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일측 신장의 허혈-재관류 모델에서 신조직내 TGF-β, TNF-α, 및 Endothelin-1 유전자 발현에 관한 연구
신영태(Young Tai Shin),김종학(Jong Hak Kim),황평주(Pyeung Joo Hwang),이강욱(Kang Wook Lee),서광선(Kwang Sun Suh),구영선(Young Sun Koo),강민규(Min Kyu Kang) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.1
N/A Although the exact pathogenetic mechanisms of the renal ischemia-reperfusion injury(I-R injury) have not been clearly elucidated yet, the reactive oxygen spe-cies(ROS) and mononuclear cell infiltration have been suggested to contribute to this renal injury process. The cytokines and growth factors produced by infiltrated leukocytes and renal parenchymal cells could accelerate the process of tissue damage by inducing cellular proliferation, fibrosis, and further recruitment of other inflammatory cells. The renin-angiotensin sys- tem(RAS) also has been suggested to be one of the most important mediators in the renal injury process of many animal models and human renal diseases. In order to evaluate the change of the levels of TNF-α, endothelin-l, and TGF-βgene expression in unilateral I-R injured renal cortical tissue, competitive RT-PCR was performed for the above mRNAs in Sprague-Dawley rats(60 minutes of ischemic time by non-traumatic vessel clamp and 24 hours of reperfusion). Also the plasma renin activity(PRA) and an-giotensin II(AII) level were measured at the time of sacrifice by radioimmunoassay. On the light miscroscopic examination, I-R injured renal cortical tissue showed typical findings of acute tubular necrosis, such as mononuclear ceU infiltration, necrosis, swelling and denudation of proximal tubular cells. Compared to control sham operated group, I-R injured group tissues showed significantiy increased level of TGF-β(p<0.05), endothelin-l(p<0.05) and TNF-α(p<0.05) gene expression in 24 hours after I-R renal injury. The levels of PRA and AIl were also significantly elevated compared to sham group(p< 0.05, p<0.05, respectively). In conclusion, we speculate that the early activation of RAS and elevated gene expression of TNF-α, endothelin and TGF-β of renal cortieal tissue may contribute to the early pathogenetic mechanism of I-R renal injury process.
신장내과로의 진료의뢰 시기가 혈액투석 환자에게 미치는 영향
이영모 ( Young Mo Lee ),이한규 ( Han Kyu Lee ),권오경 ( O Kyung Kwon ),장동석 ( Dong Seok Jang ),이수윤 ( Soo Yoon Lee ),이상주 ( Sang Ju Lee ),나기량 ( Ky Rhryang Na ),이강욱 ( Kang Wook Lee ),신영태 ( Young Tai Shin ) 대한내과학회 2004 대한내과학회지 Vol.67 No.6
목적 : 연구자들은 충남대학교병원에서 처음 말기 신부전증으로 진단 받고 혈액투석을 시작한 환자들을 대상으로 신장내과로의 진료의뢰 시기에 따른 임상적 차이점들을 비교분석하고 투석 시작 후 1년간의 추적 결과를 바탕으로 사망률의 차이를 알아보고자 본 연구를 수행하였다. 방법 : 1998년 1월 1일부터 2002년 7월 1일까지 충남대학교병원 신장내과에서 말기 신부전증으로 진단을 받고 처음 혈액투석을 시작한 217명의 환자들을 대상으로 하였다. 신장내과로 전 Background : It has been speculated that many factors including age, hemoglobin serum albumin level and socioeconomic factors are closely related with the mortality and morbidity of patients with end-stage renal disease (ESRD). Optimal management of the p
최영환(Young Hwan Choi),이정호(Jeong Ho Lee),신승훈(Seung Hun Shin),이순구(Sunn Kgoo Rhee),구대회(Dae Hoe Ku),이강욱(Gang Wook Yi),김상용(Sam Yong Kim),신영태(Young Tai Shin) 대한내과학회 1991 대한내과학회지 Vol.40 No.5
N/A To investigate the humoral immune function in patients with systemic lupus erythematosus (SLE), peripheral blood T cell subsets, and serum levels of IgG, IgA and IgM were measured in 11 patients with SLE and 17 healthy controls. IgG and IgA production by peripheral blood lymphocytes to pokeweed mitogen triggering were also evaluated. The results were as follows: 1) Serum IgG, IgA and IgM levels in patients with SLE were more significantly elevated than those of the healthy controls. 2) T cell subsets in patients with SLE were not different from those of the healthy controls. 3) Spontaneous in vitro IgG production from peripheral blood lymphocytes was significantly higher in patients with SLE than that of healthy controls (p<0. 01), but pokeweed mitogen-stimulated in vitro IgG production was significantly lower in patients with SLE(p < 0. 005). Spontaneous in vitro IgA production in patients with SLE increased without statistical significance compared with the healthy controls, but pokeweed mitogen-stimulated in vitro IgA production slight1y decreased in patients with SLE without statistical significance. 4) Stimulation indices of in vitro IgG and IgA production were significantly lower in patients with SLE than those the of healthy controls(p<0.005). It is suggested that there is a preactivation of B cells in vivo of patients with active SLE. Furher studies on the mechanism of cellular interactions in B-cell immunoglobulin production in vitro of patients with SLE should be pursued.
