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.

가토의 외상성 슬관절염의 자연적 치유 경과에 대한 고찰

김동헌,장병춘,김상윤,김동혁 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-

Articular cartilage is a highly differentiated tissue, lacking a vascular supply and having only limited regenerative capability. It has been well documented that articular cartilage of mature animals has little capacity for repair after traumatic injury. Cuts or other mechanical damage restricted to the cartilage alone do not repair. However, it has been observed both experimentally and clinically that articular defects extending to the subchondral bone eventually are resurfaced with a form of fibrous, fibrocartilagenous or hyaline like cartilagenous tissue. Author's study was designed to evaluate the healing process of osteochondral defect of the knee of rabbit. Partial thickness defect of cartilge and full thickness osteochondral defect of 30 rabbits were made with 3mm diameter of drill-bit. Experimental animals were divided into three groups : 1) Group Ⅰ: Control group 2) Group Ⅱ: Partical cartilage defect group 3) Group Ⅲ: Osteochondral defect group The healing of the defect was assessed at 1weeks, 3weeks, 5weeks, 12weeks after operation by gross and histological examination. The principal findings were as follows. 1. The initial formation of repair tissue was variable, but it ocurred in most cases. 2. In partial cartilage defect group, degenerative change was more severe. 3. There is evidence of healing of small (1-4 mm diameter) but not of large full thickness articular defect. 4. Microscopically, resurfacing of the cartilage holes repaired mainly with fibrocartilage at 5 weeks of injury.

알쯔하이머형 치매와 혈관성 치매환자에서의 ALDH2와 APOE 유전자의 다형성에 관한 연구

김동홍,김영돈,이창화,엄기춘,김은식,윤경식,김동희 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.2

연구목적: 본 연구는 국내 치매환자들을 대상으로 치매발병의 위험요소가 될 수있는 ALDH2와 APOE 유전자형이 어떤 양상으로 나타나는지 알아보기 위하여 시행되었다. 방 법: 충남 부여군에 위치한 부여노인병원에 입원중인 65세 이상의 알쯔하이머형 치매와 혈관성 또는 혼재성 치매환자 59명(남:19, 녀:40)을 대상으로 ALDH2와 APOE 유전자형을 제한효소법에 의하여 조사하였고 치매유형에 따른 유전자형과 대립유전자의 빈도를 비교하였다. 결 과: 1) 알쯔하이머형 치매환자군에서 혈관성 또는 혼재성 치매환자군보다 ALDH2*(-/2)유전자형의 빈도가 높았으나 통계학적으로 의미있는 차이는 없었다. 2) 알쯔하이머형 치매화자군에서 혈관성 또는 혼재성 치매환자군보다 APOE*(-/ε4) 유전자형의 빈도가 높았으나 통계학적으로 의미있는 차이는 없었다. 3) APOE*ε4와 ALDH2*2를 알쯔하이머병의 균등한 위험대립유전자로 가정하고 각 유전자형의 대립유전자의 수를 점수화하여 각 치매환자군의 위험유전자 전체점수를 비교한 결과 알쯔하이머형 치매환자군에서 점수가 더 높게 나왔으나 통계학적으로 의미있는 차이는 없었다. 결 론: 알쯔하이머형 치매환자군에서 혈관성 또는 혼재성치매치매환자군보다 ALDH2*2와 APOE*ε4 대립유전자의 빈도가 높게 나왔으나 통계학적으로 의미있는 차이는 없었다. A study on gene polymorphism of ALDH2 and APOE in patients with alzheimer's disease and vascular or mixed dementia. Objective : This study was designed to investigate gene polymorphism of ALDH2 and APOE, reported the risk factor of Alzheimer's disease, in korean dementia patients. Method : 59 Patients(male:19, female:40) with dementia, aged 65 and older in Buyeo geriatric hospital located in Buyeo-gun, chungnam, were finally included in this study. gene polymorphism of ALDH2 and APOE was typed with polymerase chain reaction in patients with Alzheimer's desease and vascular or mixed dementia. Results : 1) There was no difference in allelic frequency of ALDH2 gene polymorphism between patients with Alzheimer's disease and vascular or mixed dementia. 2) There was no difference in allelic frequency of APOE gene polymorphism between patients with Alzheimer's disease and vascular or mixed dementia. 3) Supposing APOE*ε4 and ALDH2*2 were equal risk allele of Alzheimer's disease, the sum of score by counting each risk allele was higher in patients with Alzheimer's disease than vascular mixed dementia, however there was no significant difference. Conclusion : The genotype frequency of ALDH2*(-/2) and APOE*(-/ε4) was higher in patients with Alsheimer's disease than vascular or mixed dementia, however there was no significant difference in allelic frequency of gene polymorphism of ALDH2 and APOE between patients with Alzheimer's disease and vascular or mixed dementia.

