위 분문부에 발생한 원발성 흑색종

박종익,강성구,박상수,윤진,김일명,신동규,Park, Jong-Ik,Kang, Sung-Gu,Park, Sang-Su,Yoon, Jin,Kim, Il-Myung,Shin, Dong-Gue 대한위암학회 2006 대한위암학회지 Vol.6 No.3

Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important. 흑색종은 피부나 점막에 존재하는 멜라닌 세포에서 기원하는 악성 종양으로 피부에 가장 흔하게 발생한다. 위장관계 점막에서도 흑색종이 발생할 수 있는데 원발성은 매우 드물고 대부분은 피부의 원발성 흑색종으로부터 전이되어 나타난다. 위에 발생한 원발성 흑색종은 매우 드물고 치료 성적이 나쁘고 전이 속도가 빨라서 예후가 매우 나쁘다. 저자들은 혈변, 복통과 체중 감소를 주소로 내원한 75세 남자로 수술 전 진행성 위암으로 진단되어 위전절제술을 시행하였으나 수술 후 위 분문부의 원발성 흑색종으로 식도-위 접합부까지 침범한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 흑색종 치료에서 수술은 가장 표준적인 치료법이다. 수술 후 보조 요법으로 항암화학요법, 방사선 치료, 면역 치료 등을 시도해 보았지만 생존율 증가가 입증된 치료 방법은 아직 없는 실정이다. 장기간 생존율을 향상시키기 위해서는 조기 진단과 수술적 치료가 가장 중요하다.

시공사례 : 울릉(사동)항 2단계 동방파제 축조공사 [초대형 케이슨 해상 원거리 운반 공사]

박종익,강진성,Park, Jong-Ik,Gang, Jin-Seong 한국수자원학회 2021 물과 미래(한국수자원학회지) Vol.54 No.1

상엽(桑葉) 함유 한약복합제 추출물의 항비만(抗肥滿)효과 연구

박종익,강경하,박은정,Park, Jong Ik,Kang, Kyung Ha,Park, Eun Jung 대한한방소아과학회 2013 대한한방소아과학회지 Vol.27 No.4

Objectives This experimental study was designed to investigate the effects of Mulberry leaves contained herbal mixture (MLHM) on body weight, serum lipid level and adipocyte differentiation in high fat diet-fed obese mice. Methods Four-week old mice (wild-type C57/BL6) were used for all experiments. Cells were incubated with MLHM at the indicated concentration (0.04-4mg/ml) for 24h, and growth rate was assessed by MTT ((3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. 3T3-L1 preadipocytes were incubated in DMEM for 2 days with the indicated concentrations of MLHM, and on Day 6, the cells were fixed and the cellular lipid contents were assessed by Oil-Red-O staining. The expression of peroxisome proliferator-activated receptor ${\gamma}$ (PPAR ${\gamma}$) and cytidine-cytidine-adenosine-adenosine-thymine (CCAAT)/enhancer-binding proteins ${\alpha}$ (C/EBP ${\alpha}$) as adipocyte-specific proteins were determined by real time RT-PCR and western blotting. In addition, body weight gain and serum lipid levels were measured in the mice with obesity induced by the high fat-diet for four weeks. Results Though MLHM did not show toxicity even at the concentration of 4mg/ml, MLHM significantly inhibited the differentiation of 3T3-L1 preadipocites in a dose-dependent manner. Also, MLHM significantly reduced the expressions of PPAR ${\gamma}$ and C/EBP ${\alpha}$ in a dose-dependent manner. Furthermore, MLHM significantly reduced body weight gain and LDL-cholesterol contents in high fat diet-fed obese mice. Conclusions These results demonstrate that MLHM exerts anti-obesity effect in 3T3-L1 cells and mice with obesity by high-fat diet.

