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급성 골수성 백혈병에서 Adenosine deaminase 측정의 임상적 유용성
고광상,박정오,강성훈,김재석,박순철,서연실,김기헌,조무자 임상병리검사과학회 1999 임상병리검사과학회지 Vol.31 No.2
배경 : Adenosine deaminase(ADA) 는 adeno-sine을 inosine으로 deamination하는 반응을 촉매하는 효소로, 혈액 종양을 비롯한 결핵, 간 질환, 등의 다양한 질환에서 활성도가 증가하는 것으로 알려져 있으며, 여러 질환에서 연구가 이루어지고 있으나 측정의 기술적 어려움으로 이용이 확대되지 못하였다. 그러나 최근 고안된 자동 화학 분석기를 이용한 ADA 와 동위효소의 분별정량 방법으로 ADA 측정의 임상적 적용이 용이 해졌다. 저자들은 이 방법으로 혈장을 이용하여 AML에서의 ADA활성도와 동위효소의 분포양상의 특성과, 치료경과에 따른 변화를 관찰하여 AML에서 ADA측정의 임상적 유용성을 알아보고자 하였다. 방법 : AML 환자군 16 예와 정상 대조군 25 예의 혈장 ADA와 동위효소의 활성도를 측정 비교하고, 환자군중 10 예에서는 치료 후 1주 간격으로 최고 8 주까지 추적 관찰을 시행하였다. ADA측정은 자동화학 분석기로 발색 정량하고, 동위효소의 측정은 ADA_(1) 선택적 억제제인 EHNA를 첨가하여 ADA_(2)를 측정하는 방법을 이용하였다. 결과 : AML 환자 군 16명의 혈장 ADA 활성도는 34.0±20.8IU/L로 정상 대조군 25명의 혈장 ADA 활성도 14.28±3.26IU/L에 비해 유의하게 높았다. 정상 대조군에서는 ADA2 가 75.0%로 우세한 것에 비해 AML군에서는 ADA_(1)이 62.5%로 우세하였고, ADA_(1)은 모두 정상대조군보다 높은 값을 보였다 . AML 환자 군 중 추적 검사를 시행하였던 10 예 (완전관해 5예 , 불완전관해 5예)에서 ADA 값과 ADA1이 10예 모두에서 4주 안에(평균 2.8주) 정상범위로 감소하였고, 5 예에서 ADA활성도가 정상범위로 감소한 후 1 주 후까지 ADA_(1)활성도가 정상범위 이상으로 지속되었다. 결론 : AML의 진단과 경과 추적에 혈장에서 측정한 ADA활성도와 동위효소 분포 양상을 이용할 수 있으며, 특히 ADA_(1)이 total ADA나 ADA_(2)보다 더 유용함을 알 수 있었다. ADA 활성도는 치료 후 관해여부와 관계없이 세포수가 감소함에 따라 모두 감소하므로 관해 여부를 예측 할 수는 없으나, 재발을 검출할 목적으로 이용할 수 있으며, 이때는 ADA 활성도가 모두 정상범위로 감소하는 치료 후 4 주 이후부터 검사하는 것이 효율적이라고 생각된다. Adenosine deaminase(ADA) activiteis in sera are increased in various disease such as hematologic malignancies, tuberculosis, and liver diseases. To evaluate the clinical value of measuring ADA and its isoenzyme activites in plasma with the automated assay in acute myeloid leukemia, we compared ADA and its isoenzyme activities in normal control group with those in acute myeloid leukemia group, and followed up those during chemotherapy in AML group. The measurements of plasma ADA and its enzymes, especially ADA_(1) were useful for AML diagnosis. But they were not valuable markers to discriminate between complete remission and incomplete remission. For the detection of relapse, it could be valuable to measure ADA activities beyond 4 weeks after chemotherapy.
