절제 불가능한 국소 진행성 위암 환자에서 Taxotere 및 Cisplatin을 이용한 선행 화학 요법제의 투여 후 근치적 절제가 가능했던 2예

이한홍,허훈,채병주,김욱,전해명,Lee, Han-Hong,Hur, Hoon,Chae, Byung-Joo,Kim, Wook,Jeon, Hae-Myung 대한위암학회 2005 대한위암학회지 Vol.5 No.1

위암의 치료에 있어서 근치적 절제는 완치를 위한 유일한 방법이나 불행이도 많은 환자들이 국소적이나 혹은 타 장기로 전이된 상태로 발견된다. 이런 경우에는 근치적 절제술의 시행이 매우 어렵고 선행 화학요법을 시행하여 병기를 낮추려는 시도가 고려되어야 한다. Docetaxel은 반합성 택산으로 튜불린의 중합 반응을 유도하고 미세관의 해중합 반을을 방해함으로서 그 작용을 나타낸다. 현재 전이성 위암의 신행화학요법에서 docetaxel의 사용이 많이 시도되고 있고 그 반응률이 보고되고 있다. 본 교실에서는 docetsxel과 cisplatin 병용요법을 시행하여 전이성 위암의 부분 관해로 근치적 절제가 가응하였던 2예를 보고하는 바이다. At diagnosis, the majority of patients with gastric cancer are found to have local invasion or distant organ metastasis, even though the sole measure for a complete cure is a curative resection. A curative resection is hardly applicable for those with invasion and metastasis; thus, trials with neoadjuvant chemotherapy for downstaging the cancer should be considered. Docetaxel is a semisynthetic taxane that promotes tubulin polymerization and inhibits microtubule depolymerization. In recent studies, many metastatic gastric cancers were treated using neoadjuvant chemotherapy with docetaxel, and the response rates were reported. We report here two cases of locally advanced, non-resectable gastric cancer that were candidates for a curative resection after induction chemotherapy with docetaxel and cisplatin.

간 외 담관 낭성확장이 동반된 선천성 담도폐쇄증

정재희,이한홍,차선욱,송영택,Chung, Jae-Hee,Lee, Han-Hong,Cha, Seon-Wook,Song, Young-Tack 대한소아외과학회 2004 소아외과 Vol.10 No.2

1988년 9월부터 1999년 4월까지 가톨릭 대학교 의과대학 부속병원 외과에서 황달, 무담즙성 변 및 복부 종괴를 주소로 내원하여 간 외 담관낭이 동반된 담도폐쇄증으로 진단받은 7예의 환자의 임상상을 검토하였다. 전체 선천성 담도폐쇄증 환아 중 9.6 %에서 간 외 담관낭을 동반한 III 형의 담도폐쇄증을 보였다. 남여 성비는 2:5로 여아에서 높았다. 모두 카사이 수술을 시행하였으며 수술 시 평균연령은 57일이었다. 7예 중 3예 (42.9 %)에서 긴 생존기간을 보였다. 예후에 미치는 인자에 대해서는 지속적인 연구관찰이 필요할 것으로 사료된다. Biliary atresia (BA) with extrahepatic biliary cysts (EHBC) is a rare disease. It has been generally recognized as type I (correctable with cystic dilatation), which means a good prognosis. From a total of 73 patients with BA who underwent operation from September 1988 to September 2003 at our institute, 7 (9.6 %) cases of type III BA with EHBC (uncorrectable with cystic dilatation) are reviewed. Clinical findings, laboratory data, radiologic findings, treatment methods and outcomes were reviewed. Female was more prevalent (male to female ratio; 2:5). All cases were type III with EHBC according to the intraoperative cholangiography, and underwent Kasai' s portoenterostomy. The mean age was 57 days at operation. Three patients(42.9 %) are long term survivors. Further evaluation is needed to determine the correlation between prognostic factors and outcome for.

조기위암으로 진단된 환자에서의 전복강경하 위전절제술의 초기 경험

이정선,이한홍,김진조,박승만,Lee, Jeong-Seon,Lee, Han-Hong,Kim, Jin-Jo,Park, Seung-Man 대한위암학회 2010 대한위암학회지 Vol.10 No.1

