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혈액은행 제조의 혈소판 농축액을 이용한 당뇨족부궤양의 치료 경험
김덕우,한승규,김우경 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.2
Many clinical trials have shown the effectiveness of the platelet releasate or the platelet gel on chronic wounds. However, the patient's own blood had to be aspirated and processed to make the platelet releasate or a platelet gel. The purpose of this study was to assess the effects of platelet concentrates from the blood bank for the treatment of diabetic foot ulcers. To obtain the basic data of the PDGF-BB content in platelet concentrates supplied from the blood bank, enzyme-linked immunosorbent assay quantification was performed. On average, 8.5pg of the PDGF-BB was released per 1 million platelets. Sixteen patients with diabetic foot ulcers ranging from 1.0 to 18.0cm2(mean, 6.1cm2) in size were treated. The platelet concentrates was centrifuged and the precipitantte was mixed with 1ml of fibrinogen. The platelets and fibrinogen mixture was dispersed on to the ulcer lesions. The liquid platelet and fibrinogen mixture was then sealed using 0.3-1.0ml of thrombin and moisture dressing was performed. The procedure was repeated every one or two weeks until wound closure. Time required for complete healing ranged from 3 to 12 weeks after treatment(mean, 7.3 weeks). Patient satisfaction was also very positive. In this study, the use of platelet concentrates from the blood bank was found to be effective in treating diabetic foot ulcers.
김덕우,정승용,김대용,손대경,임석병,장희진,정경해,정준용,최효성,박재갑 대한대장항문학회 2007 Annals of Coloproctolgy Vol.23 No.4
Purpose: In Korea, colorectal cancer (CRC) is one of the most sharply-increasing malignancies, and the National Colorectal Cancer Screening Program for persons over 50 years of age began in 2004. To determine the effectiveness of the program, comparative data regarding CRCs treated prior to 2004 must be analyzed. The present study assessed CRC status at diagnosis and treatment patterns in 2003. Methods: In 2003, 503 patients were newly diagnosed with CRC and were treated at the Center for Colorectal Cancer, National Cancer Center (NCC). Clinical data were retrospectively reviewed. Results: The 503 patients included 256 colon and 247 rectal cancer patients. Of the 256 colon cancer patients, 5 (2.0%) were diagnosed during screening colonoscopies and were successfully treated using an endoscopic mucosal resection (EMR), and 17 (6.6%) received only palliative chemotherapy because of distant metastases. Forty patients (15.6%) were treated with palliative surgery and chemotherapy, and 194 (75.8%) with curative surgery with or without adjuvant chemotherapy. Of the 247 rectal cancer patients, 9 (3.6%) were treated with an EMR, 20 (8.1%) with palliative chemotherapy with or without radiotherapy, 19 (7.7%) with palliative surgery and chemoradiotherapy, and 199 (80.6%) with curative surgery with or without chemoradiotherapy. Treatment with curative intent was possible in 199 of 256 (77.7%) colon cancer patients and in 208 of 247 (84.2%) rectal cancer patients. Conclusions: Only 12.1% of colon and 8.5% of rectal cancer patients were diagnosed early and treated without adjuvant therapies at the NCC in Korea in 2003.
복강경 대장절제술 전 대장내시경하 인디아잉크 문신술의안전성과 효용성
김덕우,손대경,최효성,장희진,한경수,임석병,정승용,박재갑 대한대장항문학회 2006 Annals of Coloproctolgy Vol.22 No.2
Purpose: Accurate tumor localization prior to a laparoscopic surgical resection is the critical. India ink tattoos properly placed in the colorectum are long lasting and have been reported to probably remain constantly in previous studies. The present study was done to review the safety and reliability of colonoscopic tattooing prior to a laparoscopic resection of a colorectal neoplasm. Methods: Between May 2003 and August 2004, 20 patients underwent colonoscopic tattooing of a colorectal neoplasm prior to laparoscopic surgery. The clinical data were retrospectively reviewed. Results: Among the 20 patients, 14 (70%) had tumors located in the sigmoid colon, 4 (20%) had tumors in the rectosigmoid junction, and 1 had a tumor (5%) in the upper rectum and descending colon. In six patients (30%) who had received an endoscopic mucosal resection (EMR), an additional surgical resection was required to remove the tumor completely, and those 6 patients needed another preoperative colonoscopy for India ink tattooing. The median time between tattooing and resection was 2 days (range: 1 to 18 days). Tattoos were visualized intraoperatively and localized the tumor accurately in 15 patients (75%). Seven patients underwent intraoperative colonoscopy; five didn't have tattoos that could be visualized intraoperatively, and two patients with visible tattoos needed intraoperative colonoscopy to confirm the site of tumor. Only one patient (5%) had mild fever with abdominal discomfort, which were relieved by hydration and administration of intravenous antibiotics for one day. Conclusions: A colorectal neoplasm can be localized with an acceptable reliability by using preoperative colonoscopic tattooing. India ink tattooing at the time of the EMR may reduce unnecessary colonoscopies if we doubt a complete resection has been achieved by using an EMR. The complications following colonoscopic tattooing were minimal.
임베디드 환경에서의 H.235 기반 VoIP 보안 단말 구현 및 안전성 분석에 관한 연구
김덕우,홍기훈,이상학,정수환 한국통신학회 2004 韓國通信學會論文誌 Vol.29 No.7C
본 논문에서는 ITU-T에서 제안한 VoIP 표준인 H.323 시스템의 보안 프로토콜인 H.235에 대하여 연구하고 이를 임베디드 환경의 IP Phone에 구현하여 VoIP 보안 프로토콜의 구현 요구사항 및 구현 결과에 따른 분석을 실시하였다. 특히 annex D에서 제안하고 있는 VoIP 단말에서의 보안 기능을 분석하여 구현하였는데, annex D에서는 HMAC-SHAI-96을 이용하여 인중과 무결성을 제공하고 Diffie-Hellman을 이용해서 음성 데이터 암호화에 사용되는 세션 키를 암호화해서 전달하며 음성 데이터의 암호화를 위한 RC2, DES, 3DES 등을 지원하고 있다. 또한 annex D의 안전성 및 상호 연동 문제점을 분석하여 취약점을 발견하고 보안을 강화하는 개선 방안을 제시하였다. In this paper, H.235 based security mechanism for H.323 multimedia applications was implemented in embedded environment. H.235 covers authentication using HMAC-SHAI -96, authenticated Diffie-Hellman key exchange, security capability exchange, session key management for voice encryption, and encryption functions such as DES, 3DES, RC2. H.235-based mechanisms were also analyzed in terms of its security and possible attacks.