미만성 대형 B-세포 림프종에서의 예후인자에 관한 연구

김삼용,곽승근,박상은,윤환중,조덕연,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

미만성 대형 B-세포 림프종은 가장 흔한 악성 림프종의 한 종류로서 우리나라에서는 전체 비호지킨 림프종의 50%를 차지한다. 비호지킨 림프종에서 병기는 호지킨병과는 달리 예후 인자로서의 유용성이 적다. 따라서 병기만을 예후 인자로서 평가하는 한계를 극복하기 위해 국제예후지표(International Prognostic Index)가 도입되었다. 특정 환자에서 IPI 점수와 함께 그 환자의 림프종의 생물학적 특성을 분석한다면 예후 예측에서 정확도가 높아질 것이다. 본 연구에서는 미만성 대형 B-세포 림프종에서 국제예후지표의 유용성을 확인하고자 하였으며, 각종 생물학적 지표의 면역화학염색을 통하여 이들을 배세포 중심 아형(germinal center subgroup : 이하 GC양 아형으로 약함)과 활성화 B-세포 아형(post-germinal center subgroup; 이후 pGC양 아형으로 약함)으로 분류하고 이들의 예후 예측에 대한 적절성을 평가하였다. 결과는 다음과 같다. 1. 연령분포는 37세에서 69세로 중앙치는 56세이었으며, 남자는 17예(65.4%), 여자가 9예(34.6%)였다. 병기는 Ⅰ, Ⅱ, Ⅲ, Ⅳ기가 각각 2예(7.7%), 11예 (42.3%), 5예(19.2%), 8예(30.8%)였다. 'B'증상은 5예(19.2%)에서 양성이었다. 진단 당시 혈청 LDH치가 상승한 경우가 11예(42.3%)였고, 거대종양(직경이 10㎝이상)을 갖는 경우가 5예(19.2%)이었다. ECOG 수행등급은 0이 2예(7.7%), 1이 18예(69.2%), 2가 5예(19.2%), 3이 1예(3.8%)이었다. 2. 면역조직화학염색 상 bcl-2의 양성은 17예(65.4%), bcl-6의 양성이 20예(76.9%)이었다. CD10이 양성인 경우가 5예(19.2%)이었다. IRF-4가 양성인 경우는 8예(30.8%)였다. 26명의 환자에서 bcl-6, CD10과 IRF-4를 이용하여 GC양 아형과 pGC양 아형으로 분류 하였는데, GC양 아형은 14예(53.8%)이었고, pGC양 아형은 7예(26.9%), 분류가 되지 않는 경우가 5예(19.3%)이었다. 3. 평균 48개월 동안 추적한 결과 중앙생존기간은 44개월이었고 생존기간은 1~100+개월에 분포하였다. Kaplan-Meier법에 의한 5년 누적 생존률은 32%이었다. 4. 병기, 'B' 증상, 혈청 LDH 농도, ECOG 수행등급, 거대종양유무가 통계학적으로 의미있는 임상적 예후 인자였다. 5. 면연조직화학염색에서는 bcl-2만이 통계학적으로 유의한 예후인자였다. 6. GC양 아형은 pGC양 아형에 비해 생존기간은 좋았으나, 통계학적 유의성은 없었다. 7. 다변량 분석결과 bcl-2 발현과 혈청 LDH치만이 예후에 영향을 미쳤다. Clinical Significanceof Expression of Biomarkers in Patients with Diffuse Large B-cell Lymphoma Diffuse large B-cell lymphoma(DLBL) is the most common type of lymphoma in Korea, representing about 50% of non-Hodgkin's Lymphomas. Although DLBL is usually considered as a specific category, the diversity in clinical presentation, morphology, genetic and molecular alterations strongly suggest that these tumors represent a heterogeneous group of neoplasia rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embraces patients with heterogeneous prognoses. It is likely that the prognostic assessment of patients with DLBL might be improved by using biological features. During the last decade, most studies dealing with the heterogeneity of DLBL have focused on individual protein expression and molecular alterations. The expression of individual antigens related to different stages of B-cell differentiation, including CD10, bcl-6, and IRF-4, may help to define groups of tumors with different clinical and pathological characteristics. To determine the clinical significance and prognostic value of individual biomarker expression and the biomarker expression patterns according to germinal center subgroup or post-germinal center subgroup of DLBL as defined by a relatively small number of single antigens, we studied 26 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for CD10, bcl-6, IRF-4, bcl-2 antigens. Two immunophenotyping profiles were distinguished according to the pattern of differentiation; germinal center(GC;CD10/Bcl-6+/IRF-4-) subgroup or postgerminal center (pGC ; CD10/bcl-6/IRF4+) subgroup. The results are as follows; 1) Baseline characteristics of patients were ; median age of patients was 56(range ; 37-69). 17 patients(65.4%) were male. 5 patients(l9.2%) had 'B' symptoms. Stages were as follows ; stage Ⅰ2 patients(7.7%), stage Ⅱ 11 patients(42.3%), stage Ⅲ 5 patients(l9.2%), stage Ⅳ 8 patients(30.8%). 11 patients (42.3%) had elevated LDH levels. 25 patients(96.2%) had ECOG performance grade 0-Ⅱ and 1 patient had grade Ⅲ. 5 patients(l9.2%) bad bulky disease. 2) The results of immunohistochemical study were as follows ; positive bcl-2 staining in 17 patients(65.4%), positive bcl-6 in 20 patients(76.1%), positive CD10 in 5 patients(l9.2%), positive IRF-4 staining in 8 patients (30.8%). 3) After a median follow up duration of 48 months, the median survival duration was 44 months with a range of survival of 1-100+ months. 5-year overall survival rate was 32% by Kaplan-Meier method. 4) The clinical factors affecting survival were elevated serum LDH level, B symptoms, bulky disease, stage at diagnosis and ECOG performance status 5) Among the biomarkers, only bcl-2 expression affected survival of DLBL patients 6) The germinal center like subgroup had superior survival than post-germinal center like subgroup but had no statistical significance. 7) Multivariate analysis showed that bcl-2 and serum LDH level had siginificance on survival Conclusion In addition to the known clinical prognostic factors, immunohistochemically defined characteristics such as bcl-2 expressionin DLBL is important and subgroups(germinal center or post-germinal center subgroup) of DLBL may have importance in predicting prognosis of DLBL patients

