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      • KCI등재

        “초기철기시대와 원삼국시대 고고학 자료의 인식”에 대한 반론

        최성락(Choi, Sung-rak),강귀형(Kang, Gui-hyung) 중부고고학회 2019 고고학 Vol.18 No.1

        이성주가 한반도 중남부지역의 초기철기시대와 원삼국시대 토기 양상을 전체적으로 파악하려는 것은 그 의미가 매우 크다. 하지만 호남지역에 한정하여 살펴보면 문제가 없지 않다. 그가 호남지역 원삼 국시대 취락이 극히 적다는 인식을 가지고 있음에도 불구하고 오히려 타날문토기의 연대를 낮추는 것은 그 시기의 공백을 더욱 조장하는 것으로 전혀 문제의 해결에 도움을 주지 못하고 있다. 편년의 체계를 바꾸기 위해서는 이를 방증하기 위한 객관적인 자료의 제시가 필요하고, 이를 바탕으로 더 나은 문화양상을 설명할 수 있을 때 가능하다. 또 영남지역의 토기양상에 대한 그의 인식을 다른 지역에 그대로 적용할 수 없음은 분명하다. 문화의 변천은 문화권마다 다를 수 있다. 하나의 틀(모델)로 한반도 중남부지역의 전체 양상을 설명하는 것은 불가능하다고 할 수 있다. 특히 호남지역에서 토기 제작기술의 변천을 살펴보면 결코 영남지역과 동일하다고 볼 수 없다. 결국 타날문토기의 연대를 더 낮추어야 한다는 이성주의 견해는 적어도 호남지역 토기양상을 이해 하는데 적절한 주장으로 보이지 않는다. It is meaningful that Lee Sung-joo understands the pottery pattern of the early Iron Age and the proto-Three Kingdoms period in central and southern part of the Korean Peninsula as a whole. However, it can be seen that there are some problems if we limit it to Honam province. Despite his perception that the settlements of the Proto-three Kingdoms period in Honam are extremely scarce, lowering the date of the beating patterned pottery is not helping to solve the problem at all by further promoting the gap at this time. In order to change the system of the chronology, it is necessary to present objective data to prove it, and it is possible to explain the better culture based on this. It is also clear that his perception of the pottery pattern in Yeongnam province can not be applied to other regions. The changes in culture would be vary from culture to culture. It is impossible to explain the whole aspect of the central and southern regions of the Korean Peninsula with a single framework (model). Especially, if you look at the change of pottery production technology in Honam province, it can not be regarded as the same as Yeongnam province. In the end, Lee Seong-joo s view that the date of the beating patterned pottery should be further lowered is not at least an appropriate recognition to understand the pottery pattern in Honam province.

      • SCOPUSKCI등재

        대구시내 각급 의료기관에서 분만하는 산모들의 특성 및 출산결과의 비교 분석

        송정흡,박정한,김귀연,김장락,Song, Jung-Hup,Park, Jung-Han,Kim, Gui-Yeon,Kim, Jang-Rak 대한예방의학회 1988 예방의학회지 Vol.21 No.1

        각 의료기관에서 분만하는 산모와 신생아의 특성을 비교분석하고 의료기관별 산모와 신생아의 위험수준을 조사하여 특정 의료기관에서 관찰한 연구결과를 해석하는데 참고 자료를 제공하기 위하여 대구시내 3개 대학병원, 2개 종합병원,2개 개인의원, 1개 조산소, 그리고 1개 모자보건센터에서 1987년 4월 1일 부터 4월 30일 까지 1개월간(1개 대학병원은 2개월간) 분만한 산모 1,410명을 대상으로 산모의 연령, 교육수준, 의료비 지불방법, 산과력 및 특정의료기관을 선택한 이유를 면담 조사하고 병원기록지에서 신생아의 출생시 체중의 조사하였다. 대학병원과 종합병원을 이용한 산모의 평균 연령은 각각 27.5세, 26.7세로 조산소(25.4세)와 모자보건센터(26.1세)를 이용한 산모보다 많았고, 교육수준은 대학병원(평균 12.7년)과 종합병원(평균 12.2년) 산모가 조산소(평균 9.2년) 및 모자보건센터(평균 9.3년) 산모보다 월등히 높았다. 그리고 의료보험 대상자도 대학병원(78.1%)과 종합병원(82.9%) 산모가 개인의원(44.3%), 조산소(29.1%)나 모자보건센터(5.4%) 보다 많았다. 모자보건센터는 2번째 출산이 47.3%로 가장 많았으나 다른 의료기관은 모두 초산부가 $56.0{\sim}61.7%$로 제일 많았다. 산모의 산과력 비교에서는 대학병원 산모가 자연유산 경험율이 상대적으로 다른 의료기관 산모보다 높았고 사산 경험자도 소수였으나 조산소와 모자보건센터에서 분만한 산모는 사산 경험자가 1명도 없었다. 대학병원 산모의 경우 37주 이하의 조산아 출생율(11.4%)과 2,499gm이하의 저체중아 출생율($5.8{\sim}13.0%$)은 타 의료기관 보다 현저히 높았다. 이에 따라 제왕절개술에 의한 분만율은 의료기관간에 차이가 많았다. 결국 대구시내 대학병원과 종합병원에서 분만하는 산모들은 사회경제적으로 중, 상류층과 소득고하를 막론하고 고위험산모들이 많고 조산소와 모자보건센터는 저소득충의 산모 가운데 산과적으로 저위험군들이 많이 이용하고 있다. 따라서 특정 의료기관을 대상으로 조사한 자료를 해석하는데 많은 제한성이 있으며 전체 산모의 특성으로 일반화하는 것은 불가능한 것으로 생각된다. This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

