천막상부 원시신경외배엽 종양의 방사선요법

김일한,유형준,조영갑,김대용,Kim Il Han,Yoo Hyung Jun,Cho Young Kan,Kim Dae Yong 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.1

목적 : 원시신경외배엽 종양은 빈번한 국소 재발 및 광범위한 지주막하 전이를 나타내는 종양이기때문에 수술 및 항암 약물요법과 함께 전뇌척수조사를 시행하는 방사선요법으로 치료 성적을 높이고자 꾸준한 노력을 시도하여 왔으며, 이에 저자들은 복합요법을 시행한 환자들의 실패 경향, 장기 생존율과 치료 후유증 등을 분석하고자 한다. 대상 및 방법 : 총 18명의 환자들을 대상으로 분석하였으며, 1세-27세 (중앙값=5세)의 연령분포 로 12명 대 6명의 남녀비를 나타내었다. 수술적 절제범위에 따라 완전절제술이 9명, 부분절제술 이 8명, 단순 조직생검술이 1명이었다. 모든 환자에서 수술후 방사선요법을 시행하였으며 방사선 조사야는 16명에서 전뇌척수조사를, 2명에서는 각각 전뇌조사 및 원발병소조사만을 시행하였고, 조사선량은 원발병소에 3120-5800cGy(중앙값=5460cGy), 전뇌부위에 1500-4200cGy(중앙값=3600cGy), 그리고 전척수부위에 1320-3600cGy(중앙값=2400cy)이었다. 항암약물요법은 13명 의 환자들에 대해서만 실시하였다. 추적관찰기간은 1개월부터 89개월로 중앙값은 45개월이다. 결과 : 치료도중 사망한 1명을 포함 총 9명의 환자에서 0-40개월뒤 재발을 확인하였으며 재발경향은 원발병소 단독 재발이 1명, 두개내의 전이성 재발은 2명, 척수부위 재발은 4명, 광범위한 뇌척수 재발이 1명, 그리고 전신적 다발성 골전이를 나타낸 환자가 1명이었다. 전뇌척수부위 방사선요법을 시행하지않은 2명의 환자중 2명 모두 척수부위 재발을 나타내었으며, 전뇌척수부위 방사선요법을 시행한 IS명의 환자중에서는 3명이 척추부위를 포함한 재발 경향을 보였고, 재발한 9명의 환자는 모두 재발 후 1-13개월내 사망하였다. 전체 환자의 2년 및 5년 생존율은 각각 $61\%,\;49\%$이며, 예후인자 분석에서는 성별, 나이, 종양위치와는 무관하였으나 완전절제술 및 항암 약물요법을 시행한 환자군에서 높은 생존율을 나타내었다. 치료 후 후유증으로는 원발병소에 5580cGy를 조사한 환자 1명에서 40개월 뒤 자기공명영상 및 자기공명분광법으로 방사선괴사로 추정되고 있으며, 생존하는 9명의 환자에서 뇌하수체기능저하증이 2명, 그리고 인지능력저하 1명, 기억장애 2명, 성장저하$(\leq5\%)$는 1명에서 관찰되었다. 결 론 : 천막상부 원시신경외배엽 종양 환자의 치료성적을 높이기 위해서는 가능한한 종양의 완전절제가 필수적이며 수술후 항암 약물요법과 방사선요법의 보조요법이 결과를 향상시킬 수 있을 것으로 기대되며, 방사선치료시 조사부위는 전뇌척수부위를 모두 포함하여 조사하여야 한다. Purpose : To evaluate the efficacy of combined treatment of surgery and chemoradiotherapy for supratentorial primitive neuroectodermal tumors (SPNET) and obtain the Prognostic factors and complications Materials and Methods .The a9e of 18 patients ranged from 1 to 27 years (median=5 years). There were 12 males and 6 females The extents of surgery were gross total (n:9), subtotal (n:8), biopsy only (n: 1). Craniospinal radiotherapy was delivered to all the patients except 2 patients who were treated only with the whole brain and primary lesion. Radiation dose were 3120-5800cGy (median=5460) to primary mass, 1500-4200cGy (median=3600cGy) to the whole brain and 1320-3600cGy (median= 2400 cGy) to the spinal axis. Chemotherapy was done in 13 patients. Median follow-up period was 45 months ranged from 1 to 89 months. Results : Patterns of failure were as follows; local recurrence (1), multiple intracranial recurrence (2), spinal seeding (3), craniospinal seeding (2) and multiple bone metastasis (1). Two of two patients who did not received craniospinal radiotherapy failed at spinal area. All the relapsed cases died at 1 to 13 months after diagnosis of progression. The 2- and 5-rear overall survival rates were $61\%\;and\;49\%$, respectively The a9e, sex, tumor location did not influence the survival but aggressive resection with combined chemotherapy showed better outcome. Among 9 survivors, complications were detected as radiation necrosis (n=1), hypopituitarism (n=2), cognitive defect(n=1), memory deficit (n=1), growth retardation (n=1). Conclusion : To improve the results of treatment of SPNET, maximal surgical resection followed by radiation therapy and chemotherapy is necessary. The extended radiation field including craniospinal axis may reduce the recurrence in spinal axis.

