각종 난치성 혈액 질환에서의 비혈연간 골수이식

김동욱,한훈,김정아,김희제,민창기,엄현석,최정현,이종욱,한치화,홍영선,최일봉,신완식,민우성,김학기,김춘추,김원일,김동집 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

목적: 비혈연간 골수이식은 혈연내에 적절한 골수공여자가 없는 만성골수성백혈병, 고위험군의 급성별혁병, 면역억제치료에 실패한 재생불량성빈혈 및 각종 난치성 조혈모세포질환의 완치를 위한 표준적인 치료방법으로 정착되고 있다. 혈연간 표준적인 동종 이식에 비하여 비혈연간 이식시에는 생착부전, 이식편대숙주반응과 감염이 더 빈번하게 발생하며, 국내에서는 아직까지 체계적인 임상연구결과가 보고된 바 없었다. 이에 본 센터에서는 1995년 10월 이후로 약 20개월간 26예의 비혈연간 골수이식을 시행하였으며 3개월 이상의 추적관찰이 가능하여 이식초기 합병증의 관찰 및 분석이 가능하였던 20예의 환자를 대상으로 이식성적 및 문제점을 보고함으로써 새롭게 확대되고 있는 이 분야의 임상연구 및 진료의 활성화를 꾀하고자 한다. 방법: 각종 혈액 종양질환으로 비혈연간 이식을 시행한 총 26예의 환자중 3개월이상의 추적관찰이 가능하였던 20예를 대상으로 후향적으로 임상경과를 분석한 후 생존 분석을 시행하였고, 환자의 연령, 성별, 질병의 상태, 조식 적합 항원의 일치정도, 이식편대 숙주 반응의 유무와 생존기간과의 상관관계를 살펴보았다. 또한 표준위험군과 고위험군으로 나누어 생존율을 비교하였고 이식과 관계된 생착 부전, 이식편대숙주반응, 감염의 발생과 양상 그리고 그 합병증을 관찰하였다. 결과: 1. 환자와 공여자간에 HLA 불일치가 20예 중 4예에서 있었으며, 생착여부의 확인이 가능했던 17예 중 16예에서 생착이 확인되어 94.1%의 생착율을 보였다. 2. 급성이식편대숙주반응은 62.5%(10/16예)에서 발생하였으며 111도 이상의 급성의 이식편대숙주 반응은 25%(4/16예)에서 발생하였다. 만성이식편대숙주반응은 40%(2/5예)의 환자에서 발생하였으며 이들 모두 국소형으로 중증의 진행형 만성이식편대숙주반응이 관찰된 환자는 없었다. 3. 호흡기 합병증은 10예(50%)에서 발생하였으며 감염성 폐렴을 포함한 호흡기 합병증이 가장 흔한 일차적인 사망 원인이었다. 호흡기 합병증이 발생했던 10예중 6예가 감염에 의한 폐렴이 의심되었고 나머지 4예는 특발성 간질성 폐렴이었다. 4. 8.5개월의 중앙추적기간 중 35%의 생존율을 관찰할 수 있었고, 생존기간은0.5개월에서 15개월 (중앙치:4개월)이었다. 한편 고위험군은 25%(3/12예), 표준위험군은 50%(4/8)의 생존율을 관찰할 수 있었다. 5. 가장 흔한 사망 원인은 감염성 폐렴을 포함한 호흡기 합병증(6예)이었고, 이외의 사망 원인으로는 급성 이식편대숙주반응과 다장기부전이 각각 2예, 생착 부전, 간정맥 폐쇄, 그리고 재발이 각각 1예였다. Unrelated bone marrow transplantation(UBMT) has been increasingly recognized as the standard treatment for cure of chronic myelogenous leukemia, high risk acute leukemia, aplastic failed on immunotherapy, and the variety of refractory hematologic diseases in patients lacking a related donor. However, as compared to HLA identical sibing transplantation, UBMT carries higher incidence of graft failure, graft versus host disease(GVHD), and infection. In our center, 26 patients underwent UMBT between October 1995 and June 1997. The minimum follow-up of 3 months was possible in 20 patients, for whom early complications and clinical outcomes were assessed. The median age of the 20 patients was 24 years. 8 patients had standard risk disease and 12 patients had high risk disease. All patients received various preparative regimens including total body irradiation according to disease and disease status. 19 patients received CsA + short course MTX for GVHD prophylaxis. One patient received marrow that was depleted of T cells ex vivo using avidinbiotin column. The class I loci were typed by serological methods and HLA-A, HLA-B and HLA-DRB1. 3 additional pairs were one minor mismatched at the HLA-B locus. Another one patients was one major mismatched at the DRBI alleles. 17 patients were evaluable for engraftment. Successful enfraftment was confirmed in 16 patients(94.1%). Only one patient who was performed one major DRBI mismatched transplants experienced graft rejection. 16 patients were evaluable for acute GVHD. The overall incidence of acute GVHD developed in 4 patients(25%). Five patients were evaluable for the development of Ⅳ acute GVHD developed in 4 patients (25%). Five patients were evaluanle for the development of chronic GVHD. 2 patients(40%) developed limited chronic GVHD. Respiratory complications including pulmonary infection developed in 10 patients(50%) and these complications were the most common primary cause of death. Of these 10patients, 6 had pneumonia due to fungus(4 patients), pacterial (1 patient), and CMV infection (1 patient) and 4(20%) had idiopathic interstitial pneumonitis and/or adult respiratory distress syndrome. The duration of median follow- up was 8.5 months and 7 of 20 patients(35%) are alive at the time of this analysis with survival duration of 0.5 to 15 months(median survival duration: 4 months). The overall survival was 25% (3/12 patients) in high risk group and 50%(4/8 patients) in standard group. From these results, we can predict that the incidence and severity of GVHD in Korea are lesser than multiracial countries and the long-term survival of patients with standard risk disease can approach that of HLA matched sibling transplants. For the past two years, the performance of UBMT has been rapidly increasing and it will be possible to analyze much larger number of patients soon in Korea. In the future the problems of graft failure, GVHD, and infection due to long lasting immunocompromised status will need to be overcome by continued medical research. In addition, the volunteer donor pool will have to be expanded by the promotion of the national awareness of its need.

