조기위암의 임상적 연구

박태준,양은수,류종철,박태군,이희승,신원창,이진호,김관엽 인제대학교 1994 仁濟醫學 Vol.15 No.1

1989년 9월부터 1993년 7월까지 인제대학교 의과대학 상계백병원에서 실시한 위내시경 소견이 조기위암이며 내시경 직시하 생검결과 선암으로 판명되어, 근치적 위절제술을 시행받은 23명의 환자에서 임상적 특징을 알아보고, 문헌고찰과 함께 보고하는 바이다. The incidence and mortality rate of stomach cancer ranks well ahead of all malignancies in Korea. The prognosis is excellent in early gastric cancer of which the overall 5 years survival rate of 85∼95% is comparative with that of advanced gastric cancer of 15∼49%. So early detection with very sensitive mordality of gastroscope and surgery is the only premise to decrease the mortality rate of gastric cancer. This report deals with the clinical aspects of 23 cases of early gastric cancer, which were confirmed with histopathologic examination of resected stomach during the 4 years from September 1989 to July 1993 at Sanggye Paik hospital, Seoul, Korea. Out of 23 cases of early gastric cancer, 14 cases were male, 9 cases were female, and the male to female ratio was 1.6 : 1. The most common type of early gastric cancer was talc type(43.5%), IIc and its combined type comprised most of them(87.0%). The most prevalent sloe of lesion was gastric angle(43.5%) and the most common direction was lesser curvature(73.9%) 19 cases of 23(78.3%) were between 1∼3cm in size, and there was no statistical significance between the size of the lesion and lymph node metastasis. Of the 9 cases with mucosal lesion, there were 2 cases with lymph node metastasis(22.2%), but 7cases(50.0% ) of 14 cases with submucosal lesion presented lymph node metastasis. Diagnostic accuracy of endoscopy on detection of early gastric cancer was 17 cases(73.9%) of total 23 cases in our study. As with other report, histopathulogic examination of resected stomach revealed adenocarcinoma, tubular type as the most common type. Frequent complaint of patients with early gastric cancer was epigastric pain(65.2%), and duration of the symptom was less than 12 months in 17 cases(73.1%) of 23 patients with early gastric cancer.

적외선 영상 획득을 위한 직육면체형 지상 표적에 대한 열해석 연구

이상엽,최준혁,박원희,김태국 중앙대학교 기술과학연구소 2003 기술과학연구소 논문집 Vol.33 No.-

육면체형 지상 표적의 적외선 영상을 획득하기 위하여 표적을 등성질의 사각형 격자로 세분하여 열해석을 수행하였다. 열해석을 위하여 전도, 대류 및 복사를 고려하였으며, 태양복사에 의한 입사량은 LOWTRAN 7을 이용하여 산출하였다. 다양한 조건에서 열해석을 수행하여서 물리적 온도를 산출하였으며, 이는 열상장비에서의 적외선 화상을 시뮬레이션을 하는데 기본 도구로 사용될 수 있다. The thermal modeling of a 3D ground target by considering the solar radiation through various atmospheric conditions and the eonvection by the atmospheric air is studied. Since the heat is dissipated by the conduction within the target, the target is subdivided into small rectangular elements to determine the local temperature distribution on the target which is the most important information in generating the infrared images from the target. For the thermal modeling, simple experimental models are applied for the conduction within the target and the convection by the atmospheric air and a realistic model called as the LOWTRAN 7 in used to determine the solar incidence on the target after passing through the atmospheric layer. The physical temperature distribution on the target is determined for various atmospheric conditions from the thermal modeling, and these data can be utilized for various purposes such as the infrared image generation of the target considered.

