불응성 자가면역질환에서의 자가조혈모세포이식

민도준,양동원,민창기,김완욱,이상헌,박성환,김동욱,이종욱,조철수,민우성,김범생,김호연,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: 기존의 치료에 불응하고 예후가 불량한 자가면역질환 환자들에게 최근 고용량 면역억제 및 조혈모 세포이식이 새로운 치료방법으로 대두되고 있다. 저자들은 다발성 경화증(multiple sclerosis, MS) 및 류마티스 관절염(rheumatoid arthritis, RA) 등 2명의 자가면역질환 환자들에서 자가조혈모세포 이식을 시행하였다. 방법: 말초혈액 조혈모세포 가동화를 위하여 cyclophosphamide (4 g/㎡) 및 granulocyte colony stimulating factor (10 g/kg/day)를 투여하였고, CD34+ 세포를 분리·채집 하였다, 이식 전처치로 MS 환자에서 BEAM 및 antihymocyte globulin (ATG) (3.75 mg/kg), RA 환자에서 fludarabine (180 mg/㎡), ATG (10 mg/kg)와 busulfan (8 mg/kg)을 투여하였다. 결과: 호중구 수가 500/㎕ 이상으로 회복되는 기간은 MS 환자에서 9일, RA 환자에서 15일이었다. 혈소판이 20.000/㎕ 이상으로 회복되는 가간은 RA 환자에서 9일 이었고, MS 환자에서는 혈소판 감소증이 발생하지 않았다. 비혈액학적 독성으로 MS 환자에서 WHO 1도의 오심 및 점막염이 관찰되었다. MS 환자는 이식 6개월 후까지 시력감소가 남아있었으나, 이식전에 관찰되던 감각이상 및 운동장애 등의 신경학적 이상 소견은 더 이상 관찰되지 않았다. RA 환자는 이식 1개월 후 관절 증상 및 검사소견의 호전을 보였다. 결론: 불응성 자가면역질환 환자에서 고용량 면역억제 및 조혈모세포이식은 적은 독성으로 높은 치료효과를 기대할수 있으며, 향후 이 시술의 임상적 의의를 규명하기 위하여 전향적이고 장기적인 연구가 필요할 것으로 사료된다. Background: High-dose immunosuppressive therapy followed by autologous hemathpoietic stem cell transplantation (HSCT) has been proposed as a new approach to treat severe, refractory autoimmune diseases. We describe two patients with refractory autoimmune diseases (one multiple sclerosis 〔MS〕and one rheumatoid arthritis〔RA〕) who underwent T-cell-depleted autologous peripheral bleed stem cell transplantation for the first time in Korea. Methods: We mobilized autologous stem cells with cyclophisphamide (4 g/㎡) and granulocyte colony-stimulating factor (10 ㎍/kg/day). Stem cells were enriched ex vivo using CD34-positive immunoselection and reinfused after high-dose chemotherapy with BEAM and antithymocyte globulin (ATG) (3.75 mg/kg) in MS, or fludarabine (180 mg/㎡), ATG (10 mg/kg) and busulfan (8 mg/kg) in RA. Results: The engraftment with an absolute nerutrophil count greater than 500㎕ occurred on day 9 in MS and 15 in RA, respectively. The time to nontransfused platelet count greater than 2.000/㎕ was 9 day in RA. MS patient did not show ant episode of thrombocytopenia. Regimen-related non-hematopoietic toxicity was minimal. For 6 months since HSCT, them patient with MS had been free from previously existed sensory and motor abnormalities except decreased visual acuity. Then patient with RA and only one tender joint and two mildly swollen joints with improvement in laboratory parameters at one month after HSCT. Conclusion: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of intractable autoimmune diseases. The durability of remission, however, remains to be clarified.

NK/T 세포 림프종 환자에서 시행된 비골수제거성 조혈모세포이식

정준원,김진석,장준호,서형찬,이승태,김현옥,양우익,민유홍,한지숙,고윤웅 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.2

저자 등은 맹장, 충수돌기 및 흉막을 침범한 고위험군 NK/T 세포 림프종 환자에서 비골수제거 조혈모세포이식을 시행한 후 이식연관 합병증 없이 무병생존하였기에 보고하는 바이다. NK/T cell lymphoma is a rare type of non-Hodgkin"s lymphomas. It has the histological features of angiocentric lymphoma characterized by prominent angio-invasion by tumor cells, and commonly presents in nasal and paranasal structures. Non-nasal form of NK/T cell lymphoma involves skin, gastrointestinal tract, or liver. With conventional chemotherapy and/or radiotherapy, NK/T cell lymphoma shows poor response rate and seldom results in long term survival. Especially, non-nasal form has more aggressive clinical manifestations and grave outcome than nasal form. We report a case of NK/T cell lymphoma presenting with small bowel perforation and malignant pleural effusion due to lymphoma infiltration, transplanted with allogeneic peripheral blood stem cells from HLA identical sibling donor after fludarabine-based nonmyeloablative chemotherapy. After transplantation, the patient achieved an enduring tri-lineage hematological complete response without any evidence of relapse for 10 months.