X선 촬영인자의 변화에 따른 영상의 주관적인 화질 평가

권덕문,박명환,김성환,박종삼,이준일,남효덕 대구보건대학 2001 대구보건대학 論文集 Vol.21 No.-

In this study, visual recognition of X-ray images were estimated using hawlet charts. The resolution has achieved excellent result when densities of film were 1.0~1.5. The more thickness of object was increase, the more the resolution was decrease, because scattered X-ray were increased. The more distance of object to film was increase, the more the resolution was decrease, because groedel effect. The more focal spot size was increase, the more resolution was decrease, because unsharpness was increase. The more field size was increase and grid ratio was decrease, the more resolution was decrease, because scattered X-ray were increase. As a result, we could to improve image quality by determination of resolution according to Radiography parameters. And, we proved that hawlet charts were useful for estimate of image quality and set up x-ray radiography.

朝鮮朝 書院敎育의 實際와 社會的 役割에 關한 硏究

張德三,李鐘祿,辛堯永,金俊基,李相基 圓光大學校 敎育問題硏究所 1989 敎育硏究 Vol.- No.8

The brief contents about the background of the appearance of Seo-won in Yi-Dynasty, the actual state of its education and its social role are as follows : 1. Our nation’s Seo-won was not settled as a Confucian educational institute until Sun Confucianism (性理學) was introduced in the middle of Yi-Dynasty. 2. The ultimate purpose of the Seo-won education was to establish the permanent aim of the following saints (法聖賢) and to cultivate sages by laying emphases on the ethical and moral education and the state examination education. 3. So-hak (小學) and Ka-lye (家禮) were introductory courses and Sa-se (四書) and Oh-kyeong (五經) were fundamental ones in the contents of education. 4. It took the educational method of Joo Ja (朱子) in Song-Dynasty and emphasized practical moral education by autere training syatem. 5. They administered it by the income of real estate which they secured, while they expanded its paddy fields with surplus income. 6. The educational system and equipment of Seo-won was similar to that of China which had a director and Yoo Sa (有司) system although there was some difference according to the class of Seo-won. 7. Seo-won did its duty as the distribution of information, the promotion of Confucianism, the enlightment of their countries, the inheritance of their traditional culture, the foundation of science and the publication or custody of publications.

KAERI 부지 주변의 환경선량 측정을 위한 온라인 감마선량 감시시스템

이정호,박두원,이원윤,이현덕,최용호,김삼랑,홍광희,이창우 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.2

환경감마선량 변동을 감시하기 위해 한국원자력연구소 부지 주변에 온라인 감마선량 감시망을 구성하였다. 모니터링 포스트에 설치된 전리함 검출기에 의해 측정된 자료는 무선전송방식으로 중앙통제소에 전송되어 실시간으로 감시된다. 무선전송 방식은 자료의 전송, 처리 및 자자에 신뢰도가 높고 경제적이었다. 감시시스템은 급격한 선량증가시 조기경보체제와 연결할 수 있게 하였다. On-line gamma monitoring system around KSERI-site was set up to monitor the radiation fluctuations in environment. Data on gamma exposure rates measured by the ionication chamber in the monitoring posts are transmitted to a computer of central control station with radio telemetry transmission and reliable on handing and storing of data. This monitroing system can triger an early warning system in the event of abnormal radiation levels.

