CD34+ 조혈 모세포 이식 2례

김정아,정현식,김원석,윤성수,이홍기,박찬형,박성규,김동욱,이종욱,한치화,민우성,김춘추,김동집 대한조혈모세포이식학회 1996 대한조혈모세포이식학회지 Vol.1 No.1

Background: In most solid tumors, the CD34 antigen has not been detected, so positive selection of CD34+ cells may reduce tumor cell contamination and the CD34+ cells are capable of reconstituting hematopoiesis. We tried CD34+ cell transplantation in two patients. Method: CD34+ cells from chemotherapy + G-CSF mobilized PBPCs or bone marrow were positively selected with an avidin-biotin immunoadsorption column (CEPRATE SC system). Case 1. One course of chemotherapy using cyclophosphamide(200㎎/㎡) and etoposide (4.2g/㎡), combined with G-CSF(5㎍/㎏) S.C. was used in a relapsed lymphoma patient. This patient responded to the induction chemotherapy. CD34+ cells from harvested bone marrow were selected by the CellPro immunoadsorption column. The total number of mononuclear cells loaded onto the CellPro was 2.4×10^(8)/㎏, with 1.1% CD34+ cells. After column separation, the total number of positively selected cells was 5.16×10^(6)/㎏. The number of CFU-GM was 76.8×10⁴/㎏. This patient was treated with melphalan (140㎎/㎡) and TBI (1200cGy) and the positively selected CD34+ cells were infused. The time to neutrophil recovery greater than 0.5×10^(9)/L was 19 days and the time to platelet recovery greater than 50×10^(9)/L was 21 days. Case 2. Two courses of mobilizing chemotherapy were given 4 weeks apart using taxol(210㎎/m2) and adriamycin(60㎎/m2), combined with G-CSF(5㎍/㎏) S.C. in a breast cancer patients with 7 axillary node metastasis. CD34+ cells from each single leukapheresis product were selected by the CellPro immunoadsorption column. In the first collection, the total number of nucleated cells was 4.4×10^(8)/kg, with 0.42% CD34+ cells. In the second collection, the total number of nucleated cell was 2.8× 10^(8)/㎏ with 0.43% CD34+ cells. After colum separation, the total numbers of collected cells were 4.0×106/kg and 4.8×10^(6)/kg, the total number of CD34+ cells were 1.2×10^(6)/㎏ and 0.82×10^(6)/㎏. Colonogenic assays of positively selected CD34+ cells gave rise to myeloid erythroid, and multilineage colonies, with a median of 190 CFU-GM, 190 BFU-E, and 164 CFU-GEMM per 1×10³ adsorbed cells, respectively. High-dose chemotherapy with cumulative doses of 40mg/㎡ mitoxantrone, 750mg/㎡ thioptepa, and 1000mg/㎡ carboplatin was administered. Positively selected CD34+ cells were rapidly infused 24 hours after the end of high-dose chemotherapy. The time to neutrophil recovery greater than 0.5×10^(9)/L was 16 days and the time to platelet recovery greater than 50×10^(9)/L was 20 days.

동종 골수이식 후 만성 이식편대숙주반응 환자에서 발생한 폐렴구균에 의한 수막뇌염 1예

신완식,김병욱,유진홍,김동집,김춘추,박종원,이종욱,김동욱,강문원,김양리 대한감염학회 1993 감염 Vol.25 No.3

Graft-versus-host disease (GVHD) is a frequent complication after bone marrow transplantation. Infectious complications are common in GVHD patients due to defect in cell-mediated immunity. A rare case of S. pneumoniae meningoencephalitis occured in a patient with extensive form of chronic GVHD after allogeneic bone marrow transplantation. He was immediately treated with full dosage of ceftriaxone and ampicillin. He suffered from various complications such as sepsis, acute renal failure, atelectasis, and seizure. Despite of aggressive treatment, he died probably due to renal shutdown and massive subacute cerebral infarction of left cerebral hemisphere. This report showed two unusual and rare features. First, the infection site was CNS rather than respiratory system. Second, the causative organism was S. pneumoniae, which is rare cause of CNS infection in immunocompromised patients.