δ- 半素環에 관하여

千章鎬,朴準元 嶺南大學校 基礎科學硏究所 1990 基礎科學硏究 Vol.10 No.-

We obtain equivalent conditions of δ-prime rings. J.Bergen, S.Montgomery and D. S. passman [1] proved that if R contains no nonzero nil δ-ideal, then R is a subdirect product of δ-prime rings with the property that every annihilator ideal is nilpotent.

만성 무릎관절 통증환자에서 내측 반월상연골 손상과 관절 퇴행성 변화의 감별을 위한 ^99mTc-MDP 무릎관절 SPECT의 진단기준

팽진철,정준기,정환정,유재호,강원준,소영,이동수,이명철,성상철,이명철 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.2

목적 : 만성 무릎관절 통증환자에서 관절의 퇴행성 변화로 인하여 ^99mTc-MDP SPECT를 이용한 관절 내 장애의 진단성능이 떨어지게 된다. 이 연구에서는 내측 구획의 섭취 증가가 관찰될 때 이를 내측 반월상연골 손상(MMI)과 퇴행성 변화(DC)로 감별 진단하기 위한 진단기준을 찾고자 하였다. 대상 및 방법 : 3개월 이상의 만성 통증으로 무릎관절 SPECT를 시행하고 이후 관절경 검사를 통해 관절 병소의 확진을 받은 환자 중 SPECT 상 내측 구회에 섭취 증가를 보인 47명, 49예의 영상을 대상으로 하였다. SPECT 영상에서 내측 경골 고원부에 초승달 모양의 섭취가 관찰될 때 MMI로 진단하는 기준(진단기준 Ⅰ), 초승달 모양 섭취 양상에 따라 전측, 중앙측, 후측 및 미만성으로 구분하고 이 중 중앙측, 후측, 미만성만을 MMI로 진단하는 기준(진단기준 Ⅱ), 이에 더해 섭취의 정도를 등급화하여 내측 구획에서 대퇴골 부위보다 경골 고원부의 섭취가 더 높을 때만 MMI로 진단하는 기준(진단기준 Ⅲ)의 세 가지 진단기준을 설정하고 이들의 진단성능을 비교하였다. 결과 : MMI 진단의 예민도와 특이도가 진단기준 Ⅰ에서 각각 93%, 14%, 진단기준 Ⅱ에서 각각 89%, 38%, 진단기준 Ⅲ에서 75%. 67%로 형태학적 기준과 섭취 정도에 의한 기준을 첨가할수록 진단성능이 향상되었다. 결론 : 이 연구에서는 무릎관절 SPECT가 적용되는 실제 임상 적응중에 가까운 만성 무릎관절 통증에서, 퇴행성 변화와 관절 내 장애를 감별하는 향상된 진단기준을 제시하였다. 이를 통하여 선별검사로서 무릎관절 SPECT의 진단적 가치를 더욱 높일 것으로 기대된다. Purpose: In patients with chronic knee pain, the diagnostic performance of ^99mTc-MDP knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake is increased in medial compartment. Materials and Methods: A total of 49 knee SPECT of the patients with chronic (more than 3 months) knee pain, which showed increased ^99mTc-MDP uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion Ⅰ, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion Ⅱ, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid posterior, and diffuse patterns were diagnosed as MMI. In Criterion Ⅲ, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. Results: The sensitivity and specificity were 93% and 14% in Criterion Ⅰ, 89% and 38% in Criterion Ⅱ, and 75% and 67% in Criterion Ⅲ, respectively. Criterion Ⅲhad significantly improved diagnostic performance, especially, specificity. Conclusion: In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain.

출력 전압 제어 콘버터의 입력단 고조파 해석 및 역율 개선에 관한 연구

金東熙,裵英鎬,丁元榮,裵相俊 嶺南大學校 工業技術硏究所 1995 工業技術硏究所論文集 Vol.23 No.2

This study describes a output voltage controlled converter eliminating low frequency harmonics and improving power factor in the AC side by symmetrical angle control and sinusodal PWM method. This method is increased the magnitude of fundamental component by symmetrical angle control and eliminated lower order harmonics componants by SPWM.

