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민도준,양동원,민창기,김완욱,이상헌,박성환,김동욱,이종욱,조철수,민우성,김범생,김호연,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1
배경: 기존의 치료에 불응하고 예후가 불량한 자가면역질환 환자들에게 최근 고용량 면역억제 및 조혈모 세포이식이 새로운 치료방법으로 대두되고 있다. 저자들은 다발성 경화증(multiple sclerosis, MS) 및 류마티스 관절염(rheumatoid arthritis, RA) 등 2명의 자가면역질환 환자들에서 자가조혈모세포 이식을 시행하였다. 방법: 말초혈액 조혈모세포 가동화를 위하여 cyclophosphamide (4 g/㎡) 및 granulocyte colony stimulating factor (10 g/kg/day)를 투여하였고, CD34+ 세포를 분리·채집 하였다, 이식 전처치로 MS 환자에서 BEAM 및 antihymocyte globulin (ATG) (3.75 mg/kg), RA 환자에서 fludarabine (180 mg/㎡), ATG (10 mg/kg)와 busulfan (8 mg/kg)을 투여하였다. 결과: 호중구 수가 500/㎕ 이상으로 회복되는 기간은 MS 환자에서 9일, RA 환자에서 15일이었다. 혈소판이 20.000/㎕ 이상으로 회복되는 가간은 RA 환자에서 9일 이었고, MS 환자에서는 혈소판 감소증이 발생하지 않았다. 비혈액학적 독성으로 MS 환자에서 WHO 1도의 오심 및 점막염이 관찰되었다. MS 환자는 이식 6개월 후까지 시력감소가 남아있었으나, 이식전에 관찰되던 감각이상 및 운동장애 등의 신경학적 이상 소견은 더 이상 관찰되지 않았다. RA 환자는 이식 1개월 후 관절 증상 및 검사소견의 호전을 보였다. 결론: 불응성 자가면역질환 환자에서 고용량 면역억제 및 조혈모세포이식은 적은 독성으로 높은 치료효과를 기대할수 있으며, 향후 이 시술의 임상적 의의를 규명하기 위하여 전향적이고 장기적인 연구가 필요할 것으로 사료된다. Background: High-dose immunosuppressive therapy followed by autologous hemathpoietic stem cell transplantation (HSCT) has been proposed as a new approach to treat severe, refractory autoimmune diseases. We describe two patients with refractory autoimmune diseases (one multiple sclerosis 〔MS〕and one rheumatoid arthritis〔RA〕) who underwent T-cell-depleted autologous peripheral bleed stem cell transplantation for the first time in Korea. Methods: We mobilized autologous stem cells with cyclophisphamide (4 g/㎡) and granulocyte colony-stimulating factor (10 ㎍/kg/day). Stem cells were enriched ex vivo using CD34-positive immunoselection and reinfused after high-dose chemotherapy with BEAM and antithymocyte globulin (ATG) (3.75 mg/kg) in MS, or fludarabine (180 mg/㎡), ATG (10 mg/kg) and busulfan (8 mg/kg) in RA. Results: The engraftment with an absolute nerutrophil count greater than 500㎕ occurred on day 9 in MS and 15 in RA, respectively. The time to nontransfused platelet count greater than 2.000/㎕ was 9 day in RA. MS patient did not show ant episode of thrombocytopenia. Regimen-related non-hematopoietic toxicity was minimal. For 6 months since HSCT, them patient with MS had been free from previously existed sensory and motor abnormalities except decreased visual acuity. Then patient with RA and only one tender joint and two mildly swollen joints with improvement in laboratory parameters at one month after HSCT. Conclusion: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of intractable autoimmune diseases. The durability of remission, however, remains to be clarified.
State Indicator of Water Quality for Surface Water and Groundwater in Agriculture
Min-Kyeong Kim,Goo-Bok Jung,An-Sung Ro,Seung-Chul Choi,Won-Il Choi,Eun-Jeong Kim,Jong-Eun Lee,Yeo-Uk Yun,Kab-Cheol Kim,Do-Young Ko,Byeong-Ho Kim,Hyeon-Ji Kim,Sang-Jo Park,Seong-Tae Lee,Jae-Young Heo,S 한국토양비료학회 2015 한국토양비료학회지 Vol.48 No.5
Indicators of environmental conditions qualitatively and quantitatively describe the state of the environment and natural resources, and the OECD (Organization for Economic Cooperation and Development) has initiated and suggested AEIs (Agri-Environmental Indicators) to assess trends over time of the effects of agriculture on the environment and the effectiveness and efficiency of agricultural and environmental policy measures since 1990’s. This study aims to develop the state indicators of water quality for agricultural water, surface and groundwater, to evaluate the environmental impacts of agricultural activities and policies by qualifying the environmental levels of a nation. Status indicators were calculated according to the agricultural water quality standards of OECD and Korea, and their trends were analyzed over time. Particularly, nitrate(NO₃<SUP>-</SUP>) status indicators of ground water in 2013 were significantly lower than the ones in 2000. Overall, the water quality indicators of surface water in 2013 were higher than the ones in 2012, except for pH and DO. The groundwater quality indicators in 2013 were lower than those of previous years. The optimal management indicators were calculated to assess agricultural surface water and groundwater quality. The findings of this study indicated that the state indicators could play a significant role to establish policies and procedures for managing and conserving water resources. This study also discussed water pollution caused by agricultural and industrial effluents.
