연부조직육종의 수술후 방사선 치료결과

김연실(Yeon Shil Kim),장홍석(Hong Seok Jang),윤세철(Sei Chul Yoon),유미령(Mi Ryeong Ryu),강기문(Ki Moon Kang),정수미(Su Mi Chung),김훈교(Hoon Kyo Kim),강용구(Yong Koo Kang) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.4

목 적 : 최근들어 연부 조직 육종의 치료방법이 광범위 구획절제에서 사지기능을 보존하는 제한적 수술과 방사선/항암화학요법의 다병용치료로 변환되고 있으며 광범위 수술과 유사한 치료성적을 거두고 있다. 저자들은 수술후 방사선 치료를 시행한 연부 조직 육종 환자를 대상으로 치료 결과 및 실패 양상을 알아보고 관련된 예후 인자를 분석하여 수술 후 방사선치료의 역할을 알아보고자 하였다. 대상 및 방법 : 대상환자는 1983년부터 1994년까지 치료한 60명이었고 모두 추적관찰이 가능했으며 평균 추적기간은 50개월이었다. 원발병소는 상·하지가 35례(58%)로 가장 많았고 체간 12례(20%), 두경부 7례(12%)였으며 병리학적 유형에 따른 구분은 악성섬유구종 14례(23%),지방육종이 10례(17%), 악성신경섬유종 7례(12%) 등 이었다. 전체환자중 6례를 제외하고는 조직학적등급의 분석이 가능했고 grade I, II, III가 각각 27례(45%), 3례(5%), 24례(40%)였다. 수술적 절제는 19례(32%)에서 광범위절제, 36례(60%)에서 변연절제, 5례(8%)에서 국소절제를 시행하였다. 방사선치료선량은 28.8- 80Gy였고 25례에서 방사선치료와 함께 항암화학 요법을 병용하였다. 결 과 : 최종분석 시 실패 양상은 국소재발이 20례(25%), 원격전이 7례(12%), 국소재발과 원격전이를 동반한 경우가 14례(23%)였다. 원격전이한 환자는 구제치료와 상관 없이 모두 사망하였고 국소재발한 환자중 5명이 구제치료에 성공하여 무병생존하였다. 전체환자의 2년 및 5년 국소제어률은 68.0%와 48.7%로 비교적 저조한 결과를 보였다. 국소제어율에 영향을 미친 예후인자는 조직학적 유형, AJCC 병기, 조직학적 등급, 수술의 범위, 수술절연 침범 유무 및 잔존종양 정도, 림프절 전이 유무(p <0.05)였다. 전체 환자의 5년 생존률과 5년 무병생존률은 각각 60.4%, 36.6%였고 평균 생존기간은 89개월이었다. 단변량 분석에 의한 생존률에 영향을 미친 예후인자로는 조직학적 유형, AJCC 병기, 림프절 전이 유무, 조직학적 등급, 수술절연 침범 유무와 잔존 종양 정도 였다. 결 론 : 결론적으로 본 연구 결과 연부 조직 육종에서 제한적 수술과 수술 후 방사선치료로 비록 저조한 국소제어률을 보였으나 사지 절단 혹은 광범위 구획절제와 비교시 유사한 생존률을 얻었다. Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 60 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patints with median follow up duration 50 months (range 6 - 162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58%) was the most frequent site of occurrence followed by trunk (20%) and head and neck (12%). Histologically malignant fibrous histiocytoma (23%), liposarcoma (17%), malignant schwannoma (12%) constitute 52% of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42%) received chemotherapy with various regimen in the postoperative period. Results : Total 4 1 patients failed either with local recurrence or with distant metastasis. There were 29 patients(48%) of local recurrence. Four patients (7%) developed simultaneous local recurrence and distant metastasis and 8 patients (13%) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck prima ry. This feature is like ly explanation for the decreased loca l control rate . Five of 29 patients who fa iled only loca lly were salvaged by re- excis ion and/or re- irradiation and rema ined free of disease . Factors affecting loca l control include histologic type , grade, stage , extent of operation and surgica l ma rgin involvement, lymph node metastas is (p <0.05). All 21 patients who fa iled distantly are dead with progress ive disease at the time of this report. Our overall survival results are similar to those of larger series . Actuarial 5 year overall survival and disease fresurvival were 60.4 %, 36.6% respectively. Grade, stage (being close association with grade), residual disease (negative ma rgin, microscopic, gross) were significant as a predictor of survival in our series (p <0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

