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      • KCI등재후보

        Immobilization with Ketamine HCI and Tiletamine-Zolazepam in Cynomolgus Monkeys

        Myung-cheol Kim,Sung-hyeok Hong,Soo-jin Lee,Young-suk Kim,Jae-il Lee 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

        with Ketamine HCl and Tiletamine-Zolazepam in Cynomolgus MonkeysJae-il Lee, Sung-hyeok Hong, Soo-jin Lee, Young-suk Kim and Myung-cheol Kim*Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon 305-764, KoreaReceived March 4, 2003 / Accepted July 2, 2003J. Vet. Sci. (2003), 4(2), 187-191JOURNAL OFVeterinaryScience*Corresponding author: Myung-cheol Kim Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon 305-764, Korea Tel: +82-42-821-6757, Fax: +82-42-822-4216 E-mail: mckim@cnu.ac.kr

      • Slide Session : OS-IFD-07 ; Infectious Disease : In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus

        ( Myung Jin Lee ),( Kye Hyung Kim ),( Jong Youn Yi ),( Su Jin Choi ),( Chung Jong Kim ),( Nak Hyun Kim ),( Kyoung Ho Song ),( Pyoeng Gyun Choi ),( Ji Hwan Bang ),( Wan Beom Park ),( Eu Suk Kim ),( San 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

        In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus Myung Jin LEE1, Kye-Hyung KIM1, Jongyoun YI2, SuJin CHOI1, Chung-Jong KIM1, Nak- Hyun KIM1, Kyoung-Ho SONG1, Pyoeng Gyun CHOI1, Ji-Hwan BANG1, Wan Beom PARK1, Eu Suk KIM1, Sang-Won PARK1, Hong Bin KIM1, Nam Joong KIM1, Myoung- Don OH1 Seoul National University College of Medicine, Korea1, Pusan National University School of Medicine, Korea2 Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV). No effective antiviral therapy is proven yet, but clinical use of ribavirin (RBV) has been tried. We investigated the antiviral effect of RBV against SFTSV in vitro. Methods: To test for cytotoxicity of RBV, Vero cells were treated with different concentrations of RBV (3.90 to 500 μg/mL, two-fold dilution) and analyzed by cell viability MTS assay 48h post-infection. To determine antiviral activity of RBV against SFTSV, Vero cells were infected with SFTSV strain Gangwon/Korea/2012 at 100 TCID50 (50% tissue culture infective dose) per well in a 96-well plate, and RBV was added at the concentrations showing no or minimal cytotoxicity. Viral RNAs were extracted from the culture supernatants and quantifi ed using one-step real-time reverse transcription- PCR to amplify the partial large segment of SFTSV. Statistical analysis was done by one-way ANOVA with Tukey`s post hoc test. Results: Cytotoxicity due to RBV was not observed at RBV concentration =31.3 μg/ mL. Viral RNAs at 24h post-RBV treatment were reduced with increasing RBV concentrations (1-32 μg/mL), compared with those of mock-treated cells (P <0.01, Figure). Half maximal inhibitory concentration (IC50) of RBV was 3.69 μg/mL at 24h post-RBV treatment. Conclusions: Our study shows that RBV has antiviral effect against SFTSV in a dose-dependent manner. Further studies are required to evaluate the effi cacy of RBV in SFTS.

