각종 난치성 혈액 질환에서의 비혈연간 골수이식

김동욱,한훈,김정아,김희제,민창기,엄현석,최정현,이종욱,한치화,홍영선,최일봉,신완식,민우성,김학기,김춘추,김원일,김동집 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

목적: 비혈연간 골수이식은 혈연내에 적절한 골수공여자가 없는 만성골수성백혈병, 고위험군의 급성별혁병, 면역억제치료에 실패한 재생불량성빈혈 및 각종 난치성 조혈모세포질환의 완치를 위한 표준적인 치료방법으로 정착되고 있다. 혈연간 표준적인 동종 이식에 비하여 비혈연간 이식시에는 생착부전, 이식편대숙주반응과 감염이 더 빈번하게 발생하며, 국내에서는 아직까지 체계적인 임상연구결과가 보고된 바 없었다. 이에 본 센터에서는 1995년 10월 이후로 약 20개월간 26예의 비혈연간 골수이식을 시행하였으며 3개월 이상의 추적관찰이 가능하여 이식초기 합병증의 관찰 및 분석이 가능하였던 20예의 환자를 대상으로 이식성적 및 문제점을 보고함으로써 새롭게 확대되고 있는 이 분야의 임상연구 및 진료의 활성화를 꾀하고자 한다. 방법: 각종 혈액 종양질환으로 비혈연간 이식을 시행한 총 26예의 환자중 3개월이상의 추적관찰이 가능하였던 20예를 대상으로 후향적으로 임상경과를 분석한 후 생존 분석을 시행하였고, 환자의 연령, 성별, 질병의 상태, 조식 적합 항원의 일치정도, 이식편대 숙주 반응의 유무와 생존기간과의 상관관계를 살펴보았다. 또한 표준위험군과 고위험군으로 나누어 생존율을 비교하였고 이식과 관계된 생착 부전, 이식편대숙주반응, 감염의 발생과 양상 그리고 그 합병증을 관찰하였다. 결과: 1. 환자와 공여자간에 HLA 불일치가 20예 중 4예에서 있었으며, 생착여부의 확인이 가능했던 17예 중 16예에서 생착이 확인되어 94.1%의 생착율을 보였다. 2. 급성이식편대숙주반응은 62.5%(10/16예)에서 발생하였으며 111도 이상의 급성의 이식편대숙주 반응은 25%(4/16예)에서 발생하였다. 만성이식편대숙주반응은 40%(2/5예)의 환자에서 발생하였으며 이들 모두 국소형으로 중증의 진행형 만성이식편대숙주반응이 관찰된 환자는 없었다. 3. 호흡기 합병증은 10예(50%)에서 발생하였으며 감염성 폐렴을 포함한 호흡기 합병증이 가장 흔한 일차적인 사망 원인이었다. 호흡기 합병증이 발생했던 10예중 6예가 감염에 의한 폐렴이 의심되었고 나머지 4예는 특발성 간질성 폐렴이었다. 4. 8.5개월의 중앙추적기간 중 35%의 생존율을 관찰할 수 있었고, 생존기간은0.5개월에서 15개월 (중앙치:4개월)이었다. 한편 고위험군은 25%(3/12예), 표준위험군은 50%(4/8)의 생존율을 관찰할 수 있었다. 5. 가장 흔한 사망 원인은 감염성 폐렴을 포함한 호흡기 합병증(6예)이었고, 이외의 사망 원인으로는 급성 이식편대숙주반응과 다장기부전이 각각 2예, 생착 부전, 간정맥 폐쇄, 그리고 재발이 각각 1예였다. Unrelated bone marrow transplantation(UBMT) has been increasingly recognized as the standard treatment for cure of chronic myelogenous leukemia, high risk acute leukemia, aplastic failed on immunotherapy, and the variety of refractory hematologic diseases in patients lacking a related donor. However, as compared to HLA identical sibing transplantation, UBMT carries higher incidence of graft failure, graft versus host disease(GVHD), and infection. In our center, 26 patients underwent UMBT between October 1995 and June 1997. The minimum follow-up of 3 months was possible in 20 patients, for whom early complications and clinical outcomes were assessed. The median age of the 20 patients was 24 years. 8 patients had standard risk disease and 12 patients had high risk disease. All patients received various preparative regimens including total body irradiation according to disease and disease status. 19 patients received CsA + short course MTX for GVHD prophylaxis. One patient received marrow that was depleted of T cells ex vivo using avidinbiotin column. The class I loci were typed by serological methods and HLA-A, HLA-B and HLA-DRB1. 3 additional pairs were one minor mismatched at the HLA-B locus. Another one patients was one major mismatched at the DRBI alleles. 17 patients were evaluable for engraftment. Successful enfraftment was confirmed in 16 patients(94.1%). Only one patient who was performed one major DRBI mismatched transplants experienced graft rejection. 16 patients were evaluable for acute GVHD. The overall incidence of acute GVHD developed in 4 patients(25%). Five patients were evaluable for the development of Ⅳ acute GVHD developed in 4 patients (25%). Five patients were evaluanle for the development of chronic GVHD. 2 patients(40%) developed limited chronic GVHD. Respiratory complications including pulmonary infection developed in 10 patients(50%) and these complications were the most common primary cause of death. Of these 10patients, 6 had pneumonia due to fungus(4 patients), pacterial (1 patient), and CMV infection (1 patient) and 4(20%) had idiopathic interstitial pneumonitis and/or adult respiratory distress syndrome. The duration of median follow- up was 8.5 months and 7 of 20 patients(35%) are alive at the time of this analysis with survival duration of 0.5 to 15 months(median survival duration: 4 months). The overall survival was 25% (3/12 patients) in high risk group and 50%(4/8 patients) in standard group. From these results, we can predict that the incidence and severity of GVHD in Korea are lesser than multiracial countries and the long-term survival of patients with standard risk disease can approach that of HLA matched sibling transplants. For the past two years, the performance of UBMT has been rapidly increasing and it will be possible to analyze much larger number of patients soon in Korea. In the future the problems of graft failure, GVHD, and infection due to long lasting immunocompromised status will need to be overcome by continued medical research. In addition, the volunteer donor pool will have to be expanded by the promotion of the national awareness of its need.

