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정태범(Jung. Tae-Bum) 한국지역개발학회 2016 한국지역개발학회 세미나 논문집 Vol.2016 No.1
Since the beginning of the 21st century, many cities have been transfigured to culture city as one of the development strategy to culture while improving the physical environment of the city, the underdeveloped urban renaissance and maintenance, Ecofriendly composition etc. Also, Incheon Metropolitan City has to try our utmost to build a dynamically future creative city with furnishing High-tech industries and knowledge-based culture of high value-added service industries as a new growth engine in order to break the negative image caused by industrialization. For this, an alternative plan, the museum and Art gallery has become a measure of this cultural city has emerged as a key industrial city. Research of this paper has analyzed the factors that direction through the empirical analysis in terms Location Characteristics about problem which is derived by factors such as locational accessibility to Incheon Metropolitan city public Museum of Art, accessibility, clusteringly, neighborhood effect, locality. Thus, as a result of this study would be expected to be able to provide theoretical foundation and basic Location factor which shall consider locational characteristics when city builds new city Museum and Art gallery.
자궁내막증 환자의 복강액의 Interleukin-8에 관한 연구
강성원,이한범,강정배,김홍배,정태범,김중석,이근영 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.8
Objective : This study was investigated to know the relationship between the level of interleukin-8(IL-8) in the peritoneal fluid of women with and without endometriosis Design : Prospective and case-control study. Setting : University hospital. Patients : Twenty six patients who had been confirmed endometriosis by operative and pathological findings were studied. The another twenty six women with benign gynecologic disease except endometriosis was studied by control groups. Main outcome and Measures : IL-8 levels in peritoneal were determined using commercial ELISA set. IL-8 concentration were compared between women with and without endometriosis, and also compared according to severity of endometriosis by which was graded the revised American Fertility Society classification. Results : IL-8 concentration was higher in the peritoneal fluid of women with endometriosis than in matched controls. The concentrations in the proliferative phase were higher than those in the secretory phase. IL-8 concentration in endometriosis stage III, IV were significant higher than stage I, II. Conclusions : Increased level of IL-8 in peritoneal fluid of patients with endometriosis may be related to the pathogenesis of endometriosis that partially contribute to the disturbed immune response.
자궁적출술의 수술적 접근방법으로 복식에서 질식경로로의 변화에 관한 연구 : 1990년부터 1997년까지 질식자궁적출술 3408예의 임상 경험적 연구
강성원,강정배,김홍배,정태범,이근영 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.1
목적 및 연구방법 : 본 연구의 목적은 자궁적출술에 선택시 복강경을 이용하지 않는 질식 방법을 일차적으로 선택하였을 경우 질식수술의 가능성 및 안전성 등을 1990년부터 1997년까지 질식자궁적출술을 받은 3408명의 환자를 대상으로 임상 및 병리학적 요소를 분석하고 같은 기간에 복식으로 접근한 자궁적출술의 비율을 분석하여 자궁적출술시 우선적 선택 방법으로의 가능성을 연구하고자 하였다. 결과 : 질식자궁적출술의 비율은 1990년 51%(VH: 268 / TAH: 258), 1991년 55%(VH:254 / AH:212), 1992년 60%(VH:346 / AH:227), 1993년 64%(VH:341 / AH:190), 1994년 72%(VH:434 / AH:168), 1995년 75%(VH:489 / AH:156), 1996년 76%(VH:632 / AH:196), 1997년 78%(VH:657 / AH:190)으로 질식 수술 비율이 현저하게 증가되었다. 수술의 적응증은 자궁근종이 53.9%, 자궁탈출증이 23.3%, 상피내암 및 미세침윤성 자궁경부암이 6.5%의 순이고, 연령 분포는 평균연령은 41.9세이며 30대에서 60대 미만의 경우가 91%, 1회의 출산 경험이 8%, 2회 이상의 다산부가 91%, 난관 결찰술을 제외한 골반내 수술과거력이 있는환자는 5.7%(193명), 수술 시간은 1시간 30분 미만의 경우가 72%, 자궁적출시 축소술(morcellation)이 필요한 경우가 34.0%, 자궁적출물의 평균 무게는 166.5g이었고 250gm 이상이 40.7%, 실혈양의 예측은 400cc 이하가 85.5%, 중요한 합병증으로는 출혈 및 수술 중 복식으로 전환을 포함한 개복술 0.26%(9예), 골반 내 혈종괴 0.3%(11예)이고, 발열이 2.8%(94예), 요저류가 5.3%(179예)이며 사망한 경우는 없었으며, 평균 재원일은 7일 이었다. 결론 : 위와 같은 임상 경험을 토대로 복강경의 적용이 없는 질식 접근은 자궁적출술이 필요한 환자에게 우선 선택될 수 있으며 시술자의 경험을 바탕으로 할 경우는 고식적 복식 접근의 환자(전체 자궁적출술의 75% 이상)의 경우를 질식 접근이 가능한 것으로 사료된다. 