Purpose: We wanted to evaluate the technical feasibility and safety of totally laparoscopic total gastrectomy (TLTG) for treating early gastric cancer. Materials and Methods: The medical records of 11 consecutive patients who underwent TLTG after being diagnosed with early gastric cancer at Incheon St. Mary's Hospital, The Catholic University of Korea from February 2005 to September 2009 were retrospectively reviewed and their clinicopathologic characteristics and the surgical results wereinvestigated. Results: The mean operation time was $385.6{\pm}94.1$ minutes, the mean time for creating an intracorporeal anastomosis was $97.5{\pm}60.0$ minutes and the mean number of the harvested lymph nodes was $46.6{\pm}15.4$ The mean number of days after operation until starting a liquid diet was the $6.1{\pm}7.6^{th}$ postoperative day and the mean hospital stay after surgery was $14.2{\pm}11.9$ days. There was no case of open conversion, but there were 2 cases of intraoperative complication and 3 cases of postoperative complication. There was one case of postoperative mortality. The patient suffered from thrombocytopenia of an unknown cause, which was refractory to platelet transfusion, on $4^{th}$ postoperative day and the patient died of intraabdominal bleeding on the $6^{th}$ postoperative day. Conclusion: TLTG was a technically feasible and relatively safe procedure. However, a long time for creating the intracoproeal anastomosis and a long operation time are still problems to be solved. 목적: 전복강경하 위전절제술(TLTG)의 방법을 보고하고 그 기술적 용이성 및 안전성을 확인하기 위하여 본 연구를 진행하게 되었다. 대상 및 방법: 2005년 2월부터 2009년 9월까지 가톨릭대학교 의과대학 인천성모병원에서 조기위암으로 진단 받은 후 TLTG를 시행 받은 11명의 환자들의 의무기록부를 후향적으로 조사하여 환자들의 임상적 특징과 수술 결과 그리고 병리학적 소견들을 분석하였다. 결과: 수술 시간은 평균 $385.6{\pm}94.1$분이었고 복강 내 문합에 소요된 시간은 평균 $97.5{\pm}60.0$분이었고 절제된 림프절의 개수는 평균 47개였다. 유동식 섭취 개시 시기는 수술 후 평균 $6.1{\pm}7.6$일이었고 수술 후 재원 기간은 평균 $14.2{\pm}11.9$일이었다. 개복 수술로의 전환 예는 없었고 수술 중 합병증이 2예, 수술 후 합병증이 3예에서 발생하였으며 한 예의 수술 사망 예가 있었는데 환자는 수술 후 4일째 혈소판 수혈에 반응하지 않는 원인불명의 혈소판 감소증이 발생하여 수술 후 6일째 복강 내 출혈에 의해 사망하였다. 결론: TLTG는 기술적으로 용이하였고 비교적 안전하였다. 그러나 긴 복강 내 문합 시간과 수술 시간은 향후 해결해야 할 과제이다.

열환경챔버의 냉방 시뮬레이션 프로그램 개발에 관한 연구

한도영(Do-young Han),이한홍(Han-Hong Lee),류규현(Kyu-Hyun Ryu) 한국공작기계학회 1999 한국공작기계학회지 Vol.8 No.5

The thermal environmental chamber has been using in maintaining weather condition, keeping thermal capacity under heating and cooling load fluctuation and for the performance testing of cooling system or air-conditioner on artificial environment. In order to make the various environmental conditions in the thermal environmental chamber, the proper cooling system is necessary to eliminate the heating load produced inside the chamber and to maintain the designed environmental condition. For this reason, the optimal design of cooling system and the prediction of performance is also required. This paper describes the prediction of performance of cooling system in the thermal environmental chamber with the capacity of 37,000㎉/hr which is developed for the test of performance in heating mode of heat pump system. In the result, this paper is trying to develop simulation program on the base of mathematical models and which can be applied effectively to the optimal design of cooling system and prediction of performance to the inside and outside change of environmental load.

전복강경하 원위부위절제술 후 델타형 위십이지장 문합술

박성균(Sung Kyun Park),이한홍(Han Hong Lee),김진조(Jin-Jo Kim),박승만(Seung-Man Park) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.2

Purpose: We conducted this study to evaluate the feasibility and the safety of a delta-shaped gastroduodenostomy after totally laparoscopic distal gastrectomy (TLDG) and to know about the factors having influence on surgeons’ performance of anastomosis and technical details of this operation. Methods: The clinical characteristics and the surgical results of 57 consecutive patients with delta-shaped gastroduodenostomy after TLDG at Incheon St. Mary’s Hospital were reviewed. The patients were divided into 2 groups (before and after 20 cases) and their clinical characteristics and surgical results were compared. The factors which influenced the anastomotic time and the technical details of the operation were also investigated. Results: There was no difference in age, gender, body mass index, surgical results except for operation time, anastomotic time, and starting day of oral feeding between the 2 groups. The experience of the surgeon was the only factor that influenced the anastomotic time. Conclusion: Delta-shaped gastroduodenostomy is a feasible and safe procedure even in the early years of a surgeon’s career. It could feasibly be done in less than 20 minutes in relatively experienced hands.

