성인 급성 림프구성 백혈병에 대한 복합 화학 요법

곽상혁,신현영,김성은,이정호,이정찬,강정현,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Although acute lymphoblastic leukemia(ALL) is one of the most frequently encountered cancer in children, only about 20% of patients who were diagnosed leukemia are ALL in adults. During past 30 years, the result of treatment of ALL in children have been markedly improved, but in adults, the result of treatment of ALL is not so good as that in children. In recent, morbidity of ALL has been increased in KOREA, but studies of long-term survival are rare. So a retrospective clinical analysis was made in patients who were diagnosed for adult acute lymphoblastic leukemia between March 1988 and February 1997, in Chungnam National University Hospital. The result of treatment, prognostic factors of survival and duration of complete remission were analyzed. In 44 patients who were newly diagnosed as ALL in Chungnam National University Hospital, total 31 patients who have received chemotherapy more than two weeks were analyzed. All patients were treated by vincristine, daunorubicine, and prednisolone in phase I induction chemotherapy. At the 28th day of phase I induction chemotherapy, bone marrow aspiration biopsy was performed and achievement of complete remission was estimated. Within one or two weeks after completion of phase I chemotherapy, phase II induction chemotherapy was done. In phase II induction chemotherapy, cyclophosphamide, cytosine arabinoside and 6-mercaptopurine were administerd. During phase II induction chemotherapy, CNS prophylaxis with intrathecal methotrexate administration and intracranial irradiation. After completion of phase I and phase II of induction chemotherapy, 4 cycles of consolidation chemotherapy were made in utilization of VP-16 and cytosine arabinoside in standard risk group, and in utilization of methotrexate with leucovorin rescue and L-asparaginase in the high risk group. And then maintenance chemotherapy with 6-mercaptopurine and methotrexate was continued till two years later from the day of treatment start. The median survival time was 15.8 months (95% C.I. 6.0-18.8 months) and the long-term survival (more than 5 years after diagnosis) rate was 28.0%. The rate of complete remission was 83.9% ( 26 of 31) and the median of the complete remission duration was 15.8 months (95% C.I. 5.6-25.9 months). The rate of relapse was 69.2%. Good prognostic factor for overall survival time was the fraction of blast cells less than 75% in bone marrow at diagnosis (P=0.001) in univariate analysis. In multivariate analysis, age below 40 (P=0.003) and blast cells less than 75% in hone marrow at diagnosis (P=0.003) were good prognostic factors for overall survival time. Good prognostic factors for disease free survival in univariate analysis were the fraction of blast cells less than 75% in bone marrow (P=0.003), absence of fever (P=0.013), and absence of hepatomegaly (P=0.025), all at diagnosis. In multivariate analysis, good prognostic factors for disease free survival were platelet count more than 50,000/uL, blast cells less than 75% in bone marrow at diagnosis (P=0.004), serum LDH level below 500U/L (P=0.016). The result of treatment of ALL in adults has been improved but is not satisfactory in comparison with that in children. Despite of marked improvement of the rate of complete remission, the rate of relapse still not so much improved. So intensified consolidation chemotherpy or allogenic bone marrow transplantation or autologous bone marrow transplantation is necessary for improvement of survival of adult ALL.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

현대건축에서 "아브젝션" 적용에 관한 연구 : 줄리아 크리스테바의 정신분석학을 중심으로 Focused on Julia Kristeva's Psychoanalysis

현정아,이동언 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(계획계)

In contemporary architecture, Postmodernism and Deconstruction express the otherness as unfamiliarity, grotesque, difference and so on. But the meaning of the above two isms are undeterminate and disseminative in the architecture text. Accordingly, it needs to make the meaning of the otherness clear in architecture. So, this paper investigates the meaning of abjection and the sublimation of abjection in Julia Kristeva who explains the otherness concretely, and relates those to architecture. Therefore it searches the potential possibility of contemporary architecture by discovering the essential meaning the sublimation of abjection and by applying the meaning to it.

창의적 인간 양성, 어떻게 가능할까?

정현주 경주대학교 창의력개발연구소 2003 創意力開發硏究 Vol.- No.6

김치축제 행사에 관한 평가 연구

정강환,노용호,김현덕 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.6

The purpose of this research was to investigate the satisfaction of visitors of Kimchi food festival in 1999, 2000, and 2003. This is the longitudinal study on the cultural festival which used Kimchi as the main resource. This study also investigated the possibility of Kimchi festival as a foreign tour product. This study has several important findings including as follows; First, the satisfaction of residents was higher than domestic visitors in most programs. Second, there were many foreign visitors to the festival and the satisfaction of foreign tourists was higher than residents and domestic tourists. More programs for the foreign visitors are recommended to be an international food festival. Third, experience based food tour events were popular. Introducing more experience oriented programs are recommended for this festival. Fourth, There should be more improvement on food price and parking.

