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재발성 상피성 난소암 및 원발성 복막 암종증 환자에서의 Topotecan/Platinum 복합요법의 효용성과 독성
유항조 ( Hang Jo You ),김용만 ( Yong Man Kim ),이신화 ( Shin Wha Lee ),이정남 ( Jung Nam Lee ),김대연 ( Dae Yeon Kim ),서대식 ( Dae Shik Suh ),김종혁 ( Jong Hyeok Kim ),김영탁 ( Young Tak Kim ),남주현 ( Joo Hyun Nam ),목정은 ( Jun 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.1
목적: 이 연구의 목적은 camptothecin 유도체로서 DNA topoisomerase I 억제제인 topotecan을 platinum제제와 복합요법으로 사용하였을 때, 재발성 상피성 난소암과 원발성 복막 암종증 환자에서의 효용성과 독성을 평가하는 것이다. 연구방법: 2000년 1월부터 2007년 6월까지 서울아산병원에서 topotecan과 platinum의 복합 항암화학요법으로 치료받은 환자들을 대상으로 하였다. 51명의 재발성 상피성 난소암과 원발성 복막 암종증 환자가 있었으며 이들 각 환자들의 의무기록과 병리 및 진단 검사 보고서를 통하여 분석하였다. 치료에 대한 반응은 측정 가능한 재발성 종괴가 있는 경우에는 RECIST 기준을 적용하였고 측정 가능한 재발성 종괴가 없는 경우에는 CA-125 기준을 적용하였다. 부작용은 미국 NCI Common Toxicity Criteria version 3.0 기준에 따라 평가하였다. 결과: 환자군의 진단 당시 평균 나이는 53.4세였다. RECIST 기준으로 평가한 44명의 환자군에서 전체 반응률을 22.8% (10/44)이었으며, 6명에서 완전관해를 보이고 4명에서 부분관해를 나타냈다. Platinum 반응군에서는 26.9%, platinum 저항군에서는 16.7%의 반응률을 보였으나 통계적으로 유의하지는 않았고 (p=0.425), 반응기간과 진행까지의 기간을 볼 때 platinum 반응군에서 의미있게 길게 나타났다 (p=0.022, p=0.042). 이전에 3회 이상의 다른 항암화학요법을 시행 받은 환자군에서는 그렇지 않은 환자군과 치료반응에 있어 의미있는 차이를 보이지 않았다. 골수억제가 가장 흔한 부작용으로서, 전체 265회 시행한 항암화학요법에서 Grade 3/4의 호중구 감소증이 30.6%, 빈혈이 42.7%, 혈소판 감소증이 8.7%로 나타났으나 모두 회복 가능한 정도였고 그 이외의 부작용은 모두 경미하거나 회복 가능한 정도였다. 결론: Topotecan과 platinum의 복합요법은 platinum 제제를 기본으로 한 일차 항암화학요법 후 재발한 상피성 난소암과 원발성 복막 암종증 환자에서 치료 효과를 기대할 수 있을 것으로 생각된다. 향후 기존의 항암화학요법과의 효과를 비교하는 무작위 대조군 연구를 통한 치료 효과의 확인이 필요할 것이다. Objective: The aim of this study was to evaluate the efficacy and toxicity of topotecan, camptothecin analogue topoisomerase I inhibitor, as the combination therapy with platinum in patients with recurrent epithelial ovarian carcinoma and primary peritoneal carcinomatosis. Method: In this study, patients who were treated with topotecan between January 2000 and June 2007 at Asan Medical Center, Seoul, Korea were reviewed. Fifty-one patients with recurrent ovarian carcinoma and peritoneal carcinomatosis were included. These patients` data were analyzed by review of medical records and pathologic and laboratory reports retrospectively. Response was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) criteria for patients with measurable disease and CA-125 response criteria for patients with non-measurable disease. The toxicities were evaluated according to NCI CTC (Common Toxicity Criteria) version 3.0. Results: The mean age of patients was 53.4 years (ranged between 37 and 69). Forty-four patients had been evaluated by RECIST criteria. The overall response rate was 22.8% (10/44). Platinum-sensitive patients showed more favorable response rate (26.9%) than platinum-resistant patients (16.7%), however, it was not significant statistically (p=0.425). Platinum-sensitive group had significantly longer response duration (12.14 vs. 3.33 months, p=0.022) and time-to-progression (11.34 vs. 7.33 months, p=0.042) than platinum-resistant group. Heavily pretreated group, three or more prior regimens were used, had no significant differences from another group. The most common adverse effect of topotecan in combination with platinum was hematologic toxicity; grade 3/4 neutropenia was 30.6%, anemia was 42.7%, and thrombocytopenia was 8.37% in total 265 cycles of chemotherapy, however, it was tolerable. Conclusion: Topotecan in combination with platinum is considered as effective regimen with acceptable toxicity in treating recurrent epithelial ovarian carcinoma and primary peritoneal carcinomatosis who have failed previous treatment with platinum-containing chemotherapy.