일반적인 Automatic Navigation System Design에서 Image Acquisition 문제점에 관한 연구

김영택,신동석 慶星大學校 1994 論文集 Vol.15 No.2

Image Processed Decision System for Automatic Navigation Control, especially for the Rear-end Collision Protection System has been proposed. Image Acquisition with temporarily consecutive Sampling Produces serious inconsistancy problem due to the pitching Sensor(CCD Camera). The phenomenon urges us to find another method to dicide a certain situation.

유해화학물질의 계통분석

박성우,박유신,이진훈,김남이,김유나,임미애,이상기,유재훈,진광호,신호상,노동석 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

적외선 열화상 카메라를 이용한 열적 결함부 자동 검출 모니터링 시스템 개발

김재열,양동조,한재호,유신,김창현,송경석 한국비파괴검사학회 2004 학술대회 논문집 Vol.- No.-

The most part of various electrics has been affected by thermal failure due to electric overload. Contact-sensor has been used, for detection to this thermal failure, until now. But, it is impossible to detect the unsuitable element by using contact-temperature-sensor. This problem, with development of the infrared thermal vision camera, will be solved. Because it take some advantages which are composed of non-contact detect and non-destructive detect for temperature distribution, it is possible to detect on the temperature of revolution part, high temperature part. We developed the automatic detection monitoring system for thermal failure part on electrics with overload by using the infrared thermal vision camera. The first stage, thermal signal was detected from the infrared thermal vision camera, and then the data that was wanted from user was shown. The second stage, if the temperature that was decided to failure coded to the program, automatically electrics was shut off. This monitoring system is possible to apply on various conveniences in the whole industrial sites.

江地開發이 地域社會發展에 미친 影響에 關한 比較硏究 : 테네시江 事例와 4大江 流域 開發計劃을 中心으로

金裕赫,琴東信,石琮顯 단국대학교 법정대학 지역개발학과 1982 地域開發論叢 Vol.3-4 No.-

유해화학물질의 계통분석

박성우,박유신,이진훈,유재훈,김유나,오세진,이진숙,김남이,박종신,남금문,노동석 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

