Celay/In-Ceram, Conventional In-Ceram, Empress 2 전부도재관의 변연적합도에 관한 비교 연구

양재호,여인성,이선형,한중석,이재봉,Yang, Jae-Ho,Yeo, In-Sung,Lee, Sun-Hyung,Han, Jung-Suk,Lee, Jai-Bong 대한치과보철학회 2002 대한치과보철학회지 Vol.40 No.2

There have been many studies about marginal discrepancy of single restorations made by various systems and materials. But many of statistical inferences are not definite because of sample size, measurement number, measuring instruments. etc. The purpose of this study was to compare the marginal adaptations of the anterior single restorations made by different systems and to consider more desirable statistical methods in analysing the marginal fit. The in vitro marginal discrepancies of three different all-ceramic crown systems (Celay In-Ceram. Conventional In-Ceram. IPS Empress 2 layering technique) and one control group (PFM) were evaluated and compared. The crowns were made from one extracted maxillary central incisor prepared with a 1mm shoulder margin and $6^{\circ}$ taper walls by milling machine. 10 crowns per each system were fabricated. Measurements or a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Non-parametric statistical analysis was performed for the results. Within the limits of this study, the following conclusions were drawn: 1 Mean gap dimensions and standard deviations at the marginal opening for the maxillary incisor crowns were $98.2{\pm}40.6{\mu}m$ for PFM, $83.5{\pm}18.7{\mu}m$ for Celay In-Ceram, $104.9{\pm}44.1{\mu}m$ for conventional In-Ceram, and $45.5{\pm}11.5{\mu}m$ for IPS Empress 2 layering technique. The IPS Empress 2 system showed the smallest marginal gap (P<0.05). The marginal openings of the other three groups were not significantly different (P<0.05). 2 The marginal discrepancies found in this study were all within clinically acceptable standards ($100\sim150{\mu}m$). 3. When the variable is so controlled that the system may be the only one, mean value is interpreted to be the marginal discrepancy of a restoration which is made by each system and standard deviation is to be technique-sensitivity of each one. 4. From the standard deviations. the copy-milling technique (Celay/In-Ceram) was not considered to be technique-sensitive in comparison with other methods. 5. Parametric analysis is more reliable than non-parametric one in interpretation of the mean and standard deviation. The sample size of each group has to be more than 30 to use parametric statistics. The level of clinically acceptable marginal fit has not been established. Further studies are needed.

<i>In vitro</i> and <i>in vivo</i> evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Park, Dae Sung,Bae, In-Ho,Jeong, Myung Ho,Lim, Kyung Seob,Sim, Doo Sun,Hong, Young Joon,Lee, So-Youn,Jang, Eun Jae,Shim, Jae-Won,Park, Jun-Kyu,Lim, Han Chul,Kim, Han Byul Elsevier 2018 Materials Science and Engineering C Vol.91 No.-

<P><B>Abstract</B></P> <P>Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO<SUB>2</SUB>) and verify its efficacy by <I>in vitro</I> and <I>in vivo</I> assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO<SUB>2</SUB> stent, everolimus-eluting N-TiO<SUB>2</SUB> (N-TiO<SUB>2</SUB>-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO<SUB>2</SUB> film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO<SUB>2</SUB> deposition (37.0%). The platelet adhesion on the N-TiO<SUB>2</SUB> surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO<SUB>2</SUB>-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO<SUB>2</SUB>-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO<SUB>2</SUB>-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, <I>n</I> = 10, <I>p</I> < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO<SUB>2</SUB> deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> N-TiO<SUB>2</SUB> surfaces can help to reduce the platelet adhesion. </LI> <LI> In porcine model, N-TiO<SUB>2</SUB> everolimus decreased in-stent restenosis and fibrin deposition. </LI> </UL> </P>

