횡문근육종 (橫紋筋肉腫) 3예

지현숙(Hyun Sook Chi),백정민(Cheong Min Paik),이상종(Sang Jong Lee),김광연(Kwang Yun Kim),박희영(Hee Yung Park) 대한소화기학회 1972 대한소화기학회지 Vol.4 No.1

Rhabdomyosarcoma is a highly malignant and aggressive tumor of the striated muscle. It is most common occurrence in the later decades of the life and involves often on the uer and lower extre- mities, head, neck, and genitourinary system. Though the clinical report of rhabdomyosarcoma was very few in this country, we have experienced three ceses, who were proved by rneans of surgery or biopsy during the past one year. Two cases were male and one was female. Two of them ranged 50-60 at the age, but one was 30. Two cases of them noticed progressive weight loss, indigestion and upper abdominal pain associated with palpated masses and the rest of them noted left lower abdominal pain and diffuse swelling of left leg. One case received surgical lavarotomy which showed the smooth encapsulated adult fist size mass attatched to the psoas muscle, being unable to excise b cause of massive adhesion, and biopsy was made for some its tissue and neighboring mesenteric lymnh nodes. The other two cases ivere proved as periheral lymph node biopsy alone. Histopathology of the tumar or lymph node ivas composed of highly cellular and pleomorphic cellular mass and tumor cells disclosed pertinent character of rhabdomyosarcoma without the exact presence of the cross striation.

A Histopathological Study on Human Cysticercosis

Hyun-Sook Chi(池賢淑),Je G. Chi(池堤根) 대한기생충학열대의학회 1978 The Korean Journal of Parasitology Vol.16 No.2

Nested Polymerase Chain Reaction을 이용한 Plasmodium falciparum과 P. vivax의 검출

유태현 ( Tae Hyun Yoo ),지현숙 ( Hyun Sook Chi ) 대한임상병리사협회 1999 임상혈액검사학회 발표자료집 Vol.5 No.1

We used the nested polymerase chain reaction(PCR) to detect P. falciparum and P. vivax infection. In the 1st PCR, small subunit ribosomal RNA gene that is common in Plasmodium genus was amplified and in the 2nd PCR, P. falciparum and P. vivax was specifically amplified using species specific primers. Blood, blood spot on the filter paper and Wright stained slide were used as a specimen in this assy. We compared the performance of PCR of each specimen and found that there was no differance in PCR results among three specimens. Blood spot on the filter paper and Wright stained slide might be useful to store or carry the specimen for a extended period. We compared the sensitivity of the PCR method with microscopic examination. PCR method could detect parasitemia earlier stages of infection or later stages after treatment when parasites were not detected in microscopy. Compare with the microscopic examination. PCR method is more useful for the detection of parasitemia on stored specimens and more sensitive for early diagnosis of parasitemia with confirmation of species.

성인 급성 림프구성 백혈병의 예후 : - 33 예의 환자들을 대상으로 한 분석 -

조유숙(You Sook Cho),이규형(Kyoo Hyung Lee),이제환(Je Hwan Lee),김성배(Sung Bae Kim),김상위(Sang We Kim),서철원(Cheol Won Suh),이정신(Jung Shin Lee),김우건(Woo Kun Kim),김상희(Sang Hee Kim),지현숙(Hyun Sook Chi),박찬정(Chan Jung Park 대한내과학회 1997 대한내과학회지 Vol.52 No.3

N/A Objectives: Rate of complete remission and long-term survival in adult acute lymphoblastic leukemia group has not been as satisfactory as that in childhood ALL. Recently introduction of induction chemotherapy of more intensive combination and various trials of postremission therapy are making improved results better looked forward to. And subtypes of ALL according to the degree of differentiation into T and B cells are identified by using immunologic markers hopefully to work out proper treatment for each subtype. Methods: We analited results of treatment and differences of complete remission rate, remission duration and overall survival as to various immunologic markers and clinicopathologic characteristics in 33adult ALL patients. Results: Eighty five percents of the 27cases that had VPDL chemotherapy achieved complete remission and both overall median survival and mediom duration of remission were 52weeks. No definite prognostic factors were detected influencing complete remission rate, remission duration and overall survival except that patients with serum albumin level higher than 4.0mg/dL showed highter complete remission rate. Although mature B-ALL showed the shortest overall median survival, degree of differenciation of B-cell and other immunologic markers did not influence on complete remission rate, remission duration or overall survival. Conclusion: Further studies are needed to delire the prognostic factors in adult ALL

Histopathologic Study on Human Sparganosis

Je G. Chi(池堤根),Hyun Sook Chi(池賢淑),Soon-Hyung Lee(李純炯) 대한기생충학열대의학회 1980 The Korean Journal of Parasitology Vol.18 No.1