노인들의 낙상 예방 활동에 관한 고찰

이재갑,김명준,김성은,김진 한국지역사회건강관리협회 대한건강과학학회 2014 대한건강과학학회지 Vol.11 No.2

Purpose : A Study on the falls and prevent falls through the study of literature from the necessity and the prevention of procedure is designed to find a way. Method : Analyze the related papers. Result : (1)Percentage falls is ① Somewhere in 30 to 50 % of older adults, experienced the falls. ② Community appeared higher than in the fall rate is 40 to 80 percent of hospitals or nursing agencies. ③ Women there is a high occurrence of falls than men. ④ The occurrence of the more difficult economic situation, fall is high. ⑤ There is a higher occurrence of cases that have experienced in falls. ⑥ If there is a disease, have a higher occurrence of falls. ⑦ The environmental problem is happening to increase the occurrence (2)Fall cause classification ; Should be categorized into groups to control of the causes of falls. Therefore, physical, psychological, environmental, classified by environmental factors. (3)The problems caused by falls : 65 percent of the fall an old man's suffered a cerebral hemorrhage, fractures, sprains, contusions, lacerations, abrasions, damaged. (5)Prevention methods : It was exercise and music, rhythm, education programs, a combination of effective. Conclusion : Evaluation of the possible fall on a regular basis. And the development of any program that combines rhythmic movements and interesting education enhances its effectiveness.

신설 사회복지학과의 정착과 지속적인 발전전략 수립 연구

고성환, 라선아, 유범상, 김영빈, 신용갑, 김석권, 임광민, 이다림, 김용수, 노지영 한국방송통신대학교 원격교육연구소 2017 정책과제 Vol.2017 No.-

ㅇ 신설과정 - 사회복지학과 신설 논의는 2000년대 초부터 진행되어 왔지만, 본격적인 논의는 2009년임. 학과신설을 논의했던 2009년 TF/T는 사회복지학과 신설은 모든 측면에서 긍정적이나 다른 학과에 미치는 영향의 측면에서 문제가 있다고 판단함. - 대안으로 사회복지연계전공이 2010년에 시작되었음. 연계전공은 사회복지에 대한 교육기회를 제공했다는 점에서 긍정적인 기여를 했음. 특히 사회복지학과 신설의 징검다리가 되었다는 점도 결과론적으로 중요한 기여로 기록될 것임. - 하지만 사회복지연계전공의 책임주체가 불분명하고, 입학부터 졸업까지 학생들의 어려움이 존재하고, 사회복지학의 정체성 확보의 어려움 등의 문제점이 노출되어 옴. 결국 사회복지학과에 대한 논의가 본격적으로 진행되었고, 2016년 학과신설이 결정됨.

