Comparison of Proliferative Activity in Each Histological Subtypes of Benign and Atypical Intracranial Meningiomas by PCNA and Ki-67 Immunolabeling

최승진,장은덕,권성오,계대곤,박춘근,이상원,강준기,Choi, Seung Jin,Chang, Eun Deok,Kwon, Seung Oh,Kye, Dae Kon,Park, Choon Keun,Lee, Sang Won,Kang, Joon Ki The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.9

목 적 : 양성 뇌수막종에 비하여 이형성 및 악성 뇌수막종이 나쁜 임상적인 예후 및 양상을 보이는 것은 잘 알려져 있으나, 양성 뇌수막종에 있어서 각각의 병리조직학적 아형에 따른 생물학적 양상의 차이에 대해서는 잘 알려지지 않거나 일부 논란이 되고있다. 본 연구에서는 이형성 뇌수막종 및 양성 뇌수막종의 각각의 병리조직학적 아형에 따른 증식능의 차이여부를 알아보고자 PCNA와 Ki-67표지지수를 분석하였다. 방 법 : 본원에서 뇌수막종으로 수술을 시행하여 얻은, 재발을 보여 재수술을 시행한 2례를 포함하여, 파라핀에 포매시킨 27개의 조직을 대상으로 병리학적인 증식능을 분석하기 위해, PCNA에 대한 단일항체 및 MIB-1 단일항체를 이용한 면역조직화학적 염색을 시행하였다. 조직학적 분류상 meningothelial type이 8례, transitional type이 9례, fibroblastic type이 5례였으며, 이형성 수막종이 5례였다. 결 과 : PCNA표지지수의 평균값은 양성 수막종에서 meningothelial type이 $4.82{\pm}5.10%$, transitional type이 $9.01{\pm}4.25%$, fibroblastic type이 $5.66{\pm}5.32%$를 보였으나 이형성 수막종에서는 $27.62{\pm}19.67%$의 높은 지수를 나타냈고, Ki-67 표지지수의 평균값은 양성 수막종의 아형에서 각각 $0.43{\pm}0.85%$, $0.44{\pm}1.08%$, $0.24{\pm}0.18%$를 보이고, 역시 이형성 수막종에서는 $0.84{\pm}0.59%$의 높은 지수를 보였다. 즉, 양성 수막종에서 각각의 아형에 따른 PCNA 및 Ki-67 표지지수는 통계학적으로 의미있는 차이는 없었으나(p>0.05), 이형성 수막종에서는 의미있는 높은 표지지수를 보여(p<0.05) 양성 수막종에서 보다 높은 증식능을 보임을 알 수 있었다. 결 론 : PCNA 및 Ki-67 표지지수를 이용한 증식능의 비교결과, 양성 뇌수막종에서는 각각의 아형에 따른 생물학적 양상이나 예후는 차이가 없을것으로 생각되나, 이형성 수막종에서는 높은 증식능을 보여 이에 대한 예후를 예상할 수 있을것으로 생각되며, 또한 이러한 표지지수가 병리조직학적으로 양성과 이형성의 감별에 많은 도움이 될것으로 사료된다. Objective : The clinical prognosis and biological behavior of atypical and especially malignant meningiomas are well known to be worse than benign meningioma, but the degree of biological aggressiveness in each classical subtypes of benign meningioma is controversy. This study was performed to see whether there is a difference in the proliferative activity between each different histological subtypes of benign meningioma as well as atypical meningioma. Methods : Paraffin-embedded surgical specimens of 27 meningiomas, including two recurrent tumors, were studied to evaluate proliferative activity by immunohistochemical method with monoclonal antibodies to proliferating cell nuclear antigen(PCNA) and MIB-1. The specimens consisted of 8 cases of meningothelial, 9 cases of transitional, 5 cases of fibroblastic subtypes and 5 cases of atypical meningiomas. Results : Mean PCNA labeling indices of meningothelial, transitional and fibroblastic meningiomas were $4.82{\pm}5.10%$, $9.01{\pm}4.25%$ and $5.66{\pm}5.32%$, but that of atypical meningiomas was $27.62{\pm}19.67%$, noting a higher value compared to all three subtypes of benign meningiomas. Mean Ki-67 labeling indices of the above 3 subtypes were $0.43{\pm}0.85%$, $0.44{\pm}1.08%$ and $0.24{\pm}0.18%$, and that of atypical meningiomas was also revealed to be of higher value ($0.84{\pm}0.59%$). PCNA and Ki-67 labeling indices were not statistically different between histological subtypes of benign meningioma(p>0.05), but the differences of both immunolabeling between benign and atypical meningiomas were statistically significant(p<0.05). Conclusion : Immunolabeling of PCNA and Ki-67 in intracranial meningiomas reveals no prognostic difference between meningothelial, transitional and fibroblastic subtypes in classical benign meningiomas by measuring expression of PCNA and Ki-67, but it seems to be helpful in differentiating benign and atypical meningioma, later showing more proliferative activity and biological aggressiveness.

