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이종석,전대근,김석준,이수용,양현석,Lee, Jong-Seok,Jeon, Dae-Geun,Kim, Sug-Jun,Lee, Soo-Yong,Yang, Hyun-Seok 대한근골격종양학회 1997 대한골관절종양학회지 Vol.3 No.1
PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.
생분해성 고형물에 흡착시켜 실험동물에 국소 투여한 홀미움- 166-키토산 복합체의 투여량, 기간 및 부위에 따른 조직의 괴사 정도와 양상
이종석,전대근,조완형,이수용,오정문,김진욱,Lee, Jong-Seok,Jeon, Dae-Geun,Cho, Wan-Hyung,Lee, Soo-Yong,Oh, Jung-Moon,Kim, Jin-Wook 대한근골격종양학회 2003 대한골관절종양학회지 Vol.9 No.2
목적: Holmium-166은 류마티스성 관절염 및 간암 치료에서 이미 임상적으로 사용이 보고된 방사성 동위원소이다. 본 연구는 holmium-166-chitosan 복합체를 외과적으로 생체에 투입하여 임상에 적용 가능한 방법을 연구하고, 투여량과 기간, 투여 부위에 따른 조직학적 반응 정도를 정성 및 정량 분석하여 임상적용의 기초로 활용하는 것이다. 재료 및 방법: Absorbable gelatin sponge에 액체상태의 holmium-166-chitosan 복합체를 50 ${\mu}l}$ 도포하여 고형제로 만들었다. 최종 삽입전에 caliberator로 측정한 방사선량은 약 1.5 mCi였다. Wistar종 흰쥐에 외과적 시술을 통하여 대퇴근육 내부와, 그리고 대퇴골에 접하게 holmium-166-chitosan 복합체가 부착된 gelatin sponge를 삽입 후 봉합하였다. 대퇴 근육내와 대퇴골에 투여한 후 2주, 4주, 6주에 육안 및 현미경 소견하에서 조직 괴사의 깊이, 조직 변화의 양상, 삽입된 gelatin sponge의 변화 등을 관찰하였다. 결과: 2주후의 현미경 소견상 holmium-166과의 접촉면에서는 정상 근육세포의 모양을 찾아 볼 수 없을 만큼 심한 괴사 소견을 보였고 근육세포의 퇴화 및 재생, 근육간 부종, 염증세포의 침윤 소견을 보였으며 유발된 괴사의 깊이는 평균 3.3 mm 였다. 대퇴골에서는 holmium-166과의 접촉면에 있는 골피질은 골소강내 골세포의 소실이 관찰되었고 골수강내의 골수 세포도 파괴되고 섬유화 또는 염증성 반응을 보였다. 괴사의 깊이는 평균 2.9 mm 였다. 4주 때 근육에서는 석회화와 보다 심해진 섬유화 소견이 추가 되었고 괴사의 깊이는 평균 3.3 mm 였다. 골조직에서도 골수강의 섬유화가 더 증가되었고 괴사의 깊이는 평균 3.3 mm였다. 경과 관찰 6주 군에는 연부 조직의 위축과 섬유화의 증가, 육아조직의 형성, 염증 소견의 소실 등이 관찰되었다. 결론: Holmium-166-chitosan 복합체를 생체 흡수 가능한 gelatin sponge에 부착시킨 후 실험동물에 삽입한 결과, 실험동물의 사망을 유발하지도 않았으며 상처의 괴사, 염증, 감염 등의 부작용이 전혀 없어, 생체에 외과적 적용이 가능하였다. 유발된 조직 괴사의 범위는 약 3 mm로 미리 예측한 정도에 근접하는 것으로 악성종양 치료에 임상적 적용이 가능할 것으로 생각한다. Purpose: The aim of this study was to find out a clinically appliable method to insert a biodegradable solid material containing holmium-166-chitosan complex into the surgical field, and to evaluate the histological changes in the normal tissues after ${\beta}$ -ray irradiation from holmium-166 according to the dose, period and type of tissues. Materials and Methods: 3.0 mCi, 50 ${\mu}l$ of the liquid state $^{166}$Ho-chitosan complex was attached to the absorbable gelatin sponge. The radiation activity measured by dose caliberator was 1.5 mCi. These $^{166}$Ho-chitosan complex containing absorbable gelatin sponges were inserted into the thigh muscles and over the femur bones of the Wistar rats. The cases were evaluated at 2 weeks after insertion, and 4, 6 weeks with respect to the histological changes of the soft tissues and bone, the depth of the tissue necrosis, and the changes of the $^{166}$Ho-chitosan complex containing absorbable gelatin sponges. Results: At 2 weeks, the muscles showed coagulation necrosis, degenerating myocytes, regenerating myocytes, intermuscular edema, and inflammatory cells. The necrosis depth was 3.3 mm. In the bones, there was no osteocyte in the lacuna of cortex (empty lacuna), marrow fibrosis, inflammation. The necrosis depth was 2.9 mm. At 4 weeks, in the muscle, calcification and increased fibrosis with necrosis depth by 3.3 mm were the additional findings. In the bone, marrow fibrosis with necrosis depth by 3.3 mm were detected. At 6 weeks, soft tissue shrinkage, increased fibrosis and granulation tissue formation, and nearly resolving inflammatory reaction were the findings. Conclusion: The local application of the $^{166}$Ho-chitosan complex attached to biodegradable gelatin material with surgery in the laboratory animals resulted in no mortality and morbidity, and satisfactory tissue necrosis. Holmium-166 can be applied to the treatment of the malignant tumor patients.
