중증 재생불량성 빈혈 환자의 동종골수이식 후에 병발한 간정맥폐색질환(Hepatic Veno-Occlusive Disease)의 임상 경과 및 혈액응고 인자들의 변화

이제환,이규형,최성준,민영주,김신,이정신,김상희,박찬정,지현숙,김우건 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

연구배경: 재생불량성 빈혈 경우에는 조혈모세포 이식 후 VOD의 발생에 관한 보고가 거의 없는 실정이다. 저자 등은 cyclophosphamide와 antithymocyte globulin으로 전처치 후에 동종골수이식을 시행한 재생불량성 빈혈 환자들을 대상으로 하여 VOD의 발생과 임상 양상, 혈액응고 인자들의 변화에 관하여 분석하여 보았다. 방법: 재생불량성 빈혈로 동종골수이식을 시행 받은 13예 환자를 대상으로 하였다. 임상적 기준에 따라 VOD를 진단하였으며 임상 경과에 따라서 경중을 분류하였다. Protein C, protein S, antithrombin Ⅲ, tPA, PAI-1 등의 혈액응고 인자들을 전처치 투여전, 골수 주입당일, 이식 후 제7, 14, 21일에 측정하였다. 결과: 7예(53.8%)에서 VOD가 발생하였으며, 경증 5예, 중등도 2예였다. VOD군에서 혈소판치가 20.000/㎕ 이상을 유지하는 데까지 걸리는 시간이 더 길었다(p=0.026). 또한 VOD군에서 적혈구 및 혈소판의 수혈 요구량이 각각 유의하게 많았다(p=0.025, 0.015). 혈액응고 인자들의 변화를 보면, 제 0일에 VOD군에서 PAI-1의 혈중 농도가 유의하게 더 높았다.(p=0.034). 결론: 재생불량성 빈혈환자에서도 조혈모세포 이식 후에 VOD의 높은 발생률을 관찰하였으며, 대부분이 경증이었다. VOD 환자에서의 혈액응고 인자들의 변화는 PAL-1이 VOD의 감별 진단을 위하여 이용될 수 있음을 시사하고 있다. Background: There are few reports about the occurrence of hepatic veno-occlusive disease(VOD) after bone marrow transplantation (BMT) for severe aplastic anemia (SAA). We analyzed the incidence and clinical outcomes of VOD and changes of coagulation factors in patients with SAA who were conditioned with cyclophosphamide plus ATG and underwent allogeneic BMT. Methods: Thirteen patients with SAA who underwent allogeneic BMT were included. A diagnosis of VOD was made according to clinical criteria, and severity of VOD was classified according to clinical course. Plasma levels of protein C, protein S, antithrombin Ⅲ, t-PA, and PAI-1 were determined before preparative chemotherapy, in the day of marrow infusion, and days 7, 14, and 21. Results: VOD occurred in 7/13(53.8%). Five were mild VOD and two were moderate VOD. Time to platelet ≥20,000/L was slower (p=0.026) and red cell and platelet transfusion requirements were higher (p=0.025,0.015) in patients with VOD . The mean plasma level of PAI-1 at 0 were higher in patients with VOD (p=0.034). Conclusion: We observed the high incidence of VOD after allogeneic BMT in patients with SAA. A majority of cases of VOD were mild. The changes of PAI-1 after BMT may be useful marker of hepatic VOD

중증 재생불량성빈혈에서 타인 혹은 HLA 불일치 혈연간 골수이식을 위한 cyclophosphamide와 antithymocyte globulin전처치 요법

