쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화

정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

운동 직후 고온 침수가 EPOC와 TG/ fatty acid cycling에 미치는 영향

조현철,김종규,강민철,홍완표,박노혁 龍仁大學校 體育科學硏究所 2005 體育科學硏究論叢 Vol.15 No.1

The purpose this study was to estimate effects of EPOC and TG/fatty acid cycling on warm water immersion of immediately after exercise. To elucidate the role of fatty metabolism, a sequence of five experiments was performed. Seven physically active, male subjects volunteered to participate in the presented study. The mean values for age, body mass and hight were 25±1.52 yr, 79.2±9.52kg, 177.2±4.62cm, respectively. After giving consent, participant visited the laboratory on six occasion: 1) 30min of treadmill exercise VO2max 55% and a further 60min recovery, 2) 30min partial body warm water immersion in a 39℃ and a further 60min recovery, 3) 30min whole body warm water immersion in a 39℃ and a further 60min recovery, 4) 30min of treadmill exercise VO2mas 55% and in 30min partial body warm water immersion in a 39℃, 5) 30min of treadmill exercise VO2max 55% and in 30min whole body warm water immersion in a 39℃. When compared by recover period within repeat on the base of changes of subjects average body temperature, not effective interactions among repeat. However, partial and whole body warm water immersion immediately after exercise shows it as the best effective exercise for VO2max 55%, partial and whole body warm water immersion. When compared by recover period within repeat on the base of changes of subjects EPOC, effective interactions among repeat(p<.05). Partial and whole body warm water immersion immediately after exercise shows it as the best effective exercise for VO2mas 55%, partial and whole body warm water immersion. The catecholamines concentration was significantly higher partial and whole body warm water immersion than exercise of VO2max 55%(p<.05). The TG concentration and free fatty acid was significantly higher partial and whole body warm water immersion immediately after exercise than exercise of VO2max 55% than Partial and whole body warm water immersion(p<.05). Based on the facts that we have discussed above, human metabolism is increased by both exercise and conditions of immersion and partial and whole body warm water immersion immediately after exercise than exercise of VO2maw 55% shows it as better effective treatment for increasing TG/Fatty acid cycling activation. Due to extremely heavy stress complained by subjects during whole body immersion, it is thought that more researches on it should be required.

실험적 급성 허혈성 신부전에서 Verapamil 이 혈중 Polyamine 동태에 미치는 영향

원동준(Dong Jun Won),권현민(Hyun Min Kwon),김용섭(Yong Seop Kim),구자룡(Ja Ryong Gu),권영주(Young Ju Kwon),조원용(Won Yong Cho),김형규(Hyung Kyu Kim) 대한내과학회 1991 대한내과학회지 Vol.40 No.6

N/A It has been proposd that calcium entry from an external medium increases intracellular free calcium to toxic levels during ischemic acute renal failure, and verapamil (ARF) has been suggested as the agentblocking calicium entry into renal cells and protecting renal function during ischemic injury. Polyamines, anorganic cations that play various roles in normal cellular proliferation and differentiation, accumulate in renal failare. Alsa it has been suggested tht the synthesis and metabolism of polyamine are influence by acute changes of the general condition, such as acute renal failure, and are mediated by a calcium influx into the cells. The study was designed to study the protective effects of systemic verapamil pretreatment on renal function and the influence on polyamine metabolism in experimental ischemic ARF in cats. For these purpose, the experimental animals were divided into 2 groups. While Group I (n=5) was an ischemic ARF model by renal artery clamping for 60 minutes, Group II (n=5) was ischemic ARF with systemic verapamil (5 ml/min/kg) pretreatment. The creatinine clearance and plasma and urinary polyamine were measured in each group before and after the renal artery clamp. The results were as follows: 1) Creatinine clearance before and after the renal artery clamp were 10.64±7.18 ml/min/kg and 2.09±1. 70 ml/min/kg in Group I, 4.47±3.38 ml min/kg and 0.60±0.79ml/min/kg in Group II, respectively, So creatinine clearance decreased more significantly in Group II campared with Group I. 2) Plasma polyamine increased after ischemia in Group I. In group I, plasma levels of putrescine, spermidine, and spermine before ischemia were 4.75±0.40 nmol/ml, 0.69±0.09 nmol/ml, and 0.83±0.63 nmol/ml, were elevated to 7.17±2.91 nmol/ml, 9.83±1.46 nmol/ ml, and 2.64±1.14nmol/ml after ischemia. But in Group II, the plasma level of polyamine was not changed, and especially, spermine decreased significantly from 0.83±0.27 before ischemia to 0.49±0.23 nmol/ml after ischenmine (p=0.033). 3) Urine polyamine excretion decreased after ischemia in Group I and Group II. In Group II, urinary excretion of spermidine and spermine before ischemia, 0.13±0.10 nmol/min and 0.17±0.13nmol/min, decreased after ischemia to 0.01±0.01nmol/min (p=0.019) and 0.032±0.26 nmol/min (p=0.0257). 4) In renal tissue, spermine content vas highest. In Group II, preischemic spermine were 397.20 nmol/g and increased to 646.66nmol/g after ischema, But there were no significant changes in the polyamine contents in Group II. From these data, it was suggested that systemic verapamil pretreatment exerts no protective effect on ischemic ARF. Plasma polyamines are elevated in ischemic ARF, and verapamil may protect these elevations.

