• Neonatal Medicine
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• 제15권1호
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• pp.38-43
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• 2008

목 적 : 태아 시기의 성장이 출생 이후 성인기에 이르기까지 대사 질환 및 심혈관 질환, 제2형 당뇨병 등의 발현에 영향을 미친다는 보고들이 있어왔다. 이에, 정상 체중 만삭아의 제대혈 내 APN 과 IGF-I 농도와 태아 성장 간의 관계에 대해서 알아보고자 하였다. 방 법 : 2003년 10월부터 2005년 3월 사이에 이대목동병원에서 출생한 정상 체중 만삭아 72명을 대상으로 하였다. 대상아들의 제대혈 내 APN과 IGF-I 농도를 ELISA 방법을 이용하여 측정하였고 측정치와 출생체중, 신장, 머리둘레, 성별, ponderal index, 태반 무게, 태아-태반 무게 비, 산모의 임신 중 체중 증가, 산모의 임신 전 BMI와의 관계를 분석하였다. 결 과: 제대혈 평균 APN 농도는 29.2${\pm}$10.46 $\mu$g/mL 였으며, 제대혈 APN 농도와 체중의 관계는 체중이 증가할수록 APN 농도가 증가하다가 일정 체중에 도달한 이후에는 APN이 감소하는 종모양의 관계를 보였다. 제대혈 APN 농도는 여아에서 남아 보다 높았으며(P=0.001), 제대혈 APN 농도와 산모의 BMI는 유의한 음의 상관관계를 보였다(r=-0.301, P=0.027). 평균제대혈 IGF-I 농도는 51.26${\pm}$21.54 ng/mL 였다. 제대혈 IGF-I 농도는 출생체중과 양의 상관관계를 보였다(r=0.312, P=0.009). 결 론: 건강한 만삭아에서 제대혈 APN 농도는 출생 체중에 따라 증가하다가 일정 체중에서부터 감소하는 패턴의 종모양의 관계를 보였다. IGF-I 은 태아 성장, 특히 출생체중과 밀접한 관계가 있었다.

• Childhood Kidney Diseases
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• 제25권2호
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• pp.84-91
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• 2021

Purpose: We aimed to study the association of plasma neutrophil gelatinase-associated lipocalin (pNGAL) and leukocyte differential count in children with febrile urinary tract infection (UTI). Methods: Medical records of 154 children aged 1 month to 13 years with febrile UTI who were hospitalized were retrospectively reviewed. Associations between pNGAL levels and blood leukocyte differential count at admission and after 48 hours of treatment were investigated in children with or without acute pyelonephritis (APN). Results: The APN group (n=82) showed higher pNGAL levels, neutrophil count, monocyte count, and neutrophil-to-lymphocyte ratio (NLR), compared to the non-APN group (n=72) (all P<0.05). After adjustment for age and sex, pNGAL showed positive correlations with neutrophil count and NLR in both groups (all P<0.05). Additionally, it was correlated with the monocyte-to-lymphocyte ratio (MLR) only in the APN group (P<0.05). Before and after treatment, pNGAL was positively correlated with neutrophil count, NLR, and MLR in patients with APN while it was related with neutrophil count and NLR in those without APN (all P<0.05). Areas under the receiver operating curve of pNGAL, neutrophil count, NLR, and MLR for predicting APN were 0.804, 0.760, 0.730, and 0.636, respectively (all P<0.05). Only pNGAL was independently associated with the presence of APN in a multivariable logistic regression analysis (P<0.05). Conclusion: In children with febrile UTIs, pNGAL might be associated with leukocyte differential count and the presence of APN.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.347-354
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• 2021

