결장직장암 환자의 임상적 고찰 : 조선대학교 부속병원의 10년 간의 결과

나은종,문성표,장정환,김권천,민영돈,김성환,조현진,김정용,김경종 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: The colorectal cancer rates 4th in the total cancer prevalence in Korea. The clinical patient demographics were considered with the incidence rate of the colon and rectal cancer. The clinicopathological factors were analyzed for the 5 year survival rate. Materials Methods: Of the 282 patients who were operated from Jan. 1, 1992 to Dec. 31, 2001 and diagnosed by pathological biopsy as colo-rectal cancer, 234 patients were followed up. The age, sex, location of the cancer, TNM stage, operation method, histopathological classification, metastatic region, complications after operation and the survival rate were investigated. Results: Of the 234 patients, male and female consisted of 120 cases (51.3%) and 114 cases (46.7%), with an average age of 61.6 years. The average follow up period was 52.3 months and the peri operative mortality was 5.6%. The site of the cancer was most frequent at the rectum with 127 cases (54.3%). The patients were classified according to the TNM stages with 38 cases of stage 1 (16.2%), 98 cases of II (41.9%), 72 cases of III (30.8%) and 26 cases of IV (11.1%). The 5 year survival rate in the age group older than 50 was 63.3 % and 73.5% in the group younger than 50. In regard to the operation type, the 5 year survival rate was 65.4% for elective operation and 65.8% for emergency operation. The 5 year survival rate for well differentiated, moderately differentiated, poorly differentiated cancer, and mucinous adenocarcinoma was 73.7%, 60.2%, 58.3%, and 92.6%, respectively. The 5 year survival rate of each of the TNM stage is 81.1%, 74.8%, 57.0%, and 11.5% for Classes I, II, III, and IV, respectively. Conclusion: The clinical factors were analyzed for the 5 year survival rate with no statistical significance for the age, sex, and location of the cancer. The TNM stage and histopathological differentiation were statistically significant. The colon cancer showed better prognosis compared to the rectal cancer.

