류마티스 관절염 환자에서의 soluble transferrin receptor측정의 유용성

전래희,김신규,이혜림,이웅수 대한임상병리학회 1998 대한임상병리학회지 Vol.21 No.3

바이러스성 호흡기 질환의 역학적 조사 및 신속한 진단법의 비교

전래희,강정옥,민도식,박일규,오재원,최태열 대한임상병리학회 1999 대한임상병리학회지 Vol.19 No.4

Human Parvovirus B19와 류마티스 관절염에서의 빈혈 및 질병 활성도와의 연관성에 관한 연구

전래희,김신규 대한임상병리학회 2001 대한임상병리학회지 Vol.21 No.4

류마티스 관절염 환자에서의 soluble transferrin receptor측정의 유용성

전래희,김신규,이혜림,이웅수 대한임상병리학회 1998 대한임상병리학회지 Vol.18 No.3

Indications and Procedure

전래희 대한임상병리학회 2002 대한임상병리학회지 Vol.22 No.부록1

류마티스 관절염 환자에서 anti-centromere antibody의 임상적 의의

전래희 ( La He Jearn ),김신규 ( Think You Kim ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.2

Objective: Anti-centromere antibody (ACA) is known to be specific for CREST syndrome, but individual studies showed variations in its distribution among related diseases. According to the authors` study on 56 ACA positive patients, 37 patients were known to have rheumatoid arthritis (RA). As a consequence, the authors studied the clinical significance of ACA positive RA patients. Methods: Specific clinical findings, radiologic studies, and laboratory data were investigated on 72 ACA positive and on 50 ACA negative RA patients. ACA tests were performed by indirect immunoflourescence assay with IT-1 cell line using IT-AIT kit (ImmunoThink(R), Korea) Results: No specific differences were noted between the ACA positive and the negative group of RA. However, there were a few notable findings between the low titer and the high titer group of ACA positive RA. In comparison with the low titer group, the high titer group showed lesser disease activity, more cases of seronegative RA (39.2%>4.8%), fewer radiologic evidences (45.1%<71.4%), more cases accompanied with Raynaud`s phenomenon (15.7%>4.8%) and thyroid diseases (11.8%>0%). They generally showed atypical RA patterns and the antibodies tend to remain at high titer state. Conclusion: Since the high titer ACA group of RA patients showed specific clinical findings, it is thought to be necessary to classify such group into a new subset of RA. And such classification would be helpful in diagnosing some atypical forms of RA patients. More studies on these new types of patients as well as their prognoses should be investigated in the future.

Human parvovirus B19와 류마티스 관절염

전래희 ( Lae Hee Chun ),김신규 ( Think You Kim ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.1

목적: Human parvovirus B19는 소아의 전염성 홍반의 원인 바이러스일 뿐 아니라 재생불량성발증, 선천성 태아수종, 급성 또는 만성 류마토이드양관절증 등 다른 질환을 일으키기도 한다. 최근 들어서는 human parvovirus B19와 RA와의 연관성에 관한 연구들이 보고되었다. 영국, 독일, 일본, 중국 등에서는 human parvovirus B19가 RA의 병발과 관련이 있다고 보고한 반면 북아일랜드, 핀란드, 프랑스 등에서는 관련이 없다고 보고하였다. 저자들은 국내 환자들을 대상으로 한국에서의 human parvovirus B19와 RA의 연관성에 대해 연구하였다. 방법: RA 환자 104명, OA 환자 40명, SLE 환자 32명의 혈청으로 anti-human parvovirus B19 IgG와 IgM에 대해 ELISA (Biotrin)로 검사하였다. 결과: RA 환자들과 비교하여 SLE 환자들과 OA 환자들의 human parvovirus B19 IgG 양성율이 통계적으로 의미있는 차이를 나타내지 않았다. IgM의 경우도 RA에서만 4명의 환자에서 양성을 보였고 SLE와 OA에서는 모두 음성이었다. 결론: 외국의 보고들 특히 주변국인 일본과 중국의 보고와 달리 한국에서는 human parvovirus B19 감염과 RA 사이에 연관성이 없다고 생각되었다. 이러한 차이는 결국 인종과 국가마다 집단의 항체 양성률이 다르기 때문으로 생각되었다. 그러므로 한국에서 RA 환자의 human parvovirus B19 항체 검사는 필요 없을 것으로 생각하였다. 결론적으로 RA 환자에 대한 human parvovirus B19 항체검사는 나라마다 적응과 결과해석을 달리해야 할 것으로 사료된다. Background: The pathogenic human parvovirus B19 is the etiologic agent of erythema infectiosum and causes other events including aplastic crisis, hydrops fetalis and fetal loss. Recently, it has been reported in many articles that human parvovirus B19 infection is associated with rheumatoid arthritis (RA). In contrast to these reports from the United Kingdom, Germany, Japan and China, different results were reported that there is no association between human parvovirus B19 and the pathogenesis of RA in Northern Ireland, Finland and France. This study aimed to investigate the association between human parvovirus B19 and RA in Korea. Methods: Sera from 104 patients with RA, 40 with osteoarthritis (OA) and 32 with systemic lupus erythematosus (SLE) were tested for IgG and IgM of human parvovirus B19 by ELISA (Biotrin), respectively. Results: There were no statistical differences among RA, OA and SLE patients in both anti-human parvovirus B19 IgG and IgM (p>0.05). Human parvovirus B19 IgM was positive in only four RA patients and negative in all SLE and OA patients. Conclusion: Human parvovirus B19 infection showed no association with RA in Korea, which is different from reports from other countries, especially Japan and China which are our neighbors. We thought that this result was due to the ethnic or national differences of baseline titer of anti-human parvovirus B19. Therefore anti-human parvovirus B19 test for RA patients is not necessary in Korea. In conclusion, we suggest that the indication and interpretation of anti-human parvovirus B19 testing in RA patients should be applied differently for each nation.

