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Treatment with vinca alkaloids which consisted of infusion of vincristine-loaded platelets, or slow infusion of vinca alkaloids or both were done in 9 patients of idiopathic thrombocytopenic purpura refractory to glucocorticoids with or without splenectomy. 2 (22%) of them showed excellent response, 5 (56%), good response, 2 (22%), poor response. However one patient of excellent response and all of good response needed repeated treatment to maintain response. The toxicity of this treatment was mininal, only mild peripheral neuropathy was observed in 2 patients. It can be concluded that the treatment with vinca alkaloids is one of the useful therapeutic modalities to manage refrectory ITP.
Phenochromocytoma is a catecholamine-secreting tumor, most of which grow at the adrenal gland. About 109p Of pheochromocytomas are detected at the extra-adrenal chromaffine tissues and are called paraganglioma. The main symptoms of pheochromacytoma include hypertension, headache, palpitation, and sweating. Gastrointestinal symptoms such as abdominal pain, constipation, and vomiting are found in 20∼40% of patients with pheochromocytoma, but these are usually overlooked because of the severe, prominant cardiovascular symptoms. Intestinal pseudo-obstruction without hypertension in pheochromocytoma is very rarely found. It is caused by the decreased motility of the intestine and the over-contraction of the intestinal sphincter, which are caused by the unbalanced activation of α-and β-adrenal receptors. It can be hypothesized that catecholamine receptors in the cardiovascular system are down-regulated or desensitized, but those in the intestine remain intact. We report herein a case of pheochromocytoma in which intestinal pseudo-obstruction was the main presenting clinical manifestation. Symptoms of intestinal pseudo-obstruction were completely relieved by administration of phenoxybenzamine, an α-receptor blocker, and excisional surgery.
In this study, two different types of complementary electrochromic devices using amorphous WO₃ films as a working electrode, V₂O_5 film and NiO film as counter electrodes respectively were investigated. For the devices using amorphous and crystalline V₂O_5 films of 100∼150nm thickness with ITO/WO₃/LiClO₄-PC/V₂O_5 /ITO structure, an optical modulation of 50∼60% were obtained at a potential range of 1 2V. It has been shown that transmittance and reflectance of light could be electrically controlled by low applied voltage. For the devices with ITO/WO₃/LiClO₄-PC/NiO/ITO structure in which NiO film was deposited by a RF reactive sputtering, the optical modulation in visible light region (λ=550nm) and in near infrared light region (λ.1=850nm) were 25% and 30%, respectively.
목적 : 혈중 IL-6의 과발현은 다발성 골수종, 악성 흑색종, 신경 교아종, 난소암, 신장암과 림프종에서의 예후와 관련이 있다고 알려져 있는데 자궁경부암 환자의 혈중 IL-6의 농도를 정량화하여 대조군과 상피내암 및 자궁경부암에서 혈중 IL-6의 상관관계를 알아 보고자 본 연구를 시행하였다. 연구방법 : 1997년 6월부터 1998년 6월까지 자궁경부 편평상피암 29명, 자궁경부 상피내암 14명, 대조군 15명을 대상으로 혈액 시료를 채취 후 분석시까지 -70℃에 보관하였으며 ELISA(BioSource International) kit를 이용하여 IL-6를 정량 분석하였다. 결과 : 혈중 IL-6의 평균농도는 대조군 4.4±1.7 pg/ml, 자궁경부 상피내암 5.3±1.7 pg/ml, 자궁경부 편평상피암 5.6±4.1 pg/ml로 자궁경부 편평상피암에서 혈중 IL-6가 증가하는 경향을 보였으나 각 군간의 통계적 의의는 없었다(p=0.478). 결론 : 정상 대조군에 비하여 자궁경부 편평상피암과 자궁경부 상피내암에서 혈중 IL-6의 농도가 증가되는 것을 확인할 수 있었으나 통계적 유의성은 관찰할 수 없었으며 더 많은 예를 중심으로 연구가 필요하리라 사료된다. Objective : To evaluate the relationship between the level of serum IL-6 and the prognosis of cervical cancer patients, because high level of IL-6 has been reported to be related with adverse prognosis in multiple myeloma, renal cancer, glioblastoma, ovarian cancer and lymphoma. Methods : From June, 1997 to June 1998, total 58 patients including 29 patients with cervical cancer, 14 Carcinoma in situ, 15 control were enrolled in this study. We examined these patients of serum IL-6 by ELISA. Result : The mean serum IL-6 was 4.35±1.68pg/ml on control, 5.29±1.72pg/ml on carcinoma in situ and 5.57±4.10pg/ml in cervical cancer patients. Conclusion : Detectable serum IL-6 levels were more often in patients with cervical cancer and carcinoma in situ than in control group, but the difference was not statistically significant because of the small number of patients.