다수당사자중재에 있어서 중재인 선정방법

강수미 韓國仲裁學會 2008 중재연구 Vol.18 No.2

When several parties are involved in a dispute, it is usually considered desirable that the issues should be dealt with in the same proceedings, rather than in a series of separate proceedings. This saves time and money, It avoids the possibility of conflicting decisions on the same issues of law and fact, since all issues are determined by the same tribunal at the same time. Where there is a multi-party arbitration, it may be because there are several parties to one contract, or it may be because there are several contracts with different parties that have a bearing on the matters in dispute. In international trade and commerce, for individuals, corporations or state agencies to join together in a joint venture or consortium or in some other legal relationship of this kind, in order to enter into a contract with another party or parties, where such a contract contains an arbitration clause and a dispute arises, the members of the consortium or joint venture may decided that they would each like to appoint an arbitrator. A different problem arises where there are several contracts with different parties, each of which has a bearing on the issues in dispute. A major international construction project is likely to involve not only the employer and the main contractor, but also a host of special suppliers and sub-contractors. Each of them will be operating under different contracts often with different choice of law and arbitration clauses. The appointment of the arbitrator or the composition of the arbitral tribunal should be in accordance with the agreement of the parties. The parties have to be equally treated in the constituting of the arbitral tribunal and the arbitral proceedings. However, the right of the parties to nominate a member of the arbitral tribunal could be taken away from them, if they are subject to the restrictions by means of the law of the country where the arbitration is taking place. That is, multiple parties jointly should nominate one arbitrator, where there they have to exercise their substantive right in common, or one of them exert his substantive right, then it has an effect on another parties, or they, whether as claimant or as respondent, get the same or similar treatment in the arbitral procedure. Therefore it is necessary to intend to settle multi-party disputes quickly and efficiently.

일부 흡연 대학생의 지각된 스트레스와 흡연실태에 대한 상관관계 연구

강초록,권시내,권혜림,박수경,송인혜,오해인,이미지,한승아,황선아,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

In spite of the seriousness of smoking harm has been developed these days. the increase of national smoking rate and that the people in the twenties are especially leading the rise of national smoking rate is an important issue of national health. Smoking of the university students can occur health problem and cause loss of manpower and expenses in their social activity period. So then the actual state for prevention of smoking and development of a program to prohibit smoking has to be seized urgently and starting with the study of the realities of university students, the effort to find a related fluent of smoking has to be studied. Related to this, the purpose of this study is to seize the general characteristics of smoking university students and to find out the relationship between perceived stress and smoking status among smoking university students. In addition, by collating the relationship between perceived stress and smoking status among smoking university students we have the purpose to furnish the basal data of stress care, the best way to cope with stress through group training and the plan for nursing implementation to decrease the smoking rate. For this study, a survey was conducted for 204 smoking university students of 13 universities in Seoul from 9th of May to 16th of May, 2003. The collected data was analyzed by t-test, Pearson Correlation and ANOVA in the statistical packages SPSS/PC. Major findings of this study are as follows; 1. Of the 204 respondents 85.4% of them were male and 14.6% of them were female. The average age of the sample was 23.19 years old and 41.8% of them were in senior, 21.4% in junior, 16.9% in sophomore, 19.9% in freshman grade. The major motivation to start smoking was 'because of curiosity'(33.8%) and the first smoking experience was at 'senior high school' (41.9%) and at 'college' (41.9%). 2 The highest scored stress factor of smoking university students were stresses about school work. 3. 72.7% had experience to quit smoking at least one or more times. Most of the reason to keep on smoking was 'short will to quit'(51.0%) and the smoking place was usually at 'school' (41.4%). Most respondents for the number ofsmoking friends were '5 people and above' (73.2%). 4. There was a negative relationship between the general characteristics and the entire perceived stress, however, there was a positive relationship between the general characteristics and the perceived stress in 4 categories which is 'sex distinction', 'major of study', 'residence form' and' inmate'. 5. There was a negative relationship between the general characteristics and the entire smoking status, however, there was a positive relationship between the general characteristics and the smoking status in 2 categories which is 'presence of hobby' and 'number of smoking friends'. 6. There was a negative relationship between the perceived stress and the smoking status. Through this study we have seized the relationship between the general characteristics, perceived stress and the smoking status of smoking university students. There was a positive relationship between some of the general characteristics with the perceived stress and the smoking status of smoking university students. Also there was a negative relationship between the perceived stress and the smoking status.