동아의료원에서 실시한 양수천자 90례의 세포유전학적 분석

한진영,이경미,신상동,차문석,제구화 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.2

설사와 산혈증에 의한 신생아 메트헤모글로빈혈증 2례

김두권,김영진,김기호,고희신,김우택,최성민,이동석,권경배 東國大學校 醫學硏究所 1995 東國醫學 Vol.3 No.-

메트헤모글로빈혈증은 환원 효소계 결핍이나 환원되지 않은 비정상 메트헤모글로빈을 가지는 선천성 질환 및 후천성 산화성 물질이나 약제에 노출될 때 생기게 되나, 신생아에서는 산화성 물질에의 감수성이 높은 동시에 환원효소의 활성이 낮으므로 산화성 물질에의 노출이 없이 설사, 산혈증 및 감염증 등에 의해서 일시적 메트헤모글로빈혈증이 일어날 수 있다. 저자들은 발열과 심한 설사 및 청색증을 주소로 내원한 생후 18일, 생후 19일된 남아 2례에서 메트헤모글로빈 혈증을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Methemoglobinemia is characterized by generalized cyanosis without cardiac and pulmonary diseases. Methemoglobin, yielded by oxidation of hemoglobin iron to the ferric state, is nonfunctional and imparts a chocolate hue to the blood. The blood of normal healthy persons contains methemoglobin, but the intraerythrocytic methemoglobin-reducing system maintains its concentration less than 2% of the total hemoglobin. Methemoglobinemia is caused by the inherited disorders of methemoglobin metabolism and the accidental ingestion of oxidizing agents and infection. Fetal hemoglobin has increased susceptability to oxidation NADH diaphorase activity is reduced to 60% of adult levels in newborn erythrocytes. Acute diarrhea and acidosis further reduce the activity of the enzyme. We experienced two cases of methemoglobinemia due to acute diarrhea and metabolic acidosis who were admitted to the department of pediatrics at Dong-Guk University Hospital. No history of toxin exposure could be elicited. Case 1 concerns a 19-day-old male neonate who had irritability, fever, cyanosis, tachypnea, severe diarrhea, mild metabolic acidosis and grunting without cardiac and pulmonary diseases. On the day of admission, methemoglobin level was 52.3% of the total hemoglobin. After the treatment with methylene blue which was purified by 0.45㎛ of Nalgene syringe filter(Nalge Co.), its level was decreased to 6% of the total hemoglobin, and then it reached a normal level at the 5th day after admission. Case 2 concerns a 18-day-old male neonate who had fever, diarrhea, mild metabolic acidosis and cyanosis around lips without cardiac and pulmonary diseases. At admission, his level of methemoglobin was 25.3% of the total hemoglobin. After twice injection of methylene blue its level was decreased to 4.4% of the total hemoglobin, and then it reached 1.3% of the total hemoglobin at the 7th day after admission. So, we report it with a brief review of relevant literatures.

Production of Porcine Parvovirus Virus-like Particles Using the Baculovirus Expression System

Seung Hee Lee,Sung Min Bae,Tae Young Sin,Won Seok Kwak,Young Oh Ahn,In Hui Kim,See Nae Lee,Dong Jun Kim,Min Joo Kim,Ra Mi Woo,Soo Dong Woo 한국응용곤충학회 2014 한국응용곤충학회 학술대회논문집 Vol.2014 No.10

Porcine parvovirus (PPV), a member of the genus Parvovirus, family Parvoviridae, is a significant causative agent in porcine reproductive failure, causing serious economic losses in the swine industry. PPV is a non-enveloped virus and its capsid is assembled from three viral proteins (VP1, VP2, and VP3). The major capsid protein, VP2 is the main target for neutralizing antibodies in PPV. When VP2 was expressed in large amounts, it assembled into virus-like particles (VLPs) similar in size and morphology to the original virions. In this study, we generated the recombinant Bombyx mori nucleopolyhedrovirus (BmNPV) to express the VP2 protein. Expression of the VP2 protein was analyzed by SDS-PAGE and Western blot. The recombinant VP2 protein of approximately 64 kDa was detected by both analyses. The formation of VLP by recombinant VP2 was confirmed through transmission electron microscopy examination. The purified VP2 protein assembled into spherical particles with diameters ranging from 20 to 22 nm.

Radiation-induced brain injury

Dong-Soo Lee,Mina Yu,Hong-Seok Jang,Yeon-Sil Kim,Byung-Ock Choi,Young-Nam Kang,Youn-Soo Lee,Dong-Chul Kim,Yong-Kil Hong,Sin-Soo Jeun,Sei-Chul Yoon 대한방사선종양학회 2011 Radiation Oncology Journal Vol.29 No.3

Purpose: This study was designed to determine the influencing factors and clinical course of pathologically proven cases of radiation-induced brain injury (RIBI). Materials and Methods: The pathologic records of twelve patients were reviewed; these patients underwent surgery following radiotherapy due to disease progression found by follow-up imaging. However, they were finally diagnosed with RIBI. All patients had been treated with 3-dimensional conventional fractionated radiotherapy and/or radiosurgery for primary or metastatic brain tumors with or without chemotherapy. The histological distribution was as follows: two falx meningioma, six glioblastoma multiform (GBM), two anaplastic oligodendroglioma, one low grade oligodendroglioma, and one small cell lung cancer with brain metastasis. Results: Radiation necrosis was noted in eight patients and the remaining four were diagnosed with radiation change. Gender (p = 0.061) and biologically equivalent dose (BED)3 (p = 0.084) were the only marginally influencing factors of radiation necrosis. Median time to RIBI was 7.3 months (range, 0.5 to 61 months). Three prolonged survivors with GBM were observed. In the subgroup analysis of high grade gliomas, RIBI that developed <6 months after radiotherapy was associated with inferior overall survival rates compared to cases of RIBI that occurred ≥6 months (p = 0.085). Conclusion: Our study demonstrated that RIBI could occur in early periods after conventional fractionated brain radiotherapy within normal tolerable dose ranges. Studies with a larger number of patients are required to identify the strong influencing factors for RIBI development.