국내 Human Immunodeficiency Virus(HIV) 감염자와 정상인의 면역학적 표지인자 비교연구

신영오,류재천,최병선,박용근 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCINE 1995 Journal of biomedical laboratory sciences Vol.1 No.1

HIV감염자는 질병의 진전에 무관하게 감염 후의 경과시기에 따라서 CD4 T림프세포등 각종 면역상태를 나타내는 표지가 변한다. 따라서 HIV감염자의 질병진전을 예보하기 위하여서는 정기적으로 CD4등 각종표지를 측정하여 감염자의 질병상태를 monitoring하게 된다. 그러나 이러한 수치를 감염자관리에 적용하기 위하여서는 우리나라 일반인의 정상치를 파악하여 이를 지표로 해야하므로 국내정상인의 각종면역치에 대한 조사가 요구된다. 현재의 기준으로는 500이하로 떨어질 때에는 예방차원에서 AZT를 복용하게 되며 200이하로 떨어지면 질병의 유무에 관계없이 환자로 관리하게 된다. 본연구에서는 한국인 185명의 감염자와 140명의 비감염자에 대하여 정기적으로 CD4 및 CD8T 림프세포와 CD4/CD8비를 측정하였다. 시험은 Flow cytometer(Facstar)를 이용하여 각각의 CD 분자에 대한 모노크로날 항체를 이용하여 2중혈광색소염색방법으로 측정하였다. HIV감염자의 CD4-T림프세로 절대수 및 백분율은 각각 462 및 18.2%이었는 반면, CD8의 수치는 1,170 및 47.0%이었다. 또한 CD4/CD8비는 0.43이었다. 이와는 대조적으로 비감염자의 경우, 한국인의 CD4의 평균세포수는 886, 백분율은 32.9%이었으며, CD8 세포수는 730, 백분율은 26.8 그리고 CD4/CD8비는 1.31이었다. 외국인과 한국인과의 면역지표수치를 비교하였을 때에 CD4세포수와 백분율, CD8의 백분율에서는 현저한 차이가 없었으나 외국인 비감염자의 경우 CD4백분율이 43.6%, CD8 T림프세포의 절대수가 560으로 한국인과 약간의 차이가 있었다. 따라서 HIV감염자관리를 위한 면역지표측정시험에서의 각종수치의 정확한 해석을 위하여서는 한국인 비감염자수치를 고려해야할 것으로 판단된다. Several studies showed that the immunological factors such as CD4+ cell number, CD4%, CD8+ cell number and CD4/CD8 ratio and the serological factors such as β²-microglobulin(β²-MG), neopterin, soluble CD4, and soluble CD8 are related to the risk of development of AIDS. Especially, the CD4+ cell counts have been used to monitor progresson of HIV disease, to stratify, and to follow patients in clinical trials. Recently, the Centers for Disease Control and Prevention(CDCP) in USA has made the CD4+ cell count as a part of the classification of HIV disease. It is composed of 3 categories such as 1, 2, and 3 which asr ≥500/㎣, 200/㎣ ≥and <500/㎣, and < 200/㎣, respectively. In this study, to estimate the differences of immunological factors between HIV-infected and normal human groups in Korea, CD4+ T and CD8+ T cells, and the CD4/CD8 ratio were measured in 185 HIV-infected subjects and 140 healthy adult subjects. The lymphocyte subsets such as CD4+ T and CD8+ T were analysed by flow cytometer(FACStar) with two-color immunofluorescent stain using monoclonal antibodies such as anti-CD4 and anti-CD8 antibodies. The absolute numbers and percentages of CD4+ T and CD8+ T and the CD4/CD8 ratio of HIV infected persons were 462±277/㎣, 18.2±7.7%, 1,170±534/㎣, 47.0±10.6% and 0.43±0.26 whereas those of uninfected persons were 886±299/㎣, 32.9±7.0%, 730± 259/㎣, 26.8±6.4% and l.31±0.46(P<0.01). In addition, estimating the reference values of peripheral blood lymphocyte subsets of Korean, the absolute numbers and percentages of CD4+ T and CD8+ T and the CD4/CD8 ratio of 140 healthy adults persons were measured and compared with those of foreigners. The reference ranges of CD4+ T cells, CD8+ T cells, CD4%, CD8%, and the CD4/CD8 ratio and 1.31t0.46, respectively. The significant differences were not observed when compared with those of foreigners. However a little difference was observed in the percentages of CD4+ T and the absolute numbers of CD8+ T between the normal values of Korean and those of foreigners were 43.6±8.9%, 560±230/㎣. This result can also be useful as a basic data for the treatment and surveillance of HIV-infected patients in Korea.

