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        연부조직육종의 수술후 방사선 치료결과

        김연실(Yeon Shil Kim),장홍석(Hong Seok Jang),윤세철(Sei Chul Yoon),유미령(Mi Ryeong Ryu),강기문(Ki Moon Kang),정수미(Su Mi Chung),김훈교(Hoon Kyo Kim),강용구(Yong Koo Kang) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.4

        목 적 : 최근들어 연부 조직 육종의 치료방법이 광범위 구획절제에서 사지기능을 보존하는 제한적 수술과 방사선/항암화학요법의 다병용치료로 변환되고 있으며 광범위 수술과 유사한 치료성적을 거두고 있다. 저자들은 수술후 방사선 치료를 시행한 연부 조직 육종 환자를 대상으로 치료 결과 및 실패 양상을 알아보고 관련된 예후 인자를 분석하여 수술 후 방사선치료의 역할을 알아보고자 하였다. 대상 및 방법 : 대상환자는 1983년부터 1994년까지 치료한 60명이었고 모두 추적관찰이 가능했으며 평균 추적기간은 50개월이었다. 원발병소는 상·하지가 35례(58%)로 가장 많았고 체간 12례(20%), 두경부 7례(12%)였으며 병리학적 유형에 따른 구분은 악성섬유구종 14례(23%),지방육종이 10례(17%), 악성신경섬유종 7례(12%) 등 이었다. 전체환자중 6례를 제외하고는 조직학적등급의 분석이 가능했고 grade I, II, III가 각각 27례(45%), 3례(5%), 24례(40%)였다. 수술적 절제는 19례(32%)에서 광범위절제, 36례(60%)에서 변연절제, 5례(8%)에서 국소절제를 시행하였다. 방사선치료선량은 28.8- 80Gy였고 25례에서 방사선치료와 함께 항암화학 요법을 병용하였다. 결 과 : 최종분석 시 실패 양상은 국소재발이 20례(25%), 원격전이 7례(12%), 국소재발과 원격전이를 동반한 경우가 14례(23%)였다. 원격전이한 환자는 구제치료와 상관 없이 모두 사망하였고 국소재발한 환자중 5명이 구제치료에 성공하여 무병생존하였다. 전체환자의 2년 및 5년 국소제어률은 68.0%와 48.7%로 비교적 저조한 결과를 보였다. 국소제어율에 영향을 미친 예후인자는 조직학적 유형, AJCC 병기, 조직학적 등급, 수술의 범위, 수술절연 침범 유무 및 잔존종양 정도, 림프절 전이 유무(p <0.05)였다. 전체 환자의 5년 생존률과 5년 무병생존률은 각각 60.4%, 36.6%였고 평균 생존기간은 89개월이었다. 단변량 분석에 의한 생존률에 영향을 미친 예후인자로는 조직학적 유형, AJCC 병기, 림프절 전이 유무, 조직학적 등급, 수술절연 침범 유무와 잔존 종양 정도 였다. 결 론 : 결론적으로 본 연구 결과 연부 조직 육종에서 제한적 수술과 수술 후 방사선치료로 비록 저조한 국소제어률을 보였으나 사지 절단 혹은 광범위 구획절제와 비교시 유사한 생존률을 얻었다. Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 60 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patints with median follow up duration 50 months (range 6 - 162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58%) was the most frequent site of occurrence followed by trunk (20%) and head and neck (12%). Histologically malignant fibrous histiocytoma (23%), liposarcoma (17%), malignant schwannoma (12%) constitute 52% of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42%) received chemotherapy with various regimen in the postoperative period. Results : Total 4 1 patients failed either with local recurrence or with distant metastasis. There were 29 patients(48%) of local recurrence. Four patients (7%) developed simultaneous local recurrence and distant metastasis and 8 patients (13%) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck prima ry. This feature is like ly explanation for the decreased loca l control rate . Five of 29 patients who fa iled only loca lly were salvaged by re- excis ion and/or re- irradiation and rema ined free of disease . Factors affecting loca l control include histologic type , grade, stage , extent of operation and surgica l ma rgin involvement, lymph node metastas is (p <0.05). All 21 patients who fa iled distantly are dead with progress ive disease at the time of this report. Our overall survival results are similar to those of larger series . Actuarial 5 year overall survival and disease fresurvival were 60.4 %, 36.6% respectively. Grade, stage (being close association with grade), residual disease (negative ma rgin, microscopic, gross) were significant as a predictor of survival in our series (p <0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

      • 영화 ‘왕의 남자’에 나타난 복식에 관한 연구

        이미연;강태임 한경대학교 2008 論文集 Vol.40 No.-

        Movie costume are important means that express and pass person's personality and psychology, atmosphere of drama indirectly, and are strong medium that can recognize life and aesthetic consciousness of those days. We will appreciate movie 'King And The Clown' that reflect period life image well that can see through period piece, and analyze about aesthetic symbolism of movie costume that appeared in works, and search expression method of dress and its ornament of costume in historical drama and meaning and costume expression method of movie costume. As a result, we could know that movie costume is acted as important element that help story progress and is expressed sensuously imposing designer's creation with historical investigation to heighten meaning and effect of movie.

