• 대한유전성대사질환학회지
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• 제21권1호
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• pp.22-27
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• 2021

프로피온산혈증은 PCCA 및 PCCB 유전자의 돌연변이로 발생하며 대사산물의 축적으로 신생아기부터 근긴장 저하, 구토, 케톤산증, 고암모니아혈증, 경련 등이 나타나 사망에 이를 수 있고, 비교적 후기에 신경학적 증상과 함께 발현하는 경과를 보이기도 한다. 저자들은 특별한 과거력 없이 지내던 중 확장성 심근병증이 확인된 16세 남아에서 유전자 검사로 프로피온산혈증이 진단된 1례를 보고하는 바이다.

• Childhood Kidney Diseases
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• 제27권2호
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• pp.97-104
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• 2023

Purpose: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are frequently employed to counteract the detrimental effects of proteinuria on glomerular diseases. However, the effects of ARBs remain poorly examined in pediatric patients with immunoglobulin A (IgA) nephropathy. Herein, we evaluated the efficacy and safety of losartan, an ARB, in pediatric IgA nephropathy with proteinuria. Methods: This prospective, single-arm, multicenter study included children with IgA nephropathy exhibiting proteinuria. Changes in proteinuria, blood pressure, and kidney function were prospectively evaluated before and 4 and 24 weeks after losartan administration. The primary endpoint was the difference in proteinuria between baseline and 24 weeks. Results: In total, 29 patients were enrolled and received losartan treatment. The full analysis set included 28 patients who received losartan at least once and had pre- and post-urinary protein to creatinine ratio measurements (n=28). The per-protocol analysis group included 22 patients who completed all scheduled visits without any serious violations during the study period. In both groups, the mean log (urine protein to creatinine ratio) value decreased significantly at 6 months. After 24 weeks, the urinary protein to creatinine ratio decreased by more than 50% in approximately 40% of the patients. The glomerular filtration rate was not significantly altered during the observation period. Conclusions: Losartan decreased proteinuria without decreasing kidney function in patients with IgA nephropathy over 24 weeks. Losartan could be safely employed to reduce proteinuria in this patient population. ClinicalTrials.gov trial registration (NCT0223277)

• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.964-970
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• 2008

목 적 : 메틸말로닌산뇨증과 프로피오닌산뇨증은 상염색체 열성으로 유전되는 아미노산 대사 이상 질환으로, methylmalonyl-CoA mutase와 propionyl-CoA carboxylse의 결함에 의해 발생하며 최근 유전자형에 대한 연구가 활발히 이루어지고 있다. 저자들은 단일기관에서 경험한 이 질환군의 임상 양상과 유전자형에 대해 조사하고자 하였다. 방 법 : 1993년부터 2007년까지 서울아산병원 소아과에서 유기산뇨증으로 진단된 20례를 대상으로 질병의 종류, 진단시 연령과 임상 양상, 유전자형, 검사 소견, 치료와 예후 등을 후향적으로 분석하였다. 혈장 암모니아, 소변 유기산 분석과 혈장 아미노산을 조사하였고, 유전자분석은 메틸말로닌산뇨증에서는 MUT, MMAA, MMAB 와 MMACHC 유전자를, 프로피오닌산뇨증에서는 PCCA와 PCCB 유전자를 분석하였다. 결 과 : 유기산뇨증으로 진단된 환아는 모두 20명이었으며, 그 중 메틸말로닌산뇨증이 12명(남아 8명, 여아 4명), 프로피오닌산뇨증이 8명(남아 6명, 여아 2명)이었다. 신생아 대사이상 검사로 진단된 환아가 5명이었으며, 6명은 신생아기에 급성 증상으로 발현하였고, 9명은 1개월 이후 발현한 지발형이었다. 신생아기 발현형에서는 6명 중 5명이 구토와 기면을 주증상으로 내원하였으며, 지발형에서는 구토와 기면 이외에도 발달 지연, 보행 장애, 혈소판 감소증 등 다양한 임상 양상을 보였다. 예후로는 메틸말로닌산뇨증 환아 중 2명(17%)이 2세경에 고암모니아혈증과 대사성 산증으로 사망하였으며, 7명(58%)이 정상발달을 보였다. 프로피오닌산뇨증 환아는 1명이 사망하였고, 4명(50%)이 정상 발달을 보이고 있다. 증상의 발현시기에 따라서는 신생아기 발현형에서 6명중에서 2명은 사망, 2명은 정상 발달, 2명은 발달지연을 보이고 있는 것에 비해, 증상 없이 신생아 대사이상 검사로 진단된 환아 중에는 2명(40%)이 정상발달을 보이고 있고, 지발형에서는 7명(63%)이 정상 발달을 보이고 있다. 유전자형은 메틸말로닌산뇨증 전례에서 규명되었으며 10명은 MUT 유전자에서 11종의 서로 다른 돌연변이가 발견되었는데 대부분 nonsense 돌연변이였다. 비타민 B12 반응형 환아 2명에서는 MMACHC 유전자에서 3종의 서로 다른 돌연변이가 발견되었으며 프로피오닌산뇨증에서는 16개 대립유전자 중 14개에서 PCCA와 PCCB 유전자의 돌연변이가 규명되었다. 결 론 : 유기산뇨증은 진단이 지연되면 매우 치명적이나, 조기에 의심하여 진단하고 적절히 치료하면 좋은 예후를 기대할 수 있는 질환이다. 유기산뇨증의 유전자형의 분석은 정확한 진단을 가능하게 할 뿐 아니라 유전상담, 산전 진단 및 표현형의 예측에도 도움이 된다.

