진행성 악성종양환자에서 항암화학요법으로 인한 호중구소증에 대한 재조합 인 과립구 - 대식세포 콜로니 자극인자 ( rhGM - CSF ) 의 임상효과

송홍석(Hong Suck Song),정강호(Gang Ho Jeong),이춘식(Chun Sik Lee) 대한내과학회 1996 대한내과학회지 Vol.50 No.4

N/A Objectives: The aim of this study was to evaluate the efficacy and toxicity of remombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF, Leukogen®) in ameliorating hematopoietic suppression in patients with uarious malignancies undergoing myelotoxic combination chemotherapy. Methods: The efficacy of recombinant human GM-CSF was evaluated in 23 patients with various solid tumor and lymphoid malignancy in Keimyung University, Dongsan Medical Hospital during the period of March, 1994 to October, 1994. RhGM-CSF was started after 24 hours after 2nd chemotherapy at a dose of 250μg/m2/day subcutaneously for 10 days. The efficacy and toxicity of GM-CSF were evaluated according to the hematologic and laboratory changes between control and GM-CSF treatment period. Results: 1) Total number of enrolled patients were 23; 15 patients with lung cancer, 2 patients with breast cancer, 2 patients with stomach cancer and 1 patient with Ewing's sarcoma, soft tissue sarcoma, thymoma and Non-Hodgkin's lymphoma respectively. 2) The mean age was 51 and male was 16 patients. 3) The nadir count of leukocyte and neutrophil were significantly increased in GM-CSF treatment period, however that of platelet in GM-CSF treatment period were similar to control period. 4) The mean duration of WBC counts less than 4,000/μL, 2,000/μL and that of neutrophil counts less than 2,000/μL, 1,000/μL and 500/μL were significantly shortened in GM-CSF treatment period. 5) The recovery time of leukocyte from nadir to over 2,000/μL, and of neutrophils from nadir to over 2,000/μL, 1,000/μL were significantly reduced in GM-CSF treatment period. 6) The days of hospitalization due to infection was significantly reduced in GM-CSF treatment period. Days with termperature exceeding 38.5℃ and days of treatment with parenteral antibiotics were decreased in the CM-CSF treatment period, but not significant to control period. 7) Adverse reactions with rhGM-CSF were observed in 11 patients(48%) which were not life threatening, and rapidly reversible. They included myalgia in 7 patients, fever in 6 patients, abdominal pain in 3 patients, dyspnea in 3 patients, vomiting in 2 patients, and bone pain, fatigue and diarrhea in 1 patient respectively. Conclusion: RhGM-CSF significantly elevated the nadir counts of leukocytes and neutrpphils, shortened the duration and the recovery time from neutropenia. We concluded that it was useful and effective for the treatment of neutropenia induced by myelotoxic chemotherapy in patients with various advanced malignancy.

소세포폐암에서 CAV / PE 교대복합화학요법의 치료효과

송홍석(Hong Suck Song),정강호(Gang Ho Jung),전영준(Young June Jeon) 대한내과학회 1995 대한내과학회지 Vol.49 No.6

N/A Objectives: The aim of this study was to evaluate the efficacy and toxicity of the 3 weekly alternating chemotherapy in previously untreated small cell lung carcinoma. Methods: Thirty-nine patients with SCLC treated with 6 alternating cycles of cyclophophamide/adriamycin/vincristinre(CAV) and cisplatin/ etoposide(PE). Thoracic irradiation and prophylactic cranial irradiation was administered 3 weeks after completion of chemotherapy to limited stage patients who attained a complete response(CR). Results: Thirty-one patients were evaluable. Overall response rate was 77,4% with 25.8% of CR. The response rate was 88.2%(29.4% CR) in patients with limited stage and 64.3%(21,4F% CR) in patients with extensive stage. and 82.4%(35.3% CR) in younger than 60-years and 71.4%(14,3% CR) in over 60-years. There were no significant difference in neither age or stage. The median survival duration was 18.5 months and the 1-year 3-year 5-year 7-year survival rate were 63.3% 14.1%, 10.6%, 10.6%, respectively. And the 3-year survival rate were significantly different according to response(57.1% in CR; 0% in PR, p<0.025), age(27.3% in age<60; O% in age>60, p<0.005), and stage (19.2% in LS; 7.7% in ES, p<0.005). Conclusion: This results suggest CAV/PE alternating chemotherapy is useful as a front-line treatment of small cell lung carcinoma, but is not superior to conventional treatment.

