위암 환자에서 Chronotherapy 의 부작용에 대한 고찰

윤욱돈(Uk Don Yun),최석렬(Seok Reyol Choi),지삼룡(Sam Ryong Jee),박성욱(Seong Wook Park),이태영(Tae Yeong Lee),이종훈(Jong Hun Lee),한상영(Sang Young Han) 대한소화기학회 2002 대한소화기학회지 Vol.40 No.4

Backgroud/Aims: Gastric cancer is one of the most common malignancy in Korea. In many reports, it has been known that chemotherapy does not improve survival rate of patients with gastric cancer. However, some Japanese reports showed that chemotherapy was effective. Side effects of chemotherapy increase with escalating dosage of chemotherapy drugs. There are some reports that chronotherapy could reduce the side effects and improve the survival rate in patients with gastric or colorectal cancer. We studied the side effects of chronotherapy in patients with gastric cancer. Methods: Fourteen patients with previously untreated gastric cancer received chronomodulated 5-FU ( 900 mg/m2/day, day 1-5) and cisplatin ( 90 mg/m2, day 1). Thirteen patients of control group received 5-FU ( 600 mg/m2/day, day 1-5) and cisplatin ( 60 mg/m2, day 1) during the daytime. The side effects of the two groups were evaluated for nausea and vomiting, diarrhea, peripheral neuropathy, mucositis, leukopenia, anemia, thrombocytopenia, and serum creatinine. Results: Compared to the control group, chronotherapy-treated group showed statistically significant decrease in nausea and vomiting ( p= 0.037), but not in others. Conclusions: Although only the incidence of nausea and vomiting was decreased significantly in the chronotherapy group, chronotherapy could be effective in reducing the side effects of chemotherapy in patients with gastric cancer considering that higher doses of drugs were used in the chronotherapy-treated group. ( Korean J Gastroenterol 2002; 40: 236-240)

신장병변을 동반한 결절성 경화증 2 예

문성훈(Sung Hun Moon),최해종(Hae Jong Choi),윤욱돈(Uk Don Yun),양두경(Doo Kyoung Yang),우영석(Young Seok Woo),장광열(Kwang Yul Chang),지삼룡(Sam Ryong Jee),오일환(Il Hwan Oh),김성은(Seong Eun Kim),김기현(Ki Hyun Kim) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.1

Tuberous sclerosis is a rare disease, which occurs sporadically or hereditarily and is recognized by its neurological and dermatological manifestations and may be accompanied with renal anomalies. The cla- ssical triad is composed of seizure, mental retardation and adenoma sebaceum on face. We experienced two cases of tuberous sclerosis in sporadic forms by mutation without any familial history which suggests the diseases were occurred by mutation rather than by autosomal dominant inheritance. In the first case, a 24-year-female patient with hypertension and abnormal renal function tests which were noted on the routine prenatal check at 32 weeks of gestation delivered normally at 37 weeks. The daughter of patient had seizure when she was 6 years old and was diagnosed as polycystic kidney disease by abdorninal computed tomography. This case developed sporadic form of disease without familial history but, the daughter of patient might inherited by autosomal dominant form. The patient's clinical feature was characterized by history of epilepsy, painless abdominal mass due to polycystic kidney disease, abnormal renal function, skin abnormalites including angiofibroma and shagreen patch. Abdominal computed tomography demonstrated numerous variable sized cysts throughout both kidney. In second case, the patient was a 32-year-female patient complaining of 5kg weight gain, abdominal distension due to palpable masses. Her clinical feature was characterized by bilateral huge renal angiomyolipoma with normal renal function and skin abnormality such as erythematous papule on the face. Abd CT and MRI revealed huge angiomyolipoma of about 15cm×18.5cm×30cm and 14.5cm×18cm×30cm res- pectively. We presented the two cases with brief review of the literatures.

간세포암의 직경과 위치에 따른 고주파 열치료의 치료효과 및 합병증에 관한 연구

유정남 ( Jung Nam Yoo ),신우원 ( Woo Won Shin ),강기태 ( Ki Tae Kang ),조정환 ( Jung Hwan Cho ),문성훈 ( Sung Hun Moon ),윤욱돈 ( Uk Don Yun ),장채령 ( Chae Ryeong Jang ),이태영 ( Tae Yeong Lee ),안원석 ( Won Suk An ),이종훈 ( Jon 대한내과학회 2002 대한내과학회지 Vol.63 No.5

N/A Background : Induction of coagulation necrosis by using thermal energy sources such as radio-frequency (RF), microwaves and lasers has recently been as a new, minimally invasive technique for percutaneous tumor ablation. RF ablation is considerd effective and safe for the local control of small HCCs. The aim of this study is to evaluate the therapeutic efficacy and complications according to the diameter and location of the HCC. Methods : Between May 1999 and December 2000, one hundred fifty patients underwent RF thermal ablation in Dong-A university hospital. Among them, forty nine patients were enrolled in this study who have no history of prior other treatment including hepatic resection, TAE, PEI, and chemotherapy, also who have follow-up CT performed at least six months after ablation. The patients devided into two groups, who have small HCC (.3 cm in diameter) and the others. Recurrence rate was also evaluated with spiral CT performd at least six months after treatment. Results : In large HCC group (>3 cm in diameter), the mean follow-up duration was 10.8 months and local recurrence rate was 51.0%?12.4. In small HCC group (.3 cm in diameter), the mean follow-up duration was 12.7 months. Local recurrence rate was 16.2%?8.6 in patients with small HCC. Among one hundred fifty patients underwent radio-frequency thermal ablation, 5 cases of intraperitoneal bleeding, 5 cases of pleural effusion and 3 cases of pneumothorax were observed. In most of cases, the necrotic area of HCC reached to the capsule of liver or located in hepatic dome. Conclusion : Radio-frequency ablation appears to be more effective and safe for the treatment of small HCC than that of large HCC and more attetion must be given to the RF ablation if the tumor is larger than 3cm or located close to the capsule of liver or in hepatic dome. (Korean J Med 63:507-512, 2002) Key Words : Radio - frequency Ablation, Carcinoma, Hepatocellular

수면내시경 검사에서 Midazolam 전처치와 Flumazenil 길항작용에 대한 연구

이종훈,한상영,신종민,신우원,노명환,최대현,윤욱돈,최석렬 대한소화기내시경학회 2000 Clinical Endoscopy Vol.21 No.1

Background/Aims : Midazolam is utilized as a premedication for uppoer gastrointestinal endoscopy. Midazolam has a more rapid onset of reaction than that of diazepam and its duration is shorter. But the Consciousness of premedicated patients has not been regained sooner. The Purpose of this study was to examine the effectiveness of flumazenil against midazolam as premedication for upper gastrointesinal endoscopy. Methods : Sixty patients underwent upper gastrointestinal endoscopy. These patients were divided to three groups: Group I included twenty patients without premedication; Group Ⅱ Included twenty patients with premedication of midazolam and then were not given an antisedative agent excluign of normal saline; and Group Ⅲ included the others with midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam injection, compared with presedation value. Modied Steward Coma Scale showed a significant increase after flumazenil injection as an antagonist of midazolam. The assessment of the endoscopist and the comfort of patients were satisfactory. When the 40 patients were asked about their willingness to undergo the same procedure in the future, thirty-four patients responded favorably. Conclusion : Midazolam was safe and effective for sedation for upper gastrointestinal endoscopy. There was rapid regaining of consciousness with flumazenil indection after midazolam, so the use of flumazenil against midazolam injection also appeared to be effective.