골에 발생한 거대세포종의 재발 인자

김한식(Han Sik Kim),김성환(Sung Hwan Kim),신규호(Kyoo-Ho Shin),한수봉(Soo Bong Hahn) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.1

목적: 골의 거대세포종으로 확진된 환자들의 재발률을 확인하여 치료결과를 평가하고, 환자에 따른 인자, 종양의 성질, 수술 방법에 따른 재발과의 상관관계 유무를 확인하고자 한다. 대상 및 방법: 1992년 3월부터 2001년 3월까지 수술적 치료를 받고, 병리학적으로 골의 거대세포종으로 확진된 환자 중 최소 2년 이상 추적관찰이 가능하였던 52예를 후향적으로 검토하였다. 임상적 특성으로 연령, 성별, 발생 부위, 병적골절 유무, Campanacci 등에 의한 종양 등급을 확인하며 치료 방법, 재발 및 재발시기, 재발 후 치료방법, 합병증, 최종 추시 결과를 확인하였다. 정기적인 임상적, 방사선학적 검사를 통해 재발이 의심되는 경우 생검을 통한 병리학적 결과를 확인 하였고, 국소재발과 각 항목과의 상관관계는 Fisher’s exact test를 사용하였으며 통계적 유의수준은 p<0.05로 하였다. 결과: 재발은 16예(31%)에서 발생하였고 재발 시기는 평균 17개월로 1예를 제외하고 모두 2년 내에 재발하였다. 성별, 발생부위, Campanacci 분류, 병적골절, 내원 시 종양의 재발여부, 절제연, 골이식, 금속내고정, 골시멘트 충전술 등 각 항목과 국소재발과는 통계적으로 상관관계를 보이지 않았다. 결론: 임상적 특성 및 치료방법과 국소 재발은 상관관계가 없었으며 재발은 대부분 수술 후 2-3년 내에 발생하므로 이 기간 내에 정기적 추시와 검사를 시행하고 이후에도 재발 및 폐 전이에 대한 장기적인 추시 관찰이 요구된다. Purpose: The aim of this study was to evaluate the recurrence rates of a giant cell tumor of the bone and determine what, if any, patient factors, tumor characteristics and surgical treatments correlate with the incidence of a local recurrence. Materials and Methods: The records of fifty two cases who were diagnosed with a giant cell tumor of the bone between March 1992 and March 2001 and were could be followed up for at least 2 years were analysed retrospectively. This study reviewed the clinical characters, and the treatment method, recurrence, complication, the result of the follow-up. A Fisher's exact test was carried out to analyse the statistics. Results: Sixteen patients (31%) had a local recurrence. The average time to recurrence was 17 months. All but case one recurred within 2 years after receiving surgical treatment. There was no significant differences in the recurrence rates based on the following variables: gender, tumor location, Campanacci grade, the presence of a pathologic fracture, primary versus recurrent tumor at presentation, resection margin, the use of a bone graft, internal fixation or polymethylmethacrylate. Conclusion: The clinical characters and methods of treatment were not correlated with a local recurrence. Most recurrences of a giant cell tumor can be expected within the first two to three years. Therefore the patient needs to be followed up in that period and longer for the a late recurrence and pulmonary metastasis.

포도막염환자 혈액에서 T , B 세포 및 OKT4 / OKT8 비

주신환(Shin Hwan Joo),고명규(Myung Kyoo Ko),정낙은(Nak Eun Chung),김신규(Think You Kim) 대한안과학회 1987 대한안과학회지 Vol.28 No.5

건축현장 마감자재 조달프로세스 영향요소 분석에 관한 연구 - 도심지 초고층 공사를 대상으로 -

김상중(Kim Sang-Jung),신규철(Shin Kyoo-Chul),김재준(Kim Jae-Jun) 대한건축학회 2003 大韓建築學會論文集 : 構造系 Vol.19 No.9

Finishing stage of high-rise building construction requires sophisticated coordination of numerous activities. Smooth and uninterrupted supply of materials is especially an essential ingredient for the successful execution of the finishing stage work. However, this is not an easy task to meet. Many undesired instances have observed at recent high-rise building construction sites.<br/> The purpose of this study is to analyze factors that are influential in the procurement process of finishing materials for high-rise building construction. The authors have reviewed existing studies related to this issue and identified their contributions and limitations. Factors influential to the procurement process of finishing materials are broadly identified through the means of literature review, interviews and surveys. Factors are, then, further classified and filtered using the AHP method. This study finally evaluates these factors with respect to their influence on the supply chain management at the job sites.

