폐결핵으로 오인된 역형성 거대세포 림프종 1례

현동우,박재용,강태경,박기수,박태인,김창호,손상균,권건영,이규보,정태훈,권삼,Hyun, Dong-Woo,Park, Jae-Yong,Kang, Tae-Kyung,Park, Ki-Soo,Park, Tae-In,Kim, Chang-Ho,Sohn, Sang-Kyun,Kwon, Kun-Young,Lee, Kyu-Bo,Jung, Tae-Hoon,Kweon, Sam 대한결핵및호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.1

저자들은 발열, 체중감소 등의 증상과 흉부 X-선 사진상 폐경화의 소견이 있었던 환자에서 폐의 병변이 역형성 거대세포 림프종으로 추측되는 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Anaplastic large cell lymphoma(ALCL) is a recently recognized large cell lymphoma characterized by large pleomorphic cells, with prominent nucleoli, expressing the CD30(Ki-1) antigen. It is often misdiagnosed as metastatic carcinoma, malignant histiocytosis or Hodgkin's disease. Primary pulmonary ALCL is extremely rare although it frequently involves extranodal sites, e.g. skin, bone, gastrointestinal tract, soft tissue and lung. We report a case of ALCL suspected as primarily involving lung.

K - 통로개방제가 배양심근세포와 생쥐 체내의 Thallium - 201 역동학에 미치는 영향

이규보(Kyu Bo Lee),이재태(Jae Tae Lee),안병철(Byeong Cheol Ahn),김은지(Eun Ji Kim),손상균(Kang Kyun Sohn),하정희(Jeoung Hee Ha),김천기(Chun K . Kim) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.4

N/A Background: Potassium channel opener (K-opener) opens ATP-sensitive K+-channel located at membrane and induces potassium efflux from cytosol, resulting in intracellular hyperpolarization. Newly synthesized K-opener is currently examined for pharmacologic potency by means of rubidium release test from smooth muscle strip pre-incubated with Rb-86. Since in-vive behavior of thallium is similar to that of rubidium, we hypothesized that K-opener can alter T1-201 kinetics in vivo. Purpose: This study was prepared to investigate the effects of pinacidil (one of potent K-openers) on the T1-201 uptake and clearance in cultured myocyte, and in-vivo biodi- stribution in mice. Methods: Spontaneous contracting myocytes were prepared to imitate in-vivo condition from 20 hearts of 3-5 days old Sprague-Dawley rat and cultured for 3-5 days before use (5×105 cells/ml). Pinacidil was dissolved in 10% DMSO solution at a final concentration of 100nM or 10uM and was co-incubated with T1-201 in HBSS buffer for 20-min to evaluate its effect on cellular T1-uptake, or challenged to cell preparation pre-incubated with T1-201 for washout study. Two, 40 or 100μg of pinacidil was injected intravenously into ICR mice at 10 min after 5μCi T1-201 injection, and organ uptake and whole body retention rate were measured at different time points. Results: Co-incubation of pinacidil with T1-201 resulted in a decrease in T1-201 uptake into cultured myocyte by 1.6 to 2.5 times, depending on pinacidil concentration and activity of T1-201 used. Pinacidil enhanced T1-201 washout by 1.6-3.1 times from myocyte preparations pre-incubated with T1-201. Pinacidil treatment appears to be resulted in mild decreases in blood and liver activity in normal mice, in contrast, renal and cardiac uptake were mildly decreased in a dose dependent manner. Whole body retention ratios of T1-201 were lower at 24 hour after injection with 100μg of pinacidil than control. Conclusion: These results suggest that treatment with K-opener may affect the interpretation of T1-201myocardial images, due to decreasing thallium accumulation and enhancing washout from myocardium.

