만성신부전 환자의 내동정맥루 형성에 대한 임상분석

장호은,강윤중,조병선,이민구,박주승 대한혈관외과학회 2001 Vascular Specialist International Vol.17 No.2

Purpose: Hemodialysis remains the most important support for patients with end stage renal disease, and vascular access is an essential component for their life. Since 1966, intemal arteriovenous fistula (AVF) has been used widely today. If vessels were not available for AVF, the alternative would be used such as prosthetic graft. But in 1997, the National Kidney Foundation-Dialysis Outcome and Quality Initiative (DOQI) recommended increased use of native arteriovenous fistula to improve overall patency and curtail angioaccess costs. This retrospective study is to review our experience and to evaluate the overall patency rate and the influencing factors on the patency of the AVF. Method: From March 1995 through October 2000, 111 fistulas were created of 111 patients in Eulji university hospital. Among them, 106 cases were able to follow up survey. The statistical analysis used by SPSS package. Result: The male versus female ratio was 1.22: 1 and the age distribution was occurred on from 3rd decade to 9th decade. the common causes of renal failure was hypertension, glomerulonephritis and diabetes (62.1%). the autogenous graft fistulas were performed in 101 cases (wrist/antecubital fossa. 101/3), Goretex graft fistula were 7 cases. The early graft failures were 12 cases (11.4%) and the causes was thrombosis or stricture, and immaturation, psudoaneurysm, venous hypertension in order of frequency. At 12, 24, 36 months, the assisted patency rates of AVF were 80.4, 76.5, 71,3%, respectively. Conclusion: We could get higher patency rate of AVF due to liberal use of native veins and aggressive intervention of the failing AVF as recommendation of DOQI.

혈장 및 혈청 유리 핵산을 이용한 RhD 및 RhCEce 항원의 유전자형 분석

장호은,박경운,황상미,홍윤지,한민제,박정수,송정한,한규섭 대한수혈학회 2014 大韓輸血學會誌 Vol.25 No.3

Background:The Rh blood group includes several antigens, of which D, C, E, c, and e are clinically important. Although nucleic acids from whole blood can be used for Rh blood group genotyping, it is also possible to genotype free circulating fetal nucleic acids from plasma and serum. We performed Rh blood group phenotyping and genotyping using nucleic acids from whole blood and free circulating nucleic acids from plasma and serum, respectively. The results were compared. Methods:Forty-four blood samples were phenotyped and genotyped for RhD and RhCE blood groups. Phenotyping was performed by hemagglutination assay. Further tests were performed on RhD-negative samples. Nucleic acids were extracted from whole blood, plasma, and serum. Plasma and serum were prepared after filtration and genotyped by real-time polymerase chain reaction. Results:RhD blood group results showed one (2.3%) discrepant case in which the DEL phenotype appeared wild RHD genotype. Among nucleic acids, there were seven discrepant results: two from plasma and five from serum based on whole blood nucleic acids. RhCE blood group results showed three (6.8%) phenotype-genotype discordances. Among nucleic acids, seven (15.9%) cases were discrepant: one from plasma and six from serum compared to phenotypes. Kappa coefficients of serum were lower than those of plasma. Conclusion:RHD and RHCE genotype could be identified by assaying free circulating nucleic acids in plasma or serum. This study suggests that plasma is more reliable than serum as a specimen for RHD and RHCE genotyping of free circulating nucleic acids.

