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최보경 ( Bo Kyung Choi ),이희선 ( Hee Sun Lee ),황인혜 ( In Hye Hwang ),신경화 ( Kyung Hwa Shin ),최문기 ( Mun Ki Choi ),최보광 ( Bo Gwang Choi ),안강희 ( Kang Hee Ahn ),남형석 ( Hyung Seok Nam ),황종민 ( Jong Min Hwang ),성은영 ( 대한내과학회 2010 대한내과학회지 Vol.79 No.4
목적: 만성 신질환 환자에서 세포성 면역기능이 감소되어 결핵에 이환될 위험성이 높으며, 특히 폐외결핵의 발생 빈도가 높은 것으로 알려져 있다. 이에 신기능에 따른 폐외결핵의 임상양상, 치료 반응, 질환과 연관된 사망률의 차이점을 비교하였다. 방법: 2003년 1월부터 2007년 12월까지 폐외결핵으로 진단된 18세 이상의 환자를 대상으로 하였고, 진단 당시의 크레아티닌 값을 이용하여 MDRD 공식으로 계산한 추정 사구체 여과율(eGFR)이 60 mL/min/1.73 m2을 기준으로 신기능 장애군(Group I)과 정상 신기능군(Group II)으로 분류하여 폐외결핵의 임상상, 치료성공률, 사망률 및 치료기간의 차이를 후향적 비교 분석하였다. 결과: 총 342명의 환자 중 Group I은 30명으로 이중 투석을 시행하고 있는 환자는 6명이었고, Group II는 312명으로, 각각의 평균 사구체 여과율은 34±19 mL/min/1.73 m2, 102±26 mL/min/1.73 m2이었다. Group I에서 고연령, 빈혈, 저알부민증이 많았으며, 고혈압, 당뇨병 및 심혈관계 질환을 동반한 경우가 많았다. 폐외결핵의 발생 부위는 두 환자군 모두 (Group I vs. Group II)에서 흉막(30.0% vs. 28.2%)이 가장 빈도가 높았고, 신경계통(23.3% vs. 16.3%)과 림프절(16.7% vs. 17.6%)의 감염이 흔하였으나, 통계학적 유의성은 없었다 (p=0.379). 모든 환자들은 표준 결핵화학요법인 HERZ, HER 및 HRZ 등을 용량 조절하여 치료하였으며, 두 환자군 모두에서 치료 실패 및 재발은 없었다. 결핵과 연관된 사망률은 Group I에서 높았으며(Group I, 22.2% vs. Group II, 2.8%, p<0.001), 연령, 혈색소 및 알부민, 당뇨병, 고혈압 및 심혈관계 질환의 유무를 보정하였을 경우에도 Group I이 사망의 위험률이 높았다(HR=11.51, 95%CI 2.512~52.741; p=0.002). 치료 중 이탈된 환자 및 사망환자를 제외하였을 경우, Group I이 치료 기간이 짧았다(278±110일 vs. 367±170일, p=0.009). 결론: 신기능 장애 환자에서 폐외결핵에 대한 치료기간이 연장되지 않았고 사망을 제외한 치료실패와 재발이 없었으나 폐외결핵으로 인한 사망률은 높았고, 신기능 저하 자체가 사망의 독립적인 위험 요소였다. 그러므로 신기능 장애 환자에서 폐외결핵에 대한 적극적인 진단 및 치료가 더 요구된다고 판단한다. Background/Aims: There is an increased risk of tuberculosis (TB) with impaired cellular immunity and extrapulmonary TB is more common in patients with chronic kidney disease. We explored the clinical features and treatment outcomes of extrapulmonary TB according to renal function. Methods: This retrospective study reviewed the medical records of patients diagnosed with extrapulmonary TB between January 2003 and December 2007. We classified the patients into two groups using the glomerular filtration rate (eGFR), estimated using the Modification of Diet in Renal Disease (MDRD) formula cut-off of 60 mL/min/1.73 m2 and evaluated their clinical features, treatment outcome and mortality (Group I vs. Group II, ≥ 60 mL/min/1.73 m2). Results: The mean eGFR of Groups I (n=30) and II (n=312) was 34±19 and 102±26 mL/min/1.73 m2, respectively. The pleura was the most frequent site of TB in both groups (Group I, 30.0% vs. Group II, 28.2%; p=0.379). There was no treatment failure or recurrence in either group. The mortality was higher in Group I (22.2% vs. 2.8%; p<0.01). In a multivariate analysis, eGFR<60 mL/min/1.73 m2 was an independent risk factor for mortality (HR=11.51, CI 2.512-52.741; p=0.002). Conclusions: Mortality related to extrapulmonary TB was higher in patients with impaired kidney function and kidney function was an independent predictor. However, there was no difference in treatment failure and recurrence according to renal function. (Korean J Med 79:387-393, 2010)
Hwang, In Hye,Chung, Joo Seop,Shin, Ho Jin,Choi, Young Jin,Song, Moo Kon,Seol, Young Mi,Cho, Goon Jae,Choi, Bo Gwang,Choi, Mun Ki,Choi, Bo Kyung,Ahn, Kang Hee,Shin, Kyung Hwa,Lee, Hee Sun,Nam, Hyung S The Korean Association of Internal Medicine 2011 The Korean Journal of Internal Medicine Vol.26 No.1
