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자가면역질환에서의 Myeloablative 치료 및 자가조혈모세포이식의 역할
안명주 ( Myung Ju Ahn ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.1
High-dose cytotoxic therapy followed by autologous stem cell transplantation has been proposed as a novel treatment modality for severe autoimmune disease. The rationale of autologous stem cell transplantation in autoimmune diseases has been based on the autoimmune animal models that marked improvement or complete eradication of autoimmune disease after syngeneic marrow transplantation. In addition, several clinical data showed that allogeneic marrow transplantation has been reported to eradicate concurrent autoimmune disease, suggesting that high-dose cytotoxic therapy may be sufficient to eradicate autoaggressive lymphocytes. Peripheral blood stem cell transplantation is widely used compared to bone marrow transplantation due to rapid marrow recovery and less treatment-related mortality. Recently, immunoablative high-dose cytotoxic therapy without stem-cell rescue also can induce complete remission in patients with refractory, severe autoimmune disease. Although several clinical data of autologous stem transplantation can achieve durable remission in severe autoimmune disease, long-term efficacy has not been fully determined yet. Further studies are needed to assess the exact role of stem cell transplantation in the treatment of severe autoimmune disease through well-designed clinical trials.
증례 : 혈액종양 ; 항암치료를 받은 소세포폐암 환자에서 폐포 출혈을 동반한 폐 분선충 감염
김윤정 ( Yoon Jung Kim ),안명주 ( Myung Ju Ahn ),박근칠 ( Keun Chil Park ),이희영 ( Hui Young Lee ),김경희 ( Kyung Hee Kim ),변경민 ( Kyung Min Byeon ),한혜진 ( Hye Jin Han ) 대한내과학회 2009 대한내과학회지 Vol.76 No.4
본 증례는 항암요법을 시행받아 면역억제상태에 있는 환자에서 분선충 중감염이 폐포출혈을 일으킨 경우로 albendazole 400 mg 하루 2회 14일간 투여 후에 재발하였고, 재발 시에는 호산구증가증을 동반하였다. 이후 albendazole을 한달 간 추가 투여하여 폐병변 및 호산구증다증이 호전되었다. 이에 면역억제상태의 환자에서 albendazole을 6주간 장기 사용하여 분선충 중감염을 치료한 증례가 있어 문헌고찰과 함께 보고하는 바이다. Strongyloides stercoralis is an intestinal nematode that infects a large portion of the world`s population, especially in tropical areas and other hot, humid regions. In immunocompromised patients, the parasite is augmented by autoinfection, resulting in hyper-infection or systemic dissemination. Pulmonary hemorrhage is a rare presentation of Strongyloides hyperinfection. We experienced a case of Strongyloides hyperinfection with alveolar hemorrhage in an immunocompromised patient. A 63-year-old man with small cell lung carcinoma on chemotherapy presented with abdominal pain and dyspnea. He developed a pulmonary hemorrhage and migrating pneumonia 1 week later, and bronchoalveolar lavage cytology revealed helminthic larvae identified as Strongyloides. The patient received albendazole therapy for 6 weeks, and the Strongyloides hyperinfection and pneumonia were resolved. (Korean J Med 76:502-505, 2009)
고희관 ( Hee Kwan Koh ),안명주 ( Myung Ju Ahn ),김태환 ( Tae Hwan Kim ),이은영 ( Eun Young Lee ),유태석 ( Tae Seok Yoo ),이제경 ( Je Kyung Lee ),장대국 ( Dae Kook Chang ),심승철 ( Seung Cheol Shim ),전재범 ( Jae Bum Jun ),정성수 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