위암 수술 후 생존율 분석: 원자력병원의 15년간 경험

박종익,진성호,방호윤,백남선,문난모,이종인,Park, Jong-Ik,Jin, Sung-Ho,Bang, Ho-Yoon,Paik, Nam-Sun,Moon, Nan-Mo,Lee, Jong-Inn 대한위암학회 2008 대한위암학회지 Vol.8 No.1

목적: 15년 동안 단일 병원에서 위절제술을 시행한 위암 환자를 대상으로 임상병리학적 특성, 생존율과 예후인자를 분석하여 보고하고자 하였다. 대상 및 방법: 1991년 1월부터 2005년 12월까지 15년 동안 원자력병원 외과에서 위암으로 위절제술을 시행받은 6,918명의 환자를 대상으로 의무기록을 후향적으로 조사하였다. 결과: 전체 위암 환자 6,918 예를 대상으로 환자들의 성별, 연령, 종양의 위치, 종양의 육안적 분류, 종양의 병리조직 학적 분류 (WHO 분류), Lauren 분류, 위벽 침윤도, 림프절 전이, 원격 전이, 수술 방법, UICC TNM 병기, 술 후 합병증, 술 후 보조적 항암화학요법, 림프관 침윤, 혈관 침윤, 신경초 침윤 등을 비교하였다. 전체 5년 생존율은 66.8%였다. 단변량 분석 결과 연령, 종양의 위치, 종양의 육안적 분류, WHO 분류에 따른 종양의 병리조직학적 분류, Lauren 분류, 위벽 침윤도, 림프절 전이, 원격 전이, 수술 방법, UICC TNM 병기, 술 후 합병증, 술 후 보조적 항암화학요법, 림프관 침윤, 혈관 침윤 및 신경초 침윤에서 생존율에 유의한 차이가 있었다. 다변량 분석 결과 연령, Borrmann type 4, WHO 분류에 따른 종양의 병리조직학적 분류, 위벽 침윤도, 림프절 전이, 원격 전이, 수술 방법, UlCC TNM 병기, 술 후 합병증, 술 후 보조적 항암화학요법 및 림프관 침윤 이 독립적인 예후인자였다. 결론: 위암 환자의 예후는 수술 당시의 병기에 의해 결정되므로 위암의 조기 진단이 중요하다. 적극적인 수술과 보조적 항암화학요법을 포함한 보다 효과적인 다병합요법이 개발되어야 전체 위암 환자의 생존율을 향상시킬 수 있을 것이다. Purpose: Gastric cancer is the most common malignant tumor in Korea. We reviewed the cases at our institution to identify the survival rates and clarify the prognostic factors of patients with gastric cancer. Materials and Methods: We conducted a retrospective study of 6,918 patients who had received a diagnosis of gastric cancer, and they underwent surgery at Korea Cancer Center Hospital during a 15-year period from 1991 to 2005. Results: The overall 5-year survival rate was 66.8%. The univariate analysis revealed that age, location of tumor, gross type of tumor, the histology according to the WHO classification, the Lauren classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, the UICC TNM stage, postoperative complications, adjuvant chemotherapy, lymphatic invasion, venous invasion and perineural invasion were the significantly different factors of the survival rates. The multivariate analysis revealed that age, Borrmann type 4, the histology according to the WHO classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, UICC TNM stage, postoperative complications, adjuvant chemotherapy and lymphatic invasion were the independent prognostic factors. Conclusion: We have shown a statistically significant association between the survival rates after operation for gastric cancer and the clinicopathologic factors. Early diagnosis of gastric cancer, appropriate surgeryand adjuvant therapy might improve the quality of life and the survival rates of gastric cancer patients.

