싸이클로포린에 의한 흰쥐 신손상에서 아포토시스의 역할

이영호(Young Ho Lee),김난희(Nam Hee Kim),윤종우(Jong Woo Yoon),이영기(Young Ki Lee),조상경(Sang Kyung Jo),김용섭(Yong Sup Kim),차대룡(Dae Ryong Cha),조원용(Won Yong Cho),김애리(Ae Ree Kim),원남희(Nam Hee Won),구자룡(Ja Ryong Ku),김형규( 대한내과학회 1997 대한내과학회지 Vol.52 No.6

N/A Objectives: Apoptosis is a physiologic or programmed cell death in contrast with necrotic cell death. Recently it has been known that apoptosis are concerned in the effects of chemotherapeutic agents or radiation therapy on tumor cells. Cyclosporine a(CsA), a potent immunosuppressant, has been effectively used in organ transplantaion, but it also has a significant toxicity in the kidneys. However the exact mechanism of CsA nephrotoxicity has not been ellucidated yet. This study was performed to investigate whether apoptosis particiates in CsA nephrotoxicity or not. Methods: Twenty seven Sprague-Dawley rats were divided into 5 groups. 1) Vehicle group(n=7) as a control: Cremopbor 50mg/kg/day/subcutaneously (sc) for 7 days, 2) CsA4 groupin=5): CsA 50mg/kg/ day/sc for 4 days, 3) CsA7 group(n=5): CsA 50mg/ kg/day/sc for 7 days, 4) R4 group(n=5): 4 days after CsA 50mg/kg/day/se for 7 days, and 5) R8 group (n=5): 8 days after CsA 50mg/kg/day/sc for 6 days, Biochemical parameters including blood pressure were measured in each group and the cell count of apoptosis in rat kidney was evaluated by in situ end labelling(ISEL) method. Results: 1) The increase of serum creatinine, blood pressure and decrease of creatinine clearance appeared in CsA4 and CsA7 groups. 2) The ce11 counts of apoptosis on tubular cells in CsA4 and CsA7 groups were significantly increased more than in control group(79.0±16.9, 98.4±11.4 vs 35.4±8.8, p<0.05), and the cell counts of apoptosis on tubular cells in R4 and R8 groups were not significantly different from that in control group(53.8±12.5, 65.2±7.1 vs 35.4±8.8, p>0.05), 3) The cell count of apoptosis on the interstitium in each group was not significantly different from that in control group(p>0.05). 4) The cell count of apaptosis on tubular cells was increased more than that on the interstitium in all groups. 5) The cell count of apoptosis on cortex only in CsA7 group was significantly increased more than that io control group(57.8±11.5 vs 21.8±2.6, p<0.05), 6) The cell count of apoptosis on medulla only in CsA4 group was significantly increased more than that in control group(636. ±17.9 vs 22.6±9.7, p<0.05). 7) Total cell counts of apoptosis only in CsA4 and CsA7 groups were significantly increased more than in contral group(96.0±21.1, 99.8±11.8 vs 46.6±11.4, p<0.05). Conclusion: CsA caused apoptosis mainly on tubular cells rather than the interstitial cells and apoptotic cells in CsA nephrotoxicity were not in- creased during the recovery phase. With the results apoptosis may play an important role in CsA nephrotoxicity.

