• 제목/요약/키워드: two-stage procedure

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백서 모델에서 수술 기구를 통한 피부악성종양의 국소 재발 가능성 (Possibility of Local Recurrence Caused by Surgical Instruments in the Mouse Skin Cancer Model)

  • 김국진;이형석;김남균;이경석;김준식;박상우
    • Archives of Plastic Surgery
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    • 제38권4호
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    • pp.339-344
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    • 2011
  • Purpose: The goal of cancer surgery is complete removal of cancer tissue and prevention of recurrence. Surgeons can change the surgical instruments after total resection of the cancer mass. The purpose of this procedure is to prevent dissemination of the cancer cells attached to the surgical instruments. Authors hypothesize the possibility of local recurrence caused by the cancer cells attached to the surgical instruments in the skin cancer cases. Methods: Skin cancers were induced by using DMBA-TPA two-stage carcinogenesis model in 10 of Balb/c mice. In 2-weeks, skin cancer was developed in all 10 mice. cancer cell attached surgical instruments were made by pinching the removed cancer tissue using Adson tissue forcep 10, 20, 30 times each. To count number of cancer cells in each forcep with different number of pinching was done, the forceps were washed in 30 mL of the normal saline and Cytospin preparation was done. To make recurrence models from cancer cell attached surgical instrument, three incisions were made in normal skin of each mouse, and local seeding was done by pinching subcutaneous tissue in 10, 20, 30 times each by using Adson teeth forceps mentioned above as cancer cell attached surgical instrument. Results: All skin cancers were squamous cell carcinoma. Local recurrences were developed in 7 mice (3 in 10 times forceping site, 2 in 20 times forceping and 3 in 30 times forceping). In the cytospin test, the mean number of squamous cells in 100 microscope was 28.6 in 10 times, 47.2 in 20 times, 93.6 in 30 times, respectively. P value was 0.002 in Wilcoxon-Sign test. Conclusion: The number of cell count was significantly increased as number of pinching was increased. And these cells are able to induce local recurrence by local seeding. Considering this result, authors are able to confirm that the minimal handling in cancer surgery is important factor to prevent local recurrence.

전폐절제술후 생긴 농흉의 치료 (Management of Post-Pneumonectomy Empyema)

  • 송종필;정승혁;허용;김병열;이정호;안욱수
    • Journal of Chest Surgery
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    • 제32권3호
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    • pp.276-280
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    • 1999
  • 배경: 전폐절제술후 발생한 농흉은 흔하지는 않지만 심각한 합병증을 유발할 수 있다. 그리고 치료는 아직 흉부외과 의사에게 문제로 남아있다. 대상과 방법: 1990년 1월부터 1996년 12월 까지 전폐절제술후 발생한 농흉환자 20례를 분석하였다. 결과: 성별비는 남자가 15명, 여자가 5명 이였으며, 평균 연령은 41.5$\pm$21.5세였다. 좌우비는 8:12였고, 선행질환으로는 폐결핵이 가장 많았다. 폐절제후 농흉이 발생하기 까지의 기간은 1개월에서 6년까지 다양하였다. 가장 흔한 증상은 발열이였고, 포도상구균이 가장 흔한 원인균이였다. 13례에서 기관지 늑막루를 동반하였으며 4명의 환자는 전경심막을 통하여 기관지 절주를 봉합한 후 Clagett 술식을 시행하였고, 그 중 한명은 재발하여 후에 대망과 근육을 이용하여 흉곽 성형술을 받았다. 나머지 9명의 환자에게는 대망과 근육을 이용한 흉곽 성형술을 실시하였다. 기관지 늑막루를 동반하지 않은 7례에서는 모두 흉곽성형술을 실시하였고 이중 2례에서는 근육 충진법을 같이 시행하였다. 평균 추적 기간은 40$\pm$32.3개월 이였다. 사망과 재발은 발생하지 않았다. 결론: 전폐절제술후 발생한 농흉 환자에 있어서 조기 진단과 적절한 배농이 일차적 처치로서 중요하며, 흉곽 성형술과 더불어 대망이나 근육 충진법으로 완전한 치료가 가능하다.

