Platinum sensitive 재발성 난소암에서 Carboplatin/Paclitaxel의 효과

장혜진,유희석,임윤경,문세희,장기홍,이정필 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

목적 : 재발성 난소암에서 platinum 감수성을 기준으로 2차 항암요법으로 사용한 Carboplatin과 Paclitaxel의 효과를 알아보기 위하여 본 연구를 진행하였다. 연구방법 : 1998년 1월 1일부터 2003년 8월 31일까지 만 5년 8개월 간 아주대학교병원 산부인과에 재발성 난소암으로 입원한 환자 중에서 최초 수술로 난소암을 확진한 후 Cisplatin 또는 Carboplatin 등 platinum 제재가 포함된 항암치료를 받은 후 6개월 이후에 재발한 환자 29명을 대상으로 Carboplatin은 5 AUC를 그리고 Paclitaxel은 175 mg/m^(2)를 투여하였으며, 최소 3회에서 최고 16회까지 투여하였다. 치료효과의 판정은 CT, MRI, Ultrasonography등 영상진단상 암종괴의 크기가 완전히 소실되었을 경우를 완전반응(complete response)으로, 50%이상 감소되었을 경우를 부분반응(partial response)으로, 50% 미만으로 감소되었거나 20% 미만 증가하였을 경우를 불변(stable disease)으로, 그리고 20% 이상 증가되었을 경우를 진행(progressive disease)로 정의하였다. 결과 : 대상 환자에서 완전반응은 6명(21%), 부분반응은 11명(38%), 그리고 불변은 5명(17%)로 전체 반응율 (overall response rate)은 59% 그리고 임상적 유용성(clinical benefit=CR+PR+SD)은 76%이었다. 결론 : 재발성 난소암환자에서 기왕에 사용한 Platinum 제재에 민감한 환자에서는 Carboplatin과 Paclitaxel의 병행 투여가 효과적이었다. Objective : To ascertain the effect of Carboplatin and Paclitaxel combination as a second line regimen for recurrent ovarian carcinoma based on platinum sensitivity. Methods : From January 1st, 1998 through to August 31st, 2003, 29 patients were retrospectively reviewed who had previously underwent primary cytoreductive surgery and adjuvant chemotherapy with Cisplatin or Carboplatin for ovarian carcinoma, and who had later recurred during follow up. All 29 patients had recurred at least 6 months after therapy, and thereafter received second line chemotherapy consisting of Carboplatin (5 AUC) and Paclitaxel (175 mg/㎡) for a minimum of least 3 cycles and a maximum of 16 cycles. Treatment efficacy was assessed by imaging studies including Computerized tomography, Magnetic Resonance Imaging, or Ultrasonography. Complete response was determined as complete disappearance of tumor, partial response at least than 50% reduction in tumor volume, stable disease as less than 50% reduction or less than 20% increase in tumor volume, and progressive disease as more than 20% increase. Results : There was complete response in 6 (21%) patients, partial response in 11 (38%), stable disease in 5 (17%), showing an overall response rate of 59%. The clinical benefit (CR+PR+SD) was 76%. Conclusion : The combination of Carboplatin and Paclitaxel administration seems to be an effective mode of second line therapy in patients with recurrent ovarian carcinoma who had been sensitive to prior platinum based chemotherapy.

요추부 경막외 스테로이드 주사에서 경추궁(經椎弓)법과경추간공(經椎間孔)법의 효과

김희상,홍장혁,안경회,김용걸 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.4

연삭기용 자동 밸런싱 장치의 설계 및 평가

장홍석,최대봉,황주호,홍준희 한국공작기계학회 2001 한국공작기계학회 춘계학술대회논문집 Vol.2001 No.-

The balance of high speed spindle system with high precision rotation like grinding machine is very important. Traditionally, we use trial and error method to balance the spindle. It takes much time. So we are developing the automatic balancing equipment being used in the grinding machine. The balancing head we develop is wireless. It will be used high-speed grinding machine. We use influence coefficient method to control the automatic balancer. Experiments are based on automatic and manual balancing. We perform test of the vibration filter. It helps to remove noise. The filter and experiments with automatic balancing controller show that automatic balancing control can be successfully achieved with the quick response and good stability characteristics.

