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소아 특발성 혈소판 감소증에서 항-HLA Class I항체의 임상적 의미
이홍준,임재영,염정숙,박지숙,박은실,서지현,박찬후,우향옥,윤희상 대한수혈학회 2013 大韓輸血學會誌 Vol.24 No.3
배경: 수혈의 기왕력이 항HLA항체의 형성과연관이 있다는 사실은 잘 알려져 있다. 하지만, 특발성 혈소판 감소성 자반증의 주 표적은 혈소판의 당단백이며, 당단백 항체와 항 HLA class I 항체의 형성기전은 완전히 다른 것이다. 이번 연구의 목적은 특발성 혈소판 감소성 자반증 환아의 항HLA class I 항체의 임상적 의미를 찾아 보고자 함에 있다. 방법: 1990년부터 2010년까지 경상대학교병원을 방문한 48명의 대조군과 48명의 특발성 혈소판감소성자반증 환아들을 대상으로 하였다. 각각의 환자들의 혈청을 Modified Antigen Capture Enzyme-linked immunosorbent assay (MACE) kit를이용하여 항 당단백 항체와 항 HLA class I 항체를 검사하였다. 결과: 두 그룹간의 항 HLA class I항체의 양성률은 의미 있는 차이를 보였으며[36/39 (92.3%) vs 29/46 (63.0%)][혈소판감소성자반증 환자군 vs 정상대조군] (P=0.002), 항HLA class I 평균항체 S/C ratio 또한 의미 있는 차이를 보였다(3.55 vs 1.51) [혈소판감소성자반증 환자군 vs 정상대조군] (P=0.0000). 하지만 혈소판 감소성 자반증 환자군에서 수혈을 받은 환자들과 수혈을 받지 않은 환자들 간의 항HLA항체 양성률은 의미 있는 차이를 보이지 않았으며[12/12 (100%) vs 24/27 (88%)][수혈을 받은 환자군 vs 비수혈 환자군] (P=0.22), 평균 항체 S/C ratio 또한 통계적으로 의미 있는 차이를 보이지 않았다(4.30 vs 3.25)[수혈을 받은 환자군 vs 비수혈 환자군](P=0.22). 수혈이후에 추적검사를 위해 채혈을 했던 환아들의샘플을 이용한 항체 양성률 및 항체가 검사에서도 의미 있는 차이는 없는 것으로 나타났다. 결론: 항 HLA class I 항체는 혈소판 감소성 자반증과 연관이 있을 수 있으나, 수혈은 혈소판 감소성 자반증 환아의 임상적 경과에 영향을 미치지 못한다. Background:A previous history of transfusion has been known to be associated with production of anti-HLA class I antibodies. However, platelet glycoproteins are the main target of idiopathic thrombocytopenic purpura (ITP). The mechanism of antibody production is known to differ significantly between glycoproteins and anti-HLA class I. The aim of this study was to evaluate the clinical significance of anti-HLA class I antibodies in childhood ITP. Methods:Enrollment for the normal control group targeted 48 people who visited Gyeongsang National University Hospital from 1990 to 2010, and 48 young children with ITP. Anti-glycoproteins and anti-HLA class I antibodies were tested using the Modified Antigen Capture Enzyme-linked immunosorbent assay (MACE) kit. Results:The positive rate of anti-HLA antibodies was significantly different [36/39 (92.3%) vs 29/46 (63%)] [ITP group vs normal control group] (P=0.002). The mean positive S/C ratio of anti-HLA antibodies was also significantly different (3.55 vs 1.51) [ITP group vs normal control group] (P=0.0000). The positive rate of anti-HLA did not differ significantly between the transfused group and the non-transfused group [12/12 (100%) vs 24/27 (88%)] [transfused ITP vs non-transfused ITP]. The mean positive S/C ratio of anti-HLA antibodies did not differ significantly between the transfused ITP group and the non-transfused ITP group (4.30 vs 3.25) [transfused ITP vs non-transfused ITP]. Consecutive testing showed that positive rate and positive S/C ratio of anti-HLA antibodies did not change significantly between sampling times in both groups [transfused ITP vs non-transfused ITP] (P=1.00 and P=0.15). Conclusion:Anti-HLA class I antibodies may be involved in childhood ITP. Transfusion did not affect the course of childhood ITP.
체외생산 소 초기배 할구세포의 Embedding Matrix에서의 발생능력
이홍준,서승운,이상호,송해범 韓國受精卵移植學會 1995 한국동물생명공학회지 Vol.10 No.2
This study was performed to establish the condition and the methods for the techniques of insertion the isolated blastomere cells into cytoplasm, in order to research the develop-mental ability of bovine embryo blastomere cells in vitro produced. After 24h in vitro ovary maturation with the ovaries from a slaughter house, in vitro fertilization was performed to the vital sperms which their mobility were decided by percoll gradient method, with 2~8 cell stage embryos, the blastomeres were isolated in +. +-free PBS, and following that embedded into agar and alginate solution, respectively. The rates of in vitro develop-ment are as follows ; in agar embedded 11 among 120(9.2%) 1 /2~1 /3 blastomers cleaved and 6 among 93(6.5%) 1 /4~1 /8 blastomeres cleaved. In sodium alginate-embedded 14 among 84(16.7%) 1 /2~1 /3 blastomeres cleaved and 6 among 85(7.1%) 1 /4~1 /8 blastomeres cleaved. In case of Na-alginate, the rate of the cells were better than those of agar. The results suggest that the techniques for embeeding the isolated blastomeres into gel may help cloning of bovine early embryo without nuclear transplantation.
Denys-Drash syndrome, septated vagina and low level of anti-Mullerian hormone in male neonate
이홍준,엄정숙,박지숙,박은실,서지현,임재영,박찬후,우향옥,윤희상 대한소아내분비학회 2014 Annals of Pediatirc Endocrinology & Metabolism Vol.19 No.2
There is a wide variety of genital abnormalities observed in patients with Denys- Drash syndrome (DDS). WT1 is thought to influence the genes related to genital development and mutations in this gene have been associated with DDS. DDS should be considered in the differential diagnosis of newborns with genital anomalies. In contrast to other conditions with 46,XY disorders of sex development, individuals with DDS often have duplicated genital organs (a double vagina, cervix or uterus). A double uterus has not yet been reported with 1390G>A (Arg464 Asn) mutation. However, duplicated genitals have been reported with other genetic mutations in patients with DDS. The duplicated genitals in DDS may be associated with low anti-Mullerian hormone (AMH) secretion. Measurement of the AMH levels may add to our understanding of variations in genital development and their abnormalities in disorders such as DDS. In conclusion, this is first case of low level of AMH and double uterus in 1390G>A (Arg464 Asn) mutations of DDS male.