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      • KCI등재
      • KCI등재

        환자의 비만도가 복강경 보조 위원위부절제술의 수술성적과 수술 후 경과에 미치는 영향

        정오(Oh Cheong),병식(Byung-Sik Kim),오성태(Sung-Tae Oh),육정환(Jeong-Hwan Yook),임정택(Jung-Taek Lim),박건춘(Gun-Chun Park),최지은(Ji-Eun Choi),갑중(Kap-Jung Kim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.2

        Purpose: Despite known advantages of laparoscopy-assisted distal gastrectomy (LADG) over open surgery, including less blood loss, less pain, faster recovery, and shorter hospital stays, many surgeons still hesitate to perform LADG in overweight patients due to concerns about increased perioperative morbidity. We investigated whether surgical outcomes in LADG differ in overweight patients and normal patients, as well as the influence of surgical experience. Methods: Between April 2004 and December 2006, 331 consecutive patients underwent LADG for preoperatively diagnosed early gastric cancer. Using the definition of overweight by western criteria, patients were classified into a low (n = 187, BMI <25 ㎏/㎡) and a high (n=144, BMI >25 ㎏/㎡) group. We retrospectively analyzed surgical outcomes, including operation time, retrieved lymph nodes, hospital courses, and postoperative complications. Results: The only differences in overweight and normal patients were longer operation time, incision length, and fewer retrieved lymph nodes. As our surgical team accumulated experience (after 250 cases in our study), there were no differences at all between the two groups. Conclusion: Technical difficulty in overweight patients could hamper some surgical outcomes but didn"t worsen the postoperative courses or complications. Moreover, those difficulties can be overcome as the surgical team accumulates experience.

      • 원형 자동문합기를 이용한 체외문합을 시행한 복강경 보조 위전절제술: 한 술자에 의한 연속적인 48명 환자의 수술성적분석

        정오,병식,육정환,오성태,임정택,갑중,최지은,박건춘,Cheong, Oh,Kim, Byung-Sik,Yook, Jeong-Hwan,Oh, Sung-Tae,Lim, Jeong-Taek,Kim, Kab-Jung,Choi, Ji-Eun,Park, Gun-Chun 대한위암학회 2008 대한위암학회지 Vol.8 No.1

        목적: 복강경 보조 위전절제술은 기술적 어려움과 환자수가 많지 않음으로 인하여 복강경 보조 위원위부 절제술에 비하여 연구가 많지 않은 상황이다. 따라서 저자들은 본원에서 시행한 복강경 보조 위전절제술의 수술성적과 수술후 경과 및 합병증 발생 예측인자와 복강경 보조 위전절제술의 학습곡선에 관하여 분석하였다. 대상 및 방법: 2005년 1월부터 2007년 9월까지 술 전 검사상 위의 중 상부에 위치한 조기위암(cT1N0)을 진단받고 한 술자에 의해 복강경 보조 위전절제술을 시행 받은 연속적인 48명의 환자를 대상으로 의무기록을 바탕을 후향적으로 분석하였다. 결과: 수술 중 합병증이나 개복수술로의 전환은 없었고 평균 수술시간은 $212{\pm}67$분이었다. 평균 적출 림프절 개수는 $29{\pm}10$개였고 모든 환자에서 안전한 종양 경계 면이 확보되었다. 수술 후 가스배출, 식이시작, 퇴원시기는 각각 평균 2.98일, 3.67일, 7.08일이었다. 외과적 합병증은 5명(10.4%)에서 발생하였고 모두 보전적 치료로 호전되었다. 단변량 및 다변량 분석에서 합병증 발생에 영향을 주는 유일한 인자는 체질량지순(P=0.035, HR=2.462)였으며 수술 시간을 기준으로 한 학습곡선 분석에서 20예가 학습곡선인 것으로 나타났다. 결론: 복강경 보조 위전절제술은 위의 중 상부에 위치한 조기위암에 대한 적절한 술식이며 수술성적과 수술 후 경과가 양호하다. 그러나 학습곡선을 단축하기 위해서는 복강경 보조 위원위부절제술의 충분한 경험이 필요하며, 특히 초기경험에서는 수술 후 합병증을 줄이기 위하여 환자 선택에 있어서 체질량지수를 고려하는 게 도움이 될 것으로 생각된다. Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

