Permanent Deformation Level Based on Initial Deformation and Time after Ligation, Thermocycling of Round Ni - Ti Wire

Chun-Chu Kim(김춘추),Ji-Hae Song(송지혜),Sae-Hyun Lee(이세현),Min-Ho Lee(이민호),Young-Mi Jeon(전영미),Jong-Ghee Kim(김정기) 대한치과재료학회 2011 대한치과재료학회지 Vol.38 No.1

골수이식후 기관지내시경을 이용한 폐렴의 진단

김태연 ( Kim Tae Yeon ),윤형규 ( Yun Hyeong Gyu ),문화식 ( Mun Hwa Sig ),박성학 ( Park Seong Hag ),민창기 ( Min Chang Gi ),김춘추 ( Kim Chun Chu ),정정임 ( Jeong Jeong Im ),송정섭 ( Song Jeong Seob ) 대한결핵 및 호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.49 No.2

녹색종이 동반된 AML의 조혈모세포 이식 4예

추은호 ( Eun Ho Chu ),김태석 ( Tae Suk Kim ),신은중 ( Eun Jung Shin ),엄기성 ( Ki Seong Eom ),김희제 ( Hee Je Kim ),민우성 ( Woo Sung Min ),김춘추 ( Chun Choo Kim ) 대한내과학회 2008 대한내과학회지 Vol.75 No.2

녹색종은 미성숙 골수구로 이루어진 침윤성의 골수 외고형 종양이며 급성 골수성 백혈병 환자의 임상경과 중 소수에서 동반되어 나타날 수 있다. 급성 골수성 백혈병에서 녹색종이 동반될 경우 좋지 않은 예후를 보이지만 아직까지 적절한 치료 원칙이 정립되지 않은 상태이다. 저자들은 녹색종이 동반된 급성 골수성 백혈병 환자에서 관해 후 조혈모세포 이식을 시행한 4예를 경험하여 문헌고찰과 함께 보고하는 바이다. Chloroma is an invasive extramedullary tumor composed of immature myeloid cells, which complicates the clinical course in a minority of patients with acute myeloid leukemia (AML). The presence of myeloid sarcoma is known to be a poor prognostic indicator in patients with AML. However, the optimal treatment of AML with concurrent chloroma has not been determined. We report four patients with AML accompanied by concurrent chloroma from the time of initial diagnosis. All of the patients underwent hematopoietic stem cell transplantation after complete remission. We also present a review of the literature. (Korean J Med 75:230-236, 2008)

동종골수이식을 받은 표준 위험군과 고 위험군 백혈병 환자간의 장기생존율 비교 - 성모병원에서의 7년간의 경험 -

최정현 ( Choe Jeong Hyeon ),김희제 ( Kim Hui Je ),이종욱 ( Lee Jong Ug ),진종률 ( Jin Jong Lyul ),한치화 ( Han Chi Hwa ),민우성 ( Min U Seong ),박종원 ( Park Jong Won ),김춘추 ( Kim Chun Chu ),김동집 ( Kim Dong Jib ) 대한내과학회 1993 대한내과학회지 Vol.44 No.4

