Clinical Significance of Classification of Graves` Disease According to the Characteristics of TSH receptor Antibodies

(Won Bae Kim),(Hyun Kyung Chung),(Young Joo Park),(Do Joon Park),(Hong Kyu Lee),(Bo Youn Cho) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.3

N/A Background:It has been widely accepted that the epitope (s) and/or functional characteristics of thyrotropin receptor antibodies (TSHRAb) from Graves` patients are heterogenous among patients. However, the clinical significance of such heterogeneity has not been systematically evaluatedyet. We were to elucidate and find the clinical significance of heterogeneity for TSH receptor antibodies in Graves` disease. Methods:We measured stimulating TSHRAb (TSAb) activities using CHO-hTSHR cells, FRTL-5 cells and chimeric receptor expressing cells (Mc1+2 and Mc2), specific blocking TSHRAb (TSBAb) activities using Mc2 cells and TBII activities using porcine thyroid membrane in 136 patients with untreated hyperthyroid Graves` disease. Results: Based on various TSHRAb activities from each patient, the patients could be categorized into 7 subgroups by cluster analysis; 1) Group 1 (n=41) was characterized by moderate TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, typical TSAb epitope, rare blocking antibodies and high TBII activities. 2) Group 2 (n=16) was characterized by the presence of blocking TSHRAb in most patients, albeit the other characteristics were the same as those in Group 1. 3) Group 3 (n=19) patients had low TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, seldom had blocking TSHRAb, but they had high TBII activities. 4) Group 4 (n=30) could be categorized as `mild disease` group, as they had low activities in all kinds of TSHRAb assay and had low antim icrosomal antibody activities. 5) Group 5 (n=14) was characterized by moderate TSAb activities with atypical epitope (s), rare blocking TSHRAb and moderate TBII activities. 6) Group 6 (n=10) patients had veryhigh TSAb activities with typical epitopes, seldom blocking TSHRAb and low TBII activities. 7) Group 7 (n=6) was characterized by very high TSAb activities with atypical epitopes and high TBII activities. Pretreatment serum thyroid hormone level was low only in group 4 patients compared to the other 6 groups (p<0.05). The size of goiter was significantly larger in those in group 1 and group 3 (p<0.05) compared to the other 5 groups. The prevalence of clinically significant ophthalmopathy was higher in group 2 patients than the other 6 groups (50%vs.27.5%,p=0.06). Among 6 kinds of TSHRAb activities, only the blocking TSHRAb activity was significantly associated with the presence of ophthalmopathy in multivariate analysis. Conclusion:These results suggest that the differences inepitopes for TSAb or the presence of blocking TSHRAb is not a major factor in determining the degree of thyrotoxicosis in Graves` disease. Although the pathogenic mechanism is not clearyet, we suggest that patients with ophthalmopathy have different TSHRAb repertoire from those without ophthalmopathy in Graves` disease.

Serum TSH Level in Healthy Koreans and the Association of TSH with Serum Lipid Concentration and Metabolic Syndrome

( Yeo Kyung Lee ),( Jo Eun Kim ),( Hyun Ju Oh ),( Kyung Sun Park ),( Soo Kyung Kim ),( Seok Won Park ),( Moon Jong Kim ),( Yong Wook Cho1 ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.4

Background/Aims: The proper treatment of subclinical hypothyroidism and the normal range of serum thyroid stimulating hormone (TSH) concentration are intensely debated. However, few reports have investigated TSH concentrations in Asian ethnic groups. Therefore, the present study was designed to define the TSH reference range in a Korean population and to investigate the metabolic significance of TSH concentration. Methods: We enrolled patients who underwent medical examination at the CHA Bundang Medical Center. Anthropometric data were evaluated, and serum TSH, free T4, and lipid profiles were assayed. Results: A total of 7,270 subjects were included. Mean TSH concentration of the study population was 1.82 ± 0.95 mU/L, and we observed a sex-related difference in TSH concentration (male, 1.67 ± 0.87 mU/L; female, 2.02 ± 1.01 mU/L; p < 0.01). When the 2.5 and 97.5 percentiles were calculated, 95% TSH reference limits were 0.52-4.29 mU/L. TSH concentration was higher in elderly subjects, during winter, in postmenopausal women, and in obese males. Moreover, TSH showed significantly positive correlations with serum total cholesterol, triglyceride, and low density lipoprotein cholesterol regardless of sex, age, season, obesity, or menopausal status (all p < 0.01). Finally, TSH concentration was positively related to the prevalence of metabolic syndrome. Conclusions: We demonstrated the association between TSH concentration within the normal reference range and serum lipid levels. TSH concentration varies according to sex, age, season, and body mass index (only in males). Moreover, high normal TSH levels were significantly associated with an increased prevalence of metabolic syndrome, which may be of importance when evaluating subjects with high normal TSH concentration.

