재발한 위암의 진단에 사용된 FDG-PET의 유용성

이현국,이규언,김윤호,정재민,양한광,정준기,이건욱,최국진,Lee Hyeon Kook,Lee Kyu Eun,Kim Yoon Ho,Jeong Jae Min,Yang Han-Kwang,Chung June Key,Lee Kuhn Uk,Choe Kuk Jin 대한위암학회 2001 대한위암학회지 Vol.1 No.3

Purpose: For curative resection of recurrent gastric cancer, it is imperative that there be no unrecognized foci of tumoral disease outside the operation field. PET (positron emission tomography) with FDG (18 fluoro-2 deoxy-D-glucose) is a whole-body imaging technique that exploits the increased rate of glycolysis in tumor cells to detect disease. The authors evaluated the usefulness of FDG-PET in assessing resectability of recurrent gastric cancer. Materials and Methods: Seven patients with recurrent gastric cancer were studied with FDG-PET from December 1998 to October 2000. All FDG-PET images were interpreted in conjunction with conventional diagnostic methods. All imaging results were correlated with the pathological diagnosis and clinical outcome. Results: A final diagnosis of recurrence was obtained at 14 sites in all 7 patients by histology or clinical follow up. Locoregional recurrence, including distant metastasis, developed in 6 of 7 patients and distant recurrence in only one. FDG-PET detected all recurrent sites (5 locoregional and 5 distant) in 5 patients without peritoneal recurrence, but did not detect peritoneal seeding in 2 patients with peritoneal recurrence. The accuracy of FDG-PET in estimating resectability was $71.4\%$ (5/7), and that of CT and PET together was $85.7\%$ (6/7). A curative resection could be performed in three of the recurrent patients (2 locoregional and 1 distant recurrence). Conclusion: Our results suggest that FDG-PET may be useful for detecting locoregional and distant recurrence of gastric cancer and for selecting appropriate treatment. However, considering that FDG-PET was limited in detecting peritoneal seeding and determining the exact anatomical extension of tumor, it should be used in conjunction with other anatomical images.

갑상선암 수술 전 진단목적의 $^{18}F$-FDG PET/CT Dual Time Point영상에서 SUV값과 방사능 농도 측정법의 유용성 평가

이현국,강현수,양승오,한만석,Lee, Hyun-Kuk,Khang, Hyun Soo,Yang, Seoung-Oh,Han, Man-Seok 대한핵의학기술학회 2012 핵의학 기술 Vol.16 No.2

Purpose : This study is designed to compare two parameters reflecting $^{18}F$-FDG uptake, SUV and radioactivity, for diagnosis of thyroid cancer in dual time $^{18}F$-FDG PET/CT imaging and to find which parameter is more useful to decide whether the tumor is malignant or not. Materials and Methods : We performed retrospective study for 40 patients. All patients are diagnosed as primary thyroid cancer and examined $^{18}F$-FDG PET/CT. First, we got the dispersion of scattering beam of neck and lung apex to set a background and compared each dispersion, mean value, standard deviation of maxSUV and radioactivity. Also, mean maxSUV, ${\Delta}maxSUV$, ${\Delta}maxBq$/ml(%) and radioactivity between groups according to lesion's size based on biopsy are compared with independent-sample t-test. Results : the values that were from maxSUV and radioactivity measurement technique were compensated and calculated to practical values for mean comparison and patients were divided to two groups based on tumor size, Group1 ($size{\leq}1$ cm, n=21), Group2 (size>1 cm, n=19) for accurate comparison. In Group1, maxSUV (semi-quantitative analysis) was increased from $5.64{\pm}5.85$ (1.89~17.84) at first image to $5.90{\pm}5.01$ (1.95~18.22) at second image and radioactivity (Bq/ml) (quantitative analysis) showed similar increase from $5.93{\pm}6.38$ (2.50~16.75) at first image to $6.01{\pm}5.25$ (2.66~16.58) at second image. In Group2, TFmaxSUV was $10.54{\pm}14.36$ (2.54~33.89) in true first image, TSmaxSUV was $9.85{\pm}12.88$ (2.62~26.20) in true second image separately. The maxSUV showed a significant difference in the mean comparison between the two groups (p=0.035) But, mean radioactivity (Bq/ml) was $5.93{\pm}6.38$ (4.81~40.99) in true first image, $6.01{\pm}5.25$ (4.51~36.93) in true second image and didn't show a significant difference statistically (p=0.126) Conclusion : In diagnosis of thyroid tumor, SUV and radioactivity depending on $^{18}F$-FDG uptake showed high similarity with coefficient of determination (R2=0.939) and malignant evaluation results using dual time also showed similar aspect. Radioactivity for evaluation of malignant tumor didn't show better specificity or sensitivity than maxSUV.

