물리적자극이 좌골신경 절단 마우스의 골격근에 미치는 영향

김철용,Kim, Chul-Yong 대한물리치료과학회 2003 대한물리치료과학회지 Vol.10 No.2

To demonstrate the effect of physical irritancy(massages) on the skeletal muscles of immobilization ddY mice models induced by right side sciatic nerve neurectomy, the cross sectional histological profiles of the muscularis (M) gastrocnemius, M. tibialis cranialis and M. tibialis caudalis were observed after 28 days of treatment of physical irritancy with the changes of body weight thickness of hind limb and individual muscle weights. In addition, changes of demonstrated with diameter of individual muscle fiber and muscle fasciculata, and number of muscle fiber in each of three types of muscles located in the calf. The massages were used in this study as physical irritancy. The experimental groups were divided into five groups, 1) Sham-operated group(Sham), 2) Neurectomized but not physical irritated control group(Control), 3) Neurectomized and physical irritated at knee pint regions(T1), 4) Neurectomized and physical irritated at calf regions(T2), and 5) Neurectomized and physical irritated at achilles tendon regions(T3). The experimental animals were used 5 per groups. The changes of number or diameter of muscle fiber in each muscles were calculated using automated image analyzer. The results are as follow : Thickness(diameter) of muscle fiber of M. gastrocnemius, M. tibialis cranialis and M. tibialis cranialis in right side of hind limb were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. However, the thickness was significantly increased in physical irritated groups compared to that of Control group in followed order : T3<T1<T2. 2. Thickness(diameter) of muscle fasciculata of M. gastrocnemius, M. tibialis cranialis and M. tibialis caudalis in right side of hind limb were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. However, the thickness was significantly increased in physical irritated groups compared to that of Control group in followed order : T3<T1<T2. 3. Number of muscle fiber in muscle fasciculata of M. gastrocnemius, M. tibialis cranialis and M. tibialis caudalis in right side of hind limb were remarkedly decreased in Control, T1, 72 and T3 groups compared to that of Sham group. However, the number was significantly increased in physical irritated groups compared to that of Control group in followed order : T3<T1<T2.

물리치료의 발전과제와 전망

김철용,Kim, Chul-Yong 대한물리치료과학회 1997 대한물리치료과학회지 Vol.4 No.2

21C's physical therapy in going to be changed by the new needs of medical demanders. Therefore we have to ready to treat these things. 1. The resolute alteration of curricula and scientific development of Korea physical therapy are urgent. 2. The levels of educational system have to be changed like developed country in short time and the master's, doctor's courses have to be formed in university. 3. The field of study has to be seperated by the needs and alterations of the times. And the association has to present vision for physical therapy's developing. 4. The university has to invest and support for training of great capacity's therapists.

마사지가 좌골신경 절단 마우스의 골격근에 미치는 영향

김철용,김성학,박상옥,배성수,박래준,Kim Chul-Yong,Kim Seong-Hak,Park sang-Ock,Bae Sung-Soo,Park Rae-Joon 대한물리치료학회 2003 대한물리치료학회지 Vol.15 No.2