Objectives: Familial adenomatous polyposis(FAP) and Gardner syndrome(GS) are inherited in an autosomal dominant manner and predispose affected family memebers to the development of colorectal cancer. Presymptomatic diagnosis of FAP/GS have been difficult to perform effectively in the past be- cause RFLP DNA markers surrounding the APC gene on chromosome 5q have not been very informative. But several polymorphic markers are now available for genetic diagnosis of the disease. We performed genetic linkage studies on both FAP and GS families by using CA repeat polymorphism at the DSS82, proximal to APC gene. Methods: Genomic DNA was extracted from the peripheral lymphocytes from 8 members of affected families with FAP and 5 members with GS. Using FCR with[α? 32P] dC'TP incorporated for labelling, DNA fragments were amplified and identified by ethidium bromide staining after agarose gel electrophoresis. The products of the PCR are loaded on 10 % denaturing(8M urea) polyacrylamide gels in TAE buffer, and the gels dried on the filter paper and the reactions visualized by autography. Results: Five and two alleles were detected in FAP and GS family members respectively. But two affected individuals in FAP family do not share a common D5S82 allele. Conclusion: A CA-repeat polymorphism offers improved diagnostic sensitivity for FAP/GS compared with RFLP DNA marker. But for the more accurate presymptomatic diagnosis, CA ? repeat. markers, more highly polymorphic and closer to the APC gene are preferable.
The pharmacokinetics of single oral dose(lgm) of pyrazinamide was studied in 20 patients with various degrees of renal insufficiency including 6 patients on long-term hemodialysis. The average 24 hr urinary recovery of pyrazinamide in patients with creatinine clearance 10 to 30 ml/hr/kg, and patients with creatinine clearance lesser than 10 ml/hr/kg were 7.5 and 0.9% of administered dose respectively. Serum half-life of the drug was slightly, but significantly(p$lt;0.05), prolonged in patients with creatinine clearance lesser than 10 ml/hr/kg(half-life; 11.25±2.55 hr) compared with normal subjects(half-life; 8.21±1.38 hr) previously reported. The mean serm half-life of pyrazinamide in patients on longterm hemodialysis was 12.26±2.92 hr. The half-life fell to 3.52±1.17 hr during hemodialysis. It was estimated that approximately 41% of drug in the body was removed into dialysate during 4 hr dialysis.The mean dialysance of pyrazinamide was 91.40±2.83 ml/min. From the observed pharmacokinetics of pyrazinamide in patients with impaired renal function, it is suggested that adjustment of dosage regimen may not be required for patients just with impaired renal function. However, replacement of dialysed fraction of pyrazinamide would be required for the maintenance of adequate serum level.
