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위장암 : 대장암에서 HER-2/neu 발현에 관한 연구
박동일 ( Dong Il Park ),오석중 ( Suk Joong Oh ),박승하 ( Seung Ha Park ),윤중원 ( Jung Won Yun ),김홍주 ( Hong Joo Kim ),조용균 ( Yong Kyun Cho ),성인경 ( In Kyung Sung ),손정일 ( Chong Il Sohn ),전우규 ( Woo Kyu Jeon ),김병익 ( B 대한소화기학회 2004 대한소화기학회지 Vol.44 No.3
목적: HER-2/neu 단백은 상피성장인자 수용체와 구조가 거의 일치하기 때문에 정상 세포의 성장과 증식 과정에 관여한다. 유방암에서 HER-2/neu의 과발현은 나쁜 생존율을 예상할 수 있는 예후인자일 뿐 아니라 항암화학요법이나 호르몬요법에 잘 반응하지 않는 등 치료에 대한 반응을 예측할 수 있는 인자이며 HER-2/neu에 대한 단일클론 항체인 Herceptin(R)은 림프절에 전이된 유방암 환자에서 장기 생존율을 향상시켜 임상에서 활발히 사용되고 Background/Aims: The HER-2/neu protein is involved in normal cell proliferation and tissue growth because it is extensively homologous and related to epidermal growth factor receptor. As a prognostic marker, HER-2/neu is used to forecast the clinical cour
프로톤 펌프 억제제 종류에 따른 비궤양성 소화불량증 환자와 소화성 궤양 환자의 Helicobacter pylori 제균율 비교
홍은정 ( Eun Jung Hong ),박동일 ( Dong Il Park ),오석중 ( Suk Joong Oh ),송민준 ( Min Jun Song ),최우혁 ( Woo Hyuk Choi ),홍철호 ( Cheul Ho Hong ),박정호 ( Jung Ho Park ),김홍주 ( Hong Joo Kim ),조용균 ( Yong Kyun Cho ),손정일 ( C 대한소화기학회 2008 대한소화기학회지 Vol.52 No.2
Background/Aims: Conflicting results have been reported whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H. pylori) eradication treatment compared with patients with peptic ulcer diseases (PUD). The aim of this study was to evaluate any difference in H. pylori eradication rates between patients with NUD and PUD according to each proton pump inhibitor (PPI). Methods: From September, 2004 to April, 2007, we retrospectively reviewed 2,297 patients with NUD (1,050 patients) or PUD (1,247 patients) infected with H. pylori. All patients received a standard 1 week triple therapy comprising of one of the five PPIs (pantoprazole, esomeprazole, omeprazole, lansoprazole, rabeprazole), clarithromycin and amoxicillin. The follow-up H. pylori test was performed 4 weeks after the completion of therapy. Results: There was no significant difference in the eradication rates between the two groups. In comparison of eradication rates according to PPI, omeprazolebased triple therapy group showed higher eradication rate than other groups in patients with NUD, but not in patients with PUD. Conclusions: This study failed to show any difference in H. pylori eradication rate between patients with NUD and PUD. There is no convincing evidence that the eradication rate may be affected by different PPI. (Korean J Gastroenterol 2008;52:80-85)
Helicobacter pylori 감염 환자에서 10일 연속 제균치료의 효과
최우혁 ( Woo Hyuk Choi ),박동일 ( Dong Il Park ),오석중 ( Suk Joong Oh ),백유흠 ( Yoo Hum Baek ),홍철호 ( Cheul Ho Hong ),홍은정 ( Eun Jung Hong ),송민준 ( Min Jun Song ),박성근 ( Sung Keun Park ),박정호 ( Jung Ho Park ),김홍주 ( 대한소화기학회 2008 대한소화기학회지 Vol.51 No.5
Background/Aims: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. Proton pump inhibitor (PPI)-based triple therapy is the most preferred regimen in clinical practice. However, a critical fall in the H. pylori eradication rate has been observed in the recent years. A novel 10 day-sequential therapy consists of five days of dual therapy followed by five days of triple therapy regimen has recently been described. We aimed to evaluate whether 10 day-sequential therapy eradicated H. pylori infection better than the PPI-based triple therapy in Korea. Methods: 158 patients with proven H. pylori infection were randomized to receive either 10 day-sequential therapy (20 mg of omeprazole, 1.0 g of amoxicillin, each administered twice daily for the first 5 days, followed by 20 mg of omeprazole, 