계태에서의 31P 자기공명분석법을 이용한 인대사변화의 추적

홍창의,임태환,이정희,이대근,유시준 울산대학교 의과대학 1994 울산의대학술지 Vol.3 No.2

Chick embryo is a convenient model for embryologic teratologic studies. We performed the present experimental study to establish the basic technology for magnetic resonance studies of chick embryos and to examine the biochemical changes occurring during the development of chick embryos. Fertilized Leghorn eggs were examined by 31-phosphours magnetic resonance spectroscopy (??P-MRS) on days 6, 9, 12, 14, 15, 17 and 20 after the start of incubation. Spectroscopic data of live embryos were acquired by using a 4.7T MR spectrometer, and signals from phosphorous metabolites were analyzed. Total phospholipid signal decreased, which resulted in the overall decrease in total phosphorous signal over time. Signals from other metabolites such as ATPs and phosphocreatine increased over time, while those from inorganic phosphate and sugar phosphates decreased. Before the incubation days 12, signals from sugar phosphates and inorganic phosphate were predominant, and other metabolites became remarkably functional between the days 12 and 14 when the decrease in the phospholipid signal was significant. MR specrtroscopy is an effective method in evaluation of the biochemical changes occurring during the developmental period of chick embryos.

Congenital Heart Surgery Skill Training Using Simulation Models: Not an Option but a Necessity

Yoo Shi-Joon,Hussein Nabil,Barron David J. 대한의학회 2022 Journal of Korean medical science Vol.37 No.38

Congenital heart surgery (CHS) is technically demanding, and its training is extremely complex and challenging. Training of the surgeon’s technical skills has relied on a preceptorship format in which the trainees are gradually exposed to patients in the operating room under the close tutelage of senior staff surgeons. Training in the operating room is an inefficient process and the concept of a learning curve is no longer acceptable in terms of patient outcomes. The benefits of surgical simulation in training of congenital heart surgeons are well known and appreciated. However, adequate surgical simulation models and equipment for training have been scarce until the recent development of three-dimensionally (3D) printed models. Using comprehensive 3D printing and silicone-molding techniques, realistic simulation training models for most congenital heart surgical procedures have been produced. Newly developed silicone-molded models allow efficient CHS training in a stressfree environment with instantaneous feedback from the proctors and avoids risk to patients. The time has arrived when all congenital heart surgeons should consider surgical simulation training before progressing to real-life operating in a similar fashion to the aviation industry where all pilots are required to complete simulation training before flying a real aircraft. It is argued here that simulation training is not an option anymore but should be a mandatory component of CHS training.

Magnetic Resonance Imaging Assessment of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia in Children

Shi-Joon Yoo,Lars Grosse-Wortmann,Robert M. Hamilton 대한심장학회 2010 Korean Circulation Journal Vol.40 No.8

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a genetically determined disease that progresses continuously from conception and throughout life. ARVC/D manifests predominantly in young adulthood. Early identification of the concealed cases in childhood is of utmost importance for the prevention of sudden cardiac death later in life. Magnetic resonance imaging (MRI) is routinely requested in patients with a confirmed or suspected diagnosis of ARVC/D and in family members of the patients with ARVC/D. Although the utility of MRI in the assessment of ARVC/D is well recognized in adults, MRI is a low-yield test in children as the anatomical, histological, and functional changes are frequently subtle or not present in the early phase of the disease. MRI findings of ARVC/D include morphologic changes such as right ventricular dilatation, wall thinning, and aneurismal outpouchings, as well as abnormal tissue characteristics such as myocardial fibrosis and fatty infiltration, and functional abnormalities such as global ventricular dysfunction and regional wall motion abnormalities. Among these findings, regional wall motion abnormalities are the most reliable MRI findings both in children and adults, while myocardial fibrosis and fat infiltration are rarely seen in children. Therefore, an MRI protocol should be tailored according to the patient’s age and compliance, as well as the presence of other findings, instead of using the protocol that is used for adults. We propose that MRI in children with ARVC/D should focus on the detection of regional wall motion abnormalities and global ventricular function by using a cine imaging sequence and that the sequences for myocardial fat and late gadolinium enhancement of the myocardium are reserved for those who show abnormal findings at cine imaging. Importantly, MRI should be performed and interpreted by experienced examiners to reduce the number of false positive and false negative readings.

