급성백혈병의 화학요법에서 조혈간세포 보충요법

이규보,배선근,손상균,이재태,이건수,이경혜,서장수 경북대학교 병원 1997 경북대학교병원의학연구소논문집 Vol.1 No.1

1. 목적 급성백혈병의 화학요법에 있어서 관해유도 요법시에 보다 더 강력한 항암화학요법을 시행하고 골수억제의 회복을 위하여 말초혈액에서 채취한 조혈모세포의 투여로 그 효과를 증대시키고자 시도하였다. 2. 방법 관해유도 화학요법후에 골수억제시기로부터 회복단계로서 백혈구감소증이 호전도면서 단핵세포가 증가될 때에 말초혈액에서 조혈간세포(stem cell)로 인정되고 있는 CD34+세포의 함유량이 1% 이상되는 시기를 찾아내고 그 때부터 평균 4차례의 단핵구를 분리채집을 하여 -74。C에 냉동보관하였다가 제2차 화학요법후에 해동시켜서 정맥주입하였다. 3. 결과 대상 급성백혈병환자는 6명에 23회의 조혈간세포를 함유한 단핵구 채집을 시행하였고 유효한 단핵구의 채집은 4례에서 가능하였고 2례에서는 유효한 채집이 못되었다. 채집효율은 39.0-74.5%로서 평균 49.8%였다. 채집 후에 혈액학적 변화는 혈색소의 약간 감소 (평균 1.34g/dl)와 혈소판의 감소 (평균20.25%)를 나타내었다. 해동 단핵구를 투여할시에 일과성인 불쾌감, 기침, 흉부압박감, 호흡곤란 등이 있었다. 4. 결론 자가골수이식에서 자기말초혈액조혈간세포이식으로 관심이 이행되는 현시점에 자가조혈간세포를 채집하여 수혈하는 기술이 확립되는 기초를 이루었다고 본다. 이번 대상들은 재발된 금성백혈병들에 시행하였으나, 향후에는 초발시에 제일차 관해유도 화학요법 과정에 시도해야할 것으로 생각한다. Object: Peripheral blood stem cells(PBSC) were collected after remission induction chemotherapy and reinfused after intensified chemotherapy in order to increase the chemotherapeutic efficacy. Method: Collection of mononuclear cells (MNC) was started when CD34+ cells above 1% and WBC above 1,000/ul with mononuclear cell percentage above 30%, the collection procedures were done 2-6 time in each patient of total 6 cases. The collected MNCs were stored in - 750C and reinfused after thawing in the water bath at 370C Results: Twenty three collection procedures from the 6 cases of acute leukemia had made effective MNC collection in 4 cases and mean collection efficiency was 49.8%(from 39.0% to 74.5%). Hematological changes after the procedure were mean reduction of hemoglobin 1.34g/dl and mean 20.25% of decreased platelet count. There were noticed transient symptoms of discomfort, coughing, chest tightness and dyspnea in association with the infusion of stored cells. Conclusion: The basic process for the peripheral blood stem cell transplantation (PBSCT) was accomplished with this supportive care for the consolidation chemotherapy of acute leukemia. Effective PBSCT would be warrented with more qualified process and high does chemotherapy. (Korean J Blood Transfus 6(2) : 41~47,1995)

제2형 당뇨병 환자에서 우연히 발견된 기종성 방광염 1례

박보민,김윤정,이영태,노정현,권수경,김동준,고경수,이병두,임경호,이순희,박정현 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Emphysematous cystitis is an uncommon disease in which bacterias produce gas within the bladder wall and surrounding tissue. Patients with diabetes, neurogenic bladder and chronic urinary tract infection are predisposed to the disease. It is usually caused by E.coli and Klebsiella. Severity of illness ranges from an asymtomatic condition to life threatening cystitis. Succesful management depends on early diagnosis with correction of underlying causes, administration of appropriate antibiotics, establishment of adequate bladder drainage and surgical excision of involved tissue when required. We report a case of 52-year-old woman who did not compain of symtoms of cystitis but epigastric pain, nausea, and vomitting. Emphysematous cystitis was revealed on the abdominal X-ray series incidentally. CT scans of the pelvis showed mottled gas bubble within the bladder. After treatment, the symtoms subsided and plain abdominal film showed no evidence of gas shadow in the pelvic cavity.

