췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

鐵筋콘크리트 構造物의 最適設計

鄭哲源,朴熙淳,孫鎔雨,崔圭文 圓光大學校 1989 論文集 Vol.23 No.2

이 論文에서는 最適化問題를 해결한다 : 彈牲設計에 비해 最大效率로 주어진 形態의 構造를 設計하여 모든 可能한 荷重組合下에서 그 構造의 崩壞와 그것의 臨界斷面의 first yield에 대한 어떤 지정된 最小荷重係數를 측정한다. 目的函數를 線形化하고, 모든 limit equilibrium constraint를 算出해 내는 方法을 개발하여 線形計劃法과 콤퓨터技法의 도움으로 그 問題를 해결한다. 관계되는 원리와 대응되는 最適解는 鐵筋콘크리트 連續보와 뼈대 構造를 例로서 설명되어 있다. The following optimization problem is solved in the paper : design a structure of given geometry for maximum efficiency vs. elastic design, so that under any possible load combination certain specified minimum load factors be guaranteed against both the collapse of the structure and the first yield of its critical sections. By linearizing the objective function and developing a method to generate all limit equilibrium constraints the problem is solved with the help of linear programming and computer techniques. The principles involved and corresponding optimal solutions are illustrated by the examples of a reinforced concrete continuous beam and frame.

복합레진의 수리 시 표면처리가 결합강도에 미치는 영향

최정인,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

본 연구의 목적은 표면처리가 기존의 레진과 새로운 레진 사이의 전단결합강도에 미치는 영향을 평가하는 것이다. 준비된 레진 시편을 6군으로 임의로 배분하여 각각의 표면처리를 한 후 수리용 레진을 축조하였다. 일주일간 보관 후 전단결합강도를 측정하였고 일원분산 분석법으로 통계처리하여 다음과 같은 결과를 얻었다. 1. 3군과 4군(air abrasion)은 1군(산부식)에 비해 전단결합강도가 유의하게 높게 나타났다(p<0.005). 5군과 6군(diamond bur)은 1군(산부식)에 비해 높은 전단결합강도를 나타냈으나 통계적으로 유의하지 않았다(p<0.005). 2. 2군(자가부식 접착제)은 1군(산부식)에 비해 전단결합강도가 낮게 나타났으나 유의한 차이는 없었다(p<0.005). 3. 3군(air abrasion)과 4군(air abrasion +산부식)에서 전단결합강도의 차이는 유의하지 않았다(p<0.005). 4. 5군(diamond bur)과 6군(diamond bur+산부식)에서 전단결합강도의 차이는 유의하지 않았다(p<0.005). 결론적으로,복합레진의 수리 시 air abrasion으로 표면처리를 했을 때의 결합강도가 가장 높았고,산부식 방법과 처리여부는 수리강도에 유의한 영향을 미치지 않았다. The purpose of this study was to evaluate the effect of surface treatment on the shear bond strength between new and old composite resin. The prepared resin specimens were separated 6 groups, and each group then received a different surface treatment. Then the repair material was added. Shear bond strengths for repair were measured after 7 days and the results were analyzed by using one way ANOVA. The results were as follows ; 1. Group 3, 4(air abrasion) showed significantly higher shear bond strength than Group l (phosphoric acid)(p<0.05). Group 5, 6(diamond bur) showed higher bond strength than Group l(phosphoric acid) but not significantly different(p<0.05). 2. Group 2(self-etching adhesive) showed lower shear bond strength than Group 1 (phosphoric acid) but not significantly different (p<0.05). 3. There was no statistically significant difference between Group 3 (air abrasion) and Group 4(air abrasion + etching). 4. There was no statistically significant difference between Group 5(diamond bur) and Group 6(diamond bur+etching). In conclusion, the surface treatment with air abrasion resulted in higher repair bond strength than other methods. Repair bond strength was not significantly affected by acid etching.