신증후 출혈열에서 Adhesion Molecule 의 발현 양상

이영호(Young Ho Lee),김난희(Nan Hee Kim),장미경(Mi Kyoung Jang),구자룡(Ja Ryong Ku),차대룡(Dae Ryong Cha),조원영(Won Yong Cho),김형규(Hyoung Kyu Kim),원남희(Nam Hee Won) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: The characteristic pathologic finding of renal biopsy in HFRS patients show diffuse mononuclear cell infiltrations in interstitium. However, their relationship between infiltrated T lymphocytes of renal interstitium and renal dysfunction has been suggested, ICAM-1 and VCAM-1 which play an important role on activation. infiltration and cytotoxicity of T lymphocyte and costimulation to T lymphocyte mediate the interaction of lymphocyte to tissue injury. Athors purposed to investigate renal expressions of ICAM-1 and VCAM-1 in HFRS patients. Methods: We detected renal expressions of ICAM-1 and VCAM-1 by immunohistochemistry using mouse monoclonal antibodys to ICAM-1 and VCAM-1 in HFRS patients(n=6) and acute tubular necrosis as a control group(n=5). Results: 1) Expression of ICAM-1 in HFRS patients was strongly positive of glomerular capillary endothelium in 4 cases of 5 (80%) and weakly positive on parietal epithelim (20%) and mesangium(40%). 2) Expression of ICAM-1 in HFRS patients was positive on renal tubular cells in 2 cases of 6 (33%) and on peritubular capillary in 3 cases of 6 (50%), but was not found on renal interstitial cells. 3) Expression of VCAM-1 in HFRS patients was negative on the glomeruli in all cases, 4) Expression of VCAM-1 in HFRS patients was strongly positive on renal tubular cells in 4 cases of 6 (67% ) and on peritubular capillary wall in 1cases of 6 (17%), but was not found on renal interstitial cells. 5) In 5 acute tubular necrosis patients as a control group, renal expression of ICAM-1 and VCAM-1 showed similar patterns with HFRS groups. Conclusion: Expressions of ICAM-1 and VCAM-1 were present on renal tubular cells at 33% and 67%, These renal tubular expression of ICAM-1 and VCAM-1 in HFRS patients may be related with the pathophysiology of HFRS, but further studies are needed to find out the exact role of adhesion molecules in pathophysionlogy of HFRS.

IgA 신증의 임상상 및 예후인자에 대한 고찰

장미경(Mi Kyung Chang),이영호(Young Ho Lee),김난희(Nan Hee Kim),차대룡(Dae Ryong Cha),구자룡(Ja Ryong Koo),권영주(Young Joo Kwon),조원용(Won Yong Cho),표희정(Hee Jeong Pyo),김형규(Hyoung Kyu Kim),원남희(Nam Hee Won) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: IgA nephropathy is a primary renal disease characterizedy prominent mesangial IgA deposition without systemic disease. The main clinical manifestaion is recurrent hematuria and proteinuria and it is most common renal disease in patients with recurrent hematuria. IgA nephropathy was initially regarded as a glomerulonephritis with a favourable course but the later investigators have found that more than 20% of the patients will progrss to end stage renal failure within 10-20 years from the diagnosis. The natutal course of the patients is very variable so that the clinical manifestations and the factors affecting the prognosis of this disease have a very important clinical aspects. Authors purposed to invastigate the clinical features and renal pathologic findings for 43 patients of IgA nephropathy in association with prognosis during recent four years. Methods: Patients were considered for entry into the study on the basis of a renal biopsy specimen which showed predominently IgA mesangial deposits an immunofluorescence(IF). They were excluded if there were clinical or serological evidence of systemic lupus erythematosus, chronic liver disease, or Henoch-Schonlein purpura. The clinical features and pathologic findings were abtained by careful retrospective study of the hospital records of each patient only after selection on the basis of the immunohistological features. Results: 1) Mean age of the patients was 28.8 years and 79% of the patients were distributed between 20-40years. Male to female ratio was 1:l. 2) The most common clinical symptom was gross hematuria(47% ). 3) Significant proteinuria(more than 1g/day) was noted in 10cases(44%) including 5 cases(12%) of nephrotic range proteinuria. 4) The most common renal pathologic finding is tubular atrophy and has significant positive correlation with mean blood pressure, level of serum creatinine and the amount of 24 hour urinary protein. 5) 9% of the cases progressed to deterioration of renal function during mean 29 months of follow up duration. Mean arterial blood pressure and the amout of 24 hour protein of these patients were 141mmHg, 4.25g/day respectively. renal biopsy showed tubular atrophy and nephrosclerosis in all cases. 6) Serum crearinine level showed statistically significant positive correlation with age(r=0.34), mean arterial blood pressure(r=0.71) and the amout of 24 hour urine proteine(r= 0.35)(p<0.05). Conclusion: Old age, mean arterial blood pressure, the amout of 24 hour urine protein and the pathologic findings of tubular atrophy or glomerulosclerosis correlate with the prognosis of the patients with IgA nephropathy

노년층 신질환자에서 시행된 신조직 검사소견 및 임상상

장미경(Mi Kyung Chang),이영호(Young Ho Lee),김난희(Nan Hee Kim),구자룡(Ja Ryong Koo),위경소(Kyoung So Wi),권영주(Young Joo Kwon),김형규(Hyung Gyu Kim),원남희(Nam Hee Won),이현순(Hyun Soon Lee),표희정(Heui Jung Pyo) 대한내과학회 1995 대한내과학회지 Vol.49 No.4

