제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

급성 골수성 백혈병 환자에서 발생한 침습성 아스페르길루스중에 대한 수술적치료 1 예

배영환;어원식;어상민;김승만 김태영;박수영;서영경;정은주;안효정 인제대학교 2011 仁濟醫學 Vol.32 No.-

Invasive pulmonary aspergillosis is known to have a poor prognosis and major cause of morbidity and motality in patients with hematologic disease. Without adequate therapy, invasive pulmonary aspergillosis will almost always progress to fatal pneumonia. Early administration of antifungal agents in patient with invasive pulmonary aspergillosis is most important. And surgical resection of aspergillous-infected tissue may be useful in patients with lesions that are contiguous with great vessel and lesions causing hemoptysis. We reported a rare case of surgical resection as curative treatment for invasive pulmonary aspergillosis patient in 58-year-old man who had the history of acute myeloid leukemia.

Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

Nanogenerators: Fully Rollable Transparent Nanogenerators Based on Graphene Electrodes (Adv. Mater. 19/2010)

Choi, Dukhyun,Choi, Min-Yeol,Choi, Won Mook,Shin, Hyeon-Jin,Park, Hyun-Kyu,Seo, Ju-Seok,Park, Jongbong,Yoon, Seon-Mi,Chae, Seung Jin,Lee, Young Hee,Kim, Sang-Woo,Choi, Jae-Young,Lee, Sang Yoon,Kim, Jo WILEY-VCH Verlag 2010 ADVANCED MATERIALS Vol.22 No.19

<B>Graphic Abstract</B> <P>The cover shows an image of fully rollable transparent nanogenerators synthesized using chemical vapor deposition grown large-scale graphene sheets as transparent electrodes and piezoelectric ZnO nanorod arrays. Sang-Woo Kim, Jae-Young Choi, and co-workers report on p. 2187 the electrical and structural stability of the nanogenerators, with excellent charge scavenging performance under external mechanical loads such as bending and rolling. This study shows that graphene-based nanogenerators are very promising for self-powered rollable transparent device applications. <img src='wiley_img_2010/09359648-2010-22-19-ADMA201090066-content.gif' alt='wiley_img_2010/09359648-2010-22-19-ADMA201090066-content'> </P>

응집에 의한 생물학적 처리수의 색도 및 난분해성 유기물 제거

서태경, 박상민, 박노백, 임지영, 전항배 충북대학교 건설기술연구소 2008 충북대학교 건설기술연구소 논문집 Vol.27 No.1

This study was to evaluate the optimum conditions for chemical coagulation to remove color and non-biodegradable organic matters from the biologically treated water of piggery wastewater. Raw water was fractionated by characteristics of dissolved organic matter. The fractions of hydrophilic substance and molecular weight cut-off(MWCO) below 500 in raw water were 51% and 74%, respectively. SC(streaming current) was measured to find out the optimum pH values and dosages for aluminium sulfate[Al₂(SO₄)₃·14H₂O] and ferric chloride[FeCl₃·6H₂O] as a coagulant, which was compared with color and turbidity removal efficiencies followed by coagulation, flocculation and sedimentation. From several jar tests, optimum pH values and dosages of coagulants were well matched with the results of SCD analyses. The optimum dosages(pH values) of aluminium and ferric were 5.84 mM(pH 4.0) and 7.03 mM(pH 5.6), respectively. At optimum conditions of coagulation, color removal efficiencies for aluminium sulfate and ferric chloride were as high as 89.3 and 97.9%, respectively. Chemical coagulation showed good performance to remove color and non-biodegradable organic matters from biologically treated water.

가열로의 열적해석 및 설계인자에 관한 연구

서용석,강성규,박원희,민동호,김태국 중앙대학교 기술과학연구소 1998 기술과학연구소 논문집 Vol.28 No.-

본 연구에서는 3차원 정육면체 가열로 내의 전도-대류-복사 복합열전달 특서을 해석하였으며, 연소가스의 유입속도, 벽면의 반사율과 매체의 흡수계수 등과 같은 인자들의 변화에 따른 영향을 살펴보았다. 가열로의 벽면들은 단열되어 있고 가열로 내부로 일정한 온도의 연소가스가 유입될 때 시스템 내부의 온도는 유입 온도와 비슷하게 균일한 온도 분포를 갖는 것으로 예측할 수 있었다. 유입 속도가 증가하더라도 가열로 내부의 온도에는 거의 영향을 미치지 않았으며, 가열로는 유입되는 연소가스의 흡수계수가 증가할수록 가열로 내부의 온도는 보다 균일하게 된다. 또한, 가열로 내부 벽의 반사율이 커질수록 벽의 온도는 감소하고 또한 벽면에 작용하는 유효복사열유속은 증가함을 알 수 있었다. 이러한 해석 결과로부터 가열로 내부의 온도 분포는 매체의 흡수계수가 클수록 그리고, 벽면 반사율이 작을수록 일정하게 유지될 수 있다는 것을 알 수 있었다. 그리고 이러한 결과들을 종합하여 볼 때 가열로의 설계 시 일정한 열의 유입과 가열로를 단열시키는 것이 중요하며, 그리고 매체의 흡수 계수를 크게 하고, 그리고 벽면의 반사율을 작게 하는 것은 가열로 내부의 온도를 일정하게 유지할 수 있는 중요한 조건이 된다는 것을 알 수가 있었다.

