위발성 위장관 악성림프종 환자에서 항암치료의 효과

김찬규,신영록,김현정,배상병,이남수,이규택,박성규,원종호,홍대식,박희숙 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Purpose: The gastrointestinal (GI) tract is the most common site of extranodal non-Hodgkin's lymphoma (NHL), which is increasing in incidence, but there is no established optimal treatment modality. Thus, this study was investigated the clinicohistologic feature, the therapeutic modalities, and the prognosis for GI-NHL, as well as the factors affecting it. Methods: We retrospectively analyzed 45 patients who had been diagnosed as having GI-NHL and had been followed up from July 1994 to February 2005 at Soonchunhyang University Hospital. The patients were divided into groups according to the site of origin and to various other features, and the survivals of the various groups were compared. The modified Ann Arbor system and WHO classification were adopted for staging and histopathologic classification, respectively. Results: GI-NHL of the stomach, small bowel, ileocecal region, and colon occurred in 28 patients (62.2%), 5 patients (11.1%), 3 patients (6.7%), and 8 patients (17.8%), respectively, In one patient, the entire gastrointestinal tract was diffusely involved. The median age of patients was b5 years (25~78 years), and male-to-female ratio was 1:1.1. Fourteen patients were in stage Ⅰ, 24 in stage Ⅱ, 4 in stage Ⅲ, and 3 in stage Ⅳ. Surgical resection was performed in 19 patients, and combination chemotherapy was performed in 43 patients. Surgical resection only was performed in 4 patients, Chemotherapy only was performed in 26 patients. The expected overall 5 year survival of 45 patients was 39.6%, and there was a significant survival difference between the stages, but between sites of origin (p=0.842). The most important factors influencing the survival was the stage and other factors were not significant. Conclusion: The stomach was the most common site of GI-NHL. Most GI-NHL were localized Stage was the most important prognostic factor. However, Prospective randomized studies are needed to approve the therapeutic modality.

흉선종 제거후에 발생한 재생 불량성 빈혈 : 증례보고

전원선,이상철,김현정,배상병,김찬규,이남수,박노진,이규택,박성규,홍대식,박희숙,원종호 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

Thymoma is associated with myasthenia gravis, Pure red cell aplasia, and autoimmune diseases such as autoimmune hemolytic anemia, aplastic anemia, and hypogammaglobulinemia. It's association with aplastic anemia is rare and aplastic anemia appearing after surgical removal of thymoma is especially rare. The authors hereby report a case of aplastic anemia occuring in a patient who was diagnosed with thymoma and myasthenia gravis and had the tumor surgically removed. The patient was treated with anti-thymocyte globulin, cyclosporin, and prednisolone, and showed partial remission with hematologic improvements after 12 months.

부신피질 자극호르몬 단독결핍 1례

박경식,이승현,최석영,박태규,이동화,이찬우,정성복,이인규 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

부신피질 자극호르몬 단독결핍은 국내에서 7례만이 보고된 희귀 질환이며 병인 및 경과 등 아직 불분명한 측면이 많다. 이는 질환지체의 희귀성도 있지만 치료후 자연경과에 대한 장기적인 추적검사가 이루어진 경우가 드물기 때문이기도 하다. 저자들은 비특이적인 전신증상을 주소로 내원한 폐경기후의 56세 여자 환자에서 자가면역질환의 증거없이 고프로릭틴혈증을 보인 부신피질 자극호르몬 단독결핍 1례를 경험하고 1년간의 부신피질호르몬 대치요법후 추적검사를 실시하였기에 문헌 고찰과 함께 보고하는 바이다. Isolated ACTH deficiency is a rare disorder which shows secondary adrenal insufficiency with normal states of other pituitary hormones. A 56-year-old postmenopausal woman complaining general weakness and intermittent mental confusion presented negligible serum cortisol and ACTH level with hyperprolactinemia and mild hyponatremia. Rapid ACTH stimulation test did not show significant increase of serum cortisol level. Combined pituitary stimulation test showed negligible response of cortisol and ACTH, and slightly decreased response of prolactin and gonadotropin. But the responses of TSH and GH were normal. There was no evidence of organic pituitary of hypothalamic lesion in brain MRI and antithyroid autoantibody was not detected in serum. After receiving 12 months of glucocorticoid replacement therapy, she skipped the medicine for 3 weeks and we performed follow-up endocrinologic tests. Serum ACTH and cortisol level was also negligible and prolonged ACTH simulation test showed normal response of serum cortisol. CRF stimulation test showed no response of serum ACTH. Basal prolactin level was decreased to near normal and combined pituitary stimulation test showed normal response of prolactin with slightly blunted response of TSH and GH. We concluded that the case was nonautoimmune origined isolated ACTH deficiency which was accompanied by hyperprolactinemia and resultant deficiency of gonadotropin, so we report this case with review of literatures.