우리나라 市.道立病院 運營管理에 關한 調査硏究

印宣東 서울大學校 保健大學院 1969 公衆保健雜誌 Vol.6 No.1

As the result of surveys conducted on the personnel, budget, and therapeutical performance of municipal and provincial hospitals in this country from Jun. 1, 1965 to May, 30, 1966, the following conclusion has been reached: 1. Surveys were conducted on a total of 46 hospitals, comperising 12 city hospitals, one county hospital, 32 provincial hospitals, and one provincial branch hospital(branch of the Cheju provincial Hospital). 2. Classifying the personnel by kind of occupation, nurses constituted the greatest proportion of 30.02 per cent of the total of 2,023 hospital employees across the nation, and physicians 16.71 per cent, while there were only two dieticians(constitution 0.10 per cent). 3. All the hospitals had physicians and nurses, while 41 of them have pharmacists, and only two of them had dieticians. 4. To break them down by province, the Special City of Seoul had 39.36 per cent of the total number of personnel, while Gyeongsangnam-do had the smallest proportion or 2.07 per cent. 5. The special City of Seoul had 39.56 per cent, the greatest proportion of a total of 4,079 beds throughout the nation while Cheju Province occupied the smallestpercentage, 2.01 per cent. The hospitals Surveyed were classefied into groups by the number of beds they had. The group of hospitals, With 51 to 100 beds each, constitued the greatest proportion or 45.66 per cent, while only one hospital fell under the category of hospisals with 151 to 200 besd, and another under that with 401 to 450 beds. Hospitals with up to 100 beds occupied 73.82 per cent or more than two thirds of the total number of hospitals surveyed. Not a single hospital had 500 or more beds. 7. A greatest proportion<41.31 per cent) of hospitals. from a total of 12 occupation were Hospitals with eight different kind of occupational classification it had the nember. The more occpational classification it had, the nember of Hospital was greater, and vice Versa Hospitals whose Personel were classified into seven to 10 kinds of occupation constituted 93.29 per cent. only one hospital (taejon Provincal Hospital) was blessesed with all of the 12 occupational kinds. No hospital, however, had six or less kinds of occupation. 8. The gross amount of receipt of all the municipal and provincial hospitals throughout the nation reached \558,43,026; broken down into 44.84 per cent of their own income and 55.16 per cent greated by the government as subsidies. 9. The gross amount of expenditure of all the hospitals was equivalent to their receipt, and the goverment subsidies was same as the balanece between expenditure and income 10. The ratios of own income to gross receipt of 31hospitals ranged from 30 to 80 per cent. One hospital (Mapo Municipal Hospital of Seoul) was operated solely with grvenment subsidies without its own income. Not a single hospital showed 100 per cent in ratio of its own income ??(원문파손으로 입력불가)gross receipt. 11. The hospitals in Kyonggi Province showed a highest average(86.03 per cent) ration of own income to gross receipt, with those in Gyeongsangnam-do indicated the lowest average ratio of 2.34 per cent. 12. The ratio of own income of Gyeonggi-do was highest or 27.57 per cent of that of whole nation, while Jeonlanam-do was lowest or 2.82 Percent . 13. The highest percentage(54.44 per cent) of the total amount of government subsidies was issued to the hospitals in the Special City of Seoul, and the smallest proportion(1.36 per cent) to those in Chungcheong bug-do 14. charged out-patients of the municipal and provincal hospitals constisued 41.20 per cent of newcomers and 50.75 per cent of oldtimers , and 43.37 per cend of their aggregate. Charged patient a constituted 48.60 per cent of in-patients in actual number of persons and 26.01 per cent in terms of aggregate of days of hospitalization. 