백서에서 혈소판 풍부 혈장의 제작과 유효성에 대한 실험적 연구

이상훈,조영욱,지현숙,안강민,이부규,Lee, Sang-Hoon,Cho, Young-Uk,Chi, Hyun-Sook,Ahn, Kang-Min,Lee, Bu-Kyu 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.2

Purpose: Platelet-rich plasma (PRP) is known to accelerate and/or enhance hard and soft tissue healing and regeneration. As such, PRP has been used in various clinical fields of surgery. Recently there have been several attempts to use PRP in the field of tissue engineering. However, some controversies still exist on exact mechanism and benefits of PRP. Therefore various animal experiments are necessary to reveal the effect of the PRP. However, even if animal experiment is performed, the efficacy of the experiment could not be validated due to absence of an animal PRP model. The purpose of this study is to establish rat PRP model by comparing several PRP fabricating methods, and to assay growth factor concentration in the PRP. Materials and methods: Rat blood samples were collected from nine SD rat (body weight: 600-800g). PRP was prepared using three different PRP fabricating methods according to previously reported literatures. (Method 1: 800 rpm, 15 minute, single centrifuge; Method 2: 1000 rpm, 10 minute, double centrifuge; Method 3: 3000 rpm, 4min and 2500 rpm, 8 min, double centrifuge). Platelet counts were evaluated in an automated machine before and after PRP fabrications. In terms of growth factor assay, prepared PRP were activated with 100 unit thrombin and 10% calcium chloride. Growth factor (PDGF-BB, VEGF) concentrations on incubation time were determined by sandwich-ELISA technique. Results: An average of 3ml (via infraorbital venous plexus) to 15ml (via celiac axis) the rat blood could be collected. By using Method 3 (3000 rpm, 4 min and 2500 rpm, 8 min, double centrifugation), around 1.5ml of PRP could be prepared. This method allowed us to concentrate platelet 3.77-fold on average. PDGF-BB concentration (mean, 1942.10 pg/ml after 1 hour incubation) and VEGF concentration (mean, 952.71 pg/ml after 1 hour incubation) in activated PRP were higher than those in untreated blood. Also PDGF-BB showed constant concentration during 4-hour incubation, while VEGF concentration was decreased after 1 hour. Conclusion: Total 11,000 g minute separation and condensation double centrifuge method can produce efficient platelet-rich plasma. Platelet-rich plasma activated with thrombin has showed higher concentrations of growth factors such as PDGF-BB and VEGF, compared to the control group. Platelet-rich plasma model in a rat model was confirmed in this study.

증례 : 감염 ; 골수 및 림프절생검에서 섬유소 고리 육아종 소견을 보인 급성 Q열 1예

조오현 ( Oh Hyun Cho ),최영실 ( Young Sill Choi ),김탁 ( Tark Kim ),박기호 ( Ki Ho Park ),오련 ( Ryan Oh ),지현숙 ( Hyun Sook Chi ),김양수 ( Yang Soo Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1S

결핵성 및 악성 흉막염에서 TNF-$\alpha$, TGF-$\beta$ 및 섬유소용해계의 역할

심태선,양성은,지현숙,김미정,정훈,제갈양진,임채만,이상도,고윤석,김우성,김동순,김원동,Shim, Tae-Sun,Yang, Sung-Eun,Chi, Hyun-Sook,Kim, Mi-Jung,Chung, Hun,JeGal, Yang-Jin,Lim, Chae-Man,Lee, Sang-Do,Koh, Youn-Suck,Kim, Woo-Sung,Kim, Dong-So 대한결핵및호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.49 No.2

