http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
장의 급성 이식편대숙주병에서 대변미생물무리이식을 시행한 2예
연상훈 ( Sang Hoon Yeon ),이명원 ( Myung-won Lee ),조덕연 ( Deog-Yeon Jo ),허부연 ( Bu-Yeon Heo ),권재열 ( Jaeyul Kwon ),송익찬 ( Ik-Chan Song ) 대한내과학회 2021 대한내과학회지 Vol.96 No.4
급성 이식편대숙주병은 동종 조혈모세포이식의 비-재발(non-relapse) 사망률과 연관되어 있는 중요한 합병증 중 하나이다. 대변미생물무리이식을 통해 장의 미생물무리를 복원함으로써 장의 이식편대숙주병을 치료하려는 노력이 시도되고 있다. 저자들은 장의 스테로이드 불응 이식편대숙주병이 있는 환자 2명에게 대변미생물무리이식을 시행한 경험을 문헌고찰과 함께 보고하고자 한다. 첫 번째 증례는 43세 남자로 형제로부터 동종 조혈모세포이식을 받았고, 두 번째는 70세 여자로 아들로부터 사람백혈구항원 반일치 조혈모세포이식을 받았다. 두 환자는 각각 이식 후 7주 및 4주째에 급성 이식편대숙주병이 장에 발생하였다. 두 환자 모두에서 조혈모세포이식의 공여자로부터 대변을 제공받아 대변미생물무리이식을 시행하였다. 이후, 두 환자 모두에서 임상적인 증상의 호전을 보였으며, 첫 번째 환자는 완전 반응을, 두 번째 환자에서는 부분 반응을 보였다. RNA 염기서열 분석을 통해 대변미생물무리이식 전과 후의 대변을 분석하였을 때 대변 미생물무리이식 후 미생물무리의 다양성이 회복되는 것이 관찰되었다. 이로써 동종 조혈모세포이식 후에 발생하는 장의 스테로이드 불응-급성 이식편대숙주병의 치료 방법으로 대변미생물무리이식을 적극적으로 고려해야 하겠다. Restoring the microbiota via fecal microbiota transplantation (FMT) can be an effective treatment for steroid-refractory acute graft-versus-host disease (GVHD) of the gut. Here, we report two adult patients who underwent FMT to treat steroid-refractory acute GVHD of the gut. The first patient was a 43-year-old man who underwent allogeneic hematopoietic stem cell transplantation (HSCT) with cells from a matched sibling donor. The second patient was a 70-year-old woman who underwent haplo-identical HSCT with cells from her son. Gut GVHD developed at 7 and 4 weeks after HSCT, respectively. After undergoing FMT, the clinical symptoms improved; the first patient had a complete response and the second patient had a partial response. Microbial analyses using RNA gene sequencing showed that a diverse fecal microbiome was recovered by 4 weeks after FMT. FMT should be considered an effective therapeutic option for managing steroid-refractory acute GVHD of the gut. (Korean J Med 2021;96:358-362)
증례 : 류마티스; 조혈모세포 이식 후 발생한 만성 이식편대숙주반응연관 피부근염 1예
김영 ( Young Kim ),강성욱 ( Seong Wook Kang ),조덕연 ( Deog Yeon Jo ),박찬걸 ( Chan Keol Park ),송규상 ( Kyu Sang Song ),김진만 ( Jin Man Kim ),김진현 ( Jin Hyun Kim ) 대한내과학회 2014 대한내과학회지 Vol.86 No.4
피부근염은 특징적인 근생검 결과와 함께 피부증상과 근위부 근력의 대칭적 약화 및 특징적 근전도 소견 및 CK의상승 등을 특징으로 하는 질환이다. 드물게 조혈모세포 이식후에 발병하는 경우도 보고되었다. 저자들은 동종 조혈모세포 이식 후 만성 이식편대숙주병이 있는 환자에서 발생한피부근염의 증례를 경험하여 보고하는 바이다. Dermatomyositis (DM) is an autoimmune disease characterized by subacute-onset proximal symmetric muscle weakness, skin abnormalities, and muscle inflammation. Descriptions of DM as a complication of chronic graft-versus-host disease (cGVHD) are very rare. We report a 50-year-old woman who developed DM associated with cGVHD after allogeneic stem cell transplantation. (Korean J Med 2014;86:523-527)
성인 급성골수성 백혈병의 DAV ( Doxorubicin Ara - C and Vp - 16 ) 복합화학요법
박철신(Cheol Shin Park),김종완(Jong Wan Kim),송민호(Min Ho Song),조덕연(Deog Yeon Jo),윤오주(Oh Joo Yune),한성필(Sung Pil Han),김삼용(Sam Yong Kim) 대한내과학회 1989 대한내과학회지 Vol.36 No.3
