발열이 있는 호중구 감소증 환자에서의 위험도 예측인자

정중식,권운용,김규석,임용수,이중의,서길준,윤여규 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. Methods: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. Results: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17,2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr < 75㎖/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). Conclusion: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-prediction factors in febrile neutropenia at the time of visiting the emergency department.

진행성 비호지킨 림프종 환자에서 ICE 구제 요법에 의한 조혈모세포 가동화 후 자가 말초혈액 조혈모세포이식

이제중,이병환,김여경,변정래,이일권,박무림,정익주,김형준 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.1

연구배경: 비호지킨 림프종에서 자가 말초혈액 조혈모세포이식술이 폭넓게 이용됨으로 인해서, 높은 치료효과뿐만 아니라 조혈모세포의 가동화 효율이 높은 구제 요법이 요구되었다. 방법: 본 연구에서는 진행성 비호지킨 림프종에서 ICE 요법을 이용하여 조혈모세포를 가동화시킨 후 자가 말초혈액 조혈모세포이식이 시행하였던 환자를 후향적으로 분석하였다. 결과: 대상 환자의 중앙 연령은 38세(범위, 16~61)였으며, ICE 요법은 환자당 4주기(범위, 1~6주기)가 투여되었고, 투여 간격은 중앙값이 24일(범위, 16~36일)이었다. 고위험도 관해군을 제외한 13예의 환자 중 완전반응은 7예(53.8%), 부분반응은 4예(30.8%), 진행성질환은 2예(15.4%)를 보였다. 치료에 따른 3~4등급의 혈액학적 독성은 중성구감소증이 13예(81.3%), 혈소판감소증이 7예(42.8%)에서 관찰되었다. 조혈모세포 채집은 ICE 요법 후 중앙값이 12일(범위, 6~20일)에 시행되었고, 각 ICE 요법당 채집한 단핵구치는 중앙값이 5.75× 10^(8)/체중, CD34^(+) 세포는 중앙값이 1.25× 10^(6)/체중, CFU-GM치는 중앙값이 1.19× 10^(5)/체중이었다. 조혈모세포이식은 11예에서 시행되었고, 중앙 추적기간 401일에 평가한 2년 전체생존율은 70.1±14.7%, 1년 및 2년 무사건생존율은 각각 60.7±15.4%와 32.3±17.1%를 보였다. 결론: ICE 요법은 재발성/불응성 비호지킨 림프종 환자에서 높은 치료 반응률과 만족할 만한 조혈모세포 가동화를 보여 주었지만, 치료에 대한 순응도가 낮아서 투여 간격이 연장되는 문제점을 안고 있어서, 우리나라 환자의 실정에 적합한 구제요법에 대한 연구가 필요할 것으로 생각된다. Background: Due to the extensive application of high-dose chemotherapy with autologous peripheral blood stem cell transplantation (PBSCT), a salvage chemotherapeutic regimen with high response rate as well as effective capacity of PBSC mobilization is needed in non-Hodgkin's lymphoma (NHL). Methods: We analyzed the applicability of ICE (ifosphamide, carboplatin, and etoposide) regimen in NHL patients who underewent autologous PBSCT. Results: The median age was 38 years (range, 16~61 years), the patients received median 4 cycles (range, 1~6 cycles) of ICE regimen, and the median interval between each chemotherapeutic cycle was 24 days (range, 16~36 days). There were 7 (53.8%) complete responses, 4 (30.8%) partial responses, and 2 (15.4%) progressive diseases after ICE regimen. Toxicity included grade 3/4 neutropenia and throm bocytopenia in 13 (81.3%) and 7 (42.8%) patients, respectively. PBSC collection began on median day 12 (range, 6~20 days) after ICE therapy. The median number of mononuclear cells, CD34+ cells, and CFU-GM was 5.75× 10^(8)/kg, 1.25× 10^(6)/kg, and 1.19× 10^(5)/kg, respectively. With a median follow- up of 401 days, the patients who underwent autologous PBSCT had overall survival with 70.1±14.7% at 2 year and event free survival with 60.7±15.4% and 32.3±17.1% at 1 year and 2 years, respectively. Conclusion: ICE chemotherapy is an effective cytoreduction and mobilization regimen in patients with NHL, but profound myelosuppression with delayed recovery might pose difficulties in applying for Korean patients. Further evaluation for appropriate salvage regimens in Korean patients should be needed.

