제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

항공환적화물 증가에 따른 인천국제공항의 발전 방안

문상영,김영근 동의대학교 경제경영전략연구소 2011 經濟經營硏究 Vol.6 No.2

The main objective of this research is to develop plans and policy implications of Incheon International Airport since a volume of air cargo transshipment in the airport has increased. General air cargo requires speed. Among many factors, speed is the most important factor influencing route choice decisions of air cargo transshipment. Incheon International Airport has advantages of its geographical location and advanced logistics information systems in order to become "hub airport" in Northeast Asia. Also the airport has tried to increase efficiency and speed of logistics systems However, the development of other airports causes fierce competition in air transport industry. This research suggests several plans for the development of Incheon International Airport including expansion of cargo terminal, the improvement of intermodal transportation service and advanced logistics information systems based on IT, invitation of global cargo companies and 3PL companies, and so on.

퍼지 이론을 이용한 다 개체 지능형 시스템의 동기화 제어기 설계 및 구현에 관한 연구

文熙根,金永卓,金秀貞,金寬衡,李尙培 한국해양대학교 산업기술연구소 2003 연구논문집 Vol.20 No.-

이 논문의 주제는 시스템의 두 DC 모터의 동기화를 위한 효과적인 PWM 듀티비 조절이다. 퍼지 제어기는 많은 불확실하고 복잡한 산업 공정에 성공적으로 적용되어왔다. 그래서 만약 목표지점의 길이가 다르다면 속도 조절을 위한 PWM 듀티비 조절을 위해 언어적인 퍼지 규칙을 이용한 퍼지 제어기를 적용했다. 그리고 미지의 플랜트를 위한 퍼지 제어기법을 이용한 미지의 변환 함수 시스템을 연구했다. 이 제어기는 시스템 동기화를 위한 PWM 듀티비 제어에 성공적으로 적용되어지고 있다. The subject of this paper is to control efficient PWM duty for two DC motor synchronousness in the system. Fuzzy controller have been successfully applied to many uncertain and complex industrial plant. So, It adapted fuzzy controller using compositional fuzzy rule so that change PWM duty for speed control if the length of destination is different. And for unknow plant, it is the study to make the unknow transfer function system with fuzzy control method. This controller has been successfully applied to PWM duty control for the system synchronousness.

제주 차귀도 연안해역 미생물 분포 및 이화학적 특성

문영건,김만철,이준백,송춘복,여인규,김종만,박근태,손홍주,최우봉,허문수 한국환경과학회 2006 한국환경과학회지 Vol.15 No.3

디지털 영상인식 방법을 통한 자세평가 및 운동가동범위 측정시스템 개발

문영진,이순호,백진호,이종각,이건범 한국운동역학회 2004 한국운동역학회지 Vol.14 No.3

Y. J. MOON, S. H. LEE, J. H. BACK, J. K, LEE, K. B. LEE. The development of posture evaluation and Range of Motion(ROM) system by using digital vision analysis method. Korean Journal of Sport Biomechanics, Vol. 14, No. 3, pp. 49-65, 2004. The purpose of this study is development of posture evaluation and Range of Motion(ROM) system by using digital vision analysis method. The results of this study are as follows. First, Scoliosis evaluation through this research measurement system represent 3mm error in 7 cervical point and deepest lumbar point, 0.7mm error in other point. This mean this research measurement system have a reliability for scoliosis evaluation. Second, for spine line evaluation on high fat subject, we need reconstrection spine line after mesurement for fat thickness in 7 cervical point and deepest lumbar point. Third, In pedioscope error test, it present 0.01848cm in X axis and 0.01757cm in Y axis. This results mean pedioscope have a reliability foot evaluation. Forth, Posture evaluation and Range of Motion measurement system by using digital vision analysis method can fast measure in range of motion and foot evaluation and posture. therefore we can expect this system application in young people posture clinic center and hospital and so on.

