수지상세포의 방사선 저항성에 대한 연구

김은실,김종순,이명호,범희승,민정준,정환정,김성민,허영준,송호천,이제중 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.3

목적 : 림프구와 비교되는 수지상 세포의 방사선 민감성을 보기 위하여 본 연구를 시행하였다. 대상 및 방법 : 말초혈액에서 분리한 T 림프구에 0 Gy, 10 Gy, 30 Gy의 방사선을 조사하고 4시간 후에 유세포 분석기를 이용하여 선량별 세포고사 빈도를 관찰하였다. 또한 조혈모세포에서 미성숙 및 성숙 수지상 세포를 단계적으로 분리 배양하여 각각 0 Gy, 10 Gy, 30 Gy, 100 Gy의 방사선을 조사하고 4시간, 24시간 그리고 48 시간 후에 선량별 세포고사 빈도를 관찰하였다. 사이토스핀(cytospin)슬라이드에 림프구와 미성숙 및 성숙 수지상세포를 3×104개 씩 분주하고 May Grunwald-Giemsa 염색한 후, 광학 현미경 하에서 각각의 세포군 당 100개의 세포에서 세포 면적당 핵의 면적 비를 측정하였다. 결과 : 림프구에서는 방사선조사 선량별로 세포고사 빈도가 유의하게 증가하였으나, 수지상 세포에서는 그 분화정도나 방사선조사 선량에 따른 세포고사의 빈도차이가 없었다. 또한 수지상 세포는 방사선선량과 관계없이 용량에 의존적으로 강력한 T-세포 자극능을 보였다. 림프구의 세포에 대한 핵의 면적 비는 미성숙 및 성숙 수지상세포의 세포에 대한 핵의 면적 비보다 현저히 큰 반면, 두 가지 수지상세포간에 유의한 차이는 없었다. 결론 : 수지상세포는 그 분화도와 상관없이 림프구에 비하여 방사선 저항성을 나타내었고, 이는 세포의 형태적 차이에 따른 표적의 크기와 관련이 있을 것으로 생각되며, 향후 분자 생물학적인 연구의 기초 자료로 활용할 수 있을 것으로 생각된다. Purpose : To evaluate radiation sensitivity of dendritic cells in comparison with lymphocytes. Materials and methods : T lymphocytes captured from peripheral blood were irradiated by 0 Gy, 10 Gy, 30Gy. Apoptosis was measured by flowcytometry for staining of Annexin V 4 hours after irradiation. Immature and mature dendritic cells processed from blood hematopoietic stern cell were irradiated by 0 Gy, 10 Gy, 30 Gy, 100 Gy respectively and apoptosis was measured by flowcytometry with time difference as 4h, 24h and 48h after irradiation. Morphometric analysis by percent nucleus was measured in three cell groups, also. Results : Lymphocytes showed radiation sensitivity by increasing apoptotic fraction according to radiation dose. However, both mature and immature dendritic cells showed consistent fraction of apoptosis in spite of increasing radiation dose. Percent nucleus ratio is significantly higher in lymphocytes than that of mature or immature dendritic cells. Stimulation of T-cell by dendritic cells was not changed after irradiation. Conclusion : Dendritic cells showed radioresistance which was associated with small size of nucleus in comparison with lymphocytes and this result would be used as a basal data of radio-labelling for the cellular trafficking studies in nuclear medicine fields.

수술실 손 소독제의 종류에 따른 균주 수의 변화

홍성윤,김정민,김소영,이수정,오은실,양서인,김화실,김남초 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: The present study purposed to compare the hand washing effect of 7.5% powidone-iodine, which is used in the operation room of C university hospital in Seoul, with that of Ethyl alcohol-CHG mixture recommended by the US Association of Operating Room Nurses (2002) and to adopt a more effective hand disinfectant. Method: In a quasi-experimental design, 48 medical staff who participated in operations during the period from November 2004 to February 2005 had hand washing using the two kinds of hand disinfectants: 7.5% povidone-iodine and the ethyl alcohol-CHG mixture. Their palms were swabbed and cultured just after hand washing and again after taking dff sterile gloves after the operation. The number of colonies from the two occasions were counted and compared. Result: The number of general bacillus increased significantly in the group using 7.5% povidone-iodine compared to that in the group using the ethyl alcohol-CHG mixture. The number of general bacillus increased signficantly in doctors compared to that in nurses. The factors affecting the increase of the number of general bacillus were disinfectants and medical personnel. The number of general bacillus was expected to increase 9.41 times with 7.5% povidone-iodine than with the ethyl alcohol-CHG mixture and 14.87 times in doctors than in nurses. Conclusion: This study shows that the ethyl alcogol-CHG mixture has a stronger hand disinfection effect than 7.5% povidone iodine. Thus we need to change the hand disinfectant used in operating rooms as soon as possible in order to minimize the infection of wounds resulting from operations.