• 한국산업보건학회지
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• 제11권2호
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• pp.111-117
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• 2001

A cross-sectional study was performed to evaluate associations between lead biomarkers, lead-related symptoms, and ${\delta}$-aminolevulinic acid dehydratase (ALAD) genotype among 598 lead workers and 144 control office workers in storage battery industries, secondary smelting and litharge making industries. Lead inhibits the second enzymes, ALAD, in the heme synthesis pathway. ALAD gene, which codes for one of three isozymic proteins (termed ALAD1-1, ALAD1-2, and ALAD2-2), seems to modify the toxicokinetics of lead. The result as follows; The percents of total workers whose genotype of ALAD1-1 and ALAD1-2 were 88.4% and 11.6%, respectively. The zinc protoporphyrin in blood (ZPP) and ${\delta}$-aminolevulinic acid in urine (ALAU) of lead workers with ALAD1-2 were significantly lower than those of lead workers with ALAD1-1, but there were no significant difference between two genotype for blood lead, age, and work duration. The proportion of ALAD1-2 genotype in control office workers was 13.2%. The proportions of ALAD1-2 genotype of lead workers were 14.0%(their mean air lead level below $0.024mg/m^3$), 10.4%($0.025-0.049mg/m^3$), 11.8%($0.050-0.099mg/m^3$), and 9.4%(above $0.100mg/m^3$), respectively. In the logistic analysis of 15 lead related symptoms, 'arthralgia'(S7) symptom of ALAD1-2 was significantly lower (OR=0.481; 95% CI=0.248-0.932) than that of ALAD1-1, but 'feeling of irritation'(S11) of ALAD1-2 was significantly higher(OR=1.636; 95% CI=1.035-2.586) than that of ALAD1-1 after controlling possible confounder (blood lead, work duration, smoking and drinking habit).

• 대한유전성대사질환학회지
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• 제16권2호
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• pp.57-61
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• 2016

IVA는 상염색체 열성의 유전방식을 보이는 leucine 대사 장애 질환이자 대표적인 유기산 혈증이다. IVD 유전자의 돌연변이에 의한 isovaleryl-CoA dehydrogenase 효소의 결핍이 질환 발생의 원인이다. Isovaleryl-CoA dehydrogenase 효소가 결핍되면 isovaleryl-CoA의 대사물질이 비정상적으로 체내에 축적되어 대사성 산증 및 고암모니아혈증 등의 급성 대사성 위기와 발달지연, 성장지연, 및 경련성질환 등의 만성 합병증을 초래할 수 있기 때문에, 급성 대사성 위기 및 만성합병증의 발생을 예방하기 위해 조기 진단에 따른 적절한 치료의 도입이 중요하다. 현재 IVA은 국내에서 시행되는 탠덤 매스 스크리닝법을 이용한 신생아 대사질환 선별검사 항목에 포함되어 있으며, C5의 상승으로 의심할 수 있다. 그러나 SBCAD 결핍증 혹은 pivalic acid 유래물이 포함된 항생제를 투여한 경우에도 C5의 상승이 동반될 수 있기 때문에, 감별진단 및 확진을 위한 추가적인 생화학적, 유전학적 검사가 필수적이다.