유전성 구상적혈구증의 임상적 고찰

송홍석(Hong Suck Song),조진환(Jin Whan Cho),곽동협(Dong Hyeop Kwak),강영우(Young Woo Kang) 대한내과학회 1987 대한내과학회지 Vol.32 No.4

N/A The authors reviewed the Kortean Literature extensively in search of hereditary spherocytosis, and find 46 patients and 22 analyzable family members. Then, a clinical study was carried out retrospectively on 73 patients with hereditary spherocytosis including 5 patients from the Dongsan hospital, Keimyung University, The result of the this study were as follows: Male to female ratio was 1:1.2 with slight female predominance and the age distribution was between 3 month and 53 years with mean age of 16.9 years. Family history was present in 54.3%. The age of onset in 53 symptomatic patients was below 1 year in 12 cases, 1-10 years in 29 cases, over 10 years in 12 cases, and the duration of symptams were below l year in 13 cases, 1-10 years in 25 cases and over 10 years in 15 cases. Pallor and jaundice were the most frequent complaint (29 cases: 41.4%). Abdominal mass was observed in 13 cases (18.6%), general weakness in 12 cases (17.1%), dizziness in 11 cases (15.7%), abdominal pain in 8 cases (11.4%), anorexia in 4 cases (5.7%) in order of frequency, and the subjective symptom was absent in 14 cases (20%). Physical findings revealed pallor in 78.5%, jaundice in 73.4%, splenomegaly in 89.4%, hepatomegaly in 68.9%, cardiac murmur in 50%, growth retardation in 11.5%, and the spleen was enlarged below the left costal margin with mean size of 6.2±4.1 cm and the liver was enlarged below the right costal margin with mean size of 3.5±1.9 cm, Laboratory findings revealed anemin (Hb<12 gm/dl) in 91,8% with mean of 8.4±2.5 (range: 3.9±14.5) gm/dl, reticulocytosis in 93,3% with mean of 9,6+11.9 (range: 0. 1 76.0)%, and hyperbilirubinemia in 93 with mean of 4.0±3.9 (range: 0.6-27.4) mg/dl. Mean corpuscular volume was increased in 20%, normal in 70%, and decreased in 14% with mean of 92.7±13.8 (range: 68-144) fl, and mean corpuscular hemoglobin concentration was in- creased in 16%, normal in 58%, and decreased in 26% with mean of 32.8±2.9 (range: 25.7-40.0) pg. In osmotic fragility test, initial concentration of hemolysis above 0.51% was 54 cases (94.7%) with mean of 0.66±0.11 (range: 0.38-0.90)%. Splenectomy was performed in 38 cases and the aver- age weight of the spleen was 633±389 (range: 150-1.500) gm, and the accessory spleen was found in 10 cases (26.3%). There was no significant difference between male and female, and also present and absent family history groups, but statistically significant correlation was found between spleen size and hemoglobin, spleen size and MCV, liver size and MCV, negatively, and MCHC and initial concentration of osmotic fragility test positively (p<0.01).

제한병기 소세포성 폐암에서 복합화학요법과 방사선요법의 병용요법시 유발되는 백혈구감소증에 대한 Gracin ( rhG - CSF ) 의 임상효과

정강호(Gang Ho Jeong),송홍석(Hong Suck Song) 대한내과학회 1995 대한내과학회지 Vol.49 No.5

N/A Objectives: The aim of this study was to evaluate the efficacy of recombinant human gra- nulocyte colony stimulating factor(rhG-CSF; Gracin®) in ameliorating hematopoietic suppression in patients with limited stage small cell lung carcinoma undergoing induction therapy with cisplatin/etoposide and concurrent hyperfaractionated split-course thoracic radiotherapy. Methods: Twenty-one patients with limited stage small cell lung carcinoma received cisplatin 25mg/m(2)+ etoposide 120mg/m(2) on day 1,2, and 3. Courses repeated every 4weeks for a total of 4courses. Thoracic irradiation 60Gy in 25twice-daily fraction of 120cGy separated by at least 6hours, 5days/week, beginning on day 1 of course 1 of chemotherapy with an approximately 2week break after the first 28.8Gy such that radiotherapy was resumed approximately 4weeks after the 1st course of concurrent chemotherapy, rhG-CSF was started on day 4 of 1st or 2nd chemotherapy at a does of 75㎍/day subcutaneously for 14days. A concurrent chemoradiotherapy course without G-CSF was a control period and another course with G-CSF was a evaluation period. The efficacy and toxicity of G-CSF was evaluated according to the laboratory and hematologic changes betwen control and G-CSF treatment period. Results: 1) Total number of enrolled patients were 21with mean age of 59.5±5.0years. 2) The nadir count of leukocyte was significantly increased in G-CSF treatment period (control 1,665.7 877.0/μL vs G-CSF 2,459.5±1,120.5/μL, p=0.001). 3) The nadir count of neutrophil was also significantly increased in G-CSF treatment period(922.4±658.0/μL vs 1,495.2±829.2/μL, p=0.003). 4) The duration of leukopenia and neutropenia were significantly shortened in G-CSF treatment period compare to control period(p<0.001). 5) The recovery time of leukocyte from nadir to over 4,000/μL(11.1±6.7 vs 2.3±2.3 days, p<0.001), and of neutrophil from nadir to over 2,000/μL(9.1±7.2 vs 1.2±1.6 days, p<0,001) were significantly reduced in the G-CSF treatment period. 6) Side effects of G-CSF were skin rash in 2patients and mild fever, myalgia and bone pain in one patient, respectively which was spontaneously subsided without specific treatment. 7) The infection was observed in 3patients in control period, but no episode of infection was observerd in G-CSF treatment period, and the total numbers of days of treatment with intravenous antibiotics were significatly lower in G-CSF treatment period compare to control period, Conclusion: This results suggest rhG-CSF is effective and useful for the treatment of neutropenia induced by concurrent chemo-radiotherapy in patients with limited stage small cell lung carcinoma.