일반논문(一般論文) : 『황제내경(黃帝內經)』에 나타난 부인과(婦人科)에 관(關)한 문헌고찰(文獻考察)

김혜원 ( Hye Won Kim ),조정훈 ( Jung Hoon Cho ),장준복 ( Jun Bock Jang ),이경섭 ( Kyung Sub Lee ) 대한한의학원전학회 ( 구 대한원전의사학회 ) 2005 대한한의학원전학회지 Vol.18 No.1

Poster Session:PS 0546 ; Nephrology : Body Composition Measurements Using Bioimpedance Analysis in Peritoneal Dialysis Patients are Affected by the Resence of Dialysate

( Kyu Hyang Cho ),( Seok Hui Kang ),( Jong Won Park ),( Kyung Woo Yoon ),( Jun Young Do ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: We report a rare case of CAPD peritonitis caused by Ochrobacterium anthropi. Introductions: Among the continuous ambulatory peritoneal dialysis(CAPD) patients, peritonitis is one of the most commonly taken complications, and also the general cause of dialytic modality exchange to hemodialysis. Usual pathogens of CAPD peritonitis may be bacteria, fungi, mycobacteria. Coagulase negative staphylococci, S. aureus, campylobacter, pseudomonas are common reported pathogens among the bacteria, of CAPD peritonitis cases, meanwhile candida is among fungi. Ochrobacterium anthropi is one species of Brucellaceae, which is rare pathogen of human disease. Case (Methods and results): 73 years old female, who was on CAPD due to diabetic end stage renal disease visited Kyung-Hee University hospital with intermittent abdominal pain. Body fi uid analysis showed increased white blood cell(WBC) count of 26,750/mm3 with her peritoneal fi uid. Culture study with peritoneal fi uid suggested O. anthropi, and DNA sequencing with PCR was consistent with O. anthropi. Intraperitoneal ceftazidime and cefazolin were administrated as empirical antibiotics. Ceftazidime resistance was noted with the result of antibiotics sensitivity test at 7th day of hospitalization, and antibiotics were changed into intraperitoneal gentamicin, which showed sensitivity to the pathogen. CAPD catheter removal and antibiotics re-exchange into imipenem and cefazolin, which were other sensitive antibiotics by the sensitivity test, were done since clinical manifestation and peritoneal fi uid WBC count was repeatedly improved and aggravated. The patient discharged with improved lab test results and resolving clinical symptoms afterward. Conclusions: We presentators report rare case of CAPD peritonitis with pathogen of O. anthropi. The pathogen of the case confi rmed by classical microbiologic, and molecular biologic Methods: The patient was unable to treat only with antibiotics, thus CAPD catheter, which might be act as colonizing source, was removed, and the disease resolved.

In vitro Mammalian Chromosomal Aberration Test of Fullerene-C60

Soo Jin Kim(김수진),Kyung Taek Rim(임경택),Hae Won Cho(조해원),Jeong Hee Han(한정희),Hyeon Yeong Kim(김현영),Jeong Sun Yang(양정선) 환경독성보건학회 2009 환경독성보건학회지 Vol.24 No.1

