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원발성 위장관 악성 림프종의 임상적 고찰 : 치료 결과를 중심으로
원종호,백승호,홍대식,오도연,박희숙 순천향대학교 1994 논문집 Vol.17 No.4
저자들은 1984년 3월부터 1992년 12월까지 순천향 대학교 부속병원에서 원발성 위장관 악성 림프종으로 진단되었던 23명을 대상으로 다음과 같은 결론을 얻었다. 1. 대상 환자의 나이의 중앙치는 44(23-75)세로 남녀비가 2.8 : 1이었다. 2. 원발병소는 위 10예(43.5%), 소장 8예(34.8%) 및 회맹장 이행부위 5예(21.7%)였고, 병기 Ⅰ??기 8예(34.8%), Ⅱ??기 12예(52.2%), Ⅲ기 2예(8.7%), Ⅳ기 1예(4.3%)였다. 동반된 다른 장기는 주로 복부 임파절이었으며 폐 임파절 침범이 1예 있었고, 간을 침범한 경우가 1예, 위장과 소장에 병발한 경우가 1예 있었다. 조직학적 분류로는 중등도 19예(82.6%) 및 고도 4예(17.4%)였고 10예(43.5%)에서 B 증후가 있었다. 3. 치료를 시행한 20예중 Ⅰ??기 7예는 수술적 치료후 보조항암화학요법을 시행하였으며, Ⅱ??기 13예중 진단적 개복술후 완전절제가 확인된 3예는 보조항암화학요법을, 불완전절제로 확인된 7예는 관해유도 항암화학요법을 시행하였고, 3예는 항암화학요법만을 시행하였다. 4. 치료를 시행한 20예의 생존기간은 중앙치 43(4-100??개월이었으며, 3년 생존율 60.9%, 5년 생존율 40.6%였다. 5. Ⅰ??기 7예의 생존기간은 중앙치 42(11-100??개월이었으며, Ⅱ??, Ⅲ기 13예에서 치료에 대한 완전 관해가 9례(70%), 부분관해(15%), 무반응이 2례(15%)로 관해율은 85%였으며, 생존기간은 중앙치 44(4-52??개월이었다. 6. 완전관해자가 진행시까지의 관해지속기간은 중앙치 43(10-56??개월이었으며, 3년 무병생존율 79.1%, 5년 무병생존율 36.2%였다. Over a 8-year period(March 1984 through December 1992), 23 patients with primary gastrointestinal non-Hodgkin's lymphoma treated at Soonchunhyang University Hospital were analyzed with the following results; 1. The mean age of the patients was 43(23-75) years with male to female ratio of 2.8 : 1. 2. The primary sites of lymphoma were stomach in 10(43.5%), small intestine in 8(34.8%), and ileocecal area in 5(21.7%) and by modified Ann Arbor system, stage Ⅰ?? was 8(34.8%), stage Ⅱ?? was 12(52.2%), stage Ⅲ was 2(8.7%), and stage Ⅳ was 1(4.3%). Histologic classification by Working formulation revealed 19 cases(82.6%) of intermediate grade and 4 cases(17.4%) of high grade. B symptoms were observed in 10 cases(43.5%). 3. Treatments were performed in 20 cases as follows : In 7 cases with stage Ⅰ, complete surgical resection with systemic combined chemotherapy was performed. In 13 cases with stage ⅡE and Ⅲ, complete resection with systemic combined chemotherapy in 3 cases, incomplete resection with combined chemotherapy in 7 cases, and combined chemotherapy only in 3 cases. 4. Median survival duration of 20 treated patients was 43(4-100?? months and 3-year survival rate and 5-year survival rate were 60.9% and 40.6%, respectively. 5. Median survival duration of 7 cases with stage Ⅰ?? was 42 months(11-100??. In 13 cases with stage Ⅱ??, Ⅲ, response to treatment was complete remission in 9(70%), partial remission in 2(15%), and no response in 2(15%) resulting 85% of response rate and median survival duration was 44(4-52?? months. 6. Disease free survival rate of achieving a complete remission was 43(10-56?? months and 3-year disease-free survival rate and 5-year disease-free survival rate were 79.1% and 39.2%, respectively.
전신성 홍반성 루프스 환자에서 발생한 자가 면역성 간염 1례
김준재,백나나,김현정,전태주,서동대,오태훈,최원충 인제대학교 2008 仁濟醫學 Vol.29 No.-
SLE 환자에서 간 효소 수치의 상승은 여러 가지 원인에 의하여 드물지 않게 관찰될 수 있다. 이 중 자가 면역 기전에 의해 발생되는 질환으로 자가 면역성 간염과 SLE에 동반된 간염이 있으며, 두 가지 질환의 감별은 환자의 예후 및 치료에 중요하다. 따라서 간 조직 검사를 포함한 정확한 진단 기준으로 조기에 진단하여야 하며, 이에 따른 적절한 치료를 통해서 간 부전 및 비가역적 간경변증으로 진행을 방지할 수 있을 것으로 사료된다. Patients with systemic lupus erythematosus (SLE) have a 25-50% chance of developing abnormal liver tests in their lifetime and various causes are related to elevation of liver enzyme, such as hepatic involvement of lupus, hepatotoxic drug, viral infection, autoimmune hepatitis and so on. Discrimination of autoimmune hepatitis from SLE-associated hepatitis is important because complications and therapy are quite different, although both are autoimmune syndromes. Here we are presenting a case of SLE patient with type I autoimmune hepatitis proved with liver biopsy.
