An Evaluation of Platelet Transfusion Response Using HLA Crossmatch-compatible Donors in Patients with Platelet Refractoriness

Background : Majority of immune-mediated platelet refractoriness is caused by HLA alloimmunization and can be effectively managed by HLA-matched platelet transfusions. However, HLA class I-typed large-sized donor registry has not been well established in Korea. We evaluated the effectiveness of platelet transfusion using HLA crossmatch-compatible donors without HLA typing. Methods : Sixteen patients showing platelet refractoriness to random donor platelets (1 hr corrected count increment [CCI] 60%) were crossmatched with 78 platelet apheresis-eligible donors using National Institute of Health (NIH) and anti-human globulin (AHG) lymphocytotoxicity methods. NIH negative/AHG negative and NIH negative/AHG positive donors were selected as best and second choice donors, respectively. Results : Eleven patients (11/16, 69%) could find NIH-crossmatch negative donors and 27 donors (27/78, 35%) belonged to the best donors. To 8 patients, 32 apheresis platelet products from 19 donors were transfused. The mean 1 hr and 24 hr CCI values from the best donors were significantly higher than those from random donors (17,893 vs 2,358, P=0.003; 8,292 vs -614, P<0.001), whereas such differences were not observed for those from the second choice donors. Platelet storage time was inversely correlated with CCI values and platelets stored :! 10 hr after collection gave significantly higher CCI values. Neither ABO match nor donor status (related vs; unrelated) affected the transfusion effectiveness. Conclusions : Effective post-transfusion platelet increment using HLA crossmatch-compatible donors was attained in patients with platelet refractoriness due to HLA antibodies, and this method can be used effectively where HLA-typed platelet donor registry is not available. 배경 : 면역학적 원인의 혈소판불응증의 대부분은 HLA 동종 면역반응에 의해 야기되며, HLA 적합 혈소판 수혈로 효과적인 혈소판 증가를 기대할 수 있다. HLA 적합 혈소판 공급을 위해서는 HLA class I 항원형별검사가 되어 있는 대규모의 헌혈자 등록제도가 필요하지만 국내에서는 이런 제도가 잘 확립되어 있지 않다. 본 연구에서는 HLA 항원형별검사를 하지 않고 HLA 교차시험 적합한 헌혈자로부터의 혈소판 수혈효과를 평가하고자 하였다. 방법 : 임의헌혈 혈소판에 대해 혈소판불응증(1시간 corrected count increment [CCI] 60%)을 보인 16명의 환자에 대해 혈소판 성분채집이 가능한 78명의 헌혈자와 세포독성검사법을 이용한 T세포 교차시험(National Institute of Health법 및 anti-human globulin법, NIH법 및 AHG법)을 시행하였다. NIH법 음성/AHG법 음성인 경우 최선의 헌혈자로, NIH법 음성/AHG법 양성인 경우 차선의 헌혈자로 선정하였다. 결과 : 11명의 환자(11/16, 69%)가 NIH 교차시험 음성인 헌혈자를 찾을 수 있었고, 27명의 헌혈자(27/78, 35%)가 최선의 헌혈자에 해당하였다. HLA 적합헌혈자를 찾을 수 있었던 환자 중 8명에게 19명의 헌혈자로부터 총 32회의 혈소판 성분채집을 시행하여 수혈하였다. 최선의 헌혈자군에서는 임의헌혈 혈소판 수혈에 비해 수혈 후 1시간 및 24시간 CCI 가 유의하게 증가하였으나(17,893 vs 2,358, P =0.003; 8,292 vs -614, P<0.001), 차선의 헌혈자군에서는 이러한 차이가 관찰되지 않았다. 혈소판 보관시간과 CCI 값은 역상관관계를 보여 채집 후 10시간 이내의 혈소판을 수혈 시 1시간 및 24시간 CCI가 유의하게 높은 값을 보였다. ABO 일치 여부와 환자와 헌혈자의 혈연/비혈연 관계 여부는 혈소판 수혈효과에 별다른 영향을 보이지 않았다. 결론 : HLA 동종면역에 의한 혈소판불응증 환자에서 HLA 교차시험 적합 헌혈자로부터 수혈 시 효과적인 혈소판 수의 증가를 보였다. 이 방법은 HLA 적합 혈소판 헌혈자 등록제도가 수립되어 있지 않은 경우에 효과적으로 이용될 수 있다.Hod E, 2008, BRIT J HAEMATOL, V142, P348, DOI 10.1111/j.1365-2141.2008.07189.xPetz LD, 2000, TRANSFUSION, V40, P1446Kiefel V, 2001, TRANSFUSION, V41, P766WU KK, 1977, TRANSFUSION, V17, P638HERZIG RH, 1977, TRANSFUSION, V17, P657KLINGEMANN HG, 1987, BRIT J HAEMATOL, V66, P115HEAL JM, 1987, BLOOD, V70, P23BOLGIANO DC, 1989, TRANSFUSION, V29, P306MOROFF G, 1992, TRANSFUSION, V32, P6331997, N ENGL J MED, V337, P1861Legler TJ, 1997, ANN HEMATOL, V74, P185Sacher RA, 2003, ARCH PATHOL LAB MED, V127, P409MCFARLAND JG, 2003, APHERESIS PRINCIPLES, P199Datema G, 2000, VOX SANG, V79, P108PARK MH, 1999, KOREAN J BLOOD TRANS, V10, P203Davis KB, 1999, TRANSFUSION, V39, P586PARK HD, 2004, KOREAN J LAB MED, V24, P426Vassallo RR, 2007, CURR OPIN HEMATOL, V14, P655