목적 : 자궁내막증 또는 자궁선근증을 가진 불임 환자의 치료에 있어 GnRH analogue를 사용한 LTDR의 과배란 유도시 그 효과를 알아보았다. 방법 및 재료 : 복강경과 질식 초음파를 이용하여 자궁내막증 또는 자궁선근증을 진단 받은 불임 여성 43명의 47 LTDR cycles이 연구 대상이 되었다. GnRH analogue를 3개월 이상 장기간 사용하여 down regulation 시킨 후 gonadotropin을 이용하여 과배란 유도를 시행한 경우를 LTDR로 정의하였으며 임신을 위해 자궁강 내 정자 주입술 또는 체외 수정 및 배아 이식이 시행되었다. 결과 : 환자의 평균 연령(meanSD)은 33.83.8이었고 자궁선근증이 10cycles였으며 자궁내막증은 34cycles(1기:12cycles, 2기:9cycles, 3기 :5cycles, 4기:8cycles)이었다. 체외 수정 시 이식된 배아는 평균(meanSD) 3.70.3개였다. 자궁내막증을 가진 34cycles중 17.6%(6/34), 자궁선근증을 가진 10cycles중 40.0%(4/10)의 임신율을 보였다. 결론 : 이 연구에서 LTDR은 자궁내막증과 자궁선근증에 의한 불임 환자의 치료에 효과적인 것으로 보이나 연구 대상군의 확대 조사가 필요하리라 사료된다. Objective : To assess the clinical efficacy of long term down regulation (LTDR) for in vitro fertilization (IVF) in infertile patients with endometriosis or adenomyosis. Materials and methods : Analysis were made from data collected from 45 paients who had endometriosis or adenomyosis diagnosed using pelvic laparoscopy and ultrasonography and had undergone intrauterine insemination or in vitro fertilization. LTDR was defined as long term, as long as three months down regulation of ovarian function followed by induction of ovulation using gonadotropins. Of these patients, 43 had undergone LTDR followed by IVF-ET, whereas 30patients in control group had undergone short or long protocol as an ovarian stimulation regimen. Results : The multiple independent parameters such as plasma basal estradiol (E2), plasma E2 level on day of hCG administration, number of oocytes retrived, number of good quality oocytes, number of embryo and number of transfered embryos were not significantly different between LTDR treated group and other control group. The clinical pregnancy rate in women treated with LTDR (17.6% in endometriosis, 40% in adenomysis, and 33.3% in endometriosis combined with adenomyosis) were comparable with those of control group (15.4% in endometriosis, 33.3% in adenomyosis and 40% in endometriosis combined with adenomyosis). Conclusions : In this study the LTDR as a ovarian stimulation regimen for IVF does not seems efficienct in infertile patients having endometriosis or adenomyosis than other protocols such as short or long, however further study with large number may be needed.
The purpose of this study is to analyze death injuries and operation troubles of urban transit. No difference was shown in death rates between Line 1 of Pusan urban transit and Line 5, 7, and 8 of Seoul metropolitan transit. And relief time by another train did not depend upon the number of crews. We concluded that thorough inspection and preventive maintenance of trains and facilities are necessary for safe and timely service of urban transit.
Objectives: Malignant histiocytosis is a rare, rapidly fatal disorder, characterized by systemic proliferation of abnormal histiocytes. Most patients present with fever, organomegaly, and pancytopenia, and die within a few months. Although malignant histiocytosis represents diagnostically an important histiocytic disorder, its pathogenesis, natural history, response to therapy are not well known. In Korea, there are few reports on malignant histiocytosis. The purpose of this investigation is to assess the clinical spectrum natural history, laboratory findings, histopathologic findings response to therapy of malignant histijiocytos is diagnosed at Seoul national university hospital. Methods: The clinical records and histologic materials from 29 cases of malignant histiocytosis diagnosed at Seoul national university hospital between 1985 and 1994 have been reviewed. The criteria for the histopathologic diagnosis of malignant histiocytosis were the presence of large, abnormal malignant histiocytes with frequent mistosis to be distinguished from reactive histiocytic proliferation. All histologic materials were fixed in formalin, embedded in paraffin, sectioned, and stained with hematoxylin and eosin. Bone marrow aspirates were stained with Jener-Giemsa. of 29 patients, 20 patients were treated with combination chemotherapy; CHOP in 8 patients, COPBLAM in 3 patients, BVP in 7 patients, C-MOPP in 1 patient, Pdplusvincristine in 1 patient. Results: The median age was 32 years, with a 2.2:1 male to female prepondance. Major physical findings included temperature elevation (93%), hepatomegaly (90%), splenomegaly (86%), jaundice (5%). Common laboratory findings were anemia (86%), thrombocytopenia (90%), splenomegaly (86%), jaundice (45%). Common laboratory findings were anemia (86%), thrombocytopenia (90%), leukopenia (72%), hypocalcemia (97%), abnormal liver function test (100%). Histologic features observed in bone marrow were increased histiocytes, atypical immature histiocytic infiltration with hemophagocytosis. Histologic features observed in lymph node were destruction of normal structure with infiltration and proliferation of immature histiocytes. Prominent features observed in liver were sinusoidal histiocytic infiltration. The response to treatment was encouraging. One patient achieved a completed remission (5%), 5 patients achieved a partial remission (25%), and overall response rates were 30%. Conclusion: The distinctive clinical and histologic findings warrant recognition and separation of malignant histiocytosis from other histiocytic and hematopoietic disorders and long-term survival is possible in some patients if treated early and aggressively with combination chemotherapy.