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Jun Eul Hwang,Ju-Young Yoon,Woo Kyun Bae,Hyun Jeong Shim,Ik Joo Chung 대한부인종양학회 2012 Journal of Gynecologic Oncology Vol.23 No.1
Cancers of an unknown primary site are heterogenous with respect to their clinical and pathologic features. They are generally very aggressive, but specific favorable subsets have a better prognosis. For these favorable subsets, taxane based chemotherapy is very effective for a subset of woman with papillary serous peritoneal adenocarcinoma. A 52 year-old woman underwent [^(18)F]- FDG PET/CT for routine health screening. On PET/CT, multiple hypermetabolic lymph nodes were detected in the paraaortic spaces, and there were no other hypermetabolic abnormalities. The patient was diagnosed with an unknown primary cancer that probably originated from the ovary or peritoneum, according to clinical studies and biopsy results. This was not a typical case of a favorable subset of cancer of an unknown primary site, but the tumor showed complete biologic response to taxane based chemotherapy as revealed by PET/CT, and necrotic tumor cells were confirmed by surgery.
Newly Developed Multiple Myeloma in a Patient with Primary T-Cell Lymphoma of Bone
Jun Eul Hwang,조상희,Ok Ki Kim,Hyun Jeong Shim,Se Ryeon Lee,Jae Sook Ahn,양덕환,김여경,이제중,김형준,정익주 대한의학회 2008 Journal of Korean medical science Vol.23 No.3
Primary non-Hodgkin’s lymphoma of bone (PLB) is rare, and generally presents as a single extensive and destructive bone lesion. Histopathologically, most cases present as diffuse large B-cell lymphoma, and T-cell lymphoma is rare. By contrast, multiple myeloma is a disease defined as the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. We report a case of multiple myeloma that developed during treatment of PLB in a type of T-cell. A 48-yr-old man was diagnosed as T-cell PLB, stage IE, 18 months ago. The patient received the chemoradiotherapy and salvage chemotherapy for PLB. However, the lymphoma progressed with generalized bone pain, and laboratory findings showed bicytopenia and acute renal failure. On bone marrow biopsy, the patient was diagnosed as having multiple myeloma newly developed with primary T-cell lymphoma of bone. In spite of chemotherapy, the patient died of renal failure.
혈액종양 : 암 환자에서 염산히드로모르폰 서방정의 효과와 내약성에 대한 연구
황준일 ( Jun Eul Hwang ),김대은 ( Dae Eun Kim ),김하나 ( Ha Na Kim ),윤주영 ( Ju Young Yoon ),배우균 ( Woo Kyun Bae ),심현정 ( Hyun Jeong Shim ),조상희 ( Sang Hee Cho ),정익주 ( Ik Joo Chung ) 대한내과학회 2011 대한내과학회지 Vol.80 No.3
목적: 암성통증은 흔한 증상 중 하나로 진통제를 이용한 통증 조절은 환자의 통증 강도에 따른 적절한 약물 선택이 중요하다. 염산히드로모르폰 서방정은 합성 마약성 진통제의 하나로 2006년에 개발된 1일 1회의 강한 마약성 진통제이며, 현재까지 기존의 마약성 진통제를 사용하던 환자를 대상으로 진행된 임상 연구 결과는 있으나, 마약성 진통제 투약 경험이 없는 환자에게서 염산히드로모르폰 서방정을 이용한 암성 통증 조절에 대한 임상 자료는 없다. 그러므로 강한 마약성 진통제 투약 경험이 없는 암환자에 대한 염산히드로 모르폰 서방정의 유효성과 안전성을 알아보고자 하였다. 방법: 20세 이상의 중등도(NRS 4) 이상의 통증을 호소하며 최근 한달 이내에 강한 마약성 진통제 투약 경험이 없는 환자를 대상으로 염산하이드로모르폰서방정 8 mg으로 투약을 시작한다. 용량 조절은 매 2일 간격으로 하며 지난 24시간 동안 4회 이상의 돌발성 통증 치료제 투약이 있었던 경우 시험약의 용량을 증량한다. 다만 이상 반응으로 인해 용량의 증가가 의학적으로 바람직하지 않다고 판단될 경우 현재 투약 중인 용량을 유지하거나 중단 혹은 낮출 수 있다. 돌발성 통증 치료제 이외의 다른 마약성 진통제는 사용하지 않는다. 평가 변수로 1차 방문과 마지막 방문에서의 지난 24시간 NRS 감소정도(%) (baseline에서 NRS minus 마지막 방문에서의 NRS/baseline에서 NRS), 연구기간 동안 지난 24시간 NRS 변화 추이, 1차 방문 이후 안정적인 통증 조절에 도달하는 피험자 비율(안정적인 통증 조절: 연속 2일 동안 지난 24시간 평균 통증 강도가 NRS 3 이하로 유지되고 돌발성 통증 마약성 진통제 투약 횟수가 3회 이하인 경우) 등을 보고자 하였다. 또한 부작용, 피험자 만족도, 연구자의 평가 등도 알아보고자 하였다. 