태영숙,강은실,이명화,박금자 고신대학교 전인간호과학연구소 2002 전인간호과학연구 학술모음집 Vol.- No.-
The Relationship among Percieved Social Support, Hope and Quality of Life of Cancer Patients Tae, Young Sook. Kong, Eun Sil. Lee, Myung Hwa. Park, Geum Ja The purpose of this study was to investigate the relationship among percieved social support, hope and Quality of life of the cancer patients and to gain the baseline data for development of nursing intervention program for promoting quality of life in cancer patients. The design of this study was a cross sectional correlational survey. The subjects were 220 out and in-cancer patients in 5 general hospitals in Pusan The data were collected from July 2 to August 1,2001. The instruments were the Percieved social support scale(16 items, 5 point scale) had developed by Tae(1986), Hope scale(12 items, 4point scale) developed by Nowotny(1989) and Quality of life scale(31 items, 10 point scale) developed by Tae et. al(2000). The data was analyzed by the SPSS/PC+ program using frequency & percentage, item mean & standard deviation, t-test, ANOVA & Scheffe test, Pearson's correlation coefficient. The results of this study was as follows : 1) The item mean score of quality of life was 6.05±1.16 (range 0-10) .The heighest score of subarea of the quality of life was the spiritual wellbeing area (7.09±1.63) and the lowest score was social wellbeing area(5.53±1.65). The mean score of perceived social support was 52.65±10.32 (최고 1, 최저 80). The mean score of family support was32.71±6.66 (range 1- 40) and the mean score of medical team support was 19.93±5.95 (range 1- 40). The mean score of Hope was 37.02±5.64 (range 1-48). 2) There were statistically significant difference in the score of quality of life according to the life effect of religion (F=3.97, p=0.00), treatment method(F=2.94, p=0.01), area of diagnosis (F=3.48, p=0.01), stage of disease (F=13.74, p= 0.00). 3) There was significant correlation between perceived social support(r=0.44, p= 0.000 ; family support: r=0.334, p=0.000, medical support; r=0.395, p=0.000), hope(r=0.563, p= 0.000) and quality of life. In conclusion, there was a significant relationship among perceived social support, hope and quality of life. Therefore perceived social support, hope intervention programs should be developed to improve the quality of life in cancer patients.
박자실 ( Ja Sil Park ),민창우 ( Chang Woo Min ),김아영 ( Ah Young Kim ),이은미 ( Eun Mi Lee ),이은주 ( Eun Joo Lee ),강경구 ( Kyung Ku Kang ),김상협 ( Sang Hyeob Kim ),이명미 ( Myeong Mi Lee ),성수은 ( Soo Eun Sung ),황미열 ( Meey 한국동물위생학회 2015 韓國家畜衛生學會誌 Vol.38 No.3
An 8-year old intact female poodle was presented to clinics due to abdominal distension, anorexia, and labored breath associated with pleural effusion. Intra-operative findings revealed multiple neoplasm of the greater omentum, involving anterolateral abdominal wall, sterna surface in the pleural cavity and diaphragm. These masses were 0.1∼0.5 cm in diameter and extended to ovaries, pancreas, and serosal surface of stomach. Microscopically, most neoplastic cells had oval nuclei with prominent nucleoli and abundant eosinophilic cytoplasm. In deeper area, neoplastic acinus or glandular structures showed invaginated growth resembling adenocarcinoma. High mitotic figures were observed. By immunohistochemistry, the neoplastic cells were strong positive both cytokeratin and vimentin. The present case described for malignant mesothelioma in a dog. Our findings might be helpful for diagnosis and information and helped the clinics choose the treatment including chemotherapy such as cisplatin.
