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      • 단기간의 저용량 Cytosine arabinoside 치료에 반응하였던 Down 증후군에 병발한 급성골수성백혈병 1례

        김현수,이정호,이정찬,강정현,곽상혁,김철희,배광봉,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        The incidence of hematologic disorders in patients with Down's syndrome is significantly increased, about 14∼30 - fold higher than in general population and includes neonatal transient abnormal myelopoieis and acute leukemias. The age of onset of leukemia in Down's syndrome is peaking first in the newborn period and then under 4 years of age. Down's syndrome with acute leukemia above the age of 20 is very rare and it's treatment oucome is unclear. The treatment of Down's syndrome with leukemia has been controversial because of toxicity and associated congenital cardiac and other abnormalities. But if treated adequately, children with Down's syndrome show a favorable response to anti-leukemia therapy. A 24-year-old man with Down's syndrome was first seen for the evaluation of anemia and thrombocytopenia. The peripheral blood morphology and bone marrow study revealed acute myelogenous leukemia, cytogenetic study of bone marrow showed trisomy 21. Beacuse of his sicioeconomic condition and medical abnormalities including deafness, visual loss, he was treated with low dose subcutaneous cytosine arabinoside(Ara-C) for 11 days. Complete remission was obtained after 37 days. The complete remission lasted for 5 months. He subsequently relapsed, and died 6 months later.

      • 항암화학요법을 받는 암 환자에 대한 Nucare^R의 영양지지효과

        조덕연,김현수,곽상혁,강정현,김철희,배광봉,김종숙,박상준,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

        Purpose : The purpose of this study was to evaluate the effect of nutritional support with enteral liquid supplement in cancer patients receving chemotherapy for possible benefit in nutritional, immunologic and golbal function of patients. Patients and Methods : From October 1995 to February 1997, 30 advanced cancer patients receving chemotherapy were divided two roups. The Nycare group, in addition to normal diet, Nucare^R enteral supplement was given for 1week right after chemotherapy for the duration of 2 chemotherapy cycles. Control group received only normal diet without parenteral fluid supplement for 2 chemotherapy cycles. Results : Median ages were 53 end 56 years for Nucare group and Contrl group respectively. Performance scores was less than 2 by ECOG scale. All patients were stage Ⅲ or Ⅳ. The physical parameters, such as weight, arm muscle circumference(AMC) and triceps skin fold(TSF) were decreased in both groups after 2 cycles of anticancer therapy. but it was less severe in Nucare group(p<0.05). Serum transferrin was maintained in mild deficit state in Nucare group, whereas it aggravated form mild to moderate deficit in Control group(p<0.05). Serum albumin level increased in Nucare group without statistical significance. but it decreased from normal to mild deficit in Control group. Serum total protein did not change significantly in Nucare group. but in Control group, serum total protein was decreased from 7.24±0.9 to 6.52±0.5(P<0.05). Total lymphocyte count did not change significantly in both groups. Conclusion : This study shows that the nutritional support with Nucare^R was effective in the prevention of nutritional deficit status in patients receving a nticancer chemotherapy.

      • 주민요구충족형 정주권 개발방향 : 자원형 산촌정주권을 중심으로 with Relevance to Resource Oriented Development

        姜秉洙,吳德成 忠南大學校 地域開發硏究所 1997 地域開發論叢 Vol.9 No.-

        In order to develop natural resources of mountain village regardless of renewable or nonrenewable resources, it is one of very important approaches to connect between county center and residents' settlement in mountain village in terms of both equity and efficiency. There are not many studies on development of mountain village. Especially there is no study on the linking mechanism between county center and residents' settlement in mountain village in terms of resource oriented development type of mountain village. So this study focused on both improvement of social infrastructure and development of mountain villages' natural resources for the vitalization of natural resource oriented mountain village development. The study was conducted by 15 interviewers with the subjects of 84 households in Bo-Eun area, 508 households in An-Dong area, and 426 households in Hong-Cheon area. From the cases, the study found natural resource development oriented strategies in mountain villages. Furthermore, the study suggested the connection model between the county center and the residents' settlement in mountain village in terms of the provision of social infrastructure.

      • 악성종양에서 혈청 Intercellular Adhesion Molecule-1의 혈청

        조덕연,김현수,박상준,김종숙,최지영,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1

        Intercellular adhesion molecule-1 (ICAM-1) is a glycoprotein serving as ligands for leukocyte intergrin receptors, i.e. LFA-1, MAC-l. It has been suggested that the expression of ICAM-1 and the levels of circulating ICAM-1 were increased in several malignancies. We measured serum ICAM-1 by ELISA in patients with stomach cancer (n=25), acute lymphoblastic leukemia (n=7), non-Hodgkin's lymphoma (n=14), and metastasis of unknown origin (n=5). Serum levels of circulating ICAM-1 in all malignancies were significantly higer than in normal controls. And serum level of ICAM-1 in stomach cancer ptients having metastatic disease was higher than in patients with localized disease (p=0.027). These results suggest that elevated serum ICAM-1 is a rather common feature for malignancies, not unique for certain types of cancer such as malignant melanoma. It remains to be clalified whether marked increase of serum ICAM-1 in metastatic stomach cancers simply reflect tumor burden or this molecule plays a role in progression in stomach cancer.

