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.

태권도 540도 뒤후려차기 동작의 운동역학적 분석

강동권 ( Dong Kwon Kang ),강서정 ( Suh Jung Kang ),유연주 ( Yeon Joo Yu ) 한국운동역학회 2013 한국운동역학회지 Vol.23 No.1

본 연구의 첫 번째 목적은 540° 뒤후려차기 동작의 운동역학적 변인들을 정량화 하는 것이고, 두 번째 목적은 지상동작이 공중동작에 미치는 영향을 밝혀내는 것이다. 지상회전 구간에서의 수직지면반력(GRF)을 분석한 결과 지상에서 180° 회전하면서 나타나는 수직지면반력(GRF)이 체중보다 낮아지는 것을 발견할 수 있었다. 이러한 결과는 반동(counter movement)을 사용하여 높게 점프하려는 전략으로 반동 동작시 발생하는 신장성수축으로 인한 근육과 건에 저장된 탄성에너지를 사용하여 높게 점프하는 SSC(stretch shortening cycle)시스템(Komi, 2003)을 사용하는 것이다. 이렇게 반동을 사용하는 것이 반동을 사용하지 않았을 때보다 높게 점프할 수 있다(Bobbert, Gerritsen, Litjens & Soest, 1996). 즉, 지상에서 회전하는 동안에는 반동 동작을 수행하지 않는 것으로 보이지만 실제로는 반동 동작을 하는 것으로 나타났다. 540° 뒤후려차기에서 각 구간에서 중요하다고 판단되어 정의한 8개의 변인들을 분석한 결과 8개의 변인에서 비슷한 패턴과 적은 표준편차를 나타냈다. 이러한 결과는 11명의 엘리트 시범단원들이 540° 뒤후려차기를 수행하는데 있어서 모두 비슷한 전략을 가지고 있는 것으로 해석할 수 있으며, 이러한 결과는 추후 540° 뒤후려차기를 연구하는 데 유용한 기초자료로 활용 될 수 있을 것이다. 540° 뒤후려차기는 돌개차기와 뒤후려차기가 결합된 복합 기술이다. 즉, 540° 뒤후려차기는 돌개차기로 점프하여 뒤후려차기로 차기기술을 수행한다. Kang과 Kim(1996)은 엘리트 선수의 돌개차기 동작을 연구하였는데, 엘리트 겨루기 선수들의 돌개차기 동작 수행시 지상회전 구간의 소요시간은 0.59±0.06 sec로 나타나 본연구의 지상회전 구간의 소요시간인 0.4±0.04 sec보다 길게 나타났다. 이는 득점을 위하여 빠르게 동작을 수행하는 엘리트 겨루기 선수들보다 540° 뒤후려차기를 전문적으로 수행하는 엘리트 시범단원들이 지상회전 구간에서 더 빠른 지상회전 동작을 수행하는 것으로 사료된다. 540° 뒤후려차기는 차기 구간에서 뒤후려차기를 동작을 수행한다. 이러한 뒤후려차기는 공을 던지는 듯 한 동작의 돌려차기(Throw-like motion)와 미는 형태의 옆차기(Pushlike motion)의 특징이 혼합된 복합운동(Kim, Jin & Shin, 1995; Choi, Lee, Kim & Kim, 2007)으로 복잡한 메커니즘을 가지고 있고, 돌려차기에 비해 뒤후려차기의 발끝 속도는 느리다(Kim, Y. K. & Kim, Y. H., 2010). Ha와 Kim(2009)은 엘리트 시범단원 3명을 대상으로 뒤후려차기의 발끝 속도를 분석한 결과 14.43±2.00 m/sec로 본 연구의 8.78±0.76 m/ses 보다 빠르게 나타났다. 하지만 선행연구는 한발을 지면에 딛고 기술을 수행한 것이고, 본 연구의 뒤 후려차기는 공중에서 수행 했다는 차이점을 가지고 있다. 본 연구의 두 번째 목적인 지상동작이 공중동작에 미치는 영향을 알아보기 위하여 각 구간별 변인들로 상관분석을 실시한 결과 예상하지 못한 결과가 나타났다. 기본적으로 체공시간(FT)과 충격량(impulse)으로 수직점프높이를 추정 할 수 있다(Richter, Rapple, Kurz & Schwameder, 2012; Yuktasir & Kaya, 2009). 따라서 두 변인간의 상관은 높게 나타나는데 본 연구의 결과에서는 체공시간(FT)과 충격량(impulse)에서 상관이 유의하게 나타나지 않았다. 또한 수직신체무게중심(COG)과 충격량(impulse)도 상관관계가 높을 것으로 예상하였으나, 본 연구의 결과 유의한 상관이 나타나지 않았다. 이는 점프동작 이외에 회전동작의 개입으로 인한 결과(Lee & Kim, 1996)로 판단된다. 또한 차기동작인 뒤후려차기를 수행하기 위하여 상체를 숙이는 것에 기인하여 수직신체무게중심(COG)과 충격량(impulse)의 상관이 나타나지 않은 것으로 사료된다. The aim of the study was a quantitative analysis of elite athlete`s 540o Dwihuryeochagi and effects of ground movements to the jumping height and kicking velocity. Eleven elite players(Taekwondo demonstration team) participated in this study. In order to get the kinetic and kinematic variables, ten Vicon cameras and a force plate were used. Foot segment velocity(FSV), vertical ground reaction force(GRF), impulse, ground time(GT) in phase 1, trunk angular velocity(TAV), vertical center of gravity(COG), flight time(FT) in phase 2 and kicking leg segment velocity(KSV) in phase 3 were measured and analyzed. Results indicated that there were similar patterns of variables among phases between subjects. Non-significant correlation(r=.145) between flight time(FT) and impulse was found. Also non-significant correlation(r=.119) between center of gravity(COG) and impulse was found. In conclusions, there were similar strategies in phase 1, phase 2, and phase 3 between subjects.