대뇌 기저핵 신경세포 일차배양에서 망간에 의해 유도된 Appoptosis : 형태학적인 소견
신동훈,김상표,정용욱,배재훈,송대규,백원기 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1
목적 : 본 실험은 대뇌기저핵의 신경세포를 배양하여 망간(MnCl₂)을 투여한 후 망간독성에 의한 신경세포의 apoptosis를 형태학적인 소견으로 관찰하였다. 방법 : 배양된 신경세포에 0.01에서 10μM Mnc12를 48시간동안 처리한 후 TUNEL (TdT-mediated dUTP Nick End Labelling)법 및 투과전자현미경학적으로 관찰하였다. 결과 : TUNEL방법을 이용하여 관찰한 결과 TUNEL반응에 갈색으로 양성반응을 나타내는apoptotic 세포의 수가 대조군에 비해 MnCl₂를 투여한 군에서 유의하게 높게 나타났으며(P〈0.05), 투과전자현미경학적 소견상 대조군의 신경세포들은 핵인(nucleolus)이 두드러지게 특징적으로 보이면서 핵막과 세포질내 소기관들이 잘 보존되어 있으며, 세포질내망(ER)과 사립체(mitochondria)를 특히 많이 가지고 있었다. Mnc12를 48시간 동안 처리한 군에서 이질염색질(heterochromatin)이 핵막으로 이동하면서 응집되어 있었으며, 핵내 불규칙한 형태의 염색질이 나타나 분절이 진행되는 소견을 보였고, Apoptosis의 가장 특징적인 초기 소견인 막으로 둘러싸인 반달모양의 핵내염색질의 분절편(fragment-ed chromatin)과 주위의 상대적으로 정상적인 소기관으로 구성된 apoptotic body를 관찰할 수 있었다. 결론 : 신경세포에서 망간에 의해 apoptosis가 유도됨을 형태학적인 방법으로 확인할 수 있었으며 망간에 의한 세포사망양상에 apoptosis가 하나의 기전이 될 수 있을 것이다. Objectives : Manganese is cytotoxic to the central nervous system including basal gan-glia. Its toxic mechanism is related to oxidative stress, mediated by toxic free radicals but is specultives. In the present study , we have investigated to manifest apoptosis in man-ganese-induced cytotoxicity in primary neuronal cell culture of rat basal ganglia. Methods : To detect apoptotic neuronal cells were stained by the terminal deoxynu-cleotide (TdT) -mediated dUTP nick end-labelling (TUNEL) method and apoptotic changesin nuclei of neurons were observed by electron microscopy. Results : We showed that TUNEL immunostain showed brownish signal in the nuclei of apoptotic cells and the proportions of apoptotic cells in Manganese treatment groups were more higher than controls. On transmission electron microscopy, there were chromatine condensation with margination toward nuclear membrane and condensation of cyto-plasm in the treated with luM MnCl²for 48 hours in a basal ganglia neurons. Apoptotic bodies were found and consisted of semilunar-like condensed nuclei with relatively intact cytoplasmic organelles. Conclusions : Apoptosis appears to be one mechanism in the manganese-induced net-ronal cell death. Manganese intoxication is a convenient model for apoptosis study.
( Dae Won Jun ),( Byung Ik Kim ),( Yong Kyun Cho ),( Hong Ju Kim ),( Young Oh Kwon ),( Soo Young Park ),( Sang Young Han ),( Yang Hyun Baek ),( Yong Jin Jung ),( Hwi Young Kim ),( Won Kim ),( Jeong He 대한간학회 2013 Clinical and Molecular Hepatology(대한간학회지) Vol.19 No.2
Background/Aims: Carnitine and vitamin complex (Godex®) is widely used in patients with chronic liver disease who show elevated liver enzyme in South Korea. The purpose of this study is to identify the efficacy and safety of carnitine from entecavir combination therapy in Alanine aminotransferase (ALT) elevated Chronic Hepatitis B (CHB) patients. Methods: 130 treatment-na?ve patients with CHB were enrolled from 13 sites. The patients were randomly selected to the entecavir and the complex of entecavir and carnitine. The primary endpoint of the study is ALT normalization level after 12 months. Results: Among the 130 patients, 119 patients completed the study treatment. The ALT normalization at 3 months was 58.9% for the monotherapy and 95.2% for the combination therapy (P<0.0001). ALT normalization rate at 12 months was 85.7% for the monotherapy and 100% for the combination group (P=0.0019). The rate of less than HBV DNA 300 copies/mL at 12 months was not statistically significant (P=0.5318) 75.9% for the monotherapy, 70.7% for the combination and it was. Quantification of HBsAg level was not different from the monotherapy to combination at 12 months. Changes of ELISPOT value to evaluate the INF-Y secretion by HBsAg showed the increasing trend of combination therapy compare to mono-treatment. Conclusions: ALT normalization rate was higher in carnitine complex combination group than entecavir group in CHB. Combination group was faster than entecavir mone-treatment group on ALT normalization rate. HBV DNA normalization rate and the serum HBV-DNA level were not changed by camitine complex treatment.