재발 또는 불응성 비호즈킨 림프종 환자에서 CDME 구제항암화학요법 후 고용량 항암화학요법 및 자가말초혈액 조혈모세포이식의 효과

김세형,한강원,배상병,김찬규,이남수,이규택,박성규,원종호,홍대식,박희숙 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Background and objectives : The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional dose chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, we compared the outcome of patients undergoing high-dose chemotherapy with autologous peripheral blood stem cell transplantation(APBSCT) with only salvage chemotherapy of cisplatin, dexamethasone, mitoxantrone, and etoposide(CDME). Materials and methods : From June 1993 to December 1999, 25 patients with relapsed or resistant NHL were treated with CDME regimen as salvage chemotherapy. Twelve patients were received four cycles of CDME chemotherapy, and 13 patients were received high-dose chemotherapy with APBSCT following two cycles of CDME chemotherapy. Results : The median follow-up duration was 12.8 months(range:4-68). The overall response rate was 41.7% (complete response rate 25%, partial response rate 16.7%) in 12 patients with CDME only. Thirteen patients who were treated with high-dose chemotherapy with APBSCT achieved 61.5% complete response rate and 15.4% partial response rate, with an overall response rate of 76.9%. The estimated 3-year progression-free survival rate was significantly higher among patients who received high-dose therapy than patients who received CDME only(41.5% vs 20.0%, p<0.05). And, 3-year overall survival rate was significantly higher among patients who received high-dose therapy(51.3% vs 25.0%, p <0.05). Conclusions : In relapsed or refractory NHL, CDME chemotherapy is an effective salvage chemotherapy and allow peripheral blood stem cell collection. Also, high-dose chemotherapy with APBSCT following CDME is superior to CDME salvage chemotherapy only.

고요산혈증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이종은,이준숙,이찬구,이한정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : Serum uric acid has now been identified as a marker for a number of metabolic and hemodynamic abnormalities. The aim of this study is to evaluate risk factors which influence hyperuricemia in the citizens of Asan. Method : The study design was cross-sectional and research subjects were 1086 citizens of Asan. General characteristics, cigarette smoking, alcohol consumption, and past history were obtained by interview using a structural questionnaire. Also, we measured height, weight and blood pressure, and serum uric acid of the subjects. Results : The mean serum uric acid level was 5.27 ㎎/㎗ in men and 4.01 ㎎/㎗, in women, In the multiple logistic regression analysis, statically significant risk factors of hyperuhcemia were gender, body mass index, blood lead concentration, and serum creatinine. Conclusion : Our results suggest that gender, body mass index, blood lead concentration, and serum creatinine might be the most important risk factors of hyperurcemia. Education program as well as routine check-up for serum uric acid was highly recommended for the effective prevention of hyperuricemia.

조혈모세포이식환자에서 조혈기능의 회복과 관련된 인자들에 관한 연구

정기주,강명수,권기두,김경하,이상철,김현정,배상병,김찬규,이남수,이규택,원종호,홍대식,박희숙 순천향대학교 의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.1

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Aspergillus awamori와 Zymomonas mobilis로 구성된 고정화혼합 배양계의 에탄올 생산에 미치는 Triton, PVA 및 PEG의 영향

이상원,서권일,박석규,손봉수,김홍출,성찬기 순천대학교 기초과학연구소 1995 基礎科學硏究誌 Vol.6 No.-

The effects of triton-X 100, PVA and PEG on the ethanol production and raw starch hydrolysis by co-immobilized A. awamori and Z. mobilis (A-Z system) were investigated. When gel beads containing A. awamori(1.25 × 10 exp (9) spores/ℓ - gel) and Z. mobilis(0.5g cell/ℓ - gel) were cultured in 2% raw starch solution at 30℃ for 120 hours, ethanol concentration, ethanol yield (Y_p/s) and pH of culture broth were 2.8g/ℓ, 0.16 and 3.8~4.0, respectively. Ethanol production and starch hydrolysis by addition of PVA was efficient, compared to that of PEG and ethanol concentration in culture broth with 0.2% PVA was 3.56g/ℓ. At A-Z 36 culture system with changing silicon check valve for cotton plug at 36 hours in A-Z culture system, ethanol yield on glucose, Y_p/s = 0.36, showed 2 times higher than that of control culture system(cotton plug culture). Ethanol production and productivity by cultivating 85g gel beads at 30℃ in a 1ℓ jar fermentor(220rpm) of medium 500㎖ were 32g/ℓ and 1.8g/ℓ/day, respectively. After 12 hours of cultivation, gel beads were distinguished oxygen-rich surface for A. awamori from oxygen-deficient central part for Z. mobilis.