담낭암의 발생에서 담췌관합류이상의 역할 규명과 암화과정에 관한 연구

한기준,송시영,정재복,이세준,김호근,강진경 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.4

The impact of pathologic differentiation (well/ poorly) and the degree of Ki-67 index in patients with metastatic WHO grade 3 GEP-NECs.

Kim, Seung Tae,Lee, Su Jin,Lee, Jeeyun,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kang, Won Ki Grune & Stratton 2017 Journal of clinical oncology Vol.35 No._suppl15

<P> e15686 </P><P> Background: Herein, we investigated the impact of pathologic differentiation (well or poorly differentiated) in metastatic grade 3 GEP-NEC patients receiving etoposide and platinum-based therapy. Simultaneously, we evaluated a more exact Ki67 index cut-off point to select patients with grade 3 GEP-NEC who might benefit from etoposide plus platinum (EP)-based therapy. Methods: Among patients pathologically diagnosed with metastatic grade 3 GEP-NECs at Samsung Medical Center between June 2013 and March 2016, 31 GEP-NEC patients receiving etoposide and platinum-based therapy were included in this study. Results: Primary sites included 13 foregut-derived GEP-NECs [stomach (n = 4), duodenum (n = 4), and pancreas (n = 5)] and 2 hindgut-derived GEP-NECs of the rectum. Sixteen unclassified GEP-NECs originated from 7 gall-bladder (GB), 6 liver and 3 unknown primary sites. According to pathologic differentiation, 14 patients had well differentiated and 17 had poorly differentiated grade 3 GEP-NECs. Between well differentiated and poorly differentiated grade 3 GEP-NECs, there was a significant difference in the distribution of Ki67 index. There was no significant difference of treatment efficacy between well and poorly differentiated grade 3 GEP-NECs (RR; 35.7% vs. 41.2%, p = 0.525). Tumor response to EP occurred in 5 of 7 patients with Ki67 > 60% and 7 of 24 with Ki67≤60%, which was significantly different (RR; 71.4% vs. 29.2%, P = 0.043). There was no significant difference in PFS according to pathologic differentiation (well differentiated vs. poorly differentiated) and Ki67 index ( > 60% vs ≤60%). Conclusions: Grade 3 GEP-NECs could be morphologically classified into well and poorly differentiated NETs. Additionally, among grade 3 GEP-NECs, there was a significant difference in ranges of Ki67 index between well and poorly differentiated NECs. Higher levels ( > 60%) of Ki67 index might be a predictive marker for efficacy of EP as a standard regimen in grade 3 GEP-NECs. </P>

