자궁내막암 환자에서 복강경하 자궁적출술과 복식 자궁적출술의 비교 연구

김종혁,이상수,김천복,김대연,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

목적 : 자궁내막암 환자에서 시행된 복강경 수술의 임상적 결과를 평가하고 수술적 지표 및 재발률에 대하여 기존의 개복 수술과 비교하고자 하였다. 연구 방법 : 1997년 8월부터 2003년 11월까지 저자들은 임상적 병기 I기인 79명의 자궁내막암 환자에서 복강경하 자궁적출술과 골반 및 부대동맥 림프절 절제술을 시행하였다. 총 79명의 환자 중, 수술적 병기 I기와 II기로 판명된 74명의 환자를 연구 대상으로 하였다. 대조군으로는 같은 기간 동안에 개복수술을 시행한 환자중 복강경 수술군과 병기가 같은 168예를 선정하였다. 결과 : 평균 수술 기간, 수혈량은 양군에서 비슷하였으며, 평균 재원 기간은 복강경 수술군에서 유의하게 짧았다. 수술전후 및 만성 합병증의 발생은 개복 수술군에서 유의하게 증가되었으며, 획득한 림프절의 수는 복강경 수술군에서 유의하게 더 많았다. 복강경 수술군에서 1예, 개복 수술군에서는 2예에서 재발하였고, 2년 무병 생존률은 복강경 수술군과 개복 수술군에서 각각 97.5%와 98.6%으로 유의한 차이는 관찰되지 않았다. 결론 : 자궁내막암 치료로서 복강경 수술은 기존의 개복술을 대신할 수 있는 안전하고 효과적인 시술 방법이다. 개복 수술과 비교해 볼 때, 재발 및 생존율 면에서 차이가 없었지만, 향후 전향적이고 더 오랜 추적기간을 갖는 연구가 필요하다고 사료된다. Objective : To evaluate the outcomes of laparoscopic surgery and to compare surgical parameters and recurrence rate of these with those of conventional abdominal surgery in patients with endometrial cancer. Methods : From August 1997 to November 2003, we have performed 79 cases of LAVH (laparoscopically assisted vaginal hysterectomy) with or without lymph node dissection. Laparoscopic approach was adapted in patients with FIGO clinical stage I by imaging study. Of the 79 patients, 74 patients who were proved to be surgical stage I and II were enrolled in this comparative study. As a control group, We selected 168 cases for the laparotomy group of the same stages. Results : The mean duration of surgery, the amount of blood transfusion and hemoglobin chamges were similar in both the laparoscory and the convertional alparotomy group. The mean duration of hospital stay was significantly shorter in patients treated by laparoscopic surgery (10.2 vs. 15.5 days). The number of lymph node obtained was significantly higher in the laparoscopy group. Two year recurrence-free survival rates were 97.5% in laparoscopy group and 98.6% in laparotomy group (p=0.763). Conclusion : Laparoscopic surgery for the treatment of early stage endometrial cancer is safe and effective altematives in terms of perioperative complications. Overall and recurrence-free survival did not differ significantly in both groups however long term risk for recurrence and survival has yet to be defined.

자궁경부에 발생한 배아성 횡문근육종 2예

박정열,조준식,김대연,이동헌,김종혁,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.3

횡문근육종은 소아와 청소년기에 가장 흔한 연부조직 육종이다. 발생 부위는 일반적으로 두부 및 경부, 그 다음으로 비뇨생식계이다 조직학적으로 배아성 횡문근육종, 국화상 육종, 폐포성 횡문근육종, 다형성 횡문근육종으로 나누어진다. 횡문근육종의 약 20%가 비뇨생식기에서 발생하고, 50% 이상이 배아성 횡문근육종이다. 여성 생식기의 배아성 횡문근육종은 드문 악성 종양으로,주로 유소아의 질에서 발생하며, 자궁경부에서 발생하는 횡문근육종은 청소년기에 흔하고, 질에서 기원하는 횡문근육종이 자궁경부에 기원하는 경우보다 5배 정도 많다. 폐경기여성에서는 자궁체부에서 가장 흔히 발생한다. 비뇨생식기의 횡문근육종의 치료는 과거에는 골반장기 적출술만으로 치료를 시도하였으나. 서서히 다중 항암화학요법, 방사선요법, 근치적 절제술을 포함한 병합요법으로 바뀌어가고 있으며, 이에 따라 생존율이 현저하게 향상되었다. 이에 저자들은 최근 본원 산부인과에서 자궁경부에 발생한 배아성 횡문근육종 2예를 경험하였기에 문헌 고찰과 아울러 보고하는 바이다. Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and young adult. Genitourinary tract is the econd most common site of rhabdomyosarcoma. Rhabdomyosarcoma can be classified into one of four major types; embryonal, alveolar, pleomorphic and undifferentiated. Embryonal rhabdomyosarcoma of the female genital tract is rare malignant tumor and usually occurs during childhood in the vagina. In rare cases, rhabdomyosarcoma can originate in the uterine cervix, with a peak incidence in the second decade. Recently we have experienced two cases of embryonal rhabdomyosarcoma of the uterine cervix. These cases are presented with a brief review of the literature.