모과내 기능성 유용성분 용매추출공정의 최적화

전주영 ( Ju Yeong Jeon ),조인희 ( In Hee Jo ),경현규 ( Hyun Kyu Kyung ),김현아 ( Hyun A Kim ),이창민 ( Chang Min Lee ),최용희 ( Yong Hee Choi ) 한국산업식품공학회 2010 산업 식품공학 Vol.14 No.2

본 연구에서는 모과내의 여러 가지 기능성 유용성분을 효과적으로 추출하기 위해서, 모과나무의 익은 열매로 만든 약재인 모과를 사용 하였다. 모과의 기능성 유용성분용매 추출 공정의 최적 조건을 확립하고자 하였다. 모과를 에탄올에 추출하여 반응표면 분석법으로 모니터링하여 최적 용매 조건을 설정하였다. 중심합성계획법에 따라 시료에 대한 용매비(X1)와 추출온도(X2), 추출시간(X3)을 요인변수로 하고 추출수율(Y1), 총페놀 함량(Y2), 전자공여능(Y3), 갈색도(Y4), 환원당(Y5)을 종속변수로 하여 시행하였다. 실험 결과 추출수율은 추출 온도와 추출 시간에 유의하게 영향을 받음을 알 수 있었다. 안장점에서 추출조건은 시료에 대한 용매비는 26.38mL/g, 추출온도는 72.82oC, 추출시간은 74.86 min에서 최대값을 나타내었다. 총페놀 함량은 용매비와 시간에 영향을 거의 받지 않았고 추출시간에는 영향을 받았으며, 최대값은 20.70mg/mL 로 나타났다. 이때의 추출조건은 시료에 대한 용매비는 22.61mL/g, 추출온도는 84.49oC, 추출시간은 77.25 min으로 나타났다. 전자공여능은 추출온도에 따라 유의하게 영향을 받은 것으로 나타났다. 안장점에서의 추출조건인 시료에 대한 용매비 10.65mL/g, 추출온도 67.78oC, 추출시간 96.75 min에서 추출수율은 94.12%로 예측되었다. 갈색도에 대한 추출조건은 시료에 대한 용매비 23.77mL/g, 추출온도 87.27oC, 추출시간 96.68 min 일 때 안장점이 나타났다. 환원당은 시료에 대한 용매비 26.83mL/g, 추출온도 82.167oC, 추출시간 81.94 min에서 10.55mg/mL로 최대값을 나타내었고 추출시간에 영향을 받았다. In this study, various active functional components in Chinese Quince were extracted by solvent extraction method. A central composit design for optimization was applied to investigate the effects of independent variables such as solvent to sample ratio (X1), extraction temperature (X2), and extraction time (X3) on the soluble solid contents (Y1), total phenols (Y2), electron donating ability (Y3), browning color (Y4) and reducing sugar contents (Y5). It was found that extraction temperature and extraction time were the main effective factors in this extraction process. The maximum soluble solid contents of 35.77% was obtained at 26.38mL/g (X1), 72.82oC (X2) and 74.86 min (X3) in saddle point. Total phenols were rarely affected by solvent ratio and extraction time, but it was affected by extraction temperature. The maximum total phenols of 20.70% was obtained at 22.61mL/g (X1), 84.49oC (X2), 77.25 min (X3) in saddle point. The electron donating ability was affected by extraction time. The maximum electron donating ability of 94.12% was obtained at 10.65mL/g (X1), 67.78oC (X2), 96.75 min (X3) in saddle point. The maximum browning color of 0.32% was obtained at 23.77mL/g (X1), 87.27oC (X2), 96.68 min (X3) in saddle point. The maximum value of reducing sugar content of 10.55% was obtained at 26.83mL/g (X1), 82.167oC (X2), 81.94 min (X3). Reducing sugar content was affected by extraction time.

