항암화학요법을 받는 암 환자에 대한 Nucare^R의 영양지지효과

조덕연,김현수,곽상혁,강정현,김철희,배광봉,김종숙,박상준,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Purpose : The purpose of this study was to evaluate the effect of nutritional support with enteral liquid supplement in cancer patients receving chemotherapy for possible benefit in nutritional, immunologic and golbal function of patients. Patients and Methods : From October 1995 to February 1997, 30 advanced cancer patients receving chemotherapy were divided two roups. The Nycare group, in addition to normal diet, Nucare^R enteral supplement was given for 1week right after chemotherapy for the duration of 2 chemotherapy cycles. Control group received only normal diet without parenteral fluid supplement for 2 chemotherapy cycles. Results : Median ages were 53 end 56 years for Nucare group and Contrl group respectively. Performance scores was less than 2 by ECOG scale. All patients were stage Ⅲ or Ⅳ. The physical parameters, such as weight, arm muscle circumference(AMC) and triceps skin fold(TSF) were decreased in both groups after 2 cycles of anticancer therapy. but it was less severe in Nucare group(p<0.05). Serum transferrin was maintained in mild deficit state in Nucare group, whereas it aggravated form mild to moderate deficit in Control group(p<0.05). Serum albumin level increased in Nucare group without statistical significance. but it decreased from normal to mild deficit in Control group. Serum total protein did not change significantly in Nucare group. but in Control group, serum total protein was decreased from 7.24±0.9 to 6.52±0.5(P<0.05). Total lymphocyte count did not change significantly in both groups. Conclusion : This study shows that the nutritional support with Nucare^R was effective in the prevention of nutritional deficit status in patients receving a nticancer chemotherapy.

Sertraline이 Bleeding Time에 미치는 영향

박현숙,장기용,김은남,강병조 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

본 연구는 선택적 세로토닌 재흡수 억제제(SSRIs), 특히 sertraline이 출혈 시간에 미치는 영향을 알아봄으로써 선택적 세로토닌 재흡수 억제제의 안전성과 혈액학적 부작용 측면을 평가하고자 하였다. 선택적 세로토닌 재흡수 억제제의 치료적 적응증에 해당하는 95명의 환자를 무작위 할당으로 sertraline 50mg 투여군, sertraline 200mg, 투여군, nortriptyline100mg 투여군, 위약(thiamine 100mg) 투여군으로 분류하여 정해진 양을 4주간 투여한 후 출혈 시간을 약물 투여 전, 약물 투여 2주 후, 약물 투여 4주 후의 3회에 걸쳐서 측정하였다. 95명의 환자 중 78명이 실험을 마쳤다. Sertraline 50mg 투여군에서 실험 전과 비교하였을 때 시간에 따르는 출혈 시간의 증가가 있었다. 다른 군에서는 실험 전과 실험 2주 후, 4주 후의 출혈 시간을 비교하였을 때 시간에 따르는 출혈 시간의 증가가 없었다. 연구 기간 동안 지혈 이상을 보인 환자는 없었다. 결론적으로 Sertraline 투여 초기에 정상 범위 내에서 출혈 시간의 증가가 있었다. Objective : This study was designed to assess the safety and hematological complications of the selective serotonin reuptake inhibitors(SSRIs) by examining the effect of sertraline on bleeding time. Method : Ninety five patients included in therapeutic indications of SSRIs were divided into sertraline 50mg, sertraline 200mg, nortriptyline 100mg, placebo(thiamine 100mg) groups. Bleeding time was measured at baseline, and repeated 2 and 4 weeks after the initiation of treatment with sertraline, nortriptyline and placebo 78 patients completed the study protocol. Result : Bleeding time was prolonged within normal range after 2 and 4 weeks of treatment in sertraline 50mg administration group. Bleeding time was not prolonged in the other groups. No patient developed clinical signs of abnormal hemostasis during the study period. Conclusion : Bleeding time was prolonged within normal range at initial period of treatment with sertraline.