이종석,전대근,김석준,이수용,박현수,Lee, Jong-Seok,Jeon, Dae-Geun,Kim, Sug-Jun,Lee, Soo-Yong,Park, Hyun-Soo 대한근골격종양학회 1995 대한골관절종양학회지 Vol.1 No.2
Twenty three rhabdomyosarcoma patients who were registered in Korea Cancer Center Hospital from Mar. 1985 to Apr. 1994 were analysed in the aspect of treatment and survival. Thirteen cases were male and 10 female. Average age was 29.5 years(range 1 to 66). Locations of the tumor were as follows: 13 in lower extremity, 6 in upper extremity and 4 in trunk. According to the UICC classification, stage II b was 1 case, stage III a 4, stage III b 10, stage IV a 3 and stage IV b 5. In histological categories, embryonal rhabdomyosarcoma was 7 cases, alveolar 7, pleomorphic 7 and undetermined 2. Average follow up period was 35.3 months(1 tk 7.5 years). Ten cases were continuous disease free, 3 no evidence of disease, 3 alive with disease and 7 died of disease at final follow up. Kaplan-Meier's actuarial 5-year survival rate was 60.3% and 5-year continuous disease free survival rate was 31.4%, Surgical margin was an important factor in local tumor control. Although there was no definite statistical significance, our results suggest chemotherapy and radiation therapy have meaningful roles in reducing local recurrence and improving survival.
이종석,전대근,이수용,김석준,정동환,박현수,Lee, Jong-Seok,Jeon, Dae-Geun,Lee, Soo-Yong,Kim, Sug-Jun,Jung, Dong-Whan,Park, Hyun-Soo 대한근골격종양학회 1997 대한골관절종양학회지 Vol.3 No.2
Twenty hundred and five out of 266 patients who were registered in Korea Cancer Center Hospital from Mar. 1985 to Jan. 1994, were analyzed in the aspect of survival and local recurrence. Fifty one patients were excluded due to inadequate data and follow up. Prognostic factors for survival were evaluated statistically. One hundred and four cases were male, 101 female. Average age was 39.7(range 1 to 77) year with a peak incidence around 4th decade. The most frequent diagnosis was malignant fibrous histiocytoma(MFH)(24.1%). Liposarcoma, synovial sarcoma, rhabdomyosarcoma, malignant peripheral nerve sheath tumor and fibrosarcoma were relatively common diagnostic entities, in decreasing order. In location, extremity was 179(87.3%) and trunk 26(12.7%). Average follow up period was 7.5 years(6 months to 10 years). Actuarial 5 years and 10 years survival rate were 64.0% and 40.8% respectively. In univariate analysis with log-lank test, significant differences in survival rate were noted in histopathological diagnosis, size(10 cm), stage and metastasis. Age, sex, tumor location, tumor depth and local recurrence didn't affect the survival rate. Adjuvant chemotherapy and/or radiotherapy did not affect overall survival rate, but lowered the local recurrence rate when compared with surgery only. Surgical margin did not affect the survival rate, but local recurrence rate was different according to each margin; 5.7% in more than wide; 39.5% in marginal; and 60.0% in intralesional excision. In multivariate analysis for results of univariate analysis with Cox's propotional model, metastasis was a meaningful factor for survival of soft tissue sarcoma.