Dose re-evaluation in personal dosimetry using the phototransferred thermoluminescence method of LiF:Mg,Cu,Si TLD

Kim, Hyoungtaek,Kim, Min Chae,Lee, Jungil,Chang, Insu,Lee, Seung Kyu,Kim, Jang-Lyul Elsevier 2018 Radiation measurements Vol.118 No.-

<P><B>Abstract</B></P> <P>Phototransferred thermoluminescence (PTTL) characteristics of LiF:Mg,Cu,Si, developed by the Korea Atomic Energy Research Institute, are presented as part of a simple and reliable method for dose re-evaluation that is compatible with routine personal dosimetry services. A 4.5 mm diameter 0.8 mm thick pellet-type thermoluminescence dosimeter (TLD) was used after dual-step thermal annealing at 300 °C for 10 min, and then at 260 °C for 10 min, in order to obtain thermal stability. For optimal UV illumination, samples were placed under a 254 nm ultraviolet (UV) lamp for 90 min. The PTTL signal was only lower than 2% that of the TL because of low residual signals in high-temperature deep traps. The difference of the PTTL signals between samples appeared up to two times, indicating high variation in the charge density of the deep traps between samples. Various thermal treatments were performed after each PTTL measurement to remove the residual PTTL signal. UV exposure at 250 °C for 20 min fully reset the residual PTTL signals to the same level as that after dual-step annealing. No degradation of the TL peak from repeated thermal treatments was observed until after the eighth treatment when a decrease was noticeable. The measured dose response of PTTL in the range of 1.14–51.3 mGy showed good linearity. The zero dose and minimal detectable dose of the PTTL were 1.36 ± 0.51 mGy and 1.53 mGy, respectively. The attenuation of the PTTL signal resulting from successive TL measurements was recorded to provide a correction factor for quarterly recorded TL measurements applicable to the dose re-evaluation of TLDs in routine personal dosimetry services.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Dose re-evaluation using LiF:Mg,Cu,Si TLD is possible. </LI> <LI> Phototransferred thermoluminescence of LiF:Mg,Cu,Si was characterized. </LI> <LI> Heat treatment is required to remove residual phototransferred thermoluminescence. </LI> </UL> </P>

해도 정보를 이용한 선박의 최적 항로 생성

김민규(Min-Kyu Kim),김종화(Jong-Hwa Kim),양현(Hyun Yang) 한국항해항만학회 2022 한국항해항만학회 학술대회논문집 Vol.2022 No.2

Min-Kyu Kim*․Jong-Hwa Kim**․†최근 자율 운항 선박에 대한 관심이 높아지고 있다. 특히, MUNIN (Maritime Unmanned Navigation through Intelligence in Networks) 프로젝트를 계기로 자율 운항 선박에 대한 개발과 연구가 활발히 진행되고 있다. 또한 국제해사기구 IMO는 자율 운항 선박 시대에대응하기 위해 자율 선박을 MASS (Maritime Autonomous Surface Ship)라 정의하고 선박 자율화 정도에 따라 4단계 등급을 제시하고 있다. 완전한 자율 운항 선박에 대한 요구조건을 만족하기 위해서는 항로 결정과 제어기술이 필수적이다. 본 연구에서는 여러 가지 기술 중 선박의최적경로를 생성하는 기법을 다룬다. 기존에 최적항로를 생성하기 위한 방법으로는   , Dijkstra와 같은 알고리즘들이 주로 사용되었다. 그러나 이와 같은 알고리즘은 섬이나 육지에 대한 충돌 회피는 고려하고 있지만 수심 및 연안 선박에 대한 규정들은 고려하지 않고 있어실제로 적용하기에는 한계점이 있다. 따라서 본 연구에서는 안전을 위해 선박의 선저 여유 수심과, 해도에 규정되어 있는 선박 운항에 대한여러 규정들을 반영하여 최적 항로를 생성하고자 한다. 최적 항로를 생성하기 위한 알고리즘으로는 강화학습 기반의 Q-learning 알고리즘을적용하였다.