To demonstrate the effect of massages on the skeletal muscles of immobilization ddY mice models induced by right side sciatic nerve neurectomy, the cross sectional histological profiles of the muscularis (M) gastrocnemius, M. tibialis cranialis and M. tibialis caudalis were observed after 28 days of treatment of massages with the changes of body weight, thickness of hind limb and individual muscle weights. In addition, changes of serum aspartate amino- transferase (AST) and creatine phosphokinase (CK) levels were also demonstrated with diameter of individual muscle fiber and muscle fasciculata, and number of muscle fiber in each of three types of muscles located in the calf. The experimental groups were divided into five groups, 1) Sham-operated group (Sham), 2) Neurectomized but not massage control group (Control), 3) Neurectomized and massage at knee joint regions (T1), 4) Neurectomized and massage at calf regions (T2), and 5) Neurectomized and massages at achilles tendon regions (T3). The experimental animals were used 5 per groups. The results are as follow: 1. No significant changes of body weight were demonstrated in this groups during whole experimental periods compared to that of Sham group. In addition, no significant changes of body weight gains during experimental periods (Day 0 - Day 27: 28 days of treatment) were also observed. 2. The thickness of intact left side hind limb was not changes in all tested groups compared to that of Sham group. However, the thickness of right side hind limb were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of thickness of hind limb between right and left sides were also significantly increased in Control and massage groups (T1, T2 and T3) compared to that of Sham group. However, the thickness of right side of hind limb were significantly increased and the differences of thickness between both sides of hind limb were dramatically decreased in massage groups compared to that of Control group in followed order: T1 > T3 > T2. 3. Absolute and relative weight of M. gastrocnemius in the intact left side of hind limb was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. gastrocnemius were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. gastrocnemius between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. gastrocnemius were significantly increased and the differences of weight between both sides of M. gastrocnemius were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 >. 4. Absolute and relative weight of M. tibialis cranialis in the intact left side was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. tibialis cranialis were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. tibialis cranialis between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. tibialis cranialis were significantly increased and . the differences of weight between both sides of M. tibialis cranialis were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 > T2. 5. Absolute and relative weight of M. tibialis caudalis in the intact left side was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. tibialis caudalis were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. tibialis caudalis between right and left sides were also significantly increased in Con

자궁경부암의 방사선치료성적

김철용,최명선,서원혁,Kim, Chul-Yong,Choi, Myung-Sun,Suh, Won-Hyuck 대한방사선종양학회 1988 Radiation Oncology Journal Vol.6 No.1

One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP. Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; in case of radiation therapy only, whole pelvic irradiation was given with Co-60 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. In satges Ia, Ib, and IIa with small primary lesion, external irradiation was initially given to pelvis up to $2,000\~3,000\;cGy/2frac{1}{2}\;-3frac{1}{2}$ weeks and then intracavitary insertion was performed using Fletcher-Mini-Declos Applicator with cesium-137 cources and followed by external irradiation of $1,000\~2,000\;cGy/1frac{1}{2}\;-2frac{1}{2}$weeks via AP and PA parallel opposing fields with midline shield to spare of bladder and rectum. However, if the primary lesion is large, external irradiation was given without midline shield. More than stages IIb, the patients were treated by external beam irradiation up to 5,400cGy/30f for 6 weeks via 4-oblique portals and at the dose of 5,040cGy/28f the field was cut 5cm from the top margin for spare of small bowel, and followed by intracavitary irradiation, If there was residual tumor an additional dose of $900\~l,200cGy/5\~7f$ was given to parametrium and/or residual tumor area. Total dose of radiation to A and B-point were as follows; A-point; In early stages, Ia, Ib, IIa; $8,000\~9,000$ B-point $5,000\~6,000 cGy$ A-point; In advanced stages IIb, IIIa, IIIb; $9,000\~10,000$ B-point $60,000\~7,000cGy$ The results were obtained and as fellows; 1 The patients distribution according to FIGO staging system were stage Ia 6, Ib 27, IIa 28, IIb 54, IIIa 12, IIIb 18, and stage IVa 9. 2. Value of CT scan were demonstration of cervix tumor mass, parametrial and pelvic side wall tumor spread, pelvic and inguinal lymph nodes metastases, and hydronephrosis. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. 3. Local control rate of tumor according to the size was $91.3\%$ for less than 5cm in size and $44.6\%$ in tumor over 5cm (p<0.0068). 4. Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the para-aortic lymph nodes were the most common site for distant metastases. 5. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. 6. The 5-year survival rates showed; stage la and Ib $95\%,\;stage\;IIa\;81\%\;stage\;lIb\;67\%,\;stage\;IIIa\;37.7\%,\;stage\;IIIb\;23\%$ and 3-year survival rate of stage IVa showed $11.6%$, retrospectively.