• 대한간호학회지
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• 제26권4호
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• pp.963-975
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• 1996

The purpose of this study was to call attention to the mental, physical and occupational hazards of the anticancer-drug-handling nurses by examining the possible urinary mutagenicity and measuring physical symptoms and stress level of the nurses exposed to anticancer drugs. The experimental group of the urinary mutagenicity assay was 14 nurses handling anticancer drugs at the medical wards of a hospital located in J city ; the control group was 12 psychiatric nurses of the same hospital. The test material was the nurses' 24hrs urine, which was concentrated by XAD-2 column chromatography. Tester strains were TA98(±S9 mix), TA100(±S9 mix), TA1535(±S9 mix) and TA1537(±S9 mix) ; Salmonella mammalian-microsomal test(Ames test) was employed for the urinary mutagenicity assay. The physical symptoms of which the nurses experienced were investigated through self-reports on open-questionnaires. The stress levels of the experimental group were measured by a stress measuring instrument developed by this author. Reliability of this instrument was found to be adequate (Cronbach's Alpha=0.9079). To ascertain the urinary mutagenicity of the experimental group, the mean and the standard deviation of the colonies of Tester strains appearing on the minimal plates were taken and compared differences between two groups. T-test was employed for the significance test of two groups. The physical symptoms were compared between the two groups through the analysis of the nurse' self-reports. The mean and standard deviation of the stress levels of the experimental group were also calculated and were examined through t-test. The results were summarized as follows : 1. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and the non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, two groups showed no difference in the non-activation method test, but the activation method revealed difference. 2. The physical symptoms were also much more frequently reported in the experimental group. 79.3% of the experimental group reported more than 1 kind of physical symptoms. On the other hand, 33.2% of the control group complained of 1 kind of physical symptom. The items with high symptom frequency were 'headache', 'itching sensation', 'corneal congestion', 'skin allergy' 3. The mean score of stress in the experimental group was 2.41(range 1-4). The experimental group showed the stress level above 2.0 in the 14 of 15 items in all. The highest stress level were recorded in the following items in the order quoted, 'I fear that anticancer drug may touch any part of body while handling it.', 'I feel concerned there is no protective countermeasure against anticancer drug handling.', 'I am afraid the anticancer drug handling may produce a fetal loss in the future'.

• 한국식품위생안전성학회지
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• 제23권2호
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• pp.169-176
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• 2008

죽상경화증(arteriosclerosis)의 예방과 치료를 목적으로 조성된 새로운 한방처방인 WK-38을 웅성과 자성 랫트에 13주간 반복 투여하여 독성을 평가하였다. WK-38은 대황(大黃, Rhei Rhizoma), 후박(厚朴, Magonoliae Cortx), 목단피(牧丹皮, Moutan Cortex Radicis)의 복합물로 구성되었다. 실험동물에게 5 mg/kg, 50 mg/kg 또는 500 mg/kg을 경구로 투여하였다. 투여기간 동안 사망, 일반증상, 섭이량, 섭수량, 및 체중증가 등을 관찰하였다. 투여된 WK-38 모든 용량에서 사망하는 개체는 없었다. 시험기간 동안 체중의 지속적인 증가가 관찰되었으며 통계학적으로 유의적인 차이는 나타나지 않았다. 안검사 및 뇨검사에서 모든 투척군에서 대조군과 비교하여 시험물질 투여에 기인한 유의성 있는 변화는 관찰되지 않았다. WK-38 투여는 혈액학적 검사 및 혈액 생화학적 검사 결과 시험물질에 의한 독성학적 변화로는 판단되는 지표는 없었다. 이상의 결과에 근거하여 본 시험 조건하의 WK-38의 랫트에 대한 13주 반복 경구투여 시험에서는 독성학적 변화가 관찰되지 않았다. 따라서 무독성량은 500 mg/kg을 상회하는 것으로 판단된다.

• Biomolecules & Therapeutics
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• 제5권3호
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• pp.284-291
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• 1997

The pharmacokinetics and tissue distribution of DWP20367 (1-cyclopropyl-6-fluoro-8-chloro-7-(2, 7-diazabicyclo[3,3,0]tract-4-ene-7-yl)-1,4-dihydro-4-oxoquinoline-3-carboxylic acid), a novel fluoroquinolone, were examined in rats and beagle dogs after a single intravenous and oral administration. Analysis of DWP20367 in plasma, tissue, and urine was determined by both HPLC and microbiological assay (bioassay). The plasma concentration-time curves of the drug in rats and beagle dogs were biexponentially declined. The terminal half-life (t$_{1}$2$\beta$/) of the drug in rats was about 60.1 $\pm$7.3 min (i.v.) and 61.3 $\pm$ 12.4 min (p.o.) in bioassay, and 86.3 $\pm$19.8 min (i.v.) and 50.9$\pm$ 14.9 min (p.o.) in HPLC. In beagle dogs, half-life of the drug determined by bioassay was about 121.8$\pm$6.2 min (i.v.) and 111.0$\pm$7.6 min (p.o.). The volume of distribution at steady-state (Vd$_{ss}$ ) was 243.8$\pm$74.1 ml/kg (bioassay) and 339.2$\pm$84.3 ml/kg (HPLC) in rats, and 1587.5 $\pm$536.9 ml/kg (bioassay) in beagle dogs. The total body clearance (Cl$_{t}$) of DWP20367 was 3.4 $\pm$ 0.4 ml/min/kg (bioassay) and 2.4$\pm$0.4 ml/min/kg (HPLC) in rats, and 12.3$\pm$ 1.0 ml/min/kg (bioassay) in beagle dogs, respectively. The extent of bioavailability after oral administration was 89.1%(bioassay) and 79.9% (HPLC) in rats, and 78.7% (bioassay) in beagle dogs. Urinary recovery (24-h) assayed by bioassay was 0.7% (p.o.) and 1.2% (i.v.) in rats, and 0.8% (p.o.) and 1.0% (i.v.) in beagle dogs. In rats, 24-h fecal recovery determined by bioassay was 11.2% (p.o.) and 0.1% (i.v.). Rat and human serum protein binding ratios at 2$\mu$g/ml were about 90~91%. This drug determined by bioassay was also distributed by the order of liver, kidney, lung, heart, spleen and muscle 30 min after oral administration.on.