500 mg of clarithromycin, 500 mg of metronidazole, each administered twice daily for the remaining 5 days) or PPI-based triple therapy (20 mg of omeprazole, 1.0 g of amoxicillin, 500 mg of clarithromycin, each administered twice daily for 1 week). Outcome of eradication therapy was assessed 8 weeks after the cessation of treatment. Results: Eradication rates of 10 day-sequential therapy and PPI-based triple therapy were 77.9% (60/77) and 71.6% (58/81) by intention to treat analysis, respectively (p=0.361). By per protocol analysis, eradication rates of 10 day-sequential therapy and triple therapy were 85.7% (60/70) and 76.6% (58/76), respectively (p=0.150). There were no significant differences in adverse event rates and treatment compliance between two groups. Conclusions: The 10 day-sequential therapy regimen failed to achieve significantly higher eradication rates than PPI-based triple therapy. (Korean J Gastroenterol 2008;51:280-284)
진행성 소화기계 종양 환자에서 영양상태와 예후와의 관계
최권 ( Kwon Choi ),김혜정 ( Hae Jeung Kim ),조현진 ( Hyun Jin Cho ),최영길 ( Young Ghil Choe ),이도영 ( Do Young Lee ),박성근 ( Sung Keun Park ),고영율 ( Young Lyul Koh ),오석중 ( Suk Joong Oh ),이승세 ( Seung Sei Lee ) 대한내과학회 2006 대한내과학회지 Vol.71 No.2
목적: 정확한 생존일 예측은 환자, 보호자 그리고 의사에게 남아있는 시간에 할 일에 대한 우선순위를 결정하는데 중요한 정보를 제공해 준다. 하지만 진행성 암 환자에서 생존 예측의 정확성을 높이려는 여러 시도들은 부정확한 예측으로 예측 능력이 낮아 좀더 정확한 예측 방법에 대한 연구가 시도되고 있다. 염증 영양 예후지표는 위독한 환자들에서 영양상태와 예후를 평가하기 위해 고안되었으며 암 환자에서 적용하여 유용한 지표로 이용될 수 있는지 보았다. 방법: 2003년 5월부터 2004년 5월까지 성균관대학교의과대학 강북삼성병원에서 조직학적 또는 방사선학적으로 소화기계 악성 종양으로 진단을 받고 항암화학요법 단독 또는 수술 및 항암화학요법을 시행 후에 더 이상의 적극적 치료가 불가능한 진행성 전이성 암 환자로 대상 선정 시에 18세 이상이며 ECOG 수행상태 1~3으로 검사에 동의한 130명을 대상으로 하였다. 염증 영양 예후지표는 급성 반응 물질인 알파 1-산 당단백질과 C-반응단백과 두 가지 내장단백인 알부민과 프리알부민 값을 이용하여 염증 영양 예후지표를 산정하여 생존일과 수행상태와의 관련성을 조사하였다. 결과: 연령의 중앙값이 57세였다. 염증 영양 예후지표는 ECOG 수행상태와 유의한 차이가 있었으며(p<0.001) 사후 검정을 시행했을 때 수행상태 3군 평균값은 1군과 2군 평균값보다 의미있게 높았고, 2군도 1군 보다 의미있게 높았다(p<0.05). 생존일도 수행상태와 유의한 차이가 있었으며(p<0.001) 사후 검정에서 각 군 간 유의한 차이가 있었다(p<0.05). 염증 영양 예후지표는 생존 일과 유의한 차이가 있었으며(p<0.001) 사후 검정을 시행했을 때 생존일 1군(≤30일)이 2군(31~180일) 및 3군 (≥181일)보다 의미있게 높은 평균값을 보였다(p<0.05). 생존일은 ECOG 수행상태와 음의 상관관계가 가장 컸으며(r=-0.602, p<0.001), 염증예후지표와의 상관관계는 약한 음의 상관관계가 있었다(r=-0.318, p<0.001). 결론: 염증 영양 예후지표 값이 진행성 소화기계 종양 환자에서 ECOG 수행상태가 나쁠수록 유의하게 상승함을 알 수 있었고, 영양상태의 판정에 독립적 변수로서 유용하게 이용될 수 있으며 생존일 예측에도 유용한 지표임이 증명되었다. 알부민은 다른 영양인자 보다 영양 상태 판정에 유용한 지표임이 증명되었으며, C-반응단백은 독립된 영양지표 및 예후지표로 이용될 수 있다. Background: Depletion of nutritional reserves and significant weight loss can lead to an increased risk of morbidity, reduced chemotherapy response, and shorter survival in patients with cancer. Numerous methodologies are used for the assessment of nutritional status. However, it remains unclear which of these tools is the most appropriate in the setting of cancer chemotherapy. The PINI (prognostic inflammatory nutritional index) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill patients. The aim of this study was designed to investigate the relationship between nutritional status after the palliative chemotherapy and prognosis in advanced metastatic cancer. Methods: This study included 130 patients with ECOG PS (Eastern Cooperative Oncology Group performance status) 1~3 in advanced metastatic cancer following the palliative chemotherapy. ECOG PS, body mass index, alpha 1-acid glycoprotein, C-reactive protein, albumin, prealbumin, transferrin, protein, lactate dehydrogenase, PINI ratio, and survival time were evaluated. Results: In 130 patients, the median age was 57 years. The ECOG PS was 1 68 patients, 