발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

성인학습자의 이러닝 준비도 측정도구 개발

김정원,강민석,신성욱 한국교육방법학회 2012 교육방법연구 Vol.24 No.2

본 연구는 성인학습자의 이러닝 준비도 측정도구를 개발하고 그 타당성을 검증하는 것을 목적으로 하였다. 이를 위해 선행연구들로부터 도출한 기초문항을 토대로 국내 모기업 성인학습자 250명을 대상으로 설문을 실시하였으며, 223명의 자료가 수집되었다. 223명의 자료는 탐색적 요인분석, 신뢰도 분석, 확인적 요인분석 등의 방법으로 분석되었다. 온라인 학습 환경에서 성인학습자의 이러닝 준비도 구인 타당성 검증 결과, ① 정보기술 활용성, ② 사회적 상호작용, ③ 정보 공유 및 관리, ④ 자기주도성의 4요인 모형이 도출되었다. 이 연구는 성인학습자의 이러닝 준비도의 구성 요소를 종합적으로 제시하고, 이를 토대로 성인학습자의 이러닝 준비도 측정도구를 실증적으로 개발하였다는 데에 의의가 있다. The purpose of this research is to develop a tool for measuring e-learning preparation level of adults and verify its validity. In order to conduct, a survey consisting of a number of basic questions derived from the previous researches was conducted on 250 adult employees of one company and, in total, data on 223 adults was collected. 4 main models were derived after verifying the validity of the level of the e-learning preparation for adults in online learning environment: (1) use of information technology; (2) social interaction; (3) openness and management of information; (4) degree of self-lead. This research attempted to do a research on the development of a measurement tool to assess our level of preparation for e-learning on the basis of domestic e-learning environment. According to this context, this research examined the existing concepts of learning preparation composition in conjunction with digital literacy. Among other important findings, this research has revealed the unacknowledged ‘utilization of information’ as a new e-learning composition element and investigated its validity and credibility.

