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.

Productivity Loss of Rheumatoid Arthritis Patients according to the Their Stages of the Disease Activity Score

( Sang-Cheol Bae ),( Jin-Hye Cha ),( Jung-Yoon Choe ),( Sung Jae Choi ),( Soo-Kyung Cho ),( Won-Tae Chung ),( Chung-Il Joung ),( Young-Ok Jung ),( Young Mo Kang ),( Dong-Wook Kim ),( Jinseok Kim ),( Y 대한류마티스학회 2018 대한류마티스학회지 Vol.25 No.2

Objective. Productivity loss was compared by 3-stage of disease activity and associations between higher disease activity and high productivity loss were identified. Methods. Data were extracted from Rheumatoid Arthritis (RA) Patient-reported Outcomes Research, which enrolled 2,000 RA patients (>20-year) on disease-modifying-antirheumatic-drugs (DMARDs) (≥ 6-month) from December 2012 to June 2013. This included 1,457 RA patients with the disease activity score (DAS-28-ESR) in their medical charts. Productivity loss in time and indirect cost was estimated using The World Health Organization Health and Work Performance Questionnaire (HPQ). Baseline characteristics and productivity loss outcomes were compared according to DAS-28-ESR groups. Results. 84.4% were females, 54.2% had low DAS-28-ESR (<3.2), and 38.2% and 7.6% had moderate (3.2∼5.1) and high DAS-28-ESR (>5.1). Patients with moderate to high DAS-28-ESR had higher lost productivity time (LPT) and monthly costs of LPT than those with low DAS-28-ESR (time in hours: 110.0±58.4 vs. 132.4±57.2 vs. 71.5±52.0, p<0.0001; monthly costs of LPT in 1,000 Korean won: 1,097±607 vs. 1,302±554 vs. 741±531, p<0.0001). Multiple regression analyses revealed significant associations with high LPT in high (adjusted odds ratio [OR]=3.87, 95% confidence interval [CI]: 2.18∼6.87) and moderate DAS-28-ESR (adjusted OR=1.88, 95% CI: 1.41∼2.52) compared to low DAS-28-ESR. In addition, positive associations with high monthly costs of LPT were observed in high (adjusted OR=3.45, 95% CI: 1.98∼5.99) and moderate DAS-28-ESR (adjusted OR=1.93, 95% CI: 1.43∼2.54) compared to low DAS-28-ESR. Conclusion. Timely therapeutic strategies should be taken into consideration given that the RA patients with moderate to high DAS-28-ESR showed strong associations with high productivity loss for effective management of RA. (J Rheum Dis 2018;25:122-130)

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.

권역심뇌혈관질환센터 사업의 비용-편익 분석

김병호 ( Byung Ho Kim ),감신 ( Sin Kam ),배상근 ( Sang Geun Bae ),김건엽 ( Keon-yeop Kim ),이원기 ( Won Kee Lee ),홍남수 ( Nam-soo Hong ),박형근 ( Hyeung-keun Park ),이혜진 ( Heyjean Lee ),조은정 ( Eun-jung Cho ),채성철 ( Shung C 한국보건정보통계학회(구 한국보건통계학회) 2017 보건정보통계학회지 Vol.42 No.1

Objectives: This study was conducted to investigate economic feasibility of operating Regional Cardiocerebrovascular Centers using cost-benefit analysis. Methods: The current study assessed cost and benefit data collected from nine hospitals which were designated as Regional Cardiocerebrovascular Centers between 2008 and 2010. Results: The operation of Regional Cardiocerebrovascular Centers reduced mortality rate and length of stay due to acute myocardial infarction and stroke and also decreased disability occurred after stroke. The total calculated cost of operating nine Regional Cardiocerebrovascular Centers was 19.85-22.30 billion won and the minimum benefit calculated was 23.98 billion won. Applying the maximum cost and the minimum benefit, the net benefit was 1.68 billion won, which is estimated to 190 million won per Regional Cardiocerebrovascular Center. Conclusions: The present study revealed that the operation of Regional Cardiocerebrovascular Centers was economically beneficial. The benefit would be larger if intangible benefit such as the long-term effects to community hospitals and enhancement of quality of life of patients and their families are considered.

