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비만을 동반한 위암 환자에서 두 병을 같이 수술 치료한 경험(증례)
최경현,윤기영,문형환,신연명,서경원,안수미,송윤미,석정희,정경연,이은하 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3
Obesity is growing problem in Korea. We had a case of bariatric surgery during gastric cancer operation. Patient was 29 year old Korean lady with early gastric cancer located in the lesser curvature side of the middle 1/3 of the stomach. Her body weight was 89 kg, height 163 cm, and thus body mass index was 33.5 kg/m2. Preoperative blood pressure was 130/90 mmHg, hemoglobin 12.9 g/dL, total lymphocyte count 3,280/mL, serum albumin 4.3 g/dL, CEA 1.1 ng/mL, CA 19-9 9.1 ng/mL, and alpha fetoprotein 2 ng/mL. Another associated disease was right thyroid follicular neoplasm. The chest X-ray was normal. After IM injection of 2,500 units of heparin 30 minutes before the induction of general anesthesia, she received curative subtotal gastrectomy and Roux en Y gastrojejunostomy when a malabsorption loop of 120 cm jejunum was incorporated between the Treitz ligament and the end to side jejuno-jejunostmy site at May 29th 2006. Her postoperative course was uneventful except a minor wound seroma and the elevations of serum amylase(up to 4 folds) and lipase(up to 2 folds). She lost her body weight 9 kg in 5th, 21 kg in 7th, and 27 kg in 10th postoperative months to became 61.5 kg. On follow up exams in July 2008, she gained 4 kg to overcome her weakness and fatigue. From the above result, the incorporation of a malabsorption loop during reconstruction phase of gastric cancer operation was a good option for obese gastric cancer patients especially in cases of early gastric cancer.
트랜잭션을 위한 데이터 우선순위 기반형 시간소인 순서화 기법
윤석환(Yoon Seok Hwan),김평중(Kim Pyoung Jung),박지은(Park Ji Eun),이재영(Lee Jae Young),이동현(Lee Tong Hyun),궁상환(Kung Sang Hwan) 한국정보처리학회 1997 정보처리학회논문지 Vol.4 No.5
Timestamp-Ordering Protocol among transaction scheduling algorithms can cause the priority reversion that a transaction with higher priority is processed after the transaction with lower priority by assigning timestamp to transactions entering system and scheduling them based on the timestamp. To prevent this reversion, we suggest a data priority-based timestamp ordering protocol to schedule transactions based on their priority within the same timestamp group after grouping transactions into constant time interval based on entering points. To evaluate the performance of this protocol, we compared the performance of this protocol with that of others after constructing the simulation environment with real time database system. We verified that the performance of proposed protocol is superior to that of timestamp ordering protocol under the condition of high load and high data conflicts.
조은희(Eun Hee Jo),윤영숙(Young Sook Yoon),김양신(Yang Sin Kim),김영경(Yong Kung Kim),김신희(Shin Hee Kim) 한국간호연구학회 2022 한국간호연구학회지 Vol.6 No.2
Purpose : This study was conducted to develop an program outcome evaluation system for the Utilizing Information and Communications Technology (ICT) and the Latest Health-Care Technology, required for nursing education accreditation. With respect to the accreditation criterion on program outcomes, it is necessary to understand the relationship between nursing education objectives, curriculum, and assessment. Methods : A methodological research design was adopted. To ensure the theoretical validity of the program outcome evaluation system, it was verified against the learning objectives of nursing education programs and a domestic literature review in Korea. The program outcome evaluation system for the Utilizing Information and Communications Technology (ICT) and the Latest Health-Care Technology Program outcome evaluation system, based on the Kim & Park’s developmental model (2008), was then developed. Results : The program outcome evaluation system was established, including implementation level, educational curriculum, performance level, evaluation method, rubrics, and closing-the-loop processes. Conclusion : The finalized program outcome evaluation system can be actively used in nursing education and contribute to enhancing the competency of nursing students and graduates in utilizing ICT and health-care technology.
간세포암 환자에서 경간동맥 화학색전술후 발생한 허혈성 담도 합병증
이상수,김혜경,서동진,윤현기,이승규,정영화,이영상,양수현,성규보,이경노,황재철,유은실,송병철 대한간학회 1999 Clinical and Molecular Hepatology(대한간학회지) Vol.5 No.3
Background/Aims: Transarterial chemoembolization (TACE) has been reported to be one of the useful palliative treatments in patients with unresectable hepatocelluar carcinoma. However, Bile duct injuries following TACE have been reported occasionally. In this study, we intended to clarify the incidence, pathogenic mechanisms and clinical implications of bile duct injuries following TACE. Methods: A total of 950 consecutive patients with hepatocellular carcinoma (HCC) were subjected. 807 patients were treated with TACE. The remaining 143 were treated with transarterial chemoinfusion (TACI) of cisplatin. Results: None of 143 HCC patients treated with TACI revealed to have any ischemic biliary injury radiologically. In contrast, out of 807 with TACE, 17 (2%) appeared to have biliary complications. Twelve out of 17 (71%) had bilomas at subcapsular area, three out of 17 (18%) had focal strictures at common hepatic duct or common bile duct with marked dilatation of intrahepatic bile ducts and two out of 17 (11%) had diffuse mild dilatation of intrahepatic bile ducts. Interestingly, two (17%) out of 12 bilomas were found at the lobe which was not embolized with Gelfoam. The median sessions of TACE to the occurrences of focal strictures tended to be longer compared with those of bilomas (median: 6 vs. 2.5; p=0.08). All three patients with focal strictures and four (33%) out of 12 patients with bilomas were associated with serious bacterial infections at presentation. Conclusions: Biloma seems to be caused by lipiodol rather than Gelfoam; focal strictures of large bile ducts by Gelfoam. It is suggested that adjustments of the amounts of lipiodol or Gelfoam and the sites or embolization may be required to reduce the ischemic biliary injuries following TACE. (Korean J Hepatol 1999;5:217-226)