필라델피아 염색체 양성 급성골수성백혈병에서 Imatinib Mesylate로 분자학적 관해를 유도한 후 성공적인 자가 말초혈액 조혈모세포이식이 시행되었던 1예

김여경,이제중,이병환,변정래,조덕,이일권,정익주,양동욱,김형준 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.1

저자들은 필라델피아 염색체 양성 급성골수성백혈병 환자에서 복합항암화학요법으로 혈액학적 완전관해를 유도하고, imatinib mesylate를 이용하여 분자학적 관해를 유도한 후, 성공적으로 자가 말초혈액조혈모세포이식을 시행하였던 1예를 경험하였기에 이를 보고하는 바이다. Philadelphia chromosome (Ph¹)-positive acute myeloid leukemia (AML) is very rare disease, comprising 3~4% of the AML, and is a clinically distinct entity with poor clinical outcome with conventional chemotherapy. We report a case of Ph¹-positive AML who underwent successful autologous peripheral blood stem cell transplantation after achieving a molecular remission with imatinib mesylate.

백서 Paraquat 두여에 의한 간과 폐 조직의 산화성 손상에서 Vitamin C와 Deferoxamine의 항산화 효과에 관한 연구

정연권,서길준,정중식,정성은,최국진,윤여규 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The toxicity of paraquat has been known to be caused by oxygen free radicals which leads to the lipid peroxidation and multiple organ failure. Although vitamin C has been known to be a potent antioxidant, recently there are numerous data which have shown that a low dose of vitamin C may act as a prooxidant due to the stimulation of the Fenton reaction with metal ions, which produces hydroxyl radicals. It has been reported that a deferoxamine in paraquat intoxication could reduce the production of the hydroxyl radicals by the inhibition of the Fenton reaction through the reduction of iron ion in tissue. The aim of this study was to evaluate the effect of the high and low dose of vitamin C and deferoxamine on lipid peroxidation and plasma TNF-α in paraquat intoxication. Methods: Female Sprague -Dawley rats were divided into seven groups: control group which was not given paraquat(20 mg/kg), P group which was given paraquat only, PVH group given paraquat and high dose of vitamin C(100 mg/kg), PVL group given paraquat and low dose of vitamin C(10 mg/kg), PVHD given paraquat, high dose of vitamine C and deferoxamine(100 mg/kg), PVLD given paraquat, low dose of vitamin C and deferoxamine, and PD given paraquat and deferoxamine. Animals were killed at 6 and 24 hours after treatment. Malondialdehyde(MDA), superoxide dismutase(SOD) and glutathione(GSH) contents, catalase activity, plasma TNF-α, and histologic changes in the lung and liver tissue were measured. Results: The lung histology in the PVH and PD or PVHD groups showed the significant decreases in the alveolar edema and interstitial thickness compared to the P group. The liver histololgy in the PVH and PVHD groups demonstrated marked differences in the central venous and sinusoidal dilatation compared to that of the P group. While the MDA levels of the lung and liver in the PVH and PD groups showed the significant reduction compared to that of the P group at 6 hours after treatment, all groups showed the significant changes compared to the P group at 24 hours. There was no significant change of the SOD levels of the lung and liver at 6 hours among all groups. At 24 hours, the SOD levels of the lung in PVH, PVL, and PVHD groups showed the significant increases compared to the P group. The increase of the SOD level in groups combined with deferoxamine, however, revealed a little reduction. The SOD level of the liver in PVH group only significantly increased compared to the P group at 24 hours. There was no significant change of the GSH level of the lung and liver among all groups at 6 hours. At 24 hours, the GSH level of the lung and liver were significantly increased in both PVH and PD group and PVH group, respectively, compared to the P group. Although the catalase activity of the lung was not significantly increased, that of liver was signiflcantly increased in both PVHD and PD groups compared to the P group at 6 hours. The catalase activities of the lung and liver were significantly increased in PVH, PD, and PVHD at 24 hours. The concentrations of the plasma TNF-α were slightly decreased at 6 hours and slightly increased at 24 hours compared to that of the P group, but they were not significant. Conclusion: This study showed that although the low dose of vitamin C had no effect, the high dose of vitamin C revealed a decrease of the MDA level and an increase of SOD, GSH, and catalase activity in the lung and liver tissues, and the effect of the high dose of vitamin C increased with time. The administration of the deferoxamine with or without high dose of vitamin C, however, significantly showed the inhibition of the lipid peroxidation and antioxidant effect and low dose vitamin C decreased the effect of deferoxamine. The effects of the vitamin C and deferoxamine on plasma TNP-α were not clearly shown.