방사선치료 Patterns of Care Study 개발을 위한 2002년 한국 방사선종양학과 전문의들의 직장암 방사선치료 원칙 조사연구

김종훈(Jong Hoon Kim),김대용(Dae Yong Kim),김용호(Yong Ho Kim),김우철(Woo Cheol Kim),김철용(Chul Yong Kim),성진실(Jinsil Seong),송승창(Seung Chang Sohn),신현수(Hyun Soo Shin),안용찬(Yong Chan Ahn),오도훈(Do Hoon Oh),오원용(Wong Yong 대한방사선종양학회 2003 Radiation Oncology Journal Vol.21 No.1

목 적 : 한국에서 발생빈도가 높은 암의 하나인 직장암의 치료에 있어 전국의 각 병원 치료방사선과(방사선종양학과)에서 시행하고 있는 치료 형태를 세부 항목별로 파악하여 방사선종양학 전문의 간의 치료원칙의 차이점을 분석하고 이를 바탕으로 향후 Patterns of Care Study를 위한 연구의 기본 자료로 제시하고자 한다. 대상 및 방법 : 경인지역 소재 18개 대학병원 및 방사선종양학과가 있는 병원들의 방사선종양학과 전문의들이 모여 직장암의 방사선치료 원칙 분석을 위한 consensus committee를 구성하고, 회합 및 설문조사를 통하여 각 의사들의 방사선치료 원칙을 파악하기 위한 세부 항목 설정과 이를 토대로 직장암 환자 개개인의 치료 내용을 측정하는 구체적인 항목들을 개발하였다. 이 항목들을 이용하여 직장암의 방사선치료를 담당하고 있는 전국의 방사선종양학과 전문의들을 대상으로 설문조사를 시행한 후 각 전문의들의 의견이 일치하는 부분과 상이한 부분들을 분석하였다. 결 과 : 전문의 별 치료원칙의 측정에 사용된 항목들은 1) 치료대상환자의 선정기준 8개 항목, 2) 수술 전후 병기 및 예후 인자 검사 20개 항목, 3) 수술 및 항암화학요법과의 병용기준 7개 항목, 4) 환자의 setup 및 처치 9개 항목, 5) 모의치료시 조사야 결정 19개 항목, 6) 치료계획 5개 항목, 7) 치료 중 상태 확인 위한 이학적/병리학적 검사 4개 항목, 8) 치료 후 추적 관찰시 검사할 10개 항목 등 총 82개의 항목이 개발되었다. 이 항목들은 전국 각 병원들의 방사선종양학과 전문의를 대상으로 설문조사 되어 치료원칙에 대한 분석이 항목별로 이루어졌다. 설문조사 결과 전국의 각 병원 방사선종양학과에서 시행되고 있는 직장암의 방사선치료 형태는 일정 범위를 유지하고 있으나, 일부 항목에 있어서는 치료자 간 의견차이가 큰 것으로 나타났으며 이들 중 전체 응답자의 50% 이상에서 합의가 되지 못한 항목들은, 1) 치료환자의 선정 기준 중 수술 전 방사선치료 대상, 2) 병기 결정 검사 중 직장내 초음파(EUS, endorectal ultrasound), 흉부 CT, 뼈 스캔 등의 시행 여부, 3) 항암제와의 병용 원칙, 4) 모의치료시 소장 위치 확인을 위한 조영제 사용, 5) 조사야의 경계선 결정, 6) 치료 후 추적 관찰 시 CEA와 대장내시경의 시행여부 등이었다. 결 론 : 이견이 많은 항목들에 대해선는 향후 담당 전문의들을 대상으로 consensus meeting등을 통한 체계적인 분석 및 합의의 도출이 필요한 것으로 보이며, 본 연구에서 밝혀진 각 병원들의 치료 내용을 토대로 향후 표준화된 치료 모델 개발을 위한 Patterns of Care Study가 진행될 예정이다. Purpose : To conduct a nationwide survery on the principles in radiotherapy for rectal cancer, and develop the framework of a database of Korean Patterns of Care. Study. Materials and Methods : A consensus committee was established to develop a tool for measuring the patterns in radiotherapy protocols for rectal cancer. The panel was composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area. The committee developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer. The survey items developed for measuring the treatment principles were composed of 1) 8 eligibility criteria, 2) 20 items for staging work-ups and prognostic factor, 3) 7 items for principles of combined surgery and chemotherapy, 4) 9 patient set-ups, 5) 19 determining radiation fields, 6) 5 radiotherapy treatment plans, 7) 4 physical/laboratory examination to monitor a patient's condition during treatment, and 8) 10 follow-up evaluations. These items were sent to radiation oncologists in charge of gastrointestinal malignancies in all hospitals (48 hospitals) in Korea to which 30 replies were received (63%). Results : Most of the survey items were replied to without no major differences between the repliers, but with the following items only 50% of repliers were in agreement : 1) indications of preoperative radiation, 2) use of endorectal ultrasound, CT scan, and bone scan for staging work-ups, 3) principles of combining chemotherapy with radiotherapy, 4) use of contrast material for small bowel delineation during simulation, 5) determination of field margins, and 6) use of CEA and colonoscopy for follow-up evaluations. Conclusion : The items where considerable disagreement was shown among the radiation oncologists seemed to make no serious difference in the treatment outcome, but a practical and reasonable consensus should be reached by the committee, with logical processes of agreement. These items can be used for a basic database for the Patterns of Care Study, which will survey the practical radiotherapy patterns for rectal cancer in Korea.