N/A Objectives: High proportion of the elderly patients with renal disease were found to have primary glomerular disease and their clinical entities may be modified by treatment, supporting the renal biopsy as a diagnostic aid to institute appropriate therapy. Methods: We have retrospectively reviewed 49 patients of 60 years old or older in whom renal biopsies were performed from September 1985 to July, 1994. We've analyzed the histopathologic distribution, clinical presentations, clinicopathologic correlations, complications related to renal biopsy and treatment, and clinical response to the immunosuppressive therapy. Results: 1) Patients were 34 men and 15 women, 60 to 79 years of age (mean, 64.8±45) 2) The most common clinical presentation was nephrotic syndrome (65%). 3) The pathologic diagnoses of primary renal disease (36.73%) were MGN (13), MPGN (5), IgA nephropathy (5), MCNS (4), FSGS (4), Crescentic GN (2), nephrosclerosis (2) and PSGN (1). 4) The pathologic diagnoses of secondary renal disease (13.27%) were amyloidosis (4), TIN (4), HBsAg associated GN (2), cryoglobulinemia (1) and TMA (1). 5) In the cases of nephrotic syndrome with immunosuppressive therapy (20), 5 (25%) patients showed complete remission and 11 (50%) showed partial remission. 6) No one has recovered in the cases of chronic renal insufficiency and rapidly progressive renal failure. Conclusion: The most common clinical presentation and pathologic finding in the elderly were nephrotic syndrome and membranous GN respectively. The response to immunosuppressive therapy in nephrotic syndrome was good, but the possible complications related to the immunosuppression should be considered prior to the therapy. Renal biopsy is a safe procedure even in the elderly, and essential for the definitive diagnosis and for the appropriate therapy.

차종별 도로교통소음레벨과 주파수 특성에 관한 연구

박상일 ( Sang Ill Park ),최형일 ( Hyung Il Choi ),정경훈 ( Kyung Hoon Cheong ),정원삼 ( Won Sam Jeong ),김난희 ( Nan Hee Kim ),이종국 ( Jong Kuk Lee ),오남승 ( Nam Seung Oh ) 조선대학교 공학기술연구원 2008 공학기술논문지 Vol.1 No.2

Quantitative evaluation for the sound source to predict the noise in the field point for the Road Traffic Noise was conducted. The traffic noise level and frequency characteristics as per types of cars for wave process until the noise reaches the field point was measured. 1. Frequency Characteristics while Driving Under freely flowing conditions of traffic, when you drive a bus on a public road, the traffic noise level showed a change of 6.2 dB(Z) from 83.1 dB(Z) to 89.3 dB(Z).The change of traffic noise level was 6.3 dB(Z) from 81.7 dB(Z) to 88 dB(Z) when a van was driven, and 10.8 dB(Z) from 79.5 dB(Z) to 90.3 dB(Z) when a one-ton truck was driven. Also, the change of traffic noise level was 18.6 dB(Z) from 81.3 dB(Z) to 99.9 dB(Z) when a motorcycle was running. All vehicles except for the motorcycle showed similar noise levels of 31.5, 500, 1 k and 2 kHz. The bus showed the highest noise level at 63 Hz and 125 Hz, and a van and an 11 ton truck showed the highest levels at 125 Hz. The one-ton truck was measured at 63 Hz for the highest noise level. The motorcycle was measured at 250 Hz with the highest noise level of 96.7 dB(Z) and at 500 Hz with 95.5 dB(Z), indicating the highest noise level among specific vehicles. 2. Characteristic of Frequency upon Departure The noise level when an urban bus stops to depart was 94.6 dB(Z), which is higher than that of stoppage and driving. When a bus stops, the normal car have an influence on the noise level, and after departure, it brings out the highest noise at 250 Hz and 500 Hz, which is caused by noises from the engine and exhaust. The noise level when a normal car stops to depart was higher than that of stoppage and driving at 85.7 dB(Z). It is high at 63 Hz as it is being reduced from 250 Hz. While a normal car is stopping, higher noise is made at 31.5 Hz, which is considered to be caused by engine noise.