양질의 수돗물 공급방안에 관한 연구

한성욱,김동일,문성덕 경운대학교 산업기술연구소 1999 産業技術硏究論文誌 Vol.2 No.1

The drinking water system has enabled us to provide a requested amount of water by a single water pipe wherever and whenever necessary, and it brings a lot of benefits to the people as well as the community concerned. The drinking water system is managed in principle, by water charge as the price of benefits brought by the system. The benefits are quite different according to the purpose of water use. Therefore, if the drinking water system can not bring various kinds of benefits to the people and community at the same time, its significance as a social infrastructure may be diminished.

혀의 위치가 경추부 근육의 근활성도에 미치는 영향

한동욱 신라대학교 자연과학연구소 2012 自然科學論文集 Vol.22 No.-

Objectives : This study researched the effect of tongue position on the muscle activation by analyzing uscle activation of muscle surrounding the cervical spine. Materials & Methods : The 20 subjects of this experiment were university students in age 20s, who had no cervical deformities or muscle problems. We selected three kinds of muscles; the upper trapezius, splenius capitis and sternoclaidomattoid, and measured the muscle activation of the muscles around cervical spine. Tongue positions were seven; neutral, anterior protrusion, posterior retrusion, superior and inferior protrusion, left and right side protrusion. Measurement device was surface EMG(LXM-3204, Korea). The value of RMS(root mean square) was used for analysis of muscle activation. Results : Even if the muscle activations of all muscles increased according to tongue positions, only the muscle activation of upper trapezius increased significantly by posterior retrusion of tongue. Others didn't show the change of muscle activation significantly. Conclusion : In view of these results, However, we knew that we have to study more to find the possibility of change of muscle activation according to tongue position because of increase tendency of muscle activation.

콘크리트 비파괴강도 추정을 위한 인발시험법에 대한 연구

한만엽,김동욱 강원대학교 부설 석재복합신소재 제품연구센터 2000 석재연 논문집 Vol.5 No.-

본 연구의 취지는 좀더 정확한 비파괴검사법에 대해 고찰해본 결과 외국에서는 널리 사용되고 있으나 아직 우리나라에서는 거의 사용되고 있지 않은 인발법에 대해서 살펴보았다. 우리나라에서는 반발경도법이나 초음파법이 많이 사용되는데 이러한 방법들ㄹ은 사용자에 따라 그 값이 많이 차이가 나서 신뢰송이 떨어지는 것이 사실이다. 본 실험에서는 같은 시험체에다 인발법, 반발경도법, 초음파법을 적용하여 압축강도와의 상관성을 조사하였는데 그 결과 인발법과 반발경도법이 모두 압축강도와 상관성이 높은 것으로 나타났고, 초음파법은 상관성이 상당히 떨어지는 것으로 나타났다. 그러나 인발법은 반발경도법과 달리 연구자들간의 오차가 거의 없어 반발경도법과 달리 신뢰성있는 압축가동의 추정이 가능한 것으로 판명되었다. 아직 인발법에 과한 연구가 우리나라에서는 미진하나 금번 실험을 시초로 인발법이 우리나라에 많이 보급되어서 신설구조물이나 기존구조물의 비파괴강도 추정에 많은 도움이 되기를 기대한다. Pullout test known as Lok test among the nondestructive test methods to evaluate concrete strength is used to decide the form removal time by assessing the early strength of concrete in a new construction, or to control the quality of newly placed concrete. This method has inconvenience to place inserts on the form work in advance, however, the placing work is quite simple and it has advantage that the strength can be measured at field as long as the inserts are placed. In this study, the first step is to investigate the properties of test method itself, by performing the laboratory test which covers deviation of the method and properties of test method itself, by performing the laboratory test which covers deviation of the method and factors affecting the results, etc. The second step is to correlate the results with cylinder strength and other NDT methods such as rebound hammer, ultrasonic method, etc. And that, the results are compared with foreign results to find the differences between the two. In this research, new factors such as moisture content, area of aggregate failure cross section and area of aggregate separation cross section as well as water-cement ratio and age are investigated.

