조선초기 문신 姜希孟의 관직생활

강제훈(Kang Jae-hoon) 한국인물사연구소 2008 한국인물사연구 Vol.9 No.-

This study aimed at looking into Kang Hui-maeing's office life for the understanding of the early Joseon society dominated by yangban(two upper classes). Through reviewing on his life we can interpret constant factors to make his way in office life in Joseon as well as variable ones. He was out of top drawer, a nephew of King Sejong's wife and got the first position in the civil service examination come up 1447, King Sejong's 29th year. He enjoyed a success career during King Sejo's ruling period(1455~1468) and reached the peak point when King Seongjong rose. He started office life in 24 years old and got a dangsanggwan position, the major third rank, 10 years later. He took office as the minister of the Ceremonies Board in 1466, King Sejo's 12th ruling year. He died at 1483 with two titles as a meritorious retainers without taking the position for state councilor. Key point of his success was to have taken good results, ranked the first class, in the successive two tests by King Sejo for inservice officers. This enabled hime to get dangsoangwan and panseo post. He was a ceremony and writing expert whom the dynasty need for establishing confucian state and keeping stable relations with Ming China. He went through almost all posts in the Ceremonies Board from jwarang(assistant section chief) to panseo (Minister). He had his son got to married to a grand daughter of Sin Sukju, first class meritorious retainer. It helped him to get the meritorious title. He participated in discussion sessions with the king Seong Jong as a Gyeongyeongwan holding additional posts and meritorious retainer. Seongjong left his first son who acceded to the throne later in Kang's care for several years and nominated him for Yijo-panseo positon, Minister of Personnel. His success story shows that in Joseon society a person could not success depending solely on one's family. For successful office life it requires to be a fine writer and to get a special status like a meritorious title.

Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

악성 갑상선 우연종의 임상상 및 초음파 소견의 진단적 가치

강한욱,김광원,이병완,강보현,김형훈,김범진,정재훈,민용기,이명식,이문규 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 최근 갑상선 초음파 검사의 빈번한 시행으로 갑상선 우연종의 발견이 증가하고 있다. 이러한 갑상선 우연종은 임상적으로 어떻게 접근하고 치료를 해야 하는지 적지 않은 문제가 되고 있다. 본 연구에서는 직경 1.5㎝ 이하의 갑상선 우연종의 유병률, 입상적 특징 및 초음파 특성, 그리고 가장 효율적인 진단적 접근에 대해 알아 봤다. 방법: 1999년 1월부터 2000년 12월까지 삼성서울병원 내과 및 일반외과로 갑상선 결절을 주소로 내원한 1457명을 대상으로 후향적 연구를 시행하였다. 우연히 발견된 직경 1.5㎝ 이하의 갑상선 결절을 가지는 환자들에서 갑상선 결절의 촉지 유무, 갑상선 기능검사, 항갑상선 항체, 갑상선 초음파 및 미세침 흡인세포검사, 99m^Tc 갑상선 스켄, 수술 조직검사 및 병기를 검토하였다. 결과: 분석한 갑상선 결절 1475예 중 갑상선 우연종의 유병률은 13.4%(198예)였다. 갑상선 우연종에서 악성률은 28.8%(57예)으로 나왔다. 양성 및 악성 갑상선 우연종에서 나이, 성별, 갑상선 기능검사, 결절 크기에는 의미 있는 차이는 없었다. 갑상선 스켄은 갑상선 우연종의 감별에 적합하지 않았다. 갑상선 결절의 초음파 지표 점수만이 양성 및 악석 갑상선 우연종의 감별에서 초음파 지표 점수의 민감도는 88.9%, 특이도는 74.4%, 양성 예측률은 92.4%로 나왔고 진단적 정환도는 85.5%였다. 갑상선암으로 수술을 받은 50명중 stage 1은 34명, stage 2는 6명, stage 3은 10명으로 대부분의 악성 갑상선 우연종은 낮은 TNM 병기로 나타났으나, 상당수에서는 국소 침범의 소견을 보였다. TNM 병기의 3기 환자 전부는 45세 이상이였고, 주로 갑상선암의 피막 침범에 의한 것이었다. 임파절 전이는 6명의 환자에서 나왔다. 결론: 악성 갑상선 우연종은 비교적 흔히 접할 수 있는 질환이며 양성 우연종과는 임상적으로 구별이 안 된다. 악성 갑상선 우연종은 발견 당시 대부분 낮은 병기이나, 갑상선의 피막 침범 및 임파절 전이가 상당수에서 발견되었다. 갑상선 우연종의 초음파 소견은 향후의 진단 방향을 제시하는 중요한 길잡이가 될 수 있다. 초음파 지표 점수 2점 이상의 갑상선 우연종에서만 초음파 유도 미세침 흡입검사를 권장한다. Background: High-resolution ultrasonography has made the detection of asymptomatic small thyroid possible. Recent increases in the detection of incidentalomas have created a clinical dilemma on how to properly manage such incidental nodules. We investigated the prevalence, clinical and ultrasonographic characteristics, and optimal diagnostic approach toward incidentally detected benign and malignant thyroid nodules of less than 1.5㎝ in size. Methods: A retrospective review was undertaken on the 1,475 patients who had visited Samsung Medical Center, Seoul Korea between January 1999 and December 2000. The review consisted of a physical examination of the thyroid gland, thyroid function test, antithyroid antibodies, thyroid ultrasonography, fine-needle aspiration biopsy, pathology and TNA staging of the incidentally detected thyroid nodules of less than 1.5㎝ in size. Results: The prevalence of thyroid incidentalomas was 13.4% and the malignancy rate within them was 28.8%. There were no significant differences in age, sex, thyroid function test and size between the benign and malignant incidentalomas. Ultrasonographic characteristics showed meaningful diagnostic value for the detection of malignancy in incidentalomas. Most malignant incidentalomas were of a low stage. Conclusion: Occult thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodules less than 1.5㎝; however, ultrasonographic findings can be used to decision of optimal management strategies (J Kor Soc Endocrinol 17:649∼656, 2002).