결론적으로 질식자궁적출술은 다른 자궁적출술보다 많이 시행되고 있고 여러가지 장점, 예를 들면 수술 후 빠른 회복과 통증의 감소에 따른 조기보행과 퇴원, 개복술에 따른 합병증 감소, 미용상의 장점, 비대한 환자의 복식수술에 따른 이환율의 감소 등이 있어 질식자궁적출술에 대한 여러 가지 장점과 수술방법의 개선으로 그 적응증이 다양해지고 있으며 수술빈도가 증가되고 있는 것으로 보아 질식자궁적출술에 대한 더욱 깊은 관심과 이해가 있어야 할 것으로 사료된다. Objective : The purpose of our study evaluate to assess the feasibility and safety of performing vaginal hysterectomy on our experience. Methods : Between 1990 year and 1997 year, 3408 women underwent vaginal hysterectomy without laparoscopic assistance at Hallym University Hospital in Korea. All hysterectomies(abdominal & vaginal) were reviewed and these were compared with all hysterectomy cases from most recent year available for complete analysis. Result : 1. In 1990 yrs ∼ 1997 yrs, vaginal hysterectomies compromised 51%(vaginal hysterectomy〔below VH〕: 268 / total abdominal hysterectomy〔below TAH〕: 258 ; 1990), 55%(VH: 254 / TAH: 212 ; 1991), 60%(VH: 346 / TAH: 227 ; 1992), 64%(VH: 341 / TAH: 190 ; 1993), 72%(VH: 434 / TAH: 168 ; 1994), 75%(VH: 489 / TAH: 156 ; 1995), 76.%(VH: 632 / TAH: 196 ; 1996), 78%(VH: 657 / TAH: 190 ; 1997), a high increased rate of vaginal hysterectomy significantly. 2. The average age of patients was 41.9± 8.18(26∼84) years old and 25 nullipara and 274 primiparas and 3109 multiparas. The mean parity was 2.74±0.36. 3. The common surgical indications were uterine myoma(53.9%), prolapse of uteri(23.3%), CIN II-III or microinvasive cervical cancer(6.5%), others(16.3%) 4. The average time of operation(hysterectomy and colporrhaphy) was 78.3± 14.2 min(40∼230). 5. The average weight of uterus was 166.5± 111.4 gm(60∼1130 gm), 34.0% was done morcellation. 6. 5.7% of operated women had previous abdominal operaton (without tubal ligation). 7. The common associated procedures were posterior colporrhaphy(47.4%), anteroposterior colporrhaphy(45.6%), adnexectomy(4.9%), other(2.1%). 8. The mean blood loss was 280± 104.4 ml and 12.4% of operated women were need of transfusion. 9. The minor complication rate was 10.6% e.g. urinary retention(5.3%-179cases), abdominal bleeding (including conversion TAH) (0.3%-9cases), pelvic hematoma(0.3%-11cases), post operation fever(2.8%-94cases), mortality cases none. 10. The mean hospital days were 7 days(4∼20) Conclusion : In our experience the following conclusions have been reached that vaginal hysterectomy is usually well tolerated by most women, a safe operation with few complications and without notable blood loss and without the need of expensive laparoscopic equipment. The incidence of vaginal hysterectomy is characterized by pronounced fluctuations suggested that no valid general guidelines have yet been established for the indication via vagina of surgical treatment. The incidence of vaginal hysterectomy correlates with the experience of individual surgeon strongly. Vaginal hysterectomy remains the method of choice for removal of the uterus in the absence of absolute contraindication.
강성원,김종렬,이근영,강정배,정태범,심정원 대한부인종양 콜포스코피학회 1999 Journal of Gynecologic Oncology Vol.10 No.1
Objective: To review recurrence and prognosis of microivasive squamous cell carcinoma of the cervix that are associated with depth of invasion, pathologic finding and management( conservative or radical treatment) Study Design: We conducted retrospective study in order to evaluate the results of therapeutic approaches in 46 patients with microinvasive cervical cancer from Jan 1987 to Oct 1996. Result: The mean age of patients was 44.6+ 8.86 years. Only one woman was nullipara, and the mean parity was 2.8, Overall diagnostic accuracy of pap smear and punch biopsy were 54.3% and 79.4%. As the depth of invasion was deeper, the diagnostic accuracy of punch biopsy increased(p$lt;0.05), The confluence pattern and lymphovascular space involvement were observed in 39.1% and 4.9%. The confluence pattern was observed with statistical significant in advanced depth of stromal invasion. In the surgical management, vaginal hysterectomy was done in 28 patients, conization(1 patient), total abdominal hysterectomy(8 patients) and radical hysterectomy with pelvic lymph node dissection(9 patients) was done, no positive node was in 104 pelvic lymph node dissected. Though all cone margin was free and all endocervical curettage was negative, residual lesion(2 patients) was present in the hysterectomy after conization, The median follow-up period was 64 months. There was no recurrence in all cases and 5 years survival rate was 100%. Conclusion: We suggest that microinvasive carcinoma of the cervix may be the disease of good prognosis and no recurrence, and less radical therapy for the patients with microinvasive carcinoma may be sufficient.