재발한 위장관 간질성 종양(GISTs) 환자들의 임상양상 분석

나건형(Gun Hyung Na),김영균(Young Kyun Kim),이한홍(Han Hong Lee),지성배(Sung Bae Ji),채병주(Byung Joo Chae),허훈(Hoon Hur),김욱(Wook Kim),전해명(Hae Myung Jeon) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.4

Purpose: Gastrointestinal stromal tumors (GISTs) are of a mesenchymal origin, and they arise predominantly from the gastrointestinal tract. This study aims to aid the post operative management of GIST patients by analyzing the clinical and immunopathological features of recurrent GISTs. Methods: We enrolled 98 GIST patients who had been operated on for their primary tumor from 1987 to 2001 at the Catholic Medical Center. Among them, 28 patients had clinical and radiological features that were proved to be recurrence, and the patients’ survival rates were compared according to the treatment modalities. Results: When the maximum length of tumor was shorter and the mitotic index lower, then these patients had higher disease free survival rates and lower recurrence rates. The Ki-67 negative group had lower recurrence rates than their Ki-67 positive counterparts. Recurrence was mostly observed as liver metastasis. The mean length of time to recur was 22.96 months. Fifteen patients received additional treatments such as surgery, chemotherapy and radiation therapy, but there was no significant difference in survival rates when they were compared to the 13 patients who did not receive further treatments. Conclusion: Of the patients diagnosed with GIST after surgery, those with worse prognostic factors, i.e. a bigger tumor size and higher mitotic index, require more meticulous surveillance for tumor recurrence, and especially for liver recurrence, which was the most common recurrence site, during the follow up exams. In addition, although there have not been any remarkably effective treatments for the recurrent GIST patients, further researches for new therapy such as STI-571 is mandated.

데이빗슨의 사건 존재론

이한홍 새한철학회 2000 哲學論叢 Vol.20 No.-

이 글에서 다룬 것들은 데이빗슨의 심리철학에서 중요한 '인과문장의 논리적 형식, 사건, 부사구, 행위'와 관련된 것이다. 이 중에서도 가장 기본이 되는 것이 '사건'이라는 개념이다. '사건이 갖는 특성이 나머지 것들에 그대로 전달되기 때문이다. 데이빗슨에 의하면 '사건'은 시·공 속의 구체적인 개별자이고 한 사건과 다른 한 사건이 '야기하다(cause)'에 의해서 연결될 때 인과관계가 성립한다. 이 인과관계를 표현하는 인과문장의 논리적 형식은 1차 언어의 2항 술어 논리의 구조를 갖는다. 그런데 '야기하다(cause)'를 문장연결사로 해석하게되면, 인과문장은 진리함수적이라는 반직관적인 결론에 이르게 된다. 데이빗슨은 프레게 논증을 사용하여 이 과정을 보여준다. '사건'에 관한 문장들은 일반적으로 부사구의 수식을 받는다. 데이뎃슨은 양화논리를 사용하여 이 부사구들이 관계를 나타내는 항으로 표현될 수 있음을 보여준다. 이런 분석을 통해서 부사구의 수식을 받는 사건문장의 함축관계가 설명된다. 데이빗슨은 행위문장도 양화논리를 가지고서 분석하는데, 그에 따르면 행위도 구체적인 시·공간을 가지는 개별자이므로 구속변항의 값으로 나타낼 수 있다. 즉 행위도 하나의 사건이라는 것이다. 행위가 하나의 사건인 이상, 그것도 인과적으로 설명할 수 있다는 것이다. The problems dealt in this paper are 'logical form of causal sentences, events, spatio-temporal adverbial modifiers, actions'. Qf these, 'event' is the basic conception. For the properties of event is conveyed to the rest. Davidson says that event is particular or individual in time-space and that when one event is related the other event by 'cause' causal relation is constituted. The relation of causality between events can be expressed by an ordinary two-place predicate in an ordinary, extensional first order language. But if we take 'cause' for sentence-operator, we are led to anti-intuition that causal sentence is truth-functional. Davidson shows this by the Frege argument. Generally, the event sentences are modified by an adverbial phrase. Davidson says that adverbial modifiers turn out to be relations events and times, or events and places with quantification logic. By this analysis, the problem of implication of event sentences modified adverbial phrase is solved. Davidson analyzes action-sentences by quantification. He says that action is particular, individuals in space-time, so it is represented by the value of the bound variable. Namely action is an event. As faf as action is an event, it is explained by cause and effect.

