기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험

최영민(Youngmin Choi),이형식(Hyung-Sik Lee),권혁찬(Hyuk-Chan Kwon),한상영(Sang-Young Han),최종철(Jong-Cheol Choi),정주섭(Ju-Seop Chung),김창원(Chang-Won Kim),김동원(Dong-Won Kim),강치덕(Chi-Duk Kang) 대한방사선종양학회 2008 Radiation Oncology Journal Vol.26 No.2

목 적: 기존치료에 반응하지 않는 다발성 간전이를 동반한 대장암 환자에서 방사선치료와 병합한 수지상세포 면역 치료의 독성과 반응도를 조사하였다. 대상 및 방법: 2004년 5월부터 2006년 11월까지 다발성 간전이가 동반된 대장암 환자들 중에서 항암화학 요법에 반응하지 않은 환자 중 지원자를 대상으로 연구를 시행하였다. 본 임상 시험에 대하여 동아대학교병원과 부산대학교병원의 임상윤리심의위원회의 허가를 획득하였고, 동의서에 서명한 환자들을 임상 시험의 대상으로 등록하였다. 환자의 말초 혈액으로부터 수지상세포를 추출하여 배양하였다. 임상시험 일자에 맞추어서 6×106개의 수지상세포를 바이알(0.5 ml)에 넣어서 디씨백/아이알 주사를 만들었다. 수지상세포 면역치료는 2주 간격으로 간전이암조직에 3회 주사하고, 5주에 내약성 평가를 하였다. 내약성 평가를 통과한 환자에게는 8주에 4번째 수지상세포 면 역치료를 하였다. 병의 악화가 없거나 임상시험에 대한 환자의 동의 철회가 없는 경우에는 5, 6번째 수지상세포면역치료를 각각 12, 16주에 시행하였다. 방사선치료는 수지상세포 면역치료를 주사할 간전이암 부위에 주사하기 전일 및 당일에 4 Gy씩을 조사하였다. 내약성 평가는 3×106개의 수지상세포로부터 시작하여, 12×106개의 수지상세포까지 시행하였다. 내약성 평가의 최대 내성 용량으로 추가 임상시험을 하였다. 수지상세포 면역치료 주사를 맞은 모든 환자들에서 안전성 평가를 하였다. 4회 이상 주사를 맞은 환자들을 대상으로 10주에 치료 반응을 평가하여 유효성을 조사하였다. 결 과: 임상시험에 등록한 24명 중 22명에서 수지상세포 면역치료를 시행하였다. 내성약 평가에는 14명이 등록하여 11명에서 평가를 완료하였다. 시험약과의 관련성이 있을 것으로 생각되는 grade 3 이상의 약물반응으로 인한 이상반응은 없었다. 12×106개의 수지상세포를 내성용량으로 확인하였고, 내성용량인 12×106개 수지상세포 면역치료를 이용하여 8명에서 추가로 시험을 하였다. 치료에 대한 환자들의 내성은 양호하였고, grade 3을 초과하는 치명적인 부작용은 발생되지 않았다. 4회 이상의 수지상세포 면역치료 주사를 받은 환자가 17명이었고, 이 중의15명에서는 종양의 반응도 평가가 이루어졌다. 본 연구의 목적은 안전성 평가이지만, 면역치료의 유효성 평가를 위해, 방사선치료와 수지상세포 면역치료 주사가 시행된 부위 외의 간전이암에서 반응도를 조사 하였다. 면역치료의 반응은 평가가 이루어진 환자들에서 정지성 병변이 4명, 진행성 병변이 11명 이었다. 결 론: 수지상세포 면역치료와 병행한 방사선치료는 이론적으로 국소 및 전신 제어에 상승효과가 있을 것으로 기대할 수 있다. 하지만 기존 치료에 반응하지 않는 매우 진행된 직장암 환자들을 대상으로 한 본 연구에서는 방사선 치료와 병합한 수지상세포 면역치료로 인한 심각한 부작용의 발생은 없었다는 결과와 4예에서의 정지성 병변의 관찰을 보고한다. 수지상세포의 최대 투여 용량, 적절한 투여 방법, 적절한 방사선의 양, 방사선과 수지상 세포의적절한 투여 간격 등에 관한 추가 연구를 통하여, 향후 제 2상, 3상 시험으로서의 진행 여부에 긍정적인 결과를얻을 수 있다고 판단한다. Purpose: To assess the toxicity and tumor response induced by DCVac/IRⓇ dendritic cell (DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of 6×106 DCs were packed into a vial (DCVac/IRⓇ, 0.5 ml) at the convenience of each patient’s schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses (3×106 to 12×106 DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The 12×106 DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The DCVac/IRⓇ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials

Cyclosporine과 Ketoconazole의 약물상호작용을 이용한 아토피 피부염 치험 2예

김동원,표형찬,은희철,이유신 大韓臨床藥理學會 1993 臨床藥理學會誌 Vol.1 No.1

마이코플라스마 폐염

이찬세,김원동,김계방 대한감염학회 1977 감염 Vol.9 No.1

경기지역 정자의 입지 및 특성에 관한 연구

김동찬,김신원,박태석 경희대학교 디자인연구원 2006 예술· 디자인학연구 Vol.9 No.1

This study investigated the location and characterization of pavilion in Gyeonggi province. There weren't only a little literature about traditional pavilion in Gyeonggi province but also it's management and preservation by the government official and cultural center was not satisfactory. furthermore the rapid growth of economy and industrialization grew worse the situation. We had grasped the location of traditional pavilion in Gyeonggi province the present researched literature in comparison with 新增東國與地勝覽(recorded in 1531) and make a field investigation, and then we could have researched into 12 sorts of architectural characteristic and location. In result we could find another special feature of pavilion in Gyeonggi province from the product of compared and analyzed with Kyungsag·Jeolla province that traditional pavilion is most distributed.