An Educational Program for Reduction of Transmission Network

원종집(Jong-Jip Won),박종배(Jong-Bae Park),신중린(Joong-Rin Shin),송형용(Hyoung-Yong Song),정윤원(Yun-Won Jeong) 대한전기학회 2008 대한전기학회 학술대회 논문집 Vol.2008 No.7(초록집)

Behcet 씨 병에서의 ELISA 법에 의한 항 Cardiolipin 항체 측정

박동준(Dong Jun Park),오종홍(Jong Hong Oho),김선하(Sun Ha Kim),박석영(Suk Young Park),김호연(Ho Youn Kim),김동집(Dong Jip Kim),박경숙(Kyung Sook Park) 대한내과학회 1989 대한내과학회지 Vol.37 No.2

N/A We evaluated the prevalence and clinical significance of anti-cardiolipin antibodies measured by enzyme- linked immunoabsorbent assay in 49 patients with Behcet`s disease. The results were as follows: 1) The prevalence of anti-cardiolipin antibodies was 28.6%. According to the subclasses of anti-cardiolipin antibodies, the prevalence of IgG anti-cardiolipin anti- body was 20.4% and that of IgM anti-cardiolipin anti- body was 8.2%. 2) The detection of anti-cardiolipin antibodies was not correlated with clinical vasculitis or major organ involvement in patients with Behcet's disease. These results suggest that anti-cardiolipin antibodies do not have a clinical significance in the major organ involvement or system vasculitis of Behcet's disease.

이기종 네트워크에서 능동 네트워크를 이용한 실시간 영상기반 가상환경 QoS 지원

박정인(Jung-Min Park),박용진(Yong-Jin Park),박종일(Jong-Il Park),원유집(Yoo-Jip Won),지정훈(Jung-Hoon Jee) 한국정보과학회 2002 한국정보과학회 학술발표논문집 Vol.29 No.2Ⅲ

본 논문은 능동네트워크기술을 적용한 가상환경시스템에 대하여 논한다. 가상환경에서는 실시간 영상이 사용 되면 대용량 실시간 영상 데이터의 전송에 따른 네트워크부하와, 데이터 렌더링에 따른 시스템 부하가 문제점으로 지적된다. 본 시스템에서는 능동네트워크 기술을 적용하여 네트워크의 중간 라우터에서 실시간 영상 데이터의 프레임 레이트(Frame Rate)를 동적으로 변화시켜 이러한 문제점을 해결하였다. 가상환경상의 객체들 사이의 물리적인 거리를 고려한 이지모델에 따른 전송기법을 채택하고, 또한 멀티캐스트 그룹에 가입하고 있는 시스템의 네트워크대역폭의 정보를 라우터에서 관리하여 각 시스템에 적합한 형태로 실시간 영상 데이터를 전송하는 방법을 사용하여 가상환경의 몰입도를 높힘과 동시에 네트워크의 부담을 감소시켰다. 이러한 시스템을 통하여 대용량의 영상 데이터의 전송을 실시간적으로 전송해야 하는 가상환경을 매우 효과적으로 지원할 수 있다.

종양용해중후군에 의한 급성신부전증의 임상적 양상

박인석(In Seok Park),임규택(Gyu Taek Lim),김성수(Sung Soo Kim),장윤식(Yoon Sik Chang),윤영석(Young Suk Yoon),진종률(Jong Yul Jin),박종원(Jong Won Park),김춘추(Choon Choo Kim),방병기(Byung Kee Bang),김동집(Dong Jip Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.5

