Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

신체적성 운동 프로그램의 참여가 성장기 아동의 체력 및 형태적 요인에 미치는 영향

김형돈,김명진,배기창 경희대학교 사회체육연구소 1996 體育科學論叢 Vol.- No.9

This study has analyzed the relativity between the physical constitution and strength by comparatively analyzing the difference between the group of 59 male and female infants which has been participating at the periodical physical aptitude program and the one of 59 male and female infants which has been taking part at art program in order to examine the effect of physical aptitude program to the physical constitution and strength. The following conclusions have been reached under the above analyzed results: 1. In the comparison of physical constitution between the group received the physical exercise and the one not received the exercise has shown that both the height and breast of the male infants showed significant difference by(p<.01) in height and(p<.05) in the breast while very high significant difference in height by (p<.001) of the female infants. This analysis has shown that the group of having exercised showed high. 2. In the comparison of physical strength, the boy infants showed very high difference in V- sitting and 25meter run by(p<.001) that the exercised group showed good records while the female infants very high significant difference in standing up and sitting by (p<.01), in 25 meter run significant difference was appeared by (p<.05) and significant high difference in round run by (p<.001). It gives us the information that the more they have exercised the better they got the records. 3. The relativity between the male and female infants in physical constitution and strength, there appeared high relativity in the height, the standing broad jump by (p<.05), in 25 meter run (p<.01), round run (p<.001) and in the weight, rising and sitting (p<.05), round run (p<.05) and in the breast, 25 meter run (p<.01) and round run (p<.01) and in sitting height, the balancing with one leg (p<.05). Other events showed no relativity.

측정값의 상황 의존성

김명석,최상돈,조상규,김정호,전헌무,김호일 慶北大學校 師範大學 科學敎育硏究所 1998 科學敎育硏究誌 Vol.22 No.-

We review the contextuality of measured values in quantum mechanics from point of view of a conventional interpretation of quantum mechanics. We will, in particular, concentrate on Bell-KS theorem which, seemingly, disproved the existence of a hidden-variable interpretation of quantum mechanics. We introduce ways to accommodate the contextuality so that Bell-Ks theorem no longer holds and therefore the existence of a hidden-variable interpretation becomes possible.

Small Cell Lung Cancer Cell Line을 이용한 Xenoplanted nude mice에서 방서선 치료후 종양의 변화 관찰에 관한 연구

김동욱,유명상,김재욱,이병돈,장혁순 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Recently, combination of ionizing radiation with inhibitors of angiogenesis has been reported to improve tumor eradication compared to treatment with irradiation alone. However, the mechanism of this effect have not been defined. For this pupose we established a non-small cell lung cancer model in nude mice. Tumor vascularization was visualized in vivo by MRI using gadolinium-DTPA as contrast agent. Further, cryosections were produced exactly in the MRI slice positions. Since we were interested to examine formation of recurrent tumor irradiation was performed with a single fraction of 6 Gy. This dose caused a partial remission followed by recurrent tumor growth 25 to 35 days after therapy. The process of partial remission as well as formation of the recurrent tumor was examined in 35 nude mice analysing the following parameters: (1) contrast agent enhancement using high-resolution MRI, (2) proliferation of tumor cells and fibroblast using Ki-67 immunohistochemistry, (3) formation of microvessels using CD31 immunohistochemistry. The latter analyses lead to differentiation of three stages. Stage 1(day 1 to 15 after irradiation) was characterized by increasing area of dead cell mass in hematoxylin-eosin stained slides that corresponded to a decrease in tumor cellproliferation as well as contrast agent enhancement. The percentage of Ki-67 positive tumor cells decreased from initially 45.1 ±6.0 to 1.4 %±1.2 % on day 15. Stage 2(days 6 to 20 after irradiation; overlapping with stage 1) was characterized by proliferation of fibroblast leading to formation of fibrotic septae with abundant microvessels. Already during late stage 2 MRI identified new contrast agent enhancing areas. Stage 3(day 20 to 40 after irradiation) was characterized by new tumor cell proliferation. Interestingly, tumor cells almost exclusively proliferated in the direct neighbourhood of the fibroblasts and blood vessels was a condition prior to foramtion of recurrent tumor tissue. Thus our results are in contrast with the view that tumors or recurrent tumors begin as avascular masses that later induce neovascularization. With respect to clinical practice our results suggest that (1) adjuvant anti-angiogenic therapy should not be limited to the day of irradiation but should cover a critical period until day 5 to day 20 after radiotherapy, (2) adjuvant therapy should also include inhibition of fibroblast proliferation, (3) MRI can identify a recurrent tumor 10 to 15 days before occurrence of new tumor growth.

