연부조직육종의 수술후 방사선 치료결과

김연실(Yeon Shil Kim),장홍석(Hong Seok Jang),윤세철(Sei Chul Yoon),유미령(Mi Ryeong Ryu),강기문(Ki Moon Kang),정수미(Su Mi Chung),김훈교(Hoon Kyo Kim),강용구(Yong Koo Kang) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.4

목 적 : 최근들어 연부 조직 육종의 치료방법이 광범위 구획절제에서 사지기능을 보존하는 제한적 수술과 방사선/항암화학요법의 다병용치료로 변환되고 있으며 광범위 수술과 유사한 치료성적을 거두고 있다. 저자들은 수술후 방사선 치료를 시행한 연부 조직 육종 환자를 대상으로 치료 결과 및 실패 양상을 알아보고 관련된 예후 인자를 분석하여 수술 후 방사선치료의 역할을 알아보고자 하였다. 대상 및 방법 : 대상환자는 1983년부터 1994년까지 치료한 60명이었고 모두 추적관찰이 가능했으며 평균 추적기간은 50개월이었다. 원발병소는 상·하지가 35례(58%)로 가장 많았고 체간 12례(20%), 두경부 7례(12%)였으며 병리학적 유형에 따른 구분은 악성섬유구종 14례(23%),지방육종이 10례(17%), 악성신경섬유종 7례(12%) 등 이었다. 전체환자중 6례를 제외하고는 조직학적등급의 분석이 가능했고 grade I, II, III가 각각 27례(45%), 3례(5%), 24례(40%)였다. 수술적 절제는 19례(32%)에서 광범위절제, 36례(60%)에서 변연절제, 5례(8%)에서 국소절제를 시행하였다. 방사선치료선량은 28.8- 80Gy였고 25례에서 방사선치료와 함께 항암화학 요법을 병용하였다. 결 과 : 최종분석 시 실패 양상은 국소재발이 20례(25%), 원격전이 7례(12%), 국소재발과 원격전이를 동반한 경우가 14례(23%)였다. 원격전이한 환자는 구제치료와 상관 없이 모두 사망하였고 국소재발한 환자중 5명이 구제치료에 성공하여 무병생존하였다. 전체환자의 2년 및 5년 국소제어률은 68.0%와 48.7%로 비교적 저조한 결과를 보였다. 국소제어율에 영향을 미친 예후인자는 조직학적 유형, AJCC 병기, 조직학적 등급, 수술의 범위, 수술절연 침범 유무 및 잔존종양 정도, 림프절 전이 유무(p <0.05)였다. 전체 환자의 5년 생존률과 5년 무병생존률은 각각 60.4%, 36.6%였고 평균 생존기간은 89개월이었다. 단변량 분석에 의한 생존률에 영향을 미친 예후인자로는 조직학적 유형, AJCC 병기, 림프절 전이 유무, 조직학적 등급, 수술절연 침범 유무와 잔존 종양 정도 였다. 결 론 : 결론적으로 본 연구 결과 연부 조직 육종에서 제한적 수술과 수술 후 방사선치료로 비록 저조한 국소제어률을 보였으나 사지 절단 혹은 광범위 구획절제와 비교시 유사한 생존률을 얻었다. Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 60 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patints with median follow up duration 50 months (range 6 - 162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58%) was the most frequent site of occurrence followed by trunk (20%) and head and neck (12%). Histologically malignant fibrous histiocytoma (23%), liposarcoma (17%), malignant schwannoma (12%) constitute 52% of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42%) received chemotherapy with various regimen in the postoperative period. Results : Total 4 1 patients failed either with local recurrence or with distant metastasis. There were 29 patients(48%) of local recurrence. Four patients (7%) developed simultaneous local recurrence and distant metastasis and 8 patients (13%) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck prima ry. This feature is like ly explanation for the decreased loca l control rate . Five of 29 patients who fa iled only loca lly were salvaged by re- excis ion and/or re- irradiation and rema ined free of disease . Factors affecting loca l control include histologic type , grade, stage , extent of operation and surgica l ma rgin involvement, lymph node metastas is (p <0.05). All 21 patients who fa iled distantly are dead with progress ive disease at the time of this report. Our overall survival results are similar to those of larger series . Actuarial 5 year overall survival and disease fresurvival were 60.4 %, 36.6% respectively. Grade, stage (being close association with grade), residual disease (negative ma rgin, microscopic, gross) were significant as a predictor of survival in our series (p <0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