cis-platin에 의한 급성구토예방의 Dexamethasone의 4가지 정주량의 비교

김원,강지은,서영선,이동민,서정균,신병철,정기영,박유환,정춘해 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

B5-hydroxytryptamine _3수용체(5-HT_3) 길항제와 dexamethasone의 동시투여가 cis-platin에 의한 급성 구토를 막는데 가장 효과적이다. 그러나 현재까지 가장 적절한 정주dexamethasone의 용량이 알려져 있지 않았다. 이에 dexamethasone의 4가지 다른 용량을 투여하여 그 효과를 비교하였다. 환자는 임의 추출되어 cis-platin 투여 45분전에 15분 동안 정주로 각각 dexamethasone 5, 10, 15, 20 mg을 투여 받았다. cis-platin 투여 30분전에는 ondansetron 8 mg이 부가하여 정주 되었다. 1999년 3월부터 2000년 2월까지 54명의 환자가 연구에 등록되어졌고 53명의 환자가 연구 대상으로 실험에 4군 (dexamethasone 5 mg 13명, 10 mg 14명, 15 mg 13명, 20 mg 13명)으로 나뉘어 평가 되어졌다. 급성구토와 구역질의 완전한 예방은 dexamethasone 5 mg을 투여 받은 환자에서 각각 69.2%, 60.9%, dexamethasone 10 mg을 투여 환자에서 69.1%, 61%, dexamethasone 15 mg 투여 환자에서 78.5%, 66.9%, dexamethasone 20 mg을 투여 환자에서 83.2%, 71.0%로 나타났다. 구토로부터 완전한 예방은 dexamethasone 20 mg을 투여 환자에서 5, 10 mg을 투여 환자와 비교하여 높았고, dexamethasone 15 mg을 투여 군에 비교하여서는 약간 우수한 효과만 있었다. 구역질으로부터의 완전한 예방도 월등한 것은 아닐지라도 20 mg을 받은 환자에서 높았다. 항 구토 치료는 특별한 불편 없이 조절되었고, 부작용의 발생에서 4가지그룹간에는 커다란 차이가 발견되지 않았다. Dexamethasone의 20 mg 정주양이 cis-platin으로 인한 급성구토를 예방하는데 가장 효과적인 예방량으로 사료되어진다. Background and objective: A 5-hydroxytryptamine _3(5-HT_3) receptor antagonist plus dexamethasone is the most efficacious antiemetic prophylactic treatment for the prevention of cis-platin induced acute emesis, but the optimal intraveous (Ⅳ) dose of dexamethasone is unknown. This prompted us to perform a randomized, double-blind, dose-finding study that compared four different doses of dexamethasone. Materials and Methods: Patients were randomized to receive dexamethasone, either 5, 10, 15, 20 mg, administered by 15-minute Ⅳ infusion 45 minutes before cis-platin. Ondansetron 8 mg was added to dexamethasone and was administered Ⅳ 30 minutes before cis-platin. From March 1999 to February 2000, 54 patients were enrolled onto the study and 53 were assessable according to the intention-to-treat principle (13 patients received 5 mg; 14 patients, 10 mg; 13 patients, 15 mg and 13 patients, 20 mg of dexamethasone). Results: Complete protection from acute vomiting and nausea was achieved by 69.2% and 60.9% of patients, respectively, who received 5 mg of dexamethasone, by 69.1% and 61.0% of those who received 10 mg, by 78.5% and 66.9% of those who received 15 mg, and by 83.2% and 71.0% of those who received 20 mg of dexamethasone. Complete protection from vomiting was significantly superior in patients who received 20 mg compared with those who received 5 and 10 mg of dexamethasone (P<05) and was superior, but not significantly, compared with those who received 15mg. Complete protection from nausea was superior, but not significantly, in patients who received 20 mg of dekamethasone. Multifactorial analysis confirmed these results. Antiemetic treatment was well tolerated, and no significant difference was found among the four groups in the incidence of adverse events. Conclusion: A 20mg single Ⅳ dose of dexamethasone should be considered the most efficacious prophylactic dose for the prevention of ois-platin induced acute amesis in treatment of cancer.

