자궁경부암 환자에서 종양표지물질 CYFRA 21 - 1 의 분석

이규완(K . W . Lee),정수경(S . K . Jung),김종오(J . O . Kim),이낙우(N . W . Lee),박용균(Y . K . Park),구병삼(P . S . Ku),최재걸(J . G . Choi),김영태(Y . T . Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10

목적 : CYFRA 21-1은 세포질에 존재하는 cytokeratin subunit 19의 분절로 폐의 편평세포암에서 유용한 종양표지물질로 알려져 있다. 자궁경부의 편평세포암에서 CYFRA 21-1의 혈청치를 측정하여 민감도와 특이도를 구하고, SCC와 비교함으로써 자궁경부암의 종양 표지물질로서의 유용성을 알아보기 위해 본 연구를 시행하였다.연구방법 : 1998년 2월부터 1999년 1월까지 고려대학교 안암병원 산부인과에서 조직학적으로 자궁경부암을 진단 받은 환자 중에서 치료전에 혈청이 채취된 24예, 자궁경부 상피내종양과 상피내암으로 진단 받은 환자 22예와 정상 대조군 21예을 대상으로 혈중 CYFRA 21-1을 측정하였다.결과 : 각 환자군의 평균연령은 자궁경부암군 50.6세, 자궁경부 상피내종양과 상피내암군 42.3세, 정상 대조군 54.5세로 나타났으며, CYFRA 21-1의 혈청 정상치를 2 ng/mg 이하로 하였을 때 자궁경부암군 24예에서 10예(41.7%), 자궁경부 상피내종양과 상피내암군 22예에서 4예(18.2%), 정상대조군 21예중 1예(4.8%)에서 양성으로 나타났다. 그리고, SCC와 CYFRA 21-1 혈청치의 병기 및 조직학적 분류에 따른 비교에 있어서 그 결과는 유의한 차이를 발견할 수 없었으며, 자궁경부암 환자에서 CYFRA 21-1의 민감도는 41.7%, 특이도는 95.2%, 양성 예측치는 90.9%이었다. 본 연구에서 자궁경부암 환자의 혈청에서 측정한 SCC는 24예중 5예로 20.8%의 민감도를 보였으며, CYFRA 21-1은 41.7%의 민감도를 보였다.결론 : CYFRA 21-1은 초기 및 진행된 자궁경부암의 진단에 SCC와 함께 보조적인 종양표지물질로 유용하게 사용할 수 있으리라 사료되지만 아직 더 많은 예에서 연구가 진행되어야 된다고 생각된다. Objective: CYFRA 21-1 is known to be a cytokeratin 19 fragment and elevated levels of CYFRA 21-1 have been detected in a large number of patients with non-small cell carcinoma of lung, particularly squamous cell carcinoma. The objective of our study were to evaluate the possibility of tumor marker of cervical cancer and to compare serum CYFRA 21-1 with serum SCC in patients with cervical cancer.Materials and methods: From February 1998 to January 1999, serum level of CYFRA 21-1 and SCC were measured in 46 patients with CIN, CIS, carcinoma of cervix before initial treatment. and 21 normal control cases. Results: Using 2.0 ng/ml as cut-off value, elevated CYFRA 21-1 levels were found in 4.8% of control cases, 25% of patients with CIN, 14.3% of patients with CIS, and 41.6% of patients with cervical cancer. Sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV) of serum CYFRA 21-1 were 41.7%, 95.2%, 90.9% and 58.8%, respectively. The sensitivity was 20.8% for SCC. The mean concentrations of SCC and CYFRA 21-1 were not correlated to FIGO stages and pathologic types. Conclusion: Serum CYFRA 21-1 was more sensitive than serum SCC for both early and advanced carcinoma of the cervix in our study. CYFRA 21-1 may be of significance as an additional marker in the management of patients with cervical cancer, but further investigation is needed.

고등교육 개혁에 따른 보건계열 전문대학 신대학 학위제도연계에 관한 연구

김영환(Y. H. Kim),이창규(C. K. Lee),오세윤(S. Y. Oh),이승관(S. G. Lee),정수경(S. K. Jung),박종성(J. S. Park),유병서(B. S. Ryu),조경진(K. J. Cho) 고려대학교 보건과학연구소 1998 보건과학논집 Vol.7 No.2

Studies on the Detection of mecA Gene and Distribution of Enterotoxin Genes in Pathogenic Staphylococci Isolated from Korea Using Molecular Biologic Technique

황선철(S. C. Whang),이동호(D. H. Lee),류정록(J. R. Ryu),정수경(S. K. Jung) 고려대학교 보건과학연구소 1997 보건과학논집 Vol.6 No.1