지각된 스트레스와 스트레스 대처방식이 직장인의 우울과 불안에 미치는 영향

최영민,이정호,이기철 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

Objectives : We attempted to clarify the relationship of perceived stress and the ways of coping to depression and anxiety in the white-collar workers. Methods : Fine Humded forty-five white-collar workers in a large enterprise were studied using a questionnaire package composed of demographic data, job stress questionnaire, global assessment of recent stress, the ways of coping checklist, Beck depression inventory, and state-trait anxiety inventory. And self reports of the subjects were statistically analyzed with the method of path analysis. Results & Conclusions : Perceived stress(job stress plus life stress) and the coping(problem-focused plus emotion-focused) determined 28.2% of the depression, 39.1% of the state-anxiety, and 35.4% of the trait-anxiety. These findings suggest that perceived stress and the coping have significant effects on the depression and state-trait anxiety of the white-collar workers. Although seemingly similar, problem-focused and emotion-focused copings, were contrary to each other in effects. Problem-focused coping reduced depression, anxiety and perceived life stress. However, emotion-focused coping didn't reduce the depression and anxiety. Furthermore, emotion-focused coping tended to increase perceived life stress. From these findings the authors inferred that emotion-focused coping interpreted the perceived stress as threatening and consequently became ineffectively defensive. On the other hand, problem-focused coping appeared to interpret the perceived stress as challenge and this challenge-appraisal mobilized effective coping resources. Applying path analysis, the aurhors could make the interactional stress model in the white-collar workers comprised of perceived job stress, perceived life stress, problem-focused coping, emotion-focused coping, depression, and state-trait anxiety.

Goretex를 이용한 융비술

최진영,민철기,명훈,황순정,서병무,이종호,정필순,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

융비술시 실리콘 고무는 다루기 쉽고 조직 반응이 적어 현대 많이 돌출의 합병증이 생길 수 있다. 저자등은 이러한 실리콘의 단점을 보완할 수 있는 goretex를 사용하여 융비술을 시행하고 비첨에 대해서 자가연골을 이식하여 만족할 만한 결과를 얻었기에 goretex가 안면부 연조직의 증강을 위한 이식재료로 적합하다고 생각되어 문헌고찰과 함께 보고하는 바이다. Many different materials have been used to provide augmentation of the nasal dorsum. this include both autogenous and homogenous materials,as well as allografts. Silicone among the artificial materials has been most widely used. The silicone has some advantages and disadvantages. Goretex(expanded polytetra-fluoroethylene) which has widely used in vascular surgery and abdominal surgery can be used for facial soft tissue augmentation. The author presemts 2 cases of nasal augmentaion using goretex with literature review.

하악 제1대구치의 치근 만곡에 영향을 주는 요인

최항문,이원진,허민석,이삼선,김정화,최순철,박태원 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Purpose : To find the cause of root curvature by use of panoramic and lateral cephalometric radiograph. Materials and Methods : Twenty six 1st graders whose mandibular 1st molars just emerged into the mouth were selected. Panoramic and lateral cephalometric radiograph were taken at grade 1 and 6, longitudinally. In cephalometric radio graph, mandibular plane angle, ramus-occlusal plane angle, gonial angle, and gonion-gnathion distance (Go-Gn distance) were measured. In panoramic radio graph, elongated root length and root angle were measured by means of digital subtraction radiography. Occlusal plane-tooth axis angle was measured, too. Pearson correlations were used to evaluate the relationships between root curvature and elongated length and longitudinal variations of all variables. Multiple regression equation using related variables was computed. Results : The Pearson correlation coefficient between curved angle and longitudinal variations of occlusal plane-tooth axis angle and ramus-occlusal plane angle was 0.350 and 0.401, respectively (p<0.05). There was no significant correlation between elongated root length and longitudinal variations of all variables. The resulting regression equation was Y=10.209+0.208X_(1)+0.745X_(2) (Y: root angle, X_(1): variation of occlusal plane-tooth axis angle, X_(2): variation of ramus-occlusal plane angle). Conclusion: It was suspected that the reasons of root curvature were change of tooth axis caused by contact with 2nd deciduous tooth and amount of mesial and superior movement related to change of occlusal plane. (Korean J Oral Maxillofac Radiol 2006; 36 : 55-62)

교통부 형식 증명 획득을 위한 창공-91 비행 시험 수행에 관한 연구

최병철,이정모 한국항공운항학회 1993 한국항공운항학회지 Vol.1 No.-

창공-91의 비행 시험의 목적은 성능 측정과 비행 특성의 확인이며 교통부의 기준은 주로 비행기의 운항에 따르는 안정성에 주안점을 두고 있다. 비행 시험으로 실속 속도와 이착륙 성능 그리고 상승 성능을 측정하여 비행 교범에 수록하였고, 안정성과 조종성의 적절함을 판단하였다. 창공-91 A2기의 비행 시험에 소요된 비행 시간은 81.5 시간이다.(창공-91 A₁기 : 52.8시간)