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민도준,양동원,민창기,김완욱,이상헌,박성환,김동욱,이종욱,조철수,민우성,김범생,김호연,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1
배경: 기존의 치료에 불응하고 예후가 불량한 자가면역질환 환자들에게 최근 고용량 면역억제 및 조혈모 세포이식이 새로운 치료방법으로 대두되고 있다. 저자들은 다발성 경화증(multiple sclerosis, MS) 및 류마티스 관절염(rheumatoid arthritis, RA) 등 2명의 자가면역질환 환자들에서 자가조혈모세포 이식을 시행하였다. 방법: 말초혈액 조혈모세포 가동화를 위하여 cyclophosphamide (4 g/㎡) 및 granulocyte colony stimulating factor (10 g/kg/day)를 투여하였고, CD34+ 세포를 분리·채집 하였다, 이식 전처치로 MS 환자에서 BEAM 및 antihymocyte globulin (ATG) (3.75 mg/kg), RA 환자에서 fludarabine (180 mg/㎡), ATG (10 mg/kg)와 busulfan (8 mg/kg)을 투여하였다. 결과: 호중구 수가 500/㎕ 이상으로 회복되는 기간은 MS 환자에서 9일, RA 환자에서 15일이었다. 혈소판이 20.000/㎕ 이상으로 회복되는 가간은 RA 환자에서 9일 이었고, MS 환자에서는 혈소판 감소증이 발생하지 않았다. 비혈액학적 독성으로 MS 환자에서 WHO 1도의 오심 및 점막염이 관찰되었다. MS 환자는 이식 6개월 후까지 시력감소가 남아있었으나, 이식전에 관찰되던 감각이상 및 운동장애 등의 신경학적 이상 소견은 더 이상 관찰되지 않았다. RA 환자는 이식 1개월 후 관절 증상 및 검사소견의 호전을 보였다. 결론: 불응성 자가면역질환 환자에서 고용량 면역억제 및 조혈모세포이식은 적은 독성으로 높은 치료효과를 기대할수 있으며, 향후 이 시술의 임상적 의의를 규명하기 위하여 전향적이고 장기적인 연구가 필요할 것으로 사료된다. Background: High-dose immunosuppressive therapy followed by autologous hemathpoietic stem cell transplantation (HSCT) has been proposed as a new approach to treat severe, refractory autoimmune diseases. We describe two patients with refractory autoimmune diseases (one multiple sclerosis 〔MS〕and one rheumatoid arthritis〔RA〕) who underwent T-cell-depleted autologous peripheral bleed stem cell transplantation for the first time in Korea. Methods: We mobilized autologous stem cells with cyclophisphamide (4 g/㎡) and granulocyte colony-stimulating factor (10 ㎍/kg/day). Stem cells were enriched ex vivo using CD34-positive immunoselection and reinfused after high-dose chemotherapy with BEAM and antithymocyte globulin (ATG) (3.75 mg/kg) in MS, or fludarabine (180 mg/㎡), ATG (10 mg/kg) and busulfan (8 mg/kg) in RA. Results: The engraftment with an absolute nerutrophil count greater than 500㎕ occurred on day 9 in MS and 15 in RA, respectively. The time to nontransfused platelet count greater than 2.000/㎕ was 9 day in RA. MS patient did not show ant episode of thrombocytopenia. Regimen-related non-hematopoietic toxicity was minimal. For 6 months since HSCT, them patient with MS had been free from previously existed sensory and motor abnormalities except decreased visual acuity. Then patient with RA and only one tender joint and two mildly swollen joints with improvement in laboratory parameters at one month after HSCT. Conclusion: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of intractable autoimmune diseases. The durability of remission, however, remains to be clarified.
