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만성 B형간염에서 간 조직내 TGF-p1과 a-SMA 단백질의 발현정도와 인터페론 치료효과와의 상관관계
국진환,김경철,황성규,최유정,홍성표,정은미,박필원,안희정,김배영,오성욱,임규성 대한간학회 1998 Clinical and Molecular Hepatology(대한간학회지) Vol.4 No.4
Backg round/Aims : The aim of this study was to evaluate the effect of α- interferon (IFN) on liver histology as well as on activation of hepatic stellate cell ( HSC) and trans for ming growth fact or β- 1 (TGF -β1) expression. We had also investigated the clinical usefulness of TGF-β1 and α- smooth muscle actin (α-SMA) expression in liver tissue for predicting a response toα- IFN therapy in chronic hepat it is B. Methods : We studied the expression of TGF-β1 and α- SMA in liver biopsys pecimens from 51 chronic hepatitis B pat ients . Using immunohistochemical staining and a semiquant it ative scoring met hod, we also evaluated TGF- β1 and α- SMA expression in liver stellate cells before and after α- IFN therapy in liver tissue from rebiopsys pecimen of the 12 chronic hepatitis B pat ients . Recombinant IFN α- 2b (Intron A) in doses of 6 MU/ d was given to patients intramus cularly three times per week for 6 months ( total doses , 432 MU). The patients were divided into two groups accordinanine aminotransferase levels as well as HBV- DNA and HBeAg s eroconversion stat e. Histological grading and staging scores were according to modified Histological Activity Index (HAI) gradingsys tems of Ishak ( 1995). Results : The index of portal inflammation and total scores of HAI grading significantly decreased in biopsies afterα - IFN t reat ment, but the scores of fibrosis staging showed no significant change in biopsies after IFN t reat ment. A significant decrease in α- SMA expression, especially in periportal area, was found, but the change of TGFβ- 1 expression was not significant. The immunoreactivity of α- S MA was significantly lower in responders than in non-res ponders , whereas the diffference of immun or eactivity of TGFβ - 1 between these two groups was not found. Conclusions : These findings suggest that α- IFN therapy may reduce the necroinflammatory activity in liver tissues of chronic B viral hepatitis and that the degree of - S MA ex pression before treatment may be employedpottent predicting indicat or for the therapeutic efficacy of IFN- alfa.(Korean J Hepatol 1998;4:317 329)
제3차 대한간학회 춘계학술대회 초록집 : 포스터연제 토의 ; 만성간염에 있어서 α-Interferon(IFN) 2b의 치료효과와 치료전후의 조직학적 변화양상
국진환 ( Gug Jin Hwan ),안희정 ( An Hui Jeong ),김배영 ( Kim Bae Yeong ),김경철 ( Kim Gyeong Cheol ),홍성표 ( Hong Seong Pyo ),박필원 ( Park Pil Won ),임규성 ( Im Gyu Seong ) 대한간학회 1997 Clinical and Molecular Hepatology(대한간학회지) Vol.3 No.2(S)
출산전후의 요오드 섭취량과 산후 갑상선염과의 상관관계에 대한 임상적 고찰
차영수,조용욱,국진환,박필원,강명서,이위현,김유리,임정은,조여원 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.4
Background: Excessive iodine intake increases the occurrence of autoimmune thyroid disorders by enhancing immunogenecity of iodine-rich thyroglobulin, In Korea, most of postpartum women take a large amount of iodine-rich seaweed. Although the excessive iodine intake may affect the thyroid function, only a few reports were available concering iodine intake, especially on postpartum period. Methods: A prospective study was undertaken in 146 of normal delivered postpartum women. Dietary intake and urinary excretion of iodine, serum T3, T4, TSH, anti-TPO Ab and anti-Tg Ab were measured before and 1, 6, 12 and 24 weeks after delivery. Iodine intake was analyzed by one-to-one interview using 24hr recall and food frequency questionnaire. Results: 1. PPT was occurred in 6(10.3%) postparturn women, It presented as hypothyroidism alone in 1(16.7%), transient thyrotoxicosis followed by hypothyroidisrn in 3(50.0%), and thyrotoxicosis alone in 2(33.3%) of the follwed-up patients. 2. During pregnancy, no difference was found in age, serum T3, T4 and TSH between PPT and normal thyroid function group. 3. In PPT group, anti-TPO and anti-Tg Ab were significantly higher than those of normal thyroid function group during pregnancy, and their sensitivity for PPT was 40% and 33%, respectively. But there was no correlation between dietary iodine intake and the titer of thyroid auto-antibodies. 4. There was no correlation between pre and post-partum dietary iodine intake and occurrence of PPT. Conclusion: In Korea, the incidence of PPT was slightly higher than other nations. The sensitivity of thyroid auto-antibodies was too low to use for prediction of PPT. Pre and post-partum iodine intake had no effect on the occurrence of PPT and post-partum thyroid function. (J Korean Soc Endocrinol 12:541-549, 1997)
