방사선 조사를 받은 두경부 병소의 재건을 위한 유리피판술

채수욱,고경석,김주봉,박상훈,한상훈,이택종,남순열,김상윤 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

Radiation therapy is an effective cancer treatment modality as a primary treatment in early cancer and as an adjuvant treatment in advanced cancer, especially in head and neck lesions, but it also causes irreversible chronic damages to overlying normal tissues that may lead to wound complications. As well, at the microscopic level, radiation injury causes both stasis and occlusion of small vessels. Therefore, surgical reconstruction of previously-irradiated lesions in the head and neck poses a great problem. Fifth-six patients with head and neck lesions underwent 57 microsurgical reconstructions between 1990-1998. Thirteen patients were irradiated before surgery. The previous radiation dose was 30∼75.6 Gy. The free tissue transfer was successful in 52 of the 57 microsurgical reconstructions(91.2%). The success rate was 92.3%(12/13) in previously-irradiated patients and 90.9%(40/44) in nonirradiated patients. Postoperative complications, such as flap loss, fistula, and infection, developed in 4 irradiated patients and 8 nonirradiated patients. Overall complication rate was 30.8%(4/13) in previously-irradiated patients and 18.2%(8/44) in nonirradiated patients. Although the failure rate of previously-irradiated patients was higher than that of nonirradiated patients, there was no statistically significant difference between them. Thus, free tissue transfers in patients with previously-irradiated head and neck lesions are suitable for one-stage reconstruction.

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.

Chlorpromazine이 백서 해마에서 전기경련 충격에 의한 MAPK 타이로신 인산화에 미치는 영향

주연호,정성훈,전송희,강웅구,김용식,김상욱,박주배 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.2

Object : In order to examine the interaction mechanisms of electroconvulsive shock(ECS) and antipsychotic drug at the level of molecular biology, we observed the effect of chlorpromazine pre-treatment on the activation of mitogen activated protein kinase(MAPK) induced by electroconvulsive shock(ECS) in rat hippocampus Method : Male Sprague-Dawley rats were divided into 2 groups. To the experimental group chlorpromazine(20㎎/㎏) was given intraperitoneally, and to the control distilled water was given instead. Thirty minutes later, ECS was given and the hippocampus was dissected out 2 minutes thereafter. Immunoblotting with antiphosphotyrosine antibody was carried out, and the signal intensity at 42kDa band was quantitized using densitometer. The obtained result was compared by student t-test between the experimental and the control group. The absolute amount of MAPK was measured by immunoblotting with anti-MAPK antibody. Result : The tyrosine phosphorylation of MAPK reached peak at 2 minutes after ECS. However, in the chlorpromazine pre-treated group, the peak level of MAPK tyrosine phosphorylation was significantly attenuated(t=-3.12, df=14, p=0.008) compared to the control. In contrast to this, the absolute amount of MAPK did not differ between the pretreated and the control group. Conclusion : Chlorpromazine attenuated the tyrosine phosphorylation of MAPK by ECS. This finding seems to be related to the fact that chlorpromazine pre-treatment changed the cfos expression by ECS in rat brain. Antipsychotic drug and ECS might interact at the level of MAPK signal transduction system, and this might explained the observed synergistic effect of two treatment modality.

9-12%Cr강의 첨가원소 및 열처리에 따른 미세조직거동과 경도변화

주성욱,유정훈,신기삼,허성강,이재현,석진익,김병훈,김정태 국립7개대학공동논문집간행위원회 2004 공업기술연구 Vol.4 No.-

9-12%Cr steel are getting increasing attention for expanded application as high temperature materials applicable for gas turbine compressors, steam turbine rotors, blade and casing. For efficient and extensive application of 9-12%Cr steel, the data in addition to the improvement of mechanical properties on the correlation of microstructural evolution and mechanical properties are inevitable and thus the investigation in this study is performed for the determination for the specimens heat-treated at 600, 650 and 700℃ for 1000, 3000 and 5000hrs. The microstructure of as-received specimen was tempered martensite, with a high dislocation density and secondary phases. Upon high temperature heat-treatment, the martensite lath got larger and dislocation density decreased resulting the reduction of the strength. In addition, sharp growth of secondary phases was observed in the specimen heat-treated at 700℃ for 5000hrs. A specimen aged at 600℃ and 650℃ Laves phase was observed. The hardness showed close relationship with the secondary phase particle and dislocation density.