Background: Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a valuable biomarker of urinary tract infection (UTI) in children. Purpose: This study aimed to compare the diagnostic accuracy of urinary NGAL (uNGAL) with those of serum C-reactive protein (CRP) and white blood cell (WBC) count for predicting UTI and acute pyelonephritis (APN) in febrile children. Methods: The medical charts of children undergoing uNGAL measurements between November 2017 and August 2019 were retrospectively reviewed. Patients with a suspected or diagnosed UTIs were included. The diagnostic accuracies of uNGAL, serum CRP, and WBC count for detecting UTI and APN were investigated. Independent predictors of UTI and APN were investigated using multivariable logistic regression analyses. Results: A total of 321 children were enrolled in this study. The uNGAL levels were higher in the UTI group (n=157) than in the non-UTI group (n=164) (P<0.05). Among children with a UTI, uNGAL levels were higher in the APN group (n=70) than, the non-APN group (n=87) (P<0.05). In the multivariate analysis, uNGAL was independently associated with UTI and APN (both P<0.05). Serum CRP and WBC count were not correlated with the presence of UTI and APN. Receiver operating curve analyses showed that the uNGAL level had the highest area under the curve (AUC) for predicting UTI and APN, respectively (AUC, uNGAL vs. CRP vs. WBC count, 0.860 vs. 0.608 vs. 0.669 for UTI; 0.780 vs. 0.680 vs. 0.639 for APN, all P<0.05, respectively). The predictive values and likelihood ratios of uNGAL were superior to those of serum CRP and WBC count for detecting UTI and APN at each cutoff level. Conclusion: UNGAL may be more useful than serum CRP and WBC count for identifying and assessing UTI in febrile children.

• 한국미생물·생명공학회지
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• 제39권2호
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• pp.140-145
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• 2011

돼지유행성설사 바이러스(porcine epidemic diarrhea virus: PEDV)는 자돈에게 감염 시 수양성설사를 동반한 급성 장염을 유발하며 매우 높은 폐사율을 보이는 그룹 1 코로나바이러스이다. PEDV는 다른 그룹 1 코로나바이러스와 마찬가지로 숙주 세포에 감염 시 aminopeptidase N (APN)을 세포 수용체로 이용한다고 알려져 있다. 코로나바이러스의 spike(S) 단백질은 숙주세포의 표면에 부착과 관련하여 감염 개시에 있어 중요한 역할을 하는 것으로 알려져 있으며 특히 S 단백질의 S1 도메인은 세포 수용체에 특이적인 결합을 매개하는 수용체 결합 도메인(receptor binding domain: RBD)을 포함하고 있는 것으로 알려져 있다. 이미 많은 코로나바이러스의 RBD의 위치가 확인되어져 있지만 PEDV의 RBD에 대해서는 아직까지 알려진 바가 없다. 본 연구에서는 돼지 APN 수용체와 결합을 매개하는 PEDV의 RBD를 규명하기 위해 S1 도메인을 주형으로 하는 일련의 재조합 truncated variant들을 제작하였고 각각의 truncated들이 실제로 pAPN과의 결합을 이루는지에 대하여 실험을 통해 확인하였다. 그 결과 S1 도메인의 N 말단 부분이 pAPN과의 결합에서 중요한 부위임을 확인할 수 있었다. 본 연구에서 도출된 결과는 향후 PEDV의 S 단백질과 pAPN간의 분자적 상호작용을 이해하는 데에 도움을 줄 것으로 판단된다.

• Advances in nano research
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• 제17권3호
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• pp.213-219
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• 2024