혈액투석 중인 만성 신부전 환자에서 발생한 Reversible Posterior Leukoencephalopathy Syndrome
구영선(Young Sun Koo),김도희(Do Hee Kim),장윤경(Yoon Kyung Chang),양종오(Jong Oh Yang),강민규(Min Gyu Kang),황평주(Pyeong Joo Hwang),송창준(Chang June Song),이강욱(Kang Wook Lee),신영태(Young Tai Shin) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.1
A Reversible Posterior Leukoencephalopathy Syndrome(RPLS) consists of neurologic symptoms and signs - headache, consciousness change, seizure, visual impairment - and brain imaging finding showing brain(espicially white matter) edema usually involving the posteior parietal-temporal-occipital areas. The causes are thought to be hypertensive encephalopathy, preeclampsia or eclampsia, renal failure with fluid overload and immunosuppressive agents such as cyclosporin A or FK506. RPLS may usually reversible if treated early by decreasing blood pressure and discontinuing offending drugs. A 23-year- old man had been hemodialyzed with chronic renal failure for two years. His blood pressure elevated to 240/150mmHg 3 days before admission and he complained of severe headache, vomiting, and total visual loss at the day of admission. Brain T2-weighted MRI imaging showed increased signal intensity involving the both parietal, posterior temporal, and occipital lobes. After antihypertensive and dexamethason treatment, a follow-up brain MRI performed on 7 days after admission showed nearly normalized findings and all symptoms including visual loss were recovered completely in one week.
신 이식 직후 신장 스캔 소견과 이식신 장기 생존의 관계
소영(Young So),이강욱(Kang Wook Lee),신영태(Young Tai Shin),안문상(Moon Sang Ahn),배진선(Jin Sun Bae),설종구(Chong Koo Sul),정인목(In Mok Jung) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.4
N/A Purpose: We investigated the possibility of early postoperative Tc-99m DTPA scintigraphy in predicting long-term renal transplant survival. Materials and Methods: 64 living donor (LD) grafts were divided into two groups according to the graft function on early post-operative renal scintigraphy. Survival analysis was performed using Kaplan-Meier method and Cox proportional hazard model. Chi-square test was performed to evaluate the difference in the frequency of acute rejection. Results: Cumulative renal transplant survival was decreased in 11 patients with abnormal renal scintigraphy, but it was not statistically significant. Decreased graft function on early post-operative renal scintigraphy was not a predictor of long-term graft survival. The frequency of acute rejection was higher in abnormal scintigraphy group, and the difference was statistically significant. Conclusion: Decreased graft function on early post-operative renal scintigraphy has no direct effect on long-term renal transplant survival in LD transplantation. But it may have an indirect effect through increasing the frequency of acute rejection. (Korean J Nucl Med 200135-251-257)
침술 및 근육 내 자극치료 (Intramuscular Stimulation)에 의한 콩팥주위 혈종
김설영 ( Seul Young Kim ),장원익 ( Won Ik Jang ),정사라 ( Sa Rah Chung ),최대은 ( Dae Eun Choi ),나기량 ( Ki Ryang Na ),이강욱 ( Kang Wook Lee ),신영태 ( Young Tai Shin ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.2
Acupuncture therapy has been widely performed by staffs of oriental medicine in Korea, and intramuscular stimulation (IMS) therapy has been introduced recently and used for controlling myofascial pain in the field of orthopedics, rehabilitation, and pain clinics. To penetrate human tissues, relatively long needles are used in both procedures and these these may have some risks to puncture blood vessels. However, there were few reports about sequelae or complications after such procedures in Korean literatures. Recently, we experienced two cases of perirenal hematoma in patients without blood coagulation abnormalities (one case induced by acupuncture in oriental medicine clinic, and the other case induced by IMS in orthopedic clinic and was also accompanied by perirenal abscess).
빈기태(Ki Tai Bin),나기량(Gi Ryang Na),오선미(Seoun Mee Oh),김종섭(Jong Sub Kim),김성숙(Seong Suk Kim),이강욱(Kang Wook Lee),신영태(Young Tai Shin),서광선(Kwang Sun Seo),이정호(Jeong Ho Lee) 대한내과학회 1996 대한내과학회지 Vol.51 No.6
N/A Objectives: IgA nephropathy is the commonest glomerulonephritis in the world. In contrast to initial report indicated a favorable prognosis, subsequent reports have shown a highly variable outcome leading to end-stage renal failure in significant proportion of patients. Because IgA nephropathy is a disease with variable rate of progression to chronic renal failure, identification of clinical and pathologic prognostic indicators for these patients is very important. Methods: To evaluate the clinical features of IgA nephropathy and clinicopathological parameters that are associated with deteriorated renal function, we analyzed retrospectively 149 patients who were diagnosed as IgA nephropathy at Chungnam National University Hospital from January, 1986 to June, 1994. We also evaluated the clinicopathological fin- dings of 23 patients who were followed for more than 36 months in order to determine the prognostic signigificance of various renal histopathological alterations and clinical parameters, Results: l) IgA nephropathy was disgnosed to 149 patients(26.5%) for same period among 565 biopsied patients. 2) It is most common in the 3rd and 4th decades. The mean age of the patients was 28.9 years, and male to female ratio ratio was 1: 1,25. 3) Fifty two percents of the patients presented with gross hematuria. Upper respiratory tract infection preceded grosss hematuria in 85% of the patients. 4) At the time of renal biopsy, 9,4% of the patients showed heavy proteinuria and nephrotic syndrome, 5) In Comparison of clinicopathological parameters between 14 patients with normal renal function and 9 patients with deteriorated renal function who had a follow-up period of more than 36 months, the results of the findings are as follows: 24 hours total urine protein more than 2.0 grams, elevated BUN and serum creatinine concentration and severe degree of renal histopathologic findings, such as mesangial proliferation and sclerosis, interstitial fibrosis and tubular atrophy showed poor prognostic results. Conclusion: Clinical features such as 24 hours total urine protein more than 2 grams, higher serum blood urea nitrogen and serum creatinine and severe degree of histopathologic features such as mesangial proliferation and sclerosis, interstitial fibrosis and tubular atrophy were associated with deteriorated renal function.