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신완식(Wan Shik Shin),한치화(Chi Hwa Han),유석환(Suk Hwan Yoo),박종원(Chong Won Park),강문원(Moon Won Kang),김춘추(Choon Choo Kim),김동집(Dong Jip Kim),정희영(Hee Young Chung),김학기(Hak Ki Kim),최일봉(Il Bong Choi) 대한내과학회 1991 대한내과학회지 Vol.41 No.1
We studied, retrospectively, the patterns of infection in 50 febrile, allogeneic bone marrow transplantation patients during the period from March 1983 to February 1989 at St. Mary's Hospital. The results were as follows: 1) Out of 50 patients, 35 were diagnosed with leukemia and 15 with aplastic anemia. In the leukemic patients, 11 had acute lymphocytic leukemia, 12 had acute myelogenous leukemia, and 12 had chronic myelogenous leukemia. 2) There were a total of 99 febrile episodes. Thirtyseven episodes (37. 4%) were during the early post-bone marrow transplantation before engraftment (<3-4 wks), 22 episodes (22.2%) during after-engraitment period (<100 days), 29 episodes (29.3%) during the late post-transplantation period, and 11 episodes (11.1%) during the pre-transplantation period. 3) Frequent sites of infection were in the lung (24 episodes, 42.7%), in the blood (10 episodes, 16.9%), and in the skin and soft tissue (7 episdodes, 11.9%) in decreasing order of the total documented infection, and 30 cases (30.3%) were microbiologically documented infections, while 29 cases (29.3%) were clinically documented infections. 4) The radiologic patterns of lung infiltration revealed the interstitial type to be the most frequent (14 cases, 58.4%). The nodular and the consolidation type of pattern were also present (5 cases, respectively). 5) The causative organisms for microbiologically documented infection were Gram negative organisms in 14 cases (34.1%), Gram positive organisms in 13 cases (31.7%), fungus in 6 cases (14.7%), M. tuberculosis in 2 cases (4.9%), and mixed organisms in 6'cases (14.6%). 6) Out of a total of 1420 cases of surveillence culture, organisms were cultured in 164 of these cases (11.5%), the positive cultures were from the oropharynx with 37 cases (22.8%), the axilla with 32 cases (19.5%), and the groin with 25 cases (15.2%). 7) Deaths in the patient population were due to complications of infection (1 case), graft failure (2 cases), graft rejection (2 cases), relapse of disease (5 cases), renal failure (1 case), and veno-occulsive disease (1 case). Rapid diagnosis, powerful treatment and the prevention of infection after bone marrow transplantation are thought to be able to reduce the number of deaths. In the future, further research and techniques aimed at preventing and treating viral infections need to be estabilished.
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신완식 ( Wan Shik Shin ) 한국산업디자이너협회 2007 산업디자인학연구 Vol.1 No.1
Functionalism is more of a philosophical notion which keeps abreast with human history than a dominant trend of though of a period in particular, Lamarck's use and disuse theory and Darwin's theory of natural selection, together with social changes in 19th century, gave momentum to the development and expansion of functionalism. The functionalism of this century, which has developed with its focus on architecture, has exerted a great influence on product design both in theory and in practice and has provided product design with a theoretical background. The doctrine and logic of functionalism that 'From follows function' can be applied only the 'glass box' products whose form and function are closely related to each other. The same can not be applied to the 'black box' products whose form and function do not bear close relation the each other. The problem lies in the fact that our material environment is mostly composed of 'black box' and that the 'black box' products make up a greater part of the objects of design. Consequently the theory of functionalism, which orginated based on the traditional notion about the form-function relation has lost its pracitical value and the very existence of academic system of design in general is being threatened. Seen in this respect a systematic and in depth study of the relation between form and function of 'black box' products is urgently called form.
