동종 골수이식을 시행받은 환자에서 폐색성 세기관지염에 의하여 발생한 자발성 기종격동과 피하 기종

이병환,이제중,이연경,안재숙,김여경,황호인,박무림,조상희,정익주,김형준 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.2

저자들은 만성골수성백혈병으로 동종 골수이식과 이식편 부전으로 인하여 추가적인 말초혈액 조혈모세포이식을 시행 받은 환자에서 만성 이식편대숙주질환과 그 폐 합병증인 폐색성 세기관지염에 동반된 자발성 기종격동과 피하 기종이 병발한 1예를 경험하였기에 이를 보고하는 바이다. Obstructive lung disorders following after allogeneic bone marrow transplantation (BMT) in association with graft- versus-host disease (GVHD) contribute significant morbidity and mortality. We report a case of a 28-year-old man who developed spontaneous pneumomediatinum and subcutaneous emphysema complicating bronchiolitis obliterans after allogeneic BMT. He received an allogeneic BMT for chronic phase of chronic myeloid leukemia. Five months after BMT, he was boostered by allogeneic peripheral blood stem cells from the same donor due to graft failure. One month after the boostering, chronic GVHD developed and were treated with cyclosporine and steroid. The patients developed spontaneous pneumomediatinum and subcutaneous emphysema secondary to severe bronchiolitis obliterans 4 months after boostering donor cells. The air-leak syndromes were recovered by conservative management, including high-flow oxygen.

진행성 비호지킨 림프종 환자에서 ICE 구제 요법에 의한 조혈모세포 가동화 후 자가 말초혈액 조혈모세포이식

이제중,이병환,김여경,변정래,이일권,박무림,정익주,김형준 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.1

연구배경: 비호지킨 림프종에서 자가 말초혈액 조혈모세포이식술이 폭넓게 이용됨으로 인해서, 높은 치료효과뿐만 아니라 조혈모세포의 가동화 효율이 높은 구제 요법이 요구되었다. 방법: 본 연구에서는 진행성 비호지킨 림프종에서 ICE 요법을 이용하여 조혈모세포를 가동화시킨 후 자가 말초혈액 조혈모세포이식이 시행하였던 환자를 후향적으로 분석하였다. 결과: 대상 환자의 중앙 연령은 38세(범위, 16~61)였으며, ICE 요법은 환자당 4주기(범위, 1~6주기)가 투여되었고, 투여 간격은 중앙값이 24일(범위, 16~36일)이었다. 고위험도 관해군을 제외한 13예의 환자 중 완전반응은 7예(53.8%), 부분반응은 4예(30.8%), 진행성질환은 2예(15.4%)를 보였다. 치료에 따른 3~4등급의 혈액학적 독성은 중성구감소증이 13예(81.3%), 혈소판감소증이 7예(42.8%)에서 관찰되었다. 조혈모세포 채집은 ICE 요법 후 중앙값이 12일(범위, 6~20일)에 시행되었고, 각 ICE 요법당 채집한 단핵구치는 중앙값이 5.75× 10^(8)/체중, CD34^(+) 세포는 중앙값이 1.25× 10^(6)/체중, CFU-GM치는 중앙값이 1.19× 10^(5)/체중이었다. 조혈모세포이식은 11예에서 시행되었고, 중앙 추적기간 401일에 평가한 2년 전체생존율은 70.1±14.7%, 1년 및 2년 무사건생존율은 각각 60.7±15.4%와 32.3±17.1%를 보였다. 결론: ICE 요법은 재발성/불응성 비호지킨 림프종 환자에서 높은 치료 반응률과 만족할 만한 조혈모세포 가동화를 보여 주었지만, 치료에 대한 순응도가 낮아서 투여 간격이 연장되는 문제점을 안고 있어서, 우리나라 환자의 실정에 적합한 구제요법에 대한 연구가 필요할 것으로 생각된다. Background: Due to the extensive application of high-dose chemotherapy with autologous peripheral blood stem cell transplantation (PBSCT), a salvage chemotherapeutic regimen with high response rate as well as effective capacity of PBSC mobilization is needed in non-Hodgkin's lymphoma (NHL). Methods: We analyzed the applicability of ICE (ifosphamide, carboplatin, and etoposide) regimen in NHL patients who underewent autologous PBSCT. Results: The median age was 38 years (range, 16~61 years), the patients received median 4 cycles (range, 1~6 cycles) of ICE regimen, and the median interval between each chemotherapeutic cycle was 24 days (range, 16~36 days). There were 7 (53.8%) complete responses, 4 (30.8%) partial responses, and 2 (15.4%) progressive diseases after ICE regimen. Toxicity included grade 3/4 neutropenia and throm bocytopenia in 13 (81.3%) and 7 (42.8%) patients, respectively. PBSC collection began on median day 12 (range, 6~20 days) after ICE therapy. The median number of mononuclear cells, CD34+ cells, and CFU-GM was 5.75× 10^(8)/kg, 1.25× 10^(6)/kg, and 1.19× 10^(5)/kg, respectively. With a median follow- up of 401 days, the patients who underwent autologous PBSCT had overall survival with 70.1±14.7% at 2 year and event free survival with 60.7±15.4% and 32.3±17.1% at 1 year and 2 years, respectively. Conclusion: ICE chemotherapy is an effective cytoreduction and mobilization regimen in patients with NHL, but profound myelosuppression with delayed recovery might pose difficulties in applying for Korean patients. Further evaluation for appropriate salvage regimens in Korean patients should be needed.