버섯 중독 환자에서의 ^(99m)Tc-galactosyl human serum albumin (GSA) scintigraphy 소견 : 간초음파 소견과의 비교 Comparison with Liver Ultrasonography

정신영,이재태,배진호,천경아,안병철,강영모,정재민,이규보 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.4

광대버섯과 같은 독버섯 중독시 간세포에 독성을 나타내어 간 기능의 이상을 유발할 수 있다. 저자들은 개나리광대버섯을 섭취한 3명의 환자에서 간 기능을 평가하기 위하여 간세포에 선택적으로 섭취되어 간기능을 평가하는데 사용되어지고 있는 99mTc-galactosyl human serum albumin (Tc-GSA)을 이용한 간 스캔을 시행하였고 간 초음파 검사와 비교하여 보았다. Tc-GSA 185MBq (3mg of GSA)을 정맥주사후 30분동안 동적 영상과 간과 심장 부위의 시간 방사능 곡선을 얻었다. 간기능의 정도를 평가하기 위하여 Tc-GSA의 간섭취 정도와 혈중 정체정도를 시각적인 평가와 간과 심장 부위의 시간 방사능 곡선을 이용한 반정량적인 평가를 시행하여 간섭취지수와 혈중제거지수를 구하였다. 시각적인 평가에서 2명의 환자에서 Tc-GSA의 경미한 정도의 간섭취 감소와 혈중 정체를 보였고 1명에서는 중등도의 간섭취 감소와 혈중 정체를 보였다. 반정량적인 평가에서는 2명의 환자에서 경미한 정도의 간섭취지수의 감소와 혈중제거지수의 증가를 보였고 1명에서 중등도의 간섭취지수의 감소와 혈중제거지수의 증가가 관찰되었다. 간초음파상에서는 1명의 환자는 지방침윤이 관찰되었으며 1명의 환자에서는 미약한 정도의 지방간이 관찰되어 급성 간기능 장애를 적절히 반영하지 못하였다. 본 증례를 통해 저자들은 간초음파 검사가 특이한 소견을 나타내지 못하여 간세포에 영향을 주는 독소나 약물 중독시에 간 영상화에는 Tc-GSA 간스캔이 유용하게 사용될 수 있을 것으로 추측할 수 있었다. ^(99m)Tc-galactosyl human serum albumin (Tc-GSA) is a radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically present in the hepatocyte membrane. Because these receptors are decreased in hepatic parenchymal damage, the degree of Tc-GSA accumulation in the liver correlates with findings of liver function test. Hepatic images were performed with Tc-GSA in patients with acute hepatic dysfunction by Amantia Subjunquillea poisoning, and compared with these of liver ultrasonography (USG). Tc-GSA (185 MBq, 3 mg of GSA) was injected intravenously, and dynamic images were recorded for 30minutes. Time-activity curves for the heart and liver were generated from regions of interest for the whole liver and precordium. Degree of hepatic uptake and clearance rate of Tc-GSA were generated by visual interpretation and semiquantitative analysis parameters (receptor index :LHL15 and index of blood clearance :HH15). Visual assessment of GSA scintigraphy revealed mildly decreased liver uptake in all of subjects. The mean LHL15 and HH15 were 0.886 and 0.621, graded as mild dysfunction in 2, and mild to moderate dysfunction in 1 subject. In contrast, liver USG showed no remarkable changes of hepatic parenchyme. Tc-GSA scintigraphy was considered as a useful imaging modality in the assessment of the hepatic dysfunction.

관절 내시경술에 의한 퇴행성 슬관절염의 치료

김동헌,장병춘,신규철,이재성 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

The arthroscopic surgery is an increasingly accepted procedure for the treatment of symptomatic arthritic knee. Authors reviewed the operative results of arthroscopic surgery in 35 knee joints of 27 patients from 1993 to 1997. 1. The average age of patients was 64 years old and the primary diagnosis was degenerative osteoarthritis in all patients. 2. Preoperative symptomes and signs were pain(98%), tenderness(85%), swelling(85%), decreased range of motion(71%) and effusion(55%). 3. The operative procedures were irrigation and synovectomy(20%), abrasion arthroplasty(57%), partial menisectomy and abrasion arthroplasty(23%). 4. The symptoms and signs were improved postoperatively: according to Nine point scale, the good results were recorded at postoperative 6 months and follow-up 2 years in nearly all patients. 5. The complications were minimal. Authors concluded that arthroscopic surgery is considered as a reliable method in the treatment of degenerative osteoarthritis of the knee but not as a curable method, needing a long term observation.