혈청 Creatine Kinase측정 표준화에 관한 연구(Ⅵ)

이창규,이승관,조경진,정수경,박종성,박상숙,류정록,남현철,김상섭,김석수,장철수,최명재 高麗大學校 倂設 保健大學 保健科學硏究所 1998 保健科學論集 Vol.24 No.1

In European countries or Japan they made an attempt for the standardization of assays in AST, ALT, ALP, CK, LD and GGT 10 years ago. For the actualization of the trial, they managed to succeeded in development of certified reference material and enzyme reference material. And they are now forecasting the unification of test results produced differently under the respective situatons. Then, through the highly developed communication system, someone can access any test results whenever or whereever only if they want to. It means that we can expect much greater improvements in medical services through the information exchanges. In this study the authors tried to ascertain the interchangeability comparing the obtained results of the CK tests between two general hospitals. Fortunately, the data got in the internal QC programs came to fall within the normal tolerances. The reference intervals for the CK test were different accarding to the chosen reagents and the results from the pooled serum were also shown differently each other. However, from the two hospitals, we could get glucose K factors, upon which the measurements were obtained and compared. Using K factors we measured the CKs, then we multiply the CK values by correction coefficients. We could found that the two results were showing good coincidence in the comparison. The main purpose of the standardization of enzyme assays is the creation of a new unified value which can be expressed differently otherwise. Using the standardized values we can exploit the data everywhere, reduce the medical costs from repeated or duplicated tests, save the foreign exchanges preventing the diversification of impart connections.

문학반응이론에 의한 보건의학기술계열 국가시험개선방안에 관한 연구

이창규,이승관,조경진,박종성,정수경,유병서,박상숙,윤효숙,황선철,문경환,김정민,함용운,김지환,임국환,김영순,윤경희,황성준 高麗大學校 倂設 保健大學 保健科學硏究所 1998 保健科學論集 Vol.24 No.1

The nationally-governed examinations for certification of allied health professions in Korea have been continued for thirty three years. During that time, there were a lot of managerial improvements in carrying out the examinations, for example, the looking-over the papers converted from manual method to computerized one. Nevertheless, the overall aspects of item management in the national examinations are still remained as obsolete style. In some developed countries they have already tried or adopted computerized system in making questions, executing item analysis, developing item banking, and in overall management of examinations, looking over papers for their national licensure examinations, and have established good reputations. Since the National Health Personnel Licensing Examination Board was established in 1998, now we can expect there would be a lots of improvements in the managerial systems and organizational structures associated with the national licensing examinations suggesting followings. 1. The contents and scope of the licensing examinations based on job analysis should be announced publicaly. 2. Items should be developed based on the scopes and contents of job characteristics. 3. All the developed items for the licensing examinations should be tested quantitatively prior to banking items. 4. All the parameters of the stored items should be fully estimated through item response theory. 5. All the efforts should be given in order to execute the examinations in individual residential areas on behalf of every examinee. 6. To the licensing examination system the Computerized Adaptive Testing system should be introduced in order to enhance the efficiencies. 7. Security enhancement on the stored items should be reminded in order to prevent leaking out the banking items. 8. Much more improvements should be made for the proper job evaluations. 9. Every efforts should be given to prevent cheatings encountable during the examinations. 10. Make the best of professional volunteers from the various fields in the execution of licensing examinations. 11. Consider a new system in that examinations can be executed twice or more in a year. 12. The current methods of presiding over the examinations should be replaced by a more reasonable one. 13. The results of the examinations should be announced as soon as possible in order not to prolong the examinees' unemployment periods. 14. The National Health Personnel Licensing Examination Board should try to rationalize the management keeping step with the information-oriented society.

Arbitrarily Primed PCR을 이용한 한국에서 유행하는 황색포도상구균의 분자유전형에 대한 연구

황선철,이창규,이승관,이동호,정수경,최현일,윤건석,정운원,윤효숙 高麗大學校 倂設 保健大學 保健科學硏究所 1998 保健科學論集 Vol.24 No.1

Eighty methicillin-resistant Staphylococcus aureus(MRSA) isolates were typed by applying arbitrarily primed-PCR(AP-PCR) method to clarify their distribution of molecular genetical characteristics. Among 40 gentamicin resistant strains of MRSA(GR-MRSA), 33 isolates drawn on the dendrogram fell into a single cluster at the similarity level of 90% when primer S₁ was used. However, with the primer S₂, 24 out of 40 strains fell into a single cluster at the similiarity 90%. In the meantime, 22 out of 40 strains amplified fell into a single cluster at the similarity of 90% when the primer E₂ was used. From the combined data obtained, it can be statistically said that 65.8% of GR-MRSA isolates are related with genetical characteristics. In 40 gentamycin susceptible MRSA(GS-MRSA) strains, 18, 19 and 13 strains drawn on the dendrogram fell into a single cluster at a similiarity level of 90% with the primers S₁, S₂ and E₂, respectively. From the combined data obtained by the three above AP-PCR profiles, it can be concluded that 41.7% of GS-MRSA isolates showed high relatedness genetically.