PASS (polyamic acid alkylamine salts) LB막의 이미드화 과정에 대한 연구

김태완,이승엽 弘益大學校 科學技術硏究所 1995 科學技術硏究論文集 Vol.6 No.-

We have aimed at the imidization condition of the polyamic acid alkylamine salts(PAAS) LB films to make the well-known polyimide LB films. The PAAS molecule, which is composed of pyromellitic dianhydride(PMDA) and oxydianiline(ODA), is a precursor of the polymide. To obtain the optimum conditions of film deposition, the π-A isotherms were examined by varying temperature, barrier moving speed, dipping speed, spreading amount of solution, and etc. The Z-type LB films were made at the surface pressure of 5mN/m and 25mN/m for the AFM study: the former surface pressure forms the gas phase and the latter one forms the solid phase. Surface morphology of the LB films made at the solid phase(2Å Surface roughness) is more smooth than that of the LB films made at the gas phase(70Å Surface roughness). The imidization was performed by thermal treatment for 1 hour at 300℃. This condition was judged by TGA and DSC analysis. Current-voltage characteristics were measured along the perpendicular direction of the LB films at room temperature. Ohmic conduction has been observed below ∼10?V/cm and the calculated electrical conductivity is about 10-13S/cm. Nonohmic conduction has been observed above ∼10?V/cm and the conduction mechanism is able to be explained by the Schottky effect.

직무지도원 요인이 지원고용 프로그램 성공에 미치는 영향

이달엽,양지은,김태영 한국장애인재활협회 2003 재활복지 Vol.7 No.1

중증장애인들을 그 서비스 대상으로 하는 지원고용은 통합고용과 지속적인 지원체계라는 내용을 가지고 장애인재활의 새로운 패러다임으로 자리잡았다. 중증장애인의개별특성을 중요시하며, 모형에 따라 개인 또는 소집단 중심으로 개별장애인의 욕구와 능력에 기반을 둔 서비스프로그램을 진행하며, 비장애인과의 통합이 강조되고 직업적으로 차별받지 않도록 하였다. 이러한 지원고용프로그램이 효율적이고 성공적 수행에는 크게 ① 고용주와 관련된 요인, ② 직업배치와 관련된 요인, ③ 장애인 개인요인, 그리고 ④ 직업재활 전문요원 관련요인이 영향을 미친다. 직업재활 전문요원으로는 직업평가사, 직업재활상담사, 직무지도원 혹은 고용전문가 등을 들 수 있으며, 본 연구에서는 특히 직무지도원 요인이 지원고용에 어떠한 영향을 미치는 지에 대해 알아보았다. 최근 3년 사이에 직무지도원 경험이 있거나 현재 직무지도원으로 활동중인 39명을 대상으로 하여 일한적 사항들을 제외한 38문항의 구조화된 질문지를 우송하여 얻은 응답을 분석하였다. 연구결과 직무지도원은 대체로 30세 전후의 대졸자로 구성되어 있었고 대다수가 직업재활과 사회복지를 전공하였다. 직무지도원의 성취욕구가 강할수록 지원고용대상자의 고용율이 높아졌으며, 직무지도원의 태도가 적극적일수록 지원고용대상자의 고용에 긍정적인 영향을 미치는 것으로 나타났다. 직무에 대한 만족도가 높으면 높을수록 지원고용프로그램이 성공에 영향을 크게 미쳤으며, 고용율과도 직접적인 상관이 있는 것으로 나타났다. 직무지도원의 전문성이 고용율과도 상관이 높은 것으로 나타났고 다른 개별적 요인들이 고용율에 상관을 보이고 서로 긴밀한 관계를 가지는 것으로 나타났다. 이러한 연구결과를 토대로 볼 때 지원고용 담당자에 대한 보수교육이나 연수교육 등을 통해 직업적 정체감과 전문성을 보다 고취시키고 전문가를 사회적으로 우대하는 문화를 조성해 나갈 필요가 제기된다. 또 각각의 장애유형과 정도에 따라 체계적이고 구조화된 지원고용프로그램이 실시되어야 할 필요가 있다. 지원고용은 이제 사회적으로 경제적으로 매우 효과적인 직업재활프로그램으로 나타나고 있는 만큼 양적, 질적서비스를 모두 증대시킬 수 있는 방안이 모색되고 취업직종에 대한 개발이 계속적으로 이루어져야 한다. The purpose of this study is to investigate the characteristics of job coaches that have impact on the success of supported employment program. In Korea supported employment for people with disabilities has begun early 1990s, The roles and functions of job coaches are not exactly the same as those of U.S.A. because of the short history and the low awareness level toward people with disabilities. In this context, the researchers scrutinized the characteristics of job coaches who carry out supported employment programs. For the study purpose, job coaching hours, personal characteristics and the professionalism of 39 job coaches were surveyed. The dependent variable, success of the supported employment program, was established by the employment rate of supported employment clients. The results of the study are as follows. Frist, the employment rate was increased as the job coaches spent more time with their clients at the job sites. Second, job coaches' personal characteristics, such as psychological needs for achievement, job satisfaction and attitudes toward their own jobs, influenced the employment rates. However, the value system of job coaches did not show any statistical significance. Third, the knowledge babe of job coaches resulted in successful supported employment. Since clients with disabilities that the job coacher were serving had moderate mental retardation, it is suggested that more severe and various types of disability population should be included in the further study.