소실모형주조법에 의한 금속기 복합재료의 제조 - 고액계면과 입자거동에 관하여 -

박종익,김영섭,김정민,김동규 ( Jong Ik Park,Young Seob Kim,Jeong Min Kim,Dong Gyu Kim ) 한국주조공학회 1997 한국주조공학회지 Vol.17 No.1

N/A A possibility of production of aluminium matrix composites by using the lost foam process was investigated. Silicon carbide particles, graphite particles, and stainless steel wires were used as reinforcement materials. The reinforcement materials were introduced to the polystyrene to form patterns via injection molding process. The results obtained from this experiment can be summarized as follows. In Al/SiC_p system, the particles with the radius of 100㎛ and over were entrapped in the matrix in the case of upward freezing of which solidification direction was opposite to floating direction of the particles. And few particles were entrapped in the matrix in downward freezing. In Al/graphite system, almost no particles were entrapped in the matrix except the area chill attached. When the thickness of polystyrene slice was 4㎜ in Al/stainless steel wire system, the floating tendency of fibers was observed to increase as the distance from the ingate was increased.

복강경 보조 유문부보존 위절제술의 초기 경험: 복강경 보조 원위부 위절제술 후 Billroth-I 재건술과의 비교

박종익,진성호,방호윤,채기봉,백남선,문난모,이종인,Park, Jong-Ik,Jin, Sung-Ho,Bang, Ho-Yoon,Chae, Gi-Bong,Paik, Nam-Sun,Moon, Nan-Mo,Lee, Jong-Inn 대한위암학회 2008 대한위암학회지 Vol.8 No.1

목적: 유문부보존 위절제술(pylorus-preserving gastrectomy, PPG)은 유문륜을 보존하여 잔위의 배출기능을 보존하고 담즙 역류를 방지할 수 있는 기능 보존 수술법으로 조기위암 치료에 적용되고 있다. 저자들은 복강경 보조 유문부보존 위절제술(laparoscopy-assisted pylorus-preserving gastrectomy, LAPPG)의 초기 경험을 LADG 후 Billroth-I 재건술과 비교 분석하였다. 대상 및 방법: 2006년 11월부터 2007년 9월까지 원자력병원 외과에서 복강경 보조 위절제술을 시행 받은 39명의 조기위암 환자 중 LAPPG (n=9)와 LADG 후 Billroth-I 재건술(n=18)을 시행 받은 27명의 환자를 대상으로 하였고, 양 군간의 임상병리학적 변수를 비교하였다. 저자들은 LAPPG 시행 중 유문하동맥, 우위동맥, 미주신경 간지, 유문지 및 복강지를 보존하였으며, 림프절 절제술은 우위동맥 림프절(No. 5)을 제외한 D1+$\beta$술식을 시행하였고, 유문륜 상방 $3{\sim}4\;cm$에서 원위부 위절제를 시행하였다. 결과: LAPPG을 시행 받은 환자 9명의 평균 연령은 $59.9{\pm}9.4$세였으며 남녀 성비는 1.3 : 1.0 (남자 5명, 여자 4명)이었고, LADG 후 Billroth-I 재건술을 시행 받은 환자 18명의 평균 연령은 $64.1{\pm}10.0$세였으며 남녀 성비는 2.6 : 1.0 (남자 13명, 여자 5명)이었다. LAPPG 군과 LADG 후 Biliroth-I 재건술을 시행받은 군에서 절제된 림프절의 개수는 각각 $28.3{\pm}11.9$개 $28.1{\pm}8.9$개, 수술 시간은 각각 $269.0{\pm}34.4$분, $236.3{\pm}39.6$분, 술 중 출혈량은 각각 $191.1{\pm}85.7\;ml$, $218.3{\pm}156.6\;ml$, 술 후 첫 가스 배출은 각각 $3.6{\pm}0.9$일, $3.5{\pm}0.8$일에 있었고 술 후 첫 유동식은 각각 $5.1{\pm}0.9$일, $5.1{\pm}1.7$일에 섭취하였고 술 후 재원 기간은 각각 $10.1{\pm}4.0$일, $9.2{\pm}3.0$일로 모두 통계학적으로 유의한 차이가 없었다(P>0.05). 술 후 합병증은 LAPPG 군에서 위저류증 1예와 창상 장액종 1예가 발생하였고, LADG 후 Biliroth-I 재건술을 시행 받은 군에서는 좌외측간엽경색 1예가 발생하였다. 결론: 조기위암의 치료에 있어서 LAPPG는 기능 보존 수술 법으로 적용 가능하며, 적절한 적응증을 사용하면 임상종양학적 측면에서도 LADG 후 Billroth-I 재건술과 동등한 결과를 보일 것으로 기대된다. Purpose: Pylorus-preserving gastrectomy (PPG), which retains pyloric ring and gastric function, has been accepted as a function-preserving procedure for early gastric cancer for the prevention of postgastrectomy syndrome. This study was compared laparoscopy-assisted pylorus-preerving gastrectomy (LAPPG) with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (LADGB I). Materials and Methods: Between November 2006 and September 2007, 39 patients with early gastric cancer underwent laparoscopy-assisted gastrectomy in the Department of Surgery at Korea Cancer Center Hospital. 9 of these patients underwent LAPPG and 18 underwent LADGBI. When LAPPG was underwent, we preserved the pyloric branch, hepatic branch, and celiac branch of the vagus nerve, the infrapyloric artery, and the right gastric artery and performed D1+$\beta$ lymphadenectomy to the exclusion of suprapyloric lymph node dissection. The distal stomach was resected while retaining a $2.5{\sim}3.0\;cm$ pyloric cuff and maintaining a $3.0{\sim}4.0\;cm$ distal margin for the resection. Results: The mean age for patients who underwent LAPPG and LADGBI were $59.9{\pm}9.4$ year-old and $64.1{\pm}10.0$ year-old, respectively. The sex ratio was 1.3 : 1.0 (male 5, female 4) in the LAPPG group and 2.6 : 1.0 (male 13, female 5) in the LADGBI group. Mean total number of dissected lymph nodes ($28.3{\pm}11.9$ versus $28.1{\pm}8.9$), operation time ($269.0{\pm}34.4$ versus $236.3{\pm}39.6$ minutes), estimated blood loss ($191.1{\pm}85.7$ versus $218.3{\pm}150.6\;ml$), time to first flatus ($3.6{\pm}0.9$ versus $3.5{\pm}0.8$ days), time to start of diet ($5.1{\pm}0.9$ versus $5.1{\pm}1.7$ days), and postoperative hospital stay ($10.1{\pm}4.0$ versus $9.2{\pm}3.0$ days) were not found significant differences (P>0.05). The postoperative complications were 1 patient with gastric stasis and 1 patient with wound seroma in LAPPG group and 1 patient with left lateral segment infarct of liver in the LADGB I group. Conclusion: Patients treated by LAPPG showed a comparable quality of surgical operation compared with those treated by LADGBI. LAPPG has an important role in the surgical management of early gastric cancer in terms of quality of postoperative life. Randomized controlled studies should be undertaken to analyze the optimal survival and long-term outcomes of this operative procedure.