스포츠법상 불법행위책임에 관한 연구

정명수,이강욱 朝鮮大學校 스포츠科學硏究所 2005 스포츠科學硏究 Vol.16 No.-

With the increase in a desire for healthy life and a sense of enjoying human life, sports activity of modern society has become one of necessary social and cultural tools. However, since sports are in substantial characterized by accomplishment orientation, competitiveness, high-difficulty technique, and challenge to the limitation of human faculty, they have high probability of serious or inevitable accidents. Under this circumstances, People's legal sense about their rights has been reinforced and victims increasingly seek their legal responsibility as a positive solution against offenders. However, considering the inherent value and essential danger of sports and peculiarities of sport events, it is not appropriate to apply a solution to dispute by a civil or criminal suit which deals with crimes or accidents in ordinary social relationship. For this reason, this study is intended to derive legal principles of protection and relief for victims and of reduction and exemption from responsibility for offenders in sport accidents caused by sports activity and participation on the assumption of comprehensive fundamental rights based on constitution and fundamental right of sports not listed. To achieve this goal, this study reviewed and analyzed domestic or international literatures, theses, academic seminar materials, and books. First, liability of illegal sports acts decides liability for the damage according to the following procedure based on the conformity rule of Art. 750 of the Civil Law. The objective of civil liability is to decide liability with its focus on victim's relief. To meet conditions of sports acts in terms of a principle of law, i)offender's deliberation and negligence of his/her harm shall be proved and ii)an act of actor with liability capacity, that is, an act of actor with discretion capacity constitutes an illegal act and has liable ability, When i) and ii) are met, the liability for damage is decided. If the act is very deliberate and harmful and has gross negligence, the scope of estimating damage shall be broadened. Second, in case supervisors such as sports teachers, directors, and coaches, or sports clubs and schools teachers are negligent in their attention duties, it shall constitute violation of supervisor's attention duties. resulting in supervisor's liability as special illegal act in accordance with Article 755 of the Civil Law. In particular, illegal sports acts related to sports activity which occur by a person without liability capacity(a minor provided in Article 753 and the non compos mentis in Article 754 of the Civil Law) constitute this case. Third. user's liability provided in Article 756 of the Civil Law defines a type of special illegal acts and acknowledges obligation to damage of sports coaches, government employees, and teachers as well as general company subjects, interpreting the scope of user's liability. In case accidents happen because of the fault of sports coaches, government employees, or teachers, they shall be primarily liable. User's liability is based on the principle of compensation liability that since users benefit from certain business, they should accept damage, and the principle of damage liability that a person making danger shall be responsible for the danger. But in case sports coaches work for public sports facilities or public schools. their liability shall be exempted in accordance with Article 756 of the Civil Law, and instead, state or public agencies shall bear compensation liability in accordance with Article 2 of the State Tort Liability Act. Finally, Article 758, Section 1 of the Civil Law defines structure liability that in case the establishment or fail to maintain of structure causes damage to others, the possessor of the structure shall be primarily liable and its owner shall be secondarily liable. Imposing a heavy duty to maintain safe state or minimize danger of structure including sports facilities or stadiums upon managers(owner·possessor) is based on the principle of danger liability that acknowledges possessor's no-fault liability about sports facilities. By taking full and complete care of maintaining sports facilities or stadiums with high danger and maintaining a safe condition in an aspect of architecture or technology of sports facilities. it guarantees sound and positive sports activity, meets policy concern, and realizes ideal social community life in terms of relief from accidents. By defining a duty of strict attention and supervision, owners and mangers of sports facilities will try to prevent danger and secure safety. In sports-related crimes·accidents. the first important purpose is to find out legal liability and give relief and protect victims. However, offenders could get into social and economic danger due to increase in economic burden caused by liability for damage or be branded as a criminal in society. Such recognition may be a great obstacle to the development and promotion of sports, impair the value or essence of sports, and even contract sports participation or activity. It is sure that legal liability should be strictly applied by civil·criminal interpretation of law about deliberation, negligence, and illegality in the level of th positive law in a constitutional state in order to secure social peace and public order and national, social, and individual benefit and protection of the law. However, from an angle of sports, given peculiarity and inherent danger of sports, the methods to reduce or exempt civil·criminal liability against tort need to be explored in order to minimize offender's economic damage, to secure his/her social and economic status, and to protect minimum human rights. The law principles of exemption are as follows. i) The principle of accepting danger(accepted danger) ii) Force majeure iii) The principle of reliance iv) The principle of self-fault v) a cause to exempt illegality For this case, the Civil Law has a provision of self-defense and emergent refugee(Article 761 of the Civil Law). Accordingly, it is reasonable to invoke a cause to exempt illegality provided in Article 20 and 24 of the Criminal Law(justifiable acts, self-defense, emergent refuge, self-help, and victim's consent) and Article 761 of the Civil Law(self-defense and emergent refuge) and apply as the principle of offender's exemption). However, in case severe accidents(e.g., death), infringement by gross negligence, or physical and property loss greatly breaks social established rules and acceptability, it shall be bear civil·criminal liability.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

골격성 Ⅲ급 부정교합자의 전치부 수직피개도에 영향을 미치는 요소 - 개교군과 피개군간의 비교

정정화,남형진,강상욱,손우성 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

신경회로망 예측기법을 이용한 Variable Rate Leaky Bucket 알고리즘의 구현에 관한 연구

강상욱,윤정오,최병진 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(B)

ATM (asynchronous transfer mode)을 이용한 B-ISDN의 출현은 다양하고 새로운 멀티미디어 서비스를 가능하게 하였다. 그러나 다양한 트래픽 자원들의 버스트성 때문에 이들 트래픽을 동시에 서비스하는데 혼잡제어 (congestion control)라는 새로운 문제에 당면하고 있다. 이를 위하여 UPC/NPC (user parameter control/network parameter control)에 대한 여러 연구가 활발히 진행되고 있는데, 트래픽 상태와 버퍼의 점유 상태에 따라 토큰 생성율을 동적으로 변화시키는 VRLB(variable rate leaky bucket) 알고리즘이 UPC/NPC 메커니즘의 좋은 예가 될 수 있다. 그러나 VRLB 알고리즘과 같은 기존의 UPC/NPC 메커니즘의 단점은 토큰 생성율이 현재 망의 상태에 기반을 두고 있기 때문에, 버스티한 성격을 지닌 트래픽 자원 하에서는 효율성이 떨어진다는 것이다. 본 논문에서는 토큰 생성율을 현재 상태에 기반을 두고 결정하는 VRLA 알고리즘의 단점을 개선하기 위해서 신경회로망의 예측기법을 이용하여 토큰 생성율을 미리 예측하여 보다 유연하고 효율적으로 혼잡제어를 수행하는 새로운 알고리즘을 제안하고, 이의 성능을 컴퓨터 시뮬레이션을 통하여 확인하였다.