만성 사구체 신염 환자들에서 신기능에 따른 경동맥 경화양상

김태형,김우식,김명재,이태원,김희진,김정훈,고용호,임천규,남기덕,노정현,김권삼 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.6

Background: Patients with chronic glomerulonephritis(CGN) have several risk factors for atherosclerosis including hypertension, renal functional disturbance, and lipid abnormality. The purpose of this study was to evaluate the intima-media thickness of carotid arteries and its association with a number of known risk factors for atherosclerosis in patients with CGN. Methods: Twenty four patients with CGN underwent B-mode ultrasound of the carotid arteries with 10 MHZ linear array probe. The intima-media thickness(IMT) was measured at two sites of far(posterior) wall of both common carotid artery and bifurcation, and the incidence of atherosclerotic plaque was examined. According to renal function, patients with CGN were divided into two groups, one group with normal renal function and the other group with decreased renal function. Normal contral consisted of 36 healthy persons. Results: Intima-media thickness of left bifurcation of carotid artery in CGN group with decreased renal function was significantly thicker than those of CGN group with normal renal function and normal control group(p$lt;0.05). Multiple regression analysis showed that increased intima-media thickness of carotid artery in CGN group was positively correlated to only age. Conclusion: The results suggest that intima-media thickness of carotid artery in patients with CGN is thicker as renal function decrease and other risk factors of atherosclerosis as well as age may influence intima-media thickness of carotid arteries.

Derivation of primordial germ cells from chicken blastodermal cells by BMP-2 and BMP-4 signaling

Duk Kyung Kim,Ki Duk Song,Yong Mok Lee,Sam Youl Seo,Jae Yong Han 한국가금학회 2002 한국가금학회 정기총회 및 학술발표회 Vol.19 No.-

도시경관에 대한 시민의 인지도 분석

김덕삼(Kim Duk Sam) 한국전통조경학회 1995 한국전통조경학회지 Vol.13 No.2

N/A N/A

홍수재해관리를 위한 3차원 GIS적용

김성삼(Kim Seong Sam),김원만(Kim Won Man),손덕재(Sohn Duk Jae),유환희(Yoo Hwan Hee) 대한공간정보학회 2004 한국공간정보학회 학술대회 Vol.2004 No.3

해양 관광 / 환경 정보 안내를 위한 음성기반 클라이언트 / 서버 시스템

김덕수(Duk Su Kim),전광명(Kwang Myung Jeon),이민지(Min Ji Lee),박남인(Nam In Park),박지훈(Ji Hum Park),윤재삼(Jae Sam Yoon),김홍국(Hong Kook Kim) 한국통신학회 2010 한국통신학회 학술대회논문집 Vol.2010 No.6

Adenoviral-mediated delivery of early growth response factor-1 gene increases tissue perfusion in a murine model of hindlimb ischemia

Lee, Young-Sam,Jang, Hyung-Suk,Kim, Jeong-Min,Lee, Jung-Sun,Lee, Jae-Young,Li Kim, Koung,Shin, In-Soon,Suh, Wonhee,Choi, Jin-Ho,Jeon, Eun-Seok,Byun, Jonghoe,Kim, Duk-Kyung Elsevier 2005 Molecular therapy Vol.12 No.2

<P><B>Abstract</B></P><P>To test the hypothesis that overexpression of early growth response factor-1 (Egr-1) contributes to the revascularization of ischemic limbs, a constitutively active form of Egr-1 (Egr-1*) was made and evaluated <I>in vitro</I> and <I>in vivo.</I> Analyses of the transduced myocytes revealed significant upregulation of bFGF, PDGF-A, PDGF-B, IGF-II, and TGF-β1. A coculture assay of the paracrine effects indicated that Ad-Egr-1* promoted proliferation and migration of endothelial cells. When Ad-Egr-1* was injected into the tibialis anterior muscle of mice, followed by explant culture in growth factor-reduced Matrigel, many capillary-like structures were observed in the Egr-1* group compared with minimal sprouting from the LacZ group, suggesting an angiogenic potential of Egr-1*. Next we evaluated Ad-Egr-1* in a murine model of hindlimb ischemia. Compared with slow revascularization in the control PBS or LacZ group, a rapid increase in tissue perfusion was observed in the Egr-1* group and the difference in flux ratio was statistically significant at day 7. In the injected muscle, expression of Egr-1*, upregulation of its target genes, and increased number of vessels staining positive for smooth muscle α-actin were observed. These results suggest that Egr-1 plays an important role in vascular recovery after occlusion and could be a potential target for therapeutic angiogenesis.</P>