15. The hospitals in Gyeongsangnam-do showed a highest percentage (95.66 per cent) of charged patients amone new out-patients, and those in JeonJanam-do showed the lowest percentage(16.29 per cent). As for the ratio of charged regular out- patients. the hospitals in Gyeongsangnam-do showed the highest percentage(92.95 per cent), and those in Jeonlabug-do the lowest percentage (9.88 per cent). In terms of aggregate, the hospitals in gyeongsangnam-do also recorede the highet ratio of 93.95 per cent, and those in Gyeongsangbug-do the lowest ratio of 21.07 per cent. In terms of actual number of persons, the hospitals in Jeju-do indicated the highest percentage(95.77 per cent)of chared in-patients, while those in Gyeongsangnam-do showed the lowest percentage (31.50 per cent). In terms of aggregate, the hospitals in Seoul showed the lowest 13.85 per cent while those in Jeju-do recorded the highest 87.36 per cent 16. Reviewing the numer of patients by province, Seoul constituted tthe greatest proportion or 39.83 per cent of newcomer outpatients, and Gyeongsangnam-do the smallest proportion or 1.34 per cent. In terms cf regular out-patients, Jeonlabug-do occupied the greatest proportion or 23.43 per cent. and Jeonlanam-do the smallest proportion of 1.81 per cent. As for aggregate, Seoul recorded the greatest proportion of 29.03 per cent , and Gyeongsangnam-do 1.43 per cent. the smallest proportion. In terms of the actual numer of persons. Seoul constituted the greatest proportion or 34.82 per cent of in-patients, and Pusan the smallest proportion or 1.19 per cent. In terms of aggregate, Swoul occupied the greatest proportion or 59.80 per cent, and Pusan 0.72 per cent, the smallest proportion. 17. The average number of days of hospitalization was 28.40 days per governument-paid in patient. and 10.56 days per charged in patient. The average number of days of hospitalization was the greatest at 483.95 days per government-paid inpatient in the sodaemun municipal Hospital in Seoul, but the smallest at 1.42 days in the Chinju Province Hospital in Gyeongsangnam-do. By province, the average number of days was the greatest at 45.50 days in Chungcheongbug-do, but the smallest at 1.88 days in Gyeongsangnam-do. The average number of days of hospitalization per charged in-patient was the greatest at 81.97 days in the Sodaemun municipal Hospital in Seoul, but was the smallest at 2.34 days in the Chinju Provincial Hospital in Gyeongsangnam-do. By province, the average number of days was greatest at 28.67 days in Jeonlanam-do, but the smallest at 2.07 days in Gyeongsang-bug-do. 18. The average number of visits to hospital per out-patient was 2.35 days. By hospital, it was the greatest at 16.53 days in the Chonan Provincial Hospital in Chungcheongbug-do and the smallest at 1.00 day in the Dongbu Municipal Hospital in Seoul. By province, it was the greatest at 4.41 days in Jeju-do, and the smallest at 1.23 days in Jeonlanam-do. 19. The average number of patient hospitalized per bed is 8.89 persons monthly. By hospital, the greatest number(37.74 persons) was recorded by the Inchon Provincial Hospital in Kyonggi-do, and the smallest number(0.86 persons) by the Sodaemun Municipal Hospital in Seoul. By province, the highest number(15.07 persons) was recorded by Kyonggi-do and the smallest number(2.60 persons) by Gyeong-sangnam-do. 20. The average bed utilization ratio was 48.02 per cent. By hospital, the Sodaemun Municipal in Seoul recorded the highest ratio of 98.03 per cent, while the ch'ongju Provincial Hospital in Chungcheongbug-do showed the lowest ratio of 3.51 per cent. By province, Seoul showed the highest ratio of 74.47 per cent, and Gyeongsangnam-do the lowest ratio of 15.41 per cent. 21. Amount of expentiture for a bed was \136,899. That of Pusan was \307,804 the highest, while Gyeongsangnam-do showed \69,323 a bed, the lowest among 8 provinces and two special cities.

