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      • 위발성 위장관 악성림프종 환자에서 항암치료의 효과

        김찬규,신영록,김현정,배상병,이남수,이규택,박성규,원종호,홍대식,박희숙 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

        Purpose: The gastrointestinal (GI) tract is the most common site of extranodal non-Hodgkin's lymphoma (NHL), which is increasing in incidence, but there is no established optimal treatment modality. Thus, this study was investigated the clinicohistologic feature, the therapeutic modalities, and the prognosis for GI-NHL, as well as the factors affecting it. Methods: We retrospectively analyzed 45 patients who had been diagnosed as having GI-NHL and had been followed up from July 1994 to February 2005 at Soonchunhyang University Hospital. The patients were divided into groups according to the site of origin and to various other features, and the survivals of the various groups were compared. The modified Ann Arbor system and WHO classification were adopted for staging and histopathologic classification, respectively. Results: GI-NHL of the stomach, small bowel, ileocecal region, and colon occurred in 28 patients (62.2%), 5 patients (11.1%), 3 patients (6.7%), and 8 patients (17.8%), respectively, In one patient, the entire gastrointestinal tract was diffusely involved. The median age of patients was b5 years (25~78 years), and male-to-female ratio was 1:1.1. Fourteen patients were in stage Ⅰ, 24 in stage Ⅱ, 4 in stage Ⅲ, and 3 in stage Ⅳ. Surgical resection was performed in 19 patients, and combination chemotherapy was performed in 43 patients. Surgical resection only was performed in 4 patients, Chemotherapy only was performed in 26 patients. The expected overall 5 year survival of 45 patients was 39.6%, and there was a significant survival difference between the stages, but between sites of origin (p=0.842). The most important factors influencing the survival was the stage and other factors were not significant. Conclusion: The stomach was the most common site of GI-NHL. Most GI-NHL were localized Stage was the most important prognostic factor. However, Prospective randomized studies are needed to approve the therapeutic modality.

      • 흉선종 제거후에 발생한 재생 불량성 빈혈 : 증례보고

        전원선,이상철,김현정,배상병,김찬규,이남수,박노진,이규택,박성규,홍대식,박희숙,원종호 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

        Thymoma is associated with myasthenia gravis, Pure red cell aplasia, and autoimmune diseases such as autoimmune hemolytic anemia, aplastic anemia, and hypogammaglobulinemia. It's association with aplastic anemia is rare and aplastic anemia appearing after surgical removal of thymoma is especially rare. The authors hereby report a case of aplastic anemia occuring in a patient who was diagnosed with thymoma and myasthenia gravis and had the tumor surgically removed. The patient was treated with anti-thymocyte globulin, cyclosporin, and prednisolone, and showed partial remission with hematologic improvements after 12 months.

      • 노인의 영적 간호요구

        최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

        This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

      • 재발 또는 불응성 비호즈킨 림프종 환자에서 CDME 구제항암화학요법 후 고용량 항암화학요법 및 자가말초혈액 조혈모세포이식의 효과

        김세형,한강원,배상병,김찬규,이남수,이규택,박성규,원종호,홍대식,박희숙 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

        Background and objectives : The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional dose chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, we compared the outcome of patients undergoing high-dose chemotherapy with autologous peripheral blood stem cell transplantation(APBSCT) with only salvage chemotherapy of cisplatin, dexamethasone, mitoxantrone, and etoposide(CDME). Materials and methods : From June 1993 to December 1999, 25 patients with relapsed or resistant NHL were treated with CDME regimen as salvage chemotherapy. Twelve patients were received four cycles of CDME chemotherapy, and 13 patients were received high-dose chemotherapy with APBSCT following two cycles of CDME chemotherapy. Results : The median follow-up duration was 12.8 months(range:4-68). The overall response rate was 41.7% (complete response rate 25%, partial response rate 16.7%) in 12 patients with CDME only. Thirteen patients who were treated with high-dose chemotherapy with APBSCT achieved 61.5% complete response rate and 15.4% partial response rate, with an overall response rate of 76.9%. The estimated 3-year progression-free survival rate was significantly higher among patients who received high-dose therapy than patients who received CDME only(41.5% vs 20.0%, p<0.05). And, 3-year overall survival rate was significantly higher among patients who received high-dose therapy(51.3% vs 25.0%, p <0.05). Conclusions : In relapsed or refractory NHL, CDME chemotherapy is an effective salvage chemotherapy and allow peripheral blood stem cell collection. Also, high-dose chemotherapy with APBSCT following CDME is superior to CDME salvage chemotherapy only.

      • 특별활동 부서 배정업무 자동화 시스템 구축

        이진관,김귀복,박기홍 군산대학교 정보통신기술연구소 2000 情報通信技術硏究論文集 Vol.4 No.-

        This thesis tries to rule out the problems of the existing method in which teachers assigns students the club activity department respectively in manual manner. The proposed system assigns club activity department automatically on the web according to the students' application. And thus it reduces both time and cost spent in organizing, arranging and managing which characteristic provides teachers with a turning point in teaching- learning fields.