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연경당 진작(演慶堂進爵)의 관극 체험과 무대미학 (The Significance of Audience's Reception and the Imagination on Transcendental World in Yungyungdang Jinjak(演慶堂進爵))

  • 사진실
    • 공연문화연구
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    • 제18호
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    • pp.379-412
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    • 2009
  • 이 연구는 순조28년(1828) 순원왕후(純元王后)의 40세 탄신일을 경축하여 거행된 연경당 진작(演慶堂進爵)을 중심으로 관객의 관극 체험을 논의하고 무대미학의 특성을 밝히고자 한다. 연구의 배경은 공연물로서 연경당 진작의 복원과 무대양식화를 위한 이론적 바탕을 마련하는 데 있다. 논의는 연경당의 공간 배치에 따른 관객의 위치와 시선을 점검하는 것으로 시작하였다. 연경당 진작의 관객 가운데 임금이나 왕비, 왕세자는 의례의 주체로서 무대 위 작품에 편입되거나 능동적으로 작품을 이끌어가는 특별한 관객에 해당한다. 이들 관객의 위상을 통하여, 엄숙한 의례나 제의의 진정성을 온전하게 수용하면서 공연예술의 감흥과 신명을 향유할 수 있는 관객의 존재 방식에 대한 논의가 활성화될 수 있다. 다음으로 정재 작품의 창작 동기와 연출 방식을 중심으로 관객에게 주어진 상상과 체험의 양상을 분석하였다. 정재 창작을 주도한 효명세자는 장생불사의 신화를 무대 위의 장경(場景)으로 꾸며내는 한편, 중국 역대 임금의 연악(宴樂)을 전거로 삼아 재창조한 장면을 무대 위의 장경으로 형상화하였다. 정재에 구현된 신화 세계의 이미지가 공간적 초월계에 대한 상상과 체험을 가능하게 했다면 실존했던 과거의 이미지는 시간적 초월계에 대한 상상과 체험을 가능하게 했다고 할 수 있다. 마지막으로 작품에 구현된 극중공간의 특성을 논의하였다. 신화와 역사를 재현함으로써 열리게 된 극중공간은 관객을 향하여 확장되거나 현실 속의 일상공간과 중첩되는 양상이 나타난다. 장생불사의 신화를 바탕으로 마련된 극중공간은 어좌와 보좌까지 확장되어 임금과 왕비가 신선을 만나는 체험을 가능하게 하였다. 역대 임금의 연악(宴樂)을 전거로 마련된 극중공간은 시간을 거슬러 올라간 역사적 풍류 공간이 현실 속의 연경당에 반복되는 체험을 가능하게 하였다. 시공간적 초월계를 '지금 여기'에 중첩함으로써 '상상의 추억'이라는 미학에 도달할 수 있다.

융합 신제품 규제 시차 관리를 위한 정성적 접근의 중요성: '산업융합 신제품의 적합성 인증제도'를 중심으로 (The Importance of Qualitative Approach to Managing the Regulatory Lag of Convergence New Products: Focusing on the Certification of Compliance of New Products of Industrial Convergence)

  • 김형진
    • 정보화정책
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    • 제29권3호
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    • pp.26-47
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    • 2022
  • '산업융합 신제품의 적합성 인증제도' (적합성 인증제도)는 개별 법령상에 융합 신제품에 적합한 인증 기준이 아직 준비되지 않았을 때, 별도의 입법 없이도 산업융합 촉진법에서 정한 바에 따라 동일 효력의 인증을 부여할 수 있는 법적 인증제도이다. 적합성 인증제도는 다른 인증제도들과 달리 규제 시차로 인한 융합 신제품의 인증애로를 해소하는 특성이 있다. 그럼에도 적합성 인증제도를 규제 개선의 관점에서 세부적으로 분석한 연구는 드물었다. 본 연구는 규제 문제가 발생 후 해소되기까지의 과정에 적합성 인증의 단계들을 순차적으로 매칭하여, 융합 신제품의 규제 시차가 적합성 인증의 절차를 통해 어떻게 감소되는지를 설명하였다. 나아가, 규제 시차 관리에 대한 관점을 정량적 측면과 정성적 측면으로 나누고, 규제 시차 감소를 위한 적합성 인증제도의 정량적·정성적 체계를 인증 절차의 각 단계별로 분석하였다. 이를 통해 본 연구는 적합성 인증제도가 융합 신제품의 규제 시차 문제를 해소할 수 있는 이유는 인증 절차별 법적 기한과 같은, 제도의 구조적 설계사항(정량적 측면) 뿐만 아니라, 개별 절차의 품질 확보를 위한 정성적 체계들을 갖추고 있기 때문임을 강조하였다.

