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.

공진 기초를 이용한 아스팔트 콘크리트의 동적 전단계수 추정에 관한 연구

우제윤,김수일,이형인 연세대학교 산업기술연구소 1985 논문집 Vol.17 No.2

In this study, a resonant footing technique to estimate the dynamic shear modulus of asphalt concrete using the torsional vibration test is developed. From this study an empirical formula is proposed to estimate the dynamic shear modulus of asphalt concrete. The numerical results are compared with the values estimated from the measurement of primary wave velocities. The oscillator made for this study has thin circular bars which are considered as springs. Heavy upper part of the oscillator is connected to lower aluminum plate by means of springs. The oscillator is designed so that torsional vibration of aluminum plate is caused by magnetic force and footing-asphalt concrete system also vibrates together with aluminum plate. From the experimental result, the maximum difference of the dynamic shear modulus from the resonant footing test and primary wave velosity detection shows 3% deviation when the Poisson`s ratio is assumed to be 0.3. The apparatus made for this study is thought to estimate the dynamic shear modulus of asphalt concrete properly. It is also found that the dynamic shear modulus is not influenced by confining pressure within the range of confining pressure applied in this study.

법랑아세포종에서의 p53 및 MIB-1 발현 : 임상 및 병리학적 요인들간의 연관성 Correlation Between Clincopathologic Parameters

이수운,한지용,권창석,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Thirty five patinets' paraffin embedded biops block , which was previously diagnosed ameloblastoma and obtained from oral and maxillofacial surgery dept. of pusan paik hospital and OMS dept of collage dentistry, pusan national university hospital, from January 1994 to march 1999, were performed immunohistochemistry with p-53 and MIB-1. On investigating the expression, correlation between clinical and histologic factor and correlation between prognosis and moleculopathologic property were examined. And we obtained the following results; 1. Age over forty, recurrence rate was 58.5%. 91.4% of the tumor was developed on mandibule, recurrence rate of maxilla area tumor was 66.7% On radiologic and histologic feature, multilocular and follicular type has high recurrence rate but no significance statistical difference was found 2. Expression of p-53 was 25.7%, When underage of forty. location on mandibule, multilocular and plexiform type, the expression of p-53 was somewhat higher and recurred cases of tumor, expression rate was 12.5%. 3. MIB-1 expression rate was 77.1%. When location on mandibule, unilocular, plexiform type tumor and previously recurred case, MIB-1 expression was 87.5% which was somewhat higher than no recurrence case of 74.1%. 4. 33.3.% of positive on MIB-1 have expression of p-53 and all p-53 positive case express MIB-1 positive. All p-53 positive case have high cell proliferation rate. From this result, age and location have closely related with the prognosis of tumor, histologic feature and MIB-1 expression has related with the prognosis of tumor. But p-53 has highly expressed on cell proliferation area, not closely related with the prognosis of tumor.

수술방법에 따른 액취증의 합병증 비교

김형우, 이의태 충북대학교 의과대학 충북대학교 의학연구소 2012 忠北醫大學術誌 Vol.22 No.1

연구목적 : 액취증은 겨드랑이에서 암내라고 불리는 특징적인 냄새를 내는 증상으로 비교적 흔하면서 환자에게 사회적, 정신적으로 많은 괴로움을 주는 질환이다. 이러한 액취증을 치료하기 위해 과거로부 터 수술적 절제술이 많이 시술되어 왔다. 하지만 불행하게도 수술적 절제술은 여러 가지 합병증이 보고 되고 있다. 현재, 액취증을 치료하기 위해 흡입술이 도입되면서 기존 치료방법과 효과와 만족도에 대한 비교의 필요성이 대두되어 왔다. 대상 및 방법 : 2005년 7월부터 2009년 3월까지 충북대학교병원 성형외과에서 액취증 일차 수술을 한 환자는 총 24명(남자 15, 여자 9)으로 이중 수술적 절제술이 8명, 흡입술이 16명이었다. 추적은 의무기록 검토 및 전화통화를 통한 설문으로 이루어 졌으며, 시술을 받은 24명의 환자중 수술적 절제 술 8명 중 7명(87.5%), 흡입술 16명 중 10명(62.5%)과 인터뷰가 이루어 졌다. 나머지 환자들은 수 신거부, 전화번호변경 등으로 추적하지 못했다. 인터뷰가 이루어진 17명의 환자들은 최소 10개월(평균 27.3개월) 간의 추적기간을 거쳤다. 액취제거에 대한 각 시술의 효과는 매우좋음, 좋음, 보통, 나쁨, 시술에 대한 만족도는 매우만족, 만족, 보통, 불만족 이렇게 각각 4단계로 분류하였다. 결과 : 효과에 대해서 수술적 절제술을 시행한 환자군에서는 매우좋음 4명(57.1%), 좋음 3명(42.9%) 으로 모두 좋음 이상의 답변을 하였고 흡입술을 시행한 환자군에서는 매우좋음 1명(10%), 좋음 5명 (50%), 나쁨 4명(40%)으로 답변을 하였다. 만족도에 대해서 수술적 절제술을 시행한 환자군 중 5명 (71.4%)이 만족 이상을 답변하였고, 흡입술을 시행한 환자군 중 4명(40%)이 만족 이상을 답변하였다. 합병증으로 수술적 절제술의 경우 과색소침착을 동반한 경계부위 조직괴사 및 과색소침착, 상처개열, 혈 종 각 1명으로 나타났고(총 3/7, 42.9%), 흡입술에서는 어떠한 합병증도 발견되지 않았다(0%). 결론 : 수술적 절제술 환자의 효과 및 만족도가 더 높지만 합병증이 흔한 것으로 나타났으며 흡입술의 경우 합병증은 없지만 효과 및 만족도가 떨어지는 것으로 나타났다. 이에 따라 두가지 방법 어느 하나 가 다른 하나에 비해 반드시 우월하다고 볼 수는 없는 것으로 보이며 환자와 상황에 따라서 알맞은 방 법을 쓰는 것이 좋을 것으로 생각된다.

