근막 결손의 복원과 자궁천골인대 고정을 통한 전자궁적출술 후 질탈출의 성공적 교정

문화숙(Hwa Sook Moon),최진국(Jin Koo Choi),김경서(Kyung Seo Kim),박근식(Kyun Sik Park),황지영(Ji Young Hwang),문성은(Sung Eun Moon),한지원(Ji Won Han),김상국(Sang Gook Kim),김상갑(Sang Gap Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

목적 : 본 연구는 전자궁적출술 후 질탈출을 부위-특이적인 결함의 개념에 입각하여 치골경부 근막과 직장질 격막의 연결을 통한 골반내 근막의 복원과 자궁천골인대 고정술을 이용한 질탈출의 성공적인 수술적 교정의 방법과 결과를 보고하고자 한다. 연구 방법 : 1999년부터 2001년 8월까지 자궁적출술 후 질궁탈출 증상으로 문화병원 산부인과를 내원, 탈출된 질의 근막을 재건시킨 다음, 이를 자궁천골인대에 고정시킴으로써 질의 부위-특이적인 교정술을 받은 3명의 환자를 대상으로 하였다. 3명중 1명은 개복술을 하였고 2명은 내시경 수술을 하였다. 결과 : 환자의 연령 분포는 49-67세였으며, 수술시간은 평균 113분 (105-125)이었다. 세 환자 모두 수술 후 질의 상태가 해부학 및 기능적으로 정상이었으며, 9일째 특이사항 없이 퇴원하였다. 수술 후 HRT를 시행한 1명을 포함한 3명 모두 각각 24개월, 12개월, 7개월간의 추적 검사에서도 특이한 합병증이나 재발 없이 좋은 경과를 보였다. 결론 : 골반 근막 결손의 복원과 자궁천골인대 고정술은 전자궁적출술 후 질탈출의 교정에 매우 안전하고 효과적이며, 기능적인 방법으로 사료되며, 자궁천골인대를 질탈출 교정에 이용한 연구는 본 연구가 국내에서 처음이다. Objective : To report the method and efficacy of the site specific-defects repair in the endopelvic fascia and uterosacral ligament suspension for the correction of posthysterectomy vaginal vault prolapse. Methods : This study was performed in 3 patients with posthyterectomy vaginal vault prolapse who underwent the surgery for the reconstruction of endopelvic fascia and the correction of vault prolapsed vagina by using uterosacral ligament suspension at the department of Obstetrics and Gynecology in Moon-Hwa Hospital. Among them, 1 patient was treated by laparotomy, and 2 patients were treated by laparoscope. Results : The age of patients ranged from 49 to 67 years. The mean operation time was 111 minutes (105-120 minutes). The status of postoperative vagina was normal in all 3 patients, who were discharged 9 days after operation without symptoms. No complication or recurrence were found in them despite long-term follow-up for 24 months, 12 months, 7 months, respectively after operation. One patient has been treated with HRT therapy. Conclusion : The reconstruction of the defect of endopelvic fascia and uterosacral ligament fixation may be very safe, effective, and functional in the correction of vaginal vault prolapse. This study reports the treatment of vaginal vault prolapse using uterosacral ligament within Korea for the first time.

달 탐사선의 발사 요구조건 및 임무궤도 사례연구

석병석(Suk, Byong-suk),민승용(Min, Seung-yong),권재욱(Kwon, Jae-wook),김창균(Kim, Chang-kyoon),문상만(Moon, Sang-man),최수진(Choi, Su-jin),구철회(Koo, Cheol-hea),김인규(Kim, In-kyu),류동영(Ryu, Dong-young) 한국항공우주연구원 2015 항공우주산업기술동향 Vol.13 No.2

