한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

슬관절 골관절염 환자에서 근육내 자극요법의 치료 효과

박영규,우종웅,안승렬,김정아,윤도경,박승회,조경환,홍명호 대한노인병학회 2001 대한노인병학회지 Vol.5 No.4

위점막조직에서 Ghrelin 양성세포의 발현

박도윤,전태용 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

슬관절 골관절염 증상이 환자에게 미치는 우울 효과

박영규,이윤영,이계우,김정아,윤도경,박승회,조경환,홍명호,박용규 대한노인병학회 2001 대한노인병학회지 Vol.5 No.4

가와사끼 병 환아에서 이상뇌파와 신경학적 합병증 발현과의 연관성에 대한 고찰

박준수,공도연,박경배,민용식,김영창,정순이,이혜경 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

목적 : 가와사끼 병의 뇌파 소견 및 다른 임상인자들과의 연관성을 알아보고자 하였다. 방법 : 1994년 1월부터 1995년 12월 사이에 순천향대학 천안병원 소아과에 입원한 23명의 신경학적으로 정상인 가와사끼 병 환아에게 뇌파검사를 실시하여 이를 검사시기, 성별, 연령, 혈소판, 간기능 검사치, 그리고 동맥류 유무등의 임상인자들과 비교하였다. 결과 : 이상뇌파가 23명중 52.2%인 12명에게서 관찰되었으며, 이상뇌파로는 예파 및 극파, 극·서파 복합 양상과 전반적인 배경파의 서파양상이 나타났다. 뇌파의 검사시기가 진단부터 1주 이내인 경우에 이상뇌파의 빈도가 그 후보다 의미있게 높았으나, 그 밖의 다른 임상인자와의 연관성은 별 의미가 없었다. 결론 : 가와사끼 병 초기에 이상뇌파가 나타나는 것은 비록 신경적 증상은 없지만 중추 신경계가 영향을 받는다는 간접적인 증거로 생각할 수 있어 향후 신경적 합병증 발생 여부에 대한 면밀한 관찰이 필요하다고 생각된다. Purpose : This study is to find out if there is any association between EEG abnormalities in Kawasaki disease with other clinical factors. Methods : We performed EEG in 23 Kawasaki disease patients without any neurologic sign who admitted in Soonchunhyang Chunan Hospital from 1994. 1. to 1995. 12. and compared it with sex, age, platelet count, liver function test and presence of coronary artery aneurysm. Results : Abnormal EEG findings were observed in 12 of 23 patients(52.2%) and as for abnormal EEG findings, sharp, spike, spike & slow wave complex, and generalized slow background activity were noted. When EEG was performed within a week after the diagnosis, the incidence of abnormalities of EEG increased significantly but there was no correlation with other clinical factors. Conclusion : EEG abnormalities in the early stage of Kawasaki disease indicate that although there is no abnormal neurologic signs clinically, central nervous system might be affected and there should be a close observation for the developement of neurologic complication.

