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      • 단기간의 저용량 Cytosine arabinoside 치료에 반응하였던 Down 증후군에 병발한 급성골수성백혈병 1례

        김현수,이정호,이정찬,강정현,곽상혁,김철희,배광봉,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        The incidence of hematologic disorders in patients with Down's syndrome is significantly increased, about 14∼30 - fold higher than in general population and includes neonatal transient abnormal myelopoieis and acute leukemias. The age of onset of leukemia in Down's syndrome is peaking first in the newborn period and then under 4 years of age. Down's syndrome with acute leukemia above the age of 20 is very rare and it's treatment oucome is unclear. The treatment of Down's syndrome with leukemia has been controversial because of toxicity and associated congenital cardiac and other abnormalities. But if treated adequately, children with Down's syndrome show a favorable response to anti-leukemia therapy. A 24-year-old man with Down's syndrome was first seen for the evaluation of anemia and thrombocytopenia. The peripheral blood morphology and bone marrow study revealed acute myelogenous leukemia, cytogenetic study of bone marrow showed trisomy 21. Beacuse of his sicioeconomic condition and medical abnormalities including deafness, visual loss, he was treated with low dose subcutaneous cytosine arabinoside(Ara-C) for 11 days. Complete remission was obtained after 37 days. The complete remission lasted for 5 months. He subsequently relapsed, and died 6 months later.

      • 냉동 제대혈 세포의 체외 증폭

        김삼용,김철희,배광봉,김현수,박상준,김종숙,윤환중,조덕연 충남대학교 암연구소 1998 癌共同硏究所 硏究誌 Vol.2 No.1

        Background : Cord blood(CB), which has no HLA restriction, is an alternative to bone marrow for hematopoietic stem cell transplantation. The use of cord blood, however, is limited by the number of progenitor/stem cells necessary to reconstitute the older child or adult. Therefore, ex vivo expansion of CB could have tremendous impact on diverse clinical settings. We studied the ex vivo expansion of isolated population of CD34_(+) cells from cryopreserved CB cells. Methods : CD34 cells were isolated from cryopreserved CB mononuclear cells. Purified cells were cultured with various combinations of hematopoietic growth factors including erythropoietin(EPO), stem cell factor(SCF), granulocyte-colony-stimulating factor(G-CSF), gra-nulocyte, macrophage-colony-stimulating factor(GM-CSF), interleukin-1β(IL-1β), 1L-3, and IL-6. After 7, 10 or 14 days of culture, the fold increases of colony-forming unit- granu-locyte, macrophage(CFU-GM), burst-forming unit-erythroid(BFU-E), colony-forming unit-mix (CFU-Mix), and high proliferative potential colony-forming cell(HPP-CFC) were evaluated. Results : Ten-day culture with the combination of EPO, SCF, G-CSF, IL-1β, and IL-3 resulted in a median of 60-fold increase of CFU-GM, which was greater than those with the combinations of less than 5 growth factors. The addition of IL-6 or GM-CSF to this combination did not enhance CFU-GM expansion. Ten-day culture was significantly superior to 7-day culture for CFU-GM expansion. Prolongation of culture to 14 days, however, revealed decreased expansion of CFU-GM compared to 10 days. BFU-E and CFU-Mix were expanded to 2~5 folds in 7-day culture with the combination of EPO, SCF, and G-CSF. Further expansion was not achieved in 10-day culture and colonies disappeared in 14-day culture. HPP-CFC was expanded to a median of 7.5 folds in 7-day culture with the combination of EPO, SCF, G-CSF, IL-1β, IL-3, and IL-6. Neither 10-day or 14 day-culture enhanced expansion of HPP-CFU. Conclusion : Cryopreserved cord blood cells maintain ex vivo expansion potential. In our system, 10-day culture with the combination consisting of EPO, SCF, G-CSF, IL-1β, and IL-3 seems to be adequate for hematopoietic progenitor/stem cell expansion from cryopreserved cord blood cells.

      • 중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

        김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

        Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

      • Azathioprine에 반응을 보인 류마티양 관절염에 의한 경막염(Pachymeningitis)1예

        배광봉,이정호,이정찬,곽상혁,강정현,김철희,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

        Rheumatoid arthritis frequently involves the cervical spine and may lead to neurologic impairement. However, direct involvement of CNS structures by inflammatory cells has been reported infrequently. The prevalence of this complication of rheumatoid arthritis is unknown. Inflammatory CNS involvement in rheumatoid arthritis reportedly occurs in the setting of longstanding, active, erosive articular disease and is accompanied by extracranial and extraspinal nodules and vasculitis. This is diagnosed by radiologic finding of CNS nodules or meningeal thickening and by biopsy or autopsy. Treatment with corticosteroid, cytotoxic agent or surgical decompression is helpful. But the majority of patients die within several months of onset of neurologic symptom. Recently, we experienced a case of pachymeningitis caused by rheumatoid arthritis, which resolved repeatedly with azathioprine treatment.