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.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

Screening of DNA Aptamers Specific to PDGF Receptor for Cell Culture Media Supplement

Eun-Sil KIM,Ji-Man CHA,Simranjeet Singh SEKHON,Ji-Young AHN,Jiho Min MIN,Yang-Hoon KIM 한국생물공학회 2015 한국생물공학회 학술대회 Vol.2015 No.10

Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study

( Eun Sil Koh ),( Kyung Do Han ),( Mee Kyoung Kim ),( Eun Sook Kim ),( Min-kyung Lee ),( Ga Eun Nam ),( Hyuk-sang Kwon ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.4

Background/Aims: Because weight control is important in treatment of type 2 diabetes, it is essential to understand the associations between weight change and the risk of microvascular complications among patients with type 2 diabetes. We examined whether weight changes early after new-onset diabetes have an impact on the clinical outcomes of diabetic nephropathy and retinopathy. Methods: Using the Korean National Health Insurance Service-National Health Screening Cohort database, 181,872 patients newly diagnosed with type 2 diabetes who were free of end-stage renal disease (ESRD) and proliferative diabetic retinopathy (PDR) during 2007 to 2012 were followed to the end of 2016. Weight change was defined as the difference in body weight from the time of diabetes diagnosis to 2 years later. Results: We identified 180 cases of ESRD and 780 cases of PDR followed up for a median of 5.5 years from the index year at 2 years after diagnosis. Those with 5% to 10% weight gain showed a significantly higher hazard ratio (HR) for ESRD, compared with those with ≤ 5% weight change after adjusting for several confounding factors, including the baseline estimated glomerular filtration rate (HR, 1.75; 95% confidence interval [CI], 1.14 to 2.70). Those with ≥ 10% weight loss showed the lowest HR for PDR (HR, 0.52; 95% CI, 0.33 to 0.83), whereas those with ≥ 10% weight gain showed the highest HR for PDR (HR, 3.20; 95% CI, 2.51 to 4.08). Conclusions: Weight gain after new-onset diabetes was associated with increased risk of ESRD and PDR whereas weight loss with decreased risk of PDR, but not ESRD.

A Case of Chloroquine-resistant Plasmodium vivax Malaria Imported from Indonesia

Kim, Eun Sil,Na, Byung Kook,Park, Yun-Kyu,Chung, Moon-Hyun,Lee, Jin-Soo,Cheon, Seung-min,Lee, Je,Shin, Jeong-hun,Kim, Eun-young,Pai, Hyunjoo 대한감염학회 2008 감염과 화학요법 Vol.40 No.1

Resistance of falciparum malaria to antimalarial agents is prevalent in many areas, whereas chloroquine-resistant vivax malaria has been reported mainly around New Guinea since 1989. Concomitant with the spread of chloroquine-resistant P. vivax and increase in number of international travelers, imported cases of chloroquine-resistant vivax malaria in travelers returning from these areas has been reported. We experienced a case of chloroquine resistance P. vivax infection imported from Mangole Island, Indonesia. Its origin is confirmed not to be indigenous by the gene encoding analysis for the polymorphic region of apical membrane antigen-1 in P. vivax. Gene sequencing of the P. vivax mdr1 gene revealed only one substitution located at the codon 1076 (F1076L). The case was managed with oral quinidine with successful outcomes. 열대열 말라리아에서 항말라리아에 대한 내성은 세계적인 현상이지만, 삼일열 말라리아에서 클로로퀸 내성은 1989년부터 뉴기니 주변 지역에서 주로 발생하고 있다. 이들 지역으로 여행하는 여행객이 증가하면서 클로로퀸 내성 삼일열 말라이아 예들 보고가 늘고 있다. 저자들은 인도네시아의 망골 섬 여행 후 발생한 클로로퀸 내성 삼일열 말라리아를 경험했으며, P. vivax의 apical membrane antigen-1을 코딩하는 polymorphic region 분석에서 환자의 삼일열 말라리아 원충은 국내 발생주와는 다른 것을 증명했고, P. vivax mdr1 gene의 염기서열 분석에서 1076 코돈이 L에서 F로 변한 것을 확인하였다. 경구 퀴니딘으로 치료하여 증상과 원충혈증이 호전되었다.

