신생아 황달질환에서의 RDW의 진단적 의의

김행미,신채옥,현명철,이건수,이상범,구자훈 慶北大學校 醫科大學 1995 慶北醫大誌 Vol.36 No.3

목적 : 신생아 적혈구는 그 모양이 불규칙하여 여러 측정치가 성인 및 소아와 다르다, 저자들은 국내에서 보고된 바 없는 신생아의 Red cell distribution width(RDW)를 조사하여 신생아 정상 측정치를 제시하는 동시에 신생아 시기의 적혈구에 손상을 미치는 질환의 RDW를 분석하여 진단상 의의를 조사하였다. 대상 및 방법 : 신생아 집중치료실에 입원한 만삭아중 감염소견이 없었던 78명과 ABO부적합증 및 패혈증 환아에서 hemoglobin, hematocrit, MV, RDW 및 망상적혈구를 측정하였다. 결과 : 생후 1일부터 7일까지의 만삭신생아의 RDW 17.4±1.5로 소아 정상치 13.4±1.2%에 비해 증가되어 있었으나 출생후 7일까지 hemoglobin, hematocrit는 의의있게 감소한 반면 RDW는 변동이 없었다. 같은 연령의 ABO 부적합증 및 패혈증 환아군은 대조군에 비해 의의있게 hemoglobin과 hematocrit가 낮았으나 RDW는 대조군과 질병군 및 각 질병군 사이에 차이를 보이지 않았다. RDW와 망상적혈구는 ABP 부적합증에서만 상관계수 0.91 (p<0.001)의 상관관계를 보였다. 결론 : 출생후 7일까지 계측한 정상 신생아의 RDW는 소아에 비해 증가되어 있으나 출생후 변화는 없었다. ABO 부적합증 및 패혈증 환아군의 RDW는 대조군과 질병군 및 각 질병군 사이에 차이를 보이지 않아 이들 질환의 진단적 의의가 없었다. ABO 부적합증에서 RDW가 망상적혈구 수와 높은 상관관계를 나타내므로서 자동 분석기로 측정된 RDW로서 망상적혈구 수를 추정할 수 있었다. The RBC distribution width(RDW) has been reported to be of value in the early and differential diagnosis of several RBC disorders, with no sufficient studies on the newborn population. Seventy-eight normal fullterm newborns were studied to establish normal values for RDW of 1st week of life. The RDW of 43 patients with ABO incompatibility or sepsis was then evaluated for the usefulness of the RDW in diagnosis of Jaundice. The RDW was 17.7 ± 1.2 and 17.5 ± 0.8 at 1st and 4-7th days of life, revealing no differences de pending on the postnatal age. The RDW of newborns with ABO incompatibility, sepsis with and without jaundice were 18.4 ± 2.2, 18.2 ± 1.1 and 17.3 ± 0.9 respectively. The RDW was found to be consistently elevated in all these newborn infants-the normal newborns and the newborns with ABO incompatibility or sepsis-when compared with normal older children at our hospital. That reveals a physiologic state of anisocytosis in the newborn, showing no significant differences between these infants. Our results suggest that RDW alone cannot be used as an indicator to distingish between jaundice induced by hemolysis and by other causes. In this study all parameters examined except the reticulocyte counts of ABO incompatibility, which showed, by regression analysis, no correlation with the RDW. High RDW in ABO incompatibility is consistent with high reticulocyte count. One clinical value of the RDW therefore may lie in its capacity for reflecting active erythropioesis in ABO incompatibility. Thus the study has confirmed that red blood cell anisocytosis, as determined by RDW, has no value to differentiate the etiology of jaundice in the newborn period but it seems that RDW plays a role in determining the reticulocyte count in newborns with ABO incompatibility.

도뇨로 치유된 신생아 방광 파열성 요성 복수 1례

김행미,곽수희,정성광,이상권 대한소아과학회 2001 小兒科 Vol.44 No.8

서울市 轉入人口에 關한 小考

鄭幸玉 梨花女子大學校 師範大學 社會生活科 1966 綠友硏究論集 Vol.- No.8

단결권 침해와 부당노동행위

이학춘,박형권 東亞大學校 2000 東亞論叢 Vol.37 No.-

The labor can organize or join the trade union by the guarantee of the rights of solidarity prescribed in the constitution. The dismissal the labor or making the labor disadvantageous because of joining the trade union, being going to join it, or being going to organize the trade union is an unjust action of labor and it is forbidden. But Though there are these forbidding rules the unjust actions of labor rise up frequently by the employers in public or not. So the aim of this study is to study the forms of infringement, the institutions and processes of relief, major cases of violation, and, by solving these problems, to make new relation between labor and capital by understanding and cooperation of them.