연구배경 : 급성 및 만성 백혈병에서 동종 골수이식을 시행할 경우 이식 당시의 임상상태는 이식후 생존율에 영향을 미치는 가장 중요한 요소중의 하나로서, 1차 관해시 혹은 조기에 이식을 할수록 진행된 상태 혹은 말기 상태에서 이식을 실시하는 경우에 비해 생존율이 높다고 한다. 저자들은 이식당시의 임상상태가 골수이식후 생존율에 미치는 영향을 분석하기 위하여 동종 골수이식을 받은 급성 및 만성 백혈병 환자들을 질환별로 표준 위험군과 고 위험군으로 분류하여 두 군간의 장기 무병생존율을 비교함으로써 이식시 관해상태와 이식후 장기생존율간의 관계를 알아보고자 하였다. 방법 : 1983년 3월부터 1990년 12월까지 가톨릭의대 부속 성모병원에서 조직적합항원(HLA)이 일치하는 형제자매로부터 동종골수이식을 시행한 58명의 급성 및 만성백혈병환자들을 대상으로 이식 당시의 임상상태에 따라 표준 위험군과 고 위험군으로 분류하여 두군간의 생존율을 후향적으로 비교하였다. 표준 위험군은 AML 및 성인형 ALL에서는 1차 관해, 소아형 ALL에서는 2차 관해까지, 그리고 CML 에서는 만성기에 이식을 시행한 경우로 하였고, 그외의 진행된 상태나 재발된 경우에 이식을 실시한 경우는 모두 고 위험군으로 분류하였다. 결과 : 1) 3개월부터 55개월(중앙치 26개월)까지 관찰한 결과 1차 관해시 이식한 AML(표준 위험군) 13명중 8명(62%) 이 생존하였고, 2차 관해 이상의 상태에서 이식한 AML(고 위험군)은 10명중 1명(10%)만 생존하여 통계학적으로 유의한 차이를 보였다(p<0.01). 2) 3개월부터 93개월(중앙치 36개월)까지 관찰한 결과 성인형 ALL은 1차 관해에서 이식을 시행한 6명중 4명(67%)이 생존하였고, 2차 관해 이상의 시기에 이식한 경우는 5명중 3명(60명)이 생존하여 통계학적인 차이는 없었다(p=0.2). 또한 소아형 ALL은 2차 관해이전(표준 위험군)에 이식을 시행한 4명중 3명(75%)이 생존하였고, 고 위험군에 속하는 예는 없었다. 3) 3개월부터 52개월(중앙치 36개월)까지 관찰한 결과 CML은 만성기(표준 위험군)에 이식을 시행한 9명중 8명(89%)이 생존하였고 가속기나 급성기에 이식을 시행한 경우는 11명중 4명(36%)이 생존하여 통계학적으로 유의한 차이를 보였다(p<0.01). 4) 표준 위험군에 속하는 백혈병에서는 32명중 23명이 생존함으로써 72%의 생존율을 보인반면, 고 위험군에서는 26명중 8명이 생존하여 31%의 생존율을 보였다(p<0.01). 5) 전체 대상환자 58예중 28예가 사망하였는데 사망원인으로는 백혈병 재발이 15예로 가장 많았으며 급성 이식편대 숙주반응이 4예, 생착부전 2예, 거부반응 1예, 간질성 폐염 1예, 패혈증 2예, veno-occlusive disease 1예, 급성 신부전 1예, 그리고 TTP-like syndrome 1예등이었다. 결론 : 이상의 결과로 급성 및 만성 백혈병에서 골수이식을 시행할 경우 이식시 임상상태로 표준 위험군(1차 관해, 만성기)에 속하였을때 장기생존율이 증가됨을 알수 있었으며, 향후 이식후 생존율을 향상시키기 위하여 이식의 시기는 1차 관해 혹은 만성기, 즉 조기에 시행하는 것이 바람직하리라고 사료된다. Background: To assese the relationship between disease status at transplant and long-term disease-free survival (DFS) in patients with acute and chronic leukemia, we compared the DFS of standard risk group ad that of high risk group after allogeneic bone marrow trasplantation (BMT). Methods: Between March 1983 and December 1990, 58 patients with acute or chronic leukemia who had been underwent the allogeneic BMT at St. Mary`s Hospital of Catholic University Medical College were assigned to a retrospective study comparing DFS of standard risk group withe that of high risk group. We defined standard risk group(n=32) as the first complete remission(CR) in AML or ALL of adult type, the second CR or ALL of childhood type and the chronic phase of CML. Advanced disease state beyond the standard risk group was considered as high risk group (n=26). Results: 1) In AML, after median follow-up of 26 months (3~55 months) long-term DFS of standard risk group was higher (62%) than that of high risk group (10%) (p<0.01). 2) In ALL of adult type, after median follow-up of 36 months(3~93 months) long-term DFS between standard risk and high risk group was 67% and 60%, respectively(p=0.2). 3) In CML, after median follow-up of 27 months (3~52 months) long-term DFS of standard risk group was 89% and that of high risk group was 36% (p<0.01). 4) Compared to the 72% (23/32) survival rate of standard risk leukemia, that of high risk leukemia was 31%(8/26)(p<0.01). 5) Relapse of leukemia was the most frequently encountered complication (29%) and the most common cause of death (54%) after allogeneic BMT. Conclusion: Our results show that the outcome of standard risk group appears to be superior to that of high risk group in patients with acute and chronic leukemia. Therefore we would like to recommend to perform BMT in the early stage of disease for the treatment of acute and chronic leukemia to improve the long-term DFS.