工場勤勞者들의 肺容積 및 肺換氣能에 關한 硏究

金鍾穆 충남대학교 의과대학 지역사회의학연구소 1979 충남의대잡지 Vol.6 No.2

This study was attempted to evaluate the effect of the working environment on the health of labors, especially their lung volumes and pulmonary functions. For this investigation, 469 labors(356 male and 113 female) working in several factories in Taejeon area, were randomly selected as an experimental group and 142 healthy normal adults (86 male and 56 female) as a control group. The experimental and control groups were devided into three age-subgroups in male and two age-subgroups in female, respectively. The measurement was made on the vital capacity(VC), maximum voluntary ventilation (MVV), maximum mid-expiratory flow(MMF) and forced expiratory volume(FEV_T) by means of spirometry. As the measurement, careful efforts were made on reducing errors by asking the subjects for their cooperation with the investigator. Each measurement was made in the standing position of the subjects, and the heighest values were taken after three repeated procedures in each manuever. All the measured values were subsequently converted into BTPS condition. The results are summarized as follows : 1. The physical characteristics of the experimental groups showed no significant differences with those of the control group. 2. The vital capacity of the male experimental groups and the ratio of vital capacity of the female experimental groups to their weight and height were significantly lowered than those of each control group. 3. The values of maximum voluntary ventilation of all experimental groups in both sexes showed lower than those of each control group. Especially, the ratio of the vital capacity to the weight in male, and to the weight and body surface area in female presented significant differences, respectively. 4. The values of maximum mid-expiratory flow of the each experimental group in .male, and its ratio of the maximum mid-expiratory flow of the female experimental groups to their weight were significantly lower than those of each control group. 5. The forced. expiratory volumes of the experimental groups in male, and at 0.5sec in female experimental groups were significantly lower than those of each control group. 6. The ratio of the forced expiratory volumes to the vital capacity at 1.0sec in male, and at 0.5 and 1.0sec in female experimental groups were significantly lower than those of each control group. From the above results, it is suggested that the industrial labors with the decreased lung volume and increased airway resistance may be due to some factors in the working environment.

대퇴-슬상부 슬와동맥간 우회로술 후 자가정맥 이식편과 인조혈관 이식편의 성적비교

김영욱,허승,나목찬,김종열 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

Purpose: Though it has been well known that the autologous vein graft is conduit of choice for infragenicular leg artery bypass, it is still less clear for above-knee femoro-popliteal artery bypass. we attempted to evaluate the outcomes of reversed saphenous vein graft in comparison with polytetrafluoroethylene (PTFE) graft in above-knee femoro-popliteal bypasses for the patients with chronic arterial occlusive disease. Method: In a period of 7 years and 9 months, 108 above-knee femoro-popliteal bypasses were performed in 96 patients (91 male, 5 female, mean age 67.3 years). The indications for bypass operation were short distance claudication 54 (50%), rest pain in 36 (33%), and toe, foot ulcer or gangrene in 18 (17%) limbs. As bypass conduit, autologouse reversed saphenous vein was used in 67 limbs, and PTFE graft in 41 limbs. We compared early (<31 days) postoperative complications, primary patency rates of grafts, and late outcomes of the limbs with proven graft occlusion between 2 patients groups (vein graft group vs. PTFE graft group). Primary cumulative graft patency rate were determined by Kaplan Meier method and compared them with log-rank test. Result: Early postoperative complications were not singificantly different between two groups. During the follow-up period, 20 (18.5%) grafts were lost to follow-up and 14 patients were dead. Primary cumulative patency rates at 1, 3, 5 years were 97.44±, 91.11±4.94%, and 75.92±14.46% for vein grafts and 81.76±7.49%, 36.15±13.42, and 36.15±13.42% for PTFE grafts respectively. Conclusion: In the patients underwent autologous vien graft for above-knee femoro-popliteal bypass, we experienced significantly better long-term patency, less serious surgical complication and less severe recurrent ischemic symptom after graft occlusion than in patients with PTFE graft.