혈액 종양 질환에서 항과립구항체 골수 스캔을 이용한 중심 골수와 말초 골수 분포의 분석

강도영,이재태,손상균,이규보 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.5

목적: 혈액 종양 질환을 가진 환자들에서 과립구에 대한 단일클론항체를 이용한 골수 수캔을 시행하여 혈액 종양 질환의 종류에 따라서 말초 곬의 분포를 등급화하고 중심성 골수의 정량적 섭취율을 구하였으며 또한 이들 상호간의 관련성을 조사하였다. 대상 및 방법: 혈액 종양 환자 중에서 골수 조직검사를 시행하여 진단이 확진되고 Tc-99m anti-granulocyte monoclonal mouse antibody BW 250/183를 이용한 골수 스캔을 시행한 환자 50명을 대상으로 하였다. 환자는 4군으로서 급성 골수성 백혈병 환자 11명, 급성 임파구성 백혈병 환자 12명, 임파선종 환자 15명, 골수이형성증후군 환자 12명이었다. 골수 스캔의 분석은 말초 골수 분포는 골수 확장 소견에 따라 4개의 등급으로 분류하였고, 중심성 골수 기능은 장골과 천골에 관심영역을 그려 섭취율을 계산하였다. 결과: 말초 골수 확장의 정도는 전체 환자 50명 중에서 1등급에 4명, 2등급에 27명, 3등급에 15명, 4등급에 4명이었다. 말초 골수 확장의 정도는 골수이형성증후군과 임파구성 백혈병에서 3, 4등급이 58% (7/12) 심하였고 임파종에서는 1, 2등급이 93% (14/15)로 가장 경하였으며 질환별로 특이적인 분포는 보이지 않았다. 중심성 골수의 섭취율은 4가지 질환 중 골수이형성증후군에서 8.5±4.0으로 가장 높았고, 급성 임파구성 백혈병에서 5.9±3.6으로 가장 낮았으나 4군 간에 통계적으로 유의한 차이는 없었다(p>0.05). 말초 골수 확장 정도에 따른 중심 골수의 정량화는 4가지 등급간에는 섭취율에 있어서 통계적으로도 유의한 차이가 있었으나(p=0.003), 개개의 환자에서 말초 골수 확장 정도와 중심 골수의 정량값의 상관관계는 거의 없었다(r=0.05). 결론: 혈액 종양 질환에서 골수 스캔은 말초 골수의 분포와 중심 골수의 기능에 있어서 질병 특이적인 소견은 보이지 않았으며, 골수의 변화는 말초 골수와 중심 골수에 서로 상관 관계없이 변화를 초래하므로 한 가지 방법으로 보다는 두 가지 방법으로 평가할 필요가 있다. Purpose: Bone marrow scintigraphy has been used to evaluate the status of bone marrow in various hematologic disorders. We have analyzed the peripheral distribution pattern and central uptake ratio of bone marrow using anti-NCA-95 monoclonal antibody and the their correlation in patients with various hematologic malignancy. Materials and Methods: Bone marrow immunoscintigraphy was perfermed using Tc-99m anti-granulocyte monoclonal mouse antibody BW 250/183. Fifty patients were classified into four groups; 11 with acute myelogenous leukemia. 12 with acute lymphocytic leukemia, 15 with lymphoma and 12 with myelodysplastic syndrome. The activity of central bone marrow was expressed as sacroiliac uptake ratio. Results: The patient's number was 4 in grade 1, 27 in grade II, 15 in grade III and 4 in grade IV according to extension of peripheral bone marrow. The extension of peripheral bone marrow was marked (58% in grade III and IV) in myetodysplastic syndrome and acute lymphocyte leukemia and mild (93% in grade I and II) in lymphoma. Sacroiliac uptake ratio was highest (8.5±4.0) in myelodysplastic syndrome and lowest (5.9±3.6) in acute myelogenous leukemia, but not significantly different among four patient groups (p>0.05). Conclusion: The pattern of peripheral bone marrow extension and activity of central hemopoietic marrow were not specific to the disease entities. Response of hemopoietic bone marrow may be evaluated on both peripheral and central bone marrow in patients with hematologic malignancy. (Korean J Nucl Med 2002;36:298-305)

