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곽상혁,신현영,김성은,이정호,이정찬,강정현,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1
Although acute lymphoblastic leukemia(ALL) is one of the most frequently encountered cancer in children, only about 20% of patients who were diagnosed leukemia are ALL in adults. During past 30 years, the result of treatment of ALL in children have been markedly improved, but in adults, the result of treatment of ALL is not so good as that in children. In recent, morbidity of ALL has been increased in KOREA, but studies of long-term survival are rare. So a retrospective clinical analysis was made in patients who were diagnosed for adult acute lymphoblastic leukemia between March 1988 and February 1997, in Chungnam National University Hospital. The result of treatment, prognostic factors of survival and duration of complete remission were analyzed. In 44 patients who were newly diagnosed as ALL in Chungnam National University Hospital, total 31 patients who have received chemotherapy more than two weeks were analyzed. All patients were treated by vincristine, daunorubicine, and prednisolone in phase I induction chemotherapy. At the 28th day of phase I induction chemotherapy, bone marrow aspiration biopsy was performed and achievement of complete remission was estimated. Within one or two weeks after completion of phase I chemotherapy, phase II induction chemotherapy was done. In phase II induction chemotherapy, cyclophosphamide, cytosine arabinoside and 6-mercaptopurine were administerd. During phase II induction chemotherapy, CNS prophylaxis with intrathecal methotrexate administration and intracranial irradiation. After completion of phase I and phase II of induction chemotherapy, 4 cycles of consolidation chemotherapy were made in utilization of VP-16 and cytosine arabinoside in standard risk group, and in utilization of methotrexate with leucovorin rescue and L-asparaginase in the high risk group. And then maintenance chemotherapy with 6-mercaptopurine and methotrexate was continued till two years later from the day of treatment start. The median survival time was 15.8 months (95% C.I. 6.0-18.8 months) and the long-term survival (more than 5 years after diagnosis) rate was 28.0%. The rate of complete remission was 83.9% ( 26 of 31) and the median of the complete remission duration was 15.8 months (95% C.I. 5.6-25.9 months). The rate of relapse was 69.2%. Good prognostic factor for overall survival time was the fraction of blast cells less than 75% in bone marrow at diagnosis (P=0.001) in univariate analysis. In multivariate analysis, age below 40 (P=0.003) and blast cells less than 75% in hone marrow at diagnosis (P=0.003) were good prognostic factors for overall survival time. Good prognostic factors for disease free survival in univariate analysis were the fraction of blast cells less than 75% in bone marrow (P=0.003), absence of fever (P=0.013), and absence of hepatomegaly (P=0.025), all at diagnosis. In multivariate analysis, good prognostic factors for disease free survival were platelet count more than 50,000/uL, blast cells less than 75% in bone marrow at diagnosis (P=0.004), serum LDH level below 500U/L (P=0.016). The result of treatment of ALL in adults has been improved but is not satisfactory in comparison with that in children. Despite of marked improvement of the rate of complete remission, the rate of relapse still not so much improved. So intensified consolidation chemotherpy or allogenic bone marrow transplantation or autologous bone marrow transplantation is necessary for improvement of survival of adult ALL.
가스터빈 연소기에서 화염 간의 상호작용이 화염전달함수에 주는 영향 분석
곽상혁(Sanghyeok Kwak),최재홍(Jaehong Choi),이민철(Min Chul Lee),윤영빈(Youngbin Yoo) 한국연소학회 2022 KOSCOSYMPOSIUM논문집 Vol.2022 No.11
The effect of flame-flame interaction on flame transfer function (FTF) were analyzed in single- and dual-nozzle combustors. FTFs of two combustors showed similar low-pass filter trend and several peaks in the gain of FTF. The frequency where gain had peak values shifted to higher frequency in the dual-nozzle combustor due to flame-flame interaction. In addition, we found that flame-flame interaction in the dual-nozzle combustor enhanced nonlinearity in forced response of flame compared to the single-nozzle combustor. In our future works, we will measure flame structure using OH* chemiluminescence imaging to find the reason why the flame-flame interaction induces differences in FTF and nonlinearity in forced responses.
골융해 골전이가 있는 악성종양 환자에서 Oral clodronate의 임상적 치료효과
김종숙,곽상혁,강정현,김철희,배광봉,김현수,박상준,최지영,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1
The skeleton is common metastatic site for cancer. Although bone metastases are not usually life-threatening, they are often the cause of severe morbidity and can produce clinical problems of both acute and a chronic nature. Characteristically. patients experience severe bone pain and pathologic fracture. Hypercalcemia and hypercalciura can occur when the metastatic lesions are predominantly osteolytic and are often worsened by the immobility that results from excessive skeletal pain, especially when weight-bearing bones are involved. The bisphosphonates are enzyme-resistant analogues of pyrophosphate, the naturally occuring inhibitor of bone mineralisation. They bind to hydroxyapatite crystals, inhibit osteoclast-mediated bone resorption. The clinical effect of oral clodronate was assessed in 20 patients with advanced cancer associated with osteolytic bone metastases in an open trial of 4 week duration. The dose was 800-1,600mg/day. The level of calcium on day 7 in hyercalcemic patients was significantly reduced by oral clodronate treatment(p<0.05). In normocalcemic patients the serum calcium level did not change significant statistically after coldronate treatment. The subjective improvement of pain was seen in 60% of patients. The side effect of clodronate was nausea and vomiting but tolerable. In conclusion, oral coldronate provided effective control hypercalcemia and pain associated with osteolytic bone metastases and was well tolerated.