악성종양에서 혈청 Intercellular Adhesion Molecule-1의 혈청

조덕연,김현수,박상준,김종숙,최지영,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1

Intercellular adhesion molecule-1 (ICAM-1) is a glycoprotein serving as ligands for leukocyte intergrin receptors, i.e. LFA-1, MAC-l. It has been suggested that the expression of ICAM-1 and the levels of circulating ICAM-1 were increased in several malignancies. We measured serum ICAM-1 by ELISA in patients with stomach cancer (n=25), acute lymphoblastic leukemia (n=7), non-Hodgkin's lymphoma (n=14), and metastasis of unknown origin (n=5). Serum levels of circulating ICAM-1 in all malignancies were significantly higer than in normal controls. And serum level of ICAM-1 in stomach cancer ptients having metastatic disease was higher than in patients with localized disease (p=0.027). These results suggest that elevated serum ICAM-1 is a rather common feature for malignancies, not unique for certain types of cancer such as malignant melanoma. It remains to be clalified whether marked increase of serum ICAM-1 in metastatic stomach cancers simply reflect tumor burden or this molecule plays a role in progression in stomach cancer.

J-R 곡선에 대한 시편크기의 영향에 관한 연구

조연제,석창성,김영진,양원호,최용식 成均館大學校 科學技術硏究所 1995 論文集 Vol.46 No.1

The objective of this paper is to investigate the constraint effect on fracture resistance curves. A series of fracture toughness tests with different specimen sizes taken from nuclear piping materials(SA312 TP347 SA516 Gr. 70) were performed. Test results show that fracture toughness is increased with increase in specimen size, probably due to the relaxation crack tip constraint. Elastic-plastic finite element analyses were also performed to investigate the constraint effect. Numerical results show that the stress triaxiality at the crack tip is the governing factor for fracture toughness.

항암화학요법을 받는 암 환자에 대한 Nucare^R의 영양지지효과

조덕연,김현수,곽상혁,강정현,김철희,배광봉,김종숙,박상준,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Purpose : The purpose of this study was to evaluate the effect of nutritional support with enteral liquid supplement in cancer patients receving chemotherapy for possible benefit in nutritional, immunologic and golbal function of patients. Patients and Methods : From October 1995 to February 1997, 30 advanced cancer patients receving chemotherapy were divided two roups. The Nycare group, in addition to normal diet, Nucare^R enteral supplement was given for 1week right after chemotherapy for the duration of 2 chemotherapy cycles. Control group received only normal diet without parenteral fluid supplement for 2 chemotherapy cycles. Results : Median ages were 53 end 56 years for Nucare group and Contrl group respectively. Performance scores was less than 2 by ECOG scale. All patients were stage Ⅲ or Ⅳ. The physical parameters, such as weight, arm muscle circumference(AMC) and triceps skin fold(TSF) were decreased in both groups after 2 cycles of anticancer therapy. but it was less severe in Nucare group(p<0.05). Serum transferrin was maintained in mild deficit state in Nucare group, whereas it aggravated form mild to moderate deficit in Control group(p<0.05). Serum albumin level increased in Nucare group without statistical significance. but it decreased from normal to mild deficit in Control group. Serum total protein did not change significantly in Nucare group. but in Control group, serum total protein was decreased from 7.24±0.9 to 6.52±0.5(P<0.05). Total lymphocyte count did not change significantly in both groups. Conclusion : This study shows that the nutritional support with Nucare^R was effective in the prevention of nutritional deficit status in patients receving a nticancer chemotherapy.

전격성 경과를 취한 만성 호산구성 폐렴 환자 1예

윤호상,진춘조,유광하,이상엽,이수인,정상만,김선두,이순제,이길도,전혜정 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Chronic eosinophilic pneumonia(CEP) is a rare disease of unknown etiology characterized by chronic infiltration of the lung with eosinophils. It presents with profound systemic symptoms comprising fever, night sweats, weight loss, dyspnea and blood eosinophilia with nonsegmental air-space consolidation confined to the outer third of the lung, the "photographic negative of pulmonary edema". Histopathologic features of chronic eosinophilic pneumonia are intraalveolar and interstitial infiltrations with eosinophils, histiocytes, giant cells, scattered lymphocytes and plasma cells. Glucocorticoid therapy cause prompt resolution of symptoms as well as disappearans of blood eosinophils, elevated serum Ig E levels and the roentgenographic lesions. Infrequent radiographic findings include nodular infiltrates, consolidations, cavitations, atelectasis and pleural effusions. Deaths from CEP although rare, have been reported, but the majorities of CEP have benign courses and do not need a therapy with ventilator. We report a case of chronic eosinophilic pneumonia, which had a sudden course associated with diffuse pneumonic consolidations on the both lung and bilateral pleural effusion.