Biwa 호수중 용존유기물질의 변화에 관한 연구

한성욱,김동일,김용환 경운대학교 산업기술연구소 1999 産業技術硏究論文誌 Vol.1 No.1(B)

Dissolved Organic Materials in Lake Biwa and its four inflowing rivers were fractionated using three resin adsorbents into six classes : divided by hydrophobic and hydrophilic from each acids, bases and neutrals. The variation of dissolved organic materials was investigated with distribution of fractionated and UV_260nm absorbance. Hydrophobic acids and hydrophilic acids were found to dominate both lake and rivers. In the lake water, hydrophilic acids were greater than hydrophobic acids, and in the river waters, the opposite was observed.

니트섬유강화 복합재료의 기계적 성질에 관한 연구

한길영,이동기,최병기,오환교,신용욱,전수영 조선대학교 에너지.자원신기술연구소 1999 에너지·자원신기술연구소 논문지 Vol.21 No.2

Using conventional textile techniques such as weaving, braiding, knitting and stitching it is possible to produce a wide range two and three dimensional fiber preforms. However, so far only a limited attention has been given to knitted fabrics in composite industry. This is mainly due to the opinion that knitted fabric reinforced composites posses low mechanical properties owing to their looped fiber architecture. But it is possible to obtain desired mechanical properties by selecting proper knitted fabric structure. In this paper, tensile failure load and displacement of one yarn, four yarns and knitted fabrics of ten yarns of kevlar fiber were determined experimentally in the unidirection. Mechanical properties of plain weft knitted fabrics reinforced composite intrusion beam for car side door application were investigated experimentally, which compared with desire value of American Fedral Motor vehicles Safety Standard (FMVSS) and presented the results.

수리계획기법을 이용한 효율적 물배분 시스템모델 : 서남부지역을 중심으로

한동욱,서종석 전남대학교 농업과학기술연구소 2000 農業科學技術硏究 Vol.35 No.-

In this study, mathematical programming was applied to solve for optimal water allocation in the south-western part of Korea, where water supply and demand are unbalanced. The water allocation system was developed to meet water balance in the region through water transfer between the Keum and the Young-San Rivers. The result of the study shows that water transfer may satisfy various water demands in the region until the year 2011 without building reservoirs.

악성 위궤양의 형태를 보인 원발성 위결핵 1예

한종대,이동욱,심성준,류운석,안현택,박찬욱,김배영,이미선 大韓消化器內視鏡學會 1999 Clinical Endoscopy Vol.19 No.부록2

경북 지역의 지하수 수질에 관한 연구 4 : 암반 종류에 따른 지하수 수질 특성 The Characterisrics of Groundwater by Rock Types

한성욱,이동섭,김복조 경운대학교 산업기술연구소 2002 産業技術硏究論文誌 Vol.5 No.1(B)

We investigated the contamination of groundwater in Gyeongbuk region about 180 points by rock types. From the view point of rock types, the obtained results were as follows; The mean depth of rock types were decreased as follows sedimentary > gneiss > granite > granodiorite. In case of pH, the difference of value was small. While, the concentration of COD showed that it's concentration was increased as the mean depth was increased. In the region of granite, sedimentary and gneiss, the value of nitrate nitrogen was 3.5mg/l, 3.3mg/l and 1.7mg/l, respectively. In case of chloride ion, the concentration was highest for granite as 30.5mg/l and was medium for sedimentary and gneiss as 29.8mg/l and 26.9mg/l, respectively. while granodiorite was lowest as 8.97mg/l. The EC values were as follows; In the region of granite, sedimentary, gneiss and granodiorite, the value of EC was 444mg/l, 430mg/l, 390mg/l and 242mg/l, respectively.

주문진지역의 환경실태에 관한 주민의견 조사

한동준,김병욱 도립 강원전문대학 1998 道立 江原專門大學 論文集 Vol.1 No.1

The purpose of this research is to survey residents' mind on environment and environmental aspects of community in Chumunjin-Up, Kangnung city. In its degree of environmental pollutions, it seems that there are pollutions in river, ocean, fetal smell, and treatments of waste. The source of pollution in Shinri river stems from the influx of waste water out of processing industry of fisheries, and the one from livestock industry from the upper side of the river. In the case of pollution in ocean, the source of it proved to be the polluted waste oil and water from ships and processing industries of fisheries. It is estimated that conservation of environment takes the priority to the development of the region. However, the personal response shows rather an egocentric tendency. The responses show us that the biggest responsibility in pollution should be on firms comprising small businesses, and community people also cannot be free from the blame. In contributions to the solution of environmental problems, the unions of environment movement are highly evaluated. In addition to this, we have learned that lots of contributions from educational institutions and experts on environment should be made as well. Through this surrey, we recognized that much investment, education, information and enlightment concerning the conservation of environment are mostly needed to solve the issues involved.