이종석,전대근,조완형,이수용,오정문,김진욱,Lee, Jong-Seok,Jeon, Dae-Geun,Cho, Wan-Hyung,Lee, Soo-Yong,Oh, Jung-Moon,Kim, Jin-Wook 대한근골격종양학회 2003 대한골관절종양학회지 Vol.9 No.2
Purpose: We analyzed our malignant peripheral nerve sheath tumor (MPNST) cases to find out their oncologic results following by each treatment modalities. Materials and Methods: Thirty four patients with MPNST were registered in Korea Cancer Center Hospital from Feb. 1986 to Nov. 1996. Seventeen cases were male and 17, female. Average age was 41 years (range 18 to 74). Location of the tumor was as follows; 17 in lower extremity, 11 upper extremity, 4 trunk, and 2 retroperitoneum. Following the AJC classification, stage IA were 2 cases, stage IIA 2, stage IIB 6, stage III 16 and stage IV 8. Twenty six patients took operations and adjuvant chemotherapy and/or radiation therapy, 3 operation only and 3 adjuvant chemotherapy or radiation therapy. Average follow up period was 33.5 months (5.6 to 146.1). Kaplan-Meiyer method was done for survival curve, and log rank test for comparison analysis. Results: Fourteen cases were continuous disease free, 2 no evidence of disease, 2 alive with disease and 14 dead of disease states at final follow up. Actual 5-year and 10-year survival rates were 53.5%, 35.7%. Local recurrence rate after operation was 24.1%. 5-year survival rates of stage I/II/III were 100/85.7/55.9% and 2-year survival rate of stage IV was 14.3% (p=0.04). In 21 cases operated with stage II-III, wide margin (15cases) had 76.0% 5-year survival rate, and marginal or intralesional marigin (6cases) had 40.0%. The actual 5-year survival rate of the group which were done 4 or more cycles chemotherapy (8cases) was 71.4% and the actual 3-year survival rate less than 4cycles chemotherapy (6cases) was 83.3% (p=0.96). In 19 cases operated with stage II-III and which had no radiotherapy, marginal or intralesional margin (5cases) had 3 cases of local recurrences (60.0%), though wide margin (14cases) had 4 cases recurrences (28.6%). There was no local recurrence in 8cases which had pre-or post-operative radiotherapy. Conclusions: Surgical margin is an important factor in local recurrence. Resection margin has a tendency to influence the survival despite insufficient statistical significance. Conventional chemotherapy has no defnite statistical sigficance in the effect on local control and survival. Preoperative and postoperative radiotherapy has some positive effect on local control. 서론: 악성 말초 신경막 종양(Malignant peripheral nerve sheath tumor, MPNST)에 대하여 수술, 항암제 투여, 방사선 치료 등을 시행하고 이에 따른 종양학적 결과를 분석하여 보다 합리적인 치료 방법을 알아보고자 하였다. 재료 및 방법: 1986년 2월부터 1996년 11월까지 본원에 등록된 MPNST 환자 34례를 대상으로 하였다. 남자가 17례, 여자가 17례였고 평균연령은 41세(18세~74세)였다. 종양의 위치는 하지가 17례, 상지 11례, 체간부 4례, 후복막 2례였다. AJC(American Joint Committee on Cancer) 분류에 의한 종양의 병기는 stage IA가 2례, stage IIA 2례, stage IIB 6례, stage III 16례, 그리고 stage IV가 8례였다. 치료 방법으로는 26례에서 수술과 항암제 투여 그리고 때에 따라서 방사선치료를 시행하였고 3례에서는 수술만, 3례에서는 항암제 투여나 방사선 치료만 시행하였다. 평균 추시 기간은 33.5개월(5.6개월~141.1개월)이었다. Kaplan-Meiyer 법으로 생존율을 구하였고, log rank test로 비교 분석 하였다. 결과: 최종 추시상 질병 상태는 14례에서 CDF(continuous disease free)였고, 2례가 NED(no evidence of disease), 2례 AWD(alive with disease), 그리고 14례가 DOD(died of disease)였다. 실제(actuarial) 5년 생존율과 10년 생존율 은 53.5 %와, 35.7%였다. 