개에서 디스템퍼 바이러스와 톡소플라즈마의 혼합 감염

강홍원,강상철,양형석,배종희,김재훈 한국임상수의학회 2004 한국임상수의학회지 Vol.21 No.1

A 3 month-old male dog with clinical signs of anorexia, soft stool, ocular and nasal discharge, cough and respiratory distress was submitted to the Cheju National University for diagnosis. At necropsy, tan to purple-red sublobar to lobar consolidations were presented in apical and cardiac lobe of lung. Histopathologically, severe diffuse bronchointerstitial pneumonia with necrotic bronchiolitis was noted in the lung. The demyelinating encephalitis and astrocytosis were presented in cerebellum and cerebrum. Numerous round, ovoid or cluster of tachyzoites were also identified in alveolar lumen, alveolar wall and cytoplasm of macrophages in the lung. The orgasnisms were demonstrated as Toxoplasma (T) gondii by immunohistochemistry. Intranuclear or intracytoplasmic eosinophilic inclusion bodies were seen in the glial cells of the cerebellum. Canine distemper virus (CDV) specific antigens were demonstrated in the cerebellum by the immunohistochemistry. In our knowledge, this is believed to be the first confirmed report of co-infection of CDV and T gondii in dog in Korea.

황해와 동중국해 표충수온의 계절변화

강재훈,방익찬,장경일 제주대학교 해양연구소 1999 해양자원연구소연구보고 Vol.23 No.-

In order to obtain the fundamental data on the auditory thresholds of fishes for Marine ranching, the auditory thresholds of Scorpion Fish Sebastiscus marmoratus were measured in the presence of masking noise in the spectrum level range of 75 - 83dB re 1 μPal□ with a classical cardiac conditioning technique. Critical ratios were about 27 - 35dB at 300Hz and 47 - 50dB at 500 - 800Hz including 19dB at 80Hz. The ratio increased almost linearly with increasing frequency to 500Hz. The noise spectrum level at the start of masking was about 60 - 65dB within the frequency range of 80 - 3NHz and 70 - 75dB a t 80, 500 and 800Hz. This suggests that hearing of the Scorpion Fish is masked in the natural environment with the noise spectrum level above 65dB. The sound pressure level of which the signal sound of 100 - 200Hz is recognized by Scorpion Fish under the ambient noise is above WdB and the critical ratio of them is above 30dB.

