다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

複合非破壞試驗法을 利用한 現場콘크리트 强度推定에 關한 硏究

조철희,김하진,이승엽,김정섭 朝鮮大學校 建設技術硏究所 1999 建設技術硏究 Vol.19 No.1

This study is to improve the reliability of compressive strength estimation using combined non-destructive testing method in estimating the compressive strength of in-situ concrete after 730 days of age, measures the values of compressive strength and non-destructive test of in-situ concrete with the combined strength of 240kg/㎠, conducts the experiment for estimating the compressive strength, makes the estimation expression of the results through simple and duplicate regressive analysis and then the results of comparing and analyzing to existing expressions to secure the range of application of estimation expression and its reliability are as follows. It is found that the positive curing is very important in the early curing of the strength revelation in long-term age and especially in hydrate and it is considered that the formation and application of estimation expression of comprressive strength according to placement and curing method are needed to enhance the degree of strength estimation of in-situ concrete. After 365 days of age, the compressive strength of concrete tends to be decreased. While the single method has not a great change of non-destructive test value according to the change of concrete strength, the combined method shows a high reliability and then it is appropriate to use it for the exact strength estimation. Existing estimation expression used for estimating the compressive strength indicates a high estimation error in comparison with the expression suggested by this research in the difference of materials used, combined strength of concrete and the difference of placement and curing methods. Accordingly, it will be desirable to use an estimation expression suitable to the in-situ conditions for the exact strength estimation. The estimation expression of compressive strength using combined non-destructive test method of in-situ concrete on 730 days of age (2 years) suggested by this research is as follows. Air Curing fc' = 7.33R+219Vp-846 [R-sq(adj) = 0.839, N=81] Water Curing fc' = 12.6R+176Vp-805 [R-sq(adj) = 0.839, N=81]

상아질의 깊이에 따른 단일 단계 접착제의 결합강도 비교

조영곤,진철희,민정범 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.4

본 연구는 단일 단계 접착제의 표충과 심층 상아질에 대한 미세인장 결합강도의 차이를 평가하기 위해서 시행되었다. 발거된 상·하악 대구치의 교합떤측에 있는 표층 상아질과 심층 상아질을 각각 15개씩 노출시킨 후, 사용된 접착제에따라 AQ 군, L-Pop 군, Xeno 군으로 분류하여 복합레진을 축조하였다. 각 시편은 상아질과 복합레진 계면의 단면적이 1.0 ㎣이 되도록 절단하였고, 각 군 당 20개의 시편을 사용하였다. 각 군의 미세인장 결합강도의 측정하여 다음과 같은 결과를 얻었다. 표층과 심층 상아질 모두에서 Xeno Ⅲ는 다른 접착제보다 가장 높은 결합강도를 나타내었다 (p<0.05). 또한 모든 접착제는 심층 상아질에서 보다 표층 상아질에서 더높은 결합강도를 나타내었으나 이들 간에 통계학적인 유의성은 접착제의 종류에 따라 다르게 나타났다. This study compared the microtensile bond strength (μTBS) of single step adhesives to different dentin depths. Superficial or deep dentin was exposed in 30 molar teeth by sectioning immediately under the DEJ or 1.5 mm area from central pit, respectively. After polishing with 600-grit SiC paper, the dentin surfaces were assigned to three groups: AQ group-AQ Bond, L-Pop group-Adper Prompt L-Pop, Xeno group-Xeno Ⅲ. The bonded specimens were sectioned into sticks and subjected to μTBS testing with a crosshead speed of 1 mm/minute. The results of this study were as follows; The μTBS to superficial dentin was higher than that to deep dentin in all group. The μTBS of Xeno group was significantly higher than that of L-Pop group and AQ group in both superficial and deep dentin (p<0.05).[J Kor Acad Cons Dent 30(4):319-326,2005]

