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김윤환 가톨릭중앙의료원 가톨릭암센터 1996 암심포지움 Vol.- No.1
간암의 조기 진단방안으로 초음파를 당연히 이용하여야 하며, 이 검사는 전처치가 필요하지 않으며, 타검사에 비해 저렴한 가격으로 간암을 조기발견하는데 크게 기여를 할수 있다. 그러나. B형 및 C형 간염 바이러스 보균자중 고위험군에서는 정기적 초음파 검사와 더불어 CT를 반드시 1년에 한번이상 시행하여야 하며, 따라서 진단율에 있어 CT에 비해 상대적으로 낮은 초음파검사의 민감도를 극복할수 있다고 사료된다.
김윤환,신현주,주웅,김승철 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.3
Objective: This prospective randomized controlled pilot study aimed to find whether gelatin-thrombin matrix used as a tissue sealant (FloSeal) can prevent the occurrence of pelvic lymphocele in patients with gynecologic cancer who has undergone pelvic lymphadenectomy. Methods: Each patient, who undergo a laparotomic pelvic lymph node dissection on both sides, was randomly assigned for FloSeal application on 1 side of the pelvis. The other side of the pelvis without any product application being the control side. The amount of lymph drainage at each side of the pelvis was measured for 3 days, and computed tomography scans were obtained 7 days and 6 months after surgery for detection of pelvic lymphocele. Results: Among 37 cases, the median amount of lymph drainage was significantly decreased in the hemi-pelvis treated with FloSeal compared to the control hemi-pelvis (p=0.025). The occurrence of lymphocele was considerably reduced in treated hemi-pelvis (8/37, 21.6%) compared with control hemi-pelvis (12/37, 32.4%) after 7 post-operative days (p=0.219), and more decreased in the treated hemi-pelvis (5/37, 13.5%) compared with control hemi-pelvis (9/37, 24.3%) after postoperative 6 months (p=0.344). Conclusion: The application of FloSeal as a tissue sealant in lymph nodes resected tissues can reduce the incidence of pelvic lymphocele in gynecologic cancer patients. A large randomized controlled study could confirm these preliminary results.
김윤환,이선미,추재신,조서윤,홍새미,신영서 질병관리본부 2016 Osong Public Health and Research Persptectives Vol.7 No.1
Objectives: The outbreak of Middle Eastern respiratory syndrome coronavirus (MERS-CoV) was one of the major events in South Korea in 2015. In particular, this study pays attention to formulating a mathematical model for MERS transmission dynamics and estimating transmission rates. Methods: Incidence data of MERS-CoV from the government authority was analyzed for the first aim and a mathematical model was built and analyzed for the second aim of the study. A mathematical model for MERS-CoV transmission dynamics is used to estimate the transmission rates in two periods due to the implementation of intensive interventions. Results: Using the estimates of the transmission rates, the basic reproduction number was estimated in two periods. Due to the superspreader, the basic reproduction number was very large in the first period; however, the basic reproduction number of the second period has reduced significantly after intensive interventions. Conclusion: It turned out to be the intensive isolation and quarantine interventions that were the most critical factors that prevented the spread of the MERS outbreak. The results are expected to be useful to devise more efficient intervention strategies in the future.
金允煥 고려대학교 의과대학 1988 고려대 의대 잡지 Vol.25 No.1
The hepatic artery and portal vein were embolized with absolute ethanol in 26 New Zealand White rabbits to compare hepatic arterial embolization group with portal vein embolization group. Follow-up arteriography, portography, liver function test, retrograde cholangiography, microangiography, and pathologic examination were performed. The results were as follows: 1. Sequential hepatic arteriography showed successful and persistent occlusion of intrahepatic arteries at different levels, and reconstitution of the intrahepatic arterial circulation via collaterals on hepatic arterial embolization group, but on portal vein embolization group, no remarkable abnormal finding of hepatic arteriography was noted, except for complete obstruction of lobar hepatic artery of one case 2. Sequential portography showed successful and persistent occlusion of intrahepatic portal veins on portal vein embolization group, but on hepatic arterial embolization group, normal protograms were noted. 3. Sequential liver function test showed elevation of SGOT and SGPT at 2 days and 1 week after embolization, and returned to normal LFT at 4 weeks, but no specific difference between two groups was noted. 4. Retrograde cholangiography revealed findings of cholangitis on involved segment on both hepatic artery and portal vein embolizatlon groups. 5. Microangiography revealed avascular area in most of cases on each groups. But in incompletely infarcted area there showed tortuous hepatic arteries, decreased perfusion of sinusoid and microcollaterals through the interlobular arteries, capsular arteries and peribiliary vascular plexus on hepatic artery embolization group. On portal vein embolization group. tortuous and decreased perfusion of sinusoid were noted , but microcollaterals were relatively less developed. 6. On microscopic findings, no remarkable difference between two groups was noted. 7. The absolute ethanol was certainly effective for permanent occlusion of intrahepatic arteries and portal veins but caused damage on sinusoid & hepatic parenchyme, and on peribiliary vascular plexus resulting in sclerosing cholangitis on both groups. So, for further clinical application, caution would be necessary to superselect the tumors supplying artery & portal vein to avoid unnecessary parenchymal damage.