시험용 달 궤도선의 발사 요구조건 사전 분석 단계로 최근 외국에서 발사한 달 탐사선의 발사 요구조건을 분석하였다. 일반적으로 달 탐사선의 발사 요구조건은 달 임무 궤도를 결정하는 중요한 요소이며, 또한 지구, 달, 태양의 상대적인 운동으로 인해 임무궤도 요구조건을 만족하는 발사 가능 시간이 주기적으로 반복되는 경향이 있다. 분석 결과 설정된 발사 요구조건들로부터 달 궤도선의 주 임무가 달의 남/북극 지역의 광학 관측 임을 간접적으로 알 수 있었다. 향후 우리나라 달 궤도선 발사 요구 조건 설정에 본 논문이 도움이 되길 기대한다. In the preliminary study on launch window requirement for Korea Path-finder Lunar Orbiter(KPLO), the recent foreign lunar orbiter’s lauch window requirement was analyzed. Normally, the launch requirements depends on the mission orbit. Based on the relationship between Moon, Earth, and Sun, the launch time will be available periodically to meet requirements. In this paper, it is understood that the launch window requirements come from payload mission requirements to take picture each poles of Moon. This paper might be a practical example to derive KPLO launch requirements in the future.

Benzoyl peroxide의 환경에서의 초기 위해성 평가

김미경,배희경,김수현,송상환,구현주,박광식,이문순,전성환,나진균 한국환경독성학회 2004 환경독성보건학회지 Vol.19 No.1

Benzoyl peroxide is a High Production Volume Chemical, which is produced about 1,375 tons/year in Korea as of 2001 survey. The substance is mainly used as initiators in polymerization, catalysts in hte plastics industry, bleaching agents for flour nad medication for acne vulgaris. In this study, quantitative Structure-Activity Relationships(QSAR) are used for getting adequate information on the physical-chemical properties of this chemical. And hydrolysis in water, acute toxicity to aquatic and terrestrial organisms for benzoyl peroxide were studied. The physical-chemical properties of benzoyl peroxide were estimated as followed; vapor pressure=0.00929 pa, Log K_(ow)=3.43, Henry's Law constant=3.54×10^(-6) atm-m³/mole at 25℃, the half-life of photodegradation=3days and bioconcentration factor(BCF)=92. Hydrolysis half-life of benzoyl peroxide in water was 5.2hr at pH 7 at 25℃ and according to the structure of this substance hydrolysis product was expected to benzoic acid. Benzoyl peroxide has toxic effects on the aquatic organisms. 72 hr-ErC_(50)(growth rate) for algae was 0.44mg/L, 48hr-EC_(50) for daphnia was 0.07mg/L and the 96hr-LC_(50) of acute toxicity to fish was 0.24mg/L. Acute toxicity to terrestrial organisms(earth worm) of benzoyl peroxide was low(14 day-LC_(50)=>1,000mg/kg). Although benzoyl peroxide is high toxic to aquatic organisms, the substance is not bioaccumulated because of the rapid removal by hydrolysis (half life=5.2hr at pH 7 at 25℃) and biodegradation(8.% by BOD after 21days). The toxicity observed is assumed to be due to benzoyl peroxide rather than benzoic acid, which shows much lower toxicity to aquatic organisms. One can assume that effects occur before hydrolysis takes place. From the acute toxicity value of algae, daphnia and fish, an assessment factor of 100 was used to determine the predicted no effect concentration(PNEC). The PNEC was calculated to be 0.7㎍/L based on the 48hr-EC_(50) daphnia(0.07mg/L). The substance shows high acute toxicity to aquatic organisms and some information indicates wide-dispersive use of this substance. So this substance is a candidate for further work, even if it hydrolysis rapidly and has a low bioaccumulation potential. This could lead to local concern for the aquatic environment and therefore environmental exposure assessment is recommended.

