방광내 BCG 점적 주입 치료 후 발생한 관절염

임미경 ( Mi Kyoung Lim ),이성순 ( Sung Soon Lee ),박효숙 ( Hyo Suk Park ),김찬 ( Chan Kim ),장윤혜 ( Yun Hae Chang ),최승원 ( Seung Woon Choi ),유빈 ( Bin Yoo ),문희범 ( Hae Bom Moon ) 대한류마티스학회 1995 대한류마티스학회지 Vol.2 No.2

Intravesical instillation of BCG (Calmette-Guerin Bacillus) is the most widely used treatment of superficial transitional cell carcinoma of the bladder. While the exact mechanisms are not yet known, it is assumed that the recognition of tumor antigen is enhanced by immunologic response of the urothelium of mycobacterium. Various complications have been reported after BCG treatment and arthritis is observed in 0.5 to% of treated patients. This from of arthritis may be attributed to an antigen of mycobacterium sharing a cross reactive epitope with an antigen in articular cartilage. A 40-year-old male had transurethral resection and intravesical instillation of BCG for transitional cell carcinoma of bladder. Within few days of the fourth instillation, he developed arthritis on right knee and right metatarsal joint. Laboratory findings showed nonspecific inflammatory sign, positive HLA B27, negative rheumatoid facor and negative antinuclear antibody. The joint effusion was aseptic. He was treated with nonsteroidal antiinflammatory drugs (indomethacin 200mg/day) with resolution of arthritis symptom. We report a patient who developed an inflammatory oligoarthritis following intravesical instillation of BCG for the treatment oof bladder cancer.

사람 혈청 Vitronectin의 정제 및 항 Vitronectin 다클론 항체의 생산

장윤혜,김백남,이성순,문경,김승후,이재담 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.2

Background: Vitronectin is one of major cell- adhesive glycoprotein in mammalian serum and plasma ; the other is fibronectin. It is a mixture of 65 and 75kDa protein in plasma which promotes spreading of a variety of cultured cells ,inhibits the cytotoxicity of membrane attacks complex C5b-7 and modulates thrombin-antithrombin III activity. Human plasma and serum contain 10-40mg of vitronectin per 100ml,but only a few mg or less of vitronectin can be isolated with a 0.5-20% recovery efficiency through very long processes or with expensive,commercially available monoclonal antibody. In this study, we purified the vitronectin from human plasma and produced anti-vitronectin polyclonal antibody using purified vitronectin. Methods: Vitronectin was purified from the human plasma by heparin-sepharose column and its efficacy was measured by cell spreading assay. Anti-vitronectin polyclonal antibody produced and confirmed by ELISA and immunoblotting. Results: This procedures produced about 0.8mg vitronectin from 100ml human plasma within 2 days. 1) Purified vitronectin promoted spreading of HepG2 hepatoma cells on substrates with a half maximal activity at 0.lug/ml. 2) In SDS-PAGE analysis of purified protein, 2 bands were found and their molecular weights were 75kDa and 65kDa,respectively. 3) The immunoblotting assay showed that the bands of molecular were same site as SDSPAGE analysis. Conclusion: Simple,rapid purified vitronectin by heparin-sepharose column and anti-vitronectin antibody may facilitate the elucidation of vitronectin function and action mechanism in human body.

Laminaria 자궁 경부 삽입에 의한 전신성 아나필락시스 1 례

조영주,김미선,장윤혜,김도연 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.4

Anaphylaxis is a life-threatening syndrome elicited in a hypersensitive individual on subsequent exposure to a sensitizing antigen with, reactions ranging widely in severity from mild pruritus and criteria to shock and death. Anaphylaxis occurs in the United States at rates estimated to be as high as one in every 3000 inpatients and may account for more than 500 deaths annu- ally. Preparations of kelp Laminaria digitata are used as tents in gynecologic procedures to di- late the cervix, and the kelp consists principally of a glucagon carbohydrate called laminarin. Laminarin is thought to function as the active ingredient in dilatation by changing osmotic pres- sure or uterine prostaglandin metabolism. The tent is inserted into the cervix several hours be fore the procedure. As the cervix desiccates and dilates, the tent develops an hourglass shape. Recently, we experienced one patient with anaphylaxis to laminaria diagnosed by skin test and showing good response to treatment.

