증례 : 혈액종양 ; 미만성 거대B세포 항암치료 중 유발된 주기적 저칼륨성 마비 1예

하경선 ( Kyung Sun Ha ),박영재 ( Young Jae Park ),박성수 ( Sung Soo Park ),이준엽 ( Joon Yub Lee ),김지현 ( Ji Hyun Kim ),장인애 ( Inae Jang ),변재호 ( Jae Ho Byun ) 대한내과학회 2014 대한내과학회지 Vol.87 No.5

이번 증례는 드문 예지만 항암치료를 위해 투여한 스테로 이드가 주기적 저칼륨성 마비의 유발 인자로 작용할 수 있음을 보여준다. 미만성 거대B세포 림프종의 치료 중 주기적 저칼륨성 마비가 있는 경우 칼륨 수치에 대한 측정과 칼륨 보충이 필요하다. Hypokalemic periodic paralysis is a rare disorder characterized by sudden onset of weakness and low serum potassium levels. We report a case provoked by combination chemotherapy including prednisolone. A 23-yr-man, diagnosed with diffuse large B-cell lymphoma, received chemotherapy. He developed significant weakness in upper and lower extremities during chemotherapy, and his serum potassium level was 1.7 mmol/L. Potassium replacement restored the weakness. Further workup revealed that prednisolone had provoked hypokalemic paralysis. As prednisolone triggered an attack of hypokalemic periodic paralysis, it should be administered with caution, particularly in patients with periodic paralysis. (Korean J Med 2014;87:625-629)

CA 19-9 상승을 동반한 전이성 골종양으로 오인된 골결핵 1예

장경윤,하경선,박경선,심은희,변재호 영남대학교 의과대학 2011 Yeungnam University Journal of Medicine Vol.28 No.2

A 73-year-old male presented a six-month history of buttock pain radiating into his thigh. The MRI revealed a large enhancing mass lesion involving the sacrum, with extension into the sacral canal. The tumor markers were measured to distinguish skeletal metastasis of carcinoma from primary bone tumor. The CA 19-9 was elevated. Despite the investigation, the primary site of cancer could not be found. Sacral bone biopsy was done. The pathologic examination revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells, consistent with tuberculosis. Sacral tuberculosis is rare in patients with no history of tuberculosis. Such solitary osteolytic lesions involving the subarticular region of large joints may mimic bone neoplasms and may be called “tuberculous pseudotumors.” This case report intends to emphasize that bone tuberculosis should be a differential diagnosis in the presence of atypical clinical and radiological features. As tuberculous lesions may be mistaken for neoplasms, a small amount of fresh tissue should be sent for culture even if clinical diagnosis of a tumor seems likely. Described herein is a case of sacral tuberculosis mimicking metastatic bone tumor with elevated CA 19-9.