피부 백혈병의 임상적 고찰

장인강 ( In Gang Jang ),이동원 ( Dong Won Lee ),한치화 ( Chi Wha Han ),김춘추 ( Chun Chu Kim ),조백기 ( Baik Kee Cho ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.4

Background: Leukemia cutis is readily recognized and documented by biopsy, in contrast. to leukemic involvement in more occult sites. Nine cases of leukemia cutis have been reported in the Korean literatures. However no collective clinical studies have been reported in Korea. Objective : We evaluated the differences in patient age and sex, the clinical appearences and distributions of the skin lesions, interval between diagnosis of systemic leukemia and skin involvement, clinical course, and prognosis according to the type of leukemias. Methods : We carried out a retvospective study of 22 cases of leukemia cutis. Clinical information was obtained from the records of of 22 patients diagnosed at St. Mary's Hospital from 1988 to 1995. All the included cases were well evaluated for their clinical and histopathologic findings. Results : 1. Among 22 patients with leukemia cutis, male patients outnumbered female by 2 to 1 and the mean age was 25.8 years. 2. The clinical appearance of leukemia cutis includes papules, macules, nodules, plaques in all types of leukemia. Ulcerative lesions and vesicles were seen infrequently in leukemia cutis. Leukemia cutis often involved saultiple location of the skin, with no specific predilection of the site. There were no differences in distribution of lesions depending on the types of systemic leukemia. 3. In 68% of the patients with leukemia cutis, the skin lesions developed after the systemic leukemia was diagnosed, and 14% of patients had concomitant, involvement. 18% of patients had skin lesions preceding the diagnosis of systemic leukemia, howevere cytochemical and cytomorphologic studies of bone marrow and peripheral blood smear were not employed at the time of the skin biopsy. 4. Fourteen of 22 patients(64%) did not achieve a complete remission following the diagnosis of leukemia cutis and two of 14 patients without having complete remission could achieve complete remissions with proper anticancer therapy after the diagnosis of leukemia cutis. Total eight patients(36%) achieved a complete remission, then they had a relapse of leukemia in the skin, without having had any skin involvement at the time of the diagnosis of leukemia. 5. Seventeen of 22 patients(77% ) who were being followed up in our series died after leukemia cutis was diagnosed. The mean intervals between diagnosis of leukemia cutis and death was 3.8 months and they died mostly within 1 year. Conclusion : The presence of leukemic infiltration in the skin may help the clinician suspect the early diagnosis and relapse of systemic leukemia. It appears that leukemia cutis is associated with a grave prognosis. (Kor J Dermatol 1996;34(4): 507-514)

성인 급성 골수성 백혈병 환자의 관해후 장기 생존율을 얻기 위한 치료 방침 - 골수이식과 항암요법의 생존율 비교 -

이종욱 ( Lee Jong Ug ),민창기 ( Min Chang Gi ),김동욱 ( Kim Dong Ug ),진종률 ( Jin Jong Lyul ),한치화 ( Han Chi Hwa ),민우성 ( Min U Seong ),박종원 ( Park Jong Won ),김춘추 ( Kim Chun Chu ),김동집 ( Kim Dong Jib ),한창순 ( Han Cha 대한내과학회 1993 대한내과학회지 Vol.44 No.4

