HBsAb와 HBcAb가 양성인 장기 공여자의 간조직에서 Hepatitis B Virus DNA의 발현

정창우,장주영,김경모,이승규,Jung, Chang-Woo,Jang, Joo-Young,Kim, Kyung-Mo,Lee, Sung-Gyu 대한소아소화기영양학회 2007 Pediatric gastroenterology, hepatology & nutrition Vol.10 No.2

목 적: 최근 HBsAb 및 HBcAb 양성인 공여자의 간이 식편을 이식 받은 수혜자에서 신생 B형 간염이 발생하는 것이 보고 되고 있으며, 저자들도 약 40%에서 신생B형 간염이 발생하는 것을 보고하였다. 한국인에서의 HBcAb 양성률은 50%가 넘는 것으로 보고하고 있는데, 이는 임상 간이식의 걸림돌이 될 수 있으며 저자들은 이를 예방하기 위한 일환으로써 본 연구를 시행하였다. 방 법: 1997년 11월부터 1998년 11월까지 12개월 동안 서울 아산병원에서 생체 간이식 공여자가 과거 B형간염과 C형 간염 감염의 증거가 없으면서 HBsAg 음성이면서 HBsAb 양성, HBcAb 양성인 성인 공여자 6명을 대상으로 하였다. 간이식 수술 시 동결 생검을 위하여 채취한 절편의 일부를 보관하여 실험에 사용하였다. 동결 절편 조직에서 DNA를 분리하여, HBV DNA의 표면 구역과 핵심 구역에 대한 시발체를 이용하여 이중 중합효소 연쇄 반응을 시행하여 검사를 시행하였다. 결 과: 공여자 6명의 조직에서 표면 구역이 모두 양성으로 관찰되었으며, 핵심 구역은 4명에서 양성으로 관찰되었다. 그 중 4명의 간을 이식받은 소아 수혜자는 모두 예방법을 시행하면서, 신생 B형 간염의 발생은 관찰되지 않고 있다. 결 론: 본 결과는 간이식 후 발생하는 신생 B형 간염의 원인으로 HBcAb 양성이 위험 인자임을 지지하고 있다. HBcAb 양성 공여자의 간이식편에서 핵심구역은 66%에서 양성으로 보여 이식 후 잠재 HBV 감염 혹은 신생 B형 간염의 발생을 막기 위해 예방적 치료가 필요할 것으로 사료된다. Purpose: It has recently been reported that de novo HBV infection following liver transplantation is caused by grafts from HBcAb positive donors, and this phenomenon has been observed in one third of the liver transplant patients in our center. Therefore, we investigated the presence of HBV virus DNA in liver tissues obtained from HBcAb positive donors to determine the mechanism by which de novo HBV infection occurs. Methods: This study was conducted on 6 patients that were HBsAg negative, HBsAb positive, and HBcAb positive who were donors for liver transplantation between November 1997 and November 1998 at Asan Medical Center. We isolated DNA from a portion of liver biopsy tissues that were obtained during the operation, and then identified the surface and core region of HBV DNA using nested PCR. In addition, four children who received liver grafts from these donors were monitored to determine if they became afflicted with non-HBV related diseases while receiving prophylaxis consisting of short-term HBIG treatment and long-term treatment with an antiviral agent. Results: The surface antigen region was identified in all 6 donors and the core antigen region was observed in 4 of the 6 donors. However, no episodes of de novo HBV infection with prophylaxis were observed. Conclusion: The results of this study support the results of previous studies, which indicated that HBV infection may be the main cause of de novo HBV infection in patients that receive HBsAb positive and HBcAb positive donor grafts.

반복적인 객혈을 보인 영아에서 진단된 선천성 폐정맥 협착 1례

정창우 ( Chang Woo Jung ),이소연 ( So Yeon Lee ),유진호 ( Jin Ho Yu ),김병주 ( Byoung Joo Kim ),윤태진 ( Tae Jin Yun ),고재곤 ( Jae Kon Ko ),홍수종 ( Soo Jong Hong ) 대한소아알레르기 및 호흡기학회 2007 소아알레르기 및 호흡기학회지 Vol.17 No.4

실변수 TABU탐색기법을 이용한 최적조류계산

정창우(Chang-Woo Jung),이명환(Myung-Hwan Lee),신중린(Joong-Rin Shin),채명석(Myung-Suk Chae) 대한전기학회 2001 대한전기학회 학술대회 논문집 Vol.2001 No.7

센서 네트워크에서 이동 가능한 노드에 대한 위치 인식 방법

곽칠성,정창우,김진현,김기문,Kwak, Chil-Seong,Jung, Chang-Woo,Kim, Jin-Hyun,Kim, Ki-Moon 한국정보통신학회 2008 한국정보통신학회논문지 Vol.12 No.2