담낭암 발생에서 담췌관합류이상의 역할 규명과 암화과정에 관한 연구

강진경,한기준,이세준,송시영,정재복,김호근 대한소화기학회 1998 대한소화기학회지 Vol.32 No.4

Baekground/Aims: To clarify the careinogenesis of gallbladder cancer (GBC) in patients with anomalous pancreaticobiliary ductal union (APBDU), we investigated the expression of mutated p53 protein and c-erbB2, the cell proliferation indices of Ki-67 and the histopathologic changes in gallbladder carcinoma and noncaneeraus mucosa which are associated with APBDU. Methods: In the clinical review, we analysed 62 patients (27 patients of GBC with APBDU and 35 patients of GBC without APBDU) who were diagnosed in Sevrance Hospital from January, 1992 to December, 1994. Immunohistochemical staining and histologic examination were performed on the specimens obtained from surgically resected gallbladders from the patients. For comparative study, the specimens were grogped as follows: 5 cases of carcinoma with APBDU, 4 eases of noneancerous mucosa with APBDU associated with GBC, 11 cases of noncancerous mucosa with APBDU not associated with GBC, 19 cases of carcinoma without APBDU and 7 cases of chronic inflammatory mucosa of gallbladder stones as controls. Results, GBC developed in 33.3% of patients with APBDU (especially, 66.7% of PC type) and showed no gallbladder stones. The frequency of papillary carcinoma was higher and depth of invasion was less in GBC with APBDU than in GBC without APBDU. Among 15 cases of noncancerous mucosa with APBDU, isolated dysplasia and adenomyomatous hyperplasia were noted in 10 cases and 4 cases, respectively. In one case of APBDU with GBC, the expression of p53 protein was noted in the focal area of low grade dysplasia. Cell proliferation indices of Ki-67 were stepwise increased with the progression of histologic findings from inflammation, papiUary hyperplasia, metaplasia and adenomyomatous hyperplasia to dysplasia. Particularly, remarkable increase was observed in adenomyomatous hyperplasia and dysplasia. Conclusions: The high incidence of isolated dysplasia and adenomyoma accompanying with increased cell proliferative indices seems to be closely related to th carcinogenesis of GBC in patients with APBDU. Additionally, the mutation of p53 may contribute to early event of carcinogenesis in some patients with APBDU.

Therapeutic Effects of Recombinant Human Epidermal Growth Factor (rhEGF) in a Murine Model of Concurrent Chemo- and Radiotherapy-Induced Oral Mucositis

RYU, Seung-Hee,KANG, Ki Mun,MOON, Soo Young,CHAI, Gyu Young,HONG, Joon Pio,CHO, Kyoung-Oh,KANG, Mun-Il,CHOI, Eun Kyung,LEE, Sang-wook Journal of Radiation Research Editorial Committee 2010 JOURNAL OF RADIATION RESEARCH Vol.51 No.5

<P>Concurrent chemotherapy with radiotherapy (CCRT) has been applied for the treatment of advanced stage of head and neck cancer patients. However CCRT is associated with several complications including mucositis, dermatitis, stomatitis, etc. This study was conducted to evaluate the therapeutic effect of systemically administrated recombinant human epidermal growth factor (rhEGF) in CCRT-induced oral mucositis in a mouse model. Oral mucositis was induced in male BALB/c mice through combination treatment with cisplatin (11 mg/kg, i.p.) and irradiation (17 Gy) of the head and neck area. rhEGF (1.0 mg/kg/day for consecutive 3 days) was administered systemically, and the therapeutic effect was determined by histological evaluation of the oral mucosa. To elucidate optimal dose of rhEGF on CCRT-induced mucositis, various concentrations (0.04–3 mg/kg) of rhEGF were injected for 3 days. Systemic rhEGF administration accelerated the recovery of body weight. Histologically, rhEGF-treated mice showed significantly increased epithelial cell layer thickness, basal cell number, and expression of Ki-67 compared to control mice. Most effective dose was 1 mg/kg among other doses tested. Systemic administration of 1 mg/kg of rhEGF reduces the severity of oral mucositis induced by CCRT in a mouse model, suggesting that rhEGF can be used for treating CCRT-induced mucositis during the cancer treatment.</P>

Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료

정남식,홍기도,하성식,박성준,강정호,심재천,Chung, Nam-Sik,Hong, Ki-Do,Ha, Sung-Sik,Park, Sung-Joon,Kang, Jung-Ho,Sim, Jae-Cheon 대한정형외과스포츠의학회 2006 대한정형외과스포츠의학회지 Vol.5 No.1