밀링가공에서의 온도분포와 절삭력 예측을 위한 연구

강재훈,송준엽,박종권 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

This paper presents a simple analytic method using 2D simulation program for predications of cutting force and machining temperature in dry type milling process. And also, comparison of cutting force and machining temperature obtained from experiment and simulation work is accomplished to distinguish of suitability.

연삭 공정의 연속 진단을 위한 모니터링에 관한 연구

강재훈 한국공작기계학회 1999 한국생산제조학회지 Vol.8 No.1

Recently, manufacturing work has been transformed to small scale production form with various types to act up to user's expectation from mass production with a little items required in the past. Then FMS using NC type machinaries has been applied actively also in domestic manufacturing line to meet thus tendency, but there are many machining troubles occured during work process not be settled yet. Nowdays high efficiency has been required no less than high precision in grinding work for the improvement of productivity. In this study, to represent more advanced FMS can be adapted to thus situation In-process type monitoring method using AE and Current sensors is suggested to investigatethe machining condition in grinding process. As results from this experimental study, it is recognized well that grinding conditions and dressing point of in time can be estimated effectively using monitoring method suggested. Furthermore, surface shape of grinding wheel on voluntary point of in time can be predicated indirectly through the observation and comparison of AE signal waveform obtained as performance of continuous dressing work.

전해 드레싱을 이용한 고품위 내면 연삭 가공에 관한 연구

강재훈 韓國工作機械學會 2000 한국생산제조학회지 Vol.9 No.2

The establishment of a practical ultra-precision grinding technique using Diamond and CBN wheels is one of the major key technolo-gies to improve production techniques for machine-to-difficult materials without finishing process such as lapping and polishing. But the special efficient dressing technique for ultra-fine grit type grinding wheels to stabilize the grinding ability was not developed. Recently, electrolytic in-process dressing technique is proposed to ultra-fine grit type metal bonded diamond wheels to protrude abra-sives continuously from the tool surface. This technology can be widely used to surface grinding and cylindrical grinding, but cannot be used efficiently to internal grinding because of the electrode attachment trouble. This paper describes the effect of interval type electrolytic dressing as proposed newly to cast iron bonded diamond wheel for efficient internal grinding with mirror type high quality ground surface.

절단된 안면신경의 일차문합술

강진성,한기환,송중원,오재훈 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.4

Because the facial nerve innervates the muscles of facial expression, injury to this nerve may cause social, psychological, and functional disability. For this reason, a transected facial nerve must be restored appropriately by any one of a variety of approaches. The choice of anastomosis should be based upon the cause, location of transection and the length of time since paralysis was first noted. Although there are numerous methods of anastomosis, none will result in complete recovery. And thus, the method must be carefully selected and tailored to suit each patient. During the 20 months between July 1988 and February 1990. We have been operated (immediate end to were epineurial repair) in 20 patients. 15 of 20 aged 23 to 60. There were 13 males and 2 females. The nerve injury was unilateral in all cases. One of 15 received a nerve graft harvested from the greater auricular nerve. 12 of 15 Stensen's duct injuries were associated with served zygomatic branch and/or buccal branch. So an end to end anastomosis of the duct was performed simultaneously with anastomosis of the nerve. Failure to repair the duct resulted in a salivary fistula in two cases. To show the success of the procedure, EMG(electromyogram) and NCV(nerve conduction velocity) were done at least 6 months following surgery. The findings have been considered good to excellent and the reinnervated muscles have showed symmetric movements in all cases.