나환자의 재발에 대한 고찰

김도원,김난희,정상립 大韓癩學會 1986 癩學 會誌 Vol.19 No.1

Juvenile Xanthogranuloma 2 예

김수남,양문호,김난희,유태연 대한피부과학회 1975 大韓皮膚科學會誌 Vol.13 No.3

Two Cases of Juvenile XanthogranuIoma(JXG) are reported with review of literatures. JXG is a rare disease, and have not yet been reported in this country. Case I: Two months oId healthy female infant has two firm, discrete, brownish yellow waxy nodules on the left postauricular region and the left forearm. The lesion had begun as erythematous pinhead sized papules, and have been enlarged rapidly to pea siez during last three weeks. Case II: Three year old healthy male has firm, discrete, pinhead to pea sized scattered 16 papules and nodules on the trunk and right side of neck. Laboratory findmgs and X-ray studies were normal in both cases and there were no evidence of metabolie disorder or bony abnormality. Histopathologic studies show similar findings in both cases. In hematoxylin-eosin staining, epidermis shows parekeratosis and slight elongation of rete ridges with suprapapillary thinning with focal spongiosis and invasion of inflammatory cells. The entire dermis, from dermal papillae to sbcutis, is replaced by granulomatous lesion composed with histioeytes and a few giant cell reaction, in addition to histiocytic proliferation, considerable amount of eosinophils are infiltrated with some lymphocytes and plasma cells. The dermal collagen fibers are partly degenerated. In the upper most portion, some foamy histiocytes are also seen. In frozen section and Sudan III fat staining, the tissue shows mild reactivities.

선천성 , 심장기형을 동반한 Klippel - TRenaunay - Weber Syndrome 1 예

김수남,김난희,유태연 대한피부과학회 1975 大韓皮膚科學會誌 Vol.13 No.3

A 17 year old female with Klippel-Trenaunay-Weber Syndrome is presented. Of particular interest was presence of congenital heart anomaly. The nevus flarnmeus invoIved her entire right leg and foot with hypertrophy, elongation and partial ulecration. Elongation of the right leg Iead cornpensatory vertebral scoliosis (Fig.1,2). The cutaneous temperature of affected side was higher than the other side, and. was larger on somatometry and osteometry (Table 1). On auscultation, grade III systolic blowing murmur was heard on left upper sternal border with second heart sound splitting. Electrocardiograrn revealed complete right bundle branch block (Fig. 3). Chest X-ray revealed cardiomegaly, increase 3 hilar shadaws and rnild pulmonary congestion (Fig. 4). Above mentioned signs suggests strongly secundum type of atrial septal defect. Femoral angiography didnt show arteriovenous malformation (Fig. 5). Authors experienced this rare variant of Klippel-Trenaunzy-Weber Syndrome acco- mapanying with congenital heart anamaly, and report this with review of literatures.

Reactive Perforating Collatenosis 의 1 예

김수남,김난희,유태연 대한피부과학회 1973 大韓皮膚科學會誌 Vol.11 No.3

Authers observed one case of typical reactive perforating collagenosis(RPC) which did not seem to have been described in the Korean literatyre. A 19 year old male patient complained of a skin eruption involving his face, upper and lower extremities, and trunk in June 1973. The skin eruption appeared at the age of 10 and consisted of discrete papules of which the earliest lesion was a pinhead-sized, skin-colord papule, but it became older, it increased in size and developed a small central area of umbilication containing keratinous material. As new papules continued to develop, the older lesions regressed and disappeared with residual scar. No subjective symption was obtained expect intermittent, mild itching sensation which probably due to a irritation. The Keobner's phenomenon was observed on the dorsum of hands. He has acne vulgaris on the face with many of the individual comedones showing development into RPC. He also had a chronic maxillary sinusitis which was seemed to aggravate the skin eruption. In foolow up period(about 5 months), the sinusitis was cured with operation, but the skin eruption was not improved. The family history was negative. Histopathological studies revealed typical RPC, i.e., a cup-shaped epidermal depression of which center was lacked the epidermis was noted, and through it, necrobiotic connective tissue, degenerating inflammatory cells and collagen bundles are extruded to form a plug. Diagnosis was confirmed by clinical appearance and typical histopathologic features. The patient did not responed to topical application of 0.1% Retinoic acid solusion and Vitamin A and D.

만성 호중구성 백혈병(CNL) 1례

장미경,김난희,최경묵,이진구,남용진,신상원,김준석,손보라,이갑노 大韓血液學會 1994 大韓血液學會誌 Vol.29 No.2