대전 유성구 성북동 동제 고찰

박종익(Jong-ik, Park) 어문연구학회 2009 어문연구 Vol.59 No.-

This study aims at examining village religious rituals of Seongbuk-dong Yuseong-gu in Dajeon City. This paper deals with three points. First, geographical locations of Seongbuk-dong village is examined because it is related to the life of village peoples who live there. Also, this chapter deals with the history and origin of place names. The result presents that place name, Seongbuk-dong originated from mountain fortress wall of Baekje Dynasty. Second, cases of village rituals ceremony of Seongbuk-dong is discussed according to communities. Seongbuk-dong cerebrated rituals for mountain gods in Shinchon, street rituals in Seonchon and mountain gods in Wijantti. The research indicates that these rituals have existed since early 1900. The purposes of these rituals are to keep village safe and village people healthy, to reap abundant harvest, to keep prosperity of livestock, and to get rid of disease. Third, one of characteristics of Seongbuk-dong rituals is to create the harmonious views of villages such as mountains, fields, rivers and roads. They believe that when the village view are harmonious, people mind will be stabilized, which eventually leads prosperity and abundant harvest of the village. The representative example is building a pagoda and planting trees in Seochon. In addition, in Seongbuk-dong, there is a club to support religious rituals. This group is called Sanjege (group that was organized to support the rituals for mountain gods) or Dongge (group that was organized to support public activities of the village). These groups support religious rituals of the village financially.

