한국인 베체트 장염 환자에서 Thalidomide의 치료 경험: 단일 기관의 초기 경험

이현정 ( Hyun Jung Lee ),천재희 ( Jae Hee Cheon ),이경주 ( Kyong Joo Lee ),장희원 ( Hui Won Jang ),정규식 ( Kyu Sik Jung ),정은석 ( Eun Suk Jung ),이진하 ( Jin Ha Lee ),전승민 ( Seung Min Jeon ),홍성필 ( Sung Pil Hong ),김태일 ( T 대한장연구학회 2010 Intestinal Research Vol.8 No.1

Intestinal Behcet’s disease (BD) often leads to severe complications, such as perforation or massive bleeding, and therefore is one of the major causes of morbidity and mortality. As thalidomide has been identified and its anti-inflammatory and immunomodulatory properties clarified, this drug has been used in cases of systemic BD with some success. Herein we report a case series of four patients with intestinal BD to share our clinical experience with thalidomide treatment. We studied the effects of thalidomide in four patients who had a chronic relapse of intestinal BD requiring the frequent use of systemic steroids due to refractoriness to prior treatments, such as 5-aminosalycylic acid and immunosuppressants. Pre- and post-treatment clinical and laboratory data, including clinical symptoms, laboratory data, disease activity index for intestinal BD, and thalidomide toxicity were recorded. Three of the four patients had a clinical and radiologic improvement after thalidomide treatment and all of the patients discontinued steroid therapy. Although two patients tolerated thalidomide, two patients could not continue the treatment because they suffered from edema and neutropenia. Thalidomide could be considered a therapeutic option for the treatment of intestinal BD. (Intest Res 2010;8:63-69)

특 집 -C형 간염의 치료 : 경구 C형 간염 치료제를 이용한 만성 C형 간염의 치료

이혜원 ( Hye Won Lee ),정규식 ( Kyu Sik Jung ),안상훈 ( Sang Hoon Ahn ) 대한내과학회 2015 대한내과학회지 Vol.88 No.6

Standard care for chronic hepatitis C has been a combination of pegylated interferon-alpha and ribavirin, although this treatment has suboptimal antiviral efficacy and significant adverse events. The hepatitis C virus treatment landscape has been transformed recently by the development of direct-acting antiviral agents (DAAs) that target NS3 protease, NS5A protein, and NS5B polymerase. Several DAAs showed potent antiviral activity leading to increased rates of sustained virological response (SVR), even in difficult- to-treat patients such as older patients and those with advanced liver disease and prior failed peg-interferon/ribavirin treatment. Use of multiple DAAs without pegylated interferon has shown dramatically high SVR rates (up to nearly 100%) with negligible side effects. Interferon-free regimens are close to becoming the new standard of care for patients with chronic hepatitis C in USA and Europe. Similarly, several DAAs are near clinical use in Korea. This review discusses DAAs that have been approved or are under investigation for approval in Korea. (Korean J Med 2015;88:635-642)

장내 포상기종으로 오인된 심층낭 대장염

정은석 ( Eun Suk Jung ),천재희 ( Jae Hee Cheon ),이경주 ( Kyong Joo Lee ),이현정 ( Hyun Jung Lee ),장희원 ( Hui Won Jang ),전영은 ( Young Eun Chon ),정규식 ( Kyu Sik Jung ),장선정 ( Seonjung Chang ),홍성필 ( Sung Pil Hong ),김태일 대한장연구학회 2010 Intestinal Research Vol.8 No.2

Colitis Cystica Profunda (CCP) is an uncommon and benign disease entity characterized by mucoid cysts located in the submucosal layer of the colon. It can mimic cystic submucosal tumors or mucinous adenocarcinoma and is usually located in the rectum. CCP is found in the ascending colon less frequently. CCP manifesting as multiple cystic tumors, similar to pneumatosis cystoides intestinalis, has not yet been reported. Recently, a case of CCP mimicking pneumatosis cystoides intestinalis in the ascending colon was treated. Here this case is reported and the literature reviewed. (Intest Res 2010;8:187-190)

