혈청 감마지티(gamma glutamyl transferase)치와 대사증후군의 연관성

장미,유병욱,조용진,오정은,홍성호,조주연 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

Background: Serum gamma glutamyl transferase(GGT) level has been widely used as an index of liver dysfunction and a marker of alcohol intake. But, recently it is identified that the elevated GGT level was associated with insulin resistance. This study aimed to examine the association between metabolic syndrome and elevated GGT level in the women who had less alcoholic influence generally. Methods: From 585 women who received their annual health check-up, 577 women were selected for analysis except for 28 women who had hepatitis B surface antigen positive or antibody to hepatitis C virus positive, Categories of serum GGT were classified into four groups by quartile and then evaluated. Results: A abnormal GGT level(≥52U/L) was seen in 29(5.2%) of the 557 women. As GGT level increased, the prevalence rate of factors(body mass index≥25kg/m2, hypertension, hemoglobin≥14g/dL, total cholesterol≥220mg/dL, triglyceride≥150mg/dL, fasting plasma glucose≥110mg/dL, HDL-choles tero1<50mg/dL) except for hyperuhcemia was increased. The GGT level was correlated with age, body mass index, thglyceride and uric acid in women with fatty liver, but not in women without fatty liver. Factors independently contributing to elevated GGT level was diabetes, hyperthglycehdemia and obesity. Conclusion: The elevated, albeit normal, GGT level was strongly associated with the factors of metabolic syndrome in Korean women. Because measurement of serum GGT level is easy, reliable, and not expensive, it might have more important implication as predictive factor of metabolic syndrome.

최근 5년간 급성 A형 간염으로 입원한 환자들에 대한 입원 내용 분석

장재영,유병욱,조용진,오정은,홍성호,조주연 순천향대학교 의학연구소 2009 Journal of Soonchunhyang Medical Science Vol.15 No.1

Abstract Background : Due to improvements in Korea's sanitary conditions, antibody rates to the hepatitis A virus is decreasing rapidly and admission due to the disease is increasing, Patients who were admitted for hepatitis A during the last 5 years were selected and yearly differences in admission, clinical picture, medical fees, and differences according to age and gender were analyzed. Methods : Patients who were admitted to the Seoul Soonchunhyang University Hospital during the 5 year period between May of 2003 and April of 2008 and tested positive for IgM anti-HAV were selected and their medical records retrospectively analyzed. Results : 156 subjects [91 male (58%), 65 female (42%) were selected. The average age was 29.2 years (range; 21.4-37), average admission period 12.6 days (range; 12.5-1 7.7) days, and average medical fees 2,295,151 (range; 932,097-3,658,205) KRW(Korean Won), Yearly incidence rates were as follows : 10 for May, 2003 to April, 2004, 14 for May, 2004 to April, 2005, 23 for May, 2005 to April, 2006, 69 for May, 2006 to April, 2007, and 41 for May, 2007 to April, 2008, The maximum value median of AST, ALT, and bilirubin during admission was 989 IU/L, 1999 IU/L, and 5.6 mg/dL each, Each factors were all positively correlated with the patient's age. Conclusions : Recent decrease in antibody positivity of the hepatitis A virus and subsequent surge of acute hepatitis A is a cause of rising socioeconomic costs. A large scale epidemiologic research on whether HAV vaccination should be made mandatory and health insurance applied seems to be needed. Key words : Hepatitis A, Age, Medical fees, Vaccination

혈청 감마지티(gamma glutamyl transferase)치와 대사증후군 연관성

장미,유병욱,조용진,오정은,홍성호,조주연 순천향대학교 의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

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성인 급성 림프구성백혈병 고위험군에서 일차관해시 동종 및 자가 조혈모세포이식의 성적 비교 : 단일기관 치료경험 A Single Center Experience