증례 : 복부대동맥류 및 발생동맥협착을 동반한 Behcet`s syndrome 1 예

박승국 ( Seung Kook Park ),송홍석 ( Hong Suck Song ),이인규 ( In Gyu Lee ),김병준 ( Byeang Jung Kim ),박성배 ( Seong Bae Park ),서정규 ( Chung Kyu Suh ) 대한내과학회 1985 대한내과학회지 Vol.28 No.1

위장관림프종의 임상적 고찰

천종욱(Jong Wook Cheon),송홍석(Hong Suck Song),김인호(In Ho Kim) 대한내과학회 1988 대한내과학회지 Vol.34 No.5

N/A A retrospective review is presented for 45 previously untreated patients with gastrointestinal lymphoma between January 1972 through September 1987 at the Keimyung University. The mean age was 42.3 years with a male to female ratio of 2.2:1. On admission abdominal pain was the most frequent symptom in 23cases (51.1%) and abdominal mass, fever, weight loss, epigastric pain, diarrhea, general weakness, anorexia were commonly presented. Physical findings revealed abdominal mass in 21cases (46.7%), peripheral lymph node enlargement in 15cases (33.3%) with cervical inguinal axillary in order of frequency. Hepatomegaly was observed in 9cases, ascites in 5cases, pleural effusion in 4cases, intestinal intussusception in 4cases, intestinal perforation in 3cases and intestinal obstruction in 2cases. Gastrointestinal involvement was as follows: small intestine in 24cases, large intestine in 12casese, stomach in 11cases, cecum in 10cases, rectum in 2cases, appendix in 12cases and duodenum in 1case. Laboratory findings revealed anemia in 37,8~%, leukopenin in 8,9%, leukocytosis in 20.0%, lymphopenia in 28.9%, thrombocytopenia in 15.4%, hypoproteinemia in 24.4%, hypoalbuminemia in 57.8%, azotemia in 20.9%, increased alkaline phosphatase in 11.9% and increased SGPT in 16.7%. Histologic classification revealed Hodgkin`s disease in 3cases of all lymphocyte depletion type, non-Hodgkin`s lymphoma in 41cases with 25cases of histiocytic type, 6cases of mixed & poorly differentiated lymphocytic type respectively, and 4cases of well-differentiated lymphocytic type. By Ann Arbor staging, stage I was 6cases (13.3%), stage II 15cases (33.3%), stage III 2cases (4.4%) and stage IV 22cases (48,9%), and B symptom was associated in 24cases (53.3%), Treatment was performed as follows: Radical resection in 18cases, radiotherapy in 2cases, combination chemotherapy in 19cases, combined modality therapy in 2cases, and complete remission was obtained in 12cases (52,2%) among evaluable 23cases. Five year survival rate of 23 treated patients was 60% with statistically very significance between complete remission and partial or no remission group (P<0.005), and no statistical significance between stage A and stage B, loco-regional ~(stage I+II) and advanced stage (stage III+IV).

전산화뇌단층촬영을 이용한 뇌졸중의 임상적 고찰

박영춘 ( Young Choon Park ),박기환 ( Ki Hwan Park ),권기영 ( Ki Yung Kwon ),송홍석 ( Hong Suck Song ),김권배 ( Kwon Bae Kim ) 대한내과학회 1982 대한내과학회지 Vol.25 No.12

악성환자에서 혈청 동의 동태에 관한 연구

전재훈(Jae Hoon Jeon),전영준(Young June Jeon),송홍석(Hong Suck Song) 대한내과학회 1990 대한내과학회지 Vol.39 No.1

