하악골에 발생한 골막 골육종

김태우,김승범,권혁찬,문선재,윤정훈,김형준,차인호,육종인,김진 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

Periosteal osteosarcoma is a distinct entity of malignant bone tumor with characteristic clinical, morphological, and histological features within the group of juxtacortical osteosarcoma. Periosteal osteosarcoma is predominantly located in the tubular long bones, and extremely rarely involving the jaws. A case of periosteal osteosarcoma of the right mandible is presented. A 27-year-old woman complained of the gingival swelling and bleeding tendency of the right posterior mandible. Clinical examination revealed a reddish brown strawberry-like swelling on the affected mucosa, which measured 1.5㎝×1.5㎝. The tumor was located on the lingual cortex of the mandible and extended into the surrounding soft tissues. Microscopically, the tumor consisted exclusively of atypical chondroblastic cells with a small osteoblastic area. A minimal bone marrow involvement was noted and the adjacent cortex was free of tumor. These findings suggested that the tumor originated from the periosteal cambium layer, which lies between the periosteal fibrous layer and the cortex of mandible.

전자상거래에 데이터마이닝 기술 적용

김종완,진승훈,김병익,김태균,김영순 대구대학교 과학기술연구소 2001 科學技術硏究 Vol.8 No.1

The definition of data mining is the non-trivial extraction of implicit, previously unknown and potentially useful knowledge from data. Also, data mining has been worked on various fields such as database, machine learning, statistics, expert systems, and data visualization, and is a process consisting of these techniques. In many E-Commerce applications, it is important to build personalized profiles of individual users from their transaction histories. These profile constitute models of individual user behavior and can be specified with sets of rules learned from user transactional histories using various data mining techniques. In this paper, we present a MAS (multi-agent system) for customer management which maintains personal user information automatically, commands retrieval of products according to user preference, and builds personalized profiles of user.

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.

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

유방암에서 bcl-2와 p53 표출에 관한 연구

김의한,김대중,강상균,양승하,홍기언 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

In order to observe the expression of bcl-2 and p53 protein in the 29 cases of invasive ductal carcinomas and to evaluate the correlationship between the two results, the author has carried out immunohistochemical staining with mononuclear antibodies against bcl-2 and p53. The results are obtained as follows: 1. bc1-2 showed positive reaction in normal duct, lobule and hyperplastic epithelium, and p53 showed no reaction in the same tissue. 2. In 15 cases of well differentiated type, the bc1-2 was positive in 14 cases (93%), and the p53 was positive only in 4 cases (26%). In 6 poorly differentiated type, the bcl-2 was positive in 2 cases (33%), and the p53 was positive in 3 cases (50%). The relationship between the bcl-2 and the p53 showed that in well differentiated type, bcl-2(+)/p53(-) expression was most commonly observed, while the bcl-2(-)/p53(+) expression was not seen in well differentiated type. 3. The size of tumor appeared to have no direct relationship to bcl-2 and p53 positive rate. 4. The expression of bcl-2 and p53 in intraductal carcinoma portion showed that when intraductal tumor component was positive, the invasive portion tumor cell was also positive. However the bcl-2 positive tumor cells in some intraductal component apeared to be negative in p53. Above findings showed that the bcl-2 protein was more frequently expressed in low grade lesion and the p53 protein was in high grade lesion. Also bcl-2 and p53 positive or negative findings showed different results in the same tumor cells.