이석,민우성,민창기,김동욱,이종욱,김유진,박은정,박윤희,김춘추 대한조혈모세포이식학회 2000 대한조혈모세포이식학회지 Vol.5 No.2

배경:성인 ALL에서 동종 조혈모세포이식은 전처치요법 및 이식편대백혈병 효과에 의한 효과적인 백혈병세포의 제거가 가능하다는 측면에서 활발히 시행되고 있으나 자가 조혈모세포이식과 화학요법과의 비교 연구에서는 대상환자의 다양성 등으로 인하여 상이한 결과가 보고되었다. 그러나 최근 진단당시 환자의 임상적·세포생물학적 특성 및 관해유도요법 후의 백혈병세포의 제거 속도 등을 기준으로 한 위험인자가 정의되면서 이를 근간으로 위험도에 따른 관해 후 치료방침의 결정이 타당성 있는 접근방법으로 제시되고 있고, 특히 고위험군에서의 동종 조혈모세포이식의 역할이 강조되고 있다. 방법: 성인 ALL 고위험군에서 일차 완전관해시 동종 조혈모세포이식의 역할을 규명하기 위해 최근 5년간 가톨릭의대 조혈모세포이식센터에서 ALL로 진단 후 일차 완전관해 상태에서 동종 및 자가 조혈모세포이식을 시행받고 임상적 특성과 세포면역학적 특성 및 세포유전학적 검사결과가 모두 확인 가능하였던 환자 중 고위험군에 해당된 50례를 대상으로 후향적 분석을 시행하였다. 고위험군은 진단시 연령이 30세 이상인 경우, 백혈구수가 30,000/μL 이상인 경우, 관해유도기간이 30일 이상 소요된 경우, Ph 혹은 t(4;11)이 동반된 경우 중 하나 이상의 인자를 갖고 있는 경우로 정의하였다. 결과: 대상환자의 중앙연령은 30세(15~43세)이었고, 남녀 비는 27:23이었다. FAB 분류상 L1 29례(58.0%), L2 21례(42.0%)였으며, precursor B-lineage 항원이 양성인 경우는 36례(72.0%), T-세포 항원이 양성인 경우는 9례(18.0%), 골수구계 항원이 동시에 발현된 경우는 5례(10.0%)였다. 세포유전학적 검사상 23례(46.0%)에서 불량한 염색체유형 [Ph 19례, t(4;11) 4례]이 동반되었다. 전체 환자 중 31례에서 동종 조혈모세포이식을 시행하였으며, 19례에서는 자가 조혈모세포이식이 시행되었다. 동종 및 자가 조혈모세포이식 환자군간의 임상적 특성은 양군간의 유의한 차이가 없었다. 대상환자의 중앙 추적관찰기간은 27개월(7~72개월)이었고, 전체 환자의 2년 무병생존율 및 전체생존율은 각각 59.0±7.6%, 68.2±7.1%이었다. 조혈모세포이식에 따른 치료성적을 비교한 결과 전체생존율은 동종 조혈모세포이식군 71.4±8.6%, 자가 조혈모세포이식군 62.7±12.4%로 양군간의 유의한 차이가 없었던 반면, 재발율은 동종 조혈모세포이식군에서 유의하게 낮은 빈도를 보였으며(25.8% vs 52.6%, P=0.05), 무병생존율에 있어서도 각각 70.6±9.0%, 42.1±12.2%로 동종 조혈모세포이식군에서 보다 높은 경향을 보였다(P=0.07). 이식 후 생존율에 영향을 주는 위험인자를 분석한 결과, 진단시 연령, 백혈구수, 관해유도기간에 따른 차이는 관찰되지 않았다. 다만 Ph 혹은 t(4;11)이 동반된 경우에서 무병생존율이 동종(28.5±16.0% vs 94.4±5.4%, P=0.0002) 및 자가 조혈모세포이식군(18.1±11.6% vs 80.0±17.8%, P=0.0046) 모두에서 유의하게 감소되었다. 결론: 본 연구를 통하여 일차관해시 조혈모세포이식을 시행받은 고위험군 성인 ALL에서는 관해 후 치료법으로써 동종 조혈모세포이식이 우선적으로 고려될 수 있는 치료법임을 확인할 수 있었다. 이는 추후 국내에서도 보다 장기간의 추적관찰을 통한 전향적 임상연구를 시행하여 보다 정립된 관해 후 치료방침의 결정 필요성을 제시하였다는 측면에서 임상적 의의가 있을 것으로 사료된다. Background:Optimal postremission therapy remains controversial in adult patients with acute lymphoblastic leukemia (ALL). In this study, we compared allogeneic bone marrow transplantation (alloBMT) with autologous peripheral blood stem cell transplantation (autoPBSCT) using the result of the human leukocyte antigen typing (HLA). Methods:Patients were eligible if they were in first remission (CR1) and had either: adverse cytogenetics [Philadelphia chromosome (Ph), t(4;11)], age >30 years, required more than 1 induction course to achieve remission (time-to-CR1 >30 days) or presenting WBC >30,000/μL. From July 1994 to June 1999, 50 consecutive adult patients with high-risk ALL underwent HLA-matched alloBMT (n=31) or autoPBSCT (n=19) at the Catholic Hemopoietic Stem Cell Transplantation Center. Results:There were 27 males and 23 females with median age 30 (range, 15~43) years. The distribution of phenotype was as follows: L1 (n=29), L2 (n=21), precursor B (n=36), T (n=9), myeloid marker coexpression (n=5). Adverse cytogenetic abnormalities at diagnosis were shown in 23 (46.0%) cases. All pretransplant characteristics were well balanced between these two groups. Most patients were treated with total body irradiation containing regimen as part of the conditioning. With a median follow-up of 27 months in both groups, disease-free survival (DFS) and overall survival probabilities at 2 years were 59.0±7.6% and 68.2±7.1%, respectively. The relapse rates were significantly different between alloBMT and autoPBSCT groups (25.8% vs 52.6%, P=0.05). There was no significant difference in overall survival between the two groups. However, alloBMT had a trend toward better DFS (70.6±9.0% vs 42.1±12.2%, P=0.07). None of the pretransplant characteristics significantly affected outcome after transplantation, except adverse cytogenetics. Prognosis of ALL with Ph or t(4;11) was significantly poorer than that of the remaining high-risk ALL patients (P<0.01). Conclusion: We conclude that alloBMT appears to be more effective than autoPBSCT in prolonging initial CR for high-risk ALL patients. Prospective studies addressing additional clinical variables are needed to guide clinical decision making about transplant choices for adult patients with ALL. New therapeutic strategies for the management of ALL with adverse cytogenetics will be also required.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