전대원 ( Dae Won Jun ),이오영 ( Oh Young Lee ),조경란 ( Gyeong Lan Jo ),백상현 ( Sang Hyeon Baeg ),양선영 ( Sun Young Yang ),한성희 ( Sung Hee Han ),이항락 ( Hang Lak Lee ),전용철 ( Young Cheol Jeon ),한동수 ( Dong Soo Han ),손주 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1
목적: 과민성 장증후군은 약 6~10%의 유병율을 가지는 매우 흔한 소화기 질환이며, 정신사회학적 증상과 밀접한 관계를 가지는 것으로 알려져 있다. 그러나 과민성 장증후군 증상을 가지고 있는 사람 중 소수만이 의료기관을 방문하는 것으로 알려져 있다. 본 연구에서는 과민성 장증후군의 증상을 가지고 있는 사람 중 의료기관을 이용하여 치료를 받고 있는 군과 치료를 받지 않는 비치료군 간의 심리적 상태 및 장외증상의 차이에 대하여 알아보고자 하였다. 대상 및 Background/Aims: Only a relatively small portion of those people suffering with IBS, estimated at 25~50%, eventually seeks medical care. Yet little is known about the difference in the characteristics between the consulter and non-consulter IBS patients.
난소의 악성 배세포종양에서 림프절 절제술의 필요성 및 보존적 수술 후 난소기능 및 가임력 유지에 대한 연구
김대연 ( Dae Yeon Kim ),남주현 ( Joo Hyun Nam ),유항조 ( Hang Jo Yoo ),김미경 ( Mi Kyung Kim ),김종혁 ( Jong Hyeok Kim ),김용만 ( Yong Man Kim ),김영탁 ( Young Tak Kim ),목정은 ( Jung Eun Mok ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.11
목적: 난소의 악성 배세포종양 환자에서 보존적 수술 후 장기적인 가임력 및 출산력을 평가하고 재발 양상을 확인하며, 보존적 수술 시 후복막 림프절 평가의 중요성을 알아보고자 하였다. 연구 방법: 1991년부터 2001년까지 서울아산병원 산부인과에 내원하여 난소의 악성 배세포종양으로 진단 받고 치료 받은 50명의 환자들의 의무기록을 후향적으로 고찰하고 전화 인터뷰를 통하여 월경력 및 출산력을 확인하였다. 결과: 54개월의 평균 추적 관찰기간 동안 6명 ( Objective: To evaluate the long-term fertility and reproductive outcomes after conservative surgery, to observe the recurrence pattern and to elucidate the significance of retroperitoneal lymph node evaluation in patients with malignant ovarian germ cell
Yersinia enterocolitica의 생물형별(生物型別)에 관(關)한 고찰(考察)
오흥백 ( Hung Back Oh ),김대식 ( Dae Sik Kim ),조용현 ( Yong Hyun Jo ),정조원 ( Jo Won Jung ),서진태 ( Jin Tae Suh ),지현숙 ( Hyun Sook Chi ),이중달 ( Jung Dal Lee ) 대한임상검사과학회 1984 대한임상검사과학회지(KJCLS) Vol.16 No.1
We have isolated 5 strains of Yersinia enterocolitica with biotypes from 803 fecal specimens of the patients for detection of enteric bacteria from November, 1980 to April, 1981 at Kyung Hee Medical Center. All the rectal swabs was inoculated in MacConkey, SS and Selenite broth and again streaking in MacConkey and S-S agar plates after 18 hours cultivation of Selenite broth. All the agar plates were put into the room temperature. After detecting the suspected colonies through first screen Urea agar, SIM and K.I.A. Media. It was given final identification of API Kit. all the strains were determined by Nilehn & Wauters method for biotypes. and The susceptibility tests were performed by National Committee for Clinical Laboratory Standard (N.C.C.L.S) regulation. The typical biochemical properties of the organisms were urea and ornithine positive, dextrose (no gas) and xylose were fermentative, lactose was oxidative, and indol & V.P. were variable at the room temperature, motility was negative at 35℃ and positive at 25℃. The pinpoint of colorless colonies showed red color after 72 hours at room temperature. It was difficult at times to detect the organisms. because of the size and color change of the colonies. As the result of susceptibility test, all the strains were highly susceptible to Gentamycin, Kanamycin, Amikacin, Chloramphenicol, Oxytetracycline but two strains (No 1 & 5) were susceptible to Ampicillin & Carbenicillin (Biotype 2). All the strains were resistant Cephalothin. Three of 5 strains was identified as biotype 3 and the rest as biotype 2 by Nilehn & Wauters method.
