질확대경검사시 자궁경관소파술의 진단적 가치

오병찬,김종덕,김경옥,정병규,이동복 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.1

1.세포진검사의 정확도는 조준생검결과와 비교하여 64.8 %이었으며, 위음성율과 위양성율은 각각 23.9%, 11.3 &였다. 2. 질확대경에 의한 추정진단의 정확도는 조준생검결과와 비교하여 73.2 %이었으며, underestimated rate는 16.9 %였다. 3. 질확대경에 의한 조준생검결과와 최종 병리조직 진단과의 일치율은 77.8 %, one pathologic degree내에서의 일치율은 96.3 %이었으며, 조준생검의 underestimated rate는 14.8 %였다. 4. 자궁경관소파술 병용군에서 경관내에 이형상피증이상의 양성율은 19.4 %(6/31)이었으며, 연령분포는 6명중 5명이 40대이었다. 5. 질확대경검사시 자궁경관소파술 비병용군과 병용군간에 치료전침윤암의 오진율은 각각 3.1 %(1/32), 4.5 %(1/22)로서 비슷하였으나, 병용군에서 침윤암 13명중 2명은 자궁경관소파술에 의해 진단되었다. With the use of colposcopy to evaluate cervical lesions, the management of patients with abnormal Papanicolaou smears has become more individualized and developed. But colposcopic accuracy depends on criteria determining its limitations and examiners experience. Most important limitation of colposcopy is incomplete visualization of transformation zone extending into the endocervical canal. To improve the diagnostic accuracy of colposcopy before management, some reporters have suggested that endocervical curettage be an integral part of colposcopic examination. This suggestion has not been accepted by all authors. This study was undertaken to compare cytologic diagnosis and colposcopic impression with the histology of colposcopically directed biopsy, to determine the accuracy of colposcopy-directed biopsy, and to demonstrate whether the addition of endocervical curettage to colposcopy-directed biopsy can eliminate further diagnostic evaluation(conization) in the management of patients with satisfactory colposcopic findings. From Jan. 1, 1986 to Sep. 30, 1988, the colposcopic examination was undertaken in 71 patients with abnormal cytologic smears, excluding grossly visible carcinoma of the cervix. The results were as follows: 1. Accuracy of cytology was 64.8% and its false negative and positive rate were 23.9%, 11.3% respectively when compared to the histology of colposcopically directed biopsy. 2. Accuracy of colposcopic impression was 73.2% and its underestimated rate was 16.9% when compared to the histology of colposcopy-directed biopsy. 3. Accuracy of colposcopically directed biopsy was 77.8% and its underestimated rate was 14.8% when compared to the histology of final surgical specimen. 4. An endocervical curettage was obtained in 31 patients and was positive in 19.4% (6/31) of those sampled, including two patients with no lesion found on directed biopsy specimen. 5. There were two cases in which an invasive cancer was missed prior to therapy, one in the non-ECC group of 32 patients (incidence 3.1%), the other ECC group of 22 patients(incidence 4.5%) when comparedto the final pathologic diagnosis.