위장질환에 따른 H.pylori 감염빈도와 검사방법의 비교분석

김대현,조재현,금민수,최성곤,이창형,탁원형,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : H. pylori가 위장관 질환의 병인에 깊은 관련이 있어 이의 적절한 진단 및 치료가 중요하게 대두되고 있다. 이에 저자들은 소화기 증상을 주소로 내원한 환자들을 대상으로 내시경 검사를 실시하여 H. pylori검출을 위한 CLO검사, IgG 항체검사 및 H&E 염색 등을 시행하여 각 질환별로 H. pylori 감염의 양성율을 알아보고 검사법에 따른 민감도 및 특이도를 그 유용성에 대하여 조사하였다. 대상 및 방법 : 1996 4월에서 8월까지 경북대학교병원에 소화기증상을 주소로 내원한 총 313명의 환자를 대상으로 내시경 검사를 실시하여 H. pylori 검출을 위한 CLO 검사, IgG 항체검사, 조직염색 검사를 실시하였다. 결과 : 전체 대상 환자수는 313명이었고 연령별 분포는 16세부터 80세 까지 다양하였으며 그중40대, 50대, 60대가 각각 69예(22%), 73예(23.3%), 65예(20.8%)로 전체 환자중 66%를 차지하였다. 남녀비는 2.07 대 1로 남자가 많았다. 대상환자의 평균나이는 52±15세였고, 전체 대상환자에서 H. pylori 양성군과 음성군의 평균나이는 각각 50±15세, 54±15세 였고, 궤양환자군에서 H. pylori 양성군과 음성군사이의 평균나이는 각각 49±14.8세, 55±13.8세로 나타났다. 각 질환별분포는 위염이 72명(23%), 십이지장 궤양이 85명(27.2%), 위궤양이 80명(25.6%), 위암이 20명(6.4%), 비궤양성 소화불량이 13명(4.2%), 기타가 43명(13.7%)이었으며, H. pylori 감염 양성율은 위염이 71%, 십이지장 궤양이 86.8%, 위궤양이 58.3%, 위암이 75%, 비궤양성 소화불량이 75%였으며 특히 유문륜 궤양에서는 100%의 양성율을 보였다. 소화성 궤양군과 비궤양군에서의 H. pylori 양성율을 비교해 본 결과 궤양군에서는 73.1%, 비궤양군에서는 72%로 통계학적으로 차이는 없었다(P=0.91). 소화성 궤양환자에서 출혈이 동반된 군과 동반되지 않은 군에서의 H. pylori 양성율을 비교해 본 결과 출혈이 동반된 군에서의 양성율은 54.5%였고, 출혈이 동반되지 않은 군에서는 77.5%의 양성율을 보여 출혈이동반되지 않은 군에서 통계학적으로 유의하게 높았다(P=0.014). 나이에 따른 양성율을 알아본 결과 50세 이하에서는 78.5%였고, 50세 이상에서는 67.5%로서 양성율이 낮았으나 통계학적으로 유의성은 없었다(P=0.052). 각 검사법에 따른 민감도 및 특이도는 전체 환자중에서는 CLO검사가 88.9%, 96.1%, IgG항체검사 90.8%, 58.5%, H&E 염색검사 86.9%, 79.2%로서 민감도는 비슷하게 나왔으나 CLO검사는 상대적으로 특이도가 다른 검사법에 비해 높았다. 궤양군에서의 CLO검사의 민감도와 특이도는 92.0%, 95.6%였고, 비궤양군에서의 민감도와 특이도는 84.3%, 96.8%로서 비궤양군에서는 CLO검사의 민감도는 약간 낮았다. 나이에 따른 CLO 검사의 민감도 및 특이도는 50세 이하에서는 91.5%, 93.1% 였고, 50세 이상에서는 86.3%, 97.9%로서 50세 이상에서는 상대적으로 CLO검사의 민감도가 낮았다. 결론 : 본 연구에서는 위장질환에 따른 H. pylori 양성율을 알아보았는데, 다른 보고에서 처럼 높게 나왔으며, 진단 방법으로 사용한 CLO검사, IgG항체 검사, 조직염색검사 등은 모두 비교적 높은 예민도를 나타냈고, 그중 CLO검사가 간편하고 경제적이라는 면에서 임상적으로 유용한 검사로 여겨지나 상대적으로 CLO검사의 민감도가 낮은 비궤양성 질환과 50세 이상의 환자군에서는 CLO검사 외에 다른 검사방법을 병행함으로써 H. pylori의 진단율을 높일 수 있을 것으로 사료된다. Background: Gastric colonization by Helicobacter. pylori is common among patients with peptic ulcer and gastritis. And various diagnostic tests are available in confirming H. pylori infection. The aim of this paper is to estimate the prevalence of H. pylori infection in Gastroduodenal disorders and compare the sensitivity and specificity of the most widely available tests. Methods: A total of 313 patients were tested for H. pylori infection by IgG Ab, CLO test and H&E stains. Results: The prevalence of H. pylori infection was significantly higher in duodenal ulcer(86.8%) than in gastric cancer(75%), gastritis(71%) and gastric ulcer(58.3%)(P=0.009). The sensitivity and specificity of each test was as follows: CLO test(88.9%, 96.1%), IgG Ab test(90.8%, 58.5%), H&E stain(86.9%, 79.2%). Sensitivity of CLO test in peptic group was 92.0%, whereas in non-peptic group, it was 86.3%. Sensitivity of CLO test in age under 50 was 91.5%, that over 50 it was 86.3%. Conculsions: There is a strong association between H. pylori and gastrointestinal disorders. CLO tests have relatively high sensitivity and specificity, especially in peptic group and younger age(below 50 yr)group. But in those patients in which CLO tests are less sensitive (age>50 or non-peptic group), more than one test may be necessary to diagnose the presence of the organism.

