간경변 환자에서 혈중 Lipoprotein (a)와 저밀도지단백 콜레스테롤 및 Apolipoprotein (a)의 상관관계

전사일,정영화,민원기 대한임상병리학회 2002 대한임상병리학회지 Vol.22 No.2

Development and Evaluation of a Laboratory Information System-Based Auto-Dilution and Manual Dilution Algorithm for Alpha-Fetoprotein Assay

정대동,김소영,이우창,Sail Chun,민원기,전사일 대한진단검사의학회 2013 Annals of Laboratory Medicine Vol.33 No.5

당뇨병 환자에서 총항산화능, 지질 과산화 및 산화 저밀도 지단백에 대한 자가항체의 측정

강윤희,전사일,장성수,홍성관,민원기 대한임상병리학회 2000 대한임상병리학회지 Vol.20 No.6

VKORC1 and CYP2C9 Genotype Variations in Relation to Warfarin Dosing in Korean StrokePatients

Sea Mi Park,이종극,Sail Chun,Hae In Lee,Sun U. Kwon,Dong-Wha Kang,Jong S. Kim 대한뇌졸중학회 2013 Journal of stroke Vol.15 No.2

Background and Purpose Variant alleles of CYP2C9 and VKORC1 account for differences in anticoagulation response. We sought to establish a warfarin dosing formula for individualized target International Normalization Ratio of Prothrombin Times (INRs) using data from single nucleotide polymorphisms (SNPs) in VKORC1 and CYP2C9 in Korean patients. Methods Ischemic stroke patients displaying stable target INR for at least 3 months before enrollment were analyzed. Warfarin and vitamin K levels were measured to adjust for confounders. Phenotypes were defined using the ’warfarin response index’ (WRI) defined as INR divided by the daily maintenance warfarin dose. We tested SNPs in CYP2C9 (3 sites: 430C>T (rs1799853), 1075A>C (rs1057910), 1076T>C) and VKORC1 (14 sites: 381C>T, 861C>A (rs17880887), 2653G>C, 3673A>G, 5496G>T, 5808T>G (r17882154), 6009C>T, 6484T>C (rs9934438), 6853C>T (rs17886369), 7566T>C, 8767G>C, 8814T>C, 9041G>A (rs17880624),and 9071G>T) using a standard sequencing method. Multivariate linear regression analysis was applied to establish the formula for warfarin dosage. Results All 204 patients had excellent drug compliance. The mean INR was 2.22 (+0.56)and mean daily maintenance dose of warfarin was 3.92 mg (+1.54). Patients with low WRI were younger (P<0.001) with high body mass index (P=0.003), high prevalence of wildtype CYP2C9 polymorphism (1075A>C, P<0.001), and six heterozygote SNPs in VRORC1(P<0.001), which were tightly interlinked (381T>C, 3673G>A, 6484T>C, 6853C>G. 7566C>T, 9041G>A) (r2=1). Based on these data, a warfarin dosing formula was established. Conclusions WRI is influenced by age, body mass index and SNPs in VKORC1 and CYP2C9in Korean stroke patients. The obtained warfarin dosing formula may be clinically applicable.

The Association between Intraocular Pressure and Predictors of Coronary Heart Disease Risk in Koreans

Yong Wha Lee,Won Ki Min,Sail Chun,Woochang Lee,Yunhee Kim,Sung Hoon Chun,Hyosoon Park,신희봉,이유경 대한의학회 2008 Journal of Korean medical science Vol.23 No.1

Elevated intraocular pressure (IOP) is one of the major risk factors for glaucomatous visual field defects. Each individual systemic risk factor of coronary heart disease (CHD) is associated with elevated IOP, although no reports have argued for a correlation between the risk factors for CHD and IOP after a comprehensive or collective analysis. The National Cholesterol Education Program Adult Treatment Panel III presented the Framingham projection, which can predict the risk of CHD quantitatively. We investigated the association between IOP and the Framingham projection in 16,383 Korean subjects. The Framingham projection was applied using the indicated risk factors. The associations between the Framingham projection and IOP and the influences of the risk factors on the IOP were examined. The Framingham projection was correlated with the mean IOP in women (p<0.05). The relationship between IOP and systemic variables other than smoking was significant (p<0.05). The mean IOP was significantly higher in the high-risk CHD group than in the low-risk group based on the Framingham projection (p<0.05). Because an elevated IOP was associated with cardiovascular risk factors, subjects with a high CHD risk based on the Framingham projection need continuous monitoring for IOP to prevent glaucomatous visual field defects.