      • KCI등재

        정신과 외래환자의 약물치료 반응과 심박동 변이의 변화 양상

        이상규,이홍석,김인주,김형태,김도훈,손봉기 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

        Objectives : The purpose of this study was to investigate the change of heart rate variability after antidepressant treatment in depressed or anxious patients. We tried to find the usefulness of heart rate variability as a predictive marker of response to pharmacological treatments in the psychiatric field. Methods : Forty-seven patients with major depression, anxiety disorder, and somatoform disorder were treated over 4 weeks with antidepressants and were then classified as responders or nonresponders according to Hamilton depression scales or CGI scores. The HRV variables were measured and compared among the responders/nonresponders and the matched normal control. Results : The responders group exhibited low heart rate, low PSI, high SDNN, RMSSD, HRV index, NN50, pNN50, LNTP, LNLF, and LNHF compared with the nonresponders after 4 weeks antidepressant treatment. However, no significant differencein HRV vanables was observed between the responders group after treatment and the nonnal control group and the responsegroup after treatment. Conclusion : These results indicate that HRV variables would are normalized after successful antidepressant treatment and it that HRV has some possible uses as a predicting marker of antidepressant response.

      • KCI등재

        허혈성 장질환의 조기진단을 위한 혈청 락테이트(lactate)의 유용성

        이미진,오동렬,박규남,김세경,양진홍,박상현 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

        Background: Intestinal ischemia remains a devastating event despite improvements in clinical recognition and in diagnostic and therapeutic modalities. The ischemic bowel diseases encompass a wide clinical spectrum from mild, reversible disease to severe, irreversible injury. The clinical picture is characterized initially by poorly localized visceral pain. Thus, it is difficult to diagnose this ischemia at an early stage. This study investigated whether an increased serum lactate level is a recognized danger signal marker for intestinal ischemia in patients who present at the emergency department because of abdominal complaints. Methods: Patients who came to our emergency department with abdominal pain and the risk factors of intestinal ischemia between Apr. 1999 and Nov. 1999 were included in this study. The data analysis included age, sex, final diagnosis, pathogenesis of bowel ischemia, and serum lactate level. Results: The serum lactate level in the intestinal ischemia group was 28.54±22.51 mg/dl; in non-ischemia group, it was 15.49±22.52 mg/dl. This difference between the two groups was significant(p<0.05). An increased serum lactate level had a sensitivity of 88.2% and specificity of 59.2%, a positive likelihood ratio of 4.92, and a negative likelihood ratio of 0.47 as a marker of bowel ischemia. These results do not represent a very meaningful revision of bowel ischemlc provability, but may make a small contribution to management of the disease, depending upon their magnitude and the clinical context in which they are applied. Conclusion: In patients with abdominal complaints, an increased serum lactate level is usually a useful aid as a diagnostic marker of bowel ischemia.

      • SCOPUSKCI등재

        제조합 대장균에서 과발현된 Citrobacter freundii KCTC2006 유래의 β-Tyrosinase를 이용한 3,4-Dihydroxyphenyl-L-alanine의 생산

        이승구,노현수,홍승표,이규종,왕지원,태동년,엄기남,방상구,김영준,성문희 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.1

        재조합 대장균에서 대량발현 시킨 Citrobacter freundii KCTC 2006 유래이 효소 β-tyrosinase를 이용하여 pyrocatechol, sodium pyruvate, ammonium acetate로부터 3,4-dihydroxy phenyl-L-alanine을 생산하기 위한 연구를 수행하였다. 이 효소반응에 적합한 온도 및 pH 조건은 각각 18℃와 8.5로 결정되었고, 반응액 중의 ammonium acetate와 sodium pyruvate의 농도는 각각 300 mM, 50 mM 이상으로 조절하는 것이 적합하였다. Pyrocatechol의 경우는 20 mM에서 가장 높은 반응성을 나타냈으나, 기질을 반복적으로 첨가하며 장시간 동안 효소반응을 수행하는 경우에는 pyrocatechol의 고갈을 피하기 위하여, 20 mM에서 50 mM 사이로 조절하였다. 한편, 반응액 중에 ethanol을 10% 첨가한 경우에는 반응속도가약 20% 증가하였다. 이상과 같은 효소반응특성에 기초하여 조제한 기질용액에 β-tyrosinase를 1 unit/㎖ 농도로 가하고, pyrocatechol과 pyruvate가 고갈되지 않도록 간헐적으로 첨가하면서 효소반응을 수행한 결과, 24시간 만에 85.2%의 수율로 31.6g/ℓ의 3,4-dihydroxyphenyl-L-alanine를 생산할 수 있었다. By using the β-tyrosinase of Citrobacter freundii KCTC2006, which was cloned and overexpressed in Escherichia coli, 3,4-dihydroxy phenyl-L-alanine (L-DOPA) was synthesized efficiently from pyrocatechol, sodium pyruvate, and ammonium acetate. Optimal temperature and pH for the reaction were determined to be about 18℃ and 8.5, respectively. The effects of substrate concentrations were also examined at different concentrations of ammonium acetate, sodium pyruvate, and pyrocatechol. Ammonium acetate and sodium pyruvate increased the reaction rate until the concentrations reached to 300 mM and 50 mM, respectively. Although pyrocatechol showed the optimal concentration at 20 mM, it was controlled between 20 mM and 50 mM to avoid the depletion of substrate during the enzymatic synthesis. Based on above results, a reaction medium for the production of L-DOPA was prepared and incubated with 1 unit/㎖ of β-tyrosinase. Pyrocatechol and sodium pyruvate was added to the reaction solution intermittently to avoid the substrate depletion during the enzymatic reaction. After 24 hour of reaction, 31.6 g/ℓ L-DOPA was accumulated in the reaction solution as soluble and precipitated ones and the conversion yield was about 85.2%.

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