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증례 : 혈액종양 ; All- trans retinoic acid 관해 유도 치료 후 중추신경계에서 재발한 급성 전골수성 백혈병 5예
김은옥 ( Eun Ok Kim ),길상현 ( Sang Hyun Gil ),최재기 ( Jae Ki Choi ),이현정 ( Hyun Jeong Lee ),김희제 ( Hee Je Kim ),이종욱 ( Jong Wook Lee ),민우성 ( Woo Sung Min ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2
급성 전골수성 백혈병은 특별한 세포의 형태, 전형적인 염색체 이상, 응고 장애 및 ATRA 치료에 반응이 좋은 것을 특징으로 하는 질환으로 일반적으로 중추신경계로의 재발은 흔하지 않다. 진단 당시 백혈구 증다증이 있는 경우에 중추신경계 재발의 위험이 증가하는 것으로 알려져 있으며 현재까지 중추신경계 재발에 대한 적절한 치료원칙은 정립되지 않은 상태이다. 저자들은 급성 전골수성 백혈병 환자 중 ATRA 치료 이후 세포학적 혹은 분자생물학적 재발을 동반하거나 동반하지 않은 중추신경계 재발 환자를 5예 경험하였다. 두부 방사선학적 검사에서 연수막 전이 소견을 보였으며 뇌척수액 검사에서도 전골수성 백혈병 세포의 침윤이 확인되었다. 환자들은 전신적 항암요법과 방사선 치료, 척수 항암치료로 치료를 받았으며 대부분은 삼산화비소로 유지치료를 받았다. 5예 중 1예에서는 2차 관해 이후 동종 조혈모세포이식을 시행 받고 안정된 경과를 유지하였다. Acute promyelocytic leukemia (APL) is distinguished from other subtypes of acute myeloid leukemia (AML) by its distinctive morphology, specific chromosomal abnormality, coagulopathy, and unique response to treatment with all-trans retinoic acid (ATRA). Central nervous system (CNS) involvement is rare in APL. Most CNS relapses occur in patients with hyperleukocytosis at initial presentation, and the optimal management of such patients is still controversial. We report five patients with APL who had CNS relapse with or without evidence of cytological and molecular disease of the bone marrow after ATRA treatment. Brain magnetic resonance imaging revealed leptomeningeal infiltration and cerebrospinal fluid examination showed the presence of promyelocytes. Patients were treated with a combination of systemic chemotherapy and radiotherapy with or without intrathecal chemotherapy, and most were subsequently treated with arsenic trioxide (ATO) as maintenance therapy. Among these patients, one received allogeneic stem cell transplantation in second complete remission. (Korean J Med 2011;80:231-237)
만성신부전증 환자에서 Vancomycin 투여 후 발생한 무과립구증 G-CSF를 이용한 성공적 치료
이병오 ( Byung Oh Lee ),김영옥 ( Young Ok Kim ),김기조 ( Ki Jo Kim ),고명범 ( Myoung Beom Koh ),정현화 ( Hyun Wha Chung ),윤선애 ( Sun Ae Yoon ),이혜경 ( Hae Kyung Lee ),이종욱 ( Jong Wook Lee ),장윤식 ( Yoon Sik Chang ),방병기 ( 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.2
Vancomycin induced agranulocytosis is a rare but life-theratenign complication. We here report a case of vancomycin induced agranulocytosis in a patient with chronic renal failure. A 36-year- old woman receiving hemodialysis via jugular cannulation developed staphylococcus sepsis. The catheter was removed and she was started on vancomycin therapy (1.0 g/week). New catheter was inserted for next hemodialysis. Second sepsis of same organism developed 12 days after initial sepsis inspite of vancomycin therapy. We removed this catheter and continued vancomycin therapy. After 19 days of vancomycin treatment, the patient developed a severe agranulocytosis with white blood cell count of 1,600/mmm^3 and the complete absence of neutrophil. Vancomycin was discontinued and teicoplanin was substituted for vancomycin therapy and G-CSF (granulocyte colony stimulating factor) therapy was begun. White blood cell count including neutropil was completely recovered after 13 days of discontinuation of vancomycin.
박노국,이종욱,이승철,이종대,류시옥,이태진 영남대학교 공업기술연구소 2000 工業技術硏究所論文集 Vol.28 No.2
The zinc titanate sorbents(ZTG40) were prepared and the tests for durability and attrition resistance were carried out to develop the highly effective desulfurization sorbents. In the attrition tests for ZTG40 the results showed that the attrition resistance was 94.08% and that the sulfur capacity was maintained above 15g S/100g sorbent throughout the 100-cycle test, its maximum being 23.05g S/100g sorbent. As compared to sorbents developed by the developed countries, ZTG40 showed superior performances. In the advanced countries 15g S/100g sorbent is a yardstick of excellency for the sulfur capacity of desulfurization sorbents. Therefore, ZTG40 developed in this study has the desirable physical and chemical properties for fluidized desulfurization of coal gases.