한국산 재래종 메밀의 에탄올추출물이 고지방식이 섭취 흰쉬의 혈중 지질수준에 미치는 영향

이명헌,하경선,이정선 한국국제농업개발학회 2019 韓國國際農業開發學會誌 Vol.31 No.4

This study was conducted to investigate the effect of the ethanol extract of common buckwheat (Fagopyrum esculentum Mӧench) on plasma lipid profile of high fat diet rats. The SD rats were divided into four groups : normal-diet control group (NC), high-fat diet control group (HFC), high-fat diet and 40% ethanol buckwheat extract (5%, w/w) treated group (HF-40) and high-fat diet and 70% ethanol buckwheat extract (5%, w/w) treated group (HF-70). The experimental diets were fed ad libitum for 4 weeks. The liver weight was increased by a high fat diet, but significantly decreased in the HF-70 group compared with the HFC group (p<0.05). GOT, GPT and total cholesterol concentration in plasma decreased in the HF-40 group and HF-70 group compared with the HFC group. Triglyceride concentration in plasma significantly decreased in the HF-40 group and HF-70 group compared with the HFC group (p<0.05). Especially, the plasma triglyceride level significantly decreased in the HF-40 group (119.1mg/dl) compared with the NC group (126.0mg/dl) (p<0.05). Compared with the HFC group's plasma cholesteryl ester level of 125.0 mg/dl, the levels of the HF-40 and HF-70 groups were significantly lowered to 116.9 mg/dl and 88.5 mg/dl (p<0.05), respectively. The levels of LDL-cholesterol in plasma were in the order of HFC group (130.6mg/dl) > HF-40 group (121.3mg/dl) > HF-70 group (85.1mg/dl) significantly (p<0.05). In conclusion, buckwheat 70% ethanol extract effectively reduce the lipid components of plasma. The HDL-cholesterol/total cholesterol ratio of the HF-70 group was significantly higher than that of the HFC group (p<0.05). Atherogenic indexes of the HF-40 group and HF-70 group had a tendency to be lower compared with those of the HFC group. Especially, atherogenic index of the HF-70 group was statistically similar to that of the NC group. These results suggest that the buckwheat ethanol extract, especially 70% ethanol extract may indicate the effect of reducing the lipid concentration in the plasma. Therefore, the buckwheat ethanol extract may be possibly effective in relieving dyslipidemia as well as circulatory diseases. 본 연구는 한국산 재래종 메밀가루를 40%, 70% 에탄올(발효주정)로 각각 처리하여 메밀 추출물을 제조하였고 이를 동결건조한 다음 고지방식이에 혼합하여 흰쥐에게 섭취시킨 후나타나는 식이성 고지혈증의 개선효과를 확인하고자 하였다. 실험군은 정상대조군(NC), 고지방대조군(HFC), 고지방-40%에 탄올메밀추출물군(HF-40), 고지방-70%에탄올메밀추출물군(HF- 70) 4군으로 나누어 4주간 실험식이로 사육하였으며 실험 결과는 다음과 같다. 1. 실험동물의 식이섭취량과 체중증가량 및 사료효율은 실험군들 간에 유의적 차이를 보이지 않았다. 2. 실험동물의 장기 중 간무게를 비교한 결과 정상대조군에비해 고지방대조군에서 유의적으로 높았고 고지방대조군에 비해 HF-70군은 유의적으로 낮았고 (p<0.05) 정상대조군도 비슷한 수준이었다. 3. 혈중 GOT, GPT 수치는 정상대조군이 가장 낮았고 고지방대조군이 가장 높았으며 HF-40군과 HF-70군은 고지방대조군보다 낮은 경향을 보였다. 혈당 농도는 전체 실험군 중에서HF-70군이 가장 낮은 경향을 보였다. 4. 혈중 중성지질 농도는 정상대조군에 비해 고지방대조군이 가장 높았고 정상대조군과 고지방대조군에 비해 HF-40군이 유의적으로 낮았으며(p<0.05) 혈중 유리지방산 농도는 실험군 간에 유의적인 차이를 보이지 않았다. 5. 혈중 콜레스테롤 농도는 정상대조군에 비해 고지방대조군에서 유의적으로 높았고(p<0.05) 고지방대조군과 비교했을때 HF-70군에서 낮은 경향을 보였으며, 혈중 유리콜레스테롤농도는 실험군 간에 유의적인 차이가 없었다. 혈중 콜레스테롤에스터 수치는 정상대조군이 71.6mg/dl로 유의적으로 가장낮았고 고지방대조군의 125.0mg/dl와 비교하여 HF-40군, HF- 70군은 각각 116.9mg/dl, 88.5mg/dl로 유의적으로 낮았다(p<0.05). 특히 HF-70군은 HF-40군에 비해서도 유의하게 낮은것으로 나타났다. 6. 혈중 LDL-콜레스테롤은 정상대조군에 비해 고지방대조군이 유의적으로 높았으며 고지방대조군(130.6mg/dl)에 비해HF-70군(85.1mg/dl)에서 유의적으로 낮았다(p<0.05). 7. 혈중 HDL-콜레스테롤은 정상대조군에 비해 고지방식이군들이 유의적으로 낮았으며(p<0.05) 고지방실험군들 간에는유의적인 차이가 없었다. 그러나 HDL-콜레스테롤/총콜레스테롤의 비율은 정상대조군에 비해 고지방대조군이 유의적으로낮았고 고지방대조군에 비해 HF-70군이 유의적으로 높았다(p<0.05). 8. 동맥경화지수는 정상대조군이 가장 낮았으며 고지방대조군이 정상대조군에 비해 유의적으로 높았고 고지방대조군에비해 HF-70군은 유의적으로 낮았다 (p<0.05). 본 실험에서 고지방식이를 섭취한 쥐의 이상지질혈증은 메밀 에탄올추출물에 의해 개선되었으며 40% 에탄올 메밀추출물보다 70% 에탄올 메밀추출물에서 더욱 많이 개선되는 것으로 확인되었다.