결과: 총 23명의 고형암 환자가 참여하였고, 그 중 3명이 탈락 되었다. 22명(95.7%)의 환자가 4기 환자였다. 1차 방문과 마지막 방문에서의 지난 24시간 NRS 감소정도(%)는 59%로 현저한 감소를 보였다. 연구기간 동안 지난 24시간 NRS 변화 추이도 1차 방문시 4.4에서 3차 방문 시 1.8로 감소를 보였다. 또한 1차 방문 이후 안정적인 통증 조절에 도달하는 피험자 비율은 100%였다. 부작용은 여느 다른 마약성 진통제의 부작용과 유사하였으며, 통증 치료에 대한 피험자의 만족도는 매우 만족 26.1%, 만족 47.8%를 보였고, 시험자의 전반적인 평가 또한 대단히 효과적 43.5%, 효과적 30.4%를 보였다. 결론: 염산히드로모르폰 서방정은 1일 1회 복용의 마약성 진통제로 강한 마약성 진통제 투약경험이 없는 환자에서 암성 통증 조절에 매우 유효하고 안전하다고 하겠다. Background/Aims: OROS hydromorphone is a synthetic opioid agent. While clinical studies have tested its effectiveness at controlling cancer-associated pain in patients who have received other strong opioids, no clinical studies have tested its effectiveness at managing cancer pain in strong opioid-naive patients. We performed the present study to evaluate the efficacy and tolerability of OROS hydromorphone in strong opioid-naive cancer patients. Methods: We administered OROS hydromorphone to patients who had not received strong opioids during the previous month. The starting dose was 8 mg/day. The dose was increased every 2 days in patients who experienced more than four episodes of breakthrough pain per day (more than four times in patients being treated with short-acting opioids). We evaluated the efficacy, safety and tolerability of ORS hydromorphone. We also evaluated patient satisfaction and investigators` global assessments. Results: We enrolled 23 patients to the study. The decrease in the numeric rating scale (NRS) was 59%. NRS variation had decreased markedly during the previous 24 h. All patients achieved stable pain control. The side effects were similar to those of other strong opioids. In total, 26% of patients were very satisfied with the treatment and 47% satisfied, and 74% of the investigators deemed OROS hydromorphone to be very effective or effective at controlling cancer pain. Conclusions: OROS hydromorphone is an osmotically driven, controlled-release preparation that is very effective and safe when administered once daily to strong opioid-naive cancer patients. (Korean J Med 2011;80:317-322)
황준일 ( Jun Eul Hwang ),우학 ( Hak Woo ),김상호 ( Sang Ho Kim ),이우석 ( Woo Seok Lee ),황재하 ( Jae Ha Hwang ),김정철 ( Jung Chul Kim ),조덕 ( Duck Cho ),박정진 ( Jeong Jin Park ),이신석 ( Shin Seok Lee ),박용욱 ( Yong Wook Pa 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.2
Necrotizing fasciitis is a life-threatening soft tissue infection involving skin, subcutaneous tissue, and superficial fascia. We report a case of necrotizing fasciitis that developed in a 76-year-old female patient taking low-dose methotrexate and prednisolone for rheumatoid arthritis (RA). A computed tomography scan of the neck during the initial work-up showed soft tissue swelling, loss of fat planes, and mild heterogeneous enhancement in the right lateral neck, suggesting cellulitis. The lesions were associated with skin necrosis and multiple bullae rapidly expanded to the right anterior chest in spite of empirical antibiotic therapy. Surgical debridement was immediately performed, and soft tissue biopsy from the lesions showed the pathologic finding consistent with necrotizing fasciitis. The skin wound defect was reconstructed by a flap operation with split-thickness skin graft. This case shows the development of necrotizing fasciitis in a elderly patient taking methotrexate and low-dose steroid for RA and highlights early recognition and prompt surgical debridement for successful management.
