상부위장관 출혈의 임상적 고찰

장금석,이승일,박삼규,조건국,장정수 조선의대 1984 The Medical Journal of Chosun University Vol.9 No.1

DMBA에 의해 유도된 생쥐 생식기 종양의 세포학적 연구

차동수,한상원,권장연,정인배,이영진,한혁동,정순희,등영건 연세대학교 원주의과대학 1993 원주의대논문집 Vol.6 No.1

급성백혈병의 화학요법에서 조혈간세포 보충요법

이규보,배선근,손상균,이재태,이건수,이경혜,서장수 경북대학교 병원 1997 경북대학교병원의학연구소논문집 Vol.1 No.1

1. 목적 급성백혈병의 화학요법에 있어서 관해유도 요법시에 보다 더 강력한 항암화학요법을 시행하고 골수억제의 회복을 위하여 말초혈액에서 채취한 조혈모세포의 투여로 그 효과를 증대시키고자 시도하였다. 2. 방법 관해유도 화학요법후에 골수억제시기로부터 회복단계로서 백혈구감소증이 호전도면서 단핵세포가 증가될 때에 말초혈액에서 조혈간세포(stem cell)로 인정되고 있는 CD34+세포의 함유량이 1% 이상되는 시기를 찾아내고 그 때부터 평균 4차례의 단핵구를 분리채집을 하여 -74。C에 냉동보관하였다가 제2차 화학요법후에 해동시켜서 정맥주입하였다. 3. 결과 대상 급성백혈병환자는 6명에 23회의 조혈간세포를 함유한 단핵구 채집을 시행하였고 유효한 단핵구의 채집은 4례에서 가능하였고 2례에서는 유효한 채집이 못되었다. 채집효율은 39.0-74.5%로서 평균 49.8%였다. 채집 후에 혈액학적 변화는 혈색소의 약간 감소 (평균 1.34g/dl)와 혈소판의 감소 (평균20.25%)를 나타내었다. 해동 단핵구를 투여할시에 일과성인 불쾌감, 기침, 흉부압박감, 호흡곤란 등이 있었다. 4. 결론 자가골수이식에서 자기말초혈액조혈간세포이식으로 관심이 이행되는 현시점에 자가조혈간세포를 채집하여 수혈하는 기술이 확립되는 기초를 이루었다고 본다. 이번 대상들은 재발된 금성백혈병들에 시행하였으나, 향후에는 초발시에 제일차 관해유도 화학요법 과정에 시도해야할 것으로 생각한다. Object: Peripheral blood stem cells(PBSC) were collected after remission induction chemotherapy and reinfused after intensified chemotherapy in order to increase the chemotherapeutic efficacy. Method: Collection of mononuclear cells (MNC) was started when CD34+ cells above 1% and WBC above 1,000/ul with mononuclear cell percentage above 30%, the collection procedures were done 2-6 time in each patient of total 6 cases. The collected MNCs were stored in - 750C and reinfused after thawing in the water bath at 370C Results: Twenty three collection procedures from the 6 cases of acute leukemia had made effective MNC collection in 4 cases and mean collection efficiency was 49.8%(from 39.0% to 74.5%). Hematological changes after the procedure were mean reduction of hemoglobin 1.34g/dl and mean 20.25% of decreased platelet count. There were noticed transient symptoms of discomfort, coughing, chest tightness and dyspnea in association with the infusion of stored cells. Conclusion: The basic process for the peripheral blood stem cell transplantation (PBSCT) was accomplished with this supportive care for the consolidation chemotherapy of acute leukemia. Effective PBSCT would be warrented with more qualified process and high does chemotherapy. (Korean J Blood Transfus 6(2) : 41~47,1995)

Paraspinal Muscle Sparing versus Percutaneous Screw Fixation: A Prospective and Comparative Study for the Treatment of L5-S1 Spondylolisthesis

Jang, Kun-Soo,Kim, Heyun-Sung,Ju, Chang-Il,Kim, Seok-Won,Lee, Sung-Myung,Shin, Ho The Korean Neurosurgical Society 2011 Journal of Korean neurosurgical society Vol.49 No.3

Objective : Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. Methods : Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. Results : Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. Conclusion : In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.

Langerhans Cell Histiocytosis Causing Cervical Myelopathy in a Child

Jang, Kun-Soo,Jung, Youn-Young,Kim, Seok-Won The Korean Neurosurgical Society 2010 Journal of Korean neurosurgical society Vol.47 No.6

Langerhans cell histiocytosis (LCH), a disorder of the phagocytic system, is a rare condition. Moreover, spinal involvement causing myelopathy is even rare and unusual. Here, we report a case of atypical LCH causing myelopathy, which was subsequently treated by corpectemy and fusion. A 5-year-old boy presented with 3 weeks of severe neck pain and limited neck movement accompanying right arm motor weakness. CT scans revealed destruction of C7 body and magnetic resonance imaging showed a tumoral process at C7 with cord compression. Interbody fusion using cervical mesh packed by autologus iliac bone was performed. Pathological examination confirmed the diagnosis of LCH. After the surgery, the boy recovered from radiating pain and motor weakness of right arm. Despite the rarity of the LCH in the cervical spine, it is necessary to maintain our awareness of this condition. When neurologic deficits are present, operative treatment should be considered.