Nanotechnology is one of the critical factors involved in enhancing the sensitivity of serum biomarker detection. To explore the relationship between serum APN, Cystatin C and MMP-9 levels in patients with hypertension during pregnancy and the severity and prognosis of the disease. A total of 75 cases of hypertensive disorder complicating pregnancy (HDCP) patients who were admitted to the hospital from February 5, 2023 to May 9, 2024, were selected as the study group, and 70 healthy pregnant women who were in the same gestational week were selected as the control group. The serum APN, MMP-9 and Cys C levels of pregnant women and HDCP patients with different disease severity were compared between the two groups, and the receiver characteristic curve (ROC) was used to analyze its diagnostic value. The serum APN, MMP-9 and Cys C levels of HDCP patients with different prognosis were compared, and the factors affecting the prognosis of patients were analyzed by Logistic regression. Nanoparticles could aslo enable the sensitive detection and quantification of APN, Cystatin C, and MMP-9 in serum samples, thus increasing the accuracy of the study. The serum MMP-9 and Cys C levels of pregnant women in the study group were significantly increased, and the APN level was significantly decreased (P<0.05). Serum MMP-9 and Cys C levels in patients with pregnancy-induced hypertension, mild preeclampsia, and severe preeclampsia gradually increased (r=0.768, 0.766; P<0.001), and APN levels gradually decreased (r=-0.748, P< 0.001). In the diagnosis of patients with HDCP, the sensitivity, specificity and AUC of APN single diagnosis were 70.00%, 82.67% and 9.848 respectively. The sensitivity, specificity and AUC of MMP-9 single diagnosis were 82.86%, 74.67% and 298.300 respectively. The sensitivity, specificity and AUC of Cys C single diagnosis were 80.00%, 74.67% and 1.301 respectively. There were significant differences in age, BMI, parity, dysthymia, disease severity, APN, MMP-9 and Cys between patients with poor prognosis of HDCP and patients with good prognosis of HDCP (P<0.001). The patient's age, BMI, disease severity, APN, MMP-9 and Cys Cwere all related to HDCP. They were related risk factors of HDCP (P<0.05).

• Journal of Korean Medical Science
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• 제33권49호
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• pp.310.1-310.11
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• 2018

Background: Acute pyelonephritis (APN) is one of the most common community-acquired bacterial infections. Recent increases of antimicrobial resistance in urinary pathogens might have changed the other epidemiologic characteristics of APN. The objective of this study was to describe the current epidemiology of APN in Korea, using the entire population. Methods: From the claims database of the Health Insurance Review and Assessment Service in Korea, the patients with International Classification of Diseases, 10th Revision codes N10 (acute tubulo-interstitial nephritis) or N12 (tubulo-interstitial nephritis, neither acute nor chronic) as the primary discharge diagnosis during 2010-2014 were analyzed, with two or more claims during a 14-day period considered as a single episode. Results: The annual incidence rate of APN per 10,000 persons was 39.1 and was on the increase year to year (35.6 in 2010; 36.7 in 2011; 38.9 in 2012; 40.1 in 2013; 43.8 in 2014, P = 0.004). The increasing trend was observed in both inpatients (P = 0.014) and outpatients (P = 0.004); in both men (P = 0.042) and women (P = 0.003); and those aged under 55 years (P = 0.014) and 55 years or higher (P = 0.003). Eleven times more women were diagnosed and treated with APN than men (men vs. women, 6.5 vs. 71.3), and one of every 4.1 patients was hospitalized (inpatients vs. outpatients, 9.6 vs. 29.4). The recurrence rate was 15.8%, and the median duration from a sporadic episode (i.e., no episode in the preceding 12 months) to the first recurrence was 44 days. The recurrence probability increased with the number of previous recurrences. The average medical cost per inpatient episode was USD 1,144, which was 12.9 times higher than that per outpatient episode (USD 89). Conclusion: The epidemiology of APN in Korea has been changing with an increasing incidence rate.

• 한국콘텐츠학회논문지
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• 제16권3호
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• pp.354-365
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• 2016

