간세포암종에서 간절제술 후 이환율과 사망률에 영향을 미치는 위험 인자

김완욱,이광웅,최성호,허진석,김용일,김성주,이대성,이환효,백승운,고광철,이준혁,최문석,유병철,조재원 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.1

목적: 간세포암종은 우리나라에서 간절제의 가장 흔한 적응증이다. 그러나 간경변을 동반한 경우가 많아 수술 후 이환율과 사망률이 높아 수술 전후 처치에 주의를 요한다. 최근에는 외과적 술기의 발전과 수술 전 및 수술 후 처치의 향상으로 이환율과 사망률이 감소하고 있으나 다른 수술에 비해 여전히 높다. 이에 본 연구에서는 간세포암종의 수술 중 위험 인자를 알아보고 수술 후 이환율과 사망률을 줄일 수 있는 방법을 찾아보고자 하였다. 대상과 방법: 1994년 11월부터 2001년 12월까지 간세포암종으로 진단받고, 간절제술을 시행받은 환자 510명을 대상으로 하였다. 대상 환자의 평균 연령은 51.6세였고, 남녀 비는 4.01 : 1이었다. 수술 전 HBsAg (+)는 76.0%, 수술 전, anti-HCV (+)는 8.2%였으며 종양의 크기는 평균 5.19 ㎝이었다. 환자 중 26.2%에서 수술 전 경도자 동맥색전술의 병력이 있었으며 8.7%에서 수술 전 경피적 간문맥색전술을 시행받았다. 시행받은 수술은 종양절제술 55예, 분절절제술 127예, 구역절제술 77예, 반간절제술 214예, 동반 혹은 확대 반간절제술 37예였다. 위험 인자로 나이, 성별과 각종 임상 지표(간기능 수치, 프로트롬빈시간, 혈청 알부민, 혈당, 알파태아단백, ICG 검사, 수술 전 경도자 동맥색전술, 경피적 간문맥색전술 시행 여부) 등의 수술 전 인자, 수술의 종류, 수술 시간, 수혈량 등의 수술 인자, 그리고 종양의 크기, 종양의 수, 간경변 여부 등의 병리조직학적 인자 등을 분석하였다. 분석자료는 대상 환자들의 의무기록을 통해 후향적 방법으로 조사하였다. 수술 사망은 수술 후 30일 이내에 사망한 경우로 정의하였고, 입원 사망은 수술 후 합병증으로 퇴원하지 못하고 사망한 경우로 정의하였다. 단변량 분석은 student t test와 x² test를 이용하였으며, 다변량 분석은 logistic regression을 이용하였다. 결과: 수술 후 합병증은 총 56예(10.5%)에서 나타났으며, 조절되지 않는 복수 19예, 호흡기 합병증 10예, 상처 합병증 8예, 간기능 이상으로 인한 고빌리루빈혈증 6예, 출혈 5예, 고질소혈증 4예 등이었다. 수술 사망은 5예(0.98%), 입원 사망은 수술 사망을 포함하여 6예(1.1%)였다. 이중 간부전과 연관된 사망이 5예였고, 간부전과 동반된 흡인성 폐렴으로 사망한 예가 1예 있었다. 이환율에 영향을 미치는 인자를 다변량 분석을 통해 알아본 결과, 수술 중 수혈량(P=0.002), 프로트롬빈시간(P=0.038), 혈당 수치(P=0.002)가 통계학적으로 의미가 있었고, 다변량 분석 상 수술 후 사망률과 관련된 인자로는 나이(P=0.028), 혈당 수치(P=0.011), 수술 전 경도자 동맥색전술 시행 여부(P=0.046) 등이 의미 있는 것으로 나타났다. 결론: 위의 위험 인자 분석을 통해 간세포암종에서 간절제시에 수술 후 이환율을 중이기 위해 가능한한 수술 중 출혈을 최소화하면서 불필요한 수혈을 피하고, 당뇨 환자에서는 수술 후 이환율과 사망률이 상대적으로 높고, 고령 환자에서는 사망률이 상대적으로 높으므로 수술 전후 처치에 세심한 주의가 필요함을 알 수 있었다. 수술전 경도자 동맥색전술 시행 여부가 수술 후 사망률과 유의한 상관성이 있었고 이에 대한 지속적인 연구가 필요하리라 생각된다. Background/Aims: Recently, mortality following surgical resection for hepatocelluar carcinoma has been reduced significantly. Morbidity, however, is still significant. This study evaluated the risk factors leading to morbidity and mortality. Methods: 510 patients who had a hepatic resection form Nov. 1994 to Dec. 2001 were included. The patient demographics showed a mean age of 51.6 years with a male to female ratio of 4:1. The HBsAg was positive in 76.0% and the anti-HCV was positive in 8.2%. The mean tumor size was 5.2 cm, 26.2% of patients had preoperative transcatheter arterial embolization (TAE), and 8.7% had preoperative percutaneous transhepatic portal embolization (PTPE). Limited resection was performed in 259 cases (50.7%), and major resection was conducted in 251 cases (49.1%). Risk factors included age, sex, laboratory findings (liver function test, prothrombin time, albumin, glucose, α-fetoprotein, ICG test), preoperative TAE, PTPE, operation type, operation time, intraoperative transfusion, tumor size, and cirrhosis. Results: The morbidity was 10.5% (54 cases). Operative death occurred in 5 cases (1.0%). Hospital death, including operative death, occurred in 6 cases (1.2%). Five cases were associated with hepatic failure and 1 case was associated with aspiration pneumonia accompanying hepatic failure. Transfusion (P=0.002), glucose (P=0.002), and prothrombin time (P=0.038) were significantly related to morbidity. Age (P=0.028), glucose (P=0.011), and TAE (P=0.046) were significantly related to mortality. Conclusions: Intraoperative transfusion, which is mainly related to intraoperative bleeding, should be reduced if possible to decrease morbidity. Diabetes mellitus patients and the elderly need careful perioperative management.(Korean J Hepatol 2004;10:51-61)

