진행성 비소세포폐암의 이차항암화학요법으로서 Docetaxel 단독요법의 성적

강현모,이정은,장필순,이연선,권선중,안진영,정성수,김주옥,김선영 충남대학교 암공동연구소 2006 암공동연구소 업적집 Vol.5 No.

Background : The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second -line chemotherapy, for which Docetaxel (Taxotere^(?)) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum-based chemotherapy. Methods : Thirty one patients with non-small-cell lung cancer, who had failed first line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either 75 mg/㎡ or 100 mg/㎡, with routine premedication every three weeks. Results : Fourteen patients (45.2%) had a partial response. The median survival and progression- free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age (< 60 years: 20.1 months vs. > 60 years: 6.6 months, p=0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. Conclusion : Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small-cell lung cancer who failed first line platinum -based chemotherapy. (Tuberc Respir DiS 2005: 58: 465-472) 연구배경 : 일차항암화학요법 후에 생존의 이득을 얻었음에도 불구하고 비소세포폐암 환자들의 대다수가 결국은 재발하거나 진행성 병변을 보인다. 이에 저자들은 기존의 여러 연구에서 보고 된 구제요법으로서 docetaxel의 항암효과와 비교적 적은 독성의 결과를 바탕으로,platinum을 근거로 한 항암화학요법을 시행 밖았으나 개발되거나 진행된 비소세포폐암 환자들을 대상으로 docetaxel 단독요법의 치료효과와 부작용에 대하여 알아보고자 하였다. 방법 : 조직학적으로 비소세포폐암으로 진단을 받고 platinum을 근거로 한 항암화학요법을 받았으나 재발 또는 진행성 병변을 보인 31명의 환자들을 대상으로 docetaxel 75 mg/m² 또는 100 mg/m²을 3주마다 정주하였다. 임상기록을 통한 후향적인 방법으로 분석하였다. 결과 : 1) 재발 또는 진행성 병변을 보인 31명중 남녀 비는 24:7이고 중앙연령은 60세였다. 2) 반응평가로 완전 관해는 없었고 부분관해는 14명(45.2%), 불변이 10명(32.3%), 진행이 7명(22.6%)으로 전체적인 반응율은 45.2%이었다. 3)중앙생존기간은 12.5개월(95% 신뢰구간: 7.3개월 17.6개월) 이었고, 1년 생존율은 52%였다. 무진행생존기간의 중앙값은 3.0개월(95%신뢰구간: 1.6개월 -4.5개월)이며, 반응군에서의 중앙반응지속피간은 3.7개월(95% 신뢰구간: 3.0개월 - 4.4개월)이었다. 4) 60세 미만인 경우(20.1 months vs 6.6 months. p=0,0105), 조직학적 아형이 선암일 경우(25.6 months vs 7.9 months, 0=0.0055) 통계적으로 유의한 생존기간의 증가가 있었다. 5) 부작용으로 3도 이상의 백혈구 감소증은 12명(38.7%),호중구 감소증에 동반된 발열은 6명(19.3%),감염이 동반된 호중구 감소증은 4명(12.9%)에서 발생했다. 치료와 관련되어 1명이 사망하였다. 6) Docetaxel 용량에 따른 생존기간의 차이나 독성의 차이는 없었다. 결론 : Platinum을 근거로 하는 항암화학요법으로 치료받은 후 재발 또는 진행성 병변을 보이는 비소세포폐암환자들에게 docetaxel을 투여하는 것은 비교적 안전하고 효과적인 항암치료법으로 사료된다.

진행성 비소세포폐암의 이차항암화학요법으로서 Docetaxel 단독요법의 성적

강현모,이정은,장필순,이연선,권선중,안진영,정성수,김주옥,김선영 충남대학교 암연구소 2006 암연구소 업적집 Vol.5 No.-

Background : The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second -line chemotherapy, for which Docetaxel (Taxotere^(?)) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum-based chemotherapy. Methods : Thirty one patients with non-small-cell lung cancer, who had failed first line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either 75 mg/㎡ or 100 mg/㎡, with routine premedication every three weeks. Results : Fourteen patients (45.2%) had a partial response. The median survival and progression- free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age (< 60 years: 20.1 months vs. > 60 years: 6.6 months, p=0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. Conclusion : Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small-cell lung cancer who failed first line platinum -based chemotherapy. (Tuberc Respir DiS 2005: 58: 465-472)