지속성 외래 복막투석환자에서 발생한 장간막경색증 1예

강동구,이준상,윤재호,장원철,조영일,송종호,전혜정 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

The mesenteric infarction, as a abdominal disease which show acute abdominal pain and almost need to emergency operation, has very high mortality. This mesenteric infarction has been reported very rarely. Also specific clinical manifestations are not clear, therefore initial diagnosis can be missed easily so that patients usually miss their opportunities for adequate treatment. Especially CAPD patients have high mortality because of their rareness and having similar symptoms like CAPD peritonitis. The authors report that the mesenteric infarction was miss-diagnosed to the CAF'D peritonitis with unspecific symptoms.

신규 방사성 항암제 DW-166HC 의 소핵시험

문은이(Eun Yi Moon),이진(Jin Lee),이원용(Won Yong Lee),최청하(Chung Ha Choi),이덕근(Dug Keun Lee),유제만(Jei Man Ryu),정용호(Yong Ho Chung),윤성준(Sung June Yoon),박경배(Kyung Bae Park) 한국응용약물학회 1997 Biomolecules & Therapeutics(구 응용약물학회지) Vol.5 No.3

DW-166HC (^(166)Holmium (^(166)Ho)-Chitosan complex) is a new radiopharmaceutic anticancer agent with a broad anti-tumorigenic spectrum, especially against human hepatic cancer. DW-166HC was evaluated for the appearance of micronucleus in polychromatic erythrocytes (PCEs) of mouse bone marrow cells after subcutaneous arid intravenous single administration. Bone marrow cells were prepared at 24 hr and 48 hr after DW-166HC-I (^(165)Ho-Chitosan complex : cold compound) administration and at 24 hr, 72 hr and 2 weeks after DW-166HC (^(166)Ho-Chitosan complex : hot compound) administration. The results showed there was no statistically significant increase of the numbers of PCEs with micronucleus in all DW-166HC-I administered groups compared with a negative control group but there was statistically significant increase of the numbers of PCEs with micronucleus at 24 hr arid 72 hr in all DW-166HC administered groups, which was recovered after 2 weeks from the drug administration. The results also showed the ratio of normochromatic erythrocytes (NCEs) to PCEs of all DW-166HC-I administered groups was not significantly different from that of a negative controi group but there was significant difference of this ratio at 24hr and 72 hr in all DW-166HC administered groups compared with that of negative group, which was also recovered after two weeks from the drug administration. These results suggested that DW-166HC-I may not cause any chromosomal damage but DW-166HC has in vivo mutagenic potential because of its radioactivity.

필러의 표면처리와 실리콘 고무의 트래킹특성

李水夫,崔鍾汶,李峻昊,池源泳 湖西大學校工業技術硏究所 1999 工業技術硏究所論文集 Vol.18 No.-

Polymer insulating materials are widely used in power distribution and transmission systems for their good dielectric properties, light weight, low cost, and good contamination performance. Tracking is one of the biggest problems to be overcome in polymer insulating materials. The alumina trihydrate(ATH) is widely used as a filler for improve the tracking performance of silicone rubber. In this paper, we have investigated the influence of surface treatment of fillers on the tracking performance of silicone insulator using the IEC 587 tracking test method.

완전대혈관 전위의 심방내 교정술 후 추적 관찰

김연우,노정일,허준,윤명자,김호성,최정연,윤용수,양세원,이정렬,김용진,노준량 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

방사선 조사에 의한 흰주 난포의 퇴축과 난포세포의 방사선 감수성

김수일,한승로,조근자,허대영,이영호,조문준,김무강,김원식 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

The aim of this study were to investigate radiation-induced atresia and radiation susceptibility in the rat ovary morphologically. Female rats (Sprague Dawley strain) of 4 weeks old were irradiated with dose of 4 Gy and 8 Gy, and sacrificed at hour 6, 12, and 24 after radiation. The H & E stain, the TUNEL method (ApopTag kit) and transmission electron microscopy (TEM) were used. In light microscopic observation, the number of atresia of ovarian follicles were increased significantly at 6h after irradiation (p<0.01). There was no significant difference between 4 Gy and 8 Gy irradiated groups. In TEM observation, granulosa cells in radio-sensitive follicles were characterized by several structural features including condensation of nuclear chromatin granules, nuclear fragmentation and apoptotic body formation. An apoptotic cell is observed to have been phagocytosed by a normal granulosa cell. Granulosa cells in radio-resistant follicles were characterized by several structural features including nuclear indentation, partial condensation of chromatin granules, mitochondrial swelling, dilatation of RER cisterns, accumulation of dense irregular masses, accumulation of lipid droplets, and increased lysosomal bodies. Number of gap junctions between granulosa cells were decreased, and intercellular space were widen than that of control animals. These findings were prominent at 6h after irradiation and were diminished at 12h and 24h after irradiation. With these results, it was concluded that radiation-induced follicular cell apoptosis and ovarian follicular atresia in rat ovary increased considerably at 6h after irradiation. Further studies are needed to reveal the more extensive differences between radiosensitive and radioresistant follicular granulosa cells.