Studies on the Detection of mecA Gene and Distribution of Enterotoxin Genes in Pathogenic Staphylococci Isolated from Korea Using Molecular Biologic Technique

Whang, S. C.,Lee, D. H.,Ryu, J. R.,Jung, S. K. 高麗大學校 倂設 保健大學 保健科學硏究所 1997 保建科學硏究論集 Vol.6 No.1

본 연구에서는 입상 검체에서 발견되는 병원성 포도상구균(S. aureus)과 methicillin 내성 포도상구균(MRSA)에서 각각 nurc과 mecA 유전자, 장독소인 enterotoxin A에서 enterotoxin E를 encoding하는 유전자들과 toxic shock syndrome toxin(tst) 유전자를 빠르개 탐지하고 독소형의 국내·외의 역학적인 분포를 조사하기 위하여 multiplex PCR을 수행하였다. 210개의 MRSA에서 두 개의 균주가 mecA 유전자 음성을 보인 것을 제외하고 모두 nuc유전자와 mecA유전자 양성을 나타냈다. 이 중 10개(80.5%)가 한 게 흑은 그 이상의 장독소에 대한 유전자를 지니고 있었으며 다른 41개 균주(19.5%)는 장독소 유전자에 대해 양성을 나타내지 않았다. 장독소A 유전자(sea)는 분리균 중 50.5%(n=105)에서 유전자가 중폭되었고 seb는 14.료쏭(n=30), sec는 23.3% (n=49), sed는 10.0%(n=21) 그리고 tst는 12.4%(n=26)가 증폭되었다. 58개의 균주들(27.68)은 두 개 이상의 장내독소 유전자가 증폭되었다. 가장 많이 나타난 독소 조합군은 sea와 seb로 26개 균주(12.4%)에서 발견되었으며 다음으로 빈번한 조합은 sec와 tst로 14균주(6.7%)로 나타났다. 210개 중 109개의 균주는 서울 지역에서 분리된 것이었고 101개는 부산 지역에서 분리된 균이었다. 부산지역에서 장내독소 A 유전자(sea)의 발생율은 서울에서보다 두 배 더 높게 나타났다(57.1% 대 23.6%). 그러나 장내독소 c유전자(sec)와 d유전자(sed)는 서울 지역에서 각각 23.6%와 17.9%로 비슷하게 나타난 반면에 부산 지역에서는 각각 2.0% 미만으로 거의 무시할 수 있을 정도로 낮게 나타났다. 한국의 장독소 형별 검출을 외국과 비교하면 장독소A의 검출빈도가 가장 높은 것은 같으나 차순으로 빈도가 높은 것이 외국의 경우 b유전자인데 반하여 한국에서는 c유전자로 실험결과 나타났다. 또한 한국에서의 d유전자 검출빈도가 b유전자 보다 높아 주된 유행형인 a유전자를 제외한 기타 독소형의 분포는 국가간 또는 지역간에도 차가 있는 것으로 결론지을 수 있다. In this study we attempted multiplex PCR for rapid detection of genes for nuc, mecA. enterotoxin A to E and TSST-l(tst) in bacterial lysates extracted from human strains of S aureus. In 210 isolates of methicillin-resistant Staphylococcus aureus (MRSA), all strains showed both nuc gene and mecA gene positive except two strains that showed only nuc gene positive. One hundred sixty nine(80.5%) of 210 MRSA isolates tested produced one or more toxins. Other 41(19.5%) isolates did not produce any of the toxins. Enterotoxin A gene(sea) was amplified in 50.5%(n=105) of the isolates, enterotoxin B(seb) in 14.3%(n=30), enterotoxin C(sec) in 23.3%(n=49), enterotoxin D(sed) in 10.0%(n=21) and TSST-l(tst) in 12.4%(n=26). Fifty eight strains(27.6%) amplified more than two enteroxin genes. The most common combination of toxin gene was sea and seb, which was found in 26(12.4%) strains, and the next frequent combination was sec and tst in 14(6.7%) strains from 210 isolates among which 109 MRSA strains tested were isolated in Seoul area and 101 in Pusan area. The frequency rate of enterotoxin A in Pusan was twice higher than that of Seoul with 57.1% to 23.6%. But the frequency rates of enterotoxins C and D genes in Seoul area are analogous with relatively narrow margin while those rates in Pusan area were almost negligible with less than 2% each. Apparent difference of enterotoxin type distribution was also found between the countries. Beside enterotoxin A which was most predominantely found in both European countries and Korea, enterotoxin C was the subsequently prevalent type of toxin in Korea instead of enterotoxin b which was found as the second most prevalent enterotoxin in some European countries