이동통신서비스의 기업능력, 경쟁전략 및 경쟁우위의 영향관계에 관한 탐색적 연구

김문구,박종현,박명철 한국경영과학회 2004 經營 科學 Vol.21 No.2

Recently domestic mobile carriers have been engaged in heated battles for survival as the market is now rapidly approaching its maturity phase, and the launch of 30 service combined with the introduction of mobile number portability is dramatically reshaping the market landscape. The mobile carriers may have to create and maintain their competitive advantage based on their core capabilities and differentiated strategies, which will lead continuous survival and profits of the firm. This paper investigated competitiveness factors among mobile carriers, and analyzed the relationships of firm capabilities, competitive strategies and competitive advantage. We found that core capabilities and competitive strategies affecting competitive advantage are different from each carrier. Finally, we discussed strategic implications for carriers to increase their competitiveness.

윌름종양의 치료에 대한 임상적 고찰

김재성,조문준,박경덕,설종구 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Wilms' tumor is the paradigm for multimodal treatment of a pediatric malignant solid tumor. Developments in surgical techniques and postoperative care, recognition of the sensitivity of Wilms' tumor to irradiation, and the availability of several active chemotherapeutic agents led to a dramatic change in the prognosis for most patients with this once uniformly lethal malignancy. This article presents four cases of Wilms' tumor managed at Chungnam National University Hospital and reviews current treatment recommendations for patients with Wilms' tumor, based upon the results of the National Wilms' Tumor Studies.

심초음파로 결정된 응급 심낭천자술의 천자부위

김성환,황성오,이강현,조준휘,강구현,문중범,이승환,윤정한,최경훈,김영식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: The aim of this study was to determine whether the conventional subcostal approach is suitable for emergency pericardiocentesis in patients with cardiac tamponade or impending cardiac tamponade. Methods: This study was a prospective, observational study conducted at the emergency department of a tertiary hospital, Patients who had symptomatic pericardial effusion and who needed emergency pericardiocentesis in the emergency department were included in this study. We measured the epicardium-to-pericardium distance at the subcostal, parasternal, and apical area with two-dimensional echocardiography to determine the appropriate puncture site for pericardiocentesis. An epicardium-to-pericardium distance of more than 1.0 cm was considered as the primary safety factor in determining the Puncture site for pericardiocentesis. The skin-to-pericardium distance was considered as secondary safety factor. Results: Ninety-five consecutive patients(55 males and 40 females; total mean age: 53 year old) with cardiac tamponade or impending cardiac tamponade were enrolled in this study. The puncture site for pericardiocentesis, as determined by echocardiography, was the subcostal area in 43 patients(45%), the apical area in 40 patients(42%), the left parasternal area In 11 patients(12%), and the right parastemal area in one patient(1%). Pericardiocentesis failed in 2 patients(2%) with the subcostal approach and in one patient(1%) with the apical approach. The average epicardium-to-pericardium distance was 31 ±21 mm in patients with the subcostal approach and 21±8 mm in patients with other approaches. There were no differences in the amount of pericardial fluid and in the intraperical pressure among patient groups according to puncture site. There were two procedure related complications: a puncture of the right ventricle with the subcostal approach and a ventricular tachycardia with the apical approach.

폐암에서 CYFRA 21-1과 다른 종양표지자의 진단적 의의

이상구,이호현,전병철,김성자,이영현,김문연,하경임 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