친환경 건축 대안평가방식의 건축물 $LCCO_2$ 평가 프로그램

이현국,금원석,태성호,신성우,Lee, H.G.,Kum, W.S.,Tae, S.H.,Shin, S.U. 한국전산구조공학회 2012 전산구조공학 Vol.25 No.1

인터넷 비즈니스

이현국,Lee, Hyeon-Guk 한국데이터베이스진흥원 1999 디지털콘텐츠 Vol.10 No.-

많은 웹사이트들이 그 디자인과 실행면에서 똑같은 실수들로 인해 결과적으로 경쟁 사이트들에게 고객을 빼앗기고 있다. 이런 오류를 방지하기 위해 미국 커머스넷의 리서치 리포트를 인용하여 E-비즈니스 사이트들의 실수하는 문제점을 크게 10가지로 분류, 대책을 제시한다. 새로운 웹사이트를 구상 중이거나 기존 웹사이트를 개선하려는 경우 본 자료를 참고하여 조금이나마 도움이 되었으면 한다.

$^{18}F$-FDG PET/CT검사에서 지연영상을 이용한 갑상선 우연종 감별의 유용성 평가

이현국,양승오,송기덕,송치옥,이기흔,Lee, Hyun-Kuk,Yang, Seoung-Oh,Song, Gi-Deok,Song, Chi-Ock,Lee, Gi-Heun 대한핵의학기술학회 2008 핵의학 기술 Vol.12 No.2

