C형간염 진단을 위한 중합효소연쇄반응의 임상적 유용성 검토

이창훈,윤갑준,임인경 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

Current serologic tests for the detection of antibody lo hepatitis C virus (anti-HCV) by enzyme immunoassay (EIA) produce occasional false positive reactions and do not provide useful data about the previous status of antibody formation. So, supplementary tests are necessary. Recently, the application of Polymerase Chain Reaction (PCR) for the detection of HCV RNA has been reported for this confirmatory purpose. The authors evaluated the clinical usefulness of this PCR assay as a routine laboratory diagnostic test for the detection of HCV infection. In this study, HCV-PCR assays were performed for 80 samples of liver disease, 27 samples of hemodialysis, and 40 samples of healthy blood donor. These assays utilized nested reverse transcriplase-PCR(RT-PCR) with two pairs of oligonucleotide primers (40S, NTA1, 80S, 300A) based on the 5'-UTR regions. The results were compared to those of tests for anti-HCV by EIA and another two primer pairs (#32, #36, #33, #48). Clinical data including ALT level were also compared. The results are as follows: HCV RNA was detected by PCR in 44/80(55%) cases. The comparison of results between PCR and EIA showed concordance in 48/72(67%) cases. Discordance that is negative by PCR but positive by EIA or positive by PCR but negative by EIA, occurred in 18/72(25%) cases and 6/72(8%) cases, respectively. In 6/72(8%) cases of positive by PCR but negative by EIA, the mean value of ALT was 145.3 IU/L, whereas the mean value of ALT was 70 IU/L in 16/72(23%) cases in which both tests were negative. The 40 healthy normal blood donors were all PCR negative. 12/27(44%) cases of hemodialysis patients were positive by PCR, but 9/12(75%) cases were negative by EIA. The comparison between two different primer pair sets showed concordance in 34/40 (85%) and discordance in 6/40 (15%) cases, respectively. In conclusion, PCR assay by simplified nested RT-PCR for the detection of HCV RNA can be a valuable diagnostic tool for the early detection of HCV infection and viremia. But further studies involving more clinical cases, in-depth analysis of possible factors causing false negative or positive reactions, and investigation of the technical aspects of specimen handling should be performed.

Comparison of Nicotinic Acetylcholine Receptor Subunit Alpha 9 between Rat and Guinea Pig

Park, Hong-Joon,Wenthold, Robert J. 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.1

Based on its high level of expression in hair cells, the recently-cloned nicotinic receptor subunit, α9, is likely to be the postsynaptic receptor for acetylcholine in hair cells either as a homomeric complex or with other subunits yet to be identified. To study this receptor further, we cloned and sequenced α9 cDNA from the guinea pig organ of Corti library. The sequence of the guinea pig a9 cDNA is similar to that of the rat, with homologies of 85% and 89% at the nudeotide and amino add levels, respectively. Most differences are in the cytoplasmic loop domain between the transmembrane segments 3 and 4. We also observed minor differences in the putative ligand binding regions. These changes could account for the different responses to the agonist 1, 1-dimethyl-4-phenylpiperazinium (DMPP) reported for rat and guinea pig outer hair cells.

신경교종 및 교모세포종 세포와 동시배양된 혈관내막세포에서 Dexamethasone의 투여에 따른 투과도 변화

윤수한,조기홍,김세혁,안영환,안영민,조경기 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.1

Even though many hypotheses have been advanced from the anatomical and functional analysis of in vivo and in vitro models of brain tumors, it is still not yet possible to explain the mechanism of peritumoral edema. Dexamethasone administration has been shown to dramatically decrease peritumoral edema, especially in patients with malignant brain tumor. We evaluated permeability changes of the endothelial monolayer co-cultured with or without glioma and glioblastoma cell lines by dexamethasone administration. All groups showed reduced permeability after dexamethasone administration: 73.6% in the endothelial monolayer culture, 83.8% in the endothelial monolayer co-cultured with C6 glioma cell line, 81.8% in the coculture with H683 astrocytoma cell line, 69.3% in the coculture with 373 MG glioblastoma cell line, and 53.0% in the coculture with 87 MG glioblastoma cell line. These results suggested that dexamethasone inhibited not only the production of some soluble factor which was secreted from the co-cultured cells to the media, but also influenced endothelial cells thus explaining the pathogenetic mechanism of peritumoral edema in malignant brain tumors.

