• 항공우주시스템공학회지
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• 제14권1호
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• pp.54-61
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• 2020

군용항공기 운용을 위해서는 군 감항당국으로부터 감항인증서를 획득해야 한다. 군 일반감항인증 절차 중, 항공기 설계가 군의 감항인증기준에 적합함을 입증하는 형식인증 절차가 있다. 수리온 헬기는 군용항공기로서 국내에서 최초로 형식인증과 생산확인, 감항인증을 획득하였고, 수리온파생형 항공기는 특수 임무를 위해 개조되어 관용으로 운용 중이다. 항공안전법에 따르면, 군용항공기인 수리온파생형 항공기를 개조하여 민간의 특수목적으로 운용(응급환자 수송, 소방활동 등)하기 위해서는 민간 감항당국으로부터 제한분류 특별감항증명을 획득해야 하며, 제한형식증명 획득은 특별감항증명을 용이하게 할 수 있는 설계에 관한 인증에 해당한다. 본 연구에서는 우리나라에서 최초로 계획하고 있는 수리온파생형 항공기에 대한 민간의 특수목적 운용을 위한 제한형식증명 획득 방안에 대해 논하였고, 국내 제한형식증명 관련 제도의 발전 방향에 대해 제언하였다.

• Radiation Oncology Journal
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• 제30권4호
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• pp.189-196
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• 2012

Purpose: To investigate the safety of high dose hypofractionated radiotherapy (RT) in patients with small hepatocellular carcinoma (HCC) in terms of liver volumetric changes and clinical liver function. Materials and Methods: We retrospectively reviewed 16 patients with small HCC who were treated with high dose hypofractionated RT between 2006 and 2009. The serial changes of the liver volumetric parameter were analyzed from pre-RT and follow-up (FU) computed tomography (CT) scans. We estimated linear time trends of whole liver volume using a linear mixed model. The serial changes of the Child-Pugh (CP) scores were also analyzed in relation to the volumetric changes. Results: Mean pre-RT volume of entire liver was 1,192.2 mL (range, 502.6 to 1,310.2 mL) and mean clinical target volume was 14.7 mL (range, 1.56 to 70.07 mL). Fourteen (87.5%) patients had 4 FU CT sets and 2 (12.5%) patients had 3 FU CT sets. Mean interval between FU CT acquisition was 2.5 months. After considering age, gender and the irradiated liver volume as a fixed effects, the mixed model analysis confirmed that the change in liver volume is not significant throughout the time course of FU periods. Majority of patients had a CP score change less than 2 except in 1 patient who had CP score change more than 3. Conclusion: The high dose hypofractionated RT for small HCC is relatively safe and feasible in terms of liver volumetric changes and clinical liver function.

• Radiation Oncology Journal
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• 제31권4호
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• pp.185-190
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• 2013

Purpose: We evaluated the effect of early chemoradiotherapy on the treatment of patients with limited stage small cell lung cancer (LS-SCLC). Materials and Methods: Between January 2006 and December 2011, thirty-one patients with histologically proven LS-SCLC who were treated with two cycles of chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy were retrospectively analyzed. The chemotherapy regimen was composed of etoposide and cisplatin. Thoracic radiotherapy consisted of 50 to 60 Gy (median, 54 Gy) given in 5 to 6.5 weeks. Results: The follow-up period ranged from 5 to 53 months (median, 22 months). After chemoradiotherapy, 35.5% of the patients (11 patients) showed complete response, 61.3% (19 patients) showed partial response, 3.2% (one patient) showed progressive disease, resulting in an overall response rate of 96.8% (30 patients). The 1-, 2-, and 3-year overall survival (OS) rates were 66.5%, 41.0%, and 28.1%, respectively, with a median OS of 21.3 months. The 1-, 2-, and 3-year progression free survival (PFS) rates were 49.8%, 22.8%, and 13.7%, respectively, with median PFS of 12 months. The patterns of failure were: locoregional recurrences in 29.0% (nine patients), distant metastasis in 9.7% (three patients), and both locoregional and distant metastasis in 9.7% (three patients). Grade 3 or 4 toxicities of leukopenia, anemia, and thrombocytopenia were observed in 32.2%, 29.0%, and 25.8%, respectively. Grade 3 radiation esophagitis and radiation pneumonitis were shown in 12.9% and 6.4%, respectively. Conclusion: We conclude that early chemoradiotherapy for LS-SCLC provides feasible and acceptable local control and safety.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2131-2135
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• 2013

