전이성 척추 종양의 수술적 치료

한정수,김기택,소재호,이정희,신동준,Han, Chung-Soo,Kim, Ki-Tack,Soh, Jae-Ho,Lee, Jung-Hee,Shin, Dong-Jun 대한근골격종양학회 2000 대한골관절종양학회지 Vol.6 No.1

목적 : 전이성 척추 종양은 가장 흔한 전이성 종양 중의 하나로 치료에 있어 보통 보존적 요법이 선호되어 왔으나 신경학적 증상과 삶의 질의 개선이 극히 불량하였다. 수술적 치료 후에 신경학적 증상의 변화와 임상증상의 개선정도, 생존 기간의 증가 등에 대해 평가하였다. 대상 및 방법 : 1991년 8월부터 1999년 6월까지 본원에서 경험하였던 전이성 척추 종양 중 수술적 치료 후 추시관찰이 가능하였던 14례를 대상으로 하여 의무기록과 방사선학적 검사 등을 후향적으로 검토하여 연령별, 성별, 해부학적 발생 부위별 분포와 각각의 원발 종양에 따른 골 전이의 양상에 대해 조사하였고, 방사선 치료로 도움이 안될 때, 신경학적 증상이 악화될 때, 척추 불안정성이 있을 때, 원발 종양을 알지 못할 때, 병적 골절이 있을 때, 기대여명이 6주 이상일 때, 만성적인 통증이 있을 때 시행하였던 수술적 치료 전후의 증상의 개선 정도를 평가하여 문헌 고찰과 함께 분석하였다. 결과 : 전이성 척추 종양은 여자에서 더 많이 발생하였고 30대에서 70대까지 연령이 다양하였으며 원발 종양으로 여자는 유방암, 남자는 폐암이 가장 많았고 가장 흔한 전이 부위는 흉추부였다. 수술 전 마비의 정도가 수술 후 임상 증상의 호전에 영향을 미친 것으로 나타났으며 수술 후 전이성 척추 종양의 평균 여명은 사망한 11례에서 8.9개월, 살아있는 3례에서 14.7개월이었다. 결론 : 전이성 종양에 대한 수술적 치료는 전이성 척수 종양이 의심될 때, 치료와 동시에 조기 진단이 가능하며 그 방법과 관계없이 동통과 신경학적 증상의 회복에 큰 도움을 줄 수 있고, 초기의 적극적 치료로 삶의 질과 생존 기간을 향상시킬 수 있다. 추후 원발 종양의 종류에 따른 전이성 척수 종양의 분류와 이에 따른 수술적 치료의 역할에 대한 평가가 더 필요하리라 사료된다. Purpose : Spine is one of the most common sites of the metastatic bone tumors. Conservative management such as chemotherapy or radiotherapy has been preferred in most cases. However, the neurologic deficit has not been usually improved, and the quality of life was poor. The purpose of this study was to show the efficacy of the surgical treatments for metastatic spinal tumors in terms of postoperative improvements of neurologic deficit and survival time. Materials and Methods : Authors have reviewed the literatures and analyzed 14 patients of metastatic spinal tumors who were received operative treatments between August 1991 and June 1999 at the our department of orthopaedic surgery. Results : The most frequent primary tumor was breast cancer in women and lung cancer in men. The thoracic region was the most common site. There was a preponderance of females over males, and the age ranged between 4th and 8th decade. The indications of surgical treatment comprised instability, progressive neurologic findings, resistance to radiotherapy, pathological fracture, long life expectancy( >6weeks), isolated metastasis and need for pathological diagnosis. The degree of preoperative neurological deficit might influence on the improvement of clinical symptoms after surgery. Conclusion : The surgical treatment reduced the neurological deficit and pain regardless of the operative methods. In the early stage of neurological deficit, the surgical treatment was important for better prognosis. Recently early active operative treatment was performed for metastatic spinal tumor to minimize the intractable pain and to prevent the progression of the neurologic deficit. Early intervention can improve the quality of life and long term survival.

제 2족지 근위 지골에 발생한 저악성도 골육종 - 증례 보고 -

한정수,정덕환,신동준,임양선,정찬종,Han, Chung-Soo,Chung, Duck-Hwan,Shin, Dong-Jun,Lim, Yang-Sun,Jung, Chan-Jong 대한근골격종양학회 2001 대한골관절종양학회지 Vol.7 No.4