청소년 흡연과 관련된 요인 : 서울시 일부 남녀 고등학생을 대상으로

강윤주,서성제 韓國保健敎育學會 1996 보건교육건강증진학회지 Vol.13 No.1

The prupose of this study is to examine the associated risk factors for adolescent cigarette smoking. In February 1995, a total of 1793 students from 17 general high schools in Seoul were assessed with a self-completing questionnaire pertainnig current smoking status and school·family·peer environmental factors. The results are as follows; 1. The overall proportion of current smoker among students in the study was 17.3%; 27.7% in males and 6.6% in females. 2. There was significant association between smoking status and all school environmental factors (ranks at school, satisfaction at school, study hours after school, extracurricular activity) examined. 3. Siblings smoking in males and family structure in females were significantly associated with the smoking status of students. 4. Functional aspect of family environmental factors, such as APGAR score, parental supervision, attachment to father or to mother were related to smoking staus of students. 5. Association with friends who smoke was significantly associated with smoking status of students. 6. In males, association with friends who smoke, ranks at school, siblings smoking were significant positive predictors and APGAR score, parental supervision, attchment to mother were significant negative predictors. In females, association with friends whosmoke, ranks at school, satisfaction at school were significant positive predictors and parental supervision, attchment to father were significant negative predictors. These findings suggest that strategies that strategies that influence smoking behavior need to be directed not only to the individual student but also to their peer group, family and school environment.

일 간호대학의 지역사회 방문간호사업 사례

강윤숙,최양자,고영애,전시자,조갑출,이옥철,주혜경,신기수,안은숙 적십자간호전문대학 2000 적십자간호전문대학논문집 Vol.22 No.-

송이 (Tricholoma matsutake) 자실체의 화학성분

이학주,최윤정,가강현,박원철 한국목재공학회 2003 목재공학 Vol.31 No.4

송이(Tricholoma matsutake) 자실체의 메탄올(methanol, MeOH) 추출물로부터 4개의 화합물을 분리하였으며, 기기분석 결과 adcnosinc (9-β-D-ribofuranosyladenine)을 비롯하여, methyl trans-cinnamate, ergosterol (ergosta-5, 7, 22-triene-3β-ol) 및 ergosta-4, 6, 8 (14), 22-tetraen-3-one으로 각각 동정하였다. One alkaloid derivatives, one amide and two steroids were isolated from the fruit bodies of Tricholoma matsutake. The structures were determinded as adenosine, methyl trans-cinnamate, ergosterol and ergosta-4, 6, 8 (14), 22-tetraen-3-one, respectively, on the basis of spectroscopic data.

다량의 하부위장관출혈이 병발된 Vibrio vulnificus 패혈증 1예

최주연,유진홍,한석원,이대훈,최민호,박순민,김연식,김선우,신완식,강문원,강성구 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.2

최근 저자들은 Vibrio vulnificus 감염에 의해 패혈증 및 이차성 피부 병변을 보인 42세의 남자 환자의 치료중 하부 위장관 출혈이 병발된 1예를 경험하였기에 보고하는 바이다. We experienced a case of Vibrop vulnificus septicemia which showed an unusual manifestation such as hematochezia. The patient was a 42-year-old man with chronic liver disease. The blood and wound culture revealed the organism. During intensive care, he suffered from massive hematochezi for several days. Colonoscopy and abdominal CT showed findings suspicious of ischemic colitis. To our knowledge, this is the first unusual case of V.vulnificus infection which showed massive lower gastrointestinal bleeding.