Hwang, Eu Chang,Yu, Seong Hyeon,Jo, Yang Hyun,Jung, Seung Il,Kang, Taek Won,Kwon, Dong Deuk,Choi, Chan,Heo, Suk Hee,Hwang, Jun Eul,Jung, Sung-Hoon,Jung, Tae-Young Medknow PublicationsMedia Pvt Ltd 2016 ASIAN JOURNAL OF ANDROLOGY Vol.18 No.1
<P>Several studies have revealed that the preoperative serum testosterone and percent tumor volume (PTV) predict extra-prostatic extension (EPE) and biochemical recurrence (BCR) after radical prostatectomy. This study investigated the prognostic significance of serum testosterone and PTV in relation to EPE and BCR after laparoscopic radical prostatectomy (LRP). We reviewed 520 patients who underwent LRP between 2004 and 2012. PTV was determined as the sum of all visually estimated tumor foci in every section. BCR was defined as two consecutive increases in the postoperative prostate-specific antigen (PSA) >0.2 ng ml<SUP>−1</SUP>. The threshold for serum total testosterone was 3.0 ng ml<SUP>−1</SUP>. Multivariate logistic regression was used to define the effect of variables on the risk of EPE and BCR. A low serum testosterone (<3.0 ng ml<SUP>−1</SUP>) was associated with a high serum PSA, Gleason score, positive core percentage of the prostate biopsy, PTV, and all pathological variables. On multivariate analysis, similar to previous studies, the serum PSA, biopsy positive core percentage, Gleason score, and pathological variables predicted EPE and BCR. In addition, low serum testosterone (<3.0 ng ml<SUP>−1</SUP>, adjusted OR, 8.52; 95% CI, 5.04–14.4, <I>P</I> = 0.001) predicted EPE and PTV (adjusted OR, 1.02; 95% CI, 1.01–1.05, <I>P</I> = 0.046) predicted BCR. In addition to previous predictors of EPE and BCR, low serum testosterone and PTV are valuable predictors of EPE and BCR after LRP.</P>
황을상 ( Hwang Eul Sang ),유화정 ( Yu Hwa Jeong ),유동수 ( Yu Dong Su ),송해준 ( Song Hae Jun ),오칠환 ( O Chil Hwan ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.12
Desmoplastic trichoepithelioma is a rare benign adnexal tumor that usually presents as an asym-ptomatic, firm, annular plaque. It most commonly occurs on sun-exposed areas in middle-aged women, especially on the face. Patients typically give a history of a single, slow-growing lesion that has been present for several years. The diagnosis of desmoplastic trichoepithelioma can be made when a triad of microscopic findings are observed in combination with a compatible clinical picture. We herein report a case of desmoplastic trichoepithelioma associated with syringomas on the face of a young woman. (Korean J Dermatol 2003;41(12):1650~1653)
수정 안정수렴법을 이용한 케이블 돔의 기하학적 비선형 동적해석
서준호(Seo Jun-Ho),한상을(Han Sang-Eul),황보석(Hwang Bo Seok) 대한건축학회 2003 大韓建築學會論文集 : 構造系 Vol.19 No.6
Cable domes deform very largely because of the characteristics of flexible hybrid system and pre-tension, and include geometrical non-linearity in those structural behavior. Especially wind load is more dominant than seismic load, because cable domes are flexible structures whose bending stiffness is very small and self-weight is very light. Therefore, in this paper, the Modified Stiffly Stable Method is applied to analyze the nonlinear dynamic behavior of cable domes and compared these results with ones of the Newmark-β Method which is generally used. The Seoul Olympic Gymnastic Arena is taken as an numerical example and three kinds of models with giving each different intensity of pre-tension are selected. And dynamic nonlinear behavior of cable domes are analyzed by artificial spectrum of wind velocity wave which is similar to actual wind loads.