Background: To evaluate the efficacy and safety of distearoylphosphatidylcholine pegylated liposomal doxorubicin (DPLD) combined with carboplatin for the treatment of platinum resistant or refractory epithelial ovarian cancer (EOC) or fallopian tube cancer. Materials and Methods: A retrospective analysis of women who received DPLD with carboplatin for recurrent EOC or fallopian tube cancer in King Chulalongkorn Memorial Hospital Thailand from January 2006 to August 2011 was conducted. Patients were identified from the medical records and data on demographic factors, stage, histology, surgical findings, cytoreduction status, and prior chemotherapies were abstracted. The efficacy and toxicity of DPLD/carboplatin were evaluated. Progression-free (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Results: A total of 65 patients, 64 with platinum resistant or refractory epithelial ovarian cancer and 1 with fallopian tube cancer, were enrolled. DPLD and carboplatin were given for an average of 4.46 cycles per patient with a total of 273 cycles. Among the 65 evaluable patients, 0% achieved CR, 7.69% PR, 15.4% SD and 76.% PD. The overall response rate was 23.1%. With a median follow-up of 27.4 months, the median progression-free and median overall survival in the 36 patients was 4.46 months and 8.76 months respectively. In the aspect of side effects, palmar-plantar erythrodysesthesia (PPE) occurred in 33.3% (Grade I 22.2%, Grade II 11.1%) and mucositis in 41.7% (Grade I 27.8%, Grade II 13.9%) of all treatment cycles, all Grade 1 or 2. Anemia, leukopenia and thrombocytopenia occurred in 58.3% (Grade I 41.7%, Grade II 16.7%), 66.7% (Grade I 47.2%, Grade II 19.4%), and 22.2% (Grade I 16.6%, Grade II 5.56%) of cycle respectively, and were mostly Grade 1 or 2. Conclusions: DPLD, the second-generation PLD drug combined with carboplatin every 4 weeks, is effective and has low toxicity for treatment of patients with recurrent platinum-resistant or refractory epithelial ovarian cancer.

• Journal of Acupuncture Research
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• 제28권5호
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• pp.103-110
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• 2011

Objectives : The purpose of this study is to investigate the effect and adverse events of Gamiwolbigachul-tang on the changes of body composition and musculoskeletal pain in overweight patients. Methods : A total of 28 patients with overweight patients who were complaining musculoskeletal pain were treated with Gamiwolbigachul-tang more than 4 weeks between January 2011 and August 2011 in Kyung Hee University Oriental Medical Hospital were observed. We have evaluated the efficacy of treatments by measuring the changes of body composition (Body weight, Body mass index, Skeletal muscle mass, Body fat mass and Waist hip ratio) and musculoskeletal pain. The 28 patients were analyzed according to the distribution of sex, age, body compostition and musculoskeletal pain. Results : 1. There were statistically significant changes on Body weight and BMI in 28 patients after 4 weeks of treatment. 2. Gamiwolbigachul-tang had effect on reducing Body fat mass rather than Fat free mass. 3. There were statistically significant changes on musculoskeletal pains such as lower back pain, knee pain after treatment. 4. There were few side effects except those common complications such as insomnia(3 patients), palpitation(2 patients) and indigestion(1 patients), which did not have effects on everyday living. Conclusions : These results suggest that Gamiwolbigachul-tang will be beneficial for overweight patients with musculoskeletal pain, having both effectiveness and safety.

• 대한치과마취과학회지
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• 제12권2호
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• pp.93-97
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• 2012

Background: Some disabled patients show insufficient cooperation during dental treatment, and general anesthesia in an outpatient setting can be successfully administered. To minimize post-anesthetic complications is an essential issue, and strict discharge protocols are required for the safety of the patients. Post-anesthetic follow-ups using telephone calls can be applied to improve the quality of the outpatient care system. The authors evaluated the post-operative condition of patients after dental treatment under general anesthesia. Methods: Total 143 patients and their caregivers included in this study. The patients received general anesthesia for dental treatment in Seoul National University Dental Hospital, Clinic for Persons with Disabilities from July, 2011 to April, 2012. Telephone calls were given to the patients or their caregivers to collect information about the patients' systemic condition and anesthesia-related complications. Results: Among 131 patients with responses of telephone calls, 87 patients (66.4%) reported no discomfort, while 44 patients (33.6%) presented post-anesthetic complications. A total of 20 patients reported mild fever, 10 patients had vomiting, and 7 patients had sore throat. Other complications included nausea, fatigue, nasal bleeding, skin sore, and body rash. Among the patients with the history of epilepsy, 63.6% showed post-anesthetic discomfort or complication (P = 0.027, ${\chi}^2$ test). Conclusions: One third of dental patients who received general anesthesia due to insufficientcooperation complained discomfort after discharged from outpatient anesthetic care.