족부에 발생하는 골육종은 전체 골육종의 0.2~2%로 매우 드물며 장관골의 골간단부에 발생하는 저악성도 골육종은 전체 골육종의 약 1.9% 정도를 차지하는 드문 종양이다. 본 교실에서는 제 2족지 근위 지골의 종물과 심한 동통으로 내원한 38세 여자 환자에서 발생한 저악성도 골육종 1례를 경험하였다. 환자는 단순 방사선 검사상 좌측 제 2족지 근위 지골 전체를 침범한 골용해성 병변이 관찰되었으며 피질골은 얇고 팽대된 소견을 보였다. 골주사 검사상 단순 방사선 사진에서 보인 것과 동일한 위치에 흡수 증가의 소견을 보여 양성 골종양으로 판단하고 종양 절제 후 늑골을 이용한 관절 재건술을 시행하였다. 수술 후 조직학적 소견상 저악성도 골육종으로 판정되었고 이차적으로 좌측 제 2족지의 근치적 광범위 절제술을 시행하였다. 제 2족지 근위 지골에 발생한 저악성도의 골육종은 매우 드문 종양으로 광범위 절제술 후 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다. The reported incidence of osteosarcoma of the foot varies between 0.2-2% of all osteosarcoma. Low grade osteosarcoma of the long bone represents only 1.9% of all osteosarcoma. A 38-year-old female had suffered painful mass in the proximal phalanx of the second toe for 1 year. Radiographic finding showed enlarged osteloytic mass which had penetrated thin cortex of the second toe and apparent increased uptake in bone scan was seen. Mass resection with autogenous bone graft using rib was performed. Histologically, the tumor was compatible with "low grade osteosarcoma". Second stage wide resection was performed. Because low grade osteosarcoma located in the proximal phalanx of the second toe is very rare, we report this unusual case with review of literature.

손목관절의 기능적 운동 특성의 동작 분석

한정수,Han Jung Soo 대한의용생체공학회 2003 의공학회지 Vol.24 No.6

Injuries of wrist in upper extremity is common onset in industrialized world. The development of joint arthroplasty and mechanical joint is area of research for biomechanical engineer and surgeon for a decade. Therefore. the knowledge of characteristic of joint motion is essential to develop the artificial wrist joint. In this study. the joint motions of wrist required for activities of daily living (ADLs). including personal hygiene and care. and general home activity were measured using flexible electrogoniometer. Total of 25 different daily activities were separated into four groups and tested on 15 subjects who did not show any abnormality of their joint functions. The maximum functional range of motion required for ADLs were obtained and standardized for analysis and comparison. Also. a least functional range of motion for ADLs were investigated. Results revealed that any significant differences were not found in least functional range of motion between left and right wrist to perform ADLs. However. a significant difference was found in different ADLs. Therefore. least range of motion obtained in this study can be used as basic data to design artificial joint and set a goal for surgeon to achieve appropriate treatment from patients.

거대세포종의 보조 요법으로의 전기소작술

한정수,김세동,박성혁,김정래,신덕섭,Han, Chung-Soo,Kim, Se-Dong,Park, Sung-Hyuk,Kim, Jung-Rae,Shin, Duk-Seop 대한근골격종양학회 2006 대한골관절종양학회지 Vol.12 No.1

목적: 거대세포종의 치료에서 보조요법으로 전기소작술을 시행한 환자들을 추시하여 종양학적 및 임상적 결과를 알아보고자 하였다. 대상 및 방법: 1989년부터 2004년까지 두 곳의 대학병원에서 치료한 94례의 거대세포종 중 보조요법으로 전기소작술을 시행하였던 47례를 대상으로 하였다. 수술방법은 종양부위의 피질골에 창을 충분한 크기로 내고, 큐렛과 speed bur를 이용한 철저한 소파술 후 Bovie로 전기 소작술을 시행하였고, 추시 환자의 의무기록과 방사선 사진들을 조사하여 임상적 및 종양학적 결과를 조사하였다. 결과: 평균 44개월의 추시 기간 중 국소재발은 8례(17%)에서 있었고, 폐전이는 1례에서 발견 되었다. Bovie를 이용한 전기소작술로 인한 합병증 또한 1례(화농성 슬관절염)에서 있었다. 결론: Bovie를 이용한 전기소작술은 거대세포종의 수술 중 사용하는 다른 보조요법에 비하여 비교적 간편하면서도, 재발율이 다른 방법에 비하여 높지 않다는 점에서 유용한 방법이라고 사료된다. Purpose: This study was designed to investigate the clinical and oncological results of giant cell tumor, treated with electrocautery as an adjuvant. Materials and Methods: We evaluated 47 giant cell tumors treated in both institution from 1989 to 2004, retrospectively. We treated all 47 cases with intralesional curettage and speed burring and followed electrocautery as an local adjuvant. Results: The mean follow up periods was 44 months and ranged from 12 to 180 months. The local recurrence occurred in 8 patients (17%) and one case lung metastasis was found. There was one case complication (septic knee) associated with electrocautery as an adjuvant. Conclusions: We thought electrocautery was feasible adjuvant treatment method of giant cell tumor, because it is very convenient technique, and the local recurrence rate was similar to any other methods.