흉골 골절의 의의에 관한 임상적 연구

원형섭,황성연,박정배,이준형,박철완,이근 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

It has been known that sternal fracture increases the risk of potentially life-threatening injuries, such as myocardial, pulmonary, and thoracic vascular injuries, and it has 25% to 45% of mortality, primarily resulting from these underlying injuries. The authors reviewed retrospectively the medical records and radiographic findings of the patients who admitted with sternal fracture at Chung Ang Gil Hospital from 1 June 1994 to 31 December 1995 to evaluate the significance and clinical course of sternal fracture. The results were followings: 1. The male to female ratio was 3:2 and the mean age was 43.1 and 45.4 years old in male and female, respectively. 2. Motor vehicle occupant accident was the most common cause of sternal fracture. 3. Of 33 cases, there was no death, but common associated injuries which were rib fracture, hemothorax, lung contusion, vertebral fracture, penumothorax, long bone fracture, myocardial contusion, flail chest, facial chest, facial bone fracture, and pericardial effusion, in order. 4. The clinical course of sternal fracture was determined primarily by associated injuries except for communited sternal fracture. 5. The patients with isolated sternal fracture, who had an otherwise normal chest x-ray, normal electrocardiogram, no other significant associated injuries and are hemodynamically stable, had a benign clinical course.

치료환경에 따른 만성정신질환자의 삶의 질

배 안,김진학,박수희,김명규,김중원 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 일 지역사회(나주시) 만성정신질환자 대상의 치료환경을 그 환경적 특성에 따라 전통적인 외래치료환경, 개방적인 입원치료환경, 폐쇄적인 입원치료환경으로 분류하고, 각각의 치료환경에 거주하는 만성정신질환자의 주관적 및 객관적 삶의 질을 평가 비교함으로서 치료환경의 특성과 차이를 알아보고자 하였다. 방 법: 전통적인 외래치료환경 환자 85명, 개방병동 입원환자 67명, 폐쇄병동 입원환자 58명이었다. 이들에게 Lehman quality of life scale을 사용하여 반구조적 면담을 시행하여 삶의 질의 객관적 및 주관적 지표들의 지수를 측정하고 세 환경간 측정치를 비교하였다. 세 집단간의 차이를 분석하기 위해 ANOVA Test와 χ²검증을 사용하였다. 결 과: 환자들의 자율성과 다양한 정신사회재활 서비스가 제공되고 있는 개방병동 환자들의 전반적인 생활에 대한 만족도가 지역사회 및 폐쇄병동의 환자들에 비해 더 높았다. 지역사회에서 외래치료를 받는 환자들은 한달 쓰는 용돈이 많고 피해를 본 경험이 적었지만, 여가활동 및 사회적 접촉빈도가 입원환자에 비해 더 낮았고, 건강과 재정, 여가활동의 주관적 만족도도 더 낮았다. 입원치료중인 만성질환자들은 지역사회 환자들에 비해 여가활동 및 사회적 접촉빈도가 더 많았고, 월 평균 쓰는 비용이 더 적었지만 주관적 만족도는 오히려 더 높았다. 또한 이들은 최근 1년간 폭력 및 비폭력에 피해를 당한 경험이 더 많았으며, 건강에 관한 만족도는 더 높았다. 결 론: 치료환경의 특성에 따라 만성정신질환자가 보고하는 삶의 질에 차이를 보였으며, 개방병동에서 생활하고 있는 만성정신질환자들의 삶의 질이 가장 높았다. 향후 지역사회에 거주하고 있는 환자들의 삶의 질 향상을 위해서는 다양한 정신사회재활 서비스가 제공될 필요성이 있을 것으로 보았다. Objectives: This study aimed to figure out the characteristics and differences of therapeutic environment by classifying into closed-ward inpatient, open-ward inpatient and community residence out-patient environment and comparing objective and subjective quality of life of each group. Methods : The subjects consisted of 67 open-ward chronic inpatients, 58 closed -ward inpatients in the National Naju Mental Hospital and 85 outpatients living in Naju. We measured objective and subjective quality of life using semi-structural interview by Leman`s quality of life scale and compared the 3 groups. We used one-way ANOVA and chi-square test to analyze the differences of the 3 groups. Results: Open-ward inpatients who have autonomy and various community service program were more satisfied with their general life than the others. Community residence outpatients spent more money and less assaults experience but their leisure activities and social contact frequencies were lower than in the inpatients. Outpatients were less satisfied with their health, finances and leasure activities. Inpatients had made leisure activities and higher social contact frequency than outpatients. They were more satisfied with their finances despite of the spending less the money monthly than the outpatients. They experienced violence and damage more often for the past one year and were more satisfied with their health. Conclusions: The quality of life reported by chronic mental patients differed according to the characteristics of therapeutic environment. The life-quality of open-ward inpatients were the highest among the 3 groups. It is necessary to serve various community service program so that we can improve the life-quality of community residence outpatients.

