위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

항생제 혼합 시멘트 정을 이용한 장관골 감염성 불유합의 이단계 치료

조세현,정순택,박형빈,황선철,하용찬,황인환 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적: 장관골 감염성 불유합의 치료 시 항생제 혼합 시멘트 정을 이용한 이단계 재건술의 결과를 분석하고자 한다. 대상 및 방법: 1998년 1월부터 2002년 9월까지 장관골 감염성 불유합으로 이단계 재건 수술을 받은 41예 (대퇴골 26예, 경골 15예)를 대상으로 하였다. 일단계 수술에서는 광범위한 변연 절제술, 부골 제거 및 세척술과 기존 고정 장치의 제거 또는 외고정 장치로의 교환을 시행한 후 시공 (dead space)과 불유합 주변 연부조직 내 항생제 혼합 시멘트 정을 삽입하였다. 임상적 감염 증상이 호전된 평균 8.7주 (3주~32주) 후 이단계 재건술로서 Ⅰ군은 내고정 장치 (금속판 5예, 골수강내 금속정 8예), Ⅱ군은 외고정 장치 (Ilizarov 25예, Monofixator 3예)로 각각 고정하고 17예에서는 골내 이동술이나 골 연장술을 시행하였다. 양군 모두 필요한 경우 골 이식과 시멘트 정의 교환을 추가하였다. 추시 기간은 16개월에서 최장 71개월로 평균 45개월 이었다. 치료 결과는 골유합 기간 및 Paley 방법에 의한 방사선상 골유합 상태와 하지 기능으로 평가하였다. 결과: Ⅰ군 13예 전부와 Ⅱ군 28예 중 26예에서 감염의 치료와 골유합을 얻었다. 이단계 재건술 후 골 이식술, 골 소파술, 외고정 핀 교환과 각변형 교정술, 피부 이식 또는 근육 피판 회전술 등의 보조적 시술이 Ⅰ군은 평균 2회, Ⅱ군은 평균 6.2회 추가되었다. 평균 골유합 기간은 Ⅰ군이 19.3주이고 Ⅱ군이 23.1주로 내고정군이 더 빨랐다. 방사선상 Paley 골유합 상태는 Ⅰ군이 우수 8예, 양호 5예이었고, Ⅱ군이 우수 18예, 양호 7예, 보통 1예, 불량 2예 이었다 (p=0.492). 기능적 결과는 Ⅰ군에서 우수 6예, 양호 6예, 보통 1예 이었고, Ⅱ군에서는 우수 10예, 양호 13예, 보통 3예, 불량 2예 이었다 (p=0.267). 결론: 항생제 혼합 시멘트 정의 골수염 치료 효과가 관찰되었으며, 감염이 호전된 후 내고정 장치로 교환해 준 군이 외고정을 유지한 군에 비하여 추가 수술 횟수가 적고, 골유합 기간도 빨랐다. Purpose: To evaluate treatment results between internal na external fixation groups in two-stage reconstruction of infected nonunion of long bones using antibiotics-impregnated cement beads. Materials and Methods: In the first stage, preexisting hardwares were removed and radical debridement was done. The dead space was filled with antibiotics -impregnated cement beads and the nonunion sits was immobilized by external fixation, cast or skeletal traction. In the second stage, all cases were divided into two groups; the nonunion was fixed by internal fixation in group Ⅰ versus external fixation in group Ⅱ. The intervening period between the first and second stage was average 8.7 weeks (range, 3~23 weeks). Results: The follow-up period was average 45 months (range, 16~71 months). Infection control and bone union were achieved in all 13 cases of group Ⅰ. Infection recurred in two of 28 cases in group Ⅱ, one underwent above-knee amputation and the other case was lost in follow-up. The mean number of supportive operations including repeated curettage, augmentation and change of infected pins, angular correction, and soft tissue flap was average 2 and 6.2 times respectively in group Ⅰ and group Ⅱ. Bony union period was average 19.3 and 23.1 weeks in each group. According to Paley's classification, group Ⅰ was similar to group Ⅱ in bony and functional result (p>0.05). Conclusion: Antibiotics-impregnated cement beads provided positive effect on infection control. Internal fixation group showed less number of additional operations and earlier bony union than external fixation group.

