서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

백혈병 마우스 모델의 동종골수이식에서 활성화된 자연살해세포들의 보충이 이식편대백혈병효과와 이식편대숙주반응에 미치는 영향

엄현석,한치화,박수정,김소연,정낙균,정대철,진종률,최일봉,양형모,서영훈,송현근,최인표,민우성,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: 백혈병에서 동종골수이식 (allogeneic bone marrow transplantation)의 성공적 치료 효과를 얻기 위해서는 이식편대숙주반응 (graft-versus-host disease, GVHD) 발생의 극복과 재발의 방지가 중요한 과제이다. 골수를 역류원심성 세포분리 (counterflow centrifugal elutriation, CCE) 방법으로 분리하여 얻은 rotor off (R/O) 세포분획은 T 세포의 수는 적지만 조혈모세포들을 다량 포함하고 있어 동종골수이식에서 주조직적합복합체 (major histocompatibility complex, MHC) 차이를 극복할 수 있고, 이식편의 생착 성공과 GVHD 발생 예방에 효과적이다. 그러나 골수로부터 T 세포를 제거하면 백혈병세포를 공격하는 이식편대백혈병 (graft-versus-leukemia, GVL) 효과가 감소되기 때문에 백혈병 재발의 빈도가 높다. 자연살해세포 (natural killer cell, NK cell)의 보충 첨가는 동종골수이식 후 GVHD 발생을 줄이면서 충분한 GVL 효과를 얻을 수가 있다. 따라서 저자는 분리 후 IL-2로 활성화시킨 NK 세포들을 골수 R/O 세포분획과 함께 백혈병 마우스 모델에 동종이식함으로써 GVHD와 GVL에 미치는 효과를 관찰하였다. 방법: Balb/c (H-2^(d)) 마우스에서 유래된 A20 (murine B-lymphoma/leukemia cell line, H-2^(d)) 백혈병 세포를 이식 2 일 전에 Balb/c 마우스에 주입하고, 치사량의 전신 방사선을 조사한 직후에 Balb/c 또는 C57BL/6 (H-2^(b)) 마우스의 골수 R/O 세포분획을 꼬리정맥을 통하여 주입하였다. 이들은 모두 이식 후 6-8 주 이내에 사망하였다. 동종이식의 대조군 (n=9)에는 1 × 10^(7)의 R/O 세포분획만을 주입하였고, 실험군 (n=9)에는 C57BL/6 마우스의 비장세포들로부터 단클론항체들을 이용한 negative selection방법으로 분리한 후 IL-2로 활성화된 5 × 10^(5)의 NK 세포분획을 1 × 10^(7)의 R/O 세포분획과 함께 주입하였다. GVL 효과의 판정은 이식 후 14 일과 28 일 째 되는 날 마우스에서 골수, 비장, 간 등을 얻어 백혈병 세포들의 침윤을 조직학적으로 관찰하였으며, GVHD의 정도는 육안적 관찰법으로 평가하였다. 결과: R/O 세포분획만을 이식한 대조군의 골수, 비장, 그리고 간 조직에서는 A20 백혈병 세포의 침윤이 각각 89% (8/9), 78% (7/9)와 22% (2/9)에서 관찰되었고, R/O 세포분획과 NK 세포분획을 함께 이식한 실험군에서는 비장과 간을 제외한 골수에서만 89% (8/9)에서 A20 백혈병 세포의 침윤이 관찰되어 두 군 사이에 장기별 분포의 차이를 볼 수 있었다 (P= 0.0001). 한편 GVHD는 두 군 모두에서 경하게 나타나서 유의한 차이는 없었다. 또한 생착 부전으로 사망한 마우스는 없었다. 결론: CCE를 이용하여 T 세포를 제거한 동종골수이식에서 NK 세포의 보충은 GVHD의 악화는 일으키지 않으면서, 백혈병의 진행을 억제하는 GVL 효과를 얻을 수 있었다. Background: Allogeneic bone marrow transplantation (BMT) with T cell-depleted marrow accompanies engraftment failure and relapse of leukemia by a loss of the graft-versus-leukemia (GVL) effect frequently, while it can prevent GVHD. Supplement of NK cells could prevent GVHD and enhance GVL effect in several murine allogeneis BMT models Roter off (R/O) cell fraction obtained by counterflow centriation elutriatio (CCO) contains small number of T cells and many hematopoietic stem cells. The aim of this study was to determine the effect of R/O cell fraction supplemented with IL-2 activated NK cells on GVL and GVHD within the leukemic mouse BMT model. Methods: Inoculation of A20 (H-2d, murine B-lymphoma/leukemia, Balb/c origin) cells into Balb/c mice via the tail vein 2 days prior to lethal total body irradiation (TBI) and infusion of the Balb/c BM or C57BL/6 (H-2b) R/O fraction were performed. It resulted in 100% mortality within 6 to 8 weeks. The irradiated mice in the control group were injected with 1 × 107 R/O cell fraction alone (n=9) and in the experimental group mice were injected with 1 × 107 R/O cell fraction plus 5 × 105 negatively selected IL-2 activated NK cell fractions of the spleens via the tail vein (n=9). On day 14 and 28 after BMT, the bone marrows, spleens, and livers of mice were harvested for histopathologic analysis of the infiltrations of leukemic cells. We then evaluated the GVHD within the mice. Results: A histopathologic study of the recipients receiving R/O fraction alone showed infiltration of leukemic cells, 89% (8/9) in bone marrows, 78% (7/8) in spleens, and 22% (2/9) in livers. The experimental group of mice showed only the infiltration of leukemic cells 89% (8/9) in bone marrows, not in spleens and livers. There were the organ differences of the leukemic cells infiltrations between the two groups (P=0.0001). There were no obvious differences in the GVHD scores between these two groups, and severe GVHD was not observed. There was no engraftment failure among groups. Conclusion: Thus, our findings suggest that R/O cell fraction obtained by CCE and supplemented with NK cells can promote GVL effect without mediating clinically overt GVHD in allogeneic BMT of mouse leukemia.