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.

자궁경부암에서 혈관 내피 성장인자 ( VEGF ) 및 VEGF Mrna 의 발현에 대한 연구

이선경(Seon Kyung Lee),김승보(Seung Bo Kim),지성길(Sung Gil Chi),염윤석(Yoon Seok Yum),이주희(Ju Hee Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.1

N/A Objective : Angiogenesis, the formation of blood vessels by sprouting from pre-existing ones, is essential for the growth of solid tumors beyond 2~3mm in diameter and for tumor metastasis. Vascular endothelial growth factor (VEGF), is known as vascular permeability factor(VPF) and mediates vascularization and tumor-induced angiogenesis. This study examined the potential of growth, invasion, and metastasis of uterine cervical carcinomas associated with neovascularization. Methods : From January 1996 to December 1999, at the Department of Obstetrics and Gynecology, Kyung-Hee University Hospital, 37 uterine cervical carcinomas and 7 normal cervical tissues were obtained and the samples were immediately frozen and stored at -70℃. Immunohistochemical staining for VEGF was carried out to study VEGF localization, and the levels of VEGF subtype mRNAs were determined by quantitative RT-PCR in specimens. The relation between VEGF subtypes expression of cervical cancers was analysed. Results : The positive staining for VEGF is seen dominantly in the cytoplasm of the cancer cells, and faintly in interstitial cells. The intensity of staining was stronger in squamous carcinomas than in adenocrcinomas, but there was no significant difference (p>0.05). Quantitative RT-PCR analysis demonstrated significantly increased VEGF121/VEGF165 mRNA expression levels (>0.56/>0.72) in 21 (56.8%) and 15 (40.5%) of 37 cervical carcinomas comparing to control groups (mean: 0.28/0.36). There was no obvious relationship between VEGF121/VEGF165 mRNA expression levels and the clinical parameters examined including age, pathology, differentiation, tumor size, lymphovascular space invasion, LN involvement and invasion depth except clinical stage (p<0.05). Conclusions : The overexpression of VEGF mRNA may be an important contributing factor in cervical carcinomas. There is no significant differenece of VEGF mRNAs levels according to clinical parameters, so it seems that the expression of VEGF is involved in the promotion of angiogenesis on cervical cancer and plays an important role in early invasion.

선행 제왕절개술 후 질식 분만: 성공의 예측인자들

동서연 ( Seo Yun Tong ),김여홍 ( Yeo Hong Kim ),최영준 ( Young Jun Choi ),김소라 ( So Ra Kim ),이보연 ( Bo Yon Lee ),이선경 ( Seon Kyung Lee ),허주엽 ( Chu Yeop Huh ),김승보 ( Seong Bo Kim ) 대한주산의학회 2003 Perinatology Vol.14 No.4