광질 및 증산억제제와 생장억제제가 플러그묘 저장시 품질과 정식 후 생육 및 개화에 미치는 영향

조성운,김희정,손기철 충북대학교 한국과학재단 지정 첨단원예기술개발 연구센터 1998 연구보고서 Vol.3 No.-

본 실험은 플러그 육묘시 빈번히 발생하는 도장현상을 해결하는 방안으로 저장시 묘품질 및 초장조절을 최적으로 유지시킬 수 있는 광질 및 증산억제제와 생장억제제의 효과를 조사하고 저장이 정식 후 생육과 개화에 미치는 영향을 알아보고자 수행하였다. 광질의 영향을 살펴보면 살비아는 백색광에서 임파첸스는 적색광에서 1-2주 저장시 외형적으로 가장 적당한 식물체를 얻을 수 있었다. 엽수는 살비아와 임파첸스 모두 청색광에서 증가하였고, 암상태에서 살비아의 엽수는 감소한 반면 임파첸스에서는 증가하였다. 이러한 양상은 정식 후에도 비슷하게 나타났다. 또한, 생체중과 건물중에 있어서 살비아와 임파첸스 모두 광질에 따른 영향이 일정하지 않았다. 개화소요일의 경우, 살비아는 암상태에서 저장했던 처리구에서 개화소요일이 지연되었고, 임파첸스는 광질과 광의 유무에 따른 경향이 일정하게 나타나지 않았다. 증산억제제와 생장억제제의 영향을 살펴보면 메리골드, 살비아 모두 2-3주 저장시 uniconazole을 처리하면 외형적으로 가장 적절한 식물체를 얻을수 있었고 초장이 감소한데 따라 충실도가 감소된 반면 살비아에 cloud cover처리시 초장이 도장한 만큼 충실도가 증가되지 않았다. 개화소요일에 있어서 메리골드와 살비아 플러그묘는 각각 uniconazole과 damonozide 처리시 다소 지연되었다.

疲勞荷重을 받는 鐵筋콘크리트 보의 炭素纖維시트 補强에 따른 構造特性에 관한 硏究

조철희,김하진,김광섭,김정섭 朝鮮大學校 建設技術硏究所 1999 建設技術硏究 Vol.19 No.1

This study is an experimental study of reinforced-concrete beam with carbon fiber sheet under fatigue load and aims at utilizing it as the basic material of strengthening design of reinforced-concrete structure under the fatigue load by examining the structural characteristics according to the fatigue load. Non-strengthening and strengthening, kind of strengthening materials(non-resin carbon fiber sheet, resin carbon fiber sheet) and the loading size (80%, 100%, 120% of static destruction load) in static and fatigue experiment are designed as the variables of experiment. The experimental results are as follows. 1. The strengthening test specimen shows the increase of yield strength of 208% in comparison with non-strengthening test specimen in the static experiment which is the standard of fatigue experiment. 2. The strengthening test specimen of non-resin CFS of K company and of resin CFS of M company indicate the increase of yield strength of 228% and 183% respectively in static experiment. 3. It is found that the strengthening test specimen in fatigue experiment has the increase of fatigue strength according to that of static yield strength. The strengthening test specimen with the loading of 120% of static load secures the fatigue yield strength of greater cycle than non-strengthening test specimen with 80% of static destruction load. Accordingly, it is judged that it is suitable to use CFS for the strengthening of reinforced-concrete due to the lack of fatigue load and structural yield strength. 4. It is shown that non-resin CFS strengthening test specimen of K company tested under the same condition secures the fatigue yield strength of greater cycle than resin CFS strengthening test specimen of M company. Initial deflection and elastic behavior have a similar form. Therefore it is thought that non-resin CFS produced at home is the strengthening material with the quality of international standard. 5. The test specimen reinforced with CFS has greater effects at static and fatigue yield strength, prevention of initial deflection and elastic deflection. So, it is considered that the reinforcement of CFS structure in actual structure may have the similar reinforcement effect to this experiment

개에서 피지선 과형성의 진단 및 치료 증례

박희서,손화영,정성목,송근호,조종기,이영원,신상태,김명철,김덕환,박성준 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

An eleven year old castrated male Maltese was presented to the Veterinary Medical Teaching Hospital of Chungnam National University. In physical examination, approximately 0.5 cm round mass was observed on tail base. This small elevated mass has also shown alopecic and firm configuration. It was differentially diagnosed as sebaceous adenoma and hyperplasia by fine needle aspiration. After surgical removal, the sample was diagnosed as sebaceous hyperplasia by histopathological examination. It has not yet shown any signs of recurrence and prognosis has teen good.