계측위치와 자유면 방향에 따른 지반진동 특성 연구

강추원,양해승,이수연 조선대학교 에너지.자원신기술연구소 1999 에너지·자원신기술연구소 논문지 Vol.21 No.2

The free face is an important part in the blasting design and plan. Most of study on the free face is referred to concern with fragmentation volume and determination of charge per delay. But the characteristic of vibration for the direction of the free face short of studies. This study shows the difference and characteristics of the vibration velocity for the measuring point and the direction of the free face. At the velocity of vibration, the back of the free face is over the front (Probably 1.20~1.29 times). A nomogram was made in relation to the maximum charge weight per delay on the basis of the 95% vibration blast equation and the velocity of vibration allowance set 5㎜/sec. Scaled distance was 29.71㎏/m^(1/2), 39.63㎏/m^(1/3) on the front of the free face and 34.03㎏/m^(1/2), 45.20m/㎏^(1/3) on the back of the free face.

고립성 직장결핵 3예

이동수,정강욱,황도연,이형화,김대현,김영성,곽동협 대한내과학회 2003 대한내과학회지 Vol.64 No.1

저자들은 장결핵 중 발생 부위상 드문 곳으로 알려진 직장에 발생한 고림성 결핵을 3예 경험하였기에 문헌고찰과 함께 보고하는 바이다. Isolated rectal tuberculosis commonly involves sigmoid, ascending, or transverse colon. Rectal involvement in tuberculosis is uncommon and poorly characterized. Isolated rectal tuberculosis was defined as focal lesions of rectum in the abscence of demonstrable lesions in the small and large bowel. Diagnosis of rectal tuberculosis was based on characteristic endoscopic appearance of lesions, histopathologic feature of tuberculosis in biopsy material and response to antitubercular therapy. Three patients with isolated rectal tuberculosis were seen at Kwak's hospital. The lesions observed was classified according to macroscopic morphology as follows: ulcerative, hypertrophic and ulcero-hypertrophic. Clinical manifestations were non-specific and consists of rectal bleeding, fever, weight loss, constipation and abdominal pain. One of the three patients had coexisting tuberculous pleurisy. Response to antitubercular chemotherapy was good. (Koeran J Med 64:96-100, 2003)

사람의 혈관 내피세포에 대한 Rickettsia typhi의 감염

안욱수,이강순,송호연 순천향대학교 1994 논문집 Vol.17 No.4

R. typhi, the etiologic agent of murine typhus, has known to cause fever, headache, maculopapular rash and vasculitis of small blood vessel. The skin rash and vasculitis are thought to be the results of endothelial cell injury from the infection with R. typhi in vivo. R. typhi showed ability to cause cellular injury of cultured human endothelial cells. The endothelial cells used in this experiment wee obtained by collagenase treatment of human umbilical cord veins. These cells were conformed to be endothelial cell by the presence of von Willebrand factor through the immunofluorescent antibody technique and Weibel-Palade bodies under the electron microscopy. Ultrastructural study revealed that there were no evidences of entry and/or escape from endothelial cells of R. typhi in 24 hours through 48 hours after infection. On the contrary, numerous particles implicating R. typhi were observed in large vacuole within endothelial cells at 48 hours after inoculations. Estimating the severe injury of endothelial cells by infection of R. typhi, the endothelial cells seems to be the primary target cells in human disease caused by R. typhi infection.

鹽化物 含有量에 따른 鐵筋腐食 및 콘크리트 强度特性에 관한 實驗的 硏究

김정섭,강연구,유덕룡,박광수 朝鮮大學校 建設技術硏究所 1999 建設技術硏究 Vol.19 No.2

As reinforced concrete buildings have been large, high-storied and high perfomance supply of river sand and gravel is insufficient and sex sand and crushed gravels which have the problem in internal force and durability are used as substitute aggregates. The problems caused by the use of sea sand lower the durability of reinforced concrete building according t o the content of chloride and shellfishes and cause the problem of corrosion and neutralization of reinforcing rod. Therefore, this study analyzes the degree of corrosion and neutralization of reinforcing rod which are the causes of lowering durability of reinforced concrete buildings with the variable of chloride content through the experiment and obtains the following results. 1. As a result of experimenting river sand and sea sand by comparison, the corrosion can be found at reinforcing rod without using rust proof paint regardless of the covering depth from 60 days of age and especially, the extensive corrosion is occurred at the damaged reinforcing rod among the same rods. 2. As a result of neutralization experiment with river sand and sea sand, there is no response in neturalization till 60 days of age. 3. As a result of strength and non-destructive strength test with river sand and sea sand, it is found that the value of strength is increased more at the test specimen using sea sand than river sand and while the specimen using river sand shows increasing value of strength continuously based on 28 days of age, the specimen using sea sand shows the decrease in strengh as it has more chloride contents. It is thought that evaluation experiment and method of durability and security and countermeasure of durability according to age on the basis of the basic materials of this study should be conducted as future research task.

