웹기반 GIS를 이용한 테마지향 역사학습시스템의 설계

정소영(So-Young Jeong),신창선(Chang-Sun Shin),주수종(Su-Chong Joo) 한국정보과학회 2001 한국정보과학회 학술발표논문집 Vol.28 No.1B

초고속통신망과 웹 인터페이스의 발전은 교육환경에 많은 변화를 가져왔으며, 더불어 웹을 기반으로 하는 교육적 활용방법이 활발히 연구되고 있다. 본 논문에서는 기존의 정적지도를 이용한 획일적 역사학습방법을 지양하고, 동적인 학습이 가능하도록 클라이언트 중심의 웹기반 GIS를 이용한 테마지향 역사학습시스템을 설계하였다. 설계된 시스템은 크게 5가지 모듈로 구성되고 학습자 관리 DB, 학습 정보 DB, GIS DB와의 인터페이스 기능을 갖도록 기술하고, 이들 관계를 OMG 클래스다이어그램으로 보였다. 본 논문의 역사학습시스템은 학습자가 학습하고자 하는 주제를 선택하여 역사학습 정보를 요구할 때 지리적 위치를 지도상에 보여줌으로서 시각적이고 공간적인 이해를 가능하게 하였다. 또한 본 시스템은 텍스트, 이미지, 사진, 동영상 등의 속성정보를 이용한 멀티미디어 정보와 효과적인 학습정보 검색을 위한 다양한 검색방법을 제공하여, 학습자의 흥미를 유발시키고 역사학습의 효율성을 높일 수 있도록 하였다.

증 례 : 재발한 자궁경부암에서 전이성 갑상선암

홍소담 ( So Dam Hong ),신재경 ( Jae Kyoung Shin ),홍희진 ( Hee Jin Hong ),허진형 ( Jin Hyung Heo ),정소영 ( So Young Chong ),오도연 ( Do Youn Oh ),오지수 ( Ji Su Oh ) 대한내과학회 2016 대한내과학회지 Vol.90 No.1

비록 자궁경부암이 갑상선으로의 전이는 매우 드물지만, 자궁경부암의 과거력이 있는 경우, 갑상선부위의 부종이나 촉지되는 결절이 발생하면 반드시 전이성 병변을 의심해봐야 한다. 비록 갑상선으로의 전이는 매우 나쁜 예후를 의미 하지만 고식적 치료로 전신항암요법 및 방사선요법이 환자의 삶의 질 개선에 도움을 줄 수 있다. 드물기는 하지만 갑상선으로의 악성전이 보고가 증가하는 추세로, 이에 대해 어떠한 치료가 가장 효과적일지에 대한 연구가 필요하겠다. Most patients with recurrent uterine cervical cancer have intra-pelvis metastasis with adjacent lymph node involvement, while a lone, distant metastasis is extremely rare. We report a 79-year-old woman with recurrent uterine cervical cancer that presented as thyroid mass with no intra-pelvic recurrence. Four years earlier, the patient had been diagnosed with uterine cervical cancer. She had undergone a course of concurrent chemoradiotherapy to the pelvis and had no subsequent evidence of recurrence. Several weeks before presenting, she had noticed a foreign body sensation in her throat and a palpable mass in the left side of her neck. Clinically, this was metastatic squamous cell carcinoma from the uterine cervix. Patients who present with swelling or palpable nodules in the neck with a previously diagnosed malignancy must be evaluated for metastatic disease, although metastasis from uterine cervical carcinoma to the thyroid gland is rare. (Korean J Med 2016;90:68-71)

증례 : 혈액종양 ; 원발성 자가면역 골수섬유증 1예

임영민 ( Yeong Min Lim ),박치영 ( Chi Young Park ),홍원정 ( Won Jung Hong ),김광일 ( Gwang Il Kim ),정소영 ( So Young Chong ),오도연 ( Do Yeun Oh ) 대한내과학회 2014 대한내과학회지 Vol.86 No.5