한국판 아동용 예일-브라운 강박 척도:신뢰도와 타당도 연구

정선주,이정섭,강윤형,조성진,서동혁,홍강의 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.1

목적 : 본 연구는 소아, 청소년의 강박 증상을 평가하기 위한 도구인 아동용 예일-브라운 강박척도(Childen's Yale-Brown Obsessive Compulsive Scale : Y-BOCS)의 한국판을 제작하여 그 신뢰도와 타당도를 검증하고자 시행되었다. 방법 : 강박장애로 진단된 42명의 아동과 청소년들을 대상으로 CY-BOCS를 시행하였다. 평가자간 신뢰도를 측정하기 위하여 20명의 환자를 2명의 평가자가 동시에 면담하였다. 수렴타당도와 변별타당도의 검증을 위해 총괄적인 임상 인상척도-강박장애(Clinical Global Impression-Obsessive Com-pulsive Disorder : CGI-OCD). 아동용 Leyton 강박 척도(Lryton Obsessional Inventory-Child Version : LOI-CV), 소아우울척도(Child Depression Inventory : CDI), 소아 상태-특성 불안척도(State-Trait Anxiety Inventory for Children : STAI-C)를 시행한다. 결과 : Cronbach's α값으로 평가한 내적 일치도는 0.86으로 높게 나타났다. CY-BOCS 전체 점수 강박사고, 강박행동 소척도 점수에 대한 군내 내적일치도는 각각 0.94. 0.94. 0.84로 우수한 평가자간 일치도를 보였다. CY-BOCS 전체 점수와 CGI-OCD 점수간의 상관관계는 매우 높게 나타났고(r-0.88), LOI-CY 총점과도 통계적으로 유의한 상관관계(r=0.51)가 관찰되었다. CY-BOCS 전체 점수와 STA-I-C의 상태불안 점수간에는 상관관계가 나타나지 않았고(r=0.25), 특성불안 점수(r=0.43) 및 CDI 점수(r=0.49)와는 유의한 상관관계를 나타냈다. 결론 : 본 연구결과, 한국판 CY-BOCS의 높은 타당도 및 신뢰도가 입증되었으며, 향후 강박 증상의 객관적인 평가 및 정량화를 위해 유용하게 사용될 수 있을 것이다. Objective : This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method : Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inven-tory-Child Version(LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory( CDI ). Results : Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion : The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity. KEY WORDS : Development · Rating scale · Obsessive-compulsive disorder · Reliability Validity.

Potassium alum과 비우식성 감미료의 병용이 Streptococcus mutans의 성장에 미치는 영향

김윤정,차정단,김지영,김강주,이흥수 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.3

Traditionally, Koreans have used potassium alum by mouth rinse when they suffered from stomatitis. This study was carried out to investigate the combined effect of potassium alum with aspartame, sorbitol and xylitol on the growth of Streptococcus mutans (S. mutans). The relative growth ratio of S. mutans JC-2 cultured at different concentrations of potassium alum and different concentrations of aspartame, sorbitol and xylitol was examined. The combined effect of different concentrations of potassium alum with 0.5% and 10.0% of aspartame, sorbitol and xylitol was examined. The lowest minimum inhibitory concentration of potassium alum was 5.0mg/ml against S. mutans JC-2. The relative growth ratio of potassium alum on S. mum JC-2 was affected at the concentration of 2.0mg/ml. The growth of S. mutans JC-2 decreased at the concentration of 10.0% of aspartame and sorbitol. Also, a combination of potassium alum and sugar substitutes was more effective against S. mum than the use of one sugar substitute alone. The inhibitory effect of potassium alum and sugar substitutes on S. mutans may be an important mechanism of caries prevention by potassium alum.

청각장애학교에서의 진로교육 현황 및 개선방안

원성옥,강윤주 대구대학교 특수교육재활과학연구소 2005 특수교육재활과학연구 Vol.44 No.4

The purpose of this study is to examine and analysis the realities of career education and to propose the its improvements in school for the deaf. We gathered opinions of 135 teachers in school for the deaf from questionnaire.The results are shown as following. First, Teachers have a correct understanding about the concept, the instruction steps, and instruction contents of career education. Second,Teachers know the necessity and importance of career education in classroom,but they didn't give the career guidance and information in classroom. Third, Teachers didn't give the career guidance and information in extra activity and counseling. Fourth,The materials and programs are not enough to provide the career education. Finally, We suggest improvements of career education based on the realities and teachers' recommendation 본 연구는 청각장애학교의 진로교육 현황을 분석하기 위해 전국에 소재하고 있는 11개 청각장애학교에 근무하고 있는 교사 135명을 대상으로 진로교육에 대한 인식과 진로교육 현황을 교과지도, 특별활동 및 진로행사, 상담활동, 진로정보자료 및 프로그램의 활용으로 나누어 조사하였다. 조사결과, 진로교육은 초등부부터 시작되어야 하며 그 필요성도 느끼고 있었을 뿐 아니라 진로교육의 의미나 학교급별 진로교육의 단계와 그에 적절한 교육 내용에 대해서도 바르게 인식하고 있었다. 그러나 교과활동을 통한 진로교육의 제공, 특별활동과 상담활동을 통한 진로교육 현황은 필요성 인식에 미치지 못하고 있는 실정이다. 이러한 현황과 교사들이 제안하는 개선방안을 바탕으로 진로교육 개선방안을 제시하였다.