미국의 사법심사에서 사법적극주의의 전개 : 워렌 대법원, 버거 대법원, 렌퀴스트 대법원, 로버츠 대법원에서의 전개논의를 중심으로

석인선 梨花女子大學校 法學硏究所 2021 法學論集 Vol.26 No.1

In the early days of the founding of the United States, the Supreme Court was an institution that received little attention. However, the U.S. Supreme Court is now an institution that has a profound influence on American society. Through judicial review, which is the core authority of the federal judiciary, it is gradually expanding its powers and exerting considerable influence on American society. The judicial superiority of the Federal Supreme Court is due to the fact that internally, the Federal Supreme Court has actively exercised the powers granted to it, and externally, the role required of the Federal Supreme Court has changed. What led to the change in the status of the Supreme Court is that the role required of the Supreme Court has changed over time. This is due to the emergence of many new legal disputes to be dealt with by the Supreme Court. There is bound to be a limit to the Supreme Court's ability to respond to these issues in the conventional way, and this situation has demanded a new role for the Supreme Court. In the past, the main role of the Supreme Court was to protect the people against violations of basic rights by the Congress or the government, but now it has moved away from this simple role to actively intervene and make decisions in the policy-making process. will be. There was a demand of the times to take a more active stance away from the passive role of the past. As a result, controversies and conflicts about the participation in decision-making of the Federal Supreme Court appeared in the form of judicial passivism and judicial activism, and were not only conducted in academia, but also among the Supreme Court justices. The expression of judicial activism differs depending on whether the Supreme Court justices participating in the judgment are conservative or progressive. In this paper, first, in Chapter II, Thayer's theory, which can be said to be the origin of judicial passivism in the judicial review of the United States, is examined, and how his discussion on judicial restraint was reflected through the Supreme Court Justices of the United States Supreme Court, and how its influence declined. look at Chapter Ⅲ examines what judicial activism as opposed to judicial passivism means and how judicial activism is expressed based on the elements that this thesis intends to focus on through the views of the Justices of the Supreme Court. In Chapter IV, I would like to evaluate the development of judicial passivism and judicial activism in the Supreme Court, focusing on the positions of the Federal Supreme Court, focusing on the Warren Court, Burger Court, Rehnquist Court, and Roberts Court. Chapter V seeks to find out the implications of how the US experience should be reflected in the Korean judiciary. 미국 연방대법원의 정책결정참여에 대한 논란과 논의대립은 사법소극주의와 사법적극주의 논의 형태로 나타났으며, 학계에서만 이루어진 것이 아니라 연방대법원 대법관들 사이에서도 나타났다. 판결에 참여한 대법관이 보수진영이냐 진보진영이냐에 따라 사법적극주의의 발현내용이 달라졌다. 사법소극주의에 대한 주요한 의미 세 가지를 보면, 첫째, 법관들은 법을 적용할뿐이고 입법을 하지 않는다는 입장이다. 