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).

냉기 치료에 따른 둔근에서의 피부 및 근육내 온도 변화

정우성,김미정,박시복,이상건,김영호,양길태,장윤희 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.2

모델의 매력도와 시선처리에 따른 광고효과 연구 : fMRI를 이용한 뇌 기능 영상자료의 분석

성영신,정건지,장영 한국방송광고공사 2004 광고연구 Vol.0 No.62

광고에 매력도가 높은 모델이 등장하는 경우와 매력도가 낮은 모델이 등장하는 경우 소비자의 반응 차이는 왜 나타날까. 또한 모델이 소비자를 바라보는 경우와 그렇지 않은 경우 소비자의 반응은 어떻게 달라질까. 모델의 매력도가 주는 광고효과에 대한 기존 연구는 많이 있으나 왜 그런 효과를 보이는 지에 대한 충분한 답은 없다. 또한, 시선은 다른 사람과 심리적 접촉을 가지려는 의도를 표현하는 신호이며 이를 통해 서로 감정을 주고받는다는 점에서 모델이 소비자와 시선을 맞추느냐, 안 맞추느냐에 따라 소비자가 느끼는 감정의 강도나 모델에게 심리적으로 접근하려는 의도가 달라질 수 있다고 본다. 본 연구에서는 모델의 매력도와 시선 처리에 따라서 소비자의 감정 반응과 접촉의도는 어떻게 달라지며 궁극적으로 어떤 광고를 더 잘 기억하는지 알아보았다. 그런데 설문조사를 통한 소비자의 반응 측정은 감정의 강도나 접촉의도, 기억의 차이는 확인할 수 있으나 어떤 메카니즘을 통해 그런 차이가 발생하는지를 알 수 없다. 따라서 특정 자극에 대한 뇌 반응 영상인 fMRI(functional Magnetic Resonance Imaging)를 이용하여 각 조건의 광고 자극물에 대한 소비자의 잠재적 반응을 알아보고, 이를 통해 광고 효과 차이를 설명하였다. 결과적으로, 고매력의 여성 모델에 대해 남성 소비자는 모델의 얼굴에 나타난 감정을 인식하고 느끼는 반응과 보상 가치를 높게 지각하는 반응을 보임으로써 더 강한 감정과 접촉의도를 느끼는 것으로 나타났다. 또한 모델과 시선을 마주치지 않는 경우 보상 가치를 지각하는 반응을 보이게 되어 호감을 더 높게 가지는 것으로 나타났다. 마지막으로, 여성 모델의 매력도와 시선처리의 상호 작용에 따라 남성 소비자가 보고한 독특성과 기억 점수가 달라짐을 확인하였다. 이 같은 상호작용 효과는 모델의 얼굴에 나타난 감정 인식과 시선 추적 반응에 의한 것임을 알 수 있었다. There are many studies about the ad effect of model’s attractiveness but no sufficient answer about the reason to have that effect. A gazing is a social cue that expresses intention to make psychological relationship with other people and communicates each other’s emotion. So, the intensity of consumer’s emotion and the intention to make a psychological relationship with a model may become different whether the model gazes consumer directly or not. Our study examined how consumer’s emotion and intention of approach to model become different in accordance with model’s attractiveness and gazing direction and which ad would be remembered best in the end. However the difference of intensity of emotion, intention to make a relationship with models, and memory can be revealed through self-report, the mechanism of that can not be found out. Therefore, we examined the potential response of consumer for the ad stimuli using fMRI(functional Magnetic Resonance Imaging) and explained the difference of the ad effect. As a result, the male consumer had stronger affect and approach intention in case of more attractive female model than less. This was why he recognized the emotion on model’s face and perceived the reward value more in case of more attractiveness. Besides, when the model made no eye contact with the consumer, he had more likeability and acceptance for the model of the advertisement because he perceived the reward value more. Finally, it was found out that male consumer’s grade of the uniqueness and memory varies as the interaction of female model’s attractiveness and gazing direction. It made this interaction that a consumer perceived emotion on the model’s face and followed the model’s gaze.

헬름홀츠 코일을 이용한 강자성체의 와전류검사

성제중,서동만,신용훈,엄태건,서동섭 한국비파괴검사학회 2003 학술대회 논문집 Vol.- No.1

Ferromagnetic material like the steel tubes can easily distort eddy current testing signal due to increased magnetic permeability for defects. Because magnetic field of the test probe is affected in an inconsistent way when the material under the testing has permeability. This permeability effect can be reduced by magnetic saturation. In this paper eddy current testing system was developed to detect flaws on the steel tubes. Magnetic saturation probe with helmholtz coil was designed for saturation and inspection of the steel tubes. When using the designed test probe, the relationship between flaw signals and noises was obviously discriminated. Additionally, a high pass filter was included in the eddy current board to minimize noises due to DC magnetic field.

신경베체트병에 의한 신경인성방광 : 증례보고

이길용,임건한,소영석,노준,김철성,장대수 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

The co-existence of mouth and genital ulceration with iritis was first defined as a syndrome by Behcet. It is now known to be a chronic and relapsing systemic disease, which involves many other systems. Neurogenic bladder dysfunction due to Behcet's disease, however, is extremely rare, and only a limited number of cases have been reported in the international literature. Voiding disfunction in Behcet's disease can be due to neurological or direct bladder involvement and can be related to bladder and sphmctehc components in both phases of micturition. We report on a 35-year old patient with a neuropathic bladder secondary to Behcet's disease.

