조혈모세포이식술이 골수기질세포의 기원 및 조골세포로의 증식 및 분화에 미치는 효과

강무일,조성원,오은숙,백기현,이원영,오기원,김혜수,한제호,윤건호,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

완전뇌허혈후 재관류시에 국소뇌혈류, 체성감각유발전위 및 신경학적 회복에 대한 Mannitol과 Thiopental의 효과

박춘근,이상원,박영섭,최승진,허필우,정동섭,강준기,최창락 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

The cardiopulmonary bypass or cerebral circulation arrest is often used in the treatment of complex aneurysm or of arteriovenous malformation to decrease the risk of intraoperative aneurysm rupture. Although experimental studies have suggested that some drugs may protect the brain from ischemic injury, there are limitations in maintaining cerebral perfusion arrest without incurring neurologic deficits due to the initiation of detrimental processes including excitotoxic neuronal injury, activation of phospholipases, influx of calcium, and generation of damaging free radicals. The purpose of this study is to determine wheter mannitol or thiopental has any favorable effects on the recovery of neurologic deficits and on the regional cerebral blood flow(rCBF), somatosensory evoked potential(SEP) and electroencephalogram(EEG) in cats which underwent 15 minutes-complete global ishcemia-reperfusion. The complete global ischemia was produced in 38 cats by temporary intrathoracic occlusion of the innominate artery and the subclavian artery following ligation of bilateral mammary arteries and simultaneous induction of hypotension. The cats were allocated randomly to one of 4 treatment groups : (1) control group, 8 cats received equal volume of saline solution : (2) thiopental group, 10 cats received 45㎎/㎏ thiopental intravenously, (3) mannitol group, 10 cats received 2g/㎏ mannitol intravenously, (4) combined mannitol and thiopental group, 10 cats received equal dose of mannitol and thiopental intravenously. The drugs were administrated in a equally divided dosage before and after the ischemic episode. The results were as follos : 1) Eight animals which received saline showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia. 2) Ten thiopental-treated animals also showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours the ischemia. 3) Both mannitol-and combined treated groups showed early recovery of EEG, good recovery of SEP and EEG without the severe postischemic hypoperfusion, and 7 of 10 mannitol-treated animals and 8 of 10 combined treated animals were significantly recovered in all parameters. There were not significant differences in all parameters between the mannitol-and combined treated groups. 4) Thirty-four of 38 animals involved in this 15 minutes-ischemia resulted in the severe neurologic deficits inspite of treatment with mannitol, thiopental or both of them. These results suggest that, in cats, mannitol treatment is effective but not thiopental in preventing severe neurologic injury following complete global ischemia and the duration of complete ischemia should be far less than 15 minutes.

벌 자상에 의해 발생한 횡문근융해증과 급성신부전

박상곤,김영대,강지은,신정현,신병철,박차영,정춘해 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2

Rhabdomyolysis is a syndrome characterized by muscle necrosis and release of intracellular muscle constituents into the circulation. The spectrum of causes is quite broad and included disorders of traumatic, metabolic, infectious and toxic origin. However, rhabdomvolvsis and acute renal failure following bee sting is rare and its pathogenesis is not well known. We experienced a case of 63-year-old man with acute renal failure and rhabdomyolysis caused by bee sting. He was stung by bee on scalp and neck. Oliguria was developed within several hours. He has fully recovered after general supportive care including fluid therapy and diuretics. This case demonstrates that rhabdomvolysis with consequent acute renal failure are able to developed by bee sting.

혈액투석 환자에서 대퇴신경범증으로 발현된 장골근 및 요근 농양 1예

이준상,강동구,신상열,윤재호,조영일,고성은,유영범,전혜정,진춘조,송종오 대한신장학회 2004 대한신장학회잡지 Vol.23 No.1

Propylthiouracil 투여에 의한 갑상선 기능저하 흰쥐 조직에서 알코올 탈수소효소 활성의 변화

백상현,김동선,이창범,박용수,안유헌,김태화,기춘석,강주섭 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.2

Background: Thyroid hormone has been known to affect hepatic alcohol dehydrogenase (ADH) activity. Although the liver is the principal site of ethanol metabolism, stomach is also responsible in part for ethanol oxidation. The effects of thyroid hormone on ADH activity in gastric mucosa and other tissues of rats had not been previously examined. Method: The effects of thyroid hormone on liver, stomach, lung, and kidney ADH activities (nM of NADH/min/mg of cytosolic protein) have been investigated in male Sprague Dawley rats treated with propylthiouracil (50 mg/kg) for 14 days. Results: Whereas hepatic ADH activities were not changed by treatment with PTU(42.9(8.6 vs 45.2 (10.1), gastric ADH activities in PTU-treated rats increased by 258.8% of control rat (6.3 ( 0.6 vs 2.2 ( 1.2, p〈0.001). In the activities of other tissues, PTU treatment decreased lung ADH activity by 59.7% of control, and increased kidney ADH activities by 247.1% of control rats. Conclusion: These data suggest that hypothyroidism causes an increase of gastric alcohol metabolism, and that the increase of gastric ADH activity can partly restore the first pass metabolism of ethanol in hypothyroid rats.

