조선조 김시습론과 절의론: 남효온, 윤춘년, 이이, 박세당의 김시습 전기를 중심으로

김영수 ( Kim Young Soo ) 서울대학교 한국정치연구소 2020 韓國 政治 硏究 Vol.29 No.2

본고의 목적은 김시습의 삶에 대한 후대의 평가를 통해 조선 전기의 절의론을 검토하려는 것이다. 김시습론은 남효온, 윤춘년, 이이, 박세당의 논의를 검토하고자 한다. 김시습의 삶을 바라보는 조선조의 핵심 패러다임은 유교적 절의론이다. 그런데 절의론의 구체적 내용을 보면, 유교가 현실정치에서 직면하는 긴장과 충돌임을 알 수 있다. 예컨대 조선조 절의론을 대표하는 정몽주, 길재, 김시습, 조광조 등의 공통점은 현실정치의 부조리에 저항했지만 좌절했다는 점이다. 그러나 이들은 유교의 순수가치에 헌신하다가 처형되거나 추방된 순교자들로서 인식되었고, 유교의 진정한 정신적 영웅으로 평가되었다. 그래서 이들 대부분은 유교의 전당인 문묘에 종사되었다. 이 때문에 김시습에 대한 절의론을 검토해보면 조선의 정치사상과 정치현실, 그리고 지식인의 정치참여의 성격을 구체적으로 이해하는 데 기여할 수 있을 것이다. 또한 광기와 풍자를 통한 김시습의 독특한 권력비판의 형식도 이해할 수 있을 것이다. The purpose of this paper is to examine not only the political fidelity, but also the tension between Confucianism and politics in Early Chosŏn Dynasty through understanding on Kim Si-sup’s life. Specifically, Nam Hyo-on, Yun Chun-Yeon, Yi, and Park Se-Dang’s will be reviewed. In Chosŏn Dynasty, political fidelity was the core paradigm to interpret Kim’s life, Then, the concrete contents of political fidelity suggest the fact that Confucianism faced tension and conflict in real politics. The most famous persons of political fidelity in Chosŏn Dynasty are Chung Mong-ju (鄭夢周), Gil-jae (吉再), Kim Si-sup, and Cho Kwang-jo (趙光祖). All of them resisted and failed in real politics. But they were recognized as the true spiritual heroes of Confucianism, because they were martyrs who had been devoted to the pure value of Confucianism and executed or deported by real politics. Therefore, this research will contribute to the concrete understanding of political ideology, political reality, and participation of intellectuals in Chosŏn dynasty. One also could understand Kim’s unique form of criticism on political power through his madness and satire.

우적가 배경설화에 나타난 시험과 오도의 양상

김영수(Kim Young-Soo) 비교민속학회 2003 비교민속학 Vol.25 No.-

While we read the old documentary records, what we should be careful about is that we should approach and analyze the real material through doubt if it has a non-logical structure. And we should avoid the way of blind following and accepting to the opinion that pre-researchers has given. Why I had interest in the myth of U-Juck-Ga(遇賊歌 : The song made by a monk 〈named Young-jae〉 of Sin-ra dynasty. Its title means the song when he met sixty bandits) was the point that the bandits reward giving the property. And at once they were very impressed after listening to the one song, and as soon as they listened to the song they turned into the buddhist. So it describes a happening like a miracle. So I think that we can't explain the identity of bandits and the meaning of song without solving this kind of strange and non-logical meaning. The background myth of U-Juck-Ga has the structure of the personal seeking after truth of monk named Young-jae(永才). The entering to mountain of the monk Young-jae has not the meaning of small hiding(小隱 : To hide somewhere like a mountain for seeking after truth 〈accompanying not so much pain or hardship〉)or big hiding(大隱 : To hide somewhere like a mountain for seeking after truth 〈accompanying very much pain or hardship〉) but almost like the meaning of being scattered hiding(散隱 : To hide like a person who doesn't exist for seeking the truth 〈accompanying extreme pain and hardship〉) as the classical scholar Huh-am(虛庵 : The title of Jung-hi-ryang〈鄭希良〉, one classical scholar of Cho-sun dynasty) appointed. We should regard him as not the monk who had fame and sang a song very well but the monk who tried to turn to buddha with his 90-year-old body. The fact that the monk Young-jae was quite good at making the Hyang-Ga(鄕歌 : a poem and song especially thrived in the period of unified Sin-ra dynasty) is just a little detail of describing about him. And we should regard that the bandits already knew the name of the monk as that the fame of the monk was already well-known to bandits. The reason why they let him to make the Hyang-ga is not because of his good talent to make it. That he was quite good at making Hyang-ga means that he had not only very high virtue but also had a good talent to persuade someone when he made Hyang-ga. As it were, it is not just a simple song but a song which is quite easy to be understood about the doctrine of buddhism. If the bandits let the 90-year-old monk sing a song just because he is good at singing a song, then it is just the behavior of making fun of him, and the fact that the bandits turned into the buddhist through the monk Young-jae can't not but to have a big contradiction. The identity of the bandits might reflect the hard time of that period, and also can be his spiritual enemy for testing his body and soul. As the U-Juck-Ga has the meaning of reflecting oneself on passed days, for the wandering bandits who had no fame the monk Young-jae could be the changed people of buddha. and In the aspect of Young-jae himself the identity of the bandits could be the changed people for testing his body and soul.