효율적인 제약만족문제 처리를 위한 유사최소신장 2-트리의 도입 및 적용

李基哲,姜水蓮 弘益大學校 科學技術硏究所 1994 科學技術硏究論文集 Vol.4 No.-

A constraint satisfaction network is a knowledge representation method suitable for representing problems which must satisfy many constraints between variables. Backtracking is basically used to solve a constraint satisfaction problem with finite domains, and many intelligent backtracking schemes have been developed up to now. This paper is about backtracking performance improvement for solving constraint satisfaction problems. First of all, the concept of complete minimum spanning 2-tree is introduced, and its practical version quasi minimum spanning 2-tree is defined and applied to 8-queens problem. In addition, dynamic variable ordering is further applied. The test results show substantial reduction of backtrackings. 2-tree based approach may be applied to more realistic problems in the near furture.

금속 촉매를 이용한 poly-Si의 결정화에 관한 연구

金善浩,李秀京,金泰延,康娜榮,金亨駿 弘益大學校 科學技術硏究所 2005 科學技術硏究論文集 Vol.16 No.-

Nickel induced crystallization of amorphous silicon (a-Si) has been studied by selective deposition of Ni on a-Si thin films. The kinetics of crystallization for MIC was found to be greatly enhanced than that of SPC. Ni-induced crystallization is a promising technique for low-temperature fabrication of poly-Si thin-film transistors needed for large area applications. Lateral growth of polycrystalline silicon mediated by the formation of nickel silicide, has been successfully employed for the fabrication of high-performance TFTs. A-Si thin films on which Ni films were deposited with various thickness were crystallized as a function of annealing temperatures. Throughout the thesis work, wise choice of both the thickness of Ni and the annealing temperature was found to produce poly-Si films with high quality, thus potentially resulting in the production of TFTs with high performance.

A rare case of extensive papillary muscle calcification in senile cardiac calcification syndrome

김은진;송봉근;강민호;손형래;홍수민;박동원;허승혜;김계연;최석구 인제대학교 2011 仁濟醫學 Vol.32 No.-

광범위 유두근 석회화는 흔하지 앉으며, 원인과 임상적 중요성에 관한 문헌만 드물게 찾아볼 수 있다. 반면에 작은 석회 침착은 노인에서 흔하며 심장 첨부에 주로 나타난다. 유두근 석회화는 관상동맥질환, 확장성 심근병증, 승모관 질환, 고칼슘혈증, 그리고 말기신부전에서 인산칼슘의 중가와 연관성이 있다. 저자는 심장초옴파와 MDCT를 통해 진단된 전외측 유두근의 광범위 석회화의 드문 사례가 있어 보고한다.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

Physical and psychological changes induced by exercise

Su-Yeon Kang,Young-Joo Kim,Ji-Young Park,Deok-Ahm Seo,Hye-Min Lee,Moon-Myeon Jung 한국운동재활학회 2014 한국운동재활학회 학술대회 Vol.2014 No.10

This study was intended to investigate the positive physical and psychological changes about the reduction of the visceral and body fat and the growth of the amount of muscle and basal metabolism by the exercise. The subjects of this study were 6 students who are 2nd grader and whose major are Exercise rehabilitation welfare in Gachon university. This study was conducted from May 7th, 2014 to June 4th, 2014 as a consensual qualitative research. For this study, 4 research tools(Body tissue composition test chart, Daily record of Exercise, Body image questionnaire and the Interview) were used. Body tissue composition test chart and Body image questionnaire were used to compare changes before and after the study. 6 Participants delineated Exercise list, time and psychological changes before and after the exercise in Daily record of Exercise. 6 participants all attended the Interview. One participant was asked by 5 participants about Daily record of Exercise. After the Interview, 5 Participants checked whether it is true or false. Based on the above research method and procedures, the following conclusion was drawn; First, all participants‘ visceral fats were reduced and the score of physical development was increased. Second, Body image satisfaction was increased by psychological changes. Third, all participants experienced various psychological changes during this study.