State Indicator of Water Quality for Surface Water and Groundwater in Agriculture
Kim, Min-Kyeong,Jung, Goo-Bok,Ro, An-Sung,Choi, Seung-Chul,Choi, Won-Il,Kim, Eun-Jeong,Lee, Jong-Eun,Yun, Yeo-Uk,Kim, Kab-Cheol,Ko, Do-Young,Kim, Byeong-Ho,Kim, Hyeon-Ji,Park, Sang-Jo,Lee, Seong-Tae,H 한국토양비료학회 2015 한국토양비료학회지 Vol.48 No.5
Indicators of environmental conditions qualitatively and quantitatively describe the state of the environment and natural resources, and the OECD (Organization for Economic Cooperation and Development) has initiated and suggested AEIs (Agri-Environmental Indicators) to assess trends over time of the effects of agriculture on the environment and the effectiveness and efficiency of agricultural and environmental policy measures since 1990's. This study aims to develop the state indicators of water quality for agricultural water, surface and groundwater, to evaluate the environmental impacts of agricultural activities and policies by qualifying the environmental levels of a nation. Status indicators were calculated according to the agricultural water quality standards of OECD and Korea, and their trends were analyzed over time. Particularly, nitrate ($NO_3{^-}$) status indicators of ground water in 2013 were significantly lower than the ones in 2000. Overall, the water quality indicators of surface water in 2013 were higher than the ones in 2012, except for pH and DO. The groundwater quality indicators in 2013 were lower than those of previous years. The optimal management indicators were calculated to assess agricultural surface water and groundwater quality. The findings of this study indicated that the state indicators could play a significant role to establish policies and procedures for managing and conserving water resources. This study also discussed water pollution caused by agricultural and industrial effluents.
제 2형 콜라겐에 의해 경구관용 유도된 DBA/1 mice에서의 세포면역반응
양형인 ( Hyung In Yang ),김완욱 ( Wan Uk Kim ),민도준 ( Do Jun Min ),박성환 ( Sung Hwan Park ),홍연식 ( Yeon Sik Hong ),이상헌 ( Sang Heon Lee ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.4
Objective: To investigate the dosage of bovine type II collagen (BnCII) for the induction of oral tolerance in CIA animals, and to verify the changes of immune response and TGF-β production of mesenteric lymph node cells in tolerized CIA animals. Methods: Oral tolerance was induced by feeding of variable doses (5㎍, 10㎍, 20㎍ and 40㎍) of BnCII to DBA/1 mice 4 times per week during 2 weeks, and control mice were given ovalbumin (1000㎍), before immunization. We examed clinical assessment; incidence of arthritis, severity of arthritis, arthritic limb by visual analysis. IgG antibodies to BnCII were measured by ELISA, T cell responses to BnCII and PHA were quantified by antigen (CII)-induced 3H-thymidine incorporation into lymphocytes of mesenteric lymph node, draining lymph node, and spleen. TGF-β in supernatants obtained from lymph node culture medium was measured by ELISA. Results: Arthritis limbs were observed in 100% of control at 5 weeks after subcutaneous BnCII injection. The incidences of CIA in all tolerized group were significantly lower than that in control 5 weeks after immunization (control 100% vs. 5㎍ feeding group: 50%, 10㎍ feeding group: 50%, 20㎍ feeding group: 50%, 40㎍ feeding group: 55.5%, P<0.01). In comparison to control, mean articular indices were lower in all tolerized groups (control 5.13: 5㎍ feeding group 3.50, 10㎍ feeding group 2.75, 20㎍ feeding group 2.87, 40㎍ feeding group 2.63, P<0.05). Arthritic limbs were also significantly lower in tolerized groups (control 58.3: 5㎍ feeding group 20.8, 10㎍ feeding group 16.7, 20㎍ feeding group 20.8, 40㎍ feeding group 20.8, P<0.05). The titers of IgG antibody to CII were lower in tolerized group than that in control [tolerized group; median 10 (min. 0, max. 48), control; median 33 (min. 8.6, max. 101), P<0.05]. The proliferative responses to BnCII were significantly suppressed in tolerized (control 8010±2319cpm, tolerized group 4500±2060cpm, P<0.01). High TGF-β production was noted in tolerized group (control; 28pg/ml, BnCII feeding group; 73pg/ml). Conclusion: Oral tolerance in DBA/1 mice was successfully induced from low doses of BnCII (5㎍) and suppressed T and B cell function in conjunction with increased TGF-β production may play an important role for the induction of CII induced oral tolerance in DBA/1 mice.