<P><B>Background/Aims</B></P><P>Autologous stem cell transplantation (ASCT) has become the treatment of choice for patients with multiple myeloma (MM). Studies have shown that maintenance treatment with interferon-alpha is associated with improved survival rates following ASCT. However, despite these recent advances in regimes, relapses are inevitable; thus, the prediction of relapse following ASCT requires assessment.</P><P><B>Methods</B></P><P>We retrospectively analyzed 39 patients who received ASCT between 2003 and 2008. All patients received chemotherapy with vincristine, adriamycin, and dexamethasone (VAD), and ASCT was performed following high-dose melphalan conditioning therapy. We evaluated the influence of the post-transplant day +14 (D+14) bone marrow plasma cell percent (BMPCp) (≥ 2 vs. < 2%), international scoring system (ISS) stage (II vs. III), response after 3 cycles of VAD therapy (complete response [CR] vs. non-CR), deletion of chromosome 13q (del[13q]) (presence of the abnormality vs. absence), and BMPCp at diagnosis (≥ 50 vs. < 50%) on progression-free survival (PFS) and overall survival (OS).</P><P><B>Results</B></P><P>During the median follow-up of 28.0 months, the median PFS and OS were 29.1 and 42.1 months, respectively. By univariate analysis, ISS stage III at diagnosis, BMPCp ≥ 50% at diagnosis, CR after 3 cycles of VAD therapy, del (13q) by fluorescence <I>in situ</I> hybridization, and BMPCp ≥ 2% at post-transplant D+14 were correlated with PFS and OS. A multivariate analysis revealed that a post-transplant D+14 BMPCp ≥ 2% (PFS, hazard ratio [HR] = 4.426, <I>p</I> = 0.008; OS, HR = 3.545, <I>p</I> = 0.038) and CR after 3 cycles of VAD therapy (PFS, HR = 0.072, <I>p</I> = 0.014; OS, HR = 0.055, <I>p</I> = 0.015) were independent prognostic parameters.</P><P><B>Conclusions</B></P><P>Post-transplant D+14 BMPCp is a useful parameter for predicting the outcome for patients with MM receiving ASCT.</P>
( In Hye Hwang ),( Joo Seop Chung ),( Ho Jin Shin ),( Young Jin Choi ),( Moo Kon Song ),( Young Mi Seol ),( Goon Jae Cho ),( Bo Gwang Choi ),( Mun Ki Choi ),( Bo Kyung Choi ),( Kang Hee Ahn ),( Kyung 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.1
Background/Aims: Autologous stem cell transplantation (ASCT) has become the treatment of choice for patients with multiple myeloma (MM). Studies have shown that maintenance treatment with interferon-alpha is associated with improved survival rates following ASCT. However, despite these recent advances in regimes, relapses are inevitable; thus, the prediction of relapse following ASCT requires assessment. Methods: We retrospectively analyzed 39 patients who received ASCT between 2003 and 2008. All patients received chemotherapy with vincristine, adriamycin, and dexamethasone (VAD), and ASCT was performed following high-dose melphalan conditioning therapy. We evaluated the influence of the post-transplant day +14 (D+14) bone marrow plasma cell percent (BMPCp) (≥ 2 vs. < 2%), international scoring system (ISS) stage (II vs. III), response after 3 cycles of VAD therapy (complete response [CR] vs. non-CR), deletion of chromosome 13q (del[13q]) (presence of the abnormality vs. absence), and BMPCp at diagnosis (≥ 50 vs. < 50%) on progressionfree survival (PFS) and overall survival (OS). Results: During the median follow-up of 28.0 months, the median PFS and OS were 29.1 and 42.1 months, respectively. By univariate analysis, ISS stage III at diagnosis, BMPCp ≥ 50% at diagnosis, CR after 3 cycles of VAD therapy, del (13q) by fluorescence in situ hybridization, and BMPCp ≥ 2% at post-transplant D+14 were correlated with PFS and OS. A multivariate analysis revealed that a post-transplant D+14 BMPCp ≥ 2% (PFS, hazard ratio [HR] = 4.426, p = 0.008; OS, HR = 3.545, p = 0.038) and CR after 3 cycles of VAD therapy (PFS, HR = 0.072, p = 0.014; OS, HR = 0.055, p = 0.015) were independent prognostic parameters. Conclusions: Post-transplant D+14 BMPCp is a useful parameter for predicting the outcome for patients with MM receiving ASCT. (Korean J Intern Med 2011;26:76-81)