폐암의 확실한 조직학적 진단이 어려울 경우 종양표지자의 검사가 보조적인 진단 수단이 되고, 조기 진단이나 경과 관찰에 이용되고 있다. 이에 저자는 CYFRA 21-1이 폐암의 종양표지자로서 효용성이 있는지 판정하고, CYFRA 21-1과 다른 폐암 종양표지자인 SCC Ag, CEA, NSE의 폐암의 조직학적 유형에 따른 민감도와 특이도를 비교하였다. 그리고 병기 진행에 따른 CYFRA 21-1치의 증가 여부를 관찰하고, 4가지 종양표지자를 동시에 측정하였을 때의 진단적 효용성을 비교하고자 하였다. 이 연구는 1994년 12월부터 1995년 11월까지 동국대학병원에 입원한 폐암 환자 40명과 양성 폐질환 환자 40명을 대상으로 하였다. 편평상피세포암 21명, 선암 10명, 소세포암 7명, 대세포암 2명이었다. 혈청 CYFRA 21-1의 cytokeratin 19 분절에 대한 쥐의 두 가지 단일 클론항체(KS 19-1과 BM 19-21)를 이용하는 RIA방법으로 측정하였다. CEA는 MEIA 방법으로, SCC 항원과 NSE는 RIA로 측정 하였다. 1. CYFRA 21-1의 혈중 농도는 폐암군 22.08±43.00ng/mL, 양성 폐질환군 1.14±1.04ng/mL로 폐암군에서 양성 폐질환군보다 유의하게 높았다(P<0.05). 폐암환자군에서 55%의 양성율을 보였고, SCC 항원 30%, CEA 44.7%, NSE 54.5%의 양성율을 나타내 CYFRA 21-1이 가장 높은 양성율을 보였다. 2.CYFRA 21-1은 비소세포암군 23.79±44.49ng/mL, 소세포암군 13.90±33.57ng/mL로 양군에서 유의한 차이를 보였다. 폐암환자군에서 민감도와 특이도는 CYFRA 21-1 55.0%와 96.7%, SCC항원 30.0%와 96.4%, CEA 42.5%와 92.8%, NSE 36.4%, 76.9%로 CYFRA 21-1에서 가장 높은 민감도와 특이도를 보였다. 폐암의 조직학적 유형에 따른 민감도는 편평상피세포암에서 CYFRA 21-1이 61.9%로 CYFRA 21-1의 민감도가 가장 높았고, 선암에서는 CEA가 88.8%로, 소세포암에서는 NSE가 85.7%로 가장 민감도가 높은 것으로 나타났다. 3. 비소세포암군에서 CYFRA 21-1치는 병기가 진행됨에 따라 증가하는 경향을 보였으나 통계학적으로 유의하지는 않았다. 4. 폐암환자에서 단일 종양표지자를 측정하는 것 보다 동시에 여러 종양표지자를 측정하는 것이 특이도는 떨어지나 민감도는 80.0%로 더 높은 것으로 나타났으며 정확도에는 큰 차이가 없었다. 양성 표지나 수에 따른 비교분석시 폐암의 상대 예측도는 두 표지자 양성인 경우가 76.5%, 3가지 표지자와 4가지 모든 표지자에서 양성으로 나온 경우는 100%로 나타났다. 본 연구 결과 CYFRA 21-1은 새로운 폐암의 종양표지자로 기존의 종양표지자 보다 민감도가 높고 비소세포암 특히, 편평상피세포암에 유용한 표지자로 사료되며, 폐암이 의심되는 환자에서 단일 종양 표지자를 측정하는 것 보다 수종의 종양표지자를 동시에 측정하는 것이 진단에 더욱 도움이 되리라 생각된다. Background: Cytokeratin 19 is a subunit of cytokeratin intermediate filament expressed in simple epithelia and their malignant counterparts. A fragment of cytokeratin subunit 19 can be measured in serum with a immunoradiometric assay using two mouse MoAb KS 19-1 and BM 19-21. Thus this cytokeratin 19 fragment is referred to as CYFRA 21-1. The aims of this study are to evaluate the clinical utility of CYFRA 21-1 in the diagnosis of lung cancer and to compare the diagnostic sensitivity and specificity of CYFRA 21-1 with those of CEA, SCC Ag, NSE according to histological type of lung cancer. Methods: In 40 patients with lung cancer(21 with squamous cell carcinoma, 10 with adenocarcinoma, 7 with small cell carcinoma, 2 with large cell carcinoma) and 40 patients with non-malignant lung disease, serum CYFRA 21-1 was measured by solid-phase immunoradiometric assay(CIS Bio International, France). Serum NSE and SCC Ag were measured by immunoradiometric assay, and CEA was measured by microparticle enzyme immunoassay. Results: 1) The mean value of CYFRA 21-1 was 22.08±43.00ng/mL in the lung cancer and 1.11±1.04ng/mL in me non-malignant lung disease group(P<O.O5). 2) Using the cut-off value of 3.3ng/mL, the sensitivity and specificity of CYFRA 21-1 were 55.0%, 96.7% in the lung cancer. The sensitivity of CYFRA 21.1 was 61.9% in squamous cell carcinoma 3) The level of CYFRA 21-1 was increasing tendency with the progression of stage in non-small cell carcinoma but statistically not significant. 4) Simultaneous determination of four tumor markers revealed increased sensitivity to 50.0% in lung cancer. As the number of positive markers was increased, the relative possibility of lung cancer was also increased. If two markers were positive, it increased to 76.5% and three markers were positive, it increased to 100%.5 Conclusions: CYFRA 21-1 is a useful serum marker for patients with lung cancer, especially in squamous cell carcinoma of the lung. The simultaneous measurement of CYFRA 21-1, CEA. SCC Ag and NSE would provide additional information for the diagnosis of lung cancer, especially in patients with high risk group of lung cancer.

