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소세포 폐암에서 Cisplatin과 Etoposide (VPP) 복합화학요법의 효과
권순인 ( Kwon Sun In ),김정희 ( Kim Jeong Hui ),김준식 ( Kim Jun Sig ),어완규 ( Eo Wan Gyu ),김시영 ( Kim Si Yeong ),윤휘중 ( Yun Hwi Jung ),조경삼 ( Jo Gyeong Sam ),홍성언 ( Hong Seong Eon ) 대한내과학회 1993 대한내과학회지 Vol.44 No.2
Background : Reports of the result of cisplatin plus VP-16(VPP) combination as second line therapy following cyclophosphamide, doxorubicin, vincristine (CAV) suggested that VPP might be non-cross resistant with the CAV regimen. We evaluated the efficancy and toxicity of VPP combination therapy as a first line therapy for small cell lung cancer (SCLD). Methods : Fifty-one patients with SCLC were treated with cisplatin (20mg/㎡ i.v., X 5 days) and etoposide (100mg/㎡ i.v., X 3 days) every three weeks. In patients with limited disease. radiation to primary site was performed after 3rd cycle VPP. Results : 1) Among the 51 treated patients, 45 were evaluated for response to VPP chemotherapy. Complete response rate was 18.6%, and partial response rate was 51.2%. 2) The median overall survival was 51 weeks. The median survival was 59 weeks in limited disease, and 50 weeks in extensive disease. There was no significant difference between the two groups. 3) The median time to progression was 51 weeks in responder. 4) The toxicities were mild to moderate degree ; anorexia, nausea and alopecia in most cases, neurotoxicities in 23.8% and nephrotoxicities in 21.4%. Leukopenia (66.7%) and thrombocytopenia (13.5%) were not severe. Conclusion : VPP combination therapy was effective in small cell lung cancer as first line chemotherapy.
김정희 ( Kim Jeong Hui ),김준식 ( Kim Jun Sig ),어완규 ( Eo Wan Gyu ),김영일 ( Kim Yeong Il ),김선희 ( Kim Seon Hui ),김시영 ( Kim Si Yeong ),윤휘중 ( Yun Hwi Jung ),조경삼 ( Jo Gyeong Sam ) 대한내과학회 1993 대한내과학회지 Vol.44 No.4
Background: Detection of the immunoglobulin (Ig) and the T cell receptor (TcR) gene rearrangements are useful markers for determining lineage and clonality in lymphoid malignancy. Antigen receptor gene rearrangements have also found in some patients with acute myeloid leukemia (AML). The significance of these rearrangements remains unclear. Methods: Ig heavy chain (IgH) gene and TcR beta chain(TcRβ) gene rearrangements were examined in leukemic cells from 25 patients with AML by Southern blot analysis. DNA was extracted from bone marrow aspirates. Three different enzymes (EcoRⅠ, BamHⅠ, HindⅢ) and two different probes(J_(H), Cβ) were used. Results: 1) TcRβ gene rearrangements were demonstrated in 2 of 25 cases(8%). But IgH gene rearrangement was not detected at all. 2) Antigen receptor gene rearrangement pattern of three cases with B cell antigen, CD19(+) and two cases with T cell antigen, CD2(+) were germline. Immunophenotyping was not performed in two cases with TcRβ gene rearrangement. 3) Of the patients with TcRβ gene rearrangement, one is alive in complete remission state after chemotherapy, and the other patient died before therapy. Conclusion: TcRβ gene rearrangement was demonstrated in some patients with AML. Antigen receptor gene rearrangment did not correlate with specific immunophenotype and prognosis. The clinical implication of antigen receptor gene rearrangement study need further study.
성인 철결핍성 빈혈 환자에서 자연 살상 세포 활성의 변화
김수홍,서정훈,김양수,어완규 고신대학교 의학부 2005 高神大學校 醫學部 論文集 Vol.20 No.1
Background: Iron deficiency is the most common casue of anemia worldwide. It is well known that iron plays an important role in the metabolism of may bacterial species. A reduction in immune competence by iron deficiency or iron excess might lead to an increased susceptibility of the host to infection. Investigations have been reported of alterations in the cell-mediated immune response in iron deficient human patients. Confounding variables in clinical studies, such as additional nutritional deficiencies, pre-existing infection or other concomitant disorder, make it difficult to conclude that iron is the only causative factor in immune alteration. In this study, we investigated the change of the cell-mediated immunity in iron deficiency patients. Methods: Twenty four patients with uncomplicated IDA were included in this study. The blood levels of hemoglobin, RBC indices, serum ferritin, serum iron, and TIBC were measured. The indices of cell-mediated immunity such as CD3, CD56 and NK cell activity were measured. The indices of cell-mediated immunity were compared with each hematologic meal group. The correlations between hematologic indices, iron parameters and the indices of cell mediated immunity were investigated. Results: The natural killer cell activity was significantly correlated with Hb(Spearman r=0.616 p=0.001), MCV(Spearman r=0.678 p=0.000) and MCH(Spearman r=0.721 p=0.000). But there was no significant correlations with iron, ferritin, TIBC and Iron/TIBC ratio. In Mann-Whitney test and Chi-Square test, NK cell activity was significantly associated with MCV, MCH and hemoglobin. Conclusion: There was significantly decreased natural killer cell activity in iron-deficient patients. In this study, hemoglobin, MCV and MCH are parameters of the NK cell activity in cell-mediated immunity. As a result, iron deficiency itself is a determinant of the NK cell activity.