류마티스 관절염 환자의 활액과 활막조직에서의 IL - 6 의 활성도

조석구(Seok Goo CHo),이상헌(Sang Heon Lee),홍연식(Yeon Sik Hong),조철수(Chul Soo Cho),박석영(Seok Young Park),박동준(Dong Jun Park),김호연(Ho Youn Kim),이정용(Jung Young Lee),김상호(Sang Ho Kim),변광호(Kwang Ho Pyun) 대한내과학회 1993 대한내과학회지 Vol.45 No.2

N/A Background: Interleukin-6 (IL-6), previously known as B cell stimulatory factor 2 (BSF-2) is a multifunctional cytokine that is produced by a various cells and plays an important role in the host defence mechanism such as regulation of immune response, acute phase reaction and hematopoiesis. Recent investigations have demonstrated that unregulated expression of IL-6 gene and overproducion of lL-6 were involved in the pathogenesis of cardiac myxoma, Castleman's disease, autoimmune disease, proliferative glomerulonephritis and certain lymphoid malignancies, especially plasmacytoma/multiple myelomas. We tried to evaluate the regulatory effect of IL 6 an the pathogenesis of rheumatoid arthritis (RA) which is characterized by hyperactivation of 8 cells, presence of various autoantibodies and increase in acute phase proteins and platelets. Methods: The IL-6 activity was measured by bioassay using the murine IL-6 dependent hybridoma cell lines (MH60. BSF2), ELISA method and immunohistochemical analysis. Results: 1) IL-6 activity was significantly elevated m synovial fluid from patients with rheumatoid arthritis (RA, n= 25) as compared with osteoarthrits (OA, n=6) and seronegative arthritis (SNA, n=4) (p<0.05). 2) IL-6 activity was also elevated in serum from patients with RA as compared with other disease (P <0.01). 3) High IL-6 activity and destructive changes in affected joints had a tendency to be correlated (r=0.716), And positive correlations between IL-6 activity and C-reactive proteins in serum were observed in patients with RA (r=0.752). 4) Immunohistachemical analysis demonstrated that positive-staining cells were located on the perivascular space. Conclusion: The results suggest that unregulated production of IL-6 may play an important role in the pathogenesis of RA and could explain local as well as generalized symptoms of RA. However, it is not known whether excessive production of IL-6 is a primary event in the disease process, or secondary consequence.

종설 : 단클론성 항체를 활용한 B 세포 악성 림프종 치료의 신기원: 리툭시맙

조석구 ( Seok Goo Cho ) 대한내과학회 2006 대한내과학회지 Vol.71 No.2

Phenytoin에 의한 항경련제 과민증후군의 스테로이드 치험증례

김영옥,서정필,김은일,조석구,이창돈,이종육,유도성,김달수,Kim, Young-Ok,Suh, Jung-Pil,Kim, Eun-Il,Cho, Seok-Goo,Lee, Chang-Don,Yi, Jong-Yuk,Yoo, Do-Sung,Kim, Dal-Soo 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.12

Anticonvulsant hypersensitivity syndrome is a rare but fatal complication. It manifests as fever, skin rash, lymphadenopathy, and hepatitis. Phenytoin, phenobarbital, and carbamazepine are the most frequently involved drugs. We here report a case of phenytoin-induced anticonvulsant hypersensitivity syndrome. A 37-year-old woman presented with fever and generalized skin rash, 3 weeks following commencement of phenytoin 400mg daily for treatment of seizure after superficial temporal artery-middle cerebral artery(STA-MCA) anastomosis for moyamoya disease. Her temperature was $39.3^{\circ}C$ and her face was edematous. Laboratory findings showed elevated hepatic enzymes and eosinophilia. Blood and urine culture were all negative. Initially, prednisolone was commenced at 30 mg daily. But fever and skin rash did not improved and hepatic function was more aggravated. After increasing dose of steroid(methylprednisolone 125mg/day), fever and skin rash disappeared and hepatic enzymes returned to normal range.

