말초혈액 조혈모세포 채혈 및 이식 후 생착에 관한 연구

손계성 ( Gye Sung Son ),권흥만 ( Heung Man Kwon ),권계철 ( Gye Cheol Kwon ) 대한임상검사과학회 2006 대한임상검사과학회지(KJCLS) Vol.38 No.1

Peripheral bood stem cell collection (PBSCC), including peripheral blood stem cell transplantation (PBSCT), has been utilized worldwide as a very beneficial treatment method instead of allogenic Bone Marrow Transplantation (BMT) because it has many advantages such as rapid bone marrow engraftment and hematopoietic recovery, easy and safe accessibility and lower risk of rejection compared with allogenic BMT. In order to identify most the observable parameter in PBSCC, we analyzed various hematological parameters before and after PBSCC, and evaluated the correlation between the time of bone marrow engraftment and the number of CD34+ cells. Thirteen patients, who underwent 54 PBSCCs from January, 2003 to August, 2004 at Chungnam National University Hospital due to various systemic neoplasms, were analyzed in aspects of various hematological parameters including CD34+ cells using by Flow Cytometry (FCM). PBSCC harvests are described below: Mononuclear cells (MNC) 2.3 ± 1.4×108/kg and CD34+ cells 0.63 ± 0.35×106/kg on average, respectively. There was a statistical significance in Hb and Hct before and after PBSCC, but not in WBC and platelet counts. The period to reach the hematological bone marrow engraftment was 13.4(10~21) days and 19.5(11~38) days according to the criteria of absolute neutrophile counts (ANC) ≥ 500/uL and platelet counts ≥50,000/μL in peripheral blood, respectively. There was a significant correlation between the numbers of CD34+ cell and ANC (p<0.05), and a borderline significance between MNC and ANC (p=0.051). We found that a group of patients, who were infused with CD34+ cells more than 3.5×106/kg, reached more rapidly the period of bone marrow engraftment in platelet counts (p=0.040). This present study suggested that Hb and Hct were the most useful parameters and should be closely monitored before and after PBSCC, that a PBSCT with the dosage of more than 3.5×106/kg of CD34+ cells was needed to perform successful bone marrow engraftment, and additionally that platelet counts could be more useful in indicating bone marrow engraftment than ANC.

임상화학 검사의 Delta Check System 개발 및 정도관리 효율성 검토

권계철,임춘화,김문희,박연보 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1

Background : The application of the delta check in tests in general chemistry detects both random and clerical errors, thus enhancing the reliability of tests. However, since this approach adds the burden of confirming the results to the laboratory, it has the disadvantage of lengthening the turn around time of tests. We speculated that an online delta check system needed to reduce the turn around time. We developed delta quality control system and evaluated its effectiveness of quality control in clinical chemistry. Methods : We developed an online delta check system based on the client-server paradigm. We used IBM PentiumⅢ PC as server and as clients. The database system used was powerbuilder 6.0. Results : In the system we developed, delta screening was performed when test results were input to the computer. The decision over the delta screening was made by comparing it against patient's clinical information and cumulative results within the same screen. Conclusions : The developed delta check method made it available to reduce the turn around time previously spent on delta screening by eliminating the batch processing of tests which was needed in previous approaches separate query cumulative results and patient's clinical informations for screening purposes.

