바터 팽대부에 생긴 유암종 1예

강명주,지삼룡,박석주,이재익,조영완,김준영,박성재,박은택,이연재,이상혁,설상영,배상균 인제대학교 2006 仁濟醫學 Vol.27 No.-

Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi and gastrointestinal tract. Within the gastrointestinal tract, appendix is the most common location for carcinoid, followed by the distal small intestine, the rectum, and the stomach. Among these, primary involvement of the ampulla of Vater is extremely rare. We report a case of carcinoid tumor of ampulla of Vater. A 62-year-old man presented with epigastric soreness. Gastroduodenal endoscopy showed hyperemic bulging mass on ampulla of Vater and diagnosed as carcinoid tumor by histologic finding, with immunohistochemical study. In ^(111)In-octreoscan, tumor had regional lymph node metastasis, but no evidence of distant metastasis. Pancreatoduodenectomy with lymph node dissection was performed.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

단백뇨 없는 Mesangial IgM Nephropathy 1예

이강휴,강경표,김원,강명재,박성광,강성귀 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

An 51-year-old woman presented with microscopic hematuria without protenuria for long time. Laboratory studies demonstrated the presence of red blood cells in urine, a normal serum IgM level, the absence of antinuclear antibodies, and a normal complement level. Renal biopsy revealed that some glomeruli are enlarged with endocapillary cell proliferation and a few glomeruli exhibit prominent vascular pole of the tufts and segmental increase in mesangial cell and matrix. Immunofluorescence studies demonstrated segmental granular deposits for IgM. Electron microscopy showed well-preserved foot process associated with focal effacement. Biopsy findings were consistent with IgM nephropathy. We present this case to promote understanding of the pathogenesis of IgM nephropathy. (Korean J Nephrol 2002;21(2):317-321)

성인 쇄골 간부 골절에서 두 가지 수술적 치료군 간의 결과 비교: 금속판을 이용한 관혈적 정복 및 내고정술과 Steinmann Pin을 이용한 경피적 겸자 정복 및 골수강내 고정술의 결과 비교

허성식 ( Sung Sik Ha ),심재천 ( Jae Chun Sim ),홍기도 ( Ki Do Hong ),김재영 ( Jae Young Kim ),강정호 ( Jung Ho Kang ),박광희 ( Kwang Hee Park ) 대한골절학회 2007 대한골절학회지 Vol.20 No.3

목적: 성인 쇄골 간부 골절에서 금속판을 이용한 관혈적 정복 및 내고정술과 Steinmann pin을 이용한 경피적 겸자 정복 및 골수강내 고정술의 결과를 분석하여 비교하였다. 대상 및 방법: 2002년 3월부터 2006년 1월까지 본원에서 치료한 총 68예의 쇄골 간부 골절을 대상으로 하였으며, 금속판을 이용한 33예, Steinmann pin을 이용한 35예의 치료 결과를 분석하였다. 최종 결과 판정은 강 등의 기준에 의한 임상적 결과와 방사선학적 골유합 기간으로 하였고, 수술 시간을 비교하였다. 결과: 임상적 결과는 우수 이상의 예가 금속판을 이용한 군의 경우 총 33예 중 29예로 88%, Steinmann pin을 이용한 군의 경우 총 35예 중 32예로 91%의 결과를 보였다. 방사선학적 골유합 시기는 각각 평균 8.9주와 9.1주였고, 수술 시간은 금속판 군에서 평균 72분, Steinmann pin 군에서 평균 18분이었다. 결론: 성인 쇄골 간부 골절의 치료에 있어 금속판을 이용한 수술 군과 Steinmann pin을 이용한 수술 군은 임상적, 방사선학적 결과 면에서 통계학적으로 큰 차이를 보이지 않았으나, Steinmann pin을 이용한 수술 군에서 수술 시간 및 회복기간의 감소로 인하여 경제적인 면과 수술반흔의 감소에 따른 미용적인 면에서 더 만족스런 결과를 보였다. Purpose: To evaluate the results between open reduction and internal fixation with the plate and percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin for clavicle shaft fractures in adult. Materials and Methods: We have studied the results in 33 cases with the plate. 35 cases with the Steinmann pin among total 68 cases of clavicle shaft fracture. The patients were followed up over a period of at least 12 months. The final postoperative outcome was analyzed with the clinical outcomes using Kang`s criteria. radiological union time and operation time. Results: The clinical outcome that was good or excellent according to the Kang`s criteria showed a distribution of 88% in the group using the plate with 29 cases out of total 33 cases. 91% in the group using the Steinmann pin with 32 cases out of total 35 cases. The mean radiological union time was 8.9 weeks in the group using the plate. 9.1 weeks in the group using Steinmann pin. The mean operation time was 72 minutes in the group using the plate, whereas was 18 minutes in the group using Steinmann pin. Conclusion: In the treatment of adult clavicle shaft fracture. two groups did not show a significant statistical difference in clinical and radiological outcomes. However, the operation time and postoperative functional recovery was significantly shorter and faster in the group using Steinmann pin. Additionally economic and cosmetic aspect was more satisfactory in the group using Steinmann pin.