Low immunoglobulin levels at 3 months after allogeneic PBSCT is related with a high incidence of acute and chronic GVHD (초)

( Joon Ho Moon ),( Soo Jung Lee ),( Jong Gwang Kim ),( Yee Soo Chae ),( Shi Nae Kim ),( Yun Jeong Kim ),( Yoo Jin Lee ),( Jang Soo Suh ),( Kun Soo Lee ),( Sang Kyun Sohn ) 대한내과학회 2008 대한내과학회 추계학술대회 Vol.2008 No.-

Low immunoglobulin Levels at 3 months after allogeneic PBSCT is related with a high incidence of acute and chronic GVHD (초)

( Joon Ho Moon ),( Soo Jung Lee ),( Jong Gwang Kim ),( Yee Soo Chae ),( Shi Nae Kim ),( Yun Jeong Kim ),( Yoo Jin Lee ),( Jang Soo Suh ),( Kun Soo Lee ),( Sang Kyun Sohn ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1S

Mobilization effects of G-CSF, GM-CSF, and darbepoetin-α for allogeneic peripheral blood stem cell transplantation

Kim, Shi Nae,Moon, Joon Ho,Kim, Jong Gwang,Chae, Yee Soo,Cho, Yoon Young,Lee, Soo Jung,Kim, Yun Jeong,Lee, Yoo Jin,Suh, Jang Soo,Lee, Kun Soo,Sohn, Sang Kyun Wiley Subscription Services, Inc., A Wiley Company 2009 JOURNAL OF CLINICAL APHERESIS Vol.24 No.5

<P>The effects of GM-/G-CSF and darbepoetin-α on stem cell mobilization were investigated. From February 2005 to March 2007, 30 allogeneic sibling donors were randomly assigned to a G-CSF group (5 μg/kg/day for 5–7 days) or triple group (GM-CSF 10 μg/kg/day on 1st and 2nd day, G-CSF 5 μg/kg/day for 5–7 days, and darbepoetin-α 40 mg on 1st day). The MNCs and CD34<SUP>+</SUP> cells were not different between the two groups, although the doses (×10<SUP>8</SUP>/kg of recipient body weight) of CD3<SUP>+</SUP> cells (3.64 ± 1.75 vs. 2.63 ± 1.36, P = 0.089) and CD8<SUP>+</SUP> cells (1.07 ± 0.53 vs. 0.60 ± 0.30, P = 0.006) were lower in the triple group. The engraftments, frequency of RBC transfusions, and hemoglobin recovery were not different between the two groups. The cumulative incidence of overall and Grades II–IV aGVHD was 64.3% vs. 61.1% and 25.9% vs. 27.1% in the G-CSF and triple regimen group, respectively, whereas the cumulative incidence of cGVHD was 20.8 ± 1.3% and 24.4 ± 1.7%, respectively. In conclusion, the triple regimen did not seem to be superior to G-CSF alone in terms of the CD34+ cell dose, hemoglobin recovery, and GVHD. However, the CD8+ cell count was significantly lower in the triple regimen group. The role of a lower CD8+ cell count in the graft may need to be elucidated in the future. J. Clin. Apheresis, 2009. © 2009 Wiley-Liss, Inc.</P>

혈액종양 ; 미만성 거대 B세포 림프종 환자 치료 후 절대림프구수 감소율의 예후적 가치

김시내 ( Shi Nae Kim ),채의수 ( Yee Soo Chae ),김종광 ( Jong Gwang Kim ),문준호 ( Joon Ho Moon ),이수정 ( Soo Jung Lee ),김윤정 ( Yun Jeong Kim ),이유진 ( Yoo Jin Lee ),손상균 ( Sang Kyun Sohn ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1

