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한국인의 반복자연유산 환자에서 Thymidylate Synthase Enhancer Region (TSER) 돌연변이형의 혈중 호모시스테인 양과의 관련성
최윤경,강명서,김남근,김선희,최동희,안명옥,이수만,Choi, Yoon-Kyung,Kang, Myung-Seo,Kim, Nam-Keun,Kim, Sun-Hee,Choi, Dong-Hee,An, Myung-Ok,Lee, Su-Man 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.3
Objectives: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. Methods: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. Results: Total homocysteine level was significantly higher in MTHFR 677TT genotype ($9.80{\pm}3.87{\mu}mol/L$) than MTHFR 677CC genotype ($8.14{\pm}1.74{\mu}mol/L$) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA ($8.42{\pm}2.65{\mu}mol/L$) and 1298CC ($6.09{\pm}0.32{\mu}mol/L$; p=0.2058) and, TSER 2R2R ($8.61{\pm}1.68{\mu}mol/L$) and 3R3R ($8.05{\pm}2.81{\mu}mol/L$; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest ($11.47{\pm}4.66{\mu}mol/L$) in individuals with TSER 3R3R ($8.05{\pm}2.81{\mu}mol/L$) and MTHFR 677TT ($9.80{\pm}3.87{\mu}mol/L$) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes ($7.69{\pm}1.77{\mu}mol/L$) had lower plasma homocysteine levels than TSER 2R2R ($8.61{\pm}1.68{\mu}mol/L$) and MTHR 677CC ($8.14{\pm}1.74{\mu}mol/L$) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. Conclusion: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
남윤성,김남근,강명서,오도연,차광열,Nam, Yoon-Sung,Kim, Nam-Keun,Kang, Myung-Seo,Oh, Do-Yeon,Cha, Kwang-Yul 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.2
Objective: To evaluate the abnormality of protein S in patients with recurrent spontaneous abortion due to antiphospholipid syndrome. Material and Method: Antigen and activity of protein S were analyzed by enzyme immunoassay and clotting method, respectively. Results: Of 18 patients with antiphospholipid syndrome, 4 patients were found to have no abnormality of protein S. There were 14 cases of protein S abnormality. Among them, there were 8 cases of type 1, 1 case of type 2, and 5 cases of type 3 protein S deficiency. Conclusion: So in the workup of patients with recurrent spontaneous abortion due to antiphospholipid syndrome, the evaluation for protein S is required.
반복자연유산 환자에서 Homocysteine과 Methylenetetrahydrofolate Reductase 돌연변이의 상관관계에 대한 분석
남윤성,차광렬,김남근,강명서,김세현,오도연,Nam, Yoon-Sung,Cha, Kwang-Yul,Kim, Nam-Keun,Kang, Myung-Seo,Kim, Se-Hyun,Oh, Do-Yeon 대한생식의학회 2002 Clinical and Experimental Reproductive Medicine Vol.29 No.3
Objective : To analyze the interrelationship between homocysteine and methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. Material and Method: Homocysteine and MTHFR mutation were tested by fluorescent polarizing immunoassay and PCR-RFLP method, respectively. Results: In patients with homocysteine level less than 5 ?mol/L, there was no case of normal group but there were four cases of heterozygosity and one case of homozygosity. In patients with homocysteine level 5$\sim$10 ? mol/L, the number of normal, heterozygosity and homozygosity group were eleven, eighteen and eight, respectively. In patients with homocysteine level $10{\sim}15$ ? mol/L, the number of normal, heterozygosity and homozygosity group were four, one and one, respectively. In patients with homocysteine level more than 15 ? mol/L, there was no case of normal and heterozygosity group but there were two cases of homozygosity. Conclusions: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. And there was a significant relationship between homocysteine and MTHFR mutation.
불임환자와 반복자연유산 환자에서 루프스 항응고인자와 항카디오리핀 항체에 대한 연구
남윤성,차광렬,백진영,김남근,강명서,오도연,Nam, Yoon-Sung,Cha, Kwang-Yul,Baek, Jin-Young,Kim, Nam-Keun,Kang, Myung-Seo,Oh, Do-Yeon 대한생식의학회 2002 Clinical and Experimental Reproductive Medicine Vol.29 No.1
Objective : To report the prevalence of lupus anticoagulants and anticardiolipin antibodies in patients with recurrent spontaneous abortion and infertility. Material and Method: Lupus anticoagulants and anticardiolipin antibodies were analyzed by Diluted Russell's Viper Venom Test (DRVVT) and solid phase enzyme immunoassay, respectively. Results : In 200 patients with infertility, there were 6 cases (3%) with positive lupus anticoagulants or anticardiolipin antibodies. Of these, 3 patients (1.5%) showed positive lupus anticoagulants and anticardiolipin antibodies, respectively. In 120 patients with recurrent spontaneous abortion, there were 13 cases (10.8%) of positive lupus anticoagulants or anticardiolipin antibodies. Of these, one patient (1%) showed lupus anticoagulants and 12 patients (10%) showed anticardiolipin antibodies. But in two groups, there was no cases with positive lupus anticoagulants and anticardiolipin antibodies. Conclusion: Lupus anticoagulants and anticardiolipin antibodies are definite cause of recurrent spontaneous abortion. There has been a speculation that they might be associated with infertility and repeated IVF failures. But it was found that the role of lupus anticoagulants and anticardiolipin antibodies in these cases are not clear.
