만성 폐쇄성 폐질환 환자에서 최대 흡기 유속과 최대 자발성 환기량과의 상관관계

류헌모(Hon Mo Ryu),최희진(Hee Jin Choi),조영복(Young Bok Jo),김기범(Ki Beom Kim),정진홍(Jin Hong Chung),이관호(Kwan Ho Lee),이현우(Hyun Woo Lee) 대한내과학회 1996 대한내과학회지 Vol.50 No.4

N/A Objectives: The 12-s maximum voluntary ventilation(MVV) provides an estimate of the ventilatory reserves available to meet the physiologic demands of exercise. Earlier studies established a correlation between MVV and forced expiratory volume in one second(FEV1). We hypothesized that the resting maximum inspiratory flow rate(MIFR) may be a determinant of MVV and evaluated MIFR as a predictor varialbe for MVV and also examined some other formulas for calculation of indirect MVV. Methods: Between December 1992 and May 1993, a total of 111 subjects, 85men and 26 women(age 53±5 yr, mean±SD), with expiratory impairment categories of severe(n=22), moderate(n=20), mild(n=17) in patients with chronic obstructive pulmonary disease(COPD) and control (n=52) based on FEV1(percentage of predicted), enrolled the study samples. We measured FEV, MIFR and MVV by body plethysmograph in all subjects and examined the relation between FEV1 and MVV, MIFR and MVV and calculated indirect MVV using the stepwise method of forward multipul linear regression. I present r2 values, coefficients of determination, as measures of linear association for regression relationships. Results: 1) The MIFR correlated with MVV in normal control(p<0.05, r2-0.681) and patients with COPD (p<0.05, r2=0.682) better than FEV. 2) MIFR joined with FEV in multiple linear regression to significantly improve the description of MVV: normal control MVV(L/min) = 20,58FEV1 (L) + 7.11MIFR(L/s) + 49.90(n=52; p<0.05, r2= 0.8735), patients with COPD MVV(L/min) = 36.64FEV1(L) + 4.64MlFR(L/s) - 7.21(n=59; p<0.05, r2=0.7173). Conclusion: MIFR is a significant determinant of MVV in normal control and patients with COPD and also contributes to improuenent in accuracy of indirect estimates of MVV.

종격동내 혼합 생식 세포종과 폐전이를 동반한 혈관육종이 동시에 존재한 중복암

류헌모 ( Hon Mo Ryu ),최희진 ( Hee Jin Choi ),신경철 ( Ghung Cheul Shin ),정진홍 ( Jin Hong Chung ),이관호 ( Kuan Ho Lee ),이현우 ( Hyen Woo Lee ),이동혁 ( Dong Hyunp Lee ),이정철 ( Jung Cheul Lee ),한승세 ( Sung Sae Han ),심영란 대한결핵 및 호흡기학회 1994 Tuberculosis and Respiratory Diseases Vol.41 No.4

늑막삼출환자에서 늑막액 Cholesterol 농도와 늑막액 / 혈청 Cholesterol 비의 진단적 의의

김성숙(Seong Suk Kim),신경철(Kyeong Cheol Shin),최희진(Hee Jin Choi),류헌모(Hon Mo Ryu),서정일(Jeong Ill Suh),임종식(Jong Sik Lim),이재성(Jae Seong Lee),정진홍(Jin Hong Chung),이관호(Kwan Ho Lee),이현우(Hyun Woo Lee) 대한내과학회 1994 대한내과학회지 Vol.46 No.3