단기간의 저용량 Cytosine arabinoside 치료에 반응하였던 Down 증후군에 병발한 급성골수성백혈병 1례

김현수,이정호,이정찬,강정현,곽상혁,김철희,배광봉,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The incidence of hematologic disorders in patients with Down's syndrome is significantly increased, about 14∼30 - fold higher than in general population and includes neonatal transient abnormal myelopoieis and acute leukemias. The age of onset of leukemia in Down's syndrome is peaking first in the newborn period and then under 4 years of age. Down's syndrome with acute leukemia above the age of 20 is very rare and it's treatment oucome is unclear. The treatment of Down's syndrome with leukemia has been controversial because of toxicity and associated congenital cardiac and other abnormalities. But if treated adequately, children with Down's syndrome show a favorable response to anti-leukemia therapy. A 24-year-old man with Down's syndrome was first seen for the evaluation of anemia and thrombocytopenia. The peripheral blood morphology and bone marrow study revealed acute myelogenous leukemia, cytogenetic study of bone marrow showed trisomy 21. Beacuse of his sicioeconomic condition and medical abnormalities including deafness, visual loss, he was treated with low dose subcutaneous cytosine arabinoside(Ara-C) for 11 days. Complete remission was obtained after 37 days. The complete remission lasted for 5 months. He subsequently relapsed, and died 6 months later.

남자 만성 정신분열증 환자에서 Risperidone 투여에 의한 치료반응과 혈장HVA 및 5-HIAA 농도와의 관계

김형섭,조숙행,강대엽,박성덕,김광현 용인정신의학연구소 1997 용인정신의학보 Vol.4 No.2

FCL(5-FU, Carboplatin, Leucovorin) 항암 화학요법에서 Gm-CSF의 효과

최지영,김현수,김종숙,박상준,윤환중,조덕연,남상륜,김삼용 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

Background: One of the major side effects of cancer chemotherapy is myelosuppression. Neutropenia and/or thrombocytopenia are dose-limiting factors in chemotherapy. Colony-stimulating factor induces proliferation and functional maturation of hematopoietic progenitor cells. GM-CSF is primarily active on progenitor cells of granulocytic and monocytic lineage. Methods: Fifteen patients with histologically proven malignancy diagnosed at Chungnam National University Hospital from January 1993 to August 1995 were included in this study. We could evaluate the clinical efficacy of GM-CSF in 13 patients undergoing FCL(5-FU, Carboplatin and Leucovorin) chemotherapy; the first cycles involved no GM-CSF while the second cycles involved GM-CSF on day 6 through 15 of chemotherapy. Results: 1) The subjects were fifteen patients in all, there were five patients with head and neck cancer, which was the most common types of maligancy. There were four patients with colon cancer, two patients with stomach cancer, and one patient with breast cancer, gallbladder cancer, cervix cancer and cholangiocarcinoma respectively, two patients, who did not complete two cycles of chemotherapy were excluded. 2) Age distribution was from 38 years to 78 years with a median age of 57. 3) In FCL chemotherapy cycles with GM-CSF, the duration of neutropenia(<500/μL) was 0.5±0.3 day, while FCL chemotherapy cycles without GM-CSF, it was 2.9±0.7 day(P=0.008). 3) There was no significant difference in platelet count between the two chemotherapy cycles(P=0.133). 4) Febrile duration without GM-CSF was 4.9±2.1 day, but with GM-CSF the duration was 1.3±0.7 day, which was significantly different(P=0.003). The duration of antibiotics use with GM-CSF was 1.7±1.2 day and without GM-CSF was 6.8±3.2 day, also significantly different(P=0.002). But hospital stay between the two cycles were not significantly different(P=0.064). Conclusion: GM-CSF was effective in preventing or restoring bone marrow depression after FCL chemotherapy.

Azathioprine에 반응을 보인 류마티양 관절염에 의한 경막염(Pachymeningitis)1예

배광봉,이정호,이정찬,곽상혁,강정현,김철희,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Rheumatoid arthritis frequently involves the cervical spine and may lead to neurologic impairement. However, direct involvement of CNS structures by inflammatory cells has been reported infrequently. The prevalence of this complication of rheumatoid arthritis is unknown. Inflammatory CNS involvement in rheumatoid arthritis reportedly occurs in the setting of longstanding, active, erosive articular disease and is accompanied by extracranial and extraspinal nodules and vasculitis. This is diagnosed by radiologic finding of CNS nodules or meningeal thickening and by biopsy or autopsy. Treatment with corticosteroid, cytotoxic agent or surgical decompression is helpful. But the majority of patients die within several months of onset of neurologic symptom. Recently, we experienced a case of pachymeningitis caused by rheumatoid arthritis, which resolved repeatedly with azathioprine treatment.