불응성 자가면역질환에서의 자가조혈모세포이식

민도준,양동원,민창기,김완욱,이상헌,박성환,김동욱,이종욱,조철수,민우성,김범생,김호연,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: 기존의 치료에 불응하고 예후가 불량한 자가면역질환 환자들에게 최근 고용량 면역억제 및 조혈모 세포이식이 새로운 치료방법으로 대두되고 있다. 저자들은 다발성 경화증(multiple sclerosis, MS) 및 류마티스 관절염(rheumatoid arthritis, RA) 등 2명의 자가면역질환 환자들에서 자가조혈모세포 이식을 시행하였다. 방법: 말초혈액 조혈모세포 가동화를 위하여 cyclophosphamide (4 g/㎡) 및 granulocyte colony stimulating factor (10 g/kg/day)를 투여하였고, CD34+ 세포를 분리·채집 하였다, 이식 전처치로 MS 환자에서 BEAM 및 antihymocyte globulin (ATG) (3.75 mg/kg), RA 환자에서 fludarabine (180 mg/㎡), ATG (10 mg/kg)와 busulfan (8 mg/kg)을 투여하였다. 결과: 호중구 수가 500/㎕ 이상으로 회복되는 기간은 MS 환자에서 9일, RA 환자에서 15일이었다. 혈소판이 20.000/㎕ 이상으로 회복되는 가간은 RA 환자에서 9일 이었고, MS 환자에서는 혈소판 감소증이 발생하지 않았다. 비혈액학적 독성으로 MS 환자에서 WHO 1도의 오심 및 점막염이 관찰되었다. MS 환자는 이식 6개월 후까지 시력감소가 남아있었으나, 이식전에 관찰되던 감각이상 및 운동장애 등의 신경학적 이상 소견은 더 이상 관찰되지 않았다. RA 환자는 이식 1개월 후 관절 증상 및 검사소견의 호전을 보였다. 결론: 불응성 자가면역질환 환자에서 고용량 면역억제 및 조혈모세포이식은 적은 독성으로 높은 치료효과를 기대할수 있으며, 향후 이 시술의 임상적 의의를 규명하기 위하여 전향적이고 장기적인 연구가 필요할 것으로 사료된다. Background: High-dose immunosuppressive therapy followed by autologous hemathpoietic stem cell transplantation (HSCT) has been proposed as a new approach to treat severe, refractory autoimmune diseases. We describe two patients with refractory autoimmune diseases (one multiple sclerosis 〔MS〕and one rheumatoid arthritis〔RA〕) who underwent T-cell-depleted autologous peripheral bleed stem cell transplantation for the first time in Korea. Methods: We mobilized autologous stem cells with cyclophisphamide (4 g/㎡) and granulocyte colony-stimulating factor (10 ㎍/kg/day). Stem cells were enriched ex vivo using CD34-positive immunoselection and reinfused after high-dose chemotherapy with BEAM and antithymocyte globulin (ATG) (3.75 mg/kg) in MS, or fludarabine (180 mg/㎡), ATG (10 mg/kg) and busulfan (8 mg/kg) in RA. Results: The engraftment with an absolute nerutrophil count greater than 500㎕ occurred on day 9 in MS and 15 in RA, respectively. The time to nontransfused platelet count greater than 2.000/㎕ was 9 day in RA. MS patient did not show ant episode of thrombocytopenia. Regimen-related non-hematopoietic toxicity was minimal. For 6 months since HSCT, them patient with MS had been free from previously existed sensory and motor abnormalities except decreased visual acuity. Then patient with RA and only one tender joint and two mildly swollen joints with improvement in laboratory parameters at one month after HSCT. Conclusion: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of intractable autoimmune diseases. The durability of remission, however, remains to be clarified.

Antiadhesive effect and safety of oxidized regenerated cellulose after thyroidectomy

Kyoung Sik Park,Kyu Eun Lee,Do Hoon Ku,Su-Jin Kim,Won Seo Park2,Hoon Yub Kim3,,Mi Ra Kwon1,Yeo-Kyu Youn1 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.84 No.6

Purpose: To evaluate the antiadhesive effects and safety of an oxidized regenerated cellulose (Interceed) after thyroidectomy. Methods: Seventy-six thyroidectomized patients were prospectively randomized into two groups with regard to the use of Interceed. We evaluated each group for their adhesive symptoms using four subjective and four objective items at the 2nd week, 3rd and 6th month after thyroidectomy. All patients were examined for vocal cord motility by indirect laryngoscope at each period. Results: Total adhesion scores at each postoperative follow-up period decreased with time, but were not significantly different in each group. The median score for swallowing discomfort for liquid was significantly lower in the Interceed group than in the control group 2 weeks after surgery. In addition, the severity of skin adhesion to the trachea was reduced in the Interceed group compared with the control group 6 months after surgery. During the study, there were no adverse effects or significant differences in postoperative complications between the groups. Conclusion: Interceed appeared to be safe and effective in improving neck discomfort at early postoperative periods and preventing skin adhesion to the trachea 6 months after thyroidectomy.