혈액투석을 시작한 말기 신부전 환자에서 골밀도와 골대사 지표의 측정
조용욱,안재형,차영수,송종훈,국진환 대한신장학회 1997 Kidney Research and Clinical Practice Vol.16 No.4
Renal osteodystrophy is well recognized complication of end stage renal disease(ESRD) and is associated with a marked morbidity. To evaluate bone loss in renal osteodystrophy, we measured bone mineral density(BMD) in distal radius by quantitative computed tomography in 43 ESRD patients on starting hemodialysis(HD) and in 84 healthy controls matched for age and sex. We also measured intact parathyroid hormone(iPTH), serum total alkaline phosphatase(T-ALP), osteocalcin(OC) and urine deoxypyridinoline(U-DPD) as bone turnover markers. 1) The mean age of ESRD patients and control groups were 49.8 and 49.7 years. M:F ratio were 1:1.1 and 1:1.3 on each groups. There was no significant differences on each groups. 2) Serum T-ALP and OC were 263.9?264.5U/L, 43.5?27.6ng/mL in ESRD patients and 167.4±46.6U/ L, 8.8?3.9ng/mL in control groups. These were significantly higher in ESRD patients(P$lt;0.001, P$lt; 0.001), while U-DPD were not significant difference on each groups(5.3?4.1 vs 5.4±1.9nM/mM. Cr.). 3) Serum iPTH aminum were 296.8±263.4pg/mL, 10.1±11.6ng/mL in ESRD patients 4) Total density, trabecular density and cortical density were 340.4±83.6, 172.9±48.4, 477.2±123.5mg/ cm in ESRD patients and 393.2±49.1, 210.6±32.9, 541.3±76.2mg/cm in control groups. BMD was statistically significantly reduced in ESRD patients (P$lt;0.001, P$lt;0.001, P$lt;0.001, respectively). Z score of total density and trabecular density were -0.62±1.12, - 0.91±0.95 in ESRD patients and 0.19±0.68, 0.06±0.59 in control groups. It was significantly reduced in ESRD patients(P$lt;0.001, P$lt;0.001, P$lt;0.001, respectively). 5) In ESRD patients, serum T-ALP, iPTH, OC, U-DPD were not correlated with BMD and Z score. But in control groups, serum OC was correlated inversly with BMD, and U-DPD was only correlated inversely with trabecular density. 6) In ESRD patients(n=22) who were having iPTH above 300pg/mL, serum OC and U-DPD were significantly higher than in ESRD patients(n=21) who were having iPTH below 300pg/mL(52.6±4 28.8ng/ mL, 6.8+5.1nM/m923.3ng/mL, 3.71.9 nM/mM.Cr. P$lt;0.05, P$lt;0.05 repectively). But serum aluminum, and T-ALP were not significant difference on each groups. BMD and Z score were also not difference on each groups. 7) In ESRD patients who were having iPTH above 300pg/mL, iPTH and serurn OC were inversely correlated with BMD but U-DPD were only inversely correlated with trabecular density. In ESRD patients who were having iPTH below 300pg/mL, bone turn-over markers were not correlated with BMD. In ESRD patients on starting HD, BMD were significantly reduced, but serum T-ALP, OC, iPTH and U-DPD were not correlated with BMD. In ESRD patients who were having iPTH above 300 pg/mL, BMD were significantly inversely correlated with serum OC, iPTH.
김경철,안희정,김배영,임규성,차영수,국진환,홍성표,박필원,오성욱 대한내과학회 1998 대한내과학회지 Vol.54 No.5
Idiopathic hemochromatosis is hereditary hemochromatosis without secondary cause. Hereditary hemoduomatosis is a common disorder of iron metabolism with a prevalence of 1 case per 250-300 persons. Affected individuals absorb excessive amounts of dietary iron for a long time and tissue iron deposition results in skin discoloration, arthropathy, hepatic cirrhosis, heart cirrhosis, heart failure, diabetes mellitus and impotence. Fly diagnosis and institution of phlebotomy tneatment will prevent these manifestations and normalize life expectancy. We report a of hemochromatosis in 65-year-old male of no transfusion and iron ingestion history who was anti-HCV(+), chronic alcoholic, hepatic iron index$gt;2.24.