웹기반 학습에서의 교류적 피드백 개발전략 탐색

정현주 이화여자대학교 교과교육연구소 2007 교과교육학연구 Vol.11 No.1

본 연구는 학습자 중심의 웹기반 학습에서 요구되는 피드백의 특성을 탐색하고 그 개발전략을 제시하는 데 목적이 있다. 종래 피드백의 역할과 내용은 평가와 교정의 역할에 초점을 맞추어 왔다. 그러나 웹기반 학습에서는 이를 대신하여 상호구성주의적 교수학습 모델에 적합한 대안적 피드백의 적용이 요구된다. 웹기반 학습 환경은 네트워크를 기반으로 풍부하고 원활한 의사소통을 가능하게 해 주며 학습자 중심의 자기 주도 학습을 지향하기 때문에 피드백은 상호작용적 메시지로 구성된 담화의 요소로서의 교류적 역할을 수행해야 하기 때문이다. 포럼을 중심으로 운영된 웹기반 학습을 사례로 하여 교류적 피드백의 개발 전략을 분석하였다. 분석 결과는 다음과 같다. 첫째, 과제적, 정의적, 그리고 전략적 피드백을 모두 다양하게 사용하여 동기 및 자극을 제공하는 피드백으로 활용한다. 둘째, 교수자가 학습자의 학습 활동에 대한 요약 피드백을 빈번하게 규칙적으로 제공하여 교류활동을 촉진한다. 셋째, 여러 가지 소규모 과제들을 수행하기 위해 포럼에서 지속적으로 상호작용이 이루어지도록 하고, 포럼에의 접근을 용이하게 하여 상호 구성주의적 학습환경을 제공한다. 심층적인 연구를 위해 후속연구에서 종래 피드백 모델에 적용된 메시지 분석틀이 아니라 교류적 피드백의 내용과 역할에 적합한 메시지의 질적 분석 도구를 개발해서 적용해야 할 것이다. The current study aims to explore the characteristics of feedback, relevant to learner-centered web-based learning. On web-based learning, the traditional understanding of feedback, concerned with its evaluative attributes, needs to be replaced by an approach to transactional feedback. The transactional feedback is likely to be a part of dialogue. A case of the web-based learning, in which interactions were activated through forum, indicated the characteristics of transactional feedback as followers: First, it gives feedback on task, affectation, and learning strategies, which functional mainly to evoking motivations and stimuli. Second, a tutor consistently and regularly provides the summary feedback on learning activities and so encourage transactional feedback based on deep empathy. Third, it is supported by co-constructive learning environments such as a number of small tasks, which are playing roles of topics on the forum, and easy access to the form for continuous interactions. However, this research adopted a conventional frame of feedback to the analysis of transactional feedback, and this results a number of difficulties in revealing its characteristics in details. A qualitative tools for the analysis of transactional feedback needs to be developed in the following study.

CORBA 디자인 패턴에 관한 연구

김정현,박세명,최항묵 인제대학교 2001 仁濟論叢 Vol.16 No.1

소프트웨어의 객체지향 패러다임이 줄 수 있는 가장 큰 이점은 다형성(polymorphism)을 통한 재사용성(reusability)이다. 이러한 재사용성은 구현측면에서 코드의 재사용, 그래픽 사용자 인터페이스의 재사용, 분산 시스템에서의 인터페이스의 재사용에서는 잘 이루어지고 있으나, 설계단계에서의 재사용성은 아직 부족한 실정이다. 본 연구에서는 이러한 객체지향 설계단계에서 재사용할 수 있는 디자인 패턴(Design Pattern)으로서 분산 객체 환경인 CORBA 시스템 설계 시 적용할 수 있는 새로운 CORBA 디자인패턴을 제안한다. Designing object-oriented software is hard, and designing reusable object-oriented software is even harder. Design should be specific to the problem at hand but also general enough to address future problem and requirement. Expert Designers reuse solutions that have worked for them in the past. This solution is Design Pattern. The propose of this paper is to record experience in designing distributed-object CORBA software as CORBA design pattern.

산업장 근로자를 대상으로 실시한 한방 건강검진의 만족도

한현정,정재열,권소희,손용선,장두섭,이기남 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.2

The examinees who received oriental and western health examination both and submitted questionnaire were 257 workers in workplace for 1 month during health examination for industrial workers. The research was to compare the satisfaction of oriental and western health examination by the questionnaire. The data that were collected by health examination were analyzed into frequencies, ANOVA, T-test with use of SPSS 10.0 program by the research purposes. The results were as follows: 1. Health examination in satisfaction comparison by the general characteristics of subject was significant in oriental health examination for the subjects who had 9-10 working hours(P〈0.05). 2. The workers who had high confidence in result of health examination, affirmative thinking for requirement of health examination, arbitrary decision for receiving the health examination, had high satisfaction in oriental and western health examination both, It was statistically significant difference. 3. For the difference in subjective health condition's recognition, the subject who answered " Healthy" had high satisfaction in western health examination, and it was statistically in western health examination, and it was statistically significant The subject who answered "Healthy" for the early detection of disease had high satisfaction in western health examination, The subject who answered skeptical for the early detection of disease had high satisfaction. in oriental health examination and it was statistically significant. 4. The respondent who said "Yes" for the question, whether you know about oriental health examination or not before receiving oriental health examinatgion had relatively high satisfaction For the question about including of oriental health examination continuously in the coming future, the subject who replied affirmative answer had high satisfaction in average, and it was significant difference(P〈0.05). 5. For the question that will be needed in the item of oriental health examination, the highest item was the requirement of specific oriental health examination for various diseases, followed by the requirement of medical specialist for individual need of medical examination by the item, and the prescription of herbal medicine, the medical examination of cancer, the interview for folk remedies, the parallel treatment for acupuncture cupping, etc, the medical examination for adult disease, the requirement of room for medical examination etc.

