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김상균,김나영,신성관,성인경,홍수진,박효진 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.2
Background/Aims: Long-term use of aspirin can be a risk factor of peptic ulcer diseases. The aim of this study was to evaluate the efficacy of Albis (Daewoong Pharmaceutical Co., Ltd.) for the prevention of gastric mucosal injury caused by aspirin. Methods: Aspirin users were enrolled and randomized into the Albis or placebo group. Screening and follow-up endoscopy were performed for modified Lanza scores (MLSs). Primary outcome was measured by the incidence rate of peptic ulcer, and secondary outcomes were measured by the incidence rate of gastritis, improvement in MLS and subjective symptoms. Results: In total, 81 aspirin users were randomized, 43 in the Albis group and 38 in the placebo group. There was no incidence of peptic ulcer in both groups. The incidence of gastritis was significantly higher in the placebo group (44.4% vs. 10.0%, p=0.003); however, the scores of mucosal edema, hyperemia and hemorrhage were not statistically different between the two groups (p>0.05). The frequency of subjective symptoms were more improved in the Albis group than in the placebo group (p=0.023). Conclusions: The incidence of gastritis was lower in the group that received low-dose aspirin and Albis. The development of peptic ulcer due to long-term use of aspirin might be prevented with concomitant use of Albis.
이동 물체의 태깅을 위한 디지털 빔포밍 기반 RFID 시스템
전성하,전현무,신성관,손채봉,양훈기,Jeon, Seong-Ha,Jeon, Hyeon-Moo,Shin, Seong-Gwan,Sohn, Chae-Bong,Yang, Hoon-Gee 한국정보통신학회 2014 한국정보통신학회논문지 Vol.18 No.7
RFID 기술은 태그 아이디 정보 획득이라는 기본적인 역할을 넘어 태그 아이디와 위치 정보를 동시에 획득하는 기술이 개발되고 있으며 최근 들어서는 이동태그의 속도, 방향 등 부가적인 정보도 획득하는 방향으로 발전하고 있다. 본 논문에서는 서로 다른 속도로 이동하는 다수의 태그 부착 물체들에 대한 태그 아이디 획득 및 거리, 속도 등 부가적인 정보를 추출할 수 있는 RFID 시스템을 제안한다. 제안된 시스템에서는 태그는 FMCW로 변조된 아이디 신호를 전송하며 리더는 배열(array) 안테나를 이용해서 방위각 방향으로 태그 신호를 일차 분리하고 이어서 FMCW 복조를 통해서 속도, 거리 외에 태그 아이디를 복조한다. 요구된 기능을 수행하기 위한 리더 수신부 구조를 제시하고 제시된 시스템이 동작 가능함을 이론적으로 분석하며 시뮬레이션을 통해서 제시된 시스템의 성능을 검증한다. RFID technology has evolved from basic operation like the acquisition of tag IDs into a more complicated operation such as the simultaneous acquisition of tag IDs and their positions and recently, is raising the possibility of obtaining additional informations, which include their velocities, directions and distances. In this paper, we present a RFID system that can fullfil aforementioned advanced functions. In the proposed system, a tag transmits a sequence of FMCW pulses modulated by ID signals and a reader separates the tag signals in azimuth direction using an array antenna, followed by the FMCW demodulation from which distances, velocities as well as the tag IDs are extracted. We propose a receiver structure of the reader and theoretically analyze its operability. Moreover, its performance is examined by simulation.
Endoscopic Management of Gastrointestinal Leaks and Perforation with Polyglycolic Acid Sheets
한소정,정현수,박준철,신성관,이상길,이용찬 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.3
Gastrointestinal (GI) leakage, fistulae, and perforations can be serious and life threatening. There has been a paradigm shift in the management approach of these conditions, from surgical to conservative, including endoscopic management. Here, we report two cases of endoscopic closure of a GI fistula and perforation using polyglycolic acid (PGA) sheets with fibrin glue. The first case is of an anastomotic leak detected after subtotal gastrectomy with gastroduodenostomy. After failed application of endoclips, a PGA sheet was applied, and the fistula was successfully closed. The second case was of a 15-mm large perforated gastric ulcer, which was also successfully closed with a PGA sheet. This is the first case report that PGA sheet was used for the treatment of overt perforation. The outcome of these cases suggests that endoscopic closure using PGA sheets can be considered as a useful alternative for the management of GI leakage, fistulae, and perforations.
