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폐암환자의 경기관지 생검조직에서 MAGE 및 GAGE 발현
정만홍(Maan Hong Jung),김지호(Ji Ho Kim),김지혜(Ji Hae Kim),박기룡(Ki Ryong Park),옥철호(Chul Ho Oak),조현명(Hyun Myung Cho),장태원(Tae Won Jang) 대한내과학회 2002 대한내과학회지 Vol.62 No.1
N/A Background: There has been significant pr ogress in the identification of tumor associated antigens. Among the tumor associated antigens, MAGE (melanoma antigen), BAGE, GAGE, PRAME, NY-ESO were named as cancer/testis specific antigens since they are only expressed in the testis or cancer cells. Because of their relative specificity, they have been considered as the appropriate targets for the specific immunotherapy, or the early diagnosis of several cancers. In bronchogenic cancer, these antigens would be useful as a promising candidate in the screening test or immunotherapy. This study was to investigate the expression of MAGE and GAGE genes in the bronchogenic cancer tissues obtained by bronchoscopy. Methods: In five normal bronchial and 26 cancer tissues obtained by bronchoscopic biopsy from 26 bronchogenic cancer patients, total cellular mRNA was extracted. Then RT PCR was run in 35 cycles, with two different kinds of primers designed to detect the several subtypes of MAGE DNA simultaneously and the similar process to detect GAGE DNA was also done. Concurrently, DNA sequencing of the isolates was done in portion to prove the isolates are cloned MAGE and GAGE DNA. With probes confirmed by DNA sequencing, the isolates were reevaluated by Southern blotting. Then the expression of MAGE or GAGE in the bronchogenic cancer tissues was evaluated by the tissue types and clinical staging. Results: In the five controls, MAGE or GAGE was not detected in any specimen and beta actin was not expressed in 4 cases, suggesting the specimen might be too small to detect beta actin by 35 cycles of PCR. In the 26 cancer tissues, the expression rate of MAGE and GAGE was 42.3% (11/26) and 42.3% (11/26) respectively and MAGE or GAGE were expressed in 17 cases (65.3%). Neither clinical staging nor tissue types were associated with the expression of MAGE or GAGE. Bet a actin was not detected in 11 cases of cancer specimen, but MAGE or GAGE were expressed in 10 cases of them. Conclusion: Using these primers in detection of MAGE or GAGE genes in the bronchoscopic cancer tissues obtained by bronchoscopy biopsy tissues seems to be effective or complimentary method in screening of bronchogenic cancer patients, who would be the candidate for the possible immunotherapy.(Korean J Med 62:58-68, 2002)
호흡기 ; 여성 폐암 환자에서 Gefitinib과 Erlotinib 치료 성적 비교
문대성 ( Dae Sung Moon ),장태원 ( Tae Won Jang ),옥철호 ( Chul Ho Oak ),정만홍 ( Maan Hong Jung ),김도현 ( Do Hyun Kim ),최인수 ( In Soo Choi ) 대한내과학회 2009 대한내과학회지 Vol.76 No.2
목적: 우리나라에서 비소세포폐암의 발생 빈도는 증가하는 추세에 있다. 여성 폐암은 대부분이 비흡연자이고 선암이 주로 발병하는 것으로 알려지고 있으며 표피성장인자수용체의 티록신 키나아제 억제제가 동양인 여성에서 더 효과가 있다는 것이 알려져 있다. 본 연구는 gefitinib과 eroltinib은 작용기전은 비슷하나 용량의 차이가 있어 각각의 치료 성적이 보고자 마다 조금씩 달라 두 약제의 치료 성적을 비교하여 보고자 하였다. 방법: 2004년 2월 2007년 4월까지 고신대학교 복음병원에서 진단 및 치료받은 여성 폐암 환자들을 의무기록을 통해 후향적으로 조사했다. 한달 이상 gefitinib, erlotinib을 복용하고 치료 평가가 가능한 환자를 대상으로 생존기간, 약물투여 기간, 독성의 발생빈도를 비교 분석하였다. 결과: 전체 환자는 42명이었고, gefitinib 치료군은 26명, erlotinib 치료군은 16명이었다. 나이의 중간값은 58세였고, 85%가 비흡연가, 83%가 선암이었으며, 병기는 IIIb가 13명(24.0%), IV가 16명(76%)이고, 생존일 중앙값은 793일이었다. gefitinib으로 치료한 군이 26명(62%)이었고, 이 중 18명(69.2%)이 3차 화학요법으로 이 약제를 사용하였고, erlotinib을 사용한 16명 중 12명(87.5%)이 2차약으로 사용하였다. 전체적인 치료 반응율은 14명에서 부분 관해를 보여 33.3%의 반응율을 보였고, 안정성 병변을 포함한 질병 조절율은 76.2%이었다. gefitinib군의 치료 반응율은 39%, erlotinib군 31%이었으며 양군 간의 통계적 차이는 없었고, 평균 생존 기간이 각각 651일, 510일이었으나 통계적 차이는 없었다. 약제 투여 기간의 중앙값은 gefitinib군에서 186일, erlotinib군이 262일로 erlotinib군에서 길었으나 역시 통계적 유의성은 없었다. 피부 독성은 gefitinib군이 27%, erlotinib군 75%로 erlotinib군에서 많이 나타났다. 결론: Gefitinib군과 erlotinib군의 치료 반응율과 생존기간 및 약제 투여기간의 차이는 없었다. Erlotinib군에서 피부 발진 빈도가 더 높게 나타났다. Background/Aims: Lung cancer is the leading cause of cancer death worldwide. There are significant gender differences in lung cancer: most females with lung cancer are non-smokers and they are diagnosed with adenocarcinoma. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are more effective in female lung cancer patients, but the results with gefitinib and erlotinib differ. This study compared the therapeutic response and toxicity of gefitinib and erlotinib in female lung cancer patients. Method: We retrospectively reviewed the clinical information on patients treated with gefitinib or erlotinib for more than one month at Kosin University Gospel Hospital from February 2004 to November 2007. Results: Forty-two patients (26 gefitinib vs. 16 erlotinib) were enrolled during this period. Their median age was 58 years. Thirty-six patients (85%) were non-smokers and 35 patients (83%) had adenocarcinoma. There were 24% at stage IIIb and 76% at stage IV. The median survival time was 793 days. In the gefitinib group, 69% of the patients received 3rd-line chemotherapy, while 12 of 16 (87.5%) in the erlotinib group received 2nd-line chemotherapy. There were no significant differences in the overall response rate (gefitinib 39% vs. erlotinib 31%, p=0.524), median survival time (gefitinib 605 days vs. erlotinib 510 days, p=0.455), and time to progression (gefitinib 186 days vs. erlotinib 262 days, p=0.660). Rashes were more common in the erlotinib group (73.3% vs. 27%, p<0.001). Conclusions: There were no significant differences in the response rate, overall survival, and time to progression between the two groups. Rashes were more common in the erlotinib group. (Korean J Med 76:179-185, 2009)
DNA probe를 이용한 비결핵항산균의 분리 및 폐질환자들의 임상적 특징
김희규 ( Hee Kyoo Kim ),김유리 ( Yu Ri Kim ),박정필 ( Jung Pil Park ),김낭희 ( Nang Hee Kim ),옥철호 ( Chul Ho Ok ),정만홍 ( Maan Hong Jung ),장태원 ( Tae Won Jang ),정석훈 ( Seok Hoon Jeong ),김철민 ( Cheol Min Kim ),박희경 ( Hee 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.58 No.3
목적 : NTM질환이 과거에는 공중 건강에 치명적인 것으로 생각하지 않았다. 최근에 NTM이 높은 빈도로 발견되고 있고, 분리균의 임상적인 중요성도 커지고 있다. 본 연구는 부산의 한 삼차 의료기관에서 의뢰한 임상 검체에서 분리된 NTM의 균종 분포와 폐질환을 일으킨 균주의 임상적 특징에 대해 알아보고자 하였다. 대상 및 방법 : 2003년 3월부터 2003년 12월까지 10개월간 진단검사의학과 임상미생물검사실에 항산균 도말 및 배양 검사가 의뢰되어 도 Background : Nontuberculous mycobacterial (NTM) infections are increasingly being recognized as a cause of chronic pulmonary disease. This study describes the prevalence of NTM species from clinical specimens and the clinical characteristics of NTM pulmon
문대성 ( Dae Sung Moon ),장태원 ( Tae Won Jang ),옥철호 ( Chul Ho Oak ),정만홍 ( Maan Hong Jung ),유찬희 ( Chan Hui Yoo ),송준영 ( Jun Young Song ),김성은 ( Sung Eun Kim ),김자경 ( Ja Kyung Kim ),장리라 ( Lee La Jang ),이은영 ( Eu 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5
Standard antituberculous therapy, including isoniazid (INH), rifampin, ethambutol, and pyrazinamide (PZA), is widely used to treat active tuberculosis. The most important side effect is hepatotoxicity. In a standard four-drug regimen, PZA was the most common cause of drug-induced hepatitis and was dose-related. The incidence of drug-induced hepatitis is high at doses of 40∼70 mg/kg per day but has fallen significantly since the recommended dose was reduced. Liver toxicity induced by PZA is rare at doses of 25 mg/kg per day or less. PZA-induced fulminant hepatic failure is also rare but fatal. We report a case of fulminant hepatic failure caused by a re-challenge of PZA. (Tuberc Respir Dis 2007;63:435-439)
증례 : 호흡기 ; 가솔린 흡인에 의한 화학성 폐장염 1예
김자경 ( Ja Kyung Kim ),장태원 ( Tae Won Jang ),정만홍 ( Maan Hong Jung ),옥철호 ( Chul Ho Oak ),문대성 ( Dae Sung Moon ),장리라 ( Lee La Jang ) 대한내과학회 2009 대한내과학회지 Vol.76 No.4
저자들은 가솔린을 복용한 후 발생한 흉부불편감과 호흡곤란으로 내원한 20세의 남자 환자에서 방사선사진상 흡인성 폐렴의 소견이 뚜렷하고 기관지 세척액에서 육안적 혈성 소견을 보였으며 군용 가솔린을 흡인함으로써 세균성감염의 기회가 높다고 판단되어 화학성 폐장염 진단 후 항생제와 스테로이드 사용하였고, 큰 합병증 없이 회복된 1예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다. Hydrocarbons are a broad group of organic bodies consisting of hydrogen and carbon. They are commonly found in the environment in the form of gasoline (e.g., butane and propane) and are also used in stain removers, adhesives, lubricants, and a variety of paints. Ingestion of the compound accounts for approximately 3% of all poisoning cases in the United States, but such reports of poisoning are rare in Korea. Hydrocarbon poisoning has many adverse effects. In addition to potentially causing major damage to the respiratory and central nervous systems, direct exposure to hydrocarbons can also cause cardiac arrhythmia, hepatic dysfunction, renal failure, neuropathy, and other injuries. We present the case of a 20-year-old soldier who accidentally ingested a small amount of gasoline. He developed chemical pneumonitis, but recovered with no serious complications. (Korean J Med 76:494-498, 2009)