연구배경 : 성인 급성 골수성 백혈병(AML)의 치료성적은 복합 항암요법의 개발 및 보조요법의 발달에 힘입어 관해률이 60~80%의 수준까지 향상되었으나, 관해 후 재발방지를 위해 항암요법(공고요법)을 실시함에도 불구하고 관해 유지기간은 약 1년정도이고, 장기 생존율은 약 20~35%에 불과하다. 한편 AML의 1차 관해시 동종골수의식(BMT)을 실시할 경우 장기 생존율은 약 45~65%이다. 방법 : 1986년 7월부터 1991년 12월까지 가톨릭의대 부속 성모병원과 국립의료원에서 AML로 진단받고 관해유도요법을 실시하여 완전관해(CR)에 도달한 92명의 환자중 40세 이하에서 1회 이상의 항암요법을 실시한 군(41명) HLA가 일치하는 형제 자매로부터 BMT를 실시한 군(16명) 간의 장기 생존율 및 재발율을 후향적으로 비교하였다. 결과 : 1) 대상환자 57명중 50명에서 추적관찰이 가능하였으며 3개월부터 57개월(중앙치 21개월)까지 관찰한 결과, 4년간 장기 생존율은 BMT 군과 항암치료군에서 각각 66%와 27%이었고(p<0.05), 4년간 재발율은 각각 24%와 69%이었다(p<0.005). 2) 전체 생존기간 및 무병 생존기간의 중앙치는 BMT 군에서는 아직 중앙치에 도달하지 않았으며, 항암치료군에서는 각각 17개월 및 13개월이었다. 3) 사망원인으로는 BMT군(16명) 은 백혈병 재발이 2예(13%), 치료와 관련된 합병증으로 2예(13%)에서 사망하였고, 항암치료군(41명)은 백혈병 재발이 21예(51%), 치료와 관련된 합병증으로 4예(10%)에서 사망하였다. 결론 : 이상의 결과로 성인 AML의 관해후 치료방침으로서 BMT가 항암치료(공고요법)보다 성적이 우수한 것으로 판단하여, 1차 관해후 40세 이하에서 HLA가 일치하는 공여자가 있을 경우 높은 장기 생존율을 얻기위해서는 BMT를 추천하는 것이 바람직하리라고 사료된다. Background: Although substantial progress in the treatment of acute myelogenous leukemia (AML) has produced complete remission (CR) in 60% to 80% of patients receiving induction chemotherapy, the median remissio duration is about 12 months and only 20% to 35% of patients undergoing consolidation chemotherapy achive long-term disease-free survival (DFS). Allogenei bone marrow transplantation (BMT) in first remission has resulted in a 45% to 65% overall survival rate. Methods: From July 1986 to December 1991, 92 patients with AML who had reached a CR following induction chemotherapy were assigned to a retrospective study comparing allogeneic BMT with consolidation chemotherapy as a postremission treatment. The results in 16 patients, aged 16 to 40 years, who underwent a HLA matched BMT in first remission were compared with those in 41 patients, age-matched, lacked an HLA-identical sibling, treated with one or more cycles of consolidation chemotherapy. Results: 1) After a median follow-up of 21 months (3~57 months), the acturaial DFS at 4 years was significantly higher in the transplantation group than in the chemotherapy group (66% v 27%; p<0.05), and the actuarial probability of leukemic relapse was considerably lower in the group treated with BMT (24% v 69%; p<0.005). 2) The median survival and DFS has not yet been reached for BMT group, and 17 months, 13 months, respectively for chemotherapy group. 3) Treatment-reached mortality was similar in both groups (13% in BMT group, 10% in chemotherapy group). Conclusion: Our results show that allogeneic BMT appears to be superior to consolidation chemotherapy and offers the best chance of long-term DFS in patients with AML in first remission. It will therefore be appropriate postremission treatment strategy to undergo allogeneic BMT for patients with AML in first remission under the age of 40 who have an HLA-identical sibling donor.

GM-CSF가 방사선 치료시 발생한 호중구감소증에 미치는 영향

장지영(Ji Young Jang),최일봉(Ihl Bohng Choi),정수미(Su Mi Chung),김인아(In Ah Kim),계철승(Chul Seong Kay),김춘추(Chun Chu Kim),한치화(Chee Hwa Han),신경섭(Kyung Sub Shinn) 대한방사선종양학회 1995 Radiation Oncology Journal Vol.13 No.1