이정희,이제환,김신,설미이,이정신,김우건,김상희,지현숙,박찬정,이규형 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: Cyclophosphamide와 ATG의 전처치 요법은 HLA가 일치하는 형제간 골수이식에서는 매우 효과적인 것으로 알려져 있으나, 타인 혹은 HLA 불일치 혈연간 골수이식에서는 전처치 요법으로서 불충분한 것으로 보고되었는데, 주요 문제는 착상 부전이었다. 우리나라를 포함하는 극동아시아 지역의 국가들에서 발표되는 보고에 의하면 타인이식을 포함하여 골수이식 후 착상 부전과 이식편대숙주질환의 발생이 서구 국가들로부터의 보고에서보다 적은 것으로 알려져 있다. 저자 등은 6예의 중증 재생불량성빈혈 환자들에서 질병 초기에 Cyclophosphamide와 ATG만을 이용하여 전처치를 한 후에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행하였다. 방법: 1999년 5월부터 2000년 4월까지 서울중앙병원에서 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 성인 중증 재생불량성빈혈 환자들을 대상으로 하였다. 골수이식을 위한 전처치 요법으로 cyclophosphamide (50 mg/kg/d x 4)와 ATG (30 mg/kg/d x 3)를 투여하였는데, 골수이식 전에 ATG에 대하여 과민 반응을 보였던 한 예 (UPN 120)에서는 ATG 대신에 fludarabine (30 mg/m2/d x 3)을 투여하였다. 이식편대숙주질환의 예방을 위하여 cyclosporine과 methotrexate를 투여하였다. 결과: 연구 기간 중에 모두 6예가 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받았는데, 5예는 타인으로부터 골수를 공여 받았으며, 1예는 HLA의 표현형이 하나의 유전자좌에서 일치하지 않는 형제로부터 골수를 공여 받았다. 타인 골수이식을 받은 5예 중에서 3예의 공여자는 HLA의 표현형이 일치하였으며, 1예는 하나의 유전자좌가 major mismatch였고, 1예는 하나의 유전자좌가 minor mismatch였다. 추적기간의 중앙값은 406일 (범위, 328-643일)인데, 6예 모두에서 착상된 상태를 유지하면서 생존해있다. 2예에서 3도의 급성 이식편대숙주질환과 전신성 만성 이식편대숙주질환이 발생하였다. 결론: Cyclophosphamide와 ATG의 전처치 요법은 재생불량성빈혈의 초기에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 한국인 환자들에서 충분히 착상을 가져올 수 있는 요법으로 생각된다. 비록 본 연구의 대상 환자 수가 적지만 결과는 매우 고무적이다. HLA가 일치하는 형제가 없는 중증 재생불량성빈혈 환자의 경우에 타인 골수 공여자에 대한 검색을 조기에 시행해야 하며, 타인 혹은 HLA 불일치 혈연간 골수이식을 질병 초기에 적극적으로 고려해야 할 것으로 생각된다. Background: Cyclophosphamide (CY) and ATG regimen was reported to be insufficient for alternative donor BMT in SAA patients due to high incidence of graft rejection. The rates of graft rejection and GVHD after allogeneic BMT including unrelated donor transplants seemed to be lower in reports from Asian countries of Far East. We applied CY/ATG regimen to six patients with early stage of SAA transplanted with marrow from alternative donors other than HLA-identical siblings. Methods: Three patients were transplanted from HLA-phenotypically identical unrelated donors, two from one-locus mismatched unrelated donors, and one from an one-locus mismatched sibling donor. Four patients received no previous therapy for SAA, and two received one course of immunosuppressive therapy with ATG. Preparative regimen was CY (200 mg/kg) plus ATG (90 mg/kg) in all patients except one who had had an anaphylactic reaction to ATG prior to BMT and received fludarabine (90 mg/m2) in place of ATG. Cyclosporine plus methotrexate were given for GVHD prophylaxis. Results: All six patients engrafted and all are alive with durable engraftment at a median follow-up of 406 days (range, 328 to 643). Two patients developed grade III acute GVHD and extensive chronic GVHD. Conclusions: CY/ATG regimen may be sufficient in Korean patients with early stage of SAA transplanted with marrow from alternative donors. Although the number of patients in present study is small, results are encouraging. Stem cell transplantation using alternative donors may be considered at early stage of aplastic anemia.

다구치법에 의한 고 규소 내산주철의 용해주조공정 최적화

신제식,이상목,문병문,김정철,한동운,백승한 대한금속재료학회 2005 대한금속·재료학회지 Vol.43 No.2

In this study, Taguchi method, one of the design tools of experiments, was applied to optimize casting process parameters of the high silicon corrosion-resistant iron. Three casting process parameters such as melting temperature, rare earth metal (mischmetal) addition, and pouring temperature were chosen. Using SN (signal-to-noise) ratio calculated from ultimate tensile strength of each experimental casting run, the relationship between the casting parameters and mechanical properties was statistically evaluated. The casting condition of a melting temperature of 1,650℃, 0.2% rare earth metal addition, and a pouring temperature of 1,350℃ led to an excellent ultimate tensile strength above 11 kgf/mm², which is beyond the industrial criterion. The effects of the casting parameters on mechanical properties and corrosion resistance were further confirmed by combined analysis of fractography, hydrogen content determination, microscopic test, and acid resistance test. (Received August 23, 2004)

膜分離에 의한 海水의 淡水化에 관한 硏究

申盛義,李性琪,崔炯一,申大允,金永範,李抵憲,姜永周 조선대학교 환경연구소 1989 環境公害硏究 Vol.6 No.-

In this study, we made investigation into water permeation, solute separation, concentration and Na^(+), K^(+), Mg^(2+), Ca^(2+), Cl^(-), SO^(2)_(4)-, HCO^(-)_(3) ions separation of seawater by the revers osmosis process using a suitable semipermeable membrane. The different thickness of membranes were prepared. On heat treatment, temperature was 80℃ and thier effects were also investigated. The flat single module system was made to be capable of treating feed solution at 200-2000cc/min and 120 atm. The experimental results can be summerized as follows: 1) As the effective operating pressure increased, permeability of pure water proportionally increased. 2) As the exposure period of the manufactured membrane in air increased, permeation rate increased, but as the thickness of the membrane increased, permeation rate decreased. 3) The capacity for being reproductive of the manufactured membrane (CA: 30wt%, Formamide: 45wt%, Acetone: 25wt%) in their performance was less than 10-30% and agreed with that reported in the literature. 4) We could separated about 85-95% of salt ion in seawater using a flat single module system.