Case Report : Primary Squamous Cell Carcinoma of the Liver Initially Presenting with Pseudoachalasia
( Mun Ki Choi ),( Gwang Ha Kim ),( Geun Am Song ),( Hyung Seok Nam ),( Yang Seon Yi ),( Kang Hee Ahn ),( Suk Kim ),( Joo Yeun Kim ),( Do Youn Park ) The Editorial Office of Gut and Liver 2012 Gut and Liver Vol.6 No.2
Pseudoachalasia secondary to primary squamous cell carcinoma (SCC) of the liver is extremely rare and has not been reported until now. Here, we report a unique case of primary SCC of the liver initially presenting with progressive dysphagia along with short periods of signifi cant weight loss. A 58-yearold man initially presented with progressive dysphagia along with significant weight loss over brief periods of time. The radiographic and manometric fi ndings were consistent with achalasia. Subsequent esophagogastroduodenoscopy revealed a moderately dilated esophagus without evidence of neoplasm or organic obstruction. However, firm resistance was encountered while traversing the esophagogastric junction (EGJ), although no mucosal lesion was identifi ed. Due to the clinical suspicion of the presence of a malignant tumor, endoscopic ultrasonography (EUS) and computed tomography scans of the chest and abdomen were obtained. A huge hepatic mass with irregular margins extending to the EGJ was found. EUS-guided fine-needle aspiration was performed, and the mass was diagnosed as a primary SCC of the liver by immunohistochemical staining. (Gut Liver 2012;6:275-279)
( Mun Ki Choi ),( Hyun Young Woo ),( Jeong Heo ),( Mong Cho ),( Gwang Ha Kim ),( Geun Am Song ),( Moon Bum Kim ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.3s
This is the first case report to describe a 44-year-old woman with a history of advanced hepatocellular carcinoma who developed toxic epidermal necrolysis (TEN) clinically after taking 400 mg sorafenib (Nexavar(R), BAY 43-9006) and tosufloxacin orally once per day. Both sorafenib and tosufloxacin were eventually discontinued, and the TEN resolved with corticosteroids and supportive treatment. Clinical physicians should be aware of this possible complication so that early interventions can be made. (Ann Dermatol 23(S3) S404~S407, 2011)
New dry carbon nanotube coating of over-lithiated layered oxide cathode for lithium ion batteries
Mun, Junyoung,Park, Jin-Hwan,Choi, Wonchang,Benayad, Anass,Park, Jun-Ho,Lee, Jae-Myung,Doo, Seok-Gwang,Oh, Seung M. The Royal Society of Chemistry 2014 Journal of Materials Chemistry A Vol.2 No.46
<▼1><P>For high rate capability and energy density of lithium ion batteries, over-lithiated layered cathodes coated by multiwall carbon nanotube were prepared by a novel dry method without decay in the structure.</P></▼1><▼2><P>Carbon serves as one of the best coating materials for the cathode in lithium ion batteries. This is because it can solve two main problems, which are surface deterioration and poor electrical conductivity. However, the conventional carbon coating procedures and, chemical carbonization processes, are especially difficult to implement for the oxide cathode, which could thereby deteriorate the oxide structure. We prepared a new dry 100 nm-thick homogeneous multi-walled carbon nanotube (MWCNT) coating on the high-capacity oxide cathode material, Li1.17Ni0.17Co0.1Mn0.56O2, by applying shear stress without breaking down the crystal structure or morphology of the cathode. The electronic conductivity of the carbon composite with the coated sample is 170 mS cm<SUP>−1</SUP>, which is over 40 times as much as the conductivity of the pristine cathode containing the same amount of carbon. In addition, at a high current condition of 2450 mA g<SUP>−1</SUP>, a specific capacity of 103 mA h g<SUP>−1</SUP> is observed even with 3 percent of the carbon (in weight) constituting the coated MWCNT. The unconventionally improved performances are explained by the suppression of the electronic resistance and surface charge transfer resistance by electrochemical analyses.</P></▼2>
