비혈연간 동종골수이식에 의해 치료된 중증 재생불량성빈혈 1예

김현중,이홍기,이방훈,이창근,이종태,정현식,김원석,윤성수,강원기,박근칠,김대식,고영혜,박찬형 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

비혈연간 동종골수이식은 혈연간 동종골수이식이 불가능한 환자에서 기존의 면역역제요법으로 효과가 없었던 경우나 재발한 경우에 적응증이 될수 있다. 이식 거부와 이식편대숙주병의 발생이 골수 이식의 성공률을 감소시키므로, 보다 강력한 conditioning regimen의 사용과 T cell이 제거된 골수를 사용하는 것이 필요하다. 기존의 high dose corticosteroid나 cyclosporine에 대하여 불응성인 이식편대숙주병의 치료를 위해서 ATG와 Mycophenolate mofetil (Cellcept®) 의 사용이나 Tacrolimus, Methotrexate와 같은 다른 면역억제제치료를 고려해 볼 수 있다. It is known that allogenic bone marrow transplantation is the most effective treatment for aplastic anemia. However, this treatment is only applicable to a minority of patients because the proportion of patients who have HLA-matched siblings about 25% to 30% of all the aplastic anemia patients. In the case of the absence of HLA-matched donor, unrelated allogenic bone marrow transplantation is considered. However, (because of severe acute and chronic GVHD and graft failure) the success rate of this approach is only 20~30%. Recently, it was reported that increased immunosuppressive condition combined with T cell depletion of the marrow graft would result in greater success. There was no case of successfully treated aplastic anemia patient by unrelated allogenic bone marrow transplantation in Korea. Here, we report a case of severe aplastic anemia successfully treated with unrelated allogenic bone marrow transplantation.

A Combination of Melphalan, Prednisone, and 50 mg Thalidomide Treatment in Non-Transplant-Candidate Patients with Newly Diagnosed Multiple Myeloma

( Hye Jung Chang ),( Jae Hoon Lee ),( Young Rok Do ),( Sung Hwa Bae ),( Jung Lim Lee ),( Seung Hyun Nam ),( Sung Soo Yoon ),( Soo Mee Bang1 ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.4

Background/Aims: The clinical efficacy and safety of a three-drug combination of melphalan, prednisone, and thalidomide were assessed in patients with multiple myeloma who were not candidates for high-dose therapy as a firstline treatment. Because the side effects of thalidomide at a dose of ≥ 100 mg daily can be a barrier to effective treatment for these patients, we evaluated the efficacy and safety of a reduced dose of thalidomide, 50 mg, for non-transplant candidates. Methods: Twenty-one patients were treated in 4-week cycles, receiving 4 mg/m2 melphalan and 40 mg/m2 prednisone on days 1-7 and 50 mg thalidomide daily. The primary efficacy outcome was the overall response rate. Aspirin (100 mg daily) was also provided as prophylactic treatment for thromboembolism. Results: The overall response rate was 57.1%; a complete response was seen in 23.8% of patients, a partial response in 33.3%, and stable disease in 9.5%. After a median follow-up time of 16.1 months, the median time to progression was 11.4 months (95% confidence interval, 2.1 to 20.6); the median overall survival was not reached. Grades 3 and 4 adverse events included infection (10%), peripheral neuropathy (5%), diarrhea (5%), thrombosis (10%), and loss of consciousness (10%). Two patients discontinued treatment due to loss of consciousness and neuropathy. Conclusions: Low-dose thalidomide (50 mg) plus melphalan and prednisone is an effective combination drug therapy option for newly diagnosed myeloma patients who are ineligible for high-dose chemotherapy.