목적: 선행제왕절개 후 질식분만을 시도한 산모들 중 성공군과 실패군을 비교하여 성공을 예측할 수 있는 인자를 알아보고자 하였다. 방법: 1997년 3월부터 2003년 2월까지 경희대학교 의과대학 산부인과에서 선행제왕절개 후 질식분만을 위하여 내원한 환자중 질식분만의 금기가 아닌 경우 위험요소 등에 대하여 충분히 상의한 후 분만을 시도한 382명의 환자를 대상으로 하였다. 대상군의 의무기록을 통하여 분만당시 산모의 나이, 분만력, 제태연령, 신생아 몸무게, 입원시 자궁경부 상태 및 Bishop score, 분만의 진행과정, 결과 및 합병증을 조사하여 성공군과 실패군의 차이를 비교분석 하였다. 결과: 292(76.5%)명이 질식분만에 성공하였다. 여러 인자 중 태아의 몸무게(odds ratio, 0.2 ; 95% confidence interval (CI), 0.1-0.4), 입원시 Bishop score(odds ratio, 1.8 ; 95% CI, 1.5-2.1), 질식분만의 과거력(odds ratio, 3.6 ; 95% CI, 1.1-11.6)이 VBAC의 성공과 관련이 있었다. 또한 선행제왕절개시 적응증이 태위이상인 경우에 성공률이 높은 것으로 나타났다(odds ratio, 3.2 ; 95% CI, 1.2~8.6). 입원시 Bishop score로 VBAC의 성공을 예측할 수 있는 지 알아보기 위하여 receiver-operating characteristic curve 분석을 시행하였고, 5점을 cut-off로 하였을 때 47.4%의 민감도와 87.6%의 특이도를 보였다(AUC, 0.765 ; p<0.05). 결론: 출생체중, 질식분만의 과거력, 입원시 Bishop score가 선행제왕절개 후 질식분만을 고려하는 경우 성공의 예측인자로서 유용하게 사용되어 질 수 있을 것이다. Objective: The purpose of this report is to determine the predictable factors for successful vaginal birth after cesarean (VBAC). Methods: In this study, 382 women who attempted VBAC at Kyung-Hee university hospital were included. The medical records of them were reviewed retrospectively. Informations was collected about demographics, medical history, obstetric history, neonatal birth weight, complications, treatment, and outcome of the index pregnancy. Results: The overall success rate was 76.5% (292 cases). Among variables, neonatal birth weight (odds ratio, 0.2; 95% confidence interval, 0.1-0.4), Bishop score at admission (odds ratio, 1.8; 95% confidence interval, 1.5-2.1 ; p<0.05), and history of vaginal delivery (odds ratio, 3.6 ; 95% confidence interval, 1.1-11.6 ; p<0.05) were significant. The Bishop score showed most significant relationship with successful VBAC. The Bishop score 5 at admission had a sensitivity of 47.4% and a specificity of 87.6% in the prediction of successful VBAC. Malpresentation as indications of previous cesarean delivery showed more tendency to succeed than others. Conclusion: Several factors such as birth weight, Bishop score at admission, and history of vaginal delivery may be used to predict the success of VBAC.

선행 제왕절개 후의 질식 분만시 성공군과 실패군의 비교연구

최현수(Hyun Soo Choi),이상욱(Sang Wook Yi),오영승(Young Seung Oh),진규섭(Kyu seop Jin),이보연(Bo yon Lee),이선경(Seun Kyung Lee),허주엽(Chu Yeop Huh),김승보(Seung Bo Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10

제왕 절개의 비율은 최근 까지 지난 20년동안 증가되어 왔으며 이러한 증가는 반복 제왕 절개의 증가와 관련된 것이다. 최근 제왕 절개후 질식 분만에 관한 연구에서는 반복 제왕절개시 올 수 있는 수술 후 합병증, 산모 및 태아의 이환율의 증가 등과 비교해 이 시도가 비교적 안전한 방법으로 등을 보고 하고있는 반면 또한 제왕 절개후 질식 분만시 올 수 있는 자궁 파열과 이로 인한 태아와 산모의 위험성에 관한 보고도 있다. 이에 본원에서는 제왕 절개후 질식 분만을 원해 내원한 산모를 대상으로 성공군과 실패군 사이에 여러 요인을 비교 분석하여 성공에 관여한 인자를 예측하고자 하였다. 연구 대상은 1997년 3월부터 1999년 3월까지 선행 제왕 절개 후 질식 분만을 위해 내원한 환자중 질식 분만 시도시 위험성이 적다고 판단되는 120명의 산모를 대상으로 했으며 성공군과 실패군 사이에 산모의 나이, 제태 연령, 질식 분만한 과거력의 유무, 선행 제왕 절개의 적응증, 초음파로 예측한 태아 몸무게, 신생아 몸무게, 입원시 자궁 경부 상태, Bishop score, CPD index(Cephalopelvic disproportion Index)를 비교 분석 하였다. 120명의 산모중 87명(72.5%)이 성공 하였으며 33명(27.5%)이 실패 하였고 자궁 파열이나 열개와 같은 합병증은 발견되지 않았다. 두 대조군 사이에 산모의 나이(P=0.012), Bishop score(P=0.002), CPD index(P=0.015)에서 의미있는 차이를 보였으며 기타 요인에서는 의미있는 차이를 보이지 않았다. 결론적으로 선행 제절 이후 질식 분만 시도 시에 금기가 아닌 경우 입원시 X선 골반 계측을 통한 CPD index와 Bishop score을 통해 성공 가능성에 대한 예측에 도움을 줄 수 있으며 앞으로 이 요인들과 함께 다른 요인들과의 연관성에 대한 연구를 통해 선행 제왕 절개후 질식 분만 시도시에 올 수 있는 위험성을 줄일 수 있을 것으로 생각된다. 이상과 같은 연구 결과로 또한 추후 성공의 예후 인자로 사용되어 질 수 있고, 앞으로 이 시도의 성공과 관련된 다른 인자와의 연관성을 통한 면밀한 검토가 필요할 것으로 사료된다. Objectives: Vaginal birth or trial of labor after previous cesarean section has become one of the most remarkable changes in obstetric practice. The safety and efficacy of a trial of labor and vaginal birth after previous cesarean are well documented. The purpose of this report is to predict the likelihood of vaginal birth in patients undergoing a trial of labor after previous cesarean delivery using factors known at the time of hospital admission. Method: In this retrospective study, 120 women who attempted vaginal birth at Kyung-Hee University Hospital from March 1997 to March 1999. An attempt to identify possible prognostic factors for success of such a trial was made and we evaluated the variables of significant predictive value and the patients' characteristics in the success group and failure group of women who attempted VBAC. Result: 87 cases(72.5%) in 120 cases succeeded in VBAC and 33 cases(27.5%) failed. In this comparative groups in VBAC, there was significant difference in CPD index(cephalopelvic disproportion index) and Bishop score, but no significant difference in gestational age, the estimated fetal weight by sonography and newborn birth weight. Conclusion: In this study, Bishop score and CPD index and age may be useful and valid predictor of success in VBAC and this information could be particularly valuable. The CPD index may prove most important in determining if a vaginal birth should occur after a cesarean section because it can clearly identify some patients who need a repeat cesarean section.

