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폐암 환자에서 항암화학치료 중 발생한 빈혈에 대한 Darbepoetin alfa의 효과
반희정 ( Hee Jung Ban ),지수영 ( Su Young Chi ),박철규 ( Cheol Kyu Park ),김은영 ( Eun Young Kim ),김윤희 ( Yoon Hee Kim ),김규식 ( Kyu Sik Kim ),주진영 ( Jin Young Ju ),권용수 ( Yong Soo Kwon ),오인재 ( In Jae Oh ),김유일 ( Yu Il 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.2
연구배경: 빈혈은 폐암 환자의 항암 치료중 발생하여 삶의 질을 떨어뜨리는 원인이 된다. 최근 사용 되는 darbepoetin alfa는 적혈구 생성 촉진 인자로 사용되고 있어 이의 효과와 부작용을 알아보고자 하였다. 방법: 2004년 9월부터 2007년 3월까지 화순전남대학교 병원을 내원한 환자 중에서 소세포 혹은 비소 세포 폐암을 진단받고 항암 화학 치료를 적어도 1개월 이상 받은 환자들 중에서 혈색소 수치 10 g/dl 미만의 빈혈이 발생한 환자들 중 darbepoetin alfa를 투여 받은 환자를 대상으로 후향적으로 분석하였다. 결과: 항암 화학 치료 후 혈색소는 9.03±0.64 g/dl로 감소하였고, darbepoetin alfa를 처치 후 혈색소 1 g/dl 이상의 증가를 보였던 환자는 62.4%였으며 최고치 10.45±1.18 g/dl, 4주째 10.09±1.17 g/dl로 관찰되었다. 경증 부작용이 일부에서 관찰되었나 모두 호전되었다. 결론: darbepoetin alfa는 항암 치료와 연관된 빈혈의 치료에 효과적이며 부작용이 심하지 않아 보조 치료제로 사용될 수 있겠다. Background: Anemia is quite common in lung cancer patients and known to decrease the quality of life. Darbepoetin alfa is an erythropoiesis-stimulating protein approved for administration to cancer patients. This study examined the efficacy and safety of darbepoetin alfa in lung cancer patients with a hemoglobin concentration <10 g/dl during chemotherapy. Methods: Lung cancer patients (n=178) received darbepoetin alfa at doses of 1.91 μg/kg per week until the hemoglobin concentration increased to >10 g/dl. The efficacy and safety were measured by comparing the hemoglobin concentration and assessing the adverse events. Results: After chemotherapy, the hemoglobin concentration decreased to 9.03±0.64 g/dl. With the darbepoetin alfa treatment, the hemoglobin concentration increased to 10.09±1.17 g/dl after 4 weeks reaching a peak hemoglobin concentration of 10.45±1.18 g/dl. The changes in hemoglobin after 4 and 8 weeks with treatment were 1.08±1.24 g/dl and 1.38±1.59 g/dl (p<0.01). At least a 1 g/dl or more increase in hemoglobin was observed in 62.4% of patients. There were no serious adverse effects except for some mild reactions. Conclusion: Darbepoetin alfa administered to lung cancer patients appears to be an effective, well-tolerated treatment for chemotherapy induced anemia.
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장선호,박철규,이병돈,장혁순,강주원 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2
Papillary adenocarcionma has been common malignant tumor of human thyroid gland, and metastasize to the lung and bone as well. But endotracheal meastasis of papillary adenocarcinoma is very unusual. A 75 years old woman was presented with a metastatic papillary thyroid adeno- carcinoma in the trachea, 10 years after total thyroidectomy. The tumor mass was located in the anterior wall of tracheal lumen. The mass was confirmed with pathologic finding. We describe a case of tracheal papillary adenocarinoma of thyroid gland origin and discuss the current recommendation for management.
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김광수,박철규,이병돈,장혁순,강주원 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2
Congenital cholesteatoma is a rare disease which originated from the ectoderm that from the primitive notochord and embryonal cell rests. It may occur in any portion of the cranial bones. Various symptoms may develope about position of the lesions. If the lesion located in the middle ear, symptoms were showed conductive hearing loss and normal tympanic membrane. We have experienced two cases of congenital cholesteatomas which were located in the middle ear. We report these cases with review of literatures.
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경고막적 및 고막외적 전극위치에 따른 와우전위의 비교연구
장동임,박철규,이병돈,장혁순,강주원 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1
Electrocochleography is a method of the measurement of electrical events generated either within the cochlea or by primary afferent neurons. It includes measures of summating potential(SP) and cochlear microphonics(CM) from the cochlea, and action potential(AC) from the auditory nerve. There are severval diffefent ways to measure the potentials, mainly transtympanic and extratympanic methods. The purpose of this study is to provide a normal data of eletrocochleography in adults and compare the results obtained by extratympanic and transtympanic methods. The following results were obstained: 1. As the intensity of sound was increased, the SP amplitude and AP amplitude were increased. There was no significant difference between extratympanic and transtympanic method. 2. As the intensity of sound was increased, the SP latency and AP latency were shortened without significant difference between two different methods. 3. As the intensity of sound was increased, the SP/AP ratio was increased without difference in both methods which was less than o.30. 4. Non-invasive method of electrocohleography, the extratympanic method, can be one of the easy method an can be used widely clinically.
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이병돈,강주원,장혁순,박철규,김장묵 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.1
Tonsillar tuberculosis, almost always secondary to pulmonary tuberculosis is very rare disease in otolaryngologic fields. Authors have experienced a case of tonsillar tuberculosis associated with miliary pulmonary tuberculosis. The patient had cough, sputum and sore throat for 1 month. On physical examinations, palatine tonsils were slightly hypertrophied, smoothly surfaced, but crypt ulceration or patches were not seen. Diffuse discrete nodules were seen in both lung fields by simple chest X-ray. In high resolution computed tomography, miliary tuberculosis was suspected and in pleural needle biopsy, granulomatous inflammaiton was diagnosed as tuberculosis. AFB smear of sputum was two positive. Histopatholoigic finding of right tonsil was consistent with tuberculosis. He was cured of it with antituberculosis medications for one year. We report the case with review of the literatures.
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慢性腎不全症患者의 聽力損失과 血液透析의 影向에 관한 臨床聽覺學的 分析
張東壬,朴哲奎,李承周,張赫淳,朴東佑,姜周元 순천향대학교 1990 논문집 Vol.13 No.3
The hearing loss in chronic renal failure patient has been observed and well known from the early part of this century. Many factors, such as ototoxic drugs, electrolyte imbalance, diabetes mellitus, presbycusis, etc., have been implicated as causes of hearing deficit. In order to evaluate the degree and type of hearing loss in patient with chronic renal failure, we were examined audiometric findings and blood chemistry who were treated with hemodialysis. The results were as follows: 1. Among 37 cases, 22 cases were male and 15 cases were famale. 2. 20(54.1%) patients has varing degree of bilateral hearing loss. Among this patient, high tone sensori-neural hearing loss were found in 11(29.7%) patients, and horizontal type in 9(24.3%) patients. 3. The incidence of clinically significant hearing loss, more than 25 dB, was 10(27.0%) cases. 4. The degree of hearing loss was corresponded to the increment of age, and not related to number of hemodialysis. 5. These were suggested that hearing deficit in chronic renal failure were common and multifatorial in etiology, not related to a single factor.
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