통증 관리에 대한 의사와 간호사의 지식과 태도 비교

이은옥,허대석,김순자,김열홍,윤성수,권인각,조석구,박명희,박정윤,Lee, Eun-Ok,Heo, Dae-Seok,Kim, Soon-Ja,Kim, Yeul-Hong,Yoon, Sung-Soo,Kwon, In-Gak,Cho, Seok-Goo,Park, Myung-Hee,Park, Jung-Yoon 한국호스피스완화의료학회 1999 한국호스피스.완화의료학회지 Vol.2 No.1

목적 : 암환자에게 있어 통증은 삶의 질을 좌우하는 가장 중요한 증상이다. 현재의 통증 치료 방법 즉, 적절한 약물 치료 방사선, 마취, 신경차단 등의 방법으로 97%정도가 통증 조절이 가능함에도 불구하고, 여러 국내외 문헌에서는 암환자의 $60{\sim}70%$가 통증을 호소하고 있음을 보고하고 있다. 이에 이 연구에서는 의료진 측면에서 적절한 통증 치료의 장애가 되는 요인을 찾고, 진통제 및 암환자의 통증에 대한 잘못된 인식과 편견을 파악하여 보다 효과적인 교육프로그램을 개발하는 기초 조사를 마련하고자 한다. 방법 : 1998년 5월 1일부터 5월 31일까지 한달 동안 서울 시내에 있는 네개의 종합병원 내과에서 근무하고 있는 의사와 간호사를 대상으로 통증 관리에 대한 지식과 태도에 관한 도구를 수정한 32개 문항의 설문지를 통해 조사하였다. 설문의 내용은 통증 사정이 6문항, 진통제 투약이 5문항, 진통제 약물 작용이 8문항, 진통제 분류가 11문항, 그리고 진통제 투약 태도 2문항으로 이루어졌다. 결과 : 의사가 99명, 간호사가 152명이 참여하였으며, 전체 정답율은 의사가 71.6%, 간호사가 70.3%였다. 그러나, 그 중 진통제 분류에서는 80% 이상의 정답율을 보였으나 나머지에서는 대부분 $50{\sim}60%$정도의 정답율을 보이면서 통증 관리에 대한 낮은 지식 정도를 보여 주었다. 통증 사정에서는 간호사의 지식이 유의하게 높았으며, 진통제의 약리작용과 진통제 분류에서는 의사의 지식이 유의하게 높았다. 그러나, 전체 통증 관리에 대한 지식과 태도에 있어 의사 평균이 21.40이었으며, 간호사의 평균은 20.87로서 유의한 차이를 보이지 않았다. 결론 : 암환자 통증 관리에 대해 의료진의 지식 정도이 부족함이 나타났고, 이에 대한 적극적인 대안으로 의사와 간호사를 위한 교육프로그램 개발과 교육이 절실히 필요한데 일시적이고 일회적인 교육보다는 지속적이고 장기적이고 자동적으로 운영되는 체계가 필요하다. This survey was designed to evaluate knowledge and attitudes of physicians and nurses toward cancer pain management in South Korea and to compare physicians' knowledge and attitudes with nurses' Ninety-nine physicians and 152 nurses working at four major institutions in South Korea were included for the study. With the 30 items of the knowledge with true and false answers about cancer pain such as pain assessment(6 items), pharmacokinetics of opioids(8 items), analgesics classification(11 items), and drug administration(5 items), total score of knowledge answered by physicians was 21.40, which was not significantly higher than 20.87 answered by nurses. Rates of the correct answer were more than 70% in both physicians and nurses. Physicians were more knowledgeable in pharmacokinetics and analgesics classification than nurses, while nurses higher only in pain assessment than physicians. Since physicians and nurses could not effectively manage the cancer pain because of inappropriate knowledge, it is important to provide intensive education to physicians and nurses about cancer pain management.

쯔쯔가무시병 환자에서 질환의 중증도의 표지자로서의 저알부민혈증의 임상적 의의

김영옥(Young Ok Kim),전희경(Hee Kyung Jeon),조석구(Seok Goo Cho),윤선애(Sun Ae Yoon),손현식(Hyun Sik Son),오수혁(Soo Hyuk Oh),채현석(Hyun Suk Chae),김관형(Kwan Hyoung Kim),채장성(Jang Seong Chae),이창돈(Chang Don Lee),이봉수(Bong Soo 대한내과학회 2000 대한내과학회지 Vol.59 No.5