혈구 감소 정도에 비해 경도의 골수섬유증을 동반한 원발성 자가면역 골수섬유증 1예로 스테로이드 및 소량의 면역억제제 사용으로 양호한 혈액학적 소견을 유지하고 골수섬유증의 호전을 보였다. 이 원발성 자가면역 골수섬유증은 선행하는 자가면역 질환이 없고 범혈구 감소증 및 자가면역항체 양성, 골수섬유화증의 증거가 있을 때 감별진단의 하나로 고려해야 할 것이다. Primary autoimmune myelofibrosis, the development of which is not preceded by a well-defined autoimmune disease, has recently been defined as a distinct clinicopathologic syndrome. We report herein a case of a 68-year-old woman who was diagnosed with primary autoimmune myelofibrosis and present a review of the literature. The patient manifested peripheral pancytopenia, was positive for autoantibodies, and developed myelofibrosis with no preceding autoimmune or hematologic disorders. Her condition was dramatically improved after administration of prednisolone. (Korean J Med 2014;86:632-636)

증례 : 호홉기 ; 호산구성 염증을 동반한 기관지 협착이 폐암으로 오인된 증례 1예

홍원정 ( Won Jung Hong ),박치영 ( Chi Young Park ),고은정 ( Eun Jung Ko ),조상호 ( Sang Ho Cho ),정소영 ( So Young Chong ),정혜철 ( Hye Cheol Jeong ) 대한내과학회 2014 대한내과학회지 Vol.87 No.6

We report a very unusual case of endobronchial involvement of eosinophilic inflammation. A 58-year-old woman visited our clinic complaining of cough. A chest computed tomography scan showed a poorly enhancing mass compressing both main bronchi in the subcarinal area. Bronchoscopy also showed stenosis of the two main bronchi with irregular mucosal thickening. A bronchoscopic endobronchial mucosal biopsy revealed eosinophilic inflammation without evidence of malignancy. The subcarinal mass disappeared after systemic steroid treatment. This is the first report of mass-forming eosinophilic infiltration involving the central airway mimicking primary lung cancer. (Korean J Med 2014,87:733-737)

한국인 위암 환자에서 Thymidylate Synthase와 Methylenetetrahydrofolate Reductase 유전자 다형성의 임상 의의

이준 ( Jun Lee ),정철권 ( Cheol Kweon Jeong ),홍성표 ( Sung Pyo Hong ),정소영 ( So Young Chong ),오도연 ( Do Yeun Oh ),황성규 ( Seong Gyu Hwang ),안대호 ( Dae Ho Ahn ),김세현 ( Se Heun Kim ),한진희 ( Jin Hee Han ),김남근 ( Nam Ke 대한소화기학회 2005 대한소화기학회지 Vol.46 No.1

성인 급성 백혈병에 있어서 감염증에 관한 고찰

김성철(Seong Cheol Kim),민유홍(Yoo Hong Min),이석(Seok Lee),정소영(So Young Chong),이승태(Seung Tae Lee),한지숙(Jee Sook Hahn),고윤웅(Yun Woong Ko) 대한내과학회 1996 대한내과학회지 Vol.51 No.6

N/A Objectives: Patients with acute leukemia have a long-term disease free survival due to improvement of chemotherapy. But the infection is the most important morbidity and mortality and is the single commonest complication resulting in an early death after chemotherapy. Therefore the effective treatment and preventive strategies of these infection is essential in order that more patients may achieve a complete remission and long-term disease free survival. The purpose of this study was to determine the recent incidence of fever/infection and to evaluate antimicrobial usage among adult acute leukemic patients. Methods: The records of 172 patients from a consecutive series of 350 admission episode between January 1990 to July 1994 were reviewed retrospectively. Datas were analyzed to compare the infectious disease complications and antimicrobial usage for patients receiving various chemotherapy for a specific phase of leukemia treatment. Results: 1) Febrile episodes were developed in 258 of 350 admission session. The microbiologically de5ned infection (MDI) & clinically defined infection (CDI) were developed in 44.8% and 49.2% of episodes, respectively. There was a 92% rate of febrile episodes among the patients receiving salvage chemotherapy. Fever was developed in 75%, 53%, and 70% in cases receiving remission induction chemotherapy, consolidation therapy, and intensified consolidation therapy, respectively. 2) The most frequent site of infection was lung (36%). Coagulase-negative staphylacocci was the most common causative organism of MDI and bacteremia. 3) The rate of overall response to antimicrobial therapy was 72.9%. The rate of overall response to antimicrobial therapy during the intensified consolidation, consolidation therapy, and induction chemotherapy was over than 75% (90.5%, 87.6%, 79.6% respectively). 4) The initial antimicrobial therapy was not modified in 45 of 258 febrile episodes. Modification of antibiotics was carried out in only 36 cases according to the results of primary bacterial culture and sensitivity tests. The initial response of initial empiric antimicrobials was 23.6%, The initial response rate of the addition of vancomycin/teicoplanin, and amphotericin-B was 21.7% and 15.2%, respectively. The cumulative rate of initial response for antimicrobials described above was 60.5%. Among the cases receiving amphotericin-B, probable fungal infection was 23.7%, while the suspected fungal infection was 61%. Conclusion: The development of intensive treatment modalities far acute leukemia has altered the encountered infectious disease problem. Although our management guidelines for infections were of relevant, more effective approaches should be evaluated by considering the changing spectrum of microbials and by using more effective prophylactic and treatment modalities including new antimicrobials.