목적: 미만성 거대 B 세포 림프종에서 IPI와 절대림프구수는 예후인자로 알려져 있다. 그러나 리툭시맙을 이용한 치료에 있어 리툭시맙과 관련하여 새로운 예후인자가 필요할 것으로 생각된다. 이에 저자는 초기 병기의 미만성 거대 B 세포 림프종 환자에서 R-CHOP 요법의 생존율 관련 예후인자를 평가하였다. 방법: 2003년 8월부터 2007년 11월까지 내원한 초기병기의 미만성 거대 B 세포 림프종 환자로 계획된 R-CHOP 요법을 시행받은 마친 78명을 후향적으로 조사하였다. 생존율분석을 위해 연령, 임상수행능력, LDH, 림프절외 침범, 병기, 절대림프구수, 백혈구 감소율 및 절대림프구수 감소율에 대해 평가하였다. 결과: 초기병기의 미만성 거대 B 세포 림프종 환자 78명 중 26명(33.3%)은 병기 1기였고, 73명의 환자들은 좋은 임상수행능력을 보였으며 20명의 환자에서 LDH 증가를 보였다. IPI 분류시 저위험군은 67명(85.9%)이고, 저중등군은 8명(10.3%), 고중등군은 3명(3.8%)이었다. 전체 반응율은 100%로서 완전관해율이 94.8%였다. 생존율 분석시 전체 생존율에서는 연령이 가장 중요한 예후인자였고(p=0.006), 무진행 생존율에 있어서는 첫 R-CHOP 요법 후 절대림프구수 감소율이 유일한 예후인자였다(p=0.037). 결론: 본 연구에서 초기 병기의 미만성 거대 B 세포 림프종 환자에서 R-CHOP 요법시 나이, IPI와 함께 절대림프구수 감소율이 의미있는 예후인자임을 알 수 있었다. Background/Aims: The International Prognostic Index (IPI) and absolute lymphocyte count (ALC) are prognostic factors in diffuse large B cell lymphoma (DLBCL). Nevertheless, in the Rituximab era, a new predictive marker related to Rituximab might be needed. We evaluated prognostic factors for survival in patients with early stage DLBCL after R-CHOP (Rituximab, cyclophosphamide, adriamycin, vincristine, prednisolone) treatment. Methods: From Aug 2003 to Nov 2007, 78 patients with early stage DLBCL, who finished R-CHOP as scheduled, were reviewed retrospectively. Survival analyses were performed according to clinical parameters (age, performance status, lactate dehydrogenase (LDH), extra-nodal involvement, stage, ALC, and the rates of reduction of the white blood count (WBC) and ALC). Results: Of the 78 patients with early stage DLBCL, 26 (33.3%) were classified as stage I. Seventy-three patients (93.6%) presented with a good performance status, while LDH was elevated in 20 patients (25.6%). According to the IPI, 67 (85.9%), 8 (10.3%), and 3 (3.8%) patients were classified in the low, low-intermediate, and high-intermediate risk groups, respectively. The overall response rate was 100%, including a 94.8% complete response. Survival analysis demonstrated that the rate of reduction of ALC following the first cycle of the R-CHOP regimen was the only factor associated with time-to-progression (p=0.037), whereas age was the single most important prognostic factor for overall survival (p=0.006). Conclusions: In our study, the rate of reduction of ALC in addition to age and IPI was found to be a significant prognostic factor in patients with early stage DLBCL treated with the R-CHOP regimen. (Korean J Med 76:52-59, 2009)

지연성 수면위상증후군 청소년에서 기상 시 어려움과 주간 졸림에 대한 Dawn Simulation 효과 연구

강시현,유한익,정석훈,왕희령,안준호,윤인영,김창윤 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Delayed sleep phase syndrome (DSPS) is characterized by difficulties in falling asleep and waking up at a desired time. Dawn simulation is a technique using a light that gradually increases in intensity before awakening in the morning, to imitate a natural sunrise. It has been found to be effective in decreasing both morning drowsiness and difficulty in awakening as well as treating symptoms of seasonal affective disorder. The aim of this study was to determine whether dawn simulation is helpful in decreasing difficulty in morning awakening and daytime sleepiness in adolescents with DSPS. Methods : Twelve adolescents with DSPS participated in a 2-week dawn simulation trial. Each subject self-assessed level of difficulty in awakening, morning drowsiness and daytime sleepiness during a 2-week baseline period and a following 2-week trial period with dawn simulator. Subjects used Stanford Sleepiness Scale (SSS) for measuring morning drowsiness and Epworth Sleepiness Scale (ESS) for measuring daytime sleepiness. Difficulty in awakening was assessed by a single-item questionnaire. Results : Dawn simulation trial decreased morning drowsiness (p=0.016) and daytime sleepiness (p=O.013) significantly compared to baseline. It also seemed to improve difficulty in awakening, but the effect was not statistically significant (p=0.092). Conclusion : Dawn simulation may help waking up in the morning and may improve daytime functioning by deceasing both morning drowsiness and daytime sleepiness in adolescents with DSPS.

선천성 낭성 선종양 기형 : 1 증례보고 Report of A Case

오미혜,유시준 世宗醫學硏究所 2000 世宗醫學 Vol.17 No.1

성인에서의 외이도 황색 육아종 1례

유동준(Dong Joon Yoo),이성훈(Sung-Hun Lee),여상원(Sang Won Yeo),박시내(Shi-Nae Park) 대한두개저학회 2014 대한두개저학회지 Vol.9 No.1

Xanthogranuloma is one of non-Langerhans cell histocytic disorders. And adult-onset huge xanthogranuloma of the external auditory canal is very rarely reported, especially on this anatomical site. We introduce a case of adult-onset huge xanthogranuloma of the external auditory canal. An 32-year-old female presented with intermittent left bloody otorrhea for two months. Radiological studies showed a solitary mass on the posterior wall of external auditory canal that had no invasion or erosion of temporal bone. The mass that originated from the posterior wall of the external auditory canal was excised and the defect site was reconstructed with ipsilateral superficial temporalis fascia. Pathologically, this huge mass was diagnosed as xanthogranuloma. We report this case as a very rare case of adult-onset xanthogranuloma in the external auditory canal as well as its excellent long-term result of surgery with the review of the literatures.