Salmonella choleraesuis 감염에 의한 흉부 농양 1예

황도유,최유경,임재윤,제현철,김명수,김준명,송영구 대한감염학회 2007 Infection and Chemotherapy Vol.49 No.1

저자들은 17세의 양성 흉선종을 동반한 남자 환자에서 Salmonella choleraesuis에 의한 흉부 농양을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Salmonella are motile, gram-negative, non-spore-forming members of the family Enterobacteriaceae. Among nontyphoid Salmonella serotypes, Salmonella choleraesuis shows a high predilection to cause systemic infections in humans. Thoracic infection is a rare complication of Salmonella infection. So far, most of reported cases of empyema caused by Salmonella spp. have involved immunocompromised patients. Herein, as we had experienced one case of thoracic empyema due to Salmonella choleraesuis related thymoma, we report it with review of literature.

Salmonella choleraesuis 감염에 의한 흉부 농양 1예

황도유,최유경,임재윤,제현철,김명수,김준명,송영구 대한감염학회 2007 감염과 화학요법 Vol.39 No.1

저자들은 17세의 양성 흉선종을 동반한 남자 환자에서 Salmonella choleraesuis에 의한 흉부 농양을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Salmonella are motile, gram-negative, non-spore-forming members of the family Enterobacteriaceae. Among nontyphoid Salmonella serotypes, Salmonella choleraesuis shows a high predilection to cause systemic infections in humans. Thoracic infection is a rare complication of Salmonella infection. So far, most of reported cases of empyema caused by Salmonella spp. have involved immunocompromised patients. Herein, as we had experienced one case of thoracic empyema due to Salmonella choleraesuis related thymoma, we report it with review of literature.

Karyotypic change between diagnosis and relapse as a predictor of salvage therapy outcome in AML patients

김윤덕,장지은,현신영,황도유,김수정,김진석,정준원,민유홍 대한혈액학회 2013 Blood Research Vol.48 No.1

Background Only a few patients who experience AML relapse derive lasting benefit from re-induction therapy. The utility of reassessing the disease karyotype at relapse is unclear. The main goals of this study were to identify prognostic factors for AML relapse and to determine the prognostic utility of karyotypic change between diagnosis and relapse as a variable for predicting response to salvage therapy for relapsed AML. Methods This retrospective study included 58 patients with relapsed AML treated at the Yonsei University College of Medicine between 2005 and 2010. Karyotypes at both diagnosis and relapse were available for 45 patients (77%). A change in karyotype at relapse was observed in 17 of 45 cases (37%), and no change was noted in 28 of 45 cases (62%). Results Karyotypic changes between diagnosis and relapse were associated with the response rate (RR) to salvage therapy (P=0.016). Overall survival (OS) and event-free survival (EFS) in the group with karyotypic changes between diagnosis and relapse were significantly different from those with no karyotypic changes (P=0.004 and P=0.010, respectively). We applied multiple multivariate Cox regression analyses to identify independent prognostic factors for overall response (OR), OS, and EFS. A change in karyotype between diagnosis and relapse was significantly associated with OS (P=0.023; RR=2.655) and EFS (P=0.033; RR=2.831). Conclusion Karyotypic changes between the diagnosis and relapse of AML could be used to predict outcomes and tailor clinical and biological therapeutic strategies for relapsed AML patients.

Clinical significance of B cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

김진석,김수정,정준원,김윤덕,황도유,Sulhee Yoon,Ji Eun Jang,Shin Young Hyun,민유홍 대한혈액학회 2011 Blood Research Vol.46 No.3

Background :BAFF (B cell-activating factor) and APRIL (a proliferation-inducing ligand) are members of the tumor necrosis factor family and promote B cell survival and proliferation. We evaluated the correlation between serum concentration of BAFF or APRIL and severity of acute graft-versus-host disease (GVHD). Methods :Fifteen patients who received allogeneic hematopoietic stem transplantation for leukemia and developed acute GVHD were enrolled. We determined serum concentrations of BAFF and APRIL at the onset of the first clinical manifestation of GVHD by enzyme-linked immunosorbent assay. Results :Nine patients had grade 2 acute GVHD, and 6 had grade 3-4 acute GVHD. The BAFF serum concentration was higher in patients with grade 3-4 acute GVHD (1,093.42 in grade 2 vs. 2,171.99 pg/mL in grade 3-4), although the difference was not significant (P=0.077). However, the ratio of BAFF serum concentration to absolute lymphocyte count (ALC) (BAFF/ALC) was significantly higher in patients with grade 3-4 acute GVHD (P=0.045). The APRIL serum concentration and APRIL/ALC ratio showed similar results (P=0.077 and P=0.013, respectively). Conclusion :Patients with grade 3-4 acute GVHD had higher BAFF/ALC and APRIL/ALC ratios than patients with grade 2 acute GVHD. These findings suggest that B cells might play an important role in the development of acute GVHD, and that the BAFF and APRIL concentrations in serum might be significant predictive factors for estimating the severity of acute GVHD. Their clinical significance should be further evaluated in a larger patient population.

