부대동맥 림프절 또는 쇄골상부 림프절에 국한된 전이가 있는 재발성 자궁경부암 환자들의 예후에 관한 연구

최석철,문형배 동국대학교 의학연구소 1998 東國醫學 Vol.5 No.-

자궁경부암에서 림프절 전이가 병소의 재발이나 환자의 예후에 악영향을 미친다는 것은 주지의 사실이다. 그러나 자궁경부암으로 일차치료 후에 재발한 자궁경부암 환자들 중에서 부대동맥 및/혹은 쇄골상부 림프절에 전이가 있는 환자들의 임상적 특징 및 예후에 대해서는 잘 알려져 있지 않다. 따라서 본 연구는 자궁경부암으로 근치적 전자궁적출술 및 골반림프절 절제술이나 방사선치료 후에 재발한 환자들 중 부대동맥 및/혹은 쇄골상부 림프절에 전이가 있는 환자들의 임상적 특징 및 예후에 대해 알아보고자 하였다. 1991년 1월부터 1995년 12월 까지, 원자력병원 산부인과에서 자궁경부암으로 일차치료 후 전산화 단층촬영 및 세침흡인 세포검사에서 부대동맥 및/혹은 쇄골상부 림프절전이가 증명된 재발성 자궁경부암 환자 55명을 대상으로 하였다. 1. 대상환자 55례 중 부대동맥 림프절에 국한된 전이가 있었던 경우는 31례(56.4%)였으며, 쇄골상부 림프절에 전이가 있었던 경우는 24례(43.6%)였다. 쇄골상부 림프절에 전이가 있었던 24례 중 8례는 쇄골상부 림프절에 국한된 전이가 증명된 경우(Supraclavicnlar lynph node : SCLN only군)였고, 나머지 16례는 부대동맥 림프절 및 쇄골상부 림프절에 전이가 동시에 있는 경우(both군)였다. 2. FIGO 임상병기별 분포는 Ⅰ기 9.1%, Ⅱ기 56.4%, Ⅲ기 32.7%, Ⅳ기 1.8%였다. 세포형태에 따른 림프절 전이율은 편평상피세포형이 96%(53/55)였다. 대상환자 55례 중 22례(40.0%)는 일차치료 당시 이미 골반림프절에 전이가 있었던 경우였다. 대상 환자들의 원발암 치료는 방사선 치료만을 시행 받은 경우가 60.0%(33/55), 방사선 치료와 항암화학요법을 시행 받은 경우가 18.2%(10/55), 수술 및 방사선 치료, 항암화학요법을 시행 받은 경우가 18.2%(10/55), 그리고 수술 및 방사선 치료를 시행 받은 경우가 3.6%(2/ss)였다. 3. 전체 연구대상 환자 55례의 3년 생존율은 14.4%이었으며, 부대동맥 림프절전이군과 쇄골상부 림프절전이군의 3년 생존율은 각각 15.4%, 10.7%이었고, SCLN only군 및 both군의 3년 생존율은 각각 0%, 19.7% 이었다. 결론적으로, 쇄골상부 림프절 전이가 있는 환자는 부대동맥 림프절에 국한된 전이가 있는 환자보다 3년 생존율이 낮음을 알 수 있었으며, 이에 따라 재발성 자궁경부암 환자에서는 쇄골상부 림프절의 전이 유무가 환자의 예후를 추정하는데 중요한 지표가 될 것으로 생각되었다. It is evident from previous reports that in patients with cervical cancer with metastases to lymph nodes have unfavorable outcome, there are, however, few reports have previously been made of the clinical characteristics and prognosis of patients with metastasis limited to para-aortic lymph nodes(PALN) only versus supraclavicular lymph nodes(SCLN) following primary treatment. This paper attempts to discuss the outcome of Patients with recurrent cervical cancer metastasis limited to these lymph nodes. This report is a retrospective analysis of 55 patients with recurrent cervical cancer metastasis limited to para-aortic or supraclavicular lymph nodes following radical hysterectomy or definitive radiation therapy treated at the Korea Cancer Center Hospital, from January 1991 through December 1995. The results were as follows. 1. Of the 55 patients entered, 31(56.4%) had positive nodes on para-aortic area only and 24(46.3%) had positive nodes on supraclavicular area. 8 of 24 patients had limited metastasis to SCLN only and 16 had metastatic nodes on both para-aortic and supraclavicular area. 2. The distribution of patients according to initial FIGO stage were 9.1% in stage Ⅰ, 56.4% in stage Ⅱ, 32.7% in stage Ⅲ, and 1.8% in stage Ⅳ. In 96.4%(53/55) of cases, the histologic type was a squamous cell carcinoma. 22(40.0%) of 55 patients had pelvic lymph node metastasis at the time of initial treatment. The distribution of patients by treatment modalities prior to recurrence was 60.0%(33/55) for patients treated with radiotherapy alone, 18.2%(10/55) for patients treated with combined chemotherapy and radiotherapy, and 18.2%(10/55) for patients treated with combined surgery, radiotherapy, and chemotherapy. 3. The overall 3-year survival rate for patients with positive nodes on para-aortic or supraclavicular area was 14.4%; those who had lymph nodes limited to para-aortic only achieved 15.4%; those who had lymph nodes limited to supraclavicular lymph node achieved 10.7%. Of these, those who had nodes on supraclavicular lymph node only or both supraclavicular and para-aortic lymph node achieved 0% and 19.7% 3-year survival rate, respectively. In conclusion, the outcome for patients with metastasis to supraclavicular lymph nodes was worse than for patients with metastasis to para-aortic lymph nodes only. This suggest that the presence of metastatic carcinoma on supraclavicular lymph node may be a reliable Predictor of probability of survival in such patients.