      • 서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

        김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

        Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

      • KCI등재

        한국인 직무 스트레스 측정도구의 개발 및 표준화

        장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

        Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

      • 배양된 쥐 인슐린종 세포에서 성장인자들에 대한 인슐린 유전자의 발현

        김성운,양인명,김진우,김영설,김광원,최영길 경희대학교 유전공학연구소 1989 遺傳工學論文集 Vol.1 No.-

        인슐린 유전자 발현의 실험실적 모델로서 쥐 인슐린종 세포(RINm5F cell;rat insulinorraceil)를 이용하여 몇 개의 성장인자에 대한 반응을 조사하고 인슐린 유전자의 활성에 관여하는 상황을 이해하고자 인슐린 유전자의 mRNA를 조사하였다. RINm5F 세포는 glucose 와 EGF 등의 성장인자에 대해 세포분화 및 성장에 자극을 받으며 인슐린, IGF-Ⅰ IGF-Ⅱ등에는 영향을 받지 않았다. 따라서 RINm5F TPVHSMS 생체내 췌도 베타세포의 기능을 대변하기는 어려웠으나 각종 성장인자의 세포내 활성양상을 간접적으로 알 수 있었다. Insulin secretion of RINm5F cells can be stimulated by some of the growth factors, however, not in the same manner compared to pancreatic islet beta cells. We observed that insulin superfamily (insulin IGF-Ⅰ, IGF-Ⅱ) were not affected to insulin mRNA of RINm5F cells, but EGF (50ng/㎖) increased insulin mRNA levels, and dexamethasone (300ng/㎖) decreased insulin mRNA levels in RIAm5F cells. So some of growth factors regulated insulin gene at transcription level in RINm5F cells line.

      • KCI등재후보

        담낭 방선균증 1예

        김형수,정진원,김양수,우준희,송현순,류지소,김명환,김남중 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

        저자들은 우상복부 통증과 소화불량을 주소로 내원한 83세 여자 환자에서 국내 최초로 담낭 방선균증을 진단하고 치료 관찰 중으로 이에 문헌고찰과 함께 보고하는 바이다. Actinomycosis is a chronic suppurative and granulomatous disease, characterized by abscess formation, tissue fibrosis, and draining sinuses. Actinomycosis of the gallbladder is very rare and has not yet been reported in Korea. We report a case of actinomycosis of the gallbladder in an 80-year-old women with history of cholelithiasis for 3 years, preoperatively misidentified as gallbladder cancer. Histologic section of the gallbladder showed Gram-positive branching bacilli compatible with actinomyces. After cholecystectomy, the patient received intravenous ampicillin for 4 days, followed by amoxicillin for 4 months thereafter.

      • 한국인 갑상선 수질암 환자에서 RET 원종양유전자 점돌연변이 양상

        김형훈,김현진,정윤재,민용기,이명식,이문규,김광원,기창석,김종원,정재훈 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

