소에서 盲腸擴張을 동반한 第4胃食滯 手術 1例

김명철,김덕환,신상태,임준호,김남중,김종만 충남대학교 수의과대학 동물의과학연구소 1998 動物醫科學硏究誌 Vol.6 No.-

Abomasal impaction with cecal dilatation was diagnosed in a 3 years old holstein cow. The clinical signs were loss of appetite, scant feces and moderate distension of the abdomen. Ping sound was revealed in the right 11th intercostal space by auscultation. Cecal dilatation and abomasal impaction were ascertained by right flank laparotomy and abdominal exploration, and intestinal content and gas were removed from the cecal apex incised. One day later, 2.5㎏ of sand was removed by ventral paramedian abomasotomy.

국가 대표급과 제주도 고교 대표급 수영선수들의 그랩 스타트의 운동학적 분석

김철원,김승곤,오만원,임상용,김성찬,이창준,남사웅,이세형,류재청,신석종,김세민 濟州大學敎 體育科學硏究所 1998 체육과학연구 Vol.4 No.-

The purpose of the study was to undertaken to analysis the Grab starting technique between national representive team(3) and Cheju's representive team(3) with 3D cinematography. The conclusions obtained were as follows: Cheju's showed more elapsed time than national representive team on starting block. and more vertical than horizontal direction of COG position, more concentrated vertical velocity & acceleration than forward direction. Therefore It is necessory for cheju's to train balanced trust force in horizontal and vertical direction in grab starting technique.

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.

위장관 출혈을 일으킨 공장의 형활근종 1예

김병수,장성종,부귀범,조운택,박찬국,김만우,변주남,김정용,전호종 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Small bowel leiomyoma is a rare tumor which may occur wherever smooth muscle is present. The small bowel is the most common site and it makes up 20~30% of all benign small intestinal neoplasms. A spectrum of symptoms are common ranging from nausea, vomiting, abdominal pain, to massive intestinal bleeding. Bleeding is the most common symptom and is usually gross and recurrent. Occasionally it may be life threatening. But, the most serious problem is both the absence of specific clinical symptoms, and the difficulties shown in radiological diagnostics of the small bowel. If conventional diagnostic methods fail to reveal any positive findings for gastrointestinal bleeding, the diagnosis of intestinal leiomyoma should be suspected and an SMA angiography shoud be performed. The angiographic criteria of small bowel leiomyoma is very characteristic. We present a case of leiomyoma with considerable and prolonged gastrointestinal bleeding, which was diagnosed by angiography. A 61-year old woman was admitted with a history of melena over the last 10 days. An SMA angiography showed a hypervascular mass with a diameter of 3×3cm. A segmental resection was performed under the impression of the gastrointestinal bleeding due to leiomyoma of the small bowel. Microscopic examination of the lesion shows interlacing or whorl bundles of spindle shaped ces and no mitosis.

신축학교 실내공기질이 초등학생들의 인지기능에 미치는 영향

김태섭,김선주,박시영,전만중,김규태,김창윤,정종학,백성옥,사공준 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 신축초등학교와 대조학교를 선정하여 교실 내 포름알데히드와 TVOCs를 측정하고 컴퓨터 신경행동검사를 이용하여 실내공기 오염물질이 학생들의 인지기능에 미치는 영향을 평가하였다. 방법: 신축초등학교 5학년 71명을 실내공기 오염물질 노출군으로 하고, 개교한지 12년째인 대구시의 일개 초등학교 5학년 2학급 63명을 대조군으로 하여 실내공기 오염물질농도 측정 및 컴퓨터 신경행동검사를 실시하였다. 결과: 신축학교에서 의도적으로 창문을 개방한 학급에서 1교시 포름알데히드 농도는 34.6 ㎍/㎥, 4교시에는 27.3 ㎍/㎥, 창문을 개방하지 않은 학급에서 1교시 80.2 ㎍/㎥, 4교시 127.1 ㎍/㎥, 대조학교에서는 2학급 각각 1교시에 12.6 ㎍/㎥, 7.5 ㎍/㎥, 4교시에 19.8 ㎍/㎥, 25.2 ㎍/㎥였다. TVOCs의 경우 신축학교의 의도적으로 창문을 개방한 학급에서 1교시에 농도는 487.2 ㎍/㎥, 4교시에 428.2 ㎍/㎥, 창문을 개방하지 않은 학급에서 1 교시에 농도는 1,283.5 ㎍/㎥, 4교시에 1,715.4 ㎍/㎥, 대조학교의 경우 2학급에서 각각 1교시에 농도는 240.9 ㎍/㎥, 150.8 ㎍/㎥, 4교시에 농도는 371.9 ㎍/㎥, 448.0 ㎍/㎥였다. 부호숫자 짝짓기의 평균반응시간은 대조학급이 1교시에 2,585 msec에서 4교시에 2,459 msec으로 감소한 반면 신축학교의 창문을 의도적으로 개방한 학급은 2,343 msec에서 2,510 msec으로, 평소대로 수업한 학급은 2,340 msec에서 2,563 msec으로 반응시간이 각각 167 msec, 223 msec 증가하였다. 1교시의 부호숫자 짝짓기 의 반응시간을 100%로 했을 때 창문을 의도적으로 개방 한 학급은 4교시에 5.9% 증가하였고(p<0.01), 평소대로 수업한 학급은8.3% 증가하였다(p<0.01). 반면에 대조학급은 4교시에 5.0% 감소하였다(p<0.01). 결론: 향후 학교의 실내공기질의 안전성 평가는 샘플링 된 공기의 오염수준의 측정뿐만 아니라 학생들의 건강영향도 함께 고려되는 것이 바람직할 것이다. Objectives: Most studies on the indoor air quality of newly built schools have focused only on the number of schools exceeding a standard or on subjective symptoms, such as sneezing, irritated eyes and an irritated nose. However, there has been no report on how poor indoor air quality affects children's academic performance. This study evaluated the effects of indoor air quality on the neurobehavioral performance of elementary school children. Methods: This study measured the indoor air pollutants and compared children's performance, using a computerized neurobehavioral test, between a newly built and a 12-year-old school. In addition, a questionnaire was administered regarding the indoor air quality related symptoms of children in a newly built and a 12-year-old school. Results: In the newly built school, the formaldehyde levels in the 1^(st) and 4^(th) classes with an open window were 34.6 and 27.3 μg/㎥, respectively. The levels in the 1^(st) and 4^(th) classes with the window closed were 80.2 and 127.1 μg/㎥, respectively. In the 12-year-old school, the formaldehyde levels in 1^(st) and 4^(th) class with open and closed window were 12.6 and 7.5 μg/㎥, and 19.8 and 25.2 μg/㎥, respectively. With respect to total volatile organic compounds, the levels in the 1^(st) and 4^(th) classes with the window open in the newly built school were 87.2 and 428.2 μg/㎥, respectively. In the 1^(st) and 4^(th) classes with the window closed, the total volatile organic compounds were 1,283.5 and 1,715.4 μg/㎥, respectively. In the 12-year-old school, the total volatile organic compounds were 240.9 and 150.8 μg/㎥, and 371.9 and 448.0 μg/㎥ in the 1^(st) and 4^(th) classes, respectively. In the case of a newly built school, the performance of the students in the neurobehavioral test in the 4^(th) class with the window closed was 8.3% lower than for those in the 1^(st) class with the window closed, but was only 5.9% lower when the windows were open. There was a statistical significant difference in the total numbers of symptoms between the two schools. Conclusions: These results suggest a proper evaluation of the indoor air quality within schools is required into both the level of contamination and the health effects of these contaminants toward children.

