담도 및 췌장 악성종양에서의 CAl9-9의 진단적 가치에 대한 평가

명승재,최승목,김은옥,최호순,이성구,김명환,민영일,류진숙 大韓消化器病學會 1995 大韓消化器病學會誌 Vol.27 No.3

동종 골수 이식한 백혈병에서 단반복 유전자로 살펴본 혼합 키메라 현상의 의의

장대영,이정신,서철원,이규형,이제환,지현숙,박찬정,한면수,최동원,김정균,최성준,김성배,김상위,김우건,김상희 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.1

연구배경 : 동종 골수 이식한 백혈병에서 키메라 현상의 분석은 착상, 질병 재발과 이식 거부를 이해하는데 도움을 줄 수 있다. 최근 STR을 PCR로 증폭한 검사법에 의해 매우 민감하고 유용하게 혼합 키메라 현상을 검출할 수 있다고 보고되고 있으나, 이 방법의 민감도와 임상적 의의는 아직 완전히 정립되지는 않았다. 따라서 PCR-STR검사법이 혼합 키메라 현상을 민감하게 검출하는지 보고, 동종 골수 이식 후 혼합 키메라 현상의 변화 양상을 관찰하고, 키메라 현상의 임상적 의의를 보고자 하였다. 방법 : 형제로부터 동종 골수 이식한 급성 백혈병 6명과 만성 백혈병 2명의 모두 8명을 대상으로 하였다. 44개 골수 검체에서 phenol/chloroform방법에 의하여 단핵세포 DNA를 추출하였다. DNA는 CTT 삼중체, vWA와 amelogenin시발체를 이용하여 증폭하였다. 증폭 산물은 5% 폴리아크랄아미드 젤에서 전기영동 뒤 은 염색으로 확인하였다. 2명의 DNA를 여러 비율로 혼합하여 상기 검사를 하여 검출 가능 최소 농도를 결정하였다. 결과 : 상기 검사법의 검출 가능 최소농도는 0.25%였다. 혼합 키메라 현상은 8명중 4명에서 관찰되었다. 혼합 키메라 현상은 보인 1명에서 급성 및 만성 이식편대 숙주 질환이 나타났고, 완전 공여자 키메라 현상을 보인 1명에서 만성 이식편 대 숙주 질환이 나타났다. 점진적으로 증가하는 혼합 키메라 현상을 보인 2명은 이식 후 12개월에 질병 재발을 보였으나, 완전 공여자 키메라 현상을 보인 경우엔 재발이 관찰되지 않았다. 결론 : PCR-STR검사법은 동종 골수 이식 후 남아 있는 환자 세포를 검출하고 키메라 현상을 관찰하는데 유용한 방법이다. 또한 이 검사법은 동종 골수 이식 후 재발의 조기 진단, 이식편 대 숙주 질환의 평가와 면역 관용에 임상적으로 응용할 수 있으리라 생각한다. Background : Chimerism analysis after allogeneic bone marrow transplantation (BMT) for leukemia could be helpful understanding of the early marrow engraftment, disease relapse, and graft rejection. Recently, a PCR technique which amplifies short tandem repeats(STR) has been reported to be highly sensitive and reliable in detecting mixed chimerism. But its sensitivity and clinical significance has not been established. The purpose of this study was firstly, to confirm whether a PCR-STR in highly sensitive enough ti assess mixed chimerism, secondly to monitor the changing patterns of mixed chimerism after allogeneic BMT, and lastly to determine correlation between the chimeric status and the clinical outcome. Methods : A study was made eight patients (six with acute leukemia and two with chronic leukemia) who underwent unmanipulated allogeneic BMT along with matched donors. DNA was extracted from mononuclear cells of 44 bone marrow samples using a phenol/chloroform method. Amplification of DNA was done using CSFIPO-TPOX-TH01(CTT) triplex with or without vWA or amelogenin primer. The amplified product was separated on 5% polyacrylamide gel and was confirmed by silver staining. The sensitivity of CTT triplex method was determined by mixing DNA from two person in serial proportion using the same method. Results : The sensitivity for CTT triplex method was 0.25% Mixed chimerism was documented in 4 of 8 patients. ONe of four patients with mixed chimerism developed acute and chronic graft versus host disease (GVHD) and one of four patients with complete donor chimerism also developed chronic GVHD. Two patient with progressive mixed chimerism relapsed at 12 months post-BMT, whereas no patient with complete donor chimerism has relapsed. Conclusion : The study has found that PCR-STR was an effective method for the detecting residual host cell and monitoring the chimeric status after allogenic BMT. PCR-STR can also be clinically applicable in early prediction of relapse, appropriate assessment of GVHD, as well as tolerance after allogeneic BMT.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

물세척법에 의한 결장루관리 실태에 관한 조사

최상경,박희자,김채숙,서문숙 대한대장항문학회 1992 Annals of Coloproctolgy Vol.8 No.2

한국인 20대남녀 정신질환자의 타액성 우식유발요인에 관한 비교연구

최기열,박상숙 국립서울정신병원 1986 臨床硏究論文集 Vol.1986 No.-

다골성 섬유성 이형성증

최갑식,박상억,이강숙 大韓口腔顎顔面 放射線學會 1994 Imaging Science in Dentistry Vol.24 No.1

Fibrous dysplasia is a benign fibro-osseous condition that is replacement of normal bone and marrow tissues by cellular fibrous tissue and immature bone, and it is divided into monostotic type and polyostotic type. Polyostotic fibrous dysplasia involves multiple bones, such as skull, jaw bones, femur and tobia. And it is also divided into two forms: the less severe Jaffe's type and the more severe Albright's syndrome. Clinically, it frequently occurs in the 2nd decade, and occurs more frequently in maxilla than in mandible. And the lesions of fibrous dysplasia tend to become static as skeletal maturity is reached. The authors experienced three cases of polyostosic fibrous dysplasia in the craniofacial area with the complaints of facial asymmetry due to painless swelling. And we discussed the clinical, radiological, and histopathological features of these cases with a brief review of the literatures.