院內政黨의 LEADERSHIP의 考察 : 英國 政黨을 中心으로

趙英彬 全北大學校 1966 論文集 Vol.8 No.-

도시지역 보건사업에서 컴퓨터의 활용방안에 관한 연구

염용태,이명숙,조병희,송동빈 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.2

Nacessity of new communication media in information society is repidly increasing in many fields of Korea. It includes the field of primary helath care in the courses of collecting informations on demographic feature, social characteristics and health behavior of peoples. In light of above reasons, the authors attempted to utilize personal computers for the primary health services to promote health of unban people as a pilot study in Guro-6- Dong, Seoul. Five nurses working in Guro-6-Dong Health Subcenter completed family health records of 3,930 households among the total of 4,270. A total of 3,904 family health records among 3,930 were computerized and sorted out in categories of population characteristics, population dymanics, characteristics of householders, housing, family planning, maternal and child health(M.C.H), health status of residents and of others. Names of risky category in M.C.H, and family planning were listed and the lists were handed to the nurses concerned in order to practice proper cares in time. Sorted data were compared with ones of City of Seoul, average of other cities, and ones of nationwide. With the results of above practice, in terms of utilization of computer in uban primary health sevices, the following strategy was proposed. In order to provide proper health services the unban people demanded, efficient devices of information collection, processing and interpretation systems on health were urgently needed in every dong unit(health subcenter) of health centers. Recommended was personal computer network as a new communication media. Additional advantages of the devices were continuity and efficiency in services, and utilization in evaluation of health services and analysis of cost -effectiveness.

트라이애슬론 참여 여부가 인간의 심리적 성숙에 미치는 관계

공창빈,조용찬,강귀자 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

The variables of psychological maturity according to triathlon participation experience The purpose of this essay was to make an inductive analysis through an open type questionnaire in order to compare the psychological. Thus to achieve the above goal, following research problems were set. First, is there any difference in the variables of psychological maturity according to triathl on participation experience? The quantitative research to solve the above problems was conducted to total 600 participants and non-participants, and the qualitative one was to 50 persons concerned. The collected data was statistically processed using frequency analysis, t-verification. The findings presented through the data analysis are as follows. First, there was difference in the variables of psychological maturity according to triathlon participation experience. The participants were shown to be higher in all variables of psychological maturity then the non-participants, and most participants were relatively higher in the factor analysis of participation experience by age and gender than the non-participants, but the age class under 20 showed no statistically significant difference in the sub-factor of psychological maturity, emotional stability, and that in their 40s showed no statistically significant difference in the positive thinking and psychological self-effectuation.

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

PLD 박막의 물리적 성질

한용진,조봉균,정재훈,이수빈,박해윤,이태기,채희백,홍진수 순천향대학교 기초과학연구소 1998 순천향자연과학연구 논문집 Vol.4 No.2

Thin amorphous carbon films were deposited by a Q-switched Nd;YAG 532nm with beam power density of ?? on the high purity graphite (99.7%). The pressure of vacuum chamber was ?? Torr. In order to estimate the quality of the Pulsed Laser Deposition films one of the most important optical properties, bandgap energy, was characterized by transmission and reflection in the range of the visible, and an optical direct bandgap energy of 2.45eV and indirect bandgap energy 0.36eV were obtained. Surface morphology of amorphous film was investigated by AFM (Atomic Force Microscopy). Its surface roughness is 70nm. Comparing our results with the published values in the literature we have confidence that our films show the good quality for optical properties.

생체분해성 고분자를 이용한 사시수술용 제형개발 및 효용성에 대한 연구

민병무,김용백,김승영,김창식,박근성,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A new device, muscle clamping system was developed to facilitate exact quatifying technique A strabismus surgery, and reduce the risk of complications. The device is composed of a lower fixing body with three jaws and an upper supporting body. They are used to clip an extraocular muscle and fix it to the sclera with a single bite. Superior rectus recession on 16 rabbit eyes were performed with this new device. Conjunctival injection, muscle adhesion strength, and light microscopic findings were examined at 1, 2, 4 and 8 weeks postoperatively. The Conjunctival injection were minimal, adhesion power ranged from 420 to 600 gram gravity, which is sufficient in withstand the normal pull of human extraocular muscle. In microscopic exam, some Inflammatory cells and fibrosis were found. The new device was technically easy, fast, and accurate, so it may be useful in stabismus surgery.