고속무선LAN설비를 위한 저소비전력형 OFDM LSI구현에 관한 연구

김성권 木浦海洋大學校 2005 論文集 Vol.13 No.-

OFDM(Orthogonal Frequency Division Multiplexing)변조방식은 데이터를 다수의 반송파를 이용해서 주파수상에서 분산해서 전송하는 디지털변조방식의 일종으로, 멀티패스 간섭에 강한 이점 등으로 인해 디지털음성방송이나 지상파 디지털TV방송 등에 적용되고 있으며, 1997년부터는 5GHz대역의 구내용 초고속무선LAN설비로서 IEEE 802.11 TG(Task gruoup)a에서의 규격작업이 이뤄짐에 따라, 관련된 연구들이 활발하게 진행되어지고 있다. OFDM방식의 초고속무선LAN설비를 구현하기 위한 송수신부의 핵심소자로서는 IFFT 및 FFT모듈이 있다. 본 논문은 IFFT 및 FFT 모듈을 행렬 원소의 라운딩기법을 기반으로한 전류모드회로를 이용해서 설계 및 구현함으로써 저소비전력화와 고속처리동작이 가능하도록 하였다. 또한 제안한 IFFT 및 FFT모듈을 IEEE 802.11a규격에 근거한 송수신부 모뎀에 적용한 경우에 대한 BER특성을 모의실험을 통해 확인함으로써, 제안한 IFFT 및 FFT모듈을 이용한 송수신 시스템 설비가 AWGN채널 환경에서 유용하게 동작함을 입증하였다. OFDM(Orthogonal Frequency Division Multiplexing)is a one of most promising digital modulation techniques adapted for Digital audio broadcasting or Digital TV since it is very robust against multipath fading channels. From 1997, since the OFDM technique was considered as the physical layer standard for the high data rate wireless LAN systems in the 5GHz band, related studies have been studied actively. The key elements to implement high data rate wireless LAN system using OFDM technique are IFFT and FFT modules. In this paper, new IFFT and FFT module are designed and implemented using current cut circuit based on the matrix-rounding process for the low-power consumptive operation and high-speed data processing. In addition to, we certify the available operation of the rounded IFFT/FFT module in the AWGN channel by using the BER performance simulation of IEEE 802.11TGa based OFDM modem with rounded IFFT/FFT module.

복강경 불임시술 후 발생한 자궁외 임신에 관한 임상적 고찰

권선호,김성민,노흥태 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1

This study is a clinico-statistical analysis of 19 cases of ectopic pregnancy which developed after laparoscopic tubal sterilization during the period from January 1983 to December 1985 in Chungnam National University Hospital. The results were as follows : 1. Among the 140 cases of ectopic pregnancy during the period, 19 cases(13.6%) were disclosed to occur after laparoscopic tubal sterilization. 2. The most frequent age group was in 26 to 30 years and the mean age was 31.2 years. 3. The average gravidity and number of living children were 4.1 and 2.6, respectively. 4. All patients were easily diagnosed preoperatively by culdocentesis, pregnancy test, diagnostic laparoscopy and sonography. 5. About 74% of the total patients presented themselves within 3 years after tubal sterilization, with shortest interval being 4 months, the longest 12 years, and mean 2 year 5 months. 6. The methods of sterilization was mostly electrocauterization (73.9%) and the rest was silastic band application (26.3%). 7. The average duration from last menstrual period of patients to the diagnosis of ectopic pregnancy was 6.2 weeks. 8. The majority of the patients presented with lower abdominal pain, nausea & vomiting, and bearing down sensation. 9. The most implantation site of ectopic pregnancy was fallopian tube(94.8%). 63.2% of the ectopic gestation was located in the distal of fimbrial segment and 31.6% in the proximal segment. 10. The average amount of intraperitoneal blood loss was 1190ml. 11. 89.6% of total cases was treated by unilateral salpingectomy or unilateral salpingooophorectomy.

韓國 初等義務 敎育機關의 特殊學級 敎育課程構成에 關한 硏究

金聖權 대구교육대학교 1981 論文集 Vol.17 No.-

This research was made by the questionaire method. I made an attempt not only to investigate and analyze 30 items covering four parts and then to grasp the instituted problems concerning the appropriateness or fitness of the current primary course curriculum system for the mentally-retarded children which was being applied to the special classes, but also to grope for the means of amendment and complement of the current special school (class) curriculum. The objects of this research are 237 teachers who have responded to the questionaires out of 397 ones in charge of the special classes. On the basis of the conclusion got by analyzing the result of this research, I want to suggest the following: 1. Although the curriculum for the special school is being applied, we have to establish another special class curriculum. We must also reorganize and reconstitute it into two parts-the curriculum for the mentally-retarded children and the curriculum for the slow-learners. 2. We must compile two kinds of textbooks for the special classes: One is for the mentally-retarded children and the other is for the slow-learners we should supply the children with the textbooks free of charge. 3. The guide books for the teachers have to be divided into some kinds, that is to say, the lower grade, the medium grade, the higher grade, the mentally-retarded children, the slow-learners, and what not. We must try to diversify both the teaching materials and the teaching cases, and try to be abundant in them, in addition. It is also necessary for us to reorganize them so that their level of quality may be improved. 4. In organizing the curriculum the organization of the current school year, the basic structure, and the standard of time assignment should be controlled and reconstituted in such a similar type as the regular class. 5. Within the limits of the current curriculum, there is a necessity for reorganizing and reconstituting the aims of all the subjects as well as the contents of teaching in the medium of higher grade by controlling ihe level and standard of them downwards.