깊은 근이완의 회복을 위한 Anticholinesterases 의 사전예비정주법
김교상,전정우,이명의,한정욱,민용진,전민선,나도준 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.12
The success of accelerating the onset of neuromvacular blocking drugs by giving them in divided doses encouraged others to attempt the same $quot;priming principle$quot; using reversal agents. Naguib et al and Abdulatif et al demonstrated that the reversal time(time to reach a TOF of 0.75) was reduced when the reversal agent was administered in divided doses at T, 10% of control. But Donati et al and Szalados et al either could not detect any differences in the rate of reversal when anticholinestereses were administered in divided doses. This study hes been conducted to evaluate the reversal effects of neostigmine or pyridostigmine with priming principle in the rabbit after pancuronium injection when pro- found relaxation(PTC=0) was confirmed. Rabbits(n=60) were randomly allocated to 4 groups. After pancuranium 0.2mg/kg IV, the onset and recovery times were evalusted. When the profound relaxation(PTC=0) was confirmed at Smin. after pancuronium injection, neostigmine 50 ㎍/kg and atropine sulfate (atropine) 20 ㎍/kg we injected in group 1. At thst time, neostigmine 10/kg and atropine 4 ㎍/kg were injected and after 3min. neostigmine 40㎍/kg and atropine 16 ㎍/kg were injected in group 2. At that time, pyridostigmine 250 ㎍/kg and atropine 20 ㎍/kg were injected in group 3. At that time, pyridostigmine 50 ㎍/kg and atropine 4 ㎍/kg were injected and after 3min. pyridostigmine 200 ㎍/kg and atropine 16 ㎍/kg were injected in group 4. The results were as follows : 1) The time until 75% recovery of twitch amplitude was 53.1±12.4min. in group 1, 44.9±212.1min. in group 2, 54.9±9.7min. in group 3 and 48.2±7.1min. in group 4. The reversal times were tended to reduce when the reversal agents were administered with $quot;priming principle$quot; at the profound relaxation. 2) At the profound relaxation the reversal effects of neostigmine were greater than that of pyridostigmine.
자가조혈모세포이식을 이용한 불응성 류마티스 관절염의 치료
민도준 ( Do June Min ),민창기 ( Chang Ki Min ),양동원 ( Dong Won Yang ),윤종현 ( Chong Hyeon Yoon ),김완욱 ( Wan Uk Kim ),이상헌 ( Sang Heon Lee ),김동욱 ( Dong Wook Kim ),이종욱 ( Jong Wook Lee ),조철수 ( Chul Soo Cho ),김호연 ( 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.1
Objective: To investigate the safety and efficacy of immunoablation and subsequent autologous hematopoietic stem cell transplantation (HSCT) in refractory rheumatoid arthritis (RA). Methods: Three patients with severe, refractory RA were treated. We mobilized autologous hematopoietic stem cells (HSCs) with cyclophosphamide (Cy) and granulocyte colony-stimulating factor. HSCs were collected and enriched ex vivo using CD34-positive immunoselection. Two different immunoablative conditioning regimens were employed; fludarabine-Cy-anti-thymoayte glonulin (ATG) in patients whose disease activity was transiently ameliorated in response to Cy used in stem cell mobilization, or fludarabine-busulfan-ATG in those who didn`t show any response to that. Results: Median time to engraftment with an absolute neutrophil count greater than 500/μl and nontransfused platelet count greater than 20,000/μl was 15 days (range 12-16) and 9 days (range 7-13), respectively. Regimen-related toxicity was minimal. Two patients were markedly improved at 2 or 3 months after HSCT, repectively. In another patient, disease activity was transiently subsided, but relapsed at 2 months after HSCT, which led to reinstitution of anti-rheumatic medications. This resulted in subsequent marked improvement of disease activity whereas her disease had been refractory to these medications. Conclusions: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of refractory rheumatoid arthritis. The durability of remission remains to be clarified.
( Kyu Min Lee ),( Sun Mi Jang ),( Seo Young Oh ),( Do Young Kim ),( Geewon Lee ),( Ahrong Kim ),( Min Ji Kim ),( Tae Hwa Kim ),( Joon Woo Park ),( Kwangha Lee ),( Ki Uk Kim ),( Min Ki Lee ),( Jung Seo 대한결핵 및 호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.4
We presented a case of unusual endobronchial inflammatory polyps as a complication following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a patient with tuberculous lymphadenitis. EBUSTBNA of the right hilar lymph node was performed in a 29-year-old, previously healthy man. The patient was confirmed with tuberculous lymphadenitis and received antituberculosis medication over the course of 6 months. Chest computed tomography, after 6 months of antituberculosis therapy following the EBUS-TBNA showed nodular bronchial wall thickening of the right main bronchus. Histological and microbiological examinations revealed inflammatory polyps. After 7 months, the inflammatory polyps regressed almost completely without need for removal.