간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

국가 대표급과 제주도 고교 대표급 수영선수들의 그랩 스타트의 운동학적 분석

김철원,김승곤,오만원,임상용,김성찬,이창준,남사웅,이세형,류재청,신석종,김세민 濟州大學敎 體育科學硏究所 1998 체육과학연구 Vol.4 No.-

The purpose of the study was to undertaken to analysis the Grab starting technique between national representive team(3) and Cheju's representive team(3) with 3D cinematography. The conclusions obtained were as follows: Cheju's showed more elapsed time than national representive team on starting block. and more vertical than horizontal direction of COG position, more concentrated vertical velocity & acceleration than forward direction. Therefore It is necessory for cheju's to train balanced trust force in horizontal and vertical direction in grab starting technique.

흉선 유암종을 동반한 제 1형 다발성 내분비 선종증

조민호 ( Min Ho Cho ),이근만 ( Kuen Man Lee ),송대훈 ( Dae Hoon Song ),안철우 ( Chul Woo Ahn ),김경래 ( Kyung Rae Kim ),황정주 ( Jung Joo Hwang ),백효채 ( Hyo Chae Baek ) 대한내과학회 2005 대한내과학회지 Vol.69 No.4

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant tumor syndrome. Thymic carcinoid tumors in MEN1 are not common and their natural history is little known. But development of thymic carcinoid tumors is important because in 1993, they were identified as a frequent case of death. There has not been a report of case in Korea so far. We encountered a case of thymic carcinoid in MEN1. A 42 year old man was referred presenting with diabetes of 12 years duration. Abnormal findings in his blood chemistry were hypercalcemia and hyperprolactinemia. 99mTc-sestamibi scintigraphy showed parathyroid adenoma and hyperplasia. Sella MRI showed pituitary macroadenoma. Abnormal CT scan demonstrated multiple pancreas islet cell tumors, bilateral adrenal tumor and thymoma. Subtotal parathyroidectomy with thymectomy was perfomed and thymic carcinoid was confirmed. This is the first report of thymic carcinoid with MEN1 in Korea.(Korean J Med 69:428-433, 2005)

제 1형 신경섬유종증 환자에서 발생한 위장관 간질종양 1예

원경준,이준,변유미,조민근,한경택,김원,홍란,임성철,김경종,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Gastrointestinal stromal tumor (GIST) is the most common non-epithelial neoplasm arising in the gastrointestinal tract, but this tumor is rarely seen in association with type l neurofibromatosis (NFl) Generally, the majority of GISTs are isolated neoplasm and they are sporadically found in the stomach, but the GISTs in NFl patients are usually multiple and usually found in the small intestine. We report a case of multiple GISTs in the jejunum of a 63-year-old woman diagnosed as NFl accompanied by complication of gastrointestinal bleeding, In this case, Patient had multiple cafe-au lait spots and neurofibroma on skin and had freckling on axilla and groin, and then, we made a diagnosis of NFl. Gastrointestinal bleeding is controlled by resection of multiple GISTs. Generally, only 3-5% of all gastrointestinal bleeding comes from the small bowel. Causes of small intestinal bleeding are angiodysplasia, neoplasm, NSAIDs induced ulcer etc. but, If patients have NFl accompanied by complication of gastrointestinal bleeding, GISTs on small bowel must be considered.

중국 길림성 조선족의 민족 정체감에 관한 연구

이호영,이동근,신승철,김만권 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.2

The present study examined the structure and patterns of ethnic identity in a sample of Korean-Chinese parents and their adolescents residing in the Jilin Province in China. The ethnic identity of these participants(total :148 parents:100 adolesents:48) includes two major components : Korean identity and Chinese identity. Each of these components was measured in three different modalities : behavioral, affective and cognitive. The results are summarized as follow ; 1) Generational comparisons between Korean identity scores of parents and adolescents indicated similarities in the modalities of cognitive and behavioral identities. Both groups shared a Korean orientation manifested in their high level of Korean behavior and cognition. However, both groups also shared a relatively high level of Chinese identity. In summary, dual identity appeared to be preserved over time. The parents scored higher than the adolescents in their affective modality of Korean identity. Chinese identity was scored higher in the adolescents than korean identity in their affective modality. The generational comparisons indicated that the adolescents were acculturated in their affect than their parents. 2) Comparison of men and women in the strength of identity' component showed higher cognitive scores among the men. in Korean identity, compared with Chinese identity. Men were more identified with "Chinese" and "Korean" in the affective component of their identity.