J.S. Bruner의 敎授理論에 關한 一考察

金聖權 대구교육대학교 1972 論文集 Vol.8 No.-

Studies were attempted to define the theory of instruction in 1960s. Some of the most remarkable, above all things, were N.L. Gage's theory of instruction, R.Glaser's model of instruction, J.B. Caroll's learning model in school, B.S. Bloom's strategy of instruction, and J.S. Bruner's theory of instruction, etc. Especially Bruner has greatly contributed to both the curriculum structuralization movement and the teaching improvement. In his theory of instruction, he explains his point of view and his approaching method on the basis of general principles or a series of propositions to form the theory of instruction, and he offers many suggestions in addition. J.S. Bruner insists that the theory of instruction must have four phases or characteristics. They are as follows: (1) A problem of predisposition to learning that can clearly indicate the concrete experience which plants the predisposition to learning most effectively in the individual learners. (2) A structuralization problem of knowledge to be able to suggest the concrete structuralizaing method so that the learners can acquire a group of knowledge most easily. (3) A problem of the learning sequence which can evidently suggest how the materials of learning should be given. (4) A problem of the learning reinforcement to be possible to indicate the applying method of reard and punishments as well as the applying character of them clearly in the process of learning and teaching. The theory of instruction is prescriptive in a sense because it gives the rules of the optimal method in which we can acquire knowledges or technical skills; and it is also normative in the other sense because it gives the standard to criticize and estimate the special instruction or the learning method. As a partof study for establishing the science of teaching, I am going to research four problems in detail on the J.S. Bruner's theory of instruction within the limit of restricted materials.

[논문]현실요법을 적용한 교육프로그램이 여중생의 학습된 무기력과 자기조절능력에 미치는 효과

허성돈,김정섭,권해수 교육혁신학술위원회 2010 교육혁신연구 Vol.20 No.2

The purpose of this study was to identify the effects of a growth program based on reality therapy on middle school girls' leaned helplessness and self-regulated learning. The subjects for study were 66 students of two classroom. A classroom students were assigned into the experimental group(33 students) and the other class was assigned into the control group(33 students). The students in the experimental group went through 10 sessions of a growth program based on reality therapy and second control group did program of a regular school curriculum. It was carried out 10 sessions in 9 weeks 45-55 minutes lasting 10 sessions. The result of this study follow. First, the experimental group which participated in a growth program based on reality therapy showed significant differences in learned helplessness from that of the control group. Second, the experimental group which participated in a growth program based on reality therapy showed significant differences in self-regulated learning ability from that of the control group. 본 연구는 현실요법을 적용한 성장프로그램이 여중생의 학습된 무기력과 자기조절학습능력에 미치는 영향을 확인하는 것을 그 목적으로 하였다. 2개 학급 66명의 학생을 대상으로 연구하였고 1개 학급 33명은 실험집단으로 다른 1개 학급 33명은 통제집단으로 임의 배정되었다. 실험집단은 10회기에 걸쳐 현실요법을 적용한 성장프로그램에 참여하였고, 통제집단은 정규 교육과정에 맞추어 수업을 받았다. 연구결과는 다음과 같다. 첫째, 현실요법을 적용한 성장프로그램에 참여한 실험집단이 통제집단 보다 학습된 무기력 수준이 감소하였다. 둘째, 현실요법을 적용한 성장프로그램에 참여한 실험집단이 통제집단보다 자기조절학습능력 수준이 증가하였다. 본 연구를 통해 현실요법이 학습무기력 수준이 높은 여중생의 내적 통제력과 자기조절능력을 향상시키는데 효과적임을 확인할 수 있었다. 끝으로 본 연구의 제한점과 향후 연구에 대한 제언을 덧붙였다.