둘째, 법관은 다른 국가기관들에 의한 결정을 매우 존중한다는 태도이다. 셋째, 법관들은 입법상 행위 또는 행정상의 행위를 위헌이라고 선언하는 것에 대해 주저하며 자제하는 태도이다. 사법소극주의(사법자제)의 연원을 보면, 그 위헌성이 명백하여 합리적 의심의 여지가 없는 경우에만 법률이 무효화되어야 한다고 주장하는 James Bradley Thayer에 의해 시작되었고 체계적으로 이론화되었다. 이러한 Thayer이론을 계승한 대법관으로는 홈즈 대법관, 브랜다이스 대법관, 프랑크퍼터 대법관을 들 수 있고 연방대법원 판례들의 법정의견들 속에 반영되어 있다. 미국의 연방대법원은 시대 상황에 따라 사법적극주의와 사법소극주의의 순환적 변동의 양상을 보여 왔다. 진보적인 사법적극주의로 특징 지워지는 워렌 대법원을 거친 후 버거 대법원, 렌퀴스트 대법원, 로버츠 대법원에서는 정치적 보수주의의 성향을 보여주고 있는 데 그 입장이 사법소극주의인지 사법적극주의를 취하고 있는 것인지에 대해 평가가 엇갈리고 있다. 20세기 이후 사법적극주의논의는 세 단계에 거쳐 주목받아왔다. 첫 번째 단계는 소위 Lochner시대로 불리우는 시기로 미연방대법원은 의회가 제정한 사회복지관련법률과 경제정책에 관한 법률을 대부분 위헌으로 결정하였던 시기이다. 이 시기에는 미연방대법원은 수정헌법 제14조에 근거하여 실체적 적법절차의 헌법원리를 도출하여 복지ㆍ경제관련법률을 위헌으로 결정하는 경우가 많았다. 두 번째 단계는 1950년대부터 1960년 후기까지 기간으로 워렌 대법원(Warren Court)시기이다. 인종차별 등 사회적 차별과 기본적 권리에 대한 사회적 침해에 대해 인권보장을 위해 적극적으로 헌법에 열거되지 않은 실체적인 권리를 인정하는 판결을 하였다. 워렌 대법원은 진보진영과 보수진영 양쪽에서 상반된 평가를 받고 있다. 세 번째 단계는 1992년 New York v. United States판결이 내리진 때로부터 2005년 렌퀴스트 대법원장이 사망하기까지 렌퀴스트 대법원 시기와 2005년 로버츠 대법원장이 임명된 때로부터 현재까지 이어지는 로버츠 대법원 시기이다. 보수적인 적극주의 경향을 보이고 있다. 사법적극주의는 하나의 개념으로 정의되기 보다는 일련의 특징을 가지고 있는 포괄적 개념으로 사용되고 있어서 어떠한 판결을 사법적극주의에 포함시킬 것인가를 엄밀하게 구별하는 일은 그리 용이하지 않다. 이러한 한계가 있음에도 불구하고 워렌 대법원, 버거 대법원, 렌퀴스트 대법원, 로버츠 대법원에서 연방대법관이 일정 판결에서 사법소극주의를 취했는지 사법적극주의를 취했는지를 결정하기 위한 주된 특징들은 연방주의, 입법부와 행정부의 결정의 무효화와 사법입법 등이 될 것이다. 워렌 대법원은 Lochner시대에 이어 사법적극주의가 등장한 시기로 평가되나. 1960년대 이후 연방대법원은 스톤 대법관의 이중기준이론을 수용하여 경제적 규제와 사회복지입법에 대해서는 사법소극주의적 입장을 취하였던 반면, 시민적 자유와 권리를 보장하기 위하여 사법적극주의를 강력하게 취하여 시민적 자유와 권리를 강력하게 보장하려고 하였다. 버거 대법원은 1980년 중반까지 형사법, 공립학교에서의 종교, 외설 등과 관련한 사건에서 워렌 대법원 시기의 주요 판결들을 일부 변경하면서도 유지하여 워렌 대법원의 법적 유산을 대부분 유지하였다는 평가가 있지만, 한편에서는, 워렌 대법원의 판결들을 유지하면서도 수정을 가하여 서서히 보수적인 대법원으로의 변화를 위한 가교 역할을 했다고 평가되기도 한 다. 1986년과 1987년 시기의 렌퀴스트 대법원은 인종차별과 성적 차별을 금지하였고 낙태를 허용하였으며, 교회와 국가를 분리하는 일련의 사회정책에서 중도적 자유주의적 경향을 보였다. 1989년과 1990년 시기에 렌퀴스트 대법원은 일반적으로 연방의회의 권한을 제한적으로 해석해야 한다는 입장을 보였다. 로버츠 대법원은 인적 구성에 있어서 많은 변화가 있어왔다. 그러나 정치적으로 보면 현재 로버트 대법원은 트럼프행정부 시기에 임명된 보수적인 3명의 대법관들로 대체되기 직전까지는 보수진영과 진보진영의 균형이 유지되어 놀랍게도 안정적인 상태를 유지하고 있었던 것으로 평가되고 있다. 로버츠 대법원은 2005년부터 2010년 초반까지 표현의 자유, 사형제도, 프라이버시권, 낙태, 선거비용, 개인의 총기 소지와 무장에 대한 권리에 관해 보수적 적극주의 입장을 취하고 있다. 미연방대법원은 전통적으로 사법부의 본질적인 한계를 강조하거나 사법심사의 소송요건을 강화함으로써 의회나 행정부와의 갈등을 피하고자 하는 태도를 보여왔으나, 20세기에 들어오면서 이러한 사법자제적 태도에 일정한 변화가 일어났고 점차 사법적극주의적 태도를 취하게 되었다. 특히 워렌 대법원은 사법심사권을 개혁의 도구로 사용하여 사회적 정치적 약자 보호에 큰 기여를 하였다. 현재 연방대법원의 로버츠 대법원에 이르는 동안 워렌 대법원시기에 내린 판결들을 최고점으로 하여 점차 보수화하는 방향으로 법리를 전개시켜 왔는데 상당한 역할을 한 것은 보수적 사법적극적인 태도라고 볼 수 있다. 사법자제와 사법적극주의의 논쟁은 종국적으로 권력분립의 시각에서 본 사법부의 바람직한 역할이 무엇인지에 대한 논쟁으로 귀착된다고 할 수 있다. 우리 헌법재판소는 동성동본금혼규정과 호주제도에 대해 헌법불합치 결정을 내렸다. 헌법재판소가 다수결주의기관들을 대신에 그 기관들 스스로가 바로 잡을 수 없었던 것에 대해 법원이 개입한 경우라고 할 수 있다. 반면, 사법적극주의가 잘못 발현된 경우의 예가 있다. 헌법재판소가 서울이 대한민국의 수도인 점을 불문의 관습 헌법으로 보아 헌법개정사항인 수도의 이전을 단순 법률의 형태로 실현시킨 것을 위헌이라고 선언한 경우이다. 결론적으로 사법심사에 있어서 사법적극주의를 취함에 있어 사법부가 가진 역할의 의미를 다수 대 소수자의 권리가 대립되는 상황에서 소수의 권리를 보호하기 위해 존재한다는 점에 두고, 의회나 행정부가 스스로 교정할 수 없는 실패가 발생한 때 여기에 개입해 민주주의의 실패를 보정함으로써 민주주의를 촉진시키는 역할을 한다는 점에 있다는 사고에서 출발한다면, 사법부에서 진보주의는 보수주의와 다른 사회ㆍ정치적 결과를 낼 것이다. 사법적극주의가 진보주의와 결합하느냐 또는 보수주의와 결합하느냐에 따라 결과가 다르게 나타났음을 염두에 두어야 한다.

