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김우성(Woo Sung Kim),정희순(Hee Soon Chung),김영환(Young Whan Kim),방영주(Yung Jue Bang),한성구(Sung Koo Han),심영수(Young Soo Shim),김노경(Noe Kyeong Kim),김건열(Keun Youl Kim),한용철(Yong Chul Han) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A To determine the role of bronchoscopy (FOB) in restaging of small cell lung cancer (SCLC) after at least 6 cycles of chemotherapy, we performed a prospective study from 1986 to 1988 in Seoul National University Hospital. Restaging was done 42 times in 38 patients with SCLC who showed no evidence of disease on chest X-ray. The results were as follows: 1) Of the 29 cases in whom FOB was done at the time of initial diagnosis, histologic or cytologic diagnosis of SCLC was made in 26cases(89.7%). 2) On restaging FOB, 18 cases showed a gross appearance suggestive of remnant tumor (mass or infiltration), of whom either bronchoscopic biopsy or cytology was positive in 8 cases (44.4%). Of the 24 cases without gross evidence of tumor, bronchoscopic biopsy or cytology at the original tumor site was positive in 2 cases(8.3%). 3) Retreatment was planned in 22 cases according to the results of restaging procedures, Of these 22 cases, 14 cases (67.6%) showed evidence of remnant tumor on restaging FOB, including 4cases in which remnant disease was detected only by FOB. In conclusion, FOB is mandatory in restaging of SCLC, and bronchoscopic biopsy and/or cytology should be done even if the gross appearance shows normal or only fibrotic changes. Also it is thought that bronchoscopic evaluation at the time of initial diagnosis is helpful for comparison on restaging.
김효진(Hyo Jin Kim),정만표(Man Pyo Jeong),허대석(Dae Seog Heo),방영주(Yung Jue Bang),한성구(Sung Koo Han),심영수(Young Soo Shin),김노경(Noe Kyeong Kim),김건열(Keun Youl Kim),한용철(Young Chol Han),김주현(Joo Hyun Kim),박찬일(Charn Il 대한내과학회 1994 대한내과학회지 Vol.46 No.2
N/A Background: This study was performed to find out the natural history of lung cancer in Korea. Method: Week studied retrospectively 764 patients with pathologically proven lung cancer from January 1980 to December 1984. We analysed the age and sex distribution, initial symptoms before diagnosis, first method yielding histologic diagnosis, cell types of lung cancer, initial stage of lung cancer, schema of overall patients, and survival of lung cancer patients. Result: 1) The overall male to female ratio was 4.7:1, and the age distribution ranged from 21 to 82 years, and the median age of overall patients was 58 years. 2) Histologic classification revealed that the most prevalent type was squamous cell carcinoma (375 cases, 49.1%), followed by small cell carcinama (189 cases, 24.7%), adenocarcinoma (134 cases, 17.5%), and large cell carcinoma (44 cases, 5.8%). 3) In non-small cell lung cancer 88% were stage III, therefore curative operation was done in only 8% of all cases, but in small cell lung cancer 66% were limited disease. 4) Median survival of overall patients was 5.8 months. 5) There was quite difference in survival between stage. In non-small cell long cancer, median survival of stage I was 41 months, median survival of stage II was 13 months and median survival of stage III was 5 months. In small cell lung cancer, median survival of limited disease was 10.4 months and median survival of extended disease was 2.8 months. Conclusion: The prognosis of patients with lung cancer was very grave. In order to increase the survival rate of lung cancer, earlier diagnosis of lung cancer is urgently needed.
김호중(Ho Joong Kim),최형석(Hyung Suk Choi),심태선(Tae Sun Shim),이혁표(Hyeok Pyo Lee),김영환(Young Whan Kim),허대석(Dae Seog Heo),한성구(Sung Koo Han),심영수(Young Soo Shim),김노경(Noe Kyeong Kim),김건열(Keun Youl Kim),한용철(Yong C 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A Pulmonary toxicity is a potentially fatal complication of bleomycin, one of the well-known anti-cancer chemotherapeutics. The incidence of bleomyicn-induced pulmonary toxicity was reported as 2-40% and fatality, 1-2%. Bleomycin-induced pulmonary toxicity is sometimes progressive even after discontinuation of the drug, but there has been no specific treatment modalities other than prevention, Forced vital capacity (FVC) and carbon monoxide diffusing capacity (DLco) have been proposed as parameters valuable in predicting subclinical bleomycin-induced pulmonary toxicity, but there are still conflicting results. To discover the predicting factors for bleomycin-induced pulmonary toxicity, 15 patients treated with 6 cycles of cyclophophamide, vinblastine, prednisolone, bleomycin, adriamycin and procarbazine (COPBLAM- III) for non-Hodgkin's lymphoma at Seoul National University Hospital between March 1989 and March 1990 were studied prospectively. Routine physical examination, complete blood count, chest X-ray and pulmonary function test including DLco were done at initial diagnosis, then every 2 cycles and at restaging, and 1 month after the last treatment. The results were as follows: 1) Carbon monoxide diffusing dapacity (DLco) decreased from the 6th cycle (cumulative dose was average 347 u) and persisited thereafter, but the decrement was not dose-dependent. 2) There were no interval changes in forced vital capacity (FVC), forced expiratory volume 1-second (FEV1), FEU1/FVC, mean forced expiratory flow during middle half of the FVC (MEF), and MEF/FVC. 3) Based on radiological critieria, bleomycin-induced pulmonary toxicity developed in 1 patient (6.7%). At this point, the cumulative dosage of bleomycin was 312 u and DLco decreased by 57%. 4) If the predictive critieria was determined as 55% decrement of DLco, the false positive rate was 66.7%. In this study, no parameters were found to predict bleomycin-induced pulmonary toxicity. In conclusion, DLco is not a universally sensitive predictor of bleomycin-induced pulmonary toxicity, but may be a preceding parameter. It is recommended that for all patients who are administered over 300 u of bleomycin, a periodic physical examination, DLco and chest X-ray should be done for early detection of bleomycin-induced pulmonary toxicity. .