敎育課程의 分析的 評價에 關한 一試案 : chiefly on the analysis test of the taching method 學習指導 分析檢査를 中心으로

金聖權 대구교육대학교 1966 論文集 Vol.2 No.-

This research is one of the writer's plans trying to evaluate the five parts of curriculums analytically. His original motive to begin this research lies in the plan to find the data and hints in the method and order on the analytic evaluation of the teaching method. But this research includes such many a defect, the limitation of the populous extent, the narrower institution of the standard of evaluation, the insufficiency of the preparatory test, the poverty in the reliability of the test itself, the unpreparedness of the basic data, and the unskilled study, etc., that he suggests this plan as a tentative one. Ⅰ. The principal aims of the research are (1) to suggest the standard on the analytic evaluation of the teaching method, (2) to suggest the order and method on the analytic evaluation of the teaching method. Ⅱ. The principal results of the research are as follows: (1) In the establishment of the standard on the analytic evaluation of the teaching method, he paid attention to the degree of the logical validity in the teaching method itself, and he established one hundred standards in all five items each part, covering twenty parts. (2) he got the following results on the order and method of the analytic evaluation the teaching method. a) Researching the reactive tendency from the view point of evaluation, A, C, F, G, P, and Q were better as a whole ; H, I, M, N, and T were worse than A, C, F, G, P, and Q. We need to correct and improve the twenty items from the A…5, B…10, C…13, and D…19 to the T…96, T…97, T…98, T…99, and T…100, etc. b) Researching the reactive tendency from the graduated schools, there were no special differences between the normal schools and the others each other: A, F, P, and Q had the good responses and M, N, and T had the bed responses. c) Researching the reactive tendency from the service years - a long term of service (more than ten years) and a short term of service (less than ten years), - A, F, P, and Q were good and H, I, M, N, and T were necessary to be improved and corrected. Without question of the graduated schools or the years of service short or long, in consequence, it is our common problem to identify what we have to improve in teaching method. So it is necessary that we should improve them immediately. Regardless of the schools we attended or the length of service in the field, it is the common problems for teachers to identify what we have to improve in the teaching method. This task needs to be tackled without delay.

갑상선에 전이된 유방암 1예

장기훈,김준성,조현진,김권천 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.1

The thyroid gland has been considered as an infrequent metastasis site. However, the incidence of thyroid involvement in reported autopsy series varies from 1.25% to 24%. In most autopsy series, breast and lung cancers have been the most frequent metastatic diseases to the thyroid gland, In contrast, renal cell carcinoma is the most frequent source of metastasis in clinical series. Many reports suggested that ultrasonography and subsequent ultrasonography-guided FNAB are mostly best suited for diagnosis of thyroid metastasis. Metastasis to the thyroid gland is associated with a poor prognosis and the prognosis depends essentially on the primary cancer. Surgery may prolong survival in a patient in whom the thyroid metastasis isolated, and thus early diagnosis and aggressive treatment should be performed in patients with the history of cancer.

위암의 근치절제술 후 생존율과 예후인자

차윤정,박진영,장정환,김성환,김권천,조현진,민영돈 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives: Gastric cancer is still the leading cause of cancer death in Korea, and surgery remains the only method of treatment that offers the potential for a cure. Purpose: The aims of this study are to examine the outcome of the patients with gastric adenocarcinoma who underwent curative resection and to identify the prognostic factors leading to improved survival rates in these patients. Materials and Methods: The medical records of 278 patients with gastric adenocarcinoma, treated curatively at the Chosun University Hospital between January 1990 and December 1994, were reviewed retrospectively from January 2000 to March 2000. Follow-up was obtained for 250 patients(89.9%). The survival rates were calculated by the Kaplan-Meier method, and the significance of differences between patient factors(age and sex), tumor factors(location, size, gross type, tumor depth, lymph node metastasis, and stage) and treatment factors(operation method and reconstruction type) were evaluated statistically by the log-rank test. Results: The overall five-year survival probability was 59.6%. There was no survival difference according to age and sex. The 5-year survival rates according to the tumor depth were 97.0% for Tl, 74.5% for T2, 39.6% for T3, and 23.1% for T4(p=0.0000); to the lymph node metastasis were 81,4% for N0, 51.9% for N1, and 21.2% for N2(p=0.0000); to the TNM stage were 96.7% for stage I a, 79.5% for stage I b, 68.8% for stage II, 52.9% for stage III a, 25.9% for stage III b, and 7.5% for stage IV(p=0.0000). Other statistically significant differences were shown in tumor location, size, gross type, operation method, and reconstruction type after subtotal gastrectomy. Conclusion: The most definitive prognostic factors affecting the survival rate of gastric adenocarcinoma were tumor depth, lymph node metastasis, and tumor stage. The keys to successful outcome includes early diagnosis and curative resection with radical lymph node dissection at early stage as possible.