남윤성,김남근,이수만,강명서,오도연,차광렬,Nam, Yoon-Sung,Kim, Nam-Keun,Lee, Su-Man,Kang, Myung-Seo,Oh, Do-Yeon,Cha, Kwang-Yul 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.3
Objective : To evaluate factor XII deficiency in patients with recurrent spontaneous abortion and its relation to aPTT. Material and Method: Factor XII was analyzed by clotting method. Results: Of 70 patients with recurrent spontaneous abortion, there were 35 cases of factor XII deficiency. Among them, there were only 3 cases of prolonged aPTT. Conclusions: It is still unclear whether factor XII deficiency is related to recurrent spontaneous abortion. Molecular approaches should be used to understand further the causal relationship. But based on this result, in the workup of patients with recurrent spontaneous abortion, factor XII should be included. aPTT is not likely to represent the abnormality of factor XII.
반복자연유산 환자에서 Antithrombin III 결핍증에 대한 연구
남윤성,차광렬,김남근,강명서,오도연,Nam, Yoon-Sung,Cha, Kwang-Yul,Kim, Nam-Keun,Kang, Myung-Seo,Oh, Do-Yeon 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.4
Objective : To analyze the antithrombin II deficiency in patients with recurrent spontaneous abortion. Material and Method: The blood samples were tested by chromogenic assay to evaluate the activity of antithrombin III. Results: There was only one case of antithrombin III deficiency. This patient experienced one neonatal death after delivery and one FDIU (fetal death in utero). And also this patient showed a lupus anticoagulant and the prolongation of PTT. Conclusions: Women with recurrent miscarriage who have no obvious identified cause should consider hematologic screening. Antithrombin III deficiency could be a cause of recurrent spontaneous abortion. But the incidence is very rare in Korean patients.
Continuous Ambulatory Peritoneal Dialysis 를 받고 있는 만성신부전 환자에서 지단백과 Apolipoprotein B 의 변화에 관한 연구
박금수(Keum Soo Park),강명서(Myung Seo Kang),조한선(Han Sun Cho) 대한내과학회 1992 대한내과학회지 Vol.43 No.2
N/A Background: Although the potential metabolic impact of continuous ambulatory peritoineal dialysis (CAPD) and hemodialysis (HD) might be expected to differ significantly, the plasma lipid and lipoproteins have been studied in much less detail in CAPD patients than in HD patients, The purpose of the present study was to investigate the lipid and lipoproteins in CAPD patients, and to compare these results with values obtained from HD patients and a control group with normal renal function. Methods; Total cholesterol(TC), triglyceride(TG), high-density lipoprotein(HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein(Apo) Al and B were measured in 36 CAPD patients and in 44 HD patients and in 24 healthy persons for a control group. Resuls: The levels of TC, LDL Cholesterol, HDL Cholesterol, Apo B and Apo al were reduced in HD patients, HDL Cholesterol and Apo Al were reduced in the CAPD patients compared with normal controls. In CAPD patients, elevated TC, LDL Cholesterol, Apo B and Apo Al were frequent in the female patients compared with the male patients. However, there were no differences between the male and female patients in HD patients. The levels of TC, TG and LDL Cholesterolwere reduced in HD patients compared with CAPD patients. There were same results between two subgroups selected for patients with the similar le of time on dialysis. Conclusion: Our results suggest that the risk of developing cardiovascular disease in patients treated with CAPD cannot be related to changes in the TC, LDL Cholesterol and Apo B.