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer

김인아(In Ah Kim),최일봉(Ihl Bhong Choi),강기문(Ki Mun Kang),장지영(Jie Young Jang),문한림(Han Lim Mun),송정섭(Jung Sub Song),이선희(Sun Hee Lee),곽문섭(Mun Sub Kuak),신경섭(Kyung Sub Shinn) 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.1

목 적 : 국소진행된 III기 비소세포성 폐암에서 방사선감작제로서의 저용량 Cisplatin과 방사선 동시병합요법의 효과를 알아보고자하여, 관해율, 전체생존율, 무병생존율 및 치료에 따른 부작용을 방사선 단독치료군과 후향적으로 비교분석하였다. 대상 및 방법 : 1992년 4월부터 1994년 3월까지 32명의 III기 비소세포성 폐암환자(IIIa 12명, IIIb 20명)가 항암제 및 방사선동시병합요법을 받았다. 방사선치료는 3000cGy/ 10회를 2주간에 걸쳐 시행한 뒤 3주후에 2500cGy/ 10회를 추가하였으며, 방사선감작제로 cis platin 6mg/m2를 매일 방사선치료 전에 정맥주사하였다. 추적관찰기간은 13개월에서 48개월로 중간값은 24개월이었다. 방사선단독치료군 32명(IIIa 13명, IIIb 19명)은 매일 170- 200cGy씩 총 5580- 7000cGy (중간값 5960cGy) 치료받았으며, 추적관찰기간은 36개월에서 105개월로 중간값은 62개월이었다. 결 과 : cis platin- 방사선동시요법군이 방사선 단독치료군에 비해 유의하게 높은완전반응률(18.8% vs . 5.6%)및 낮은 조사야내 재발율(25% vs . 47%)을 나타내었다. 2년 전체생존율은 Cisplatin- 방사선동시요법군이 17%, 방사선단독치료군이 9.4%로 유의한 차이는 보이지 않았다.국소재발 없는 2년 무병생존율(16.5% vs. 5.3%) 및 원격전이 없는 2년 무병생존율(17% vs. 4.6%)도 두군간에 유의한 차이를 보이지 않았다. 그러나 Karnofsky performance scale 80 이상인 환자군만을 대상으로 분석한 결과, cisplatin- 방사선동시요법군이 방사선단독치료군에 비해 유의하게 높은 2년 전체생존율을 보였다(62.5% vs. 15.6%). 전체생존율에 영향을 미치는 예후인자로 cisplatin- 방사선동시요법군에 있어서는 performance status 및 조직학적 진단유형(상피세포암 vs. 비상피세포암)으로 나타났고, 방사선단독치료군에 있어서는 performance status 및 병기(IIIa vs. IIIb)로 나타났다. 치료에 따른 급성부작용으로 RTOG/ECOG grade 2 이상의 오심, 구토는 cisplatin- 방사선동시요법군이 방사선단독치료군 (22% vs. 6%)에 비해 유의하게 높은 빈도를 나타내었다. Gra de 2 이상의 혈액학적 독성은 Cis platin- 방사선동시요법군에서 방사선단독치료군에 비해 높은 빈도를 나타내었다(25% vs. 15.6%). 방사선단독치료군에 비해 cis platin- 방사선동시요법군에서, RTOG/ECOG Grade 2 이상의 폐독성의 빈도(31% vs. 19%)나 WHO Grade 3 이상의 폐섬유화의 빈도(38% vs. 25%)의 유의한 증가는 관찰되지 않았다. 방사선치료부위의 면적이 200cm2 이상이었던 경우, 두군 모두에서 폐독성 빈도의 유의한 증가를 보였다. 결 론 : cisplatin- 방사선동시병합요법이 방사선단독치료군에 비해 높은 국소제어율을 나타내었으나, 전체생존율이나 무병생존율의 유의한 증가는 보이지 않았다. KPS 80이상인 환자군에 있어서는 cisplatin- 방사선동시요법군이 방사선단독군에 비해 높은 전체생존율을 보였다. cisplatin- 방사선동시병합요법군에서 급성부작용이 증가되는 경향을 보였으나, 방사선에 의한 폐독성의 유의한 증가는 관찰되지 않았다. cisplatin- 방사선동시병합요법군이 방사선단독치료군에 비해 1년 이내에 조기사망율이 높은 반면, 2년이상 장기생존율이 높은 경향을 보여, 이러한 환자군에 대한 장기적인 추적조사를 통해 생존율에 대한 본 치료의 영향을 좀더 명확하게 평가할 수 있을것으로 기대되며, 향후 치료효과를 증가시키기위해 large fraction size의 split course RT 대신 continuous course의 conventional RT 혹은 hyperfractionated RT와 Cisplatin의 동시병합요법 등이 고려되어야할 것으로 사료된다. Purpose : This study was tried to evaluate the potential be nefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation thera py alone in stage III non- small cell lung cancer. The end points of analyses were responserate , overalls urvival, survival without locoregional failure , survival without distant metastasis , prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months . Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170- 200cGy) radiation therapy a lone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months . Results : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group(17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastas is (17% vs. 4.6% at 2 years) also had no significant differences . In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors . RTOG/EORTC grade 2-3 nausea and vomiting(22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmona ry toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group(38% vs . 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had s ignificantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performa nce status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good pe rformance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. The refore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

노인에서의 외과 환자에 대한 임상적 연구

배진선,강민규,송인상 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

378 patients over 65 years old were reviewed, who were admitted during the period from June. 1. 1985 to December 31. 1988 in the Department of Surgery, Chungnam National University Hospital. The results were as followings: 1. The rate of patients over 65 years to all who were admitted during same period was 11.3%. 2. The number of male patients was 183, that of female 195, the overall ratio of male to female being 1:1.07. In benign diseases, that was 1:0.95, and in malignant diseases 1:1.26. 3. Hemoglobin value at admission was below 10.0gm% in 7.5% of patients with benign diseases and in 15.0% of patients with malignant diseases. 4. Serum albumin at admission was below 3.5gm% in 60% of patients with benign diseases and in 50% of patients with malignant diseases. 5. As to the distribution of benign diseases, disease in biliary system was most frequent(33%), followed by appendicitis(25%), ileus and trauma in jejunum and ileum(13%), and peptic ulcer(6%) in the order of frequency. 6. As to the distribution of malignant diseases, stomach cancer(51%) was most frequent, followed by colorectal cancer(25%), and hepatobiliary cancer(10%) in the order of frequency. 7. 47% of patients with benign diseases and 44% of that with malignant diseases had associated diseases, among which hepertension was most frequent, followed by lung disease, hearth disease, diabetes mellitus, liver disease and renal disease in the order of frequency. 8. Complications were most prevalent in the patients with hepatobiliary diseases, followed by appendicitis and colorectal cancer, and among complications, would infection was most frequent, followed by urinary tract infection and respiratory infection in the order of freguency. In the patients with colorectal cancer, mechanical lieus was second frequent complication after wound infection. 9. The mortality rate was highest in the patient with colorectal cancer(22.2%), followed by in those with benign biliary disease(10%), overall mortality rate being 4.3%. 10. Major causes of deaths were sepsis, respiratory failure, bile peritonitis and renal failure.