알레르기질환을 가진 소아청소년의 수면 장애 연구

오은민 ( Eun Min Oh ),은소희 ( So Hee Eun ),박수화 ( Su Hwa Park ),서영실 ( Yeong Sil Seo ),김지현 ( Ji Hyun Kim ),서원희 ( Won Hee Seo ),안강모 ( Kang Mo Ahn ),정지태 ( Ji Tae Choung ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.1

Purpose: Although allergic disease has been recognized as a common chronic disease related to the sleep disturbance of children, studies on sleep disturbance in children with allergic disease are scanty in Korea. The aim of this study was to evaluate the sleep disturbance of children with allergic disease. Methods: Children aged 2 to 12 years were assessed using the sleep questionnaires. From July 2011 to June 2012, surveys were conducted on patients who were diagnosed with allergies in 3 general hospitals and in an elementary school in Seoul and the capital area. The analysis was done in 3 groups according to age. Results: The sleep questionnaires of 1,174 children were evaluated. Children with allergic disease were 341 (209 males and 132 females) and those in the control group were 833 (428 males and 405 females). Parasomnia symptoms were common in young children (ages 2 to 5 years) than in the control group (P<0.05). Symptoms of sleep-disordered breathing were more common in early adolescent children (ages 11 to 12 years) than in the control group (P<0.05). The presence of allergic rhinitis, gender, and body mass index did not correlate with a sleep disturbance in children with allergic disease. Conclusion: To our knowledge, this study was the first report of sleep disturbance in children with allergic disease in Korea. This study suggests that children with allergic disease from early children may have poor sleep quality than those without. Therefore, proper treatment of and great interest in sleep disturbance are required for children with allergic disease.

Comparison of Abbreviated MRI and Full Diagnostic MRI in Distinguishing between Benign and Malignant Lesions Detected by Breast MRI: A Multireader Study

Kim Eun Sil,Cho Nariya,Kim Soo-Yeon,Kwon Bo Ra,Yi Ann,Ha Su Min,Lee Su Hyun,Chang Jung Min,Moon Woo Kyung 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.3

Objective: To compare the performance of simulated abbreviated breast MRI (AB-MRI) and full diagnostic (FD)-MRI in distinguishing between benign and malignant lesions detected by MRI and investigate the features of discrepant lesions of the two protocols. Materials and Methods: An AB-MRI set with single first postcontrast images was retrospectively obtained from an FD-MRI cohort of 111 lesions (34 malignant, 77 benign) detected by contralateral breast MRI in 111 women (mean age, 49.8. ± 9.8; range, 28–75 years) with recently diagnosed breast cancer. Five blinded readers independently classified the likelihood of malignancy using Breast Imaging Reporting and Data System assessments. McNemar tests and area under the receiver operating characteristic curve (AUC) analyses were performed. The imaging and pathologic features of the discrepant lesions of the two protocols were analyzed. Results: The sensitivity of AB-MRI for lesion characterization tended to be lower than that of FD-MRI for all readers (58.8– 82.4% vs. 79.4–100%), although the findings of only two readers were significantly different (p < 0.05). The specificity of AB-MRI for lesion characterization was higher than that of FD-MRI for 80% of readers (39.0–74.0% vs. 19.5–45.5%, p ≤ 0.001). The AUC of AB-MRI was comparable to that of FD-MRI for all readers (p > 0.05). Fifteen percent (5/34) of the cancers were false-negatives on AB-MRI. More suspicious margins or internal enhancement on the delayed phase images were related to the discrepancies. Conclusion: The overall performance of AB-MRI was similar to that of FD-MRI in distinguishing between benign and malignant lesions. AB-MRI showed lower sensitivity and higher specificity than FD-MRI, as 15% of the cancers were misclassified compared to FD-MRI.

중년 여성의 스트레스, 우울, 회복탄력성과의 관계

민은실(Eun-Sil Min) 한국엔터테인먼트산업학회 2017 한국엔터테인먼트산업학회논문지 Vol.11 No.4

본 연구는 중년기 여성의 스트레스, 우울 및 회복탄력성을 파악하고, 이들의 상관관계를 확인하기 위해 시도된 조사연구이다. 연구 대상자는 만 40~59세의 중년여성을 대상으로 총 151부를 자료 분석하였다. 수집된 자료는 PASW statistics 20.0 program을 이용하여 분석하였으며, t-test, ANOVA, Pearson"s correlation coefficient로 분석하였다. 연구결과 중년여성의 스트레스는 평균 97.58점, 우울은 평균 13.88점, 회복탄력성은 총점 평균 60.66점이었다. 스트레스는 우울과 정적 상관관계를 보였으며, 우울은 회복탄력성과 부적 상관관계를 나타내었다. 본 연구 결과를 바탕으로 중년여성의 회복탄력성을 향상시킬 수 있는 중재 프로그램이 마련이 필요하겠다. The purposes of this study were to investigate the relations stress, depression and resilience of middle-aged women. The participants in this study were 151 who were middle-aged women recruited in the D and K city. Collected data were analyzed using a descriptive analysis, t-test, ANOVA, Pearson`s correlation with PASW statistics 20.0 program. Average score were 97.58 for stress, 13.88 for depression and 60.66 for resilience. There were statistically significantly positive correlations between stress and depression. But, depression and resilience were positive correlations. Thus it is suggested that management of stress and resilience have a positive impact for middle-aged women. There is a need for an effective strategy to decrease stress and depression to develop resilience-enhancing programs for middle-aged women.