정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

콩 단백 성분 및 연령이 암컷 흰쥐의 혈장 지질 농도와 인지질 지방산 패턴에 미치는 영향

정은정(Eun-Jung Chung),김수연(Soo-Yeon Kim),김지영(Ji-Young Kim),안지영(Ji-Young Ahn),박정화(Jung-Wha Park),차명화(Myung-Hwa Cha),이양자(Yang-Cha Lee Kim) 한국식품영양과학회 2003 한국식품영양과학회지 Vol.32 No.2

혈중 지질농도는 식이단백질 종류보다는 연령의 영향을 많이 받아, young군보다 old군의 총 콜레스테롤, TG, HDL-콜레스테롤, LDL+VLDL-콜레스테롤 및 AI 모두 높았다. 한편 콩 단백질군에서 HDL-콜레스테롤 수준이 증가하고, LDL+VLDL-콜레스테롤와 AI는 감소하여, 심혈관질환에 대한 콩 단백질의 유익한 효과를 확인할 수 있었다. 식이단백질에 의해 유의한 영향을 받은 혈장 인지질의 지방산조성중 22:0, 18:1ω9, ∑MUFA 조성은 카제인군에서 콩 단백질군 보다 높았으며, 반대로 ∑SFA 조성은 카제인군에서 낮았다. 연령에 의해 혈장 인지질 지방산 조성에 있어 유의한 차이를 보인 지방산 중 22:0, 18:1ω9, 22:1, 18:3ω3 및 22:4ω6는 young군에서 높은 반면에, 22:6ω3, ∑ω3, 18:2ω6, 20:4ω6, ∑ω6 및 ∑PUFA의 조성비율은 old군에서 높게 나타났다. 이와 같이 식이 단백질의 종류보다 연령의 영향력이 더 많이 나타난 것은 혈중 콜레스테롤 수준이 식이 단백질보다는 연령의 영향을 더 크게 받았기 때문으로 생각된다. 혈장 인지질 지방산의 대사지표 중 Δ7-desaturation index(16:0⇒16:1ω7)와 Δ9-desaturation index(18:0⇒18:1ω9)가 식이 단백질의 영향을 받아 카제인군에 비해 콩 단백질군에서 유의하게 낮았다. Δ7- 및 Δ9-desaturation index만이 식이 단백질의 영향을 받은 것은 식이 단백질보다 desaturase 활성에 더 큰 영향력을 미치는 콜레스테롤이 식이에 첨가되었기 때문이라 생각된다. Δ-4 desaturation index (22:4ω6⇒22:5ω6)는 young군에 비해 old군에서 높았으며, elongation index(20:4 ω6⇒22:4ω6)는 old군에서 낮았다. 대부분의 elongation과 desaturation 단계는 연령에 따라 유의한 차이를 보이지 못하였으나, ω3계 지방산의 전체적인 elongation-desaturation 단계를 나타내는 ∑products-fatty acid(ω3)/α-LNA(ω3) 비율이 old군에서 young군보다 유의하게 높아, 연령에 따른 PUFA 대사의 변화가 관찰되었다. 이상에서와 같이, 콩 단백질의 섭취로 흰쥐 혈장 인지질의 ∑MUFA 조성은 낮고 ∑SFA 조성은 높아 다른 지질 강화성분의 섭취와 유사한 결과를 나타내었다. 혈중 콜레스테롤 수준이 높은 old군에서 체내 막조직의 유동성을 유지하기 위해 PUFA의 합성 특히 ω3계 지방산의 elongation-desaturation이 증가하여 총 PUFA 조성이 young군보다 높았다. 연구결과로 이소플라본을 포함한 콩 단백질의 혈중 지질저하 기전에 대해 체계적인 설명은할 수 없지만, 콩 단백질이 혈장 지방산의 조성을 변화시킴으로써 간접적으로 심혈관계 질환에 대해 유익한 효과를 미침을 알 수 있었다. 한편, 이러한 혈관의 건강과 관련된 콩의 유익한 효과는 이소플라본과 같은 콩의 특정 성분의 단독효과라기보다는 콩 단백질과의 복합효과에 의한 것이라는 주장은 매우 설득력 있다고 생각된다. Effects of soy protein concentrate (SPC) containing isoflavone and casein diets on plasma phospholipid (PLs)-fatty acid patterns were investigated in 7- & 40- wk old female rats. Diets containing 16% SPC (soy/young: SY, soy/old: SO) and casein (casein/young: CY, casein/ old: CO) supplemented with 0.5% cholesterol were fed for 4 wks. Fatty acid compositions of plasma PLs were determined by TLC and GLC. Compared to the dietary protein effects, age effects on serum lipids were more profound. The levels of total cholesterol (Chol.), triglyceride, HDL-Chol., (LDL+VLDL)-Chol. and atherogenic index (AI) were higher in older groups (OC & OS) than younger groups (YC & YS). Soy groups had higher HDL-Chol. level and lower (LDL+VLDL)-Chol. and AI, compared with casein groups. The compositions of C22:0, C18:1ω9 and sum of MUFA in plasma PLs were significantly higher in casein group (CY & CO) than soy group (SY & SO), but those of sum of SFA were higher in soy group. The compositions of C22:0, C18:1ω9, C22:1, C18:3ω3 and C22:4ω6 were higher and those of C22:6ω3, sum ofω3, C18:2ω6 C20:4ω6, sum ofω6 and sum of PUFA were lower in plasma PLs of younger rats. The average P/S and ω3/ω6 ratio in older group was higher. The Δ-7 desaturation index (16:0⇒16:1ω7) and Δ-9 desaturation index (18:0⇒18 : 1ω9) were lower in soy group than casein group, while Δ-6 and Δ-5 desaturation index were not affected by dietary protein. The Δ-4 desaturation index (22:4ω6⇒22:5ω6) were higher and, elongation index (20:4ω6⇒22:4ω6) were lower in older group. The ratio of the products of ω3 fatty acid series/precursor of ω3 fatty acid series (C18:3) was significantly higher in older group, which in- dicated that age affected the plasma PUFA metabolism. On the other hand, older rats had higher serum cholesterol level compared with younger rats. Taken together, these changes in fatty acid composition might cause minimal changes in the membrane fluidity induced by the increase serum cholesterol level.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