N/A Objectives: To validate the use of pleural cholesterol and the pleural cholesterol/serum cholesterol ratio (P-/S-CHOL) for differentiating between transudates and exudates in pleural effusion of diverse etiology and to compare the diagnostic efficacy of these parameters with those of Light criteria. Methods: Between September 1991 and June 1992, 118 patients with pleural effusion were studied. We measured pleural protein/serum protein ratio, pleural LDH, pleural LDH/serum LDH ratio, pleural cholesterol and pleural cholesterol/serum cholesterol ratio. Mean values of the parameters in transudates group and exudates group were compared, and the misclassification rate and the diagnostic efficacy for each parameters were calculated. Results: 1) The pleural cholesterol (P-CHOL) values were 21.88±8.86rng/dl for transudates, 86.38±30.09mg/dl for tuberculous exudates, 76.96±18.63 mg/dl for neoplastic exudates, and 85±24.69mg/dl for the parapneumonic effusion group (p<0.001 in tuberculous and neoplastic exudates, p<0.05 in parapneumonic effusion group). And the pleural cholesterol/serum cholesterol ratio (P-/S-CHOL) were 0.17±0.07 for transudates, 0.64±0.16 for tuberculous exudates, 0.52±0.16 for neoplastic exudates, and 0.68±0.17 for the parapneumonic effusion group (p<0.001). 2) Misclassification rates for each parameters in seperating the exudate group from the transudate group were as follows; pleural protein/serum protein ratio (P-/S-PROT) 1 69%, P-/S CHOL 2.54%, P-CHOL 3.38%, pleural LDH (P-LDH) 4.23%, pleura LDH/serum LDH ratio (P-/S-LDH) 4.23%. 3) With a cut-off value of 50mg/dl, P-CHOL had a sensitivity of 96% and a specificity of 10096 for diagnosis of exudates, and with a cut-off value of 0.3, P-/S-CHOL had a sensitivity of 98% and a specificity of 94%. 4) Diagnostic efficiencies for each parameters in seperating the exudate group from transudate group were as follow; P-/S-PROT 98%, P-/S-CHOL 97%, P-CHOL 96%, P-LDH 95%, and P-/S-LDH 95%. 5) In the exudate group, pleural cholesterol was significantly correlated with serum cholesterol (r=0.5S84, p<0.001) and the pleural LDL/Cholesterol ratio was significantly correlated with the serum LDL/Cholesterol ratio (r=0.4408, p<0.001). Conclusion: we think that measurements of P-CHOL and P-/S-CHOL is of great value for distinguishing between pleural exudates and transudates, and high P-CHOL and P-/S-CHOL values appear to be related to increased permeability of pleural capillaries. Therefore, we suggest that determination of these parameters should be included in routine laboratory analysis of pleural effusions.

폐 침윤을 동반한 특발성 과호산구 증후군 1례

류헌모,권영수,정진홍,이관호,이현우,김동석,이삼범 영남대학교의과대학 1994 Yeungnam University Journal of Medicine Vol.11 No.2

저자들은 말초 혈액에서 현저한 호산구 증가를 보이면서 간, 임파선, 골수 및 폐에 호산구 침윤을 보여 hydroxyurea로 치료한 특발성 과호산구 증후군 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The idiopathic hyperecoinophilic syndrome consists of peripheral blood eosinophilia of 1500/㎣ or more without a known cause, plus signs and symptoms of organ eosinophilia. The prognosis of HES without treatment is poor. However, about one third of the patients with this syndrome may respond to corticosteroid thrapy. Morever, the majority of the remainder may have a favorable response to hydroxyurea. We present here a case of hypereosinophilic syndrome without any identifiable causes, involving bone marrow, liver, lungs and cervical lymph node. We tried corticosteroid as a treatment but it showed on response. However the hydroxyurea showed good response.

양 클론성 감마글로불린장애(Biclonal Gammopathy)를 보이는 다발성 골수종 1례

최재혁,오현아,이구,이상엽,김병덕,류헌모,이경희,현명수 大韓血液學會 2000 大韓血液學會誌 Vol.35 No.3

말초혈액 조혈모세포 채집 시기를 결정하기 위한 예측지표의 평가

김병덕,이은영,정항재,최재혁,이상엽,류헌모,이경희,현명수 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.1