체육실제학습시간(ALT-PE)의 이론적 고찰

김영명,이종목,옥영철 東亞大學校 附設 스포츠科學硏究所 1997 스포츠科學硏究論文集 Vol.15 No.-

I've researched on the method of learning time; considering the concept of learning time. AT has the property of learning opportunity. TOT and ALT can't clarify cognitive processes although they contain it. We can get an efficiency in learning time by concentrating on cognitive efforts. So the extension of learning time should not only represent the extension of learning opportunity but also the efficiency of learning time. The extension of learning time can be accomplished by increasing the proportion of the learning time, that students participate voluntarily within allowed time, and reducing the managing time that is needed for learning. In conclusion ALT is the most condensed concept in respect of quality. However, the students can's accomplish the efficiency of learning unless they don't have ALT. So we have to extend ALT in direction of AT in physical education.

Coating을 시행한 뇌동맥류 파열환자의 예후

박종혁,석종식,목진호,박관,김영백,민병국,황성남,최덕영 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.6

In rare occasions in which aneurysmal neck clipping is nearly impossible, coating is employed. During the period from 1985 to 1992, 312 patients with aneurysm underwent surgery ; aneurysmal neck clipping were performed in 284 cases while coating only in 28. The reasons that coating was required were ; wide and broad neck in 13, perforators arising from the neck in 4, neck tearing during dissection in 3, very friable neck in 2, severe adhesion with surrounding structures in 3, and small aneurysm without enough room for clipping in 3. In twenty-three cases, cotton wisp and bioglue were used as coating materials. In another five cases, the aneurysmal wall was reinforced using Surgicel or Gelfoam. Patients were followed for 24 months on average of all the patients. Four had last contact Six died(4 due to rebleeding and 2 due to pneumonia). Fourteen were good and 4 were moderately disabled. There were no rebleeding incidences during first three months' follow-up after coating. We thus concluded that coating an aneurysm offers some protection from rebleeding, particularly when the rebleeding risk period is over.

하악지 시상분할골절단술시 과두위치 유지를 위한 간편계측의 술후경과

류동목,이상철,김여갑,이백수,박종오 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.6

This study was intended to evaluate condyle position using simple ruler method in sagittal split ramus osteotomy for mandibular setback in 15 patients by paired t-test. We used oblique transcranial radiographs taken before operation and immediate after operation. And we concluded as follows ; 1.The joint spaces changed under 0.2mm were 21.2%, 0.2mm to 1.0mm were 67.7%, above 1.0mm were 11.1%. 2.The mean changes of AJS, SJS, PJS were all increased and SJS was most changed of them, but there is no statistically significant change in SJS. 3,Comparing the preop. measurements with the postop. ones, there is no statistically significant changes in over all joint spaces (P>0.05)

WO₃계 NO_(x)센서의 검지 특성과 바인더 첨가 효과

양종인,한상도,김일진,손영목,임한조 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

The effects of various binderssuch as PVA, silica sol and alumina on the sensing characteristics of TiO_(2) (4 wt. %)-doped WO_(3)-based NO_(x). sensors were investigated. The sensor with PVA (polyvinyl alcohol) binder showed an improved sensitivity (R_(gas)/R_(air)- in NO_(x) 15 ppm = 375), response time and cross-sensitivity (selectivity) for interference gases (CO, SO_(2), CH_(4), C_(3)H_(8)). It could also be operated at a lower consumption power (about 1.6W at 180℃). The sensors with silica sol and alumina binders showed a decreased sensitivity (R_(gas)/R_(air) in NO_(x) 15 ppm = 63 and 31, respectively) for NO_(x) gas sensing, but they showed an improved cross-sensitivity, response and recovery time (1 -2 min. and 1 min., respectively) than the sensor fabricated without binder.