環境保全을 위한 地方政府의 役割

이학춘,박형권,정연만 東亞大學校 2000 東亞論叢 Vol.37 No.-

Currently, it is said that one of the most important and urgent problems to be solved by our society is the environment problem. Our people, domestically, tends to make much of improvement of quality of life than quantity growth of it because of increase of income by rapid economic growth, and, internationally, to claim, we call, green round to enforce national environment preservation and international competitive power. With this increase of concernments on national and international environment, another change in the problem of environment in local self-governing body arises. With this age of local self-governing, the troubles between the government and people cause the group egoism on the environment problem, important or not, like construction of the field of disposal of radioactive waste matter, that of burning of waste, and that of reclamation of waste. At this point of time it will be very meaningful that we should investigate what environment policy the local self-governing bodies frame and carry out, and what way of policy they have to take.

신생 쥐 저산소-허혈성 뇌장애에 있어서의 Nimodipine의 치료효과

홍인희,김행미 경북대학교 의학연구소 1999 경북대학교병원의학연구소논문집 Vol.3 No.1

Purpose : Recent studies suggest that nimodipine, a potent calcium-channel blocker, may improve neurological outcome after experimental hypoxia-ischemic brain injury. This study was conducted to evaluate the therapeutic effect of nimodipine on hypoxia-ischemia in immature rat brain. Methods : Seven-day postnatal rats were subjected to hypoxia-ischemia by unilateral common carotid artery occlusion combined with 2 hours of hypoxia(in 8% oxygen at an ambient tempera-ture of 36℃). Then 20 rats received an intraventricular injection of nimodipine while the remaining 23 rats were injected with saline. Histologic examinations and morphometric analyses of brain tissue specimens were carried out 2 weeks after the hypoxia-ischemia. Resu1ts : Histopathological analysis of each rat showed that the brains of the nimodipine-treated animals were less damaged when compared with control rats treated with saline. Fifty percent of nimodipine treated rats but only 13% of saline-treated rats revealed normal histologic findings(p<0.05). Gliosis &/or nerve cell necrosis were observed, over three brain lobes in 15% of nimodi-pine-treated rats and 57% of saline-treated rats respectively(p<0.05). At the level of dorsal hippocampus, saline-treated rats revealed 0.18±0.17mm smaller ipsilateral cerebral hemispheres than contralateral hemispheres to artery disections but nimodipine-treated rats showed only 0.07±0.14mm smaller hemispheres(p<0.05). The difference between contralateral and ipsilateral cerebral cortex was 0.4±0.36mm in saline-treated rats and 0.11±0.14mm in nimo-dipine-treated rats(.p<0.05). The contraction of cerebral hemisphere and cortex were significantly reduced in nimodipine-treated rats. Conclusion : The finding indicates that post-insult nimodipine treatment in the immature rat decreases the extent of hypoxic-ischemic brain damage. (J Korean Pediatr Soc 1999;42:1552-1558)

폐 상피양 세포암에 특이한 Ribonuclease의 작용기전에 관한 연구

이성윤,지행옥,고재경 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.1

A neutral ribonuclease (RNase) specific to the epidermoid carcinoma of the lung was isolated from the lung cancer tissue to investigate processes involved in carcinogenesis and suppression of the lung cancer. Also studied were the substrate specificity and mechanism of action of the neutral RNase specific to the lung cancer. Neutral RNase activity in the lung tissue obtained by surgery was unchanged in four varieties of lung cancers (epidermoid carcinoma in 20 cases, 472±1859 umole/g/hr; adenocarcinoma in 5 cases, 5165±1575 umole/g/hr; karge cell carcinoma in 3 cases, 5870±2305 umole/g/hr; small cell carcinoma in 3 cases, 5405±2822 umole/g/hr; control in 31 cases, 4380±1520 umole/g/hr), indicating that RNase assay in the lung tissue could not be used as a biochemical marker for the lung cancer. Neutral RNases in the epidermoid carcinoma tissue of the lung were separated by a DEAE-cellulose column chromatography into 6 peaks, of which the peak Ⅰ neutral RNase isozyme was specific to the epidermoid cancer of the lung. High performance liquid chromatorgraphy (HPLC) and polyacrylamide gel electrophoresis (PAGE) patterns for peak Ⅰ protein from epidermoid carcinoma tissue of the lung appeared to be different from those of control lung tissue. The subpeak Ⅰ-5~8 (in HPLC pattern) that was supposed to be associated with RNase was greatly increased in the lung cancer, indicating that peak Ⅰ protein from epidermoid carcinoma tissue of the lung was specific to the lung cancer and that peak Ⅰ RNase specific to the cancer was located in HPLC subpeak Ⅰ-5~8. The peak Ⅰ neutral RNase was observed to be highly active toward poly C, poly AC and poly ACU and less active toward poly U and RNA, indicating that the peak Ⅰ neutral RNase was the secretory type of RNase. No activity was found toward polydezyribonucleotides and double stranded polyribonucleotides. Majority of products of poly C digest by the peak Ⅰ neutral RNase was analyzed to be oligoribonucleotides, indicating that the RNase was endonuclease in nature. Observations that the peak Ⅰ neutral RNase was specific to the epidermoid carcinoma of the lung and that the enzyme was endonuclease in nature suggested that the RNase might play an important role in process involved in the suppression of the lung cancer.