경쟁적 효소면역검사를 이용한 혈청내 매독균 항체 검사의 유용성

최하영,박건,장숙진,박영진,문대수 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background : Laboratory methods for detection of syphilis are Venereal Disease Research Laboratory (VDRL) and rapid plasma reagin (RPR) test to non-treponemal tests, and fluorescent treponemal antibody absorption (FTA-ABS) and microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP) to treponemal tests. However, RPR card test had many false positive results and FTA-ABS IgM method required high degrees of technical ability and experience. Recently, enzyme immunoassay (EIA) kits for IgM and IgG antibodies to T. pallidum in syphilis have been developed. So, we evaluated that usefulness of competitive EIA for detection of T. pallidum antibody in serum. Methods : RPR positive 38 specimens and negative 6 specimens were compared by T. pallidum hemagglutination (TPHA), two commercial competitive EIA kits for detection of syphilis and FTA-ABS IgM. Those data were compared with concordant and discordant rate of each RPR, TPHA, EIA and FTA-ABS IgM. Results : 28 of 34 RPR positive specimens were TPHA(+) and EIA (+), and 6 of 6 RPR negative specimens were TPHA (-) and EIA (-). The data of two EIAs were same results with TPHA. 3 of 28 EIA positive specimens were FTA-ABS IgM (+), and 16 of 16 EIA negative specimens were FTA-ABS IgM (-). Conclusion: Two commercial competitive EIA kits for detection of syphilis were evaluated. The EIA method could be replaced with RPR and TPHA, and this method was possible to combination for detection of syphilis.

지능기법을 이용한 가공시스템의 설계 및 모니터링에 관한 연구

金永卓,文熙根,金秀貞,金寬衡,李尙培 한국해양대학교 산업기술연구소 2003 연구논문집 Vol.20 No.-

본 논문은 지능 기법과 영상처리기법을 이용하여 특정 대상물의 절단위치를 검색하는 방법을 제시한 것으로서, 최근에는 기존의 아날로그 센서를 대신한 CCD(Charge-Couple Decive)카메라로 얻어진 화상 데이타(data)를 이용하여 물체의 정보를 추출하는 방법이 많이 응용되고 있다. 최근에 영상의 형태학, 신경망, 지식기반의 영상 해석 시스템에 대한 관심이 높아지면서, 거의 모든 분야에 화상처리기법들이 사용되어지고 있다. 따라서 본 논문에서는 실시간 그레이 레벨의 입력 화상에 대하여 영상처리기법을 이용하여 특정 물체의 특정위치검출 방법을 제안하고, 실제의 시스템에 적용한 예를 제시하려고 한다. In this paper proposed detecting specific position of the object using intelligent method and image processing. Recently instead of classifying the object by shade using existing analog sensor, app.y a theory to detect of the object information by using image data from CCD camera. It takes interest in the morphology of image, neural networks and image analysis system on knowledge base. and now days, image processing method was used in the most part of field. So, In this paper proposed detecting method on specific position of specific object about real time gray level input image using image processing method and application case in real system.

진행암 환자에서 Cisplatin 병용화학요법 시 Ondansetron의 오심 구토 조절 효과

조문준,윤환중,전의건,길준영,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Ondansetron is a novel agent that selectively binds to the 5-hydroxytryptamine_3 receptor, and has been reported to have a prominent effect in the prevention of anti-neoplastic agent induced nausea and vomiting. Twenty solid tumor patients who were scheduled to receive cisplatin containing combination chemotherapy participated in a prospectively open-labeled study to evaluate the antiernetic efficacy and safety of ondansetron. The male to female ratio was 11 : 9 and median age was 49(16-70). The sites of primary neoplasms and number of patients were as following : head and neck 4, metastatic carcinoma of unknown primary site 3, stomach 3, osteosarcoma 2, ovary 2, esophagus 1, melanoma 1, penile 1, bladder 1, cervix 1, and extragonadal germ cell 1. Ondansetron was given as an 8mg loading dose IV before chemotherapy followed by 8mg IV every 8 hours until 24 hours after chemotherapy completion. Complete or major control(0 to 2 emetic episodes) of emesis was achieved in 17 of 20 patients(85%;complete 50%, major 35%) receiving ondansetron during the first 24hrs of chemotherapy. During the period of day 2 through clay 5 of chemotherapy, 14 of 20(75%) patients had complete or major control of emesis(complete 35%, major 35%). No severe side reactions were recorded in ondansetron treated patients, while mild to moderate headache was noted in 20% of patients. These results show that ondansetron is effective in the control of cisplatin induced nausea and emesis, and can be administered safely with minimal side effects.