N/A Background : Although hypoalbuminemia is common in patients with tsutsugamushi disease, acute rickettsial infectious disease, its impact on the severity of disease is not reported. Therefore, we studied the role of hypoalbumiemia as a marker of the severity of disease in patients with tsutsugamushi disease. Methods : We retrospectively reviewed clinical data of 95 patients with tsutsugamushi disease who were admitted between January 1994 and December 1999 at Uijongbu St. Mary's hospital. We compared clinical and laboratory findings, complications, and mortality between hypoalbuminemic group (serum albumin < 3.0 g/dL) and control (serum albumin ≥ 3.0 g/dL). Results : Of the total 95 patients, 50 patients (52.6%) had hypoalbuminemia. In hypoalbuminemic group, the incidence of hypotension was higher (20.0% vs 2.2%, p=0.006) and the duration of admission was longer (12.0±4.5 vs 8.8±2.7 days, p<0.001), compared to control. The degree of thrombocytopenia in hypoalbuminemic group was severer than that in control (84,000±46,000 vs 138,000±75,000/mm3, p<0.001). Hypoalbuminemic group showed higher incidence of interstitial pneumonia (64.0 vs 13.3%, p<0.001), hypoxia (40.0 vs 6.6%, p<0.001), metabolic acidosis (12.0 vs 0%, p=0.018), and acute renal failure (18.0 vs 4,4%, p=0.038), compared to control. Four patients who had hypoalbuminemia died due to septic shock and multiorgan failure. Conclusion : This study shows that hypoalbuminemia could be used as a marker of the severity of disease in patients with tsutsugamushi disease.(Korean J Med 59:516-521, 2000)

골수이형성증 환자에서 발생한 베체트병

민정아 ( Jung Ah Min ),김정은 ( Jung Eun Kim ),오신택 ( Shin Taek Oh ),조석구 ( Seok Goo Cho ),조백기 ( Baik Kee Cho ),박현정 ( Hyun Jeong Park ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.11

Behcet`s disease (BD) is a multisystemic inflammatory disease that affects various organs and it causes mucocutaneous lesions. BD is only rarely associated with leukemia or other hematologic disorders. Many cases of BD associated with myelodysplastic syndrome (MDS) have recently been reported and these cases are mainly in East Asia and the Mediterranean. We herein report on a case of a 34-year-old man who developed Behcet`s disease 8 years after the onset of MDS. He had two, firm, subcutaneous nodules on both shin and recurrent oral ulcer for 2 months. He also had a retinal vasculitis. Skin biopsy from the left shin showed the septal panniculitis, which was consistent with erythema nodosum. He had multiple ileal ulcers observed on the colonoscopy exam, so he was diagnosed with intestinal Behcet`s disease. Yet the chromosomal analysis revealed nonspecific abnormality and not trisomy 8. This is the first reported case of intestinal Behcet`s disease associated with MDS in the Korean dermatologic literature. (Korean J Dermatol 2009;47(11):1309~1313)

악성 림프종 환자에서 BEAM 고용량화학요법과 자가조혈모세포이식

박진노(Jin No Park),홍영선(Young Seon Hong),송치원(Chee Won Song),조석구(Seok Goo Cho),이종욱(Jong Wook Lee),민우성(Woo Sung Min),김춘추(Chun Choo Kim),이경식(Kyung Shick Lee) 대한내과학회 2001 대한내과학회지 Vol.61 No.3

N/A Background : The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, the outcome of patients undergoing high-dose chemotherapy and autologous peripheral stem cell transplantation (APBSCT) was evaluated, and the main prognostic factors were determined. Methods : 17 patients with relapsed or resistant NHL (5 complete response group, 7 partial response group, 4 primary refractory group, 1 resistant relapse) underwent BEAM (carmustine, etoposide, cytarabine, melphalan) chemotherapy and APBSCT between July 1997 and February 1999. Results : The median follow-up duration was 17 months (range: 4-47). The response rate was 58.3% (complete response 33.3%, partial response 25.0%) in 12 patients in whom complete response group was not included. The 2-year, 3-year overall response rate were 41.2%, 27.5%, respectively. And 2-year progression free survival was 35.3%. The disease status before high-dose chemotherapy was the only significant prognostic factor in determining overall survival (univariate p=.024, multivariate p=.059) and progression free survival (univariate p=.013, multivariate p=.026). Patients with complete response to salvage regimen had better overall survival (p=.021) and progression free survival (p=.008) than patients with refractory response. WBC (≥ 1,000/uL) was recovered at the median 11 days (range; 8-24), and platelet (≥ 50,000/uL) was recovered at the median 18 days (range; 9-44). There was no treatment-related death and no grade 3 and 4 toxicity. Neutropenic infection was in 4 patients (1 Herpes zoster, 1 typhlitis, 1 perianal infection, 1 otitis externa). Conclusion : The pre-transplant disease status was the main prognostic factor. Patients with complete response to salvage regimen had the significant benefit in survival from high-dose chemotherapy and APBSCT, but patients with refractory or resistant relapsed NHL did not have any significant benefit.(Korean J Med 61:255-263, 2001)

