중증 재생불량성빈혈에서 타인 혹은 HLA 불일치 혈연간 골수이식을 위한 cyclophosphamide와 antithymocyte globulin전처치 요법

이정희,이제환,김신,설미이,이정신,김우건,김상희,지현숙,박찬정,이규형 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: Cyclophosphamide와 ATG의 전처치 요법은 HLA가 일치하는 형제간 골수이식에서는 매우 효과적인 것으로 알려져 있으나, 타인 혹은 HLA 불일치 혈연간 골수이식에서는 전처치 요법으로서 불충분한 것으로 보고되었는데, 주요 문제는 착상 부전이었다. 우리나라를 포함하는 극동아시아 지역의 국가들에서 발표되는 보고에 의하면 타인이식을 포함하여 골수이식 후 착상 부전과 이식편대숙주질환의 발생이 서구 국가들로부터의 보고에서보다 적은 것으로 알려져 있다. 저자 등은 6예의 중증 재생불량성빈혈 환자들에서 질병 초기에 Cyclophosphamide와 ATG만을 이용하여 전처치를 한 후에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행하였다. 방법: 1999년 5월부터 2000년 4월까지 서울중앙병원에서 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 성인 중증 재생불량성빈혈 환자들을 대상으로 하였다. 골수이식을 위한 전처치 요법으로 cyclophosphamide (50 mg/kg/d x 4)와 ATG (30 mg/kg/d x 3)를 투여하였는데, 골수이식 전에 ATG에 대하여 과민 반응을 보였던 한 예 (UPN 120)에서는 ATG 대신에 fludarabine (30 mg/m2/d x 3)을 투여하였다. 이식편대숙주질환의 예방을 위하여 cyclosporine과 methotrexate를 투여하였다. 결과: 연구 기간 중에 모두 6예가 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받았는데, 5예는 타인으로부터 골수를 공여 받았으며, 1예는 HLA의 표현형이 하나의 유전자좌에서 일치하지 않는 형제로부터 골수를 공여 받았다. 타인 골수이식을 받은 5예 중에서 3예의 공여자는 HLA의 표현형이 일치하였으며, 1예는 하나의 유전자좌가 major mismatch였고, 1예는 하나의 유전자좌가 minor mismatch였다. 추적기간의 중앙값은 406일 (범위, 328-643일)인데, 6예 모두에서 착상된 상태를 유지하면서 생존해있다. 2예에서 3도의 급성 이식편대숙주질환과 전신성 만성 이식편대숙주질환이 발생하였다. 결론: Cyclophosphamide와 ATG의 전처치 요법은 재생불량성빈혈의 초기에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 한국인 환자들에서 충분히 착상을 가져올 수 있는 요법으로 생각된다. 비록 본 연구의 대상 환자 수가 적지만 결과는 매우 고무적이다. HLA가 일치하는 형제가 없는 중증 재생불량성빈혈 환자의 경우에 타인 골수 공여자에 대한 검색을 조기에 시행해야 하며, 타인 혹은 HLA 불일치 혈연간 골수이식을 질병 초기에 적극적으로 고려해야 할 것으로 생각된다. Background: Cyclophosphamide (CY) and ATG regimen was reported to be insufficient for alternative donor BMT in SAA patients due to high incidence of graft rejection. The rates of graft rejection and GVHD after allogeneic BMT including unrelated donor transplants seemed to be lower in reports from Asian countries of Far East. We applied CY/ATG regimen to six patients with early stage of SAA transplanted with marrow from alternative donors other than HLA-identical siblings. Methods: Three patients were transplanted from HLA-phenotypically identical unrelated donors, two from one-locus mismatched unrelated donors, and one from an one-locus mismatched sibling donor. Four patients received no previous therapy for SAA, and two received one course of immunosuppressive therapy with ATG. Preparative regimen was CY (200 mg/kg) plus ATG (90 mg/kg) in all patients except one who had had an anaphylactic reaction to ATG prior to BMT and received fludarabine (90 mg/m2) in place of ATG. Cyclosporine plus methotrexate were given for GVHD prophylaxis. Results: All six patients engrafted and all are alive with durable engraftment at a median follow-up of 406 days (range, 328 to 643). Two patients developed grade III acute GVHD and extensive chronic GVHD. Conclusions: CY/ATG regimen may be sufficient in Korean patients with early stage of SAA transplanted with marrow from alternative donors. Although the number of patients in present study is small, results are encouraging. Stem cell transplantation using alternative donors may be considered at early stage of aplastic anemia.