Electrodiagnostic Study of bulbocavernosus reflex

의학과/석사[영문] [한글] 배뇨 중추(micturition center)와 발기에 관련되는 성 반사(sexual reflex) 중추는 모 두 제2-4 천수에 위치하기 때문에 배뇨 장애나 성기능 장애환자에 있어서 구해면체반사(b ulbocavernosus reflex)의 검사는 임상적으로 매우 중요하다. 그러나 임상절인 검사만으로는 반응의 유무만을 알 수 있으며 반응이 확실하지 않은 경 우도 있고 간혹 가음성(false negative)반응을 보이기도 하며 부분적인 신경손상이 있는 경우에는 그 정도를 측정할 수가 없어 정확한 평가가 어려웠다. 본 연구에서는 전기진단학적 방법을 이용하여 구해면체반사의 잠복시간을 측정함으로써 그 진단적 가치 및 임상적 기여도를 알아보고자 하였다. 1984년 6월부터 1986년 1월까지 연세대학교 의과대학부속 세브란스병원 재활의학과 근 전도 검사실에서 정상 성인 13명을 대상으로 구해면체반사의 잠복시간을 측정하여 그 표 준치를 구하고 성기능 장애자와 척수손상 환자 119명을 대상으로 구해면체반사의 잠복시 간을 측정하여 다음과 같은 결과를 얻었다. 1. 정상 성인의 구해면체반사의 잠복시간 표준치는 33.9±3.04msec이었으며 (정상 범위 27.9-40.Omsec) 좌우측의 잠복시간 사이에는 통계학적으로 유의한 차이가 없었다(p>0.05 ). 2 .기능적인 성기능 장애자와 천수 상부의 척수손상 환자에서는 잠복시간의 평균치가 각각 34.6±3.45msec와 34.6±3.44msec로정상인의 표준치와 유의한 차이가 없었다(p>7.05 ). 3. 성기능 장애를 호소한 당뇨병 환자의 46.2%에서 잠복시간이 비정상으로 나타났으며 이들에서는 당뇨병성 신경병변이 성기능장애의 주원인이라고 생각할 수 있었고, 잠복시간 의 평균치(41.1±7.20msec)는 표준치와 유의한 차이가 있었다(P<0.01). 4 .성기능 장애를 호소한 골반 및 회음부손상 환자의 36.0%에서 잠복시간이 비정상치를 보였으며 말초신경에 손상이 있음을 진단할 수 있었다. 5. 척수원추 및 마미손상 환자에서는 전기진단학적인 검사방법으로 성기능 장애와 신경 인성 방관의 유형을 구분하거나 손상의 정도를 측정하는 데에 도움을 줄 수 있었다. Electrodiagnostic Study of Bulbocavernosus Reflex Myoung Hee Park Department of Medical Science The Graduate School, Yonsei University (Directed by Assistant Prof. Chang Il Park, M.D.) Clinical evaluation of the bulbocavernosus reflex is very Important in patients with voiding difficulty and sexual dysfunction because the physiologic micturition center is located in the S2-S4 spinal cord level which is also associated with the mechanism of sexual reflex, especially of erection. However, accurate assessment was difftcult because: (1) with clinical examination alone, only the presence of reaction could be assessed (2) reaction may not be definite (3) often false negative reaotions appeared, and (4) degree of injury could not be assessed in cases with partial nerve inJury. The obtectives of this study were to demonstrate the diagnostic value and the clinical usefulness of the electrodiagnostlc test in measurement of latency time of the bulbocavernosus reflex. Thirteen normal adult males served as controls for this study. 119 pations with sexual dysfunction and spinal cord injury who were referred to the EMG laboratory of Rehabilitation Medicine Department, Severance Hospital, Yonsei University, were studied from June 1984 to January 1986. The results are as follows : 1. The latency time of the bulbocavernosus reflex in normal subjects was 33.9±3.04 msec (normal range : 27.9-40.0 msec) and there was no significant difference between right and left sides(P>0.05). 2. The mean bulbocavernosus reflex latency time in cases of functional sexual dysfunction and suprasacral spinal cord injury was not significantly different compared with normal mean values(P<0.01). 3. 46.2% of diabetic patients with sexual dysfunction skowed abnormailty in latency time and the main cause of sexual dysfunction in thls group might be due to diabetic neuropathy. The mean in latency time of the diabetic group showed a significant difference(P<0.01). 4. 36.0% of patients with pelvic and perineal area injury and sexual dysfunction showed an abnormality in latency time and could be diagnosed to have peripheral nerve injury. 5. Electrodliagnostic study in the patients with conus medullaris and/or cauda eaulna lesion was useful in classifying the types of sexual dysfunction and neurogenic bladder and the degree of injury.restrictio