Screw Fixation without Fusion for Low Lumbar Burst Fracture : A Severe Canal Compromise But Neurologically Intact Case

Jang, Kun-Soo,Ju, Chang-Il,Kim, Seok-Won,Lee, Sung-Myung The Korean Neurosurgical Society 2011 Journal of Korean neurosurgical society Vol.49 No.2

The low lumbar spine is deeply located in flexible segments, and has a physiologic lordosis. Therefore, burst fractures of the low lumbar spine are uncommon injuries. The treatment for such injuries may either be conservative or surgical management according to canal compromise and the neurological status. However, there are no general guidelines or consensus for the treatment of low lumbar burst fractures especially in neurologically intact cases with severe canal compromise. We report a patient with a burst fracture of the fourth lumbar vertebra, who was treated surgically but without fusion because of the neurologically intact status in spite of severe canal compromise of more than 85%. It was possible to preserve motion segments by removal of screws at one year later. We also discuss why bone fusion was not necessary with review of the relevant literature.

Treatment for Acute Stage Complex Regional Pain Syndrome Type II with Polydeoxyribonucleotide Injection

Jang, Kun Soo,Kim, Hyeun Sung The Korean Neurosurgical Society 2016 Journal of Korean neurosurgical society Vol.59 No.5

Complex regional pain syndrome (CRPS) type II is a syndrome that develops after nerve injury. Symptoms may be severe, and vary depending on the degree of sympathetic nerve involvement. As yet, there is no satisfactory treatment. We report the case of a female patient who had an L5 left transverse process fracture and an S2 body fracture, who developed symptoms of CRPS type II in her left lower leg that were aggravated during ambulation in spite of absolute bed rest for one month after the trauma. Several treatments, including bed rest, medication, and numerous nerve blocks were attempted, but the pain persisted. We finally tried injection of polydeoxyribonucleotide (PDRN) solution at the left L5 transverse process fracture site because we knew of the anti-inflammatory effect of PDRN. One day after this treatment, her symptoms had almost disappeared and three days later, she was discharged. We will also further discuss the possibility of using PDRN solution for the treatment of CRPS.

Co-occurrence patterns of Korean and Japanese adverbs expressing speculation

Jang Kun Soo 한국일본학회 2018 日本學報 Vol.0 No.115

이 연구에서는 추측을 나타내는 한국어와 일본어 부사를 대상으로 문말의 어떠한 표현과 공기관계를 맺고 있으며, 그 차이점은 무엇인가에 대해 분석하였다. 분석의 대상으로 한 부사는 일본어의 ‘たぶん’, ‘どうやら’, ‘もしかすると’와 이에 대응하는 한국어의 ‘아마(도)’, ‘아무래도’, ‘어쩌면’이다. 분석을 통해 도출한 한일 부사어의 차이점은 다음과 같다. 먼저, 일본어의 부사는 ‘ダロウ’가 나타내는 ‘추량’, ‘ヨウダ/ラシイ/シソウダ’가 나타내는 ‘증거성’, ‘カモシレナイ’가 나타내는 ‘가능성’이라는 문말형식의 의미범주에 따른 공기 양상이 두드러진다는 특징이 있다. 특정 형식과의 공기가 강하고 타 형식과의 공기는 어울리지 않는다는 점에서 부사에 따른 공기 양상이 ‘상보적’인 관계에 있다고 할 수 있다. 다음으로, 한국어의 부사도 특정 형식과의 공기관계가 현저하게 나타나지만, 일본어의 부사에 비해 그 정도가 낮고, 우언적 표현과 공기하는 비율이 높다. 일본어 부사에 비해 ‘추량’, ‘증거성’, ‘가능성’이라는 의미범주와의 공기 양상이 두드러지지 않고 서로 ‘연속적’인 관계에 있다고 할 수 있다. 즉 넓은 의미의 ‘추측’이라는 점에서 사태가 실현되는 개연성의 차이를 나타낸다고 할 수 있다. This study analyzed which expression of a sentence-end Korean and Japanese adverbs for expressing speculation have a co-occurrence relationship and what the difference is. The objects of analysis are Japanese adverbs ‘tabun’, ‘douyara, and ‘moshikasuruto’, and the corresponding Korean adverbs ‘ama(do) (probably)’, ‘amuraedo(seems like・anyway)’, and ‘eojjeomyeon(maybe)’ respectively. The differences between Korean and Japanese adverbs derived from the analysis are as follows: Japanese adverbs are characterized by a remarkable co-occurrence with the semantic categories of sentence-end forms such as ‘conjecture’ indicated by ‘darou’, ‘evidentiality’ indicated by ‘youda/rashii/-shisouda’, and ‘possibility’ indicated by ‘kamoshirenai’. They have a strong co-occurrence with a particular form while having an inconsistent relationship with other forms. In that sense, it can be said that co-occurrences according to adverbs have ‘complementary’ relationships. Korean adverbs also have a strong co-occurrence with a particular form. However, they have a relatively low co-occurrence compared to Japanese adverbs, and instead have a strong co-occurrence with allegorical expression. Moreover, they don’t have as much remarkable co-occurrence with semantic categories such as ‘surmise’, ‘evidentiality’ and ‘possibility’ as Japanese adverbs, but they have a ‘continuous’ relationship to each other. This means that they represent the difference in probability that the situation is realized in the broad sense of ‘speculation’.