고품질 복숭아 만생종 ‘진백’ 육성

이기우(Gi-Woo Lee1),박원흠(Won-Heum Park),권오흔(Oh-Heun Kwon),정경미(Kyung-Mi Jung),이형일(Hyung-Il Lee) 한국원예학회 2018 한국원예학회 학술발표요지 Vol.2018 No.10

림프종 환자에서의 갈륨, TI-201 그리고 Tc-99m MIBI 섭취의 비교

천경아,조인호,원규장,이경희,이형우,현명수,이재태,이규보 영남대학교 의과대학 2002 Yeungnam University Journal of Medicine Vol.19 No.2

Purpose; Ga-67 scintigraphy has been used for the evaluation of tumors, especially lymphoma. Recently, Tl-201 and Tc-99m MIBI were also used to tumor imaging. Tl-201 and Tc-99m MIBI had better physiologic characteristics than Ga-67, so we studied 32 biopsy proven lymphoma patients (male 24, female 8, mean age 46 years) with Ga-67, Tl-201 or Tc-99m MIBI and compared the scan findings. Materials and Methods: Twenty-three of 32 patients were injected 74-111 MBq (2-3 mCi) of Tl-201, before chemotherapy and imaged with dual-headed SPECT (Prism 2000, Picker, USA) at 30 minutes after injection. Delayed images were obtained after 3 hr in 8 patients. Twenty seven of 32 patients were injected 740 MBq (20 mCi) of Tc-99m MIBI and imaged at 30 minutes after injection. 111-185 MBq (3-5 mCi) of Ga-67 was injected in 12 patients and imaged at 48 and 72 hours after injection. Twenty eight patients were diagnosed as non-Hodgkin's lymphoma and others were Hodgkin's lymphoma. Results: Twenty patients were positive on Tl-201 scan and 3 patients showed negative findings. One of these 3 patients, Tc-99m MIBI and Ga-67 scan were positive. Twenty two patients were positive on Tc-99m MIBI scan and 5 patients showed negative findings. One of these 5 patients, Tl-201 was positive and 2 were positive on Ga-67 scan. Ten of 12 patients showed positive findings on Ga-67 scan. The sensitivity of these agents were 83.3%, 87.0% and 81.5% for Ga-67, Tl-201 and Tc-99m MIBI, respectively. The sensitivity was highest in Tl-201 scan, but there were no significant differences among three tests. In this study, there was no significant difference of uptake ratios between early and delayed images of Tl-201. Conclusion: Scintigraphy with Tl-201 and Tc-99m MIBI in lymphoma patients have similar sensitivity with Ga-67.

관상동맥 질환에서 SDF-1α의 농도

김보영,박용규,박형서,노상필,정승현,이유선,이정우,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

자동차 커넥팅 로드에 대한 형상 최적설계

이병우,박형진 동의공업대학 2001 論文集 Vol.27 No.1

The demand for lightweight parts of high strength has been increased by the rapid development of technology for automobile. And the effort to reduce exhaust gas of automobile which is the main cause of environmental pollution is also necessary. A connecting rod among automobile parts must be confirmed its strength and reduced its weight to minimize vibration and influence for crank or bearing. While conventional design rule or experience is generally used to reduce the weight of a part, structural weak point is often found and re-design is needed. Therefore rationalization of design using technique of optimization is needed to solve these problems. In this paper, the shape optimization of a connecting rod is carried out to reduce weight and confirm strength in design stage by using ANSYS optimization module.