Effect of Retinly Palmitate on the Hepatic Fibrosis Induced by Prolonged Administration of Carbon Terachloride

의학과/박사[한글] 간소엽의 섬유화에 있어서 교원섬유의 세포학적 기원으로는 Ito세포와 간세포가 거론되고 있다. 그 중 Ito세포는 간장내 비타민 A의 저장과 교원섬유합성 등 적어도 2가지의 기능을 가지고 있다고 생각하고 있다. 그러므로 실험동물에 비타민 A를 투여하면 Ito세포의 양면기능 중교원섬유 합성 기능이 억제될 가능성이 있다. 따라서 주로 간소엽 손상을 초래하는 사염화탄소를 반복 투여하여 간소엽 섬유화를 일으키고, 비타민 A의 병행투여가 이에 미치는 영향을 구명하고자 본 연구를 시행하였다. 실험에는 숫컷 흰쥐 200마리를 대조군(정상대조군 및 salad oil단독투여군), 비타민 A 단독투여군, 사염화탄소단독투여군, 사염화탄소와 비타민 A 병행투여군으로 나누어 사용하였다. 사염화탄소를 장기간 반복투여하기 위하여 예비실험으로부터 첫회 투여량을 정하고, 그후부터는 매일 동물의 체중을 측정하면서 투여량을 증감하여 1주마다 한번씩 1∼15회 경구투여하였다. 비타민 A투여군에는 retinyl palmitate 5×10**4 IU/rat를 사염화탄소 첫회 투여 1주일 전부터 4주간격으로 피하주사하였다. 사염화탄소에 의한 간 손상을 촉진시키기 위하여 사염화탄소 첫회 투여 3일전부터 3회에 걸쳐 15mg/day의 sodium phenobarbital을 복강내 주사하였다. 대조군과비타민 A 단독투여군은 매 4주마다, 사염화탄소단독 및 비타민 A 병행투여군은 매 2주마다 5마리씩 도살하여 혈청 GPT, 간장의 무게, 간조직내 자가형광세포의 수, 급성 간 손상정도, 간섬유화과정 및 정도, 간세포 및 Ito세포 내외의 미세구조변화를 관찰한 바 다음과 같은 결과를 얻었다. 1. 사염화탄소 단독 및 비타민 A 병행투여는 혈청 GPT치를 상승시키고 간무게를 증가시키며, 이는 비타민 A 병행투여시에 더 심하였고 사염화탄소 단독 투여군에서는 단기간 투여한 경우에만 뚜렷하였다. 2. 사염화탄소 단독 및 비타민 A 병행투여는 간소엽내, 주로 말단간세정맥주변에 자가형광세포수를 현저하게 증가시켰으며, 이는 특히 비타민 A 병행투여군에서 더 심하였다. 3. 사염화탄소 단독 및 비타민 A 병행투여는 간세포 종창, 초점괴사, 말단간세정맥주변괴사등의 급성 간소엽변화를 초래하였으며, 이러한 변화들은 사염화탄소 단독투여보다 비타민 A 병행투여시 좀더 심하고 늦게까지 관찰되었다. 4. 사염화탄소 단독 및 비타민 A 병행투여는 말단간세정맥주변에서부터 시작하여 인접 말단간세정맥 및 문맥역과 연결되는 일련의 섬유화률 초래하며, 이러한 섬유화는 사염화탄소 단독투여시에 보다 심하고 빨리 진행되었다. 5. 사염화탄소를 단독 또는 비타민 A화 병행하여 5회이상 투여한 경우에는 간세포내에서 교원섬유가 발견되었으며, 이러한 소견은 사염화탄소 단독투여시에 더 자주 관찰되었다. 또한 사염화탄소 단독 투여는 Ito세포로부터 이행형 Ito세포로의 변형을 촉진하였다. 이상의 결과를 종합하면 사염화탄소 반복 투여는 간실질의 손상을 거쳐 일련의 섬유화를 유발하는데 이러한 섬유조직은 이행형 Ito세포와 간세포에서 합성되며, 비타민 A 병행투여는 사염화탄소 단독 투여에 의한 급성 간손상을 증가시키는 반면 이행형 Ito세포로의 변형율 억제하여 사염화탄소에 의한 섬유조직합성을 지연 또는 감소시키는 것으로 사료된다. [영문] The cellular origin of hepatic intralobular fibrosis is not completely known. Although there are reports indicating that hepatocyte itself synthesizes collagen fibers, it is widely accepted that Ito cell Participates in collagen formation. It? cells contain most of hepatic vitamin A in their abundant lipid droplets, and recent studies have suggested that the administration of vitamin A mar allow Ito cells to devote themselves in storing the vitamin A, which in turn inhibits transformation of the Ito cells to collagen forming cells. The present study is undertaken to determine the effect of vitamin A on the development of fibrosis induced by repeated administration of CCI^^4 Two hundred male albino rats, weighing about 190 gm, were divided into control groups(normal and given salad oil alone) and experimental groups(treated with vitamin A, CCI^^4,arid CCI^^4 plus vitamin A), The maximal nonlethal dose of CCI^^4 was determined in a preliminary experiment. The initial oral dope of CCI^^4 administration was followed by 2 to 15 subsequent weekly dosers of CCI^^4 which were modified according to the changes in body weights. Retinyl palmitate(5×10**4 IU/rat) was administered subcutaneously