서론 : 결핵성 흉막염은 치료후에도 약 50% 정도에서 흉막비후가 발생한다. 일부 연구에서 흉막액내 TNF-$\alpha$의 증가 및 섬유소융해의 장애등이 흉막비후의 원인으로 제시되었지만, 아직 흉막비후의 발생기전 또는 예측인자에 대하여는 잘 알려져 있지 않다. TGF-$\beta$는 섬유화를 촉진시키며 결핵성 흉막액에서 증가되어 있음이 보고되었다. 한편 결핵성 흉막염 및 악성 흉막염은 림프구 우세성 삼출액 소견을 나타내는 질환으로 감별진단이 중요하다. 본 연구자는 결핵성 흉막염과 악성 흉막염 환자를 대상으로 TNF-$\alpha$, TGF-$\beta$ 그리고 섬유소 융해계 인자들을 측정하여 양 군간에 비교하였고, 결핵성 흉막염에서 치료 후 흉막비후 발생의 예측인자를 찾고자하였다. 방법 : 1997년 2월부터 1999년 8월까지 서울중앙병원에서 결핵성 흉막염과 악성 흉막염으로 진단받고, 흉막액 검체가 보관되었던 각각 35명과 14명을 대상으로 하였다. 결핵성 흉막염은 모두 4제병용 1차 항결핵 치료를 시행하였다. 각 군에서 임상상을 비교하였고, 흉막액에서 일반 흉막액 검사를 시행하고, TNF-$\alpha$, TGF-$\beta$1, tPA, PAI-1, plasminogen, $\alpha$2-antiplasmin, 그리고 D-dimer를 측정하였다. 결핵성 흉막염 환자 중에서 치료를 종료한 30명을 대상으로 흉막비후가 2mm 미만인 군과 2mm 이상인 군으로 나누어 양 군간에 흉막액 검사소견 및 임상상을 비교하였다. 결과 : 결핵성 흉막염 환자에서 TNF-$\alpha$ tPA, PAI-1, plasminogen, $\alpha$2-antiplasmin, 그리고 D-dimer 모두 말초혈액보다 흉막액에서 증가되어 있었고, 악성 흉막액 환자에서는 plasminogen, $\alpha$2-antiplasmin, 그리고 D-dimer가 말초혈액보다 흉막액에서 증가되어 있었다. TNF-$\alpha$, TGF-$\beta$, PAI-1, plasminogen, 그리고 $\alpha$2-antiplasmin 는 악성 흉막액 보다 결핵성 흉막액에서 유의하게 증가되어 있었다. 항결핵치료 종료 후 2mm 이상의 흉막비후가 발생한 군과 발생하지 않은 군 사이에 TNF-$\alpha$, TGF-$\beta$ 그리고 섬유소융해계의 측정치들간의 차이는 발견할 수 없었다. 결론 : 결핵성 흉막염 환자의 흉막액 TNF-$\alpha$ TGF-$\beta$ 및 섬유소융해계가 흉막비후에 관여할 것으로 추측되었으나, 흉막비후 발생의 예측인자는 찾지 못하였다. 또한 양 질환의 감별에도 기존의 검사들에 비하여 추가적 유용성은 없었다. Background : Residual pleural thickening (RPT) develops in about 50% of tuberculous pleurisy ($PL_{TB}$). Some reports have suggested that elevated TNF-$\alpha$ and impaired fibrinolysis could be the cause of RPT, but until now, the mechanism and predictors of RPT have not been well known. TGF-$\beta$ has been known to promote fibrogenesis and is increased in tuberculous pleural fluid (PF). $PL_{TB}$ and malignant pleurisy ($PL_{MAL}$) manifest lymphocyte-dominant exudative pleural effusion, and it has clinical implications in the differentiation of the two diseases based on the findings of pleural effusion. We performed this study to compare pleural fluid TNF-$\alpha$ TGF-$\beta$, and fibrinolytic parameters between $PL_{TB}$ and $PL_{MAL}$, and to find the predictors of RPT in $PL_{TB}$. Methods : Thirty-five $PL_{TB}$ and 14 $PL_{MAL}$ patients who were admitted to the Asan Medical Center from February 1997 to August 1999 were enrolled. All $PL_{TB}$ patients were prescribed a primary, short-course, anti-tuberculosis regimen. INF-$\alpha$ tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), plasminogen, $\alpha$2-antiplasmin, and D-dimer were measured in both PF and PB. TGF-$\beta$was measured only in PF. Clinical characteristics, TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters were compared between patients with RPT less than 2 mm and patients with more than 2 mm of the thirty patients who completed the anti-tuberculosis treatment. Results : The levels of TNF-$\alpha$ tPA, PAI-1, plasminogen, $\alpha$2-antiplasmin, and D-dimer in PF were higher than those in peripheral blood (PB) in $PL_{TB}$, whereas only plasminogen, $\alpha$2-antiplasmin, and D-dimer were higher in PF than in PB in $PL_{MAL}$. Pleural fluid TNF-$\alpha$ TGF-$\beta$, PAI-1, plasminogen, $\alpha$2-antiplasmin were increased in $PL_{TB}$ compared with $PL_{MAL}$, but these factors did not show any further advantages over ADA in differentiation between $PL_{TB}$ and $PL_{MAL}$. TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters did not show any differences between patients with RPT less than 2 mm and patients with RPT more than 2 mm. Conclusion : Our data suggest that TNF-$\alpha$, TGF-$\beta$ and fibrinolytic parameters may play some role for the development of RPT in $PL_{TB}$, but they failed to predict the occurrence of RPT in $PL_{TB}$. Also these parameters did not seem to have any advantages over ADA in differentiating between two diseases.

