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Waldenstrom's Macroglobulinemia의 임상소견을 보이는 저도 종격동 MALT 림프종
주영돈,이원식,김윤정,김기향,김애란,권민정,박보민,김찬환,손창학 대한혈액학회 2004 Blood Research Vol.39 No.3
Low-grade B cell mucosa-associated lymphoid tissue (MALT) lymphoma makes up 8% of non-Hodgkin's lymphomas. It has been characterized by a prolonged clinical course and persistent disease at the site of origin. Most patients with low-grade B cell MALT lymphoma occur in the stomach, orbit, intestine, lung, thyroid, salivary gland, skin, soft tissues, bladder, kidney, and central nervous system. The diagnosis of MALT lymphoma can be established by a characteristic finding of infiltration of small lymphocytes that are monoclonal B cell and CD5 negative. Bone marrow involvement seems uncommom but has been developed. Waldenström's macroglobulinemia (WM) is usually defined as bone marrow infiltration of lymphoplasmacytoid lymphocytes with a high level of circulating macroglobulin IgM. Lymphadenopathy and splenomegaly occurs in 20~40% of WM. It is very hard work to do differential diagnosis between disseminated low-grade B cell MALT lymphoma and WM with organ involvement by a bone marrow examination. We reprot one case of low grade mediastinal MALT lymphoma with bone marrow involvement and a high level of serum monoclonal IgM with clinical appearance of WM.
소세포 폐암에서 Ifosfamide, Cisplatin, Etoposide(ICE) 복합화학요법의 치료효과
주영돈,손창학 인제대학교 1997 仁濟醫學 Vol.18 No.1
소세포 폐암은 방사선 및 화학요법에 민감하게 반응한다. 그러나 과거 20여년간의 장기 생존자는 드물었다. 따라서 소세포 폐암의 치료 반응율과 생존율을 증가시키는 새로운 제제의 추가와 조합이 요구되어 이에 저자들은 기존의 cisplatin 및 etoposide에 새로운 약제인 ifosfamide를 추가한 ICE 복합화학요법의 치료 반응율과 생존율을 분석하여 치료 효과에 대한 영향을 알아 보고자 하였다. Small cell lung cancer accounts for 20% of all cases of lung cancer and has characteristics of early metastasis but highly sensitive to both radiotherapy and chemotherapy. The response rate has been increased by chemotherapy, but long term survivors are rare. The new drugs which have better response rate and increased duration of survival should be developed. The authors tried to treat small cell lung cancer with newly developing ifosfamide, cisplatin, etoposide(ICE) combination chemotherapy which include ifosfamide, derivative of cyclophophamide, in preexisting etoposide, cisplatin (EP) regimen. Twenty-eight patients with small cell lung cancer who were admitted to Inje University Pusan Paik Hospital between October 1974 and September 1996 were treaded with ICE regimen which infused every 3 weeks for total 6 cycles. Radiotherapy to chest was added to the patients with limited stage disease. Prophylactic cranial irradiation (30 Gy) was applied to all complete responders. The overall response rate was 75% and complete response rate was 25%. The response rate was 80% in limited stage disease(complete response 30%, partial response 50%) and 72% in extensive stage disease(complete response 22%, partial response 50%) The prognostic factors such as stage of disease, performance score. LDH level, age, and weight loss were not significantly related with response rate. The overall median survival duration was 5 months(1 - l4+). The median survival duration of complete responders, partial responders, and no responders were 14, 11, and 2 months, respectively(p=0.38). The complete responders, partial responders, no responders were not significantly related with median survival duration. However, the median survival durations of the patients with limited and extensive stage diseases were 12 and 8 months, respectively(p = 0.008). In conclusion, these results suggest that ICE combination chemotherapy might be useful as a treatment strategy in small cell lung cancer, but long term investigation with more patients is necessary.
주영돈,김경림,김양욱,손창학 인제대학교 1999 仁濟醫學 Vol.20 No.1S
다발성 골수종은 발생 빈도가 높지 않고 다양한 임상증상을 나타내며 지난 30년간 치료발달에도 불구하고 표준 항암 화학요법으로는 완치가 불가능한 질환으로 평가받고 있다. 국내에서 여러 보고들이 있었지만 단일기관에 의한 산발적인 보고였고 체계적인 분석은 드물었다. 저자 등은 1988년 9월부터 1998년 8월까지 인제대 부산백병원에서 다발성골수종으로 진단받은 68명의 환자를 대상으로 하여 임상상 및 치료에 대한 분석을 시행하였다. 분석결과 표준 항암 화학요법으로서의 2제요법과 다제 요법은 반응율과 생존에 있어 차이가 없었고 치료에 반응을 보이는 경우 생존율의 향상을 관찰할 수 있었으며 그 외 임상상은 다른 보고들과 비슷하였다. Treatment results and clinical findings were analysed in 68 cases diagnosed as multiple myeloma between September 1988 and August 1998 at Pusan Paik Hospital. The results were as follows : 1) The peak incidence was 7th decade and male to female ratio was 1:1.12. 2) Most common chief complaint was bone pain in 43%, followed by general ache in 21% and fatigue in 18% of patients. 3) Laboratory findings showed severe anemia in 50%, renal failure in 41% and hypercalcemia in 18% of patients. Elevated beta-2 microglobulin was 79%. 4) X-ray findings showed multiple osteolytic lesion, pathologic fracture, normal finding in 71%, 59%, 19% of patients, respectively. 5) Clinical stage was swage I, II, III in 1.4%, 11.8%, 86.8% of patients, respectively. 89% of patients with renal insufficiency were in stage III. 6) The M-component showed in 91.2% and mean M-protein concentration was 5.3g/ dl. M-component was IgG in 66% and kappa to lambda ratio was 2.5 : 1. 7) Response rate to two drug regimens and combination chemotherapy(>3 drug) were 39%, 42%, respectively. The overall median survival of patients was 72 weeks.
주영돈,이창용,이동주 한국산업경영시스템학회 2018 한국산업경영시스템학회 학술대회 Vol.2018 No.추계
Joint order and transportation system which can be used for the franchise business is considered. It is assumed that several agents exist on the same vehicle route and each agent has an EOQ inventory policy and the same order cycle. It is also assumed that transportation cost is proportional to the distance of farthest agent from the supplier. Various methods for rational and fair cost allocation such as line rule, AMEF, the Shapley value, nucleolus, and proportional method were researched and applied to the inventory transportation problem. The core is the basic condition for rational and fair cost allocation. Therefore, we examined if the solutions of various allocation methods are existed in the core through an example.