전국 단위 감시체계의 현황과 전망

강성규,안연순,지영구,김형옥,하미나,권호장,백남종,김성아,홍윤철,김재용,강대희,정혜선,하은희 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

『鄕藥集成方』의 데이터베이스 구축을 위한 원문의 전산처리

강연석,안상우 한국한의학연구원 2001 한국한의학연구원논문집 Vol.7 No.1

The 85 books were compiled into Hyangyakjipseongbang(鄕藥集成方) at the period of the king Sejong(世宗). That books were assembled on the late stage of the Korea dynasty(高麗) and the first stage of the Chosun dynasty(朝鮮). It is a great work on medicine and a textbook of native herbs representing independent medicine of the dynasty of Chocun. The original text was written in technical chinese character terms and this was processed with a newly developed text cognizance program which helped decrease the time and energy needed and increase accuracy. We hope that the ground work and experience gained from this process would be analyzed and used for future in computerized information management for medical classic literature.

실존철학적 인격교육

강연숙 韓南大學校 敎育硏究所 2011 교육연구 Vol.19 No.1

이 글에서는 비인간적이고 학생의 주체성과 자율성을 간과하면서 교육의 본질을 상실한 오늘의 우리교육을 반성하고 그 대안적 의미로서 실존철학적 인격교육을 제시하고자 하였다. 이를 위해 이 글에서는 먼저 실존적인 인간의 특징을 주체성, 지유선택·책임, 그리고 인격의 측면에서 살펴보았다. 다음으로 실존적인 인간을 대상으로 하는 교육의 문제를 실존철학적 인격교육의 목적, 내용, 그리고 방법을 중심으로 살펴보았다. 다음으로 만남을 통한 인격교육의 문제, 즉 학교라는 교육의 장에서 하나의 인격체인 교사와 또 다른 인격체인 학생의 교육적인 만남을 통해 학생들이 비본래적인 나로부터 본래적인 나로 나아가도록 하는 단속적인 인격교육의 의미를 검토하였다. 또한 위기, 각성, 충고, 상담 등의 실존적 계기를 통한 인격교육의 가능성을 모색함으로써 현대 교육적인 의미를 고찰하였다. The purpose of this paper is to explore the possibility of the existential education of personality in our modern society and school causing the dehumanizing phenomenon in the student's subjectivity and autonomy which is cannot be ignored. To this end, first, I examined the existential characteristics of humans such as subjectivity, freedom, choice, responsibility, and personality. Second, I examined the existential education of humans, that is to say, the matter of the characteristic of existential knowledge or personal knowledge, and the personality education based on this knowledge which is existential awareness. Third, I examined the concept of encounter as existential instrument or educational relationship between the teacher and student in school. And I explored some existential instruments such as crisis, counseling, advice, adventure, failure and frustration as personality education methods. The main substances of this paper to the existential education of personality are like this. First, human beings subjectively shape their life and personality based on individual freedom of choice and responsibility. That is to say, we should deal with human as personality having the existential characteristics such as subjectivity, freedom, choice, and responsibility. Second, to educate a unique and free personality of human, school must provide the existential experience of personal knowledge, in other words existential awareness. Hence, first of all, school education should teach to become the man with subjectivity and education to awaken personal subjectivity of pupil should be to teach personal knowledge. Third, educational encounter between the teacher and pupil in school is a good educational foundation to shape a pupil's personality. And the relationship between teacher and pupil should become the mutual respect relationship based on mutual inclusion. And existential instruments such as crisis, counseling, advice, adventure, failure and frustration have possibility as a good method of personality education. They are intermittent educational instruments of personality resulting qualitative changes of pupil's life and personality.