멀티코어 시스템에서 흐름 수준 병렬처리에 기반한 리눅스 TCP/IP 스택의 성능 개선

권희웅,정형진,곽후근,김영종,정규식,Kwon, Hui-Ung,Jung, Hyung-Jin,Kwak, Hu-Keun,Kim, Young-Jong,Chung, Kyu-Sik 한국정보처리학회 2009 정보처리학회논문지 A Vol.16 No.2

최근 멀티코어가 장착된 시스템이 증가하면서 이를 통한 애플리케이션 성능향상에 대한 노력이 계속 되어왔다. 하나의 시스템에 다수의 처리장치가 존재함으로 인해 프로세싱 파워는 기존보다 증가했지만 기존의 소프트웨어나 하드웨어들은 싱글코어 시스템에 적합하게 설계된 경우가 많아 멀티코어의 이점을 충분히 활용하지 못하고 있는 경우가 많다. 기존의 많은 소프트웨어들은 멀티코어 상에서 공유 자원에 대한 병목현상과 비효율적인 캐시 메모리 사용으로 인하여 충분한 성능향상을 기대하기 어려우며 이러한 문제점들로 인하여 기존 소프트웨어는 코어의 개수에 비례한 성능을 얻지 못하며, 최악의 경우 오히려 감소될 수 있다. 본 논문에서는 TCP/IP를 사용하는 기존의 네트워크 애플리케이션과 운영체제에 흐름 수준 병렬처리 기법을 적용하여 성능을 증가 시킬 수 있는 방법을 제안한다. 제안된 방식은 개별 코어단위로 네트워크 애플리케이션, 운영체제의 TCP/IP 스택, 디바이스 드라이버, 네트워크 인터페이스가 서로 간섭 없이 작동할 수 있는 환경을 구성하며, L2 스위치를 통해 각 코어 단위로 트래픽을 분산하는 방법을 적용하였다. 이를 통해 각 코어 간에 애플리케이션의 데이터 및 자료구조, 소켓, 디바이스 드라이버, 네트워크 인터페이스의 공유를 최소화하여, 각 코어간의 자원을 차지하기 위한 경쟁을 최소화하고 캐시 히트율을 증가시킨다. 이를 통하여 8개의 멀티코어를 사용하였을 경우 네트워크 접속속도와 대역폭이 코어의 개수에 따라 선형적으로 증가함을 실험을 통해 입증하였다. With increasing multicore system, much effort has been put on the performance improvement of its application. Because multicore system has multiple processing devices in one system, its processing power increases compared to the single core system. However in many cases the advantages of multicore can not be exploited fully because the existing software and hardware were designed to be suitable for single core. When the existing software runs on multicore, its performance improvement is limited by the bottleneck of sharing resources and the inefficient use of cache memory on multicore. Therefore, according as the number of core increases, it doesn't show performance improvement and shows performance drop in the worst case. In this paper we propose a method of performance improvement of multicore system by applying Flow-Level Parallelism to the existing TCP/IP network application and operating system. The proposed method sets up the execution environment so that each core unit operates independently as much as possible in network application, TCP/IP stack on operating system, device driver, and network interface. Moreover it distributes network traffics to each core unit through L2 switch. The proposed method allows to minimize the sharing of application data, data structure, socket, device driver, and network interface between each core. Also it allows to minimize the competition among cores to take resources and increase the hit ratio of cache. We implemented the proposed methods with 8 core system and performed experiment. Experimental results show that network access speed and bandwidth increase linearly according to the number of core.

시그너처 해싱 기반 고성능 침입방지 알고리즘 설계 및 구현

왕정석,정윤재,권희웅,정규식,곽후근,Wang, Jeong-Seok,Jung, Yun-Jae,Kwon, H-Uing,Chung, Kyu-Sik,Kwak, Hu-Keun 한국정보처리학회 2007 정보처리학회논문지 C : 정보통신,정보보안 Vol.14 No.3