Copolang의 항암 효과 및 면역기능에 미치는 영향

조성기,김성호,윤택구 대한암학회 1987 Cancer Research and Treatment Vol.19 No.1

단기배양을 통한 말초혈액 CD34 양성세포의 체외증폭

박상준,김철희,배광봉,김현수,김종숙,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Background: It is suggested that clinical practice in the areas of bone marrow transplantation and gene therapy might rely on the ex vivo expansion of hematopoietic stem/progenitor cells. However, the condition for ex vivo expansion of hematopoietic progenitor cells is not well established. The authors pursued a series of experiments to define the proper conditions for the expansion of hematopoietic cells in the short-term liquid suspension culture of mobilized peripheral blood CD34+ cells. Methods: 1.0ml cultures were initiated with 9×10^3 PB CD34+ cells, which were isolated from PB mononuclear cells (MNCs) by high-gradient cell sorting, in 12 well plates with the various combinations of hematopoietic growth factors(HGF). The following recombinant human HGFs were used: stem cell factor(SCF) 100ng/ml, granulocyte colony-stimulating factor(G-CSF) 100ng/ml, GM-CSF(granulocyte, macrophage colony-stimulating factor) 100ng/ml, interleukin-1 beta(IL-1B) 1ng/ml, interleukin-3(IL-3) 20ng/ml, interleukin-6 (IL-6) 100ng/ml. At the end of culture, colony-forming cells were evaluated by semisolid clonogenic assay. Results: 1) Using the high-gradient magnetic sorting system, CD34^+ cells were isolated with a yield of 40 3% 2) In 7 day culture of PB CD34^+ cells(9×10^3 cells), nucleated cells expanded mean 10×10^3(range, 9 to 20×10^3) with the addition of SCF alone, 35×10^3(range, 10 to 60×10^3) with SCF plus G-CSF plus GM-CSF, and 130×10^3(range, 40 to 300×10^3) with the combination of SCF, G-CSF, IL-1, IL-3, IL-6, GM-CSF. In 14 day culture, nucleated cells expanded 10×10^3 to 1,860×10^3 with combination of human hematopoietic growth factors. 3) In 10 day culture without medium change of PB CD34^+ cells, CFU-GM numbers expanded 16. 5 fold(range, 7 to 59 fold) with the addition of SCF plus G-CSF plus Il-1 plus IL-3, 31.3 fold(range, 20.5 to 101.1 fold) with the combination of SCF, G-CSF, IL-1, IL-3, GM-CSF. In 14 day culture with or without medium change of PB CD34^+ cells was inferior to 10 day culture for CFU-GM expansion. 4) There was no significant difference for CFU-GM expansion between five growth factors(SCF,G-CSF,IL-1,IL-3,GM-CSF) and six growth factors(five growth factors plus IL-6). Conclusion: The authors could confirm that short-term suspension culture of peripheral blood CD34+ cells could expand hematopoietic progenitor cells. Ten-day culture with medium change of CD34+ cells with the addition of five growth factors, i.e. SCF, G-CSF, IL-1B, IL-3, and GM-CSF, might be the most efficient in this system.

동일한 국제예후지표(International Prognostic Index)를 나타내는 미만성 대형 B-세포 림프종에서 Bcl-2와 p16의 임상적 중요성

박상은,박수진,곽승근,박남숙,천재민,윤환중,조덕연,김삼용,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