거대세포바이라스 감염과 Protein C, S 결핍증이 동반된 간문맥 혈전증 1례

강영훈,엄태민,송민섭 인제대학교 2009 仁濟醫學 Vol.30 No.-

Portal vein thrombosis in early childhood may be a result of perinatal events such as omphalitis, umbilical vein cannulation, intraabdominal sepsis, dehydration, or hypercoagulability states. In more than 50% of cases, the cause of portal vein thrombosis is unknown. We describe a 2-month-old girl with portal vein thrombosis associated with both cytomegalovirus infection and protein C and S deficiency.

획을 이용한 소형 전자기기용 한글 입력 시스템

정영준,엄종진,박민현,한욱표 강원대학교 정보통신연구소 2007 정보통신논문지 Vol.11 No.-

With advance of cellular phone technologies, the use of short message transmission with small or portable electronic devices has been explosively increasing. In spite of such demands there have been not many studies for Korean characters and their symbol combinations (below "Hangul"). While some other studies have been focused on the Hangul vowel, in this paper we proposed a new Hangul input system which presents Hangul consonants with basic symbol components (called as "hweok"). And we have performed performance evaluation with comparison to SK's Chunjiin and LG's Naragul in terms of the number of key buttons, finger moving distance and key strokes. The proposed system can make all of Korean characters with 5 or 6 Hangul hweoks without significant degradation of system performance.

안정된 초고속 홈네크워크를 위한 整合 케이블을 이용한 Wiring System

정영철,엄상현,지민석,이승학,강성관,박종안 조선대학교 전자정보통신연구소 2003 電子情報通信硏究所論文誌 Vol.6 No.1

Recently the integrated applicable interfacing technologies using IEEE1394 and UTP cables are considered to be applied to the apartments architecture This paper proposes a wiring system for a high-speed and long-distance data transmission in the future home network system using balanced cables As interfacing a medium UTP-Cat 5 is known as a cable used for LAN connection between PCs Although there are broadband transmission media such as coaxial cables and optical fibers, blanced cables are used because they are cheaper and easer to install The proposes a wiring system enables simultaneous transmission of the IEEE1394 signals of A/V-Data for Digital Consumer Electronics and the Ethernet signals of PCs LAN data using only on UTP-Cat.5 cable, which consists of four unshieled twisted pairs. In order to test the feasibility of this wiring system, we have evaluated the signal transmission and EMC characteristics Furthermore, for the purpose of experimentation, the wiring system is actually installed and evaluated by eye-diagram and BER. The obtained results show that the proposed wiring system can transmit IEEE1394 signals and Ethernet signals simultaneously using 10∼100m UTP-Cat.5 cables at 100Mbps.