미세가공기술을 이용한 Interdigitated Array 전극의 제작 및 응용

이강신,김태한,김승렬,신민철,이원용,박제균 경북대학교 센서기술연구소 1998 센서技術學術大會論文集 Vol.9 No.1

Interdigitated array (IDA) electrodes were fabricated using silicon technology for highly sensitive biosensing. Thin-film platinum and gold IDA electrodes were fabricated with 10 μm band width and 7 μm gap between the bands using photolithographic techniques. The IDA electrode has 100 fingers consisting of 50 finger anodes and 50 finger cathodes. By applying both the oxidation and the reduction potentials of a reversible redox couple, ferrocyanide, to the pairs of the IDA electrode, an increased current generation can be observed. In our experiment, the collection efficiency of IDA electrode was 46% and amplification factor was 12.6. This preliminary experiment implies that the IDA electrode could be applied to biosensor fabrications as the sensitive electrochemical transducer when a lower detection limit is needed such as phenol sensor for drinking water analysis.

골수이식 후 골밀도 및 골대사의 변화 : 2년 추적관찰 2-Year Prospective Study

이원영,강무일,오은숙,오기원,한제호,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

거대 청신경초종의 수술치료성적 : 수술전 안면신경전위의 예견 Preoperative Prediction of Facial Nerve Displacement by MRI

정신,김태선,김재휴,김수한,강삼석,이제혁 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

A total of 22 patients(13 males and 9 females : mean age 49 years) with large acoustic neurinoma who underwent the retrosigmoid transmeatal approach from May 1993 to May )995 at the Chonnam university Hospital was reviewed retrospectively. The authors investigated the surgical results and accuracy in predicting the direction of displaced facial nerve which was determined by preoperative magnetic resonance(MRI) findings. In all cases the preferred method was the suboccipital transmeatal approach. The direction of displacement of the facial nerve could be predicted by preoperative axial and coronal MRI scans and verified intraoperatively. Gross total removal was performed in 82%, the accuracy rate for facial nerve displacement was 77% and anatomical preservation was accomplished in 82.3% of the totally removed cases. During follow-up good functional outcomes were achieved in 91% and fair in 45%. The authors conclude that such good surgical results can be attributed to advances in microsurgical technique and intraoperative facial monitoring. In addition preoperative prediction of the direction of displaced facial nerves has significantly reduced the incidence of severe facial nerve weakness.

코크스 폐수를 이용한 활성슬러지 모델 파라미터의 민감도 분석

오재일,이병준,심효영,최상교 대한상하수도학회 2002 상하수도학회지 Vol.16 No.3

Activated sludge model (ASM, IAWQ Task Group) was developed as a general mathematical model to express major biological processes in municipal wastewater treatment. Therefore this model could be applied for the design of a wastewater treatment plant and used for finding optimal conditions in plant operation. Since biological processes adopting biodegradation have been also used to treat lots of industrial wastewater such as coke's wastewater, it is worthy to examine the applicability of ASM on the industrial wastewater treatment. In order to evaluate this possibility, the sensitivity analysis of seven parameters (Y_H,μ_H, b_H, k_h, K_S, K_(O,H), K_x) in ASM was conducted with regard to the SCOD (soluble chemical oxygen demand) removal in coke's wastewater treatment. It has shown that μ_H (maximum specific growth rate) of ASM was the most sensitive one in the SCOD removal process, and relative sensitivity was decided in order of μ_H >> b_H, K_S > Y_H, K_(O,H), K_h, K_x, consequently. Based on the sensitivity analysis and calibration procedure of ASM with the data from coke's plant, the decided parameter values were valid for the proper simulation of this industrial wastewater plant, showing adequate fitting between real and simulated data. In summary, the mathematical model of ASM was suitable for the simulation of coke's wastewater treatment plant.

Vibrio cholerae균 증식에 있어서 Ferric Citrate가 미치는 영향

장광식,이신제,고광균 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

This study was performed to find a method of more high isolation rate of Vibrio cholerae from contaminated foods and the carrier of cholera. Ferric citrate, an ingredient of TCBS agar that has been used most freguently as a selective media for identification of Vibrio spp., was known to inhibit growth of enteric bacteria than Vibrio species. So, We investigated the effect of the ferric citrate on the growth of Vibrio cholerae 1. The growth of Vibrio cholerae was not inhibited in agar plate medium including low concentration of ferric citrate but Vibrio cholerae was inhibited in medium containing high concentration of ferric citrate. 2. TCBS agar medium was not suitable for isolation of Vibrio cholerae.

Vibrio vulnificus균의 Capsule이 병인론에서의 역할

조관식,이신제,고광균 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

To elucidate the pathogenesis of hematogenous Vibrio vulnificus infection in vibrio septicemia. Vibrio vulnificus was inoculated to cultured endothelial cells. The ultrastructural change in infected cell were observed by electron microscope. Vibrio vulnificus was used two distinct colony type designated as opaque and translucent. Opaque strains are encapsulated, in contrast translucent strains are unencapsulated. The cytopathic effect of the endothelial cell was appeared at the initial stage of Vibrio vulnificus infection and also when inoculated with cultured supernatant, the cytopathic effect was appeared. We conclude that endothelial cell invasion, and injury are potential mechanisms in the pathogenesis of vibrio septicemia.