목적: 전위성 쇄골 간부 골절의 치료로 관혈적 정복술 후 LCP를 사용하여 내고정을 시행한 환자를 대상으로 방사선학적, 임상적 결과를 분석하여 전위성 쇄골 간부 골절의 치료에 있어서 LCP의 유용성을 알아보고자 하였다. 대상 및 방법: 2003년 5월부터 2004년 11월까지 본원에서 쇄골 간부 골절에 대해 LCP를 이용한 관혈적 정복, 금속내 고정술을 시행하고 6개월 이상 추시가 가능하였던 26례를 대상으로 하였다. 수술 후 최종 평가는 방사선 결과와 fang s criteria를 이용한 임상적 결과로 분석하였다. 결과: 수술 후 평균 9.3주에 모든 예에서 지연유합 없이 골유합 되었으며 임상적으로 Kangs criteria에 따라 구분한 결과, 우수 이 상이 22례로 나타났다. 특히, 견관절 운동은 상완골 골절이 동반된 두 경우를 제외한 24례에서 2.9주내에 정상 범위로 빠른 회복을 보였다. 합병증으로는 견관절 운동 장애 2례, 수술 절개 부위의 켈로이드 형성 1례였으며 그 이외에 다른 주요 합병증은 없었다. 결론: 전위성 쇄골 간부 골절에서 LCP를 이용한 관혈적 정복 및 금속내 고정술은 기존의 금속판에 비해 수술 후 합병증을 줄이고 효과적인 골유합과 조기 견관절 운동에 도움을 줄 수 있는 좋은 치료 방법 중 하나라고 사료된다. Purpose: To assess the effectiveness of the Locking compression plate (LCP) after open reduction for the treatment of the displaced clavicular shaft fracture, the clinical and radiologic outcome of the patients who were managed with the LCP for internal fixation after open reduction has been analyzed. Materials and Methods: We reviewed 26 cases with a displaced clavicular shaft fracture treated by internal fixation using Locking compression plate after open reduction between May 2003 and November 2004. The patients were followed up for at least six months period, and final postoperative outcome was evaluated using clinical results based on Kang's criteria, radiologic signs of fusion. Results: All fractures united by an average of 9.3 weeks without delayed union and showed fast recovery of motion fraction and shoulder function. In addition,24 cases without the fractures of proximal humerus recovered to normal range of shoulder notion within 2.9 weeks. Clinically, according to Kang's criteria, the outcome was good or better in 22 patients. The complications included shoulder joint dysfunction in two cases and keloid formation in one case, and no other complications were observed. Conclusion: The internal fixation using LCP for the treatment of displaced clavicular shaft fracture is a safe, reliable method of treatment, with few complications, and offers rapid recovery of shoulder joint function and bone union.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