The Changes of Skin Temperature on Hands and Feet During and after T3 Sympathicotomy for Palmar Hyperhidrosis

Tae-Yop Kim,Ji-Yeon Sim,Sung-Moon Jeong,Yong-Bo Jeong,In-Cheol Choi 대한의학회 2006 Journal of Korean medical science Vol.21 No.5

노인 수술 마취의 문제점 (Considerations for Geriatric Anesthesia)

Tae-Yop Kim 대한외과학회 2020 대한외과학회 학술대회 초록집 Vol.2020 No.11

국제형사법상 전시 지휘관 책임의 법적 성격

이태엽 ( Tae Yop Lee ) 법조협회 2007 法曹 Vol.56 No.11

전시 지휘관 책임에 대한 대표적 선례인 야마시타 사건에서 미국 전범위원회는 부하들의 잔혹행위에 대해 알지 못하였다고 주장하는 야마시타의 주장에 대해 전시 지휘관으로서 부하들의 잔혹행위를 방지하기 위한 아무런 조치를 취하지 않았으므로 부하들의 반인도 범죄행위에 대해 그 자신이 형사책임을 져야 한다고 판시하였다. 그 이후 1977년 제네바협약 제1추가의정서와 1993년에 설립된 ICTY, 1994년에 설립된 ICTR, 그리고 1998년에 설립된 ICC는 그 설립근거규정에서 지휘관의 책임을 성문화하였다. 우리나라의 경우 2002. 12. 13. ICC의 설립근거규정인 로마규정에 대한 비준서를 기탁하였으므로 로마규정이 우리나라에도 적용되게 되었다. 로마규정 제28조에 규정된 지휘관의 책임의 법적 성격에 대해 과실범에 대해서도 그 처벌을 확장한 것이라는 견해, 종래의 공범이론에서 벗어난 제3의 영역으로 이해하여야 한다는 견해 등이 있으나, 부진정 부작위범으로 체계화할 수 있을 것이다. 향후 ICC가 어떠한 법리를 형성할 것인지 지켜봐야 할 것이지만 각 국가의 국내형사법 이론과 충돌되지 않도록 법리를 형성하여 국제형사법상의 지휘관의 책임이론을 각 국가의 국내법원에서 적용되는 보편적인 법 원리로 발전시켜야 할 것이다.

증례보고 : 개심술 마취에서 동맥압 파형분석을 이용한 심박출량과 중심정맥 산소포화도

김태엽 ( Tae Yop Kim ),권원경 ( Won Kyoung Kwon ),윤창룡 ( Chang Yong Yoon ),김혜경 ( Hae Kyoung Kim ),김준석 ( Jun Seok Kim ),지현근 ( Hyun Keun Chee ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1