딥러닝 오픈소스 프레임워크의 사례연구를 통한 도입 전략 도출 (Deriving adoption strategies of deep learning open source framework through case studies)

  • 최은주;이준영;한인구
    • 지능정보연구
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    • 제26권4호
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    • pp.27-65
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    • 2020
  • 많은 정보통신기술 기업들은 자체적으로 개발한 인공지능 기술을 오픈소스로 공개하였다. 예를 들어, 구글의 TensorFlow, 페이스북의 PyTorch, 마이크로소프트의 CNTK 등 여러 기업들은 자신들의 인공지능 기술들을 공개하고 있다. 이처럼 대중에게 딥러닝 오픈소스 소프트웨어를 공개함으로써 개발자 커뮤니티와의 관계와 인공지능 생태계를 강화하고, 사용자들의 실험, 적용, 개선을 얻을 수 있다. 이에 따라 머신러닝 분야는 급속히 성장하고 있고, 개발자들 또한 여러가지 학습 알고리즘을 재생산하여 각 영역에 활용하고 있다. 하지만 오픈소스 소프트웨어에 대한 다양한 분석들이 이루어진 데 반해, 실제 산업현장에서 딥러닝 오픈소스 소프트웨어를 개발하거나 활용하는데 유용한 연구 결과는 미흡한 실정이다. 따라서 본 연구에서는 딥러닝 프레임워크 사례연구를 통해 해당 프레임워크의 도입 전략을 도출하고자 한다. 기술-조직-환경 프레임워크를 기반으로 기존의 오픈 소스 소프트웨어 도입과 관련된 연구들을 리뷰하고, 이를 바탕으로 두 기업의 성공 사례와 한 기업의 실패 사례를 포함한 총 3 가지 기업의 도입 사례 분석을 통해 딥러닝 프레임워크 도입을 위한 중요한 5가지 성공 요인을 도출하였다: 팀 내 개발자의 지식과 전문성, 하드웨어(GPU) 환경, 데이터 전사 협력 체계, 딥러닝 프레임워크 플랫폼, 딥러닝 프레임워크 도구 서비스. 그리고 도출한 성공 요인을 실현하기 위한 딥러닝 프레임워크의 단계적 도입 전략을 제안하였다: 프로젝트 문제 정의, 딥러닝 방법론이 적합한 기법인지 확인, 딥러닝 프레임워크가 적합한 도구인지 확인, 기업의 딥러닝 프레임워크 사용, 기업의 딥러닝 프레임워크 확산. 본 연구를 통해 각 산업과 사업의 니즈에 따라, 딥러닝 프레임워크를 개발하거나 활용하고자 하는 기업에게 전략적인 시사점을 제공할 수 있을 것이라 기대된다.