석주형,Dae Hyun Kim,Hye Jih Kim,Hang Hyo Jo,김은영,Jae-Hwang Jeong,Young Seok Park,Sang Hun Lee,Dae Joong Kim,Sang Yoon Nam,Beom Jun Lee,Hyun Jik Lee 대한수의학회 2022 Journal of Veterinary Science Vol.23 No.5
Background: Previous studies have presented evidence to support the significant association between red meat intake and colon cancer, suggesting that heme iron plays a key role in colon carcinogenesis. Epigallocatechin-3-gallate (EGCG), the major constituent of green tea, exhibits anti-oxidative and anti-cancer effects. However, the effect of EGCG on red meat-associated colon carcinogenesis is not well understood. Objectives: We aimed to investigate the regulatory effects of hemin and EGCG on colon carcinogenesis and the underlying mechanism of action. Methods: Hemin and EGCG were treated in Caco2 cells to perform the water-soluble tetrazolium salt-1 assay, lactate dehydrogenase release assay, reactive oxygen species (ROS) detection assay, real-time quantitative polymerase chain reaction and western blot. We investigated the regulatory effects of hemin and EGCG on an azoxymethane (AOM) and dextran sodium sulfate (DSS)-induced colon carcinogenesis mouse model. Results: In Caco2 cells, hemin increased cell proliferation and the expression of cell cycle regulatory proteins, and ROS levels. EGCG suppressed hemin-induced cell proliferation and cell cycle regulatory protein expression as well as mitochondrial ROS accumulation. Hemin increased nuclear factor erythroid-2-related factor 2 (Nrf2) expression, but decreased Keap1 expression. EGCG enhanced hemin-induced Nrf2 and antioxidant gene expression. Nrf2 inhibitor reversed EGCG reduced cell proliferation and cell cycle regulatory protein expression. In AOM/DSS mice, hemin treatment induced hyperplastic changes in colon tissues, inhibited by EGCG supplementation. EGCG reduced the hemin-induced numbers of total aberrant crypts and malondialdehyde concentration in the AOM/DSS model. Conclusions: We demonstrated that EGCG reduced hemin-induced proliferation and colon carcinogenesis through Nrf2-inhibited mitochondrial ROS accumulation.
저나트륨혈증을 급속교정후 발생한 Central Pontine and Extrapontine Myelinolysis 3예
정항재,신현길,이광호,조용욱,배원경,김대호 대한내과학회 1993 대한내과학회지 Vol.44 No.6
저자들은 심한 저나트륨혈증을 급속히 교정하고 난 후 강직성 사지마비와 구음장애, 연하곤란 등의 가성구마비 징후를 보이고, MRI상 뇌교 및 다른 여러부위에 광범위하게 고음영병변을 보인 3명의 Central pontine and extrapontine myelinolysis 환자들을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Central pontine and extrapontine myelinolysis(CPM) is clinically charaterized by quadriplegia, pseudobulbar palsy, and consciousness change, usually following rapid correction of hyponatremia, but the exact mechanism of the pathophysiology remains obscure. Pathologic study reveals well-circumscribed areas of myelin loss sparing neurons and axons in pons and extrapontine region. Vascular changes and inflammation are absent. In the past, the diagnosis of CPM has generally been made on the basis of autopsy findings, but at the present, magnetic resonance imaging has made it possible to make the diagnosis before autopsy for the detection of pontine and extrapontine lesions. We report three cases of central pontine and extrapontine myelinolysis associated with typical clinical symptoms following rapid correction of hyponatremia. MRI showed high-signal areas in basis pontis, bilateral thalamus, caudate nucleus, and putamen.