기능성척추측만증에 근막이완요법 및 전침치료 증례

김성욱,강영화,이상훈,권혜연,조태성,송춘호,안창범 동의대학교 한의학연구소 2001 동의한의연구 Vol.5 No.-

목적 : 우리는 신체를 근막의 통합된 전체로 보는 근막이완요법과 TrP를 파괴하는 전침요법을 기능성 척추측만증에 적용시킬수 있는지 알아보았다. 방법 : 22세의 기능성 척추측만증을 가진 남성에게 다양한 형태의 근막이완요법을 적용하였고, 중둔근, 요방형근, 슬괵근에 전침요법을 적용하였다. 결과 : 3주시술후 다리길이차이, 근막구축, Cobb's 각과 척추회전변위가 감소되었고 흉부압박감 같은 전신적증상이 호전되었다. 결론 : 근막이완요법과 전침병행치료가 신체를 근막의 일체로 보는 관점으로 인체의 구조적불균형을 바로 잡아줄수 있는 새로운 치료법의 기능성을 찾았다. Objective: We investigated this study in order to see the adaptation capability of myofascial release that translating the body being integrated fascial totality and electroacupuncture treatment that breaking trigger points in functional scoliosis. Methods: We applied myofascial relase by three patterns and electroacupuncture in TrPs of gluteus medius, Quadratus lumborum and Hamstring muscle to 22 year-old who have had functional scoliosis. Results: After 3 weeks, The leg length, fascial restriction. Cobb's angle and rotation scoliosis are decreased. Systemic symptoms, for example; chest discomfort are improved. conclusion: Myofascial release and electroacupuncture treatment is new methods that treating the sturctural unbalance in view of body's fascial network.

대량의 각혈로 사망한 장티푸스 1예

한상우,유진홍,권순석,김성훈,박지찬,홍은정,최경성,박용완,장준희,안지원,박유경,강지영,박상미,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

골수이식 후 골밀도 및 골대사의 변화 : 2년 추적관찰 2-Year Prospective Study

이원영,강무일,오은숙,오기원,한제호,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

동종골수이식 후 혈당 및 혈중 지질농도의 변화양상 및 관련인자

이원영,강무일,오은숙,오기원,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘주 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.6