지방정부의 목표관리와 예산관리의 연계를 위한 모형 연구 - 부산광역시를 중심으로 -

박영강 ( Park Young-kwang ),강성권 ( Kang Sung-kwon ),강재호 ( Kang Jae-ho ),이강웅 ( Lee Gang-woong ),이종필 ( Lee Jong-pil ) 부산연구원 2004 연구보고서 공동연구 Vol.2004 No.0

There are two recent trends in improving performance of local government: The one is result-oriented budget system developed in European countries; the other is Management By Objectives (MBO) carried out in the United States. Japanese local governments, in which changes in budget system occur relatively slow, attempt to introduce performance-oriented administrative evaluation system while in Korea, Seoul local government makes a move to improve MBO by including performance-based budget system. Busan Metropolitan City has drawn up partially performance-based budgets(PB) in four areas (Financial Management Division, Environment Bureau, Busan Cultural Center and the Special Accounts for Transportation Project) since 2003, but budget system in general remains the same because, the performance proposals in budgets were merely linked with general directors and managers' objectives under MBO. The purpose of this study is to examine expected problems in introducing objective- budget connection system and to find alternatives and implications by analyzing the cases of three cities: Seoul of Korea, Suginami-Gu of Tokyo, Japan, City of Phoenix, U.S.A. Results showed that Suginami-Gu's administrative evaluation system was less effective than that of Phoenix mixing with PB and MBO. That of Seoul having a similar model to Phoenix budget system was turned out to be less effective. This means experience and technique of evaluation are more important in the efficiency of evaluation model rather than structural factors of evaluation model itself. Based on these results, we proposed basic directions of an objective-budget connection system to improve the efficiency of the system and institutional and technical alternatives as follows: First of all, when Korean local governments look for a new objective-budget connection system, Seoul's performance-management model will be a major alternative. Suginami-Gu's administrative evaluation system can be easily applicable, but it is not yet linked with personal compensation and promotion so that it may be passive in developing an evaluation index and its techniques. There for the operational experience and model of Phoenix having a similar model to Seoul's would be helpful. When we introduce a performance-management system of Seoul, we may have to consider the following institutional and technical alternatives in order to increase its efficiency: ① It is required to renovate the structure of Seoul's performance-based budgetary system. The case of Phoenix would be an alternative. ② To develop a performance index corresponding to the characteristics of Busan, it is needed to keep close bondage between evaluation-in-charge department and project departments, and to obtain external institutions' support and NGO's involvement. In this process, an organization's mission should be identified. In the setting up managers' personal goals require a concrete and diverse index like Phoenix's. ③ For performance evaluation as a core function of object-budget connection system, it is required to reinforce evaluation-in-charge department, to establish an adequate evaluation procedure and to carry out systematic training for supervisors' evaluation skill improvement and active participation of staff members. ④ To promote the efficiency of connection model, the inducement measure should be strengthened and its application should be expanded gradually. In Busan's case, bonus is offered as a means of the inducement. As the inducement effect of bonus is not high, the standard for bonus distribution should be varied to enhance the inducement effect. Structural renovation of budget system in the proposed alternatives requires central government's changes in the guide on the compilation of budget, but it can be done on the local government level. Reorganization of the evaluation agency and financial inducement structure can be achieved through local government's individual revision of ordinances and regulations. Thus, institutional restriction is unlikely to occur in the process of introducing a new objective-budget system. Those alternatives are considered as basic contents when Busan Metropolitan City introduces a new system mixing MBO with PB. But supplementary case studies on each country's budgetary structure and related financial system will be desirable. To realize these alternatives, it is required to overcome resistance from members of an organization and to secure political force to settle down the new system. It is desirable for a mayor of local government to have his/her confidence to pursue administrative reform and to obtain supports from community's council and opinions at the same time. This study is jointly conducted by Busan Development Institute and Dong-eui University in the form of Research-Academia consortium. Professor Kang, Jae-Ho of Busan National University participated in the project as a special researcher. We appreciate the advice and help of those who offered relevant materials from domestic and overseas. Especially, we would like to express our sincere thanks director Sakae Sueki and his staff members in the Department of Planning at Suginami-Gu of Tokyo, Professor Hiroshi Sato of Chuogakuin University in Japan, and Mr. Bob Wingenroth, City Auditor and his Deputy City Auditors, Ms. Diane L. Artrip, JoAnne M. Dukeshire in Phoenix, Arizona.

