• Proceedings of the KAIS Fall Conference
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• 2010.11b
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• pp.509-512
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• 2010

본 논문에서는 지방환자의 서울진료의 추이와 치료결과를 살펴보기 위해 2005년, 2008년의 퇴원환자 조사 자료를 재원일수를 이용하여 분석하였다. 그 결과 2005년 퇴원환자 333,280명과 2008년 퇴원환자 419,873명의 성별, 연령별, 주진단 분포는 유사한 것으로 나타났으며 치료결과 재원일수는 2005년에 30일 이상이 7.2%, 20~29일이 5.9%인데 비해 2008년은 30일이상이 6.2%, 20~29일 6.0%로 나타나 재원일수는 절감되었다. 전체퇴원환자의 재원일수에 영향을 끼치는 요인에 대해 회귀분석 결과 연도, 성, 보험유형, 의료기관유형, 입원경로, 내원 경유, 주진단, 거주지의 효과를 통제한 후 지방환자의 진료지역에 따른 재원일수를 살펴본 결과 서울이 가장 낮은 것으로 나타났다. 또한 암환자의 재원일수에 영향을 끼치는 요인에 대해서도 연도, 성, 보험유형, 의료기관유형, 입원경로, 내원 경우, 주진단, 거주지의 효과를 통제한 후 지방환자의 진료지역에 따른 재원일수를 살펴본 결과 서울이 가장 낮은 것으로 나타났다. 즉, 지방환가 거주지에서 진료를 받는 것에 비해 서울에서 진료를 받는 것이 치료결과가 짧았다. 이는 타 지역 진료의 간접의료비 영향으로 서울지역에서 조기 퇴원하여 거주지에서 진료하였거나 서울 진료자가 중증도가 낮은 환자가 많아 재원일수가 낮을 수 있다는 것도 배제 할 수 없다. 이에 대한 중증도 보정 후 서울 진료환자의 재원일수가 낮은 요인을 분석하는 추후 연구가 필요하다.

• Korean Journal of Bronchoesophagology
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• v.17 no.2
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• pp.98-103
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• 2011

Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.

• Special Issue of the Society of Naval Architects of Korea
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• 2006.09a
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• pp.106-111
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• 2006

The steel outfitting structures installed in engine room are vibrated by an excitation of the engine and the propeller. Vibration problems such as cracks and fitting breakages are mainly induced at the near range of the resonance. The excitation frequency estimation is possible by engines and propeller specifications, but the natural frequency of a steel outfitting structure is not easily estimated due to the complication and variety of the designed shape. This paper represents natural frequency data of simple steel outfitting structures. As a vibration analysis tool, MSC/NASTRAN was used to calculate natural frequencies. Natural frequencies were compared in case of the shape and boundary condition changes of simple models, and anti-vibration models of the steel outfitting structures were presented on the basis of results.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.161-167
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• 2001

Background and Objectives： Total laryngectomy is often required for advanced cases. But this operation induced the many inconvenience of basic daily life. Early diagnosis of laryngeal cancer is very important to prevent from this disastrous condition. In this point of view, mass screening test for early detection of laryngeal cancer is necessary. Screening test using voice has many advantages such as simple, less interventional. Voice collection by Automatic Response System(ARS) is comfortable and easy to got acoustic sample. Thus author tried to got the acoustic parameters which can differentiate normal, benign. and malignant laryngeal diseases and also checked the availability of parameters on neural network system. Materials and Methods: Author has evaluated the voice from 17 laryngeal cancer patients and 45 benign laryngeal disease patients who visited at Department of Otolaryngology, Pusan National University Hospital from May 1998 to April 2001, and 15 normal control. Author chose the sir Parameters (Jitt. vFo, Shim, vAm, NHR, SPI) that was thought to be related with voice collected by ARS among thirty-three parameters analysed by a Multi-Dimensional Voice Program (MDVP). Two-step neural network was used for the availability of six parameters. Results: The detection rate of normal voice by ARS voice analysis is 78.5% and detection rate of abnormal voice was 97.1 o/o. Among abnormal voice, the detection rate of benign laryngeal diseases and laryngeal cancers were 82.4 o/o, 70.6% respectively. Conclusion: Author concluded that six parameters and Matlab based neural network software may be effective in development of acoustic screening system for laryngeal cancer and further study should be necessary for development of new acoustic parameters.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.172-176
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• 2000