CEDIA범을 이용한 Theophylling,Valproic acid 및 Phenytoin 측정 평가

김문희,신소영,권계철,구선회,박종우 대한임상병리학회 2001 대한임상병리학회지 Vol.21 No.5

Techzyme® HBsAg, Anti-HBs 시약의 유용성 평가

신소영,김문희,박윤미,권계철,구선희,박종우 대한임상검사정도관리학회 2001 臨床檢査와 精度管理 Vol.23 No.2

배경:B형 간염은 우리나라에서 만연하고 있는 질환중의 하나이며, 이에 대한 혈청학회 검사는 B형 간염 진단에 중요하다. 최근 개발된 국산시약인 Techzyme®(Asan, Korea)을 이용하여 B형 간염의 표면 항원(HBsAg ), 항체 (Anti-HBs)의 임상적 유용성을 검토하고자 하였다.<br> 방법: 2001년 1월부터 3월 사이에 충남대학교 병원 임상병리과에 의뢰된 150검체를 대상으로 민감도와 특이도를 검사하였으며 Techzyme®음성대조 물질과 양성 대조물질을 이용하여 검사 중 정밀도와 검사간 정밀도를 구하였다. 고농도 환자 혈청을 단계 희석한 후 직선성을 구하였다.<br> 결과:정밀도에서 음성 표준물질인 경우 일간 재현성 검사와 일일 재현성 검사에서 HBs Ag은 변이계수가 7.48%와 11.2%이고 Anti-HBs는 7.02%와 14.6%이었다. 양성표준물질인 경우 일간 재현성 검사와 일일 재현성 검사에서 HBsAg은 변이계수가 2.34%와 4.14%이고 Anti-HBs는 2.43%와 4.97%이었다. 직선성의 평가에서는 HBsAg의 경우 R²=0.9903이고 Anti-HBs는 R²=0.9977이었다. 항원, 항체 검사에서 94%, 92%의 일치율을 보였고 민감도와 특이도는 항원 검사에서는 100%, 100%이고 항체 검사는 각각 95.6%,96.3%이었다.<br>결론: 새로 개발된 국산시약 Techzyme®은 우수한 정밀도와 직선성을 보였고 민감도와 특이도가 높아 임상적으로 유용하게 사용될 수 있으리라 생각된다. Background: The hepatitis B virus was one of the most prevalent infectious agent in Korea. Serologic assays of the detection for hepatitis B surface antigen (HBsAg) and hepatitis B antibody(Anti-HBs) were useful markers for the diagnosis of viral hepatitis. Some of domestic hepatitis enzyme immunoassay (EIA) reagents have been developed. We analyzed one of them, Techzyme® ELISA 3.0 HBsAg and Anti-HBs (Asan, Korea), to evaluate the clinical usefulness.<br> Methods: The precision, linearity, sensitivity and specificity of Techzyme® HBsAg and Anti-HBs were evaluated with 150 clinical specimens from January to March, 2001.<br> Results: The within-run and between-run coefficient of variance (C.V.) HBsAg were 7.48% and 11.12% in negative control and were 2.34% and 4.14% in positive control, respectively. The within-run and between-run CV for Anti-HBs were 7.02% and 14.6 in negative control and 2.43% and 4.97% in positive control. On linearity test, the R² for HBsAg was 0.9903 and the R² for Anti-HBs was 0.9977. The concordant results were 94% and 92% for HBsAg and Anti-HBs with conventional reagents, respectively. The sensitivity and specificity for HBsAg were 100%, both. And the sensitivity and specificity for Anti-HBs were 95.6% and 96.3%, respectively.<br> Conclusions:In conclusion, because of high sensitivity, specificity and high linearity, Techzyme® ELISA 3.0 HBsAg and Anti-HBs appeared to be suitable for detecting HBs Ag and Anti-HBs in clinical laboratories.

재생불량성빈혈 치료에서 Oxymetholone의 역할

신현영,김성은,곽승근,박상은,박수진,윤환중,조덕연,김삼용,권계철 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Response rate to androgen therapy in aplastic anemia has been reported at 20-50%, and patient survival of the treatment group was not different from control group in several randomized trials. We wanted to confirm our hypothesis that the clinical behavior of aplastic anemia in Korea is different from western countries by documenting better response rate and longer survival of aplastic anemia patients who were treated with androgen only. We analyzed retrospectively the data of 51 patients with aplastic anemia who were diagnosed and treated with 100㎎/day of oxymetholone during the period of January 1990 - December 2000. The results are as follows. The sex ratio was 23:28 or 1.21. There were 26 moderate aplastic anemia versus 25 severe aplastic anemia patients. The median age of patients was 42 (18-82) years. 43 (84.3%) patients received oxymetholone as the first-line treatment (Group l), whereas 8 (15.7%) patients received oxymetholone after failure of immunosuppressive therapy (Group 2) Among 43 patients in Group 1, 7 (16%) patients obtained complete response and 16 (37%) patients achieved partial response with an overall response rate of 53%, and among 8 patients in Group 2,1 (13%) patients obtained complete response and 5 (63%) patients partial response with an overall response rate of 75%. There was no significant difference in survival rates between Group 1 and Group 2 (p=0.259). The overall response rate was 57%. Among 29 patients in response group, 21 (72%) patients survived and among 22 patients in Non-response group, 8 (36%) patients survived. There was a significant difference in survival rates between Response group and Non-response group (p=0.020). The overall survival rate was 57%. Kaplan-Meier analysis revealed a longer survival in responders (p=0.0029). The oxymetholone treatment in patients with aplastic anemia increases survival rates and prolongs the survival duration.