胃疾患의 食餌療法

강미경,김미숙,김선숙,김수향,양이선 효성여자대학교 가정대학 학도호국단 1987 家政大論集 Vol.6 No.-

The circumstance being surrounded with a rapidly changing society causes us to build up manystresses during our modern life. For this reason, there is increasing the occurrence of gastroentericdisorder in frequency. The dietary treatment of gastroenteric disorder requires to prepare the program necessary fora meal's amount quality and cookery with careful attention. In addition, it is essential for gastroentericpatients to fully supplement the needed nutritive substance depending on the degree of the trouble,by controling their mealtimes. Consequently, the successful dietary treatment entirely depends uponthe close cooperation between the patient involving his family and doctors and dietitians becausethe patient has to observe the standard of the programed dietary treatment. And it also is very impor-tant that the person who prepares table for these patients, attempts to improve their appetite, bysupplying foods suitable for their digestion and taste on the basis of the dietary treatment's standard. Several mental elements of gastroenteric patients have great effect upon the recovery of their di-sorder so that their family and nurses must lead these patients to stabilize their mind and to berestored to health as well as the adequate medical treatment.

해운대 달맞이 언덕에 있어서 바다조망경관의 역사적 변천에 관한 연구

강영조,신수안,조미나,이현주,박은희 동아대학교 건설기술연구소 2000 硏究報告 Vol.24 No.1

The purpose of this study is to clarify the historic transition of the prospects on Haeundae dalmaji hill. Dalmaji hill is well known for a character of configuration on the ground with the scene of the sea. We will infer that how did it change the prospects of Dalmaji hill's sea through the analyzing of the preset situation and location of building on the hill. (1) We investigated the stories of the building, the history, the business condition. (2) We collect the twenty four view points which is able to have seascape on the hill, being easily approaching to the road, and condition of changing the building. (3) We clarified the transition of seascape prospect and considered the characteristics of the six types from which were divided the condition of seascape prospect.

남자대학생의 흡연태도와 행동에 관한 연구

강경진,김정미,민혜영,안소진,오경숙,은경희,이현,이희선,홍주미,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

There have been so many researches about problems of cigarettes and relation of smoking and heath since 1950's and generally known that smoking is one of the worst factor of increasing disease and mortality. No matter what such many proofs about various problems of smoking have been researched, smoking rate of current male collage students has not been decreased. Besides, most of the researches about cigarette use and its addiction have been focused on the adolescent or adult women smokers or adult male, not male collage student. Therefore, the subject of this study is about smoking attitude and smoking behavior of male collage students by general features. Smoking attitude was analyzed by modifying 'Guidelines for the content of tobacco smoking surveys of the general population'(WHO, 1982). Two hundred of male collage students participated to the distributed questionnaire for one week in May. The smoking attitude was categorized into duration of smoking and number of cigarette per day(CPD), and nicotine dependency, investigated by Fagerstrom Tolerance Questionnaire(FTQ) (Fagerstorm & Schneider, 1989). All statistics were performed by procedure of SAS according to number, percentage, mean, standard deviation, and ANOVA. The results are as follows: 1. Smoking attitude level was mean 25.73±5.15 marks, ranging from 13 to 39 marks of the total 40 marks. 2. Duration of cigarettes, number of cigarette per day, and nicotine dependency were mean 5.14±2.84 years, 12.88±6.85 pieces, and 4.78±1.69, respectively. 3. Smoking attitude showed significance according to general features such as marital state and allowance, but the significance according to marital state is not valuable because the numerical difference is so big between married one and single that they cannot be compared with each other. 4. Duration of smoking was significant according to general features such as age and allowance. 5. Smoking amount showed significance the factors of age only. 6. ll1ere was no significance in nicotine dependency according to general features. As a result, smoking attitude of male collage student in this study shows moderate level. Smoking attitude and duration is significant according to allowance, and smoking amount is significant according to age. Nicotine dependency according to general features is not significant but comparing with the preceding study about adult male, male collage students in this study are respectively more nicotine-dependent than adult male smokers. In conclusion, the right allowance usage strategies and effective heath education focused on the young are needed. In addition, helpful programs and information spreading strategies are necessary for establishing higher level of smoking attitude. At last, systemic regulations in daily living for ""anti-nico-dependent"" and perspective reforming of male university student are needed for reducing nicotine dependency.