진성 복압성 요실금 환자에서 복강경하 방광경부현수술의 유용성: 타술식과의 비교 연구

김용태,엄민식,이석영,신관희,서정원,윤석중,이상철,김원재 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: 진성 복압성 요실금의 치료법으로서 복강경을 이용한 Burch 수술을 타수술법과 비교하여 그 유용성을 알아보고자 하였다. 대상 및 방법: 진성 복압성 요실금을 주소로 본원 비뇨기과에서 수술을 시행받은 44명의 환자를 수술법별로 분류하여 수술법에 따른 성공률, 수술 시간, 입원 기간 및 합병증의 빈도를 비교 분석 하였다. 결과: 전체 환자에서 수술 성공률은 86.4% 였으며 이들 중 복강경을 이용한 Burch 수술군에서는 성공률이 100% 이었다. 복강경을 이용한 Burch 수술군은 타수술군에 비하여 입원 기간이 짧았다. 복강경을 이용한 Burch 수술군은 합병증이 매우 경미하였으며 전체 환자의 31.8%에서 단기간의 배뇨곤란을 호소하였으나 장기간의 배뇨곤란은 없었으며 슬링 수술군에서는 3례(16.7%)에서 심한 절박성 요실금을 호소하였다. 결론: 복강경을 이용한 Burch 수술은 높은 치료 성공률과 낮은 합병증의 빈도를 나타내어 진성 복압성 요실금의 치료에서 매우 우수한 수술법으로 사료된다. Purpose: We performed this study to investigate the usefulness of laparoscopic Burch colposuspension as a treatment of genuine stress incontinence compare to other anti-incontinence operation. Materials and Methods : We analyzed success rate, operation time, admission day, and complication rate of various anti-incontinence operations in 44 genuine stress incontinence patients who have been received operation in our hospital. Results : Overall success rate was 86.4%, but laparoscopic Burch coposuspension showed 100% success rate. Laparoscopic Burch colposuspension required shorter admission day compared to other anti-incontinence oparations. Complication rate was lower in laparoscopic Burch colposuspension group. Short-term voiding problems were identified in 31.8% of total patients but 3 patients(16.7%) who have received sling operation complained severe urge incontinence. Conclusion : Laparoscopic Burch colposuspension is considered as an effective surgical method for genuine stress incontinence due to high success rate and low complication rate.

유세포 측정을 통한 CD34^(+)세포의 정량방법 비교

양형모,서영훈,엄현석,민창기,김희제,정대철,이종욱,진종율,한치화,김춘추,김학주 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

본 연구소에서는 현재 CD34^(+) 세포의 정량에 사용되고 있는 4가지 서로 다른 방법을 가지고 골수에 적용하여 그 결과를 비교하였다. 각각의 방법들이 편리한 점과 불리한 점들을 가지고 있었지만, 통계적으로는 유의한 차이를 보이지 않았다. 1) CD34-PE/CD45-FITC 방법13(ISHAGE: International Society of Hematotherapy and Graft Engineering), 2) CD34-PE/CD14-FITC 방법, 3) CD34-PE/CD14-FITC/CD45-PerCP 방법, 4) DNA dye/CD34-PE/CD45-PerCP4(Becton Dickinson) 등을 비교하였으며 그 결과 CD34^(+) 세포의 농도는 다음과 같았다. 1) 0.473±0.345, (%Mean±SD, N=70) 2) 0.663±0.519, (N=20), 3) 0.543±0.381 (N=46), 4) 0.624±0.341, (N=32). 시료로는 여의도 성모병원 카톨릭 조혈모세포이식 센터에서 채혈한 골수를 이용하였다. Four different methods for flow cytometric quantitation of CD34+ cell were compared using bone marrow samples (n=168). Following combination of antibodies were used for the analysis : A) CD45-FITC/CD34-PE (n=70), B) CD14-FITC/CD34-PE (n=20), C) CD14-FITC /CD34-PE /CD45-PerCP(n=46), D) DNA dye/CD34-PE/CD45-PerCP (n=32). Each method showed no significant differences among them (P=0.126, ANOVA test, SPSS Version 7.5). When we compare these methods using same samples (n=12), the P value became 0.832. The mean % of CD34+ cells calculated in this experiment were A) 0.474%, B) 0.663%, C) 0.548%, D) 0.624% respectively. In our laboratory, we decided to use CD45-FITC/CD34-PE methods as a routine protocol.

