) was 2.10(±0.04) mmol/L in uncontrolled type 2 DM patients, 2.60(±0.03) in controlled type 2 DM patients and 2.70(±0.16) in healthy control subjects. TAS was significantly lower(P<0.05) in uncontrolled type 2 DM patients, but no significant association between in controlled type 2 DM patients and healthy control subjects. The TAS was 2.00(±0.17) mmol/L in complicated type 2 DM patients and 2.10(±0.29) uncomplicated type 2 DM patients. There was no significant associations between complicated type 2 DM patients and uncomplicated type 2 DM patients. Conclusion: Poor glycemic control is associated with reduced TAS in type 2 DM patients. TAS was thought indirect index that predict glycemic control of type 2 DM patients.
김은주,한상훈,김홍수,이문호,김선주,정재화,박상흠,정일권,차건영,황의원 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.3
Behcet`s disease characterized by recurrent oral and genital ulceration and ocular inflammation has been recognized as a multi-system disorder with numerous manifestitions including gastrointestinal tract. Therminal ileum and cecum are the most frequently involved portions of the gastrointestinal tract in Behcet`s disease and esophageal involvement is very uncommon. We experienced a case of Behcet`s disease involved esophagenal and ileocecal region which had been diagnosed by endoscopy. A 20-year-old male was admitted by dysphagia and substernal discomfort. There was a history of recurrent aphthous stomatitis and genital ulcers. The large geographic ulcers surrounded with edematous mucosa were forund at mid esophagus and the huge ulcer with exudate was noted on ileocecal valve area in endoscopic examination. The microscopic finding of endoscopic biopsy showed chronic nonspecific inflammation with necrotic inflammatory exudate. Pathergy test was positive. So he was diagnosed as Behcet`s disease, and his symptoms and signs were resolved after steroid treatment.