Optode형 glucose 센서의 개발

강신원,고광락,이수미,김수진 경북대학교 센서기술연구소 1997 연차보고서 Vol.1997 No.-

인간의 미각은 단맛 (甘味, sweet taste), 신맛 (酸味, sour taste), 짠맛(鹽味, saline taste), 쓴맛 (苦味, bitter taste)의 4가지 기본요소와 우마미 (Umami)^1)로 이루어져 있다. 본 연구에서는 그 중 글루코오스를 감지할 수 있는 당도 (糖度)센서인 초보적인 미각센서의 개발을 위하여 광섬유를 이용한 optode형의 센서소자를 제작하여 glucose의 농도 1×10 exp (-7) ∼ 1×10 exp (-2) M의 범위에 대해 측정하였다. 본 센서의 측정원리는 광섬유를 통한 광의 전달시 감지막의 글루코오스에 대한 반응에 따른 흡광 특성에 의해 일어나는 출력광의 감소 즉, 소산파의 흡수를 측정하는 원리를 이용하였다. The taste is composed of five fundamental tastes, sweet, sour, saline, bitter taste and umami. This research purposed to develope a glucose sensor, sweet taste sensor. The glucose sensor device used five kinds of dye/PMMA polymer sensing membranes containing five dyes. All experiment processor is based on the pH 7.4, 0.05 M tris-HCl buffer solution and glucose concentration from 1×10 exp (-7) to 1×10 exp (-2) M range. The fiber optode of the sensor device is made of skipped cladding in the fiber's middle site and then coated by dye/PMMA membrane. The principle of the sensor is based on the absorbance change of the evanescent wave of the sensing membrane according to glucose concentration change. In this experiments, we made a response pattern of the glucose sensor system using the evanescent wave.

仲裁合意의 成立 내지 效力에 관한 準據法

강수미 韓國仲裁學會 2006 중재연구 Vol.16 No.2

If the existence and effect of the arbitration agreement becomes an issue in international business transactions, it is the key point how we shall determine the applicable law by national rules for the conflict of laws, or by other methods. The argument in determination of the applicable law to the existence and effect of the arbitration agreement is related to regal nature of the arbitration agreement. As there are foreign factors in international arbitration, therefore we must consider such an aspect. Besides, we have to examine whether the general theory of contract is universally applicable to the arbitration agreement. Currently, it is the general trend that the party's autonomy principle is applicable in determining the applicable law for the arbitration agreement. However, it is a difficult problem to recognize the applicable law chosen by the parties, whether it is based on any regal standard(for example New York Convention or the private international law or the essential quality of the arbitration agreement). In the light of the actual transactions, when the parties don't make a choice of the applicable law expressly, it will finally come down to presuming the party's implied intent. Nevertheless, finding the implied intent is a difficult problem. Some argue that we shall presume the choice of applicable law by an objective standard such as a place of arbitration, to prevent too much expansion of the scope of the recognition. But we need to review that this interpretation harmonizes with the principle of party autonomy. Especially, if we desire to detect the vital point where it is most closely linked to the arbitration agreement, we have to inquire how we will decide such a relation by means of any standard. However, as the existing Arbitration Act doesn't offer the solution to these issues, therefore we have to settle these problems through the development of adjudications and theories.

고위험군 가와사끼병에서 스테로이드 추가 요법의 효과

강선미,문은경,인수미,길홍량 대한소아과학회 2002 小兒科 Vol.45 No.12

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.