폐경전후 및 폐경후 골감소에서 호르몬대체요법과 Fluocalcic Effervescent® 병합치료 후 골밀도 및 골대사의 생화학 지표의 변화

어완규,이창원 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background: Sodium fluoride stimulates bone formation and has been used to treat osteoporosis for decades despite debate about the antifracture efficacy. For women with low bone mass, the ideal therapy should not only inhibit bone resorption but simultaneously stimulate bone formation to increase the bone mass, the ideal therapy should not only inhibit bone resorption but simultaneously stimulate bone formation to increase the bone mass above the fracture threshold. We thus performed an intervention study to investigate the effect of a low dose fluoride prospectively, in combination with HRT, on bone mineral density (BMD) and biochemical markers of bone turnover. Methods: Thirty perimenopausal or postmenopausal osteopenic women were enrolled, and were treated with Fluocalcic effervescent® (disodium monofluorophophate [MFP] 100㎎ + calcium carbonate 1,250 ㎎) 1 tablet BID and conjugated equine estrogen (HRT) 0.625㎎ QD for 12 months in Department of Internal Medicine, Kosin University Gospel Hospital from January 2001 to December 2002. BMD and chemical markers of bone turnover, serum alkaline phosphatase, serum osteocalcin, and urine deoxypyridinoline(DPD), were evaluated before and 12 months after starting treatment. Results: Serum alkaline phosphatase, serum osteocalcin, and urine DPD after 12 months were not significantly different from those of pre-treatment values. The post-treatment BMD's but they were not correlated with all the pretreatment chemical markers of bone metabolism. Changes of the BMD of L2-L4 were not correlated with the changes of chemical markers except urine DPD. Pretreatment markers, BMD of L2-L4 , serum osteocalcin, serum alkaline phosphatase, and FSH were correlated with changes in BMD of L2-L4. There was no chemical markers correlated with the change in BMD of femoral neck. Conclusion: Twelve-month treatment with MFP and HRT was not associated with improvement in BMD. Pretreatment markers, BMD of L2-L4, serum osteocalcin, serum alkaline phosphatase, and FSH may predict changes in the BMD of L2-L4.

공격성 비호지킨 림프종의 예후인자로서의 혈청 LDH

어완규,이지현,김종철 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Introduction: The purpose of this study was to find prognostic factors influencing overall survival in patients with aggressive non-Hodgkin's lymphoma. Methods: Eighty eight patients, all diagnosed with aggressive lymphoma and treated with conventional chemotherapy, were registered in the section of hematology/medical oncology. Gospel Hospital. Busan. Korea. We analyzed the response rate and survival time by the pre-treatment several variables including age, serum LDH, performance state, number of extranodal site, stage, B-symptom, bone marrow involvement, international prognostic index (IPI), and serum beta2-microglobulin (B2M) to identify the prognostic variables in the patients. Results: The median age was 53 years. Forty-five (56.9%) patients achieved complete response, and 26 (32.9%) achieved partial response to conventional chemotherapy. Of the variables serum LDH, performance status, extranodal involvement, stage, IPI, and serum B2M were predictive of complete response (P=0.000, 0.005, 0.022, 0.002, 0.000, 0.035, respectively). Estimated overall survival at 5 years was 56.5%. By univariate analysis, 6 variables significantly influenced overall survival: serum LDH, performance status, stage, serum B2M, IPI, and response to chemotherapy (P=0.0005, 0.0022, 0.0022, 0.0161, 0.0131, 0.0000, respectively). By multivariate analysis only serum LDH was the significant variable(P=0.001). Conclusion: Serum LDH appears to be a useful marker for predicting survival in patients with aggressive non-Hodgkin's lymphoma treated with conventional chemotherapy.

Diffuse Large B-cell Lymphomas의 예후인자로서의 혈청 β2-microglobulin

어완규,신성훈 KOSIN UNIVERSITY COLLEGE OF MEDICINE 2006 高神大學校 醫學部 論文集 Vol.21 No.1

Background: This study was undertaken to see whether serum β2-microglobulin (B2M) could be used as a prognostic factor or not in patients with previously untreated diffuse large B-cell lymphoma (DLBCL). Methods: One hundred and forty-six consecutive patients with previously untreated DLBCL were participated in this study between 1995 and 2004. Serum B2M was measured by a radioimmunoassay in pretreatment serum samples of patients with DLBCL. Patients were then treated with CHOP or equivalent regimens with or without radiotherapy. Results: Serum B2M was available in 127 out of 146 patients enrolled. The median age was 54 years (15-80). Serum B2M levels greater than 2.5 mg/L were found in 27/127 (21.3%) patients. Higher serum levels were associated with old age, high serum LDH, poor performance status, increased number of extranodal site(s), advanced stage, constitutional symptom, bone marrow involvement, and high International Prognostic Index (P=0.001, 0.000, 0.000. 0.024, 0.000, 0.010, 0.040, and 0.000, respectively). The complete response rate was 40.7% vs. 68.0% for patients with serum B2M levels greater than 2.5 mg/L vs. control (P=0.010). The median overall survival was 11 months vs. 74 months for patients with serum B2M levels greater than 2.5 mg/L vs. control (P=0.0000). Conclusions: Serum B2M level was a good predictor of complete response and overall survival in patients with previously untreated DLBCL and could be used as a prognostic factor.