간세포암의 고주파 열치료 후 천자침 경로를 통한 전이 1례

조영완,박석주,진한영,김준영,이재익,강명주,박정하,윤정희,박성재,지삼룡,이연재,이상혁,설상영 인제대학교 2006 仁濟醫學 Vol.27 No.-

Radiofrequency ablation(RFA), as a form of minimally invasive therapy for hepatocellular carcinoma, has become an important treatment modality. Because of limitation of surgery, RFA has become standard therapy for hepatocellular carcinoma in some situations. But there are some complications of RFA such as bleeding, infection, hematoma, adjacent organ thermal damage including intestinal perforation, needle track seeding, and so on. There are few reports in the literature that systematically evaluate the incidence of needle tract seeding and its associated risk factors. And only 2 cases of needle tract seeding of hepatocellular carcinoma after RFA were reported in Korea. We report a case of needle tract seeding of hepatocellular carcinoma after RFA.

Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료

정남식,홍기도,하성식,박성준,강정호,심재천,Chung, Nam-Sik,Hong, Ki-Do,Ha, Sung-Sik,Park, Sung-Joon,Kang, Jung-Ho,Sim, Jae-Cheon 대한정형외과스포츠의학회 2006 대한정형외과스포츠의학회지 Vol.5 No.1

목적: 전위성 쇄골 간부 골절의 치료로 관혈적 정복술 후 LCP를 사용하여 내고정을 시행한 환자를 대상으로 방사선학적, 임상적 결과를 분석하여 전위성 쇄골 간부 골절의 치료에 있어서 LCP의 유용성을 알아보고자 하였다. 대상 및 방법: 2003년 5월부터 2004년 11월까지 본원에서 쇄골 간부 골절에 대해 LCP를 이용한 관혈적 정복, 금속내 고정술을 시행하고 6개월 이상 추시가 가능하였던 26례를 대상으로 하였다. 수술 후 최종 평가는 방사선 결과와 fang s criteria를 이용한 임상적 결과로 분석하였다. 결과: 수술 후 평균 9.3주에 모든 예에서 지연유합 없이 골유합 되었으며 임상적으로 Kangs criteria에 따라 구분한 결과, 우수 이 상이 22례로 나타났다. 특히, 견관절 운동은 상완골 골절이 동반된 두 경우를 제외한 24례에서 2.9주내에 정상 범위로 빠른 회복을 보였다. 합병증으로는 견관절 운동 장애 2례, 수술 절개 부위의 켈로이드 형성 1례였으며 그 이외에 다른 주요 합병증은 없었다. 결론: 전위성 쇄골 간부 골절에서 LCP를 이용한 관혈적 정복 및 금속내 고정술은 기존의 금속판에 비해 수술 후 합병증을 줄이고 효과적인 골유합과 조기 견관절 운동에 도움을 줄 수 있는 좋은 치료 방법 중 하나라고 사료된다. Purpose: To assess the effectiveness of the Locking compression plate (LCP) after open reduction for the treatment of the displaced clavicular shaft fracture, the clinical and radiologic outcome of the patients who were managed with the LCP for internal fixation after open reduction has been analyzed. Materials and Methods: We reviewed 26 cases with a displaced clavicular shaft fracture treated by internal fixation using Locking compression plate after open reduction between May 2003 and November 2004. The patients were followed up for at least six months period, and final postoperative outcome was evaluated using clinical results based on Kang's criteria, radiologic signs of fusion. Results: All fractures united by an average of 9.3 weeks without delayed union and showed fast recovery of motion fraction and shoulder function. In addition,24 cases without the fractures of proximal humerus recovered to normal range of shoulder notion within 2.9 weeks. Clinically, according to Kang's criteria, the outcome was good or better in 22 patients. The complications included shoulder joint dysfunction in two cases and keloid formation in one case, and no other complications were observed. Conclusion: The internal fixation using LCP for the treatment of displaced clavicular shaft fracture is a safe, reliable method of treatment, with few complications, and offers rapid recovery of shoulder joint function and bone union.