무선 센서 노드의 거대한 네트워크를 통해서 환경을 감시하려는 연구가 매우 활발히 진행되고 있다. 무선 센서 노드들은 매우 작고, 가볍고, 비용이 저렴하여야 한다. 네트워크 안에서 주어진 노드가 어디에 물리적으로 놓여져 있는지를 알아내는 위치인식은 무선 센서 네트워크에서 아주 중요한 문제들 중의 하나이다. 그러나 노드의 크기 제한, 비용 등의 제약조건에 의해 GPS사용을 배제한 간단한 위치인식 방법이 요구된다. 본 논문에서는 RF 통신을 사용하는 건물 밖의 환경에서 위치인식을 위한 아주 단순한 접속성를 이용한 방법을 제안한다. 제안된 방법은 모의실험을 통해 그 효용성을 입증한다. The Study of environment monitoring through huge network of wireless sensor node is worked with activity. The sensor nodes must be very small, light and low cost. The localization which may determine where a given node is physically located in a network is one of the quite important problems for wireless sensor network. But simple localization method is required as excluding the usage of GPS(Global Positioning System) by the limit condition such as the node size, costs, and so on. In this paper, very simple method using connectivity for the outdoor RF communication environment is proposed. The proposed method is demonstrated through simulation.

COL2A1 유전자의 새로운 돌연변이에 의한 제 1형 Stickler 증후군으로 진단된 1례

이진(Jin Lee),정창우(Chang Woo Jung),김구환(Gu-Hwan Kim),이범희(Beom Hee Lee),최진호(Jin-Ho Choi),유한욱(Han-Wook Yoo) 대한의학유전학회 2011 대한의학유전학회지 Vol.8 No.2

저자들은 고도근시, 망막 이상, 납작한 콧등, 구개열, 하악후퇴, 소하악증, 저신장, 양쪽 손가락의 관절구축증(arthrogryposis)이 있고, 방사선 검사상 불규칙한 대퇴골과 경골의 골단면, 척추골단이형성증이 보이는 Stickler 증후군 환자 1례에서COL2A1 유전자의 새로운 돌연변이를 국내 최초로 증명하였기에 문헌고찰과 함께 보고하는 바이다. Stickler syndrome is a very rare connective tissue disorder. The authors of the present study describe an 11-month-old girl with high myopia, retinal abnormalities, flat nose, cleft palate, retrognathia, micrognathia, short stature and arthrogryposis. Radiological evaluation also showed irregularity of the epiphysis of the femur and tibia and spondyloepiphyseal dysplasia. Genetic analysis using a peripheral blood sample revealed a novel variant c.787G>A (p.Gly246Asp) mutation of the COL2A1 gene. This is the first Korean case with Stickler syndrome confirmed by genetic testing.

PCBM을 이용한 하악골 재건술

전주홍(Ju Hong Jeon),정창우(Chang Woo Jung),문재필(Jae Pil Moon) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.1

A retrospective study was made of 10 consecutive patients who underwent mandibular reconstruction with PCBM from December 1994 to July 1996. Free autogenous iliac bone in the from of particulate cancellous bone and marrow was densely packed into the crib that was adapted to bridge the mandibular discontinuity defect. Frozen-treated autogenous mandibular bone, splitted autogenous rib, and titanium mesh(Dumbach, Leibinger) were used as cribs carrying the PCBM. All ten cases underwent successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequential panoramic radiographs. The mean horizontal dimension of the madibular defects was 44mm and the mean vertical dimension of the reconstructed segments was 23mm. The bony height of the reconstructed segments retained about 90% of the bony height of over a 1-year period. We confirmed that PCBM grafts were the most successful and predictable grafts in mandibular discontinuity reconstruction.

진행위암 수술후 복막전이를 예방하기 위한 복강내 온열관류 요법의 안전성 및 효과에 대한 예시 고찰

김진영(Jin Young Kim),박은섭(Eun Sub Park),박승균(Seung Kyun Park),송광재(Kwang Jae Song),홍성기(Sung Kee Hong),위선복(Sun Bok Wee),박길영(Kil Young Park),정창우(Chang Woo Jung),신미경(Mee Kyung Sin) 대한외과학회 1992 Annals of Surgical Treatment and Research Vol.43 No.2

경막외강에 1회 주입된 Triamcinolone 40 mg이 혈중 부신피질자극 호르몬과 코티졸에 미치는 영향

이인배,김홍렬,조성정,윤영중,정창우 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.4

Background : Epidural steroids injections are often used for the treatment of low back pain but their effects on the endocrine system have not been determined. Few studies have quantified the degree or duration of the suppression of the hypothalamic-pituitary-adrenal(HPA) axis in humans given epidural triamcinolone injection(ETI) for low back pain. The evaluation of the blood adrenocorticotropic hormone (ACTH) and cortisol was undertaken to determine the extent of suppression of the HPA axis in patients given ETI. Methods : Lumbar epidural triamcinolone injections were performed on the painful lumbar intervertebral space with patients in the lateral decubitus position. The injection consisted of 40 mg of triamcinolone acetonide diluted in 10 mL of 1% lidocaine. Patients remained in the lateral position for 10 min after the procedure. Basal blood sampling was performed at 30 min before ETI and tested blood sampling was obtained at 7 days, 10 days, and 14 days after ETI. Results : The blood cortisol level was significantly decreased at 7 days and 10 days but at 14 days was not significantly decreased and the blood ACTH level was not significantly decreased at 7 days, 10 days, and 14 days. Conclusions : Above results demonstrate that blood ACTH and cortisol level normalize 7 days and 14 days, respectively, after epidural triamcinolone 40 mg injection. (Korean J Anesthesiol 1997; 33: 692∼696)