Background and Objectives： The treatment of laryngeal carcinoma is not settled to date and surgeons have used lasers for a variety of benign and malignant lesions in the larynx with good success. The aim of this study is to evaluate the potential role of laser surgery for laryngeal carcinoma. Materials and Methods : Medical records from patients who had undergone laser surgery for laryngeal carcinoma at Seoul National University Hospital between January 1988 3nd December 1998 were reviewed retrospectively. Results : A total of 47 patients were seen during that period and their mean follow-up length was 29 months. Their local control rate was 91％ (94% for glottic T1, 60% for glottic T2, 50% for supraglottic T1 and 100％ for supraglottic T2). The cure rate after laser surgery with or without postoperative radiotherapy was 87％ and 6 of 47 patients showed local or regional recurrences. For those 6 patients, neck dissection, partial or total laryngectomy with or without postoperative RT were conducted and they were all followed up without evidence of disease. All 47 patients who had undergone laser surgery for laryngeal squamous cell carcinoma were followed up with NED and their larynx preservation rate was 96%. Conclusion： This study demonstrates the oncologic validity of laser surgery to the treatment of unadvanced laryngeal carcinoma. However, strict case selection is needed to avoid locoregional recurrences and consequent salvage operations.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.42-42
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• 1991

부비동에 발생하는 악성종양은 자각증상이 비교적 늦게 나타나 병변이 많이 진행된 후에 발견되는 경우가 대부분이다. 진행된 부비동압의 치료는 수술, 화학요법, 방사선요법의 병용치료법이 종래부터 시도되어왔으며 대부분의 경우 광범위한 수술적 절제가 필요하여 이에 따른 후유증이 크고 치료결과는 아직 많은 논란이 있다. 저자들은 진행된 부비동암 (T4)환자 10명에서 유도화학요법 (Cisplatin, 5-FU)후 수술 (상악절제술 4예, 두개안면 절제술 1예 )과 방사선 치료 (약 7000 cGy)를 받은 5명과 유도화학요법후 방사선치료만 받은 5명을 비교하여 다음과 같은 결과를 얻었다. 1. 수술을 포함한 병용요법을 받은 환자 6명중 3명은 평균추적기간 28개월 동안 재발의 증거가 없었으나 2명에서 국소재발이 있었고 이들은 국소 절제술 및 방사선치료후 현재 1년 이상 무병상태이다. 2. 수술을 포함한 병용요법을 받은 환자 5명중 4명에서 초진시 안와내 종양침윤의 소견이 있었으나 수술시 안와를 보존하였고 그 후 안와 부위의 국소 재발은 없었다. 3. 유도화학요법과 방사선치료만을 받은 5명 모두 6개월 이내에 국소재발하였다. 4. 진행된 악성 부비동암은 수술을 포함한 병용요법으로 좀 더 좋은 치료성적을 얻을 수 있을 것으로 기대된다.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.138-144
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• 2010

Background: Tracheal deviations are encountered frequently in head and neck tumors especially in thyroid cancer. Dyspnea and stridor are symptom calling for surgery. The method of evaluation in tracheal deviation is not well established yet. This paper is aimed to suggest objective tools to evaluate tracheal deviation in relation to cervical vertebra. Material and Method: Ten cases of thyroid cancers were recruited retrospectively. Tracheal inner shadow and shape of cervical vertebra were reconstructed three dimensionally using 3D-doctor to compare position of trachea in relation to vertebral body. Extent of deviation was scored in relation to both lateral borders of vertebral body. Angles between trachea and spinous process were measured in axial CT and compared between study group and control group. Results: Deviation scores were statistically significant between study group (mean=1.1) and control group (mean=0) (p=0.0008). Deviation angles at maximal tumor size in study group (mean=160.3 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0007). Angles at maximal deviation of three dimensional images ages in study group (mean=162.6 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0089). Conclusion: Tracheal deviation can be evaluated using scoring of three dimensional images and measuring angle between trachea and vertebral spine.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.73-78
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• 1998

