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).

지난 2년간의 학회지 "신경정신의학" 심사 평가보고

김찬형,김세주,김도관,김성곤,박원명,송동호,박용천,이영문,오강섭,정영철,이상열,김주한,이동영,이헌정,함병주,김율리,김문두,김정진,이강욱,천근아,김재진,홍진표,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

우리나라 일부 석면사업장의 석면폐 유병률

백도명,백남원,최정근,손미아,임정기,이원진,문영한,박정선,최병순 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.1

Asbestos industry has been in operation over 60 years in Korea. However, the prevalence of asbestosis has not been yet reported. With rapid turn-over of workers, previous cross-sectional studies of current workers on the job could not find cases with exposures long enough for the development of asbestosis. This study was done to evaluate asbestosis prevalence of those worksites with operation history of more than 20 years. In total, 139 workers from 5 worksites were examined. Asbestos industries covered in the study include 2 asbestos textile, 1 brake lining, and 2 ship repairing worksites. Chest x-ray was taken from all workers and read by two experts familiar with pneumoconiosis classification according to 1980 ILO guidelines. Those with findings compatible with asbestosis were further ckecked with high resolution computerized tomography (HRCT). Pulmonary function tests were done according to ATS guidelines, and occupational and previous medical history was taken through a standardized interview. Air-borne asbestos was measured according to NIOSH method 7400. The air-borne asbestos concentrations ranged from 0.2-1.3 f/cc for asbestos textile, from 0.7-1.0 f/cc for brake lining, and from 6.3-7.8 f/cc during asbestos removal at ship repairing worksite. Of the 139 workers 25 had abnormal chest radiographic findings, and 10 of them had findings compatible with pneumoconiosis. When work history and current asbestos measurements were accounted, 9 workers who had more than 10 years of asbestos exposure history showed chest radiographic findings of pneumoconiosis with Finally, 4 workers showed finding of pulmonary fibrosis and/or pleural thickening at HRCT, and 2 of them had restrictive lung function changes. The study results showed that, among 139 subjects, there were 4(3%) definite asbestosis cases confirmed with HRCT. The prevalence of probable asbestosis was 7% for 10-14 years of exposure, 13% for 15-19 years of exposure, and 23% for 20 or more years of exposure. The prevalence of compensable asbestosis with abnormal lung function was 4-6% for those with 15 or more years of exposure.

Cardiolipin-Lecithin 抗原과 Reagin間의 沈降反應 및 補體結合反應成績의 比較檢討

梁學道,芮薰海,李楨浩,尹秉文,全東雨,金晉郁,金永洙 醫藥係社 1955 綜合 醫學 Vol.12 No.2

복합구조물의 파괴에 관한 치수효과의 중요성

정영화,김경진,원치문,심도식 江原大學校 産業技術硏究所 1995 産業技術硏究 Vol.15 No.-

In this paper, the importance of the size effects on the strength ratio is demonstrated by numerical results. The rate of decrease of tensile strength is for glass fiber, based on the experience of a composite manufacturing specialist. For other material, similar procedure may be used until detailed test result on such material is available. The strength criteria used is that of Tsai-Wu for stress space. The factors influencing the ratio are, reducing the tensile strength alone or both tensile and compression strengths, selection of the normalized interaction term, that is, the generalized Von Mises criterion or the Hill's criterion, and the status of applied stresses. Some of the numerical results are presented for a guideline for the furture study.

삼척시 원덕읍 주민을 대상으로 한 류마티스 관절염 및 종양 진단

문수인,이도영,강진석 남서울대학교 2012 남서울대학교 논문집 Vol.18 No.1

Diagnosis of rheumatoid arthritis and cancer requires specific proteins as antigens and it has been developed by using a rapid detection kit and latex agglutination which identify circulating antibodies in the blood sera. In this study conducted by Namseoul University Health Medicine Care Service in October 2010, with the residents in Wondeok-eup, Samcheok city, Kangwon-do, the rapid diagnosis of the rheumatoid arthritis and cancer was performed by analyzing patients' blood sera. Rheumatoid arthritis and cancer were diagnosed in 3 and 1 patients, respectively in a total of twenty-six persons. In the rapid diagnosis of rheumatoid arthritis using by latex agglutination, there were one positive case of C-reactive protein (CRP), one positive case of Rheumatoid factor (RF) and one positive case of both CRP and RF detected. In the rapid diagnosis of cancer, one positive case of prostate specific antigen (PSA) was observed. Key Words : Diagnosis, Kit, Rheumatoid arthritis, Cancer

