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( Yoon Goo Kang ),( Sung Bae Cho ),( Jae Seung Yun ),( Ki Dong Yoo ),( Yong Moon Park ),( Seung Hyun Ko ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Objective: The aim of this study was to investigate the development of severe hypoglycemia (SH) in the presence of cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes. Research Design and Methods: From January 2001 to December 2002, a total of 894 patients with type 2 diabetes were enrolled. A cardiovascular autonomic function test (AFT) was performed using heart rate variability parameters: expiration-to-inspiration ratio, response to Valsalva maneuver and standing. From the results of the each three test (0 for normal, 1 for abnormal), a total AFT score of 1 was defined as early CAN, and a AFT score of ≥ 2 was defined as definite CAN. Results: The median follow-up time was 9.5 years. The mean age was 54.5±10.1 years and the duration of diabetes was 8.9±6.3 years. One hundred and ninety-six (31.4%) patients showed an abnormal cardiovascular AFT score at baseline. Sixty-two (9.9%) patients experienced 77 episodes of SH (1.33 per 100 patient-years). The events of SH increased as the CAN score increased (23 (5.4%) patients with normal, 17 (17.2%) patients with early, and 22 (22.7%) patients with definite CAN; P for trends <0.001). Cox proportional hazard regression analysis revealed that SH was associated with definite CAN (normal vs. definite CAN, HR 2.43, 95% CI 1.21-4.84; p=0.012). Conclusions: Definite CAN was an independent prognostic factor for the development of SH in patients with type 2 diabetes.
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방수미,EunKyungCho,CheolwonSuh,Sung-SooYoon,ChuMyungSeong,KyungSamCho,YoonGooKang,SeonyangPark,Myung-JuAhn,YoungSukPark,DoyeunOh,정철원,SamyongKim 대한의학회 2003 Journal of Korean medical science Vol.18 No.5
We conducted a phase II multicenter trial to estimate the response and survival of patients with newly diagnosed multiple myeloma to high dose melphalan therapy followed by autologous peripheral blood stem cell transplantation. Eligible patients who had undergone induction with vincristine, adriamycin and dexamethasone (VAD) should have adequate cardiac, pulmonary and renal function (creatinine <2 mg/dL). Melphalan at 200 mg/m2 was used as a conditioning regimen. Eighty patients were enrolled from 13 centers. The median age of the patients was 53 yr (range; 20 to 68 yr). The initial stage was IA/IIA/IIB/IIIA/IIIB in 3/8/1/54/14 patients, respectively. Beta2-microglobulin, CRP and LDH were increased in 74, 42 and 34% of the patients examined. Cytogenetic data were available in 30 patients, and 6 patients showed numeric or structural abnormalities. Two therapy-related mortalities occurred from infection. Among the 78 evaluable patients, CR/PR/MR/NC/PD were achieved in 48/26/2/1/1patients, respectively. After a median follow-up of 30 months, the median overall and event-free survivals were 66 months (95% CI: 20-112) and 24 months (95% CI: 18-29), respectively. This study verifies the efficacy and feasibility of high dose melphalan therapy with autologous stem cell transplantation in newly diagnosed multiple myeloma.
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