전이성십이지장 내분비암으로 항암화학요법 시행 받고 완전 관해 1년 후 발생한 십이지장 선암 1예

( Bun Kim ),( Ji Hye Heo ),( Joo Won Jung ),( Moon Jae Chung ),( Jeong Youp Park ),( Seung Min Bang ),( Si Young Song ),( Seung Woo Park ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1

위장관내분비암으로 치료 후 동일 부위에서 선암이 발생한 예는 극히 드물다. 저자들은 전이성 십이지장 내분비암으로 항암치료 받고 완전 관해 1년 후 같은 부위에서 선암이 발생하여 보고하는 바이다. 60세 남환은과거력상 30년 전 콩팥결핵으로 결핵 치료받았다. 한달 간의 전신 무력감과 흑색변으로 2009년 6월 외부병원 내원하여 시행한 검사상 십이지장암과 간전이 의심되어 본원으로 전원되었다. 내원 당시 혈압 130/80 mmHg, 맥박 92회, 체온 36.8도이었다. 일반혈액검사상 WBC 4,730/mm3, Hb12.4 g/dL, platelet 144,000/mm3, 혈청생화학검사상 Bun/Cr 17.7/1.16 mg/dL, AST/ALT 15/13IU/L이였다. 종양표지자는 CEA 0.73 ng/mL, CA 19-9 1.8U/mL이었다. 본원에서 시행한 상부위장관내시경상 십이지장의 상부하행각에 궤양융기형 덩어리가 발견되었다. 조직검사상 십이지장에서 poorly differentiated neuroendocrine carcinoma 진단되어 십이지장 내분비암 및 간전이로 2009년 11월까지 6차례 5-FU (1000 mg/m2, Day1~3)/Etoposide(100 mg/m2, Day1~3)/Cisplatin (70 mg/mg2, Day1) 항암치료 후 영상 및 상부내시경 검사상 완전관해 소견 보였으며 이후 정기적 추적관찰 중이었다. 2011년2월 시행한 상부위장관내시 경상 이전 십이지장 병변에 새롭게 생긴 용종으로 조직 검사 시행하여 선암 진단되었다. 영상 검사상 간 S6/7,S7 두군데에 전이 의심되어 intraop RFA 고려하고 2011년 2월 28일 수술 시행하였다. 십이지장 선암은 8번, 12번, 13번 림프절 확장 소견 보여 병합절제와 췌두부 절제술을 시행하였다. 수술 중 초음파로 간종괴는 찾을 수 없었으나 수술전 시행한 MRI상 간우정맥우연을 따라 종괴가 2개 관찰되어 간우후구역절 제술을 함께 시행하였다. 수술 후 병리 조직 검사상 간 조직은 염증 소견 보이고 십이지장은 선암 진단 되었다. 최종적으로 십이지장 선암은 pT1bN0M0으로 1기로 진단되어 추가 항암치료 없이 외래 경과 관찰 중이다. 저자들은 전이성 십이지장 내분비암으로 항암치료 받고 완전 관해 되었으나 1년 후 같은 부위에서 선암이 발생하여 수술 시행후 완전 절제 되어 보고하는 바이다.

농촌지역 유아교사의 재교육 실태 연구

박분희,정성배 한국영유아보육학회 2002 한국영유아보육학 Vol.0 No.28

The purpose of this study was to investigate the actural condition of reeducation for teachers who work at a infant educational institution, and to analyze the difference of it, depending on vocational career, form of foundation. In order to research questionaries was gaven to 264 teachers working farm villiage in Jeonranamdo. Feeling of satisfaction about chance of reeducation was 3.22 point in total average. There was meaning of difference depending on vocational career. Feeling of satisfaction about content of reeducation was 2.63 point in total average. There was meaning of difference depending on vocational career and form of foundation. The number of times 1~2 was the higtest rate in degree of attendant reeducation. The number of times 3~4 was the secondary rate. Newspaper in Education(NIE) was the hightest rate in the content of reeducation, The secondary rate was content of basic learning ability and the third rate was compensatory education. Not often attended at reeducation the reason why were not concerned to the program. It is rate was average 4.06 point. For the reformation, there was adoption of auxiliary teacher(average 2.28), endowment of additional point(average 2.27), variation of content(average 2.14), enforcement of special vacation(average 1.93), positive expense support(average 1.74).