      • KCI등재후보
      • KCI등재후보

        중앙아시아 벽화 보존처리(1) : 벽화(본4074, 본4096)의 상태조사

        강형태,이용희,유혜선,김연미,조연태,시고 아오키,노리코 야마모토,켄타로 오바야시 국립중앙박물관 2001 박물관보존과학 Vol.3 No.-

        국립중앙박물관은 용산 새 박물관의 전시 유물로 선정된 중앙아시아 벽화의 연차적인 보존처리를 위해 “독립행정법인 일본 도쿄문화재연구소’’와 공동연구를 모색하게 되었다. 2001년에 본4074, 본4096 작은 벽화편 2점의 보존처리를 시작하면서 벽화의 균열 박락 등 손상상태, 구조와 구성재료, 이전 보존처리에서 적용된 재료와 방법에 대한 기초조사를 실시하였다. 조사결과 본4074, 본4096 2점의 벽화는 흙과 지푸라기를 반죽하여 만든 벽체에 석고를 발라 바탕으로 하고 그 위에 채색을 한 것으로 나타났으며 벽체 속에 포함된 지푸라기의 방사선 탄소연대측정 결과 본 벽화는 10세기 말에서 13세기 초에 만들어진 것으로 나타났다. 또한 X-선회절 분석 결과 화면의 흰색 바탕은 gypsum[Ca(SO₄)·2H₂O]과 CaSO₄, Calcite(CaCO₃)가 적색계통은 연단(鉛丹:Pb₃O₄)과 led arsenate[Pb(As₂O₆)], 녹색계통은 Cuprite(Cu₂O)와 arsenolite(As₂O₃), arsenic oxide(As₂O₄) 등이 사용된 것으로 조사되었다. This article is about a joint project carried out by the National Museum of Korea and the Tokyo Cultural Properties Research Institute for the conservation of central Asia Wall painting that has been selected for the exhibition at the new Seoul National Museum of Korea at Yongsan. The investigation of the wall painting revealed very useful information. This includes the condition of the object, and the identification of evident damage, such as cracks, loss of pigment, plus materials and methods employed during the object's creation, as well as previous conservation treatment. The object was mainly made by applying plaster to the body (wall) that consisted of a mixture of soils and rice straws. Then, on the surface of the wall-painting, pigments were used to draw and to colour it. As a part of the investigation, radiocarbon dating was conducted using straw samples taken from the object. The result indicates that the object is probably dated form between the end of the 10th Century and the beginning of the 13th Century. The result of X-ray diffraction also revealed the composition of the pigments used on the surface. These are 1. gypsom[Ca(SO₄)·2H₂O], CaSO₄ and Calcite(CaCO₃) and Calcite(CaCO₃) that were used for the white background. 2. Pb₃O₄ and led Arsenate [Pb(As₂O₆) that were used for the red colouring. 3. Cuprite(Cu₂O), Arsenolite(As₂O₃) and Arsenic Oxide(As₂O₄) that were used for the green colouring.

      • 노인의 영적 간호요구

        최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

        This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

      • 동북아 지역의 외래어 수용 양상에 대한 연구

        이화연,강윤옥,이미숙 이화여자대학교 영미학연구소 2005 영어학 연구 Vol.- No.10

        The primary aim of this study is to examine the different patterns of accepting foreign cultures through a cross-linguistic analysis of loan words in Korean, Chinese, and Japanese. Based on the data collected from 2000 to 2002, the investigator analysed the loan words of Korean, Chinese, and Japanese in terms of five different categories: IT(Information Technology), high-technology, computer, internet, and multi-media broadcasting. This study also investigated the characteristics of individual loan words, their transcribed patterns, and their specific features of word formation. The results of the study showed the similarities and differences of patterns in formulating loan words among the three East-Asian countries.