Fullerene의 유전독성을 평가하기 위하여 Chinese hamster유래의 난소유아세포(CHO-K1 cell)를 이용하여 직접법(-S9)과 대사활성화법(+S9 mix)의 염색체이상시험을 실시하였다. 시험물질은 1% CMC 나트륨염의 현탁액(l% CMC 용액)에 희석하여 조제하였다. 대사활성화를 시키지 않은 직접법의 염색체이상시험에서 24시간 투여군은 8단계의 농도(0.078, 0.156, 0.313, 0.625, 1.25, 2.5, 5, 10mM)로 투여하여 실시하였다. 투여 농도 증가에 따른 염색체이상의 빈도가 증가하는 양상이 나타나지 않았다. 48시간의 투여군에서는 8단계의 농도(0.078, 0.156, 0.313, 0.625, 1.25, 2.5, 5, 10mM)로 투여하여 실시하였는데 투여 농도 증가에 따른 염색체이상의 빈도가 증가하는 양상이 나타나지 않았다. 배수체의 염색체이상은 직접법에서 관찰되지 않았다. 대사활성화법을 이용하여 6시간 시험물질을 투여한 시험에 있어서는 8단계의 용량단계 (0.078, 0.156, 0.313, 0.625, 1.25, 2.5, 5, 10mM)를 설정하였는데 투여 농도가 증가함에 따른 염색체이상빈도의 증가양상이 관찰되지 않았다. 이상의 결과를 종합할 때 본 시험물질은 본 시험 조건하에서 CHO-K1세포에서 대사활성화를 시켰을 때 염색체 이상을 유발하지 않는 것으로 판단된다.

Antimutagenic Effects of Ginsenoside Rb$_1$, Rg$_1$ in the CHO-K1 Cells by Benzo[a]pyrene with Chromosomal Aberration Test and Comet Assay

Kim, Jong-Kyu,Kim, Soo-Jin,Rim, Kyung-Taek,Cho, Hae-Won,Kim, Hyeon-Yeong,Yang, Jeong-Sun The Korean Society of Toxicogenomics and Toxicopro 2009 Molecular & cellular toxicology Vol.5 No.2

The usage and types of chemicals are advancing, specializing, large-scaled increasing, and new chemical exposed workers are concerning to occupational disease. The generation of reactive oxygen in the body from carcinogen, mutation and DNA damage in cancer is protected by natural antioxidants (phytochemicals) with antimutagenic effect. There were many reports of ginsenoside Rb$_1$, Rg$_1$ grievances of the genetic mutation to suppress the effect confirm the genetic toxicity test with chromosomal aberration test and the Comet (SCGE) assay confirmed the suppression effect occurring chromosomal DNA damage. We had wanted to evaluate the compatibility and sensitivity between the chromosomal aberration (CA) test and the Comet assay. We used the CA test and Comet assay to evaluate the anti-genotoxicity of ginsenoside Rb$_1$ and Rg$_1$, in CHO-K1 (Chinese hamster ovary fibroblast) cell in vitro, composed negative control (solvent), positive control (benzo[a]pyrene), test group (carcinogen+variety concentration of ginsenoside) group. The positive control was benzo[a]pyrene (50 $\mu$M), well-known carcinogen, and the negative control was the 1 % DMSO solvent. The test group was a variety concentration of ginsenoside Rb$_1$, Rg$_1$ with 10$^{-8}$%, 10$^{-6}$%, 10$^{-4}$%, 10$^{-2}$%, 1%, 10%. In chromo-somal aberration test, we measured the number of cells with abnormally structured chromosome. In Comet assay, the Olive tail moment (OTM) and Tail length (TL) values were measured. The ratio of cell proliferation was increased 8.3% in 10$^{-8}$%, 10$^{-6}$%, 10$^{-4}$%, 10$^{-2}$%, 1%, 10% Rb$_1$ treated groups, and increased 10.4% in 10$^{-10}$%, 10$^{-8}$%, 10$^{-6}$%, 10$^{-4}$%, 10$^{-2}$%, 1% Rg$_1$ treated groups. In the CA test, the number of chromosomal aberration was decreased all the Rb$_1$ and Rg$_1$ treated groups. In the Comet assay, the OTM values were decreased in all the Rb$_1$ and Rg$_1$ treated groups. To evaluate the compatibility between CA and Comet assay, we compared the reducing ratio of chromosomal abnormalities with its OTM values, it was identified the antimutagenicity of ginsenoside, but it was more sensitive the CA test than the Comet assay. Ginsenoside Rb$_1$ and Rg$_1$ significantly decrease the number of cells with chromosomal aberration, and decrease the extent of DNA migration. Therefore, ginsenoside Rb$_1$, Rg$_1$ are thought as an antioxidant phytochemicals to protect mutagenicity. The in vitro Comet assay seems to be less sensitive than the in vitro chromosomal aberration test.