Perceptional Change of a New Product, DMB Phone

  • Kim, Ju-Young;Ko, Deok-Im
    • 마케팅과학연구
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    • 제18권3호
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    • pp.59-88
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    • 2008
  • Digital Convergence means integration between industry, technology, and contents, and in marketing, it usually comes with creation of new types of product and service under the base of digital technology as digitalization progress in electro-communication industries including telecommunication, home appliance, and computer industries. One can see digital convergence not only in instruments such as PC, AV appliances, cellular phone, but also in contents, network, service that are required in production, modification, distribution, re-production of information. Convergence in contents started around 1990. Convergence in network and service begins as broadcasting and telecommunication integrates and DMB(digital multimedia broadcasting), born in May, 2005 is the symbolic icon in this trend. There are some positive and negative expectations about DMB. The reason why two opposite expectations exist is that DMB does not come out from customer's need but from technology development. Therefore, customers might have hard time to interpret the real meaning of DMB. Time is quite critical to a high tech product, like DMB because another product with same function from different technology can replace the existing product within short period of time. If DMB does not positioning well to customer's mind quickly, another products like Wibro, IPTV, or HSPDA could replace it before it even spreads out. Therefore, positioning strategy is critical for success of DMB product. To make correct positioning strategy, one needs to understand how consumer interprets DMB and how consumer's interpretation can be changed via communication strategy. In this study, we try to investigate how consumer perceives a new product, like DMB and how AD strategy change consumer's perception. More specifically, the paper segment consumers into sub-groups based on their DMB perceptions and compare their characteristics in order to understand how they perceive DMB. And, expose them different printed ADs that have messages guiding consumer think DMB in specific ways, either cellular phone or personal TV. Research Question 1: Segment consumers according to perceptions about DMB and compare characteristics of segmentations. Research Question 2: Compare perceptions about DMB after AD that induces categorization of DMB in direction for each segment. If one understand and predict a direction in which consumer perceive a new product, firm can select target customers easily. We segment consumers according to their perception and analyze characteristics in order to find some variables that can influence perceptions, like prior experience, usage, or habit. And then, marketing people can use this variables to identify target customers and predict their perceptions. If one knows how customer's perception is changed via AD message, communication strategy could be constructed properly. Specially, information from segmented customers helps to develop efficient AD strategy for segment who has prior perception. Research framework consists of two measurements and one treatment, O1 X O2. First observation is for collecting information about consumer's perception and their characteristics. Based on first observation, the paper segment consumers into two groups, one group perceives DMB similar to Cellular phone and the other group perceives DMB similar to TV. And compare characteristics of two segments in order to find reason why they perceive DMB differently. Next, we expose two kinds of AD to subjects. One AD describes DMB as Cellular phone and the other Ad describes DMB as personal TV. When two ADs are exposed to subjects, consumers don't know their prior perception of DMB, in other words, which subject belongs 'similar-to-Cellular phone' segment or 'similar-to-TV' segment? However, we analyze the AD's effect differently for each segment. In research design, final observation is for investigating AD effect. Perception before AD is compared with perception after AD. Comparisons are made for each segment and for each AD. For the segment who perceives DMB similar to TV, AD that describes DMB as cellular phone could change the prior perception. And AD that describes DMB as personal TV, could enforce the prior perception. For data collection, subjects are selected from undergraduate students because they have basic knowledge about most digital equipments and have open attitude about a new product and media. Total number of subjects is 240. In order to measure perception about DMB, we use indirect measurement, comparison with other similar digital products. To select similar digital products, we pre-survey students and then finally select PDA, Car-TV, Cellular Phone, MP3 player, TV, and PSP. Quasi experiment is done at several classes under instructor's allowance. After brief introduction, prior knowledge, awareness, and usage about DMB as well as other digital instruments is asked and their similarities and perceived characteristics are measured. And then, two kinds of manipulated color-printed AD are distributed and similarities and perceived characteristics for DMB are re-measured. Finally purchase intension, AD attitude, manipulation check, and demographic variables are asked. Subjects are given small gift for participation. Stimuli are color-printed advertising. Their actual size is A4 and made after several pre-test from AD professionals and students. As results, consumers are segmented into two subgroups based on their perceptions of DMB. Similarity measure between DMB and cellular phone and similarity measure between DMB and TV are used to classify consumers. If subject whose first measure is less than the second measure, she is classified into segment A and segment A is characterized as they perceive DMB like TV. Otherwise, they are classified as segment B, who perceives DMB like cellular phone. Discriminant analysis on these groups with their characteristics of usage and attitude shows that Segment A knows much about DMB and uses a lot of digital instrument. Segment B, who thinks DMB as cellular phone doesn't know well about DMB and not familiar with other digital instruments. So, consumers with higher knowledge perceive DMB similar to TV because launching DMB advertising lead consumer think DMB as TV. Consumers with less interest on digital products don't know well about DMB AD and then think DMB as cellular phone. In order to investigate perceptions of DMB as well as other digital instruments, we apply Proxscal analysis, Multidimensional Scaling technique at SPSS statistical package. At first step, subjects are presented 21 pairs of 7 digital instruments and evaluate similarity judgments on 7 point scale. And for each segment, their similarity judgments are averaged and similarity matrix is made. Secondly, Proxscal analysis of segment A and B are done. At third stage, get similarity judgment between DMB and other digital instruments after AD exposure. Lastly, similarity judgments of group A-1, A-2, B-1, and B-2 are named as 'after DMB' and put them into matrix made at the first stage. Then apply Proxscal analysis on these matrixes and check the positional difference of DMB and after DMB. The results show that map of segment A, who perceives DMB similar as TV, shows that DMB position closer to TV than to Cellular phone as expected. Map of segment B, who perceive DMB similar as cellular phone shows that DMB position closer to Cellular phone than to TV as expected. Stress value and R-square is acceptable. And, change results after stimuli, manipulated Advertising show that AD makes DMB perception bent toward Cellular phone when Cellular phone-like AD is exposed, and that DMB positioning move towards Car-TV which is more personalized one when TV-like AD is exposed. It is true for both segment, A and B, consistently. Furthermore, the paper apply correspondence analysis to the same data and find almost the same results. The paper answers two main research questions. The first one is that perception about a new product is made mainly from prior experience. And the second one is that AD is effective in changing and enforcing perception. In addition to above, we extend perception change to purchase intention. Purchase intention is high when AD enforces original perception. AD that shows DMB like TV makes worst intention. This paper has limitations and issues to be pursed in near future. Methodologically, current methodology can't provide statistical test on the perceptual change, since classical MDS models, like Proxscal and correspondence analysis are not probability models. So, a new probability MDS model for testing hypothesis about configuration needs to be developed. Next, advertising message needs to be developed more rigorously from theoretical and managerial perspective. Also experimental procedure could be improved for more realistic data collection. For example, web-based experiment and real product stimuli and multimedia presentation could be employed. Or, one can display products together in simulated shop. In addition, demand and social desirability threats of internal validity could influence on the results. In order to handle the threats, results of the model-intended advertising and other "pseudo" advertising could be compared. Furthermore, one can try various level of innovativeness in order to check whether it make any different results (cf. Moon 2006). In addition, if one can create hypothetical product that is really innovative and new for research, it helps to make a vacant impression status and then to study how to form impression in more rigorous way.