In Korea, malignant lymphoma is a common cancer, comprising about 2.7% of all malignant neoplasm. Diffuse large B cell lymphoma is the most common lymphoma, representing about 50% of all Non-Hodgkin's lymphoma. Diffuse large B-cell lymphoma is usually considered as heterogeneous group of neoplasms rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embrace patients with heterogeneous prognoses. But International Prognostic Index scoring system is not sufficiently predict the prognosis. It is likely that the prognostic assessment of patients with diffuse large B-cell lymphomamight be improved by using biological features. Bcl-2 protein and p16 protein expression is recognized as useful biologic markers predicting the prognosis of patients with diffuse large B-cell lymphoma. To determine the clinical significance and prognostic value of bcl-2 and p16 proteins expression patterns, we studied 18 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for bcl-2, p16. The results are as follows; 1) The median age was 54(rage : 37-69). There were 12 male patients(66.7%) and 6 female patients(33.3%) The 'B' symptom was abscentin all patients. The stages were as follows : Ⅰ, 2 patient(11.1%), Ⅱ, 10 patient(55.6%), Ⅲ, 4patient(22.2%) and Ⅳ, 2patient(11.1%). 3 patients(16.8%) had the elevated LDH level, 14 patients(77.8%) had the normal LDH level and 1 patients(5.6%) was not identified the LDH level. 2 patients(11.1%) had the bulky disease and 16 patients(88.7%) had no bulky diease. The distribution of ECOG status were O, 2 patients(11.1%c), 1, 14patients(77.8%) and 2, 2patients(11.1%). 2) Theimmunohistochemistry results are as follows bcl-2:+,10 patients(55.6%), bcl-2:-, 8patinets(44.4%), p16:+,3 patients(16.7%), p16:-, 15patients(83.3%) 3) After a median follow UP durations of 67 months, the median survival time was 57 months with a rage of 7-100+ months. 5-years overall survival rates was 44% by Kaplan-Meier method. 4) Reduced overall survival was demonstrated in the patients who expressed bcl-2 protein(P=0.0174). 5-year overall survivial rate was 12%(bcl-2 expression) versus 88%(no bcl-2 expression) 5) Among diffuse large B-cell lymphoma patients with IPI score 0-1, reduced overall survival was demonstrated with bcl-2 expression(P=0.023). 5-year overall survival rate was 18%(bcl-2 expression group) versus 100%(no bcl-2 expressiongroup) 6) Median survival durtation of diffuse large B-cell lymphoma patients negative for p16 expression was 57 months whereas p16 postive patients' median survival duration was not reached(P=0.4478). In diffuse large B-cell lymphoma patients with identical IPI scores, bcl-2 expression had additional prognostic value.

우심방과 우심실의 거대 심장 혈관종 1예

김제열,조상호,김건일,허경림,김현숙,조구영,최영진,이원용,임종윤 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Cardiac tumors, especially the primary tumors involving any part of the heart are extremely rare and its relative incidence has been reported to be approximately 0.02%. We report a patient with huge cardiac hemangioma who complained of shortness of breath, general weakness, and dizziness, Imaging study by echocardiography and computed tomography of thorax revealed a huge lobulating mass like a bunch of grapes in the right chamber of heart. The surgical exploration of thorax was performed and a histological diagnosis of spindle cell hemangioma was obtained by microscopy. The patient was treated by surgical resection of the tumor and doing well after surgery. Our experience indicated that prompt diagnosis and treatment of cardiac hemangioma is imperative for patients' prognosis.

Gullian Barre Syndrome 患者 1例에 대한 症例報告

임승민,안정조,최영,조현경,김민상,유병찬,오병렬,김윤식,설인찬 대전대학교 한방병원 2002 惠和醫學 Vol.11 No.1

Gullian Barre Syndrome is an acute symmetric polyradiculoneuropathy that typically presents as a progressive flaccid paralysis. The pathology is believed to be caused by both cellular and humoral immune processes The possibility of death is 3-5% and About 20% of patients require mechanical ventilaton. Recently We have experienced a patient who had suspected Gullian Barre Syndrome for 60days, his condition weakness and pain was impoved through the herb and acupucture Therefore I reported it for the treatment.

림프절 종창의 임상적 관찰

김삼용,김현수,김종숙,박상준,최지영,윤환중,조덕연 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Objectives : Clinical management of patient with lymphadenopathy requires judicious judgement of clinicians. Careful evaluation of lymph node enlargement by various clinical parameters will help to disclose the etiology of lymph node enlargement. This study was conducted to identify the clinical manifestations and etiology of lymphadenopathy in korean patients. Methods : A total 192 patients with lymph node enlargement were studied retrospectively. All patients who underwent excisional lymph node biopsy during the period from January 1992 to July 1994 were included. The lymph node biopsy and clinical records were reviewed and patient characteristics were analyzed by various clinical parameters. Results : A female predominance was noted in lymphadenopathy of tuberculosis (58.5%), Kikuchi's syndrome (70%). In lymphadenopathy of nonspecific, tuberculosis, kikuchi syndrome, per centage of patients younger than 40 years of age were 84.5%, 75.6%, 100%, respectively. In lymphadenopathy of tuberculosis and metastatic cancer, the duration of lymphadenopathy below 30days were 51.2%, 73.9%, respectively. The two most common etiology of cervical lymphadenopathy were nonspecific lymphadenitis (47.7%) and tuberculous (26.8%). The two most frequent etiology of supraclavicular lymphadenopathy were nonspecific lymphadenitis (46.3%) and metastatic lymphadenopathy (26.8%) and the most common etiology of axillary lymphadenopathy was nonspecific lymphadenopathy (34.5%). The most common frequent of lymph node enlargement with size below 1㎠ was nonspecific lymphadenitis, while above 2.25㎠ it was metastatic lymphadenopathy. Conclusion : Careful evaluation regarding patient age, sex, size of lymph node, consistency, location of lymph node, presence or absence of systemic symptoms should be pursued before performing a biopsy and management.