한국인 심부전증 환자 심근에서의 인형 거대 세포 바이러스 감염

이명용,이무용,김영권,한성식,최성준,김효수,이영우,서정돈 단국대학교 1998 論文集 Vol.33 No.-

Objectives: In order to evaluated the prevalence and the site of infection of cytomegalovirus in terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. Methods: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts(N=5) and polymerase cain reactions(PCRs) were done for detection of late gene sequence coding pp150 glycoprotein. The products were confirmed by electrophoresis on the 1% agarose gel. n order to improve the detectability of cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. In situ PCRs also were done with the samples which were confirmed as positive for CMV viral genome by nested PCRs. Results: All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing heart(3 cases/22. 13.5%) and normal hearts( 1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/2, RV 4/22, RA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 2/5, RA 2/5). These was no significant change in positivity of cytomegaloviral DNA genome between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to the nested PCR results. The positivity of cytomegaloviral DNA by n situ PCR was 33.3%(4/12), and the site of positive reaction was the nuclei of the myocardial cells. Conclusion: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. The result of the in situ PCR showed the site of the cytomegaloviral infection was nuclei of the myocardial cells. Cytomegalovirus, however, might have no direct causal relationship in the development of terminal heart failure.

비만자의 운동수행이 혈중지질 및 혈청 효소에 미치는 영향

이은송,김형돈,김명진 慶熙大學校 社會體育硏究所 1998 體育科學論叢 Vol.- No.11

The purpose of this study was to examine the effects of acute exercise on the blood lipids(Low density lipoprotein-cholesterol, High density lipoprotein-cholesterol) and serum enzyme (Aspartate aminotransferase, Alanine aminotransferase) in obesity. The subjects divided by two groups were normal(N=8) and obesity (N=8). This subjects were required to go through a maximum aerobic test. After the analysis of blood composition following results were concluded. The LDL -C compared of the normal and obesity groups were significant differences during rest (p<0.05) The LDL-C significant increased of normal group right after maximum exercise(p<0.001) The HDL-C compared of the normal and obesity groups were significant differences during rest (p<0.05) The HDL-C significant increased of both groups right after maximum exercise (p<0.01). The AST compared of the normal and obesity groups were significant differences during rest (p<0.01) and right after maximum exercise (p<0.05) The AST significant increased of both groups right after maximum exercise(p<0.001). The ALT compared of the normal and obesity groups were no significant in rest and right after maximum exercise. The ALT significant increased of both groups right after maximum exercise (p<0.01).

염처리에 따른 벼 遊離 Proline 축적과 생육반응

정진일,김기영,최돈향,오명규,이승엽,이동진 한국국제농업개발학회 2003 韓國國際農業開發學會誌 Vol.15 No.4

염처리에 따른 무기성분 흡수 및 Proline 축적등을 비교하여 수도의 내염성 품종육성의 기초자료를 얻고자 Annapurna를 대비품종으로 일반계 6품종, 통일계 5품종을 공시하여 얻은 결과는 다음과 같다. 1. 초장, 건물중 및 고사율은 염처리시 감소하였으며, 시간이 경과될수록 감소율이 증가하였다. 2. K/Na비와 건물중 감소율 및 고엽율과는 부의 상관을 보였다. 3.proline 축적은 염농도가 증가함에 따라 증가하였으며 일반계품종들이 통일계품종들보다 축적량이 높았다. 4. Proline 함량과 건물중비율과는 정의 상관을 보였다. In other to find out the basic information on cultivation and breeding for salt tolerance in rice, these studies were conducted in treatment hydroponics added in NaCl using 6 Japonica type varieties and 5 Tongil type varieties compared to the salt tolerance variety, namely Annapurna. The following results were obtained. Plant height, ratio of dry weight and ratio of dead leaf were decreased with increasing periods of salt treatment. Negatively significant correlation was observed between Rario of K/Na were highly negative correlated with the rate of dead leaf and rate of dry weight. The accumulation of proline increased as the salt content higher. The content of proline was positively correlated with the ratio of dry weight after salt treatment.