N/A Serum copper levels have been found to be elevated in the presence of certain neoplastic process such as leukemia, Hodgkin's disease, malignant lymphoma, sarcoma, lung cancer, cervical cancer, and carcinoma of the digestive tract. It was found to be of great value in assessing the disease activity, prognosis, and therapy in these patients. From November 1987 to March 1989, the serum copper levels were checked by a plasma scanner of Labtann in previously untreated, pathologically confirmed cancer patients; stomach cancer in 73, hepatoma in seven, colorectal cancer in 12, esophageal cancer in four, lung cancer in 38, leukemia in nine, non-Hodgkin's lymphoma in 13, and normal control in 161. 1) In the normal controls, seurm copper levels were not different betwen sexes but significantly higher values were found in those in their, 50's (90.9±64.8 μg/ml) than in those in their 40's (66.6±22.0 μg/ml) (p<0.01) and 30's (66.0±35.4 μg/ml) (p<0.025). 2) Mean serum copper levels showed significantly higher values in stomach cancer (108.8±45.9 μg/ml), colorectal cancer (125.5±50.6 μg/ml), lung cancer (141.4±68.9 μg/ml), leukemia (133.5±71.5 μg/ml), Non-Hodgkin's lymphoma (147.0±48.5μg/ml) (p<0.0005), and in hepatoma (114.7±63.6 μg/ml) and esophageal cancer (122.0±34.5 μg/ml) (p<0.025) than that of nor mal control (75.4±46.3 μg/ml). 3) In stomach cancer the mean serum copper level differed significantly between stage IA vs. IIIA, stage II vs. IIIB(p<0.05). and stage II vs. IIIA and IU(p<0.025), but its difference was not related to the status of lymph node or distant metastasis, and there were no significant differences between pre-and post-operative values (98.0 vs. 119.2 μg ml) in curatively resected patients. 4) In lung cancer, serum copper level was not different between small cell carcinoma (161.7±84.2 μg/ml) and non-smal cell carcinoma (13.1±63.8 μg/ml), stage IIIA (128.1±70.7 μg/ml), stage IIIB (140.1±72.8 μg/ml) and stage IV (146.3±74.7 μg/ml). These data suggest that serum copper levels can be an useful parameter in assessing various malignancies, but there was no clinical significance to predict prognosis and response to therapy.

장티푸스와 파라티푸스 30 예에 대한 임상적 고찰 및 Thiamphenicol 의 치료효과

박창호(Chang Ho Park),김종서(Zong Suh Kim),남상숭(Sang Soong Nam),기세길(Se Kil Kee),윤덕구(Duk Koo Yun),송홍석(Hong Suck Song) 대한내과학회 1986 대한내과학회지 Vol.31 No.1

N/A We reviewed 30 cases of bacteriologically con- firmed salmonellosis which performed hone marrow culture from March I984 to August 1985 at the Keimyung University. The results of study were as follows: Among 30 cases, paratyphoid A was 13 cases and group D typhoid fever was 17 case. Age distribution was from 16 to 63 years and most frequent in 2nd decade. Male to female ratio was 1: 3.3 in group A and 1: 1.4 in group D with female predominance. Clinical symptoms were fever, chill, general weakness, headache, anorexia, eneral ache in order of frequency and there was no difference in both group. Physical findings revealed abdominal tenderness in 14 cases(47%) and most common in right lower quadrant area. Splenomegaly was 3 cases(10%) and hepatomegaly was 4 cases(13%). Laboratory findings revealed anemia in 13%, leukopenia in 30%, thrombocytopenis in 10%, positive stool occult blood in 27%, proteinuria in 33% and hypoalbuminemia in 20%. Increased alkaline phosphatase was 20%, increased was 73%, increased SGPT was 80% and positive SGOT widal test above 1: 160 titer was 43%. With blood culture 73% was isolated, 20% with stool culture, 0% with urine culture, 77% with bone marrow culture and 20% isolated with bone marinrow culture only. Mean duration of defervescence was 4.1 days in chloramphenicol-treated group and 5.5 days in thiamphenicol-treated group. Neutropenia after drug therapy was occurred 62% in CP-treated group and 67% in TP-treated group. Complications occurred in 5 cases of typhoid fever: Intestinal hemorrhage in 2 cases and intestinal perforation, pleurisy, 1st degree AU block in 1 case respectively.

원발성 기관지 반지세포암

최원일 ( Won Il Choi ),손정호 ( Jeong Ho Sohn ),권오영 ( Oh Young Kwon ),허정숙 ( Jeong Suk Hur ),황재석 ( Jae Seok Hwang ),한승범 ( Seong Beom Han ),송홍석 ( Song Suck Song ),전영준 ( Young June Jeon ),권건영 ( Kun Young Kwon 대한결핵 및 호흡기학회 1994 Tuberculosis and Respiratory Diseases Vol.41 No.5