간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

대학생의 대학교육비 지출과 재원조달에 관한 연구

姜庚錫 仁荷大學校 學生生活硏究所 1997 學生生活硏究 Vol.17 No.-

팔체질침을 이용한 반월판 관절경부분절제술 환자의 치험례

강영화,김성욱,손인석,서정철,윤현민,장경전 동의대학교 한의학연구소 2001 동의한의연구 Vol.5 No.-

슬관절은 지속적인 압력을 받거나 충격때문에 동작범위의 한계에 이를 때 손상받기 쉽다. 반월판 파열 환자는 일상생활에 지장을 주는 동통, 정복되지 않는 잠김, locking이나 giving way가 자주 일어나는 경우, 지속적인 신전제한이 있을 때 수술의 적응증이 된다. 반월판 파열 환자의 재활에 있어서 관건은 대퇴사두근의 근력과 ROM의 회복이다. 팔체질침 시술후 반월판 부분절제술을 시행한 환자가 동통의 강도와 동통 재발의 감소, ROM의 개선, 전반적 상태면에서 체침이나 MPS 시술 때보다 더 나은 경과를 얻었다. Knee joints are apt to be injured when they are over the limit of ROM by continuous pressure or impact. The patient of meniscus tear has to be operated in case that he has the symptom of knee pain obstructive to daily life, unreducable locking, frequent locking or giving way, continuous extention limit. In the rehabilitation of the patient of meniscus tear, the key is the progress of musculi quadratus femori's power and ROM. After 8 constitutional acupucture therapies, partial menisectomy patient has the better process about decrease of pain intensity and relapsing pain frequence, development of ROM, general condition more than general acupucture or MPS medical treatment.

共同住宅團地 外部空間의 活性化와 團地內 犯罪被害經驗率의 關係에 대한 硏究

강석진,이경훈 대한건축학회 2004 대한건축학회논문집 Vol.20 No.2

The purpose of this study is to investigate about the effect of outdoor space activation on the experienced crime victimization rate through comparison between the activated and non-activated outdoor space in Multi-Family Housings. In order to fulfill this objectives, this study was processed as follows : first, the analyses the results of questionnaire survey through the simple comparative statistical analyses among the variables such as the socio-demographic factors, the psycho-behavioral factors, the utilization rate and satisfaction of outdoor space and experienced crime victimization rate last 5-years in the present dwellings. ; second, analyses of the correlations among all of the variables included the physical site planning factors. ; third, comparing analyses the difference of the variables between the Multi-Family Housings along to the utilization rate in outdoor space. The result revealed that the activation of outdoor space through the physical site planning factors such as the number of households, building coverage, available green space rate and psycho-behavioral factors such as neighborhood relations, the cognitive life environmental fields, and positive territorial attitude would effect on the decrease of experienced crime victimization rate in the Multi-Family Housing.

호산구성 간농양 54예의 임상상

강혜련,권혁수,송우정,이상민,김태범,박혜경,장윤석,김윤근,조상헌,민경업,김유영 대한알레르기학회 2004 천식 및 알레르기 Vol.24 No.2

랜덤하중스펙트럼하에서 AL 2024-T3 합금판재의 균열진전에 관한 연구

강기경,황영진,이석순 경상대학교 생산기술연구소 2000 生産技術硏究所論文集 Vol.16 No.-

Damage Tolerance Design Concept lessens defects and damages when a aircraft is manufactured and operated. And it make back up plane before the critical crack size using quantitative analysis of the residual defect size, fatigue crack propagation. So residual strength of a structure in damage tolerance range should be proved using analysis and test for endurance of design maximum load. A aircraft are exposed to the various load conditions such as thrust, gravity, lift and so on at the same time. The complicated load condition is the random load rather than the constant amplitude load. In this study, the experimental resu1ts and the theoretical values of residual strength and crack growth rate using the fatigue test for aluminum alloy plates usually being used for the aircraft skin under random load have been compared and considered.

찰성 및 메성 大麥의 品質에 關한 硏究

金碩鉉,韓鏡秀,姜晋鎬 慶尙大學校 1985 論文集 Vol.24 No.2

國內外에서 蒐集한 찰보리의 栽培 可能性을 檢討하고 몇가지 品質特性을 메성보리와 比較하기 위하여 慶尙大學校 田作圃場에서 메보리 8品種, 찰보리 7品種과 맥주보리 4品種을 試驗栽培하여 分析한 結果를 要約하면 다음과 같다. 1. 收量은 찰보리가 메보리 보다 낮고 導入찰보리인 Wanubet와 Wafranubet가 各各 73%, 77%로서 標準品種안 창녕 보다 낮다. 2. Amylose 含量은 맥주보리, 피과맥 메성, 찰보리의 順이며 導入철보리와 國內에서 育成한 찰보리 간의 差異는 없다. 3. 炊飯吸水率과 밥白度는 찰성이 메성보다 높다. 4. Amylogram 의 粘性에서 糊化溫度와 最高粘度時溫度는 찰성이 메성보다 낮고 最高粘度는 활성이 메성 보다 높다. 導入찰성과 國內에서 育成한 찰성보리간에는 差異를 認定 할 수 없다. Changes in the grain quality were examined in 8 non-waxy, 7 waxy and 4 malting barley cultivars(Hordeum,vulgare L.) collected from Korea and the U.S.A. Yield was higher in non-waxy barley. Wanubet and Wafranubet collected from the U.S.A. were 73 and 77%, respectively, of Changyeong in the yield. Malting and non-waxy barley contained more amylose than waxy types. No significant difference was observed in amylose content between Korea and U. S. A. cultivars. Waxy barley showed a higher water absorption ratio and cooking whiteness than non-waxy barley. Gelatinization temperature and the temperature at which maximum viscosity was lower in waxy than non-waxy barley. The reverse was true ill maximum viscosity. There was no significant difference in the viscosity of amylogram between Korea and U. S. A. cultivars.

혈관외피종 -1증례 보고-

강유미,지미경,양기화,강석진,김병기,김선무,정수일 대한병리학회 1990 Journal of Pathology and Translational Medicine Vol.24 No.2

응급실 내원 환자의 만족도 평가 및 관련 요인에 대한 연구

서강석,감신,박정배,이정헌,김종근,윤영국,곽경숙,이원기,우석정 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: To examine the influencing factors on patients' satisfaction in the emergency department(ED) for quality assurance. Methods: Patients who visited to the ED were prospectively investigated from November 1 to December 31, 1997. Authors developed questionnaire to investigate influencing factors on patients' satisfaction. A Chi-square test and LISREL 7.0 were applied for statistical analysis. Results: Patients' satisfaction was significantly related to physical environment variables, accessibility variables, kindness of hospital personnel variables, and patient's trust for doctors variables. In path analysis, willingness for revisit was influenced by patients' satisfation, accessibility, physical environment, patients' trust for doctors in order, and willingness for recommendation was influenced by accessibility, patients' satisfaction, and kindness of hospital personnel in order. Conclusions: The influencing factors on patients' satisfaction are physical environment, accessibility, kindness of hospital personnel, and patient's trust for doctors. Willingness for revisit and willingness for recommendation are influenced by patients' satisfation. In spite of some limitations, the results of this study can be used as a baseline information for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the study of patients' satisfactoin in the ED.