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      • KCI등재후보

        유전자 재조합 과립구 - 단구 집락촉진인자 ( rhuGM - CSF ) 자극이 장기 골수배양 ( LTBMC ) 에 미치는 영향에 관한 연구

        민유홍(Yoo Hong Min),고윤웅(Yun Woong Ko),이선주(Sun Ju Lee),한지숙(Jee Sook Hahn) 대한내과학회 1991 대한내과학회지 Vol.41 No.2

        N/A Long-term bone marrow culture (LTBMC) for human hemopoiesis supports continous proliferation and differentiation within the myeloid progenitor population by the formation of an adherent stromal layer. LTBMC represents the most suitable in vitro model for the study of regulatory mechanisms in human hemopoiesis. We studied the effects of short-term incubation of bone marrow cells from 13 patients with a recombinant human granulocyte-macrophage colony stimulating factor (rhuGM-CSF) on the LTBMC. The cells (2×10(6)/ml) were incubated with 100ng/ml rhuGM-CSF for 24 hours in a culture medium supplemented with 12.5% fetal bovine serum and 12.5% horse serum. After preincubation, the LTBMCs were started and maintained over a period of 6 weeks. At 1 week in culture we observed a statistically significant difference in the number of nonadherent cells in the LTBMCs containing the bone marrow preincubated with rhuGM-CSF (105.6±37.0×10(s) vs 75.3±24.2×10(5); p<0,05). This increase was considered due to the expansion of mature myeloid cells. At the same time, the number of GM-colony forming units (CFU-GM) per flask with rhuGM-CSF preincubated bone marrow slightly increased compared to the controls (2,497.4±1,512.7 vs. 1,837.3±1,057.8). After 1 week of LTBMCs, no significant difference could be observed between the rhuGM-CSF-pretreated LTBMCs and the control cultures. These results may confirm that rhuGM-CSF is a stimulator of in vitro myelopoiesis in LTBMCs without causing a depletion of the hemopoietic stem cell pool.

      • KCI등재

        에스겔서의 감금 모티프와 언어장애 모티프

        민유홍(Yoo Hong Min) 대한성서공회 2016 성경원문연구 Vol.- No.38

        In this study, motifs of confinement and dumbness in Ezekiel 3:22-27 were analysed in order to understand their meaning, and to investigate their structural role in the macro context of the book of Ezekiel. First of all, 3:22-27 and 4:1-5:17 together form an independent, well-closed text unit, in which they are combined as introduction and development. This text unit was intended to supplement and to extend the first calling vision (1:4-3:15). Regarding the confinement motif, if Ezekiel’s confinement in his house is interpreted as a symbolic action for the siege of Jerusalem, then its meaning fits to the context at most. Two text passages, 12:1-16 and 24:15-27, in which Ezekiel himself (or his wife) and his house are used as symbols for residents in Jerusalem and the city Jerusalem respectively, and verses 8:1; 14:1; and 20:1, which imply Ezekiel’s confinement, attest that the confinement motif plays a structural role of determining the story in the macro context of the book. In all probability, the dumbness motif (3:26-27; 33:21-22) is an editorial element, which was secondly added to the confinement motif. The dumbness symbolizes that the final judgement of God on Jerusalem is decided and can never be cancelled, so that it is prohibited for the prophet to warn and to admonish the people of Israel about the judgement of God. The confinement and the dumbness motifs are combined to a motif complex, which plays a structural role to divide the entire book into an era of retribution and an era of new hope for restoration. Finally the motif complex provides a way, through which an element of restoration can be incorporated into the calling vision (1:4-3:15), which is strongly coined with the perspective of calamity. Therefore the calling vision is extended to encompass the horizon of restoration.