Purpose : To assess the efficacy of recombinant human granulocyte-macrophage colony-stimulating factor(GM-CSF) in the neutropenia by radiotherapy. Materials and Methods : Eleven patients with various solid tumor were treated with a daily subcutaneous dose of GM-CSF(3-7microgram/kg) for 5days during the radiotherapy. Before and during the course of the study all the patients were monitored by the recording of physical examination, the complete blood count with differential and reticulocyte count and liver function test. Eight patients received prior or concurrent chemotherapy. Results : In 10 patients, the neutrophilic nadir was significantly elevated and the lenght of time that patients had a neutrophil count below 10³/mm³, a threshold known to be critical to acquiring infective complications was shortened following GM-CSF injection. A significant rise (two fold or greater) of neutrophil count was seen in 10 of 11 patients. In most patients, discontinuation of GM-CSF resulted in a prompt return of granulocyte counts toward baseline. However the neutrophil count remained elevated over 10³/mm³ during radiation therapy, and radiotherapy delays were avoided. Other peripheral blood components including monocytes and platelets also increased after GM-CSF treatment. No significant toxicity was encountered with subcutaneous GM-CSF treatment. Conclusion : GM-CSF was well tolerated by subcutaneous route and induced improvement in the neutropenia caused by radiotherapy.

STI571에 의한 약진의 임상 및 병리조직학적 연구

오찬석 ( O Chan Seog ),박현정 ( Park Hyeon Jeong ),이준영 ( Lee Jun Yeong ),조백기 ( Jo Baeg Gi ),김동욱 ( Kim Dong Ug ),김춘추 ( Kim Chun Chu ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.10

N/A Background : STI571, which is a selective inhibitor of the BCR-ABL tyrosine kinase, is a promising new drug for the treatment of patients with chronic myelogenous leukemia. But it has been noted that this drug is frequently associated with an adverse cutaneous reaction. Objective : The purpose of this study was to find the clinical and histopathological characteristics of drug eruptions caused by STI571. Method : We reviewed the clinical records of 10 patients diagnosed as drug erupions caused by STI571. Result : 1. The mean age was 36.4 years and it was observed predominantly in females as the sex ratio of 7:3. 2. The most common clinical type was exanthematous eruption(70%), and followed by erythema multiforme-like eruption(20%), urticarial eruption(10%). In most cases(90%), the distribution was generalized, which involved trunk and extremities. 3. The mean latent period was 17.1 days and peak incidence(70%) was noted between 1 and 2 weeks. 4. Commonly associated adverse effects included fever(60%) and diarrhea(30%). 5. Histopathologically, common findings included perivascular inflammatory cell infiltration(100%), eosinophil(80%), exocytosis(80%). Conclusion : Because drug eruptions caused by STI571 are dose-related and develop with a high frequency, we need a careful monitoring of patients who are treated with STI571, especially with a high dose.(Korean J Dermatol 2003;41(10 : 1291~1296)

급성 이식편 대 숙주병

구대원(Dae Won Goo),이대성(Dae Sung Lee),이종육(Jong Yuk Yi),조백기(Baik Kee Cho),허원(Won Houh),김춘추(Chun Chu Kim) 대한피부과학회 1988 대한피부과학회지 Vol.26 No.5

We report a case of acute graft-versus-host disease, which developed after bone marrow transplantation because of acute myelocytic leukemia in a 39-year old male, The pruritic, erythematous maculopapular eruptions began to developed on the perioral regions, and spreaded the face, the oral mucosa, both hands, and buttocks at the twenty fourth day after bone marrow transplanta.tion. The eruptions were confluent to form erythematous patches. Iistopathological findings show parakeratosis, lymphoid cell exocytosis, and papillary edema, lymphohistiocytic infiltration, and melanophage in the upper dermis, and basal vacuolation. He was treated systemically by methylprednisolone, and antilymphocytic globulin, and tapically by emollients and steroids.

급성 피부 이식편 대 숙주질환의 임상 및 병리학적 고찰

이지선 ( Lee Ji Seon ),박현정 ( Park Hyeon Jeong ),이준영 ( Lee Jun Yeong ),조백기 ( Jo Baeg Gi ),강창석 ( Kang Chang Seog ),김춘추 ( Kim Chun Chu ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.9

Background : Graft-versus-host disease (GVHD) refers to the spectrum of organ dysfunction that occurs when immunocompetent leukocytes attack specific tissue in a relatively immunocompromised host. The most common clinical setting for GVHD is after bone ma