한국산 재래종 메밀의 에탄올추출물이 고지방식이 섭취 흰쥐의 혈중 지질수준에 미치는 영향

이명헌,하경선,이정선 한국국제농업개발학회 2019 韓國國際農業開發學會誌 Vol.31 No.4

본 연구는 한국산 재래종 메밀가루를 40%, 70% 에탄올(발효주정)로 각각 처리하여 메밀 추출물을 제조하였고 이를 동결건조한 다음 고지방식이에 혼합하여 흰쥐에게 섭취시킨 후 나타나는 식이성 고지혈증의 개선효과를 확인하고자 하였다. 실험군은 정상대조군(NC), 고지방대조군(HFC), 고지방-40%에 탄올메밀추출물군(HF-40), 고지방-70%에탄올메밀추출물군(HF- 70) 4군으로 나누어 4주간 실험식이로 사육하였으며 실험 결과는 다음과 같다. 1. 실험동물의 식이섭취량과 체중증가량 및 사료효율은 실험군들 간에 유의적 차이를 보이지 않았다. 2. 실험동물의 장기 중간무게를 비교한 결과 정상대조군에 비해 고지방대조군에서 유의적으로 높았고 고지방대조군에 비해 HF-70군은 유의적으로 낮았고 (p<0.05) 정상대조군도 비슷한 수준이었다. 3. 혈중 GOT, GPT 수치는 정상대조군이 가장 낮았고 고지방대조군이 가장 높았으며 HF-40군과 HF-70군은 고지방대조군보다 낮은 경향을 보였다. 혈당 농도는 전체 실험군 중에서 HF-70군이 가장 낮은 경향을 보였다. 4. 혈중 중성지질 농도는 정상대조군에 비해 고지방대조군이 가장 높았고 정상대조군과 고지방대조군에 비해 HF-40군 이 유의적으로 낮았으며(p<0.05) 혈중 유리지방산 농도는 실험군 간에 유의적인 차이를 보이지 않았다. 5. 혈중 콜레스테롤 농도는 정상대조군에 비해 고지방대조군에서 유의적으로 높았고(p<0.05) 고지방대조군과 비교했을 때 HF-70군에서 낮은 경향을 보였으며, 혈중 유리콜레스테롤 농도는 실험군 간에 유의적인 차이가 없었다. 혈중 콜레스테롤에스터 수치는 정상대조군이 71.6mg/dl로 유의적으로 가장 낮았고 고지방대조군의 125.0mg/dl와 비교하여 HF-40군, HF- 70군은 각각 116.9mg/dl, 88.5mg/dl로 유의적으로 낮았다 (p<0.05). 특히 HF-70군은 HF-40군에 비해서도 유의하게 낮은 것으로 나타났다. 6. 혈중 LDL-콜레스테롤은 정상대조군에 비해 고지방대조군이 유의적으로 높았으며 고지방대조군(130.6mg/dl)에 비해 HF-70군(85.1mg/dl)에서 유의적으로 낮았다(p<0.05). 7. 혈중 HDL-콜레스테롤은 정상대조군에 비해 고지방식이군들이 유의적으로 낮았으며(p<0.05) 고지방실험군들 간에는 유의적인 차이가 없었다. 그러나 HDL-콜레스테롤/총콜레스테 롤의 비율은 정상대조군에 비해 고지방대조군이 유의적으로 낮았고 고지방대조군에 비해 HF-70군이 유의적으로 높았다 (p<0.05). 8. 동맥경화지수는 정상대조군이 가장 낮았으며 고지방대조군이 정상대조군에 비해 유의적으로 높았고 고지방대조군에 비해 HF-70군은 유의적으로 낮았다 (p<0.05). 본 실험에서 고지방식이를 섭취한 쥐의 이상지질혈증은 메밀 에탄올추출물에 의해 개선되었으며 40% 에탄올 메밀추출 물보다 70% 에탄올 메밀추출물에서 더욱 많이 개선되는 것으로 확인되었다. This study was conducted to investigate the effect of the ethanol extract of common buckwheat (Fagopyrum esculentum Mӧench) on plasma lipid profile of high fat diet rats. The SD rats were divided into four groups : normal-diet control group (NC), high-fat diet control group (HFC), high-fat diet