• Journal of Chest Surgery
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• 제29권7호
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• pp.713-722
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• 1996

폐이식후의 수용자들의 낮은 생존율은 주로 거부반응 또는 면역억제제 사용에 따른 합병증과 관련이 있다. 따라서 이식편에대한 수용자의 관용을 유도해낼 수 있는 더욱 좋은 방법이 절실히 요구된다. 저자 는 동종의 골수간세포가 주입되어진 혼합동종이 인자형 키메라 쥐에서 특정 동종 공여군의 공여 폐이식 편에대한 관용의 초래여부를 연구하였다. Fisher(F344)와 Wistar Forth(WF)종주의 쥐에서 치사량의 (1100c0y) 방사선조사후 T-임파구를 제거한 동일종주와 동종이인자형 골수의 혼합물로 재구성하였다 (F)44+WFIWF, AC1+F3441F3f4).28일후 말초혈액에서 임파구형의 검사로 혼합형 키메리즘이 확 인된 쥐에서 특정 공여군 또는 제3군의 동종 공여폐로 좌측의 동소 폐이식을시행하였다. 이식후 어떠 한 면역억제제도 투여하지 않았다. 이식편의 거부는 흉부 X선검사로 관찰하였고 조직학적으로 확인하 였다. 혼합형 키메라쥐들은 특정 공여군의 폐들을 받아들였으나 종주들 끼리의 특정효과에의한 것은 아 니었고, 이들에서 150일이상 거부반응을 관찰할 수 없었다. 이식편에대한 관용은 키메리즘의 백분율과 는 관계없이 일어났으며 제3군의 공여폐에대해서 \ulcorner정상대조군에서와 마찬가지로 10일내에 이식편에 대한거부반응이 완료되었다. 이 결과들은흔합형 키메라에서 정상적인 면역기전을 유지하면서도,특정 공여군의 폐이식후 안정적이고_1. 지속적 인, 이식 편에대한 관용이 일어난다는 것을 보여준다.

• 한국식품위생안전성학회지
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• 제16권1호
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• pp.27-32
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• 2001

장감염성 설사환자의 가검물로부터 분리된 30균는 모두 Shigella sonnei로 동정되었다. 이들 균주의 항생제 내성을 조사한 결과 30균주 중 27균주가 Tr(Trimethoprim-sulfamethoxazol)에서 내성을 보였고, 이들 중 SG-48균주는 Ap(Ampicillin), Cp(Cephalothin); Pi(Fiperacillin)에 대해서도 내성을 보인 반면, 나머지 3균주는 모든 항생제에 감수성을 나타내었다. 분리된 30균주 중 4균주를 선발하여 성장 검사를 실시한 결과 선발된 S. sonnei는 pH 4와 pH 9의 조건에서는 모두 성장이 저해되었으며, NaCl 9%첨가구의 경우 4균주의 성장이 저해되었으나 SG-73균주는 배양24시간 이후부터 성장하였다. 선발된 S. sonnei를 4$^{\circ}C$에서 배양한 경우 모든 균의 성장이 저해되었으나, 1$0^{\circ}C$에서 배양한 경우 배양 5일 이후부터 성장하였으며 영양결핍환경에서는 배양 15일까지 높은 균수를 유지하였다. 선발된 S. sonnei를 6$0^{\circ}C$에서 30분간 가열처리 한 경우 4~5 log cycle 감소하였으며, 7$0^{\circ}C$에서 5분 가열처리에 의해서는 검출되지 않았다.