호산구증가증과 PDGFRB 유전자 재배열을 보인 골수 종양 1예

조남길 ( Nam Gil Cho ),김대진 ( Daejin Kim ),심민정 ( Minjung Shim ),정소영 ( So Young Chong ) 대한내과학회 2017 대한내과학회지 Vol.92 No.1

본 증례에서 알 수 있듯이 PDGFRB 골수증식 종양에서 im-atinib의 사용은 과호산구증가증의 자연 경과에 지대한 영향을 미쳤다. 과거 imatinib을 사용하지 않던 환자들의 경우 2년 생존율이 55% 정도였던 것에 비해 imatinib을 사용하는 경우 10년 생존율이 90%로 극적인 상승이 있었다. 따라서 과호산구증가증 보이는 경우 PDGFRB 재배열을 동반한 골수 종양에 대한 고려가 반드시 필요하며 분자유전학적으로 PDGFR재배열을 보일 경우 즉시 imatinib의 치료가 필요하다. Myeloid neoplasia with eosinophilia and platelet-derived growth factor receptor beta (PDGFRB) rearrangements is an uncommon Philadelphia-negative myeloproliferative neoplasm. Their most common morphological diagnosis is chronic myelomonocytic leukemia with eosinophilia, which is associated with t(5;12)(q33;p13) and results in the formation of the ETV6-PDGFRB fusion gene. Here, we report a 49-year-old man with a myeloid neoplasm with a PDGFRB rearrangement, who was incidentally diagnosed with hyperleukocytosis and eosinophilia during a health screening. A chromosome analysis of a bone marrow sample revealed 46, XY, t(5;12)(q33;p13), and fluorescence in situ hybridization analysis revealed the PDGFRB gene rearrangement. The patient was treated with imatinib and subsequently achieved complete hematological and molecular remission. (Korean J Med 2017;92:79-83)

증례 : 혈액종양 ; 항암 치료 후 발생한 급성B림프모구백혈병 2예

신석표 ( Suk Pyo Shin ),송상희 ( Sang Hee Song ),고은정 ( Eun Jung Ko ),김지수 ( Ji Su Kim ),박치영 ( Chi Young Park ),오도연 ( Do Yeun Oh ),정소영 ( So Young Chong ) 대한내과학회 2013 대한내과학회지 Vol.85 No.1

치료관련 골수성 백혈병은 잘 알려져 있으며 치료와의 연관성이 정립되어 있으나 치료관련 급성B림프모구백혈병은 드물고 이전의 악성 종양의 항암 치료와 방사선 치료가 급성B림프모구백혈병 발생에 영향을 미치는지는 아직 논란이 많다. 최근에 세포독성 치료와 연관된 급성B림프모구백혈병의 보고가 있으며 국내에서도 드물게 보고되고 있다. 이에 저자들은 과거 세포독성 치료를 한 뒤 급성B림프모구백혈병이 발병한 증례 2예를 경험하였기에 보고하는 바이다. Therapy-related myeloid neoplasms have been well characterized. However, precursor B-cell acute lymphoblastic leukemia in patients with prior malignancies is uncommon, and the effect of prior cytotoxic therapy on development of precursor B-cell acute lymphoblastic leukemia is controversial. Therapy-related precursor B-cell acute lymphoblastic leukemia has been reported occasionally. However, cytotoxic therapy-related precursor B-cell acute lymphoblastic leukemia has been reported in Korea only rarely. We herein describe two cases of therapy-related precursor B-cell acute lymphoblastic leukemia. (Korean J Med 2013;85:96-100)