      • 시각적 피드백을 병행한 어깨복합운동프로그램이 어깨비대칭 청년들의 어깨 근력과 정렬에 미치는 영향

        강순희, 강은지, 목미경, 박지연, 손혜림, 연우정 한국교통대학교 2016 한국교통대학교 논문집 Vol.51 No.-

        The purpose of this study was to identify whether shoulder complex exercise program with visual feedback could improve the shoulder muscular strength and postural alignment in adolescents with shoulder asymmetry. Twenty eight subjects were recruited from the K university and divided into three groups: experimental 1, 2group(Each n=10) and control group(n=8). For 4 weeks, the experimental group 1 performed shoulder muscle complex exercise program and the experimental group 2 performed shoulder complex exercise program with visual feedback. The control group did not perform exercises. The shoulder muscle strength and difference between the height of left and right shoulders were assessed before, after training using the hand-held dynamometer and Global Posture System. Subordination variables, general characteristics analysis, χ² test and Kruskal Wallis H test were conducted to evaluate differences between groups and training before, after changes were checked Wilcoxon signed rank test with using the PASW 18.0 statistical program. The results of the study were as follows. 1) Both the experimental 1, 2group showed improvements in muscle strength of several muscles following training (p<.01). The control group showed significant reduction in the left posterior deltoid (p<.05), and did not show significant changes in examining other muscles (p>.05). And there were differences among three groups in shoulder muscle strength (p<.001). Muscle strength changes in several muscles were greater in the experimental 1, 2group compared with the control group (p<.001). Muscle strength changes in the several muscles were greater in the experimental group 2 compared with the experimental group 1 (p<.001) 2) Both the experimental 1, 2group showed significant decreases in the difference between the left and right shoulder heights following training (p<.01). The control group did not show change (p>.05). Changes in the difference between the left and right shoulder heights were greater in the experimental 1, 2group compared with the control group (p<.001).

      • 화재 피해를 입은 고 강도 철근 콘크리트 보의 보수 성능

        신미경,신영수,이차돈,홍성걸,강지연 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

        This paper is to evaluate practically the techniques and materials of repair for high strength concrete elements with fire damages as well as to investigate the structural behavior of beams according to pre- or post-repair after fire-damages. For this purpose, flexural specimens with high strength concrete were exposed to high temperatures by the ISO 834 specification. After natural cooling and post-fire-curing in a natural environment for 1 months, 6 specimens were loaded to failure after they were repaired with polymer cement mortar for 1 month curing.

      • 국내 설사환자로부터 분리된 Escherichia coli 균의 혈청군 및 Verocytotoxin 생성능

        김호훈,강연호,김성한,박미선,유재연,이복권 대한감염학회 1998 감염 Vol.30 No.5

        목적: 국내 설사 환자에게서 분리 동정된 인체 감염 유래 E. coli 균의 혈청군, verocytotoxin 생성능을 구명하여 EHEC 균의 인체 감염 실태를 구명하고, 동물 및 식품 유래 분리균주의 성상과 비교 검토하여 인체 감염 위험성에 대한 기초적 자료를 의학계에 제공하고자 하였다. 방법: EHEC 감염의심 설사 환자 분변 검체로부터 분리된 균주 중 생화확적 성상에 따라 대장균을 분리하였고 이들 균주 중 E. coli O157:H7를 분리하기 위해서는 Dsorbitol 음성균을 선별하였으며, 분리균에 대하여 항혈청으로 응집 시험을 실시하여 혈청군을 구명하였다. 혈청군이 확인된 균주에 대하여 중합효소 연쇄반응 (PCR) 및 역수동라텍스 응집시험 (Reversed Passive Latex Agglutination:RPLA) 으로 verocytotoxin 생성능을 구명하였다. 결과: 장출혈성 대장균 감염 의심설사 환자의 분변검체로부터 25주의 E. coli 균을 분리 동정하였으나 이들 균주는 모두 verocytotoxin을 생성하지 않았다. 분리 동정된 대장균으로부터 확인된 혈청군은 16종으로서 E. coli O1, O6, O8, O15, O20, O25 O26, O28, O29, O44, O86a, O119, O126, O128, O152, 및 O157:H-였으며 E. coli O157:H-혈청형 균주와 E.coli O25 혈청군 균주가 각각 3주씩 분리되어 비교적 높은 분리율을 보였다. 결론: 장출혈성 대장균 감염 의심설사 환자 분변 가검물로부터 총 25주의 E. coli균을 분리 동정하였으나 verocytotoxin을 모두 생산하지 않았다. Background: Since 1982, many countries has reported outbreaks or sporadic cases caused by enterohaemorrhagic Escherichia coli (EHEC) serogroup strains, mainly E. coli O157:H7 type strain. However, systemic investigation about EHEC agents, including E. coli O157:H7, have not been done in Korea. Therefore, we investigated serogroup and verotoxin productivity of E. coli strains isolated from diarrheal patients and estimated risk of human infection in comparison with EHEC strains isolated from cow, pig, and food material in Korea. Methods: Diarrheal patient stool samples were collected and E. coli strains were isolated, according to biochemical characteristics. In order to isolate E. coli O157:H7, D-Sorbitol negative strains were selected. Serogrouping of the E. coli isolates was done by agglutination test. Verocytotoxin productivity was investigated by polymerase chain reaction (PCR) and reversed passive latex agglutination (RPLA). Human infection risk was estimated in comparison with EHEC strains isolated from cow, pig and food materials in Korea. Results: Twenty-five E. coli strains were isolated from the diarrheal patients who were suspected to be infected with EHEC. However, none of these E. coli strains produced verocytotoxin. Out of 25 E. coli isolates, 16 serogroups of E. coli O1, O6, O8, O15, O20, O25, O26, O28, O29, O44, O86a, O119, O126, O128, O152 and 157:H-were found. In each of the E. coli O157:H-and O25 serogroups 3 strains were found. Conclusion: None of 25 E. coli isolated from diarrheal patients who were suspected of EHEC infection produced verocytotoxin producing E. coli have been reported recently in Korea.

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