Aggressive 비호즈킨 림프종의 예후인자 분석과 고위험군 환자 선별을 위한 International Prognostic Index Model

김경태(Kyung Tae Kim),김태유(Tae You Kim),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),이창희(Chang Hee Lee),곽영임(Young Im Kwak),류백렬(Baek Yeol Ryoo),성주병(Ju Byeung Sung),이영우(Young Wo Lee),장은정(Eun Jung Jang),김재학(Jae Ha 대한내과학회 1997 대한내과학회지 Vol.53 No.3

N/A Objective: Although the therapeutic outcome of aggressive non-Hodgkin's lymphoma (NHL) has been considerably improved by the introduction of combination chemotherapy, many patients still fail to achieve complete response(CR) and/or long-term survival. Because the outcome appears to depend on certain prognostic factors, long term prognosis can be predicted by identification of risk group. And also, the patients in high risk group may benefit from new therapeutic modality. In 1993, the international prognostic index model for aggressive NHL as developed far the purpose of predicting outcome and designing of therapeutic trial. Thus, analysis of prognostic factors was performed to identify independent factors for the end points of CR, overall survival, and disease-free survival. Methods : From 1989 to 1994, total 340 patients were treated with combination chemotherapy and/or radiotherapy for NHL in Korea Cancer Center Hospital. Among 340, informations on eleven prognostic factors(sex, age, performance status, Ann Arbor stage, serum LDH level, tumor size, number of extranodal disease sites, bone marrow involvement, presence of B symptom, sex, time to CR, and histologic grade) were avaliable for 273 patients. Among these, 221 patients with aggressive NHL(NCI clinical schema) were eligible for the prognostic factor analysis for the response and survival. Also, 186 patients were eligible to determine whether International Prognostic Index Model could be applicable for Korean NHL. Results: One hundred fifty patients(68%, 95% CI 62-74%) achieved a complete remission, 43 patients (20%) a partial remission. With a median follow-up of 3,5 years, overall 3 year survival rate was 6396, and 3 year DFS for the 150 CRs was 72%. In a univariate analysis for the CR and survival, Ann Arbor stage, number of extranadal disease, performance status, presence of B symptoms, presence of BM involvement, serum LDH level and histologic grade were found to be statistically significant prognostic factors. Among them, by multivariate analysis, number of extranodal disease(RR 0.2, 95% CI 0.1-0.7), B Symptoms (RR 0.4, 95% CI 0.2-0.9), and histologic grade(RR 0.2, 95% CI 0.08-0.7) showed to be independent adverse prognostic factors for CR. For disease-free survival, Ann Arbor stage(RR 2.6, 95% CI 1.1-6.4) was independent risk factor. For overall survival, number of extranodal involvement(RR 2, 95% CI 1.3-4) and histologic grade(RR 2, 95% CI 1.2-3.7) were independently significant prognostic factors. With these 2 independent prognostic factors for survival, we could establish a prognastic index model which could separate the high risk patients. However, the usefulness of this model should be confirmed in a larger patient population. The dose intensity of cyclophosphamide, during initial 3 months of treatment, was significantly associated with CR rate and overall survival(p=0.01 & 0.03, respectively). When International Prognostic Index Model was applied to our patients, patients in the lower risk groups had significantly better outcome than patients in the higher risk groups(3 year survival and RR: 77% & 1 for low risk group, 61% & 1.9 for low-intermediate risk group, 50% & 2.2 for high-intermediate risk group, and 25% & 6 for high risk group). Conclusion: In this study, we confirmed that features other than the Ann Arbor stage were independently associated with CR and survival, and the International Prognostic Index Model would be an useful tool for the selection of high-risk patients who could be benefited from more aggressive chemotherapy.

Klinefelter 증후군에 병발된 원발성 종격동 생식세포종

김용조 ( Yong Jo Kim ),권교선 ( Gyo Seon Kwun ),이영우 ( Young Wo Lee ),김경태 ( Kyung Tae Kim ),박연희 ( Yeon Hee Park ),류백렬 ( Baek Yeol Ryoo ),김태유 ( Tae You Kim ),임영혁 ( Young Hyuck Im ),이춘택 ( Choon Taek Lee ),강윤구 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.6

왕겨/모래/왕겨 회재의 유동 및 혼합 특성 연구

김보화 ( Bo Hwa Kim ),서명원 ( Myung Won Seo ),국진우 ( Jin Woo Kook ),최희망 ( Hee Mang Choi ),라호원 ( Ho Won Ra ),윤상준 ( Sang Jun Yoon ),문태영 ( Tae Young Mun ),김용구 ( Yong Ku Kim ),이재구 ( Jae Goo Lee ),이영우 ( Young Wo 한국화학공학회 2016 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.54 No.4