The determination of arterial pressure wave-derived cardiac output (APCO) and central venous O2 saturation (ScvO2) has been introduced as a less invasive procedure for monitoring cardiac function and oxygen delivery. We have used an APCO sensor (FloTrac(TM)) and a monitor for ScvO2 (Vigileo(TM)) in two cases of cardiac valve surgery, where placement of pulmonary artery catheter (PAC) was not applicable due to unfavorable cardiac structure (case 1) and was contraindicated due to an unstable cardiac conduction disorder and arrhythmia (case 2). In case 1, monitoring of APCO was started from the beginning of anesthesia induction and a ScvO2 monitoring central venous catheter was inserted just after anesthesia induction. APCO, ScvO2 and other hemodyanamic information such as arterial BP, CVP, and data obtained from transesophageal echocardiography (TEE) during the pre-cardiopulmonary bypass (CPB) period were measured. APCO and ScvO2 during the post-CPB period showed a reliable correspondence with continuous cardiac output (CCO) and mixed venous O2 saturation (SvO2) as measured by PAC at the end of CPB. In case 2, APCO and ScvO2 were monitored instead of CCO and SvO2. The values of APCO showed a good correlation to intraoperative COs indirectly calculated by the velocity-time integral of the aortic outflow determined in the TEE examination. We experienced that monitoring APCO and ScvO2 is useful for anesthesia management in cardiac valve surgery and can be an alternative to CCO and SvO2 if the placement of PAC and the thermodilution method are not applicable. (Korean J Anesthesiol 2007; 53: 109~14)

임상연구 : 관상동맥우회로이식술 환자에서 심폐체외순환 후 동맥혈 산소분압/투여 산소분획 비(PaO2/FiO2 ratio): Amrinone-Dopamine과 Isosorbide Dinitrate-Dopamine

김태엽 ( Tae Yop Kim ),임병원 ( Byung Won Lim ),박태식 ( Tae Sik Park ),이성호 ( Seong Ho Lee ),김인규 ( In Kyu Kim ),신명근 ( Myoung Keun Shin ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.45 No.4

복수중에서의 혈청 및 복수내 Adenosine Deaminase 활성도 측정의 진단적 가치

박태군(Tae Koon Park),양은수(Eun Soo Yang),박태준(Tae Joon Park),이희승(Hee Seung Lee),류종철(Jong Cheol Ryu),신원창(Won Chang Shin),최원충(Won Chong Choi),이진호(Jin Ho Lee),김관엽(Kwan Yop Kim) 대한내과학회 1994 대한내과학회지 Vol.47 No.1

N/A Objectives: In this study, we would like to evaluate the diagnostic value of adenosine deaminase activity in serum and ascitic fluid from patients with ascites of various causes, including tuberculous peritonitis, liver cirrhosis with or without hepatoma, and cancer peritonitis. Methods: The ADA was assessed in serum and ascitic fluid, and simultaneous calculation of ascitic fluid/ serum ADA ratios were obtained in 89 patients with ascites due to various causes; 42 for liver cirrhosis, 18 for hepatoma, 14 for tuberculous peritonitis, 15 for malignant ascites. Results: 1) Serum ADA activity was significantly higher in patients with liver cirrhosis than those with other causes of ascites, with the level of 61.3±49.0 U/L, and the corresponding ADA levels of other diseases were 42.8±20.4 U/L in hepatoma, 46.1±21.9 U/L in tuberculous peritonitis, 24.0±19.8 U/L in malignant ascites (p<0.05). 2) Ascitic fluid ADA activity was highest in patients with tuberculous peritonitis than those with non-tuber-culous causes of ascites, with the level of 82.0±72.3 U/L, and the corresponding ADA levels of other diseases were 21.1±31.7U/L in liver cirrhosis, 8.8±7.7U/L in hepatoma, 29.0±19.7 U/L in malignant ascites (p<0.05). Ascitic fluid ADA level greater than 80 U/L had a specificity of 97%, sensitivity of 50%, and diagnostic efficiency of 76% for the diagnosis of tuberculous peritonitis. 3) The ascitic fluid/serum ADA ratios were significantly higher in patients with malignant ascites than those with other causes of ascites, with the level of 3.5±7.0, and the corresponding levels of other diseases were 0.8±1.8 in liver cirrhosis, 0.3±0.4 in hepatoma, 1.7±1.3 in tuberculous peritonitis (p<0.05). Conclusion: These results suggest that the assessment of serum and ascitic fluid ADA activity, and simultaneous calculation of ascitic fluid/serum ADA ratios would be useful in the differential diagnosis between patients with tuberculous peritnnitis and non-tuberculous causes of ascites.