본 연구의 목적은 $^{18}F$-FDG PET/CT검사 시 우연히 발견된 갑상선병변의 악성여부를 평가하기 위하여 위양성으로 판독되어지는 양성종양이나 염증질환과 악성 종양의 감별이 가능한 검사법으로 지연영상(Delay scan)을 적용하고 결과 값(SUV)의 기준안을 마련하며 이 연구에서 제시되는 검사법의 유용성을 평가하는데 그 목적이 있다. 2008년 1월부터 2008년 4월까지 E대학병원에 내원하여 $^{18}F$-FDG PET/CT를 시행한 환자 800명을 대상으로 후향적 분석을 실시하였다. 같은 연구기간 중에 갑상선의 원발암으로 $^{18}F$-FDG PET/CT을 실시한 1명은 연구에서 제외하였다. 최종적으로 799명이 연구대상이었으며 $^{18}F$-FDG PET/CT검사를 실시한 이유는 기존에 암이 증명되어 예후 관찰로 검사하거나 암이 의심되는 경우가 696명, 건강 검진 목적으로 실시한 경우가 103명이었다. $^{18}F$-FDG PET/CT영상 촬영은 SIEMENS사에서 만든 Biograph-Duo에서 시행하였으며, $^{18}F$-FDG PET/CT 정상영상(1 hr)을 취득한 후 갑상선 이상섭취가 있고 SUV 2.0 이상인 환자를 대상으로 1시간 후에 갑상선부위를 1 bed 지연영상을 촬영하였고, 한 bed에 2분 동안 영상을 얻었다. 갑상선 이상섭취가 있고 SUV 2.0 이상인 환자를 대상으로 이상섭취가 있는 부위의 1시간 영상과 2시간 지연영상의 SUVmax를 측정하여 비교 분석하였다. 본 연구에서 $^{18}F$-FDG PET/CT 검사 시 우연히 갑상선에 $^{18}F$-FDG 섭취를 보인 환자 중 갑상선 우연종(Thyroid incidentaloma)이 5명으로 0.63%로 나타났으며 모두 양성병변을 시사하는 소견을 나타냈다. 그리고 우연히 갑상선에 $^{18}F$-FDG섭취가 있는 경우 먼저 갑상선부위의 2시간 지연검사를 통해 $SUV_{max}$의 변화치를 이용하여 간접적으로 양성 혹은 악성여부를 판단하는 하나의 기준이 될 수 있고 판독의 오류도 줄일 수 있다. 발견된 갑상선 우연종(Thyroid incidentaloma)의 경우 1) 국소부위의 갑상선병변 SUVmax가 5.0 이상이고, 2) $^{18}F$-FDG PET/CT 정상검사(1 hr)와 지연검사(2 hr)의 갑상선병변 $SUV_{max}$차이가 $1.0{\pm}0.5$인 경우 Malignant를 의심하고 조직학적 확진을 진행한다. 그렇지 않은 경우에도 추후 PET이나 CT를 이용한 면밀한 영상검사로 추적 관찰하는 것이 병변의 진단을 위한 합리적인 접근방법이라고 생각한다. Purpose: To evaluate the degree of malignancy of incident thyroid lesion found in $^{18}F$-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods: A retrograde study was conducted of 800 patients who were admitted in E hospital to receive $^{18}F$-FDG PET/CT examination. One patient who was diagnosed as primary thyroid cancer and received $^{18}F$-FDG PET/CT examination was excluded. The number of final patients of this study was 799, the reasons of $^{18}F$-FDG PET/CT examination of these patients were follow-up of old cancer or suspicious tumorous lesion in 696 and disease screening in 103. $^{18}F$-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal $^{18}F$-FDG PET/CT image (1 hr) and then 1 hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid $^{18}F$-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1 hr later, we took a 1 bed-delayed image and then made a comparative study between measured $SUV_{max}$ of 1 hr-abnormal uptake image and that of 2 hr-delayed image. Results and Conclusion: In this $^{18}F$-FDG PET/CT study among the patients who showed incidental $^{18}F$-FDG thyroidal uptake the number of thyroid incidentaloma was 5 (0.63%), all of then showed benign findings. And in the case of incidental $^{18}F$-FDG uptake in thyroid, $SUV_{max}$ variance obtained from 2 hr delayed image can be a indirect criteria in differentiating benign tumor from malignancy and decrease finding error. In the cases found thyroid incidentaloma when 1) $SUV_{max}$ of focal thyroid lesion is above 5.0 and 2) $SUV_{max}$ variance between normal $^{18}F$-FDG PET/CT exam and 2 hr delayed is $1.0{\pm}0.5$, they are suspected as malignancy and confirming biopsy is to be followed. Otherwise, I also think that distinct follow-up PET or CT image study is a reasonable diagnostic method.

연하 유발성 심방세동

이현국 ( Hyeon Gook Lee ),전국진 ( Kook Jin Chun ),이동완 ( Dong Wan Lee ),이혜정 ( Hye Jeong Lee ),김준홍 ( June Hong Kim ),홍택종 ( Taek Jong Hong ),신영우 ( Yung Woo Shin ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-

Deglutition tachyarrhythmias are rare. We report a case of atrial fibrillation triggered by swallowing. A 63 year old female presented to our hospital with a 20 day history of paroxysmal palpitations lasting approximately 5 to 10 seconds in duration and precipitated by ingestion of solids but not liquids. Cardiovascular examination, chest radiography, Echocardiography, upper GI endoscopy and thyroid function tests were normal and 24 hour ambulatory monitoring showed sinus rhythm except for numerous episodes of atrial fibrillation with rates of 150 to 200 beats/minute during meals. Most episodes spontaneously reverted to sinus rhythm within few minutes. The patient`s exercise tolerance was good with the achievement of 96% of the age predicted maximum heart rate. Her symptoms were controlled by verapamil. She is currently symptom-free with regular doses of verapamil under clinical follow-up. (Korean J Med 69:S818-S823, 2005)