뇌실외 배액술 관리에 대한 이해 및 업무수행 실태

김정숙,윤미선,송소이,이지은,문경선,고지운,임분남,김경희,박경숙 중앙대학교 간호과학연구소 2001 중앙간호논문집 Vol.5 No.2

The objective of this study was to investigate the managing realities of EVD and provide a descriptive survey with the attempt to obtain basic data needed for the standardization of EVD management. For that purpose, 220 questionnaire copies were distributed to those nurses who were working with intensive care units at university hospitals, general hospitals, semi-general hospitals in Seoul, Kyongki-de and local areas. Of 158 returned questionnaire copies, 139 were used for analysis. Data were collected during the term of academic seminars of Neurosurgery Nursing Committee and KICA (Korea Intensive Care Association), ranging from Oct. 26 through 27. 2000. The tools utilized a structured questionnaire form consisting of 21 questions on general characteristics, the level of understanding, the level of work performance, standard management guidelines, etc. The data collected were analysed with frequency, percentage, mean vague, chi -square test using the SPSS 10.0 program Findings were revealed, as follows: For managing the prevention of EVD infection, aseptic technique was found to be of the most importance (48.9%),'the technique should be carried out at an operation room'(92.8%), but it was actually performed at intensive care units (over 51.5%). 'The term of antibiotics use should be less than 7 days' (81.8%), while it was actually executed for less than 7 days (49.5%). 'The proper time of quittance from it should be within less than 7 days'(74.1%) but actual quittance was executed only by 51.1%. 'Set exchange is needed' by 54.0% but actual exchange was implemented merely by 28.1%. 'The subject of management should be nurses' was reflected by 40% but actually 52.0% were carried out. As a result of hating analysed the understanding of the management of EVD by general characteristics, a significant difference was found in the necessity for set exchange by hospitals, in the time of quittance of a catheter, and in ablution items by work experience. The result of hating analysed the work performance levels of EVD management by general characteristics revealed that a significant difference in administration facilities of medicine by the classification of hospitals, especially the use of antibiotics and the quitting time of a catheter by the classification of intensive care units, and in the use of antibiotics and ablution items by the standard management guidelines.