once every 4 weeks to the experimental animals to be given vitamin A. Beginning 3 days prior to the initial dose of CCI^^4, rats were given sodium phenobarbital(15 mg/rat/day) by intraperitoneal injection for induction of the microsomal enzyme and to facilitate the CCI^^4 induced liver injury. Five animals were killed every 4 weeks for the control and vitamin A alone groups, and every 2 weeks for the CCI^^4 alone and CCI^^4 plus vitamin A groups. The changes of serum GPT activity, liver weights, and the numbers of autofluorescent cells within hepatic lobule were determined. Also, the microscopical changes of acute liver injury and hepatic fibrosis, and the ultrastructural changes in and about the liver parenchymal and Ito cells were determined. The results were summarized as follows : 1. Administrations of CCI^^4 plus vitamin A Produced increases of serum GPT levels and relative liver weights throughout the experiment. These increases were also induced by administering CCI^^4 alone, but were distinct only following the first few administrations. 2. Repeated Administrations of CCI^^4 alone or in combination with vitamin A led to a marked increase in the numbers of hepatic autofluorescent cells, moat of which were found in perivenular areas. The increase was more severe in animals given the combination of CCI^^4 and vitamin A, particularly in the lest half of the experimental duration. 3. Administration of CCI^^4 alone or in combination with vitamin A led to acute changes of the liver, such as liver cell swelling, focal hepatocytolysis and perivenular necrosis. These changes were more or less severe and long-tasting in the animals given CCI^^4 plus vitamin A. 4. Administration of CCI^^4 alone or in combination with vitamin A gave rise to hepatic fibrosis. The fibrosis began initially around THV, gradually extending to join with the nearby perivenular fibrosis and then with portal tracts, and eventually to form complete septa. This progression of hepatic fibrosis appeared t? be more rapid and severe in animals treated with CCI^^4 alone. 5. In animals treated 5 times or more with CCI^^4, there were several hepatocytes containing collagen fibers within their cytoplasm. These hepatocellular collagen seemed less frequent in animals given CCI^^4 plus vitamin A. Transformed Ito cells were also more frequent in animals treated with CCI^^4 alone than those treated with CCI^^4 pius vitamin A. In conclusion, repeated administrations of CCI^^4 cause an acute liver injury, which is followed by consecutive collagenous fibrosis Within the hepatic lobules, and the transformed Ito cello as well as the liver calls are considered to be responsible for the collagen formation. Treatment with vitamin A aggrevates the CCI^^4 induced acute liter injury and yet, inhibits or delays the progression of hepatic fibrosis by interfering the transformation of Ito cells to collagen producing cells.restrictio