김정민,권영준,주영수,임형준,이태경,강혜련,백도명 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.3
목적: 일개 제빵회사에서 제빵공 천식 유병률을 조사하여 제빵공 천식으로 인한 국내 질병부담을 파악하는데 기초자료를 제공하고자 하였다. 방법: 일개 제빵회사의 생산관련 근로자 596명에서 수습기간(3개월) 중이거나 참여를 거부한 216명을 제외하고,380명을 연구대상으로 하였다. 밀가루분진 노출형태에 따라 직접노출군과 간접노출군으로 직무 카테고리를 분류하고,설문조사는 ISAAC 설문항목에 직업력 등을 추가한 설문지를 사용하였다. 설문조사에서 천식이나 알레르기병과 관련된 증상이나 병력이 전혀 없는 간접노출군은 임상검사대상에서 제외하였다. 임상검사대상 233명에게 피부단자검사,혈청 특이 IgE 항체검사,산업의학 전문의와의 면담을 시행하였고,면담에서 천식이나 알레르기비염과 관련된 증상이나 병력이 확인된 31명을 연속적 PEFR 측정대상으로 하였다. PEFR 변동률로써 메타콜린 기관지유발검사대상을 선정하였고,메타콜린 기관 지유발검사에서 기관지과민성이 확인된 경우에 특이 기관지유발검사를 시행하였다. 제빵공 천식은 특이 기관지유 발검사에서 천식반응이 확인된 경우로 정의하였다. 결과: 연구대상의 밀가루 민감화율은 21.0%(직접노출군 25.9%,간접노출군 13.3%), 제빵공 천식 유병률은 3.2%(직접노출군 5.1%,간접노출군 1.8%)였다. 직접 노출군이 간접노출군에 비해 밀가루에 민감화될 위험이 높았으며(OR 2.15,95% CI=1.03∼4.51), 제빵공 천식에 이환될 위험은 통계적으로 유의하지 않았다(PR 2.52,95% CI=O.78∼8.18). 밀가루에 민감화된 군이 그렇지 않은 군에 비해 제빵공 천식에 이환될 위험이 매우 높았다(PR 38.63, 95% CI=6.14∼243.22). 결론: 이번 연구결과는 직업적으로 밀가루에 노출되는 국내 근로자에서 제빵공 천식이 적지 않을 것임을 시사하고 있다. 향후 제빵공 천식으로 인한 질병부담을 보다 정확히 파악하기 위해서는 국내에서 연구된 바 없는 밀가루 취급 사업장(제분회사 등)에 대한 연구가 필요하며,근로자의 건강과 사회경제적 위치를 보호하기 위한 체계적인 연구도 요구된다. Objectives: To determine the prevalence of baker's asthma due to flour dust in an industrial bakery in Korea. Methods: Of the 596 active workers, 380 were allocated to a category of either direct exposure (DE) or indirect exposure (IE) to flour dust and completed a modified ISAAC questionnaire. Of the 380 participants, 233 were screened by an occupational physician interview, a skin prick test, and an ELISA for serum-specific IgE antibodies to wheat flour extracts. Selected workers received serial monitoring of peak expiratory flow rate (PEFR), and positive PEFR respondents received a methacholine challenge test. The diagnosis of baker's asthma was confirmed by a specific inhalation challenge with wheat flour extracts. Results: The prevalence of sensitization to wheat flour and baker's asthma was 21.0% (25.9% DE, 13.3% IE) and 3.2% (5.1 % DE, 1.8% IE), respectively. DE had an increased risk of sensitization to wheat flour (OR 2.15, 95% CI = 1.03∼4.51). Sensitization to wheat flour and the prevalence of baker's asthma correlated significantly (PR 38.63, 95% CI = 6.14∼243.22). Conclusions: These findings indicate a considerable prevalence of baker's asthma among flour-exposed workers in Korea. Future studies will be required to survey the situation in flour mill companies and seek ways to protect the health and socioeconomic position of flour industry workers.
자가조혈모세포이식을 이용한 불응성 류마티스 관절염의 치료
민도준 ( Do June Min ),민창기 ( Chang Ki Min ),양동원 ( Dong Won Yang ),윤종현 ( Chong Hyeon Yoon ),김완욱 ( Wan Uk Kim ),이상헌 ( Sang Heon Lee ),김동욱 ( Dong Wook Kim ),이종욱 ( Jong Wook Lee ),조철수 ( Chul Soo Cho ),김호연 ( 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.1
Objective: To investigate the safety and efficacy of immunoablation and subsequent autologous hematopoietic stem cell transplantation (HSCT) in refractory rheumatoid arthritis (RA). Methods: Three patients with severe, refractory RA were treated. We mobilized autologous hematopoietic stem cells (HSCs) with cyclophosphamide (Cy) and granulocyte colony-stimulating factor. HSCs were collected and enriched ex vivo using CD34-positive immunoselection. Two different immunoablative conditioning regimens were employed; fludarabine-Cy-anti-thymoayte glonulin (ATG) in patients whose disease activity was transiently ameliorated in response to Cy used in stem cell mobilization, or fludarabine-busulfan-ATG in those who didn`t show any response to that. Results: Median time to engraftment with an absolute neutrophil count greater than 500/μl and nontransfused platelet count greater than 20,000/μl was 15 days (range 12-16) and 9 days (range 7-13), respectively. Regimen-related toxicity was minimal. Two patients were markedly improved at 2 or 3 months after HSCT, repectively. In another patient, disease activity was transiently subsided, but relapsed at 2 months after HSCT, which led to reinstitution of anti-rheumatic medications. This resulted in subsequent marked improvement of disease activity whereas her disease had been refractory to these medications. Conclusions: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of refractory rheumatoid arthritis. The durability of remission remains to be clarified.