가열처리에 의한 단감의 이화학적 특성

손규목,김광호,성태수,김종현,신동주,정지영,배영일 한국식품영양학회 2002 韓國食品營養學會誌 Vol.15 No.2

단감의 기능성 소재 및 기호성이 우수한 부원료로서의 이용 가능성을 확인하기 위하여 단감새옥를 전처리별 즉, 열처리 온도 (25℃, 75℃ 및 95℃) 에서 NaCl (0, 1, 3%) 농도별로 침적 (1, 5분) 하여 동결건조한 시료구를 대상으로 탄닌, 비타민 C, 색도 및 조직감 등을 분석한 결과는 다음과 같다. 탄닌 성분은 열처리 온도, NaCl 농도 및 침적시간이 증가할수록 탄닌함량이 감소하는 경향을 나타내었으며, 특히, 대조구 (420 mg%) 에 비해 95℃에서 1% 및 3% NaCl 농도에 5분간 침적시 각각 228 및 198 mg%로 감소하였다. 비타민 C 함량은 대조구 (122.4 mg%)에 비해 95℃에서 3% NaCl 농도에 5분간 침적시 75.8 mg% 로 감소하였고, 색도는 열처리 온도, NaCl 농도 및 침적시간이 증가할수록 L(명도) 및 b(황색)값이 뚜렷하게 증가한 반면, a(적색도) 값은 감소하였고, ??E 값은 증가하여 처리조건이 가중될수록 색의 변화가 진행됨을 알 수 있었다. 단감껍질과 전처리한 시료 (95℃, 1% NaCl, 5 분)의 flavonol 함량은 껍질에 myricetin(2.0 ㎍/g), quercetin (34. 5 ㎍/g) 및 kaemferol (1.1 ㎍/g) 성분이 검출되었고, 전처리한 시료는 myricetin (9.5 ㎍/g), quercetin (5.5 ㎍/g)이 검출되었다. 조직감은 대조구에 비해 전처리 (95℃, 1% NaCl, 5분) 한 시료에서 부서짐성, 응집성, 점성 및 씹힘성이 우수하였다. 관능검사는 95℃에서 1% NaCl에 5분 및 3% NaCl 농도에 1부간 침지한 시료가 좋은 평가를 받았다. Sweet persimmon were tested in order to identify their use as secondary material which is excellent in function and taste as food. Samples were soaked for 1 and 5 min with NaCl concentration (0, 1 and 3%) at a certain heating temperature (25, 75 and 9r℃), and then tannin, vitamin C, flavonol, color intensity, sensory test and textural properties were analyzed. The results of the analyses were as follows. Tannins were decreased as heating temperature, NaCl concentration and soaking time were increased, especially, that the control was 420 mg% but decreased 228 and 198 mg% at 95℃ (1 and 3% NaCl concentration) for 5 min, soaked in each. Vitamin C content also decreased more in higher temperature and NaCl concentration than control (122.4 mg%). Color intensity showed higher value in L and b than in heating temperature, NaCl concentration and soaked time longer remarkably, but a value decreased. The peel of sweet persimmons was analyzed myricetin (2.0 ㎍/g), quercetin (34.5 ㎍/g) and kaemperaol (1.1 ㎍/g), but in pre-treatment sample ( 95℃, 1% NaCl concentration and 5 min, soaked ) was showed higher myricetin (9.5 ㎍/g) and quercetin (5.5 ㎍/g). Textural properties were good in pre-treatment sample ( 95℃, 1% NaCl concentration and 5 min, soaked) such as brittleness, cohesiveness, gumminess and chewiness. In sensory analysis, the pre-treatment samples (95℃, 1% NaCl concentration and 5 min, soaked and 95℃, 3% NaCl concentration and 1 min, soaked) were showed higher point than others.

질산술코나졸겔의 제조 및 약물방출에 관한 연구

현종목,김경국,지웅길 충남대학교 약학대학 의약품개발연구소 1996 藥學論文集 Vol.12 No.-

Sulconazole nitrate(SCN), an imidazole derivative which has been effective in the treatment of dermatophytosis, tinea versicolor and candidiasis, was formulated as a gel containing drug, poloxamer 407, ethanol and propylene glycol. The resulting SCN gels were evaluated with respect to their viscosity, drug release rate, skin permeation rate. The apparent viscosity of SCN gel increased in proportion to poloxamer 407, drug and propylene glycol concentration. In case ethanol was added, the apparent viscosity decreased. The drug release rate of SCN gel increased in proportion to temperature and ethanol concentration. But the drug release rate decreased as the concentration of poloxamer 407 increased. The increase of drug concentration induced nonlinear increase of drug release rate. When propylene glycol was added at the level of 10%, the drug release rate increased but from 15% it decreased. The skin permeation rate decreased in high concentration of poloxamer 407. The skin permeation rate of SCN gel containing 15% ethanol increased about twice than that of gel without ethanol. The increase of drug concentration induced nonlinear increase of skin permeation rate. When propylene glycol was added at the level of 10%, the skin permeation rate increased but from 15% it decreased.