고환종양의 임상 및 병리조직학적 연구

의학과/석사[영문] [한글] 고환종양은 희귀하지만 비교적 젊은 연령에 호발하고 다양한 조직학적 양상과 임상적 특징을 나타내며, 대부분은 악성종양이다. 우리나라에서는 고환종양에 대한 연구가 비교 적 적으므로 본 연구를 시작하였다. 연구재료 및 방법 연구재료로는 1959년 7월 1일부터 1979년 6월 30일까지 20년간 연세대학교와 이화여자 대학교 의과대학, 1968년 7월 1일부터 1979년 6월 30일까지 11년간 고려병원 및 1974년 7 월 1일부터 1979년 6월 30일까지 5년간 백병원에서 검색된 총 68예의 고환종양을 대상으 로 하였다. 임상기록을 참고할 수 있었던 34예에 대해서는 기록을 조사분석 하였으며 병 리조직학적 검색은 10%중성 포르말린에 고정한 후 파라핀에 포매하고 6μ의 두께로 세절 하여 hematoxylin-eosin염색후 현미경적 검색을 하였다. 연구결과 1. 조직학적 분류와 빈도에 있어서는 태생암이 17예(25%)로 가장 많았고 정상피종이 15 예, 기형종이 12예, 난황낭종, 혼합형 생식세포종양, 악성임파종이 각각 7예씩이었고 횡 문근육종이 2예, 생식선 아세포종이 1예였다. 조직학적 소견을 세분해 보면 정상피종 15예중 정상형이 13예, 역형성형이 2예였으며, 간질조직의 섬유화와 임파구 침윤정도는 중등도 이상이 각각 8예(54%) 및 9예(60%)였다. 간질세포 증식 유무를 관찰할 수 있었던 13예중 6예에서 간질세포 증식을 보였다. 2. 전체 고환종양의 평균연령은 22세였으며 정상피종이 35.6세, 태생암이 15.4세. 난황 낭종이 2.4세, 기형종이 12.7세, 악성임파종이 42.7세였고 연령별 빈도는 5세 이하와 20 ∼39세에서 높은 빈도를 보여주었다. 3. 주 임상증상은 동통을 수반하지 않은 음낭내 종괴촉지가 38%로 가장 많았고, 다음이 동통을 수반한 음낭내 종괴촉지, 복부 종괴촉지 등의 순서였으며 내원시 까지의 병력기 간은 6개월 미만이 36.4%로 가장 많았고 2년 이상의 긴 병력기간을 가진 경우도 21.2%나 되었다. 4. 고환종양의 발생부위를 보면 위치를 알 수 있었던 57예 중 음낭내가 50예로 88%였고 복부가 6예, 서해부가 1예였으며, 좌우 발생빈도는 같았다. 양측성으로 발생된 경우가 4 예였고 이중 2예에서는 양측이 각각 다른 조직학적 양상을 보여주었다. 5. 치료방법을 알 수 있었던 33예 중 고환절제술만 시행한 경우가 24예(73%)로 가장 많 았다. Clinico-Pathological Studies on Testicular tumors among Koreans Hyoung Hee Park Department of Medical Science, The Graduate School, Yonsei University (Directed by Yoo Bock Lee, M.D., D.M.Sc.) Tumor of the testis comprises only a small percentage of all human malignancy, but they unfortunately strike with greatest frequency young and productive men. No other organ, except the ovary, manifests the broad spectrum of clinical behavior or the wide structural range of neoplasia as that encountered in the testis. There has been very little comprehensive study on testicular tumors among Koreans. The present study is, therefore, intended to establish a basic studies of testicular tumors among Koreans from clinical and pathological aspects. Materials and Method Sixty-eight cases of testicular tumors were examined in the Department of Pathology, Medial College, Yonsei University and Ewha Women's University from July 1, 1959 to June 30, 1979, Korean General Hospital from July 1, 1968 to June 30, 1979 and PAIK. Hospital from July 1, 1974 to June 30, 1979. All Specimen were surgically excised on the assumption that they were testicular neoplasms. The histologic observations were made on hematoxylin and eosin stained sections available for all cases. For 34 cases of the testicular tumor whose clinical records were available, age, sex, location, chief complatints and symptom duration were investigated. Result and Summary Based on clinical and histopathological studies of 68 cases of testicular tumor, following results were obtained. 1. Of 68 cases, seminoma was 15(22.1%) cases, embryonal carcinoma was 17(25%) cases, teratoma was 12(17%) cases, yolk sac tumor, combined type of germ cell tumor, and malignant lymphoma were 7(10.3%) cases, respectively, rhabdomyosarcoma was 2 cases and gonadoblastoma was 1 case. Among 15 cases of seminoma, 13 were classical seminoma and 2 were anaplastic seminoma. Of 12 cases of teratoma, 9 were mature teratoma and 3 were immature teratoma. 2. The most frequent chief complaint was palpable scrotal mass without pain which were present in 13 cases out of 34 cases whose clinical records were available. In 35% of these 34 cases symptoms were present for less than 6 months, and in 21% symptoms were present for over 2 years. 3. The tumor incidence was equal for each testis. Among 57 cases whose records were available, 4 cases had bilateral lesions and 6 cases occured in undescended testes. 4. The mean age of total 68 testicular tumors was 22 years, and 35.6 years in seminoma, 15.4 years in embryonal carcinoma, 2.4 years in yolk sac tumor, 12.7 years in teratoma, and 42.7 years in malignant lymphoma. The most frequent age group was the first decade. 5. among 33 cases whose records were available, 24 cases(73%) received orchidectomy only.restrictio