슬관절 주위 악성 및 침윤성 골종양의 분절 절제술 후 회전 성형술

한수봉,박홍준,김형식,김성훈,신규호,Hahn, Soo-Bong,Park, Hong-Jun,Kim, Hyoung-Sik,Kim, Sung-Hun,Shin, Kyoo-Ho 대한근골격종양학회 2001 대한골관절종양학회지 Vol.7 No.2

목적 : 어린이나 혹은 성인에 생긴 대퇴부 절단술이 필요한 슬관절 주위의 악성 및 침윤성 골종양에서, 분절 절제 및 회전 성형술을 시행한 치험례를 분석하여 보고하는 바이다. 대상 및 방법 : 1988년 2월부터 1994년 6월까지 슬관절 부위의 악성 및 침윤성 골종양으로 하지 분절 절제 및 회전 성형술을 시행 받은 2 6명을 대상으로 하였으며, 추시 기간은 악성종양의 경우 평균 57(6~120)개월이었고, 평균 연령은 21.4(5~37)세였다. 26례 중 stage IIB 이상의 골육종이 18례, 활막 육종이 2례, 병적골절 또는 재발된 거대 세포종이 6례였다. 결과 : 기능적 결과는 사망 또는 절단술을 받은 4례를 제외한 22례에 대하여 Shriner's rating system에 따라 실시하였으며, 18례에서 우수, 3례에서 양호, 1례는 보통이었다. 족관절의 평균 운동범위는 $-11^{\circ}$(족배굴)~$80^{\circ}$(족저굴)였으며, 보조기 착용 후 일상 생활의 보행이 가능하였다. 국소 재발은 2례, 원격 전이는 10례에서 관찰되었다. 초기 합병증은 혈전증 3례와 패혈증 1례가 있었다. 후기 합병증은 불유합 및 지연유합이 6례, 부정 회전이 2례, 족관절의 운동제한이 1례 있었다. 결론 : 약 10세 미만의 소아에서 많은 하지 부동이나 성장에 따른 골수강의 확장으로 종양 삽입물의 해리가 예상되는 경우와 악성 및 침윤성 골종양으로 절단술이 불가피한 경우에, 기능적으로 우수한 회전 성형술은 부분 사지 구제술로써 유효한 방법으로 사료된다. Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

성인의 두피에 발생된 황색육아종

천영일(Young Il Chun),김신규(Shin Kyoo Kim),안규중(Kyu Joong Ahn),오영진(Young Jin Oh),이유신(Yoo Shin Lee) 대한피부과학회 1985 대한피부과학회지 Vol.23 No.3

Juvenile xanthogranuloma is characterized by one, or oftener many, yellow, re3dish yellow, or, brown 4-to-20 mm papules or nodules on the face, scalp, trunk, and mostly, extensor surfaces. It may involve internal organ besides the skin such as eye, gastrointestinal and genitourinary tracts. anthogranuloma in adult is usually solitary and dose not involve organs other than skin, and generally dose ncit resolve without treatment. Histopathologically, characteristic Touton giant cells usually appear numerously. We report a case of juvenile xanthogranulorna which occured on scalp of 49 year-old male showing typical clinical and histopathological findings.

류마토이드 관절염 환자에서 항 핵주변인자의 진단적 가치에 관한 연구

최일용(Il Yong Choi),이광현(Kwang Hyun Lee),김신규(Shin Kyoo Kim),임병규(Byeong Goo Lim) 대한정형외과학회 1995 대한정형외과학회지 Vol.30 No.6

Merkel 세포암

권기환(Ki Hwan Kwon),심효섭(Hyo Sup Shim),김봉수(Bong Soo Kim),박세호(Se Ho Park),김태승(Tei Seung Kim),신규호(Kyoo Ho Shin),김충배(Choong Bai Kim),김순일(Soon Il Kim),김유선(Yu Seun Kim),박기일(Kiil Park) 대한외과학회 2002 Annals of Surgical Treatment and Research(ASRT) Vol.63 No.6

Monilethrix 1 예

김진택,김신규 대한피부과학회 1979 大韓皮膚科學會誌 Vol.17 No.4

Monilethrix is a rare hereditary disorder of hair first described by Walter G. Smith in 1879, and usually transmitted as autosomal dominant trait. It is characterized hy bead like enlargement af the affected hair, alapecia resulting from ha.ir breakage and keratosis pilaris. This 3 year old female child patient has been suffered from easy destrurtion of beaded scalp hair and follicular hyperkeratosis of the occipital region since infancy. past hiatory was ncecontributory and the pe,digree of family showed autosomal dominant trait. Physical examinatior was not rernarkable except skin lesian and laboratory findings were within normal limit. Microscopic finding of the affected hair showed alternating constrictians and node. The scalp bivpsy findings showed mild hyperkeratosis, keratotic plug, mild cellular infiltration of papillary derrnia and perifollicular area.

현장물류관리 효율제고를 위한 마감자재 조달프로세스의 영향요소 규명

김상중,신규철,김재준 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

According to the trend of high-rise and large-size building recently, there are many different types of materials handled in the site. Especially, because words occur concurrently in the period of finishing work, work movement and circulation of materials in the site are very complex. Therefore, the necessity of efficiency increase in site management during finishing work period is required. The purpose of this study is to identify influence factors in procurement process of finishing materials for efficiency increase of site management. First, this study suggested the limit and the flow of existing studies through survey of the existing studies related to site management. Second, influence factors and relation of procurement process defined. Third, through literature survey, procurement process of materials during the period of finishing work derived. Finally, this study identified influence factors in procurement process through interview of experts in the site.

후복막강 지방육종 1예

김학기,이진섭,신규덕,이풍만 최신의학사 1981 最新醫學 Vol.24 No.5