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급성 전염성 단핵구증 환아에서 Epstein-Barr 바이러스의 감염형과 사람 백혈구 항원형 연구
한승훈,신완식,한훈,강진한,Hahn, Seung-Hoon,Shin, Wan-Shik,Han, Hoon,Kang, Jin-Han 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.5
목 적 : EBV는 전 세계적으로 다양한 질환을 일으키고, EBV는 지역과 EBV에 노출된 사람의 면역 또는 병적 상태에 따라 감염형이 달라 EBV 감염형에 관한 연구는 EBV의 역학연구와 EBV 관련 질환의 병인연구에 제일 기본적이다. EBV의 잠복감염 유전인자들에 의한 세포독성 T 림프구 면역상태는 EBV에 의한 다양한 질환의 병인적 역할이 있으며 HLA에 의하여 유발되어지는 것으로 알려져 있다. 과거에 시행한 많은 연구에서 EBV 감염과 HLA형과의 연관성은 객관적으로 입증되지 않았으나, HLA II형에 속한 항원이 EBV의 인체 내 침투에 관여한다는 사실이 최근에 보고됨으로써 이에 대한 관심이 재조명되고 있다. 이에 저자들은 EBV 감염에 의한 국내 급성 전염성 단핵구증 환아에서 주된 EBV 감염형의 분포를 확인하고, 급성 전염성 단핵구증의 발생이 HLA형과 연관성이 있는 지를 분자생물학적 분류법으로 알아보고자 이 연구를 실시하였다. 방 법 : 연구 대상은 6세에서 13세 사이의 급성 전염성 단핵구증으로 확진된 24명의 환아 이었다. 감염형의 비교 대조군은 건강한 정상 소아 중 면역혈청학적 검사로 EBV 노출이 확인된 동일한 연령의 58명이었고, HLA형 분류의 비교 대조군은 연구대상 환아와 동일한 연령의 정상 소아 200명을 대상으로 실시하였다. EBV에 의한 급성 전염성단핵구증 환아에서 중합 효소 연쇄반응법으로 EBV 감염형을 분류하여 주된 감염형을 확인하고, ARMs PCR법으로 HLA-A, B, C 항원형을, PCR-SSOP법으로 HLA-DRB 항원형을 분류하여 다음과 같은 결과를 얻었다. 결 과 : 1) EBV 감염형 결과 : 연구 대상 환아 24명에서 EBV A형이 20명(83.3%)이었고, B형은 4명(16.7%)이었다. 비교 대조군의 경우에는 58명 중 14명(24.1%)이 EBV가 검출되고 이들 중 A형은 11명(78.6%)이었고, B형이 3명(21.%)이었다. 2) HLA 형 분류 결과 : HLA I형 결과는 HLA-A24형에서 비교 대조군 200명 소아 중 69명이 양성이었고, 연구 대상 환아 24명 중 14명이 양성을 보여 RR치가 3.5724, chi-square치가 5.26, P<0.05으로 통계적 유의성을 보였다. 그러나 HLA-B, C항원형에서는 통계적으로 유의한 결과가 없었다. HLA II형 결과는 HLA-DRB1*07형에서 비교 대조군 200명 소아 중 18명이 양성이었고, 연구 대상 환아 24명 중 8명이 양성을 보여 RR치가 5.6173, chi-square치가 9.73, P<0.01로 통계적 유의성을 보였다. 결 론 : 위의 연구 결과를 통하여 국내 급성 전염성 단핵구증 환아의 EBV 감염형은 정상 비교 대조군의 소아에서 주된 감염형인 A형과 동일한 감염형임을 확인하였다. 그리고 HLA형 연구에서 HLA-A24형과 HLA-DRB1*07형이 정상 대조군과 비교하여 통계적 유의성을 보여 EBV에 의한 급성 전염성단핵구증 발생이 HLA형과 연관성이 있음을 추정하였다. Purpose : The Epstein-Barr virus(EBV), gamma herpesvirus, is an important pathogen that is widespread around the world. The EBV causes various diseases depending on the geographic location, and on the immunity or the premorbid condition of the person exposed to EBV. To evaluate EBV typing may be the most important step to figure out the pathogenesis of EBV associated diseases, and we need to re-evaluate the pathologic role of human leukocyte antigen(HLA) in developing Epstein- Barr virus associated acute infectious mononucleosis by using newly developed methods. Methods : This study included 24 children(age range : 6 to 13 years), serologically confirmed with acute infectious mononucleosis. The control group for the HLA type consisted of 200 age-matched healthy children. To classify HLA I, modified ARMs-PCR was used, while modified PCR-SSOP was utilized in typing of HLA II. Also, we performed EBV typing in study patients by using a one-step PCR. Results : The results of HLA types : In HLA class I, HLA-A24 was positive in 69 of 200 healthy children and positive in 14 of 24 patients in the study group(relative risk : 3.5724, chi-square; 5.26, P<0.05). In HLA class II, HLA-DRB1*07 was detected in 18 of 200 healthy children, and eight of 24 patients in the study group(relative risk; 506173, chi-square; 9.73, P<0.01). The results of EBV types : In the research group, 20(83.8%) of 24 patients were shedding type A virus, while 4(16.7%) were type B. Conclusion : We conclude that development of infectious mononucleosis may be associated with HLA types, and these results suggest that acute infectious mononucleosis could have hereditary traits. And we confirm that type A EBV is highly prevalent in patients with acute infectious mononucleosis in Korea. Also, our results suggest that further large scale studies, including adult groups, regarding the association between pathogenesis of EBV with HLA-DP or HLA-DQ will be warranted.