(The) analysis has concluded that the 5-day stop smoking program has favorably influenced adolescents to quit smoking

역학 및 건강증진학과/석사[한글] 본 연구는 청소년 5일금연프로그램 실시 6개월 후의 금연율과 금연 실패요인을 분석하여 향후 청소년 금연프로그램의 방향을 제시하고자 실시하였다. 2002년 3월부터 12월까지 서울위생병원부설 5일금연학교에서 교육을 받은 고등학생을 대상으로, 2003년 6월 각 학교를 방문하여 94명에게 설문을 받았다. 수집된 자료분석은 SAS 통계프로그램을 이용하였다. 일반적 특성은 실수와 백분율로, 금연 성공자와 실패자의 특성 비교는 t-test와 X2-test 그리고 ANOVA분석으로, 대상자의 특성과 금연기간의 비교는 life-test를 이용한 Log-Rank 방법으로, 금연 실패에 가장 큰 영향을 미치는 요인 분석은 Cox''s 비례위험 회귀분석을 이용하였다. 본 연구의 결과는 다음과 같다. 1) 청소년 금연프로그램 실시 6개월 후의 금연 성공률은 55.32%이었다. 금연 성공자의 65%가 금연프로그램의 영향을 받은 것으로 조사되었고, 가장 도움이 되었던 프로그램은 금연영화와 의료강의였다. 2) 금연 성공자의 특성을 살펴보면 남학생의 43.86%, 여학생의 72.97%가 금연에 성공하고 있었다. 금연 성공자에게 있어서 금연을 유지하기 힘들었던 이유는 스트레스 받을 때(38.46%)와 습관성(36.54%)때문이라고 하였으나, 건강에 대한 생각(44.23%)과 강한 의지(32.69%)로 금연을 유지할 수 있었다고 했다. 금연을 하면서 좋아진 것은 용돈이 절약(34.62%) 되고 운동 시 숨이 차지 않는 것(23.08%)이었다. 3) 금연 실패자의 특성은 초·중학교 때 첫 흡연을 시작한 학생의 51.23%가 금연에 실패하고 있었다. 금연에 실패한 이유는 담배에 대한 습관성(50.00%)과 의지부족(16.67%) 때문이었고, 실패자의 95.24%가 앞으로 금연 할 계획을 갖고 있었다. 4) 금연 실패에 영향을 미치는 요인을 종합 분석해 본 결과, 가장 유의하게 나온 변수는 첫 흡연 시작시기였다. 초·중학교 때 흡연을 시작한 경우에 비해 고등학교 때 흡연을 시작한 경우 금연에 실패할 확률이 0.13배로 나타났다. 이상의 연구결과를 종합해 보면, 금연 성공자의 65%가 금연프로그램의 영향을 받은 것을 볼 때, 청소년 금연프로그램은 확실한 효과가 있었다. 그러나 청소년 금연 실패에 가장 영향을 미치는 요인이 첫 흡연 시작시기인 것을 감안한다면, 유치원생과 초등학생 대상으로 흡연예방 프로그램을 개발하여 실시한다면 더욱 큰 효과가 있을 것이다. [영문]This study was performed on adolescents 6 months after completing the stop smoking program. The purpose of this study was to investigate the percentage who had stopped and other factors that influenced them. All 94 students were selected for this study. The whole population was investigated by questionnaire. The data analysis is used for SAS statistics program with X2-test, T-test, ANOVA, life test and Cox''s proportional hazard regression analysis. The results are as follows: 1) The stop smoking rate was 55.32% after completing the stop smoking program. 68% of them were influenced by the stop smoking program. The participants especially enjoyed stop smoking movies and medical lectures. 2) 43.86% of male students and 72.97% of female students succeeded in breaking the habit of smoking. The main reason for their overcoming the smoking habit was that they possessed strong will-power and they strongly desired good health. As they stopped smoking, they were able to save their pocket money and comfortably breathe. 3) The main reason some participants failed was lack of will-power. Most of them started smoking in elementary school or middle school. 51.3% of them failed because of their addiction to tobacco and their lack of will-power to stop. But 95.24% of them have a plan to quit smoking in the future. 4) Their first smoking experience was found to have a very significant influence on the possibility of success in stopping the habit quit smoking. Adolescents who started in elementary or middle school were less likely to successfully stop smoking than those who started in high school. In conclusion, all the study revealed that a long effective period of smoking cessation can''t be generalized. Because the students in this study were chosen with some limitations. But the rate of the successful overcomers is relatively high with 55.32%. Therefore we surely must develop the most effective smoking cessation programs possible. It is very important to teach kindergarten and elementary school students to avoid tobacco because of its bad effects on health.ope