Effect of Outlier Elimination on the 99th Percentile Upper Reference Limits of High-Sensitivity Cardiac Troponin I Assays Based on a Strictly Selected Healthy Reference Population

Ahn Sunyoung,Kim Hyun-Ki,Lee Woochang,Chun Sail,Min Won-Ki 대한진단검사의학회 2022 Annals of Laboratory Medicine Vol.42 No.3

Background: We established high-sensitivity cardiac troponin I (hsTnI) 99th percentile upper reference limits (URLs) for the Centaur XPT High-Sensitivity Troponin I assay (Centaur hsTnI; Siemens, Erlangen, Germany) and Atellica IM High-Sensitivity Troponin I assay (Atellica hsTnI; Siemens) and assessed the effect of outlier elimination. Methods: The reference population comprised 380 men and 387 women, satisfying the strict systematic reference population criteria. After reference population verification by the N-terminal pro-B-type natriuretic peptide (NT-proBNP) assay, 99th percentile URLs for Centaur hsTnI and Atellica hsTnI were calculated before and after outlier elimination. Results: The 99th percentile URL for Centaur hsTnI was 60.4 (men, 74.7; women, 57.5) ng/L and that for Atellica hsTnI was 59.6 (men, 75.2; women, 55.1) ng/L. After the elimination of 61 (8.0%) outlier samples in Centaur hsTnI and 58 (7.6%) in Atellica hsTnI, the 99th percentile URLs were 13.5 ng/L (men, 15.3 ng/L; women, 11.9 ng/L) and 13.4 ng/L (men, 15.5 ng/L; women, 12.9 ng/L), respectively, significantly lower than those before outlier elimination. The CVs at the 99th percentile URLs were 5.2% and 3.5%, respectively. The measurable fractions among the reference population were 91.5% and 93.4%, respectively. Performance evaluation of Atellica B-type natriuretic peptide (BNP), Atellica NT-proBNP, Centaur hsTnI, and Atellica hsTnI showed outstanding results. Conclusions: The Korean hsTnI 99th percentile URLs calculated in this study were significantly lower after outlier elimination than before. Centaur hsTnI and Atellica hsTnI meet the “Guideline acceptable” and “Level 3 (second generation, high sensitivity)” requirements, satisfying international standards.

Inflammatory and Hemostatic Biomarkers Associated With Early Recurrent Ischemic Lesions in Acute Ischemic Stroke

Kang, Dong-Wha,Yoo, Sung-Hee,Chun, Sail,Kwon, Kyum-Yil,Kwon, Sun U.,Koh, Jae-Young,Kim, Jong S. Ovid Technologies Wolters Kluwer -American Heart A 2009 Stroke Vol.40 No.5

<P>BACKGROUND AND PURPOSE: Early recurrent ischemic lesions (ERILs) on diffusion-weighted imaging after acute ischemic stroke have been suggested as a potential marker of early recurrent stroke. We hypothesized that biomarkers of inflammation or coagulation may be associated with the pathogenesis of ERILs and sought to investigate whether these biomarkers provide prognostic information on the risk of development of ERILs independently of clinical and imaging variables. METHODS: This prospective study enrolled 153 consecutive patients with acute ischemic stroke who underwent diffusion-weighted imaging within 24 hours and subsequently at 5 days after onset and whose plasma or serum for biomarkers (C-reactive protein, fibrinogen, d-dimer, tissue plasminogen activator, and plasminogen activator inhibitor-1) were collected within 24 hours of onset. Those receiving thrombolysis or interventional therapy were excluded. ERILs were defined as new ischemic lesions on 5-day diffusion-weighted imaging separate from the index stroke lesions, which were not accompanied by subsequent recanalization. RESULTS: ERILs were observed in 37 patients (24.2%). In univariate analysis, shorter time from onset to initial MRI (P=0.013), initial acute multiple infarcts (P<0.001), initial larger infarct volume (P=0.005), stroke subtype (P<0.001), elevated d-dimer (P=0.028), and anticoagulation after admission (P=0.001) were associated with ERILs. In multivariate analysis, initial acute multiple infarcts (OR, 16.60; 95% CI, 5.73 to 48.08), large artery atherosclerosis (OR, 4.62; 95% CI, 1.51 to 14.11), and log d-dimer (OR, 3.20; 95% CI, 1.14 to 9.00) remained independent predictors of ERILs. CONCLUSIONS: These data suggest that elevated d-dimer level reflecting increase of thrombin generation and fibrin turnover may be an independent factor predicting ERILs.</P>

Comparison of Red Blood Cell Hemolysis Using Plasma and Serum Separation Tubes for Outpatient Specimens

고대현,민원기,원다해,정태동,이우창,Sail Chun 대한진단검사의학회 2015 Annals of Laboratory Medicine Vol.35 No.2