수면무호흡증이 혈압에 미치는 영향

이희상,이성훈,조현상,남궁기,한승진,방승규 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.1

본 연구에서는 수면무호흡증이 혈압에 미치는 영향을 살펴보고자 하였다. 연구대상은 1995년 1월1일부터 1995년 10월 31일까지 코골기와 수면무호흡 증상으로 인해 연정 뇌기능 수면 연구소에 수면다원검사가 의뢰된 140명의 환자를 대상으로 하였으며 그 중에서 원발성 고혈압을 제외한 심혈관계 질환이 있거나 항고혈압제를 복용하고 있는 환자, 그리고 자료가 불충분하거나 수면무호흡증으로 진단되지 않은 24명을 제외하고 나머지 116명을 최종분석 대상으로 하였다. 이들 대상 환자들로부터 얻은 자료를 수면변수와 호흡변수로 나누어 혈압과의 관계를 Pearson 상관관계와 다중회귀분석을 통해 다음과 같은 결과를 얻었다. 1) 평균 수축기 및 확장기 혈압과 유의한 상관관계가 있는 변수는 수면무호흡의 총시간 및 총횟수, 총수면시간중 평균 혈중산소포화도, 무호흡지수, 중추성 수면무호흡의 총시간 및 횟수, 폐쇄성 수면무호흡의 총시간등 이었다. 2) 다중회귀분석 결과 평균 수축기 및 확장기 혈압에 유의한 영향을 미치는 것으로 나타난 변인은 수면무호흡의 총시간이었으며 이것이 평균 수축기 및 확장기 혈압에 미치는 영향의 도는 각각 7.9%와 6.2%였다. 이상의 결과로 볼 때, 수면무호흡증이 혈압에 미치는 영향은 적은 것으로 나타났으며 무호흡의 유형에 관계없이 수면무호흡의 총시간만이 혈압에 영향을 주는 것으로 나타났다. 그리고 중추성 수면무호흡의 경우 평균 혈중 산소포화도의 감소, 각성에 따른 교감신경계 활성도의 증가이외에도 다른 기전에 의해 혈압 상승이 나타날 가능성이 있을 것으로 생각된다. Objects : This study was conducted to investigate the effects of sleep apnea syndromes on th systemic blood pressure. Methods : The subjects were 140 patients who were consulted to Yon-jung brain function and sleep research center for polysomnography due to snoring and sleep apnea from Jan. 1st 1995 to Oct. 31st 1995. Twenty-four out of 140 were excluded due to cardiovascular diseases other than systemic hypertension, antihypertensive medication, inadequate data or diagnosis other than sleep apnea syndrome. The remaining 116 were accepted as proper subjects. Using Pearson's correlation and multiple regression analysis, we looked for the relationship between sleep and respiratory variables to systemic blood pressure. Results : The results were as follows : 1) According to the correlation analysis, statistically significant variables to mean systolic and diastolic blood pressure were the total time and total number of sleep apnea, degree of oxygen saturation of total sleep time, apnea index, total time and total number of central apnea, and the total time of obstructive apnea. 2) According to the multiple regression analysis, only the total time of sleep apnea significantly affected mean systolic and diastolic blood pressure, and the degrees of affection were 7.9% and 6.2% respectively. Conclusion : these findings showed that sleep apnea syndrome had lower influence over systemic blood pressure than expected and regardless of the type, only the total time of sleep apnea influenced systemic blood pressure. In the case of central apnea, mechanisms other than hypoxemia and the increase of sympathetic activity during arousal may make it possible to increase systemic blood pressure.

여성노인의 저항운동 시 세트구성 방법의 차이가 Myokine에 미치는 영향

김명수 ( Kim¸ Myung-soo ),이승환 ( Lee¸ Sung-hwan ),민병남 ( Min¸ Byung-nam ),김재훈 ( Kim¸ Jae-hoon1 ),방현석 ( Bang¸ Hyun-seok ),김성희 ( Kim¸ Sung-hee ) 한국융합과학회(구 한국시큐리티융합경영학회) 2020 한국융합과학회지 Vol.9 No.4