쇄골 간부 골절 불유합의 수술적 치료 : 재건 금속판 고정 및 골 이식술 Reconstruction Plate Fixation and Bone Grafting

변영수,유찬훈,안혁수,문성건,신동주,박준우 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 쇄골 간부 골절 불유합에 대하여 관혈적 정복, 재건 금속판 고정 및 골 이식을 시행하고 술후 조기 관절 운동을 허용한 저자들의 경험을 보고하는 것이다. 대상 및 방법: 1997년 1월부터 2001년 12월까지 수술적 치료를 시행한 쇄골 간부 골절 불유합 16예를 대상으로 하였다. 위축성 불유합이 10예, 비후성 불유합이 6예였으며, 수상 후 불유합에 대한 수술까지의 기간은 평균 6.5개월이었다. 수술적 치료로 불유합 부위를 노출시켜 섬유조직을 제거하고 골수강을 천공하였으며, 골편을 정복하고 재건 금속판으로 고정하였으며, 자가 골 이식을 하였다. 수술 후 관절 운동은 1주일 이내에 시작하였다. 결 과: 평균 추시 기간은 22.0개월이었으며, 전 예에서 평균 10.0주에 골유합을 얻었다. 최종 추시 시의 견관절 운동범위는 전 예에서 정상으로 회복되었으며, 나이가 50게 이상인 6예 중 3예에서 동측 견관절에 간헐적인 동통을 호소하였다. 술후 감염, 재검 금속판의 파손, 고정상실, 불유합, 재골절 등의 합병증은 발생치 않았다. 결 론: 쇄골 간부 골절 불유합에 대한 관혈적 정복, 재건 금속판 고정 및 골 이식은 안정성 고정으로 조기 재활이 가능하고 견고한 골유합을 얻을 수 있어 안전하고 확실한 치료방법으로 사료된다. Purpose: The purpose of this study is to present out experience with open reduction, 3.5-㎜ reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fratures. Materials and Methods: Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-㎜ reconstruction plate, and bone-grafting. Postoperative mobilization started within one week. Results: The average duration of follow-up was 22.0 months. All fracture were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 our of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant. Conclusion: The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.

TiN 박막 형성에 미치는 ion beam 조사 효과

안병건,추관식,문두수,안정식,김영대,김형자,이규용 釜慶大學校 2002 釜慶大學校 論文集 Vol.7 No.-

Low energy high current N_2 ion beam was used to modify the morphology and chemical composition of cemented carbide WC-Co(Co:10 wt%, TiC + TaC:15 wt%, WC:bal) hard material surface for the fabrication of the TiN thin film by sol-gel method. The effects of ion beam treatment on preparation of the TiN thin film by sol-gel mothod were investigated by XPS, SEM, AFM and GXRD. According to the N_2 ion beam bombardment, the surface roughness was increased and TiC binders in WC were dissolved. The dissolved Ti was recombind with nitrogen ion to form the TiN nucleuses which were acted as seeds for the forming of the TiN thin film on the cemented WC-Co surface. Besides, the sputter deposited Ti interlayer prevented the diffusion of TiO_2 sol into the porous WC-Co during the formation of TiN thin film.