and 40% ethanol buckwheat extract (5%, w/w) treated group (HF-40) and high-fat diet and 70% ethanol buckwheat extract (5%, w/w) treated group (HF-70). The experimental diets were fed ad libitum for 4 weeks. The liver weight was increased by a high fat diet, but significantly decreased in the HF-70 group compared with the HFC group (p<0.05). GOT, GPT and total cholesterol concentration in plasma decreased in the HF-40 group and HF-70 group compared with the HFC group. Triglyceride concentration in plasma significantly decreased in the HF-40 group and HF-70 group compared with the HFC group (p<0.05). Especially, the plasma triglyceride level significantly decreased in the HF-40 group (119.1mg/dl) compared with the NC group (126.0mg/dl) (p<0.05). Compared with the HFC group's plasma cholesteryl ester level of 125.0 mg/dl, the levels of the HF-40 and HF-70 groups were significantly lowered to 116.9 mg/dl and 88.5 mg/dl (p<0.05), respectively. The levels of LDL-cholesterol in plasma were in the order of HFC group (130.6mg/dl) > HF-40 group (121.3mg/dl) > HF-70 group (85.1mg/dl) significantly (p<0.05). In conclusion, buckwheat 70% ethanol extract effectively reduce the lipid components of plasma. The HDL-cholesterol/total cholesterol ratio of the HF-70 group was significantly higher than that of the HFC group (p<0.05). Atherogenic indexes of the HF-40 group and HF-70 group had a tendency to be lower compared with those of the HFC group. Especially, atherogenic index of the HF-70 group was statistically similar to that of the NC group. These results suggest that the buckwheat ethanol extract, especially 70% ethanol extract may indicate the effect of reducing the lipid concentration in the plasma. Therefore, the buckwheat ethanol extract may be possibly effective in relieving dyslipidemia as well as circulatory diseases.