Plummer-Vinson 증후군 치험 1예

손상균,정병천,김광원,이재태,이규보 大韓血液學會 1990 大韓血液學會誌 Vol.25 No.1

혈액 종양 질환에서 항과립구항체 골수 스캔을 이용한 중심 골수와 말초 골수 분포의 분석

강도영,이재태,손상균,이규보 경북대학교 병원 2003 경북대학교병원의학연구소논문집 Vol.7 No.1

목적: 혈액 종양 질환을 가진 환자들에서 과립구에 대한 단일클론항체를 이용한 골수 스캔을 시행하여 혈액 종양 질환의 종류에 따라서 말초 골수의 분포를 등급화하고 중심성 골수의 정량적 섭취율을 구하였으며 또한 이들 상호간의 관련성을 조사아혔다. 대상 및 방법: 혈액 종양 환자 중에서 골수 조직검사를 시행하여 진단이 확진되고 Tc-99m antigranulocyte monoclonal mouse antibody BW 250/183를 이용한 골수 스캔을 시행한 환자 50명을 대상으로 하였다. 환자는 45군으로 급성 골수성 백혈병 환자 11명, 급성 임파구성 백혈병 환자 12명, 임파선종 환자 15명, 골수이형성증후군 환자 12명이었다. 골수 스캔의 분석은 말초 골수 분포는 골수확장 소견에 따라 4개의 등급으로 분류하였고, 중심성 골수 기능은 장골과 천골에 관심영역을 그려 섭취율을 계산하였다. 결과: 말초 골수 확장의 정도는 전체 환자 50명 중에서 1등급에 4명, 2등급에 27명, 3등급에 15명, 4등급에 4명 이었다. 말초 골수 확장의 정도는 골수이형성증후군과 임파구성 백혈병에서 3, 4등급이 58%(7/12)로 심하였고 임파종에서는 1, 2등급이 93%(14/15)로 가장 경하였으며 질환별로 특이적인 분포는 보이지 않았다. 중심성 골수의 섭취율은 4가지 질환 중 골수이형성증후군에서 8.5±3.6으로 가장 낮았으나 4군 간에 통게적으로 유의한 차이는 없었다(p?.05). 말초 골수 확장 정도에 따른 중심 골수의 정량화는 4가지 등급간에는 섭취율에 있어서 통계적으로도 유의한 차이가 있었으나(p=0.003), 개개의 환자에서 말초 골수 확정 정도와 중심 골수의 정량값의 상관관계는 거의 없었다(r=0.05). 결론: 혈액 종양 질환에서 골수 스캔은 말초 골수의 분포와 중심 골수의 기능에 있어서 질병 특이적인 소견은 보이지 않았으며, 골수의 변화는 말초 골수와 중심 골수에 서로 상관 관계없이 변화를 초래하므로 한 가지 방법으로 보다는 두 가지 방법으로 평가할 필요가 있다. Purpose: Bone marrow scintigraphy has been used to evaluate the status of bone marrow in various hematologic disorders. We have analyzed the peripheral distribution pattern and central uptake ratio of bone marrow using anti-NCA-95 monoclonal antibody and the their correlation in patients with various hematologic malignancy. Materiais and Methods: Bone marrow immunoscintigraphy was performed using Tc-99m anti-granulocyte monoclonal mouse antibody BW 250/183. Fifty patients were classified into four groups; 11 with acute myelogenous leukemia, 12 with acute lymphocytic leukemia, 15 with lymphoma and 12 with myelodysplastic syndrome. The extension of peripheral bone marrow was categorized into four grades: Ⅰ, Ⅱ, Ⅲ and Ⅳ. The activity of central bone marrow was expressed as sacroiliac uptake ratio. Results: The patient's number was 4 in grade Ⅰ, 27 in grade Ⅱ, 15 in grade Ⅲ and 4 in grade Ⅳ according to extension of peripheral bone marrow. The extension of peripheral bone marrow was marked(58% in grade Ⅲ and Ⅳ) in myelodysplastic syndrome and acute lymphocytic leukemia and mild(93% in grade Ⅰ and Ⅱ) in lymphoma. Sacroiliac uptake ratio was highest(8.5±4.0) in myelodysplastic syndrome and lowest(5.9±3.6) in acute myelogenous leukemia, but not significantly different among four patient groups(p>0.05). Sacroiliac uptake ratio of whole patients was significantly different among four grades(p=0.003), but there was not correlated between grade of peripheral bone marrow and sacroiliac uptake ratio(r=0.05). Conclusion: The pattern of peripheral bone marrow extension and activity of central hemopoietic marrow were not specific to the disease entities. Response of hemopoietic bone marrow may be evaluated on both peripheral and central bone marrow in patients with hematologic malignancy.

