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진행성 간세포암에 대한 Epirubicin , Cisplatin 및 5 - FU 병용 화학요법의 치료효과
박병채 ( Byung Chae Park ),한병훈 ( Byung Hoon Han ),이상욱 ( Sang Wook Lee ),구자영 ( Ja Young Koo ),서승연 ( Sung Yeon Suh ),이성계 ( Sung Kae Lee ) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.3
N/A Forty-eight patients with unresectable primary hepatocellular carcinoma (PHC), not complicated with ascites (Group IIA) and 39 patients with ascites (Group IIB) were treated with a combination of Epirubicin (60 mg/m, IV, Day 1, q 3 weeks), cisplatin (60 mg/m, IV, Day 2, q 3 weeks) and 5 -fluorouracil (1000 mg, IV, Day 3, q 3 weeks). Partial response (PR: tumor had diminished at least 50 % from its original size) and survival rate of the treated patients were closely matched and compared with those of the untreated control patients (118 cases) who had similar tumor burden, performance status, and the presence or absence of ascites. This regimen was, in most cases, safe with moderate toxicity: nausea, vomiting, temporary ascites formation, and hair loss. PR in Group IIA was observed in 9 cases, always within the third dose with a 18.7% response rate. No complete response was observed in this group of patients. In Group IIB patients, however, PR was observed in only one case. Thirty-two (77%) of 42 symptomatic Group IIA and 13 (36%) of 36 symptomatic Group IIB patients achieved pain reduction. Survival rate of Group IIA patients (46% at 24 weeks and 20% at 48 weeks) was significantly (p<0.05) higher than those of the untreated control patients (Group IA: 20% at 24 weeks and 0% at 48 weeks). Though survival rate of Group IIB patients (9% at 16 weeks and 4% at 16 weeks) was somewhat better than contrcl patients (Group IB: 4% at 16 weeks and 0% 24 weeks), this figure was not significant statistically. In conclusion, this therapy has given more anticancer effect to the patients with advanced PHC, not complicated with ascites, than the other systemic chemotherapy. And therefore, it can be expected to be useful as a first-choice for PHC patients without ascites, prior to, or unsuitable for, chemoembolization and/or radioembolization therapy.
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간장및 담도 : 복수를 동반한 간경변증 환자에서 혈청 Albumin 및 Aldosterone치의 변화와 Atrial Natriuretic Factor의 대응에 관한 연구
구자영(Ja Young Koo),박병채(Byung Chae Park),서승연(Sung Yeon Suh),한병훈(Byung Hoon Han),이상욱(Sang Wook Lee),서보원(Bo Won Suh),최경희(Kung Hee Choi),남철우(chul Woo Nam) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
N/A In order to evaluate the role in 24hr urinary sodium retension of serum albumin, aldosterone and ANF concentration in patients with decompensated liver cirrhosis, we measured the levels of serum albumine, aldosterone, ANF and 24hr urinary sodium excretion in patients with compensated liver cirrhosis (Group I,n=15), decompensated liver cirrhosis (Group II, n=15) and normal control person (Group III, n=13). The results are as follows; 1) Albumin, aldosterone, 24hr urinary sodium output show no defference between group I & III, but albumin and 24 hr urinary sodium output was significanctly decreased (p<0.005), aldosterone was significantly increased (p<0.005) in group II. 2) ANF was 38.0 +- 17.9 fmol/ml in group I, 50.2 +- 33.9 fmol/ml in group II, 23.4 +- 20.3 fmol/ml in group III, showed significant difference between group II and III (p<0.025). 3) Albumine shows positive correlationship with 24 hr urinary sodium output (r=0.642, p<0.005), negative correlationship with ANF (r= -0.346, p<0.025) and aldosterone (r=-0.529, p<0.005). These findings indicate that decreased albumine concentration has a strong relationship with sodium retention and ascites development. ANF begins to increase to compensate the sodium retension at early liver cirrhosis, but not enough at the late stage of liver cirrhosis so brings the ascites, and aldosterone increament is only but a secondary phenomenon to ascites.
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권오종,박근용,송홍석,서승연,전동석,권석룡 대한내과학회 1987 대한내과학회지 Vol.33 No.6
A 66-year-old farmer was admitted with dizziness and dyspnea on exertion. The peripheral blood showed hematocrit of 8.4 gm/dl with microcytic hypochromic anemia, serum iron of 26 ㎍/dl, total iron binding capac- ity of 316 ㎍/dl, and ferritin of 1.64 ng/ml. The bone marrow smear revealed normal cellularity with 4:1 of myeloid/erythroid ratio, 2.9% of plasmacytosis with normal morphology, and no stainable iron. Protein electrophoresis revealed prominent monoclonal gam-mopathy in gamma-fraction and arc of IgM-kappa type in both serum and urine. After observation of 1 year with iron supplementation, M-component of serum and urine is increased 33% and 71% from initial value. This case is 1st case of idiopathic IgM monoclonal gammopathy in korea which associated with iron deficiency anemia, and regular examination is needed whether the disorder is progression to the lymphoproliferative malignancy.
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안수열,임학,문미경,최영식,차태준,서승연,구자영,박병채 대한내과학회 1992 대한내과학회지 Vol.42 No.2
We assessed 79 cases of chloangiocarcinoma which was diagnosed histologically at Kosin General Hospital and Kim Hae Gospel Hospital from 1986 to 1990 and the results are as follows; 1) More than half of all patients were beyond sixth decade, the ratio of male to female was 2:l and 2.8:1 in intra and extrahepatic cholangiocarcinoma, respectively. 2) Prevalence rate of clonorchiasis was 30%, 18.4% in intrahepatic and extrahepatic cholangiocarcinoma, respectively, and prevalence rate of clonorchiasis in intrahepatic cholangiocarcinoma was markedly higher than that (19.6%) of general population in Pusan, Kyungnam area. 3) The predominant symptoms were general weakness (90.0%), abdominal pain (53.3%), jaundice (46.7%) in intrahepatic cholangiocarcinoma, and in extrahepatic cholangiocarcinoma, jaundice was the most frequent symptom (75.5%). 4) Of the 11 patients with distant metastases in in trahepatic cholangiocarcinoma, the most common site of metastases was abdominal lymph nodes (91 .O%) followed by liver (36.4%), peritoneum (27.3%) and kindey (18.2%). 5) Serum CEA level was more than 10ng/㎖ in 66.7% of intrahepatic cholangiocarcinoma and 26.5% of extrahepatic cholangiocarcinoma which suggested that serum CEA level may be more useful in the diagnosis of intrahepatic cholangiocarcinoma than extrahepatic cholangiocarcinoma. Serum CA 19-9 level was more than 37 U/㎖ in 80.0% of intrahepatic cholangiocarcinoma and 67.3% of extrahepatic cholangiocarcinoma. 6 ) Of the 11 patients with distant metastases in intrahepatic cholangiocarcinoma. 9 patients (81.8%) had serum CEA levels of more than 60ng/㎖, and 5 of 19 patients (26.3%) with localized tumor showed CEA levels of more than 60 ng/㎖, the difference between these two groups was statistically significant (p< 0.05).
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