• 대한두경부종양학회지
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• 제16권2호
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• pp.228-234
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• 2000

Objectives: Esthesioneuroblastoma is a rare malignant neoplasm that originates from the olfactory sensory cells. This tumor grows from the upper nasal cavity and ethmoid sinus and invades surrounding structures through the cribriform plate into intracranium or orbit in advanced stage. Even though there has been some controversies in determining standard treatment due to rarity of this tumor, the combination treatment of surgery and adjuvant radiation has been recommended for the locally advanced esthesioneuroblastomas. However, the recent clinical experiences of advanced cases showed that combination chemotherapy is highly effective to reduce tumor mass and improve clinical outcomes. Materials and Methods: The authors conducted a retrospective analysis of 6 esthesioneuroblastoma patients who were treated in our hospital from 1986. Results: The age of these patients was between 19 and 86 year-old. Among the 6 cases, 2 were diagnosed at stage B and 4 at stage C, according to Kadish classification. Anti-tumor treatments were performed in 5 patients. One patient refused active treatment and was lost to follow-up. Better survival outcome were observed in 3 patients who were treated with combination chemotherapy alone or combined modality treatment including chemotherapy. Conclusion: Based on our retrospective study, the combined treatment consisting of surgery, radiotherapy, and combination chemotherapy should be used to improve treatment results. And furthermore, innovative clinical approaches such as neoadjuvant chemotherapy, high-dose chemotherapy and autologous peripheral stem cell transplantation, which have been reported to have good therapeutic results, should be considered and applied actively.

• 대한두경부종양학회지
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• 제16권2호
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• pp.172-176
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• 2000

Objectives: To improve local control and reduce toxicity, 3-D conformal radiotherapy was used as a boost the primary tumor site following fractionated radiotherapy in patients with nasopharyngeal carcinoma. Materials and Methods: Eight patients with previously untreated nasopharyngeal carcinomas were treated with 3-D conformal radiotherapy following fractionated radiotherapy from September 1998 to April 2000. All patients had biopsy confirmation of disease before radiation therapy. Stages were II in 1, III in 5, and IV in 2. Two patients received cisplatin based chemotherapy in addition to radiation therapy; induction chemotherapy in 1, concurrent chemoradiation in 1. 3-D conformal radiotherapy delivered using 6MV Linac as a boost(range 25.2-28.8Gy, median 25.7Gy) following conventionally fractionated radiotherapy(range 50.4Gy). Average total dose ranged from 75.6-79.2Gy(median 76Gy). Follow-up time was 4-21 months(median 9.6 months). Results: Seven of 8 patients were evaluated radiologically within 3 months after completion of radiation therapy. All 7 patients were seen complete remission. One of 7 patients had distant metastasis after 5 months and local failure after 7 months. The tree interval of local recurrence was ranged from 4 - 21 months(median 10.2 months). One patient without radiological evaluation got complete remission clinically. Treatment related toxicity was grade 1-3 xerostomia, dysphagia, and mucositis. During 3-D conformal radiotherapy, there was no aggravation of any toxicity. Conclusion: Although the number of patients was small and follow-up period was short, 3-D conformal radiotherapy following conventional radiotherapy improved tumor control and dose escalation without increased toxicity. Survival and late toxicity should be evaluated through long term follow-up. In addition, it is necessary to confirm the benefits of 3-D conformal radiotherapy in nasopharyngeal carcinoma with randomized trial.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.23-32
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• 1988

저자는 1986년 3월부터 1988년 2월까지 2년동안 영남대학교 의과대학 부속병원 성형외과에 내원한 수지절단환자 75명, 102수지에 재해 수지재접합술을 시행하여 다음과 같은 결과를 얻었다. 1. 연령별분포에서는 20대에서 가장 많이 발생하였고, 남녀의 비율은 약 5:1로써 남자에서 현저히 많이 발생하였다. 2. 좌 우수의 발생빈도는 비슷한 분포를 보였으나 지배수와 비지배수의 비율에서는 지배수가 2배 이상 많이 발생하였다. 3. 수지별분포에서는 시지에서 가장 많이 발생하였고 그 다음으로는 중지에서 많이 발생하였다. 4. 손상의 원인으로는 압력기종류가 가장 흔하였고, 손상형태로는 좌멸창이 가장 많았다. 5. 마취방법에서는 국소마취와 전신마취가 비슷한 분포로 시행되었다. 6. zone II절단인 경우에는 77.8%의 성공률을, zone III의 절단인 경우에는 80%의 성공율을 나타내었다. 7. zone III절단인 경우보다 zone II절단인 경우에서 술후 수지기능이 더 좋았다. 8. 수지재접합술은 손상상태의 정도나 원인, 허혈시간에 관계없이 시행하였으며, 환자의 재접합술에 대한 요구도 무시할 수 없는 사항이었다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2531-2535
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• 2015

Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7171-7177
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• 2013

Purpose: To compare the safety and efficacy of first-line chemotherapy regimen with or without doxorubicin in treating patients with advanced soft tissue sarcoma (STS). Patients and Methods: We retrospectively analyzed a cohort of 56 patients histologically confirmed with STS who were treated at Jiangsu Cancer Hospital and Research Institute from July 2011 to June 2012.The basic element of first line chemotherapy contained epirubicin in group B and lacked epirubicin in group A. Response was assessed using RECIST criteria. The Kaplan-Meier method was used to estimate progress free survival (PFS). Results: According to RECIST criteria, patients in group treated by chemotherapy without epirubicin, the objective response (OR) ratio was 6.5 % (CR0%+PR6.5%). Disease control rate (DCR=CR+PR+SD) was 25.8% with a median follow-up of 14.6 months, including 2 patients achieving a partial response (PR 6.5%) and a stable response (SD 19.4%) in 6. In group B with epirubicin based regimens, no patient had complete response, PR (28 %) was observed in 7 and SD (24 %) in 6. DCR was observed in 13 patients (52%). By Fisher's exact test, the DCR difference between the two groups was statistically significant (p=0.046). In group A, median PFS was 3.0 months (95%CI:2.1-3.8), compared with 4.0 months (95% CI:3.03-4.97) in group B (p=0.0397 by log-rank test). Epirubicin based chemotherapy and ECOG performance status 0-1 were identified as favorable factors for progression in our cohort of patients. Differences of nonhematologic and hematologic toxicities were not statistically significant between the two groups, and the addition of epirobicin was not associated with cardiac toxicity (p=0.446). Conclusion: Our study demonstrates that epirubicin-based chemotherapy is effective and well tolerated, and is superior to chemotherapy without epirubicin regarding efficacy. Therefore it is recommended that epirubicin-based chemotherapy should be considered as first line for patients with advanced STS.

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.592-599
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• 2018

Objective : Metastatic brain tumors (MBTs) often present with intracerebral hemorrhage. Although Gamma Knife surgery (GKS) is a valid treatment option for hemorrhagic MBTs, its efficacy is unclear. To achieve oncologic control and reduce radiation toxicity, we used a radiosurgical targeting technique that confines the tumor core within the hematoma when performing GKS in patients with such tumors. We reviewed our experience in this endeavor, focusing on local tumor control and treatment-associated morbidities. Methods : From 2007 to 2014, 13 patients with hemorrhagic MBTs were treated via GKS using our targeting technique. The median marginal dose prescribed was 23 Gy (range, 20-25). GKS was performed approximately 2 weeks after tumor bleeding to allow the patient's condition to stabilize. Results : The primary sites of the MBTs included the liver (n=7), lung (n=2), kidney (n=1), and stomach (n=1); in two cases, the primary tumor was a melanoma. The mean tumor volume was $4.00cm^3$ (range, 0.74-11.0). The mean overall survival duration after GKS was 12.5 months (range, 3-29), and three patients are still alive at the time of the review. The local tumor control rate was 92% (tumor disappearance 23%, tumor regression 46%, and stable disease 23%). There was one (8%) instance of local recurrence, which occurred 11 months after GKS in the solid portion of the tumor. No GKS-related complications were observed. Conclusion : Our experience shows that GKS performed in conjunction with our targeting technique safely and effectively treats hemorrhagic MBTs. The success of this technique may reflect the presence of scattered metastatic tumor cells in the hematoma that do not proliferate owing to the inadequate microenvironment of the hematoma. We suggest that GKS can be a useful treatment option for patients with hemorrhagic MBTs that are not amenable to surgery.