노령의 대퇴 전자간 골절 치료에서 압박고 나사못의 안정성 및 유용성

김종오,노권재,윤여헌,고영도,유재두,정준모,방한천,정재학 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 노령의 대퇴 전자간 골절에서 압박고 나사못의 안정성에 영향을 주는 인자들간의 상관 관계와 골절 양상에 따른 술후 고관절 기능을 평가 및 분석하였다. 대상 및 방법: 압박고 나사를 이용하여 수술적 치료를 시행한 231명의 환자 중 6개월 이상 추시가 가능하였던 60세 이상 84명의 환자들을 대상으로 했다. 방사선적 계측은 압박고 나사못의 활강 길이 및 내반각, 가압 나사 위치, 정복 상태, 원위 골편의 내측 전위를 측정하였으며 술후 기능은 Clawson의 기능 평가표로 하였고 골절 양상에 따라 방사선 계측과 기능 회복과의 상관 관계를 평가하였다. 결 과: 임상 결과는 불안정 골절에서 양호가 10례, 불량이 23례, 안정 골절에서는 양호 40례, 불량이 11례로 안정 골절에서 임상 결과가 좋았고(p<0.001), 압박고 나사 활강은 10 ㎜ 이상일 때 양호가 4례, 불량이 21례, 10 ㎜ 이하에서 양호가 46례, 불량이 13례로 10 ㎜ 이상 활강시에 술후 결과가 불량했다(p<0.001). 다르 방사선적 계측 요인은 결과에 의미있는 차이를 보이지 않았다. 또한, 불안정 골절 중에서 전위 양상 골절의 경우 10㎜ 이상 활강이 12례, 10㎜ 이하 활강이 8례, 분쇄 양상 골절의 경우는 10㎜ 이상이 11례, 10㎜ 이하가 2례로 분쇄 양상의 불안정 골절에서 10㎜ 이상 활강이 의미있게 많았다 (p<0.001). 결 론: 10㎜ 이상의 지연 나사 활강은 고관절 기능 회복 약화를 유발시킬 수 있으며 불안정 골절 분쇄 양상 골절은 이런 지연 나사의 활강이 과도하게 유발될 수 있으므로 불안정 분쇄 양상 골절에서 압박고 나사의 단독 사용은 재고해 보아야 할 것이다. Purpose: To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fracture of the elderly. Materials and Methods: Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification. Results: There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10㎜, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10㎜, good results were obtained in 46, and poor in 13. (p<0.001).But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10㎜ and 10 cases with less than 10㎜. In comminuted type, there were 11 cases with lag screw sliding more than 10㎜ and 2 cases with less than 10㎜(p<0.001). Conclusion: The sliding of lag screw more than 10㎜ may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not good treatment option.

Cytochrome P450 1B1 promotes cancer cell survival via specificity protein 1 (Sp1)-mediated suppression of death receptor 4

Kwon, Yeo-Jung,Cho, Nam-Hyeon,Ye, Dong-Jin,Baek, Hyoung-Seok,Ryu, Yeon-Sang,Chun, Young-Jin Informa UK (TaylorFrancis) 2018 Journal of toxicology and environmental health. Pa Vol.81 No.9

Biological roles of cytochrome P450 1A1, 1A2, and 1B1 enzymes

Yeo‑Jung Kwon,Sangyun Shin,Young‑Jin Chun 대한약학회 2021 Archives of Pharmacal Research Vol.44 No.1

