주물공에서 발생한 Goodpasture증후군 1예

김민기,고동희,이선웅,조민희,유희용,김보연,이준혁 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1

Background: Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known as risk factors of Goodpasture's syndrome. We studied a patient with Goodpasture's syndrome who had worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome, we describe and discuss our study results. Case: A 46-year-o1d man, who had worked as a foundry worker for 27 years and had a 12 1/2 pack-year history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing, chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomeru-lonephritis. Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at lung biopsy. Finally, we diagnosed the worker's illness as Goodpasture's syndrome and carried out hemodialysis and plasmapheresis. In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA(0.0106 mg/m³), which was calibrated for overtime. Conclusion: Based on both the clinical test and industrial hygiene examination, we concluded that the Goodpasture's syndrome in this case was caused by long-term silica exposure. 배경: 유리규산에 노출되면 말기 신질환의 주요원인인 사구체신염이 증가할뿐만 아니라. 자가면역질환인 Goodpasture 증후군도 발생하는 것으로 보고되어 있다. 저자들은 27년간 주물공으로 근무한 근로자에서 발생한 Goodpasture 증후군이 작업관련성 조사를 통해 유리규산에 의해 발생하였을 가능성이 높다고 판단하였기에 이를 고찰과 함께 보고하는 바이다. 증례: 25년간 반갑씩 흡연을 하였고. 주물공장에서 수동 및 자동조형작업을 27년간 하였다. 내원 2주전부터 발생한 흉통과 기침으로 입원하였으며, 내원 당시 혈뇨, 단백뇨 및 중증의 제한성 폐기능 장애를 보였다. 이후 갑작스럽게 혈액요소질소와 크레아티닌이 증가하였다. 면역검사에서 ANA (+), ANCA (-), Anti-GBM Ab가 36.8 EU/mL(참고치 0∼10 EU/mL)로 양성이었으며, 신조직검사에서 무면역 사구체신염, 기관지내시경에서 출혈이 보여 Goodpasture 증후군으로 진단하고 투석 및 혈장분리 반출술을 시행하였다. 노출평가에서 호흡성분진 중 석영이 0.0793 mg/m³로, 근무시간으로 보정한 노출기준인 0.0106 mg/m³를 초과하였다. 결론: 본 증례는 노출평가와 작업력조사를 통해 유리규산 노출이 확인되었고 다른 전신질환으로 인한 신질환이 아니며 신세뇨관의 기능 이상이 사구체신염보다 먼저 나타난 이유로 유리규산에 노출되어 발생한 Goodpasture 증후군으로 판단된다.

Treatment for relapsed acute promyelocytic leukemia: what is the best post-remission treatment?

Gi-June Min,Byung-Sik Cho,Sung-Soo Park,Silvia Park,Young-Woo Jeon,Seung-Ah Yahng,Seung-Hawn Shin,Jae-Ho Yoon,Sung-Eun Lee,Ki-Seong Eom,Yoo-Jin Kim,Seok Lee,Chang-Ki Min,Seok-Goo Cho,Jong Wook Lee,Hee 대한혈액학회 2022 Blood Research Vol.57 No.3

Background Arsenic trioxide (ATO) is the standard treatment for relapsed acute promyelocytic leukemia (APL). However, consensus on post-remission therapies is still lacking. Methods We evaluated 52 patients who experienced relapse following initial treatment of APL between 2000 and 2019 at Catholic Hematology Hospital. Among them, 41 patients received reinduction treatment, 30 with ATO-based regimen, whereas 11 with conventional intensive chemotherapy (IC). Results The ATO reinduction group showed a significantly higher second molecular complete remission (mCR2) rate, superior neutrophil and platelet recovery, and a lower infection rate than the IC reinduction group. No significant differences were observed in survival outcomes after post-remission treatment among the ATO-based (N=19), autologous (N=12), and allogeneic (N=6) hematopoietic stem cell transplantation (HSCT) groups. In the ATO-based and autologous HSCT groups, among patients with mCR2 after ATO reinduction, nine and five patients experienced a second relapse, respectively (50.7% vs. 41.7%, P=0.878). Among these patients, seven received salvage allogeneic HSCT; six remained alive. The other seven patients received ATO without HSCT. Five died from disease progression, and two survived and have been in mCR2 since. Conclusion Post-remission treatment outcomes of patients with relapsed APL were not significantly different, regardless of the treatment option, suggesting the feasibility of ATO-based treatment without HSCT in mCR2. Allogeneic HSCT may be an effective salvage treatment modality for patients with a second relapse. Owing to a few cases of relapsed APL, multicenter prospective studies may help elucidate the efficacy of each post-remission treatment.