Tumor Lysis Syndrome in a Patient with Metastatic Colon Cancer after Treatment with 5-Fluorouracil/Leucovorin and Oxaliplatin: Case Report and Literature Review

김형덕,하경선,우인숙,정윤화,한치화,김태정 대한암학회 2014 Cancer Research and Treatment Vol.46 No.2

Development of tumor lysis syndrome (TLS) may occur after chemotherapy or spontaneouslyin bulky or rapidly growing tumors. This syndrome is frequent but preventablein patients with hematologic malignancies. TLS following therapy has beenreported infrequently in various types of solid tumors. TLS associated with oxaliplatincontaining chemotherapy in a solid tumor has never been reported. A 59-year-oldman received 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) chemotherapy formetastatic colon cancer. Development of TLS occurred three days after administrationof chemotherapy. Two days later, his abnormal laboratory findings were recoveredwith appropriate management. To the best of our knowledge, the current case is thefirst report on development of acute TLS following oxaliplatin containing chemotherapyin a patient with colon cancer. We also review the literature on tumor lysissyndrome in patients with colorectal cancer.

Clinical Features of Male Breast Cancer: Experiences from Seven Institutions Over 20 Years

홍지형,하경선,정윤화,원혜성,안호정,이국진,강동훈,박지찬,박사라,변재호,서영진,김정수,박우찬,정상설,박일영,정수미,우인숙 대한암학회 2016 Cancer Research and Treatment Vol.48 No.4

Purpose Breast cancer treatment has progressed significantly over the past 20 years. However, knowledge regarding male breast cancer (MBC) is sparse because of its rarity. This study is an investigation of the clinicopathologic features, treatments, and clinical outcomes of MBC. Materials and Methods Clinical records of 59 MBC patients diagnosed during 1995-2014 from seven institutions in Korea were reviewed retrospectively. Results Over a 20-year period, MBC patients accounted for 0.98% among total breast cancer patients, and increased every 5 years. The median age of MBC patients was 66 years (range, 24 to 87 years). Forty-three patients (73%) complained of a palpable breast mass initially. The median symptom duration was 5 months (range, 1 to 36 months). Mastectomy was performed in 96% of the patients. The most frequent histology was infiltrating ductal carcinoma (75%). Ninety-one percent of tumors (38/43) were estrogen receptor–positive, and 28% (11/40) showed epidermal growth factor receptor 2 (HER-2) overexpression. After curative surgery, 42% of patients (19/45) received adjuvant chemotherapy; 77% (27/35) received hormone therapy. Five out of ten patients with HER-2 overexpressing tumors did not receive adjuvant anti–HER-2 therapy, while two out of four patients with HER-2 overexpressing tumors received palliative trastuzumab for recurrent and metastatic disease. Letrozole was used for one patient in the palliative setting. The median overall survival durations were 7.2 years (range, 0.6 to 17.0 years) in patients with localized disease and 2.9 years (range, 0.6 to 4.3 years) in those with recurrent or metastatic disease. Conclusion Anti–HER-2 and hormonal therapy, except tamoxifen, have been underutilized in Korean MBC patients compared to female breast cancer patients. With the development of precision medicine, active treatment with targeted agents should be applied. Further investigation of the unique pathobiology of MBC is clinically warranted.

Hypermagnesemia Accompanied with Colonic Perforation in a Hemodialysis Patient

윤혜은,김영욱,하경선,심은휘,고승우,신석준 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.3

We report a case of a chronic hemodialysis patient who developed hypermagnesemia due to an overdose of magnesium-containing laxative and paralytic ileus resulting in colonic perforation. Despite intravenous calcium infusion and daily hemodialysis,the patient developed ischemic colitis and intestinal perforation. Colonic perforation accompanied with hypermagnesemia in hemodialysis patients has rarely been reported. This case suggests that hypermagnesemia should be considered in renal failure patients as this can result in life-threatening events despite prompt treatment.

뼈 세포의 효소 및 무기질대사에 미치는 PTH와 Calcitonin 호르몬의 효과와 인산화 반응

정차권(Chung Cha Kwon),하경선(Ha Kyung Sun) 韓國營養學會 1995 Journal of Nutrition and Health Vol.28 No.8

식이 Ca 수준과 호르몬 투여가 생쥐의 골밀도에 미치는 영향

정차권(Chung Cha Kwon),하경선(Ha Kyong Sun),김현숙(Kim Hyun Sook),강익원(Kang Ik Won),배범승(Bae Bum Sung) 韓國營養學會 1996 Journal of Nutrition and Health Vol.29 No.9

Anomalous Arterial Supply to Normal Basal Segment of the Right Lower Lobe: Endovascular Treatment with the Amplatzer Vascular Plug

김지훈,박영근,김신승,하경선,배준기 대한결핵및호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.76 No.6

Pulmonary systemic arterialization to normal basal lung without sequestration is a rare congenital anomaly. In this rare abnormality, arterialization of the left lower lobe is the most common type. In general, surgical treatments have been performed. Recently, for reducing the complications and risks of surgery, embolization is mainly attempted by using coils. We report a case of 22-year-old male patient with a 10 mm anomalous arterial supply to his normal lung, which is being successfully treated by transcatheter embolization when using the Amplatzer Vascular Plug that has been adapted for the treatment of high-flows and large artery occlusions.