Choi, Seok,Cho, Kyung-Won,Reu, Jong-Hyun,Kim, Jun-Soo,Mun, Hyun-Sik,Kim, Myung-Young,Park, Kwang-Chul,Heo, Gwang-Sik,Chang, Sung-Jong,Yeum, Cheol-Ho,Yoon, Pyung-Jin,Jun, Jae-Yeoul The Korean Society of Pharmacology 2004 The Korean Journal of Physiology & Pharmacology Vol.8 No.3
The interstitial cells of Cajal (ICCs) are the pacemaker cells in gastrointestinal tract and generate electrical rhythmicity in gastrointestinal muscles. Therefore, ICC may be modulated by endogenous agents such as neurotransmitter, hormones, and prostaglandins (PGs). In the present study, we investigated the effects of prostaglandins, especially $PGE_2$, on pacemaker currents in cultured ICCs from murine small intestine by using whole-cell patch clamp techniques. ICCs generated spontaneous slow waves under voltage-clamp conditions and showed a mean amplitude of $-452{\pm}39\;pA$ and frequency of $18{\pm}2$ cycles/min (n=6). Treatments of the cells with $PGE_2$ $(1\;{\mu}M)$ decreased both the frequency and amplitude of the pacemaker currents and increased the resting currents in the outward direction. $PGE_2$ had only inhibitory effects on pacemaker currents and this inhibitory effect was dose-dependent. For characterization of specific membrane EP receptor subtypes, involved in the effects of $PGE_2$ on pacemaker currents in ICCs, EP receptor agonists were used: Butaprost $(1\;{\mu}M)$, $EP_2$ receptor agonist, reduced the spontaneous inward current frequency and amplitude in cultured ICCs (n=5). However sulprostone $(1\;{\mu}M)$, a mixed $EP_1$ and $EP_3$ agonist, had no effects on the frequency, amplitude and resting currents of pacemaker currents (n=5). SQ-22536 (an inhibitor of adenylate cyclase; $100\;{\mu}M$) and ODQ (an inhibitor of guanylate cyclase; $100\;{\mu}M$) had no effects on $PGE_2$ actions of pacemaker currents. These observations indicate that $PGE_2$ alter directly the pacemaker currents in ICCs, and that the $PGE_2$ receptor subtypes involved are the $EP_2$ receptor, independent of cyclic AMP- and GMP-dependent pathway.
Primary Squamous Cell Carcinoma of the Liver Initially Presenting with Pseudoachalasia
Choi, Mun Ki,Kim, Gwang Ha,Song, Geun Am,Nam, Hyung Seok,Yi, Yang Seon,Ahn, Kang Hee,Kim, Suk,Kim, Joo Yeun,Park, Do Youn The Korean Society of Gastroenterology; the Korean 2012 Gut and Liver Vol.6 No.2
<P>Pseudoachalasia secondary to primary squamous cell carcinoma (SCC) of the liver is extremely rare and has not been reported until now. Here, we report a unique case of primary SCC of the liver initially presenting with progressive dysphagia along with short periods of significant weight loss. A 58-year-old man initially presented with progressive dysphagia along with significant weight loss over brief periods of time. The radiographic and manometric findings were consistent with achalasia. Subsequent esophagogastroduodenoscopy revealed a moderately dilated esophagus without evidence of neoplasm or organic obstruction. However, firm resistance was encountered while traversing the esophagogastric junction (EGJ), although no mucosal lesion was identified. Due to the clinical suspicion of the presence of a malignant tumor, endoscopic ultrasonography (EUS) and computed tomography scans of the chest and abdomen were obtained. A huge hepatic mass with irregular margins extending to the EGJ was found. EUS-guided fine-needle aspiration was performed, and the mass was diagnosed as a primary SCC of the liver by immunohistochemical staining.</P>