      • 대학생의 노인복지에 대한 인식도

        차병준,김무룡,김기열,차경미,김귀희,김현실,서인선,임상규,이순자,위광복,남철현 慶山大學校 保健福祉硏究所 1999 保健福祉硏究 Vol.2 No.-

        The purpose of this study is to grasp the change of consciousness of young people in order to seek new approach of policy for aged era. 1,200 students attending collages and universities in three small or medium sized cities were inquired for 2 months, from October 1 to November 30, 1996. The result is as follows. 1. The characteristic of the respondents of this survey is that they include 72.1% of women, 40.4% of people aged between 20 to 21, and 49.1% of people who do not have any religion. Those who are from big cities and those who are form farming villages or fishing village occupy equally 40.2%, those who reside in that cities for a long period 49.0%, and those who live with their family 60.9%. 2. The family feature of the subject is that 31.5% of them are those whose father is the age of 55 and more than 55, 10% of them are those whose mothers age is so, 33.1% of them have 5 family members, 29.5% of them have the family income of 1,000,000 to 1,490,000 won, 83.9% of them are from middle class, 47.7% of them are the people whose grand parents have passed away, 70.4% of them live apart from their grand parents, and 60.9% of them are second child. 3. 64.0% of males, 70% of respondents who are aged over 24, 58.1% of respondents who are from rural communities, 62.4% of respondents who live in rural area, and 58.3% of respondents who live alone, prefer to live with grand parents, marked higher rate than other groups. The groups whose father and mother are the age of more than 55 marked higher rate of 55.9% and 58% each than any other groups(p<0.05). The groups whose family member is less than three, whose grand parents both have passed away in middle class, who live with their grand parents, and who are second children, give more positive answers than any other groups. 4. Those who are older, who are buddhists, who are from rural area or live in rural area, whose family is small, whose family income is small, who are from lower class and whose grand parents are still alive, shows preference to support their parents after marriage. 5. Females(89.4%), those who are from small or medium sized cities(89%), who live with their family(85.6%), whose father is the age of 55 and more than 55, whose mother is the age of 54 and less than 54, whose family member is 6, who are from middle class, whose grandparents are still alive and who are the eldest child in their family, give more response that they prefer to live apart from their children in their old age than any other groups. 6. What elderly people need most right now is past time(42.3%), and the respondents whose age is 20 to 21, who are buddhists, who are from middle sized cities and live alone, whose parents are the age of more than 55, who have small family income, who live with their grand parents and who are second children show higher level than any other groups. 7. 76.8% of respondents answer that they do not need their parent's fortune, marked still higher rate than the opposite answer. Those who are older, who are buddhists, who are from big cities, who reside in rural area, who live alone and have smaller family, who are in bad family economic conditions and who live with grand parents present higher rate of positive response. 8. 59.3% of respondents reply that they think about death from time to time, and those who are female, who are in the age of 20 to 21, who are christian, who live with their family, whose siblings or other family members offer their education expenses show higher rate than any other groups. 9. 92.3% of respondents answer that the budget for welfare facility for elderly people is very small. The younger the respondents are and the worse economic condition they have among those who live in big cities, the more answered that. 10. 50% of respondents think social security should provide for their old age, and 42.8% of them believe they themselves provide against it. The respondence that social security ought provide for it appeared more among those whose age are over 24, who are female, who reside in rural area, who are christian, who are in bad economic condition, and who ever used medical institutions in recent one month, marked higher level than other groups. 11. The adequate time of retirement is 59.97±5.60 for public officers, the highest and 59.28±6.35 for teachers, the next. 12. 35.2% of respondents reply that the adequate budget for the old age after their retirement at the age of 60 is 220 million won, showed the highest level of respondence. 13. The factors which affect on the old people in the charged welfare facilities are sex(p<0.01), the type of housing(p<0.05) and whole family income(p<0.05). 14. The factors which affect on remarriage are sex(p<0.05) and religion(p<0.05). For varying old population and expanded welfare service for them, government and relevant authority should give more attention to secure the budget, establish effective plans to expand various program and the facilities for elderly people in order that elderly people spend the rest of life time more happily and more fruitfully. To do that, each college and university should open Health courses, and educate and inform about health and welfare.

      • SCOPUSKCI등재
      • 강진만 갯벌의 자정능력 평가

        김도희,김광수,조현서 木浦海洋大學校 2001 論文集 Vol.9 No.2

        We estimated the self purification capacity of tidal flats in KanJin Bay, southwestern coast of Korea during flood tide and ebb tide in September, December, 1997 and March, 1998. The net flux of 17.8 gDIN/m²/yr with tidal current outflow to sea was estimated in September and 16.0 gDIN/m2/yr outflow to sea in December, while 0.57 gDIN/m²/yr influx into the tidal flat in March. The flux of 1.29 gDIP/m²/yr outflow to sea was estimated in September, while 2.64 gDIP/m2/yr and 5.90 gDIP/m²/yr influx into the tidal flat in December and in March, respectively. The SS flux of 0.849 kgSS/m²/yr and 5.28 kgSS/m²/yr outflow to sea were estimated in September and in March, while 12.0 kgSS/m²/yr inflow into the tidal flat in December. The net flux of 339 gCOD/m²/yr was inflow into the tidal flat was estimated in September, 254 gCOD/m²/yr in December and 63.7 gCOD/m²/yr in March, respectively. The capacity of COD purification of the tidal flats was 219 gCOD/m²/yr for a period of the diurnal tide.

      • 노인환자에서 전신마취 후 발견된 뇌경색

        이광범,김정률,안용미,최준석,박천희 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

        Perioperative cerebral infarction is rare but may be fatal. This is a case report of acute cerebral infarction following general anesthesia in geriatric patient. A 72 year old female patient was admitted for transabdominal hysterectomy and bilateral saipingooophorectomy and pelvic lymphnode dissection. Preanesthetic assessment revealed a history of hypertension and diabetes mellitus. After surgery, she was alert but she gradually appeared to have right hemiparesis and confusion. Emergency CT brain scan showed early cerebral infarction in the middle cerebral artery territory. She was transferred to the depart ment of neurology and received treatment. She was discharged at 19 days after surgery with improved symptoms.

      • KCI등재

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