연구배경: 류마티스 관절염은 활막세포의 비정상적인 증식과 단핵세포의 침윤으로 인한 종양처럼 활막의 증식 등을 특징으로 하는 질환이다. Telomerase가 류마티스 관절염 환자에서 활성화되어 류마티스 관절염의 병인에 관여하는지 알아보기 위해 본 연구를 시행하였다. 방법: 류마티스 관절염 환자와 대조군으로 퇴행성 관절염 환자에서 얻은 활막조직, 배양된 활막세포, 활액에서 추출한 단핵세포 등에서의 telomerase의 활성도를 TRAP(telomeric repeat amplification protocol) assay를 이용하여 비교 관찰하였다. 결과: Telomerase 활성도는 류마티스 관절염의 활막에서 높은 활성도를 보였고(70.6%: 12/17), 퇴행성 관절염 환자의 일부(30%: 3/10)에서도 역시 관찰되었다. 그러나 배양된 활막세포는 류마티스 관절염 환자의 일부에서만(50%: 2/4) 관찰되었다. 또한 류마티스 관절염 환자의 활액에서 추출한 단핵세포는 모두 telomerase 활성도가 관찰되었다. 결론: Telomerase 활성도는 류마티스 관절염의 병인에 관여할 수 있으리라 사료되며 앞으로 류마티스 관절염에서 telomerase의 생물학적 기능과 활성기전에 대해서도 보다 많은 연구가 있어야 할 것으로 사료된다. Objective: Rheumatoid arthritis(RA) is a disease characterized by infiltration of mononuclear cells into synovium and abnormal proliferation of synovial cells leading to pannus formation, which shows tumor-like growth. To determine whether telomerase is activated in RA and telomerase might be involved in the pathogenesis of RA, we measured telomerase activity in patients with RA. Methods: Telomerase activity was measured by using TRAP(telomeric repeat amplification protocol) assay in synovial tissues obtained from 17 patients with RA and 10 patients with osteoarthritis(OA), in cultured synovial cells from 4 patients with RA and 2 patients with OA, and in extracts of mononuclear cells from synovial fluid of 6 patients with RA. Results: Twelve of synovial tissues from 17 patients with RA(70.6%) showed telomerase activity, where three of synovial tissues from 10 patients with OA(30%) showed telomerase activity with low activity. Telomerase activity was detected in two of the cultured synoviocytes from 4 patients with RA(50%), but synoviocytes from patients with OA did not reveal any telomerase activity, if any. Telomerase acivity was detected in mononuclear cells extracted from synovial fluid of all patients with RA. Conclusion: Telomerase activity is highly positive in RA synovial tissues than OA synovial tissues and in RA synoviocytes as in mononuclear cells from synovial fluid. Taken together, these findings indicate that telomerase may playa role in the pathogenesis of RA.
증례 : 혈액종양 ; 방사선치료 후 비출혈로 나타난 추체내경동맥의 가성동맥류 1예
이수진 ( Su Jin Lee ),안희경 ( Hee Kyung Ahn ),김수아 ( Su A Kim ),김건하 ( Keon Ha Kim ),안용찬 ( Young Chan Ahn ),박근칠 ( Keun Chil Park ),안명주 ( Myung Ju Ahn ) 대한내과학회 2010 대한내과학회지 Vol.78 No.2
비인두암으로 동시 항암방사선치료를 받았던 환자가 2개월 전부터 청력저하와 두통을 호소하였고, 비출혈이 있어 응급실에 내원하였다. CT상 좌측 경동맥의 가성동맥류가 의심되어 혈관조영술을 시행하였고, 이로써 가성동맥류를 확진하였다. 이후 코일을 이용하여 좌측 경동맥 폐색술을 시행하였고, 이후 환자의 증상은 호전되었다. 방사선치료를 받은 비인두암 환자에서 내경동맥 가성동맥류의 발생은 그 빈도가 매우 적으며, 현재까지 한국에서 보고된 바 없기에 문헌고찰과 함께 Rupture of an internal carotid artery pseudoaneurysm is a rare but lethal complication in patients with nasopharyngeal cancer. Here, we report a case of severe nasal bleeding from a left petrous internal carotid artery aneurysm after chemoradiotherapy in a
유방암세포주에서 고농도 5-fluorouracil의 세포주기 조절효과
장정순,양중일,장세호,이원섭,이종석,안명주,박병규,Jang, Joung Soon,Yang, Jung Ill,Chang, Seho,Lee, Won Sup,Lee, Jong Seok,Ahn, Myung-Ju,Park, Byung-Kiu 대한면역학회 2002 Immune Network Vol.2 No.1