엉겅퀴(Cirsium japonicum var. ussuriense KITAMURA)의 조직배양에 의한 식물체의 재분화

강호종,박상현,박기관,김재환 진주산업대학교 1993 論文集 Vol.32 No.-

To examine proper part and medium in in-vitro culture shoot formation of in-vitro Crisium japonicum var. ussurinese KITAMURA, the test was carried out. The results are as follow: The wsa good in differentiation of the plant on the medium was good in MS+BA 10.0+Ki 10.0㎎/ℓ. In the results of formation and roots formation, proper medium was MS+Ki 0.1/ℓ. The case of MS+Ki 0.1㎎/ℓ was much no of shoots, ratio of roots, no of roots, also was good on growth.

용융염 전해정련 계에서 초 우라늄 대용물질로서 cerium dysprosium의 적용

강영호,황성찬,심준보,유재형 한국공업화학회 2003 공업화학 Vol.14 No.3

회토류원소 중 cerium과 dysprosium은 악틴족 원소와 염화물 생성 자유에너지의 차이가 크지 않기 때문에 분리하기가 매우 어렵다. 즉, 용융염을 사용 하는 전해정련 공정에서는 이들 회토류 원소가 악틴족 원소와 함께 석출되는 특성을 나타낸다. 이러한 성질을 이용하여 본 연구는 용융염을 전해질로 이용하는 전해정련실험에 cerium과 dysprosium금속을 초 우라늄원소의 대용 물질로 사용하여 그들의 모사 특성을 고찰하었다. 실험 결과 용융염 중 낮은 염화우라늄농도에서는 이 두 회토류 원소가 초 우라늄과 유사한 전해 특성을 나타냈으나, 높은 염화우라늄 농도에서는 회토류 원소의 거동을 보여주었다. The rare earth elements, especiaily cerium and dysprosium are very difficult to be separated from actinide elements due to their narrow differences in the Gibbs free energy of formation of chloride. That is, they are codeposited with actinide elements in electrorefining process with molten salt. Using this characteristics, present study discusses the feasibility for use of cerium and dysprosium metals to simulate the electrorefining characteristics of the transuranium. The experimental results show that the electrolytic behaviors of these two rare earth elements are similar with the transuranium in low concentration range of uranium chloride in molten salt. However, in high concentration range of uranium chloride they behave as the rare earth elements.

CORBA 기반의 분산 객체 관리 모델 구현

강재효,서재현,김상균 인제대학교 1998 仁濟論叢 Vol.14 No.1

본 논문에서는 CORBA(Common Object Request Broker Architecture) 객체의 관리를 위한 ObjectMonitor의 설계를 제안한다. 본 ObjectMonitor의 특징을 요약해 보면 다음과 같다. 첫째는 URN(Uniform Resource Name)기반의 객체에 대한 위치 투명성은 물론 한 단계 추가된 추상화기법을 통해 위치 독립성을 제공한다. 둘째는 서버들간의 부하 분담(Load Balancing)을 위한 정책을 쉽게 그리고 동적으로 제공한다. 셋째는 오브젝트의 오류 상황을 체크하여 제어할 수 있는 기능을 첨가함으로써 결함 허용(Fault Tolerant) 시스템을 지원한다. 이런 특징들을 바탕으로, 제안된 ObjectMonitor는 이질의 분산환경에서의 신뢰성을 부여하고, 확장이 용이하며, 또한 객체의 이동성을 제공한다. 이런 특성은 클라이언트와 서버간의 고품질의 서비스 제공을 가능하게 한다. This paper proposes a design of ObjectMonitor to manage CORBA(Common Object Request Broker Architecture) Object. The features of this ObjectMonitor are: 1) this provides not only Location Transparency of object based on URN (Uniform Resource Name) but also Location Independence through the abstract technics developed one more level; 2) it provides the policy for Load Balancing among servers easier and dynamically; 3) it supports Fault Tolerant System by adding functions that detect the error situations and fix them. The ObjectMonitor gives reliability in different distributed environment, and makes it easy to extend, and provides migration of objects. These kinds of features make it possible to give high quality service between Client and Server. Moreover, performing real-time object management dynamically, we get synergy that real time Load Balancing Policy can be used easily.