면역학적 접근법을 이용한 미소대장암의 진단 및 외과적 치료

이기형,이석환,고석환 경희대학교 1997 慶熙醫學 Vol.13 No.1

Argon 이온 레이저 중합에 의한 Composite resin의 물성에 관한 연구

조현경,이정석 大韓齒科保存學會 1992 Restorative Dentistry & Endodontics Vol.17 No.1

An experimentalj investigation of the physical properties of light curing composite resin P-50 was performed, in which an argon ion laser beam was irradiated. The physical and mechanical properties of laser polymerized composite resin were determined by measuring the compressive strength, diametral tensile strength, curing depth and microhardness depending upon the experimental conditions such as the laser irradiation time(10sec, 20sec, 30sec) and laser power(300mW, 500mW, 1000mW). These observations were compared with a conventional visible light curing technique. In addition, to evaluate the marginal adaptation, Class V cavity was prepared on the buocal or lingual surface of the extracted premolar and filled with P-50 light curing resin. The test samples were irradiated with both light sources so that the interface between the restoration and the tooth structure were observed under scanning electron microscope. The most of physical and mechanical properties of the laser cured resin showed a remarkable improvement than those treated with the conventional light source, while the observations with the scanning electron microscope provided no significant difference for two polymerized sources. From the results in the experiment it appears that the potential of an argon ion laser is of important value of the use in the polymerization of composite resin.

SiH_4 기체 방전 파라미터 해석

이형윤,하성철,유회영,김상남,임상원,문기석 동국대학교 산업기술연구원 1997 산업기술논문집 Vol.9 No.-

This paper describes the discharge parameters in SiH_4 gas calculated for the range of E/N values from 0.5~300(Td) by the Monte Calro simulation and Boltzmann equation method using a set of electron collision cross sections determined by the authors and the values of the discharge parameters are obtained for the TOF method. The theoretical results of the discharge parameter such as the electron drift velocity, characteristic energy agree with the experimental values for the range of E/N. The electron energy distributions function were analyzed in monosilane at the E/N : 30, 50(Td) for a case of equilibrium region in the mean electron energy. The validity of the results obtained has been confirmed by the TOF method.