침입방지 시스템(IPS, Intrusion Prevention System)은 인라인모드(in-line mode)로 네트워크에 설치되어, 네트워크를 지나는 패킷 또는 세션을 검사하여 만일 그 패킷에서 공격이 감지되면 해당 패킷을 폐기하거나 세션을 종료시킴으로서 외부의 침입으로부터 네트워크를 보호하는 시스템을 의미한다. IPS에서 주로 사용되는 시그너처 기반 필터링에서는 침입방지시스템을 통과하는 패킷의 페이로드와 시그너처라고 불리는 공격패턴들과 비교하여 같으면 그 패킷을 폐기한다. 시그너처의 개수가 증가함에 따라 하나의 들어온 패킷에 대하여 요구되는 패턴 매칭 시간은 증가하게 되어 패킷지연 없이 동작하는 고성능 침입탐지시스템을 개발하는 것이 어렵게 되었다. 본 논문에서는 패턴 매칭 시간을 시그너처의 개수와 무관하게 하기 위하여 시그너처 해싱 기반에 기반한 고성능 침입방지시스템을 제안한다. 제안한 방식을 리눅스 커널 모듈 형태로 PC에서 구현하였고 월 발생기, 패킷발생기, 스마트비트라는 네트워크 성능 측정기를 이용하여 시험하였다. 실험결과에 의하면 기존 방식에서는 시그너처 개수가 증가함에 따라 성능이 저하되었지만 본 논문에서 제안한 방식은 성능이 저하되지 않았다. IPS(Intrusion Prevention Systems), which is installed in inline mode in a network, protects network from outside attacks by inspecting the incoming/outgoing packets and sessions, and dropping the packet or closing the sessions if an attack is detected in the packet. In the signature based filtering, the payload of a packet passing through IPS is matched with some attack patterns called signatures and dropped if matched. As the number of signatures increases, the time required for the pattern matching for a packet increases accordingly so that it becomes difficult to develop a high performance US working without packet delay. In this paper, we propose a high performance IPS based on signature hashing to make the pattern matching time independent of the number of signatures. We implemented the proposed scheme in a Linux kernel module in a PC and tested it using worm generator, packet generator and network performance measure instrument called smart bit. Experimental results show that the performance of existing method is degraded as the number of signatures increases whereas the performance of the proposed scheme is not degraded.

수술적 절제술 후 급격한 원격 전이의 재발을 보인 간세포암종 1예

김미연 ( Mi Yeon Kim ),이혜원 ( Hye Won Lee ),정규식 ( Kyu Sik Jung ),김범경 ( Beom Kyung Kim ),김승업 ( Seung Up Kim ),박준용 ( Jun Yong Park ),안상훈 ( Sang Hoon Ahn ),한광협 ( Kwang Hyub Han ),김도영 ( Do Young Kim ) 대한간암학회 2015 대한간암학회지 Vol.15 No.2

Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis. However, surgical resection is the treatment of choice as curative aim for early HCC with preserved liver function. A 5 year survival rate after curative resection is over 50%. We experienced a case of rapidly recurred HCC with bone metastasis after surgical resection. In our case, microscopically microvessel invasion was present after resection. Microvascular invasion (MVI) is an important factor to influence survival and/or HCC recurrence. So we suggested the patients with MVI need to follow up intensively and adjuvant therapy may be considered. (J Liver Cancer 2015;15:136-139)

간낭종 경화 치료 후 발생한 기관지담관루에 의한 담즙성 객담

이상훈 ( Sang Hoon Lee ),이경종 ( Kyung Jong Lee ),김송이 ( Song Yee Kim ),이상국 ( Sang Kook Lee ),정규식 ( Kyu Sik Jung ),박병훈 ( Byung Hoon Park ),정지예 ( Ji Ye Jung ),손지영 ( Ji Young Son ),윤여운 ( Yoe Wun Yoon ),강영애 ( 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.2

Bronchobiliary fistula is a rare disorder consisting of an abnormal communication between the bronchial tree and the biliary duct. In Western countries, trauma, postoperative biliary stenosis, and biliary lithiasis are the predominant causative factors of bronchobiliary fistula. Bilioptysis (bile stained sputum) is a pathognomic finding for bronchobiliary fistula. To date, there are just a few reported cases of bronchobiliary fistula after sclerosis of a liver cyst. We describe the case of a 74-year-old woman who developed bronchobiliary fistula after sclerosing therapy of a liver cyst. The diagnosis was confirmed by the presence of bilioptysis and the chest and dynamic liver CT findings. The patient was successfully treated with antibiotics and percutaneous transhepatic catheter drainage.