뇌경막내에 위치한 수막성 골종 증례보고

조영도,조준,문창택,장상근,윤상애 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

This case report deals with a 75-year-old female. The patient was admitted for headache due to passenger traffic accident. Plain radiographs of the skull showed the finding of dense calcified lesion in the right parietal bone. In the Brain CT scan, this lesion showed uniformly hyperdense and non-enhancing mass. The clinical examination showed no gross abnormalities. In the operation field, this lesion attached to the inner surface of the dura by the dense fibrous band and protruded into the cerebral cortex. One fragment was about 1cm×1.4cm×1.6cm and the other about 3mm×2mm×3mm. Histologic examination of the surgical specimen(H/E stain) showed a benign osteoma.

개 대뇌겉질에서 Platelet-Derived Growth Factor α-Receptor의 출생 후 발달에 관한 면역조직화학적 연구

윤영,안병수,김인정,양경철,박선홍,김기훈,박도영,김장만,문정석,장인엽,조하영 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background and Objectives : The localization of platelet-derived growth factor-α receptor (PDGF-α R) was commonly restricted to oligodendrocyte progenitors during late embryonic and postnatal development. However, several studies recently demonstrated that mature neurons could also synthesize PDGF-α, Materials and Methods : In the present study, to analyze the distributional pattern of PDGF-αR during postnatal development of the canine cerebral cortex, we used immunohistochemistry on sections of canine brain tissue. Results : We found that neurons of various regions of cerebral cortex exhibited the immunoreactivity to PDGF-αR as early as postnatal day 0, and slightly decreased after postnatal day 14. Whereas neuronal PDGF-αR were maintained at all ages, the oligodendroglia-like expression of PDGF-αR could not be confirmed. Conclusion : The localization of PDGF-αR in immature and mature neurons supports the several roles of PDGF during development, protection and survival of neurons.

β-agarase를 생산하는 해양균의 분리 및 효소 특성연구

김문수,김도만,박혜영,강미화,천종훈 전남대학교 촉매연구소 2000 觸媒硏究 論文集 Vol.21 No.-

An agar degrading bacteria was isolated from the south ocean of Korea and was identified as Aeromonas sp. This strain produced the amount of agarase (1.4U/ml) with agar as a carbon source and casamino acid as a nitrogen source. The optimum concentration of NaCl for both cell growth and enzyme activity was 2.5%. The agarase was purified by DEAE-cellulose and hydroxyapatite column chro-matograpy. The purified agarase showed a single protein band upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) and its molecular weight was estimated to be 50 KDa. The optimal temperature and pH for the enzyme activity were 28℃ and 7.2, respectively. The agarase was stable at pH 6.5 - 8 and 22 - 37℃. The agarase activity was notably inhibited by EDTA, Mn2+, Hg2+, Fe2+ and slightly activated by Na+ and Ba2+.

시스템 다이내믹스를 이용한 간호단위별 간호인력 산정에 관한 연구

김문실,성영희,권경자,김도형,김정아,신덕신,유인자,유재국,이현숙 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: The purpose of the study was to forecast manpower by building the nursing manpower-staffing model(surgical-medical nursing unite). Method: The system dynamics approach was adapted to build a simulation model for calculating medical-surgical nursing manpower-staffing. The model was built up on Venism 5.0b DSS. Result: The results in the basic circumstance are in following. The level of nursing service quality, patientsatisfaction, and nurse job satisfaction maintains higher at medical-surgical nursing unit of the tertiary hospitals with the ratio of bed to nurse 2.5:1-3.0:1 than at any other situations. The level of nursing service quality, patient satisfaction, and nurse job satisfaction maintains higher at madical nursing unit of the secontary hospotals with the ratio of bed to nurse 3.0:1 and at surgical nursing unit of the secondary hospitals with the ratio of bed to nurse 3.0:1-3.5:1 than at any other situations in the fundamental from. The results in the simulation circumstance are in following, As author raises the operating rate of bed into 95-100%, and cut skilled nursing staff down, the level of nursing-service quality, patient satisfaction, and nurse job satisfaction drops slightly. Conclusion: In terms of economic efficiency on tertiary hospotals, the ratio of bed to nurse for the best reasonable medical-surgical nursing manpower-staffing is 3.0:1. In terms of economic efficiency on secondary hospitals, the ratio of bed to nurse for the best reasonable medical nursing manpower-staffing is 3.0:1 and surgical nursing manpower-staffing is 3.5:1