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홍택원,김순길,김태엽,정재면,고동희,이재웅,김경수,김정현,임헌길,이방헌,이철범 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2
Spontaneous coronary artery dissection is a rare cause of myocardial infarction. It occurs in relatively young people with a striking predilection for women, mainly during or after prognancy. The optimal management of spontaneous coronary artery dissection has not been established yet and may vary, depending upon the presence of intimal versus extramural compromise. Coronary artery bypass, stenting, and thrombolysis may have been successful and also may have failed, owing to extension of dissection. We describe a case of acute myocardial infarction caused by spontaneous coronary artery dissection which occurs in a 51-year old man. The coronary angiography showed a spiral dissection of right coronary artery, from the origin of conus branch to the distal portion of right coronary artery. An intimal plaque with 35% obstruction and normal (TIMI 3) flow was demonstrated. The patient was functionally recovered after conventional midical treatment including heparin, beta blockers and long acting nitrates. Four months later, follow up coronary angiography showed stabilization of coronary lesion and improvement of stenosis.
만성 호중구성 백혈병(Chronic Neutrophilic Leukemia) 1예
정재면,홍택원,고동희,강준구,김태종,이웅수,최정혜,안명주,김인순,최일영,이영열 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2
Chronic neutrophilic leukemia is a very rare myeloproliferative disorder characterized by splenomagaly, persistent neutrophilia, bone marrow granulocyte hyperplasia, elevated leukocyte alkaline phosphatase, the absense of philadelphis cheomosome. Recently we have experienced a case of chronic neutrophilic leukemia in a 73 years old woman who complained of general weakness. On admission, peripheral blood examination showed leukocytosis with mature neutrophil: Hb 10.5g/㎗, WBC 33,200/㎣, platelet 751,000/㎣ and neutrophoil 93% in differential count. The underlying disease for leukemoid reaction has not been detected. Leukocyte alkaline phospatase score was elevated. Bone marrow study revealed hypercellular marrow with prominent neutrophilic hyperplasia and without myelofibrosis. The cytogenic study shows normal bone marrow cell karyotype without philadephia chromosome.
질편모충(Trichomonas vaginalis)의 시험관내에서의 용혈능
안명희,류재숙,홍택원,민득영 한양대학교 의과대학 1995 한양의대 학술지 Vol.15 No.2
To evaluate the hemolytic activity of T. vagindlis from Korean women and fresh human RBC of A type were nsed for hemolytic assay. RBC(1×10 /ml) was added to RPMI-TPS media(RPMI 1840:TPS-1= 20 : 1) containing T. vaginalis(2×10 ) and incubated at 37℃, 5% CO₂incubator for 6hr and hemolysis was measured by spectrophotometer at 412m. We investigated the parasite to erythrocyte ratio and lemperature needed for hemotysis. Optimal erythrocyte lysis by T. vaginalis was achieved at ratio of 1 : 5 and optimol temperature 37℃. Minimal hemolytic activity was detected in lysates of T. vaginalis. No hemolysis occured when a membrane a 3㎛ pore size was nsed to prevent contact between parasites and erythrocytes. These data suggest a need for contact for trichomonol hemolysis. Hemolytic activity did not correlated with the production of subcutaneous abscess in mice.
고동희,정재면,홍택원,김동욱,전재범,김태환 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2
Myositis ossificans progressiva is rare heritable disorder of connective tissue characterized by congenital malformation of the great toes and by progressive ossification of striated muscle and connective tissue associated with pain and disability. Myositis ossificans progressiva occurs sporadically and is transmitted as a dominant trait with variable expression and complete penetrance. The disease progress from axial to appendicular, cranial to caudal, and proximal to distal sites. We present an 21-year-old man with typical muscle ossification, skeletal malformation and spondylopathy and a review of the pathogenesis, clinical manifestations and treatment options of the rare disease.