Enhanced Extraction of trans-Resveratrol from Polygonum cuspidatum by a Combination of Thermal and Enzymatic Treatment

Kyu Hyun Kim,Min Ju Kim,Yu Jin Lee,Eun Jeong Kwon,Chan Ho Jang,Jong-Sang Kim 한국식품영양과학회 2021 한국식품영양과학회 학술대회발표집 Vol.2021 No.10

Resveratrol (RES), a naturally occurring phytoalexin, has been known for health beneficial functions, such as cardioprotective, antihypertensive, and antiaging properties. The root of Polygonum cuspidatum Sieb. et Zucc. (P. cuspidatum) is extensively used as a good source of trans-RES, the most bioavailable form of RES. Our previous study showed an improved conversion rate of piceid (PD) present in grape peel into RES by pre-heating at 95°C for 10 min, followed enzymatic hydrolysis at 50°C for 60 min. In this study, we examined if combined thermal and enzymatic treatment could maximize extractability of PD and RES from P. cuspidatum. Results from this study showed that the treatment of P. cuspidatum with Viscozyme dramatically increased the conversion of PD into RES as well as the entire extractability of RES and PD among several enzymes tested. Furthermore, 60% and 80% ethanolic solvents showed the best extraction yield of RES. The extraction method established in this study is a low-cost green processing strategy and could be applied to maximize extraction of bioactive trans-RES from P. cuspidatum.

초기 자궁내막암 환자에서의 복강경유도하 질식 자궁절제술과 복식 자궁절제술에 대한 비교 연구

김민규 ( Min Kyu Kim ),최동석 ( Dong Seok Choi ),김우영 ( Woo Young Kim ),최철훈 ( Chel Hun Choi ),김태중 ( Tae Joong Kim ),이정원 ( Jeong Won Lee ),김병기 ( Byoung Gie Kim ),이제호 ( Je Ho Lee ),배덕수 ( Duk Soo Bae ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12

목적: 초기 자궁내막암의 수술적치료 시 복강경유도하 질식 자궁절제술 및 골반림프절절제술군과 복식수술군의 수술결과 및 재발율에 대해 비교하고자하였다. 연구 방법: 2003년 3월부터 2005년 5월까지 초기 자궁내막암 환자를 인구학적 특성이 같은 63명을 선택하여 복강경유도하 질식 자궁절제술 및 골반림프절절제술군 26명, 복식수술군 37명으로 나누어 수술 전후 혈색소 차이, 평균수술시간, 취득한 골반림프절갯수, 평균재원일수, 추가치료율, 재발률을 비교하였다. 결과: 복강경유도하 질식 자궁절제술 및 골반림프절절제술을 시행한 군과 복식수술을 시행한 군과의 비교에서 수술 전후 혈색소 차이, 평균수술시간, 취득한 골반림프절 갯수, 평균재원일수, 재발률에 통계적으로 유의한 차이가 없었다. 결론: 초기 자궁내막암의 수술 시 복강경유도하 질식자궁절제술 및 골반림프절절제술 방법이 복식방법에 비해 수술결과 및 재발률에 통계적으로 유의한 차이가 없으며 그 대체 수술법으로 많은 활용이 기대되었다. Objective: To compare laparoscopic surgery with conventional abdominal surgery in patients with early stage endometrial cancer. Methods: A retrospective review of 63 patients with early stage endometrial cancer managed between March 2003 and May 2005. Two groups were defined whether they had been treated by laparoscopy (case group: n=26) or by laparotomy (control group: n=37). We compared age, body mass index (BMI), hemoglobin change, operation time, number of pelvic lymph nodes, hospital stay, case with adjuvant treatment and recurrence between two groups. Results: There was no statistical difference in characteristics (age, BMI, nulliparity, previous abdominal surgery, FIGO stage, histologic grade). between case and control group. In addition, there was no statistical difference in operation data and outcomes between two groups. Hemoglobin changes were 1.1 g/dL (case group) vs 1.7 g/dL (control group) (p=0.072). Operation time was 131 min vs. 115 min. The numbers of lymph nodes obtained were 8.7 vs 7.7 (right) 9.2 vs. 7.6 (left). Hospital stays were 8.4 vs. 9.2 days. Adjuvant treatment cases were 7 vs. 15. Recurrent case was one in each group. Two patients initially evaluated by laparoscopy were converted to laparotomy due to bleeding and adhesion. Conclusion: Laparoscopic surgery for treatment of early endometrial cancer is a safe and effective alternative to laparotomy . However, long-term survival and risk of recurrence have yet to be determined.