주민참여예산제의 현황과 과제: 시·도교육청과 시·도청의 비교를 중심으로

이현국(Lee, Hyunkuk) 한국교육재정경제학회 2018 敎育財政 經濟硏究 Vol.27 No.1

주민들의 예산과정에의 참여를 제도화한 주민참여예산제를 도입한지 시 도청의 경우에는 13 년, 시 도 교육청의 경우에는 7년 정도의 시간이 흘렀다. 시간의 흐름에 따라 각 지방자치단체 별로 주민참여예산제도는 다양한 형태로 변화되었지만 지금까지의 연구들은 이러한 변화된 제도를 유형화하고, 유형별로 특징을 분석하기 보다는 도입의 당위성, 목적, 성과를 중심으로 연구해 왔다. 본 연구는 주민참여예산제도를 숙의성과 주민들의 영향력의 정도를 기준으로 시 도청과 교육청 주민참여예산제의 유형분류를 시도하였다. 그 결과 주민들의 숙의과정을 제도화하고 참여의 영향력도 강한 숙의민주형, 숙의과정의 제도화는 되었으나 참여의 영향력은 적은 상징기구형, 숙의과정은 제도화되지 않았으나 다양한 제안제도를 통해 참여 영향력은 높은 사업 제안형, 숙의과정에 대한 제도화와 영향력도 모두 낮은 자문기구형으로 유형을 분류하였다. 이후 시 도 교육청과 시 도청의 주민참여예산제도를 분석하여 유형화를 시도하였다. 숙의과정에 대한 제도화는 조례의 규정을 기준으로 하였으며, 영향력의 정도는 위원회 위원의 구성과 주민 참여예산액과 편성의 범위를 기준으로 분석을 하였다. 그 결과 시 도교육청과 시 도청 모두 자문기구형이 가장 많은 것으로 나타났다. 다만 주민참여예산제도의 도입 역사가 오래된 시 도청이 숙의민주형이 더 많고 자문기구형은 상대적으로 적은 것으로 나타났다. 마지막으로 이러한 차이가 나타나는 원인과 향후 제도의 발전방안에 대해 모색해 보았다. In the case of the municipal and provincial offices had 13-years experiences for participatory budgeting, but municipal and provincial offices of education had seven years of time. As time went by, the budget system for residents participation in each local government changed into various forms. However, the researches so far have focused on the justification, purpose, and achievement of the introduction rather than analyzing the characteristics of these changed institutions has come. This study attempted to categorize the korean government participatory budget system based on the deliberation and the degree of influence of residents. As a result, categorizes such as institutionalization of residents deliberation process and strong influence of participation, “deliberative democracy type”, institutionalization of deliberation process, but symbolic structure with little impact of participation, “symbolic operation type”, the process of deliberation was not institutionalized. but strong influence of participation, “Idea proposal model”, And institutionalization and influence on the deliberation process were all classified as low “advisory type”. After that, the city and provincial office of education and the city and the provincial government were analyzed into four typology of the participation budget system. The institutionalization of the deliberation process was based on the provisions of the Ordinance. The degree of influence was analyzed based on the composition of the committee members and the scope of the budget and composition of the residents participation budget. As a result, compare to the city-provincial office of education, the city-provincial government had more deliberative democracy form and less advisory type. Finally, I searched for the cause of this difference and how to develop the future system.