경락(經絡)과 정신양생(精神養生)의 관계 설정(設定)에 대(對)한 고찰(考察)

백진웅,김광호,Baek Jin-Woong,Kim Kwang-Ho 대한예방한의학회 2001 대한예방한의학회지 Vol.5 No.2

It is thought that Kim Hong-kyeong followed the existing theory of Meridian(經絡) and supplemented his unique perspectives in interpreting it. And he tried to relate Meridian with hygiene of mind. I took up with the research on the assumption that the review of Kim's method can present new perspectives to the study of relationship between Meridian and hygiene of mind. The results of my study are as follows: 1. Kim followed common theory of Meridian and then added his unique perspectives to it. His method of interpretation has one characteristic. By introducing Idealism(唯心論), he understood 'Meridian' as the path of the mind and the emotion. Especially I think his hypothesis that acupuncture can be widely used in mental diseases as well as body related diseases and its applications to treatment are very valuable. 2. Meridian and hygiene of mind are close together. I think Kim's unique trial is something new in studying relationship between Meridian and hygiene of mind but requires more research on it.

Evaluation of Renal Toxicity by Combination Exposure to Melamine and Cyanuric Acid in Male Sprague-Dawley Rats

Son, Ji Yeon,Kang, Yoon Jong,Kim, Kyeong Seok,Kim, Tae Hyung,Lim, Sung Kwang,Lim, Hyun Jung,Jeong, Tae Cheon,Choi, Dal Woong,Chung, Kyu Hyuck,Lee, Byung Mu,Kim, Hyung Sik Korean Society of ToxicologyKorea Environmental Mu 2014 Toxicological Research Vol.30 No.2

Melamine-induced nephrotoxicity is closely associated with crystal formation in the kidney caused by combined exposure to melamine (Mel) and cyanuric acid (CA). However, there are few dosage-finding studies for toxicological evaluation of chronic co-exposure to Mel and CA. The objective of this study was to investigate the possible mechanism by which a Mel and CA mixture lead to renal toxicity in rats. Mel and CA were co-administered to rats via oral gavage for 50 days. Nephrotoxicity was determined by measuring blood urea nitrogen (BUN) and serum creatinine (sCr) levels. Relative kidney weights were significantly increased in rats after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg) mixtures. BUN and sCr levels were significantly increased after Mel and CA co-exposure. Taken together, significant increase in KIM-1, NGAL, and calbindin levels were observed in the urine of rats exposed to Mel+CA (63/6.3 or 630/6.3 mg/kg) compared with the corresponding control group. Histological analysis revealed epithelial degeneration and necrotic cell death in the proximal tubules of the kidney after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg). Our data suggest that Mel-mediated renal toxicity may be influenced by CA concentrations in Mel-contaminated milk or foods.