급성전골수성백혈병에서 백혈구성분채집술에 이은 치명적인 뇌출혈 2예

오윤정,박소윤,김윤정,한동석,김현수,최진혁,남동기,임호영,김효철,주희재 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.1

The aim of this study is to report 2 cases of acute promyelocytic leukemia who died from intracranial hemorrhage following leukapheresis and to provide proper preventive measures against hemorrhage following leukapheresis. From 1994 to 1997, a total of twenty-six patients with leukemia underwent leukapheresis to control hyperleukocytosis at Ajou University Hospital. Two patients with acute promyelocytic leukemia received all-trans retinoic acid but developed drug-induced hyperleukocytosis. Shortly after leukapheresis, they died from intracranial hemorrhage. The risk factors for fatal hemorrhage are thought to be coexisting disseminated intravascular coagulation(DIC), thrombocytopenia aggravated by leukapheresis, exacerbated coagulopathy related to mechanical trauma through leukapheresis and the excess use of citrate during leukapheresis. To reduce the risk of the bleeding associated with leukapheresis, it is necessary to replace platelet sufficiently before and after leukapheresis and to give calcium to correct coagulopathy induced by excess citrate which is used as anticoagulant as well as the correction of disseminated intravascular coagulation.

May-Hegglin Anomaly 가족 1예 보고

임영애,전희선,강원형,곽정식,곽연식 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

The May-Hegglin anomaly is characterized by thrombocytopeiua, giant platelets and inclusion bodies in granulocytes. This disorder is inherited as autosomal dominant traits and has been reported in only 2 families in Korea. We experienced May-Hegglin anomaly in a 46-year-old woman who visited the Dermatology outpatient Clinic for care of brown pigmentation around the bilateral periorbital area. This pigmentation occurred after trauma several years ago. The patient had a history of hematuria one year prior to visit and was diagnosed as having idiopathic thrombocytopenic purpura. One of her sisters also had a history of severe bleeding during the surgery in an other hospital about one year ago, and had been diagnosed as having myelodysplastic syndrome by bone marrow biopsy. In peripheral blood smear both patient and her sister were noted to have thrombocytopenia, giant platelets and basophilic inclusion bodies present in the granula-free zone of cytoplasm in the periphery of neutrophils and eosinophils. Transmission electronmicroscopy revealed abnormal cytoplasmic inclusions in granulocytes. The inclusions were characterized by parallel collection of rough endoplasmic reticulum. The findings of bone marrow aspiration and biopsy were normal, except for the presence of basophilic inclusions in myelocytes. The results of PT, aPTT, bleeding time and platelet aggregation test were normal except for decreased aggregation to epinephrine.

Reactive Nitrogen and Oxygen Species Transducers as well as Effectors

Chung, Hun-Taeg 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.2

Occupational Asthma Caused by Serratial Peptidase and Lysozyme Chloride in a Pharmaceutical Industry

Park, Hae-sim,Nahm, Dong-ho 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

There have been very few documented cases of occupational allergies caused by serratial lysozyme and peptidase. In this paper, we report a case of occupational asthma and rhinitis caused by Serratial pepridase and lysozyme chloride which are used as anti-inflammatory agents. The patient had strong positive responses to peptidase and lysozyme extracts on skin-prick tests. Bronchoprovocation tests showed a dual asthmati response to peptidase but only an early asthmatic response to lysozyme. Serum specific IgE antibodies to peptidase and lysozyme were detected by enzyme-linked immunosorbent assay (ELISA). In order to further characterize the allergenic component of these extracts, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and electroblotting studies were also performed. Two lgE binding components (67, 10.9 kDa) were detected within the lysozyme extracts, and more than ten components ranging from 7.3 to 83.1 kDa found in peptidase extracts. The findings suggest that inhalation of peptidase and lysozyme can induce IgE-mediated bronchoconstriction in an exposed worker.

