방사선 조사를 받은 두경부 병소의 재건을 위한 유리피판술

채수욱,고경석,김주봉,박상훈,한상훈,이택종,남순열,김상윤 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

Radiation therapy is an effective cancer treatment modality as a primary treatment in early cancer and as an adjuvant treatment in advanced cancer, especially in head and neck lesions, but it also causes irreversible chronic damages to overlying normal tissues that may lead to wound complications. As well, at the microscopic level, radiation injury causes both stasis and occlusion of small vessels. Therefore, surgical reconstruction of previously-irradiated lesions in the head and neck poses a great problem. Fifth-six patients with head and neck lesions underwent 57 microsurgical reconstructions between 1990-1998. Thirteen patients were irradiated before surgery. The previous radiation dose was 30∼75.6 Gy. The free tissue transfer was successful in 52 of the 57 microsurgical reconstructions(91.2%). The success rate was 92.3%(12/13) in previously-irradiated patients and 90.9%(40/44) in nonirradiated patients. Postoperative complications, such as flap loss, fistula, and infection, developed in 4 irradiated patients and 8 nonirradiated patients. Overall complication rate was 30.8%(4/13) in previously-irradiated patients and 18.2%(8/44) in nonirradiated patients. Although the failure rate of previously-irradiated patients was higher than that of nonirradiated patients, there was no statistically significant difference between them. Thus, free tissue transfers in patients with previously-irradiated head and neck lesions are suitable for one-stage reconstruction.

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.

9-12%Cr강의 첨가원소 및 열처리에 따른 미세조직거동과 경도변화

주성욱,유정훈,신기삼,허성강,이재현,석진익,김병훈,김정태 국립7개대학공동논문집간행위원회 2004 공업기술연구 Vol.4 No.-

9-12%Cr steel are getting increasing attention for expanded application as high temperature materials applicable for gas turbine compressors, steam turbine rotors, blade and casing. For efficient and extensive application of 9-12%Cr steel, the data in addition to the improvement of mechanical properties on the correlation of microstructural evolution and mechanical properties are inevitable and thus the investigation in this study is performed for the determination for the specimens heat-treated at 600, 650 and 700℃ for 1000, 3000 and 5000hrs. The microstructure of as-received specimen was tempered martensite, with a high dislocation density and secondary phases. Upon high temperature heat-treatment, the martensite lath got larger and dislocation density decreased resulting the reduction of the strength. In addition, sharp growth of secondary phases was observed in the specimen heat-treated at 700℃ for 5000hrs. A specimen aged at 600℃ and 650℃ Laves phase was observed. The hardness showed close relationship with the secondary phase particle and dislocation density.

Chlorpromazine이 백서 해마에서 전기경련 충격에 의한 MAPK 타이로신 인산화에 미치는 영향

주연호,정성훈,전송희,강웅구,김용식,김상욱,박주배 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.2

Object : In order to examine the interaction mechanisms of electroconvulsive shock(ECS) and antipsychotic drug at the level of molecular biology, we observed the effect of chlorpromazine pre-treatment on the activation of mitogen activated protein kinase(MAPK) induced by electroconvulsive shock(ECS) in rat hippocampus Method : Male Sprague-Dawley rats were divided into 2 groups. To the experimental group chlorpromazine(20㎎/㎏) was given intraperitoneally, and to the control distilled water was given instead. Thirty minutes later, ECS was given and the hippocampus was dissected out 2 minutes thereafter. Immunoblotting with antiphosphotyrosine antibody was carried out, and the signal intensity at 42kDa band was quantitized using densitometer. The obtained result was compared by student t-test between the experimental and the control group. The absolute amount of MAPK was measured by immunoblotting with anti-MAPK antibody. Result : The tyrosine phosphorylation of MAPK reached peak at 2 minutes after ECS. However, in the chlorpromazine pre-treated group, the peak level of MAPK tyrosine phosphorylation was significantly attenuated(t=-3.12, df=14, p=0.008) compared to the control. In contrast to this, the absolute amount of MAPK did not differ between the pretreated and the control group. Conclusion : Chlorpromazine attenuated the tyrosine phosphorylation of MAPK by ECS. This finding seems to be related to the fact that chlorpromazine pre-treatment changed the cfos expression by ECS in rat brain. Antipsychotic drug and ECS might interact at the level of MAPK signal transduction system, and this might explained the observed synergistic effect of two treatment modality.