최근 5년간 요로감염의 원인균 및 항생제 감수성

김세웅,임필빈,정웅교,이승주,이지열,조용현,윤문수 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.3

배경 : 최근 요로감염 원인균에 대한 내성 증가로 항생제 감수성에 변화를 가져와 요로감염 환자에게 경험적 1차 치료를 위한 항생제 선택에 어려움을 주고 있다. 단순 및 복잡성 요로감염으로 진단 받은 환자들을 대상으로 원인균과 그에 따른 항생제의 감수성을 살펴봄으로써 향후 단순 및 복잡성 요로감염에 대한 항생제의 선택에 도움을 받고자 한다. 대상 및 방법 : 1996년 6월부터 2001년 5월까지 요배양 검사상 요로 감염균이 10^5cfu/ml 이상의 집락이 형성된 200명을 대상으로 해부학적 또는 구조적인 장애 유무에 따라 단순 요로감염 및 복잡성 요로 감염으로 나누어 각각의 원인균과 그에 따른 항생제의 감수성을 후향적으로 분석하였다. 결과 : 복잡성 요로감염의 가장 흔한 원인질환은 신경인성 방광이었다. 단순 요로감염의 가장 흔한 원인균은 E. coli (61.35%)였고 복잡성 요로감염에서는 E. coli 이외의 균이 E. coli 보다 더 흔한 원인균이었다(58.9%). 단순 및 복잡성 오료감염 중 그람 양성균에서는 vancomycin, penicillin 이 높은 감수성을 보인 반면 ciprofloxacin, imipenem이 낮은 감수성을 보였고 그람음성균에서는 amikacin, imipenem이 높은 감수성을 보인 반면 ampicillin, bactrim이 낮은 감수성을 보였다. 결론 : 단순 및 복잡성 요로 감염의 주 원인균으로 그람 음성균주 특히, Ecoli에 의한 감염이 많은 비중을 차지하고 있으나 빈도가 점차적으로 감소하는 추세이다. 또한 병원성 감염 및 도뇨관의 장기 유치에 따른 교대균의 증가, 비병원성 세균의 출현 등으로 인한 E. coli 이외의 기타 그람음성균 및 그람양성균의 증가하는 추세이다. 향후 임상에서 요로감염의 일치 치료제로 많이 사용되고 있는 ampicillin과 bactrim 등의 항생제의 감수성이 낮으므로 사용시 필요하다고 사료된다. Backround : The increasing frequency of failure of urinary tract infections (UTIs) may be due to emerging resistance to commonly prescribed antimicrobials. We studied the causative microorganisms and their antibiotic sensitivities in uncomplicated and complicated UTIs. Methods : We analyzed 219 microorganisms and their antibiotic sensitivities of 200 outpatients who had more than 10^5cfu/ml on urine from June 1996 to May 2001 retrospectively. The patients weredivided into 2 groups, uncomplicated UTI group and commplicated UTI group according to with or without underlying disease. Results : The most common underlying disease of complicated UTI was neurogenic bladder. The most common pathogenic microorganism was Escherichia coli (E. coli) (61.35%) in uncomplicated UTI group but in complicated UTI, non-E, coli(58.9%) was more common than E. coli. In uncomplicated and complicated UTI, vancomycin, penicillin showed relatively higher sensitivity of gram positive organisms, while ciprofloxacin, imipenem showed relatively lower sensitivity, and imipenem, amikacin showed relatively higher sensitivity of gram negative organisms, while bactrim, amipicillin showed relatively lower sensitivity. Conclusion : We consider that gram negative microorgansisms, especially E. coli, is the main cause of UTI. But, we should concern about the increase of gram positive organsms and other gram negative organisms besides E. coli. Bactrim, amipicllin which were prescribed empirically in UTIs, showed relatively lower sensitivity. Regarding tom the choice of adequate drug in the treatment of UTI, it is necessary to consider the change of pathologic microorganisms.

만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2