노치 형상 및 냉각속도에 따른 Zr-2.5Nb 압력관의 DHC거동

김상재,김영석,임경수,김성수,정용무 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.1

The objective of this study is to investigate the delayed hydride cracking (DHC) velocity and the incubation time for the water-quenched and furnace-cooled Zr-2.5Nb tube with the different radius of a notch tip. DHC tests were carried out at constant K_1 of 20 MPa√m and 250℃ on the cantilever beam (CB) specimens subjected to furnace cooling or water quenching after electrolytic charging with 57 or 72 ppm hydrogen, respectively. An acoustic emission sensor was attached to the CB specimens to detect the incubation time before the start of DHC. The shape of the notch tip changed from the fatigue crack to the dull crack with its radius ranging from 0.1 to 0.15 mm. The DHC incubation time increased remarkably with the increasing radius of the notch tip, which appeared more strikingly on the furnace-cooled CB specimens than on the water-quenched ones. However, both furnace-cooled and water-quenched CB specimens indicated little change in the DHC velocity with the radius of the notch tip unless their notch tip exceeded 0.125mm. These results demonstrate that the uncleation rate of hydrides at the notch tip determines the incubation time and the DHC velocity becomes constant after the concentration of hydrogen at the notch tip reaches the terminal solid solubility for dissolution (TSSD). This observation agrees well with Kim's DHC model. A difference in the incubation time and the DHC velocity between the furnace-cooled and water-quenched specimens is discussed in terms of the uncleation rate of hydrides at the notch tip and the hysteresis of hydrogen solubility.