유도선수의 시합전 경쟁상태 불안에 관한 연구

한태준,이한홍 경성대학교 2000 論文集 Vol.21 No.1

The purpose of this study was to examine the level of competitive state-anxiety before the game among 408 Judoists in Middle school players (108 boys and 57 girls) & High school players (104 boys and 103 girls) and inquire the difference of competitive A-state intended for them according to the sex, object. Competitive State Anxiety Inventory-2 (CSAI-2) was used as the instrument of the study and measured data carried out Two-way ANOVA after computing the mean and standard deviation according to the factors. The conclusions of the study are as follows; 1. The levels among cognitive state anxiety, somatic state anxiety, state self-confidence according to the sex were significantly different in the statistical aspect The girl players' levels of both cognitive state anxiety any somatic state anxiety were higher than those of the boy and in the level of state self-confidence the boy players' level was higher than that of the girls. 2. The levels among cognitive state anxiety, somatic state anxiety, state self-confidence according to the object were significantly different among them and that of both cognitive state anxiety and somatic state anxiety was the highest in girls' high school and the lowest in boys' middle school. The level of state self-confidence was the highest in boys' middle school and lowest in girls' high school

희곡 『왕자 홈부르크』 에 나타난 하인리히 폰 클라이스트의 군사 지휘 사상

이한홍 한국독어독문학회 1997 獨逸文學 Vol.64 No.1

In jedem literarischen Werk spiegeln sick notwendigenveise die Welen und-anschauungen des Verfassers wider. Heinrich von HIeist wLwde in einer typischen Junker-Familie geboren und war selbst 7 Jahm Soldat. Obwohl er, von banausischer und versteifter Atmospha¨re der damaligen preußischen Offizierkreise fief entta¨uscht, den Offu¨zienenif aufgab, wa sein Intemsse an der Armee und am Schicksal des deutschm Vaterlundes u¨beraus groß. Am 14. Oktober 1806 siegte Napoleon in der Doppelschlacht bei Jena und Auerstedt u¨ber die preußische Armee. Die Niederlage besiegelte das Schidsal Preußens. HIeist hatte die Vorga¨nge beobachtet und war von der vemichtenden Niederlage sehr betroffen. Die Gru¨nde fu¨r die Niederlage sah er in der Unschlu¨ssigkeit und Zaghaftigkeit der preußischen Fu¨hrung. Der darnalige Feldmachall Hemog von Bramsc:hweig wau z. B. so u¨bervorsichtig und zaghaft, daß er keinen rechtzeitigen Entschluß fassen konnte und dadurch jede gunstige Gelegenheit versa¨umte. Im Drama Prinz Friedrich vrnz Homburg hundelt es sich um den Konflikt eines milita¨rischen Fu¨hrers zwischen Gehorsam und Selbsta¨ndigkeit im Kriege. Print Friedrich erstneitet zwar dmch rechtzeitige Ergreifung der Initiative einen erfolgreichen Sieg. Aber der Kunu¨nt sieht im Hundeln Homburgs eine nicht hinnehmbare Selbsta¨n-digkeit und schlicht milita¨rischen Ungehozsam. Deshalb la¨ßt er ihn vom Kriegsgericht zum Tode vemrteilen. Dieser ffeht um Begnadiglzng, ohne seine Schuld anzuerkennen. Aber in dem Moment, als er vom Kurfu¨rsten zum Richter u¨ber sick selbst ernannt wig, bejaht aus eigener Einsicht die Richtigkeit des Rechtsspruchs, so daB ihn der Kmfu¨tst fceisprechen kann. Das Drama gent zuletzt gliu¨cklich aus. Aber diesel Beispiel zeigt, wie problematisch ein Abweichen vom Auftrag auch darn sein kann, wenn es fu¨r sick betrachtet erfolgreich ist. In der Tat spielt sick die kriegerische Hundlung in einer derart unu¨berschaubaren und wechselvollen $quot;Nebelsituation$quot; ab, so daß der Untergebene den Befehl seines Vorgesetzten nicht wortgetreu ausfu¨hren kann. Er loll vielrnehr im Sinne des Ganzen selbsta¨ndig denken und verantwortungsbewußt gehorchen. Bereits in den Einigungskriegen setzte dal preußisch leutsche Fu¨hrungsdenken auf den Vorteil des selbsta¨ndigen Hundelns gegenu¨ber passivem Verhalten und verlangte Mut zur Initiative und Kreativita¨t. Man ra¨umte hierfu¨r schon damals bemerkenswerte Selbsta¨ndigkeit ein. Es war dal Verma¨chtnis der Niederlage bei Jena und Auerstedt. Es gelang der deutschen Armee, im Sinne einer Fiheit im Gehorjam die Selbsta¨ndieit mit der Folenmg nach stu¨ktem Gehorsam zu vereinigen. Diesel typisch deutsche Fu¨hrungsverhalten nennt man heute Auftragstakhk und gilt seit Jahrhunderten als dumhaus bewa¨hrt. Das Ziel der vorliegenden Arbeit liegt darin, die Hroblerratik des Konflikts zwischen Gehorsam und Selbsta¨ndigkeit anhund des HIeistschen Werkes Frinz Friedrich van Homburg zu beleuchten und die Bedeutung seiner Gegenu¨betstellung 'Buchstabe des Gesetzes' und 'Order des Hetzens' in )ßczug auf die Auftragstaltik zu interpretieren.