무성산 산신제의 형성과 변천

박종익(Park Jong-Ik) 한국민속학회 2009 韓國民俗學 Vol.49 No.-

공주시 우성면 부전동에는 17세기 이전에 형성된 대동계가 존재한다. 사족중심으로 형성된 이 대동계는 마을자치를 실현하는 한편 무성산 산신제를 시행해 왔다. 이 논문에서는 부전동 무성산 산신제를 대상으로 그 시원과 성격 및 변천과정을 다루었다. 산신제에 대한 논의에 앞서 부전동의 행주형 입지를 살펴보고 제의공간인 무성산의 생산기반 및 제의공간의 위상을 분석하였다. 본 논의에서는 부전동 대동계의 문서를 대상으로 산신제의 시원을 탐색하였다. 그 결과 무성산 산신제가 부전대동계에 의해 1854년부터 시행되었음을 확인하였다. 그리고 이 제의가 기록 시점 이전부터 존재하였을 가능성을 제시하였다. 이어 무성산 산신제가 돌림병과 같은 질병퇴치와 맹수퇴치를 목적으로 시행된 제의임을 확인하였다. 끝으로 무성산 산신제의 변천과정을 1914년과 1924년에 작성된 각각의 『浮田大洞? 重修案』을 통해서 살펴보았다. 이들 자료를 통하여 산신제의 물적기반과 제의주체의 역할을 정리하였다. 그리고『浮田大洞? ?員名簿竝 收支簿記帳』 및 『浮田大洞? 收支簿』를 자료로 1941년 이후부터 2000년대 초에 이르는 제의 변천과정을 논의하였다. There exists a mutual-aid society called "Daedong-gae" in Bujeon-dong, Wooseung-myon, Gongju-si, which was organized before the 17th century. The Daedong-gae, whose members were chiefly of noble birth, took a leading part in the government of the town and performed a mountain god ritual. This study explores the origin, characteristics and development of the Museong Mountain God ritual performed in Bujeon-dong. Prior to the examination of the ritual, it describes the ship-shaped(行舟形) topography of Bujeon-dong. It also examines the topology of the Museong Mountain as a ritual place. The archival documents of the Bujeon-dong Daedong-gae were examined in order to identify the origin of the ritual. As a result, it was found that the Museong Mountain God ritual was first performed by the Bujeon Daedong-gae in 1854. It was also suggested that the ritual might have existed even before it was recorded. It was assumed that the ritual was performed from the wish to he safe from infectious diseases and beasts. 『Bujeon Daedong-gae Joongsooan(『浮田大洞? 重修案』), which were produced in 1914 and 1924, were studied to investigate the historical development of the Museong Mountain God ritual. Those data were further reviewed to identify the financial sources and performers of the ritual. 『Bujeon Daedong-gae Membership List & Account Book(浮田大洞? ?員名簿竝 收支簿記帳)』 and 『Bujeon Daedong-gae Account Book(浮田大洞? 收支簿)』 were also examined to determine the changes in the ritual from 1941 to the early 2000's Such examination is essential for the historical research of the modem development of the ritual by the Bujeon Daedong-gae.

