췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

P.S. 콘크리트 보의 비선형 최적설계

정철원,최규문,손용우 圓光大學校 1994 論文集 Vol.28 No.2

비선형 최적설계법을 개발하였다. 이 방법의 목적은 PC구조물의 극한에서 나타나는 거동을 예측하는 것이다. 그에 따른 주요결과를 제시하였고 콘크리트와 강의 실제 거동의 실험 과정에서 겪는 난점을 거론하였다. 특히 PC강선에서 이용가능한 다양한 응력-변형 관계를 비교하고 실제 특성에서 나타난 차이점을 관찰하였다. 그 관계들에 관하여 추천된 식들의 해당계수를 제시하였다. 그 결과는 PC강선의 종류와 양, 비 프리스트레스 인장과 압축철근의 양, 극한 콘크리트압축변형 등과 같은 주요 변수들의 극한 거동에서 영향이 나타난다는 것이다. 그 영향과 결과를 유도한 규준을 비교하는 데에 중점을 두었다. 이 연구에서 얻은 결과들로써 만약 추천된 규준을 사용하는 경우에 그 규준이 불안정한 설계를 유도할 가능성이 있는 부분과 또 관찰된 경향에 알맞게 규준을 수정하기 위하여 필요한 점을 지적할 수 있게 되었다. An approximate nonlinear design procedure is development. It is the aim of the procedure to predict the behavior at ultimate of prestressed and partially prestressed concrete members. We showed the main results and discussed some difficulties which we come (on in) simulating the actual behavior of concrete and steel. Especially the various available stress-strain relationships for prestressing steels are compared and variability in their actual properties is observed. Corresponding coefficients of recommended equations are given. It is the result that the influence on ultimate behavior of major variables such as type and amount of prestressing steel, the amount of nonprestressed tensile, compressive reinforcement, and the ultimate concrete compressive strain exists. Then we put an empasis on comparing the influence with code derived results. By results of this study, we could point out that if used. where the recommended code may lead to an unsafe design and what modifications may be needed to make the code suitable to the observed trends.

후두 미세수술 후 발생한 일시적인 설인신경 및 설하신경 장애 1예

정철우,주영민,박성철,최정섭 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.11

상분리법을 통하여 제조된 새로운 개념의 지지형 액막의 기체투과특성

최평호,김범식,이정민,김철웅,구기갑,이상학 한국공업화학회 2004 공업화학 Vol.15 No.1

새로운 지지형 액막(SLM)을 용매 증발에 따른 1차, 2차 상분리법으로 3성분 고분자 용액으로부터 제조하였다. 액막재로 이온액인 BMIBF_(4) (BMI+ =1-(1-butyl)-3-methylimidazolium, BF_(4)=tetra-fluoro boratr)와 매트릭스 고분자로 polyvinylidenefluoride(PVDF)가 사용되었다. 이 고정화 액막의 O_(2), N_(2) 그리고 CO_(2) 기체 투과특성을 여러 조작 조건에서 조사하였다. SLM은 가혹한 조건에서 조작하였음에도 불구하고 오랜 시간동안 높은 CO_(2) 투과도 및 선택성을 유지하였다. 투과거동을 나타내는 인자인 투과도, 확산도, 그리고 용해도를 연속 측정 장치를 통하여 구함으로써 특성을 관찰하였다. SLM은 다른 기체에 비하여 CO_(2)에 대해서 높은 투과도와 선택도를 갖고 있었다. 특히, 막내 CO_(2)의 용해도는 다른 기체들에 비하여 매우 높은 반면 확산도는 큰 차이를 보이지 않았다. 또한 막내 이온액의 조성은 CO_(2) 용해도에 영향을 관찰할 수 있었다. 막내 이온액의 조성이 증가함에 따라서 CO_(2) 의 투과도 및 선택도가 극격히 증가하였다. 이는 SLM를 통한 기체 투과에 있어서 용해도가 주인자로 큰 영향을 끼침으로써 막내 이온액 조성 증가 SLM의 투과에 큰 영향을 미침을 확인하였다. The new supported liquid membranes (SLMs) were fabricated from ternary polymer solution contained ionic liquid in which primary and secondary phase separations were induced by the solvent by the solvent evaporaton. The used ionic liquid and polymer matrix were BMBF_(4) (BMI+=-(1-butyl)-3-methylimidazolium, BF_(4)-tetra-fluoro boratel and polyvinylidene fluoride (PVDF). Gas permeation properties of the SLM to O_(2), N_(2) and CO_(2) were studied at various operating conditions. Although the SLM were operated under severe operating condition, it maintained high CO_(2) permeability and selectivity for quite long time. The solubility coefficient of CO_(2) in the membrace was very high in comparison with those of other gases; whereas there was no big difference in the diffusivity between CO and other gases. Moreover, in the permeation of pure gases, it is observed that the ionic liquid content in the membrane affected the solubility of CO_(2) in the memhranc. With increasing ionic liquid content in the membrane, the permeability and selectivity of CO_(2) increase significantly. There fore, in the permeation of gases through SLM, the overall permeation performances weir affected mainly by solubility coefficient. This observation can be discussed in terms of the influence of solubility coefficient with ionic liquid content in the membrane.