청소년 문화축제참여가 자아정체성과 사회공존지수에 미치는 영향

정명수,송은미,이강욱,정진영 朝鮮大學校 스포츠科學硏究所 2006 스포츠科學硏究 Vol.17 No.-

This study aims to examine the influence of the participation in the festivals on the development of the self identity and the influence of the emotional outlooks based on the participation in the festivals and the emotional outlooks produced by the interaction with others on the development of the self identity with the young people who participated in the 2004 Yeosu International Youth Festival as the subjects. Putting these findings together, it is shown that the participation of the adolescents in cultural festivals has a positive influence on the development of their self-identity, and, in particular, it is also shown that the emotional outlooks produced by the participation in cultural festivals and the emotional outlooks obtained through the interaction with others have a positive influence on the self-identity of the adolescents. Accordingly, it is necessary to study those programs producing no oppositions and the methods of participation for the development of the self-identity of the adolescents, and it is also necessary to develop natural programs and incentives to smooth the complex and diverse interactions among the participants.

驅動部 動特性을 高慮한 可變構造 制御 알고리듬

강익호,김정욱,신휘범,이정훈,고상호 慶尙大學校生産技術硏究所 1997 生産技術硏究所論文集 Vol.13 No.-

In this paper, the dynamics of actuators for generating the input of plants is considered in a design of the variable structure systems. While the input for plants is usually implemented by means of a certain actuator, the actuator dynamics is not incorporated in most of the VSS researches until now. The control algorithm of a VSS incorporating actuator dynamics is presented. and the simulation is given the usefulness of the algorithms.

방사선치료 후 영구치 치배 발육장애 증례보고 : REPORT OF CASE

강명봉,김영재,김정욱,장기택,이상훈,한세현,김종철 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.2

두경부 악성 종양에 대한 방사선치료는 유용한 방법이다. 하지만 방사선치료의 부작용으로 다양한 구강내 합병증을 동반한다. 이 글에서 치열 발육 단계에 방사선치료를 받은 두 증례를 보고하는 바이다. 첫 번째 증례는 생후 19개월에 급성 골수성 백혈병으로 진단 받아 방사선치료를 받은 7세 여자 환아로 영구치 치배의 선천적 결손과 왜소치 소견을 보였다. 두 번째 증례에서는 생후 13개월에 양측성 망막아세포종으로 진단 받아 방사선치료를 받았고 영구치 치배의 선천적 결손, 왜소치, 치근의 저형성 그리고 법랑질 저형성증 소견을 보였다. Radiotherapy for head and neck tumors is a viable treatment modality. However, a wide range of potentially debilitating dental complications may be accompanied by this treatment. We report two cases of developmental disturbance of permanent tooth germs after radiotherapy. The one was that of a seven-year-old girl, who had congenitally missing teeth, and microdontia of permanent tooth germs. she had received radiotherapy for acute myelocytic leukemia at the age of 19 months. The other was that of a nine-year-old boy, in which congenitally missing teeth, microdontia, root hypoplasia, and enamel hypoplasia of permanent teeth were observed. He had undergone a course of radiotherapy for bilateral retinoblastoma at the age of 13 months.

MAN 급의 망에서 공정성 개선에 관한 연구

강상욱,윤정오,최병진 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(C)

In this paper we introduce a solution to improve the unfairness problem and to remove the waste of bandwidth in the distributed queue dual bus system. This solution requires only a minor modification of the current protocol and further shows no bandwidth wastes when we try to resolve the unfairness problem occurred in current DQDB protocol. There has been many problem in DQDB system in terms of fairness of sending message in each node. In order to solve this problem, Bandwidth Balancing technic and proportional assignment technic have been introduced. It is, however, to note that the waste of bandwidth problem is still existing in those technics, even though there has been significant improvement as to the fairness problem. In this paper we introduce a new solution to remove the waste of bandwidth problem while we are still obtaining the improved fairness of the network. By following this new solution, the simulation result shows higher throughput and lower message delay than previously proposed technics.