• 한국임상수의학회지
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• 제29권6호
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• pp.509-512
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• 2012

암컷, 4년령, 6.5 kg의 단모종 고양이가 배뇨실금 및 배뇨곤란 증상을 주증으로 내원하였다. 신체 검사에서 방광 팽창을 동반한 배뇨곤란 증상을 확인 하였고, 방사선 검사와 초음파 검사에서 2개의 작은 방광 결석과 방광내 슬러지를 각각 확인 하였다. 소변 검사에서 혈뇨와 세균뇨를 확인 하였다. 식염수를 이용한 방광 세척과 항생제 치료를 4주간 실시 하였으나 치료 효과가 미미하였다. 선천적 이상을 확인하기 위해 배설성 요로조영술을 실시하였고, 작은 게실이 방광 앞쪽 끝에서 관찰 되었다. 방광요막관 게실이 의심 되어 탐색적 개복술을 실시 하였고 삼각형 모양의 게실이 방광 앞쪽 끝에서 확인 되었다. 방광 결석 제거를 위해 방광 절개술이 실시 되었고 게실 절제를 위해 방광 부분 절제술이 실시 되었다. 방광 앞쪽 끝 부분을 지름 약 2 cm 정도 절제 하였다. 수술 후 5일 째 정상 배뇨가 가능하였다. 수술 후 정기 검진은 신체 검사를 통해 2년 동안 실시 되었으며 배뇨 곤란과 배뇨 실금 증상이 관찰 되지 않았다.

• 대한약침학회지
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• 제13권4호
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• pp.5-41
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• 2010

Objectives: This study was performed to analyse four week repeated dose toxicity of Sweet Bee Venom(Sweet BV) extracted from the bee venom in Beagle dogs. Methods: All experiments were conducted under the regulations of Good Laboratory Practice (GLP) at Biotoxtech Company, a non-clinical study authorized institution. Male and female Beagle dogs of 5-6 months old were chosen for the pilot study of four week repeated dose toxicity of Sweet BV which was administered at the level of 0.56mg/kg body weight which is eighty times higher than the clinical application dosage as the high dosage, followed by 0.28 and 0.14mg/kg as midium and low dosage, respectively. Equal amount of excipient(normal saline) to the Sweet BV experiment groups was administered as the control group every day for four weeks. Results: 1. No mortality was witnessed in all of the experiment groups. 2. All experiment groups were appealed pain sense in the treating time compared to the control group, and hyperemia and movement disorder were observed around the area of administration in all experiment groups, and higher occurrence in the higher dosage treatment. 3. For weight measurement, Neither male nor female groups showed significant changes. 4. In the urine analysis, CBC and biochemistry didn't show any significant changes in the experiment groups compared with control group. 5. For weight measurement of organs, experiment groups didn't show any significant changes compared with control group. 6. To verify abnormalities of organs and tissues, thigh muscle which treated with Sweet BV, cerebrum, liver, lung, kidney, and spinal cords were removed and conducted histologocal observation with H-E staining. In the histologocal observation of thigh muscle, cell infiltration, inflammatory, degeneration, necrosis of muscle fiber, and fibrosis were found in both thigh tissue. And the changes were depend on the dose of Sweet BV. But another organs were not detected in any abnormalities. 7. The proper high dosage of Sweet BV for the thirteen week repeated test in Beagle dogs may be 0.28mg/kg in one time. Conclusion: Above findings suggest that Sweet BV is relatively safe treatment medium. Further studies on the subject should be conducted to yield more concrete evidences.