Induction of Micronuclei in Human and Mouse Lymphocytes Irradiated with Gamma Radiation and Effect of Panax ginseng C.A. Meyer

Kim,Sung-Ho,Oh,Heon,Lee,Song-Eun,Lee,Yun-Sil,Kim,Tae-Hwan,Jung,Kyu-Sik,Ryu,Si-Yun 대한방사선 방어학회 1997 방사선방어학회지 Vol.22 No.3

사람의 말초혈액림프구와 C57BL/6마우스의 비장림프구를 사용하여 시험관내에서 감마선을 조사하고 배양하여 세포질분열 차단 림프구내에 형성되는 미소핵의 빈도를 측저하였다. 미소핵 발생빈도는 방사선조사 선량에 비례하여 증가하였으며 linea-quadratic 곡선식에 적용하여, 세포 당 0.2개의 미소핵이 유도되는 방사선량을 산출하면 사람의 말초혈액 림프구에 비하여 마우스 비장림프구에서 1.67배 민감하였다. 미소핵시험방법을 이용하여, 사람의 말초혈액 림프구에 대한 인삼의 방사선 방호효과를 시험관내 시험으로, 마우스의 비장림프구에 대한 효과를 생체내 시험으로 검정하였다. 사람림프구에 있어서 방사선(3Gy)에 의해 유도되는 미소핵의 수는 방사선조사 전 및 후 투여군에서 공히 감소하였으며(p<0.01), 마우스를 사용한 생체시험에서도 림프구의 미소핵 발생빈도는 낮게 관찰되었다(p<0.025). 이상의 결과에서 인삼은 인체에서도 방사선에 의한 세포장해를 감소시킬 가능성을 나타냈다. The frequencies of γ-ray-induced micronuclei (MN) in cytokinesis-blocked (CB) lymphocytes at several doses were measured in three donors of human and C57BL/6 mice. Measurements performed after irradiation showed a dose-related increases in MN frequency in each of the donors studied. The relative sensitivity of mouse in spleen lymphocytes (SLs) compared with human peripheral blood lymphocytes (PBLs) was estimated by best fitting linear-quadratic model based on the radiation-induced MN data over the range from0 cGy to 400 cGy. In the case of MN frequency with 0.2 per CB cell, the relative sensityvity of mouse SLs was 1.67. Compared with radiation-induced MN formation in the PBLs of human, the SLs of mouse were more radiosensitive. Using this MN assay with human PBLs and mouse SLs, studies were performed ot determine whether the water fraction of ginseng (Panax ginseng C.A.Meyer) against radiation-induced MN in human PBLs after in vitro irradiation (3Gy) and in SLs of C57BL/6 mice after in vivo irradiation (3Gy). The frequency of MN in human PBLs was reduced by water fraction of ginseang (0.5㎎/ml of medium) both pre-and post treatment (p<0.01) in vitro. In addition, the frequency of MN in mouse SLs was also reduced by pretreatment of ginseng (2㎎/ml of drinking water for 7days) in vivo. The data suggested that the ginseng may reduce cell damage caused by γ-rays in vitro and in vivo. Further studies are needed to characterize better the protective nature of ginseng extract, its fractions and compounds.

급성 호산구성 폐렴 3 예

김대현,박종남,김기환,장태원,이병건,정만홍,정규식 대한내과학회 1996 대한내과학회지 Vol.51 No.2

Three previously healthy patients presented with an acute febrile illness, severe hypoxemia (PaO₂$lt;60 mmHg), diffuse pulmonary infiltrates, an increased number of eosinophils(mean 74%) in bronchoalveolarlavage fluid, and an absence of infection and previous atopic illness. The patients rapidly improved after treatment with or without corticosteroid therapy, and none have relapsed since the steroid was discontinued. These findings were consistent with acute eosinophilic pneumonia. We present three cases of acute eosinophilic pneumonia and review the pertinent literature.