북한 이탈주민의 외상후 스트레스장애에 대한 3년 추적연구

홍창형,유정자,조영아,엄진섭,구현지,서승원,안은미,민성길,전우택 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objective : This study is a follow-up of a first survey of 200 North Korean defectors who entered South Korea in 2001. The purpose of this study is to examine changes in the current prevalence of partial PTSD and full PTSD after 3 years and to evaluate related factors. Methods : This study followed up on 151 of the 200 North Korean defectors from our first survey. 20 interviewers conducted face-to-face interviews and assisted defectors in completing a self-report assessment. The traumatic events which participants with chronic PTSD and delayed onset PTSD experienced were then examined. Results : Over the 3 years, the current prevalence rate of partial PTSD was reduced from 31.8% to 5.3%, and the current prevalence rate of full PTSD was reduced from 27.2% to 4.0%. Of particular interest was that 88.8% of those diagnosed with full or partial PTSD in the first survey had recovered after 3 years. Conclusion : The current prevalence rate of partial and full PTSD rapidly decreased during 3 years.

각종 난치성 혈액 질환에서의 비혈연간 골수이식

김동욱,한훈,김정아,김희제,민창기,엄현석,최정현,이종욱,한치화,홍영선,최일봉,신완식,민우성,김학기,김춘추,김원일,김동집 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

목적: 비혈연간 골수이식은 혈연내에 적절한 골수공여자가 없는 만성골수성백혈병, 고위험군의 급성별혁병, 면역억제치료에 실패한 재생불량성빈혈 및 각종 난치성 조혈모세포질환의 완치를 위한 표준적인 치료방법으로 정착되고 있다. 혈연간 표준적인 동종 이식에 비하여 비혈연간 이식시에는 생착부전, 이식편대숙주반응과 감염이 더 빈번하게 발생하며, 국내에서는 아직까지 체계적인 임상연구결과가 보고된 바 없었다. 이에 본 센터에서는 1995년 10월 이후로 약 20개월간 26예의 비혈연간 골수이식을 시행하였으며 3개월 이상의 추적관찰이 가능하여 이식초기 합병증의 관찰 및 분석이 가능하였던 20예의 환자를 대상으로 이식성적 및 문제점을 보고함으로써 새롭게 확대되고 있는 이 분야의 임상연구 및 진료의 활성화를 꾀하고자 한다. 방법: 각종 혈액 종양질환으로 비혈연간 이식을 시행한 총 26예의 환자중 3개월이상의 추적관찰이 가능하였던 20예를 대상으로 후향적으로 임상경과를 분석한 후 생존 분석을 시행하였고, 환자의 연령, 성별, 질병의 상태, 조식 적합 항원의 일치정도, 이식편대 숙주 반응의 유무와 생존기간과의 상관관계를 살펴보았다. 또한 표준위험군과 고위험군으로 나누어 생존율을 비교하였고 이식과 관계된 생착 부전, 이식편대숙주반응, 감염의 발생과 양상 그리고 그 합병증을 관찰하였다. 결과: 1. 환자와 공여자간에 HLA 불일치가 20예 중 4예에서 있었으며, 생착여부의 확인이 가능했던 17예 중 16예에서 생착이 확인되어 94.1%의 생착율을 보였다. 2. 급성이식편대숙주반응은 62.5%(10/16예)에서 발생하였으며 111도 이상의 급성의 이식편대숙주 반응은 25%(4/16예)에서 발생하였다. 만성이식편대숙주반응은 40%(2/5예)의 환자에서 발생하였으며 이들 모두 국소형으로 중증의 진행형 만성이식편대숙주반응이 관찰된 환자는 없었다. 3. 호흡기 합병증은 10예(50%)에서 발생하였으며 감염성 폐렴을 포함한 호흡기 합병증이 가장 흔한 일차적인 사망 원인이었다. 호흡기 합병증이 발생했던 10예중 6예가 감염에 의한 폐렴이 의심되었고 나머지 4예는 특발성 간질성 폐렴이었다. 4. 8.5개월의 중앙추적기간 중 35%의 생존율을 관찰할 수 있었고, 생존기간은0.5개월에서 15개월 (중앙치:4개월)이었다. 한편 고위험군은 25%(3/12예), 표준위험군은 50%(4/8)의 생존율을 관찰할 수 있었다. 5. 가장 흔한 사망 원인은 감염성 폐렴을 포함한 호흡기 합병증(6예)이었고, 이외의 사망 원인으로는 급성 이식편대숙주반응과 다장기부전이 각각 2예, 생착 부전, 간정맥 폐쇄, 그리고 재발이 각각 1예였다. Unrelated bone marrow transplantation(UBMT) has been increasingly recognized as the standard treatment for cure of chronic myelogenous leukemia, high risk acute leukemia, aplastic failed on immunotherapy, and the variety of refractory hematologic diseases in patients lacking a related donor. However, as compared to HLA identical sibing transplantation, UBMT carries higher incidence of graft failure, graft versus host disease(GVHD), and infection. In our center, 26 patients underwent UMBT between October 1995 and June 1997. The minimum follow-up of 3 months was possible in 20 patients, for whom early complications and clinical outcomes were assessed. The median age of the 20 patients was 24 years. 8 patients had standard risk disease and 12 patients had high risk disease. All patients received various preparative regimens including total body irradiation according to disease and disease status. 19 patients received CsA + short course MTX for GVHD prophylaxis. One patient received marrow that was depleted of T cells ex vivo using avidinbiotin column. The class I loci were typed by serological methods and HLA-A, HLA-B and HLA-DRB1. 3 additional pairs were one minor mismatched at the HLA-B locus. Another one patients was one major mismatched at the DRBI alleles. 17 patients were evaluable for engraftment. Successful enfraftment was confirmed in 16 patients(94.1%). Only one patient who was performed one major DRBI mismatched transplants experienced graft rejection. 16 patients were evaluable for acute GVHD. The overall incidence of acute GVHD developed in 4 patients(25%). Five patients were evaluable for the development of Ⅳ acute GVHD developed in 4 patients (25%). Five patients were evaluanle for the development of chronic GVHD. 2 patients(40%) developed limited chronic GVHD. Respiratory complications including pulmonary infection developed in 10 patients(50%) and these complications were the most common primary cause of death. Of these 10patients, 6 had pneumonia due to fungus(4 patients), pacterial (1 patient), and CMV infection (1 patient) and 4(20%) had idiopathic interstitial pneumonitis and/or adult respiratory distress syndrome. The duration of median follow- up was 8.5 months and 7 of 20 patients(35%) are alive at the time of this analysis with survival duration of 0.5 to 15 months(median survival duration: 4 months). The overall survival was 25% (3/12 patients) in high risk group and 50%(4/8 patients) in standard group. From these results, we can predict that the incidence and severity of GVHD in Korea are lesser than multiracial countries and the long-term survival of patients with standard risk disease can approach that of HLA matched sibling transplants. For the past two years, the performance of UBMT has been rapidly increasing and it will be possible to analyze much larger number of patients soon in Korea. In the future the problems of graft failure, GVHD, and infection due to long lasting immunocompromised status will need to be overcome by continued medical research. In addition, the volunteer donor pool will have to be expanded by the promotion of the national awareness of its need.