N/A Background: Tumor lysis syndrome (TLS) occurs as a result of the rapid release of intracellular ions and metabolites into the bloodstream which can overwhelm the reanl capacity to excrete and then increase to lifethreatening concentrations. The syndrome is characterized by hyperuricmia, hyperkalemia, hyperphos-phatemia and hypocalcemia. Recently, intensive chemotherapy for hematologic malignancy have introduced and tumor lysis syndorme occurred with increasing tendency. Methods: Renal and metabloic complications of tumor lysis of ten episodes are reviewed in nine patients with various hematologic malignancy during last 2 years. Results: The ten episodes of tumor lysis syndrome had developed in one of malignant lymphoma. five of acute lymphocytic leukemia and four of chronic myelocytic leukemia. The mean serum BUN and creatinine concentration was 68.0 and 4.4 mg/dl, respectively. The mean serum calcium was 5.2 mg/dl, phosphorus 11.5 mg/dl, uric acid 13.9mg/dl. Clinical manifestations of tumor lysis syndrome had developed abruptly within 24 hours after chemotherapy in all episodes. Prophylactic treatment including intravenous hydration, potent diuretics, alkalinization of urine and allopurinol were not always successful in preventing or aborting it. The two major clinical features of tumor lysis syndrome were oligoanuria (6/10) and neurologic symptoms such as carpopedal spasm (5/10). Conclusion: We had experienced ten episodes of tumor lysis syndrome from 9 patients. Except three patients who expired due to unrelated causes, the overall recovery was good. The mean recovery day in three conservative-treated patients and four hemodialysis- Bsekground: Tumor lysis syndrome (TLS) occurs as a result of the rapid release of intracellular ions and metabolites into the bloodstream which can overwhelm the reaol capacity to excrete and then increase to lifethreatening concentrations. The syndrome is characterized by hyperuricmia, hyperkalemia, hyperphos- phatemia and hypocalcemia. Recently, intensive chemotherapy for hematologic malignancy have introduced and tumor lysis syndorme occurred with increasing tendency. Methods: Renal and metabloic complications of tumor lysis of ten episodes are reviewed in nine patients with various hematologic malignancy during last 2 years. Results: The ten episodes of tumor lysis syndrome had developed in one of malignant lymphoma. five of acute lymphocytic leukemia and four of chronic myelocytic leukemia. The mean serum BUN and creatinine concentration was 68.0 and 4.4 mg/dl, respectively. The mean serum calcium was 5.2 mg/dl, phosphorus 11.5 mg/dl, uric acid 13.9mg/dl. Clinical manifestations of tumor lysis syndrome had developed abruptly within 24 hours after chemotherapy in all episodes. Prophylactic treatment including intravenous hydration, potent diuretics, alkalinization of urine and allopurinol were not always successful in preventing or aborting it. The two major clinical features of tumor lysis syndrome were oligoanuria (6/10) and neurologic symptoms such as carpopedal spasm (5/10). Conclusion: We had experienced ten episodes of tumor lysis syndrome from 9 patients. Except three patients who expired due to unrelated causes, the overall recovery was good. The mean recovery day in three conservative-treated patients and four hemodialysistreated patients was 10 and 16 days, respectively.

AMSA가 포함된 복합화학요법에 의한 재발된 혹은 불응성 급성 골수성 백혈병의 재관해유도

이종욱,한치화,민우성,박종원,김춘추,김동집 大韓血液學會 1990 大韓血液學會誌 Vol.25 No.2

중증 재생 불량성 빈혈의 면역조절요법 Ⅱ

박종원,양철우,김동욱,김혜순,한치화,김춘추,김동집 大韓血液學會 1987 大韓血液學會誌 Vol.22 No.2

불응성 진성적혈구 형성부전 환자에서 시행한 자가 CD34+ 말초 조혈모세포 이식 1례

박수정,이종욱,김희제,서정곤,민창기,민우성,김춘추,김동집 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