연구배경:골수이식은 비교적 젊은 연령의 환자들을 대상으로 하며 면역억제제의 사용기간이 비교적 짧으므로, 주로 고령의 만성 질환 환자에서 시행되는 고형장기이식에서와는 달리 당대사 및 지단백 대사에 있어서 많은 차이점이 있을 것으로 추측된다. 저자들은 전향적 연구를 통하여 골수이식 후 시기별로 혈당 및 혈중지단백 변화 양상을 알아보고 이와 관련된 임상인자들을 규명하고자 하였다. 방법:1998년 10월부터 1999년 8월까지 가톨릭대학교 성모병원에서 동종골수이식을 시행한 환자들 중 43명을 대상으로 이식 전 및 이식 후 1, 2, 3, 4주와 3개월, 6개월에 공복 혈당, 혈중 총 콜레스테롤, 중성지방, 고밀도지단백을 측정하여 골수이식 후 시기별 변화를 관찰하고 여러 임상인자들에 따른 차이를 알아보았다. 결과:1. 공복혈당은 골수이식 수 첫4주 동안 상승하였고 이후 감소하였으나 이식 6개월 시점의 평균 공복혈당은 이식 전보다 유의하게 높게 관찰되었다. 혈중 총 콜레스테롤은 이식 후 1주에 최고치를 형성하였고 이후 기저수준으로 회복되었다가 이식 수 3,6개월에 다시 증가하여 기저치에 비해 유의하게 높았다. 혈중 중성지방은 이식 후 1개월까지 유의하게 증가하였고 이후 감소하여, 3,6개월에는 기저치와 유의한 차이가 관찰되지 않았다. 혈중 고밀도지단백은 이식 후 2,3주에 이식 전보다 유의하게 감소하였고 이후 이식 전 수준으로 회복되었다. 혈중 저밀도지단백은 총 콜레스테롤의 변화와 매우 유사하였다. 2. 골수이식 후 6개월 시점에서 공복 혈당이 126㎎/dL이상인 환자는 7명(16%)이었다. 이들 환자들과 공복혈당 126㎎/dL 미만의 환자 36명을 비교한 결과, 공복혈당이 126㎎/dL 이상인 환자군에서 스테로이드 평균 투여량이 많았고 고밀도지단백이 유의하게 낮았다. 3. 이식편대숙주질환이 발생한 환자는 그렇지 않은 환자보다 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤이 더 낮았고, 3개월의 공복혈당이 더 높았다. 혈연골수이식 환자군은 비혈연골수이식 환자에 비해 투여된 스테로이드 용량이 더 적음에도 불구하고 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤 수치가 더 높았다. 스테로이드 고용량 투여군(하루 평균 7.5㎎기준)은 저용량군보다 이식 후 3개월 시점의 공복혈당이 더 높았으나 나머지 시점의 혈당, 혈중 지질농도에 있어서는 유의한 차이가 관찰되지 않았다. 결론:골수이식 후 초기시기에 주로 당 대사 및 지질대사이상이 관찰되며 이는 면역억제제 투여와 관련이 있음을 알 수 있었다. 면역억제제가 고용량 투여되는 합병증 발생 시 이들 대사이상에 관심을 기울여 대처해야 할 것이다. Background: In bone marrow transplantation(BMT), recipients are usually younger and immunosuppressants are open used in shorter period than in solid organ transplantation. Therefore, there might be a difference in glucose and lipid metabolism between BMT and solid organ transplantation. However, the serial changes of metabolic parameters following BMT have not been studied. Therefore, the aim of this study is to investigate the serial changes of blood glucose, lipids and the putative factors that are related with these changes after BMT. Methods: We have prospectively investigated 43 patients who underwent allogeneic BMT. Fasting plasma glucose(FPG), total cholesterol, triglyceride and high-density lipoprotein(HDL) were measured before BMT, and at 1, 2, 3, 4, 12 weeks and 6 months after BMT. The serial changes of these metabolic parameters according to clinical factors including type of BMT, mean daily steroid dosage, and occurrence of graft versus host disease (GVHD) were examined. Results: 1. Mean FPG level increased during 4 weeks after BMT and remained above basal value at post-transplant 6 months. Total Cholesterol level was increased during initial 4 weeks after BMT and was above basal value at post-BMT of 3 and 6 months. Triglyceride level was progressively increased during initial 4 weeks after BMT, but returned to basal value there after. HDL-cholesterol level was significantly decreased during initial 4 weeks after BMT, but returned to basal value there after. 2. Patients with FPG above 126 mg/dL and the other patients, the former received larger amounts of daily steroid and had lower HDL-cholesterol level. 3. The changes of metabolic parameters were different according to type of BMT, steroid dose, and occurrence of GVHD. Conclusion: Although there was increase of FPG, TC, TG and decrease of HDL-C during initial 4 weeks after BMT, these metabolic changes recovered slowly thereafter. Immunosuppressants are thought to be associated with these changes. Further observation will be needed for the long-term effect of BMT on metabolic changes(J Kor Diabetes Asso 24:689~698, 2000).

자가면역 용혈빈혈의 임상적 분석

박치영,강지은,박상곤,김상현,김형선,정춘해 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background: Autoimmune hemolytic anemia (AIHA) is a very uncommon disorder with the incidence between one and three cases per a hundred thousans a year. There have been very few studies about AIHA in Korea because of its low incidence. Most AIHA studies in Korea were about case history. The aim of this study was to review the clinical features, therapy and outcome of AIHA patients in single institution clinic. Methods: We reviewed retrospectively the medical records of AIHA patients from December 2002 to December 2006. Results: Twelve patient with AIHA were identified, and their median age was 49 years (range 27-75). Male to female ratio is 9:3. The median hemoglobin level was 5.0 g/㎗ (range 2.5-8.2). Warm type AIHA was most common (8/12), cold type was three, and mixed type was one. There was histories of associated disease in six patients. Two patients were complicated by systemic lupus erythematosus and mycoplasma infection and one patient by idiopathic myelofibrosis and solid tumor. Oral steroid was used as the first-line treatment in nine patients. An initial response was observed in eight patients with complete response. One patient had not responded to the initial steroid treatment, and then showed complete response with rituximab. Two relapsed patients were treated with rituximab and partial splenic embolization. Conclusion: The majority of patients can be treated with steroid. Rituximab can improve the response rate in relapsed and refractory AIHA.