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      • SCOPUSKCI등재

        만성 C 형 간염 환자에서 인터페론치료에 의한 갑상선질환의 발생

        김민대(Min Dae Kim),전익수(Ik Soo jeon),강승수(Seung Su Kang),엄재섭(Jae Sup Eum),손호성(Ho Seung Son),박현용(Hyung Lyong Park),윤병철(Byung Cheol Yun),이상욱(Sang Uk Lee),한병훈(Byung Hoon Han) 대한소화기학회 2001 대한소화기학회지 Vol.37 No.6

        Background/Aims: It has been suggested that hepatitis C virus is associated with the autoimmune disease and interferon also induces hepatic and non-hepatic autoimmune reaction. We conducted this study to assess the effect of interferon-alpha (INF-α) on the induction of thyroid autoantibodies and clinical thyroid disease and to know whether the thyroid autoantibodies affect the IFN-α efficacy in patients with chronic hepatitis C. Methods: Twenty-nine patients with chronic hepatitis C were enrolled. Anti-thyroglobulin antibody (ATA), anti-microsomal antibody (AMsA), thyroid stimulating hormone and free thyroxine were measured before, during, and after IFN-α therapy. Results: Two of the 29 patients (6.5%) were positive for ATA and AMsA before IFN-α therapy. Of these two patients, one patient was a woman, who showed hyperthyroidism druing IFN-α therapy. Of the 27 patients who had been negative for ATA and AMsA, one female patient became ATA positive with the development of hyperthyroidism, and 3 male patients became AMsA positive during IFN-α therapy. There was no difference in the efficacy of INF-α therapy between the thyroid autoantibody positive and negative groups. Conclusions: IFN-α therapy induced thyroid disease with high prevalence in the patients with chronic hepatis C. Thus, thyroid status should be checked even in patients without thyroid autoantibodies, especially in woman. Antithyroid autoantibodies seem unlikely to affect the efficacy of IFN-α therapy. (Korean J Gastroenterol 2001;37:436-442)

      • 한국형 인공심장에 대한 동물실험(AnyHeart™)

        선경,손호성,이성호,신재승,이혜원,김승철,원용순,이경갑,정종태,김종원,노양래,이혁수,민병구 제주대학교 인공심장이식연구소 2001 인공심장 연구 Vol.2 No.2

        말기심부전증의 새로운 치료대안으로 제시되는 한국형 인공심장(AnyHeartTM)의 효용성과 안정성을 평가하기 위하여 동물실험을 실시하였다. 지난 2년간 고려대학교 안암병원과 제주대학교 동물병원에서는 총 28마리(송아지 18, 면양 4, 실험견 3, 말 2, 산양 1마리)의 다양한 동물에서 한국형 인공심장 이식실험이 실시되었으며, 좌심보조장치로 적용한 1예와 체외휴대형으로 적용한 각 1예를 제외하고 모두 심장보존형 인공심장(이식형 양심보조장치)의 형태로 완전 이식하였다. 수술방법은 주로 우측개흉법을 (Korea University Technique)을 사용하였다. 펌프 박출량은 최대 6 L/min로 평균 3-3.5 L/min를 유지되었으며, Fitting test 4례와 초기 적응과정의 2마리를 제외하고 모두 수술에서 회복되었다. 최장 관찰기간은 37일로 합병증 없이 건강한 상태에서 기초자료 확보를 위해 관찰을 임의종료하였다. 모든 생존동물에서 기계장치와 관련된 부작용은 발견되지 않았고, 임상적으로 나타나는 혈전전색 소견이나 간기능, 신기능, plasma hemoglobin, fibrinogen 등에 이상은 없었다. 적절하게 조기부검이 이루어진 경우에는 인공심장 내부에 혈전이 발견되지 않았고, 간/콩팥/비장 등의 중요장기에 병리검사에서도 전색소견은 발견되지 않았다. 결론으로, 한국형 인공심장은 생체 내에 이식하였을 때 안정적이며 기능이 우수한 것을 알 수 있었다. 한국형 인공심장은 현 상태에서 임상에 적용할 수 있다고 판단되며, 가까운 시일 내에 인체 내 안정성와 유효성에 대한 평가가 가능할 것으로 기대한다. Korean artificial heart (AnyHeartTM) is a new vision in the management of end stage heart failure. We performed the animal experiments to evaluate the performance and safety of AnyHeart. For last 2 years, 28 various animals (cattle 18, sheep 4, canine 3, goat 1) underwent AnyHeart implantation at Korea University Medical Center and Cheju University Animal Hospital. AnyHeart was applied as an implantable BVAD except a case of implantable LVAD or wearable BVAD. A standard technique of implantation was a right thoracotomy approach (Korea University Technique). The pump output was 6 L/min in maximum and 3-3.5 L/min in average. Other than 4 cases of fitting tests and 2 in the early learning period, all animals were recovered from the operation. The longest observation was made until 37th postoperative day, and the observation was terminated to get a control data while the animal was healthy without complications. All survivors were free from device-related morbidity, and there were no evidence of clinically significant thromboembolic episode, liver functions, renla function, plasma hemoglobin, fibrinogen abnormalities. Appropriate autopsy did not show thrombus in the device or embolism in the organs. Conclusively, AnyHeart has been proved efficient and safe during in-vive implantation. The authors believe that AnyHeart can be applied to clinical situations at the moment and expect to perform a clinical trial to test safety and efficacy in the human body within near future.

      • 이중박동펌프를 이용한 체외생명구조장치의 효과

        백광제,김준식,선경,손호성,기웅,한승백,민병구 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4

        Purpose: The purpose of this study was to observe and compare the changes in the patterns of hemodynamic and blood profiles on the circuit of Extra-corporeal life support system (ECLS) by using a dual pulsatile pump (T-PLS). Methods: An acute heart failure model using partial pulmonary artery banding was constructed in 12 piglets (20-25 ㎏). The animals were divided into centrifugal (n=6) and dual pulsatile pump (n=6) group. Each animal was placed on an ECLS system with a membrane oxygenator bypassing the right atrium and the aorta for 2 hours under general anesthesia. The parameters mainly observed were intra-circuit pressure changes, arterial pulsatility (pulse pressure), plasma free hemoglobin, hemodynamic changes, and other blood profiles. The parameters obtained just prior to the bypass wee compared with the corresponding parameters obtained two hours after the bypass. Results: Before bypass, the parameters were statistically the same between the groups. Two hours after the bypass, no significant differences were observed between the groups in ABGA, VBGA,, AST/ALT, BUN/Cr, and electrolytes; the plasma free hemoglobin was 14.8±4.7 g/dl in the dual pulsatile group and 19.1±9.1 g/dl in the centrifugal group (p=NS). The pulse pressure was higher in the dual pulsatile pump than in the centrifugal pump group (35±8 vs. 11±7 mmHg, p=0.0253 mmHg). The highest circuit pressure was generated at the inlet of the membrane oxygenator and was higher in the dual pulsatile group than in the centrifugal group (173±12 mmHg vs. 222±8 mmHg, p=0.0000). Conclusion: The results demonstrate that a dual pulsating mechanism lessens blood cell trauma while providing physiologic pulsatile blood flow. The ECLS system using a dual pulsatile pump (T-PLS) can be useed as an effective and safe driving motor for an ECLS.

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