호중구감소증 환자에서의 기관-기관지 아스페르길루스증 1예

권재철,송명준,김기조,오유경,김성용,박선희,최수미,이동건,이석,신완식,김춘추 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

저자들은 급성 림프구성 백혈병 환자에서 항암치료 후 호중구감소증이 지속되는 상태에서 침습성 아스페르길루스증의 드문 형태인 치명적인 아스페르길루스 기관기관지염을 경험하고 문헌고찰과 함께 증례를 보고하는 바이다. Tracheobronchial aspergillosis is an uncommon clinical form of invasive aspergillosis, particularly found in patients with AIDS and in lung transplant recipients than in other immunocompromised patients. The rapidity of the disease progression can result in fatal airway obstruction in a short period of time that the patient may need emergency tracheostomy without knowing the cause of the obstruction. We describe a case of fatal tracheobronchial aspergillosis which developed in a 43-year-old female patient with acute lymphoblastic leukemia. Dyspnea and stridor developed on the 20th day after 2nd consolidation chemotherapy, which was during the prolonged neutropenic period. Airway narrowing was observed on the computed tomograph scan of neck and emergency tracheostomy was performed. Infiltration with aspergillus hyphae was found in the tracheal ring and bronchial mucosa. Despite the use of amphotericin B, the patient died of bleeding and airway obstruction.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

Anticancer Effect of Silymarin on Breast Cancer Cells through Inhibition of Akt and MAPK Pathway Expression

Choo Gang Sik,Yoo Eun Seon,Kwon Yoo Jung,Kim Sung Hyun,Woo Joong Seok,Kim Hyeong Jin,Park Young Seok,Kim Sang Ki,Pork Byung Kwon,Kim Byeong Soo,Jung Ji Youn 한국실험동물학회 2017 한국실험동물학회 학술발표대회 논문집 Vol.2017 No.8

Anti-inflammatory effects of <i>Dendropanax morbifera</i> in lipopolysaccharide-stimulated RAW264.7 macrophages and in an animal model of atopic dermatitis

Choo, Gang-Sik,Lim, Dong-Pyo,Kim, Sae-Man,Yoo, Eun-Seon,Kim, Sung-Hyun,Kim, Chang-Hyun,Woo, Joong-Seok,Kim, Hyeong-Jin,Jung, Ji-Youn SPANDIDOS PUBLICATIONS 2019 MOLECULAR MEDICINE REPORTS Vol.19 No.3

<P><I>Dendropanax morbifera</I> (<I>D. morbifera</I>), known as Dendro, means ‘omnipotent drug’ (Panax), and has been called the panacea tree. Various studies on <I>D. morbifera</I> are currently ongoing, aiming to determine its medicinal uses. The present study investigated the anti-inflammatory effects and underlying mechanism of a natural extract of <I>D. morbifera</I> leaves (DPL) in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages. In the present study, the following assays and models were used: MTT assay, nitric oxide (NO) assay, western blotting, ELISA and mouse models of atopic dermatitis. DPL extract markedly reduced the production of NO, inducible NO synthase and interleukin-6, as well as the nuclear translocation of nuclear factor-κB (NF-κB). Additionally, the LPS-induced activation of extracellular signal-regulated kinase 1/2 (ERK1/2), P38 and c-Jun N-terminal kinase (JNK) was suppressed by DPL extract. Taken together, these results indicate that NF-κB, ERK1/2, P38 and JNK may be potential molecular targets of DPL extract in the LPS-induced inflammatory response. Subsequently, the present study investigated the effects of DPL extract in a 2,4-dinitrochlorobenzene-induced atopic dermatitis mouse model. Ear thickness, serum immunoglobulin E levels and histological analysis revealed that the DPL extract was effective in attenuating the inflammatory response. These results indicate that DPL extract has anti-inflammatory potential and may be developed as a botanical drug to treat atopic dermatitis.</P>

Low-Cycle Flexural Fatigue Behavior of Concrete Beam Reinforced with Hybrid FRP-Steel Rebar

Choo, Jinkyo F.,Choi, Young-Cheol,Kwon, Seung-Jun,Park, Ki-Tae,Yoo, Sung-Won Hindawi Limited 2018 Advances in civil engineering Vol.2018 No.-

<P>Studies examined experimentally the flexural behavior of concrete beams reinforced with the hybrid FRP-steel rebar but very few among them evaluated their fatigue performance. In this study, the fatigue test has been performed, and an analytical model for simulating the flexural fatigue behavior of the concrete beam reinforced with the hybrid bar considering its postyielding behavior is developed. A formula relating the postyielding fatigue strain of the rebar to the number of the fatigue cycle is suggested and used in the proposed procedure. The method simulating the low-cycle behavior of the reinforced concrete beam is found to be satisfactory and can predict the number of cyclic loading to failure.</P>