자궁내막암 환자에서 복강경하 자궁적출술과 복식 자궁적출술의 비교 연구

김종혁,이상수,김천복,김대연,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

목적 : 자궁내막암 환자에서 시행된 복강경 수술의 임상적 결과를 평가하고 수술적 지표 및 재발률에 대하여 기존의 개복 수술과 비교하고자 하였다. 연구 방법 : 1997년 8월부터 2003년 11월까지 저자들은 임상적 병기 I기인 79명의 자궁내막암 환자에서 복강경하 자궁적출술과 골반 및 부대동맥 림프절 절제술을 시행하였다. 총 79명의 환자 중, 수술적 병기 I기와 II기로 판명된 74명의 환자를 연구 대상으로 하였다. 대조군으로는 같은 기간 동안에 개복수술을 시행한 환자중 복강경 수술군과 병기가 같은 168예를 선정하였다. 결과 : 평균 수술 기간, 수혈량은 양군에서 비슷하였으며, 평균 재원 기간은 복강경 수술군에서 유의하게 짧았다. 수술전후 및 만성 합병증의 발생은 개복 수술군에서 유의하게 증가되었으며, 획득한 림프절의 수는 복강경 수술군에서 유의하게 더 많았다. 복강경 수술군에서 1예, 개복 수술군에서는 2예에서 재발하였고, 2년 무병 생존률은 복강경 수술군과 개복 수술군에서 각각 97.5%와 98.6%으로 유의한 차이는 관찰되지 않았다. 결론 : 자궁내막암 치료로서 복강경 수술은 기존의 개복술을 대신할 수 있는 안전하고 효과적인 시술 방법이다. 개복 수술과 비교해 볼 때, 재발 및 생존율 면에서 차이가 없었지만, 향후 전향적이고 더 오랜 추적기간을 갖는 연구가 필요하다고 사료된다. Objective : To evaluate the outcomes of laparoscopic surgery and to compare surgical parameters and recurrence rate of these with those of conventional abdominal surgery in patients with endometrial cancer. Methods : From August 1997 to November 2003, we have performed 79 cases of LAVH (laparoscopically assisted vaginal hysterectomy) with or without lymph node dissection. Laparoscopic approach was adapted in patients with FIGO clinical stage I by imaging study. Of the 79 patients, 74 patients who were proved to be surgical stage I and II were enrolled in this comparative study. As a control group, We selected 168 cases for the laparotomy group of the same stages. Results : The mean duration of surgery, the amount of blood transfusion and hemoglobin chamges were similar in both the laparoscory and the convertional alparotomy group. The mean duration of hospital stay was significantly shorter in patients treated by laparoscopic surgery (10.2 vs. 15.5 days). The number of lymph node obtained was significantly higher in the laparoscopy group. Two year recurrence-free survival rates were 97.5% in laparoscopy group and 98.6% in laparotomy group (p=0.763). Conclusion : Laparoscopic surgery for the treatment of early stage endometrial cancer is safe and effective altematives in terms of perioperative complications. Overall and recurrence-free survival did not differ significantly in both groups however long term risk for recurrence and survival has yet to be defined.

환경농업조성지구내 용수원 및 채수시기별 수질비교

김찬용,김창배,김종수,서영진,윤재탁 한국환경농학회 2002 한국환경농학회지 Vol.21 No.3

A study was conducted to investigate the seasonal changes in water quality of watershed in the Agricultural Environment Promotion Zone. samples collected were 12 GW (ground water), 2 IW (irrigation water), 2 SW (stream water) in An-Doug City, 4 GW, 6 IW, 11 SW in Young-Yang Gun, and sampling was conducted separately during dry and rainy season. In the ground water, EC and ionic species, except pH, were higher than those in stream water, and especially NO_3-N concentration exceeded the limitation of drinking water. Concentration of ions decreased as the sampling depth was far from the soil surface. During a rainy season, the concentrations of NO_3-N and K In the stream water were slightly higher than those during season. COD was lower during dry season in Yong-Yang, while the trend was contrasted to An-Doug. These results suggest that ground water was polluted by fertilization and compost while streamwater was polluted by loss of soil and organic during the rainy season. Principal chemical components related with changing water quality were EC, NO_3^-, Ca, Mg, Na, CI^-, SO_4^- in ground water, whereas NH_4-N, K, Mg, CI^-, SO_4^- in stream water.