Studies on the Distribution of HLA Antigens in Normal Koreans

The distribution pattcrn of HLA-A,B,C antigens was investigated in 105 normal healthy unrelated Korean adults. The HLA-A, B, C typing was carried out by the standard NIH technique , using trays obtained from UCLA Tissue Typing Laboratory. Gene frequencies were estimated from antigen frequencies using the formula GF=I 、I f-二AI' and haplotype frequencies and gametic associations between HLAAlB and HLA-B/C loci were calculated according to Mattiuz et a1 The data were analyzed and summarized as follows l. In normal Korean population, most frequent antigens for the HLA-A locus were A2 51. 4%, Aw24 49.5% , Aw33 23.8% and All 15.2% and for the HLA-B locus Bw51 22.9%, Bw62 21. 0%, Bw44 18.1%, Bw61 13.3% and Bw54 13.3% and for the HLA-C locus Cw3 49.5%, Cwl 37.1% and Cw4 I I. 4% in decreasing order of frequency. Antigens of very low frequeneies C1%~2%) were AI. Aw23, A29, Aw34, B8, B37, Bw38 and Bw63. HLA-A25, A28, Aw32, BI4, BI8, Bw41, Bw42, Bw45, Bw46, Bw47, Bw49, Bw50, Bw53. Bw56 and Bw57 antigens were absent. Blank gene frequencies were rather low; HLA-A locus 1. 7%, HLA-B locus 5.3%, HLC-C locus 42.8%. 2. These HLA antigen frequencies of the Korean population were quite similar to the Japanese population, but in the Korean population, frequeneies of A3, Aw30, Aw33, BI3, B27 and Bw 58 were higher and those of A26 and Bw52 were lower compared to the Japanese population. 3. The common haplotypes(per 10,000) in the Korean population were A2 Bw5!(647) , Aw33 Bw44(616) , Bw54 Cw!(690) and Bw58 C、，3(589). Significant positive gametic associations were noted for eight haplotypes(p<O. 05); Aw24 Bw52, Aw31 Bw51, Aw33 Bw44, Aw33 Bw58, Bw54 Cwl, BX Cwl, Bw58 Cw3 and Bw62 Cw4. 4. Although some differences were noted , the haplotype frequencies and the patterns of gametic associations in the Korean population were more or less similar to those of the Japanese population. Further studies are needed to confirm the genetic similarities and differences for the HLA antigen system between these two ethnic population