        연구배경: 갑상선 수질암의 25∼30%는 유전성으로 발현되는데, MEN 2A, MEN 2B 또는 가족성 수질암의 형태로 나타난다. RET 원종양유전자의 점돌연변이가 유전성 갑상선 수질암의 발생에 중요한 역할을 하므로, 진단 당시의 연령이나 가족력 유무에 관계없이 모든 갑상선 수질암 환자나 또는 RET 변이가 발견된 수질암 환자의 가족 구성원들에서 RET 변이 검색을 하여야 한다. 또한 일부 문헌에서 RET 변이의 양상에따라 임상상이 다르게 표현됨이 보고된 바 있다. 이에 저자들은 한국인 갑상선 수질암 환자에서 RET 원종양유전자의 점돌연변이의 양성률을 알아보고, 변이 양상에 따른 임상상의 차이가 있는지를 알아보고자 본 연구를 시행하였다. 방법: 치근 7년간 본원에서 갑상선절제술을 통해 갑상선 수질암으로 진단받은 29예에서 RET 원종양유전자의 점돌연변이 검사를 시행하였다. 29예의 평균연령은 39세(20∼60세)이었고, 남자 7예, 여자 22예 이었다. 이들의 말초혈액에서 genomic DNA를 분리하고, 특이 시발차를 이용하여 RET 원종양유전자의 exon10, 11, 13, 14, 16부위를 증폭하였다. 증폭된 부위를 자동염기서열분석기를 이용하여 직접 분석하였다. 양성으로 나온 경우는 모든 가족 구성원을 대상으로 RET 변이 유무를 검색하였다. 결과: 대상 환자 29예 중 9예 (31%)에서 RET 원종양유전자 점돌연변이가 발견되었다 RET 변이가 발견된 9예 (남자 3예, 여자 6예)의 평균 연령은 33세 (20∼51세)로 RET 변이가 발견되지 않은 20예의 평균연령 42세(24∼60세)보다 의미 있게 적었다. RET 변이가 발견된 9예 중 MEN 2A가 5예, 가족성 수질암이 1예, 그리고 산발성 수질암이 3예이었고, MEN 2B는단 1예도 진단되지 않았다. MEN 2A 5예 중 4예는 exon 11의 codon 634번(C634R 2예, C634Y 2예)에서, 그리고 나머지 1예는exon 10의 codon 618번 (C618R)에서 변이가 각각 발견되었다. 가족성 수질암 1아는 codon 634번(C634W)에서, 산발성 수질암 3예도 모두 codon 634번 (C634y 2예, C634s 1예)에서 각각 변이가 발견되었다. RET변이 양상 또는 위치에 따른 임상상의 차이는 발견할 수 없었다. 결론: 갑상선 수질암 환자 31%에서 RET 원종양유전자의 점돌연변이를 발견할 수 있었다. 유전성 수질암 중 가족성 수질암 1예를 제외하고 나머지 5예는MEN 2A이었다. 저자들의 5예와 지금까지 국내에서 보고 된 7예를 합친 국내 MEN 2A 12예 중 75% (9/12)는 exon 11의codon 634번(C634R 4예, C634y 4예, C634w 1예)에서, 그리고 나머지 25% (3/12)는 exon 10의 codon618번(C618R 2예, C618s 1예)에서 변이가 발견되었다. 국내에서는 codon 634과 codon 618 두 곳에만 국한된 양상이었고, codon 634에서의 C634R 변이는 1/3에서만 나타났다. 비록 본 연구에서는 제한된 환자 수 때문에 변이 양상과 임상상의 관계를 규명할 수 없었지만, 향후 많은 수의 환자를 대상으로 전향적인 연구를 시행하여 genotype-phenotype 관계 규명을 하는 것이 필요하다. Background: Medullary thyroid carcinomas (MTC) have been reported as hereditary in about 25 -30% of cases. The identification of germline mutation in RET proto-oncogene is important in the diagnosis of hereditary MTC, and occurs in three forms: MEN 2A, MEN 2B and familial MTC (FMTC). To evaluate the prevalence of the relationship of RET proto-oncogene mutation and genotype-phenotype was studied in Korean patients with MTC. Methods: Genomic DNA was obtained from 29 patients, with MTC, who underwent a total thyroidectomy, between 1997 and 2003, at the Samsung Medical Center. There were 7 male and 22 female patients, with an average age of 39, ranging from 20 to 60 years. Exon 10, 11, 13, 14 and 16 of the RET proto-oncogene were amplified, with specific primers, using PCR. A sequencing analysis was performed on the PCR product using an automatic sequencing analyzer. Results: Nine of the 29 patients (31%) were identified as having RET mutations. The average age of these 9 patients was 33 years, ranging from 20 to 51, with a female to male ratio of 2. Five patients had MEN 2A and one had FMTC, with the other 3 thought to have non-hereditary (sporadic) MTC. The 4 patients with MEN 2A had RET mutations on codon 634 of exon 11 (2 patients, C634R; 2 patients, C634Y) and the other patient on codon 618 of exon 10 (C618R). One patient with FMTC had a mutation on codon 634 (C634W). Three patients with sporadic MTC had RET mutations on codon 634 (2 patients, C634Y; 1 patient, C634S). However, no genotype- phenotype relationship could be found, due to the limited number of patients. Conclusion: Thirty-one percent (9/29) of the patients with MTC had RET proto-oncogene mutations. Three-quarters (9/12) of the Korean patients with MEN 2A, including another 7 patients reported in 3 papers in Korea, had RET mutations on codon 634 of exon 11 (4 patients, C634R; 4 patients, C634Y; 1 patient, C634W), but a quarter (3/12) had mutations on codon 618 of exon 10 (2 patients, C618R; 1 patient, C618S). Although no relations could be found between the genotypes and phenotypes, extensive prospective studies will be required to verify this (J Kor SOC Endocrinol 18:360-370, 2003).