수술 후의 국소 재발율은 24.1%였다. 병기별 5년 실질 생존율은 stage I이 100%, stage II 85.7%, stage III 55.9%였고 stage IV의 경우 2년 실질 생존율이 14.3%였다(p=0.04). Stage II, III에서 수술한 경우 21례에서, 광범위 이상의 절제연을 얻었던 경우가 15례로 5년 실질생존율이 76.0%였고 병소내이거나 변연부 절제연의 경우는 6례로 40.0%였다(p=0.26). 4회차 이상의 항암화학요법제를 투여한 군(8례)의 5년 실질생존율은 71.4%였고 3회차 이하의 불충분한 항암제투여를 시행한 군(6례)의 3년 실질생존율은 83.3%였다(p=0.96). Stage II, III 중 방사선 치료 없이 수술 받은 19례에서 병소내 절제나 변연부 절제를 시행했던 5례는 3례가 국소 재발하였고(60.0%) 광범위 절제를 시행한 14례는 4례가 국소 재발하였다(28.6%). 수술 전 또는 후에 방사선치료를 시행하였던 8례에서는 국소재발이한 예도 없었다. 결론: 외과적 절제연(surgical margin)이 국소 재발에는 중요한 요인이었고, 통계적으로 의미있는 수치는 아니었지만 생존율에도 영향을 주는 경향이 있는 것으로 생각된다. 기존의 항암제 투여는 국소 재발이나 생존율상에 통계적으로 의미있는 차이를 보이지 못하였다. 수술전과 수술후 시행하였던 방사선치료는 국소 재발을 줄이는데 어느 정도의 효과를 보였다.
이종석,맹봉재,차영기,Lee, Jong-Seok,Myeng, Bong-Jae,Cha, Young-Kee 한국방재학회 2006 한국방재학회논문집 Vol.6 No.1
본 연구는 강우시 소하천 수로구간에서 유사농도의 연직분포를 유사량 측정기 (ASM-IV)로 실측하여 그 특성을 분석하고자 한다. 이를 위해 충남 연기군 서면에 위치한 월하천 시점부분의 수로구간을 연구대상으로 선정하였다. 실측된 부유사농도의 분석자료는 상하류구간에서 각각 1시간 11분 30초 및 40분 32초 동안에 2초 간격으로 측정된 2,145개 및 1,216개중 16개씩의 시간구간 자료가 사용되었다. 분석한 결과, 상류구간의 실측치 Rouse 수는 $0.00129{\sim}0.02394$로 분포하고, 평균값은 0.01129로 나타났으며, 하류구간에서는 $0.00118{\sim}0.00822$, 평균값은 0.00436으로 하류의 값이 상류의 값보다는 훨씬 작게 분포하는 것으로 나타났다. 계산치 Rouse 수는 상류구간의 경우 $0.065115{\sim}0.065295$, 평균값은 0.06521로 나타났고, 하류구간의 경우에는 $0.057315{\sim}0.059109$, 평균값은 0.05795로 하류구간이 상류구간보다 약간 작은 값을 갖으나, 실측치 비교에서의 차이보다는 적게 나타났다. 그러나 실측치와 계산치의 비교에서는 상류구간보다 하류구간에서 더 큰 차이를 갖는 것으로 나타났는데, 이 오차는 하류구간의 침강속도 산정시 높은 수온에 대한 동점성계수 값을 본 연구에서 유도한 경험식으로 계산한 것도 원인중의 하나에 포함될 것이다. This study aims to analysis of suspended-load concentration in related to those data by measuring vertical sediments distribution with rainfall using the ASM (Argus Surface Meter)- IV at the channel reach of a upstream and a downstream in small river. The watershed, small river basin where had taken for experimental study was selected, which is a drainage area lied at Walha in Yunkee-Gun, Chungnam Province. Measured data of suspended-load concentration consists of two groups with 2,145 data during 1hr 11min 30sec and 1,216 data during 40min 32sec for measuring time of 2 second in the study reaches at river, respectively. In order to analyze of the vertical concentration distribution, using the data sets are selected the measuring time 16 sets one of these data by random in the study reaches. As a results, the Rouse number of a measured and a calculated value show that a rang of $0.00129{\sim}0.02394$, averaged value of 0.01129 md, a rang of $0.00118{\sim}0.00822$, averaged value of 0.00436 in upstream reaches, and also a rang of $0.065115{\sim}0.065295$, averaged value of 0.06521, and a rang of $0.057315{\sim}0.059109$, averaged value of 0.05795 in downstream reaches, respectively. These difference show that measured Rouse number compared with downstream reach errors of less than in upstream reach, but between measured and calculated of the Rouse number compared with downstream reach errors of more than in upstream reach, respectively. It seems to will be included one of the occurrence errors of variable estimations when Rouse number of calculated value to be made computed by the fall velocity with a high temperature of water using equation of empirical kinematic viscosity was derived in this study.
