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맹치훈,고영혜,임도훈,강은석,최준영,김원석,김석진 대한암학회 2017 Cancer Research and Treatment Vol.49 No.1
Purpose This retrospective study was conducted for comparison of survival outcomes and toxicities of autologous stem cell transplantation (ASCT) based on the use of total body irradiation (TBI) as a part of the conditioning regimen in patients with mature T- and natural killer (NK)- cell lymphomas. Materials and Methods Patients who underwent ASCT in the upfront or salvage setting between January 2000 and December 2013 were analyzed. Patients were dichotomized according to the TBI group (n=38) and non-TBI group (n=60) based on the type of conditioning regimen for ASCT. Results Patients with responsive disease underwent upfront ASCT (TBI, n=16; non-TBI, n=29) whereas patients with refractory disease (TBI, n=9; non-TBI, n=12) or relapsed disease (TBI, n=13; non-TBI, n=19) underwent ASCT after salvage treatment. Hematologic and non-hematologic toxicities were manageable, and the median cumulative toxicity score according to Seattle criteria was estimated as 2 (range, 0 to 7) in both groups. No significant difference in 100-day mortality was observed between the TBI (13%, 5/38) and non-TBI (12%, 12/60) groups, and most deaths were related to disease progression. There was no difference in overall and progression-free survival; however, the TBI group showed a trend of better survival in upfront and salvage ASCT than the non-TBI group. However, patients with refractory disease showed the worst outcome regardless of the use of TBI. Patients who showed complete response before ASCT showed better progression-free survival than those who showed partial response. Conclusion TBI could be used as an effective part of conditioning for ASCT in patients with mature T- and NK-cell lymphomas.
맹치훈,장재영,주광로,동석호,김효종,김병호,장영운,이정일,장린,김윤화 대한소화기내시경학회 2006 Clinical Endoscopy Vol.32 No.4
Hyperplasia of Brunner's glands is considered an uncommon finding; its wide range of morphological variation has led to confusing identifying terminology which includes: hyperplasia, adenoma, and hamartoma. Some investigators have suggested that hyperplasia of Brunner's glands is hamartomatous in nature, whereas others have favored a causative relationship that results from gastric acid hypersecretion. Although most commonly an incidental finding, that appears as multiple small submucosal sessile nodules, usually located in the duodenal bulb, it can lead to clinically significant symptoms including gastrointestinal bleeding, abdominal pain, and intestinal obstruction. Here, we report a case of hyperplasia of multiple cystic Brunner's glands on the duodenal bulb in a patient with acute pancreatitis; they were discovered incidentally on abdominal CT and duodenoscopy. This is the first report of hyperplasia of Brunner's glands with these morphological characteristics. (Korean J Gastrointest Endosc 2006;32:283-286) Brunner선 과다형성(hyperplasia)은 형태학적 다형성으로 인해 과다형성, 선종, 과오종 등 다양한 용어로 불리고 있는 십이지장의 드문 종양성 병변이다. 발생 원인은 위산의 과다분비 또는 과오종의 한 형태로 생각하고 있으며 대부분 무증상으로 우연히 발견되나 간혹 위장관 출혈, 복통, 장폐색 등 심각한 임상양상을 나타내기도 하고 주로 십이지장 구부에 호발하며 다발성의 점막하 결절이다. 본 증례는 급성췌장염 환자의 CT와 십이지장경에서 우연히 발견한 다발성 Brunner선 과다형성으로 이전의 보고와 다른 낭성 형태인 특이하고 매우 드문 예로서 문헌고찰과 함께 보고한다.
이윤규,맹치훈,김도연,김봉석 대한암학회 2020 Cancer Research and Treatment Vol.52 No.4
Purpose This study aimed to investigate the prevalence and risk factors of burnout and occupational stress among medical oncologists in Korea. Materials and Methods A survey was conducted of medical oncologists who were members of Korean Society for Medical Oncology (KSMO) using the Korean Occupational Stress Scale, the validated Maslach Burnout Inventory (MBI) and supplemental questions about work and lifestyle factors. Results Among 220 active KSMO members, 111 responses were collected. The median age was 42 years (range, 32 to 63 years). Two-thirds of responders worked 6 days per week and half of them worked a total of 60-80 hours per week. Each medical oncologist treated a median of 90-120 patients per week in outpatient clinics and 20-30 patients per week in patient practices. MBI subscales indicated a high level of emotional exhaustion in 74%, a high level of depersonalization in 86%, and a low level of personal accomplishment in 65%: 68% had professional burnout according to high emotional exhaustion and high depersonalization scores. The risk of burnout was higher for medical oncologists aged from 30-39 than 40-49 years, and unmarried than married. Considering personal accomplishment, females had a higher risk of burnout. The median score of occupational stress was 63 (range, 43 to 88). Having night-duty call was the strongest risk factor on more stress. A higher stress score was associated with a higher prevalence of burnout. Conclusion Burnout and occupational stress are quite common amongst Korean medical oncologists. Achieving a healthy work-life balance, ensuring balanced workload distribution, and engaging in proper stress relief solutions are necessary.
임상시험심사위원회(Institutional Review Board)의 임상시험에 대한 위험평가 분류조사연구
이선주,강수진,맹치훈,신유진,유소영,Lee, Sun Ju,Kang, Su Jin,Maeng, Chi Hoon,Shin, Yoo Jin,Yoo, Soyoung 대한기관윤리심의기구협의회 2022 대한기관윤리심의기구협의회지(JKIRB) Vol.4 No.2
Purpose: The purpose of this study is to evaluate how university hospital Institutional Review Boards (IRBs) in Korea classify risk when reviewing clinical trial protocols. Methods: IRB experts (IRB chairman, vice chairman, IRB administrator) in the university hospitals obtaining a Human research protection program (HRPP) or IRB accreditation in Korea were asked to fill out the Google Survey from September 1, 2020 to October 10, 2020. Result: Among the 23 responder hospitals, 8 were accredited by the American Association for Human Research Protection Program (AAHRPP) and 8 were accredited by the HRPP of Ministry of Food and Drug Safety (MFDS). Seven were accredited by Forum for Ethical Review Committees in Asia and the Western Pacific or Korea National Institution for Bioethics Policy. Thirteen of 23 hospitals (56.5%) had 4 levels (less than minimal, low, moderate, high risk), 4 hospitals had 3 levels (less than, slightly over, over than minimal risk), 1 hospital had 5 levels (4 levels plus required data safety monitoring board), and 1 hospital had 2 levels (less than, over than minimal risk) risk classification system. Thirteen of 23 hospitals (56.5%) had difficulty classifying the risk levels of research protocols. Fourteen hospitals (60.9%) responded that different standards among hospitals for risk level determination associated with clinical trials will affect the subject protection. Six hospitals (26.1%) responded that it will not. Three hospitals (13.0%) responded that it will affect the beginning of the clinical trial. To resolve differences in standards between hospitals, 14 hospitals (60.9%) responded that either the Korean Association of IRB or MFDS needs to provide a guideline for risk level determination in clinical trials: 5 hospitals (21.7%) responded education for IRB members and researchers is needed; 3 hospitals (13.0%) responded that difference among institutions needs to be acknowledged; and 1 hospital (4.3%) responded that there needs to be communication among IRB, investigator, and sponsor. Conclusion: After conducting a nationwide survey on how IRB in university hospital determines risk during review of clinical trials, it is reasonable to use 4-level risk classification (less than minimal, low, moderate, high risk); the most utilized method among hospitals. Moreover, personal information and conflict of interest associated with clinical trials have to be considered when reviewing clinical trial protocols.