비소세포 폐암 환자의 이차 치료로서 Gemcitabine과 Vinorelbine 혼합 요법의 효과

장필순,강현모,이정은,권선중,안진영,이연선,정성수,김주옥,김선영 충남대학교 암공동연구소 2006 암공동연구소 업적집 Vol.5 No.

Background : Both gemcitabine and vinorelbine are effective anticancer drugs with mild toxicity on non-small cell lung cancer, and monotherapy of these drugs are effective as a second-line chemotherapy. The aim of this trial was to assess the response and toxicity of a combination of gemcitabine and vinorelbine in patients of previously treated for non-small cell lung cancer. Materials and Methods : 24 patients, initial stage III A/B,IV and previously treated with platinium and taxane based regimens, were enrolled from June 2000 to March 2004. The regimens consisted of vinorelbine 25mg/㎡ followed by an infusion of gemcitabine 1000mg/㎡ on day 1 and day 8 every three weeks. This course was repeated more than twice. Results : Twenty-four patients were analyzed for the response, survival rate, and toxicities. The overall response was 17% with a complete remission rate of 4%. The median time-to progression (TTP) was 3.1 months (95%, CI l-10months), and the survival time was 8.2 months (95%, CI 1-23 months). The grade 3/4 toxicities encountered were neutropenia (12.5%), anemia (0%), thrombocytopenia (0%). Non-hematological 3/4 toxicities were not observed. Conclusion : A combination of gemcitabine and vinorelbine in patients previously treated for non-small cell lung cancer provides a relatively good response rate, and a low toxicity profile. However, further study will be needed to confirm its effectiveness. (Tuberc Respir Dis 2005; 58: 344-351) 배경 : Gemcitabine, paditaxel, docetaxel, vinorelbine, ir-rinotecan 새로운 항종양제의 출현으로 일차 치료의효과가 증대 되고 있고 재발시에도 좋은 신체 활동도를 보이고 있어서 이차 치료의 대상군도 늘어나는 효과를 보이고 있다. 치료의 필요성은 증대 되고 있지만 현재까지 표준 치료가 확립되지 않은 상황에서 Gem-citabine과Vinorelbine모두 독성이 강하지 않아서 혼합 요법이 가능한 장점이 있고 비소세포 폐암에 대한효과도 입증이 되어있어서 본 연구는 반응이 없거나 반응을 보인후에 재발된 진행된 비소세포 폐암에 ge-mdtabine과 vinorelbine 흔합 요법을 시행하여서 치료 반응률과 생존율 그리고 부작용을 평가하였다. 대상 및 방법 :2000년 6월부터 2004년 3월까지 충남대학교병원에내원하여 진행성 비소세포 폐암 IIIA/IIIB, IV로 진단을 받고 일차 항암화학요법치료를 받은 환자중에 초기 치료에 반응이 없거나, 치료에 반응이 있었으나 병이 진행된 환자로 추적 관찰 기간이 6개월 이상인 환자를 대상으로 생존율과 반응률 그리고 독성을 분석하였다. 결과 : 총 치료 반응률은 17%. 반응 유지기간의 중앙값은 3.1개월(1-10개월)이었고 생존기간의 중앙값은 8.2개월 (1-23개월) 그리고 1년 생존율은 35%였다. 항암화학요법에 의한 독성은 3도 이상의 중성구 감소가 12%, 오심과 구토가 12.5% 였다. 결론 : 일차 치료에 반응이 없거나 재발한 비소세포 폐암환자의 이차 치료로 gemcitabine과 vinorelbine 혼합요법은 효과적이라고 생각되며 향후 3상 연구를 통한다른 약제와의 비교 연구가 필요하다고 생각된다.