ANCA 검사의 임상적 유용성에 관한 재평가

전래희 ( La He Jearn ),김신규 ( Think You Kim ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.1

Objective: Antineutrophil cytoplasmic antibody (ANCA) is known to be associated with vasculitides. But recently ANCA has been reported in some chronic inflammatory diseases regardless of vasculitic condition. Although the incidence of vasculitis was low in Korea, we occasionally encounter patients with positive ANCA. And it was doubtful whether ANCA positivity of reports, in time that ANCA test was introduced in Korea, was true. So this study aimed to reevaluate the clinical utility of ANCA with the modern stabilized substrate. Methods: 162 patients with positive ANCA from Jan. 2002 to Jan. 2003 were investigated. ANCA was tested by indirect immunofluorescence assay using ALCA kit (ImmunoThink(R), Korea). Results: Of 162 patients, 158 were P-ANCA positive, 2 were C-ANCA positive and 2 were atypical C-ANCA positive. Most of the ANCA positive patients had chronic inflammatory diseases-129 patients (79.6%) with rheumatoid arthritis (RA), 4 (2.5%) with lupus and 4 (2.5%) with ulcerative colitis. Only 3 patients (1.9%) had vasculitides and the remaining seventeen patients had other diseases. Among the RA patients with ANCA, 27.9% were seronegative RA. Conclusion: In order to increase the clinical applicability of ANCA test in diagnosing vasculitides, it is essential to decrease the false positivity by using stabilized substrate and by adapting professional interpretation from experts. And our results suggest that ANCA test can be useful for diagnosing chronic inflammatory diseases such as rheumatic diseases (especially RA) along with vasculitides in Korea. Further study will be needed for the diagnostic utility of ANCA in RA.

신경과 질환에서의 자가면역표적 검사의 임상적 유용성

김수현,전래희,김신규 대한진단검사의학회 2017 Laboratory Medicine Online Vol.7 No.3

Background: Many studies have reported the association between several anti-neuronal antibodies and neurologic diseases. However, there is no useful autoantibody screening test for neurologic diseases unlike the antinuclear antibody test for rheumatologic diseases. Hence, we investigated the clinical utility of the autoimmune target (AIT) test as screening test for autoantibodies in neurologic diseases. Methods: We retrospectively analyzed the results of the AIT test for 375 serum samples of patients diagnosed with several neurologic diseases such as motor neuron disease (MND), amyotrophic lateral sclerosis (ALS), Parkinson’s disease (PD), encephalopathy (EC), polyneuropathy (PN), cerebral ischemic attack, encephalitis, myelitis, epilepsy, and stroke. Results: The overall positive rate of the AIT test in aforementioned diseases was 77.9%. The positive rates for MND, ALS, PD, EC, PN, and the others were 81.3%, 83.9%, 84.8%, 59.3%, 73%, and 75%, respectively. Conclusions: Our results indicate high positive rates in the AIT test. We believe that the AIT test has potential application for autoantibody screening in the neurologic diseases. We look forward to last as the study about relations between the results of the AIT test and the specific antibodies for neurologic diseases. 배경: 많은 연구를 통해 신경과 질환과 관련된 항신경성 항체들이 밝혀졌다. 그러나, 신경과 질환에서는 류마티스 질환에서 쓰이는 항핵항체 검사와 같은 유용한 자가항체 선별검사가 존재하지 않는다. 이에 저자들은 신경과 영역에서 자가면역표적(autoimmune target, AIT) 검사의 선별적 검사로서의 유용성에 관한 연구를 시행하였다. 방법: 운동뉴런질환(motor neuron disease, MND), 루게릭병(amyotrophic lateral sclerosis, ALS), 파킨슨병(Parkinson’s disease, PD), 뇌증(encephalopathy, EC), 말초신경병증(polyneuropathy, PN), 뇌허혈발작(cerebral ischemic attack), 뇌염(encephalitis), 척수염(myelitis), 뇌전증(epilepsy), 그리고 뇌졸중으로 진단받은 총 375명의 혈청을 대상으로 시행한 AIT 검사 결과를 후향적으로 분석하였다. 결과: 전체 대상에 대한 AIT 검사의 양성률은 77.9%였다. MND, ALS, PD, EC, PN, 그리고 그 외 질환의 양성률은 각각 81.3%, 83.9%, 84.8%, 59.3%, 73%, 그리고 75%였다. 결론: 대상이 된 신경과 질환들은 AIT 검사에 높은 양성률을 보였다. 신경과 영역에서 AIT 검사는 자가항체 선별로서의 역할을 할 수 있을 것으로 생각된다. 향후 AIT 검사와 특이적 항체들과의 연관관계에 대해 활발한 연구가 진행되길 기대한다.