      • SCOPUSKCI등재
      • KCI등재후보

        성인 급성 백혈병에 있어서 감염증에 관한 고찰

        김성철(Seong Cheol Kim),민유홍(Yoo Hong Min),이석(Seok Lee),정소영(So Young Chong),이승태(Seung Tae Lee),한지숙(Jee Sook Hahn),고윤웅(Yun Woong Ko) 대한내과학회 1996 대한내과학회지 Vol.51 No.6

        N/A Objectives: Patients with acute leukemia have a long-term disease free survival due to improvement of chemotherapy. But the infection is the most important morbidity and mortality and is the single commonest complication resulting in an early death after chemotherapy. Therefore the effective treatment and preventive strategies of these infection is essential in order that more patients may achieve a complete remission and long-term disease free survival. The purpose of this study was to determine the recent incidence of fever/infection and to evaluate antimicrobial usage among adult acute leukemic patients. Methods: The records of 172 patients from a consecutive series of 350 admission episode between January 1990 to July 1994 were reviewed retrospectively. Datas were analyzed to compare the infectious disease complications and antimicrobial usage for patients receiving various chemotherapy for a specific phase of leukemia treatment. Results: 1) Febrile episodes were developed in 258 of 350 admission session. The microbiologically de5ned infection (MDI) & clinically defined infection (CDI) were developed in 44.8% and 49.2% of episodes, respectively. There was a 92% rate of febrile episodes among the patients receiving salvage chemotherapy. Fever was developed in 75%, 53%, and 70% in cases receiving remission induction chemotherapy, consolidation therapy, and intensified consolidation therapy, respectively. 2) The most frequent site of infection was lung (36%). Coagulase-negative staphylacocci was the most common causative organism of MDI and bacteremia. 3) The rate of overall response to antimicrobial therapy was 72.9%. The rate of overall response to antimicrobial therapy during the intensified consolidation, consolidation therapy, and induction chemotherapy was over than 75% (90.5%, 87.6%, 79.6% respectively). 4) The initial antimicrobial therapy was not modified in 45 of 258 febrile episodes. Modification of antibiotics was carried out in only 36 cases according to the results of primary bacterial culture and sensitivity tests. The initial response of initial empiric antimicrobials was 23.6%, The initial response rate of the addition of vancomycin/teicoplanin, and amphotericin-B was 21.7% and 15.2%, respectively. The cumulative rate of initial response for antimicrobials described above was 60.5%. Among the cases receiving amphotericin-B, probable fungal infection was 23.7%, while the suspected fungal infection was 61%. Conclusion: The development of intensive treatment modalities far acute leukemia has altered the encountered infectious disease problem. Although our management guidelines for infections were of relevant, more effective approaches should be evaluated by considering the changing spectrum of microbials and by using more effective prophylactic and treatment modalities including new antimicrobials.

      • KCI등재후보

        노령층 급성백혈병의 치료성적

        이승태(Seung Tae Lee),민유홍(Yoo Hong Min),한지숙(Jee Sook Hahn),장길진(Gil Jin Jang),송준현(Joon Hyun Song),이선주(Sun Ju Lee),고윤웅(Yun Woong Ko) 대한내과학회 1995 대한내과학회지 Vol.49 No.2