高靭性 纖維補强 시멘트 複合體를 使用한 耐震要素의 履歷特性

양일승,윤현도,김선우,박완신,한병찬,문연준 대한건축학회 2005 大韓建築學會論文集 : 構造系 Vol.21 No.1

Concrete is one of the principal materials for the structures and It is widely used all over the world While advanced technologies of concrete have been recently focused especially on developing high performance concrete In which possess high compressive strength and durability, such concrete shows extremely brittle failure under shear and tension To Improve such a poor properties, high performance fiber reinforced cement composites(HPFRCC) has been developed For forming multicrack, a large number of fiber and/or the high specific area with thinner fibers are required However, It causes difficulties for the extrusion because of the poor workability So, this theses was suggested adequate mixing method and mix proportion for cach fibers and experimentally observed Structural performance of the seismic devices made by steel bar and HPFRCC These dampers will be applied for reducing damage as weil as seismic response The advantages of the HPFRCC damper is selective structural performance, strength, stiffness, and ductility by changing configuration, bar arrangements and type of materials used The experimental results indicate that elemental ductility is much increased with decreasing damage when the HPFRCC are applied to the damper It means cementitious seismic damper for structure control is available, which has much merit in performance and cost

돼지 신장세포(PK15)의 이종이식 거부반응에 대한 재조합 IL-18의 영향

최연실,김은미,김영관,박상연,심정현,윤도영,강형식,명평근 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

Various cytokines including IL-1β, IL-2, IL-4, IL-10, IL-12p40, IFN-r, and TNF-α have been recently reported to play important roles in both host and donor cell activations during xenotransplantation. Interleukin (IL)-18, a proinflammatory cytokine, can induce IL-4 and IL-13 production in T cells, NK cells, B cells, mast cells, and basophils. IL-18 has the capacity to stimulate innate immunity and both Th1-and Th2- mediated responses, but little is known to involve in the xenograft rejection. In order to investigate the role of IL-18 in xenograft rejection, we transplanted the pig kidney (PK15) cells to C57BL/6 mouse with or without intraperitoneal injection of mouse recombinatant IL-18, It was analyzed the population of T cell, B cell and NK cell in the mice transplanted with PK 15 cells and recombinant IL-18 by flow cytometry. We found that splenic CD3+ T cells were increased in mice injected PKl5 cells with recombinant IL-18. These results suggest that recombinant IL-18 is critical in the xenograft rejection by increasing T cell population of the recipients.

돼지 신장세포(PK15)의 이종이식 거부반응에 대한 재조합 IL-18의 영향

최연실,김은미,김영관,박상연,심정현,윤도영,강형식,명평근 충남대학교 생물공학연구소 2004 생물공학연구지 Vol.10 No.1

Various cytokines including IL-1β, IL-2, IL-4, IL-10, IL-12p40, IFN-γ, and TNF-α have been recently reported to play important roles in both host and donor cell activations during xenotransplantation. Interleukin (IL)-18, a proinflammatory cytokine, can induce IL-4 and IL-13 production in T cells, NK cells, B cells, mast cells, and basophils. IL-18 has the capacity to stimulate innate immunity and both Th1-and Th2- mediated responses, but little is known to involve in the xenograft rejection. In order to investigate the role of IL-18 in xenograft rejection, we transplanted the pig kidney (PK15) cells to C57BL/6 mouse with or without intraperitoneal injection of mouse recombinatant IL-18. It was analyzed the population of T cell, B cell and NK cell in the mice transplanted with PK 15 cells and recombinant IL-18 by flow cytometry. We found that splenic CD3+ T cells were increased in mice injected PK15 cells with recombinant IL-18. These results suggest that recombinant IL-18 is critical in the xenograft rejection by increasing T cell population of the recipients.