경피적 중심 정맥 도관의 임상적 적용에 관한 연구

이희경,김영창,이혜경,박보림 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

신생아실에서의 미숙아 및 선천성 기형의 치료의 발달과 함께 중심 정맥의 필요성이 증가되면서 경피적 중심 정맥 확보인 경피적 정맥 도관(PCVC)을 시행하게 되었으며 현재 널리 이용하계 되었다. 1995년 5월에서부터 1997년 4월까지 본원 신생아실에서 경피적 정맥 도관을 시행받은 78례에 대상으로 후향적으로 성공률의 유무, 도관 유지, 문제점, 합병증등을 알아 보아 향후 치료에 도움을 얻고자 본 연구를 시행하였다. 1. 경피적 정맥 도관을 시행한 78례중 64례(80.8%)에서 시술에 성공하였으며 본 시술만 전담하는 간호사에 의해 시행한 1997년 1월에서 4월까지 성공률은 95.3%였다(p<0.001). 2. 73.1%가 총정맥 영양법을 위해 시행되었고 이중 43.6%가 미숙아로 인한 총정맥 영양법을 위해 본 시술이 필요하였으며 17.9%는 항생제를 포함한 장기간의 약제 사용을 위한 정맥 확보를 위해, 9%에서 고농도의 용액의 사용을 위해 시술되었다. 3. 시술 부위는 주관절 정맥이 59.4%로 가장 많았고 액와 정맥이 35.9%로 많았다. 4. 시술후 도관의 위치는 우심방이 44.9%, 상대 정맥이 12.8%, 액와 정맥이 21.8%, 하대 정맥이 1.3%, 무명정맥이 1.3%로 우심방과 상대 정맥에 위치한 경우와 그이외 말초 부위에 위치한 경우를 비교했을 때 우심방과 상대 정맥에 위치한 경우가 도관의 유지기간이 의의있게 길었다(p<0.001). 5. 도관 제거의 이유는 더 이상 수액 제제가 피료치 않아 계획적으로 제거된 경우가 56.3%, 기계적 폐색등으로 제거된 경우가 21.9%, 도관과 관련된 감염으로 제거된 경우가 3%순이었다. 6. 도관 제거후 배양 검사를 시행한 36례중 9례(25%)에서 균이 배양되었고 staphylococcus epidermidis와 candida albicans가 대부분을 차지하였다. Percutaneous central venous catherization(PCVC) is performed commonly as a vascular access procedure for a various indications in the neonatal intensive care unit (NICU). We evaluated a total of 78 PCVC cases performed in the NICU over 2 years from April, 1995 to April, 1997 in terms of age, success rate, indications, insertion sites, indwelling time and causes of removal of catheters, and associated complications including sepsis retrospectively. The results are described below ; 1. Patient ages and body weights at the time of insertion ranged from 1-120 days (average age, 10.9 days) and from 660-4,100 gm(average weight, 2,119 gm) respectively. 2. The overall success rate of insertions was 80.8%, however, the insertions attempted by highly- trained nurse were successful in 95.3 % from Jan. to April, 1997. 3. The most common indication was total parenteral nutrition (73.1%). 4. The insertion sites were cubital vein(59.4%), axillary vein(35.9%), and external jugular vein(3.1%). 5. The locations of catheter tip were right atrium(44.9%), axillary vein(21.8%), superior vena cava(12.8%), and inferior vena cava(1.3%). 6. The indwelling time ranged from 1-52 days (average, 12.6 days). When the catheter tips were placed in the right atrium or superior vena cava, the catheter was placed in the longer duration compared to those of other sites significantly. 7. The causes of removal of catheter were elective (56.3 %), mechanical obstruction(21.9%) and catheter related infection(3%). 8. The cultures of catheter tip were done after removal in 36 cases, among them cultures were positive in 9 cases(25%) the most common causes were S. epidermidis and Candida albicans.