Changes in Prostate Cancer Aggressiveness over a 12-Year Period in Korea

김도정,최대헌,임주현,윤종현,정인갑,유달산,홍준혁,안한종,김청수 대한비뇨의학회 2012 Investigative and Clinical Urology Vol.53 No.10

Purpose: To investigate whether tumor aggressiveness in patients with prostate cancer has changed in Korea since the introduction of prostate-specific antigen (PSA) testing. Materials and Methods: The data from 2,508 patients with pathologically confirmed prostate cancer who underwent radical prostatectomy at Asan Medical Center between 2000 and 2011 were reviewed. The patients were divided into four 3-year time series, and the changes between the groups in terms of serum PSA levels, pathological Gleason score (GS), and pathological stage were assessed. The change in GS over time in organ-confined disease and in patients whose PSA was below 10 ng/ml was also analyzed. Results: The mean PSA levels dropped significantly over the 12-year period (p<0.001). The frequency of organ-confined disease increased (55.7% vs. 64.7% vs. 62.9% vs. 63.5%, p=0.043). The frequency of patients with a GS of 8 or more decreased (38.9% vs. 25.7% vs. 18.2% vs. 19.7%) and the frequency of patients with a GS of 6 or less increased (15.0% vs. 18.9% vs. 26.7% vs. 18.2%, p=0.003). However, the vast majority (more than 70%) of all cases had a high GS (7 or greater) at all time points. The GS distribution did not change over time in patients whose PSA levels were below 10 ng/ml or in those who had organ-confined disease. Conclusions: In 2000 to 2011, the preoperative PSA, pathological stage, and pathological GS dropped. However, the majority of the prostate cancers in Korean men were poorly differentiated, even when the patients had organ-confined disease or their PSA levels were less than 10 ng/ml.

Candida glabrata 감염에 의해 발생한 엉덩허리근 농양 1예

김미,정창수,장주현,안병무,송원근,이재갑 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.1

Infections due to Candida species are becoming more frequent in several patient population and settings. The proportion of non-albicans Candida spp. causing candidemia has increased during the recent decades. Especially, fungaemia due to Candida glabrata has reduced susceptibility to azoles. We report a case of iliopsoas abscess caused by Candida glabrata. A 51-year-old male diabetic patient was admitted with fever and both hip joint pain. Abdominal CT scan revealed huge left iliopsoas intramuscular abscess and left perinephric abscess. The abscess was drained percutaneously. Cultures of the pus were positive for Candida glabrata. The patient’s condition improved after abscess drainage and was discharged with oral antifungal agent.

영구치 TWINNING예 대한 증례보고

김성오,최형준,이종갑,이승일 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.4

As one of the developmental disturbance in shape of teeth, a twinning very rare frequency in permanent teeth. Because it is possible to diagnose the twinning by use of the radiograph, it is very important to detect this anomaly early by careful examining the radiographs. The twinning produces several orthodontic problem such as crowding, protrusion, ectopic eruption of adjacent teeth. Therefore it is necessary, in proper time, the extraction and orthodontic treatment should perform.

3차원 전산화 단층촬영을 이용한 상악 정중 과잉치의 진단

이종갑,김성오,홍영우,손흥규 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

저자는 매복된 상악 정중 광잉치를 주소로 내원한 환아를 3차원 전산화 단층촬영술을 이용해 매복된 과잉치의 위치를 파악하였으며 다음의 결론을 얻었다. 1. 인접한 영구치에 대한 위해한 영향을 주지 않기 위해 상악 정중 매복 과잉치의 정확한 위치 편별이 요구된다. 2. 3차원 전산화 단층촬영법은 매복 과잉치의 위치판별에 있어서 객관적인 중요한 정보를 제공한다. The prevalence of the supernumerary tooth is 1~4%. It usually occurs in the permanent dentition. It frequently occurs in the maxillary midpalatal area. The presence of the supernumerary tooth causes the following problems;(1) interfering the eruption of successional tooth, (2) displacing the neighboring teeth, (3) resulting large diastema, (4) forming cystic change. So the supernumerary tooth should be remobed as soon as oissuble. To extract the supernumerary tooth, the exact position must be noticed first. Radiographic techniques that were used in the past are tube shift technique, right angle technique, sterioradiography, using radiopaque contrast media and conventional tomography. But these methods include the subjective opinion of the operator. So, a technique eliminating the operator's opinion and showing the position 3-dimentionally can be used. 3-dimentional computed tomography eqipped with dental softwares can show the position of the impated supernumerally tooth in 3-dimentionally position. It has an adzantage to eliminate the subjective opinion of the operator with a fast computer this techenique is done in a relatively short period of time . the data 3-dimentionally. sequential removal of the soft tissue and hard tissue(bone) CT number leaves the teeth alone in 3-dimentional position. The image can be seen from anywhere, so the operator can see the image in front, rear, upper, and lower positions. In both cases 1 and 2 the position of the impacted supernumerary tooth is viewed by the 3-dimensional computed tomography. And it made the operator easy to figureout the exact position.