證據性判斷を表す副詞について

장근수(Jang Kun-Soo) 일본어문학회 2004 일본어문학 Vol.26 No.-

「ほうがいい」의 서법성에 대해

장근수 ( Kun Soo Jang ) 한국일어교육학회 2014 일본어교육연구 Vol.0 No.30

이 논문에서는 ‘평가모달리티’에 관한 연구의 일환으로 ‘ほうがいい’의 서법성에 대해 분석하였다. 지금까지의 연구에서서는 ‘ほうがいい’가 지닌 모달리티적인 성질에 주목해 왔으나, ‘유사(의사)모달리티’로서의 성질도 포함한 주변적인 성격의 용례도 분석할 필요성이 있다는 점을 주장하였다. 이러한 시도를 통해 청자에 대한 화자의 ‘충고·조언’이라는 모달리티 용법부터 보다 명제적인 용법의 실체를 제시할 수 있었다. 이러한 점을 고려하여 ‘ほうがいい’에 관한 표현을 크게 세 가지 그룹으로 분류하여 제시하였다. 첫 번째 그룹은 ‘雨が降りそうだから、傘を持っていった方がいいよ。’처럼 ‘ほうがいい’가 문말에 위치하고, 청자에 대한 화자의 ‘조언’이나 ‘충고’, ‘권유’라는 명제내용과의 관계성을 표명하는 ‘진성모달리티’로서 기능하는 것이다. 두 번째 그룹은 형태적으로 ‘ほうがいい’를 취하고 있으나 비교구문에 나타나서 비교되는 것 중의 하나를 선택한다는 의미를 나타내는 것, 혹은 문말의 위치가 아닌 가정조건절이나 연체수식절과 같이 문중에 나타나는 것, 그리고 ‘ほうがよかった’의 형태로 화자의 평가가 아닌 객관적인 사실을 나타내는 것, 마지막으로 ‘ほうが’와 ‘いい’ 사이에 부사성분 등이 개입되어 형식으로서의 일체성에 문제가 있는 것 등이 여기에 속한다. 소위 ‘유사(의사)모달리티’로서 기능하는 그룹이다. 세 번째 그룹은 ‘ほうがましだ’, ‘ほうが望ましい’처럼 ‘ほうがいい’와 의미적인 유사성이 보이지만, 형태적으로는 ‘~ほうがいい’와 같은 고정된 형식를 취하지 않는다. 모달리티로서 문법화되어 있지 않은 표현으로 취급할 수 있다. 이들 세 가지 그룹은 모달리티로서 기능하는 것부터 명제적인 표현형식으로 이어지는 연속적인 관계에 있다고 할 수 있다. 이는 ‘사태선택’이라는 서법성의 강약이라는 의미적 스케일에서의 연속성으로 인정할 수 있다. 本稿では、評價のモダリティに關する硏究の一環として、「ほうがいい」がもつ敍法性について分析した。今までの硏究においては、主に「ほうがいい」のモダリティとしての性質に注目されてきたが、疑似モダリティとしての性質も含めた周邊的な用例をも視野に入れた分析が必要であることを主張した。このようなアプロ一チにより、「忠告·助言」というモダリティの用法からより命題的な用法の實體を提示することができた。これを踏まえ「ほうがいい」に關わる表現類を大きく三つのグル一プに分類した。一つ目のグル一プは「雨が降りそうだから、傘を持っていった方がいいよ。」のように、「ほうがいい」が文末に位置し、聞き手に對する話し手の「忠告」や「助言」「勸誘」といった命題內容との關係性を表す眞性のモダリティとして機能するものである。二つ目のグル一プは、形態的には「ほうがいい」の形をしているが、比較構文に現れ、比較されるものの中から一つを選擇するという意味を表すもの、そして文末の位置ではなく、가定條件節や連體修飾節のように文中に現れるもの、さらには「ほうがよかった」の形で話し手の評價ではなく、客觀的な事實を表すもの、最後に「ほうが」と「いい」の間に他の成分が介入され、形式としての一體化に問題があるものである。いわゆる疑似モダリティとして動くものである。三つ目のグル一プは、「ほうがましだ」「ほうが望ましい」のように「ほうがいい」との意味的な類似性が見られる表現類であるが、形態的には「ほうがいい」のように固定された形を取っていないものである。モダリティとして文法化されていない表現として位置づけられる。これらの三つのグル一プはモダリティとして動くものから命題的な表現へとつながる連續的な關係にあると考えられる。それは「事態選擇」という敍法性の强弱という意味的なスケ一ルにおける連續性として捉えられる。