문화재 유형에 따른 안내표지판 디자인 사례조사 연구 : 충청남도 문화재를 중심으로

오병찬 충남연구원 2020 충남연구 Vol.4 No.1

우리나라 곳곳에는 우리나라를 대표하거나 그 지역을 대표하는 다양한 문화재들이 자리하고 있지만, 우리에게 잘 알려져 있는 국보급 문화재를 제외하면 특별한 안내 정보가 없어 지나치기 쉽고 문화재로 인식하지 못할 경우도 있다. 또한 문화재가 접근이 쉬운 주택지 등에 노출되어 있는 등 주민들의 생활 속에서 훼손의 우려도 있어 이를 위한 대책 마련이 요구된다. 본 연구는 광역도 차원의 문화재와 유형에 따른 표지판 유형 체계 분석결과를 통해 국가지정문화재와 광역도 문화재 간의 위계의 혼선을 줄여, 문화재 안내표지판의 디자인 계획 및 관리와 운영이 효율적으로 되도록 하는데 목적이 있다. There are various cultural assets representing Korea or regions in Korea, but except for the national treasure grade cultural assets well known to us, it is easy to overlook them as cultural assets because guidance is lacking. In addition, there are concerns of damage to cultural assets that are easily accessible in residential areas, and measures need to be taken to prevent such damage. The purpose of this study is to reduce the confusion of hierarchy between state-designated cultural assets and metropolitan cultural assets through an analysis of the guide sign system according to cultural asset types in the metropolitan area, thereby making the design planning, management, and operation of cultural heritage information signs more efficient.

충청남도 지방중소도시 가로 공간 분석에 관한 연구

오병찬 한국공간디자인학회 2019 한국공간디자인학회논문집 Vol.14 No.7

(연구배경 및 목적) 지방중소도시는 역사와 문화가 어우러진 콘텐츠가 강하게 작용하여 지역마다 조금씩 다른 이미지가 형성되며, 지역의 경제와 역사문화의 영향으로 공간 규모의 차이가 다르게 나타난다. 지방중소도시의 가로 공간을 개선하기 위해서는 지역의 가로 공간을 형성하는 물리적요소에 대한 전반적인 실태조사를 추진하고, 가로 공간 형성 요소별 특징을 도출하여 그에 따른 차별화된 계획을 추진하여야 한다. 본 연구의 목적은 지방중소도시의 가로 공간과 대도시의 가로공간의 현상적인 차이를 물리적, 비물리적 형성요인으로 구분 및 데이터화 하여 객관적인 지표로 제시하고 공간의 차이가 있음을 증명하고자 한다. (연구방법) 연구의 범위는 지방중소도시로 한정하였다. 지방중소도시의 가로를 실태조사하기 위한 방법으로 첫째, 지방중소도시의 가로 공간을 형성하고 있는 영향 요인을 도출 하였다. 둘째, 도출된 영향요인을 물리적 요소(건물, 차도, 보도)와 비 물리적인(인문) 요소로 구분하여 데이터화 하였 다. 사람에 의해 형성되는 비 물리적 요인은 가로 공간에 영향을 주는 사람의 이동과 경제요소 등이 포함된다. 마지막으로 데이터화된 값을 3차원 그래프로 구성하여 지방중소도시의 가로와 대도시의 가로를 비교하여 증명하였다. (결과) 지방중소도시의 가로 현황을 조사 및 분석한 결과 충청남도의 경우 평균 건물의 층수는 2.78층, 도로는 4.33차로, 보도는 3.83m로 나타났다. 이 결과를 통해서 지방중소도시 중심상권의 가로현황을 수치로 환산하여 판단할 수 있었으며 대도시의 중심상권 수치가 대부분 높은 것으로 가정하였을 때 대도시와 지방중소도시의 편차가 상당히 크게 타나나는 것을 객관적 지표로 확인 할 수 있다. (결론) 본 연구에서 다룬 지방중소도시의 가로공간 조사 결과는 가로공간의 일반적인 물리적 요소와 비물리적 요소를 데이터화된 3차원 지표로 표현하여 지방중소도시의 가로 공간 현황에 대한 이해를 쉽게 하였고, 연구에서 제시된 분석방법이 활용된다면 각 지자체 마다 가로공간에 대한 등급화가 가능할 것으로 판단된다. (Research background and purpose) Local small and medium-sized cities are strongly influenced by content that combines history and culture, creating a slightly different image from region to region. Differences in space size appear due to the influence of local economy and history culture. To improve the street space of local small cities, the overall survey of the physical factors that form the street space in the area should be carried out, and a differentiated plan should be implemented accordingly by deriving the characteristics of each building element of the street space. The purpose of this study is to distinguish and archive the phenomenal differences between the street space of small and medium-sized cities and the street space of large cities as physical and non-physical factors, presenting them as objective indicators and proving that there are differences in space. (Method) The scope of the study was limited to local small and medium cities. To survey the streets of local small and medium cities, the influence factors forming the horizontal space of local small and medium cities were derived. Second, the derived influence factors were classified into physical factors (buildings, driveways, sidewalks) and non-physical (humanities) factors. Non-physical factors formed by people include people's movement and economic factors that affect the horizontal space. Finally, the data values were constructed in a three-dimensional graph and verified by comparing the streets of small and medium cities with those of large cities. (Result) The results of the survey and the analysis of the street status of small and medium-sized cities in the provinces showed that the average number of floors of buildings in Chungcheongnam-do Province was 2.78 stories, 4.33 lanes of roads, and 3.83 meters of sidewalks. The street status of the central commercial districts of small and medium-sized cities could be determined by numerical values and the deviation between large cities and small cities could be significantly increased, as shown in the graph of the highest central business area figures in large cities. (Conclusion) The results of the survey in this study indicated the general physical and non-physical elements of the street space as dataized and three-dimensional, making it easier to understand the current state of the street space in small and medium-sized cities, and if the analysis methods presented in the study are utilized, it is deemed possible for each local government to grade the street space.