자궁경부 소세포암 4예의 임상적 특징과 예후에 관한 연구

오영림,김흥열,어완규,김홍배 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : To investigate clinicopathologic finding of patients with small cell carcinoma of uterine cervix, and to evaluate the recurrence pattern and survival time of small cell carcinoma of uterine cervix Methods : The medical records of four patients who were diagnosed with small cell carcinoma of the uterine cervix and whose initial treatment was between January 1990 and December 2006 were studied retrospectively Results : Patient ages ranged between 43 and 50 years. The clinical stages at diagnosis were Ib, IIa, IIb, IIIa. All patients presented with abnormal vaginal bleeding. Tumor size at diagnosis was under 2cm in 1 patient and over 2cm in 3 patients. Disease recurred in 3 patients at 5~26 months and all of them died. Through analyzing overall survival time, FIGO stage and tumor size were significant prognostic factors in small cell carcinoma of the uterus Conclusion : Small cell carcinoma of uterine cervix revealed poor prognosis. Our study found FIGO stage and tumor size were significant prognostic factors in small cell carcinoma of the uterine cervix. Because of limitation of number of patients, further large scaled multicenter studies are needed.

폐경기 자궁 액체 축척 여성에서 자궁두께에 따른 조직학적 소견

김흥열,김흥배,어완규 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Objectives : The aim of the study was to assess the hitologic appearance according to endometrial thickness in postmenopausa endometrial fluid accumulation women. Methods : A group of 20 postmenopausal women with an endometrial fluid accumulation confirmed by ultrasonography and underwent Dilatation & Curettage. The patients were divided into two groups according to the endometrial thickness(ET). Sixteen women had thin endometrium (<4mm) and four women had the thick endometrium (≥4mm). Results : When ET was ≥ 4mm, proliferative endometrium was found in 2 patients (50%), atrophic endometrium was in I patient (25%) and endometritis was in I patient (25%). When ET was < 4mm, atrophic endometrium was found in 14 patients (87%), A majority of patients with ET of less than 4mm in ultrasound had atrophic endometrium. The incidence of intrauterine pathology increased with the increasing thickness of endometrium as abserved by ultrasound. Conclusion : The presence of endometrial fluid accumulation in postmenopausal patients without any symptoms seems to be a benign condition. Normal endometrium of less than 4mm observed by ultrasound in postmenopausal women without vaginal bleeding dose not necessarily need further surgical investigation.

급성 골수성 백혈병 환자의 말초혈액 단핵구로부터 수지상세포로의 분화 유도

손상희,이대희,박재선,어완규 고신대학교 의학부 2002 高神大學校 醫學部 論文集 Vol.17 No.1

Background Dendritic Cells (DCs) are the most potent naturally occuring antigen presenting cells and play an important role in T-cell activation. DCs may be suited for in vivo immunotherapy for its capability to stimulate naive T cell. Effective presentation of tumor antigens is fundamental to strategies aimed at enrolling the immune system in eradiation of residual disease after conventional treatments. Myeloid malignancies provide a unique opportunity to derive dendritic cells (DCs), functioning antigen presenting cells, from the malignant cells themselves. These may then co-express leukemic antigens together with appropriate secondary signals and be used to generate a specific, antileukemic immune response. Methods In this study, peripheral blood mononuclear cells (PBMCs) from 5 patients with acute myeloid leukemia (AML) were cultured with combinations of Flt-3 Ligand (FL), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-4(IL-4), and tumor necrosis factor-α(TNF-α), and development to DCs was assessed. Peripheral blood mononuclear cells (PBMCs) were obtained from 40-60㎖ of peripheral blood of patients with acute myeloid leukemia (AML) by Ficolling. Cells were resuspended in X VIVO-20 medium supplemented with FL (100ng/㎖), GM-CSF(100ng/㎖), IL-4(50ng/㎖), and TNF-α(20ng-㎖) and seeded into T75 culture flasks at 3×107/50㎖. Results After 12 days in culture, cells from 5 samples exhibited morphological and immunophenotypic features of DCs, including expression of CDla, CD83, and CD86. Conclusion This study indicates that cells with enhanced antigen-presenting ability can be generated from PBMCs of patients with acute myeloid leukemia, that these cells can effectively prime autologous cytotoxic T cells in vitro, and that they may be used as potential vaccines in the immunotherapy of AML.