편측안면경련의 미세혈관 감압술시 안면근전도의 수술중 감시 : 임상연구 Clinical Research

이강운,고원일,최영근,박주현,백민우,강준기 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.9

일부 지역 주민에서 초기 신기능 저하의 지표로서 혈청 Cystatin C 농도의 유용성

원기범,김준섭,박준형,강혁주,이정호 동국대학교 의학연구소 2009 東國醫學 Vol.15 No.2

혈청 cystatin C농도는 혈청 creatinine농도에 비해 신기능을 정확히 반영한다고 알려져 있지만, 대규모 연구 자료가 제한적이었다. 따라서 저자는 다수의 일부 지역 주민을 대상으로 cystatin C를 creatinine과 비교하여 신기능의 지표로서 cystatin C의 유용성을 알아보고자 하였다. 2008년 7월부터 9월까지 포항지역의 건강 검진자 999명 (남자: 324명, 여자: 657명)을 대상으로 혈청 cystatin C, 혈청 creatmine, 나이, 체중을 측정하고, Cockcroft-Gault식으로 사구체 여과율을 계산하였다. 계산된 사구체 여과율을 National Kidney Foundation의 Kidney Disease Outcomes Quality Initiative (KDOQI)에서 제시한 만성 신장병 분류 기준에 따라 5단계로 분류하였지만 4단계 (중증의 사구체 여과율 저하) 및 5단계 (신부전 또는 투석) 에 포함되는 대상자들의 숫자가 적어 (4단계: 4명, 5단계: 1명) 연구 대상에서 제외하였다. 대상자들의 평균 나이는 52.1 ± 17.1 세, 평균 체중은 59.7 ± 11.3 Kg,평균 혈청 cystatin C농도는 0.9 ± 0.2 mg, 평균 creatinine 농도는 1.0 ± 0.2 mg/dL이었다. 사구체 여과율을 각 단계별로 비교해 본 결과는 다음과 같이 혈청 cystatin C농도는 1 단계 (정상 신기능)는 0.8 ± 0.1 mg, 2단계 (경도의 신기능 저하)는 0.9 U 0.1 mg, 3단계 (중등도의 신기능 저하)는 1.0 d=0.1mg로 각각 유의한 차이를 보였다 (p<0.05).혈청 creatinine농도는 1단계는 0.9 ± 0.2 mg/dL, 2단계는 0.9 ± 0.1 mg/dL, 3단계는 1.0 ± 0.1 mg/dL로 l단계와 2단계 간에 차이가 없었으나 (p>0.05), 2단계와 3단계 간에는 유의한 차이를 보였다 (p<0.05).혈청 cystatin C농도와 혈청 creatinine농도는 나이 (cystatin C: r=0.275, p<0.05; creatinine: r=0.300, p<0.05) 및 체중 (cystatin C: r=0.075, P<0.05; creatinine: r=0.162, p<0.05) 과 양의 상관 관계를 보였다. 혈청 cystatin C 농도는 성별 간의 차이가 없었고, 혈청 creatinine농도는 남성에서 유의하게 높았다. 혈청 cystatin C농도는 혈청 creatinine농도에 비해 초기 신기능 저하를 반영하는 유용한 지표라고 생각된다. Although serum cystatin C has been suggested to be a better alternative marker than serum creatinine for estimating renal function, there have been limited data about its superiority over creatinine in a large number of populations. The aim of this study was to evaluate cystatin C as a renal marker compared to creatinine in a large population of the local community. We measured serum cystatin C, creatinine, age, body weight from 999 volunteers (Male; 324, Female; 657) of a single local cohort, Phohang, from July to September, 2008, and then calculated the GFR according to Cockcroft Gault(CG) formula. The population was divided into five stages followed by the chronic renal disease classification presented by KDOQI. The numbers in stage 4 (severe renal impairment), and 5 (renal failure) were too small (4 in stage 4, 1 in stage 5) to perform statistical analysis, so we excluded them. The mean age was 52.1 ± 17.1, and body weight 59.7 ± 11.3 Kg; serum cystatin C 0.9 ± 0.2 mg/L; serum creatmine 1.0 ± 0.2 mg/dL; CG GFR 70.6 ± 19.1 ml/min/1.73 m^(2). The tests completed for the comparison among each stage suggested the following results; serum cystatin C levels in stage 1 (normal renal function), stage 2 (mild deterioration of renal function), and stage 3 (moderate deterioration of renal function) showed the significant differences (stage 1 vs 2: 0.8 ± 0.1 vs 0.9 ± 0.1, p<0.05; stage 2 vs 3: 0.9 ± 0.1 vs 1.0 ± 0.1, p<0.05). Serum creatinine levels showed no significant differences between stage 1 and stage 2 (stage 1 vs 2: 0.9 ± 0.2 vs 0.9 ± 0.1, p>0.05), but showed significant differences between stage 2 and stage 3 (stage 2 vs 3: 0.9 ± 0.1 vs 1.0 ± 0.1, p<0.05). Serum cystatin C and creatinine presented positive correlation between age (cystatin C: r=0.275, p<0.05; creatinine: r=0.300, p<0.05) and body weight (cystatin C: r=0.075, p<0.05; creatinine: r=0.162, P<0.05). Serum cystatin C levels showed no significant difference in sex, but serum creatinine levels were significantly higher in men than women. Serum cystatin C level is suggested to be more useful parameter than serum creatinine level to evaluate early renal impairment.

고위험군의 원발성 전신성 유전분증 1례 보고 및 조혈모세포이식에 대한 문헌고찰

심준,박수정,엄현석,김기영,박은정,강인중,조병식,이안희,한치화 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.2

저자 등은 클론성 형질세포질환과 동반된 젊은 연령의 원발성 전신성 유전분증 환자를 진단하였기에 다발성 골수종과의 감별 진단, 치료 , 예후 및 고용량 항암화학요법과 조혈모세포이식에 관하여 문헌고찰과 함께 보고하는 바이다. Primary systemic amyloidosis (AL) is a rapidly fatal disorder related to plasma cell dyscrasia. Conventional dose of melphalan, which prolongs the duration of survival by about 10 months, does not improve the functions of impaired organs in most cases. The high dose chemotherapy followed by autologous hematopoietic stem cell rescue for AL, in spite of its high treatment-related mortality, is a new approach to achieve high response rate and better survival. We experienced a 35-year old man with AL(involving heart, liver, stomach, kidneys, peripheral nerve, and rectum) who did not respond to the standard schedule of melphalan plus prednisone and had rapidly fatal course with organ failure. Hence, we evaluate its availability by reviewing the recent reports of high dose chemotherapy in AL.