일 시립병원 정신과 폐쇄병동에서 재원기간에 영향을 미치는 요인

박종익(Jong-Ik Park),이광섭(Kwang-Sup Lee),방수영(Soo-Young Bhang),서동우(Tong-Woo Suh),홍진표(Jin-Pyo Hong) 대한사회정신의학회 2003 사회정신의학 Vol.8 No.2

목적: 국내에서는 정신병상 규모를 줄이고 지역사회 정신보건체계로 전환하라는 WHO의 권고에도 불구하고 장기입원은 좀처럼 줄어 들지 않고 있다. 비용효과적이고 적정한 입원을 유도하는 제도 도입을 위해 재원기간에 영향을 주는 요인들을 알아보고자 하였다. 방법: 서울 소재 시립병원 정신과 폐쇄병동에 2003년 2월 21일부터 4월 5일까지 연속적으로 입원한 83명의 환자를 대상으로 사회 인구학적 특성, 의료비 지불형태, 입원결정자, 유병기간, 입원횟수 등의 기초 자료와 진단명, PANSS, 사회적 지지도, 생활 스트레스 등을 조사하였다. 결과: 연구 대상자 83명의 평균 재원기간은 65.9일(표준편차 54.2)이었고, 재원기간의 분포는 4일에서 194일이었다. 대상군의 평균 연령은 37.9세(표준편차 13.8)였고, 평균 유병기간은 110.3개월(표준편차 96.5)이었다. 진단군에 따른 평균 재원일수에서 유의한 차이가 있었는데(p<0.01), 정신분열병군(83.3±59.8)과 기질성 장애군(82.5±59.7)이 가장 길었고, 알코올 장애군(40.3±21.7)과 기분장애군(31.8±15.5)이 상대적으로 짧았다. 또 의료비 지불형태에서 의료보험군(49.7±38.8)이 의료급여군(87.6±67.1)이나 행려군(74.2±54.5)에 비하여 유의하게 재원일수가 짧았다(p<0.05). 단순회귀분석에서는 PANSS 총점수(p<0.01) 및 하위척도의 점수(p<0.01), 유병기간(p<0.05)이 통계적으로 유의하게 관련이 있었다. 그 외의 요소는 재원기간에 유의한 영향을 주지 않았다. 진단군, 의료비 지불형태, 유병기간, 가족 지지도를 최종모델로 한 다중회귀분석에서는 진단군과 의료비 지불형태가 재원기간에 유의하게 영향을 주었다(F=4.56, p<0.01;F=5.06, p<0.01). 결론 진단군과 의료비 지불형태가 재원기간을 예상하는데 주요한 요인이었다. 다양한 병원, 포괄적 진단군, 개방병동 등을 포함한 대상군에서 추가 연구가 필요하다.

충남지역 동제의 성격과 제의구조 고찰

박종익(Jong-ik Park) 어문연구학회 2009 어문연구 Vol.60 No.-

This study aims to analyze the purposes and structures of the village rituals performed in South Chungcheong. For convenience of discussion, the villages anr classified into 3 types : remote mountain villages, inland plain villages and coastal island villages. The main point of interest is the purposes and structures of the village rituals according to the village type. What is first proposed in relation to the purposes is that the village rituals are performed for the preservation of the peace of the villages. Based on this the village rituals performed in the remote mountain villages, inland plain villages and coastal island villages were examined respectively. As a result, it was verified that they were performed from the wish to be safe from infectious diseases, evil spirits or wild beasts. An analysis was made of the fact that another purpose of the village rituals is the prayer for prosperity and wealth. As a result, it was found that the rituals performed in the remote mountain and inland plain villages are to pry for a rich harvest and community prosperity. The rituals performed in the coastal island villages are to pray for a good catch of fish. In relation to the structures of the village rituals, two shrines are located in the mountain and the village, respectively. In the mountain there is an Upper Shrine(上常), where the Upper God stays. In the village there is a Lower Shrine(下常), where the Lower God stays. The dual structure of Upper and Lower Shrines is prevalent regardless of the village type. However, there are some villages that have only one of the two. The rituals are performed in the manner of the Confucian memorial service held on an anniversary of death.(忌祭祀). The rite of offering the third libation(終獻) and then burning sacrificial paper burning(燒紙) is performed to pray for a rich harvest and the peace and prosperity of the village and residents. This is a common rite regardless of the village type. In the village rituals performed in the coastal island villages, however, an exorcism by a shaman was performed after a Confucian ceremony. In short, they are a combination of a Confucian ritual and an exorcism.