Peripheral Blood Lymphokine-Activated Killer Cell Activity Can Predict Response to Conventional Chemotherapy in Aggressive Non-Hodgkin's Lymphomas

Eo, Wan Kyu,Kim, Dae Hyun,Chang, Seong Hoon,Lee, Jee Young,Kim, Yang So 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1

목적 : 복합화학요법은 과거 치명적이던 진행성 비호지킨림프종을 치료가 가능하게 하였지만 아직도 많은 환자들이 이병으로 사망한다. 만일 치료전에 고식적인 화학요법으로는 치료가 어려운 고위험군으로 판단된다면 새로운 치료방법을 고려해 볼 수 있을 것이다. 이에 따라 저자는 말초혈액의 림포카인으로 활성된 세포 (LAK)가 화학요법의 결과를 예측할 수 있는 지표로서의 가치가 있는가를 분석하였다. 방법 : 치료경력이 없는 중등도 이상의 비호지킨 림프종 환자 42명을 대상으로 하였다. LAK 활성은 말초혈액의 단핵세포를 분리하여 IL-2와 72시간 배양한 뒤, 표적세포인 RAJI 세포주와 4시간 동안 반응시켜 유리된 ^(51)Cr 양을 측정하였다. 복합화학요법을 받은 환자를 대상으로 LAK 활성을 포함한 여러 인자와 치료 반응과의 관계를 분석하였다. 결과 : 1. 환자와 대조군의 말초혈액 LAK 활성의 평균은 각각 69.7%와 75.1%로서 유의한 차이가 없었다(P=0.079). 2. 환자의 LAK 활성과 임상 및 검사상의 지표들, 즉 연령, 성별, LDH, 운동능력, 림프절외 장소의 병변, 병기, B 증상, 골수침범, CD3 양성 세포비, CD3음성/CD56양성 세포비의 상관관계를 분석한 결과 LAK 활성은 B증상과 유의한 상관관계가 있었다(P=0.037). 3. 26명에서 치료에 대한 반응을 분석한 결과, 전체 관해율이 88.5% (완전관해율 57.7%, 부분관해율 30.8%)였다. 3예(11.5%)는 치료에 반응이 없었다. 4. LAK 활성, B증상, LDH, IPI 등이 완전관해를 예측할 수 있는 지표였다 (각각 P=0.005, 0.010, 0.011, 0.011, 0.024). 결론 : LAK 활성은 중등도 이상의 비호지킨 림프종에 대한 고식적 화학요법의 효과를 가장 잘 예측하는 지표였는데, 이에 따라 LAK 활성은 장기 생존율을 예측케 하는 가치가 있다. LAK 활성이 낮은 군에서는 고용량 화학요법 등 강력한 치료가 필요하리라 생각된다. Background/Objective Combination chemotherapy has transformed aggressive non-Hodgkin's lymphoma from a fatal disease into one that is often curable. However, many patients still die of their disease. Patients at high risk who are not effectively treated with current regimens may benefit from new experimental approaches. To determine whether in vitro measurement of lymphokine-activated killer (LAK) activity can predict results after conventional chemotherapy, we analyzed the correlation between in vitro LAK activity and tumor response. Methods Forty-two newly diagnosed intermediate or high-grade non-Hodgkin's lymphoma patients were enrolled. LAK cells were made by incubating mononuclear cells from peripheral blood with IL-2 for 72 hours, and measured its activity against RAJI cell line by counting released 51Cr during 4 hours. In those patients who got chemotherapy, value of LAK activity as a predictor of response to conventional treatment was assessed. Results 1. The mean LAK activities of peripheral blood from patients and controls were 69.7% and 75.1%, respectively (P=0.079). 2. An analysis of the LAK activity in patients with respect to various clinical and laboratory variables including age, sex, LDH, performance status, extranodal sites, stage, B symptom, bone marrow involvement, CD3-positive cell fraction, and CD56-positive cell fraction showed that B symptom (P=0.036) was correlated with LAK activity. 3. Twenty-six patients were eligible to response assessment. The objective response was achieved in 23 cases (88.5%). A complete response was achieved in 15 cases (57.7%), and partial response in 8 cases (30.8%). Three cases did not respond to chemotherapy (11.5%). 4. LAK activity, B symptom, age, LDH, and IPI were predictive of complete response (P=0.005, 0.010, 0.011, 0.011, and 0.024, respectively). Conclusion LAK activity was the best predictor of complete response to conventional chemotherapy in intermediate or high-grade non-Hodgkin's lymphomas. It means it can also be an important predictor of long-term survival. More aggressive chemotherapy including high dose chemotherapy followed by stem cell rescue is suggested for those with low LAK activities.