어메니티와 청년인구변화: 대전광역시 사례를 중심으로

이현국(Lee, Hyunkuk),강영환(Kang, Young Hwan) 서울행정학회 2019 한국사회와 행정연구 Vol.30 No.3

본 연구는 도시지역 내부의 청년인구의 변화와 그 원인을 살펴보는 것을 목적으로 하였다. 기존 연구들은 주로 전체 인구변화의 원인을 살펴보았으며, 특히 그 원인으로 불균형이론에 따른 노동시장의 수요-공급으로 인구변화의 원인을 살펴보았다. 반면에 본 연구에서는 청년인구의 변화원인을 살펴보는 것을 목적으로 하였으며, 그 원인으로 어메니티에 초점을 두고자 하였다. 국가 전체적으로 살펴본 청년인구의 이동은 주로 노동시장의 수요-공급으로 설명할 수 있으나 대도시 지역 내의 청년인구의 이동은 어메니티가 큰 영향을 주었을 것으로 보았기 때문이다. 다양한 어메니티 중에서 어떤 요인들이 청년인구의 이동에 영향을 주었는지를 분석하기 위해서 대전광역시의 동구, 중구, 대덕구의 45개 동의 8년간의 인구, 사업체조사 자료를 패널 분석방법을 활용하여 분석하였다. 그 결과 제조업과 같은 어메니티는 청년인구에 오히려 부정적인 영향을 미치고 있는 반면, 도서관 · 사적지 · 여가서비스업, 유원지 및 기타오락관련서비스와 같은 어메니티는 긍정적인 영향을 미치는 것으로 분석되었다. The purpose of this study was to examine the changes and causes of the youth population in urban areas. Existing studies mainly examined the causes of total population change, and in particular, the causes of population change due to the supply-demand of labor market. On the other hand, the purpose of this study is to examine the causes of change in the young population and to focus on amenities. The movement of the youth population as a whole can be explained mainly by the demand-supply of the labor market, but the movement of the youth population in the metropolitan area seems to have had greatly affected the amenities. In order to analyze what factors influenced the movement of young population among various amenities, data of 45 dongs and 8 years in Dong-gu, Jung-gu and Daedeok-gu of Daejeon were analyzed using panel analysis. As a result, amenities such as manufacturing have a negative effect on the young population, while amenities such as libraries, historic sites, leisure services, amusement parks, and other entertainment-related services have positive effects.

초 · 중등학교 목적사업비 배분 분석

이현국(Lee Hyun Kook),정동욱(Jeong Dong Wook) 한국교육재정경제학회 2016 敎育財政 經濟硏究 Vol.25 No.2

본 연구에서는 서울시 초 · 중등학교 목적사업비 배분에 대해 분석하였다. 목적사업비는 단위학교의 특정사업을 위해 지원되는 경비이다. 목적사업비는 교육청에서 단위학교로 배부되는 금액 중 가장 큰 비중을 차지하나 단위학교 간에 큰 편차를 나타내고 있다. 단위학교의 교육여건을 나타내는 지표인 단위학교 교육비 결정요인에서도 목적사업비의 영향이 큰 것으로 나타나고 있다. 이러한 편차에 앞서 목적사업비의 배분 과정에 있어서 목적 이외의 다른 영향요인이 존재하는지 확인하고자 하였다. 본 연구에서 설정한 연구문제는 다음과 같다. 첫째, 단위학교 간 목적사업비 배분의 현황은 어떠한가? 둘째, 단위학교 간 목적사업비 배분의 영향 요인은 무엇인가? 본 연구에서는 서울시교육청 2009~2013년 각 학교별 목적사업비 교부 자료와 2009~2013년 EDSS(EduData Service System)에서 제공하는 에듀데이터를 결합하여 사용하였다. 전체를 대상으로 분석한 이후에 목적사업비의 목적이 다른 점을 감안하여 형평성, 시설, 교육프로그램, 인적자원운용 4개의 영역을 선정하여 영역별로 분석하였다. 분석방법으로 이원고정효과모형을 사용하였다. 연구결과는 다음과 같다. 첫째, 목적사업비는 단위학교재정에서 가장 큰 비중을 차지하고, 배부기준은 목적사업별로 다르다. 학교기본운영비 대비 그 배분편차가 2.6배 수준(지니계수 기준) 인 것으로 나타났다. 둘째, 단위학교 간 목적사업비 배분의 영향요인으로 교장공모제 학교여부 등이 유의하게 나타나 원래의 목적 이외의 다른 영향 요인이 존재한다는 것을 확인하였다. 본 연구는 단위학교에서 큰 비중을 차지하지만 학교기본운영비에 비해 그 동안 관심이 적었던 목적사업비 배분에 대해 관심을 가졌다는 점, 목적사업비 배분에 있어 공모교장여부, 학교 SES 등 다른 영향요인이 존재한다는 것을 확인하였다는 점에서 의의가 있다. 목적사업비 배분에 있어서 원래의 취지와 기준에 따라 배부되어야 하나, 다른 요인의 영향으로 인해 보다 실질적인 필요가 있는 학교가 소외될 수 있으므로, 이들에 대한 관심을 가져야 한다. This study analyzed the allocation of the targeted funding to elementary and secondary schools in Seoul. The targeted funding is a grant to support each school's targeted program. Although the targeted funding occupied a large portion of each school's budget from districts, it had led to substantial inequities across schools. Moreover, the targeted funding also has had a similar effect on each school's educational expenditure, which is an index of school-level environmental conditions. The current study examined other influential factors on the allocation of the targeted funding before the emergence of disparity across schools. More precisely, it investigated two research questions: (1) What is a current trend in the allocation of the targeted funding across schools? (2) What are other influential factors on the allocation of the targeted funding across schools? This study used data from Seoul Metropolitan Office of education report in 2009~2013 allocation of targeted Funding and Edudata Service System (EDSS) and combined them. With respect to consideration of the various purposes in the targeted funding, this study firstly analyzed overall results, then sub-areas results in four perspectives: equity, facilities, educational program, and human resource management. Two-way fixed effects model was conducted to address research questions. Followings are research results. First, the targeted funding occupied the largest portion of each school's budget considering its size and weight, and the criteria of allocation differed by targeted programs. The distribution deviation of the targeted funding was 2.6 times (based on the criteria in gini coefficient) larger than the basic school management expenditure in school level. Second, the results showed that the employment of open-recruited principal and so on were influential factors on the allocation of the targeted funding across schools. These findings suggest that there are other additional factors beyond its original purpose. The study triggered people' interests and confirmed the existence of other influential factors on the allocation of the target funding, which has had less attention. We should pay attention to schools, which substantially need financial supports from the neglect, affected by other influential factors on the allocation of the targeted funding regardless of original purpose and criterion.