결핵성 흉막염과 악성 흉수의 감별진단에 있어서 흉수 IFN-$\gamma$ 측정의 유용성

김명선,양성은,지현숙,김우성,김원동,Kim, Myung-Sun,Yang, Sung-Eun,Chi, Hyun-Sook,Kim, Woo-Sung,Kim, Won-Dong 대한결핵및호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.2

연구배경: 결핵성 흉막염과 악성 흉수는 임상증상, 징후와 흉수내 백혈구 세포조성, 생화학적 검사로 감별하기 어렵고 미생물학적 검사와 세포진 또는 조직검사에 의해서도 확실히 진단하기 어렵다. 이런 문제 때문에 최근들어 결핵성 흉막염을 interleukin-2 (IL-2), interferon-$\gamma$(IFN-$\gamma$), tumor necrosis factor-$\alpha$(TNF-$\alpha$) 같은 면역 매개물질들을 이용하여 진단하려는 시도들이 있어 왔다. 결핵균에 대한 면역반응으로 주로 $Th_1$ 세포에 의해 분비되는 IFN-$\gamma$는 결핵성 흉막염에서 제 1형 반응이 거의 일어나지 않는 악성 흉수 보다 휠씬 높게 측정되므로 흉수내 IFN-$\gamma$ 수치의 차를 이용하여 두 질환을 감별할 수 있다. 이에 저자들은 흉수 IFN-$\gamma$의 진단적 가치를 ADA, CEA와 비교하여 보고 한국인에서의 민감도와 특이도를 알아보았다. 방 법: 결핵성 흉막염 40예, 악성 흉수 42예를 대상으로 흉수의 세포 조성, 생화학 검사와 IFN-$\gamma$, ADA, CEA 수치를 측정하였다. 결 과: 흉수내 IFN-$\gamma$와 ADA는 결핵성 흉막염에서 악성 흉수 보다 유의하게 높았고, CEA는 악성 흉수에서 결핵성 흉막염보다 유의하게 높았다. 결핵성 흉막염에서 IFN-$\gamma$는 민감도 0.97, 특이도 1.0을 나타내었고 ADA는 만감도 0.87, 특이도 0.97을 나타내었다. 악성 흉수에서 CEA는 민감도 0.67, 특이도 1.0을 나타내었다. ADA 활성도와 IFN-$\gamma$ 수치 사이에는 유의한 상관관계가 없었다. 결 론: IFN-$\gamma$는 결핵성 흉막염과 악성 흉수 감별에 매우 예민하고 특이적인 양상을 보이기 때문에 경제적인 검사는 아니나 결핵성 흉막염의 진단에 유용한 검사방법으로 사용될 수 있을 것으로 사료되었다. Background: It is sometimes difficult to differentiate tuberculous pleural effusion from malignant pleural effusion by clinical symptoms, signs, by routine tests of pleural fluid, and by pathologic studies. And recently, it was discovered that cytokines such as IL-2, IFN-$\gamma$, TNF-$\alpha$ are elevated in tuberculous pleural fluid, and there have been several attempts to diagnose tuberculous pleural effusion by using these immunological mediators. There are several studies regarding the diagnostic value of IFN-$\gamma$, and there are two studies in Korea. But the diagnostic values of IFN-$\gamma$ in these studies were slightly lower than those in other countries. To compare the diagnostic value of IFN-$\gamma$ with those of CEA and ADA, and to determine the sensitivity and specificity of IFN-$\gamma$ in Korean, we mesured IFN-$\gamma$, CEA level and ADA activity in pleural effusions. Methods: ADA activity, IFN-$\gamma$ level and CEA level as well as cell count, differential count, and biochemical assays such as protein content and lactate dehydrogenase were measured in 40 cases of tuberculous pleuritis and 42 cases of malignant pleural effusion. Results: Tuberculous pleural fluid showed higher levels of IFN-$\gamma$ and ADA ($832.6{\pm}357.2$ pg/ml and $82.5{\pm}25.9$ U/L, respectively) than those of malignant pleural effusion ($2.6{\pm}8.0$ pg/ml and $19.2{\pm}10.9$ U/L, respectively) (p<0.01). Malignant pleural effusions showed higher median value (102.2 ng/ml) than tubercalous pleural effusions (1.8 ng/ml) (p<0.01). The sensitivities of IFN-$\gamma$, ADA, CEA were 0.97, 0.87, 0.67 and the specificities of IFN-$\gamma$, ADA, CEA were 1.0, 0.97, 1.0, respectively. There was no significant correlation between ADA activity and IFN-$\gamma$ level. Conclusion: This study showed that IFN-$\gamma$ test would be a very useful clinical test for differential diagnosis of tuberculous pleuritis and malignant pleural effusion because it is very sensitive and specific, although it is an expensive test.

원저 : 1986 년 여름철 경의의료원에서 분리된 Salmonella 균속에 관한 연구 ( Original Article : A Study on 39 Cases of Salmonella Species Isolated in Kyung Hee Medical Center )

서진태(Jin Tae Suh),지현숙(Hyun Sook Chi),이정국(Jung Kook Lee) 경희대학교 경희의료원 1987 慶熙醫學 Vol.3 No.1