Fractal을 이용한 多孔質 硅素의 微細孔 形成 課程에 관한 硏究

김영유,최동희,류지욱,홍사용,이춘우 公州大學校 基礎科學硏究所 1997 自然科學硏究 Vol.6 No.-

단결정 실리콘(P형)을 양극 산화반응으로 다공질 규소를 제작하고 AFM과 이차원 DLA 모델을 사용한 컴퓨터 모의 실험으로 표면구조를 조사했다. 컴퓨터 모의 실험에는 양공의 확산거리 D를 변수로 사용했다. AFM 측정 자료와 컴퓨터 모의 실험을 비교해본 곁과 전하 밀도 lmA/cm2에 해당하는 확산거리는 약 100nm였으며 그 때 프랙털 차원은 1.85였다. 또한 반응전류 10 mA/cm2에 해당하는 확산거리는 약 150nm의 결과가 얻어졌으며 그 때의 프랙탈 차원은 1.75이다. 이러한 컴퓨터 모의 실험 결과와 AFM을 통하여 관찰한 p-PS의 표면 구조를 비교해보면 양극 반응 전류와 양공의 확산 길이는 비례 관계가 있다. Surface structures of porous silicon are investigated by AFM and a qualitative theoretical model based on 2 dimensional DLA model is used to explain their fractal structures. The diffusion length L is used as a starting parameter, which sets the distance of a hole which can reach to a tip of a pore. The best result is obtained when the diffusion length was 100 nm (200 lattice distance). In this condition, the average pore distance is about 650nm, which corresponds to lmA/cm2 current density in the experiments and its fractal dimension is 1.85. Our results verify that a diffusion length L is proportional to the current density used in an experiment.

고비중 척추마취시 필첨바늘의 출구방향이 신경차단범위와 차단기간에 미치는 영향

김동연,김종학,이춘희 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.5

Background: The endogenous and exogenous factors influence the distribution of local anesthetic solutions within the subarachnoid space. This study was designed to examine the influence of direction of pencil-point tip needle sideport using a 25 gauge Whitacre needle(Vygon, France). Methods: Thirty adult male patients undergoing orthopedic, urologic or anal surgery were divided randomly into two groups according to the direction of the needle sideport(cephalad or caudad). Intrathecal anesthesia were performed with 10mg of 0.5% hyperbaric bupivacaine. The technique was typically performed using a midline approach at L4-5 interspace in the lateral decubitus position and the patients were turned to supine position immediately after the block. After the injection, we registered the segmental spread of analgesia(pin-prick). Duration of block(two segment regression time) and degree of motor block(Bromage scale) were measured. Results: There were no significant differences in onset time to maximal level of sensory and motor block, two segment regression time between groups. Mean maximal sensory level was T6.1± 1.6 for the cephalad group vs T7.0±1.8 for the caudad group, but no statistical significance was found. Conclusions: This study suggests that needle sideport direction of Whitacre needles does not significantly influence extent and duration of hyperbaric spinal anesthesia.

공용주차장 시공성평가 프로세스에 관한 연구

김춘우,김태삼,정동욱,김대석,현창택 대한건축학회 2000 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.20 No.2

As public facilities, public parking buildings are built with tremendous resource investments socio-nationally, and its outcomes affect general public's interests, much more near environments. Public parking building projects have been implemented focusing on how its initial costs could be economical. With literature reviews and expert interviews, elements affecting the construction type of public parking buildings were selected. The comprehensive constructability evaluation process which could be practical in the field is proposed through the classification of evaluation criteria influencing t#e constructability of public parking buildings and sequential evaluation process which modified the analytic hierarchical process. AHP was used as a basis of comprehensive constructability evaluation system, and vector nomalization and linear transformation in multi-criteria decision making technique were applied to each evaluation attributes to select the optimal alternative of public parking buildings.

溫室保溫커튼의 材料特性에 따른 保溫效果分析

金榮福,金容換,李昇揆,金成泰,羅又禎,閔永鳳,朴重春,崔東烈 慶尙大學校 1991 論文集 Vol.30 No.2

The effects of the material properties of thermal curtains upon reduction of the greenhouse heat loss were studied. A theoretical analysis procedure with equations and computer programs was developed to estimate them by using energy balance principles. Curtain effectiveness for every three kinds pf value level of the material properties were studied and compared. The results of this study would be useful for the developent and management of greenhouse thermal curtains.

교사가 지각한 유아교육기관의 조직문화와 조직효과성과의 관계 연구

김동춘 서울여자대학교 1998 아동연구 Vol.2 No.-

[초록 없음]

20세기 국가폭력과 과거청산

김동춘 성공회대학교 인권평화센터 2001 인권과 평화 Vol.2 No.1