신부전이 동반된 당뇨병 환자에서 발생된 침습성 모균증 : 수술과 Liposomal amphotericin B 및 GM-CSF 병합 요법에 의한 성공적인 치험 1예

이원영,오기원,임국희,장재혁,이동건,최정현,강무일,신완식,차봉연,이광우,손호영,강성구 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.4

저자들은 신부전이 동반된 당뇨병 환자에서 발생된 부비동형 모균증에 대하여 수술과 함께 liposomal amphotericin B 및 GM-CSF의 복합치료를 하여 성공적으로 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Mucormycosis (zygomycosis) primarily affects diabetic or immunocompromised patients and typically progresses rapidly, necessitating surgical excision and antifungal therapy with amphotericin B. Large doses of amphotericin B are needed for cure, but it has the risk of causing significant renal toxicity. The recent development of liposomal amphotericin B allows antifungal therapy to be administered with potentially improved efficacy and reduced nephrotoxicity. We have experienced a case of paranasal mucormycosis successfully treated with surgery, liposomal amphotericin B and GM-CSF. A 59-year-old male suffering from diabetes mellitus for 6 years was admitted with pain at left maxillary area. He was diagnosed as mucormycosis after cytologic exam on the necrotic nasal mucosa, which showed typical hyphae. He have had diabetic nephropathy with macroproteinuria and had rapidly rising serum creatinine levels with the amphotericin B treatment: creatinine levels reverted to basal level with the use of liposomal amphotericin B. Despite surgical excision and continued antifungal therapy, his infection was not effectively controlled. Therefore, GM-CSF was administered additionally to improve phagocytic activity of leukocytes. He was finally cured after receiving a combination of aggressive surgery, liposomal amphotericin B and GM-CSF. To our knowledge, this is the first detailed clinical description of the treatment of mucormycosis with liposomal amphotericin B in Korea.

바이오인포메틱스에 기반을 둔 웹 페이지 분석 도구

윤효근,이상용 공주대학교 생산기술연구소 2001 論文集 Vol.9 No.-

This paper proposes a new webpage analysis tool based on bioinformatics. The tool puts web pages into single chromosome and expresses each character and image in the pages by gene, DNA. It analyzes similarity of gene by PCR during the process. Similarity of web page is calculated using fitness Function of gene algorithm.

國際物品賣買契約下의 FRUSTRATION에 관한 硏究

金永根,韓成一 진주여자전문대학 1991 論文集 Vol.14 No.-

In the contract of international sale of good, a contract of sale may be frustrated where, after the contract has been entered into and without default of either party, the contract has become impossible of performance or incapable of being performed. The purpose of this study is to examine the frustration in the contract of sale. Beford this study will be exaimined, a number of assumptions must be satisfied as follows ; (1) The goods must be specified goods. (2) there must be an agreement to sell goods. (3) the risk must not yet have passed to the buyer. (4) there is no default of either party. Thus, this study put a focus on the condition and effect of frustration through British Law and Precedent Case. First, Conditions upon which contract is frustrated are as follsws ; (1) Destruction of Subject-matter (2) Outbreak of War (3) Export and Import Prohibition of the Government (4) Export & Import Licence and Quota (5) Fundamental Change in Circumstance Second, Effects of frustration are as follows ; (1) Extinction of Contract automatically (2) Repayment of Advances paid Finally, in order to prohibit the dispute regarding frustration, both parties must insert the doctrine of frustration and force majeure clause in contract.

가스크로마토그래피/질량분석법에 의한 최적화 유도화 과정을 통한 Atrazine의 새로운 분석방법 개발

박승건,김승진,유영재,이용일 昌原大學校 基礎科學硏究所 2003 基礎科學硏究所論文集 Vol.15 No.-

Pesticides, with their high degrees of toxicity constitute a very impOrtant group target compound in environment samples. The use of many pesticides has been restricted or even banned while several years bemuse of their long residue times, persistence and bio-accumulation. Atrazine was derivatized using a single-step procedure by N,O-bis(trimathylsilyl)-acetamide acetonitrile in various solvent systems such as methanol, ethyl acetate, pyridine, and tetrahy&ofuran(Tl). The variables selected for study were the amount of reagents, the temperature and reaction times. The elelctron impact ionization mass spectra of the resulting derivatives are acquired and properly interpreted. Under the optinaized gas chromatographic conditions employed, an enhanced (3 times) peak height and an improved peak shape without any tailing. The purpose of this study was the development and application of GC-MS method for efficient analysis of atrazine.

保險者의 擔保危險과 免責危險에 관한 考察

金永根,金相助 진주여자전문대학 1991 論文集 Vol.14 No.-

The purpose of this paper is to analyze the risks covered clauses and the general exclusions clauses between the New ICC(1982) and the ICC(1963) out of mutual comparison. The risks covered and exclued have influenced upon themselves conversely, on account of the rationalization of insurance management and other interests concerned between the insurer and insured. Although this new ICC(1982) clauses had been used brief and easy terms for the insured to make sense the original object, the scope of practical risks covered resulted in disadvantageous effects and rather lessened the scope of risks above mentioned in comparison of the old clauses over the insured, owing to the notation of the explicit risks excluded. The new ICC(A) and the ICC A/R(1963) are all but the same with respect to risks covered under the open liabilities, but the above mentioned risks founded risks covered as the risk of accident form. Thus, the risks of causes form lessened the scope of risks covered as of ultimate avoidence. Therefore, by means of risks excluded effect, the practical extension of risks covered and excluded which are influenced by the interests concerned between the insurer and insured, we could find the refusal response of the new clauses, which was revised more beneficial to the insurer than the insured. Consequently, the only way to protect the insured is to give the compensation through the reasonable adjusment of primium, and through this the insurer will obtain the managerial profit.