중독한 추체로 증상을 보인 cyclosporine에 의한 뇌증 1예

강정현,곽승근,신현영,김성은,이정호,이정찬,곽상혁,윤환중,조덕연,김삼용,김제,송창준 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

The use of cyclosporine(CsA), a potent immunosuppressive agent, is associated with numerous side effects. Neurotoxicity was earlier less well known, but with growing experience central nervous system side effects are now reported up to 40% of patients. Among various CsA-induced neurotoxicities, tremor is most common and posterior leukoencephalopathy is well characterized. An encephalopathy presenting with pyramidal weakness, however, seems to be rare and poorly documented. We report here a case of encephalopathy presenting with multiple generalized seizures followed by fluctuating quadriparesis developed a few days after starting CsA and resolved spontaneously after withdrawal of the drug . A 48-year-old woman with aplastic anemia was placed upon immmunosuppressive treatment consisting of antithymocyte globulin(ATG), CsA, and methylprednisolone. Two days after starting the therapy, she developed a generalized seizure. The next day she developed 2 more episodes of seizure and the therapy was stopped. Computed tomogram of the brain was normal. Six days after starting therapy, she developed mild motor weakness and paresthesia of both lower extremities, which progressed to a definite quariparesis confining her to a bed in 3 days. Magnetic resonance imaging(MRI) of the brain revealed asymmetric, bilateral high-signal abnormalites in the subcortical white matter of fronto-temporal areas. After reaching to a maximum with some fluactuation(14 days after starting the therapy) the motor weakness started to be resolved. She was discharged with a almost complete resolution of the weakness 45 days after starting the therapy. Five months later she did well and brain MRI was negative.

자가발전원 적용 바코드스캔을 이용한 유량원격검침시스템 개발에 관한 연구

곽명철(Myeong-Cheol Kowak),조용성(Yong-Sung Jo),함동령(Dong-Young Ham),김병각(Byeong-Kak Kim),송광석(Kwang-Seok Song) 대한전기학회 2016 대한전기학회 학술대회 논문집 Vol.2016 No.7

성인 급성 림프구성 백혈병에 대한 복합 화학 요법

곽상혁,신현영,김성은,이정호,이정찬,강정현,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Although acute lymphoblastic leukemia(ALL) is one of the most frequently encountered cancer in children, only about 20% of patients who were diagnosed leukemia are ALL in adults. During past 30 years, the result of treatment of ALL in children have been markedly improved, but in adults, the result of treatment of ALL is not so good as that in children. In recent, morbidity of ALL has been increased in KOREA, but studies of long-term survival are rare. So a retrospective clinical analysis was made in patients who were diagnosed for adult acute lymphoblastic leukemia between March 1988 and February 1997, in Chungnam National University Hospital. The result of treatment, prognostic factors of survival and duration of complete remission were analyzed. In 44 patients who were newly diagnosed as ALL in Chungnam National University Hospital, total 31 patients who have received chemotherapy more than two weeks were analyzed. All patients were treated by vincristine, daunorubicine, and prednisolone in phase I induction chemotherapy. At the 28th day of phase I induction chemotherapy, bone marrow aspiration biopsy was performed and achievement of complete remission was estimated. Within one or two weeks after completion of phase I chemotherapy, phase II induction chemotherapy was done. In phase II induction chemotherapy, cyclophosphamide, cytosine arabinoside and 6-mercaptopurine were administerd. During phase II induction chemotherapy, CNS prophylaxis with intrathecal methotrexate administration and intracranial irradiation. After completion of phase I and phase II of induction chemotherapy, 4 cycles of consolidation chemotherapy were made in utilization of VP-16 and cytosine arabinoside in standard risk group, and in utilization of methotrexate with leucovorin rescue and L-asparaginase in the high risk group. And then maintenance chemotherapy with 6-mercaptopurine and methotrexate was continued till two years later from the day of treatment start. The median survival time was 15.8 months (95% C.I. 6.0-18.8 months) and the long-term survival (more than 5 years after diagnosis) rate was 28.0%. The rate of complete remission was 83.9% ( 26 of 31) and the median of the complete remission duration was 15.8 months (95% C.I. 5.6-25.9 months). The rate of relapse was 69.2%. Good prognostic factor for overall survival time was the fraction of blast cells less than 75% in bone marrow at diagnosis (P=0.001) in univariate analysis. In multivariate analysis, age below 40 (P=0.003) and blast cells less than 75% in hone marrow at diagnosis (P=0.003) were good prognostic factors for overall survival time. Good prognostic factors for disease free survival in univariate analysis were the fraction of blast cells less than 75% in bone marrow (P=0.003), absence of fever (P=0.013), and absence of hepatomegaly (P=0.025), all at diagnosis. In multivariate analysis, good prognostic factors for disease free survival were platelet count more than 50,000/uL, blast cells less than 75% in bone marrow at diagnosis (P=0.004), serum LDH level below 500U/L (P=0.016). The result of treatment of ALL in adults has been improved but is not satisfactory in comparison with that in children. Despite of marked improvement of the rate of complete remission, the rate of relapse still not so much improved. So intensified consolidation chemotherpy or allogenic bone marrow transplantation or autologous bone marrow transplantation is necessary for improvement of survival of adult ALL.