High Malaria Prevalence among Schoolchildren on Kome Island, Tanzania

Min-Jae Kim,Bong-Kwang Jung,Jong-Yil Chai,Keeseon S. Eom,Tai-Soon Yong,Duk-Young Min,Julius E. Siza,Godfrey M. Kaatano,Josephat Kuboza,Peter Mnyeshi,John M. Changalucha,Yunsuk Ko,Su Young Chang,Han-Jo 대한기생충학열대의학회 2015 The Korean Journal of Parasitology Vol.53 No.5

In order to determine the status of malaria among schoolchildren on Kome Island (Lake Victoria), near Mwanza, Tanzania, a total of 244 schoolchildren in 10 primary schools were subjected to a blood survey using the fingerprick method. The subjected schoolchildren were 123 boys and 121 girls who were 6-8 years of age. Only 1 blood smear was prepared for each child. The overall prevalence of malaria was 38.1% (93 positives), and sex difference was not remarkable. However, the positive rate was the highest in Izindabo Primary School (51.4%) followed by Isenyi Primary School (48.3%) and Bugoro Primary School (46.7%). The lowest prevalence was found in Muungano Primary School (16.7%) and Nyamiswi Primary School (16.7%). These differences were highly correlated with the location of the school on the Island; those located in the peripheral area revealed higher prevalences while those located in the central area showed lower prevalences. Plasmodium falciparum was the predominant species (38.1%; 93/244), with a small proportion of them mixed-infected with Plasmodium vivax (1.6%; 4/244). The results revealed that malaria is highly prevalent among primary schoolchildren on Kome Island, Tanzania, and there is an urgent need to control malaria in this area.