Hydrocortisone sodium succinae (solucoref) 정맥주사에 의한 아나필락시스 1 례

박경원,조영주,김미선,이경은,장윤혜,전정현,김효정 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.6

Corticosteroids are widely used in treatment of allergic or idiosyncratic anaphylactic reactions, paradoxically, they can be responsible for anaphylactic reactions. Although several reports of suspected allergic reactions to corticosteroids had already appeared, Mendelson et al reported the first instance of immediate anaphylaxis ascribed to solucortef in 1974. We present a review of the literature, and report on one patient with wheat allergy suffered from anaphylactic shock after injection of hydrocortisone sodium succinate. In patients with systemic severe reactions to injectable corticosteroids, we recommend careful and comprehensive skin testing with most avail- able corticosteroids, as well as the components of the injectables.

Oddi 괄약근 운동 이상 환자 16예의 임상 양상

김명환,이성구,서동완,유병무,민영일,이근찬,정훈용,장윤혜,정성애,명승재,이미화,방혜승,김삼정 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.4

We evaluated the clinical characteristics of patients with SO dyskinesia(n=16) who were confirmed by ERCP manometry during past 5 years. They were 14 male and 2 female and mean age was 52-year-old(range, 32-75). According to the criteria suggested by Hogan and Geenen, 13 patients were classified into biliary type and 3 patients into pancreatic type. Among the patients with biliary type(n=13), 12 patients fulfilled the criteria for group II dysfunction of SO and 1 patient for group III. Among the patients with pancreatic type(n=3), all fulfilled the criteria for group II. The manometric abnormalities were increased basal pressure(n=4), tachyoddia(n=7), increased retrograde propagation(n=3), tachyoddia and increased retrograde propagation(n=l), and tachyoddia and increased basal pressure(n=l). As treatment, 12 patients received conventional endoscopic sphincterotomy and 3 patients received endoscopic pancreatic sphincterotomy in addition to conventional endoscopic sphincterotomy. Satisfactory results (complete absence or marked reduction of pain) were obtained in 13(87%) out of 15 patients by endoscopic treatment. In conclusion, SO dyskinesia is not so common disease and the detection of patients with SO dyskinesia may increase by frequent application of ERCP manometry.

사람 내피세포에서 염증 전구사이토카인이 VCAM - 1의 발현에 미치는 영향

조영주,박수길,이재담,황온유,문희범,장윤혜,김승후,홍혜남 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.2

Background: The expression of adhesion molecules contribute to development of systemic diseases. Vascular cell adhesion molecule-l(VCAM-1) is an endothelial cell membrane glycoprotein that has been implicated in leukocyte/endothelial cell interactions in inflammation. Ojective: The aim of this study was to characterize the surface expression and regulation of VCAM-1 on two different endothelial cells. Methods: We examined the effects of the expression of VCAM-1 in two different endothelial cells, isolated from human umbilical cords and human glomerulus. Expression of VCAM-1 was measured by enzyme-linked immunosorbent assay(ELISA) and flow cytometry. Results: In human umbilical cord endothelial cells(HUVECs), both interleukin-lβ(IL-lβ) and tumor necrosis factor-α(TNF-α) increased VCAM-1 expression. VCAM-1 expression increased by TNF-αwas higher than that increased by IL-lβ. In human glomerular endothelial cells(HGECs), IL-lβand TNF-αmarkedly increased VCAM-1 expression. Conclusion. The regulation of VCAM-1 appears to be somewhat different in HGECs compared with HUVECs. These differences between the responsiveness of the two cells may possibly indicate inherent differences in endothelial cell derived from different vascular beds.