An Improved Synthesis of Methyl p-Hydroxyphenylalkanoates

Choi, Hong-Dae,Kowak, Yong-Sil,Geum, Dak-Hyun,Son, Byeng-Wha The Pharmaceutical Society of Korea 1994 Archives of Pharmacal Research Vol.17 No.3

Friedel-Crafts reaction isopropoxybenzene with methyl $\alpha$-chloro-$\alpha$-(maethylthio)acetate 1 afforded methyl $\alpha$-methylthio-p-isopropoxyphenylacetate 2d, which was readily converted into methyl p-isopropoxyphenylacetate 3 by reductive desulfurization with zinc dust in acetic acid. Methylation of 3 with sodium hydride and methyl iodide gave methyl $\alpha$-(p-isopropoxyphenyl)propionate 5. Methyl p-hydroxyphenylakanoates (4,6), useful intermediates for some medicines, were easily prepared by treatment of 3 and 5 with titanium tetrachloride, respectively.

An Improved Synthesis of Methyl p-Hydroxyphenylalkanoates

Choi, Hong Dae,Kowak, Yong Sil,Geum, Dek Hyun,Son, Byeng Wha 동의대학교 기초과학연구소 1995 基礎科學硏究論文集 Vol.5 No.1

Friedel-Crafts reaction of isopropoxybenzene with methly α-chloro-α-(methylthio)acetate 1 afforded methyl α-methylthio-p-isopropoxyphenylacetate 2d, which was readily converted into methyl p-isopropoxyphenylacetate 3 by reductive desulfurization with zinc dust in acetic acid. Methylation of 3 with sodium hydride and methyl iodide gave methyl α-(p-isopropoxyphenyl)propionate 5. Methyl p-hydroxyphenylalkanoates (4,6), useful intermediates for some medicines, were easily prepared by treatment of 3 and 5 with titanium tetrachloride, respectively.

항염증제로서 2-아릴-5-벤즈옥사졸프로피온산 유도체의 합성

최홍대,곽용실,금덕현,손병화 동의대학교 기초과학연구소 1995 基礎科學硏究論文集 Vol.5 No.1

A facile synthesis of 2-aryl-5-benzoxazolepropionic acid derivatives(10a-d), which are potent antiinflammatory agent, is reported. Methyl α-(p-hydroxyphenyl)propionate(5) was prepared from Froedel-Crafts reaction of isopropoxy benzene with methyl α-chloro-α(methylthio) acetate(1), followed by desulfurization, methylation and clevage of ether bond. Compounds(10a-d) were made from(5) by sequence of nitration, reduction, formation of benzoxazole ring, and hydrolysis in good yields, respectively.