간질발작후 MRI 영상에서 뇌 종창을 보인 3예 보고

홍현숙,김대호,이혜경,박재성,박성진,조준희,차장규,백상현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

We report seizure induced brain swelling in three patients. MRI revealed a cortical, subcortical(3/3), and basal ganglia(2/3) high signal intensity on T2- weighted and FLAIR images. The lesion shows low signal on T1-weighted image, and enhanced after contrast administration. Follow up study after 27 days in one case revealed complete resolution of the lesion. The reversible MRI findings may be the results of a local brain swelling, breakdown of blood-brain permeability, and a defect of cerebral autoregulation during seizure activity. The transient nature of such findings have to be considered in the differential diagnosis such as reversible ischemia, migraine, inflammation and infection.

인간 면역부전 바이러스(HIV) 감염자 사이에서의 1기 및 2기 매독의 유행

장희창,조재현,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 HIV 감염자 사이에서 발생한 매독의 유행을 보고하고, 그 역학적 특성을 규명하고자 하였다. 재료 및 방법 : 1999년 7월부터 2003년 9월까지 서울대학교 병원에서 추적 관찰을 받아온 HIV 감염자를 대상으로 하여 1기 및 2기 매독의 발생을 조사하였다. 발생률을 정확히 구하기 위해 추적 관찰을 받은 모든 HIV 감염자의 인년을 6개월 간격으로 구하였다. 결과 : 51개월 동안, 465명의 HIV 감염자가 서울대학교 병원에서 추적 관찰을 받았다. 이중 38명이 1기 및 2기 매독으로 진단되었다. 1기 및 2기 매독의 발생률은 이기간 동안 100인년 당 4.1명이었다. 1999년 7월부터 2001년 12월 사이에는 발생자가 없었으나, 이후 발생률은 꾸준히 증가하여 2003년 9월에는 100인년 당 18.8명이 되었다. 1기 및 2기 매독의 발생률은 동성애자 및 양성애자에서 이성애자에서보다 4.3배 높았고, HAART로 치료를 받지 않은 환자에서 HAART로 치료를 받고 있던 환자에서 보다 10.9배 높았다. 결론 : 2002년부터 국내 HIV 감염자 사이에서 1기 및 2기 매독이 유행하기 시작하였고, 이러한 유행은 동성애자와 양성애자 및 HAART로 치료를 받고 있지 않던 사람 사이에서 발생하였다. Background : This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. Materials and Methods : A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. Results : In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). Conclusion : The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.

3'-Methyl-4-dimethylaminoazobenzene이 백서의 정상 및 재생간의 EGF Receptor 변동에 미치는 영향

홍장희,허강민,석정호,이재흔 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

To study the changes of EGF receptors in the rat liver regeneration and hepatic carcinogenesis, ^125I-EGF binding sites were measured in the regenerated liver cell membrane after partial hepatectomy of normal rat and 3-methyl-4-dimethylaminoazobenzene treated rat. 1. EGF binding sites (Bmax) in the normal rat liver cell membrane were 553.8fmole/mg protein and were markedly decreased at the 1st day after partial hepatectomy. These sites were increased at the 3rd day(Bmax-161.0fmole/mg protein) and were 29% of the normal liver EGF binding sites. 2. EGF binding sites (Bmax) in the normal cell membrane of the 3-methyl-4-dimethylaminoazobenzene-treated rat, were 72.8fmole/mg protein and were significantly less than those in the normal rat live cell membrane. At the 1st day after partial hepatectomy, EGF binding sites were markedly decreased and increased at the 3rd day (Bmax=155.8fmole/mg protein). 3. Kd values in EGF receptor binding were not much altered in both liver cell membranes of the normal rat and the 3-methyl-4-dimethylaminoazobenzene treated rat. From these result, it is suggested that decreased EGF binding sites in the liver cell membrane of regenerating rat liver and 3-methyl-4-dimethylaminoazobenzene treated rat may be due to the alteration of EGF receptor number.