혈관신경성부종의 문헌적 고찰 및 증례 보고

서보영,임재석,김 온,김성문 大韓顎顔面成形外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.1

Angioneurotic edema is rarely seen in dental practice and manifested by acute attacks of swelling of the extremities, face, airway, or abdominal visera, occuring spontaneously and suddenly or secondary to trauma. Two types are recognized : hereditary and nonhereditary. Prophylatic therapy may be used by fresh frozen plasma or antifibrinolytic agents in hereditary type. Good supportive care for acute attacks, together with a knowledge of course of the disease, can prevent asphyxiation from airway obstruction. A case of acute angioneurotic edema of the facial area in a 19-year-old man is presented in conjunction with a review of the literature. Angioneurotic edema attacks him acutely after the extraction of the lower, right 3rd molar.

Helicobacter pylori 양성인 소화성 궤양 및 위염 환자에서 Helicobacter pylori 제균에 대한 판토프라졸 포함 삼제 요법의 임상효과 및 내약성에 대한 연구

서영호,이완식,주영은,김현수,최성규,유종선,김행재,서순팔,김세종 최신의학사 2000 最新醫學 Vol.43 No.11-12

기업ㆍ민간 스포츠센터 소비자의 이용만족도 비교 분석

서봉한,노영태,이상봉,이영덕,정용제,박병주 부산대학교 체육과학연구소 2000 體育科學硏究所 論文集 Vol.16 No.-

The purpose of this study was to analyze differences between satisfaction of members who attend sports center managed by enterprise and those of members who attend sports center managed by private. We hoped through these analysis, consumer could get useful date for choosing sports center and managers could gets data for establishing effective marketing strategy. The objective of this study was 500 members of sports center managed by enterprise and by private in city of Ulsan. Questionnaires were completed through self-administration. We used SPSSWIN 8.0 to analyze gathered data Chi-square test was used for analyzing conditions of members. All statistical data were tested with p〈.05. The result were as follows. 1.Satisfaction of facility and service 1) According to sex, men showed higher satisfaction with enterprise center. In detail, men showed higher satisfaction with enterprise center in exercise facility, dressing room, shower room and sanitation. 2) According to age, 30's show the highest satisfaction with enterprise center in all items but in parking lot. In the comparison of whole mean, 50's showed the highest satisfaction with both enterprise and private center. 3) According to education level, more than college graduation, college student or dropout and high school graduation showed their satisfaction in turn in enterprise center and college student or dropout, more than college graduation and high school graduation showed their satisfaction in turn in private center. In the comparison of whole mean, the satisfaction of enterprise center was higher than that of private center. 4) According to income, all groups but group(100-149 million won) showed higher satisfaction with enterprise center in the comparison of whole mean. 5) According to the type of job, salary worker and functional occupation showed higher satisfaction with enterprise center and educational occupation and owner of small business or store showed higher satisfaction with private center. 2.Satisfaction of offered service 1) According to sex, men showed higher satisfaction with both centers. 2) According to age, in the comparison of whole mean, 50's showed the highest satisfaction with both enterprise and private center. 3) According to education level, more than college graduation, college student and high school graduation showed their satisfaction in turn with both centers. In the comparison of whole mean highschool graduation and college graduation showed the highest satisfaction with enterprise center and college student or dropout showed the highest satisfaction with private center. 4) According to income, all groups but the group(250-299 million wons) showed higher satisfaction with enterprise center in the comparison of whole mean. 5) According to the type of job, salary worker and functional occupation showed higher satisfaction with enterprise center and worker in special jobs and owner of small business or store showed higher satisfaction with private center.

반도체-원자 초격자의 광전자 특성

서용진,정소영,박성우 대불대학교 2002 論文集 Vol.8 No.1

Optoelectronic characteristics of the superlattice as a function of deposition temperature and annealing conditions have been studied. The nanocrystalline silicon/adsorbed oxygen superlattice formed by molecular beam epitaxy (MBE) system. Consequently, the experimental results of superlattice with multilayer Si-O structure showed the stable photoluminescence(PL) and good insulating behavior with high breakdown voltage. This is very useful promise for Si-based optoelectronic and quantum device as well as for the replacement of silicon-on-insulator(SOI) in ultra high speed and lower power CMOS devices in the future, and it can be readily integrated with silicon ULSI processing.