초록(抄錄) : ABO 유전자형의 분석

장호은 대한임상병리사협회 2002 임상수혈검사학회 발표자료집 Vol.7 No.1

국내 의료기관 헌혈자에서 Xenotropic Murine Leukemia Virus-Related Virus (XMRV)의 분석

장호은,박경운,홍윤지,황상미,김택수,배우경,송정한,한규섭 대한수혈학회 2013 大韓輸血學會誌 Vol.24 No.2

Background:Xenotropic murine leukemia virus-related virus (XMRV) has been detected in peripheral blood mononuclear cells (PBMNs), therefore, it has been regarded as being infectious and transmittable by transfusion. Thus, we attempted to detect XMRV in blood samples in order to confirm the absence of XMRV from blood donors. Methods:We achieved 165 blood donors and four chronic fatigue syndrome (CFS) patients. We performed real-time polymerase chain reaction using the LightCycler 480 (Roche, Penzberg, Germany) for the gag and env genes of the XMRV genome. DNA was extracted from peripheral blood samples. We used Uracil-N-Glycosylase in order to prevent contamination and DNA extracted from mouse embryonic fibroblasts (MEF) for amplification control. Results:No XMRV was detected in any of the blood donors in both the gag and env genes. In four CFS patients, amplification was not detected in the gag gene. In two of four CFS patients, amplifications were detected and the melting temperature was in agreement with that of MEF control in the env gene. Conclusion:Although XMRV was not present in blood samples from blood donors, this is the first report on XMRV in Korean blood donors. We confirmed the absence of XMRV in Korean blood donors, the same as studies reported in other countries. 배경: 말초혈액에서 XMRV가 검출됨에 따라새로운 수혈전파성 감염원으로서 XMRV에 대한논란이 있었다. 이에, 국내 헌혈자를 대상으로XMRV 검출 가능성에 대해 확인해 보고자, 말초혈액에서의 XMRV 검출을 시도해 보았다. 방법: 헌혈자 165명과 만성피로증후군으로 진단받은 환자 4명을 대상으로 하였다. 헌혈자 검체의 전혈을 이용하여 핵산을 추출하고 XMRV의검출을 위해 LC480 (Roche, Penzberg, Germany)을이용하여 gag 유전자와 env 유전자 각각에 대한실시간-중합효소연쇄반응을 시행하였다. 모든 실시간-중합효소연쇄반응에는 오염에 의한 위양성을 방지하기 위해 Uracil-N-Glycosylase를 사용하였고, 양성대조물질은 mouse embryonic fibroblast 에서 추출한 핵산을 이용하였다. 결과: 165명의 헌혈자군에서는 gag 유전자와env 유전자 모두에서 양성반응을 보이지 않았다. 만성피로증후군의 진단을 받은 환자 4명 중 2명은 gag 유전자에서는 증폭을 보이지 않았으나, env 유전자를 대상으로 한 반응에서 증폭곡선을나타내었고, 융해온도도 양성대조의 융해온도와오차범위 내에서 일치하였다. 이 두 개의 검체는gag 유전자의 결과를 종합하여 최종 음성으로 판독되었다. 결론: 말초혈액에서 검출되는 만성피로증후군의 병원체 XMRV가 저자들이 대상으로 한 165명의 헌혈자 검체에서는 검출되지 않았다. 이는 국내에서 헌혈자를 대상으로 한 XMRV 검출의 첫시도로, 해외 보고와 같이 한국인 헌혈자에서도XMRV가 검출되지 않음을 확인할 수 있는 것으로 생각되었다.

항-K 항체가 검출된 세 예와 한국인에서의 KEL 유전자 빈도

장호은,이경,홍윤지,김택수,송상훈,박경운,송정한,한규섭 대한수혈학회 2011 大韓輸血學會誌 Vol.22 No.1

Background: Anti-K is one of the most significant unexpected antibodies that cause hemolytic transfusion reactions. Individuals with anti-K have to be transfused with K antigen-negative red cells. Although Koreans rarely have the K antigen, we have detected three cases of anti-K and we analyzed the Kell blood group genotypes for the KEL*1/KEL*2 alleles at the same time. Methods: We analyzed the KEL*1/KEL*2 allele genotypes from 261 blood donors at Seoul National University Bundang Hospital. Kell genotyping were carried out using polymerase chain reaction (PCR) and restriction enzyme length polymorphism (RFLP). Identification of anti-K was performed using three kinds of methods;37oC albumin, an anti-human globulin phase tube, a bead cassette and a gel card. Three cases of anti-K also underwent PCR with a sequence specific primer (SSP) for Kell genotyping. For comparison, the KEL*1 allele (698C>T) was synthesized by site-directed-mutagenesis. Results: All 261 donors were KEL*2/KEL*2 homozygotes and a digested KEL*1 allele was not found. The three patients with anti-K were also KEL*2/KEL*2 homozygotes and the reactivities of the anti-K identification test were the same. Conclusion: The KEL gene frequency for the KEL*1/KEL*2 allele corresponded with that of the Kell phenotype,as was previously reported. We experienced three cases of anti-K and two out of the three were assumed that they had been transfused with the K antigen-positive blood of foreigners. This study revealed that the possibility of anti-K alloimmunization and hemolytic transfusion reactions cannot be excluded in Koreans.

실시간-중합효소연쇄반응을 이용한 결핵균의 검출

장호은,허세란,유광철,송상훈,김성한,김홍빈,박경운,송정한,이재호,박성섭,김의종 대한진단검사의학회 2008 Annals of Laboratory Medicine Vol.28 No.2

Background : For the detection of Mycobacterium tuberculosis complex (MTB), PCR is known to be sensitive, specific, and rapid compared to the conventional methods of acid-fast-bacilli (AFB) smear and culture. We evaluated a new approach for MTB detection using real-time PCR. Methods : The specificity of real-time PCR was evaluated using 20 MTB isolates and 37 nontuberculous mycobacteria (NTM) isolates identified by AccuProbe Mycobacterium tuberculosis complex colony identification test (Gen-Probe Inc., USA) and Myco-ID (M&D, Korea). One hundred sputum specimens (50 AFB smear-positive and 50 negative specimens) were analyzed using real-time PCR and Amplicor Mycobacterium tuberculosis test (Roche, Germany). The results of real-time PCR positives (55 samples) and negatives (598 samples) were analyzed by AFB smear and culture. Results : The real-time PCR assay accurately discriminated between MTB and NTM species. Realtime PCR and Amplicor test yielded the same results in 96.0% (96/100) of the sputum specimens tested. The sensitivity and specificity of real-time PCR based on AFB culture were 97.4% and 88.5%, respectively. Of the 55 real-time PCR positive specimens, 83.6% (46/55) were culture-positive, 30.9 % (17/55) were smear-positive, 52.7% (29/55) were smear-negative and culture-positive, and 14.5% (8/55) were both smear and culture-negative. Among the 598 real-time PCR negative specimens, 60 were not tested for AFB smear or culture and 10 were contaminated. Of the remaining 528 specimens, 478 (90.5%) were both smear and culture-negative and 39 (7.4%) were culture-positive. Conclusions : For the detection of MTB, real-time PCR was sensitive and specific and comparable to conventional methods. It can be used for rapid identification of M. tuberculosis in clinical laboratories. (Korean J Lab Med 2008;28:103-8)

