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투석막 접촉후 흰쥐 메산지움 세포의 세포외기질 발현에 대한 연구
권영주,표희정,김윤희,이영기,차대룡,조원용,김형규,윤수영,이갑노 고려대학교 의과대학 1997 고려대 의대 잡지 Vol.34 No.2
The rate of decline of residual renal function is faster in patients on hemodialyaia than in patients on peritoneal dialysis. Recent evidences show that the generation of the terminal membrane attack complex and variable cytokines during hemodialysis may be involved. Also renal fibrosis -remodeling of the mesangial matrix- is a final common pathway in all forms of chronic progressive renal diseases. As a sequelae of inflammation and injury, the humoral factors by infiltrating and resident renal cells stimulate the overproduction of the extracellular matrix, leading to end stage renal disease. We performed this study to evaluate the biocompatibility, ie. the direct effect of different dialyzer membranes on surface expression of extracellular matrix in mesangial cell. We tested the surface expression of extracellular matrix -type Ⅳ collagen, fibronectin, laminin- by flow cytometry in mouse mesangial cells(ATCC CRL-1927, SV40 MES 13, passage 27) after contact with dialyzer membranes (cuprophane : polysulphone) for 24 hours. There were no significant differeces in surface expression of extracellular matrix in mesangial cells after contact with or without dialyzer membranes. Therfore further study such as quantitative PCR, western or northern blot is needed to clarify the effect of dialyzer membranes on production of extracellular matrix in mesangial cell.
ANCA와 연관된 혈관염 및 사구체 신염에서 환자 생존 및 신장관해에 대한 연구
한상엽,권영주,신진호,조상경,차대룡,조원용,표희정,김형규,윤수영 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.3
ANCA-associated vasculitis and glomerulonephritis encompasses a variety of conditions such as Wegener's granulomatosis(WG), microscopic polyangiitis (MP), Churg-Strauss syndrome(CS) and renal-limited vasculitis[pauciimmune necrotizing cre sctric glomerulonephritis(NCGN)]. To analyze risk factors for poor patient survival and renal remission, we examed sixteen patients diagnosed as ANCA-associated vasculitis and glomerulonephritis according to age, ANCA, extrarenal vasculitis and a presenting serum creatinine level. Diagnosis of sixteen patients(male 10/ female 6, mean age 51.2 years, range 21-74 years) were 5 WG, 4 MP, 1 CS, and 6 NCGN. Ten patients were ANCA positive(c-ANCA 5, p-ANCA 5) and six patients were ANCA negative. Six patients showed extrarenal vasculitis, especially lung involvement. The median value of a presenting serum creatinine was 4.55mg/dl(range 0.3-18mg/dl). According to age, older patients than 60 years(n=7) are at greater risk than younger patients in patient survival(n=9)(P= 0.01). In patient survival and renal remission, patients who present serum creatinine above 4.55mg/ dl(n=8) are at greater risk than below(n=8)(P=0.018, P=0.02). The other factors such as ANCA and extrarenal vasculitis did not influence on patient survival and renal remission. In conclusion, the poor prognostic factors were older age above 60 years of age and a presenting serum creatinine level above 4.55mg/dl. Therefore, patient survival and renal remission appear to have improved with early diagnosis and early recognition of disease activity before serum creatinine rises.