약침용(藥鍼用) 봉독액(蜂毒液)의 국소독성시험(局所毒性試驗)에 관(關)한 연구(硏究)
이종석,고형균,김창환,Lee, Jong-Seok,Koh, Hyung-Kyun,Kim, Chang-Hwan 대한한의학회 1995 대한한의학회지 Vol.16 No.1
Pursuant to the Medical Product Safety Administration Guidelines for safety assessment of Korean bee vonom for herb-acupuncture, rabbits were used for skin, eye balls, subcutaneous and muscle irritation test. The results were as follows; 1. The skin irritation test of bee venom for herb-acupuncture did not produce any irritation reactions, when the skin was covered with bee venom. 2. The eye irritation test produced moderate to severe stimulating reactions, once the eye mucous membrane was contacted with bee venom. 3. The subcutaneous and muscle irritation test of bee venom showed such local inflammatory reactions as death of cells, infiltration of inflamed cells, dropsical swelling, and congestion, once injected under the skin and in the muscle. As the results of the study on bee venom for herb-acupuncture indicate that severe reactions in such tests as eye balls, subcutancous and muscle irritation exist in the laboratory, more professional caution should be taken in clinical application of the therapy. In addition, further study on subacute, chronic toxicity and allergy reactions should be pursued.
온수양생을 이용한 초고강도 콘크리트의 강도 조기 추정에 관한 실험적 연구
이종석,명로언,공민호,백민수,이영도,정상진,Lee, Jong-Seok,Myung, Ro-Oun,Gong, Min-Ho,Paik, Min-Su,Lee, Young-Do,Jung, Sang-Jin 대한건축학회 2011 대한건축학회논문집 Vol.27 No.5
In this study, prediction of later-age compressive strength of ultra-high strength concrete, based on the accelerated strength of concrete cured in hot water was investigated. Comparing other acceleration method, hot water curing method is relatively easy and intuitive to use in the real construction site. The amount of time for evaluation of the concrete strength using the hot water curing method in KS and JIS is too long to predict the strength of the ultra-high strength concrete that are used in the tall building structure. For that reason, curing temperature of 40, 50, $60^{\circ}C$ 3 levels were examined to shorten the amount of time for the evaluation of the strength. When curing in warm water, different strength characteristics are verified from the experiment. In case of F3 substituting 30% fly ash in combination, because of the curing temperature sensitivity of fly ash, differences of strength expression velocity was verified according to the curing temperature at the same age. In case of B4 substituting 40% ground granulated blast furnace slag, there were no big strength expression velocity differences of the specimen cured in 3 different level of curing temperature(40, 50, $60^{\circ}C$). The results show reliable accuracy by regression relation between 28day strength cured by standard curing method and accelerated strength of concrete cured in warm water.(y=1x-0.0002 $R^2$=0.9866) As a result, the feasibility of 3day-prediction was confirmed using warm water curing method with accelerated strength of concrete cured for three days in warm water.