Typhoid Vi Capsular Polysaccharide Vaccine의 임상시험에 관한 연구

허준호,김행미,이건수 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.1

목적 : 장티푸스 예방 접종 중 살모넬라 Ty2 균주에서 강력한 항원성을 갖는 Vi 협막성 다당질항원을 분리 정제한 백신이 국내에서 개발된 바 그 효능과 부작용에 대하여 알아보고자 이 연구를 시행하였다. 대상 및 방법 : 1993년 4월부터 1995년 4월까지 주식회사 녹십자의 타이포박스®를 경남 울산군소재 애리원생 86명을 대상으로 접종 전과 접종 후 1개월, 3개월 및 12개월에 혈액 3㎖를 채취하여 혈청을 분리하고, 이를 녹십자 종합연구소에 의뢰하여 수동혈구응집반응법(passive hemagglutination)으로 Vi 항체가를 측정하였다 결과 : 예방 접종 후 Vi 항체의 양성율은 1개월에 96.5%(검사 대상 86례 중 83례), 3개월에 96.5%(86례 중 83례), 12개월에 96.4%(86례 중 81례)였으며 부작용으로는 경미한 국소 발적 반응과 경한 통증이 각각 5례, 경한 발열이 2례에서 있었다. 결론 : Vi 협막성 다당질 항원을 분리 정제한 타이포박스®는 접종 후 높은 항체가와 경미한 부작용을 나타내어 장티푸스 예방 접종 주사로서의 임상적 가치가 높다고 사료된다. Purpose : Recently, Vi capsular polysaccharide from Salmonella typhi Ty2 has been purified and manufactured as a vaccine(Typhovax®, Korea Green Cross) in Korea. To evaluate the safety and immunogenicity of Vi capsular polysaccharide vaccine this study was performed. Methods : A single dose of 0.5㎖(25㎍) was injected subcutaneously to 86 persons aged 8-44 years. Anti-Vi antibody titers were measured by passive hemagglutinarion test before and 1, 3, and 12 months after vaccination. Results : The rate of seroconversion was 96.5% at 1 month after vaccination. The antibody titers were sustained for at least 12 months. Transient local reactions, including pain and erythema, were noted in 5 cases(5.8%) and mild fever was developed in two cases(2.3%). Conclusions : To see whether this acquired level of Vi antibody titers protects infection from typhoid fever and the elevated level of Vi antibody titers persists, further clinical and epidemiological studies would be required.

BCG 접종후의 결핵반응검사의 변화

김진경,김기홍,김행미,안두홍 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.1

신생아 시기에 BCG를 접종받은 영아를 대상으로 3±개월, 7-8개월 및 15-16개월에 Mantoux 검사를 시행하여 다음과 같은 결과를 얻었다. 3-4개월째 측정한 결절의 크기는 5.8±4.5㎜, 7-8개월째 7.9±4.9㎜,15-16개월째 6.7±4.9㎜로서 7-8개월째 의의있게 (p<0.55)증가되어 있었다. Mantoux 검사상 결절의 크기가 5㎜미만인 경우를 음성으로 간주하였을대 3-4개월째 38.5%, 7-8개월째 26.0% 및 15-16개월째 35.2%가 음성이었으며 15㎜이상의 강양성은 3-4개월째 1.9%, 7-8개월째 12%, 15-16개월째 7.5%를 차지하였다. 33례의 미숙아에 있어서 BCG 접종후 18개월 동안 5㎜ 이상의 반응을 보인 양전례는 63.6%인 21례로 이들 양전군과 비양전군 사이에는 출생시 제태연령, 체중 및 BCG 접종시기에 유의한 차이를 보이지 않았으며 만삭아의 양전율과 비교 하였을 때 의의있는 차이를 보이지 않았다. We conducted this study to evaluate the change of tuberculin reaction after neonatal BCG vaccination in Korea. Seventy-four infants were followed for 15-16 month after birth. BCG vaccination were given within 4 weeks after birht and 3 times of Mantoux test were performed at 3-4 months, 7-8 months and 15-16 month after birth. During the same period, Mantoux test were done on 238 cases of 3-4 months-old infants, 107 cases of 7-8 months-old infants and 85 cases of 15-16 months-old infants who were given BCG vaccination within 4 week after birth. We evaluated the results without distinction of these infants because there was no statistically significant difference between two groups. The size of induration was significantly increased at 7-8 months(7.9±4.9㎜) compare to the size at 3-4 months (5.8±4.5㎜) and 15-16months(6.7±4.9㎜) (P<0.05). But 38.5%, 26.8% andn 32.5% of infants were not converted ( < 5㎜) at 3-4months, 7-8 months and 15-16 months after birth respectively. Thirty-three preterm infants were followed for 18 months after birth. Twenty-one out of 33 (63.6%) were converted during this period. There was no difference of gestational age, birth weight, age on BCG vaccination between converters and nonconverters. There was no difference of conversion rate compatre to full term infants.

腎盂穿剌에 依한 腎盂撮影法 所謂 ANTEGRADE PYELOGRAPHY

朱權源,文孝重,金幸錫 醫藥係社 1958 綜合 醫學 Vol.3 No.5