      • 척수손상 장애인의 자가운전 특성에 관한 연구

        김수일,나은우,김덕용,배하석 한국전문물리치료학회 2003 한국전문물리치료학회지 Vol.10 No.2

        The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.

      • 우리나라 산촌정주권의 유형과 연계개발모형

        강병수,오덕성,최영일 忠南大學校 地域開發硏究所 1998 地域開發論叢 Vol.10 No.-

        In order to develop natural resources of mountain village regardless of renewable or nonrenewable resources, it is one of very important approaches to connect between county center and residents' settlement in mountain village in terms of both equity and efficiency. There is no study on the linking mechanism between county center and residents' settlement in mountain village in terms of types of mountain villages including resource oriented development, tourist and resort types. This study focused on the improvement of social infrastructure for the vitalization of the mountain village development, and the comparison of three types of mountain villages. Finally, the study suggested the connection model between the county center and the residents' settlement in Korean mountain villages according to each three type.

      • FCL(5-FU, Carboplatin, Leucovorin) 항암 화학요법에서 Gm-CSF의 효과

        최지영,김현수,김종숙,박상준,윤환중,조덕연,남상륜,김삼용 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

        Background: One of the major side effects of cancer chemotherapy is myelosuppression. Neutropenia and/or thrombocytopenia are dose-limiting factors in chemotherapy. Colony-stimulating factor induces proliferation and functional maturation of hematopoietic progenitor cells. GM-CSF is primarily active on progenitor cells of granulocytic and monocytic lineage. Methods: Fifteen patients with histologically proven malignancy diagnosed at Chungnam National University Hospital from January 1993 to August 1995 were included in this study. We could evaluate the clinical efficacy of GM-CSF in 13 patients undergoing FCL(5-FU, Carboplatin and Leucovorin) chemotherapy; the first cycles involved no GM-CSF while the second cycles involved GM-CSF on day 6 through 15 of chemotherapy. Results: 1) The subjects were fifteen patients in all, there were five patients with head and neck cancer, which was the most common types of maligancy. There were four patients with colon cancer, two patients with stomach cancer, and one patient with breast cancer, gallbladder cancer, cervix cancer and cholangiocarcinoma respectively, two patients, who did not complete two cycles of chemotherapy were excluded. 2) Age distribution was from 38 years to 78 years with a median age of 57. 3) In FCL chemotherapy cycles with GM-CSF, the duration of neutropenia(<500/μL) was 0.5±0.3 day, while FCL chemotherapy cycles without GM-CSF, it was 2.9±0.7 day(P=0.008). 3) There was no significant difference in platelet count between the two chemotherapy cycles(P=0.133). 4) Febrile duration without GM-CSF was 4.9±2.1 day, but with GM-CSF the duration was 1.3±0.7 day, which was significantly different(P=0.003). The duration of antibiotics use with GM-CSF was 1.7±1.2 day and without GM-CSF was 6.8±3.2 day, also significantly different(P=0.002). But hospital stay between the two cycles were not significantly different(P=0.064). Conclusion: GM-CSF was effective in preventing or restoring bone marrow depression after FCL chemotherapy.

      • 림프절 종창의 임상적 관찰

        김삼용,김현수,김종숙,박상준,최지영,윤환중,조덕연 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

        Objectives : Clinical management of patient with lymphadenopathy requires judicious judgement of clinicians. Careful evaluation of lymph node enlargement by various clinical parameters will help to disclose the etiology of lymph node enlargement. This study was conducted to identify the clinical manifestations and etiology of lymphadenopathy in korean patients. Methods : A total 192 patients with lymph node enlargement were studied retrospectively. All patients who underwent excisional lymph node biopsy during the period from January 1992 to July 1994 were included. The lymph node biopsy and clinical records were reviewed and patient characteristics were analyzed by various clinical parameters. Results : A female predominance was noted in lymphadenopathy of tuberculosis (58.5%), Kikuchi's syndrome (70%). In lymphadenopathy of nonspecific, tuberculosis, kikuchi syndrome, per centage of patients younger than 40 years of age were 84.5%, 75.6%, 100%, respectively. In lymphadenopathy of tuberculosis and metastatic cancer, the duration of lymphadenopathy below 30days were 51.2%, 73.9%, respectively. The two most common etiology of cervical lymphadenopathy were nonspecific lymphadenitis (47.7%) and tuberculous (26.8%). The two most frequent etiology of supraclavicular lymphadenopathy were nonspecific lymphadenitis (46.3%) and metastatic lymphadenopathy (26.8%) and the most common etiology of axillary lymphadenopathy was nonspecific lymphadenopathy (34.5%). The most common frequent of lymph node enlargement with size below 1㎠ was nonspecific lymphadenitis, while above 2.25㎠ it was metastatic lymphadenopathy. Conclusion : Careful evaluation regarding patient age, sex, size of lymph node, consistency, location of lymph node, presence or absence of systemic symptoms should be pursued before performing a biopsy and management.

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