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동결보존 배아 이식에서 저 용량 아스피린 투여가 임신율과 착상율에 미치는 영향에 관한 연구 (Effect of Low-dose Aspirin on Implantation and Pregnancy Rates in Patients Undergoing Frozen-thawed Embryo Transfer)

  • 김민지;이현정;유영;서백경;차선화;김해숙;송인옥;변혜경;궁미경;강인수;양광문
    • Clinical and Experimental Reproductive Medicine
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    • 제32권3호
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    • pp.243-251
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    • 2005
  • Objective: Low-dose aspirin have been proposed to improving endometrial receptivity and pregnancy rate in COH-IVF by increasing endometrial perfusion. However, the effect of low-dose aspirin in COH-IVF could be negligible because there have been large quantity of other important factors responsible for changing endometrial perfusion accompanied by COH procedure. In contrast, in frozen-thawed embryo transfer cycles which were not accompanied by COH procedure, the effects of low-dose aspirin in endometrial blood flow seems to be more certain than in COH-IVF cycles. In this study, we analyzed the effect of low-dose aspirin treatment on implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer Methods: From January 2003 to December 2003, total 264 cycles from 264 patients who attended infertility clinic at Samsung Cheil Hospital were enrolled in this study. All cases included in this study, embryos were frozen and thawed at the pronuclear stage and three days after incubation, at least 2 or more good quality embryos were transferred into uterus. In study group, low dose aspirin (100 mg/day) was administrated from the first or second date of menstrual day to 9 days after embryo transfer. On the other hand, control group did not take any medicine except estradiol valerate for endometrial priming. Several variables including implantation and pregnancy rates were compared in both groups. After then, each groups were stratified by endometrial thickness checked at embryo transfer (ET) day such as (28 mm versus <8 mm) and same variables above described were compared between study and control groups. Results: The mean age, infertility duration, endometrial thickness at embryo transfer day and mean number of transferred embryo were not significantly different in both groups. Also, implantation rates (study group: 15.8%, control group: 20.5%) and pregnancy rate (study group: 45.1%, control group: 43.5%) were not significantly different between two groups. (p>0.05) After we analyzed same variables stratified by endometrial thickness checked at embryo transfer day, we could not found any significant difference between study and control groups. Conclusions: Low-dose aspirin treatment seems to have no advantage of improving implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer.