Methicillin-Sensitive Staphylococcus aureus Pericarditis after burning a butt

장호은,한양천,이일수,권태정 대한내과학회 2017 대한내과학회 추계학술대회 Vol.2017 No.1

위급상황 음성인식이 가능한 LED 조명제어시스템 연구

장호은(Jang Ho Eun),전지혜(Jeon Ji Hye),허수진(Heo Su Jin),박종화(Park Jong Hwa),김경만(Kim Kyoung Man),박구만(Gooman Park) 한국통신학회 2015 한국통신학회 학술대회논문집 Vol.2015 No.1

구연발표 : 파라핀 블록에서 실시간 PCR을 포함한 다양한 분자기법에 의한 결핵의 검출

박정옥,장호은,황대현,명재경,설혜실,박경운,최기영,이혜승 대한임상병리사협회 2009 조직세포검사학회 발표자료집 Vol.2009 No.-

배 경 결핵균 검출의 표준 검사는 항산균 도말 및 배양이나 검사에 소요되는 시간이 길고 파라핀 블록으로는 검사가 불가능한 단점이 있다. 최근 중합효소연쇄반응(PCR)을 이용한 검사법이 발달하면서 파라핀 블록에서 신속하게 결핵균을 검출할 수 있게 되었다. 그러나 PCR은 DNA 추출, 시발체의 부위, 이중 PCR 또는 실시간 PCR 등에 따라 결핵균 검출의 유용성에 차이가 있다. 이에 실시간 PCR을 포함한 다양한 분자기법을 이용하여 검사의 유용성을 알아보고자 하였다. 방 법 2007년부터 2008년까지 의뢰된 검체 913건 중 46예(결핵균 배양 검사로 결핵균이 확인된 31예, 임상 및 병리 소견상 결핵을 의심할 만한 소견이 전혀 없는 10예 및 BCG 치료에 의한 BCG 육아종으로 진단된 5예)를 대상으로 5가지 방법의 PCR (PCR1, PCR2, PCR3, PCR4, PCR5)과 실시간 PCR을 시행하여 결핵균 검출에 대한 재검율, 민감도, 특이도, 진단율 등을 비교 분석하였다. 결 과 5가지 PCR 및 실시간 PCR에서 PCR4은 재검율이 13%이었고, 나머지는 재검율 0%를 보였다. PCR1은 표적이 IS6110인 이중 PCR로 민감도 74.1%, 특이도 90%, 진단율 78%이었다. PCR2는 표적이 MPB64와 IS6110인 이중 PCR로 민감도 77.4%, 특이도 80%, 진단율 78%이었다. PCR3은 표적이 RD1인 단일 PCR로 민감도 70.9% , 특이도 100%, 진단율 78%이었다. PCR4는 표적이 RD인 이중 PCR로 민감도 82.1% , 특이도 85.7%, 진단율 82.8%이었다. PCR5는 표적이 IS6110인 이중 PCR로 민감도 70.9% , 특이도 90%, 진단율 75.6%를 나타냈다. 실시간 PCR은 senX3-regX3 intergenic region을 표적으로 TaqMan probe를 사용했으며, 민감도 67.7%, 특이도 100% 및 진단율 75.6%를 보였다. BCG 치료에 의한 BCG 육아종 5예는 PCR1에서 1예(20%)가 양성이었고, PCR2에서 2예(40%)가 양성이었으며, 다른 방법에서는 모두 음성이었다. 고 찰 파라핀 블록을 이용한 결핵균 검출에 있어 PCR은 검사방법이 용이하고 검사시간이 짧은 장점이 있었다. IS6110을 표적으로 한 이중 PCR은 민감도가 높았고, RD1을 표적으로 한 단일 PCR 및 실시간 PCR은 특이도가 높았다. 결핵균 검출을 위한 PCR로 BCG에 의한 조직 반응과 결핵균 감염을 감별하기 어려우므로 임상적 고려가 필요하다.

구연발표 : 구연3 ; 혈소판제제의 세균오염 검출을 위한 검사방법 제안(유세포분석법과 실시간-중합효소연쇄반응법)

김미정,장호은,서지원,송상훈,박경운,송정한 대한임상병리사협회 2008 임상혈액검사학회 발표자료집 Vol.10 No.1