산발성 장형 위선암 환자의 Microsatellite Instability와 병리학적 양상

조창희,홍유찬,안지현,최경현,이상호,신영명,윤기영,정민정,장희경 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Background : Through many researches, microsatellite is expected to be a good diagnositic and prognostic factor in colorectal cancer, endometrial cancer, gastric cancer, and the others. The prevalence of microsatellite instability (MSI) in gastric carcinoma has reported variously, 13~44%. Purpose : We aimed to determine the prevalence of MSI-high and the relationship between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma of stomach. Material and Methods : We analyzed 106 sporadic intestinal type adenocarcinoma specimens excised from patients who were over thirty-five years old to determine the statue of microsatellite by DNA sequencing. The tissues were formalin-fixed and paraffin embedded. DNA were extracted and amplified by polymerase chain reaction (PCR). MSI was determined using five markers recommended by National Cancer Institute (NCI). Specimens were also studied with five patholical factors-differenciation of tumor cells, depth of invasion, lymph node metastasis, vessel invasion, and perineural invasion- to determine pathological state. Result : The microsatellite statue was determined as MSI-High in 5 cases (4.7%), no MSI-low, and MSS (microsatellite stable) in 101 cases (95.3%). Within the frequency, there was no large gap in the distinction of gender in MSI cases, but in MSS cases, there was three-times more cases in male. MSI cases had moderate-to-poor differenciation and trend to invade toward serosa. All MSI cases showed no perineural invasion. But we could not find any statistical significance between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma. Conclusion : Results suggest that MSI can not make any certain pathological significance in sporadic intestinal type adenocarcinoma. Even though less than 5% of sporadic intestinal type adenocarcinoma patients showed MSI, it can be used as a influential prediagnostic factor of gastric cancer. Further study with large scale of cases will be followed to verify these results.

결장을 이용한 식도재건 환자에서 경피 내시경하 결장루술 1예

채희복,윤수인,홍장수 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

뇌졸중, 파킨슨 병, 척수신경손상 등으로 연하관련 근육들의 협동운동장애가 발생한 환자에서 흡인성 폐렴이 반복되거나 경장영양이 곤란하게 된다. 이러한 경우에 경피내시경하 위루술(percutaneous endoscopic gastrostomy)은 이들 환자의 생명을 유지하는데 매우 중요한 역할을 해 왔다. 위궤양 혹은 위암 등으로 위절제술을 받은 환자에서 위루술 대신에 부득이 경피내시경하 공장루술(direct percutanous endosopic jujunostomy)이 시행되었던 경우는 국내외에 몇 례의 보고가 있다. 본 증례는 과거 후두암 때문에 후두부식도절제술 후 결장 끼어듬(colon interposition) 수술을 받은 65세 남자 환자로 최근 좌측중대뇌동맥 경색으로 연하장애가 발생되었다. 저자들은 이 환자에게 지속적인 영양공급을 위하여 경피내시경하 결장루술을 합병증 없이 시행하였기에 보고하는 바이다. Dysphagia is a loss of coordination in the swallowing musles. It has occurred in patients with cerebrovascualr accident, head injury, Parkinson's disease or cervical cord injury. Dysphagia results in nutritional deficiency or repeated aspiration pneumonia. Percutaneous endoscopic gastrostomy have helped these patients to maintain healthy and save lives. Several cases of direct percutaneous endoscopic jejunostomy have been reported in patients who received gastric resection for a stomach cancer or peptic ulcer hemorrhage. A 65-year-old male patient, who was suffering from dysphagia, whose symptom was caused by left middle cerebral infarction. He was referred to the division of gastroenterology for the provision of permanent enteral feeding. His esophagus had been resected and replaced with a part of colon because of laryngeal cancer 5 years ago. We could not approach the stomach because the angle of anastomosis was acute and the colonic graft was long. We performed direct percutaneous endoscopic colostomy without any complications. Herein, we report on this successful case.