Propylthiouracil에 의한 중증 급성간염 1예

임종주,심미령,이명수,김태현,오석규,안선호,박무림,김남호,박병현,조성구 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

PTU에 의한 간염의 발생은 매우 드물게 발생하는 것으로 알려져 있으나 저자들은 Graves씨 병으로 진단 받고 propylthiouracil 투여를 받고있던 환자에서 중증의 급성 간염이 발생한 1예를 경험하였기에 보고하는 바이다. Propylthiouracil is widely used to treat patients with hyperthyroidism. This drug has been associated with severe hepatotoxicity rarely. We presented the case of jaundice and profound liver dysfunction from a 23-year old woman treated with propylthiouracil for hyperthyroidism. Viral, metabolic, and autoimmune liver disease could be excluded and liver biopsy revealed a pattern of acute hepatitis. After discontinuing the drug, there was a progressive resolution of hepatic symptoms and decrease in biochemical data of the liver. Despite propylthiouracil induced hepatitis in rare case, patients receiving propylthiouracil are exposed to develope severe hepatotoxicity. Therefore it might be advisable to monitor level of the transaminase on regular base from patients receiving propylthiouracil.

호중구감소증과 연관된 중증 감염 환자에게 과립구집락자극인자와 덱사메사손으로 가동화된 정상 공여자로부터 과립구 수혈치료

이병환 ( Byoung Hwan Lee ),이제중 ( Je Jung Lee ),김여경 ( Yeo Kyeoung Kim ),조상희 ( Sang Hee Cho ),신동현 ( Dong Hyeon Shin ),조덕 ( Duck Cho ),양동욱 ( Dong Wook Ryang ),박무림 ( Moo Rim Park ),정익주 ( Ik Joo Chung ),김형준 ( 대한내과학회 2003 대한내과학회지 Vol.64 No.4

목적 : 과립구 수혈치료는 적절한 항생제의 사용에도 불구하고 반응을 보이지 않는 호중구감소증과 연관된 중증 감염에 이용되어 왔다. 정상 공여자에게 백혈구를 가동화시키기 위하여 백혈구 조혈촉진인자나 스테로이드가 이용되어 왔으나, 최근에는 이를 병합하여 사용하는 추세이다. 본 연구는 과립구집락자극인자와 dexamethasone 병합 요법을 이용하여 공여자로부터 과립구를 채집한 후, 호중구감소증과 연관된 중증 감염 환자를 대상으로 과립구 수혈치료를 시행하여서 Background : Granulocyte transfusions have been used to treat severe, progressive infections in neutropenic patients who fail to respond to antimicrobial agents. Although corticosteroid or granulocyte colony-stimulating factor (G-CSF) were previously used

컨테이너 터미널에서 효율적인 게이트 관리를 위한 멀티 에이전트 시스템 개발

최형림 ( Hyung Rim Choi ),박병주 ( Byoung Joo Park ),유동호 ( Dong Ho Yoo ),강무홍 ( Moo Hong Kang ) LGCNS 엔트루정보기술연구소 2007 Entrue Journal of Information Technology Vol.6 No.2

컨테이너 터미널들은 최근 급증하고 있는 컨테이너 물량의 처리를 보다 신속하고 효율적으로 수행하여 생산성을 높이기 위한 노력을 하고 있다. 특히 컨테이너 터미널 게이트의 경우 컨테이너 터미널 내에 출입하는 모든 트럭 및 컨테이너를 인식하고 처리해야 하므로, 그 데이터의 양과 처리량은 기하급수적으로 늘어나고 있다. 곧 게이트 현황 파악과 반입 및 반출 게이트의 관리는 사람이 할 수 없을 정도의 상황에 도달할 것이며, 기존 방식을 계속 고수할 경우 보다 많은 오류를 범하게 되고 또한 처리 효율성도 떨어지게 될 것이다. 본 논문에서는 사람을 대신하여 이러한 작업들을 수행할 수 있는 에이전트 기술을 적용하여 문제를 해결할 수 있는 방안을 제시 하고자 한다. 본 연구에서 제안하는 멀티 에이전트 시스템은 TOS(Terminal Operating System)에서 미리 받은 COPINO 정보로 컨테이너 및 트럭의 유효성을 검사하여 컨테이너 트럭의 반출입을 통제하는 기능을 수행한다. 그리고 현재의 게이트 반출입 현황을 분석하고 반입, 반출 게이트의 수를 유연하게 조정하여 게이트의 효율성을 높이는 반출입 게이트 관리 기능을 수행한다. Recently global container trade is steadily increasing. In an effort to cope with this trend, major ports of the world are stepping up the introduction of high-tech equipments, trying to establish a highly efficient information system, and improving the internal work processes of their container terminals. For speedy and effective cargo handling, they are making every effort in the diverse fields. The purpose of this study aims at developing an intelligent multi-agent system for the gate work of a container terminal, which is the place of authority transfer in a container terminal. The multi-agent system suggested in this study makes a comparison between COPINO information by TOS (Terminal Operating System) and information on containers and trucks recognized at the gate, and then performs the function of controlling truck`s gatein/out. Also, based on the records of outside truck`s gate passage, some gates can be operated flexibly, consequently enhancing the efficiency of the gate function. The multi-agent system focuses on minimizing the bottlenecks taking place at the container terminal gate, reducing the waiting time of visiting trucks, and improving the productivity of yard cranes.