Karyotypic change between diagnosis and relapse as a predictor of salvage therapy outcome in AML patients

김윤덕,장지은,현신영,황도유,김수정,김진석,정준원,민유홍 대한혈액학회 2013 Blood Research Vol.48 No.1

Background Only a few patients who experience AML relapse derive lasting benefit from re-induction therapy. The utility of reassessing the disease karyotype at relapse is unclear. The main goals of this study were to identify prognostic factors for AML relapse and to determine the prognostic utility of karyotypic change between diagnosis and relapse as a variable for predicting response to salvage therapy for relapsed AML. Methods This retrospective study included 58 patients with relapsed AML treated at the Yonsei University College of Medicine between 2005 and 2010. Karyotypes at both diagnosis and relapse were available for 45 patients (77%). A change in karyotype at relapse was observed in 17 of 45 cases (37%), and no change was noted in 28 of 45 cases (62%). Results Karyotypic changes between diagnosis and relapse were associated with the response rate (RR) to salvage therapy (P=0.016). Overall survival (OS) and event-free survival (EFS) in the group with karyotypic changes between diagnosis and relapse were significantly different from those with no karyotypic changes (P=0.004 and P=0.010, respectively). We applied multiple multivariate Cox regression analyses to identify independent prognostic factors for overall response (OR), OS, and EFS. A change in karyotype between diagnosis and relapse was significantly associated with OS (P=0.023; RR=2.655) and EFS (P=0.033; RR=2.831). Conclusion Karyotypic changes between the diagnosis and relapse of AML could be used to predict outcomes and tailor clinical and biological therapeutic strategies for relapsed AML patients.

R-CHOP 요법으로 치료한 장기이식 후 림프증식 질환 2예

윤설희,김수정,이혜원,황도유,김진석,정준원,민유홍 대한혈액학회 2008 Blood Research Vol.43 No.2

Posttransplant lymphoproliferative disorder (PTLD) is a group of heterogeneous lymphoid diseases that cause serious complications after organ or stem cell transplantation. The onset of PTLD is mostly due to EBV infection-induced B-cell proliferation and a defect in cytotoxic T cell function that occurs with immunosuppression. The usual treatment strategy for PTLD is reduction or withdrawal of immunosuppressive drugs with or without the administration of antiviral agents. Recently, various studies on the efficacy of rituximab or chemotherapy have been reported. We report two cases of rapidly progressing and complicated PTLDs after kidney transplantation that were successfully treated with a combination regimen consisting of rituximab, cyclophosphamide, adriamycin, vincristine and prednisolone (R-CHOP).

Circulating Tumor DNA Reflects Histologic and Clinical Characteristics of Various Lymphoma Subtypes

김진주,김혜민,김홍경,김수정,이승태,최종락,신새암,황도유 대한암학회 2024 Cancer Research and Treatment Vol.56 No.1

Purpose We designed and evaluated the clinical performance of a plasma circulating tumor DNA (ctDNA) panel of 112 genes in various subtypes of lymphoma.Materials and Methods Targeted deep sequencing with an error-corrected algorithm was performed in ctDNA from plasma samples that were collected before treatment in 42 lymphoma patients. Blood buffy coat was utilized as a germline control. We evaluated the targeted gene panel using mutation detection concordance on the plasma samples with matched tissue samples analyzed the mutation profiles of the ctDNA.Results Next-generation sequencing analysis using matched tissue samples was available for 18 of the 42 patients. At least one mutation was detected in the majority of matched tissue biopsy samples (88.9%) and plasma samples (83.3%). A considerable number of mutations (40.4%) that were detected in the tissue samples were also found in the matched plasma samples. Majority of patients (21/42) were diffuse large B cell lymphoma patients. The overall detection rate of ctDNA in patients was 85.7% (36/42). The frequently mutated genes included <i>PIM1, TET2, BCL2, KMT2D, KLHL6, HIST1H1E</i>, and <i>IRF8</i>. A cutoff concentration (4,506 pg/mL) of ctDNA provided 88.9% sensitivity and 82.1% specificity to predict ctDNA mutation detection. The ctDNA concentration correlated with elevated lactate dehydrogenase level and the disease stage.Conclusion Our design panel can detect many actionable gene mutations, including those at low frequency. Therefore, liquid biopsy can be applied clinically in the evaluation of lymphoma patients, especially in aggressive lymphoma patients. Purpose We designed and evaluated the clinical performance of a plasma circulating tumor DNA (ctDNA) panel of 112 genes in various subtypes of lymphoma. Materials and Methods Targeted deep sequencing with an error-corrected algorithm was performed in ctDNA from plasma samples that were collected before treatment in 42 lymphoma patients. Blood buffy coat was utilized as a germline control. We evaluated the targeted gene panel using mutation detection concordance on the plasma samples with matched tissue samples analyzed the mutation profiles of the ctDNA. Results Next-generation sequencing analysis using matched tissue samples was available for 18 of the 42 patients. At least one mutation was detected in the majority of matched tissue biopsy samples (88.9%) and plasma samples (83.3%). A considerable number of mutations (40.4%) that were detected in the tissue samples were also found in the matched plasma samples. Majority of patients (21/42) were diffuse large B cell lymphoma patients. The overall detection rate of ctDNA in patients was 85.7% (36/42). The frequently mutated genes included PIM1, TET2, BCL2, KMT2D, KLHL6, HIST1H1E, and IRF8. A cutoff concentration (4,506 pg/mL) of ctDNA provided 88.9% sensitivity and 82.1% specificity to predict ctDNA mutation detection. The ctDNA concentration correlated with elevated lactate dehydrogenase level and the disease stage. Conclusion Our design panel can detect many actionable gene mutations, including those at low frequency. Therefore, liquid biopsy can be applied clinically in the evaluation of lymphoma patients, especially in aggressive lymphoma patients.

