Successful Rechallenge with Imatinib in a Patient with Chronic Myeloid Leukemia Who Previously Experienced Imatinib Mesylate Induced Pneumonitis

고성우,김부경,이성학,김태정,허주연,이종민,하직환,김동휘,조민정,김태완,강지영 대한결핵및호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Imatinib mesylate is a targeted therapy that acts by inhibiting tyrosine kinase of the bcr-abl fusion oncoprotein, which is specific to chronic myeloid leukemia (CML), and the c-transmembrane receptor, which is specific to gastrointestinal stromal tumors. Interstitial pneumonitis is a rare adverse event of imatinib therapy. It is clinically difficult to distinguish from infectious pneumonia, which can frequently occur due to the underlying disease. The standard treatment for imatinib-induced pneumonitis is to discontinue the medication and optionally administer corticosteroids. However, there are a few cases of successful retrial with imatinib. We describe a case of successful rechallenge of imatinib in a patient with imatinib-induced interstitial pneumonitis and CML without a recurrence of the underlying disease after 3 months of follow-up.

췌장암의 조기 발견에 있어서 내시경 초음파의 역할

고성우,황준성,송태준 대한췌장담도학회(구 대한췌담도학회) 2019 대한췌담도학회지 Vol.24 No.3

췌장암은 진단 당시 대부분 진행된 병기에서 발견이 되기 때문에 예후가 매우 좋지 않은 암으로 알려져 있다. 치료 기술의 발전에도 불구하고 국내 췌장암의 5년 생존율은 약 11%로 위암, 대장암 등 다른 암종에 비하여 성적이 매우 좋지 않다. 췌장암의 조기 진단을 위하여 많은 연구가 이루어지고 있는데, 특히 EUS가 췌장암의 조기 진단에 있어서 유용한 영상학적 진단 방법으로 주목을 받고 있다. 현재 EUS는 췌장의 종양을 발견하는 데 있어서 가장 예민한 검사법으로 인정받고 있다. 특히 종양의 크기가 2-3 cm 이내로 작을수록 CT보다 민감도가 우월하다는 연구 결과들이 많다. EUS는 종양 자체뿐 아니라 림프절, 혈관 등 주위 인접 장기들까지 평가가 가능하기 때문에 수술적 절제 가능성 평가에도 많이 활용되고 있다. CT, MRI와 달리 EUS는 영상을 보면서 실시간으로 조직 검사까지 가능하다는 장점이 있고 이는 췌장암의 조직 확진과 다른 췌장 종양과의 감별 진단에 유용하게 사용되고 있다. 췌장암의 선별 검사는 고위험군에 한하여 제한적으로 이루어지고 있는데, EUS는 췌장 병변의 발견율이 우수하여 선별 검사에서도 중요한 역할을 할 것이라 예상한다. Pancreatic cancer was the 9th most common cancer in Korea in 2016, and the incidence is on the rise. Despite advances in diagnostic and therapeutic methods, 5-year survival rate of pancreatic cancer is about 11.7% in Korea, and its prognosis is very poor compared to other cancers. At present, although complete surgical resection is the most effective treatment, only less than 20% of patients are even candidates for resection because diagnosis is usually delayed. So early detection of pancreatic cancer is one of the main objective in the treatment of pancreatic cancer. Among imaging modalities, computed tomography-scan is the most widely available, and the most frequently used. However as endoscopic ultrasound (EUS) techniques have evolved and based on the results of researches that EUS is superior to computed tomography-scan in the diagnosis of small pancreatic tumor, the role of EUS in the early diagnosis of pancreatic cancer is attracting attention. Herein, the authors focused on the role of EUS in early pancreatic cancer.

S-552 : 류마티스 관절염 환자에게서 발생한 EBV 양성 호지킨스 림프종의 자발적 퇴행(spontaneous regression)