2 43, 3 19. The mean value of PINI was PS 1 16.0±47.8, PS 2 55.6±106.9, PS 3 106.3±141.6. The mean survival was PS 1 144.0±71.8, PS 2 68.9±41.2, PS 3 32.0±6.9 days. In the PS 3 group, the mean values of alpha 1-acid glycoprotein, C-reactive protein, and lactate dehydrogenase were significantly higher than in the PS 1 group. In the PS 3 group, the mean values of albumin, prealbumin, and transferrin were significantly lower than in the PS 1 group. The survival time was correlated with the ECOG PS (r=-0.602, p<0.001,), PINI (r=-0.318, p<0.001,), alpha 1-acid glycoprotein (r=-0.265, p=0.002), C-reactive protein (r=-0.345, p<0.001), albumin (r=0.324, p<0.001), prealbumin (r=0.260, p=0.003) and transferrin (r=0.277, p=0.001). Conclusions: The PINI may be a useful scoring system for the assessment of nutritional status and prognosis in advanced metastatic cancer following palliative chemotherapy, but the ECOG PS is most strong correlation with the survival time.(Korean J Med 71:132-140, 2006)
Trimethoprim / Sulfamethoxazole ( TMP / SMX ) 을 복용 중인 외래 환자에서 발생하는 경구 칼륨 투여 후 칼륨 대사 장애
최춘식(Chun Sik Choi),유영조(Young Jo Yoo),김태영(Tae Young Kim),민경환(Kyung Hwan Min),한상웅(Sang Woong Han),노광호(Kwang Ho Roh),양성규(Seong Kyu Yang),유준호(Jun Ho Yoo),오석중(Suk Joong Oh),문중돈(Jung Don Mun),김호중(Ho Jung Ki 대한내과학회 1999 대한내과학회지 Vol.57 No.1
N/A TMP/SMX has been shown to cause hyperkalemia in a few outpatients on standard-dose. This prospective study was aimed at investigating other associated factors inducing clinically important hyperkalemia in outpatients on standard-dose of TMP/SMX. Methods : Age-matched diabetic(n=22) and non-diabetic (n=20) patients with UTI on standard dose of TMP/SMX for 5 days were given acute oral intake of 40 mEq of potassium chloride(KCl). Results : Before the intake of TMP/SMX, basal levels of serum potassium(K), serum BUN and creatinine, plasma renin activity(PRA), aldosterone(PA), and transtubular potassium gradient(TTKG) were comparable between diabetic and non-diabetic subjects. Also after TMP/SMX was taken, all parameters didnt reveal any overt changes except a slightly increased serum K but not significantly (from 4.20±0.15 to 4.14±0.21mEq/L in non-diabetics; from 4.13±0.18 to 4.25±0.13mEq/L in diabetics). Following acute oral KCl load, however, the peak increases of serum K changes were significantly higher in diabetics compared to non-diabetics(0.34 0.06 vs 0.62 0.09mEq/L, p<0.01). Furthermore, 8 out of 22 diabetics but none of non-diabetics after acute KCl load developed hyperkalemia(> 5.0 mEq/L). After KCl load, PRA did not show any significant changes, whereas PA was increased simultaneously with the increments of serum K in both diabetic subgroups hyperkalemic(n=8) and normokalemic (n=14) diabetics. But increment was blunted in hyperkalemic diabetic subgroup. TTKG was increased prominently in normokalemic diabetic subgroup(9.20 from 4.50), while it was slightly increased in hyperkalemic diabetic subgroup(4.63 from 3.79mEq/L). There was statistical difference between two subgroups(p < 0.05). In conclusion, Besides the known effect of blocking sodium channels in distal K secreting cells by TMP/SMX, insulinopenia(DM). Hypoaldosteronism with its decreased tubular bioactivity, and increased exogenous K intake in concert could cause clinically overt hyperkalemia on standard-dose of TMP/SMX. When standard- dose of TMP/SMX is administered to patients with deranged K homeostasis, especially to diabetics with hypoaldosteronism, blood K level should be monitored meticulously to avoid hyperkalemia.