A-SCR을 이용한 직렬 공진형 CONVERTER의 특성평가와 설계

裵英鎬,丁元榮,金東熙 慶一大學校 1992 論文集 Vol.8 No.1

This paper discussed the operational principal and characteristics of Voltage Resonant Type DC-DC Converter of HF-Bridge Inverter Switching Control using A-SCR as switching elements. The characteristics of DC-DC Converter circuit were analyzed using the diagrams of design circuit and dimensionless control variables.

알루미나/Mo 복합체의 미세구조와 파괴인성에 미치는 제3상 첨가의 영향

배원태,김용진,최태현,정원도 국립경상대학교 공과대학 부설 첨단소재연구소 1993 尖端素材 Vol.3 No.-

In order to improve the fracture toughness of alumina-Mo composite, three-component systems has been studied : Al₂O₃-Mo-CeO₂, Al₂O₃-M0-(TZ-2Y), and Al₂O₃-Mo-(Ce-TZP). The particle size and volume fraction of Mo in alumina were fixed at 0.6㎛ and 5 vol.%. The microstructural change and the fracture toughness of these systems were analyzed. When the Ce-nitrate as CeO₂source was added, Mo and Ce-β-alumina were observed in the alumina matrix. When 2 mole% of Ce-nitrate was added as colloidal form, the composite showed a maximum fracture toughness(about 5.8MN/m?). However, standard deviaton of fracture toughness was large because of the nonhomogenity of the microstructure. On the other hand, when Ce-nitrate was added as solution, the higher the Ce-nitrate content, the lower the fracture toughness of the composite. When the TZ-2Y was added, Mo, ZrO₂(m), and ZrO₂(t) were observed in the alumina matrix. This composite showed a maximum fracture toughness(about 5.2MN/m) at 15 vol.% of TZ-2Y. When the Ce-TZP was added, Mo, Ce-β-alumina, ZrO₂(m), and ZrO₂(t) were observed in the aluminal matrix. This composite showed a maximum fracture toughness(about 6.3MN/m?) at 30 wt.% of Ce-TZP. This value is larger than that of hot pressed alumina/0.6 ㎛-5 vol.% Mo composite(about 6.1MN/m?).

Al₂O₃의 미세구조와 기계적성질에 미치는 Mo 첨가의 영향

정원도,배원태 국립경상대학교 공과대학 부설 첨단소재연구소 1991 尖端素材 Vol.1 No.-

The effects of Mo addition on the microstructure and mechanical properties of Al₂O₃ were studied, Mo powders with average sizes of 6, 1.6, and 0.6 ㎛ were dispersed in Al₂O₃. Mo particles suppressed the grain growth of Al₂O₃. With the increase of Mo amount, the relative densities of Al₂O₃/Mo composites decreased. Regardless of the particle size of Mo, the bending strength and the fracture toughness were maximized when 2.5 and 5 vol% of Mo were added respectively. When the 0.6 ㎛ Mo was used, the relative density, the bending strength, and the fracture toughness were higher than others. Comminution of 0.6 ㎛ Mo was not effective in increasing the bending strength and fracture toughness. The toughening mechani는 of Al₂O₃/Mo composite are thought to be the crack deflection and microcracking.

설계방식과 주거질 지표에 따른 공동주택 계획기준 개선연구 : 현상설계방식을 중심으로 Focused on Design Competition Method

배웅규,정종대,김원필 대한건축학회 2005 대한건축학회논문집 Vol.21 No.3

This study is aimed at evaluating the current multi-family housing projects under the site planning criteria by examining its application and design process to improve the current criteria. In order to assess the application of the current site planning criteria, two competition schematic designs were compared each other on the same land area. The research found that facilities such as retail shop, security posts, maintenance office, nurseries and libraries were not provided according to the current site planning criteria. In addition, it showed that parking lots and other community facilities did not follow the current site planning criteria but rather changed based upon individual needs. When evaluating the criteria in lieu of the number of residents and unit size, the study found that a block with more residents and smaller unit size (block A) less stringently adhered to the site planning criteria, comparing with a block that has larger unit size and less residents (block B). In order to strengthen the current site planning criteria, seven quality indicators were examined for the evaluation of the competition schematic design by per floor space and per housing unit, verifying that good design also scored well on every quality index. It was also maintained that the need to review the current criteria scope of resident and unit size, along with module size was important for the qualitative housing design.