허혈성 심질환에서 나타나는 황상화지수, 사이토카인 및 염증지표의 변화

전상훈,안지훈,방덕원,온영근,현민수,김성구,권영주 순천향대학교 의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

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Modified 9Cr-1Mo 강의 항온변태처리에 따른 미세조직 및 경도변화

유정훈,주성욱,허성강,신기삼,이수,정연길 국립7개대학공동논문집간행위원회 2003 공업기술연구 Vol.3 No.-

Evolution of microstructure and its relation with hardness in the modified 9%Cr-1%Mo steel which was isothermally heat-treated has been investigated in various heat-treatment temperatures and time of duration. For microstructural and crystallographic analyses, optical microscope, scanning and transmission electron microscopes, energy dispersive spectrometer, and X-ray diffractometer were used. Vickers microhardness tester were used for the measurement of hardness. Precipitates of the complex M23C6, M(C,N) formed at grain boundaries and interiors of grains had led to the secondary hardening. Normalized specimen and all of the isothermally heat-treated ones showed no evidence of retained austenite.

회귀예측신경망을 이용한 음절인식

김주성,김상범,김수훈,허강인 東亞大學校 附設 情報通信硏究所 1996 情報通信硏究所論文誌 Vol.4 No.1

In this paper, we perform the recognition test for Korean 100 monosyllabes using RPNN(recurrent prediction neural networks). The RPNN is trained to nonlinear predictor, accoding to time variation of speech pattern, is not use time sequential algorithm. In recognition experiment we got the recognition rate 69.0%, 72.30% and 71.20% using RTRL(real-time recurrent learning) training algorithm when the predition order is 2, 3 and 4.

信賴性 制約條件을 고려한 鋼材 트러스構造의 最適設計

邊根周,韓相勳,梁在成 연세대학교 산업기술연구소 1982 논문집 Vol.14 No.1

The reliability analysis of truss members is considered and a relationship between the reliability and the optimization is established. The applications of optimization techniques to the minimum weight design of the trusses are discussed. Finally a optimization algorithm of designing truss members for minimum weight to obtain a specified reliability index is presented. The reliability based optimum design of plane truss structures is conidered on some detail. The crosssectional dimensions of the structures are considered as random design variables. The constrained opti-mization problems are solved by using the SUMT (Modified Newton-Raphson Method) and the Rosenbrock's Hill technique. Numerical examples are presented to illustrate the computationl effectiveness of the two algorithms presented. It has been obesrved that the SUMT algorithm may be considered as a very efficient and accurate solution technique in the structural optimum design problem with the reliability constraints.