연구목적: 본 연구는 여성노인을 대상으로 저항운동 시 사용되는 set구성 방법에 중 ascending set, descending set, drop set를 각각 적용시켜 Myokine의 변화를 알아보고자 하였다. 연구방법: 연구대상은 노인복지시설을 이용하고 있는 만 65-72세 사이의 여성노인 32명을 대상으로 ascending set, 8명, descending set 8명, drop set 8명, control group 8명으로 구분하였다. 자료처리는 반복측정에 의한 이원변량분석(two-way ANOVA with repeated measure)을 사용하였으며, 유의도는 .05로 하였다. 결론: 운동프로그램은 12주간 주 3회 실시하였으며, 신체구성과 IL-15, BDNF, VEGF, Irisin의 변화를 관찰하였다. 연구결과 신체구성의 체중, 체지방률, 제지방량 모두 유의한 차이가 없었다. IL-15와 BDNF는 운동 전·후의 비교결과 Descending set와 Drop set에서 운동 후 유의하게 증가하였고, 집단 간의 차이에서 Descending set와 Drop set 집단이 대조집단에 비하여 높게 나타났다. VEGF는 운동 전·후의 비교결과 Descending set와 Drop set 집단이 유의하게 증가하였으며, 집단 간의 차이에서 Descending set와 Drop set가 Ascending set와 control group 보다 높게 나타났다. Irisin은 집단 간 차이는 없었지만 Ascending, Descending, Drop set집단에서 운동 전에 비하여 운동 후 유의한 차이로 증가하였다.. Purpose: The purpose of this study is to identify the change of Myokine by applying ascending set, descending set, and drop set which are set composition used during elderly women’s resistance training. Method: 32 participants aged 65 to 72 who were users of welfare facilities for the aged were divided into 4 groups. They were ascending set group of 8, descending set group of 8, drop set group of 8, and control group of 8. The training program was conducted 3 times a week for 12 weeks and the change of body composition, IL-15(interleukin-15), BDNF(brain derived neurotrophic factor), VEGF(Vascular endothelial growth factor) and Irisin was observed. Two-way ANOVA with repeated measure was used for data processing. Result: The result of this study is as follows. Weight, %fat, and LBM(lean body mass) without fat showed no significant change. IL-15 and BDNF increased significantly after training in Descending set group(p<.05; p<.01)and Drop set group(p<.01; p<.05). VEGF significantly increased in descending set group(p<.01) and drop set group(p<.05). Among groups, VEGF was higher in descending set and drop set groups than ascending set and control groups. Irisin showed no difference between groups, but it showed significant increase after training in ascending(p<.05), descending(p<.05), and drop set groups(p<.05).

Percutaneous Left Atrial Appendage Occlusion Yields Favorable Neurological Outcomes in Patients with Non-Valvular Atrial Fibrillation

Oh-Hyun Lee,김영대,김중선,Nak-Hoon Son,박희남,정보영,Cheol Woong Yu,Hyun-Jong Lee,Woong Chol Kang,Eun-Seok Shin,Rak-kyeong Choi,Do-Sun Lim,Yo Han Jung,Hye-Yeon Choi,Kyung-Yul Lee,Bang-Hoon Cho,Sang Won Han,Joong 대한심장학회 2021 Korean Circulation Journal Vol.51 No.7

Background and Objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment. Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively. Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions: Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.

체외수정시술을 위한 과배란유도에 있어 GnRH Antagonist 다회투여법과 GnRH Agonist 장기요법의 비교연구

이방현 ( Bang Hyun Lee ),김정훈 ( Chung Hoon Kim ),오영미 ( Young Mi Oh ),김성훈 ( Sung Hoon Kim ),채희동 ( Hee Dong Chae ),강병문 ( Byung Moon Kang ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.6

목적 : 체외수정시술을 위한 과배란유도방법으로 GnRH antagonist 다회투여법을 표준화된 GnRH-a 장기요법과 비교 분석함으로써 이 방법의 효용성을 평가하기 위함이다. 연구 및 방법 : 체외수정시술 대상환자들 중 난관인자만이 불임의 원인으로 작용하였던 57명을 대상으로 하였다. 과배란유도를 위하여 GnRH antagonist 다회투여법이 시행되었던 연구군 (n=28)의 경우 가장 큰 난포의 평균직경이 14 mm에 도달한 날부터 hunan cho Objective : To evaluate the efficacy of GnRH antagonist multiple dose protocol (MDP) in controlled ovarian hyperstimulation (COH) for in vitro fertilization and embryo transfer (IVF-ET) comparing with the standard GnRH agonist long protocol (GnRH-a LP). M