Background: Chemotherapy with 5-fluorouracil (5-FU) has been one of the mainstay in breast cancer treatment. The effects of high dose 5-FU on cell cycle regulation were studied in breast caner cells. Methods: A breast cancer cell line MCF-7 was used. Protein expressions of G1/S cyclins, $p21^{Waf1/Cip1}$, cdk2, E2F1 and retinoblastoma were tested by western blot analysis. Immunoprecipitation and immune complex kinase assay were done for the assessment of E2F1/RB interacton and the activity of cdk2 respectively. Results: $p21^{Waf1/Cip1}$ expression was barely detectable in control cells. With addition of 5-FU level of $p21^{Waf1/Cip1}$ were induced and cyclin D3 level was decreased as cell growth decreases. In accordance with increased expression of $p21^{Waf1/Cip1}$, cyclin E-associated cdk2 kinase activity was reduced. Retinoblastoma protein (RB) became dephosphorylated and E2F-1 binding activity with RB was increased. Conclusion: In this situation of high concentration of 5-FU breast cancer cells tend to be G1/S cell cycle arrested. Overexpression of $p21^{Waf1/Cip1}$ and dephosphorylation of RB may mediate the effectss of 5-FU by inhibiting E2F-1 activity, which contributes to G1/S cell cycle arrest. These results could be an indicating landmark for further study of high dose chemotherapy with 5-FU.
이재호(Jae Ho Lee),윤호주(Ho Ju Yun),안명주(Myung Ju Ahn),김태화(Tae Hwa Kim),김성윤(Seong Yoon Kim),김목현(Mok Hyun Kim) 대한내과학회 1987 대한내과학회지 Vol.33 No.6
N/A We compared the genetic distances between the Far-Eastern populations to investigate the relationship between them. Sampled regions were nine countries. The method was microcytotoxicity of NIH by use of antisera received from 3rd AOHWS. We used the results of HLA frequency published from 3rd AOHWS. The genetic distances are calculated by Nei et all equation. The following are the results. 1) The nearest GD with Southern Korean is Japanese. Historically, this was reflected of close relationship between Korean and Japanese. 2) There were near GD between North Chinese neigh-boring populations. This thought that North Chinese had a close contact with neighboring countries. 3) However, this should be confirmed again after subdivision of regions, and also be required of many investigations to cover the defect of this study.
이형접합제 PiMZ 및 α1 - Antitrypsin 결핍을 보인 간경변증
기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),안명주(Myung Ju Ahn),고윤석(Youn Suck Koh),함준수(Joon Soo Ham),이종철(Song Chul Lee),강종명(Jong Myung Kang) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
In 1969, Sharp described the first cases of aplhai-antitrypsin deficiency disease in children with juvenile liver cirrhosis. Since then, this inborn error has been recognized as one of the more common factors in cirrhosis of infancy and childhood, especially in Caucasians of Northern Europeans. PiZZ phenotype is the only one associated with liver disease, there have been a few rescent reports of cirrhosis in heterozygous patients. We experienced a case of 24-year-old male patient who was diagnosed as liver cirrhosis by biopsy but had no defintie causes of liver cirrhosis. The laboratory findings were compatible with liver cirrhosis. By biopsy, the liver is composed of variable sized, micro and macronodules. Dense fibrous tissue encase these nodules. The hepatocytes are strongly positive granules and diastase resistant. Pi phenotype was Pi MIZ by IEF (immunoelectric Focusing) method and the plasma alphai- antitrypsin level is lower than normal.