노년의 대퇴골 원위부 골절 시 동시에 시행한 전슬관절 성형술 및 금속판 내고정술 : 8예 보고 Report of Eight Cases

김동헌,장병춘,신규철,양준호 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

Supracondylar fracture of the femur can be treated by a wide variety of methods. Although satisfactory results have been achieved with either open and closed treatment, less certain results are obtained for the elderly who have pre-existing osteoarthritis and osteoporosis. Particularly, elderly patients who have preexisting osteoarthritis are at increased risk of posttraumatic arthritis, stiff knee, persistent pain. Primary total knee arthroplasty(TKA) might obviate many of these potential problems and help to return the high-risk patient to an ambulatory functional status immediately. There are few reports about this study. The purpose of this study is to evaluate the results treated by simultaneous internal fixation and TKA for the supracondylar fracture in the elderly who have osteoarthritis of the knee joint. From 1994 to 1998, eight primary TKAs using posterior cruciate sparing PFC knee(Press Fit Condylar, Johnson & Johnson, Raynham, U.S.A) were performed after internal fixation for the supracondylar fracture of the femur with Judet plate or condylar buttress plate by conventional means. Patella was not resurfaced in all knees. According to the M ller classification of the supracondylar fracture of the femur 5 fractures were type A, 2 in type B, 1 in type C. Five patients were female, 3 patients were male. The ages ranged from 66 to 81, with an average of 74 years. Patients were followed for at least 1 year(average 3 years). The mean interval between the injury and operation was 2 weeks(range, 1 week to 4 weeks). Active knee joint exercise was encouraged in a hinge brace under the postoperative pain control. Partial weight bearing was permitted at the postoperative 4 to 6 weeks using crutches. Full weight bearing was allowed after union of the fracture. Fractures were united in all patients and the average duration of bony union was 16 weeks. The average amount of flexion and average flexion contracture for the all patients at the most recent follow-up were 96 degrees (range, 45 to 120 degrees) and 7 degrees (range, zero to 20 degrees), respectively. Using the knee rating score advocated by the American Knee Society, the average postoperative score was 87 for pain and 80 for function. We concluded that simultaneous internal fixation and TKA for supracondylar fracture of the femur in elderly patients who have advanced knee osteoarthritis may provide satisfactory pain relief and function with acceptable morbidity.

EXPONENTIAL DECAY OF $C^1$ LAGRANGE POLYNOMIAL SPLINES WITH RESPECT TO THE LOCAL CHEBYSHEV-GAUSS POINTS

Shin, Byeong-Chun,Song, Ho-Wan Korean Mathematical Society 2001 대한수학회논문집 Vol.16 No.1

In the course of working on the preconditioning $C^1$ polynomial spline collocation method, one has to deal with the exponential decay of $C^1$ Lagrange polynomial splines. In this paper we show the exponential decay of $C^1$ Lagrange polynomial splines using the Chebyshev-Gauss points as the local data points.

$-bicubic spline interpolant on an irregular mesh

Shin, Byeong-Chun Korean Mathematical Society 1996 대한수학회논문집 Vol.11 No.2

In the course of working on the preconditioning of $C^1$-bicubic collocation method, one has to deal with the $C^1$-bicubic splines. In this paper we are concerned with $C^1$-bicubic spline interpolant for a given function. We construct a basis for the space of $C^1$-bicubic splines for a given partition and find the $C^1$-bicubic spline interpolant for a given function defined on a set.

NEGATIVE NORM LEAST-SQUARES SPECTRAL METHODS FOR THE ELLIPTIC PROBLEM

BYEONG CHUN SHIN 한국산업응용수학회 2006 Journal of the Korean Society for Industrial and A Vol.10 No.1

In this paper, we develop and analyze an negative norm first-order system least-squares spectral method for the second-order elliptic boundary value problem. We consider a least-squares functional defined by the sum of the L²- and H<SUP>-1</SUP>-norm of the residual equations. We define a discrete negative norm and then define the discrete negative norm least-squares functional for spectral approximation. The spectral convergence is derived for the proposed method and we provide some numerical results.

Negative Norm Least-squares Spectral Methods for the Elliptic Problem

( Byeong Chun Shin ) 한국산업응용수학회(구 한국산업정보응용수학회) 2006 한국산업정보응용수학회 Vol.10 No.1

Preconditioning Cubic Spline Collocation Methods for a Coupled Elliptic Equation

Shin, Byeong-Chun,Kim, Sang-Dong Department of Mathematics 2010 Kyungpook mathematical journal Vol.50 No.3

A low-order finite element preconditioner is analyzed for a cubic spline collocation method which is used for discretizations of coupled elliptic problems derived from an optimal control problrm subject to an elliptic equation. Some numerical evidences are also provided.

Preconditioning spectral element collocation method on the domain with curved element

BYEONG-CHUN SHIN,Peyman Hessari 한국산업응용수학회 2009 한국산업응용수학회 학술대회 논문집 Vol.4 No.2