리포솜 면역측정법을 이용한 CH50 검사의 유용성에 대한 재평가

이준,전래희,김신규 대한진단검사의학회 2021 Laboratory Medicine Online Vol.11 No.3

Background: This study aimed to evaluate whether the 50% hemolytic complement (CH50) is a suitable screening test to investigate complement activity by comparing its liposomal immunoassay-based results with C3 and C4 values and determine if it meaningfully reflects changes in the complement system. Methods: A retrospective study was conducted on 35,908 test samples that were simultaneously evaluated using C3, C4, and CH50 assays. Liposomal immunoassay was used for CH50 test, and rate nephelometry or immunoturbidimetry was used for C3 and C4 tests. The CH50, C3, and C4 results were divided into low, normal, and high groups for comparison and analysis. The distribution of C3 and C4 measurements according to the three different CH50 groups was analyzed. Results: Of the 35,908 cases, the C3 and C4 results were decreased in 19,051 (53%) and 14,666 (41%) cases, respectively. However, CH50 results were decreased in 6,257 cases (17%), which were lower than those for C3 and C4. A statistically significant difference was observed in the distribution of C3 and C4 values among different CH50 groups (P<0.001). Conclusions: The CH50 test based on the liposome immunoassay does not sensitively reflect the decrease in C3 and C4. However, it tends to show a better decrease at low concentrations proportional to the decreased amount of C3 and C4. Hence, it can be useful for severe complement deficiency screening. Therefore, there are limitations with the use of the CH50 test alone for the screening of complement activity, and care should be taken during result interpretation. 배경: 리포솜 면역측정법을 이용한 CH50 검사 결과와 C3, C4 측정치의 비교를 통해, CH50 검사가 보체의 증감을 유의하게 반영하고 있는지에 대하여 확인하고, 해당 결과를 통해 CH50 검사가 보체기능의 선별검사로서 사용하기에 적절한지 그 유용성을 평가하고자 하였다. 방법: C3, C4와 CH50 검사를 동시에 시행한 35,908건의 검사를 대상으로 후향적 연구를 시행하였다. CH50 검사는 리포솜 면역측정법으로, C3와 C4 검사는 비율비탁측정법 또는 면역혼탁측정법으로 측정하였다. CH50 결과와 C3, C4 결과를 감소, 정상, 증가군으로 나누어 비교 분석하였고, CH50 결과의 증감에 따른 C3, C4 측정치 분포를 분석하였다. 결과: 35,908건의 검사 중, C3는 19,051건(53%)에서 감소하였고, C4는 14,666건(41%)에서 감소하였다. 반면 CH50 결과는 6,257건(17%)에서 감소하여, C3와 C4의 감소율에 비해 낮았다. CH50 증가, 정상, 감소군 간에 C3와 C4 측정치 분포는 통계적으로 유의한 차이가 있었다(P<0.001). 결론: 리포솜 면역측정법에 의한 CH50 검사는 C3, C4의 감소를 민감하게 반영하지 못한다. 다만 C3, C4의 감소량에 비례하여 낮은 농도에서 더 뚜렷이 감소되는 경향을 보이므로 심한 보체결핍에서는 유용하게 사용될 수 있다. 따라서 CH50 검사를 단독으로 보체기능에 대한 선별검사로 사용하기에는 제한적이며 그 결과의 해석에 주의를 요한다.