분자역학적 방법을 이용한 부산시내 대형건물 냉각탑수의 레지오넬라균의 형별 분류

김정만,정석훈,서대영,박은희,송은주,최재철,이은엽,장철훈 대한임상미샐물학회 2004 Annals of clinical microbiology Vol.7 No.1

국내 공공부문 설계시공일괄입찰방식의 낙찰자 선정방법 개선에 관한 연구

김만철,서용철,구교진,현창택 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

Design-Build is considered as the project delivery system to manage construction process more efficiently than design-bid-build. So Korea government has encouraged Design-Build in public sector. But single selection method of weighted criteria doesn't provide the greatest value to owner. Therefore, there is a need to improve selection method to meet owner's needs and project characteristics. This study proposes four types of selection method. Each of selection method is focused on price, qualification, time. The use of these selection methods enable owner to provide the greatest value.

경상남도 일부지역 농업인의 농약관련 인지도 및 실행도 결정요인

김정민,전만중,고광욱,유병철,이용환 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : The amount of pesticide to be produced and consumed have rapidly growed in Korea and the evidences for pesticide intoxication to human body, natural environment and consumers have evoked. But the studies concerned to pesticide intoxication are inactive. So, we conducted this study about the determinants of awareness and performance for prevention of pesticide intoxication. Methods : The study conduced during the period from July to August 2007 with population consisted of 111 farmers. The toolkit was produced through referencing previous studies. Data analysis was performed with t-test, ANOVA and multiple linear regression analysis using SPSS 14.0K program. Results : The mean awareness score was 3.07 ± 0.75, the mean of total performance score was 2.72 ± 0.69, mean of subtotal performance score for keeping safety guideline was 2.72 ± 0.69 and mean of subtotal performance score for wearing protective equipments was 2.43 ± 0.83. Awareness score was associated with sex, age and family income. Female, older people and people with high income were tend to show low awareness score. Performance score was associated with sex, family income and educational level. Female, people with low education and high income were tend to show low performance score. Conclusion : We concluded that educational effort for noticing the harmful affects of pesticide, the importance of keeping safety guideline and wearing protective equipments to farmers especially female, older people, people with low education and high income were significant factors for prevention of pesticide intoxication.

골프스윙에서 볼의 비행거리에 미치는 요인분석 : 1번 드라이브를 중심으로 Focused on 1st driver

김철원,오만원,류재청 濟州大學敎 體育科學硏究所 1995 체육과학연구 Vol.1 No.-

The purpose of the study was to investigate factors influencing ball flight distance in 1st golf driving, and utilize the available training data investigated. The experimental method for the purpose was cinematography with 2 camera equipped front direction(#l camera) and rear direction(#2 camera) using air-ballon synchronization method. 1. physical fitness The characteristics of physical fitness was classified Zgroup, one(OMW, KJI) was superior power, muscular strength, normal blood pressure, the other(LHJ, LHJ) was not. 2. Temporal The elapsed total time from address to full followthrough in all subjects was mean 0.321 sec., 3 phases centering on impact was elapsed 0.132 ±O.OOsec(7.29%), 0.151 ±O.O32sec (7.87%), 0.183±0.057sec.(10.67%) in order of OMW, LHJ, KJI, KJH. The acceleration analysed was transferred with adequately suited timing to ball momentum obtained during downswing in OMW, decelerated centering impact the acceleration obtained during downswing, and the other 2 subjects was mid-level timing of the former 2subjects. 3. The horizontal displacement of COG was rear direction from address to backtopswing and front direction from topswing to followthrough. On considering COG displacement in rear or front, the most stable driving was in order OMW, KJH, KJI, LHJ. 4. The cocking range of foream-shift angle, topswing was in order OMW, KJI, KJH, LHJ, continuing followthrough was performed to ball flight direction on condition of uncocking from impact to followthrough in OMW, the others pulled instantly in just later impact. The shoulder-trunk mean angle was 136±3.94deg. in topswing, 18.65±3.10deg. in just before impact, 143.00±20.04deg. in followthrough considering the resulting, OMW showed the smaller degree, but the larger trunk twist to vertical axis while LHJ, KJH showed the contrast phenomenon. The trunk-thigh mean angle was 167.20±19.80deg., characteristics analysed divided into overextended(l86±2.16deg.) in OMW, overflexed(l41± 19.49deg) in LHJ and elbow flexion was mean 126.85±21.96deg, the range was in order of OMW, LHJ, KJI, KJH.in topswing and 64.60±10.87 deg in followthrough, the, elbow flexion range was the largest but the smallest in shaft-forearm incline in OMW while shaft-forearm incline was largest but largest flexion in LHJ. 5. Trunk Incline to vertical axis showed flexible followthrough in 25.20cm, 28.40cm of OMW, LHJ, but the others almost was not. 6. The rather high relation with muscular strength and Power factor showed rather high,and negative relation(r=-.92) with elbow flexion, with trunk incline(r=.84) in followthrough in correlation between ball flight distance and variables related with driving.