카드뮴 중독과 연관된 성인형 Fanconi 증후군 1 예
박수현,한진석,구자룡,남은숙,여미애,곽성재,채동완,김근호,박규용,노정우,김형직,전로원,김현태,전은실 대한내과학회 2001 대한내과학회지 Vol.61 No.3
Adult Fanconi syndrome is a very rare disease characterized by renal glycosuria, generalized aminoaciduria, hypophosphatemia, hypouricemia and proximal renal tubular acidosis. It is divided into inherited and acquired forms. Proximal tubular transport defect in acquired Fanconi syndrome has been known to be resulted from multiple myeloma, dysproteinemias, heavy metal poisoning and chemical intoxications. A 50-year-old woman was admitted because of nausea for 2 weeks and body weight loss for 4 months. Leukocyte count, hemoglobin level and platelet count were 7,870/mm3, 11.7 g/dL 404,000/mm3 each. The urinalysis showed pH of 7.0, 3 positive for glucose and 3 positive for protein. The serum calcium, phosphate, uric acid and potassium were low to 8.9 mg/dL, 1.0 mg/dL, and 1.7 mEq/L. Serum creatinine level was 1.3mg/dL. The arterial blood gas analysis showed that the pH was 7.292 and bicarbonate was 14.7 mmol/L. Determination of amino acids in 24 hour urine specimen revealed the generalized aminoaciduria. Renal biopsy showed degeneration and necrosis of proximal tubules with normal glomeruli. Some tubular epithelial cells had enlarged nuclei and prominant nucleoli with vacuolated large mitochondrias. Cadmium concentrations of blood and urine were definitely higher than normal. The concentration of β2-microglobulin in urine was also high. Bicarbonate loading tests showed increased fractional excretions of bicarbonate in urine (6.129% at blood pH 7.248 and plasma HCO3 18.8 mEq/L, 13.7% at blood pH 7.315 and plasma HCO3 21.8 mEq/L). 24 hour urine protein electrophoresis showed no monoclonal gammopathy. This case of adult Fanconi syndrome was regarded to be related with cadmium intoxication. But no case of adult Fanconi syndrome related with cadmium toxicity has been reported yet in Korea. So authors report this case with brief review of literatures. (Korean J Med 61:276-280, 2001)
Park, Jin Hyun,Im, Seock-Ah,Byun, Ja Min,Kim, Ki Hwan,Kim, Jin-Soo,Choi, In Sil,Kim, Hee-Jun,Lee, Kyung-Hun,Kim, Tae-Yong,Han, Sae-Won,Oh, Do Youn,Kim, Tae-You 한국유방암학회 2017 Journal of breast cancer Vol.20 No.4
<P><B>Purpose</B></P><P>This study aimed to evaluate the efficacy and safety of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) chemotherapy beyond standard treatment for anthracycline- and taxane-pretreated metastatic breast cancer (MBC).</P><P><B>Methods</B></P><P>We consecutively enrolled 158 MBC patients who underwent CMF chemotherapy in a palliative setting at two academic hospitals in Korea between 2002 and 2016.</P><P><B>Results</B></P><P>The median age of the 158 enrolled patients was 51 years (range, 30–77 years). The enrolled patients were treated with a median of 5 lines of systemic treatment (range, 2–11) before CMF therapy, and the median time from diagnosis of MBC to CMF administration was 36.0 months (range, 7.1–146.7 months). The median number of cycles of CMF treatment was 3 (range, 1–19), and the relative dose intensity was 90.4%. The toxicity profile was mild, with an observed 3.1% of grade 2 and 5.0% of grade 3/4 neutropenia. Among 147 patients (93.0%) whose response to CMF was evaluated, the response rate was 10.9% (16/147), with complete response (CR) in one and partial response (PR) in 15. In addition, the disease control rate (calculated as CR+PR+stable disease) was 44.2% (65/147). The median progression-free survival and overall survival were 3.1 months (95% confidence interval [CI], 2.7–3.6) and 9.4 months (95% CI, 7.1–11.6), respectively.</P><P><B>Conclusion</B></P><P>CMF therapy is effective and tolerable as salvage treatment for heavily pretreated MBC.</P>