건강소비자의 고품질 간호요구가 증대됨에 따라 전문간호사 제도가 시행된 이후 전문간호사의 직무에 대한 임파워먼트, 직무만족, 조직몰입의 수준을 파악하고 일반간호사와 비교한 연구가 필요한 시점이다. 이에 본 연구는 서울과 인천지역의 6개 상급종합병원과 4개 종합병원의 전문간호사와 간호사를 대상으로 직접 배포하거나 이메일을 통해 설문지를 받아 분석하였다. SPSS 18.0을 사용하여 t 검정과 ANOVA 분석을 실시하였다. 임파워먼트 평균은 전문간호사($3.56{\pm}0.53$)와 간호사($3.50{\pm}0.54$)간에 유의한 차이가 없었다(t =-. 861, p = 0.390). 직무만족 평균도 전문간호사($3.36{\pm}0.53$)와 간호사($3.25{\pm}0.46$)간에 유의한 차이가 없었다(t =- 1.575, p = 0.117). 조직몰입 평균도 전문간호사($3.11{\pm}0.34$)와 간호사($3.05{\pm}0.36$)간에 유의한 차이가 없었다(t =- 1.301, p = 0.195). 임파워먼트, 직무만족, 조직몰입 모두 전문간호사와 일반간호사 집단간 유의한 차이가 없었다. 이는 한국에서 전문간호사 역할이 명확하게 정립되어 있지 않고 고용과 보상이 적절하지 않은 점과 전문간호사 제도의 운용과 효율이 부족한 실정에 기인한다고 생각된다.

• 한국수산과학회지
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• 제53권1호
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• pp.123-131
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• 2020

In this study, we investigated the protective effects of a Neutrase enzymatic hydrolysate derived from Korea pen shell Atrina pectinata (APN) against hydrogen peroxide (H₂O₂)-induced oxidative damage in hepatocytes. First, we confirmed that APN has antioxidant activities by scavenging 2,2-azino-bis (3-ethylbenzthiazoline)-6-sulfonic acid radical (ABTS⁺) and H₂O₂ and increasing oxygen radical absorbance capacity (ORAC) value. Also, the treatment of APN increased the cell viability by reducing the intracellular reactive oxygen species (ROS) production in H₂O₂-stimulated hepatocytes. In addition, APN decreased the sub-G₁ DNA contents and the apoptotic body formation increased by H₂O₂ stimulation. Moreover, APN modulated the protein expression of apoptosis related molecules (Bcl-2, Bax and p53) by suppressing the activation of nuclear factor NFkB and ERK/p38 signaling in H₂O₂-stimulated hepatocytes. Furthermore, APN led to the activation of Nrf2/HO-1signaling known as antioxidant systems. These results suggest APN protects hepatocytes against oxidative damages caused by H₂O₂ stimulation.

• Clinical and Experimental Pediatrics
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• 제58권9호
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• pp.341-346
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• 2015

Purpose: To evaluate the practical applications of the diagnosis algorithms recommended by the American Academy of Pediatrics urinary tract infection (UTI) guideline. Methods: We retrospectively reviewed the medical records of febrile UTI patients aged between 2 and 24 months. The patients were divided into 3 groups: group I (patients with positive urine culture and urinalysis findings), group II (those with positive urine culture but negative urinalysis findings), and group III (those with negative urine culture but positive urinalysis findings). Clinical, laboratory, and imaging results were analyzed and compared between the groups. Results: A total of 300 children were enrolled. The serum C-reactive protein level was lower in children in group II than in those in groups I and III (P<0.05). Children in group I showed a higher frequency of hydronephrosis than those in groups II and III (P<0.05). However, the frequencies of acute pyelonephritis (APN), vesicoureteral reflux (VUR), renal scar, and UTI recurrence were not different between the groups. In group I, recurrence of UTI and presence of APN were associated with the incidence of VUR (recurrence vs. no recurrence: 40% vs.11.4%; APN vs. no APN: 23.3% vs. 9.2%; P<0.05). The incidence of VUR and APN was not related to the presence of hydronephrosis. Conclusion: UTI in febrile children cannot be ruled out solely on the basis of positive urinalysis or urine culture findings. Recurrence of UTI and presence of APN may be reasonable indicators of the presence of VUR.

• Clinical and Experimental Pediatrics
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• 제59권3호
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• pp.139-144
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• 2016

Purpose: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). Methods: We retrospectively evaluated 298 pediatric patients ($age{\leq}36months$) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. Results: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). Conclusion: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.