고등학생들의 음란물 접촉실태 및 관련요인

윤분희,정문숙,한창현,어윤국 慶山大學校 保健福祉硏究所 2002 保健福祉硏究 Vol.7 No.-

본 연구는 성에 민감한 청소년들의 음란물 접촉 실태를 알아보기 위하여 1998년 11월 30일부터 12월 30일까지 경상남도 J시 소재 고등학교 2학년 학생 732명을 대상으로 설문 조사 분석한 결과는 다음과 같다. 음란물 접촉실태는 대상자가 가장 많이 접촉하는 음란물은 성인용 비디오(76.9%)이었고 성인용 만화(70.1%), 성인용 주간지(55.9%), 음란 컴퓨터 프로그램(51.2%), 포로노 비디오(50.3%), 포로노 잡지(34.4%) 및 포로노 사진집(28.1%) 순이었다. 인문계 학생이 가장 많이 접촉하는 음란물은 성인용 만화이었고, 실업계 학생은 성인용 비디오였으며 남학생이 여학생보다, 실업계 학생이 인문계 학생보다 음란물 접촉 경험이 더 많았다.(p<0.01) 음란물 접촉 시 특성을 보면 대부분 학생이 "중학교"때 처음 접촉했으며 접촉경로응 "친구를 통해서"가 가장 많았고, 접촉이유는 "호기심 때문에"가 가장 많았다. 제반 변수들에 따른 음란물 접촉과의 연관성을 알아본 결과 자위행위, 성 경험, 이성교제, 학생성적, 흡연, 음주는 모든 음란물의 접촉과 상관성이 있는 것으로 나타났다.(p<0.01) 음란물 접촉 유무를 종속변수로 하여 다중 로지스틱 분석을 한 결과는 남자일수록, 자위행위를 할수록, 학교 성적이 낮을수록, 담배를 피울수록, 술을 마실수록, 외향성일수록 음란물을 보는 경험이 더 많았다.(p<0.01) 이상 결과들을 볼 때, 청소년들을 음란물로부터 보호하기 위해서는 성적충동을 올바르게 표출하고 승화할 수 있도록 개개인의 취향에 맞는 운동이나 취미활동을 권장하고 이를 개발할 수 있도록 도와주어야 할 것이며 유해환경에 대한 규제를 강화하여 학생들이 살고 잇는 사회의 성문화 정화에 모두 관심을 가져야겠다. This study was conducted to examine the sex-sensitive adolescents' actual condition of contact with lecherous things from November 11th to December 20th, 1998 with 732 high school sophomores in Chinju, Kyungsangnam-do. And the results are as follows. According to the actual condition of contact with lecherous things the most lecherous thing subject group came into contact was adult videos(76.9%) and adults cartoons(70.1%), adults magazines(55.9%), lecherous computer programs(51.2%), porn videos(50.3%), porn magazines(34.4%) and porn photo collections(28.1%) in highest order. The most lecherous thing academic high school students came into contact was adults cartoons and that of business high school students was adults videos and contact experiences to it of male students and business school students were higher than those of female students and academic school students respectively(p<0.01%). In view of students' characteristics of contact with lecherous things, most students made first contact with them in their middle school years and from their friends curiosity. In the result of study of relevance to the contact with lecherous things due to all sorts of variables, it shows that masturbations, sex experiences, intersexual acquaintances, school records, smoking and drinking are related to the all contacts with lecherous things(p<0.01). In the result of Multiple Logistic Analysis with the presence of contact with lecherous things as subordinate variable, the more they are men, doing masturbations, the person with bad school records, smoking, drinking and extroversive the more they are inclined to contact with lecherous things(p<0.01). To protect adolescents from the access to lecherous things, in view of above results, we have to encourage and help adolescents to enjoy and develop sports or hobbies of their own to express and purify their sexual impulses right. And we also have to concern the purification of sexual culture of the society in which students live by strengthening our regulatory systems for unsound circumstances.

敎育投資에 대한 所得推定 : 個人의 選擇이 미치는 誤差에 대한 硏究

林海正,李範烈 群山大學校 1997 論文集 Vol.24 No.-

본 연구의 목적은 학교교육에 대한 투자가 어느만큼의 소득을 실현하는가에 대하여 개개인의 선택이 미치는 오차를 고려하는데 있다. 분석자료는 미국 노동부에서 조사한 National Longitudidinal Survey of Young Men에서 발췌하였는데, 1981년에 근로소득이 있는 표본만을 대상으로 하였다. 교육의 선택을 Ordered Probit Model로 분석하여 선택오차를 수정하였는데, 그 결과 개인의 선택으로 인한 오차의 중요성이 발견되었고, 교육투자를 통한 소득효과가 기존의 방법으로 검증된 것과는 상당한 차이가 있음이 나타났다.