척수손상 환자의 합병증

김봉옥,박상균,남명호,윤승호 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

To evaluate the rehabilitative care needs of the patients with spinal cord injury in this regional area, the complications which were seen in the department of rehabilitation medicine in Chungnam National University Hospital during the 1st year since the opening of the isolated rehabilitation medicine ward in September 1989 were analyzed. The study population was consisted of 25 men and 2 women. Nine cases (33.3%) were in the 20-29 age group and 11 cases (40.8%) were injured by traffic accident, the most common cause of traumatic spinal cord injury in this study. Sixteen cases(59.2%) were paraplegics and eleven cases(40.8%) were quardriplegics. The duration from the onset of injury to admission to the department of rehabilitation medicine ranged from 21 days to 14 years with mean of 18 months. The complications seen in this study were as follows. 1. Urinary tract infections, most common complication, were found in 14 cases (51.6%) followed by decubitus ulcers (44.4%), edema of leg (22.2%), spasticity (18.5%). 2. The most common organism of urinary tract infection was E.coli(43.0%). 3. Among the 22 cases which underwent IVP and VCUG, 2 cases showed hydronephrosis in IVP and 4 cases showed vesicoureteral reflux in VCUG. 4 The most common site of pressure sores was sacrum(53.3%). 5. The mean duration of pressure sore healing with non-surgical treatment was 18 days in Grade II and 42 days in Grade III. With the above results, it is concluded that most frequent complications of patients with spinal cord injury were urinary tract infection and pressure sores, with most of them being occurred before the admission to department of rehabilitation medicine and being treated completely during the stay in the department of rehabilitatiom medicine, and that the comprehensive rehabilitation treatment for the prevention of complications is necessary from the onset of injury.

Stage II B형 골육종에 대한 술전 항암화학요법 및 수술적 치료 결과

김정만,우영균,김형민,김훈교,이승구,강용구 가톨릭중앙의료원 가톨릭암센터 1997 암심포지움 Vol.- No.1

Recent advances in imaging techniques, surgery and combination anti-cancer chemotherapy have brought high survial rates in osteosarcoma. To investigate the survival rate, local recurrence and complications in treatment, we analysed 25 osteosarcoma cases who had been treated with preoperative neo-adjuvant chemotherapy, surgery and post operative chemotherapy at Department of Orthopedic Surgery, Catholic University. From May 1988 to April 1995, 42 cases of stage IIB osteosarcoma were admitted in Department of Orthopedic surgery. Among them, 17 cases who didn't follow our treatment guidance were excluded in this study. The average age were 19 years. There were 21 males and 4 females. The involved sites were 4 humerus, 10 femur, 10 tibia and 1 talus. Eleven cases had received intra-arterial cisplatin and intravenous adriamycin chemotherapy, and 7 T-10 protocol and 7 intravenous ifosfamide, ADR, methotrexate, cisplatin. Among twenty-three cases were treated with limb salvage surgery, and 2 amputation. The average follow-up was 35 months(3-82). There were 14 cases of continuous disease free, 9 cases of died of desease, 1 case of alive with disease, and 1 case of no evidence of disease at final follow-up. There were three cases of local recurrence at 6,8 and 12 months after operation. The Estimated kaplan-Meier's 5 year survival rates for all, ADR-cisloatin group, T-10 protocol group, and ifosfamide regimen group were 66%, 73%, 44% and 72%, respectively.

위선암에서 p53과 P-glycoprotein의 분포에 관한 연구

김대중,김의한,강상균,양승하,민병철 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.1

Gastric adenocarcinoma express many oncogenes, such as p53, c-erbB, k-sam, etc. The p53 especially acts as tumor suppressor in normal tissue and various mutational changes. of p53 are known as doing important role in carcinogenesis of gastric adenocarcinoma. P-glycoprotein, as a pleotrophic membrane transport protein, shows specific distribution in many normal tissues and malignant tumors. This protein, produced by MDR gene, shows multidrug resistance to anticancer drug by pumping out intracellular drug. resulting in resistance to chemotherapeutics. The expression of p53 and P-glycoprotein according to clincopathologic findings in gastric adenocarcinoma has been studied, even though their results are controversial. To observe the relationship between both antigens and clinicopathologic findings of gastric adenocarcinoma. we were analysesed 40 cases gastric adenocarcinoma then processed for immunohistochemical stain by SLAB method using p53 and JSB-1 monoclonal antibodies. The results were as followings: 1) The p53 and P-glycoprotein showed positive in 20 cases(50%) and 21 cases(52.5%) of 40 cases respectively, and 10 cases(25%) showed positive reaction to both antigens. 2) p53 revealed higher positive rate in intestinal type(54.6%), differentiated form(57.1%), advanced form(58.1%) compared to diffuse type(28.6%), poorly differentiated form(42.1%), early cancer(22.2%), but no difference according to age, sex, lymphatic metastasis and signet ring cell within tumor. 3) P-glycoprotein revealed higher positive rate in interstinal type(54.6%), differentiated form(61.9%), advanced form(58.1%), absence of signet ring cell (63.3%) compared to diffuse type (28.6%), poorly differentiated form (36.8%), early cancer(33.3%), presence of signet ring cell(20.0%), but no difference according to sex, age, lymphatic metastasis. 4) Positive rate in intestinal type, differentiated form, advanced form, and presence of signet ring cells in gastric adenocarcinoma showing both positive reaction of p53 and P-glycoprotein, are higher, but no difference according to age, sex, lymphatic metastasis. 5) In noneoplastic mucosa adjacent to cancer, p53 revealed negative reaction in all cases. P-glycoprotein showed positive reaction in all metaplastic glands 33 cases and parietal cells 17 cases, and in 16 cases(40%) of 40 cases of luminal surface and gastric glandular epthelium, and showed negative reaction in all 12 cases of chief cell. Above results revealed that positive rates of p53 and P-glycoprotein in gastric adenocarcinoma are almost same and there is no relationships between both antigens. Both antigens showed simillar high positive rate in intestinal type, differentiated form and advanced form, indicating association with these clinicopathologic findings.