Fly-By-Wireless 비행제어 기술의 연구 동향

한정수,하철수,오수헌,강승은,고상호,Han, Jung-Soo,Ha, Chul-Su,O, Su-Hun,Kang, Seung-Eun,Ko, Sangho 한국항공운항학회 2014 한국항공운항학회지 Vol.22 No.1

This paper deals with recent research cases and directions of Fly-By-Wireless (FBWLS) flight control technology. FBWLS is a new type of flight control system technology with the aim of solving the problems mainly caused by the increasing amount of wires in aircraft to which Fly-By-Wire (FBW) technology applies. Therefore, in FBWLS flight control system the wired communication system is replaced with a wireless communication system. Currently the FBWLS flight control technology is at an initial development stage and thus this paper surveys deals with the cases in the viewpoint of technology feasibility. In this context, this paper analyzes technology that needs further studies to secure the reliability, stability and accuracy to the similar level of the corresponding FBW system. Since the major problems of FBWLS technology are packet losses and time delays so that this paper suggests the research direction of wireless communication protocol selection, optimization of wireless communication network and controller design considered communication environment.

고려후기 天災地變과 王權

韓政洙(Han Jung-Soo) 역사교육연구회 2006 역사교육 Vol.99 No.-

Coming into the 12th century, since the reigns of Kings Yaejong and Injong, unusual changes in the weather, atmospheric disturbances and astronomical phenomena had been continuing to frequently occur. Examining how these atmospheric and astronomical events and disasters had taken place, how the government tried to handle those situations, what exactly was the King’s role in dealing with the challenges and what those roles meant, are all important questions. They should be answered if we are to acquire understanding of the nature of national ruling order, including the King’s own ruling authority, and the changes that occurred inside the political ideology around the time of adoption of the Neo-Confucian philosophy. The ‘Heaven’s order’ theory based upon the suggested correlation between heaven and men, which was favored, understood and utilized by the Goryeo dynasty’s royal family, had played its role admirably as a ruling ideology which had contributed to the stability of the Goryeo society. And that was the characteristic of the Goryeo dynasty in this matter.

고려전기 천변재이와 유교정치사상

한정수 ( Jung Soo Han ) 한국사상사학회 2003 韓國思想史學 Vol.0 No.21

염기처리에 의한 셀룰로오스 소재의 습윤강도 변화

한정수(Jung Soo Han),강동석(Dong Suk Kang),강시원(Si Weon Kang),김상윤(Sang Yoon Kim),서영범(Yung Bum Seo) 한국펄프·종이공학회 2018 한국펄프·종이공학회 학술발표논문집 Vol.2018 No.4

조선 초기 王氏處分論의 대두와 전개

한정수(Han, Jung-Soo) 한국사학회 2014 史學硏究 Vol.- No.114

본 연구는 조선 건국 후 전 왕실세력인 고려 왕씨를 어떻게 대우하며 처리하려 하였는가와 그 배경을 살펴보려는 것이다. 이를 위해 본 연구에서는 먼저 태조 즉위 과정과 그 명분을 검토하고, 다음으로는 고려 왕씨에 대한 처분론의 대두와 그 방향을, 마지막으로는 大義에 입각한 결단을 반영한 王氏永節論의 적용과 그 전개를 정리하고자 하였다. 태조의 즉위는 자신들이 추대한 공양왕을 다시 폐하여야 한다는 면에서 명분이 약하였다. 그러나 태조 및 그 추대세력은 이를 극복하기 위하여 왕씨처분을 모색하였다. 하나는 前朝의 군주와 遺民들에 대해 일정지역에 국한하여 제후로 책봉하고 제사를 잇도록 하는 放置封建및 祭祀의 봉행이었다. 다른 하나는 전조의 왕실세력은 화란의 근원이 되므로 발본색원하여 誅殺하여야 한다는 것이었다. 왕씨영절론이 이에 해당하였다. 태조는 즉위 후 고려 왕씨에 대해 封君하여 제사를 받들게 하고, 편한 대로 거처하도록 하는 德을 베풀었다. 하지만 태조추대세력은 우?창을 죽여 反正을 완성한 것처럼 왕씨들을 발본색원-주살하자 하였다. 결국 태조 역시도 주살영절론을 수용할 수밖에 없었고, 1394년 ‘甲戌之誅’가 발생하였다. 이 왕씨영절론은 태종 13년에 가서야 “왕씨의 후예로서 생존한 자들은 그들로 하여금 각각 생업에 안정하게 하라.”는 명이 내려지면서 그게 되었고, 고려왕조를 위한 제사시설인 崇義殿의 마련으로 귀결되었다. 명의 고명을 받은 태종 대에 주살영절론이 해제된 것으로 볼 때 왕씨 처분론의 전개는 태조 즉위와 조선 건국의 불안요소를 제거하고 방벌혁명을 행하였다는 대의명분의 완성이라는 성격을 띠었다 하겠다. This paper aims to search how Wang family, the previous royal power, was treated and disposed after the establishment of Joseon and the setting of this situation. For this purpose, I examine the procedure and cause of the accession of Taejo (first king of Joseon), search the raising discussion for the disposal of Wang family and its course and arrange the application and development of discussion for eternal extinction of Wang family which reflected decision based in great cause. The accession of Taejo was justified insufficiently, because King Gongyang (Gongyangwang) who ascended to the throne by Taejo himself should be dethroned for it. Taejo and his supporting power looked for the disposal of Wang family to overcome this problem. There were two possible ways. One was the neglecting feudality accompanying memorial ceremony in which the ruler of the previous dynasty was invested as feudal lords in the specific region with his wandering people and allowed to hold memorial ceremony for his ancestors. Another was discussion for eternal extinction of Wang family in which the previous royal power was the source of disaster and revolt and should be eradicated and put to death. Taejo treated Wang family with favor after his accession. He invested them as feudal lords and allowed to hold memorial ceremony and live in their desired region. However, his supporting power insisted that Wang family should be eradicated and put to death, as they completed restoration by killing King U(Uwang) and King Chang(Changwang). Finally, Taejo accepted discussion for putting to death and eternal extinction. There was Gapsuljiju in 1394. The discussion for eternal extinction of Wang family was ceased with the order of Taejong in which the surviving posterity of Wang family could live securely with their occupation. It was concluded in establishing Sunguijeon, the shrine for Goryeo dynasty.