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Prevotella 침습성 감염증의 임상적 특징 및 예후
이경원 ( Kyung Won Lee ),신완식 ( Wan Shik Shin ) 대한내과학회 2003 대한내과학회지 Vol.64 No.3
DIC는 전신적 혈관내 응고기전의 활성화를 특징으로 하는 증후군으로 광범위한 순환계의 섬유소 침착을 초래한다. 섬유소 침착이 여러 장기부전을 초래함이 실험적 병리학적 근거에 의하여 확인되었다. 심하고 지속적인 혈액응고계의 활성화는 혈소판, 혈액응고인자 등을 고갈시키고 출혈을 일으킨다. DIC는 그 자체가 질환이 아니나, 심한 감염, 염증, 손상, 암 등 여러 질환의 합병증으로 일정하게 나타난다. DIC의 진단은 일반적인 여러 검사를 복합 사용하여 진단할
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위암 , 대장암 및 유방암에서 표피성장인자수용체의 발현과 악성종양 진행과의 관계 - 수정 보완한Alkaline Phosphatase 면역조직화학법으로 -
김재광(Jae Kwang Kim),신완식(Wan Shik Shin),안병민(Byung Min Ahn),선희식(Hee Sik Sun),김응국(Eung Kuk Kim),강진한(Jin Han Kang),유진영(Jin Young You) 대한내과학회 1996 대한내과학회지 Vol.51 No.5
57.8% (26/45) of breast cancer tissues, in 20.0% (2/10) of benign tumor tissues, and in 10.0% (1/10) of noncancerous breast tissues (Chi-square test, p<0.05). And it was detected in 16.7% (2/12) of metastatic lymph nodes. 3) The positivity of EGFR of stomach cancers was gradually increased from 25.0% of stage 1, 45.8% of stage 2, 61.8% of stage 3 to 77.8% of stage 4 (Bartholomew test, p<0.01). Moreover the positivity was gradually increased according to tumor invasion and lymph node metastasis (relationship of expression of EGFR with histological type, distant metastasis, localization of cancer. The positivity of EGFR of human colon cancers was also gradually increased from 12.5% of stage A, 22.2% of stage B1, 16.7% of stage B2, 42.8% of stage C1 to 76.9% of stage C2 (Bartholomew test, p<0.05). And the positivity of EGFR was related to their depth of invasion of cancer cells (Chi-square test, p<0.05). There was no relation between the positivity of EGFR and the size, site of cancer. The EGFR was expressed only in well differentiated cancers (47.6%, 10/21) and moderately differentiated (34.8%, 8/23) cancers, while not expressed in poorly differentiated (0.0%, 0/5) colon cancers (Bartholomew test, p<0.05). The positivity of EGFR of breast cancers was also related to clinical stage; positivity of stage 1 was 60.0%, stage 2 was 62.1%, and stage 3 was 45.5%, respectively (Chi-square test, p<0.05). The positivity of EGFR was related to breast tumor size; positivity of tumor size<2㎝ was 60.0%, tumor size 2-5㎝ was 61.3%, tumor size>5㎝ was 44.4%, respectively (Chi -square test, p<0.05). 4) There was no correlation of the staining percentage of EGFR with clinical stage, tumor invasion, lymph node metastasis, and distant metastasis of stomach cancers. The staining intensity was in inverse proportion to clinical stage and lymph node metastasis (measure of association, gamma, p<0.005, p<0.005, respectively), while no correlation was observed with distant metastasis. The staining intensity of EGFR was gradually increased according to clinical stages of colon cancers (measure of association, gamma, p<0.05). It was increased in stage 1 and 2 than stage 3 of breast cancers (measure of association, gamma, p<0.05). 5) The patients with EGFR-positive adenocarcinoma had much worse prognosis than those with EGFR-negative adenocarcinoma (log-rank test, p<0.0005). The mean survival duration of the patients with EGFR-positive was shorter than those with EGFR-negative (32 months vs. 48 months, median survival). The expression of EGFR had an inverse relation between both estrogen and progesterone receptor expressions (Chi-square test, p<0.05). Conclusion: These results suggested that this improved immunohistochemical technique offers a rapid, economic, reliable and sensitive method for detection of EGFR. In stomach cancer, the expression of EGFR may act on the tumor invasiveness and lymph node metastasis to some degree, but not on distant metastasis. In colon cancer, the more the clinical stage progress, the more it may act on tumor invasiveness and metastasis. In breast cancer, it may play an important role in early stage than late. Namely, the expression of EGFR may act on different stage of each cancer and may serve as a useful prognostic marker of malignancy in patients with stomach, colon, and breast cancer in Korea.
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