연구배경: 자가 말초혈액 조혈모세포 이식술은 다양한 혈액질환과 항암 화학요법에 반응하는 고형종양의 치료에 있어 고용량의 화학요법 후 골수기능 재건에 종전의 골수 조혈모세표의 대체원으로 광범위하게 사용되고 있다. 그러나 자가 말초혈액 조혈모세포 이식술은 말초혈액 내로 조혈모세포가 최대한 가동화된 시기를 포착하여 최소의 백혈구분반술로 최대의 조혈모세포를 채집하는 것이 필수적이다. 본 연구자는 본원에서 혈액종양과 고형종양으로 자가 말초혈액 조혈모세포 이식술을 시행하기 위해 백혈구분반술을 시행한 환자를 대상으로 채집직전에 말초혈액에서 CD34^(+) 세포 수, 단핵구 수, 백혈구 수를 측정하고 채집된 조혈모세포 부유액 내의 CD34^(+) 세포수와 CFU-GM치 등과의 상관관계를 비교 분석함으로써 조혈모세포의 가동화 시기를 가장 정확히 예측하여 백혈구분반술 시행의 최적 시기를 예측할 수 있는 지표를 찾고자 하였다. 방법: 영남대학병원 내과에 입원하여 자가 말초혈액 조혈모세포이식술을 시행할 예정인 환자 12명을 대상으로 조사하였다. 본연구에서는 말초혈액의 백혈구수가 1-2×10^(6)/kg 이상으로 갑자기 증가하는 시기를 택하여 백혈구분반술을 시행하였고, 매일 한번씩 8-12L의 전혈(평균10 L)을 처리하여 성공적인 말초 조혈모 세포 이식에 필요한 최소한의 CD34^(+) 세포수로 알려진 2-5×10^(6)/kg 이상으로 CD34^(+)세포가 채집될때까지 12명의 환자를 대상으로 총 55회의 백혈구 분반술을 시행하였다. 말초혈액의 백혈구 수, 단핵구 수, CD34^(+) 세포 수를 측정하여 채집된 조혈모세포 부유액 내의 CD34^(+) 세포수 혹은 CFU-GM 집락수와의 상관관계를 SPSS (SPSS, USA)를 사용하여 Pearson 상관계수로 처리하여 말초조혈모세포 채집시기 결정의 예측인자로서의 의미를 조사하였다. 결과: 총 12audd의 환자를 대상으로 환자당 2-6(평균 4.58회), 총 55예의 백혈구분반술을 시행하였고 백혈구분반술 1회당 평균 0.88±0.65×10^(6)/kg의 CD34^(+) 세포, 1.03±1.02×10^(8)/kg의 단핵구, 그리고 0.63±0.62×10⁴/kg의 CFU-GM을 얻을수 있었다. 말초혈액의 여러 지표 가운데 백혈구분반술 당일의 말초혈액 CD34^(+) 세포수(n=29)와 백혈구 수(n=55)가 조혈모세포 부유액내의 CD34^(+) 세포수와 통계학적으로 유의한 상관관계(r=0.433 and r=0.275, respectively)를 나타내었고, 말초혈액의 단핵구 수는 통계적으로 유의한 상관관계가 관찰되지 않았다. 결론: 말초혈액 조혈모세포 채집시기를 결정을 위한 여러 예측인자 중에서 말초혈액의 CD34^(+) 세포 수 측정이 조혈모세포의 가동화를 예측할수 있는 가장 좋은 검사 방법으로 판단되었으나 기준이 되는 CD34^(+) 세포의 절대수 결정을 위해서는 더 많은 환자를 대상으로 연구가 필요할 것으로 생각된다. Background: Peripheral blood stem cell transplantation (PBSCT) has been widely used as a substitute of bone marrow transplantation in treatment of various hematologic disorders and solid tumors. To obtain enough peripheral blood stem cells (PBSC), ensuring successful transplantation with the least number of leukapheresis procedure, the optimal time for collection must be predicted as accurately as possible. We analyzed our experiences of PBSC collections and evaluated the peripheral blood parameters that may predict the PBSC yields. Methods: The study comprised 12 patients undergoing varied mobilization regimens with chemotherapy and G-CSF/GM-CSF for both soild tumors and haematological maligncies. Fifty- five PBSC harvests were collected. Full blood counts and CD34^(+) cell enumeration were performed assayed for full blood samples taken immediately prior to leukapheresis. All PBSC collections were number of CD34^(+) cells collected a single leukapheresis harvest were evaluated. Results: The white blood cell count on the day of harvest showed only weak correlation (r=0.27, p=0.04) with the total number of CD34^(+) cells more strongly correlated with CD34^(+) cells of corresponding apheresis product (r=0.44, p=0.01) Conclusion: Monitoring the circulating CD34^(+) cells in peripheral blood samples during a patient's mobilization regimen is a very useful predictor of when to collect PBSC to provide an adequate harvest of successful engraftment. But, because the CD34^(+) cell enumeration is not a standardized test between laboratories, it is important to evaluate the absolute level of peripheral blood CD34^(+) cells that predicts when to perform the leukapheresis.