韓醫學的 診斷類型에 따른 韓藥方劑의 抗癌 및 免疫調節作用에 미치는 影響

朴鐘鉉,金楨氾,崔昇勳,安圭錫 대한동의병리학회 1994 동의생리병리학회지 Vol.9 No.1

연구배경 : 암은 사망의 주요한 원인이 되는 질환으로서, 우리나라에 있어서도 급격히 증가하는 추세이다. 한의학에서는 암의 유형을 크게 간울기체형, 기체혈어형, 비허습담형, 음허내열형 등으로 분류하고 있는데, 각 유형에 응용할 수 있는 소요산, 소복축어탕, 사군자탕, 육미지황탕의 항암효능을 비교 연구함으로써, 암치료에 대한 한약재의 임상활용도를 높이고자 함. 방법 : Mouse에 Sarcoma-180으로 복강암을 유발한 후, 약제를 21일 간 투여하고 생존율, T cell, B cell, 혈청항체가, IL-2 생산능, NK cell의 세포살상능을 측정하였다. 결과 : 생존기간의 연장효과는 모든군에서 증가하는 경향이 있었으나 유의성이 없었고, T cell 및 B cell은 모든군에서 증가하였으며, 임파구 증식반응 및 IL-2 생산능은 사군자탕과 육미지황탕에서, NK cell 활성도는 소복축어탕 엑기스 투여군에서 유의성이 있었다. 결론 : 이상으로 보아 이들 처방은 면역조절작용을 통한 항암효과가 있을 것으로 볼 수 있으며, 변증분형에 따라 처방을 달리해야 함을 알 수 있다. In order to investigate the effects of Formules according to Pattern Identification on anti-tumor and immunodulatory reaction to the ICR and C57BL/6 mice which have abdominal tumor after Sarcoma-180 cells were transplanted, the extracts of herbal medicines above mentioned were orally administered to the mice for 21 days to observe the extention of survial duration of the mice, quantitation of T cells and B cells, productivity of interleukin-2, lymphocytes transformation, hemagglutinin titer and hemolysin titer and activity of splenic natural killer cells. The results are summarized as follows ; 1. In the effect of life extention, all groups appeared to survive longer than the Control group, which are not meaningful. 2. Considering T cell and B cell content, all groups had a meaningful increase in both T cell and B cell (P<0.01). 3. Considering serum antibody titer was no significant difference between all groups. 4. In lymphocyte transformation marked a significant increase the sijunzitang-medicated mice group, marked a significant (P<0.01), and showed a significant increase the mice group medicated with Liuweidihuangtang (P<0.05). 5. As for the productivity of interleukin-2, showed a significant increase the mice group medicated with Sijunzitang ans Liuweidihuangtang (P<0.05). 6. In the effect of activity of NK cells, Shaofuzhuyutang-medicated mice group had a meaningful increase (P<0.05).

CORBA 기반 의료영상 회의 시스템 설계

김정현,서재현,최항묵 인제대학교 1997 仁濟論叢 Vol.13 No.1

본 연구에서는 CORBA를 기반으로 하여 JAVA언어로 개발된 의료 영상 회의 시스템(MICS :Medical Image Conference System)을 설계 제안한다. MICS는 정지영상, 텍스트 데이터 그리고 음성정보를 ORB를 통해서 전달하는 시스템이다. 플랫폼에 독립적이면서 미들웨어(Middle ware)인 CORBA를 이용한 MICS는 시스템을 개발, 확장성 및 유지 보수가 쉽다는 장점과 비용 절감 효과를 가진다. CORBA의 이러한 장점과 JAVA 언어의 특성을 이용하여 원거리 병원간의 MRI영상이나 X-ray영상, CT영상 등 정지 영상에 관한 회의 시스템을 설계하였다. In recent years, many researchers have worked on CORBA which is independent of platform, object oriented and makes real-time processing possible in distributed objdct environment. And, as the superhigh speed network systems are generalized, the studies on image conference, cyber university, virtual classroom and group co-working are actively pursued. In this paper, Medical Image Conference System based on CORBA in JAVA language is suggested. MICS is a system that can transmits static image, text data and voice information through the ORB. MICS can provides good facilities of development, extensibility and maintenance with reduced cost by using CORBA which is independent of platform and a middleware. For the demonstration, we will show the conference system which can transmit especially the static images such as MRI, X-ray, CT images between remote hospitals, considering those advantages of CORBA and the features of JAVA.