중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

건축물 전과정평가를 위한 건축 용도 및 구조형식별 주요 건축자재 물량 분석에 관한 연구

김현숙(Kim, Hyeon-suk),태성호(Tae, Sung-Ho),김현식(Kim, Hyeon-Sik),조강희(Jo, Kang-Hee) 대한건축학회 2021 대한건축학회 학술발표대회 논문집 Vol.41 No.1

간호정보 표준화를 위한 표준 간호서식 개발

박현애,조인숙,윤순자,한주랑,최원자,정연이,유경순,이영선,박정숙,김숙현,김경덕,근효근,Park, Hyeon-Ae,Jo, In-Suk,Yun, Sun-Ja,Han, Ju-Rang,Choe, Won-Ja,Jeong, Yeon-Lee,Yu, Gyeong-Sun,Lee, Yeong-Seon,Park, Jeong-Suk,Kim, Suk-Hyeon,Kim, Gyeon 대한간호협회 1999 대한간호 Vol.38 No.2

The Tight Upper Bound on the Offline Cop Number

Hyeon-Suk Na(나현숙),Yu-Seok Jo(조유석) 한국정보과학회 2013 정보과학회논문지 : 시스템 및 이론 Vol.40 No.4

지정된 경로를 따라 n×n 격자 그래프를 탐색하는 경찰들이 있다. 도둑은 이들의 경로를 미리 모두 알고 있지만, 경찰은 도둑의 위치에 대해 전혀 알지도 못하고, 경로를 수정할 수도 없다. 그러면 유한한 시간 내에 도둑을 잡기 위해서는 몇 명의 경찰이 필요할까? 이 숫자, 즉 도둑을 잡기위해 필요한 최소의 경찰수를 오프라인 경찰수 라고 한다. 오프라인 경찰수에 대해 알려진 자명한 상한은 n인데, 왜냐하면 n명의 경찰이 일렬횡대로 서서 격자그래프를 바닥부터 천장까지 탐색해간다면 도둑은 어떻게 해도 n 시간 내에 잡힐 수밖에 없기 때문이다. Brass et al. [1]은 교번모델 - 매시간 먼저 경찰이 최대 s(≥1)개의 간선을 이동한 후 도둑이 최대 한 개의 간선을 이동하는 모델 - 에 대해서, 도둑은 언제나 ?n/(s+1)? 명의 경찰을 피할 수 있으며, ?n/(s+1)?+1명의 경찰이 어떠한 도둑도 잡을 수 있도록 하는 탐색경로를 제시했다. 즉, 오프라인 경찰수의 하한이 ?n/(s+1)?+1이고 상한이 ?n/(s+1)?+1 임을 증명했다. 또한 s=1인 경우, ?n/2?+1명의 경찰이 도둑을 잡는 탐색경로를 제시함으로써, s=1인 교번모델의 오프라인 경찰수가 ?n/2?+1임을 보였다. 이 논문에서는 나머지 경우, 즉 s≥ 2인 교번모델에서, ?n/(s+1)?+1명의 경찰이 어떠한 도둑도 잡을 수 있도록 하는 탐색경로를 제시하여 오프라인 경찰수가 ?n/(s+1)?+1임을 보인다. Imagine that cops patrol the n×n grid on fixed routes. The robber has full knowledge of the cops’ routes in advance, but the cops know nothing of the robber’s position and cannot change their routes. Then how many cops are necessary to catch the robber in finite time? This number, the minimum number of cops needed to catch the robber is called the offline cop number. A trivial upper bound is n since n cops standing abreast and sweeping the grid from the bottom to the top will catch any smartest robber within n time in spite of knowing nothing of the robber’s position. In an alternating-move-model where at each time the cops first move (at most) s(≥1) edges at a time and then the robber moves at most one edge, Brass et al. [1] proved a lower bound of ?n/(s+1)?+1 and an upper bound of ?n/(s+1)?+1; they showed that a robber can always escape detection of ?n/(s+1)? cops indefinitely and provided a strategy for ?n/(s+1)?+1 cops to catch the robber. They closed the gap in the case where s=1, by giving a strategy for ?n/2?+1 cops to catch the robber. In this note, we close the gap for the other case where s≥ 2 by presenting a strategy for ?n/(s+1)?+1 cops to catch the robber.