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Complication of Intraoperative Radiation Therapy (IORT) in Gastric Cancer
김명세(Myung Se Kim),김성규(Sung Kyu Kim),송선교(Sung Kyo Song),김홍진(Hong Jin Kim),권굉보(Koing Bo Kwan),김흥대(Heung Dae Kim) 대한방사선종양학회 1992 Radiation Oncology Journal Vol.10 No.2
영남대학교 의료원 치료방사선과에서 1988년 6월 15일에 위함 환자의 수술중 방사선치료를 시작한 이래 1992년 8월 30일까지 총 58예에서 시도하여 그중 53예에서 IORT를 실시하였으며, 정기적인 추적검사에서 한명의 국소개발 환자도 보고되지 않고 있다. 출혈(3예), 장관폐쇄(3예), 폐혈증(2예), 골수기능저차(1예)를 포함한 총 9예(17%)의 합병증이 보고되었고, 이중 6예(13%)가 사망하였다. IORT(1500cGy), 외부 방사선치료 (-4500cGy)와 강한 항암제를 병합치료 하였음에도 불구하고 주등(수술과 항암제 치료)의 25.2%, 김등(수술 불가능한 환자에서 항암제 투여)의 18%, 리등(수술)의 18.5%, Kraming등(IORT 2800-3500cGy)의 35.3%에 비해 낮은 합병증을 보여 IORT가 위암의 치료에 공헌할 수 있음을 시사하였다. 그러나 비교적 높은 치사율(11.3%)은 더욱 세심한 수술수기 및 수술 후 환자의 치료가 필요하며 외부 방사선치료와 항암제치료의 적절한 시기 조절 및 치료선량의 가감이 필요할 것으로 생각된다. Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and increase distant metastasis free survival. IORT is the modality which could increase local control without increasing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988 and performed 53 IORT in patients with gastric cancer. No local failure had been reported including interstinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's 25.2% (chemotherapy + operation), Kim's 18% (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500cGy), external irradiation (--4500cGy) and extensive chemotherapy (FAM, 5FU + MMC, BACOP). Our data encouraged us to re-inforce further IORT in stomach cancer treatment.
가진실험을 통한 배관 엘보우의 변형과 손상거동에 미치는 대형 지진하중의 영향 평가
홍진의(Jin Ney Hong),김진원(Jin Weon Kim),김상언(Sang Eun Kim),이대영(Dae Young Lee),박흥배(Heung Bae Park) 대한기계학회 2021 대한기계학회 춘추학술대회 Vol.2021 No.11
Elbows in piping systems, which are designed to absorb energy by plastic deformation under an excessive external load, are vulnerable to cyclic deformation and related damage during beyond design basis earthquake (BDBE) events. Thus, understanding the deformation and failure behaviors of pipe elbows under large amplitude seismic loads is important to evaluate the structural integrity of piping system under BDBE condition. In this study, therefore, the present study performs excitation tests on elbow specimen using a shaking table under two types of input accelerations simulating excessive seismic loading. In the tests, two types of elbow materials were used and pressurized and unpressurized conditions were regarded. From the results, the effect of excessive seismic loads on the cyclic deformation and failure behaviors of pipe elbows for different elbow materials and internal pressures.
Lennox-Gastaut 증후군으로 발현된 3-Methylcrotonyl-CoA Carboxylase 결핍증 1례
강훈철,한유석,이홍진,김흥동,Kang, Hoon Chul,Han, Yu Sok,Lee, Hong Jin,Kim, Heung Dong 대한유전성대사질환학회 2004 대한유전성대사질환학회지 Vol.4 No.1
3-Methylcrotonyl-CoA carboxylase (MCC) is a biotin-dependent enzyme involved in leucine metabolism. We describe a patient with MCC deficiency who manifested with Reye syndrome-like illness with status epilepticus, metabolic acidosis, hypoglycemia, hyperammonemia, elevated liver enzymes and neurologic impairments after the viral gastroenteritis and then, has suffered from Lennox-Gastaut syndrome. Urinary organic acid analysis revealed increased excretion of 3-hydroxyisovaleric acid and 3-methylcrotonylglycine. This patient was managed with leucine restriction diet and supplementation of biotin and carnitine but was not so effective. He has suffered from neurologic sequelae such as Lennox-Gastaut syndrome, motor and cognitive impairement.
Lennox-Gastaut 증후군으로 발현된 3-Methylcrotonyl-CoA Carboxylase 결핍증 1례
한우석(Yu Sok Han) 강훈철(Hoon Chul Kang) 이홍진(Hong Jin Lee) 김흥동(Heung Dong Kim) 대한소아신경학회 2004 대한소아신경학회지 Vol.12 No.1
본 증례는 MCC를 동반한 Lennox-Gastaut 증후군 환아로, 비교적 양성 경과를 보이는 것으로 알려진 연령에 발생하였으나, 난치성 간질을 포함한 신경학적 휴유증의 경과를 보인 환아로, 임상 증상과 함께 이중질량분석기(Tandem mass spectrometry)를 이용한 유전 대사 질환의 선별 검사로 조기에 진단이 내려질 경우 보존적 치료로 보다 나은 임상 경과를 기대할 수 있어 MCC 결핍증에 대한 인식이 요구된다 하겠다. 3-Methylcrotonyl-CoA carboxylase(MCC) is a biotin-dependent enzyme involved in the leucine metabolism. We describe a patient with MCC deficiency who manifested with Reye syndrome-like illness with status epilepticus, metabolic acidosis, hypoglycemia, hyperammonemia, elevated liver enzymes and neurologic impairments after a viral gastro-enteritis and then suffered from Lennox-Gastaut syndrome. Urinary organic acid analysis revealed increased excretions of 3-hydroxyisovaleric acid and 3-methylcrotonylglycine. This patient was managed with a leucine restriction diet and supplementation of biotin and carnitine, which was not so effective. He suffered from neurologic sequelae such as Lennox-Gastaut syndrome, motor and cognitive impairements.