      • SCOPUSKCI등재

        어린이에서 수술 중 엎드린 자세와 누운 자세에서의 심박수변이도의 비교

        김혜경,김종성,김성덕,김희수,염명걸,백진우 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

        Comparison of Heart Rate Variability between the Supine and Prone Plsition during General Anesthesia in Children Hee-Soo Kim, M.D., Jin-Woo Baik, M.D., Chong Sung Kim, M.D., Seong Deok Kim, M.D. Myung0Kul Yum, M.D.^*, and Hae Kyung Kim, M.D.^?? Department of Anesthesiology, College of Medicine, Seoul National University ^*Department of Pediatrics, College of Medicine, Hanyang University ^??Department of Anesthesiology, College of Medicine, Inha University, Incheon, Korea Background: It is well known that the prone position affects hemodynamics. In this study, we investigate whether the prone position will affect the heart rate variability compard with the supine position. Methods: Sixty five pediatric patients were assigned to supine group (n = 36) and prone group (n = 29) according to position during surgery. The patients were indeced with thiopental and vecuronium and maintained with O_2-enflurane-N_2O. ECG data was collected for 15 minutes after saturation at the end tidal concentration of the inhalent agent. From the ECG data, power spectral analysis was performed and approximate entropy was calculated. Results: IN the prone group, low frequency power and ratio of low to high frequency power were lower and approximate entropy was higher than those in the supine group. Mean heart rate and blood pressure were no different between the two groups. Conclusions: IN the prone position, sympathetic autonomic activity and balance of the autonomic nervous system decreased. However the complexity of regulation of heart rate variability was maintained in the prone position. (Korean J Anesthesiol 2001; 41: 455~460)

      • 정상과 갑상선 종양조직에서 사람 IGF-I 유전자의 발현

        김성운,장현하,박상미,김덕윤,우정택,양인명,김진우,김영설,김광원,고석환,홍성화,최영길 경희대학교 유전공학연구소 1993 遺傳工學論文集 Vol.5 No.-

        Many of the growth-promoting properties of growth hormone(GH) are mediated by insulin-like growth factor-I(IGF-I), a highly conserved circulating 70-amino acid peptide. Recent studies have shown that multiple mechanisms influence IGF-I gene expression, including transcription from two promoters, alternative RNA splicing, and variable polyadenylation. In thyroid tissue, thyroid stimulating hormone(TSH) and IGF-I are the most possible candidates for follicular cell proliferation and hypertrophy. Actually IGF-I had autocrine and paracrine effect for tissue growing. We prepared thyroid tumor tissue mRNAs using single step method for detecting IGF-I levels according to different tissues, i.e., thyroid adenoma or papillary thyroid carcinoma. We used Northern blot analysis for IGF-I mRNA and RNase protection assay (RPA) for IGF-I transcription start sites. For Northern blot, we used whole human IGF-I cDNA as a DNA probe and for RPA, we used IGF-I exon 1 containing noncoding promoter 1 as a riboprobe. We got good RNA bands from Northern blot analysis around 1 kb (IGF-IA) and 7.5 kb (IGF-IB) region. To clarify the amount of both IGF-IA and IB mRNAs, we measured autoradiographied signal of IGF-I mRNAs bands using densitometer. In IGF-IA signals, there's no change among liver and thyroid tissues, but in case of IGF-IB mRNA bands, the signal was markedly increased in thyroid carcinoma tissues than that of normal thyroid tissue (85% vs 14%). In the study of RPA, all thyroid tissues used the same transcription start sites as those of liver's. We concluded that that this different regulation of IGF-I mRNA was originated from tissue specificity. That meant some tissue specific transcription factor/s were related to tissue IGF-I expression.

      • SCOPUSKCI등재

        한국인 제1형 당뇨병에서 체도 세포질 항체의 양성률 : 항GAD항체, 항ICA512항체, 항phogrin항체의 조합 측정으로의 대체 가능성 Possible Replacement with Combined Measurement of Anti-GAD, Anti-ICA512, and Anti-phogrin Antibodies

        김경아,김동준,정재훈,민용기,이문규,김광원,진동규,고경수,김상진,이명식 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