Effect of Soil Amendments on Arsenic Reduction of Brown Rice in Paddy Fields
Dae-Won Kang,Da-Young Kim,Ji-Hyock Yoo,Sang-Won Park,Kyeong-Seok Oh,Oh-Kyung Kwon,Seung-Hwa Baek,Won-Il Kim 한국토양비료학회 2018 한국토양비료학회지 Vol.51 No.2
There is an increasing concern over arsenic (As) contamination in rice since Codex Committee on Contaminants in Food (CCCF) discuss on maximum levels for As in rice in 2010. This study was conducted to reduce As concentration in rice by soil amendment treatments in paddy field soils contaminated by As. The selected four amendments were poultry manure, agri-lime, steel slag, and gypsum with the addition of 3% or 5% (w/w) on a dry basis. The As reduction effect could not be verified, as a result of the pot test by adding poultry manure to the paddy soil around the mine located in Yesan. Among the agri-lime treated rice cultivated pots, the As concentration increased up to 32.1%. On the other hand, the content of As in the sample pots treated with steel slag and gypsum decreased by 65.4% and 63.4%, respectively. On the basis of the results of these pot experiments, the field test was carried out in the As polluted rice field around the mine located in Yesan, and when the four amendments were treated, the As content in the brown rice reduced in all the amendment treatments compared with the control plot. The As reduction in brown rice of the amendment was confirmed to be higher efficiency by the order of gypsum > steel slag > poultry manure > agri-lime. As a result of pot experiments using paddy soil around the mine located in Seosan, As stabilization efficiency in rice and As reduction effect could not be determined by comparison to the control. From the rice cultivated from agri-lime treated pot, As concentration increased by 15.8% in rice. On the other hand, the As content of the pots treated with steel slag and gypsum decreased by 39.1% and 60.2%, respectively. In conclusion, distinguished As reducing effectiveness could be expected by soil amendment treatments for rice cultivation.
( Dong Won Baek ),( Han-seung Park ),( Sang Kyun Sohn ),( Dae Young Kim ),( Inho Kim ),( Jae-sook Ahn ),( Young Rok Do ),( Se Ryeon Lee ),( Hyeon-seok Eom ),( Won-sik Lee ),( Sung-hyun Kim ),( Ho Sup 대한내과학회 2023 The Korean Journal of Internal Medicine Vol.38 No.5
Background/Aims: We performed a prospective study to determine the efficacy and safety of rituximab including chemotherapy in CD20-positive acute lymphoblastic leukemia (ALL). Methods: Patients with newly diagnosed ALL, aged ≥ 15 years, were eligible for the study if their leukemic blast cells in bone marrow expressed CD20 ≥ 20% at the time of diagnosis. Patients received multiagent chemotherapy with rituximab. After achieving complete remission (CR), patients received five cycles of consolidation with concomitant rituximab. Rituximab was administered monthly from day 90 of transplantation for patients who received allogeneic hematopoietic cell transplantation. Results: In patients with Philadelphia (Ph)-negative ALL, 39 of 41 achieved CR (95.1%), the 2- and 4-year relapse-free survival (RFS) rates were 50.4% and 35.7%, and the 2- and 4-year overall survival (OS) rates were 51.5% and 43.2%, respectively. In the group with Ph-positive ALL, all 32 patients achieved CR, the 2- and 4-year RFS rates were 60.7% and 52.1%, and the 2- and 4-year OS rates were 73.3% and 52.3%, respectively. In the Ph-negative ALL group, patients with higher CD20 positivity experienced more favorable RFS (p < 0.001) and OS (p = 0.06) than those with lower CD20 positivity. Patients who received ≥ 2 cycles of rituximab after transplantation had significantly improved RFS (hazard ratio [HR], 0.31; p = 0.049) and OS (HR, 0.29; p = 0.021) compared with those who received < 2 cycles. Conclusions: The addition of rituximab to conventional chemotherapy for CD20-positive ALL is effective and tolerable (Clinicaltrials.gov NCT01429610).