상악 정중부에 역위 매복된 과잉치의 악골 내 이동

이석우,이제호,김성오,최형준,손홍규,최병재 大韓小兒齒科學會 2008 대한소아치과학회지 Vol.35 No.4

과잉치는 상악 정중부에서 주로 발견되며,과잉치의 발생 기전은 유전적 또는 환경적 원인에 의하여 치배 형성기 동안에 정상 치판의 비정상적 증식에 의한 것으로 보고되었다. 과잉치로 인한 합병증으로는 인접 영구치의 맹출 장애와 전위,회전,정중이개,비강으로의 맹출,낭종 형성 등 이 있다. 과잉치를 외과적으로 발거하기 위한 시기에 대해서는 논란이 되고 있다. 인접치의 배열과 맹출 장애,전위를 야기할 수 있기 때문에 조기에 발거하자는 견해와 어린이의 행동 조절 및 인접 영구치의 치근 형성 정도를 고려하여 8~l0세 이후에 발거 하자는 견해가 있다. 후자와 같이 외과적 발거 시기를 연기할 경우,역위 및 수평 매복된 과잉치는 악골 내에서 비강 또는 경구개,소구치 부위 등으로 이동할 수 있으며,과잉치의 이동과 전상악골의 수직고경 증가로 인하여 외과적 발거 시 난이도가 높아질 수 있다. 따라서,역위 및 수평 매복된 과잉치의 외과적 발거 시기를 결정하기 위하여 연기하는 경우에 과잉치의 악골 내 이동을고려해야한다. 이 증례는 상악 정중부에 역위 매복된 과잉치가 있어서 내원한 6~7세의 어린이에서 과잉치의 외과적 발거 시기를 결정하기 위하여 주기적인 방사선 학적 검사로 관찰하던 중에 2~3년 후 과잉치 위치가 악골 내에서 초진 시 위치로부터 이동된 경우로 이를 보고하는 바이다. Supernumerary teeth are frequently found in the anterior portion of the maxilla and develop as a result of abnormal proliferation of the dental lamina during tooth germ formation, caused by genetic or environmental factors. They may result in various complications, such as eruption interference, displacement, rotation of adjacent teeth, diastema, eruption into the nasal cavity, and development of dentigerous cyst. The optimal time for surgical extraction of supernumerary teeth has been a controversial issue. Someone prefer early surgical extraction because supernumerary teeth can cause eruption interference and displacement of adjacent teeth, eventually altering occlusion. Others prefer to delay surgical extraction until 8~10 years of age in consideration of root maturation of the adjacent teeth and also patient's behavior. When surgical extraction of supernumerary teeth is postponed, there is possibility that impacted supernumerary teeth in the inverted or horizontal position move toward the nasal cavity, hard palate, or premolar area. When such intraosseous tooth migration is combined with the vertical growth of the maxilla. surgical approach becomes even harder. Therefore, possibility of intraosseous tooth migration should be considered as an important factor when deciding appropriate time for surgical extraction. We are presenting cases of mesiodens which showed intraosseous migration during 2~3 years of follow-up period since the first diagnosis had been made at the 6~7 years of age.