프로무용수의 열정과 자기인식 분석

김인선 ( In Sun Kim ),김승일 ( Seoung Il Kim ) 大韓舞踊學會 2009 대한무용학회논문집 Vol.60 No.-

This study aims to investigate and analyze passion and self-awareness of professional dancers from a diversified and in-depth perspective. To obtain this goal, this study conducted a qualitative case research on two currently active professional dancers. Relevant data was collected through in-depth interviews, documentation and descriptive survey research. The collected data was analyzed using encoding and the constant comparative method in order to verify the reliability, validity and ethical aspect of the study. The investigation of the passion and self-awareness of professional dancers is divided into dancers` personal dispositions, dancing activity and perception of the dancing community. Conclusions, based on the research methods and process of this study, are proposed as follows. First, the research participants exhibited differences in practice methods depending on personal dispositions. Since they are continuously active as professional dancers, most dancers use their leisure time for reinvigoration through relaxation, the modes of which also varied with personal propensities. Moreover, in terms of religious life, both survey participants showed commitment to and reliance on their respective beliefs. Dancer A claims to find psychological reassurance in prayers before stepping on stage, while dancer B believes he overcame an injury before an important concours through religion and faith. The personal dispositions of professional dancers differed drastically according to their sex. Second, regarding dancing activity, this research category was further divided into passion for social activity and dancing itself. In terms of social activity, dancer A adopts techniques that seem complimentary by observing the characteristics of fellow dancers. Regarding their wage, they believe their should be a gradation in accordance with dancers` performance, and were generally dissatisfied with their wage level. As for their passion for dancing, dancer A, her constant image training and movement practice attest to her sense of purpose and strong will to achieve set goals. Meanwhile, dancer B went as far as quitting highschool in order to learn dancing. he focuses as much on mental training through image training as he does on actual training. The participants showed passion to continue their career as a dancer either as a trainer, professor or a choreographer. Third, regarding their perception of the dancing community, the survey participants were aware of the importance of traditional dancing among other forms of creative activity. Furthermore, they were in agreement in their disappointment in the low valuation of culture and art in society.