        연구배경:최근 당뇨병의 분류를 새로 제정함에 있어 자가항체가 양성이면 임상형에 상관없이 제1형 당뇨병으로 분류하자는 제안이 나옴으로써 자가항체의 중요성은 더욱 커질 것으로 예상된다. 특히 우리나라와 같이 비비만형인 제2형 당뇨병이 많은 나라에서는 당뇨병의 병인 규명에 자가항체가 중요한 위치를 차지할 것으로 사료된다. 자가항체 중에서 전통적으로 측정되어온 췌도 세포질 항체(ICA)는 표준화하기 어렵고 기술적으로 제한점이 많으며 현실적으로도 췌장 공여자가 적은 점 등이 문제로 알려져 있다. ICA의 대응 항원들로는 GAD(glutamic acid decarboxylase), IA­2(islet­associaated antigen­2;ICA512), IA­2β(phogrin)등이 있다. 이러한 대응 항원에 대한 특이적인 자가항체의 측정은 ICA에 비해 표준화되었으며 최근에는 방사면역측정법(radioimmunoassay;RIA)키드까지 등장하여 손쉽고 정확히 이를 측정할 수 있게 되었다. 연구자들은 한국인 제1형 당뇨병에서 측정법이 표준화 되어 있는 항GAD항체 및 항ICA512항체 조합(combimation)의 조합으로 ICA의 측정을 대신할 수 있는지를 조사하였고 더 나아가 항phogrin항체의 조합 측정으로 임상적 유용성이 있는지 보고자 하였다. 방법: ICA는 면역조직화학 염색법을 이용하였다. 항 GAD항체는 상업화 된 키드(RSR??, United Kingdom)를 이용하였다. 항 ICA512항체와 항phogrin항체의 측정은 in vitro transcription&translation한 후 이를 이용해 방사면역 침전법을 이용하였다. 대상 환자로는 전형적 제1형 당뇨병 76명, 지진형 제1형 당뇨병 22명, 제2형 당뇨병 39명이었으며 각 군간의 연령은 각각 22.8±14.0, 37.9±13.9, 45.3±12.3세였다. 결과:1)전형적인 제1형 당뇨병에서는 ICA의 양성률이 30%, RIA조합만의(항GAD항체 또는 항 ICA512항체 또는 항phgrin항체 한가지에라도 양성인 경우)양성률이 57%이었다. 지진형 제1형 당뇨병에서는 각각 18%, 50%이었다. 제2형 당뇨병에서는 각각 7.7%, 5.1%이었다. 2)각 군에서 ICA가 양성인 군에서 RIA조합 양성률을 보면 전형적 제1형 당뇨병에서는 96%, 지진형 제1형 당뇨병에서는 100%에서 양성이었고 제2형 당뇨병에서는 RIA 조합 양성이 없었다. 각 군에서 ICA가 음성인 군에서도 RIA 조합시 전형적 제1형 당뇨병에서는 40%, 지진형 제1형 당뇨병에서는 39%에서 양성이었고, 제2형 당뇨병에서는 5.6%에서 양성이었다. 3)전형적 제1형 당뇨병에서 ICA가 양성인 군(n=23)에서 96%가 RIA조합 양성이었는데 이때 각각의 RIA유형을 보면 항GAD항체 양성이 87%였다. 한편 항 ICA512항체 양성이 48%, 항phogrin항체 양성이 44%이고 항GAD항체 도는 항ICA512항체 양성이 96%를 차지한다. 지진형 제1형 당뇨병에서는 ICA가 양성인 군(n=4)에서는 항 GAD항체 양성이 3명, 항ICA512항체 양성이 1명이었다. 따라서 기존의 ICA를 RIA조합으로 대체할 수 있을 것으로 사료되었는데 이때 항GAD항체와 항ICA512항체의 조합이 도움이 되겠고 항phogrin항체의 추가적인 검사는 일부의 환자에서만 도움이 되리라 사료된다. 4)이환 기간에 따라 ICA와 RIA조합을 비교시 ICA는 차이가 없었으나 RIA조합의 양성률은 지진형 제1형 당뇨병에서 4년 이상의 이환 기간이 지나면 그 이전보다 떨어졌다. 5)발병 연령에 따라 ICA와 RIA조합을 비교시 ICA 양성률이 전형적 제1형 당뇨병에서 15세 이전에 발병한 그룹에서 그 이후에 발병한 그룹보다 유의하게 높았다. 결론:이상의 결과를 요약하면 항GAD항체 및 항ICA512항체 측정의 조합은 ICA보다 민감도가 높아 기존의 ICA를 대체함은 물론 임상적 이용에서 현격한 우월성을 보이며, 성인에서 발병한 비전형적인 당뇨병의 분류에도 도움이 될 것으로 사료되었다. 추가적인 항phogrin항체의 측정은 임상적 유용성이 없었다. Background : Type 1 diabetes includes all forms of autoimmune-mediated and idiopathic beta-cell destruction leading to an absolute insulin deficiency. Evidence of an autoimune pathogenesis was assessed by studying cytoplasmic islet cell antibodies (ICA), antibodies to glutamic acid decarboxylase (GADA), antibodies reacting with an islet tyrosine phosphatase-related molecule referred to as ICA 512 (ICA 512A), or its homologue phogrin (phogrin-A). In comparison with ICA, the best validation to assess the risk of type 1 diabetes, shows that a combination of antibodies to GADA with ICA 512A has the power to detect a majority of ICA and 97 ~ 100% of subjects who progressed to overt diabetes. These findings suggest the possibility of replacing the laborious ICA test in the screening programs to identify subjects at risk of progressing to type 1 diabetes or for classifying the stage of diabetes at the time of diagnosis. Up to now, it is unclear whether these results are applicable to the slowly progressive type 1 diabetes that appears to be more prevalent in