신이식후 발생하는 감염에 대한 고찰

김재필(Jae Phil Kim),조대옥(Dae Ok Cho),고경식(Kyung Sik Ko),안재형(Jai Hyung Ahn),이태원(Tae Won Lee),임천규(Chun Gyoo Ihm),김명재(Myung Jae Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: Renal transplantation is a major therapeutic advance for patients with chronic renal failure. But recipients of renal transplantation are prone to infection with both common and unusual organisms. And infectious diseases remain a major cause of morbidity and mortality in renal transplant recipients. This study was to analyze the infections in renal transplant recipients; its occurrence according to sites and organisms; comparison among immunosuppressive agents; prognostic differences of urinary tract infections(UTI) between those developed during 1 month after transplantation and those not developed; graft outcome; and patients mortality. Mothods: 181 renal transplant recipients were examined. They received renal transplantion between january 1979 and December 1992 at the Kyung-Hee University Hospital. 158 of them received transplantation from living-related donors, 22 from living-unrelated donors, and 1 from cadaver donor. Their age at the time of transplantation ranged from 14 to 66 years(mean 35.6 years), and the male to female ratio was 2.3: 1. The observation period ranged from 1 to 144 months(41.26±31.71, mean±S. D.). Results: 1) 110 recipients(60.7% of total) had 232 episodes of infectious complications whereas 71(39.3% of total) had no infectious episodes. About half of infectious episodes(128 episodes, 55.2% ) occurred during 1 month after transplantation. 2) The most common site of infection was urinary tract(138 episodes, 59.2%) whth the next sites coming in this order, bacteremia(32 episodes, 13.8%), pulmonary(21 episodes, 9.1%), and skin(21 episodes, 9.1%). 3) The causative organisms of UTI ranked in this order E. coli 21.7%, staphylococcus spp 14.5%, and pseudomonas spp 13.0%. 4) The causative organisms of bacteremia ranked in this order E. coli 34.4% salmonella spp 18.8%, pseudomonas spp 12.5 %, and staphylococcus spp 12.5%. 5) There was no significant differences of infectious episodes among immunosuppressive regimens. 6) Early UTI group(UTI occurred during 1 month after transplantation) recorded significantly higher incidence of urinary tract infections after 1 month that followed than non-UTI group. But there was no differences between two groups on graft and patients outcome. 7) The major cause of death was life-threatening infections(63.2 %). Conclusion: Most infections due to various organisms may occur during 1 month after transplantation. And still they constitute a major cause of death in renal transplant recipients.

중풍환자(中風患者)의 혈관성치매에 대한 임상적(臨床的) 관찰(觀察)

김원찬,김영석,문상관,고창남,조기호,배영섭,이경섭,박정미,Kim Won-Chan,Kim Young-Suk,Moon Sang-Kwan,Ko Chang-Nam,Cho Ki-Ho,Bae Hyung-Sup,Lee Kyung-Sup,Park Jung-Mi 대한한방내과학회 1998 大韓韓方內科學會誌 Vol.19 No.2

Background : Vascular dementia occurs mainly due to cerebral vascular disease. So we performed this clinical study to investigate the incidence and characteristics of vascular dementia in stroke patients. Methods : This study was performed on the patients hospitalized from April 1, 1998 to August 31, 1998 at the department of circulatory internal medicine, hospital of Oriental medicine, Kyung-Hee University, and diagnosed cerebral infarction or hemorrhage by Brain CT or MRI. we devided the patients into two groups; vascular dementia group and non dementia group according to MMSE-K(Mini Mental State Examination Korean version), Hasegawa dementia scale. Patients were diagnosed dementia using DSM-IV. We compared general characteristics, stoke types and laboratory findings between the two groups and investigated the correlationship between MMSE-K and Hasegawa dementia scale. Results : Results showed that the incidence of vascular dementia was about 27.8% in stroke patients. The greater number of subjects with dementia were women in the lower educational classes and had lower MBI(Moderfied Bathel Index) scores. Vascular dementia were more common in patients with large brain lesion size($>20cm^3$). There was a positive correlationship between Hasegawa scores and MMSE-K.