        N/A Objectives: Approximately 40-60% of acute myelogenous leukemia(AML) and 30% of acute lymphoblastic leukemia(ALL) occur in patients over 60 years old. The elderly leukemic patients showed less complete remission rate and shorter survival, and there have not been universal agreements on the desirable anti leukemic therapy for the elderly patients with acute leukemia. We investigated the clinical characteristics and therapeutic outcomes of 22 patients aged 60 or over diagnosed as acute leukemia during the last 5 years. Methods: Between January 1988 and December 1992, 31 patients aged 60 or over among 174 patients with newly diagnosed acute leukemia, were entered into this study. Among 31 elderly patients, 22 patients underwent remission induction chemotherapy. Remission induction chemotherapy in patients with AML consisted of TAD chemotherapy and low dose cytarabine, and patients with ALL received VPD chemotherapy. Clinical characteristics and therapeutic outcomes of the patients were analyzed retrospectively by review of patiet's medical records. Results: 1) Among 174 patients with acute leukemia, 31 patients were aged 60 or over(17.8%), consisted of 27 AML and 4 ALL patients and male to female ratio was 1: 1.1 median age of them was 65 years. There were no differences in hemogram, bone mar- row findings and complications such as infection, bleeding at the time of initial diagnosis between elderly patients and younger patients. 2) Of 22 elderly patients with acute leukemia received remission induction chemotherapy, twelve patients(55%) achieved complete ramission, comparable to that of younger patients(61%). But median duration of disease free survival and overall survival were significantly shorter(143 days vs 549 days, p= 0.001 and 251 days vs 368 days, p=0.008 respectively) in elderly patients. Complete remission rate of 18 elderly patients with AML was 50%, comparable to that of 77 younger patients with AML(64%), but median duration of disease free survival was significantly shorter(144 days vs 625 days, p=0.014). 3) Complete remission was achieved in 6(60%) of 10 elderly patients with AML received TAD induction chemotherapy, comparable to that of younger patients with AML received TAD chemotherapy(62.7 %) and early death rate was also comparable(10% vs 9% ). There was a trend toward longer durations of disease free survival in younger patients compared to that of elderly patients(625 days vs 144 days). Of whom achieved complete remission, 3 elderly AML(50% ) underwent consolidation chemotherapy as postremission chemotherapy and 88% of younger patients with AML underwent consolidation chemotherapy. 4) Of the 8 elderly patients with AML received low dose cytarabine as induction chemotherapy, 3 patients achieved complete remission and median duration of disease free survival was 85 days, trends toward lower remission rate and shorter duration of disease-free survival compared to that of patients received TAD induction chemotherapy(37.5% vs 60%, 85 days vs 144 days, respectively), but early death rate was camparable(12% vs 10% ). 5) There were no differences in durations of neutropenia, thrombocytopenis, transfusion requirement, infection and bleeding of grade 3 of more between elderly and younger patients with AML during remission induction chemtherapy. Elderly AML patients received TAD chemotherapy needed more frequent platelet transfusion compared to elderly patients received low dose cytarabine as induction chemotherapy(60 units vs 38 unit, p=0,045). Conclusion: The complete remission rate of the elderly patients with acute leukemia after remission induction chemotherapy was comparable to that of the younger patients, and further evaluations about more intensive postremission chemotherapy and supportive cares involving the use of hematopoietic growth factors in the elderly may be warranted.

      • KCI등재

        동종조혈모세포이식술 시술기관의 진료량이 이식후 생존율에 미치는 영향

        박춘선,문희경,강혜영,민유홍,조우현,Park, Choon-Seon,Moon, Hee-Kyung,Kang, Hye-Young,Min, Yoo-Hong,Cho, Woo-Hyun 대한예방의학회 2004 예방의학회지 Vol.37 No.1

        Objective : To examine the association between hospital procedure volume and treatment outcomes following allogeneic bone marrow transplantation (allo-BMT). Methods : Out of 1,050 patients who received allo-BMTs between 1998 and 2000 in 21 Korean hospitals, 752 with first allo-BMT and complete data were included in this study. Study subjects were divided into the following three groups according to cumulative hospital experience of all-BMTs during the study period: low (<30 cases), medium (30-49) and high ($\geq$50 cases) volume. Patient outcome was defined as early survival at day 100 and one-year survival. Multiple logistic regression analyses were performed to examine the association between hospital experience and survival at day 100 and one year. Results : When the low volume group was defined as the reference group, the adjusted relative risks (RR) of survival at day 100 for the high volume group were 2.46(95% CI, 1.13-5.36) for all patients, 2.61(1.04-6.57) for those with leukemia, and 2.20(0.47-10.32) for those with aplastic anemia. For one-year survival, adjusted RR for the high volume group were 2.52(1.40-4.51) for all patients, 1.99 (1.01-3.93) for leukemia, and 6.50(1.57-26.80) for aplastic anemia. None of the RR for the medium volume group was statistically significant. Patient factors showing significant relationship with survival were donor-recipient relation, human leukocyte antigen matching status, time from diagnosis to transplant, and disease stage. Conclusions : The study results suggest that the cumulative experience of hospitals in providing allo-BMT is positively associated with patient survival.

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