Background: To rapidly obtain outpatient results, we use plasma separation tubes (PST) for chemistry analysis. If lactate dehydrogenase measurement is required, serum separation tubes (SST) are used. There has been no evaluation of hemolysis with these tubes. We compared the hemolytic index (HI) obtained by using PST and SST and applied this for choosing appropriate tubes for clinical laboratories. Methods: The HI of specimens obtained from outpatients visiting Asan Medical Center between July and December 2012 was analyzed. The HI was scored from 0 to 10 by using the Toshiba 200FR (Toshiba Medical Systems Co., Japan). HI was classified by sample tube type, and significant hemolysis was defined as a HI of 2 or more. For significant hemolysis cases, medical records were reviewed to identify the causes. Results: Among 171,519 specimens, significant hemolysis was observed in 0.66% of specimens (0.68% of PST specimens, 0.46% of SST specimens). The mean HI in PST was 0.18 (SD: 0.43) and that in SST was 0.14 (SD: 0.37). The proportion of significant hemolysis was significantly higher in PST than in SST (P=0.001). The cause of significant hemolysis was identified as chemotherapy and prosthetic valve in 48.1% of specimens. Complex sampling errors may have caused significant hemolysis in the remaining 51.9% of specimens. Conclusions: The incidence of hemolysis was slightly higher for PST than SST, although both were <1%. PST are thought to be more useful than SST in outpatient testing because of rapid turnaround time, greater sample volume, and less risk of random errors due to fibrin strands.

Accuracy of the New Creatinine-based Equations for Estimating Glomerular Filtration Rate in Koreans

Jeong Tae-Dong,Hong Jinyoung,Lee Woochang,Chun Sail,Min Won-Ki 대한진단검사의학회 2023 Annals of Laboratory Medicine Vol.43 No.3

Background: New creatinine-based estimated glomerular filtration rate (eGFR) equations, including the 2021 Chronic Kidney Disease Epidemiology Collaboration (2021 CKD-EPI) and European Kidney Function Consortium (EKFC) equations, have been introduced recently. We assessed the performance of the 2021 CKD-EPI and EKFC equations in the Korean population. Methods: We analyzed 1,654 Korean patients aged ≥18 years who underwent chromium-51-ethylenediamine tetraacetic acid GFR measurements (mGFR). Bias (eGFR–mGFR), root mean square error (RMSE), and proportion of eGFR within 30% of mGFR (P30) of the 2009 CKD-EPI, 2021 CKD-EPI, and EFKC equations were compared. The concordance rate between eGFR and mGFR categories was evaluated. Both eGFR and mGFR categories were classified into six groups: ≥90, 89–60, 59–45, 44–30, 29–15, and <15 mL/min/1.73 m2. Results: The median bias (mL/min/1.73 m2) was 1.8 for the 2009 CKD-EPI equation, 4.8 for the 2021 CKD-EPI equation, and –0.3 for the EKFC equation. The P30 and RMSE were 78.2% and 17.0 for the 2009 CKD-EPI equation, 75.6% and 17.4 for the 2021 CKD-EPI equation, and 80.0% and 16.7 for the EKFC equation, respectively. The overall GFR category concordance rate between eGFR and mGFR was 63.4% for the 2009 CKD-EPI equation, 60.5% for the 2021 CKD-EPI equation, and 61.0% for the EKFC equation. Conclusions: Among the three eGFR equations, the EKFC equation had the smallest bias and highest P30 in Koreans. The 2009 CKD-EPI equation had a lower bias than the 2021 CKD-EPI equation.

Serial Change Pattern Is Better than Single Point Measure-ment of Serum Alpha-Fetoprotein for the Detection of Early-Stage Hepatocellular Carcinoma

( Jonggi Choi ),( Young-suk Lim ),( Woochang Lee ),( Sail Chun ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Current surveillance strategy for hepatocellular carcinoma (HCC) is based on the single point measurement rather than the serial change of alpha-fetoprotein (AFP). Methods: We performed a National Cancer Institute’s Early Detection Research Network(EDRN)-defined phase 3 biomarker, nested case-control study by using prospectively collected samples from cirrhotic patients at high risk for HCC development. Forty-two cases of HCC were included and matched to controls (N=168) without HCC in a 1:4 ratio by age, gender, etiology of liver disease, and cirrhosis. All patients were screened every 6 months with serum AFP and imaging modalities with a median follow-up of 24 months. Blood samples at the time of HCC diagnosis and months -6, and -12 and at corresponding time points form the matched controls were eval uated for AFP. Results: Of the 42 patients with HCC, 32 (76.2%) had very early-stage HCC (a single nodule <2 cm) and 4 (9.5%) had early-stage HCC (single 2-5 cm or 2-3 lesions each <3 cm). The mean of most recent AFP (ng/mL) was significantly higher in HCC cases than in controls (35.4±78.6 vs 5.0±17.1, respectively, p<0.001). HCC cases had a higher level of standard deviation of AFP than controls (17.1±42.8 vs 1.7±9.9, respectively, p=0.026), as well as rate of AFP increase (7.3±18.8 in HCC cases vs 0.0±4.1 in controls, p=0.017). Rate of AFP increase was the most strongly associated with the development of HCC (odds ratio [OR], 1.10; area under curve [AUC], 0.747; p=0.03), followed by standard deviation of AFP (OR, 1.03; AUC, 0.723; p=0.02) and most recent AFP (OR, 1.02; AUC, 0.740; p=0.03). Conclusions: Serial change pattern of AFP is better marker of early stage HCC than single point AFP.