고성우,윤종현,고윤호,정채호,장은덕 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

서론: 국내에서 류마티스 관절염 환자에서 발생한 비호지킨스 림프종은 6건 정도가 보고가 되었으나 호지킨스 림프종은 보고가 없다. 림프종에서 자발적 퇴행(spontaneous regression)은 드물게 발생하는데 특히 호지킨스 림프종은 비호지킨스 림프종에 비해서 빈도가 더 낮다. 경부 림프절 종대가 4년 동안 지속된 류마티스 관절염 환자에서 고열을 동반한 급성 림프절병 양상을 보인 호지킨스 림프종의 자발적 퇴행을 경험하여 보고하는 바이다. 증례: 70세 여자환자, 2008년 본원에서 류마티스 관절염 진단받은 분으로 진단 약 1년 뒤인 2009년 8월에 우측 경부 림프절 종대가 촉진되었다. MTX 중단하였으며 2009년 9월 Neck CT 촬영을 시행하였고, 우측경부 림프사슬에 림프종으로 의심되는 다발성 림프절 병소가 관찰되었다. 림프절 조직검사를 권유하였으나 환자 동의가 없어 시행하지 못하고 외래 경과관찰하였다. 환자는 지속적으로 경부 림프절의 크기가 증가하였고 2011년 Follow up Neck CT에서도 이전에 비해 크기 증가를 관찰하였다. 2013년 5월 발열, 오한으로 입원 하였으며, 경부 림프절에 열감, 발적, 압통이 있고 CRP는 21.85 mg/dL로 상승되어 있었다. 감염으로 인한 림프절 병증으로 추정하여 항생제 투여 후 증상 호전되고 CRP 3.11 mg/dL로 감소하였으며, 경부 림프절 종대 크기가 현저이 감소하였다. 경부 림프절 조직검사 권고하였으나 환자 거부하여 퇴원 후 경과관찰 하던 도중, 2013년 6월 다시 오한, 발열 주소로 내원하였다. 항생제 치료 하였으나 증상 호전이 없어, Core needle로 림프절 조직검사 시행하였으며 Reed-Sternberg cell 관찰되어 호지킨스 림프종으로 진단하였다. EBV 면역염색에 양성소견 보였다. 항생제 중단하였고 3일 후 발열이 자연 소실되었다. 림프종에 대한 병기검사 시행하였으며 Stage IV-B로 항암요법 하며 경과관찰 중이다.

PHYSICAL EVIDENCE OF SEAT BELT RELEASE IN OBLIQUE FRONTAL IMPACT

고성우,이재완 한국자동차공학회 2020 International journal of automotive technology Vol.21 No.4

According to the buckle release theories, the seat belt can be released during an impact and the occupant sustained injuries without a benefit from the restraint system. A few studies have been published demonstrating that the seat belt release during an impact results in belt entanglement of occupant's outboard arm. However, there is no previous belt entanglement study using airbag equipped vehicle. Two controlled sled tests in 30-degree oblique frontal impact using airbag equipped vehicle were conducted at 44 km/h delta V to compare the driver occupant kinematics, physical evidence on seat belt system and occupant interaction with the seat belt in fully restrained and partially restrained condition. The fully restrained test demonstrated the nature and extent of the physical evidence placed on a latched and properly worn restraint system. Loading marks were found on restraint's webbing and hardware including the latch plate and guide loop (D ring). The partially restrained test results showed that a release of the latch plate was followed by webbing engagement with the ATD left arm and subsequent loading. This loading event produces large contact forces on the left arm which can produce significant surface injuries.

십이지장스텐트 삽입 중 발생한 위천공

고성우,소훈섭,방성조 대한소화기학회 2022 대한소화기학회지 Vol.80 No.5

Gastric outlet obstruction is a major symptom in patients with advanced pancreatic cancer. Endoscopic intervention is often challenging in severe strictures because the guidewire cannot pass beyond the stricture. Sometimes, the air itself cannot pass beyond the stricture, which can result in a severely distended stomach. Such a stomach is vulnerable to excessive air insertion or mechanical stress during endoscopic procedures, and endoscopists may encounter a higher rate of complications. Gastric perforation is rare but could be fatal. However, endoscopic management can show a favorable result if the perforation is noticed early. The authors report a case of the perforation of a gastric tear during duodenal stent insertion in a patient with a gastric outlet obstruction.