• 한국임상약학회지
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• 제30권2호
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• pp.113-119
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• 2020

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

• 한국의학물리학회지:의학물리
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• 제25권1호
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• pp.1-7
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• 2014

온열 치료는 방사선치료와 병행했을 때 종양에 대한 효과적인 치료방법이다. 환자의 안전과 효과적인 치료를 위해서는 가온 시 인체의 온도의 분포를 확인하는 것이 중요하다. 본 연구는 사용중인 고주파온열치료기와 제조사가 권하고 있는 protocol를 이용하여 펜톰의 온도를 높여주었다. 온도측정에 사용된 펜톰은 한천(agar)으로 5 cm두께로 단면을 측정할 수 있게 제작되었다. 가온 시 온도의 분포는 에너지가 클수록 온도가 높게 올라갔으며, 온도 분포는 에너지에 상관없이 비슷한 영역이 가온되었다. 아래쪽보다 위쪽으로 온도가 높게 올라가는 경향을 보이고 있으며, 큰 전극보다는 작은 전극을 사용했을 때 온도가 높게 올라가고 치우치는 온도분포를 보인다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6883-6888
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• 2013

Background: Platinum based concurrent chemo-radiation is the de-facto standard of care in the non-surgical management of locally-advanced head and neck cancer of squamous origin. Three-weekly single agent cisplatin at 100 $mg/m^2$ concurrent with radical radiotherapy has demonstrated consistent improvement in loco-regional control and survival. This improvement is however at the cost of considerable hematologic toxicity and poor overall compliance. The routine use of this regime is improbable in developing countries with limited resources. We therefore aimed to determine the safety and efficacy of an alternative regime of weekly cisplatin and concurrent radiotherapy in such patients. Materials and Methods: January-05 and April-12, 188 patients of locally-advanced head and neck cancer of squamous origin were treated with concurrent weekly-cisplatin at $35mg/m^2$ and conventional radiotherapy 60-66Gy/30-33 fractions/5days per week. Results: Overall, 95% patients received planned doses of RT while 74% completed within the stipulated overall treatment time of <50 days. Eighty-two percent received at-least 5 weekly cycles. Grade-III/IV mucositis was seen in 58%/9% respectively, which resulted in mean weight loss of 9.2% from a pre-treatment mean of 54.5 kg. Grade-III hematologic toxicity-0.5%; grade II nephrotoxicity-2.5% and grade III emesis-3% were also seen. Grade-III/IV subcutaneous toxicity-10%/1% and grade-III/IV xerostomia-10%/0% were observed. Complete responses at the primary site, regional nodes and overall disease were seen in 86%, 89% and 83% patients respectively. The median and 5-years disease-free survival were 26 months and 39.4% respectively, while the median and overall survival were 27 months and 41.8% respectively. Conclusions: Weekly-cisplatin at 35 $mg/m^2$ when delivered concurrently with conventional radical RT (at-least 66y/33 fractions) in locally-advanced head and neck cancer is well tolerated with minimal hematologic and neprologic toxicity and can be routinely delivered on an out-patient basis. It is an effective alternative to the standard 3-weekly cisplatin especially in the context of developing countries.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권2호
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• pp.137-142
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• 2005

목 적: 소아의 선천성 및 후천성 식도 질환의 치료에 있어 내시경적 풍선 확장술의 안전성, 효과 그리고 기술적인 문제들을 평가하였다. 방 법: 1993년부터 10년 동안 선천성 및 후천성 식도 질환의 치료로 부산대학교병원 소아과에서 내시경적 풍선 확장술을 시행한 8명을 대상으로 이들의 의무 기록을 후향적으로 분석하였다. 시술은 풍선 카테터를 내시경 겸자구를 통해 삽입하여 내시경 직시 하에서 시행되었으며 최초로 사용되는 풍선의 크기는 식도의 내경과 협착 부위의 직경에 기초하여 결정하였다. 협착이 아주 심한 경우에는 먼저 유도 철선을 통과시킨 후, 유도 철선을 따라 풍선 카테터를 삽입시켰다. 풍선을 협착 부위에 위치시키고 서서히 확장하면서 목표하는 크기로 풍선이 팽창되면 1분 동안 확장된 상태를 유지하였다가 감압하여 1분 이상의 휴식을 가졌다. 확장 후 합병증이 없으면 풍선의 직경을 1 mm 간격으로 늘리면서 추가 확장하였다. 결 과: 남아가 3명, 여아가 5명이었고, 평균 연령은 4.2세였다. 8명의 환자에서 27회(환자 당 평균 3.2회)의 확장이 시행되었다. 기저 질환의 종류는 선천 성 식도 폐쇄에 대한 수술 후 발생한 식도 협착이 3예, 식도윤이 2예, 그 외 식도 무이완증, 빙초산에의한 부식성 식도염 그리고 고압성 식도 하부 괄약근이 각각 1예였다. 6~15 mm 직경의 풍선을 사용하였고, 최초 풍선의 크기는 협착의 형태와 정도에 따라 결정되었다. 합병증으로는 식도 천공과 심한 호흡 곤란이 각각 1예 있었다. 6예(75%)에서 시술 후 정상적인 음식 섭취를 보였다. 결 론: 내시경적 풍선 확장술은 소아의 선천성 및 후천성 식도 질환을 치료하는데 있어 안전하고 효과적인 방법이다.