효율적인 간호인력 관리를 위한 주기적 근무일정 편성 시스템 개발

김용순,박지원,김미아,임영이,정경수,조훈 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

An efficient computer-based nursing scheduling module has been developed in order to facilitate nursing duty management throughout hospital wards. Manual maintenance of a nursing schedule has been known to be a formidable task because ward nursing must be maintained around the clock with limited number of personnel to manage three regular shifts (day, evening, and night) as well as off duties. The nursing scheduler has been integrated as a functional component of the hospital information system via order communication system, which can transfer relevant nursing information to and from other related modules such as administrative or payroll department. The implementation based on cyclical scheduling provides capability of even distribution of nurses and predictability of each member's plan on a weekly basis, which eliminates redundant manual scheduling at every management cycle. The LAN interconnected hospital information system incorporates client-server technology, where UNISYS U6000 used as a server, PCS as clients, INGRES for DBMS, and C and VISION programming languages running under UNIX operating system. The prototype implementation used preliminary data collected from a tertiary care hospital nursing department. The data include work shift patterns, classified nursing groups, and principles of work schedule. The scheduling programs are designed to enter/store/update information about the duty nurses, to create worklist, to manage duty time table, and to print out scheduling report. The initial results indicate that the scheduling module is easy to learn, convenient to use, and flexible to adapt to numerous nursing requirements.

식도암의 임상적 고찰

김영수,송시영,정재복 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

We treated 210 patients for esophageal cancer between January 1986 and December 1990. This report analyses the clinical features, survival rate, and prognostic factors affecting survival. Most patients were in their fifties and sixties and the mean age was 61.7 years. The ratio of male to female was 22.3 : 1. The most common symptom was dysphagia; the mean duration of illness was 3 months. There was a correlation between esophageal cancer and consumption of cigarettes and alcohol. The most frequent site of cancer was the middle thoracic esophagus. In order of frequency, 87 cases were of the protruding type, 41 cases were ulcerative and localized, 34 cases ulcerative and infiltrative, and 27 cases diffuse infiltrative as determined by endoscopy. The histologic types were squamous cell carcinoma in 206 patients, adenocarcinoma in two patients, and undifferentiated and adenosquamous carcinoma in one patient each. The most common site of direct invasion was the aorta and the most frequent site of distant metastasis was the liver. The median survival duration for all patients was 10 months. The median survival by stage was 19 months for stage Ⅰ(7 cases of 168 patients), 19 months for stage Ⅱ(41 cases), 9.7 months for stage Ⅲ(89 cases), and 7.2 months for stage Ⅳ(31 cases)(p<0.05). The median survival duration by treatment group was 19.7 months for combined chemotherapy and radiotherapy(22.4% of all patients), 18.9 months for combined therapy including curative operation(15.2%), 9.6 months for chemotherapy alone(31.9%), 5.0 months for radiotherapy alone(11.9%), 3.9 months for conservative treatment(18.6%)(p<0.05). Prognostic factors affecting survival in esophageal cancer were stage of disease and treatment modality, therefore early diagnosis and combined therapy are warranted.

Affinity-Labeling Study for Determining Interacting Sites of an Anti-DNA Antibody on DNA Double Helix

Jang, Young-Ju,Stollar, B. David 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

Previously, a purified monoclonal mouse (MRL-lpr/lpr) IgG anti-DNA autoantibody, H241, was reported to interact with major groove and possibly with phosphate backbone of synthetic helical oligonucleoride of 18 base pairs in affinity-labeling experiment. Experiments were performed to determine further the interacting sites of the autoantibody, H241, on the DNA double helix. Two oligonucleotides which were specifically modified in the minor groove of double-stranded DNA were cross-linked covalently to H241. The ratio of L chain to H chain cross-linked was decreased with the modified oligonucleotide, compared to that with an unmodified helical oligonucleotide. With the more extensively modified oligonucleotide in the minor groove, the ratio was further decreased. This indicates that the anti-DNA autoantibody, H241, possibly interacts possibly with the minor groove as well.