      • KCI등재

        유두상 혈관내막 증식증의 임상적 보고

        이정우,정호윤,이석종,김귀락,최강영,양정덕,조병채,Lee, Jeong-Woo,Chung, Ho-Yun,Lee, Seok-Jong,Kim, Gui-Rak,Choi, Kang-Young,Yang, Jung-Dug,Cho, Byung-Chae 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.3

        Purpose: Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson's pseudoangiosarcoma, is a rare disease which is now considered as a reactive process of the endothelium rather than a benign neoplasm. It can occur in any blood vessels in the body but more common in the head and neck region as a solitary, often tender, bluish or reddish nodule. IPEH is characterized by the development of endothelial-lined papillary projections in a vascular lumen, usually associated with thrombotic material, the endothelial cells in the papillary structures showing only slight atypia and occasional mitotic Figures, the absence of tissue necrosis. Methods: 8 patients with IPEH were enrolled in the study from 2002 to 2007. All 8 lesions were surgically excised for histopathologic diagnosis. Results: 4 patients were female. The duration of the lesions ranged from 3 months to 15 years. The tumors were first noted between the ages of 20 and 72 years. 4 patients had lesions on the head; 2 on the toe; 1 on the back; and 1 on the finger, respectively. All lesions were solitary, ranged in size from 2 mm to 27 mm. There were no recurrences. Conclusion: The clinical appearance of IPEH is not specific, presented as a primary neoplasm, and the diagnosis can be established by microscopic examination. Complete surgical excision is the best choice of therapy for patients with IPEH, and is both diagnostic and curative. Awareness of this lesion will prevent incorrect diagnosis and overly aggressive treatment.

      • KCI등재

        유방암 환자에서 피부보존 유방절제술 후 실리콘 보형물을 이용한 즉시 유방재건술

        조영규,양정덕,김귀락,정호윤,조병채,박호용,Cho, Young-Kyoo,Yang, Jung-Dug,Kim, Gui-Rak,Chung, Ho-Yun,Cho, Byung-Chae,Park, Ho-Yong 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.6

        Purpose: Since skin sparing mastectomy removes the mammary gland and the nipple-areolar complex preserving all mammary skin, it makes the widespread use of implants in immediate reconstruction. This article reports our experience in immediate breast reconstruction after skin sparing mastectomy by using the silicone implants in patients especially who have small to moderate sized and minimal ptotic breast. Methods: From September of 2007 to July of 2009, we performed breast reconstruction for 44 breasts of 40 women with silicone implant after mastectomy. Tumors were divided into 5 malignant types (21 IDC, 18 DCIS, 2 ILC, 2 phylloides tumor, 1 mucinous carcinoma). The implant is placed in a submuscular pocket or in a submuscularsubfascial pocket depending upon the condition of the muscles and skin flaps after mastectomy. Results: The mean age was 47 years and the average follow-up period was 11 months. Cosmetic outcome was assessed by evaluation of photographs and assessment of breast volume and shape, breast symmetry, and overall outcome. About 80% of each of these parameters was scored as good or excellent. Breast complication was developed in a total of 6 cases including 2 capsular contracture, 2 partial skin necrosis due to blue dye injection and 2 implant infection. Conclusion: The use of definitive implants in a skin sparing mastectomy is a one-stage immediate breast reconstruction with low morbidity and acceptable result. This method is considered reliable with favorable aesthetic result.