N/A To evaluate the therapeutic effect and usefulness of DAV combination chemotherapy, 12 patients with adult acute myelogenous leukemia were treated with a DAV (Doxorubicin 45 ㎎/㎡ 4, days 3-5, Ara-C 100 ㎎/㎡ 4, days 1-8 and VP-16 100 ㎎/㎡ 4, days 6-8) regimen for remission induction. The results were as follows: 1) The rate of complete remission was 10/13 (76.9%) including one case of re-induction chemotherapy. 2) The median remission duration and the median survival duration in-completely remitted patients were 8 months (1-16 months) and 10 months (2-25 months), respectively. 3) Two among the 9 remitted patients were relapsed (22%). 4) The 2-year survival rates of all patients, the completely remitted patients and the in-completely remitted patients were 33%, 50% and 0%, respectively. 5) The drug toxicities of grade 3 or more (grade 2 or more in anorexia, nausea and alopecia) according to ECOG (Eastern Cooperative Oncology Group) toxicity criteria were as follows: leukopenia-11/12 (92%), anorexia and nausea-8/12 (67%), alopecia-8/12 (67%), mucositis and stomatitis-7/12 (58%) and hemorrhage-5/12 (42%). Thus, we conclude that DAV combination chemotherapy is one of the useful and encouraging therapeutic regimens in remission induction of adult acute myelogenous leukemia.
암환자의 통증치료에 대한 $Ultracet^{(R)}$의 유효성과 안전성
이효진,진선아,윤각원,양영준,박남환,천재민,박남숙,윤환중,조덕연,김삼용,Lee, Hyo-Jin,Jin, Sun-Ah,Yun, Gak-Won,Yang, Yung-Joon,Park, Nam-Whan,Chun, Jae-Min,Park, Nam-Sook,Yun, Hwan-Jung,Jo, Deog-Yeon,Kim, Sam-Yong 한국호스피스완화의료학회 2006 한국호스피스.완화의료학회지 Vol.9 No.2
목적: 외래에 내원하는 암환자들을 대상으로 암성통증의 조절에 있어서 $Ultracet^{(R)}$의 효과와 안전성에 대해 알아보고자 하였다. 방법: 암으로 진단을 받고 통증 조절을 목적으로 $Ultracet^{(R)}$을 투여한 61명의 환자를 대상으로 통증조절의 정도와 통증이 환자의 삶의 질에 미치는 영향에 대한 평가를 위해 Korean version of Brief Pain Inventory를 이용하였다. 약물의 안전성은 복용 후 나타나는 부작용 정도에 의하여 평가하였다. 결과: 대상환자의 평균연령은 59.9세였고 성별분포는 남자가 34명, 여자가 27명이었다. 환자의 진단은 폐암, 위암, 육종, 대장암, 췌장암, 자궁 경부암, 두경부암, 그리고 림프종 등의 순이었다. 대상환자에서 가장 심했을 때의 통증 정도는 $Ultracet^{(R)}$을 사용하기 전후에 유의한 감소를 보이지 않았으나($5.18{\pm}1.41\;vs.\;4.82{\pm}1.94$; P=0.113), 가장 약했을 때의 통증 정도($1.2{\pm}1.05\;vs.\;0.87{\pm}1.35$; P=0.038), 환자가 느끼는 통증의 평균 정도($3.65{\pm}1.01\;vs.\;3.13{\pm}1.73$: P=0.022)와 바로 지금 느끼는 통증정도($3.63{\pm}1.25\;vs.\;2.85{\pm}1.94$; P=0.003)는 유의하게 감소되었다. $Ultracet^{(R)}$의 사용으로 인한 부작용은 전반적으로 경미하여 2도의 오심과 구토 각 1예와 1도의 변비, 소양증, 안면 홍조가 각각 1예씩 관찰되었으나 3도나 4도의 독성은 관찰되지 않았다. 결론: $Ultracet^{(R)}$은 외래환경에서 암환자의 통증조절에 있어서 안전하게 사용할 수 있는 비교적 효과적인 약물로 생각된다. Purpose: We aimed to investigate the efficacy and side effects of $Ultracet^{(R)}$ in relieving cancer pain in setting. Methods: Sixty-one cancer patients over 18 years old, who had cancer pain with or without medication, were enrolled. Pain and other variables were evaluated before and after treatment with $Ultracet^{(R)}$ for 2 weeks, using Korean version of Brief Pain Inventory. Results: Of 61 patients with assessable efficacy data, the maximum pain intensity(PI) experienced in a day were $5.18{\pm}1.41\;and\;4.82{\pm}1.94$, before and after treatment with$Ultracet^{(R)}$ respectively (P=0.113). The minimum PI experienced in a day were $1.2{\pm}1.05\;and\;0.87{\pm}1.35$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.038). The average PI experienced in a day were $3.61{\pm}1.01\;and\;3.15{\pm}1.73$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.022). The current PI were $3.63{\pm}1.25\;and\;2.85{\pm}1.94$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.003). Regarding the quality of life, only mood changed for the better in 49 patients who were treated with $Ultracet^{(R)}$ alone ($1.98{\pm}1.73\;and\;1.35{\pm}1.15$, before and after treatment respectively; P=0.046). There were five (8.2%) adverse events associated with $Ultracet^{(R)}$ treatment. Conclusion: $Ultracet^{(R)}$ seems effective and safe in ambulatory patients with cancer pain.
손상균 ( Sang Kyun Sohn ),정철원 ( Chul Won Jung ),조덕연 ( Deog Yeon Jo ),정준원 ( June Won Cheong ),대한혈액학회만성골수성백혈병연구회 ( Chronic Myelogenous Leukemia Working Party The Korean Societ ),김대영 ( Dae Young Kim ),이정옥 ( 대한내과학회 2015 대한내과학회지 Vol.88 No.4
Background/Aims: The first edition of the Korean treatment guidelines for chronic myelogenous leukemia (CML) was published in 2006. We intend to update those guidelines to include the use of next-generation tyrosine kinase inhibitors (TKIs). Methods: New guidelines were developed in 2012 based on the results of a survey and a consensus meeting of various Korean experts, the reports of recent clinical studies, and updated guidelines from external study groups. Results: An assessment of risk factors is strongly recommended before treating newly diagnosed chronic phase CML. Imatinib, dasatinib, and nilotinib are reimbursable in Korea as first-line treatments, and the patient`s age, comorbidities, and possible adverse events should be considered in the choice of treatment. Molecular studies are recommended for assessing treatment efficacy instead of invasive cytogenetic response evaluations, and an early response is believed to correlate with a good prognosis. Second-line TKIs can be considered for patients who fail or are intolerant of first-line therapy, pending analysis of ABL tyrosine kinase mutation status. For treating advanced stages, a combination of TKIs with cytotoxic agents and hematopoietic cell transplantation is recommended. The adverse effects of TKI therapy can be managed via dose reduction and supportive care, or switching to an alternate TKI. Conclusions: The use of TKIs has improved the outcome of CML treatment. Treatment-free remission after discontinuing TKIs might be possible in select patients who achieve sufficient response, indicating that curative treatment for CML can be expected in the future.