혈청 LDH 효소분석 검사의 효준화에 관한 연구(Ⅴ)

이창규,이승관,조경진,박종성,정수경,유병서,박상숙,류정록,남현철,김석수,김상섭,김재영,이국성 高麗大學校 倂設 保健大學 保健科學硏究所 1998 保健科學論集 Vol.24 No.1

Since the Korean Association of Quality Assurance for Clinical Laboratory was established in 1976, the numbers of the participating hospitals nowadays were increased from 40 to 450 or more hospitals all over the country. In the early day the both internal and external quality control programs were started at the same time, however, the external QC programs prevailed over the internal ones putting the cart before the horse. The accuracy and the precision of the data are not satisfying in spite of the 20 years experiences of quality control programs. All the daily data should be reported after the validity is assured by the self-evaluation not by third party evaluation. It is regret that the CVs of enzymatic tests in external QC are exceeding 10% and there is no sign of diminishing CVs. One of the major reasons is that the types of anaytical instrurments and reagents are diverisified. Moreover, most of them are subject to the standards of the respective country of manufacturer. Accordingly, we can make a suggestion that the reagents and instruments should be imported or supplied meeting the established requirements for Korean standardization.

고등교육 개혁에 따른 보건계열 전문대학 신대학 학위제도연계에 관한 연구

김영환,이창규,오세윤,이승관,정수경,박종성,유병서,조경진 高麗大學校 倂設 保健大學 保健科學硏究所 1998 保建科學硏究論集 Vol.7 No.2

It is encouraging that the government has enacted some laws for the continuing educations of junior college graduate personnel, from which the graduates can get earn their bachelors degrees. However, not all the fields are covered by the newly enacted laws. Therefore, the excluded fields during the preparation of the higher education law should be complemented through further investigations enstudies. Under the present diversified and complicated structures of job classifications, it would cost too much for the government to manage the various types of technical expertises. For the effective management, a great deal of authorities or power of the government should be decentralized from the governmental bodies and moved to the non-governmental organizations such as scholastic societies or academies. In order to meet the needs of the information-oriented society, and to survive in ever changing high technologies, all the technical exports are urged to be equipped with updated information and sufficient knowledge on their major fields. For the solution of urgent problems the graduates of junior health alleges implicated with their works, and for the reformation of higher education system for the allied health professions, the following suggestions can be provided. 1. For the allied health professions, the enactment of the newly developed laws and regulations is urgently needed. 2. Like other industrial fields, the laws and regulations for the national qualification systems for the allied health professions should be revised for stratified ranking system such as MLA, MLT, MT in developed countries. 3. Some health professions should be developed as new kinds of jobs according to the diversified settings in health professions. 4. The present nationally-governed examination system for the allied health professions should be changed from a norm-referenced evaluation to a criterion-referenced evaluation. 5. In the performance appraisal of the employees, individual job performing proficiency should be highly rated prior to seniorities. 6. The priority of financial supports should be given to the higher educational organizations where the continuing education system is enforced. 7. Autonomy for the reorganization and restructuring should be given to each educational organization so that they can easily attain the goals of their own. 8. The continuing education for allied health professionals should be intensified even after the acquisition of license or certification. 9. The highly evaluated organizations should be awarded to promote themselves as specialized institutions. 10. The higher education policies should be established in consideration of the local autonomy situation.

초임유체를 매개로 하는 폐타이어의 분해공정에서 유효자원의 추출

김원일,김형진,홍인권,김성덕,정수경 한국공업화학회 1999 응용화학 Vol.3 No.1

In this study the change of molecular weight and products from process such as pyrolysis and supercritical THF pyrolysis were carried out for tire and SBR. The benzene types identified as major component of the oil derived from pyrolysis of SBR. Likely, benzene based products were found to be more for supercritical pyrolysis than other products relatively. The degradation was found to went well as variables such as pressure, temperature, and time increased.