S-552 A case of IgG4-related Disease Mimicking Lymphoma in the Retroperitoneum

( Gi-june Min ),( Young-woo Jeon ),( Seok-goo Cho ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

The IgG4-related disease is characterized by fibro-systemic disease entity with high serum IgG4 with lymphoplasmacytic IgG4 plasma cell infiltrates, whorled-pattern fibrosis, and obliterative phlebitis that responds favorably to steroid treatment. In this report, retroperitoneal masses which mimic lymphoma finally diagnosed IgG4RD by aggressive diagnostic procedure, serial imaging study, and successfully treated with steroid therapy. A 41-year-old male patient presented to the local clinic with 7-day duration of fever. A patient had 1.0x1.0cm sized mass nearby Rt. SCM and abdomen CT showed homogeneously enhancing masses around the infrarenal aorta. Rt. SCM mass excision biopsy revealed Lymphoproliferative lesion. After 1st CHOP chemotherapy under an impression of lymphoma, he referred to our hospital because of poor response. Raising serum creatinine level was newly noted during outpatient observation and follow-up abdomen CT revealed an obstructive nephropathy due to engulfed left ureter by retroperitoneal masses. Subsequent excision biopsy revealed chronic lymphoplasmacytic inflammation with IgG4 30% of plasma cells, which suggestive of IgG4RD. Retroperitoneal masses size regressed significantly after two months of prednisolone treatment. The clinician should not hesitate made an effort to confirm a diagnosis of IgG4RD for avoiding either unnecessarily invasive treatments or serious organ dysfunction. Although steroid is a mainstay of managing IgG4RD, azathioprine and cyclophosphamide can be used as a second line remission-maintenance regimen.

The clinical, laboratory, and radiologic improvement due to siltuximab treatment in idiopathic multicentric Castleman’s disease

( Gi-june Min ),( Young-woo Jeon ),( Sung-soo Park ),( Silvia Park ),( Seung-hawn Shin ),( Seung-ah Yahng ),( Jae-ho Yoon ),( Sung-eun Lee ),( Byung-sik Cho ),( Ki-seong Eom ),( Yoo-jin Kim ),( Seok L 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.2

Background/Aims: Idiopathic multicentric Castleman disease (iMCD) comprises approximately 30% of all cases of Castleman disease. It is characterized by constitutional symptoms, enlarged lymph nodes at multiple anatomical sites, and laboratory test abnormalities, which are primarily related to the overproduction of interleukin 6 (IL-6). Siltuximab is a human-mouse chimeric immunoglobulin G1κ monoclonal antibody against human IL-6. In view of the limited treatment options for iMCD, this study aimed to evaluate the efficacy and safety of siltuximab in the management of this condition. Methods: In this real-world retrospective study, we administered siltuximab to 15 patients with iMCD who previously received conventional chemotherapy and/or steroid pulse therapy. The median time to a durable symptomatic response was 22 days (range, 17 to 56). The serum hemoglobin and albumin levels and erythrocyte sedimentation rates significantly normalized after the first 3 months of siltuximab treatment. Lymph node involution, assessed using imaging, was relatively gradual, demonstrating a complete or partial response at 6 months. Results: On an average, the improvements in clinical, laboratory, and radiologic parameters of iMCD in responders were observed after one, three, and eight cycles of siltuximab treatment, respectively. Siltuximab demonstrated a favorable safety profile, and prolonged treatment was well-tolerated. Conclusions: Despite the small sample size of the present study, the results are encouraging and demonstrate the potential of siltuximab as the first-line treatment of iMCD. Further large multicenter studies are needed to evaluate the clinical outcomes and adverse events associated with siltuximab.

Impact of an Additional Chromosome on the Clinical Outcomes of Hematopoietic Stem Cell Transplantation in Philadelphia Chromosome–Positive Acute Myeloid Leukemia in Adults

Min, Gi June,Kim, Hee-Je,Yoon, Jae-Ho,Kwak, Dae-hun,Park, Sung-Soo,Jeon, Young-Woo,Lee, Sung-Eun,Cho, Byung-Sik,Eom, Ki-Seong,Kim, Yoo-Jin,Lee, Seok,Min, Chang-Ki,Cho, Seok-Goo,Kim, Dong-Wook,Lee, Jon Elsevier 2018 BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION Vol.24 No.8