두경부 림프종에 대한 방사선과학적 접근: 충북대학교병원에서의 경험

차상훈,김주창,한기석,김성진,박길선,궁성수 충북대학교 의과대학 충북대학교 의학연구소 1999 忠北醫大學術誌 Vol.9 No.2

목적: 충북대학교병원에서 두경부의 림프종으로 진단된 증례들을 방사선학적으로 분석하여 임파절외 병변과 임파절 병변의 특징에 관하여 알아보고 이전의 문헌들과 비교하여 고찰하고자 하였다. 대상 및 방법: 병리학적으로 두경부의 림프종으로 진단된 31명을 대상으로 후향적 분석을 하였다. 조직검사로 확인된 병변 외에 다발성 병변에서는 조직 검사로 확인되지 않았더라도 치료 전 CT나 MRI 상 분명한 경우, 치료 후의 추적 CT 또는 MRI 상 명백한 호전이 있으면 병변으로 간주하였고 특히, 치료 전 림프절의 크기가 1-1.5cm보다 작아도 치료 전·후 분명한 차이를 나타내면 병변으로 간주하였다. 림프절외 병변의 부위, 림프절 병변의 위치와 크기, 전신 림프종 여부, 림프종의 병리학적 진단 등에 관해 분석하였다. 결과: 호지킨 림프종은 1명이고 림프절 병변만이 분명하였다. 나머지 30명은 비호지킨 림프종으로서 그중에는 혼합형 병변이 가장 많았으며(n=20) 림프절 외 병변만 있는 경우가 7명, 림프절 병변만 있는 경우가 3명이었다.림프절 외 병변은 Waldeyer's ring의 다발성 병변이 대부분이었는데 이중 인후부에 별도의 병변이 동반된 경우, lingual tonsil 만 침범된 경우가 각기 1례씩 있었다. 또한 Waldeyer's ring 병변이 mouth floor나 soft palate로 침범하기도 하였다. 비강 림프종이 진단된 7명 중에 최초 진단 시 또는 치료후 경과 추적 시 양측 비강이 침범된 각 1명씩이 있었고 3명에서는 비익과 주변조직으로의 침범이 있었으며 세포유형은 다양하였다.다형성 세망증으로 진단된 병변은 모두 4례로 비강에 2례, Waldeyer's ring 2례 등이었다.림프절 병변은 23명의 환자에서 모두 71개 림프절 군이 진단되었는데 20명은 2개 이상의 림프절군이 양성인 다발성 병변을 가졌고 이 중 36개 림프절 군에서 1cm이하의 림프절 병변이 진단되었다. 림프절과 림프절 외 병변이 동반된 혼합성 림프종(n=20)의 경우 림프절 외 병변과 동측에 림프절 병변이 있는 환자가 7명이고 양측의 림프절 병변은 13명이었으며 반대측에만 림프절 병변이 확인된 것은 없었다. 결론: 본 연구를 통하여 충북대병원에 내원하였던 두경부 림프종 증례들의 방사선학적 특성을 알 수 있었으며 림프절 외 병변과 림프절 병변이 동반된 경우가 많았는데 이는 치료 전후의 비교를 하여 기존의 연구들과 다른 기준을 설정하였기 때문인데 이에 관하여는 추후 별도의 연구가 필요하다고 여겨진다. Purpose: 31 cases were retrospectively assessed to analyse radiological features of nodal and extranodal lesions which were diagnosed at Chungbuk National University Hospital(CNUH) and literature review was focused to the previous Korean reports. Materials and Methods: Other than biopsy-proven lesions, nodal and extranodal lesions showing definite size reduction in the post-treatment CT and MRI were also analysed. Cervical lymph nodes smaller than 1-1.5cm in initial size were included when the treatment caused significant improvement. Case analysis was focused to size and location of the nodal and extranodal lesions, pathological types, presence of the systemic involvement. Results: Only one patient was HD with nodal disease. NHL patients(n=30) had both nodal and extranodal(combined) disease(n=20), extranodal disease only(n=7) and nodal only(n=3). Waldeyer's ring was the most common extranodal location. Among the seven nasal cavity NHLs', both sides were occupied by the tumor initially(n=1) or during the follow-up(n=1) and 3 cases showed the invasion to ala nasi and cheek, and cell types were various. 2 cases of PMR(n=4) involved nasal cavity and other 2 had diseased Waldeyer's ring. 23 patients revealed nodal disease in total of 71 cervical spaces, most of them(20/23) had more than 2 diseased L/N groups. Among 71 L/N groups, 36 showed node size smaller than 1cm initially. NHL patients with combined nodal and extranodal pathology(n=20) had nodal lesions ipsilateral to extranodal disease in 7, bilateral in 13. Conclusion: Combined nodal and extranodal disease was more prevalent in our study than in the previous literatures because the inclusion criteria for the nodal lesion was wider. We could note several differences that should be pursued in further studies.

CFG를 이용한 제어문 음성 인식에 관한 연구

김상범,김주성,김수훈,허강인 東亞大學校 附設 情報通信硏究所 1996 情報通信硏究所論文誌 Vol.4 No.1

In this study, we perform continuous speech recognition system using context free grammar. We use DDCHMM as train model, that is able to express time-transient-variation very well. Using one pass DP method as recognition algorithm which is attempted by expanding dynamically a finite automaton from a part of suggesting context-free-grammar of recognition process. We can increase the recognition rates of control sentence speech recognition. Car control command, robot control command, and newspapers editorial continuous speech are made to test recognition rates of control sentence speech using context-free-grammer.