The mutation of p53 is the most common genetic alteration found in human cancers and has oncogenic properties. mdm-2 is a recently discoverd that controls the p53 activity by binding of its protein, so negative feedback loop has been suggested in which p53 induces mdm-2 expression. The purpose of this study was to analyze the expression of p53 in leukoplakias, mdm-2 in squamous cell carcinomas, and relationship between p53 and mdm-2 expression in leukoplakias and squamous cell carcinomas. The results were as follows : 1) The p53 was expressed 33.4% in leukoplakias 2) The mdm-2 was expressed 8.3% in leukoplakias and 22.7% in squamous cell carcinomas. 3) The expression rate of p53 was higher in specimens negative for mdm-2 than in specimens positive for mdm-2, but there was not significant relationship between p53 and mdm-2 expression. In conclusion p53 was thought to participate in early phase of oncogenesis, and mdm-2 was thought to have a role as a oncogene in squamous cell carcinoma of head and neck. Though there was not significant relationship between p53 and mdm-2 expression, mdm-2 was thought to inhibit p53 activity.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2022.09a
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• pp.66-66
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• 2022

속성수로 활용되는 버드나무속 식물들은 생식기관과 영양기관의 성장 시기가 달라 형태적 특성 평가를 위해 수년간의 조사 기간이 요구된다. 따라서 바이오매스 우수 버드나무속 교잡종 육성의 성공 여부를 조기 판별하기 위한 식별 기술이 필요하다. DNA 마커는 식물의 생장단계와 관련 없이 탐색할 수 있으며 환경에 영향을 받지 않는 장점이 있다. 식물의 계통 분류 시 주로 사용되는 엽록체 DNA는 유전자 염기서열의 변이가 비교적 크지 않은 장점이 있으나 대부분의 활엽수에서 모계를 통해 유전되는 특징이 있다. 하지만 종간 교잡종의 식별은 각각의 부모종과 구분할 수 있어야 하므로 본 연구는 엽록체 DNA가 아닌 핵 DNA를 대상으로 분석하였다. 본 연구의 목적은 호랑버들을 암나무로 갯버들을 수나무로 인공교배하여 육성된 종간 교잡종을 식별하는 핵 DNA 마커를 탐색하는 것이다. 이를 위해 버드나무속에서 개발된 총 35개의 nSSR (nuclear Simple Sequence Repeat) 마커를 대상으로 호랑버들과 갯버들, 종간 교잡종의 식별 가능성을 평가하였다. 분석 결과 호랑버들과 갯버들, 종간 교잡종 간 차이를 나타내는 2개의 핵 DNA 마커를 선발하였다. 따라서 선발된 핵 DNA 마커를 활용하여 호랑버들과 갯버들, 종간 교잡종의 조기 식별에 활용이 가능할 것으로 사료된다.

• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.31-42
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• 2002

Purpose : The purpose of this study was to evaluate the present status of hospice palliative care programs in Korea as a basic database for standardization of hospice palliative care. Method : The data was collected from July to October, 2001. The instrument used for this study was the questionnaires which was consisted of the general characteristics of organization, recipient of service, manpower, contents of service, financial conditions and facilities. Sixty-four hospice palliative care programs answered the questionnaires, confirmed by telephone. Results : They were 40 hospital-based hospice palliative care programs and 24 nonmedical hospice palliative care programs. 11 Hospital-based hospice palliative programs have isolated unit or hospital affiliated free standing hospice. 6 Non-hospital hospice palliative programs have a free standing hospice. Major subjects of hospice palliative program were terminal cancer patients but patients with non-terminal illness were also included. Only 24 of 64 hospice palliative programs had all of the essential professionals : physicians, nurses, social workers, and clergies. Home hospice palliative care programs have a referral system in hospital based (89.7%) and nonmedical programs (73.7%). 24hr hospice are were provided in 26 hospital-based (65.0%) and 9nonmedical programs (37.5%). There were rooms for family in half of hospital-based programs. 73.9% of hospice palliative care programs have financial problems. 62.0% of Hospice palliative care programs need financial support from government. Conclusion : 64 Hospice palliative care programs provided hospice palliative services but had many problems in manpower, quality of care and facility. For improving the quality of terminal patients' life and promoting the cost effectiveness of health care resources, it is necessary to consider the standardization and institutionalization of hospice palliative care.