재발 및 불응성 비호즈킨 림프종 환자의 치료에서 IVAM ( Ifosfamide , VP-16 , Ara-C , Methotrexate ) 복합화학요법의 치료 효과

송치원(Chi Won Song),박진노(Jin No Park),조석구(Seok Goo Cho),이종욱(Jong Wook Lee),홍영선(Young Seon Hong),민우성(Woo Sung Min),김춘추(Chun Choo Kim),이경식(Kyung Shick Lee) 대한내과학회 2001 대한내과학회지 Vol.61 No.2

N/A Background : Patients with non-Hodgkin's lymphoma who do not respond to first-line chemotherapy or those who relapse after obtaining a complete response have a poor prognosis and are rarely cured with usual salvage chemotherapy. We investigated the treatment responses, toxicities, prognostic factors and mobilization efficacy of peripheral blood stem cells (PBSC) used as salvage chemotherapy. Methods : 55 patients with refractory (36) or relapsed (19) NHL were treated from Novembr 1997 to October 1999 with IVAM (ifosfamide, etoposide, cytarabine, methotrexate) regimen. Each patients was scheduled to receive one to three cycles of chemotherapy. When the leukocyte count reached 5×109/L after chemotherapy, PBSC collection was performed. The treatment was repeated every 4 weeks. Results : The median age was 48 years (range, 19-76). Median 2.1 cycles of chemotherapy were administered. 15 patients (27.3%) achieved complete response and 29 (52.7%) partial response, with an overall response rate of 80.0%. Myelosuppression was the major toxicity, with 98.2% of grade 3, 4 neutropenia and thrombocytopenia, but there was no serious hemorragic event. Neutropenic fever occurred in 25.5% of the patients with one treatment-related death due to sepsis. Non-hematologic toxicity was modest. PBSC was collected in 36 patients for high dose chemotherapy and autologous stem cell transplantation. The median number of mononuclear cells collected was 9.9×108/kg and the median number of CD34(+) cells collected was 11.9×106/kg. After a median follow-up of 13 months (range, 3-26), median progression free survival were 12 months and median overall survival has not been reached yet. 1-year overall survival and progression free survival were 61.9% and 46.1%, respectively. In univariate analyses, unfavorable prognosis was associated with poor performance status (p=0.001), high LDH (p=0.041), stage III,IV (p=0.04), extralymphatic lesion (p=0.027), B sx (p=0.034), bone marrow involvement (p=0.039) and performing high dose chemotherapy (p=0.005). Multivariate analysis showed that performance status(p=0.0042), B sx(p=0.049) was a significant independent risk factors for death. Conclusion : These results suggest that IVAM is an effective salvage chemotherapy for refractory or relapsed NHL and allow effective PBSC collection for high dose chemotherapy and autologous PBSCT.(Korean J Med 61:141-150, 2001)

혈소판증다증 환자에서 급성신우신염 발병 후 동반된 대동맥궁 혈전증

김계월 ( Kye Weol Kim ),김영옥 ( Young Ok Kim ),김민국 ( Min Kuk Kim ),유승희 ( Seung Hee Yoo ),김영수 ( Young Soo Kim ),송선화 ( Sun Wha Song ),노상영 ( Sang Young Roh ),조석구 ( Seok Goo Cho ),윤선애 ( Sun Ae Yoon ),장윤식 ( Yoo 대한신장학회 2005 Kidney Research and Clinical Practice Vol.24 No.6

말초혈액조혈모세포에 의한 동종골수이식후 불안정 생착의 극복

조석구,정익주,김유진,김동욱,한치화,민우성,김춘추,김동집 한국BRM학회 1996 한국 BRM학회지 Vol.6 No.1