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염증성 장질환 환자에서 Azathioprine 사용방법에 따른 골수억제 부작용의 빈도
현경희 ( Kyung Hee Hyun ),이석호 ( Suck Ho Lee ),신재민 ( Jae Min Shin ),박동일 ( Dong Il Park ),이창균 ( Chang Kyun Lee ),신정은 ( Jeong Eun Shin ),은창수 ( Chang Soo Eun ),허규찬 ( Kyu Chan Huh ),황보영 ( Young Hwangbo ) 대한장연구학회 2012 Intestinal Research Vol.10 No.3
Background/Aims: The most important adverse effect of azathioprine (AZA) is bone marrow toxicity (BMT). Many physicians have preferred a gradual dose increment (GDI) policy for the prevention of BMT. The aim of this study was to evaluate the efficacy of GDI for the prevention of AZA-induced BMT in inflammatory bowel disease (IBD) patients. Methods: The medical records of IBD patients who received AZA in 6 university hospitals were reviewed. The patients were divided into two groups: the GDI group (initial dose <1.5 mg/kg, gradually increased to a therapeutic dose) and the non-GDI group (initial therapeutic dose ≥2 mg/kg). Results: A total of 308 patients were enrolled (male to female ratio, 1:2.3; mean age, 34.91±14.19 years; ulcerative colitis, 43.5%; Crohn`s disease, 55.2%; and intermediate colitis, 1.3%). The overall incidence of BMT was 16.2% (50/308). BMT developed most frequently between fourth to eighth week (26%, 13/50). The rate of BMT of the non-GDI group was significantly higher than that of the GDI group (27.5%, 11/40 vs. 14.6%, 39/268, P=0.038). A multivariate analysis showed that the only factor related to BMT was a non-GDI policy (P=0.036; odds ratio, 2.41; 95% confidence interval, 1.06-5.49). Conclusions: A GDI policy could be useful for reducing AZA-induced BMT in Korean IBD patients. (Intest Res 2012;10:244-250)
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김나래 ( Na Rae Kim ),정동해 ( Dong Hae Chung ),백정흠 ( Jeong Heum Baek ),박연호 ( Yeon Ho Park ),경희은 ( Hee Eun Kyung ),노미숙 ( Mi Sook Roh ),하승연 ( Seung Yeon Ha ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2
Squamous cell carcinoma of the rectum is extremely rare. Herein we report two cases of rectal squamous cell carcinoma. Case 1 was a 44-year-old Korean female presenting with abdominal pain and rectal bleeding for 3 months before her hospital visit. A colonoscopic examination revealed an ulcerated rectal mass 8 cm proximal to the anal verge. Chemoradiotherapy was administered following Hartmann``s procedure in case 1. The patient remained alive during 19 months of follow up. Case 2 was a 43-year-old Korean female who had severe constipation for 2 months. A barium enema and computed tomography of the pelvis showed a rectal mass adherent to the sacrum. Based on the results of a colonoscopic biopsy, a diverting colostomy was performed in case 2, with no further treatment. The pathologic findings showed that both tumors were composed of oval-shaped cells with abundant eosinophilic cytoplasm and intercellular bridges with keratin pearls, and thus were diagnosed as well-differentiated squamous cell carcinoma. Neither of the cases showed evidence of HPV infection. The pathogenesis of rectal squamous cell carcinoma has not been clarified. Herein we report two cases of rectal squamous cell carcinoma and briefly discuss the possible histogenesis. (Intest Res 2010;8:172-176)
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강경진,김정미,민혜영,안소진,오경숙,은경희,이현,이희선,홍주미,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37
There have been so many researches about problems of cigarettes and relation of smoking and heath since 1950's and generally known that smoking is one of the worst factor of increasing disease and mortality. No matter what such many proofs about various problems of smoking have been researched, smoking rate of current male collage students has not been decreased. Besides, most of the researches about cigarette use and its addiction have been focused on the adolescent or adult women smokers or adult male, not male collage student. Therefore, the subject of this study is about smoking attitude and smoking behavior of male collage students by general features. Smoking attitude was analyzed by modifying 'Guidelines for the content of tobacco smoking surveys of the general population'(WHO, 1982). Two hundred of male collage students participated to the distributed questionnaire for one week in May. The smoking attitude was categorized into duration of smoking and number of cigarette per day(CPD), and nicotine dependency, investigated by Fagerstrom Tolerance Questionnaire(FTQ) (Fagerstorm & Schneider, 1989). All statistics were performed by procedure of SAS according to number, percentage, mean, standard deviation, and ANOVA. The results are as follows: 1. Smoking attitude level was mean 25.73±5.15 marks, ranging from 13 to 39 marks of the total 40 marks. 2. Duration of cigarettes, number of cigarette per day, and nicotine dependency were mean 5.14±2.84 years, 12.88±6.85 pieces, and 4.78±1.69, respectively. 3. Smoking attitude showed significance according to general features such as marital state and allowance, but the significance according to marital state is not valuable because the numerical difference is so big between married one and single that they cannot be compared with each other. 4. Duration of smoking was significant according to general features such as age and allowance. 5. Smoking amount showed significance the factors of age only. 6. ll1ere was no significance in nicotine dependency according to general features. As a result, smoking attitude of male collage student in this study shows moderate level. Smoking attitude and duration is significant according to allowance, and smoking amount is significant according to age. Nicotine dependency according to general features is not significant but comparing with the preceding study about adult male, male collage students in this study are respectively more nicotine-dependent than adult male smokers. In conclusion, the right allowance usage strategies and effective heath education focused on the young are needed. In addition, helpful programs and information spreading strategies are necessary for establishing higher level of smoking attitude. At last, systemic regulations in daily living for ""anti-nico-dependent"" and perspective reforming of male university student are needed for reducing nicotine dependency.
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