Atropine 투여 용법에 따른 유기인제 , 중독성의 예후 비교

김문중 ( Moon Jung Kim ),허기석 ( Ki Suck Huh ),김형진 ( Hyung Jin Kim ),신대균 ( Dae Kyun Shin ),신명진 ( Myung Jin Shin ),손창학 ( Chang Hak Shon ) 대한내과학회 1984 대한내과학회지 Vol.27 No.1

중등도 혹은 고도의 악성 림프종 환자에서 ProMACE-CytaBOM 복합화학요법의 치료 효과

손창학,주영돈,정준용 인제대학교 1997 仁濟醫學 Vol.18 No.3

비호지킨 악성 림프종은 면역체계에 발생하는 종양으로 표준항암화학 요법으로 40-70%에서 완치를 기대할 수 있다. 화학요법은 1970년대 이후 제1세대, 제2세대, 제3세대로 발전되어 왔으며, 제3세대의 경우 80-85%의 완전 관해율과 60-65%의 장기 생존율이 보고되었다. 이에 저자들은 제3세대인 proMACE-cytaBOM 복합화학요법을 1991년부터 1993년까지 3년간 중등도 이상의 비호지킨 악성 림프종 환자 25예에 적용하여 완전관해율, 생존을, 부작용 등을 검토하여 본 교실에서 1991년 대한암학회지에 발표한 Modified COP-BLAM과 비교하여 보고 하고자 한다. Between July 1991 and December 1993, 25 patients of intermediated or high grade Non-Hodgkins lymphoma were treated with ProMACE-CytaBOM (Cyclophosphamide 650mg/m2 IV day 1, Doxorubicin 25mg/m2 IV day 1, Etoposide 120mg/m2 IV day 1, Cytarabine 300mg/m2 IV day 8, Bleomycine 5mg/m2 IV day 8, Vincristine 1.4 mg/m2 IV day 8, Methotrexate 120mg/m2 IV day 8, Prednisone 40mg/m2 PO day 1-14, Cotrimoxazole 2mg/m2 PO day 1-14). The median age was 39(range 16-67) and M : F ratio was 2.6 : 1. The most common histologic type was diffuse large cell(52%). Of the 25 patients, 7(28%) had clinical stage II ; 10(40%) stage III, 8(32%) swage IV according to Ann Anbor criteria. 9(36%) patients had B symptoms. Bulky disease was found in 9(32%) patients. Overall complete remission(CR) was 60% and median duration of CR was 13 months (range 2-34+). The 2-year relapse free survival ramie was 47% and overall 2-years survival rate was 34%. there was not a significant difference between the result of ProMACE-Cyto-BOM chemotherapy and the result of Modified COP-BLAM chemotheraphy, which were performed between January 1987 and July 1990 in Pusan Paik Hospital.

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).

재발성 피부 혈관염으로 발현된 급성 골수세포성 백혈병 1 예

김석주,윤상조,주영돈,김두일,김동욱,손창학,강창일 인제대학교 1997 仁濟醫學 Vol.18 No.4

급성 골수성 백혈병 환자에서 비특이적 피부 혈관염이 발생하는 경우는 드물게 보고되고 있으며 특히 피부 혈관염이 초기 증상으로 발현되는 경우는 아직까지 국내에서 보고된 바 없다. 저자들은 재발성 피부 혈관염을 주소로 내원한 환자에서 급성 골수성 백혈병(FAB 분류, 아형 M2)으로 진단된 1예를 경험하였기에 문헌고찰과 함께 보고한다. Small-vessel vasculitis involving predominantly the skin belongs to the hypersensitivity group of vasculitides. The association between cutaneous vasculitis and myeloproliferative and lymphoproliferative malignancies has rarely been reported. For this reason, we describe a patient presenting with cutaneous vasculitis as the initial clinical manifestation in whom a diagnosis of acute myeloblastic leukemia was subsequently established by skin biopsy, peripheral blood smear and bone marrow biopsy examinations. There is no previous case report in Korea, so we report this case.