수출입 컨테이너 장치장 배정을 위한 소프트웨어의 개발

김갑환,김홍배,홍봉희,김기영,배종욱,최진오,김두열,이영기,박영만,박강태,손행대 한국경영과학회 1995 經營 科學 Vol.12 No.3

The Pusan Container Terminal faces a rapid increase in berthing time of container ships as well as in waiting time of external trucks, which is due to an absolute lack of yard space. This research is focused on the development of a decision support system for the planning of the container terminal yard assignment so that the yard space would be utilized most effectively. Efforts should be given to the reasonable assignment of the yard storage and the dynamic adaptation to the ever changing environment. The software introduced here is based o the know-how of the field exports and its framework takes the approach of the hierarchical decision making.

정전위 SSRT법에 의한 해양구조물용 Cu함유 고장력저합금강의 수소취성한계전위 규명에 관한 연구

김성종,박태원,심인옥,김종호,김영식,문경만 한국해양대학교 해양과학기술연구소 2001 硏究論文集 Vol.10 No.1

A marine structural material was well known to have high tensile strength, good weldability and proper corrosion resistance . Cu-containing high strength low alloy (HSLA) steel was recently developed for their purposes mentioned above, And the steel is free about preheating for welding, therefore it is reported that shipbuilding cost by using it can be saved more or less. However the marine structural materials like Cu-containing HSLA steel are being generally adopted with cathodic protection method in severe corrosive environment like natural sea water but the high strength steel may give rise to Hydrogen Embrittlement due to over protection at high cathodic current density for cathodic protection. In this study, Cu-containing HSLA steel using well for marine atructure was investigated about the susceptibility of Hydrogen Embrittlement as functions of tensile strength, strain ratio, fracture time, and fracture mode, etc. and an optimum cathodic protection potential by slow strain rate test(SSRT) method as well as corrosion properties in natural sea water. And its corrosion resistance was superior to SS400 steel , but Hydrogen Embrittlement susceptibility of Cu-containing HSLA steel was hider than that of SS400 steel. However Hydrogen Embrittlement of its steel by SSRT method was showed with pheonomena such as decreasing of fracture time. strain ratio and fracture mode of QC (quasi-cleavage) Eventually it is suggested that an optimum cathodic protection potential not presenting Hydrogen Embrittlement of Cu-containing of HSLA steel by SSRT method was from-770mV(SCE) to - 900mV(SCE) under natural sea water. (Received September 21, 2000)

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

췌장을 침습한 위의 암육종 1 예

김병호,김효종,조진만,김윤화,이정일,동석호,장영운,황일섭,장 린 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.1

Carcinosarcoma of the stomach is regarded as a rare malignant neoplasm composed of both carcinomatous and sarcomatous components in a given tumor. Few cases have been reported since 1904. This is a case of carcinosarcoma of the stomach in a 61-year-old man. He suffered from indigestion, vomiting, and epigastric pain. Endoscopic finding showed a huge protruding mass with intact mucosa on the posterior wall of the antrum up to the pylorus. Surgery was performed and carcinosarcoma with pancreatic invasion was confirmed by pathology.