송인지,김현주,이지애,박준철,신성관,이상길,이용찬,정현수 대한위암학회 2017 Journal of gastric cancer Vol.17 No.4
Purpose: Bleeding is one of the most serious complications of advanced gastric cancer (AGC) and is associated with a poor prognosis. This study aimed to evaluate the clinical outcomes of endoscopic hemostasis for bleeding in patients with unresectable AGC. Materials and Methods: This study included 106 patients with bleeding associated with gastric cancer who had undergone endoscopic hemostasis between January 2010 and December 2013. Clinical characteristics, treatment outcomes, including rates of successful endoscopic hemostasis and rebleeding, risk factors for rebleeding, and overall survival (OS) were investigated. Results: Successful initial hemostasis was achieved in 83% of patients. Rebleeding occurred in 28.3% of patients within 30 days. The median OS after initial hemostasis was lower in patients with rebleeding than in those without rebleeding (2.7 and 3.9 months, respectively, P=0.02). There were no significant differences in disease status and rebleeding rates among patients with partial response or stable disease (n=4), progressive disease (n=64), and first diagnosis of disease (n=38). Univariate and multivariate analyses (P=0.038 and 0.034, respectively) revealed that transfusion of ≥5 units of RBCs was a significant risk factor for rebleeding. Conclusions: Despite favorable success rates of endoscopic hemostasis for bleeding associated with gastric cancer, the 30-day rebleeding rate was 28.3% and the median OS was significantly lower in patients with rebleeding than in those without rebleeding. Massive transfusion (≥5 units of RBCs) was the only significant risk factor for rebleeding. Patients with bleeding associated with AGC who have undergone massive transfusion should be observed closely following endoscopic hemostasis. Further research on approaches to reduce rebleeding rate and prevent death is needed.
김현주,서양권,이용찬,이상길,신성관,조병철,이창걸 대한암학회 2017 Cancer Research and Treatment Vol.49 No.3
Purpose The correlation between radiation dose and loco-regional control (LRC) was evaluated in patients with stage II-III esophageal cancer treated with definitive concurrent chemoradiotherapy (CRT). Materials and Methods Medical records of 236 stage II-III esophageal cancer patients treated with definitive CRT at Yonsei Cancer Center between 1994 and 2013 were retrospectively reviewed. Among these, 120 received a radiation dose of < 60 Gy (standard-dose group), while 116 received ! 60 Gy (high-dose group). The median doses of radiation in the standard- and high-dose groups were 50.4 and 63 Gy, respectively. Concurrent 5-fluorouracil/cisplatin chemotherapy was administered to most patients. Results There were no differences in patient characteristics between the two groups except for high Karnofsky performance status and lower-thoracic lesions being more prevalent in the standard- dose group. The median progression-free survival (PFS) and overall survival (OS) times were 13.2 months and 26.2 months, respectively. Patients in the high-dose group had significantly better 2-year LRC (69.1% vs. 50.3%, p=0.002), median PFS (16.7 months vs. 11.7 months, p=0.029), and median OS (35.1 months vs. 22.3 months, p=0.043). Additionally, LRC exhibited a dose-response relationship and the complete response rate was significantly higher in the high-dose group (p=0.006). There were no significant differences in treatment-related toxicities between the groups. Conclusion A higher radiation dose (> 60 Gy) is associated with increased LRC, PFS, and OS in patients with stage II-III esophageal cancer treated with definitive CRT.
Stricture Occurring after Endoscopic Submucosal Dissection for Esophgeal and Gastric Tumors
김광하,지삼룡,장재영,신성관,최기돈,이준행,김상균,성재규,최석채,전성우,장병익,허규찬,장동경,정성애,금보라,조진웅,최일주,정훈용,the Korean ESD Study Group 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.6
Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric and esophageal cancer. Compared to endoscopic mucosal resection, ESD has the advantage of enabling en bloc removal of tumors regardless of their size. However, ESD can result in a large artificial ulcer, which may lead to a considerable deformity. Circumferential mucosal defects of more than three-fourths the esophageal circumference, long longitudinal mucosal defects (>30 mm), and lesions in the upper esophagus are significant risk factors for the development of post-ESD strictures of the esophagus. In the stomach, a circumferential mucosal defects more than three-fourths in extent and longitudinal mucosal defects >5 cm are risk factors of post-ESD stricture. If scheduled early, regular endoscopic balloon dilation is effective in controlling and preventing post-ESD stricture. Moreover, intralesional steroid injections or oral steroids can achieve remission of dysphagia or reduce the need for repeated endoscopic balloon dilation. However, further study is needed to improve the prevention of stricture formation.