스포츠복지문화 활성화를 위한 정책요인의 우선순위 산정

김민규 ( Kim Min-kyu ),박수정 ( Park Soo-jung ),박병권 ( Park Byung-kwon ) 인하대학교 교육연구소 2018 교육문화연구 Vol.24 No.4

본 연구는 스포츠복지문화 활성화를 위한 정책요인에 대해서 AHP를 활용하여 가중치를 도출하고, 향후 어떠한 정책요인부터 우선적으로 실현해야 하는지에 대한 제언하는데 목적이 있다. 이를 위하여 김민규와 송정란(2018)이 연구한 스포츠복지문화 활성화를 위한 정책요인들을 활용하여 우선순위 산정을 실시하였다. 이에 따른 주요 결론은 다음과 같다. 첫째, 계층 1은 정책 요인이, 둘째, 계층 2의 하위계층은 서비스전달체계 요인이, 셋째, 계층 2 중 정책 요인의 하위계층은 서비스전달체계 요인이, 넷째, 계층 2 중 인프라 요인은 콘텐츠웨어 인프라 요인이, 다섯째, 층 2 중 연구개발 요인은 전문가양성운영체계 요인이, 여섯째, 정책 요인의 계층 3 중 유관 법안 개정 요인은 관련 법안의 지원에 대한 논의 요인이, 일곱째, 정책 요인의 계층 3 중 정책개발 요인은 스포츠복지 정책사업 개발 요인이, 여덟째, 정책 요인의 계층 3 중 인식개선 요인은 지자체 및 유관기관의 복지적 관점 증진 요인이, 아홉째, 정책 요인의 계층 3 중 서비스전달체계 요인은 행정지원 부처 결정 및 역할 정립 요인이, 열 번째, 정책 요인의 계층 3 중 예산관련 요인은 예산확보방안 요인이, 열한 번째, 인프라 요인의 계층 3 중 하드웨어 인프라 요인은 기존 스포츠 시설 활용의 효율성 제고 요인이, 열두 번째, 인프라 요인의 계층 3 중 휴먼웨어 인프라 요인은 스포츠복지 강사충원 요인이, 열세 번째, 인프라 요인의 계층 3 중 콘텐츠웨어 인프라 요인은 스포츠복지 프로그램 개발 요인이, 열네 번째, 연구개발 요인의 계층 3 중 전문가 양성 운영체계 요인은 스포츠복지학의 교육과정 개발 요인이, 열다섯 번째, 연구개발 요인의 계층 3 중 기초자료 조사 요인은 스포츠와 복지 전문가의 상호교류 요인이, 열여섯 번째, 연구개발 요인의 계층 3 중 기획연구개발 요인은 스포츠복지 대체 프로그램 개발요인이 최우선 고려되어야 하는 것으로 분석되었다. 본 연구의 결과는 정책과정 전반과 학문의 유기적 결합에 도움이 될 것이다. 추후 학계와 현장의 의견 교류 및 비교분가 가능한 질적연구가 이루어져야 할 것이다. The purpose of this study is to identify the weight of the policy factors by using AHP for the purpose of activating sports welfare culture and make suggestions as to which policy factors should be implemented in the future. For this, priorities were set for the policy factors for activating sports welfare culture as studied by Kim Min-Kyu and Song Jung-Ran (2018). The key conclusions were as follows. First, for layer 1, it is the policy factors that top priority should be given to. Second, for the sublayer of layer 2, it is service delivery system. Third, for the sublayer of policy factors for layer 2, it is service delivery system. Fourth, for the infrastructure factor, it is content ware infrastructure. Fifth, for the R&D factor of layer 2, it is professionals training system. Sixth, for the related legislative amendment in layer 3 of the policy factors, it is the discussion of supports for related legislative proposals. Seventh, for the policy development factor in layer 3 of the policy factors, it is sports welfare policy project development. Eighth, for improved perception in layer 3 of the policy factors, it is the greater focus on welfare with local governments and related agencies. Ninth, for service delivery system factor in layer 3 of the policy factors, it is the determination of the government ministry and its roles for administrative supports. Tenth, for budget in layer 3 of the policy factors, it is how to get budget. Eleventh, for hardware infrastructure in layer 3 of the infrastructure factors, it is the increase of efficiency in using the existing sports facilities. Twelfth, for human ware infrastructure in layer 3 of the infrastructure factors, it is the recruit of sports welfare instructors. Thirteenth, for content ware infrastructure in layer 3 of the infrastructure factors, it is the development of sports welfare programs. Fourteenth, for the professional training and operation system in layer 3 of the R&D factors, it is the development of a curriculum for sports welfare studies. Fifteenth, for basic data research in layer 3 of the R&D factors, it is the mutual exchange between sports and welfare professionals. Sixteenth, for planning and R&D in layer 3 of the R&D factors, it is the development of alternative programs in sports welfare. The results of the study will be helpful in organically combining the policy course as a whole with the academic disciplines in general.