Acquired pure red cell aplasia(PRCA) is a rare hematological condition, characterized by severe anemia and reticulocytopenia, with normal white cell and platelet counts, and selective aplasia of the erythroid cell line in the marrow. It is considered an autoimmune disorder. Antibodies directed against heme synthesis or erythroid progenitors have been described. Based upon the autoimmune nature of PRCA, a variety of immunomodulatory agents and method including corticosteroids, antithymocyte or antilymphocyte globulins, azathioprine, cyclophosphamide, cyclosporine, and plasmapheresis is used for patients with PRCA but the optimal therapeutic strategy for refractory patients to the conventional treatment has not been defined. For PRCA patients with refractory to conventional treatments, disease morbidity is increased and life expectancy is significantly shortened because of increased infection risk or multiorgan failure due to chronic immune suppression status and prolonged transfusions. Results of recent studies and observations of severe refractory autoimmune disease control in autologous peripheral stem cell transplantation setting have recently prompted interest in a potential role for high dose immunosuppressive therapy as a treatment modality. We report our experience the high dose immune suppression with cyclophosphamide (50mg/ Kg/day, for 4 days) followed by autologous CD34+ enriched peripheral stem cell transplantation for refractory PRCA patient, and she is hematologically remission for 6 months after transplantation. To our knowledge, this is the first report of autografting for patient with PRCA.

G-CSF로 투여받은 정상공혈자로부터 원심분리기와 적혈구침강촉진제를 이용한 효과적인 백혈구수집의 임상경험

박성규,한치화,김동욱,이종욱,김상돌,송차숙,최정현,민우성,신완식,김춘추,김원일,김동집 대한조혈모세포이식학회 1996 대한조혈모세포이식학회지 Vol.1 No.1

In recent days, the granulocyte transfusion is re-emerging because several investigators reported the effectiveness of large granulocytes (mord than 2×10^(10)per day) to control life-threatening infections for severe neutropenic patients. Application of continuous cell separators as well as erythrocyte sedimentation enhancing agents (hydroxyethylstarch, HES) made it possible to collect enough therapeutic number of granulocytes from a single donor. To increase the efficiency of granulocyte collection we gave G-CSF to normal donors at least 12 hours before harvest. Also, 10% pentastarch solution (low molecular weight-HES) which has minimal side effects compared with 6% hetastarch (high molecular weight-HES) was used to enhance erythrocyte sedimentation during centrifugation. We measured the vitro effect of HESs on the erythrocyte sedimentation rate (ESR) of peripheral whole blood depending their concentrations; the ESR (mm/hr) of 10% PS was significantly higher than that of 6% PS or HS(39.19±11.52 vs 11.62±7.26 or 15.23±6.86, p< 0.01) and that of PBS (5.17±2.85, p< 0.01). We compared the efficiency of granulocyte collection between G-CSF treated (n=9) and untreated (n=30) donors: the total number of granulocytes in the latter cases ranged 0.2 to 1.7×10^(10) (median 2.9×10^(10)) (p<0.01). Of interest, the peripheral WBC counts of donors when the counts were over 10,000/mm³ on the day of collection, correlated with the yield of granulocytes in the final products (r=0.75). Except one donors who had peripheral WBC count more than 10,000/mm³ without G-CSF, all cases showing peripheral WBC count over 10,000/mm³ had received G-CSF before collection. Furthermore, the WBC kinetics in G-CSF trealed donors showed that the peripheral WBC counts rose over 10,000/mm³ quickly (within 12 hours) and sustained during the period of injection. Among three neutropenic patients who had been received large dose grannlocgtes daily due to definitive critical infection, two patients (one in induction for ALL, and the other in early recovery phase of allogeneic BMT for severe aplastic anernia) recovered completely. However one who firstly diagnosed as SAA showed only temporary responses during granulocyte transfusion. Therefore, we suggest that (1) collection of large dose of granulocytes using a continuous cell separator with 10% PS is possible from a donor when pretreated by G-CSF, (2) such therapeutic granulocyte transfusion is effective to control life-threatening infections of severe neutropenic patients whose granulocyte counts are expected to recover within several days.