각국의 경찰부패통제제도에 관한 비교 연구

이황우,남형수 동국대학교 사회과학연구원 2008 사회과학연구 Vol.15 No.1

Although the South Korean government has for a long time exerted to prevent and control corruption of public officials, it seems still pervasive in South Korea. The corruption scandals of the police are also considered a part of this social problem. For example, the extent of police corruption cases has been reduced since the National Police Agency in South Korea vigorously implemented anti-corruption policies and attempted to clean its organization. However, it is seemed that police corruption still remains in the particular divisions in a police department, such as investigation bureau, order maintenance team, and so forth, in which the officers frequently make contacts with citizens in a daily manner. For citizens, police corruption is perceived as a barometer of corruption of public officials since the police department is a frontline entity of law enforcement agencies. Police corruption undermines police accountability and legitimacy of law and authority. In order to enhance citizens' confidence of the police, it is inevitable to establish effective policies and measures to prevent police corruption. This study, by comparing diverse anti-corruption policies of the police across countries, aims to suggest a new systemic control model of police corruption 1) enhancing the education of police ethics, 2) improving police culture, 3) encouraging self-cleaning activities by a practical evaluation, 4) considering the settlement of systemic innovation, 5) establishing an anti-corruption system, and 6) encouraging citizen participation. 정부에서는 그동안 공직부패 척결을 위하여 범정부차원에서 다양한 정책적 노력을 기울여 왔으나 여전히 부패가 만연한 나라라는 오명을 벗지 못하고 있다. 경찰도 예외는 아니라서 강력한 부패근절방안과 조직 차원의 지속적인 자정노력으로 경찰부패가 많이 사라졌지만, 아직까지도 사건수사와 풍속업무분야 등 대민접점부서에서의 비리는 완전히 근절되지 않고 있다는 평가를 받고 있다. 경찰은 최일선의 법집행기관으로서 경찰부패는 국민이 피부로 느낄 수 있는 공직사회 부패의 바로미터로 인식되고 있다. 이러한 경찰부패는 법집행력의 약화를 초래하게 되고, 법을 집행하는 경찰이 법을 어기거나 제대로 집행하지 않는 다면 법과 권위를 스스로 깨뜨리는 행위가 된다. 따라서 국민으로부터 신뢰받는 경찰이 되기 위해서는 경찰의 부패방지대책을 수립하는 것이 급선무라고 생각한다. 이에 이 연구에서는 각국의 경찰부패통제제도를 비교 분석하여 보다 근본적이고 새로운 경찰부패통제시스템의 도입방안으로 경찰관의 윤리교육 강화, 조직문화의 개선, 실질적 평가를 통한 자율적인 부패방지 노력, 제도적 개선사항의 정착화 방안의 강구, 조직의 반부패시스템 구축, 시민참여제도의 강화 등을 제시해 보았다.