림프절의 림프종의 임상적 , 병리적 소견 및 예후 인자

어완규(Wan Kyu Eo),최종수(Jong Soo Choi),김양수(Yang Soo Kim),박병채(Byung Chae Park) 대한내과학회 1995 대한내과학회지 Vol.48 No.4

N/A Objectives: A substantial number of lymphomas arise in various extranodal sites including gastrointestinal tract and Waldeyer's ring rather than in nodal structures. However, systematic studies on clinicopathological features and prognostic factors of extranodal lymphomas are still rare worldwide. Methods: One hundred and fifty-six patients with newly diagnosed extranodal lymphomas in stage I / II seen over a 10-year period at Kosin University Hospital were included. The clinical characteristics, primary sites, and pathological subtypes were evaluated, and overall five--year survival rate and prognostic factors in evaluable patients were determined. Results: 1) The male to female ratio was 1.7: 1, and median age was 48 years. 2) The primary sites were head/neck(51%), gastrointestinal tract(35%), skin(4%), bone(3%), urogenital tract(2%), retroperitoneal soft tissue(2%), and breast, peripheral nerve and spinal cord(1% each) in order. In head/neck areas, Waldeyer's ring was the most common (78%), and in gastrointestinal tract, both stomach(44%) and small intestine(31%) were common sites. 3) The most common histological subtypes were diffuse histiocytic lymphomas(60%) and diffuse poorly differentiated lymphocytic lymphomas(18%). The two subtypes constituted the major subtypes of head/neck as well as gastrointestinal tract. 4) Forty five percent of the patients were stage I, and fifty five percent were stag II. Twenty six percent had B symptoms. 5) The overall 5 year survival rate was 67.5%. The 5 year survival rate of head/neck area was 64.0 %, and that of gstrointestinal tract was 74.0%. But there was no significant difference in survival among major sites(p=0.8990). In methods, chemotherapy only, chemo-radiotherapy and radiotherapy only(p= 0.2776). And in gastroin-testinal tract, there also was no difference in survival among surgical resection with adjuvant chemotherapy, surgical resection with radiation and chemotherapy only in gastrointestinal tract(p = 0.9752). 6) In univariate analysis, age, B symptoms, sex LDH were significant prognostic factors(p=0.0007, 0.0079, 0.0137, and 0.0259 respectively). In multivariate analysis, patients with B symptoms or age over 58 years had poor prognosis(relative risks of 2.45 and 2.73 respectively). Conclusion: The most common sites were head/ neck and gastrointestinal tract in order, and diffuse histiocytic lymphoma constituted the most common histologic subtype. Presence of B symptoms or age over 58 years was poor prognostic factors. Finally, as the number of the patients in this study was not sufficient, and the method was retrospective, large prospective randomized clinical trials are required.

급성 전골수구성백혈병에서 RARα/PML융합전사 발현의 RT-PCR을 이용한 연구

어완규,김영일,김정희,김시영,윤휘중,조경삼 大韓血液學會 1995 大韓血液學會誌 Vol.30 No.3

비만국민학생들의 체지방율에 따른 체력 및 혈중 지질성분 비교연구

강민완,최용어,조준용,이규성,강명신 韓國體育大學校附屬 體育科學硏究所 1993 韓國體育大學校附屬 體育科學硏究所論文集 Vol.12 No.1

The purpose of this study was to investigate physical fitness and blood lipid componenis by body fat rate of obese students consisted of 118 (male : 79, female : 39) in elementary school. By means of body fat rate, obese students were classified such as M-1: 20-29%, M-2: 30-39%, M-3: above 40 %, for male and F-1: 30 - 39%, F-2: 40-49%, F-3: above 50 % for female, respectively. Also physical fitness test items were subdivided into 1600m runinng, sit and reach and sit -ups tested by obese students and fasting blood samples were obtained and analyzed for blood glucose, triglyuceride (TG), total cholesterol, high density lipoprotein (HDL-C) from obese students in elementary school. The results of this study were as follows : ①There were no significant differences among physical fitness items including 1600m runinng, sit and reach, and sit - ups by body fat rate of male and female obese students in elementary school, respectively (p<.o5). Among physical fitness test items, Only sit and reach item was equal to criterion referenced standard of physical best test proposed by AAHPERD (1989). According to increasing body fat rate, It was shown that the levels of all physical fitness were decreased. ②Ther were no significant differences among blood lipid components including blood glucose, triglyce-ride (TG), total cholesterol, high density lipoprotein (HDL-C) by body fat rate of obese male and female students in elementary school, respectively (P<1/.05¾. Among blood oipid components, Only cholesterol was exceeded to normal range of this investigation. According to increasing body fat rate, It was shown that the levels of blood lipid components were increased.