혈소판 Cyclic Nucleotide, Inositol Trisphosphate 및 [Ca^(++)]_(i)의 응집반응성 변동에 대한 항우울성 약물의 영향

최상현,박석산,이민수,전보권,천연숙 고려대학교 의과대학 1992 고려대 의대 잡지 Vol.29 No.3

The pharmacodynamic mechanisms of available antidepressant drugs have not yet clarified. Major depression is common and may more frequently occur for the first time in the eldery, and the incidence of thromboembolism is increased with advancing of age. And many studies have shown an usefulness of platelet as models of monoaminergic neurons. Therefore, this paper. deals with the anti-platelet activity of antidepressant drugs in view of the common action in platelet signal-transduction system of three antidepressants showing different modes of action. The IC_(50)s of amitriptyline alprazolam. and rolipram were 1.39×10^(-4), 2.63×10^(-4), and 8.11×10^(-4)M. respectively, and that of each of the reference drugs : sodium nitroprusside. chlorpromazine. and spermine were 1.26×10^(-6), 5.76×10^(-5) and 4.28 ×10^(-3)M. Rolipram and alprazolam produced the significant increase of platelet cGMP level with slight cAMP increase. showing their selectivity on typeⅡ cGMP-specific PDE. Spermine and antidepressants, particularly used in this study induced the marked increase of platelet IP_(3) level with the anti-platelet and [Ca^(++)]_(i),-decreasing activities. These findings suggest that the mechanism of action of antidepressant drugs seems to be related with their enhancing property of the neuronal IP_(3)-mediated signalling. and that the paradoxical mode of their actions on platelet metabolisms of [Ca^(++)]_(i) and IP_(3) may be a clue of the uncovering of a new cellular [Ca^(++)]_(i)-regulating mode.

지능과 신경심리 검사의 상관 관계

최병건,구애숙,이성훈 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.5

Objects : In order to find what kind of brain function the intelligenece test reflects, the authors investigated the relationship between the intelligence tests and neuropsychological tests. Methods : The subjects were 56 patients including 6 psychiatric patients, 4 neurological patients and 46 brain-injured patients. Korean Wechsler Intelligence Scale(KWIS) was used for the assessment of intelligence. Halstead-Reitan neuropsychological test battery and computerized neuropsychological tests were used for the assessment of neuropsychological function. Pearson correlation coefficients between KWIS scores and the scores of neuropsychological tests were obtained. Results : Digit symbol test, spatial memory test, trail making test type A and Wechsler memory scale showed high correlation with total intelligence. These tests require simple attention ability and immediate memory of the subjects. On the other hand, tactual performance test, trail making test type B, stroop test, continuous performance test and Wisconsin card sorting test showed no correlation with total intelligence. These tests require more continuous attention ability and psychomotor coordination. Conclusion : According to our study, total intelligence seems to have some limitations in representation of more comprehensive brain function. However, by considering verbal and performance subscales of intelligence, it will be possible to obtain more precise decision about brain function of the subjects.

자외선 차단 소재가 착용자의 온열쾌적성에 미치는 영향 : Effects of UV protective materials on the Wearer's Thermal Comfort

최성심, 신윤숙 전남대학교 가정과학연구소 2001 生活科學硏究 Vol.11 No.-

In this research, the thermal comfort and thermophysiological reactionses of the subjects were analyzed and compared when the young men wore the 2 types of clothing combination which made of two types of men's suit(general material, uv protective material) in a hot environments. The wear tests were performed in clomatic chamber controlled 27℃ air temperature, 50±10%RH and 0.5m/s air movement. Five healthy young men participated in this experiment. The experiment schedule was planned 3 steps, that is, sedentary posture during 20 minutes - walking on treadmill by 2.5mph during 10 minutes - sedentary posture during 20 minutes. The results obtained is as follows; ①The mean temperature was lower in the case T1 than in the case T2(P<.001). ②The oral temperature. sBP, HR. subjective sensations were not significant. ③The microclimate temperature within clothing was lower in T1 than in T2(P<.001) . The microclimate humidity within clothing was lower in T2 than in T1 (P<.05 over).

도시주민의 B형 간염에 대한 예방적 건강행위 이행에 관한 연구

崔翔旭,李明淑,廉容泰 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.3

Hepatitis B infection is one of the most prevalent epidemic diseases in Korea. As a control measure, improving the preventive health behavior and concerns of appropriate people cannot be overemphasized. In light of the above reasons, an interview survey was performed to clarify the relationships between the variables related to health behavior and those related to health beliefs on hepatitis B infection. A total of 509 housewives who were invited to a hepatitis B screening campaign was selected for the study. These women were separated into two groups :those who participated in the campaign(258 persons) and those who did not participate(251 persons). The results were as follows : 1. Variables of socio-demographic characteristics, cue to action, and health belief were significantly associated with variables of preventive health behavior on serological test for hepatitis B. 2. The participating group had higher degree of general knowledge, susceptibility, severity, benefit and health concerns of hepatitis B infection. 3. Results of multiple regression study with variables of health beliefs, cue to action, and socio-demographic characteristics showed that the total of those variables could explain 65.4% of preventive health behavior for hepatitis B. 4. Stepwise discriminant analysis study between the participating and nonparticipating group with all the detailed variables of health belief, cue to action, and socio-demographic characteristics resulted in a hit ratio of 89.5%.