증례 : 혈액종양 ; 동종 조혈모세포이식 후 다발성 근염으로 발현된 만성 이식편대숙주반응

이혜원 ( Hye Won Lee ),최희경 ( Hee Kyung Choi ),김수정 ( Soo Jeong Kim ),황도유 ( Doh Yu Hwang ),최준용 ( Jun Yong Choi ),정준원 ( June Won Cheong ),민유홍 ( Yoo Hong Min ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1

동종 조혈모세포이식 후의 합병증으로 드물게 다발성근염으로 만성 이식편대숙주반응이 생길 수 있으며, 경우에 따라 치명적일 수 있으므로 조기 진단이 중요하겠다. 그러나, 임상 양상이 비특이적일 경우 진단이 쉽지 않으며 이식 후 수년 뒤에도 유일한 이식편대숙주반응으로 발현될 수 있어 동종 조혈모세포이식을 받았던 환자를 진료할 때에는 이에 대한 주의가 필요하겠다. Chronic graft-versus-host disease (cGVHD) remains one of the major complications of allogeneic hematopoietic stem cell transplantation. Although cGVHD has various manifestations in almost all organs, cases of cGVHD involving skeletal muscle are rare. We experienced a 26-year-old man with polymyositis with no other concurrent cGVHD after HLA-matched myeloablative transplantation for acute myelogenous leukemia. He had a history of acute and chronic GVHD. The patient complained of fever and myalgia 3 years after transplantation. The serum creatine kinase (CK, 2,223 IU/L) and aldolase (87.6 sigmaU/mL) were elevated. The muscle biopsy and electromyographic findings were consistent with myositis with necrosis. His condition improved dramatically with immunosuppressive therapy. Although muscle involvement, alone, in cGVHD is very rare, early diagnosis and proper treatment are still important. (Korean J Med 76:110-113, 2009)

급성림프구성백혈병 환자에서 막성 콩팥병증으로 나타난 만성 이식편대 숙주병 1예

정지예 ( Ji Ye Jung ),윤설희 ( Sul Hee Yoon ),황도유 ( Doh Yu Hwang ),정준원 ( June Won Cheong ),김진석 ( Jin Seok Kim ),정현주 ( Hyun Joo Jung ),민유홍 ( Yoo Hong Min ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1S

Aurora A kinase expression is increased in leukemia stem cells, and a selective Aurora A kinase inhibitor enhances Ara-C-induced apoptosis in acute myeloid leukemia stem cells

김수정,Ji Eun Jang,정준원,Ju-In Eom,Hoi-Kyung Jeung,김윤덕,황도유,민유홍 대한혈액학회 2012 Blood Research Vol.47 No.3

Background The overexpression of Aurora A kinase (AurA) has been reported in various malignancies, including acute myeloid leukemia (AML). However, the expression of AurA and the effects of AurA inhibition in cancer stem cells are not yet fully understood. We investigated the expression and inhibition of AurA in AML stem cells (CD34+/CD38−). Methods Expression of AurA was investigated in cell lines (NB4 and KG1) that express high levels of CD34 and low levels of CD38. Primary AML cells were harvested from 8 patients. The expression of AurA and cell death induced by inhibition of AurA were analyzed in CD34+/ CD38− cells. Results AurA was shown to be overexpressed in both primary AML cells and leukemia stem cells (LSCs) compared to normal hematopoietic stem cells. Inhibition of AurA plus cytarabine treatment in LSCs resulted in increased cytotoxicity compared to cytarabine treatment alone. Additional stimulation with granulocyte-colony stimulating factor (G-CSF) increased the cell death caused by AurA inhibition plus cytarabine treatment. Conclusion To our knowledge, this is the first report describing increased expression of AurA in LSCs. Our results suggest that selective AurA inhibition may be used to reduce LSCs, and this reduction may be enhanced by stimulation with G-CSF. Further exploration of relationship between nuclear factor kappa-B and AurA inhibition and the potential of AurA inhibition for use in leukemia treatment is needed.