      • SCOPUSKCI등재

        Cohort Infant Mortality Rate of Gunwee and Hapchun Counties and an MCH Center in Taegu

        박정한,예민해,천병렬,송정흡,김귀연,김장락,조성억,김현,정한진,조재연,Park, Jung-Han,Yeh, Min-Hae,Chun, Byung-Yeol,Song, Jung-Hub,Kim, Gui-Yeon,Kim, Jang-Rak,Cho, Sung-Euk,Kim, Hyun,Chung, Han-Jin,Cho, Jae-Yeon The Korean Society for Preventive Medicine 1990 예방의학회지 Vol.23 No.1

        1985년 4월 1일부터 1987년 3월 31일 사이에 경상북도 군위군에 거주하는 49세이하의 가임여성들과 1987년 3월 1일부터 1988년 2월 28일 사이에 경상남도 합천군에 거주하는 49세이하의 가임여성들 그리고 1985년 4월 1일부터 1987년 3월 31일 사이에 대구시 남구 모자보건센터에 분만을 위해 찾아온 모든 임산부들을 대상으로 이들에게서 태어난 출생아들을 두 군지역에서는 생후 1년간 그리고 모자보건센터에서 출생한 경우는 생후 27일간 추적하여 영아사망률과 신생아 사망률을 각각 조사하였다. 조사기간중에 군위군과 합천군에서 출생한 1,359명의 영아들 가운데 생후 1년 동안에 17명이 사망하여 농촌지역의 영아사망률은 출생아 1,000명당 12.5이었다. 총 영아사망중 신생아사망이 82.4% 그리고 신생아 후기 사망이 17.6%를 차지하였다. 대구시 남구 모자보건센터에 내원한 산모들에게 태어난 6,001명의 출생아들 가운데 4,834명(80.6%)만이 생후 27일까지 추적되었는데 이들 중 36명이 사망하여 신생아 사망률은 출생아 1,000명당 7,4명이었다. 추적된 산모와 추적 안된 산모의 특성 및 신생아 체중을 비교한 결과 현저한 차이를 나타내지 않았다. 신생아 후기 사망률의 비를 6 : 4로 가정했을 때 모자보건센터에서 출생한 영아의 영아사망률은 출생아 1,000명당 12.3명으로 추정되었다. 군위군과 합천군의 영아사망률과 대구시 남구 모자보건센터에서 관찰된 신생아사망률, 영아사망의 사망시기별 분포와 영아사망원인 그리고 저체중아출생률을 고려할 때 1985년부터 1988년 사이의 한국의 영아사망률은 출생아 1,000명당 12에서 15명일 것으로 추정되었다. We followed up all the infants born to the married women under 50 years of age residing in Gunwee county, Kyungpook Province, between 1 April 1985 and 31 March 1987, and those born to the married women under 50 years residing in Hapchun County, Kyungnam Province, between 1 March 1987 and 28 February 1988, to their first birthday. Likewise, we followed up the infants born to the women who visited the MCH Center of South District Health Center in Taegu City for delivery between 1 April 1985 and 31 March 1987 to the 27th day after birth and obtained the infant mortality rate and the neonatal mortality rate, respectively. There were 17 infant deaths among 1,359 live births in Gunwee and Hapchun Counties and the infant mortality rate was 12.5 per 1,000 live births. Out of 17 infant deaths, 82.4 percent were neontal death and 17.6 percent were postnonatal deaths. Out of the 6,001 live births born to the women visited the MCH Center, 4,834 infants (80.6%) were followed up to the 27th day after birth. Of these 4,834 infants, 36 infants died before the 28th day after birth and thus the neonatal mortality rate was 7.4 per 1,000 live births. Comparison of the maternal characteristics and the birth weight between infants who were followed up and those who were lost to follow-up showed no significant differences. Assuming that the neonatal and postneounatal mortality ratio had been 6:4, the infant mortality rate for the infants born at the MCH Center would have been 12.3 per 1,000 live births. Taking such findings into consideration as the infant mortality rate observed in Gunwee and Hapchun Counties, the neonatal mortality rate at the MCH Center, the causes of infant deaths, and the low birth weight incidence rate, a conservative estimate of infant mortality rate of Korea would be between 12 and 15 per 1,000 live births in $1985{\sim}1988$.

      • KCI등재

        과다 유두(Supernumerary Nipple) 2례

        이정우,양정덕,이정훈,최강영,김귀락,정호윤,조병채,Lee, Jeong-Woo,Yang, Jung-Dug,Lee, Jung-Hun,Choi, Kang-Young,Kim, Gui-Rak,Chung, Ho-Yun,Cho, Byung-Chae 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.5

        Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

      • KCI등재

        진행성 유방암에 있어 유방절제술 후 발생한 광범위 피부결손 부위의 가슴배피판을 이용한 흉벽재건술

        김학태,양정덕,정호윤,조병채,김귀락,최강영,이정훈,박호용,Kim, Hak-Tae,Yang, Jung-Dug,Chung, Ho-Yun,Cho, Byung-Chae,Kim, Gui-Rak,Choi, Kang-Young,Lee, Jung-Hun,Park, Ho-Yong 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.6

        Purpose: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap. Methods: From August 2008 to June 2009, 4 cases of thoraco-abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly. Results: Their mean age, 55.7 years and the average follow-up interval was 9 months. Patients' oncologic status ranged from stage IIIc to stage IV, it was classified according to the TNM staging system. Flap dimensions ranged between $15{\times}15$ and $25{\times}25\;cm$. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap. Conclusion: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single-stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.

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