Eaton-Lambert 증후군과 항이뇨 호르몬 과다 분비 증후군을 동반한 소세포 폐암 1예

김희,김선운,김인기,이형준,김양욱,주영돈,손창학 인제대학교 1999 仁濟醫學 Vol.20 No.1

종양수반 증후군은 암의 원발 부위 또는 전이 이의의 부위에서 발생하는 다양한 증상이라 증후를 일컬으며 진단 전에도 나타날 수 있다. 이 중 Eaton-Lambert 증후군은 드물게 나타나는 신경학적 종양수반 증후군이며, 항이뇨 호르몬 과다 분비증은 종양에 의한 항이뇨 호르몬의 이소성 분비에 의해서 생기며 이 두 가지 종양수반 증후군이 소세포 폐암에서 병발할 예는 매우 드물며 국내에서는 아직 보고된 바가 없다. 이에 저자 등은 최근 소세포 폐암으로 진단된 56세 남자 환자에서 Eaton-Lambert 증후군과 항이뇨 호르몬 과다 분비증이 동반된 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다. The paraneoplastic syndrome refers to the ability of some tumors producing signs and syndromes at a distance from the site of the primary tumor or its metastasis. Eaton-Lambert syndrome has a rare neurologic menifestations and Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is developed by ectopic secretion of antidiuretic hormone. The small cell lung cancer which is accompanied by above two paraneoplastic phenomenon is very rare and has not been reported in Korea. We report a case of 56-year-old male who has samll cell lung cancer accompanied by Eaton-Lambert syndrome and SIADH.

위암과 대장암이 병발한 동시성 이중 원발성 암 2예

고영재,김희승,이정회,권태경,최선희,윤중근,양윤식,손창학 인제대학교 2000 仁濟醫學 Vol.21 No.2

Double primary cancer is defined as the case of primary malignant tumors, which must be arise in different sites and have different histological appearances. In the two patients with their seventh decades. synchronous double cancers on colon and stomach are reported. Two patients had ascending colon cancer, sigmoid colon cancer respectively and early gastric cancer, which were diagnosed by endoscopic and organ resection biopsy. We describe the cases with review of literatures.

호즈킨병 30예의 임상적 분석

최정식,김희,엄수정,김인기,주영돈,손창학 인제대학교 2000 仁濟醫學 Vol.21 No.1

Objectives: This study was performed to analyze the clinical outcomes and prognostic factors of 30 cases of Hodgkin's disease treated with radiotherapy, combination chemotherapy and combined -modality therapy. Methods: From Mar. 1981 to Dec. 1998, in Pusan Paik hospital, the prognostic factor and therapeutic response of 30 patients with Hodgkin's disease were evaluated. Results: Out of 30 patients, 17 patients were evaluated. Patients showing complete remission were 13(76%). The 5-year overall survival rate was 74%. In 11 patients treated with C-MOPP/ABV hybrid regimen, 9 patients(82%) showed complete remission and the 5 year overall survival rate was 59%. The analysis of prognostic factor of complete remission could not reveal any significant factor. Toxicities of CMOPP/ABV hybrid regimen were leukopenia(11%), thrombocytopenia(2%), anemia(9%), anorexia(27%), nausea/vomiting(18%), stomatitis(9%), alopecia(18%), and peripheralneuropathy (27%), which were relatively tolerable. Conclusion: The outcomes of treatment of Hodgkin's disease were good, especially CMOPP/ABV hybrid chemotherapy was effective and tolerable.

급성 골수성 백혈병의 자연 완전 관해 1예

김선운,김희,박성재,최경환,김양욱,주영돈,손창학 인제대학교 1999 仁濟醫學 Vol.20 No.1

급성 골수성 백혈병의 자연 완전 관해는 매우 드문 현상으로 1980년대 이후로 전 세계적으로 20예 이하로 보고되고 있다. 저자 등은 급성 골수성 백혈병(AML, M5b)으로 진단된 55세 남자 환자에서 병발된 급성 췌장염, 급성 후두개염으로 인해 전신화학 요법을 연기하는 도중 자연 완전 관해된 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Spontaneous complete remission of acute myeloid leukemia are extremely rare. It is an uncommon variant of the natural course of acute myeloid leukemia in the adult. The pathophysiologic features are still unclear, but most of cases were related either to the infections, transfusions or termination of pregnancy. The duration of spontaneous remission was relatively short and then relapsed after several months. This case is highly representative of the potential antileukemic activity of the human immune system by a probable consequence of the profound immunologic modifications. It encourages the development of immunological therapeutic strategies in patients with acute myeloid leukemia. We have experienced a case of acute myeloid leukemia with spontaneous complete remission, which was combined to concurrent acute pancreatitis and epiglottitis. There is no previous case report in Korea, so we report this case with the brief review of the literature.