서혜부 탈장 복원수술시 Lidocaine 의 침윤이술후 통증에 미치는 영향

이인배,이상록,김홍렬,조성정,정창우,고활영 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.2

Background: Recently many studies reported that the postoperative pain was prevented or decreased from preoperative regional anesthesia by preventing the establishment of central sensitization(pre-emptive analgesia). Therefore, we evaluated the efficacy of preincisional lidocaine infiltration on the postoperative pain. Methods: We conducted a study to compare preinfiltrating group with 1% lidocaine(30ml), postinfiltrating group with 1% lidocaine(30 ml) and non-infiltrating group in 45 patients scheduled for elective inguina1 herniorrhaphy. During operation, all patients received a general anesthesia with thiopental, isoflurane and nitrous oxide in oxygen. Postoperatively, pain scores on visual analogue scale(VAS) and on verbal rating scale(VRS) at rest, coughing and movement from supine into sitting position were assessed. Also the time to first request for an on-demand postoperative analgesics and the total dose of postoperative analgesics were assessed. And the number of patients who didnt require any analgesics during postoperative period was assessed. Results: The VAS and VRS at rest, coughing, movement were low in preinfiltrating group than in non-infiltrating group and postinfiltrating group postoperatively, but it was statistically significant only in early postoperative period. The time to first request for an on-demand postoperative analgesics occurred later in preinfiltrating group than in non-infiltrating group and in postinfiltrating group and the total dose of supplemental analgesics(ketorolac) was smaller in the preinfiltrating group than in non-infiltrating group and postinfiltrating group, and the patients without analgesic treatment was less in the preinfiltrating group than in non-infiltrating group and postinfiltrating group, but it was not statistically significant. Conclusions: In patients with inguinal herniorrhaphy, we can not support the pre-emptive analgesia clinically with preincisional lidocaine infiltration.

말초 전기침 자극의 임상적 연구

김완식,박동호,심재철,서정국,정창우,황영희,김유재,강귀빈,유희구 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.2

Recent studies in western countries have reported that the mechanism of pain are concorded with gate control opiate receptor binding sites and the release of intrinsic morphine like substances, sodium glutamate and also with bradykinin, serotonin, histamine and prostaglandin E. Otherwise the mechanism of the stimulation producing analgesia has been reported to involve a neurophysiologic and neurohumoral inhibitory effect at the level of spinal cord, brain stem, thalamus and cortex. This has been clarified but further study should improve the chance of understanding the mechanism of pain. From the standpoint of pain management, medications used to manage pain have some unfortunate side effects. Nerve blocks cause anesthesia toxicity, major neurosurgical procedures have many complications. Subarachnoidal and epidural analgesics have unknown irritation pneumonia and drug toxicity, and celiac plexus or pituitary gland block with phenol or alcohol has unevenful complication. From January 1980 to december 1982, electrical acupuncture stimulation has been used on 210 cases at HANYANG university hospital in the pain clinic I found it useful in relieving pain which has not responded to various conventional methods which included medications, nerve blocks, neurosurgical intervention and neuropolytics. The results are as follows; 1) There are two kinds of treated patients; One is consultation case-12 from internal medicine, 16 from orthopedic surgery, 10 from neurosurgical and 2 from psychiatry. Another 170 cases were patients who directly to the clinic. And the age distribution shows the higest number of patients in the 3rd decade (21%) and in the 4th decade (24.8%). 2) The region of pain was 21% lumbar, 13.8% shoulder, 10% lower leg and head or face with 9.5%. 3) The duration of the pain showed 10 days 25.7%, 1~2 month 18.6%, one year 11.4% and the longest up to 20 years. 4) Patients who were able to walk into the clinic were 19.5%, moderate cases who to be accompanied were 58.6% and bedridden cases were 21.9%. 5) Treatment was conducted mainly on low frequency stimulation with various waves that included the general dynamic activity point plus reactive electro permeable point (REPP) 81.9% and REER plus head in situ needle 18.1%. 6) In 16.7% only one treatment was administered, in 46.1% 2~5 treatments were given, in 28.6% 6~10 treatments were given and in 3 cases more than 100 treatments were administered. 7) Of the 210 cases, 43.3% showed marked improvement, 41.4% were improved, 13.8% showed transient improvement and there were 3 cause of no improvement. The total confidence was 84.7%. 8) There are no serious complications except hypertensive shock case, submucosal hemorrhagic petechia 7 cases and generalized fatigue 18 cases. In conclusion, electrical acupuncture stimulation of the peripheral nervous system can be used to relieve pain replacing such conventional means as medications, nerve blocks, major neurosurgical procedures, neuroytics and physiopsychic therapy which are generally less effective.