류마티스 질환에서 혈청 Soluble Fas Ligand (sFasL), FasL-Fas 복합체, FasL-IgG 복합체 측정
민준기 ( Jun Ki Min ),민소연 ( So Youn Min ),조미라 ( Mi Ra Cho ),정재연 ( Jae Yeon Jeong ),주대명 ( Dae Myung Jue ),민도준 ( Do June Min ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.4
Objective: To quantify the soluble Fas ligand (sFasL) and to measure FasL-Fas complex and FasL-IgG complex in the sera of patients with various rheumatic diseases: systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), and adult onset Still`s disease (AOSD). Methods: Serum samples were obtained from 37 patients with SLE, 40 with RA, 30 with SSc, 20 with AOSD, and 40 healthy controls. The serum sFasL, FasL-Fas complex, and FasL-IgG complex were measured using a sandwich enzyme-linked immunoabsorbent assay. Hospital medical records were retrospectively reviewed for clinical and laboratory characteristics in patients with SLE. Disease activity in SLE patients was assessed by the SLE Disease Activity Index (SLEDAI) score. Results: In patients with SLE, serum sFasL levels (383.1±208.9pg/ml) were significantly higher (p<0.001) than those of healthy controls (192.0±84.7pg/ml). sFasL levels in patients with RA (150.8±30.7pg/ml, p=0.014), SSc (115.4±13.5pg/ml, p<0.001), and AOSD (137.5±12.9pg/ml, p=0.001) were significantly lower compared with healthy controls. The frequencies of positive FasL-Fas complex and FasL-IgG complex were higher in patients with SLE (56.8%, 56.8% respectively) than in healthy controls (2.5%, 0% respectively) (p<0.001). All patients with RA or AOSD were negative for FasL-Fas complex and FasL-IgG complex. No patients with SSc were positive for FasL-Fas complex. On the other hand, the positive frequency of FasL-IgG complex was greater in patients with SSc (16.7%) than in healthy controls (0%) (p=0.012). Serum levels of FasL-IgG complexes in active SLE patients (OD 0.467±0.050) were tended to be lower than those in inactive SLE patients (OD 0.509±0.055) (p=0.060). SLEDAI score was tended to be negatively correlated with the serum levels of FasL-IgG complex in patients with SLE (r=-0.308, p=0.068). Conclusion: These results suggest that FasL may possibly play a role in the pathogenesis of SLE.
Do-Hyung Cha,Hye-Jin Cho,Byung-June Min 한국인사조직학회 2017 한국인사ㆍ조직학회 발표논문집 Vol.2017 No.1
A commonly held view is that a hazardous short-termism has taken hold across the publicly held firms. Critics say that top managers have become myopic due to capital market pressures which may lead them into negative career consequences (e.g., executive dismissal) if they miss quarterly earnings forecasts by security analysts. As a result, business press and general public express concerns that companies may have become to invest too little. This study examines whether CEO duality leadership structure can mitigate this myopic behavior in the context of corporate R&D investments under the pressures from the capital market intermediaries, securities analysts. We hypothesize that if CEO duality leadership leverage ‘unity of command’, they may differ on the myopic behavior on R&D investments but this view was not supported by empirical results. So we turn to agency theorists who argue that CEO duality will become the entrenched power at the top by holding two most powerful positions -the CEO and board chair - to benefit themselves for short-term profits at the expense of long-term competitive advantage. This study shows, though preliminarily, that CEO duality tend to cut R&D investments when the CEO faces the pressures from the capital market, especially when they miss the performance target, which is consistent with the managerial entrenchment hypothesis. We test these hypotheses by a large-scale, cross-industry data from a sample of U.S. manufacturing firms during the period of 1992 to 2015. With regard to theory, this research offers fresh implications for CEO duality literature on the interaction with capital market. With regard to practice, it shed light on the dark side of market feedback by securities analysts and calls for curtailing the ‘short-termism’ of capital markets and supports the corporate reforms on separating the role of chief executive officer and board chairperson.