<춘향전>의 멜로드라마적 양식 원리와 그 토대

이현국(Lee, Hyun-gook) 한국어문학회 2011 語文學 Vol.0 No.113

The aim of this paper is to reveal the nature of its popular and interesting through closely examining the popularity of Chunhyangjeon. In this paper, first of all, on the internal ground about the popularity of Chunhyangjeon the principle form of melodrama was studied, and the results are as follows; First, the epic development of Chunhyangjeon shows dramatic narrative structure by irony, the swift change and reverse using contingency, contradiction, and the typical melodramatic principle of form that is episode structure. Second, the aspects of conflict structure not only shows the conflict type dichotomizing good and evil, but also the characteristic of the conflict shows melodramatic structure principle that is collision between old custom and the extrusion of new desire. And, the solution aspects of conflict also shows the typical melodramatic structure principle on the side of the moral esthetics presenting the moral vision and making a happy ending by encouraging the good and punishing the evil. Third, the subject that the epic narrative development and the conflict structure of Chunhyangjeon means, has the typical melodramatic subject in the that female desire exposing through Chuhyang overcomes the forbidden and oppression of patriarchal ideology symbolizing class distinction and fulfills the romantic love. Fourth, the inserting narrative song, the exaggerated acting and gesture, and the pattern of emotional excess which is reflected in the private poetic diction and the mise-en-scene element of the detail description method, that is the musical element of Chunhyangjeon, they indicate the melodramatic structure principle of Chunhyangjeon. Also, in the view of the results of study on the Korean breeding foundation of Chunhyangjeon that has the soap opera form principle, its aspects of the latter part of Joseon Dynasty period was created in modern turning point, is similar to the breeding foundation of Western melodrama. Therefore, it was revealed that the melodramatic Korean breeding foundation of Chunhyangjeon had been arranged to some extent. The result of above discussion that has melodramatic characteristics is inner proof that Chunhyangjeon has received popularity and interest from the public for centuries. It can be said that the melodramatic form principle of Chunhyangjeon itself is popularity. That is to say, that is the reason that the popularity of a work is thought on the premise of favor and interest of the public. The result that Chunhyangjeon has melodramatic characteristics is significant of that its popular and interest is inner merits of this novel. In addition, in that the melodramatic characteristic, that has been revealed the inner strength of the work, is the stylistic and structural features of the work, the melodramatic formal characteristics are the essential basis and proof of the popularity and interest of the novel Chunhyangjeon.