8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

도시화에 따른 온천천 유역의 유출특성 변화

강주복,강인식,정연태 釜山大學校生産技術硏究所 1997 生産技術硏究所論文集 Vol.52 No.-

본 연구에서는 도시화로 인한 유출특성의 변화를 정량적으로 분석하고자 하였으며, 유출해석 모형으로는 선형저수지 모형을 선택하였다. 1960년대 이후 급격한 도시화를 겪었던 부산지방의 온천천 유역을 연구대상유역으로 선택하였으며 몇 가지 경우에 대한 유출해석을 수행하였다. 연구대상유역은 두 개 지점에서의 유량자료를 갖고 있다. 한 관측소(세병교 지점)는 현재의 자료를 갖고 있으며, 다른 하나(이섭교 지점)는 1972년의 측정자료를 보유하고 있다. 선형저수지 모형은 두 지점에서의 홍수수문곡선을 잘 재현하였으며, 대상유역에 대한 그 적용성을 입증하였다. 유효강우량 산정법별로는 Φ-index 법이 일정비손실법보다 더 나은 결과를 준다는 것을 알 수 있었다. 이섭교 지점에서 과거 측정된 홍수수문곡선과 모의를 통해 계산된 수문곡선을 비교함으로써 약 20년간에 걸친 도시화로 인하여 첨두홍수량의 크기는 증가하고 유역의 평균 지체시간의 크기는 감소하였다는 사실을 확인할 수 있었으며, 이를 정량적으로 평가할 수 있었다. This study was to figure out the runoff characteristics changes due to urbanization. The linear reservoir model was chosen and runoff analyses for several cases were conducted for the purpose. The On-Cheon stream watershed in Pusan was selected as its study area, which has experienced a radical urbanization since 1960's. There were two gaging stations in the study area one had the recent flow data and the other kept the flow data observed in the past. The linear reservoir model regenerated flood hydrographs well for both of the gaging stations and its applicability to the study area was proven. The results of runoff analyses were investigated depending on methods for estimating effective rainfall or rainfall excess. The Φ-index method provided better results than the constant percentage method. The comparisons of hydrograph observed in the past with the simulation results at the Ie-Seop Bridge site revealed that the peak discharges had increased and the mean lag of the study area had decreased due to the urbanization for two decades, and made it possible to evaluate the effects of urbanization quantitatively.

초고속 통신망에서 비디오의 주관적 품질 평가에 관한 연구

강명화,강진석,최연성,김장형 제주대학교 산업기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.1

According to information communication business faces with competitions in a various spheres with the development of multimedia and information communication, the time when we have to make an effort to improve a quality comes from an era when we devote ourselves to quantitative expansion. we will try to perform quality assessments of real-time interactive multimedia service, and so on - in this research and present criteria of new subjective quality assessments which is fit on Korea by analyzing examples of ITU-T and foreign countries and Korea.

1990년대 한국의 직업성암

강성규,안연순,정호근 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

The proportion of cancer as a cause of dearth in Korean has been continuously increas-ing. In 2000, 24 % (59,020 of 247,346) of deaths were caused by cancer. Occupational exposure would have contributed to the deevelopment of some cancers. It would have accounted for more than 2,000 cancers in a year if 4% of all cancer or 10% of lung cancer was regarded as arising from the work environment. However, occupational cancer has not been reported as much as expected. The first case of occupational cancer reported officially was mesothelioma caused by asbestos exposure at an asbestos textile industry in 1992. Following the report, many cases of occupational cancers have been reported such as lung cancer due to exposure to asbestos, chromium, exhaust gases, coke oven emissions, and silica, as well as leukemia due to exposure to benzene or other solvent and bladder cancer arising from exposure to benzidine salts. The Health Examination for retirees has been conducted since 1992 in order to detect occupational cancer early in workers who have been exposed to 11 carcinogenic sub-stances. However, to date no occupational cancer has been detected through the Retirees' Health Examination. The Korea Labor Welfare Corporation (KLWC) has referred 108 claims for occupational cancer to the Korea Occupational Safety and Health Agency (KOSHA) between 1992 and 2000. Thirty-three cases were accepted, including 14 cases of lung cancer, eight cases of hematopoietic cancer and six cases of mesothelioma. KLWC has accepted the claim for primary lung cancer developed with pneumoconiosis as an occupational cancer, of which there were 31 cases in 1999 and 61 cases in 2000. In conclusion, special attention is required to detect occupational cancer due to their long latency period and the fact they are usually found after retirement.

G.729기반 VoIP망 음질의 주관적 평가에 관한 연구

강영도,강진석,최연성,김장형 제주대학교 산업기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.1

This paper researched the scale of subjective speech quality measurement over VoIP(Voice over IP) service which is a component of broadband networks. Though objective parameters of multimedia services like PSNR or Jitter can be easily measured and defined, those factors are not easily met the users' perceptual recognition. It is suggested that the scale of speech quality measurement through the subjective measurement is more adequate for end-to-end speech quality which is composed of sender-side quality, transmission quality, receiver-side quality, which provides the degree of correctness in speakers' representation, the degree of impairment caused by various factors, and the degree of recognition processed speech, respectively. It's also examined by the proposed method and verified by it's availability.