Physical Evidence of Airbag Performance in a High-Speed Frontal Crash

고성우,Hu Jingwen 한국자동차공학회 2021 International journal of automotive technology Vol.22 No.4

Field data (NASS) analyses showed that 0.9 % of frontal airbags deployed in motor vehicle collisions sustained at least one type of damage. Crash investigators often need to determine whether a damaged airbag inflated in a timely manner to provide occupant protection during the crash. This study provided a comparison of physical evidence from the restraint system and the seat resulted from high-speed frontal impacts with and without airbag deployment. Evidence of an airbag deployment event was collected from a real-world vehicle crash, in which the airbag was found damaged at the scene. A sled test was conducted with an 80 km/h delta-V in an exemplar vehicle to demonstrate the occupant loading evidence on vehicle components when the airbag was absent in a crash of the same severity as the real-world crash. In the test, the load limiter was activated and provided webbing spool out until bottoming out, severe abrasions and markings occurred on the seatbelt webbing and the D-ring, and the seat bottom deformed downward. These occurrences were absent in the real-world crash, suggesting that the frontal airbag was inflated in a timely manner and absorbed occupant\'s kinetic energy during the high speed frontal impact.

Wire-cut 방전가공 조건이 STD11의 변질층에 미치는 영향

김진무,고성우 울산대학교 1997 공학연구논문집 Vol.28 No.2

본 연구에는 열처리된 금형강(STD11)을 사용하여 가공조건으로 가공전류, 와이어장력, 이송속도 등을 변화시켜 변질층 깊이와 경도를 현미경 조직사진을 통한 조직변화의 고찰과 경도시험을 하여 검토하였다. 그 결과 다음과 같은 결론을 얻었다. (1) 변질층의 경도는 가공전류 3A, 와이어장력 1500gf 및 이송속도 80%일 때 Hv685(HRC59.5)로 가장 높았다. (2) 변질층의 깊이는 가공전류 3A이며 와이어장렬 1500gf이고, 이송속도 80%일 때 약 6㎛로서 가장 낮았다. In this study, deformed layer thickness, hardness and microstrucre of deformed layer were investigated with the variations of peak current, wire tension and feed rate, and the material is heat-treated STD11. The results have shown that (1) deformed layer thickness is minimum at 3A, 1500gf, and 80% and (2) hardness is the highest at peak current 3A, wire tension 1500gf and feed rate 80%.

제주 곶자왈 숲 자연 놀이 체험 학습이 초등학생의 환경 감수성 변화에 미치는 영향

고성우(Sung-Woo Ko),홍승호(Seung-Ho Hong) 한국환경교육학회 2010 環境 敎育 Vol.23 No.3

The aims of this study are to develop and apply a Nature Game program for the ecological experience learning in Jeju Gotjawal forest and analyze the environmental sensitivity change of the students. The results obtained in 4th graders of A elementary school of Seogwipo-city are as follows: It was found that attention, susceptibility and practice will of environment protection for forest environment of the experimental class were significantly higher than those of the comparison class. And it was found that interest and curiosity into forest environment were also elevated in the results of the qualitative evaluation, suggesting that we could get the effect of developed Nature Game program on ecological experience learning. If various ecological experience learning programs considering the regional-specific characteristics are developed to cause students' interest and curiosity, students would come to participate in the protection activity of environment aggressively a little more.

췌장암에서 간 문맥 순환 종양 세포의 임상적인 유용성

윤승배,고성우 대한소화기암연구학회 2023 Journal of Digestive Cancer Research (JDCR) Vol.11 No.1

Despite recent advancements in the diagnosis and treatment of pancreatic cancer, clinical results remain dismal. Furthermore, there are no reliable biomarkers or alternatives beyond carbohydrate antigen 19-9. Circulating tumor cells (CTCs) may be a potential biomarker, but their therapeutic application is constrained by their rarity in peripheral venous blood. Theoretically, the portal vein can be a more appropriate location for the detection of CTCs, because the first venous drainage of pancreatic cancer is portal circulation. According to several studies, the number and detection rate of CTCs may be higher in the portal blood than in the peripheral blood. CTC counts in the portal blood are strongly correlated with several prognostic parameters such as hepatic metastasis, recurrence after surgery, and survival. The phenotypic and genotypic properties analyzed in the captured portal CTCs can assist us to comprehend tumor heterogeneity and predicting the prognosis of pancreatic cancer. The investigations to date are limited by small sample sizes and varied CTC detection techniques. Therefore, a large number of prospective studies are required to confirm portal CTCs as a valid biomarker in pancreatic cancer.

Clinical Outcomes of Gastric Cardia Cancer During a Recent Decade of Korea

견우진,고성우,정우철,김연지 대한내과학회 2018 대한내과학회 추계학술대회 Vol.2018 No.1