중진국의 정보유통체제 연구 (A Survey of the Current Information Activities in the Advanced Developing Countries)

  • 최성진
    • 한국문헌정보학회지
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    • 제7권
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    • pp.89-195
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    • 1980
  • The advanced developing countries including Korea are assumed to have reached a developmental stage which necessitates them to formulate and implement a plan for a national information network. Most of the governments in the advanced developing countries are well aware of the necessity for such a plan and some of them have actually commenced their studies on the feasibility of a national network of their own hoping to achieve maximum utility of their limited information resources. Two urgent problems facing planners in the design of a national information network are identified. One is lack of an optimum organisational model to enable them to meet their own situations, and the other is lack of a guideline to help designers evaluate the alternative structures and models when they are available. In resolving these two problems, network planners in the advanced developing countries would benefit from the achievement of the objectives of the present study. The major objective is to elicit and describe common information needs, desires and value of the people using information, and other common factors which are responsible for the present information services in the advanced developing countries and which have implications for the basic structure of the national information network. The value of this study is to aid administrators in Korea and those in the other advanced developing countries who are responsible for making national policies and who are now beginning to recognise the need for information services with the planning of economic and social development so as to enable all the groups in the community to have access to the information which are essential for decision making, research work, studies and even for recreational reading. This recognition will hopefully give them a rational basis for formulating right policies on information services. The methodology utlised for collecting the required data in this study falls under the category of observation and largely consists of the two techniques: literature review and postal questionnaire. Background information on the individual advanced developing: countries was gathered from monographic and periodical literature. and country reports presented at the various international conferences were analysed for other relevant data. For most of the data needed for the present study, a questionnaire on 'Library and Information Services as They Are Available in the Selected Countries' was formulated. This questionnaire was designed to be completed without help, by an expert who was well informed of the library and information services in his or her country. The questionnaire was intended to look in details at what information services in the advanced developing countries were doing-whom they were serving, in what way, and how well and establish to what extent they were meeting the nation's information requirements. It was also intended to ascertain the respondents' ideas on possible future developments in information provision in their countries, that is, in the advanced devanced developing countries. The questionnaire was posted to a total of 63 natinal librarians, directors of national information centres and those of other major libraries or information centres in 21 selected countries. Complete usable responses were received from 34 persons in 14 countries. In order to identify common characteristics of the information needs and desires in the advanced developing countries and the present situation of the information services to meet them, and the requirements and constraints peculiar to those countries which bought to be considered in the design of a national information network for advanced developing countries, an individual report on the current status of information activities for each of the fourteen countries chosen for this study, was presented. The procedure used was to arrange the data acquired in the questionnaire responses and other sources, in the form of fifteen country reports to be summarised by cross-section characteristics later.

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슬관절 전치환술 후 인공관절 주위 진균 감염의 임상적 결과 (Clinical Result of a Staged Reimplantation of Fungus Related Periprosthetic Joint Infection after Total Knee Arthroplasty)