허혈성 심질환에서 나타나는 황상화지수, 사이토카인 및 염증지표의 변화

전상훈,안지훈,방덕원,온영근,현민수,김성구,권영주 순천향대학교 의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

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신뢰성 제약조건을 가진 평면 트러스의 최적 설계

변근주,김왕구,한상훈 연세대학교 산업기술연구소 1981 논문집 Vol.13 No.1

The aim in this presentation is to explore the relationship between optimum design of structures and reliability of structures. In this paper, the concept of probability of failure is explained for a general structural system. The concept emphasized in the paper is the employment of probability of failure constraint in the mathematical programming problem to determine the set of design parameters which minimizes the weight of the truss structures. Specific reliability based optima for multi-member systems are shown for weakest-link structures which fail if any element fails. Several examples of optimization with failure probability constraints are presented, and then the sensitivity of optimum design to reliability level as well as parameters in the reliability analysis is discussed. The results presented indicate: 1) The results indicate the feasibility of using probability of failure constraints in solving for optimum m lti-member structural designs. 2) An important factor influencing the magnitude of the optimum design as well as its member sizes will be the choice of load and strength frequency distributions and their parameters particulary the coefficients of variation. 3) The optimum value increases with both allowable failure probability and increase in coefficients of variation. 4) The classical approach to optimum design using a safety factor to represent conservation often results in unnecessary weight and cost.

회귀예측신경망을 이용한 음절인식

김주성,김상범,김수훈,허강인 東亞大學校 附設 情報通信硏究所 1996 情報通信硏究所論文誌 Vol.4 No.1

In this paper, we perform the recognition test for Korean 100 monosyllabes using RPNN(recurrent prediction neural networks). The RPNN is trained to nonlinear predictor, accoding to time variation of speech pattern, is not use time sequential algorithm. In recognition experiment we got the recognition rate 69.0%, 72.30% and 71.20% using RTRL(real-time recurrent learning) training algorithm when the predition order is 2, 3 and 4.

水紅花子의 抗癌活性 및 抗轉移 效果에 關한 硏究

曺永周,金聖勳,金東熙 대전대학교 한의학연구소 2002 혜화의학회지 Vol.10 No.2

To evaluate the antitumor activity and antimetastatic effects of Polygoni Orientalis Fructus(POF), studies were done experimentally. The results were obtained as follows: 1. In cytotoxicity against A549, and XF498 cell concentration inhibiting cell growth up to below 30% of control was recognized at 200㎍/㎖ of POF. Also POF inhibited cell growth up to below 30% of control against SK-OV-3, SK-MEL-2, HCT15 and MCF-7 cell at 100㎍/㎖. 2. The concentration inhibiting adhesion of A549 and SK-OV-3 to complex extracellular matrix up to below 70% of control was recognized at 100㎍/㎖ of POF. 3. In pumonary colonizatin assay, a number of colonies in the lungs were decreased signiicantly in POF treated group as compared with control group. These results suggested that POF extracts might be usefully applied for prevention and treatment of cancer.

만성 정신분열병 환자에서 지연성 운동장애와 음성증상 및 인지기능 장애와의 연관성

심주철,반철식,성기수,이정구,정도운,정청,윤진상,김영훈 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