「心因性皮膚疾患크리닉」환자들에 關한 豫備調査

金哲應,趙斗英,姜民熙 大韓神經精神醫學會 1985 신경정신의학 Vol.24 No.1

1983年 3月부터 1984年 2月까지 서울大學校病院 皮膚科 외래진료소내의 「心因性皮膚疾患크리닉」에 諮問依賴된 患者 51명 (남:32명, 여:19명) 을 對象으로 社會人口學的持性을 調査分析하고 呼訴하는 症狀, 身體部位, 依賴前 皮膚科診斷, 依賴後 精神科的 診斷 및 治療등에 대해 분석하고 이를 外國의 경우와 比較ㆍ考察하였다. 1. 男ㆍ女 비율은 男子에서 높았고 (1.68:1), 年齡別 有意한 差異는 없었다. 2. 職業은 非生産的인 狀態가 많았고 (68.18%) 經濟狀態는 中下位가 많았다. 3. 依賴된 患者는 대부분 (8401%) 이 皮膚疾患과는 관계없이 精神疾患者이었다. 4. 呼訴하는 증상은 瘙痒感이 가장 많았다(29.55%) 5. 呼訴하는 身體部位는 男子의 경우 肛門生殖器部位(45.45%), 女子는 顔面部位 (54.55%)가 많았다. 6. 객관적인 皮膚病變은 男子, 78.57%, 女子의 82.25%에서 없었다. 7. 依賴前 皮膚科診斷은 「診斷保留」가 많았고 (38.69%), 精神科的診斷은「單症性健康念慮精神病 」이 많았다 (25.0%). 8. 精神科治療를 권유 했을때 거부하는 例가 많았으나 (46.15%) 6개월이상의 장기 추적치료는 精神科外來에서 하는게 더 효과적이다. 이상의 結果에서 시사되는 바와 같이 본 크리닉에서의 정신과 諮問醫의 연결활동은 여러면에서 의의가 있었다. 그러나 본 연구조사는 소수의 대상환자들에게서 관찰된 것인 바 앞으로 본 크리닉에 의뢰되는 더 많은 환자들을 對象으로 한 각각의 문제점에 대한 철저한 硏究는 물론 개개의 환자들에 대한 보다 더 깊이있는 정신의학적 접근이 필요하다고 생각된다. In 1983 the psychodermatoloy outpatient clinic was established at the Seoul National University Hospital, open one afternoon a week, where one liaison-psychiatrist and one dermatologist conjointly treat the patients referred from the dermatology outpatient clinic. This study purported to investigate the demographic characteristics and clinical aspects of the total 51 patients treated at the clinic during the period from March 1, 1983 to Feb. 28, 1984, and the results were summarized as follows; (1) Males predominated over females (62.7% vs 36.6%) and there were no age-specific findings. Majority of the patients came from middle-and-lower socioeconomic classes (90.0%) and majority of the patients suffered from psychiatric problems rather than actual dermatologic disorders (81.0%). (2) Pruritus was the most frequent complaint among them, with males on the anogenital regions (45.5%) and females on the facial region (54.6%), and the most frequent psychiatric diagnosis was monosymptomatic hypochondriacal psychosis (25.0%). (3) While two-fifth (42.1%) of the patients dropped-out after 1-2 visits, the fact that another two-fifth (39.5%) continued to visit the clinic more than 5 times showed our liaison activities gave some positive impacts in the care of psychodermatologic problems. It also seemed that with a better psychological preparations for those patients upon the referral by the dermatologists the early drop-out rate could be markedly reduced.

자가부식 프라이머의 적용시간이 법랑질 접착에 미치는 영향

진철희,조영곤,김수미,이명선 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.3

이 연구의 목적은 6종의 자가부식 프라이머 접착시스템에서 제조사에서 추천한 프라이머 적용시간과 2배의 프라이머 적용시간에 따른 법랑질에 대한 미세전단 결합강도와 전자현미경적 소견을 비교하기 위하여 시행하였다. 이 연구의 결과 법랑질에 대한 자가부식 프라이머 접착제의 결합강도는 제조사에서 추천한 프라이머의 적용시간보다 프라이머의 적용시간을 2배 증가시킨 경우 높게 나타났으며, 특히 pH가 높은 프라이머를 사용하였을 때 통계학적으로 높은 결합강도를 나타내었다. 이는 법랑질에서 pH가 높은 프라이머를 사용할 경우, 제조사에서 추천한 시간보다 더 긴 시간동안 적용하는 것이 결합강도를 증가시킬 수 있을 것으로 생각된다. The purpose of this study was to compare the normal and two times of application time of six self-etching primers applied to enamel using microshear bond strength (uSBS) test and the finding of scanning electronic microscope (SEM). Crown of sixty human molars were bisected mesiodistally and buccal and lingual enamel of crowns were partially exposed and polished with 600 grit SiC papers. They were divided into one of two equal groups subdivided into one of six equal groups (n = 10) by self-etching primer adhesives. After the same manufacture' s adhesive resin and composites were bonded on the enamel surface of each group, the bonded specimens were subjected to uSBS testing and also observed under SEM. In conclusion, generally two times of primer application time increased the enamel uSBS, especially with the statistical increase of bond strength in adhesives involving high-pH primers.

심부전 백서의 대동맥과 폐동맥에서 보이는 C형 이뇨단백에 대한 이완반응의 이상

김철호,김광일,조영석,조주희,오병희,이명묵,박영배,최윤식,이영우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8