위선암에서 조직면역학적 방법을 이용한 P-glycoprotein의 분포에 관한 연구

김만성,양승하,김의한,강상균 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

P-glycoprotein, as a pleotropic membrane transport protein, shows specific localization in many normal tissue and malignant tumor. It act as an energy dependent drug pump in malignant tumors and makes difficulty for treating these tumors with anticancer drugs. Many malignant tumors such as colon carcinoma, renal cell carcinoma, hepatoma, islet cell tumor of pancreas, and adrenal cortical carcinoma, show high expression of P-glycoprotein and resistance to chemotherapy. However reports for P-glycoprotein in gastric adenocarcinoma is rare. The difference of its expression according to differentiation of gastric adenocarcinoma has been studied and its results are controversial. To observe the relationship of P-glycoprotein positivity according to differentiation of carcinoma, age and sex, adenocarcinoma 82 cases and dysplastic lesions 12 cases were analysed then processed for immunohistochemical stain by avidin-biotin complex using mAB JSB-1. The results were as followings : 1. Positive rate of P-glycoprotein in gastric adenocarcinoma and dysplastic lesions were 48.78%(40/82) and 50%(6/12). 2. Well, moderate and poorly differentiated adenocarcinoma showed positive reaction of P-glycoprotein in 51.28%(20/39), 46.43%(13/28) and 46.67%(7/15) respectively. 3. Positive reaction of P-glycoprotein in male was 53.85%(35/65) and female in 29.41%(5/7) which indicate high positive rate in male. 4. Positive rate of P-glycoprotein according to age distribution were 25%(1/4) in 20-30 decade, 42.8%(6/14) in 40 decade, 44.83%(13/29) in 50 decade, 57.14(12/21) in 60 decade and 57.14%(8/14) in 70 decade. It indicate that P-glycoprotein positivity is increased with age. The above results reveal that the expression of p-glycoprotein in gastric adenocarcinoma as related with sex and age but not with differentiation of carcinoma. These results implies that P-glycoprotein may be implicated with hormone dependent.

수압팽창술을 이용한 동결견의 치료

김봉옥,박상균,윤승호 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

The purpose of this study was to evaluate the effectiveness of hydraulic management in patients with frozen shoulder which were not improved with previous conservative treatment. The study population was consisted of 4 men and 6 women, 6 cases were affected in the dominant side and 4 cases in the non-dominant side and the duration of frozen shoulder was ranged from 3 to 18 months, with mean duration of 8.8 months. Associated conditions were trauma or fractures in 5 cases and cervical radiculopathy in 2 cases. The results were as follows : 1. The pre-treatment shoulder ROM was 77° of flexion, 53° of abduction, 21° of external rotation, and 39° of internal rotation, and more severely limited in external rotation and abduction than in flexion and internal rotation. 2. The post-treatment ROM was 132° of flexion, 118° of abduction, 64° of external rotation, and 68° of internal rotation. 3. With the hydraulic management, increased ROM were 55° of flexion, 65° of abduction, 43° of external rotation and 29° of internal rotation. 4. The performance of ADL's and subjective symptoms such as pain, stiffness, sleep disturbance showed moderate to marked improvement in 8 cases. 5. No complications were observed with the hydraulic management. With the above results, hydraulic distension was thought to be the effective method for improvement of subjective symptoms and increment of ROM in patients with frozen shoulder.