동종 조혈모세포 이식 후 발생한 호산구 근막염(Eosinophilic Fasciitis)
김진만 ( Jin Man Kim ),김진현 ( Jin Hyun Kim ),김민경 ( Min Kyung Kim ),강성욱 ( Seong Wook Kang ),조덕연 ( Deog Yeon Jo ),유인설 ( In Seol Yoo ),송승택 ( Seung Tak Song ) 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.1
Eosinophilic fasciitis (EF) is a relatively rare disorder characterized by eosinophilia of the peripheral blood and inflammation of fascia and skin. The etiology of EF is unknown but it can precede or occur concomitantly with hematologic disorders including malignancy. EF can rarely occur after bone marrow transplantation and is a feature of chronic graft-versus-host disease (cGVHD). We report a 49-year-old man who developed EF as the first manifestation of cGVHD after allogeneic hematopoietic stem cell transplantation (AlloHSCT).
전신홍반루푸스에 병발된 하시모토 갑상선염과 재생불량성 빈혈 1예
권오경 ( Oh Kyung Kwon ),정재훈 ( Jae Hoon Jung ),이영모 ( Young Mo Lee ),나기량 ( Ki Ryang Na ),조덕연 ( Deog Yeon Jo ),이강욱 ( Kang Wook Lee ),신영태 ( Young Tai Shin ) 대한내과학회 2006 대한내과학회지 Vol.70 No.6
전신홍반루푸스는 자가면역질환으로 다양한 장기의 손상을 동반 할 수 있으나 동반될 수 있는 여러 가지 합병증 중 동일한 환자에서 하시모토 갑상선염과 재생 불량성 빈혈이 동시에 병발된 경우로 별다른 합병증 없이 성공적으로 치료를 하여 보고한다. We report a 45-year-old female who presented with azotemia, pancytopenia, pericardial effusion, hypothyroidism, decreased complement and positive ANA and was diagnosed as systemic lupus erythematosus (SLE). She referred to our hospital for the evaluation o
소화기암 세포주에 대한 Interferon 의 항암제 세포독성 증강 효과
김성철(Sung Chul Kim),길준영(Jun Young Kil),전의건(Eui Gun Chun),윤환중(Hwan Jung Yun),조덕연(Deog Yeon Jo),김삼용(Sam Yong Kim),김영건(Young Kun Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.5
N/A Background: 1nterferons (IFN) have antiproliferative activity and immune moduiatory function. Interferons and cytotoxic drugs have different mechanism of action on cancer cells. To investigate the interaction of interferons with cytotoxic drugs, we treated human gastrointestinal cancer cells with combinations of anti- cancer drugs and interferons. Methods: Using the colorimetric [3-(4, 5-dimethlyth- iazo1-2-yl)-2, 5-diphenyltetraxolium bromide] (MTT) assay, we evaluated the chemosensitivity of anticancer drugs (5-fluorouracil, adriamycin), and the inhibitory effects of alpha interferon and gamma interferon, and the cytotoxic effects of the combination of interferons and anticancer drugs against the human gastric cancer cell line SNU-5 and the colon cancer cell line SNU-C. Results : Both 5-FU and adriamycin produced dosedependent inhibition of cancer cell growth; the alpha interferon and the gamma interferon had 12% and 18% inhibitory effects against SNU-5 cells respectively, and they showed 29% and 30% inhibitory effects against SNU-C1 cells respectively. Cytotoxicity of anticancer drugs was markedly augmented by the addition of alpha or gamma interferons. The II4 values of 5-FU and adriamycin decreased to 1/ 37 and 1/33, respectively, when alpha interferon was added to these drugs, and ID50 values of 5-FU and adriamycin decreased to 1/7 and 1/5.4, respectively, when the gamma interferon was added. Conclusions: The results indicate that interferons, when used concomitantly with the cytotoxic drug 5-FU or adriamycin, can augment the cytotoxicity of the latter drugs. A clinical trial incorporating interferons with anticancer drugs in gastrointestinal malignancies should be warranted.