고려 전기 賜給老人制의 실시와 老人賜設儀의 성립

한정수(Han, Jung Soo) 역사실학회 2020 역사와실학 Vol.72 No.-

고려시대 노인사설의는 성종 5년 사급노인제 설행에서 시작되었다. 현실적으로 『예기』나 『대당개원례』등에서의 양로연 실시가 어려웠던 만큼 성종이후 사급노인제는 양로와 구휼, 효제 및 절의의 장려를 위한 국왕의 饗禮와 賜物로 내용이 확대되었다. 참여 및 사급 대상은 80세 이상 국로와 서로, 命婦 및 여성, 효자순손, 의부절부, 승속, 환과고독, 독폐질자까지 확대되었다. 설행계기는 국왕 즉위 등 경사, 재이와 관련한 기양, 노인봉양과 효의 권장 등 다양한 차원에서 행해져 정기성은 약하였다. 문종 및 숙종 대에 이르러서는 노인사설의의 내용에 해당하는 참여대상, 의례공간, 절차 등이 갖춰졌으며, 결국 인종 16년 이후 의종 대 『상정고금례』정비 과정에서 노인사설의로 상정되었다. 이에 사급노인제를 넘어 노인사설의는 국왕의 양로와 구휼을 반영하면서 국왕중심 與民同樂의 仁政완성을 위한 면이 강화되었고, 효제와 절의 권장이라는 풍속 교화의 일환에서도 행해져 국왕 통치와 지배를 상징하는 면이 커졌다 하겠다. During the Goryeo Dynasty, the grant ceremony for the aged began with the execution of the grant system for the aged in the fifth year of King Seongjong"s reign. In reality, it was difficult to perform the banquet for the aged in "Yegi" and "Daedanggaewonrae," so after King Seongjong"s reign, the grand system for the aged was expanded to the celebration and gift of the king for the aged to encourage taking cae of the aged,, helping people in a bad year, filial piety, and fidelity to one"s principle. The list of participants and grantees was expanded to include national meritorious and ordinary persons aged over their 80 or older, women and ladies invested with the titles nobility, grandson offering piety to grandfather, virtuous women to the stepfather, the clergy and the laity, widowers, widows, orphans and childless persons, and patients suffering from incurable diseases. The occasion was held at various levels, including the king"s ascension to the throne, the rich and bad year related to natural calamities, and the recommendation of the elderly"s care and filial piety, so its regularity was weak. The subjects of participation, ceremonial spaces, and procedures corresponding to the contents of the grant ceremony for the aged were provided during the reigning periods of King Munjong and King Sukjong, and it was finally introduced as the grant ceremony for the aged in the course of the reorganization of the "Sangjeonggogeumrye" for the event after the 16th year of King Injong. In this regard, beyond the grant system for the aged, the grant system for the king was strengthened in terms of completing the king-centered policy of sharing enjoyment with people and benevolent rule whiling reflecting the king"s and taking care of the aged and helping people in a bad year, and it was practiced as part of enlightening the custom through the recommendation of filial piety and fidelity to one"s principle., which greatly symbolized the king"s rule and control.