연쇄가지반응 모델에 의한 화학반응 장치의 안전성

이상록,염치호,박찬규 동아대학교 공과대학부설 생산기술연구소 1997 生産技術硏究所硏究論文集 Vol.2 No.1

The method for determining the stability and multiplicity of steady states, and steady reaction region in phase plane for chain branching reaction model in perfectly mixed flow tank reactors is proposed. The results proposed are as follows : 1) stability and multiplicity of steady states exist 2 points (T_S1 : node, T_S2 : saddle) in T<T_1 range, and 2 points (T_S3 : focus, T_S4 : saddle) in T>T_2range on F(T)=0 curve. 2) steady reaction region containing the steady states can be constructed by the state varialbes of a reactor in phase plane. All trajectories of the representative points pass into the region at the boundary surface since the representative points in the region never drift out, it is safe to keep the reactor operation in the region.

르네 샤르, 마을의 시학

이찬규 프랑스문화예술학회 1999 프랑스문화예술연구 Vol.1 No.-

Le monde privilegie de Char commence la ou le decor moderne ou citadin s'arrete. On pourrait dire que c'est un motif obsedant qui parcourt les divers recueils du poete, et celui-ci maintient toujours un regard attentif sur le paysage de son pays natal. Ne a l'Isle-sur-Sorgue, petit village de la Provence, Char nous montre la valeur du village qui fournit une communication vive entre les hommes bien sur, mais aussi entre la nature et l'homme. A mesure que le village provencal est caracterise de prime abord par le soleil. celui-ci est bien une des sources de l'ecriture charienne. Or le poete associe frequemment le soleil a la realite des <matinaux> du village. Autrement dit, le soleil est bien valable pour Char en tant que le soleil qui se leve. Si le village provencal est indiscretement explite comme cite touristique, les hommes doivent perdre non seulement le beau paysage, mais aussi le temps vif des paysants qui se l'vent avec la lueur matinale. La petanque est un jeu tres repandu dans la region provencale. Ce jeu, aime de notre poete, si accueillant, offre sans cesse le plaisir d'une rencontre avec les autres. Ce jeu populaire semble donc evoquer la poesie charienne qui est marquee par le phenomene de la rencontre. On peut constater combien, dans ses diverses ecritures, l'esprit du poete s'attache a la beaute de la rencontre simple entre les hommes. Le monde du vegetal charien repose sans exception sur le paysage de la Provence : char a une predilection pour l'olivier, l'amandier et la lavande, ous indissociables des realites de son pays d'origine. Or ce qui est plus proprement charien dan le monde vegetal, c'est que le poete y saisit d'emblee l'image du feu. Dans un poeme qui evoque l'enfance du poete, <l'herbe> est le sujet du verbe <allumer> : <Jadis l'herbe, a l'heure ou les routes de la terre s'accordaient dans leur declin, elevait tendrement ses tiges et allumait ses clartes>. C'est dans la vie vegetale que Char rend visible l'origine de l'acte d'allumer la lampe. Alors que la nuit etend ses voiles combres sur le paysage, le centre de la nuit est, pour Char, le petit cercle de la lampe allume dans la fleur qui eclot : <J'approche de la rose/ La pointe de ma flamme>. L'alliance magique du vegetal et de la flamme a rapport en quelque sorte avec <le village allume par des lampes> pendant la nuit, qui est loin de la vie citadine. Comme l'a dit G. Bachelard, <l'ampoule electronique ne nous donnera jamais les reveries de cette lampe vivante qui, avec de l'huile, faisait de la lumiere>. Le <village allume> entre la montagne et la riviere revele une experience poetique permettant d'acceder a une intensite de mysteres et, enfin d'emotions qu'on ne doit pas perdre dans la vie citadine.

상부위장관 출혈을 일으킨 Warfarin Sodium에 의한 위점막내 혈종 1예

이봉규,김태원,박찬국,김만우 조선대학교 부설 의학연구소 1998 The Medical Journal of Chosun University Vol.23 No.2

A case of warfarin sodium-induced intramural hematoma and upper gastrointestinal bleeding is described, and the literature on this adverse effect is reviewed. A 83-year-old woman who has been receiving warfarin came to a emergency room because of hematemesis. She had a history of cerebral infarction. Physical examination was anemic conjunctiva, no abdominal mass and melena. The emergency gastroscopic finding was submucosal mass. Her hemoglobin and hematocrit concentration had falled to 6.7g/㎗ and 20%, Her prothrombin time (PT) was 130 sec and partial prothrombin time (aPTT) was 133 sec. The patient underwent an emergency exploratory laparotomy. The name of operation was hemigastrectomy with gastrojejunostomy(Billorth-Ⅱ). The pathology report indicated the presence of submucosal hematoma formation with mucosal ischemic necrosis and mucosal ulceration and regenerating epithelium.