한우 체외수정란의 동결보존 및 핵이식에 관한 연구 : Ⅱ. 체외수저란의 동결방법이 동결.융해후 생존율에 미치는 영향 Ⅱ. Effects of Survival Rates of Frozen-Thawed Embryo Frozen Methods

정장용,박희성,홍승표,김정혁,桑潤滋,離素娟 진주산업대학교 농업기술연구소 1999 農業技術硏究所報 Vol.12 No.-

본 연구는 수정란의 동결기법을 확립하고자 배반포기에 있는 한우 체외수정란을 이용하여 유리화 및 직접이식 동결방법으로 동결을 실시하여 동결·융해후 생존성, 동해방지제의 종류, 평형 및 할구의 손상여부 등에 대한 영향을 조사한 결과는 다음과 같다. 유리화 동결방법중 GESD-VS와 EFS 용액을 동해방지제로 사용하였을 때 동결·융해 수정란의 생존율은 각각 69.8 및 37.3%로써 이들간에 유의적(P<0.05)인 차이가 있었으며, 동결기를 이용한 직접이식 동결법은 생존율이 56.0%로써 유리화 동결방법과는 유의적(P<0.05)인 차이가 없었다. 동결·융해후 생존한 수정란의 발달율은 GESD-VS용액을 사용하였을때가 53.4%로써 EFS용액을 사용하였을때의 24.0%보다는 유의적(P<0.05)으로 높게 나타났다. 1 및 2단계 평형시 단계별 생존율은 각각 11.7 및 23%로써 이들간에 유의적(P<0.05)인 차이가 없었으며, 동결·융해 수정란의 발달율도 각각 10 및 16.8%로써 평형방법간에 유의적(P<0.05)인 차이가 없었다. 신선수정란, 유리화 동결수정란 및 동결비를 이용한 직접이식 동결법으로 동결하였을 때 동결·융해 수정란의 할구수는 각각 98.7±2.3개, 69.1±2.6 및 84.2±2.7개로써 동결방법들간에 유의적(P<0.05)으로 할구수의 차이가 많았다. This study was carried out to investigate the effect of cryoprotectants, equilibration step, number of blastomeres on survival and developmental rates of bovine in vitro fertilized blastocysts(Korean native cattle) frozen/thawed by vitrification and frozen for direct transfer(1.8M ethylene glycol). The bovine oocytes were collected from 2-5mm follicles, matured for 24hrs in 5% CO_2 incubator and then fertilized with cauda epididymis sperm. Blastocyst at day 7-9 ater IVF were frozen in vitrification and frozen for direct transfer(1.8M ethylene glycol). Survival and developmental rates of frozen-thawed IVF embryos were examined. The results were as follow ; The survival rate of IVF blastocyst after vitrification in GESD-VS, EFS and 1.8M ethylene glycol solution were 69.8, 37.3 and 56.0%, respectively(P<0.05). When equilibrated in 1 step(11.7%) was similar to the result from 2 step(23.0%), and no significantly(P<0.05) different between the equilibrated steps. The number of blastomere at blastomere at blastocyst of bovine embryos frozen/thawed in fresh, vitrification and freezing for direct transfer were 98.7±2.3, 69.1±2.6 and 84.2±2.7, respectively, and were significantly(P<0.05) different between the freezing methods.

개에서 심실 조율부위 및 조율주기에 따른 혈역학적 변화

김희열,김재형,노태호,김종진,진승원,유기동,이만영,채장성,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9