Productivity Loss of Rheumatoid Arthritis Patients according to the Their Stages of the Disease Activity Score

( Sang-Cheol Bae ),( Jin-Hye Cha ),( Jung-Yoon Choe ),( Sung Jae Choi ),( Soo-Kyung Cho ),( Won-Tae Chung ),( Chung-Il Joung ),( Young-Ok Jung ),( Young Mo Kang ),( Dong-Wook Kim ),( Jinseok Kim ),( Y 대한류마티스학회 2018 대한류마티스학회지 Vol.25 No.2

Objective. Productivity loss was compared by 3-stage of disease activity and associations between higher disease activity and high productivity loss were identified. Methods. Data were extracted from Rheumatoid Arthritis (RA) Patient-reported Outcomes Research, which enrolled 2,000 RA patients (>20-year) on disease-modifying-antirheumatic-drugs (DMARDs) (≥ 6-month) from December 2012 to June 2013. This included 1,457 RA patients with the disease activity score (DAS-28-ESR) in their medical charts. Productivity loss in time and indirect cost was estimated using The World Health Organization Health and Work Performance Questionnaire (HPQ). Baseline characteristics and productivity loss outcomes were compared according to DAS-28-ESR groups. Results. 84.4% were females, 54.2% had low DAS-28-ESR (<3.2), and 38.2% and 7.6% had moderate (3.2∼5.1) and high DAS-28-ESR (>5.1). Patients with moderate to high DAS-28-ESR had higher lost productivity time (LPT) and monthly costs of LPT than those with low DAS-28-ESR (time in hours: 110.0±58.4 vs. 132.4±57.2 vs. 71.5±52.0, p<0.0001; monthly costs of LPT in 1,000 Korean won: 1,097±607 vs. 1,302±554 vs. 741±531, p<0.0001). Multiple regression analyses revealed significant associations with high LPT in high (adjusted odds ratio [OR]=3.87, 95% confidence interval [CI]: 2.18∼6.87) and moderate DAS-28-ESR (adjusted OR=1.88, 95% CI: 1.41∼2.52) compared to low DAS-28-ESR. In addition, positive associations with high monthly costs of LPT were observed in high (adjusted OR=3.45, 95% CI: 1.98∼5.99) and moderate DAS-28-ESR (adjusted OR=1.93, 95% CI: 1.43∼2.54) compared to low DAS-28-ESR. Conclusion. Timely therapeutic strategies should be taken into consideration given that the RA patients with moderate to high DAS-28-ESR showed strong associations with high productivity loss for effective management of RA. (J Rheum Dis 2018;25:122-130)

Liquid biopsy using cfDNA to predict radiation therapy response in solid tumors

Won Kyung Cho(Won Kyung Cho),Junnam Lee(Junnam Lee),Sung-Min Youn(Sung-Min Youn),Dongryul Oh(Dongryul Oh),Do Hoon Lim(Do Hoon Lim),Han Gyul Yoon(Han Gyul Yoon),Eun-Hae Cho(Eun-Hae Cho),Jae Myoung Noh( 대한방사선종양학회 2023 Radiation Oncology Journal Vol.41 No.1

Purpose: This study explored the potential feasibility of cell-free DNA (cfDNA) in monitoring treatment response through the measurement of chromosomal instabilities using I-scores in the context of radiation therapy (RT) for other solid tumors. Materials and Methods: This study enrolled 23 patients treated with RT for lung, esophageal, and head and neck cancer. Serial cfDNA monitoring was performed before RT, 1 week after RT, and 1 month after RT. Low-depth whole-genome sequencing was done using Nano kit and NextSeq 500 (Illumina Inc.). To measure the extent of genome-wide copy number instability, I-score was calculated. Results: Pretreatment I-score was elevated to more than 5.09 in 17 patients (73.9%). There was a significant positive correlation between the gross tumor volume and the baseline I-score (Spearman rho = 0.419, p = 0.047). The median I-scores at baseline, post-RT 1 week (P1W), and post-RT 1 month (P1M) were 5.27, 5.13, and 4.79, respectively. The I-score at P1M was significantly lower than that at baseline (p = 0.002), while the difference between baseline and P1W was not significant (p = 0.244). Conclusion: We have shown the feasibility of cfDNA I-score to detect minimal residual disease after RT in patients with lung cancer, esophageal cancer, and head and neck cancer. Additional studies are ongoing to optimize the measurement and analysis of I-scores to predict the radiation response in cancer patients.