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      • KCI등재

        류마티스 관절염 환자에서 Shared Epitope의 임상적 의의

        민도식 ( Doh Sik Minn ),김신규 ( Think You Kim ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.1

        Objective: The application of DNA sequencing and molecular-based typing to detect HLA-DRB1 alleles showed that those associated with rheumatoid arthritis (RA) shared a consensus amino acid sequence (QKRAA or QRRAA) at positions 70-74 of the third hypervariable region of the HLA-DRB1 chain. This is defined as the so-called `shared epitope`. Many studies reported that shared epitope was associated with RA susceptibility and disease severity. Also, DRB1*0401 and DRB1*0404 alleles confer genetic predisposition to RA in Caucasian. We studied the frequency of shared epitope, DRB1*04, DRB1*0401, and DRB1*0404 in Korean RA patients using monoclonal antibodies. We also tried to investigate the influence of these factors on susceptibility and severity in RA patients and to evaluate the method. Methods: RA patients were 32 persons with classical or definite RA who attended the Hospital for Rheumatic Diseases, Hanyang University Hospital, Seoul, Korea. We separated lymphocytes from whole blood and used indirect immunofluorescence staining method using four monoclonal antibodies (Terra Nova, Canada). Results: The frequency of DRB1*04 and shared epitope were 56% and 56%, respectively. That of DRB1*0401 and DRB1*0404 were positive in 19% and 9% of all patients, respectively. There were no association between share epitope and disease severity. Conclusion: The shared epitope is expressed with high frequency, as many as DR4 frequency in Korean RA patients. But the frequency of DRB1*0401 and DRB1*0404 is low different from Caucasian. The used method is simple and easy to screen shared epitope.

      • KCI등재

        류마티스 인자 측정의 가장 우수한 방법은?

        민도식 ( Doh Sik Minn ),전래희 ( La He Jearn ),김신규 ( Think You Kim ) 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.1

        Objective: Rheumatoid factor (RF) is used as one of the criteria for the diagnosis of rheumatoid arthritis (RA). Nephelometers are widely used in laboratories to quantitatively measure RF. In nephelometric ways of measurement, there are endpoint nephelometry and rate nephelometry. BN II System (BN II) (Dade Behring Marburg GmbH, USA) is a well known endpoint nephelometer while IMMAGE System (IMMAGE) (Beckman Coulter, USA) is a well known rate nephelometer. We compared these two automatic nephelometric analyzers to evaluate which method shows the best results. Methods: We measured RF (n=195) using the two machines. We evaluated the correlation between BN II and IMMAGE. We compared the results of BN II with those of IMMAGE in terms of interference and clinical usefulness. Results: The correlation coefficient (r) of RF was 0.9310 (p<0.0001). We could not find any significant interference for BN II with high concentration of triglyceride or bilirubin, but IMMAGE showed significant interferences with high concentrations of triglyceride and bilirubin. The sensitivity and specificity of BN II for the diagnosis of RA were 90.3% and 82.4%. Those of IMMAGE were 86.1% and 74.5%. Conclusion: BN II was enough to satisfy the analytical features and it showed better results than IMMAGE. We expect BN II, the endpoint nephelometer, to be the best equipment in measuring RF for diagnosis of RA.

      • 새로이 개발된 비탁법을 이용한 혈청 저밀도 지단백 콜레스테롤의 직접 측정법의 평가

        민도식,김덕언,박일규 한양대학교 의과대학 1999 한양의대 학술지 Vol.19 No.1

        The association between elevated levels of low-density lipoprotein cholesterol (LDL-C) and increased risk of premature coronary heart disease has been clearly demonstrated. Currently, most of laboratories rely on indirect measurement of LDL-C by using Friedewald equation which are not applied in samples of non-fasting or over 400mg/dL of triglyceride level. For these reasons, a newly developed direct LDL-C assay by turbidimetric method was evaluated and compared with Friedewald equation. Also, we evaluated the quality control materials which are made in our laboratory. Total cholesterol, triglyceride, HDL-C, direct LDL-C and Friedewald LDL-C are measured on commercial control sera, two patient's pooled sera and patient sera using automated chemistry analyzer (Hitachi-747, Japan). Direct LDL-C assay using LDL Cholesterol homogeneous (Boeringer Mannheim, Germany) was performed using automated chemistry analyzer (Hitachi-747, Japan). Within-run precisions of Friedewald LDL-C and direct LDL-C were 113.83±3.70 mg/dL (3.31%) and 124.83±2.25 mg/dL (1.80%), respectively in control sera. Between-run precision were 112.53±2.60 (2.31%) and 120.64±2.39 (1.98%) repectively. The correlation coefficient between Friedewald LDL-C and direct LDL-C methods in 64 patient's samples was 0.87 and the linear regression equation was Y = 0.593X + 40.868 at triglyceride levels below 400 mg/dL. There was no significant decrease in LDL-C determined by direct LDL-C assay for non-fasting versus fasting sera and their values were 97.2±42.9 mg/dL, 95.9±41.0 mg/dL respectively. In two pooled sera, intra-assay CV of lyophilized serum which was restored by 1 mL distilled water was 1.84% and the other serum which was thawed after freezing was 17.90%. Precisions of direct LDL-C using LDL Cholesterol homgeneous were better than calculated LDL-C values using Friedewald equation in control sera. There was a good correlation between two methods with triglyceride levels below 400 mg/dL. Thus this direct LDL-C assay is recommended in place of Friedewald equation which has a few limitation for use. And the lyophiized sera from pooled sera is recommended to use in quality control instead of company-made control sera which are expensive and have many shortcoming.

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