BEAMnrc code를 이용한 Varian 21Ex 선형가속기 모델링

김정인,박종민,박양균,최창헌,김희정,최윤석,조운갑,예성준 대한방사선방어학회 2009 대한방사선방어학회 학술발표회 논문요약집 Vol.2009 No.11

소아의 치성감염에 관한 분석연구

김성오,이종갑 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.1

본 연구의 목적은 소아의 치아우식증이 치은농양 및 봉와직염으로 진행될 수 있는 분석하여 소아에서 이 질환의 성격을 보다 명확히 하기 위함이다. 1991년 1월부터 1992년 12월까지 연세대학교 치과대학 부속병원 소아치과에 내원한 신환 7,936명을 대상으로 치성감염을 분석한 결과 다음과 같은 결론을 얻었다. 1.소아의 치은농양과 봉와직염의 원인은 대부분이 유치였다. 2.치은농양의 원인치아는 상악에서 A, D, B, C의 순으로, 하악에서 D, E, A, C의 순으로호발하였다. 3.봉와직염의 원인치아는 상악에서 D, A, E, B, C의 순으로, 하악에서 D, E의 순으로 호발하였다. 하악 A, B, C에서는 발생하지 않았다. 4.소아에서 치성감염의 발생은 기후와는 관계가 없었다. 소아의 치아우식증은 중증의 질환을 유발시킬 위험성을 갖고 있는 질환으로 반드시 치료 해야 하고, 예방적인 치아우식증의 치료도 권장해야 할 것이다. This article is to study the risk factors of odontogenic infection, which includes not only dental decays but also gumboils and cellulitises. 7936 young patients who visited the department of pediatric dentistry, Dental Hospital of Yonsei University from Jan 1st 1991 until Dec 31st 1992 were reviewed and statistically analyzed. The results are : 1. Frequencies of the source of odontogenic infection are ordered from high to low : Gumboil Upper A〉D〉B〉C Lower D〉E〉A〉D Cellulitis Upper D〉A〉E〉B〉C Lower D〉E 2. There was no statistically significant relationship between odontogenic infection and seasonal weather change.

전남지역의 소득 및 고용구조 개선에 관한 연구

송문갑,김병무 순천대학교 지역개발연구소 1990 地域開發硏究 Vol.1 No.-

According to the traditional economic theory, a regional economy is supposed to go through a balanced growth rather than an unbalanced one mainly due to equi-marginal efficiency of capital among different regions. Unfortunnately, however, this traditional theory doesn't seem to be realized in Chonnam region even thought the central goverment has been implementing economic development projects in the last three decades. Accordingly, this study was begun to analyze and find out the causes why Chonnam region has been retarded in economic growth in Korea. Some of the findings could summarized as follows: 1)VA(value added) elasticity of capital in Chonnam region was turned out to be relatively higher, but that of labor was lower, than the national everage; 2)Localization of agriculture has ben very high but that of manufacturing industry was very low in Chonnam region compared to national figure according to the statistical analysis done in this study; 3)Lobor forces were over-croweed in agricultural sector, whereas only a amall portion of labor was employed by manufacturing industry in this region; 4)Economic growth of Chonnam has been retared and very slow in this part of the country, mainly due to the isolation from the main stream of national economic development. In sum, Chonnam region couldn't improve the current situation of economic under-development in relative terms unless there is heavy investment in manufacturing industry in Chonnam region.