Placenta Derived Mesenchymal Stem Cells in Combination with Polycaprolactone-20% Tricalcium Phosphate Scaffolds for the Treatment of Critical-Sized Defects of the Mandible

( Eui Seok Lee ),( Byoung Moo Seo ),( Jae Suk Rim ),( Hyon Seok Jang ),( Jong Jin Kwon ) 한국조직공학과 재생의학회 2010 조직공학과 재생의학 Vol.7 No.3

Objectives: Polycaprolactone-20% tricalcium phosphate (PCL-TCP) polymers allow for cellular adherence and differentiation and are adequate scaffolds for bone regeneration in tissue engineering strategies. The placenta contains multipotent stem cells. This study evaluated the utility of placenta derived mesenchymal stem cells (PDMSCs) seeded onto PCL-TCP scaffolds for bone tissue engineering. Materials and Methods: PDMSCs were isolated from placenta. PCL-TCP scaffolds with PDMSCs were implanted in full-thickness mandibular bone defects (2×2 cm) in minipigs. In the first experimental group, defects were treated with amnion-derived MSCs placed onto the scaffold, whereas in the second experimental group, defects were treated with deciduas-derived MSCs placed onto the scaffold. As a control, a third defect was treated with the scaffold only. Histological and radiographic examinations were performed twelve weeks post-implantation. Results: Soft radiographic measurements showed that experimental groups had twice the bone density of control group. Experimental groups had a statistically significant increased bone regeneration potential compared to control group in mandibular bone defects in minipigs. Micro CT showed that experimental groups had higher levels of percent of regenerated volume fraction, regenerated bone volumes and regenerated bone surface than control group. The histologic examination revealed the presence of regenerated bone at the central area of defect. Conclusion: PDMSCs seeded into the PCL-TCP scaffolds enhance bone regeneration in mandibular defects. Therefore PCL-TCP scaffold with placenta derived mesenchymal stem cels can increase bone regeneration.

Incidental finding of capillaria hepatica in a raccoon

Chae-woong Lim,Byoung-moo Rim,Seong-hun Kim,Hong-ki Do,Hong-ji Yang 대한수의학회 1996 대한수의학회 학술대회발표집 Vol.1996 No.-

비마약성 진통제 복용 후 간질성 신염없이 발생된 미세변화 신증후군 1예

이재훈,심혁,염주진,이명수,박병현,오석규,김남호,박무림,안선호,송주흥 대한내과학회 2002 대한내과학회지 Vol.63 No.2

The use of nonsteroidal antiinflammatory drugs (NSAIDs) can be complicated by severe forms of renal dysfunction. These include fluid and electrolyte abnormalities, acute renal insufficiency due to alteration in renal hemodynamics, or interstitial nephritis and proteinuria secondary to glomerular pathology, which has the histologic characteristics of minimal change glomerulopathy (MCG). While NSAID-induced nephrotic syndrome characteristically consists of MCG with interstitial nephritis, which is the most common clinical manifestation, it rarely consists of MCG without interstitial nephritis, which has been reported in a handful of patients who took fenoprofen, ibuprofen, sulindac, diclofenac, or zomepirac. We experienced a 66-year-old female patient who presented with low serum albumin, proteinuria and generalized edema and received Geworin^ for about 2 year before developing symptoms. She histologically had MCG without interstitial nephritis and achieved a complete remission thirty-fifth days after discontinuing the drug. A cause-and-effect relationship of this disease to Geworin^ administration is strongly suggested by the resolution of the proteinuria after the drug was stopped and by no evidence of any impairment in renal function after twenty eight months of follow-up.

Poster Display : Gout Induced by Intoxication of Sodium Bicarbonate in Korean Native Broilers

( Sohail Ejaz ),( Jong Hwan Lee ),( Chae Woong Lim ),( Byeong Kirl Baek ),( Byoung Moo Rim ) 한국수의병리학회 2004 학술대회 Vol.8 No.-

Poster Display : Cyclopia in a Calf

( Hee Jin Park ),( Sang Gi Hyong ),( Sohail Ejaz ),( Chae Woong Lim ),( Byoung Moo Rim ) 한국수의병리학회 2004 학술대회 Vol.8 No.-