저선량 γ선 조사가 참박의 초기 생육과 효소 활성 및 광합성 능에 미치는 영향

이혜연,김재성,백명화,이영근,임돈순 한국환경생물학회 2002 환경생물 : 환경생물학회지 Vol.20 No.3

저선량 γ선 조사가 참박의 초기생육과 생리활성에 미치는 효과를 알아보기 위하여 참박 종자에 γ선을 O~2OGy 수준으로 조사하여 생육을 관찰하였다. 저선량 γ선에 의한 참박의 초기생육은 대조구에 비해 4~16Gy에서 다소 증가하였고, 생육 조사시 측정한 자엽의 경우 catalase와 peroxidase활성이 대조구에 비해 8Gy조사구에서 가장 높았으며 본엽은 peroxidase 활성이 4Gy 조사구에서 확연히 증가하였다. 저선량 γ선을 조사한 박 식물체의 광 스트레스에 대한 반응효과는 광계Ⅱ의 광화학적 효율이 대조구와 8Gy의 경우 50%정도 감소되었으나 4Gy에서는 40%정도의 감소를 보였다. 반면 Fo는 광저해가 진행됨에 따라 약간의 증가를 보였으나 대조구나 저선량 조사구사이의 차이는 거의 없는 것으로 나타났다. 광계Ⅱ의 광양자 수율, φ_PSⅡ과 광계Ⅱ 반응중심의 흥분 포획능, 1/Fo-l/Fm 또한 광저해가 진행되는 동안 감소하여 φ_PSⅡ는 대조구와 8 Gy의 경우 20%정도 감소를 보인 반면 4Gy조사구는 15%의 감소를 보였고, 1/Fo-lF/m은 대조구와 8Gy는 55%,4 Gy는 45%의 감소를 나타냈다. 비광화학적 소멸인 NPQ는 대조구와 저선량 조사구 모두 70% 정도 감소되는 경향을 보였다. 이러한 결과를 볼 때 종자의 종피를 투과한 저선량의 γ선이 참박의 생육을 촉진시키고 4Gy에서 광 스트레스에 대한 저해가 감소되었다. Gourd seeds were irradiated with the doses of 0∼20 Gy to investigate the effect of the low dose ??-radiation on the early growth and physiological activity. The stimulating effects of the low dose ??-radiation on the early growth were not noticeably high, but were increased generally at 4∼16 Gy irradiation group. The catalase and peroxidase activity of cotyledon from seeds irradiated with ??-radiation were increased at 8 Gy irradiation group. The peroxidase activity of leaf was noticeably high at 4 Gy irradiation group. The photochemical yield of PSⅡ, estimated as Fv/Fm, decreased with increasing illumination time by 50% after 4hrs in the control and 8 Gy irradiation group, while Fo slightly increased. However, Fv/Fm in the 4 Gy irradiation group decreased by 40% of inhibition, indicating that photoinhibition decreased by the low dose ??-radiation. Changes in the effective quantum yield of PSⅡ, Φ_PSⅡ and 1/Fo-1/Fm, a measure of the rate constant of excitation trapping by the PSⅢ reaction center, showed similar pattern to Fv/Fm. NPQ decreased by 70% after photoinhibitory treatment with showing similar pattern between the control and the irradiation group. These results showed the positive effect of low dose ??-radiation on the seedling growth and the reduction of photoinhibition in the 4 Gy irradiation group.

백혈병과 과립구 감소증에서의 감시배양(surveillance culture) : 예방적항균제 사용에 따른 균총의 변화

최강원,김성민,오명돈,김병국,김의종 대한화학요법학회 1991 대한화학요법학회지 Vol.9 No.1

A surveillance culture was to monitor the changes in flora during prophylactic antibiotics(PA) in patients whith granulocytopenia. Twenty patients with granulocytopenia were included: divided into 3 PA groups. Terimthoprim-sulfamethoxazole(TS) group consisted of 7 patients who underwent induction chemotherapy, Cipprofloxacin plus nystatin(CN) group consisting of 7 patients and Gentamicin plus Nystain(GN) group consisting of 7 patients. All of the latter 2 group underwent bone marrow transplantation and were put in protected environment (laminar air flow, sterile food) in addition to PA. Normal flora and other colonizing microorganisms were replaced with antibiotic resistant bacteria and fungus : MRSA, methicillin resistant CNS, P. aeruginosa, Enterobacter spp. and candida spp. and truolopsis. Entreobacteriaceae were diminished markedly, expecially with CN. Two episodes of bacteremia were preceded by the colonization with the same organisms in the skin, throat, and stool. Surveillance culture seems useful in the helping to design prdventive measures, select antibiotics n selected cases.

인간 면역부전 바이러스(HIV) 감염자 사이에서의 1기 및 2기 매독의 유행

장희창,조재현,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 HIV 감염자 사이에서 발생한 매독의 유행을 보고하고, 그 역학적 특성을 규명하고자 하였다. 재료 및 방법 : 1999년 7월부터 2003년 9월까지 서울대학교 병원에서 추적 관찰을 받아온 HIV 감염자를 대상으로 하여 1기 및 2기 매독의 발생을 조사하였다. 발생률을 정확히 구하기 위해 추적 관찰을 받은 모든 HIV 감염자의 인년을 6개월 간격으로 구하였다. 결과 : 51개월 동안, 465명의 HIV 감염자가 서울대학교 병원에서 추적 관찰을 받았다. 이중 38명이 1기 및 2기 매독으로 진단되었다. 1기 및 2기 매독의 발생률은 이기간 동안 100인년 당 4.1명이었다. 1999년 7월부터 2001년 12월 사이에는 발생자가 없었으나, 이후 발생률은 꾸준히 증가하여 2003년 9월에는 100인년 당 18.8명이 되었다. 1기 및 2기 매독의 발생률은 동성애자 및 양성애자에서 이성애자에서보다 4.3배 높았고, HAART로 치료를 받지 않은 환자에서 HAART로 치료를 받고 있던 환자에서 보다 10.9배 높았다. 결론 : 2002년부터 국내 HIV 감염자 사이에서 1기 및 2기 매독이 유행하기 시작하였고, 이러한 유행은 동성애자와 양성애자 및 HAART로 치료를 받고 있지 않던 사람 사이에서 발생하였다. Background : This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. Materials and Methods : A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. Results : In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). Conclusion : The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.