老齡産母의 姙娠과 出産에 關한 硏究

오병찬 전북대학교 의과학연구소 1987 全北醫大論文集 Vol.11 No.1

In this study, 33 cases of pregnant women aged over 40 among total 3,808 gravid women visited to our university hospital from January 1,1980 to June 31,1985 were clinically observed and statistically reviewed. Many authors reported increased incidence of both maternal and fetal complication and more operative intervetion during labor in elderly gravida. Two hundred women among gravidas aged below 35 were used as a control group. The results were obtained as follows ; 1.The incidence of pregnant women aged over 40 was 0.87%. 2. Maternal age distribution ranged between 40 and 45 years. 3. Parity distribution ranged between 1 and 9 in the study group. 4. Cesarean section was required in 42.4% of the deliveries in pregnant women aged over 40. 5. Concerning antepartal complications, the incidence of hypertensive disorder was 24.2% in the study group while 9% in the control group. The incidence of SPRM in the stndy group was 9.1% while 7.5 in the control group. 6. There were increased incidences of both low and high birth weight infants in the study group. 7. Perinatal mortality rate was 212 in the stndy group while 45 in the control group.

자궁부속기 질환의 치료에 있어서 골반경 수술과 개복수술의 비교연구

오병찬,김종덕,류철희,김관식 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

목적: 양성종양의 불필요한 개복수술과 악성종양의 부적절한 골반경수술을 피하고 자궁부속기종양 골반경수술의 비율을 높이기 위함 연구방법: 정해진 개복수술의 지침에 따라 자궁부속기 종괴의 개복 또는 골반경수술을 시행하고 수술방법, 수술시간, 재원기간, 합병증, 개복수술 요인과 개복수술의 적합성 여부에 대한 수술자 의견 등이 분석됨. 결과: 18개월간 자궁부속기 종괴로 개복수술[159명]과 골반경수술[129명]이 시행됨. 개복수술/골반경수술 비율은 전체적으로 55.2%/44.8%, 비종양성 종괴는 44.5%/55.5%, 양성종양은 58.1%/41.9%, 경계성종양 100.0%/0.0%, 악성종양 91.7%/8.3%임. 주요 개복이유로 비종양성 자궁부속기 종괴는 복막염 또는 혈복강을 의심하는 증상 징후와 함게 불안정한 생체활력징후[32.1%]와 중증 골반강내 유착의 강력한 의심이나 확인[24.5%], 양성종양은 세밀한 낭종박피술이 필요한 직경 6cm 이상의 종괴[26.7%]와 중증 골반강내 유착의 강력한 의심이나 확인 [18.6%]임. 난소암 골반경수술은 1례[0.78%]임. 수술자는 개복수술의 28.9%가 골반경수술에 적합했을 것으로 판단함. 결론: 자궁부속기 종양에 있어 골반경수술이 개복수술보다 더 나은 방법이며 유착을 의심하는 환자나 의심스런 종괴에 대해서도 신중한 골반경수술의 재고가 필요하리라 사료됨. 또 한편 골반경수술 적용을 위해 더 주의깊은 수술 전, 수술 중 검사가 이뤄져야 할 것임. Objective: To increase proportion of pelviscopic surgery, and besides, avoid unnecessary laparotomy for benignity and pelviscopic surgery of malignancy in adnexal masses. Methods: Adnexal masses were managed by laparotomy or laparoscopy under the stated guideline. We analyzed data of the surgical procedure, operative time, hospital stay, and complication, guideline applied and the operator`s opinion on the adequacy of each laparotomy. Results: Over an 18-month period, laparotomy [n=159] or pelviscopy [n=129] were performed. Mean operative time and hospital stay in the pelviscopy group were shorter than those in the laparotomy group. The proportion of laparotomy/pelviscopy were 55.2%/44.8% in overall, 44.5%/55.5% in non-neoplastic tumors, 58.1%/41.9% in benign neoplasm, 100.0%/0.0% in borderline tumor and 91.7%/8.3% in malignancy. The main reasons of laparotomies were unstable vital sign with some symptoms and signs of generalized peritonitis or hemoperitoneum[32.1%] and suspected severe pelvic or abdominal adhesion [24.5%] in non-neoplastic tumor. The patients of benign neoplasms had laparotomies chiefly due to elaborate enucleation in the cyst of diameter 6cm for fertility[26.7%] and suspected severe pelvic or abdominal adhesion [18.6%]. Pelviscopic surgery of ovarian cancer was 1 case [0.78%]. Operator was of opinion that the rate of inadequacy in laparotomies was 28.9% in overall. Conclusion: Pelviscopic surgery is superior to laparotomy in the management of adnexal masses and may be considered prudently in patients of pelvic adhesion suspected and in adnexal tumors those can`t confirm as benignancy. In addition to preoperative evaluations, operative findigs and frozen biopsy should be obtained more carefully for pelviscopy of adnexal tumors.

AI 기반 계통한계가격 예측 기법 성능 개선 방안에 관한 연구

오병찬,최연주,최봉기,김지수,권오은,이덕우,곽희진,장정호,이성훈,양시은,김성열 대한전기학회 2019 대한전기학회 학술대회 논문집 Vol.2019 No.11

원격전이된 재발성 난소 윤상소관형 성기삭 종양 (SCTAT) 의 화학요법 경험 1 예

오병찬,김종덕,진소자,김관식 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.6

저자들은 18세 터너증후군으로 확인된 환자에서 발생한 난소 SCTAT의 보존적 수술을 시행한 후 6년 8개월 만에 두경부, 골반부, 복부림프절의 재발 및 전이가 확인되어 BEP 병합 화학요법을 3회 시행하였다. 환자는 마지막 추적검사에서 부분적 관해를 보였으며 치료 중단 후 만 1 년이 넘은 현재에도 특이한 증상 및 불편감 없이 생활하고 있다. 이에 임상적인 문헌 고찰과 함께 보고하는 바이다. Sex cord tumor with annular tubules (SCTAT) is an unusual ovarian neoplasm. The standard treatment for recurrent SCTAT was not established. This tumor was considered as a tumor with low-grade malignancy. A case of recurrent ovarian sex cord tumor with annular tubules in a 24-year old female with Turner`s syndrome was reported. The recurrence and metastasis were diagnosed accidentally through the operation of a palpable neck mass in the department of ENT in our hospital. Retroperitoneal lymphatic metastasis was thought to an important pathway of spread. Persistent amenorrhea, pelvic mass, and para-aortic masses were important clinical features. The patient was treated with combination chemotherapy of three cycles. The regimen consisted of bleomycin, etoposide, and cisplatin.