Haemonetics MCS 3p에 의한 혈소판 성분채혈 후 혈소판 감소율, 회수량 및 효율에 대한 연구
김종화 ( Jong Hwa Kim ),강명서 ( Myung Seo Kang ),남정모 ( Chung Mo Nam ),이미화 ( Mi Hwa Lee ) 대한임상검사과학회 2006 대한임상검사과학회지(KJCLS) Vol.38 No.1
The purposes of this study were to evaluate the changes in hematologic indices after plateletpheresis and to identify the preapheresis platelet count and clinical factors (age, gender, height, and weight) that showed some influence on the percentage of platelet decrement, yield and efficiency. Plateletpheresis was performed on 101 healthy donors in Bundang CHA general hospital. The data was analyzed using the SAS program with t-test, ANOVA test and Multiple regression. The mean percentage decrease after plateletpheresis was 2.0% in hemoglobin, 1.8% in hematocrit, and 29.7% in the platelet count, while a WBC count showed an increase of 2.6%. The mean percentage decrease of hemoglobin and hematocrit were 1.7% and 1.4%, in males and 3.6% and 3.7% in females, respectively. Particularly the percentage decrease of platelet count was significantly higher in females (40.0%) than in males (27.2%). The platelet decrementage and yield were significantly higher in females, but the efficiency did not differ significantly between males and females. The yield showed the lowest levels in subjects who were 40 years old or over but the platelet decrement and efficiency did not change according to age. The platelet decrement increased as height and weight increased. Also, the platelet decrement and yield increased as the initial platelet counts increased, but the efficiency did not. From multiple regression analysis, the platelet decrement was associated with gender, weight, and initial platelet count. The yield was related to the initial platelet count, but the efficiency was not related to gender, age, weight, height or initial platelet counts. This study has a limitation of the generality of the study results since this study was conducted only in a single university hospital. Further study would be necessary to find out a subpopulation that is sensitive to the hematologic change after plateletpheresis, and to determine the standard criteria for blood donation based on the subpopulation.
반복자연유산에서 Methylenetetrahydrofolate Reductase 돌연변이에 대한 분석
남윤성,차광렬,김남근,김선희,임진우,강금덕,강명서,김세현,오도연,Nam, Yoon-Sung,Cha, Kwang-Yul,Kim, Nam-Keun,Kim, Sun-Hee,Lim, Jin-Woo,Kang, Geum-Duk,Kang, Myung-Seo,Kim, Se-Hyun,Oh, Do-Yeun 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.3
Objective: To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. Material and Method: The blood samples of patients with recurrent spontaneous abortion were tested by PCR-RFLP method. Results: Of 51 cases of study group, 14 (27.5%) were normal, 25 (49.0%) were heterozygosity, and 12 (23.5%) were homozygosity. Of 58 cases of control group, 20 (34.5%) were normal, 30 (51.7%) were heterozygosity, and 8 (13.8%) were homozygosity. But the difference between two groups was not significant (p=0.190). Conclusion: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the study for MTHFR mutation should be included in the workup of recurrent spontaneous abortion.
정상 간기능 수치를 보이는 비알코올지방간 환자의 임상특징
이소영 ( So Young Lee ),김수경 ( Soo Kyung Kim ),권창일 ( Chang Il Kwon ),김문종 ( Moon Jong Kim ),강명서 ( Myung Seo Kang ),고광현 ( Kwang Hyun Ko ),홍성표 ( Sung Pyo Hong ),황성규 ( Seong Gyu Hwang ),박필원 ( Pil Won Park ),임 대한소화기학회 2008 대한소화기학회지 Vol.52 No.3
Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is known to be closely associated with various metabolic abnormalities including metabolic syndrome. However, there are few data available on the association of metabolic syndrome with the sonographically fatty liver and normal range of liver function test. The purposes of this study were to find the incidence of ultrasonographic fatty liver with normal range of liver function test and to evaluate the association with metabolic syndrome in apparently healthy Korean adults. Methods: We examined 538 men and women, aged 30-80 years, who participated in a health screening test. Among the people with normal ALT level, we compared clinical characteristics and prevalence of metabolic disorders according to the presence of nonalcoholic sonographyally fatty liver, and then they were subdivided into upper normal range and lower normal range of ALT level. Results: Compared to the people without sonographic fatty liver, people with sonographic fatty liver and normal range of ALT level had odds ratios for metabolic syndrome of 4.53, insulin resistance 4.83, hypertension 2.69, dyslipidemia 6.90, and obesity 5.39, respectively. Furthermore, the prevalence of metabolic syndromes and other metabolic disorders were increased in both sonographically fatty liver group or ultrasonographically normal liver group with upper normal range of ALT level compared with lower normal ALT level (p<0.01). Conclusions: The nonalcoholic sonographically fatty liver was strongly associated with metabolic syndrome and common metabolic abnormalities even with normal liver function test. (Korean J Gastroenterol 2008;52:161-170)