Evaluation of Renal Toxicity by Combination Exposure to Melamine and Cyanuric Acid in Male Sprague-Dawley Rats

Ji Yeon Son,Yoon Jong Kang,Kyeong Seok Kim,Tae Hyung Kim,Sung Kwang Lim,Hyun Jung Lim,Tae Cheon Jeong,Dal Woong Choi,Kyu Hyuck Chung,Byung Mu Lee,Hyung Sik Kim 한국독성학회 2014 Toxicological Research Vol.30 No.2

Melamine-induced nephrotoxicity is closely associated with crystal formation in the kidney caused by combined exposure to melamine (Mel) and cyanuric acid (CA). However, there are few dosage-finding studies for toxicological evaluation of chronic co-exposure to Mel and CA. The objective of this study was to investigate the possible mechanism by which a Mel and CA mixture lead to renal toxicity in rats. Mel and CA were co-administered to rats via oral gavage for 50 days. Nephrotoxicity was determined by measuring blood urea nitrogen (BUN) and serum creatinine (sCr) levels. Relative kidney weights were significantly increased in rats after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg) mixtures. BUN and sCr levels were significantly increased after Mel and CA co-exposure. Taken together, significant increase in KIM-1, NGAL, and calbindin levels were observed in the urine of rats exposed to Mel+CA (63/6.3 or 630/6.3 mg/kg) compared with the corresponding control group. Histological analysis revealed epithelial degeneration and necrotic cell death in the proximal tubules of the kidney after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg). Our data suggest that Mel-mediated renal toxicity may be influenced by CA concentrations in Mel-contaminated milk or foods.

21세기 장애유아 통합교육의 발전과제

김광웅 강남대학교 인문과학연구소 1998 인문과학논집 Vol.6 No.-

濟州地域語의 中和現象에 대한 硏究

金光雄 제주대학교 1986 논문집 Vol.22 No.1

In the case of substantives,. the neutralization of obstruents in syllabic ending is formed strongly with simple word, derived word, and compound word. The rule is as follows : ◁그림 삽입▷ (원문을 참조하세요) In the case of declinable word, the neutralization of obstruents in syllabic ending shows syllabic enlagement with most words, and it is shown with few words. The nouns ending with /k^h/, /p^h/ turn into /k/, /p/ when connected with vowel ending, and the nouns ending with /t/, /cˇe/, /cˇ^h/ turn into /s/ when such phonemes come before vowel ending In the case of consonant cluster of stem ending, the second consonant is deleted when the second consonant is [+cor] , the first consonant is mostly deleted when the second consonant is [-cor]. But in the case of declinable words, syllables are enlarged with /??/ or /i/ intervened In the case of substantives ending with consonant cluster of stem ending, one consonant is deleted, and it is the same with compound words. When the ending of declinable words is simple consonant or consonant cluster, most of such words show syllabic enlargement with affixes like /??/,/u/, /i/. This phenomenon seems to effect clarity in pronunciation and meaning transmission with the emphasis on audiotory image.

孔子, 佛陀, 예수, Allport의 成熟人格觀 比較硏究

金光雄 淑明女子大學校 1980 論文集 Vol.20 No.-

The question "what is the mature personality like?" has been one of the crucial subjects of psychology. But we cannot answer this question solely in terms of pure psychology. To some degree philosophical or ethical judgement must be involved. The main purpose of the present paper was to make a comparative study of the psychological characteristics of mature person proposed in Confucianism, Buddhism, Christianity, and western psychology. Confucian Analects and the Gospels were analyzed and culled to confirm the attributes of mature personality of Confucianism and Christianity. In the case of Buddhism, personality attributes of Arahat(ideal type of healthy personality in Buddhism) interpreted by Rune Johansson(1970) were arranged. And the six criteria of maturity advanced by Gordon Allport(1965) were discussed with regard to modern psychology. Result of the present study clarified considerable agreement on the norms of maturity. This common ground of agreement can be summarized as follows: moral and ethical obligation, human relations, emotional stability, cognition, self-insight, self-acceptance and achievement of meaning of life, and realization of individuality. In confucianism, however, the standard places more emphasis upon moral obligation relevant to human relations. Buddhism and Christianity put more stress on control of physical desire, compassion and kindness, righteousness, and self-insight. And in western psychology the standard lay great emphasis on individuality, on realizing one's own personal potential.