Cariogram을 이용한 모자간 우식활성도의 상관성 및 우식위험요소 평가

이석우,송제선,최병재,최형준,이제호 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.3

영유아기 치아우식증은 복잡하고 다인자적 질환으로 숙주 및 미생물, 식이, 시간 등의 위험요소에 의해 질환이 진행된다. 이 중 미생물로 대변되는 Streptococcus mutans(S. mutans)는 우식 개시에 있어 중요한 역할을 하며, 어머니를 통한 수직 감염이 잘 알려져 있다. 영유아기의 어머니를 통한 조기 감염은 향후 유치열기 우식 발생과 높은 연관성을 나타내므로 우식위험요소에 대한 조기 파악은 미래의 치아우식증 예방에 있어 매우 중요하다. 최근 치아우식증의 원인 및 이에 미치는 요소들에 대한 연구가 활발하게 이루어지면서 우식 진행에 대한 정확한 예측을 위한 여러 가지 우식위험도평가(caries risk assessment) 도구가 개발되었는데, 이 중 대표적인 한 가지가 Cariogram이다. Cariogram은 개인의 우식활성도 및 우식위험요소(caries risk factor)의 상호작용을 그래프로 나타낸다. 이번 연구의 목적은 3~5세의 중증 유아기우식증(Severe Early Childhood Caries; S-ECC)에 해당되는 어린이들과 그들의 어머니 사이에서 우식관련타액검사 및 최근 개발된 Cariogram을 이용하여 S. mutans의 수준 및 우식활성도에 대한 상관관계가 존재함과 우식위험요소 간의 연관성을 파악해 보았는데, 이를 통해 다음과 같은 결론을 얻을 수 있었다. 1. 중증 유아기우식증을 보이는 어린이에서 구강 내 존재하는 Streptococcus mutans의 수준은 비우식군보다 높았다(p<0.05). 2. 모자간 구강 내 존재하는 Streptococcus mutans 수준은 상관관계를 보였다(p<0.05). 3. 모자간 우식활성도를 Cariogram을 통해 측정해 본 결과 상관관계를 보였다(p<0.05). 4. 우식활성도에 미치는 우식위험요소는 어린이에서 숙주요소가 가장 큰 영향을 주는 것으로 나타났다. 이상의 결과로 S. mutans가 향후 치아우식증 발생 가능성을 예측하는데 있어 유용한 우식위험요소가 될 수 있으며, Cariogram을 통한 향후의 우식진행과 관련된 여러 가지 우식위험요소가 예측 가능하므로 이에 대한 조기 대처 및 예방적 처치가 가능하리라 사료된다. Dental caries during infantile and early childhood period is a complex disease resulting from multiple caries factors. Streptococcus mutans(S. mutans) plays a critical role in the initiation of caries, and its early transmission through mothers provides a strong etiologic factor for future development of caries in the primary dentition. Therefore, early detection of caries risk factor is important for prevention of caries. Recent studies about etiologic factors of caries have brought advent of various tools for caries risk assessment in order to predict progress of caries more accurately. Cariogram is a common tool for caries risk assessment, which illustrates present caries risk assessment and correlation of caries risk factors for an individual graphically. The aim of this study was to assess if there is any correlation in the level of S. mutans and caries activity and to verify the effect of caries risk factors between children with age ranging from 3 to 5 years with severe early childhood caries(S-ECC) and their mothers using caries-related salivary test and Cariogram. The results of this study were as follows. 1. Children with S-ECC had a statistically higher level of Streptococcus mutans compared to caries-free children(p<0.05). 2. There was significant correlation between mothers and their children in the aspect of the level of Streptococcus mutans(p<0.05). 3. When caries activity was assessed using Cariogram, significant correlation between mothers and their children was found(p<0.05). 4. When each caries risk factor was evaluated for its affect on caries activity, host was more influential factor compared to microorganism and diet in children. Based on these results, we could conclude that assessing the level of S. mutans can be an effective tool for predicting possibility of caries formation in future. Since prediction of future caries progression and evaluation of caries risk factor became possible with Cariogram, we may conduct early and preventive measures for treatment of caries.

3차원 전산화 단층촬영을 이용한 상악 정중 과잉치의 진단

이종갑,김성오,홍영우,손흥규 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

저자는 매복된 상악 정중 광잉치를 주소로 내원한 환아를 3차원 전산화 단층촬영술을 이용해 매복된 과잉치의 위치를 파악하였으며 다음의 결론을 얻었다. 1. 인접한 영구치에 대한 위해한 영향을 주지 않기 위해 상악 정중 매복 과잉치의 정확한 위치 편별이 요구된다. 2. 3차원 전산화 단층촬영법은 매복 과잉치의 위치판별에 있어서 객관적인 중요한 정보를 제공한다. The prevalence of the supernumerary tooth is 1~4%. It usually occurs in the permanent dentition. It frequently occurs in the maxillary midpalatal area. The presence of the supernumerary tooth causes the following problems;(1) interfering the eruption of successional tooth, (2) displacing the neighboring teeth, (3) resulting large diastema, (4) forming cystic change. So the supernumerary tooth should be remobed as soon as oissuble. To extract the supernumerary tooth, the exact position must be noticed first. Radiographic techniques that were used in the past are tube shift technique, right angle technique, sterioradiography, using radiopaque contrast media and conventional tomography. But these methods include the subjective opinion of the operator. So, a technique eliminating the operator's opinion and showing the position 3-dimentionally can be used. 3-dimentional computed tomography eqipped with dental softwares can show the position of the impated supernumerally tooth in 3-dimentionally position. It has an adzantage to eliminate the subjective opinion of the operator with a fast computer this techenique is done in a relatively short period of time . the data 3-dimentionally. sequential removal of the soft tissue and hard tissue(bone) CT number leaves the teeth alone in 3-dimentional position. The image can be seen from anywhere, so the operator can see the image in front, rear, upper, and lower positions. In both cases 1 and 2 the position of the impacted supernumerary tooth is viewed by the 3-dimensional computed tomography. And it made the operator easy to figureout the exact position.