조경란,김태엽,강준구,홍택원,백상현,정재면,박준성,김동욱,신성준,최찬범,최정혜,안명주,김인순,최일영,김병국,김은실,이영열 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2
배경: 재생불량성빈혈 치료 중 하나인 항림프구 글로블린(ALG)/항흉선세포 글로블린은 조혈세포의 자극에 의한 조혈세포 성장인자의 분비 때문일 것이라는 연구가 최근 보고되고 있어 생체 외에서 ALG의 조혈과정에 미치는 영향을 규명하고자 하였다. 방법: 말초혈액 단핵구는 정상인의 말초혈액을 Ficoll-Hypaque에 의해 분리한 후 단구는 2회 연속 부착법으로, T 림프구는 양적혈구를 이용하여 분리하였고 이 순수도는 flow cytometer에 의해 95% 이상임을 확인하였다. 분리된 각 세포는 conditioned medium으로 처리한 후 thymidine uptake test로 세포 증식을 관찰하였고 조혈세포 생체 외 배양은 methylcellulose를 이용한 반고형 배지법을 사용하였다. 결과: 말초혈액 단핵구에 대해 ALG 농도 50μg/mL사이에서 증식을 관찰할 수 있었으며 최대의 효과를 나타낸 농도는 250μg/mL였다. T 림프구 단독 혹은 T 림프구와 단구에서도 ALG 농도 50μg/mL에서 500μg/mL사이에서 효과를 관찰할 수 있었으며 최대효과를 나탸낸 농도는 250μg/mL였다. 그러나 이들 세포군에서는 말초혈액 단핵구보다는 낮은 cpm 값을나타냈고 T 림프구보다는 T+ 단구의 경우에서 더 높은 값을 보여 주었다. 단구만을 대상으로 실험한 경우에서는 모든 ALG 농도에서 세포 내로의 methyltritiated thymidine의 incoporation을 관찰할 수 없었다. ALG-stimulated T lymphocyte-conditioned medium에서는 생체 외 배양에서 얻어진 colony (CFU-GM)가 154개로서 대조군으로 삼은 PHA-LCM의 경우보다 훨씬 많이 형성되었고 ALG-stimulated monocyte-conditioned midium으로 세포배양을 했을 때는 CFU-GM이 64개로 phytohemagglutinin-stimulated leucocyte-conditioned midium의 79개보다는 적지만 12시간 혹은 3일간 세포없이 ALG만으로 배양한 conditionde midium인 12h ALG-M, 3d ALG-M이나 ALG없이 Isocove's modified Dulbecco's medium과 세포만으로 배양한 경우(ALG-0)보다는 많이 관찰되었다. 결론: 본 연구에서 ALG가 정상인에서 면역 자극효과가 있고 혼합배양에서 더 큰 증식효과가 발견되어 둘 사이에 상승효과가 있음을 발견하였다. 생체 외에서 과립구생성(granulopoiesis)을 조절하는 조혈인자의 생성에는 T림프구와 단구의 복잡한 상호작용에 의해 조절되고 항림프구 글로불린으로 자극받은 단구에서 조혈형성인자의 분비됨을 알 수 있었다. 이로서 재생불량성빈혈 환자에서 항림프구 글로블린으로 치료하기 전 생체 외 검사를 시행함으로서 임상 반응을 관찰하는 데 도움이 되리라 생각된다. Background/Aims: Several studies revealed that the antilymphocyte globulin(ALG) / antithymocyte globulin had immunostimulatory effect on hematopoiesis. The aim of this study was to evaluate how the ALG act on the hematopoiesis. Methods: Peripheral blood mononuclear cell (PBMNC) was isolated from normal human blood by Ficoll-Hypaque, monocyte from PBMNC by 2 sequential adherence method and T lymphocyte from sheep RBC. Thier purity was all above 95% by flow cytometer. The clones isolated from each cells were cultured in conditioned midium, observed by thymidine uptake test. The cultures of hematopoietic cells, in vitro were obtained using methylcellulose media. Results: The clones of PBMNC, T lymphocyte and monocyte all started to proliferate at ALG conc. 50μg/mL with their peak at ALG conc.250μh/mL. The proliferation was achieved at a greater degree in a T lymphocyte and monocyte mixture than when done separately in ALG conc.250μg/mL. The clones from ALG-stimulated T lymphocyte- conditioned medium or ALG-stimulated monocyte-conditioned medium proliferated more than in a medium without these stimulatory cells. Conclusion: We found that ALG had immunostimulatory effect on hematopoiesis, with its effect potentiated by interaction with T lymphocyte and monocyte, which could be controlled, in vitro.