<P><B>Abstract</B></P> <P>The incidence of Philadelphia chromosome positivity (Ph<SUP>+</SUP>) in adults with acute myeloid leukemia (AML) is very low. Ph<SUP>+</SUP> AML is considered to be high risk for failure to attain remission or for early relapse after standard chemotherapy. Because of the low incidence of the disease, it has been difficult to determine the best treatment, including the effects of tyrosine kinase inhibitors. We retrospectively analyzed 29 patients with Ph<SUP>+</SUP> AML (median age, 45 years; range, 18 to 80) managed at our center between 2002 and 2016. Two patients were not treated at all, 3 received repeated low-dose cytarabine, and 24 were treated with 3 + 7 standard induction chemotherapy. All 27 treated patients also received interim imatinib 400 mg orally until the day of the next chemotherapy cycle began or as conditioning for allogeneic hematopoietic cell transplantation (HCT), which was performed in 17 patients. Of the 29 patients with Ph<SUP>+</SUP> AML, 7 (24.1%) had additional inv(16), 3 of whom had therapy-related AML. In the 7 with inv(16), the median age was younger (31 versus 44 years, <I>P</I> = .083) and the complete remission (CR) rate was relatively higher (85.7% versus 54.5%, <I>P</I> = .214) than in those without inv(16). Among the 27 treated patients, 20 (74.1%) achieved CR after standard chemotherapy with interim imatinib and 2 (7.4%) achieved CR after low-dose cytarabine with interim imatinib. After a median follow-up of 65.5 months (range, 13.4 to 156.6), the 5-year overall survival (OS) among all 27 treated patients was 43.1%. For the 17 patients who underwent HCT the 5-year OS of 17 patients (10 in subgroup without inv(16) and 7 in subgroup with inv(16)) treated with allogeneic HCT was 69.3%. All 7 with inv(16) were still alive at the end of the study. In contrast, all patients not treated with HCT died within a median of 6.25 months (range, .2 to 18.2). Interim imatinib combined with chemotherapy yielded an acceptable remission rate in adult patients with Ph<SUP>+</SUP> AML. Allogeneic HCT as a postremission therapy provided long-term disease control in two-thirds of those who underwent the transplant. We also demonstrated that inv(16) was related to a favorable outcome in Ph<SUP>+</SUP> AML, including therapy-related AML.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Philadelphia chromosome–positive AML patients can benefit from TKI interim therapy along with standard chemotherapy to achieve complete remission. </LI> <LI> Minimal residual disease negativity could be a predictor of better clinical outcome after allogeneic hematopoietic cell transplantation. </LI> <LI> The presence of inv(16) in patients with Ph<SUP>+</SUP> AML is associated with better survival outcome. </LI> </UL> </P>

Crystallization Mechanism of a Family of Embedded Isoreticular Zeolites

Min, Jung Gi,Choi, Hyun June,Shin, Jiho,Hong, Suk Bong American Chemical Society 2017 The Journal of Physical Chemistry Part C Vol.121 No.30

<P>We have recently been successful in predicting and synthesizing a series of body-centered cubic zeolites with expanding structural complexity and embedded isoreticular structures, termed the RHO family. Here we propose a plausible formation pathway for ECR-18, ZSM-25, and PST-20, the three members of this zeolite family, in the presence of tetraethylammonium ions as an organic structure-directing agent, based on the C-13 MAS NMR, IR, and CO2 adsorption results obtained from the solid products recovered as a function of time during their crystallization processes, together with the quantum-chemical calculation results. The nucleation of these three zeolites, all of which consist of seven different structural units, begins with the almost simultaneous construction of 26-hedral lta and 14-hedral t-plg cages and their subsequent connection via shared 8-rings in the diagonal direction of the cubic unit cell. As a logical next step, 8-hedral t-oto and 12-hedral t-phi cages are built around the preorganized t-plg cages. The remaining embedded spaces are readily filled up with 10-hedral t-gsm cages, as well as with t-oto and t-phi cages. Finally, 10-hedral d8r and 14-hedral pau cages are alternately constructed along the cubic edges. Over the outer surface of the resulting nuclei of the RHO family zeolites, the crystal growth may occur in a similar manner as described above.</P>

Implementation and Design of a Fuzzy Power System Stabilizer Using an Adaptive Evolutionary Algorithm

Gi-Hyun Hwang,Min-Jung Lee,June-Ho Park,Gil-Jung Kim 대한전기학회 2003 KIEE International Transactions on Power Engineeri Vol.a3 No.4

Soil ecosystem multifunctionality of gold mining area based on the energy flux

June Wee,Hyun-Gi Min,Yun-Sik Lee,Taewoo Kim,Yongeun Kim,Kijong Cho 한국응용곤충학회 2022 한국응용곤충학회 학술대회논문집 Vol.2022 No.10

수중 Surveillance 시스템 구축을 위한 초음파 트랜스듀서의 설계

채민구(Min-Ku Chae),김대환(Dae-Han Kim),김영진(Young-Jin Kim),조영준(Young-June cho),표기형(Gi-Hyong Pyo),우종식(Jong-Sik Woo),김승범(Seung-Bum Kim),김광식(Kwang-Sik Kim),이재익(Jae-Ik Lee) 대한전기학회 2012 정보 및 제어 심포지엄 논문집 Vol.2012 No.4

수중 Surveillance 시스템용 압전 복합 재료를 이용한 초음파 트랜스듀서의 설계

채민구(Min-Gu Chae),김대환(Dae-Han Kim),김영진(Young-Jin Kim),조영준(Young-June Cho),표기형(Gi-Hyong Pyo),우종식(Jong-Sik Woo),장미경(Mi-Kyung Jang),박상진(Sang-Jin Park),이재익(Jae-Ik Lee) 대한전기학회 2010 정보 및 제어 심포지엄 논문집 Vol.2010 No.4

FSRU(Floating Storage and Regasification Unit : 부유식 LNG 처장 및 재기화 플랜트) 주변 수중의 영상을 획득하여 접근 물체에 대한 감시 및 경보 시스템으로 수중 Surveillance 시스템이 필요하다. 이 시스템용 Transducer의 압전재료로 Piezo composite를 이용하여 대역폭을 증가시키고 압전 세라믹 대비 side lobe가 개선되도록 설계 및 제작하고, 수조에서 TVR, RVS, Beam pattern을 측정함으로써 설계 사양을 검중하였다.