UV-TiO_2 광촉매 반응기를 이용한 미생물의 살균효과

김시욱,이정섭,정혜광,박열,윤성명,유진철,이범규,이인화,박진열 조선대학교 환경연구소 1998 環境硏究 Vol.14 No.1

UV-TiO_2 반응기를 이용하여 Escherichia coli와 Aspergillus oryzae var. oryzae의 살균효과를 측정하였다. 254㎚에서 최대 14 watt의 자외선 방출량을 내는 램프를 원형 Pyrex유리관 중앙에 설치하였고 TiO_2는 석영관에 박막증착(Thin Film Coating)된 형태와 슬러리 형태로 나누어 회분식으로 살균정도를 측정하였다. E. coli에 대한 살균력은 1.7×10^7 cells/㎖에 대해 5분간 자외선 조사를 하였을 경우 2.0×10^2 cells/㎖으로 감소하였고, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 3.4×10 cells/㎖으로, 자외선 조사와 함께 TiO_2가 석영관에 박막증착된 경우에는 7.6×10^2 cells/㎖으로 감소하였다. 한편 위와 같은 조건에 유리관 하부에서 기포를 주입수 11분 동안 자외선을 조사시킨 경우에는 1.3×10^2 cells/㎖으로, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 1×102 cells/㎖으로, 자외선 조사와 함께 TiO_2가 박막증착된 경우에는 7.9×10 cells/㎖을 나타내었다. 결국 UV-TiO_2 반응기에 사용되는 TiO_2가 슬러리 형태일 때 최대 살균효과를 나타내었으나 기포가 첨가되었을때는 오히려 살균에 장애를 받는 것으로 나타난 반면 석영관에 박막증착된 경우에는 기포가 첨가되는 것이 살균에 효과적인 것으로 관찰되었다. The killing effect of UV-TiO_2 photocatalytic system on the Escherichia coli DH5-α and Aspergillus oryzae var. oryzae (KCTC 6095) was studied. The UV lamp which emits maximum 14 watts at 254 ㎚ was set on the center of pyrex round glass tube. Two types of TiO_2, one of which is slurry and another which is thin film coated form, were used to determine the killing effect. When UV was irradiated to 1.7×10^5 cells/㎖ of E. coli for 11 min, the living cell number decreased to 4.0×10^0 cells/㎖. The effect of UV system together with slurried TiO_2 was less than 1 cells/㎖, whereas that of UV-coated TiO_2 system decreased to 7.1×10^3 cells/㎖. To study the effect of bubble on the killing of microorganisms, air was bubbled to the bottom of glass tube. When 1.7×10^5 cells/㎖ were exposed to UV for 11 min in combination with air bubble, the living cell number decreased to 1.3×10^2 cells/㎖. In the same condition except the addition of slurried TiO_2, the living cells were 1×10^2 cells/㎖. However, more cells could be killed by the system which consists of UV, coated TiO_2, and air bubble (7.9×10^1 cells/㎖). From these results, it was found that UV-slurried system is the most effective one, but its killing effect is not stimulated by air bubble. However, bubbling was very effective in the UV-coated TiO_2 system.

경골 골수정 고정술후 교합나사의 파단

박형빈,강번중,송해룡,구경회,정순택,조세현 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 경골 골절에서 골수정 고정술후 발생하는 교합나사 파단의 빈도와 발생 원인을 밝히고자한다. 대상 및 방법 : 1995년 3월부터 2000년 10월까지 골수정으로 치료하였던 경골 간부골절 82예중 내고정물 파단이 발생하거나 골유합이 이루질 때까지 추시 가능하였던 75예를 대상으로 하였다. 내고정물 파단 빈도와 위치, 골절의 양상, 술후 골절부 신연 및 골유합 이상 여부를 조사하였다. 결 과 : 교합나사 파단은 7예였고 (9.3%), 근위부 두 번째 나사의 파단이 가장 흔하였다. 교합나사으 ㅣ파단은 AO분류 B형과 C형 골절, 술후 골절부가 신연된 경우, 개발성골절, 자연유합 및 불유합의 경우 발생하였다. 결 론 : 교합나사 파단의 주된 요인은 골절부의 골과 골 접촉이 불안정하기 때문이며, 개방성 골절, 지연유합 및 불유합도 교합나사 파단의 위험인자라고 생각한다. 교합나사 파단을 예방하기 위해서는 수술시 골절부 신연을 피해야하며 골절부 골접촉이 불안정한 경우 완전 체중부하를 골유합시까지 제한하여야할 것으로 생각한다. Purpose : The aims of this study were to investigate the prevalence and the causes of crew breakage in tibia nailing. Materials and Methods : Between 1995 and 2000, eighty-two tibial diaphyseal fracture were treated with interlocking nails. The loss of follow-up was 7 cases. We retrospectively reviewed seventy-five cases. We investigated the rate and location of metal failure and evaluated the fracture pattern, the presence of distraction after nailing and union abnormality. Results : Screw breakage was identified in seven cases (9.3%) and most frequently occurred on the second proximal locking screw. Screw breakage occurred in AO type B or C type fractures, fracture site distraction after nailing, open fracture, delayed union and nonunion. Conclusion : The main cause of screw breakage is unstable bone to bone contact on the fracture site caused by comminution of distraction. The open fracture, delayed union, and nonunion also contributing factors for screw breakage. For preventing screw breakage, it is necessary to avoid fracture site distraction and delay full weight bearing in cases having unstable fracture site contact.