콘크리트 鋪裝의 初期計測을 통한 初期擧動 特性分析

정원경,김동호,권혁찬,윤경구 강원대학교 산업기술연구소 2003 産業技術硏究 Vol.23 No.A

The purpose of this paper is to analysis of initial behavior of concrete pavement with initial measurement strain gauge for concrete pavement at field, and to investigate the field test results for field applicability testing. The early-age behaviors of concrete pavement slabs were measured using the strain gauges. From the slab depths and positions, the outputs from each gauges were recorded at initial curing period The initial measurement of concrete pavement and check of crack at the joint were performed. the results could be summarized as follows. From the results of concrete strength, compressive strength and flexural strength were showed 271kgf/㎝', 43kgf/㎝' respectively. From the tests of early-age strain measurement, it was found that the strain varied at the maximum value of 150μ ε and early1 behavior of concrete slab was showed a tensile strain However. for long-term was showed a compressive strain due to dry-shrinkage.

PROM을 使用한 펄스信號 發生回路 構成

金炳贊,元東豪 成均館大學校 1981 論文集 Vol.29 No.-

In this paper, pulse signal generating circuit which is composed of PROM or MUX is suggested and its characteristics have been studied. It is not enable to change the output waveform, division and duty factor for pulse signal generating circuit with PROM. It contains many pulse signal generating programs in an IC Package. While, pulse signal generating circuit with MUX is enable to change the output at will. As a result of experiment, high speed pulse signal generation has been obtained.

영상처리를 통한 접합면 검사 시스템

김영동,김아현,김영수,강원찬,정헌 조선대학교 에너지.자원신기술연구소 2003 에너지·자원신기술연구소 논문지 Vol.25 No.2

In this paper, we present the new method for joint aspect inspecting system. We use the image processing and laser maker for light source. We can find the matrial joint status through processing the line pattern which is made by laser maker. To get the line pattern, in first, we had done the preprocss of threshold. If the shape of line had over two segments, then the joint status is abnormal. We show our system efficency by experiment on tire facility.

신체화장애의 임상 양상

김호찬,도정수,오동원 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.2

In this study, the authors investigated clinical characteristics of 32 inpatients with somatization disorder, who visited the Kosin medical center during the period from July, 1990 to May, 1991. And a comparative study on the clinical pictures between somatization disorder without depression and somatization disorder with depression was made. The results were as follows: 1) The average number of symptoms per patient was 14.3 2) 50% of patients were housewives without out-of-home job and 78.1% of patients had below high school level education. 3) Patients most frequently complained of gastrointestinal symptoms (bloating, abdominal pain) and cardiopulmonary symptoms(palpitation, dizziness). 4) Frequencies of symptoms were not significantly different between men and women. 5) Except for one symptom (sexual indifference), patients with somatization disorder were not significantly different from patients with somatization disorder and depression in frequencies of symptoms. 6) 8.7% of patients with somatization disorder and depression had positive results in DST, its rate was lower than the rate of patients with somatization disorder(22.2%).

폐분체 도료의 재활용 방안에 관한 연구

신동철,김영훈,이순기,김경원,신선명,강헌찬 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.1

With the progress of industry, the much more demand of paint around us grows rapidly. However, the whole quantity of raw materials used to make powder coatings is presently imported to fill the domestic needs. Moreover, it is well known that the waste powder coatings from the domestic industries are mostly incinerated. The method of destructing the waste powder coatings by fire causes VOC to be generated, and this results in some serious environmental problems such as air pollution and so on. Therefore, the effective and proper measure must be devised to reuse the waste powder coatings for the purpose of eliminating waste of resources and avoiding the outflow of foreign currency. This study aims to make the plan to recycle the waste powder coatings, and its conclusion is drawn as follows: First, it can be seen that the waste powder coatings with a weak electrostatic power restore gradually to the original state of electrostatic power through the process of fusion and retreatment. Second, it can be estimated that those coatings, with the use of the cyclon, can be removed by dividing a powder of particles less than 10㎛. Third, it can be ascertained that the possibility of reusing the waste powder coatings is proved when it is divided into particles by cyclon and a revolving screen after the process of fusion, rolling, crushing and pulverization.

다양한 해석법을 이용한 고층건물의 비선형 거동예측

이찬문,최원호,이동근 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

There are various methods that have been recommended for seismic performance of a building structure such as Displacement coefficient Method, Capacity Spectrum Method, Direct Capacity Spectrum Method, Modal Pushover Analysis etc. Evaluation of seismic performance based on the these methods generally used for estimation of seismic deformation capacity and demand of a building structure in the performance based earthquake engineering. In this study, a new improved method of seismic performance evaluation for a high-rise steel moment frame building, which take into account the higher mode effects and accurate inelastic seismic responses, is presented. And the various approaches including the proposed method are carried out for estimating deformation capacity for a high-rise building subjected to various earthquake ground motions and compared with responses such as plastic hinge formations, interstory drifts and energy dissipation etc. of inelastic time history analysis.