Asian than in western countries. The prevalence of combined autoantibody testing (1≥ of GADA, ICA512A, or phogrin-A) was investigated in the patients with type 1 diabetes (typical and slowly progressive) and type 2 diabetes, and compared with that of ICA which is a more laborious and insensitive test. Methods : The ICA assay was performed using immunoenzymatic staining of frozen human (blood group O) pancreatic sections with serial dilutions of serum samples with peroxidase-labeled protein A. For the GADA determination, commercially available GADA radiommunoassay kits utilizing the ^125I-labeled recombinant GAD65 (RSR®, United Kingdom) as an antigen was used. Either ICA512A or phogrin-A were detected by a radioligand-binding assay after in vitro transcription and translation using the clone ICA512bdc or phogrin c DNA. Serum was obtained from 76 patients with type 1 diabetes(mean age 45.3± 12.3 years). Typical and slowly progressive type 1 diabetes patients had the disease for between 4.0±4.6 and 10.1±9.5 years, respectively at the earliest serum sampling. Results: 1) In typicaltype 1 diabetes, 30% of patients tested positive for ICA and 57% for the combined autoantibody test. In type 2 diabetes, 7.7% and 5.1% tested positive, respectively. 2) Ninety-six percent of ICA-positive patients expressed one or more of the 3 auto-antibody specificities in typicaltype 1 diabetes. Among the 53 ICA-negative patients with typicaltype 1 diabetes, 40% had one or more of these auto-antibodies. In the slowly pregressive type 1 diabetes, 100% of the ICA-positive and 39% of the ICA-negative patients expressed one or more of the 3 autoantibody specificities. 3) Of the 23 patients with ICA-positive typical type 1 diabetes patients, 87% had a positive result for GADA, 48% FOR ICA512A, 44% for phogrin-A, and 96% for GADA or ICA512A. Of the 4 patients with ICA-positive slowly progressive type 1 diabetes, three had a positive result for GADA, and 1 for ICA512A. 4) When the prevalence of combined autoantibody testing was analyzed according to the duration of diabetes, the prevalence in patients tested within 4 years after the diagnosis and more than 4 years after the diagnosis was 61% and 52%, respectively in typical type 1 diabetes. Furthermore, that for the ICA was 37% and 21%, respectively. In the slowly progressive type 1 diabetes, the prevalence of combined auto-antibody testing was 88% and 25%, respectively (p<0.05), while that of ICA was 25% and 13%, respectively. 5) In typical type 1 diabetes, ICA were detected more frequently in patients younger than 15 years of age (48%) than in older patients (23%) (p<0.05), while the prevalence of combined auto-antibody testing -was not different according to the onset age(65% vs 53%). Conclusion : Combined autoantibody testing for GADA and ICA512A is more sensitive that ICA in type 1 diabetes. Therefore, it could replace the laborious ICA measurement and may be useful for discriminating the etiology of adult onset a typical diabetes(J Kor Diabetes Asso 25 :430~445, 2001).

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