백혈병 세포에서 Multidrug Resistance Gene-1 (mdr1)의 과발현이 ^99m Tc-sestaMIBI 섭취에 미치는 영향

천경아,이재태,이상우,강도영,손상균,이종기,정준기,전수한,이규보 경북대학교 의학연구소 2000 경북대학교병원의학연구소논문집 Vol.4 No.1

Purpose: To determine whether 99mTc-MIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively 99mTc-MIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular 99mTc-MIBI uptake were also investigated in the presence of multidrug resistance gene-1(mdr1 gene) overexpression. Materisls and Methods: We measured percentage uptake of 99mTc-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of 99mTc-MIBI were also evaluated with or withouts overexpression of mdr1 gene in Cultured murine leukemia L1210 cells. Results: The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of 99mTc-MIBI was higher in mdr1 negative L 1210 cells than those of mdr1 positive cells, and higher when incubated in 37℃ than 4℃. In the presence of verapamil, cyclosporin or dipyridamole, 99mTc-MIBI uptake was increased upto 604% in mdr1 positive cells. Conclusion: Cellular uptake of 99mTc-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MDR-reversing agents increase cellular uptake. These results suggest that 99mTc-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents in vitro. (Korean J Nucl Med 1999;33: 152-62)

사이클로스포린 신경독성에 의한 가역성 뇌관류 저하 : 증례보고 A Case Report

이상우,천경아,강도영,이재태,이규보,안병철,손상균 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.4

We experienced a case of cerebral hypoperfusion due to cyclosporine neurotoxocity confirmed only by Tc-99m ECD brain SPECT. A 53-year-old female had received allogenic peripheral blood stem cell transplantation due to refractory plasmacytoid lymphoma. Cyclosporine and steroid had been administrated to prevent graft versus host disease. Twenty days after transplantation, she became delirious and suffered from generalized tonic-clonic seizure. Immediately, brain MRI and MR angiography were performed and these studies did not show any abnormal findings. However, Tc-99m ECD brain SPECT showed diffuse hypoperfusion in the left cerebral hemisphere and blood cyclosporine level was 962.6 ng/ml. Cyclosporine administration was stopped and discontinuation of cyclosporine resulted in disappearance of all neurological symptoms. The same neurological symptoms recurred with cyclosporine re-administration for management of exacerbated graft versus host disease. In this case, Tc-99m ECD brain SPECT proved very helpful in the diagnosis of cycloporine neurotoxicity. (Korean J Nucl Med 2000;34:360-5)

백혈병 세포에서 Multidrug Resistance Gene-1 (mdr1)의 과발현이 99mTc-sestaMIBI 섭취에 미치는 영향

이상우,천경아,강도영,전수한,정준기,이규보,손상균,이재태,이종기 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.2

Purpose: To determine whether Tc-99mMIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively Tc-99mMIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular Tc-99m-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr1 gene) overexpression. Materials and Methods: We measured percentage uptake of Tc-99m-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of Tc-99m-MIBI were also evaluated with or without overexpression of mdr1 gene in cultured murine leukemia L1210 cells. Results: The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of Tc-99m-MIBI was higher in mdr1 negative L1210 cells than those of mdr1 positive cells, and higher when incubated in 37℃ than 4℃. In the presence of verapamil, cyclospor or dipyridamole, Tc-99m-MIBI uptake was increased upto 604% in mdr1 positive cells. Conclusion: Cellular uptake of Tc-99m-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MDR-reversing agents increase cellular uptake. These results suggest that Tc-99m-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents In vitro.