합성곱 신경망을 활용한 단락흔 · 용융흔의 판별 기법 제안

조장훈(Jang Hoon Jo),방준호(Junho Bang),유정훈(Jung Hoon Yoo),선로빈(Robin Sun),천현준(Hyun Jun Chun),방선배(Sun Bae Bang),홍성준(Seong Jun Hong) 대한전기학회 2020 대한전기학회 학술대회 논문집 Vol.2020 No.7

자궁내막증 치료에 있어서 로렐린(R)의 치료 효능성에 대한 임상 연구

김성훈 ( Sung Hoon Kim ),권용순 ( Yong Soon Kwon ),오영미 ( Young Mi Oh,),이방현 ( Bang Hyun Lee ),채희동 ( Hee Dong Chae ),김정훈 ( Chung Hoon Kim ),강병문 ( Byung Moon Kang ),남주현 ( Joo Hyun Nam ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.3

목적 : 국내에서 생산되고 있는 저장 형태의 성선자극호르몬 유리호르몬 동족체, leuprorelin acetate 제제인 로렐린(R)의 자궁내막증 치료에 있어서의 임상적 효용성과 안전성을 평가하기 위하여 시행되었다. 연구 대상 및 방법 : 수술시 자궁내막증으로 확진된 자궁내막증 환자 20명을 대상으로 약 21주간 추적 관찰하였다. 수술 직후 로렐린(R) 3.75 mg을 피하주사한 후 4주 간격으로 6차례에 걸쳐서 피하주사하였다. 로렐린(R) 투여 전과 Objective : To evaluate the clinical efficacy and safety of Lorelin(R), a depot form of leuprorelin acetate made in Korea, in the treatment of endometriosis. Materials and Methods : Twenty patients with surgically proven endometriosis were recruited and f

Recent trends of skin cancer in Korea from 2007 to 2013: a nation-wide cancer registry-based study with multicenter study

( Chul Hwan Bang ),( Hyun-min Seo ),( Ji Hyun Lee ),( Gyeong Mun Kim ),( Dong Soo Yu ),( Hyun Jeong Park ),( Shin Tack Oh ),( Hoon Kang ),( Chul Jong Park ),( Jeong Deuk Lee ),( Jun Young Lee ),( Youn 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

Background: Although the incidence rates of skin cancers tend to increase, there have been few nation-wide epidemiologic studies on skin cancer in Korean. Objectives: We sought to investigate the incidence rates of skin cancers and time trends in Korean. Methods: We analyzed data of skin cancers from the Korean Central Cancer Registry (KCCR) from 2007 to 2013 and from our eight affiliated hospitals from 2007 to 2014. Results: Based on KCCR data and clinical records of dermatology outpatients from eight affiliated hospitals, a total of 27,757 cases were retrospectively reviewed. Overall incidence of skin cancer increased from 5.9/100,000 in 2007 to 9.2/100,000 in 2013. The incidence rates of non-melanoma skin cancer (NMSC) and malignant melanoma (MM) increased from 5.1 /100,000 to 8.3/100,000 and from 0.78/100,000 to 1.01/100,000 during the same period, respectively. BCC (75.5%) and MM (39.9%) were the most common skin cancer in the head and neck area and in the extremities, respectively. Conclusion: Our results suggest that recently the incidence rates of skin cancers have increased in Korean, and that epidemiological data from our study can contribute to establishing diagnostic and treatment guidelines for skin cancers in Korean.

SC-MMH 시스템에서 저해상도 영상의 화질이 조건부대체 알고리즘의 성능에 미치는 영향

정광훈(Jung Gwang Hoon),이승현(Lee Seung Hyun),방민석(Bang Min Suk),김성훈(Kim Sung Hoon),정세윤(Jeong Se Yoon),김휘용(Kim Hui Yong),정경훈(Jung Kyeong Hoon) 한국통신학회 2015 한국통신학회 학술대회논문집 Vol.2015 No.1