단순포진

오병찬 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.5

성기단순포진은 아직도 성인과 신생아에게 광범위하게 분포되어 있는 감염성 질환으로 남아 있다. 의료인들은 성기포진의 정신적 충격이 흔히 실제 신체적 장애보다 더 심각하다는 것 을 알아야 한다. 분만중 감염된 여성의 조기발견을 통해서 신생아 감염의 빈도를 최소화하 는 것은 중요한 일이다. 최근의 지침은 성기포진의 위험이 높은 여성의 관리에 대한 이론적 근거를 제시하고 있다. 그러나 새로운 혈청학적, 면역학적 검사가 임상적으로 이용 가능해지 고, HSV 감염의 정확하고 신속한 진단이 이루어질 때까지, 분만중 감염된 여성의 조기발견은 상세한 병력청취, 이학적검사 및 바이러스 배양을 통해서 이루어져야 한다.

환자표본자료를 이용한 간세포암종 환자의 의료이용 특성 및 치료별 의료비용 분석

오병찬,조정연,권순홍,이의경,김혜린 한국임상약학회 2021 한국임상약학회지 Vol.31 No.2

Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service–National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.

Candida성 질염에 대한 Fluconazole의 임상적 치료 효과

오병찬,안진섭,김종덕,황수경,이희섭,차경연,양재이 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.11

저자 등은 1991년 2월 1일부터 9월 30일까지 대하, 음부소양증 및 작열감을 주소로 전북대학교병원 산부인과 외래에 내원한 환자중 질분비물 직접도말검사와 배양검사에 의해 candida가 확인된 비임신 여성 33명을 대상으로 fluconazole 1회 경구요법을 사용하여 다음과 같은 결과를 얻었다. 1. 환자의 연령분포는 28∼60세이며, 평균연령은 37.7세였고 분만횟수는 2회 군이 21례로 63.6%를 차지했다. 2. 치료후 자각증상의 소실은 작열감이 100%, 대하증이 81.5% 음부소양증이 76.9%였으며 질경소견상의 호전은 외음 및 질의 표피박라기 91.7%, 홍반이 85.0%, 분비물이 73.3%였다. 3. 진균성 질염의 원인균은 candida albicans가 29례로 88%차지하였다. 4. Sabouraud dextrose배지를 이용한 배양법에 의해 치료판정한 결과 치료 1주후의 추적검사에서 90.0%의 치료성적을 보였으며 4주후의 추적검사에서 93.1%의 치료 지속효과를 나타냈다. 5. 약제의 부작용은 자각적 증상이나 검사학적인 면에서 발견할 수 없었다. A clinical study about effectiveness of single dose Fluconazole (Diflucan) therapy in vaginal candidiasis has been carried out in 33 patients who visited Department of Obstetrics and Gynecology, Chonbuk National University Hospital form February 1st, 1991 to September 30th, 1991. Ages ranged from 28 years to 60 years with a mean of 37.7 years and the mean height was 157.1 cm and the mean body weight was 53.0kg. The majority of contanception methods (69.7%) were IUD and surgically sterilized methods. The most offending organism was Candida albicans (88%). The subjective symptoms such as discharge, pruritus, burning were ameliorated after treatment in 81.5%, 76.9% and 100%, respectively. The clinical signs such as erythema, excoriation, erosion and discharge were ameliorated after treatment in 85.0%, 91.7%, 71.4% and 73.3%, respectively. Ninety-one percent(30/33) of patients treated with the single dose were found to be cured at the 1-week follow-up, and this persisted in 93.1%(27/29) of patients to the 4-week follow up. There were no undesirable side effects in all patients during and after treatment. Fluconzole may become the orally active antifungal agents capable of treating vaginal candidiasis with single dose therapy.