南北韓 國史敎科書에 登場하는 國王, 王族의 人物 比較

김인식,김선규 한국교육과정학회 2000 교육과정연구 Vol.18 No.2

본 연구는 남북한의 중등학교 국사 교과서에 등장하는 인물 중 국왕·왕족에 대하여 양적인 측면에서는 각 교과서별·시대별 분포와 설명이 있는 인물의 수 및 비율을, 질적인 측면에서는 공통으로 등장하는 인물에 관한 서술을 비교하는 것이었는데, 비교 대상 교과서는 남한의 중학교 및 고등학교 <국사>교과서와 북한의 고등중학교 국사교과서인 <조선력사>였다. 먼저 남북한 국사 교과서에 등장하는 전체 등장 인물의 수 및 비율을 각 교과서별·시대별·유형별로 분류하였다. 이어 남북한 국사교과서에 등장하는 국왕·왕족의 수 및 비율을 각 교과서별·시대별로 양적으로 분석하고, 각 인물의 양적인 비교를 보완하기 위하여 단순 등장 인물과 설명이 있는 인물의 등장 횟수 및 비율도 산출하였다. 아울러 이들 국왕·왕족이 남북한 국사교과서에 공통 및 어느 한쪽에만 등장하는 인물로 분류하여 각 시대별로 나누어 제시하였다. 다음으로 남북한 공통 등장 인물에 대한 질적인 비교는 인물의 '활동 분야·역할'의 측면, 서술 방식·비중'의 측면, 그리고 '인물 평가'의 측면으로 나누어 고찰하되 주로 각 측면별로 남북한이 상이하거나 부분적으로 일치하는 인물의 서술을 중심으로 논의 하였다. 비교의 결과 남북한 국사 교과서의 등장 인물을 양적으로 분석하면 인물의 수는 남한의 <국사>가, 설명이 있는 등장 인물은 북한의 <조선력사>가 더 많았으며, 남북한 공통 등장 인물보다 어느 한쪽에만 등장하는 인물의 수가 더 많았다. 이들 국왕·왕족을 질적으로 비교하면 인물의 '활동 분야·역할'과 같은 사실적 진술보다는, 인물의 '서술 방식·비중' 및 '인물 평가'의 측면에서 상이하거나 부분적으로 일치하는 노력이 요청된다. 하지만 남북한의 국사 교과서에는 이질적인 측면뿐만 아니라 유사하거나 동질적인 부분도 많은 만큼 공통적인 점은 더욱 심화·확대시키고, 차이점에 대해서는 이질성 극복을 위한 보다 적극적인 대처가 필요하다고 본다. The purpose of this study was to analyze the historical characters appearing in national history textbooks of South and North Korea, and to compare their similarities and differences in terms of quantitative dimension and qualitative dimension, In order to achieve these goals, this study overviewed the existing curricular structure and history education of South and north Korea, and analyzed the following three history textbooks ; <Junghak Kooksa> which is the history textbook for middle schools of South Korea, <Kogyo Kooksa> , which is the history textbook for high schools of South Korea, <Josun Ryuksa> which is the history textbook for secondary education of North Korea. As the quantitative approach, this study counted the frequency of all characters appearing in the textbooks, and divided them into a group of commonly appearing characters and a group of characters appearing in one part among three textbooks. Then, the frequency and the rate of all characters' appearance were calculated separatedly and compared with each other. As a result, some quantitative differences were founded in total counts of appearing characters in three textbooks. In total frequency of characters appearing in textbook, the history textbook of South Korea (<Junghak Kooksa> : 393, <Kogyo Koodsa> : 512) contained much more characters than North Korea's (<Josun ryuksa> : 348). And, commonly appearing characters in three comparative textbooks were 133, which amounted to only 18% of total numbers of appearing characters(735). It means that there are lots of differences between south Korea and north Korea in the number of appearing characters. And, as the qualitative approach, this study tried to analyze and discuss the similarities and difference of commonly appearing characters in three textbooks in terms of a character's activity area and role, description and weight of him/her, and historical evaluation of him/her as a whole. As a result, much more similarity was found in character's activity area and role any other aspects. On the other hand, in the aspect of description and weight of a character, difference between three textbooks was much more than similarity, and partially accordant characters were the most in historical evaluation of characters. Nowadays waking to the unification of South and North is faster and faster. So when we compare and study south and north Korean history education and characters in textbooks, we need to study more about 'how same' than 'how different'. Since appearing characters in textbook were deeply connected with their historical background and situation, how to describe a character would greatly influence on the historical interpretation. Therefore, in order to identify the reality of a character, we need a careful analysis on the historical viewpoint of textbook writers. It exceeds. however, the task and the focus of this study. In other word, based on the results of this study, a much more in-depth analysis on types of characters, modes of explaining them, and socio-cultural context should be continued in the future.

DMBA 유도 햄스터 협낭암 발생과정에서 방사선 조사가 증식세포핵항원(PCNA)의 발현과 apoptosis 유발에 미치는 영향

전인성,허민석,최항문,이삼선,최순철 대한구강악안면방사선학회 2000 Imaging Science in Dentistry Vol.30 No.3

Purpose : This study was carried out to investigate the effect of irradiation on the expression of proliferating cell nuclear antigen (PCNA) and apoptosis induction during the carcinogenesis in hamster buccal pouch. Materials and methods : Three months old Syrian golden hamsters were divided into control and 2 experimental groups, Hamsters in control group were left untreated on buccal pouchs. Twenty four hamsters were treated with 0.5% DMBA tri-weekly on the right buccal pouch. Forty eight hamsters were treated with 0.5% DMBA tri-weekly and irradiated with the dose of 5 Gy and 10 Gy at 6,9, 12, 15 weeks after DMBA application. Resected buccal pouches were sectioned and examined for potential expression pattern of PCNA and apoptosis. Results : The PCNA index was increased with the stages of buccal pouch epithelium carcinogenesis except the hyperplasia stage in control group (p< 0.05). The irradiation did not effect on the PCNA index in the dysplasia and the carcinoma in situ stage, but in the hyperplasia stage, the PCNA index was increased with 10 Gy radiation and decreased in the carcinoma stage (p< 0.05). The apoptotic index was significantly decreased from the carcinoma in situ stage and the lowest in the carcinoma stage, The apoptotic index was significantly decreased in the hyperplasia and dysplasia stage with the 5 Gy irradiation and significantly increased only in the carcinoma stage with the 10 Gy irradiation (p< 0.05). Conclusion : The PCNA and apoptotic index were varied according to the irradiation period and dosage in each carcinogenesis stage. (Korean J Oral Maxillofac Radiol 2000; 30: 207-216)

위암환자에서 수용성 Intercellular Adhesion Molecule-1의 의의

배진선,송인상,김완식 한국의학사 1999 診斷과治療 Vol.19 No.8