정신분열병환자와 기질성뇌증후군환자에 있어서 KWIS 하위검사들의 비교

최영택,박영남,정철호 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.3

In order to compare the cognitive functions between schizophrenia and organic brain syndrome, the authors performed Korean Wechsler Intelligence Scale(KWIS) for 30 schizophrenics and 30 patients with organic brain syndrome. Schizophrenics had significantly higher scores than patients with organic brain syndrome on the subscales of 'information', 'similarities' and 'block design' of KWIS, but no significantly differences were found between the two groups on the subscales of 'comprehension','arithmetic' and 'picture arrangement' of KWIS. These findings suggest that schizophrenics might be less impaired than patients with organic brain syndrome in the cognitive functions which required only simple memory or spontaneous visuomotor task, but there seemed to be no differences between two groups in those cognitive functions which required more complex, abstract and logical thinking or sustained attention.

지각된 스트레스와 스트레스 대처방식이 직장인의 우울과 불안에 미치는 영향

최영민,이정호,이기철 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

Objectives : We attempted to clarify the relationship of perceived stress and the ways of coping to depression and anxiety in the white-collar workers. Methods : Fine Humded forty-five white-collar workers in a large enterprise were studied using a questionnaire package composed of demographic data, job stress questionnaire, global assessment of recent stress, the ways of coping checklist, Beck depression inventory, and state-trait anxiety inventory. And self reports of the subjects were statistically analyzed with the method of path analysis. Results & Conclusions : Perceived stress(job stress plus life stress) and the coping(problem-focused plus emotion-focused) determined 28.2% of the depression, 39.1% of the state-anxiety, and 35.4% of the trait-anxiety. These findings suggest that perceived stress and the coping have significant effects on the depression and state-trait anxiety of the white-collar workers. Although seemingly similar, problem-focused and emotion-focused copings, were contrary to each other in effects. Problem-focused coping reduced depression, anxiety and perceived life stress. However, emotion-focused coping didn't reduce the depression and anxiety. Furthermore, emotion-focused coping tended to increase perceived life stress. From these findings the authors inferred that emotion-focused coping interpreted the perceived stress as threatening and consequently became ineffectively defensive. On the other hand, problem-focused coping appeared to interpret the perceived stress as challenge and this challenge-appraisal mobilized effective coping resources. Applying path analysis, the aurhors could make the interactional stress model in the white-collar workers comprised of perceived job stress, perceived life stress, problem-focused coping, emotion-focused coping, depression, and state-trait anxiety.

교통부 형식 증명 획득을 위한 창공-91 비행 시험 수행에 관한 연구

최병철,이정모 한국항공운항학회 1993 한국항공운항학회지 Vol.1 No.-

창공-91의 비행 시험의 목적은 성능 측정과 비행 특성의 확인이며 교통부의 기준은 주로 비행기의 운항에 따르는 안정성에 주안점을 두고 있다. 비행 시험으로 실속 속도와 이착륙 성능 그리고 상승 성능을 측정하여 비행 교범에 수록하였고, 안정성과 조종성의 적절함을 판단하였다. 창공-91 A2기의 비행 시험에 소요된 비행 시간은 81.5 시간이다.(창공-91 A₁기 : 52.8시간)