골융해 골전이가 있는 악성종양 환자에서 Oral clodronate의 임상적 치료효과

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

The skeleton is common metastatic site for cancer. Although bone metastases are not usually life-threatening, they are often the cause of severe morbidity and can produce clinical problems of both acute and a chronic nature. Characteristically. patients experience severe bone pain and pathologic fracture. Hypercalcemia and hypercalciura can occur when the metastatic lesions are predominantly osteolytic and are often worsened by the immobility that results from excessive skeletal pain, especially when weight-bearing bones are involved. The bisphosphonates are enzyme-resistant analogues of pyrophosphate, the naturally occuring inhibitor of bone mineralisation. They bind to hydroxyapatite crystals, inhibit osteoclast-mediated bone resorption. The clinical effect of oral clodronate was assessed in 20 patients with advanced cancer associated with osteolytic bone metastases in an open trial of 4 week duration. The dose was 800-1,600mg/day. The level of calcium on day 7 in hyercalcemic patients was significantly reduced by oral clodronate treatment(p<0.05). In normocalcemic patients the serum calcium level did not change significant statistically after coldronate treatment. The subjective improvement of pain was seen in 60% of patients. The side effect of clodronate was nausea and vomiting but tolerable. In conclusion, oral coldronate provided effective control hypercalcemia and pain associated with osteolytic bone metastases and was well tolerated.

항염증제로서 2-아릴-5-벤즈옥사졸프로피온산 유도체의 합성

최홍대(Hong Dae Choi),곽용실(Yong Sil Kowak),금덕현(Dek Hyun Geum),손병화(Byeng Wha Son) 대한약학회 1994 약학회지 Vol.38 No.5

A facile synthesis of 2-aryl-5-benzoxazolepropionic acid derivatives(10a-d), which are potent antiinflammatory agent, is reported. Methyl alpha-(p-hydroxyphenyl)propionate(5) was prepared from Friedel-Crafts reaction of isopropoxy benzene with methyl alpha-chloro-alpha-(methylthio) acetate(1), followed by desulfurization, methylation and clevage of ether bond. Compounds(10a-d) were made from(5) by a sequence of nitration, reduction, formation of benzoxazole ring, and hydrolysis in good yields, respectively.

Synthesis of 7-[p-(Methylthio)benzoyl]-5-benzofuranacetic Acid

Geum, Dek Hyun,Choi, Hong Dae,Kowak, Yong Sil,Son, Byeng Wha 동의대학교 기초과학연구소 1994 基礎科學硏究論文集 Vol.4 No.1

A new method was described for the preparation of 7-[p-(methylthio)benzoyl]-5-benzofura-nacetic acid 6, which is an analgesic agent. Methyl 5-(2,3-di-hydrobenzofuran)acetate 3 was obtained by Friedel-Crafts reaction of 2,3-dihydrobenzofuran with methyl α-chloro-α-(methylthio)acete 1 and desulfurization of 2. Tifurac 6 was synthesized from acylation of 3 with p-(methylthio)benzoyl chloride followed by bromination of 4. dehydrohalogenation, and hydrolysis of 5.

Synthesis of 2-(2-Fluorenyl)propanoic Acid

Choi, Hong-Dae,Geum, Dek-Hyun,Kowak, Young-Sil,Son, Byeng-Wha The Pharmaceutical Society of Korea 1994 Archives of Pharmacal Research Vol.17 No.1

Friedel-Crafts reaction of fluorene with methyl ${\alpha}$-chloro-${\alpha}$-(methylthio)acetate 1 gave methyl $\alpha$-methylthio-2-fluoreneacetate 2. Cicloprofen 8, a potent antiinflammatory agent, was prepared by methylation of 2 followed by reductive desulfurization of methyl 2(2-fluorenyl)-2-(methylthio)propionate 6 and hydrolysis of methyl 2-(2-fluorenyl)propionate 7.