Lab-scale 기포유동층 반응기(D=0.1 m, H=1.5 m)에서 왕겨와 모래를 혼합하여 가스화를 통해 합성가스를 얻고 남은 왕겨 회재는 고부가가치 물질로 사용하기 위한 연구의 선행연구로서 왕겨/ 유동사/ 왕겨 회재(실리카)의 혼합 및 유동 특성을 규명하였다. 왕겨/유동사를 5:95, 10:90, 20:80, 30:70의 부피비로 유속 범위(0~0.63 m/s)조건으로 수행하였으며, 또한 왕겨 회재는 왕겨를 기준으로 부피비 6%로 결정하였다. 왕겨/유동사, 왕겨/유동사/왕겨 회재의 혼합실험을 통해 왕겨 부피비 0%, 5%, 10%에서는 최소유동화속도가 0.19~0.21m/s임을 확인하였고, 20%일때는 0.3m/s로 증가하였으며, 30%일때는 분리현상이 나타나 최소유동화속도가 측정 되지 않았다. 또한, 실험데이터에 따라 Brereton과 Grace의 mixing index를 이용하여 각 조건 별로 mixing index값을 도출한 결과 왕겨/유동사의 혼합은 0.8~1, 왕겨/유동사/왕겨 회재의 혼합은 0.88~1 사이임을 확인하였다. 이를 통하여 왕겨/유동사의 혼합과 왕겨/유동사/왕겨 회재 혼합의 최적 조업조건을 도출할 수 있었으며, 운전조건을 결정할 수 있었다. We investigate fluidization characteristics of the mixture of rice husk, silica sand and rice husk ash as a preliminary study for valuable utilization of rice husk ash obtained from gasification of rice husk in a fluidized bed reactor. As experiment valuables, the blending ratio of rice husk and sand (rice husk: sand) is selected as 5:95, 10:90, 20:80 and 30:70 on a volume base. Rice husk ash was added with 6 vol% of rice husk for each experiment and air velocity to the reactor was 0~0.63 m/s. In both rice husk/sand and rice husk/sand/ash mixture, the minimum fluidization velocity (Umf) is observed as 0.19~0.21 m/s at feeding of 0~10 vol.% of rice husk and 0.30 m/s at feeding of 20 vol.% of rice husk. With increasing the amount of rice husk up to 30 vol. %, Umf can not measure due to segregation behavior. The mixing index for each experiment is determined using mixing index equation proposed by Brereton and Grace. The mixing index of the mixture of rice husk/sand and rice husk/sand/ash was 0.8~1 and 0.88~1, respectively. The optimum fluidization condition was found for the good mixing and separation of rice husk ash.

심장 점액종의 임상적 고찰

황의석(Eui Seock Hwang),김용석(Yong Seok Kim),최진오(Jin Oh Choi),채인호(In Ho Chae),손대원(Dae Won Sohn),김철호(Cheol Ho Kim),오병희(Byung Heui Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),이영우(Young Wo 대한내과학회 2002 대한내과학회지 Vol.62 No.1

N/A Background: Cardiac myxoma is uncommon, even though accounts for 50% of primary cardiac tumor, histologically benign disease but may be lethal because of its strategic position. It has diverse clinical manifestations mimicking various diseases, which can be described under the three headings: constitutional, obstructive and embolic and the diagnosis can be easily missed unless clinician has high index of suspicion. A correct diagnosis is made before operation with the development of echocardiography. We reviewed our clinical experience in diagnosis and management of 21 cases of myxomas from 1985 to 2000. Methods: There were 4 males (19%) and 17 females (81%). Their ages ranged from 17 to 66 years (mean 42.2 years). All the patient`s medical records on their clinical features, laboratory findings, chest X-rays, electrocardiograms, echocardiographic findings, operative findings and post operative follow-up were reviewed. Results: Seventeen cases (81%) of the myxomas originated in left atrium and four (19%) in right atrium. Most common symptom was that of intracardiac obstruction such as dyspnea or dyspnea on exertion (62%). Fatigue which accounted for most of the constitutional symptom found in 38% of the 21 patients while embolism accounted for 38%. In all patients, echocardiography was used for diagnosis and the diagnostic accuracy of echocardiography was 100%. All patient s received surgical treatment and immediate postoperative complications occurred in seven patients (33%). Among them, serious complications were found in two cases and one expired due to congestive heart failure. Follow-up duration ranged from 2 months to 15 year s. There was no recurrence or other problem in all patient s during the follow-up period. Conclusion: Although clinical suspicion is difficult due to the nonspecific presentation of myxoma, the diagnosis can be made easily with echocardiographic examination in all cases and surgical excision of myxoma may be curative with good long-term result.(Korean J Med 62:49-57, 2002)

Cyclophosphamide 를 포함한 항암화학요법 후 발생한 간질성 폐렴 3 예

김경태,박연희,이춘택,이승숙,이진오,강태웅,강윤구,남승모,류백렬,임영혁,김태유,성주병,이영우,장은정,허남현 대한내과학회 1997 대한내과학회지 Vol.53 No.4

Development of diffuse pulmonary infiltrates in patients receiving chemotherapy is a major diagnostic challenge. Diffuse pulmonary infiltrates may be due to infection, pulmonary hemorrhage, pulmonary edema or drug-induced lung injury. Among these, pulmonary toxicity caused by antineoplastic agent is being recognized more frequently. Cyclophosphamide, an alkylating cytotoxic drug, is used widely in the treatment of malignancies including lymphoma. The incidence of pulmonary toxicity is probably less than 1 percent, and its relation with total dosages and schedule of the drug is not yet defined. The typical pictures of cyclophosphamide-induced pulmonary toxicity are non-productive cough, dyspnea, fever, hypoxemia with respiratory alkalosis and interstitial pneumonitis. However, relatively infrequent pulmonary toxicity of cyclophosphamide and frequent development of infectious pulmonary infiltrate in the patients treated with chemotherapy may hamper the early diagnosis of cyclophosphamide toxicity. Interstitial pattern and unresponsiveness to antibiotics of the pneumonitis might be the clues of suspicion. The best ways to treat the patients with cyclophosphamide toxicity are early diagnosis, discontinuation of the drug and early corticosteroid trial, although usefulness of steroid has not been firmly established. Recently, we experienced three cases of interstitial pneumonitis developing during cyclophosphamide-containing chemotherapy for non-Hodgkin's lymphoma in the absence of neutropenia or thrombocytopenia. Early use of corticosteroid in later two cases could resolve the pulmonary complication completely, whereas the pneumonitis failed to improve in spite of the massive use of multiple antibiotics in the first case.