• 한국산학기술학회논문지
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• 제19권4호
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• pp.276-292
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• 2018

본 연구는 재난관련 국내외 연구동향을 체계적 문헌고찰 방법을 통해 검토하고 이를 토대로 미래 재난관련 대응과제 및 발전방향에 대한 기초를 설정하기 위해 시도되었다. 관련 문헌검색은 국내외 데이터베이스를 통해 2000년 이후부터 2017년 2월 28일 까지 재난관련 용어를 조합하여 수행되었고, 총 177편의 문헌 중 선택 및 배제기준을 통해 최종 79편의 문헌이 분석에 활용되었다. 연구 결과, 재난관련 연구의 유형은 양적 연구가 31.6%로 가장 많았으며 전공 학문 영역별로는 의학분야에서 수행된 연구가 29.1%로 가장 많았고, 그 외 공학(18.9%), 행정학(13.9%), 간호학(11.4%) 순이었다. 국외의 경우 다중손상사고에서의 환자분류를 위한 트리아제 관련 연구가 많은 반면 국내에서의 트리아제 관련 연구는 전체의 30.4%에 불과하였으며, 대부분 트리아제 개발이나 개발된 트리아제의 효과평가 연구, 트리아제 관련 조사연구, 고찰 등이었다. 또한, 국제간호협회의 재난간호 역량 틀에 따라 분석한 결과, 대응 단계 관련 연구가 72.3%로 가장 많았다. 향후 재난관련 연구는 학제간 융합, 다중손상사고시의 생존율 향상을 위한 환자 분류체계 및 기술 통합 등이 필요하며, 다학제 간 공동연구결과를 기반으로 한 통합시스템이 필요한 것으로 사료된다.

• Journal of Chest Surgery
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• 제29권10호
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• pp.1102-1110
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• 1996

1955년 9월 부터 1995년 7월까지 230례의 승모판치환수술이 시행되었다. 이 중 남자는 77명 여자가 153명이 었고 평균 연령은 35.7였다. 동반된 수술은 대동맥 판막치 환술(40례), 삼첨 판윤성 형술(25례), 대동맥판치환술+삼첨판성형술(8례),삼첨판치환술(2례)등이 있었다. 139례의 기계판막과 91개의 조직판막이 치환되었으며, 판막의 크기와 사용된 수는 31 mm(75개), 29mm(66개), 33mm(46개), 27mm(29개) 및 25mm(14개) 등이었다. 수술전 NYHA 기능적 등급은 II(76례), III(123례), IV(31례)였으며 술후 I(175례), II(49례) 등으로 호전되었다. 술후 조기 합병증은 28에서 발생하였으며 저심박출증씨 8례로 가장 많았다. 조기사망은 6례 (2.6%)였으며 사망원인은 저심박출증(2례), 부정맥(2례), 심장파열(2례) 등이 었다. 총 추적 기간 누계는 764.4 환자-년이었으며 평균추적 기간은 43.9개월이었다. 판막과 유관한 장기 합병증은 21례에서 발생하였으며 이중 판막파괴가 10례(1.3%1환자-년), 항응혈제 출혈 5례(0.7%/환자-년), 심내막염 4례(0.5%1환자-년) 혈색전증 2례(0.3%/환자-년) 등이었고 심장에 연유한 사망은 5례(0.7%/환자-년)에서 발생하였다. 9년 장기추적중 합병증 및 사망비발생률이 판막 상호간에 유의한 차가 없었으나 판막파괴비 발생률이 기계 판막(100%)과 조직 판막(34.4%) 사이에 유의한 차가 있었다(p=0.032). 9년간 보험통계적 생존률은 96.6%였다.