위암으로 전위절제술을 시행한 환자에서의 비타민 B12 결핍성 빈혈

고윤웅(Yun Woong Ko),민진식(Jin Sik Min),서형찬(Hyung Chan Suh),조준식(Joon Sik Cho),이석(Seok Lee),정소영(So Young Chong),유내춘(Nae Choon Yoo),민유홍(Yoo Hong Min),한지숙(Jee Sook Hahn) 대한내과학회 1998 대한내과학회지 Vol.54 No.3

N/A Objectives: We attempt to find out the decremental character of serum vitamin B12 level and features of patients with vitamin B12 deficiency anemia occurring earlier than 4 years after total gastrectomy. Methods: We studied 91 patients who underwent total gastrectomy and select 59 patients who evaluate serum vitamin B12 level within 4 years after total gastrectomy to characterize the features of vitamin B12 deficiency anemia group occurring earlier than 4 years after the operation. Results: 1) In 91 patients, the mean postoperative duration is 31.9(range: 0-135) months and mean serum vitamin B12 level 158.9(total 159 times, range: 20.0-806.2) pg/mL. Correlation equation is y=403.30×e-0.09x +175.93×e-0.02x (r2=0.804). The postoperation duration that serum vitamin B12 level falls below 200pg/mL is 20 months. 2) Among 59 patient, there were 20 cases of vitamin B12 deficiency anemia group(Group I), 21 cases of vitamin B12 deficiency(Group II) and 39 cases of non-vitamin B12 deficiency group(Group III). Preoperation symptom duration in Group I was longer than that in Group II(18.2 vs 9.6 weeks, p<0.01). Group 1 and Group II showed lower serum vitamin B12 level than Group III(126.7 & 96.0pg/mL vs 330.4pg/mL, p<0.01). 3) Eleven cases had associated diseases(9 alcoholics and 2 liver cirrhosis) with vitamin B12 deficiency anemia and these disease had significant influence on the incidence of vitamin B12 deficiency anemia(p<0.01) within 4 years. Among the 30 cases who could measure iron profile, 10 patients had an iron deficiency anemia, There was a higher incidence of vitamin B12 deficiency anemia in iron deficiency anemia group(7/10, 70%) than that in non iron deficiency anemia group(7/20, 35%) but no statistical significance(p=0.12). 4) Although anti-cancer chemotherapy did not have a significant influence on the incidence of vitamin B12 deficiency anemia, vitamin B12 level in anti-cancer chemotherapy group was higher than that in non-chemotherapy group(201.83 vs 127.66pg/mL, p=0.01) at similar mean postoperation duration(27.8 vs 27.7 months, p=0.97). 5) The independent predictor of vitamin B12 deficiency anemia within 4 years were associated disease(p=0.002) and preoperation symptom duration(p=0.004), Conclusion: Red cell indices such as Hb or MCV did not have any clinical significances in predicting the development of vitamin Biz deficiency. To prevent vitamin B12 deficiency anemia and promote better quality of life in total gastrectomized patients with stomach cancer, careful monitoring of serum Vitamin B12 level and replacement therapy should be necessary at least 20 months after operation, especially in patients with associated disease and longer preoperation symptom duration.

무릎관절의 미만형 색소 융모 결절성 활액막염에서 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료

장세경(Sei Kyung Chang),김재화(Jae Hwa Kim),하두회(Doo Hoe Ha),강혜윤(Hae Youn Kang),정소영(So Young Chong),신현수(Hyun Soo Shin) 대한방사선종양학회 2006 Radiation Oncology Journal Vol.24 No.3

색소 융모 결절성 활액막염(pigmented villonodular synovitis, PVNS)은 병인이 밝혀지지 않은 증식성 질환으로, 병변 의 범위에 따라 국소형과 미만형으로 분류되며, 조직학적으로 양성이지만 파괴적인 성향을 보이므로 연골의 파괴나 주위 조직으로 광범위한 침윤이 가능한 질환이다. 활액막 절제술이 일차적인 치료방법이지만 미만형인 경우에는 주위 조직을 침윤하는 성향 때문에 재발률이 높다. 재발이 반복된 후에는 수술적 절제가 어려워져서 병변부위의 절단이 필요하게 되므로, 광범위한 병변인 경우, 수술이 용이하지 않은 경우, 또는 불완전 절제가 시행된 경우 등에서 방사선치료를 시행하여 재발을 방지할 수 있다고 보고되고 있다. 저자들은 무릎관절의 미만형 색소 융모결절성 활액막염으로 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료를 시행한 2예를 경험하였기에 문헌고찰과 함께 보고하고자 한다. Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.