이상 유동에서 영상 복원을 위한 EIT system 회로의 안정성 평가

이보안,현종관,이헌주,김신,김경연 제주대학교 산업기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.1

The EIT(Electrical Impedance Tomography) system is one of the methods for tomography technologies. The EIT measurement is less expensive than other methods because the system is relatively simple and easy to construct compared to other methods. In this study, the real voltage values were compared to theoretical values. The rmse(root mean square error) of measured data was 2.99%. So that, this EIT system circuit was a accuracy circuit for a reconstruction algorithm.

安神淸腦湯이 알츠하이머질환 병태 모델의 생화학적 변화 및 기억에 미치는 영향

이상룡,김보경 대한동의병리학회 2001 동의생리병리학회지 Vol.15 No.5

This experiment was designed to investigate the effects of Ansinchengnoy-tang(ASCNT) on the Alzheimer's disease. The results were summarized as follows ; ASCNT extract suppressed the expressions of AChE, NOS-II mRNA in PC-12 cell stimulated by CT105. ASCNT extract suppressed the activity of AChE and the expressions of APP, PS-1, PS-2 in cell lysate of PC-12 cell stimulated by CT105 significantly. ASCNT extract increased glucose, decreased uric acid and AChE in the serum of the memory deficit rats induced by scopolamine. ASCNT extract showed significant inhibitory effect on the memory deficit of mice treated with scopolamine in the Morris water maze. ASCNT extract inhibited the overexpressions of proinflammatory cytokines such as IL-1β, IL-6, TNF-α mRNA in the THP-1 cell treated by CT105. ASCNT extract suppressed the expressions of proinflammatory cytokines such as IL-1β, TNF-α and reduced the production of ROS in the microglial cell of the mice. According to the above results, ASCNT extract can be applied for the symptomatic treatment and prevention of Alzheimer's disease and amnesia. this also must be done more evaluation.

W(110) 표면에 CO의 흡착

이경희,유위량,한현석,부진효,이순보,곽현태 성균관대학교 기초과학연구소 1998 論文集 Vol.49 No.-

The interaction of CO with W(110) surface was investigated through LEED, TDS, and photoelectron spectroscopy using synchrotron radiation under UHV condition. After CO saturation at RT, two desorption states, called α and β , were observed at about 400 and 1150 K in thermal desorption spectra, respectively. The kinetics of 3-CO followed the first order kinetics, indicating the existence of molecular CO on W(110) surface. This is contrary to the previous results. The O 1s BE(binding energy) of CO adsorbed on W(110) surface at room temperature was 529.9 eV. On the other hand, the O 1s BE of β-CO after heating to 900 K was different from that of oxygen adsorbed W(110) surface, suggesting a different adsorption state. According to the UP valence band spectra, we observed two peaks at near -10.7 eV (4σ) and -7.0 eV (5σ+1π), indicating the molecular adsorption of CO at room temperature. Furthermore we could see the 4σ peak at the various photon energy and elevated temperatures. Comparing the energy separation, Δ(4σ-1π) , between 4σ and 1π UP peaks of chemisorbed CO, we found that an increased separation reflects an decreased C-O bond strength. Therefore on the basis of TDS and photoelectron spectroscopy, we could suggest that β state of CO on W(110) may not be dissociated and has an adsorption geometry of lying-down mode.