  • 김형주;배기철;민경근;최형욱
    • 대한정형외과학회지
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    • 제54권1호
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    • pp.52-58
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    • 2019
  • 목적: 슬관절 전치환술 후 진균에 의한 감염은 드물지만 심각한 합병증으로 알려져 있으며 그 치료에 있어 항진균제 투여 기간이나 수술의 방법에 대해서는 이견이 있다. 이에 저자들은 인공 관절 주위 진균 감염에 대한 치료 결과 및 임상경과를 알아보고자 하였다. 대상 및 방법: 2006년부터 2017년까지 슬관절 전치환술 후 진균 감염으로 계명대학교 동산의료원에서 2단계 재치환술을 시행받은 10명의 환자를 같은 기간 비진균 인공 슬관절 주위 감염으로 치료받은 119명의 환자와 비교하였다. 임상적 평가는 2단계 재치환술에 의한 감염 조절의 실패율과 감염의 재발률 및 정주용 항생제 및 항진균제 사용기간, 2단계 재치환술 후 관절 운동 범위, 한국형 슬관절 점수(Korean knee score, KKS), 적혈구 침강속도(erythrocyte sedimentation rate, ESR), C-반응성 단백질(C-reactive protein, CRP)을 평가하였다. 결과: 진균이 동정된 군 총 10예 중 7예(70.0%)에서 감염조절의 실패를 보였고 일반 감염군 119예 중 7예(5.9%)에서 감염조절의 실패를 보였다(p=0.04). 진균이 동정된 군에서는 정주용 항진균제의 평균 사용기간은 15.3주로 일반 감염군에서의 정주용 항생제 평균 사용기간인 6.2주에 비해 9.1주 더 길었다(p<0.001). 감염 조절술 시행 전 슬관절 운동 범위는 두 군에서 모두 증가하였다(p=0.265). 최종 추시 시 KKS는 일반 감염군에서 평균 71.01점으로 나타났고 진균이 동정된 군에서 61.3점이었다(p=0.012). ESR과 CRP는 두 군에서 모두 감소하였으나 CRP만 두 군 간에 유의한 차이를 보였다(p=0.007). 결론: 슬관절 전치환술 후 발생한 인공관절 주위 진균 감염에 대한 수술적 치료는 일률적으로 양호한 결과를 보이지 않으므로 감염 조절술 시행 시 항진균제 혼합 시멘트 삽입과 재치환술 후 경구용 항진균제 사용을 고려하는 것이 필요하다.

직장암의 수술 후 방사선치료의 성적 - 예후 인자와 전체 치료기간이 미치는 영향에 관한 고찰 - (Results of Postoperative Radiation Therapy of Rectal Cancers - with the Emphasis of the Overall Treatment Time -)

  • 김주영;이명학;이규찬
    • Radiation Oncology Journal
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    • 제16권3호
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    • pp.303-310
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    • 1998
  • 목적 : 국소적으로 진행된 직장암의 방사선치료에 있어 전통적인 치료방법으로 알려져 있는 근치적 수술 및 보조 방사선 및 항암치료의 성적을 알아보고 이에 영향을 미치는 예후 인자를 알아보기 위함이다. 대상 및 방법 : 1989년 7월 부터 1993년 12월 까지 항문상방 15 cm 이내에 존재하는 직장암으로 진단받고 근치적 수술을 받은 71명의 환자를 대상으로 후향적 분석을 시행하였다. 방사선치료는 6 MeV 선형가속기를 사용하여 주5회씩 5040 cGy 까지 조사되였고 수술후 21일에서 94일 사이에 시작되었고 5-FU와 ACNU chemotherapy가 4주 간격으로 시행되었다. 결과 : 전체환자의 5년 생존율과 5년 무병생존율은 각각 58.8$\%$및 57$\%$였다. 대상환자들의 2년 국소제어율은 76.6$\%$였다. 생존기간 및 무병생존기간의 중앙값은 각각 30개월 및 27개월이었다. 단변량 및 다변량분석시 무병생존율에 의미있게 예후인자로 작용했던 요인은 국소림프절로의 전이여부, 4개 이상의 임파선 전이, 6주이상의 수술과 방사선치료 시작 사이의 간격 및 7일 이상 지속되는 방사선치료 도중의 휴식기간 등이었다. 결론 : 국소적으로 진행된 직장암의 경우 근치적 수술 및 방사선치료 및 5-FU/ACNU를 기본으로 한 항암제를 시행하였을 때 B3 이상의 병기에서는 아직도 생존율이 저조하며 bowel wall penetration이 있거나 국소 림프절전이가 있을 때는 국소제어율도 환자의 절반 정도에서 밖에 얻을 수 없을 뿐만이 아니라 림프절전이가 없는 경우라도 원격전이율이 치료실패의 많은 부분을 차지함을 알 수 있었다. 이는 좀더 효과적인 항암치료제의 선택과 투여 방법이 방사선치료와 병행될 필요가 있음을 시사하며 수술 후 보조적인 방사선치료를 시행함에 있어서 방사선치료가 시작되는 기간이 지연될 때, 또 방사선치료가 7일 이상 중단될 때 치료결과에 영향을 줄 수 있음을 보여준다. 직장선암의 경우 수술과 방사선치료시작까지의 기간이 필요이상으로 연장되거나 치료중 휴식기간이 생겨 전체치료기간이 길어지지 않게 하여야 할 것이다.

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