意味辨別法에 의한 女大生의 職業觀 分析

金光雄 淑明女子大學校 1977 論文集 Vol.17 No.-

The main purpose of the present study was to investigate the vocational image of women's college students by semantic differential technique developed by C.E. Osgood. Five hundred and forty eight students (sophomore and junior) in Sookmyung Women's University were employed for the present study. The instrument was a semantic differential scale constructed by the presesent researcher. The scale consists of fifteen pairs of adjectives appropriate for the assessment of vocationas image. Five pairs of adjectives such as positive∼negative, large∼heavy, large∼small, weak∼strong, and bright∼stupid constitute the potency scale. And the other five pairs, such as good∼evil, dirty∼cean, beautiful∼ugly, black∼white, and good∼bad constiute the evaluative scale, and the rest of the pairs such as quick∼slow, blunt∼sharp, active∼dull, new∼old, and early∼late the activity scale. The concepts of twenty professions were rated through the above scales, namely professors, diplomats, enterprisers, artists, doctors, journalists, lawyers, judges, engineers, teachers, white-collar workers, politicians, public officials, pharmacists, nurses, military officers, bank clerks, entertainers, police officers, and technicians. The results of the present study can be summarized as follows: 1. Diplomats, enterprisers, politicians, judges, doctors, lawyers, and journalists were conceived as more potent professions by the women's college students, while bank clerks, entertainers, white-collar workers, and public officials as less potent. 2. Professors, teachers, artists, doctors, nurses, pharmacists, and lawyers were rated by the present subjects as more valuable in a moral sense, while entertainers, politicians military officers, enterprisers and police officers as of less prize. 3. Journalists, diplomats, enterprisers, engineers, lawyers, and artists were appreciated as more active professions, while public officials, teachers, pharmacists, judges, white-collar workers, and bank clerks as less active.

부모권력구조에 대한 아동기 경험이 여대생의 결혼태도에 미치는 영향

김광웅,조유진 숙명여자대학교 건강·생활과학연구소 2004 生活科學硏究誌 Vol.- No.21

The purpose of this study was to investigate how marital attitudes of female college students were related to their childhood experiences of parental power structure. Questionnaire survey was conducted with 425 female college students regarding their childhood experiences of parental power structure and their marital attitudes. The results of the analysis are as follows; First, the female college students formed different marital attitudes dimensions only in home economy area when their experiences of parental power hierarchy were measured individually in subfactors(family events and relative-related, child education, and home economy). Second, multi-response logit analysis was used in order to take into account of all the subfactors of parental power structure at the same time. As a result, childhood experiences of parental power hierarchy on child education, and on home economy were found to be closely related to the marital attitudes in the female college students. That is, the female college students, whose fathers had power on their children's education through active participation and decision-making, were likely to develop negative image of marriage. On the other hand, those whose mothers had power in home economy were likely to develop negative image of marriage.

차세대 무선 통신 시스템을 위한 안테나 신기술

김형락,권세웅,황광선,윤영중 延世大學校 電波通信共同硏究所 2002 電波通信論文誌 Vol.6 No.1

차세대 통신 시스템에서 공통적으로 요구하는 소형화, 광대역화, 집적화추세에 따라 RF소자는 광대역화, 소형화, 집적화를 향해 발전하고 있으며 안테나 기술도 현재 추세에 발맞추어 소형화, 능동집적화, 광대역화를 통하여 개발 방향을 모색하고 있다. 본고에서는 현재 추세인 소형 안테나, 능동 안테나와 더불어 최근 관심이 집중되고 있는 임펄스 통신에 이용될 수 있는 초광대역 안테나 기술에 대해 소개한다. The technical trends of the next generation wireless communication are miniaturization, broad-band operation, and integration. Thus, in accordance with this trend, RF devices and components are being developed in such way, and same with the antenna. In this paper, technology of small antenna, active antenna, and ultra wideband antenna, which can be applied to impulse communication system, are introduced.