英語 句讀法에 관한 硏究

李錫炯 건국대학교 1983 論文集 Vol.16 No.1

Punctuation is a kind of agreed system with fuction to help a written languge to express elements of speech, that is, mainly pause, pitch, and trees, which cannot be written on paper conveniently. There are several ways to classify punctuation, but according to the position there are Paragraphs which distinguish between sentences, capital letters, periods or full stops, question marks, and exclamation marks, which appear in the beginning and ending of the sentence. There are comma(,), semiclon(;), colon(:), dash(-), brack(( )) within a sentence and hyphen(-), abbreviation mark(.) , dot(.), etc. related on words. In this paper it was mainly studied that according to function I classified sepuence, or series, or enumeration, and adjunct and inclusion or seperation, uses in a sentence. Sequence consists of words, phrases, and clauses, when sequence consists of words, comma is used. And two elements, we don't use comma but in the case of three elements, it is common that we use comma. In the continuant phrases semicolon is used except comma, but when sequence consists of two phrases it is common that only conjunction is used without punctuation. When we write several clauses we rose comma and semicolon, but when we write two co-ordinate clauses we might not use comma and semicolon. We classify adverbs in two trays according to its function, one is a sentence modifier and the other is a conjunctive adverb which functions as advert and conjunction between two sentenses. When the adverb of a sentence modifier appears in the beginning of the sentence we can use comma or not, but at the end of the sentence comma is not usually used. In the beginning or ending of the sentence adverb phrases which need comma are the following : at any rate, at least, for example, for instance, in any case, in fact, in short, of course, on the contrary, on the one hand, on the otter hand, etc. What a clause consists of an apposition means a relative clause, non-restritive. At this. time there is no change of punctuation whether the position is changed or not. We use comma, bracket, dash, colon to classify a main sentence to provide materials and additional informations to the meaning of the main sentence even though they are not important elements. Punctuation shows various appearances according to individual style as a way of a group of rhythmical, visual expression, so it should be studied futher as a kind of means for readers to read and write very fast and correctly.

Quinlolone 유도체 국소도포에 의한 좌창치료의 임상적 연구

권철욱,노영석,김재홍,조소연,강형철,함정희 大韓臨床藥理學會 1994 臨床藥理學會誌 Vol.2 No.2

7β-(5-Phenyl-2H-Tetrazolyl-2-Acetamido) Cephalosporanic Acid의 合成 및 抗菌作用에 관한 硏究

高玉鉉,姜馨龍,金京洙,金泳秀,洪石淳,金燦範 조선대학교 약학연구소 1992 藥學硏究誌 Vol.14 No.1

7β-(5-Phenyl-2H-tetrazolyl-2-acetamido) cephalosporanic acid was synthesized by condensation of 7-aminocephalosporanic acid(7-ACA) with(5-phenyl-2H-tetrazol-2-yl) acetyl chloride. This compound was tested for antimicrobial activity in vitro against Bacillus licheniformis ATCC 14580, Bacillus subtilis ATCC 6633, Candida albicans ATCC 10231, Escherichia coli ESS, Micrococcus luteus ATCC 9341, Pseudomonas aeruginosa IFO 13130, Staphylococcus aureus ATCC25923, Staphylococcus aureuss FDA-209p and Salmonella typhimurium SL 1102. This compound revealed excellent antibacterial activity against Bacillus subtilis ATCC 6633, Micrococcus luteus ATCC 9341, Staphylococcus aureus ATCC 25923 and Staphlococcus aureus FDA 209p. This compound have no antimicrobial activity against Candida albicans ATCC 10231, Pseudomonas aeruginosa IFO 13130 and Salmonella typhimurium SL 1102.

鎔接이음한 構造用鋼의 疲勞龜裂進展擧動

정영화,이형근,김익겸,정진석 江原大學校 産業技術硏究所 1998 産業技術硏究 Vol.18 No.-

In recently, according to increase the construction rate fo steel bridge, it is necessary to develop the high strength, high toughness steel. Thus, this study show to evaluate the fatigue characteristic of SWS 570 B first used within a country. With the weld-joined compact tension specimens compared with each other, that is, transverse and lengthwise about the crack propagation, high and low in the imput heat level, the fatigue test were performed. The log-log curves between the fatigue crack propagation rate da/dN and the transition range of the stress intensity factor △K ahead the crack tip were drawed, with these data. By using this curve, we obtained C and m which is material constant from Paris-Erdogan power law. The opbtained resutls from this study indicate that fatigue crack growth rate of SWS 570 B is not heat input weld is carried out. Softening effects, which affect fatigue properties, are shown that it is not affected to the fatigue growth rates significantly.

물체-검출기 동기회전 방식의 X-선 단층영상시스템 설계 및 성능개선에 관한 연구

강성택,조형석,노병옥 제어·자동화·시스템공학회 1999 제어·자동화·시스템공학논문지 Vol.5 No.-

This paper describes my experiences in delivering a 3-year of psychological service to the Korean National Archery Team(1996-1998). The process of developing psychological skills training programs(PSTP) over a 3-year period is outlined. The contents of PSTP are explained and the importance of full cooperation from coaches, sport organization, and the ethics of the coach is discussed as well.

우측 대장게실의 병인론: 선천성인가 후천성인가?

이길연,이석환,고석환,윤충,이기형 대한대장항문학회 1994 Annals of Coloproctolgy Vol.10 No.2