연구목적: 정신과 전문병원에 입원해 있는 만성정신분열병 환자들을 대상으로 첫째 지연성 운동장애의 유병율과 위험인자들을 조사하고, 둘째 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성을 조사하고자 한다. 방법: 연구대상자는 마산동서병원에 입원 중인 환자 중 DSM-IV의 정신분열별 진단기준에 부합하며, 최근 3개월 이상 동일 용량의 항정신병약물 복용한 271명(남자 174명, 여자 97명)의 환자들이었다. 지연성 운동장애에 대한 평가는 Abnormal Involuntary Movement Scale(AIMS)을 이용하였고, DSM-IV와 Sc-hooler와 Kane(1982)의 진단기준 양자에 부합하는 환자들만을 지연성 운동장애군으로 분류하였다, 정신 분열병 정신병리에 대한 평가는 Brief Psychiatric Rating Scale(BPRS)와 Schedule for the Deficit Syndrome(SDS)을 이용하였고, 인지기능에 대한 평가는 Mini-Mental Status Examination(MMSE)을 이용하였다. 결과: 지연성 운동장애의 유병율은 50.9%이었고, 50세 이상, 남자에서 높았다. 그러나 입원기간과 항정신병 약물의 일일 사용량에 따른 차이는 없었다. 지연성 운동장애의 호발부위는 혀, 상지, 입술과 입 주위의 순이었다. BPRS 총점 및 소항목 척도점수와 SDS 척도점수는 지연성 운동장애의 유무에 따른 차이가 없었다. MMSE 총점 및 소항목 점수도 지연성 운동장애의 유무에 따른 차이가 없었다. 결론: 평균입원기간이 9년 이상인 만성정신분열병 환자들에게서의 지연성 운동장애의 유병율은 50.5%이었고, 연령이 가장 의미있는 위험인자임을 확인했다. 만성정신분열병 환자들이 주 대상인 본 연구에서는 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성은 입증하지 못했다. Objectives: The purpose of present study was to determine the prevalence rate of tardive dyskinesia and to search for its risk factors in chronically institutionalized schizophrenic subjects. We also examined the relationship between tardive dyskinesia and both negative symptoms and cognitive impairments in the same subjects. Methods: Subjects were 271 in-patients(174 males, 97 females) at Masan Dongsuh Hospital. They met DSM-IV criteria for schizophrenia and had been taking fixed doses of antipsychotics for at least 3 months. Tardive dyskinesia was assessed by Abnormal Involuntary Movement Scale(AIMS). Cases of tardive dyskinesia were ascertained by the criteria of Schooler and Kane (1982) and DSM-IV. The rating of psychopathology was acquired using Brief Psychiatric Rating Scale(BPRS) and Schedule for the Deficit Syndrome(SDS) and the assessment of cognitive function using Mini-Mental State Examination(MMSE). Results: The prevalence of tardive dyskinesia is 50.9% and the frequency of tardive dyskinesia was high est in male above the age of fifty. But there was no statistically significant relationship between the frequency of tardive dyskinesia and both the length of hospitalization and the daily dose of antipsychotics. The frequency order of abnormal movement in the patients with tardive dyskinesia was as follows : tongue, upper extremities, lips and perioral area. We couldn't find any significant difference in the total and subscale scores of BPRS between the groups with and without tardive dyskinesia. There were no differences in MMSE scores between the groups with and without tardive dyskinesia. Conclusion: This study gave us that the prevalence of tardive dyskinesia was high in chronically institutionalized schizophrenic inpatients and that age was the most significant risk factor of tardive dyskinesia. The relationship between tardive dyskinesia and both negative symptoms and cognitive impairment, however, was not revealed.

대망에 발생한 방선균증 1례

송상훈,심찬섭,이문성,김진오,조주영,김영석,문종호,이진우 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

Actinomycosis is an uncommon chronic suppurative disease characterized by multiple abscess, draining sinuses, abundant granulation, and dense fibrous tissue, caused by the actinomyces organisms. It occurs in three major sites: cervicofacial, abdominal, and thoracic. The abdomen is the second most common involved site in previous studies, and there are three ways this organism can affect the gastrointestinal tract: through a blood-borne infection, by swallowing, or by proliferation at a more distal intestinal area. Abdominal actinomycosis is an unusual disease but remains an important differential diagnosis in patients with abdominal mass. Obtaining the diagnosis is difficult and rarely made preoperatively, but provide the key to its management. Medical therapy is effetive in eradicating the disease; however, because of the large amount of reactive fibrosis formed by the infection, it requires long-term therapy. Surgical treatment may be essential in many cases, primarily when malignancy cannot be excluded or if extensive necrotic tissue exists. There are a few description for actinomycosis involving omentum. We report a case of patient with omental actinomycosis, suspected to have a malignancy requiring an exploratory laparotomy with resection.