Blood coagulation studies in patients with cancer

A study of hemostatic abnormalities in 102 randomly selected cancer patients was undertaken t() evaluate the overall incidence and types of bemostatic derangements in these patients by 15 coagulation tests. The results are as follows: L Majority of the patients showed one or more abnormal coagulation tests and two thirds had four or more abnormal results. Most common abnormalities were hyperfibrinogenemia (62%) and prolonged serial thromhin time (61%) followed by elevated factor VIII (45%) and VII (38%) , elevated FDP (36%) and decreased antithrombin III (28%) levels in decreasing order of frequency. 2. Patients with distant metastases (53%) more frequently had elevated FDP level compared to those without distant metastases (8%). Patients with elevated FDP level showed much higher frequency of prolonged prothrombin time, positive protamine sulfate test and decreased antithrombin III level compared to those with normal FDP level. Majority of the patients with increased FDP level showed laboratory features of compensated or overcompensated intravascular coagulation and fibrinolysis. 3. Patients with hepatoma revealed marked abnormalities in coagulation tests, and compared to patients with other types of cancer these patients showed significantly high frequency of prolonged prothrombin time as well as decreased factor II, elevated FDP, prolonged thrombin time, thrombocytopenia and decreased antithrombin III in addition to markedly increased factor VIII level; these abnormaIities were considered to be manifestations of underlying liver cirrhosis. Hepatoma patients without underlying liver cirrhosis showed normal or elevated platelet count, fibrinogen and factor VII, whereas these were markedly decreased in two thirds of the control patients with liver cirrhosis. 4. Patients with stomach cancer had significantly shortened prothrombin time and activated partial thromboplastin time compared to normal controls. and these findings along with markedly elevated fibrinogen, factor VII and VIII suggested hypercoagulability of blood. However about 30% of the patients had abnormally shortened euglobulin lysis time, representing features of increased fibrinolysis

Changes in the E-rosette Formation and PHA Blastogenesis of Lymphocytes in Stored Blood.

Changes in the ability of lymphocytes in stored bank blood to form E-rosettes and to respond to PHA were studied together with change of other blood cell components at intervals during two to three weeks of storage at 4T in ACD-B and CPD plastic bags. The results were as follows. 1. There was no significant change in red blood cell count, hemoglobin and hematocrit during 21 days of storage. 2. Leucocyte count decreased to 90% of the initial value after 1 week and then there was no significan t decrease up to 3 weeks of storage. Viability of lymphocytes was maintained up to two weeks at 9096 level and that of neutrophil declined rapidly to 1/3 of the initial value after 1 week's storage. 3. Platelet count decreased rather slowly and 60% of the initial value "vas present after 3 weeks' storage. 4. E-rosette formation of lymphocytes was relatively well maintained during the first 3 days and decreased to 2/3 on day 4, and to less than 1/2 after 10-14 days' stroage. 5. Spontaneous and PHA stimulated lymphocyte blastogenesis decreased progressively during storage. but was not completely abolished after 14-17 days' storage

Association of HLA-A, B antigens with susceptibility to advanced endometriosis in Koreans

BACKGROUND: Endometriosis is defined as the presence of endometrial tissue outside the uterus, causing diverse diseases, including infertility, pelvic pain, dysmenorrhea, and constipation. While there is a growing body of evidence that genetic and immunologic factors play important roles in the pathogenesis of the disease, HLA-A, B antigens have been reported to be associated with the risk of endometriosis in the Japanese population. This study was performed to determine whether the susceptibility to advanced endometriosis is also associated with HLA-A, B antigens in the Korean population, which is the closest ethnic group to Japanese. METHODS: We recruited 50 Korean patients with advanced endometriosis confirmed by surgical and histolological examinations. Distribution of HLA-A and B antigens was compared with that of 200 unrelated ethnically matched individuals. HLA-A and B genotyping was carried out using a PCRsequence specific oligonucleotide hybridization method. RESULTS: An increased frequency of B39 was observed in endometriosis patients compared with control subjects, but the difference was not statistically significant after correcting for multiple comparisons (4.0% patients vs 0.8% controls, OR=5.5, 95% CI=1.21-25.04, P=0.03, P(c)=not significant). No significant differences were found between the patients with endometriosis and the general control group with regards to the distribution of other HLA-A and B antigens. CONCLUSIONS: The findings of the present study suggest that the susceptibility to advanced endometriosis, unlike in the Japanese population, is not associated with HLA-A, B antigens in the Korean population.인제대학교 학술연구조성비(2006) 보조에 의한 것임