혈전 발생의 위험 인자가 없는 환자에서 급성 신우신염에 의해 유발된 신정맥 혈전증 및 폐색전증

이광수,김아름,이승연,정주홍,김미정,이진수,정문현,홍기천,조순구 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

Renal vein thrombosis (RVT) is not an uncommon condition amongst patients with nephrotic syndrome or malignancy. Septic pulmonary embolism (SPE) is associated with risk factors such as intravenous drug use, pelvic thrombophlebitis, and suppurative processes in the head and neck. However, acute pyelonephritis is a rare cause of RVT and SPE. Case reports on RVT and SPE due to acute pyelonephritis are rare. In most of the earlier cases, patients had underlying conditions such as diabetes mellitus, renal carcinoma, calyceal stones, and hyperhomocysteinemia. We report a case of acute pyelonephritis complicated by RVT and SPE that occurred in a patient without any predisposing risk factors for thromboembolism. RVT and SPE were diagnosed using computed tomography and ventilation/perfusion scan. The patient recovered with antibiotics and anticoagulation therapy without any surgical interventions.

보건관리 대행사업 평가 지표 및 척도개발에 관한 연구

박정일,조병희,구정완,김광종,김현욱,원종욱,이명숙,이원철,정문희 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.3

This study was carried out to develop the index and the scales for the evaluation of the group occupational health services(GOHS). The possible variables of each step, firstly, based on an evaluation model composed of four steps, input, throughout, output and outcome, were selected through several meetings of professional committee. And five types of questionnaire(for doctor, nurse, industrial hygienist, employer, and employee) were developed based on the selected variables. A pilot survey for four GOHS institutions and 12 enterprises was conducted using the questionnaires and correlation analysis for extracting variables was done. The results were as follows: 1.The evaluation scale was composed of three areas(evaluation on workers' health and work environment, evaluation by institution and employer, and evaluation by employee)which were devided into ten subscales. 2.Among firstly selected ninety-six variables, forty-three variables (11 for input, 14 for throughout, and 18 for output indices) were extracted by correlation analysis. 3.Based on the extracted variables, the questionnaires were simplified as five items for doctor, thirty-six items for nurse, nine items for industrial hygienist, and twenty-six items for employer and employee. 4.The total score of evaluation model was defined on the basis of four-hundred points as sum of four indices (input, throughout, output and outcome) given one-hundred points each.

복숭아에서 변색봉지 괘대 시기가 수확시 과피색 및 과실품질에 미치는 영향

문병우(Byung Woo Moon),윤익구(Ik Koo Yoon),김임수(Im Soo Kim3),남기웅(Ki Woong Nam) 한국원예학회 2010 한국원예학회 학술발표요지 Vol.2010 No.10