소고춤에서의 자반뛰기 동작 분석에 관한 이론적 고찰

조원민,이정분 釜山大學校 附設 體育科學硏究所 1996 體育科學硏究所 論文集 Vol.12 No.-

The instrumental music of peasants which preserved and transmitted the tradition and beautyy peculian to our nationality is the aboriginal culture as well as a spot one. It has our national emotion and common harmony in local society. The purpose of this study is to offer a correct data and prevent the ovice and the dancers from getting the injury and damage of the body by studying the motion anaylsis theoretically of Jaban Jump in So-go dance. Thus we study the kinematic variables of Jaban Jump : prime mover, moving trace of each parts of the body knee angles of landing foot in leap motion, movement distance at distance at rotation and the required time staying time in the air, etc. Therefore we can establish the science of art by offering the scientific data on a peculiar to Korea throughout this study of motion analysis. We can also expect to teach the dancers effectively and correctly in theory and sublime it into a real art opening a new world of expression.

秋剛 金東旻의 生涯 및 藝術世界

조원민,엄옥자,이정분 釜山大學校 附設 體育科學硏究所 1997 體育科學硏究所 論文集 Vol.12 No.-

Dong Min Kim with a pen name of Chukang was born as a first son of the great lanlord Yang-san in 1910. He majored in law at the Myung-chi university in Japan but had great interests and the special affection toward Korean folk dance of Kutgery dance, Buddhist dance, Sanjo dance, Drum, Ajaeng, etc. He also learned the technique of the Korean drum from the late Tae-Heung Kang who was a master in Kayagum. He opened the research institute of Korean folk dance for the first time in Pusan in 1945 and taught our classical dance at elementary, middle and high school. This resulted in the initiative of dance institute which was not Kyeonbon in pursuit of the truly genuine art. He cultivated many disciples with talent, who have been working as famous professors in the universities. Most of disciples have been leading the circles of dance in Pusan as elder presidents in dancing institutes. Therefore Chukang brought a vital power in a stagnated circles of dance and in the cultuural barren area of Pusan. With his special affection was greatly elevated the cultural level of Pusan. He raised the many dancers in Pusan and is a live witness in the modern history of dance in Pusan at the same time.

우울장애 환자에서 자살 시도와 트립토판 수산화 효소(Tryptophan Hydroxylase) A218C 유전자 다형성과의 관련성

심세훈,황보영,권영준,정희연,이분희,김용구 대한신경정신의학회 2008 신경정신의학 Vol.47 No.2

Objectives : Several lines of evidence suggest the serotonergic dysfunction involved in the biological susceptibility of suicide. Tryptophan hydroxylase (TPH), the rate-limiting enzyme in the biosynthesis of serotonin, Plays a vital role in serotonin metabolism. In a case-control study, we investigated whether the TPH gene was a susceptible factor for suicidal behavior in depressive patients. Methods : The subjects were 218 depressed patients who attempted suicide and visited emergency rooms in multi-medical centers. One hundred thirty hospitalized non-suicidal depressed patients and the 161 normal controls were matched with the suicidal group. Individuals in all 3 groups were evaluated independently by a Structured Clinical Interview for the purpose of establishing a DSM-IV criteria diagnosis (SCID). The severity of depressive symptoms was evaluated using Hamilton depression rating scale (HDRS). Results : There was no significant difference in genotype distributions and allele frequencies of TPH intron 7 A218C polymorphisms among 3 groups. Furthermore, no significant difference in genotype counts and allele frequencies of the polymorphisms was found among lethal suicidal depressed patients, non-suicidal depressed patients and the normal controls. Conclusion : This study suggests that the A218C polymorphism of the TPH gene is unlikely to have a major effect on the susceptibility of suicidal behaviors in depressive patients.