바인더용 고분자 첨가제에 따른 잉크젯 인화지의 잉크흡수 특성변화

김철용(Chul Yong Kim),이명천(Myung Cheon Lee) 한국고분자학회 2006 폴리머 Vol.30 No.6

計劃確定節次의 導入問題

金鐵容(Kim Chul-Yong) 행정법이론실무학회 1999 행정법연구 Vol.- No.4

비강 편평상피암의 방사선치료 역할 및 증례보고

김철용(Chul Yong Kim),반성범(Sung Beom Ban),최명선(Myung Sun Choi) 대한두경부종양학회 1986 대한두경부 종양학회지 Vol.2 No.1

Tumors of the nasal cavity are rare and are usually classified and reported jointly with tumors of the paranasal sinuses. Neverthless their frequency, diagnostic problems, management, and prognosis differ considerably from the latter and justify their study as a separate entity in order to define clearly and evaluate their chara-ctenstics. Males outnumbered females in a ratio of 2 to 1. Regional lymph node metases is infrequent; only 10% of the patients presented nodes on admission. Radiation therapy is more favorable method of treatment for nasal cavity tumor secondary to good cosmetic results and high local control rate. The tumor doses are in the range of 5,000 to 6,000 rads in 5 to 6 weeks and an additional dose of 500 to 1,000 rads were given through reduced field to residual disease area. The results of two cases of nasal cavity tumor treated by radiation alone were reasonably good, and review of literature indicated that the radiation alone can give high local control rate and good cosmetics. Therefore, at present time, we recomend radiation therapy for the nasal cavity tumor.

이른바 선택적청구권(選擇的請求權)의 문제(問題)

김철용 ( Chul Yong Kim ) 건국대학교 법학연구소 1996 一鑑法學 Vol.1 No.-

Primary Malignant Melanoma of the Cervical Spinal Cord

김철용(Chul Yong Kim),최명선(Myung Sun Choi) 대한방사선종양학회 1987 Radiation Oncology Journal Vol.5 No.1

척수의 원발성 흑색종양은 매우 희귀한 것으로 알려져 있다. 이러한 종양의 가장 유효한 치료로서는 가능한 종양을 완전히 제거하는 것이며, 수술 후에 방사선치료를 같이 병행하고 있으나 증례가 적어서 방사선치료의 효과는 아직 잘 알려져 있지 많다. 치료 후 2년 생존율은 16% 이하로 극히 저조하며, 대부분이 1연 내에 사망하는 아주 예후가 나쁜 종양으로 보고되고 있다. Primary malignant melanom of the spinal cord is extremely rare. The best treatment appears to be total surgical excision, when possible and postoperative irradiation, but the value of radiotherapy is unknown because the number of cases that have been irradiated postoperatively is small. The 2-year survival rate for primary malignant melanoma of the spinal cord is usually less than 16% and most patients died within 1 year. The prognosis of this tumor is poor.