Human cytochrome P450 enzymes (CYPs) playa critical role in various biological processes and human diseases. CYP1 family members, including CYP1A1, CYP1A2,and CYP1B1, are induced by aryl hydrocarbon receptors(AhRs). The binding of ligands such as polycyclic aromatichydrocarbons activates the AhRs, which are involved in themetabolism (including oxidation) of various endogenousor exogenous substrates. The ligands that induce CYP1expression are reported to be carcinogenic xenobiotics. Hence, CYP1 enzymes are correlated with the pathogenesisof cancers. Various endogenous substrates are involvedin the metabolism of steroid hormones, eicosanoids, andother biological molecules that mediate the pathogenesisof several human diseases. Additionally, CYP1s metabolizeand activate/inactivate therapeutic drugs, especially, anticanceragents. As the metabolism of drugs determines theirtherapeutic efficacy, CYP1s can determine the susceptibilityof patients to some drugs. Thus, understanding the role ofCYP1s in diseases and establishing novel and efficient therapeuticstrategies based on CYP1s have piqued the interest ofthe scientific community.

Mutational Patterns and Novel Mutations of the <i>BRAF</i> Gene in a Large Cohort of Korean Patients with Papillary Thyroid Carcinoma

Jung, Chan-Kwon,Im, So-Young,Kang, Yeo-Ju,Lee, Hyoungnam,Jung, Eun-Sun,Kang, Chang-Suk,Bae, Ja-Seong,Choi, Yeong-Jin Mary Ann Liebert 2012 Thyroid Vol.22 No.8

Dendropanax morbifera Léveille extract ameliorates D-galactoseinduced memory deficits by decreasing inflammatory responses in the hippocampus

Kwon Young Lee,Hyo Young Jung(강사),Dae Young Yoo,Woosuk Kim,Jong Whi Kim,Hyun Jung Kwon,Dae Won Kim,Yeo Sung Yoon,In Koo Hwang,Jung Hoon Choi 한국실험동물학회 2017 Laboratory Animal Research Vol.33 No.4

In the present study, we examined the effects of Dendropanax morbifera Léveille leaf extract (DML) on Dgalactose-induced morphological changes in microglia and cytokines, including pro-inflammatory cytokines (interleukin [IL]-1β, IL-6, and tumor necrosis factor [TNF]-α) and anti-inflammatory cytokines (IL-4 and IL-10) in the hippocampus. Administration of DML to D-galactose-treated mice significantly improved D-galactose-induced reduction in escape latency, swimming speed, and spatial preference for the target quadrant. In addition, administration of DML to D-galactose-treated mice significantly ameliorated the microglial activation and increases of IL-1β, IL-6, and TNF-α levels in the hippocampus. Administration of D-galactose significantly reduced IL-4 levels in the hippocampus, while administration of DML to D-galactose-treated mice significantly increased IL-4 level. However, we did not observe any significant changes in IL-10 levels in hippocampal homogenates. These results suggest that DML reduces D-galactose-induced mouse senescence by reducing pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α, as well as increasing anti-inflammatory cytokine IL-4.

Annexin A5 as a New Potential Biomarker for Cisplatin-Induced Toxicity in Human Kidney Epithelial Cells

( Yeo Jung Kwon ),( Jin Joo Jung ),( Na Hee Park ),( Dong Jin Ye ),( Dong Hak Kim ),( Aree Moon ),( Young Jin Chun ) 한국응용약물학회 2013 Biomolecules & Therapeutics(구 응용약물학회지) Vol.21 No.3

Cisplatin is a member of platinum-containing anti-cancer drugs that causes cross-linking of DNA and ultimately cancer cell apoptosis. The therapeutic function of cisplatin on various types of cancers has been widely reported but the side effects have been discovered together and nephrotoxicity has been regarded as major side effect of cisplatin. To select candidates for new sensitive nephrotoxicity biomarker, we performed proteomic analysis using 2-DE/MALDI-TOF-MS followed by cisplatin treatment in human kidney cell line, HK-2 cells, and compared the results to the gene profi le from microarray composed of genes changed in expression by cisplatin from formerly reported article. Annexin A5 has been selected to be the most potential candidate and it has been identifi ed using Western blot, RT-PCR and cell viability assay whether annexin A5 is available to be a sensitive nephrotoxic biomarker. Treatment with cisplatin on HK-2 cells caused the increase of annexin A5 expression in protein and mRNA levels. Overexpression of annexin A5 blocked HK-2 cell proliferation, indicating correlation between annexin A5 and renal cell toxicity. Taken together, these results suggest the possibility of annexin A5 as a new biomarker for cisplatin-mediated nephrotoxicity.