      • KCI등재

        고도진행성 위암에서의 수술 전 화학요법

        정오(Oh Jeong),병식(Byung Sik Kim),육정환(Jung Hwan Yook),최지은(Ji Eun Choi),갑중(Kab Jung Kim),오성태(Sung Tae Oh) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.4

        Purpose: The prognosis of advanced gastric cancer is still dismal despite of aggressive surgical treatment. Many investigational approaches such as the use of adjuvant chemotherapy and neoadjuvant chemotherapy with or without radiation therapy have been widely attempted for highly advanced gastric cancer. There are, however, few studies about the use of these types of treatment in Korea. Methods: Between 2001 and 2004, 38 patients with highly advanced gastric cancer underwent preoperative chemotherapy using the DXP (Docetaxel, Xeloda, and Cisplatin) regimen before surgery. An retrospective analysis including clinicopathological features, recurrence, and survival was performed using patient medical records. Results: Twenty-five patients had locally advanced gastric cancer without a distant metastasis, and 13 patients had a distant metastasis or peritoneal metastasis. Patients received the chemotherapy regimen an average of 4.2 times. A partial response and stable disease were found in 28 (73.7%) and 10 (26.3%) patients, respectively, according to the RECIST criteria. Twentyone (84%) of 25 patients without a distant metastasis had a curative resection compared to 6 (46.2%) of 13 patients with a distant metastasis (P=0.024). Four patients (10.5%) had complications with 1 postoperative death. The overall 5 year survival rate was 34% and the median survival duration was 22 months (49%, 34 months for the locally advanced group vs. 0%, 10 months for the distant metastasis group; P<0.001). The only predictor of prognosis of patients as determined by multivariate analysis was the pathological TNM stage. Conclusion: Preoperative chemotherapy can be safely performed without increased postoperative morbidity and mortality. To define the actual benefits for patient survival after preoperative chemotherapy, a large scale randomized prospective control study should be performed.

      • KCI등재

        산칠량이 (産漆量) 많은 옻나무개체의 선발에 관한 연구

        정오,만조,이세표 ( Jung Oh Hyun,Mahn Jo Kim,Shae Pyo Lee ) 한국산림과학회 1993 한국산림과학회지 Vol.82 No.2

        This study was conducted to investigate characteristics related to lacquer yield and to evaluate possibility of indirect selection of Rhus verniciflua Stokes. Twenty-four lacquer trees were randomly selected for measuring growth, urushiol content and bark thickness. Urushiol content showed a significant positive correlation with outer bark thickness and secretory canal density at 1% level, and with inner bark thickness at 5% level. Bark thickness and secretory canal density could be used as indicators for high urushiol content within bark and thus for high lacquer yield. Mass selection for high lacquer yield was made based on urushiol content within bark. Sixteen individuals with the highest urushiol content value were selected for breeding. As expected, the selected trees had thicker bark. higher density of secretory canal, better developed secretory canals compare to the non-selected lacquer trees.

      • SCOPUSKCI등재

        알루미늄 다채널 평판관내 R-22 응축에 관한 연구

        김정오,조진표,내현,Kim, Jung-Oh,Cho, Jin-Pyo,Kim, Nae-Hyun 대한기계학회 2000 大韓機械學會論文集B Vol.24 No.2

        In this study, condensation heat transfer tests were conducted in flat aluminum multi-channel tubes using R-22. Two internal geometries were tested ; one with smooth inner surface and the other with micro-fins. Data are presented for the followin~ range of variables ; vapor quality($0.1{\sim}0.9$), mass flux($200{\sim}600kg/m^2s$) and heat flux($5{\sim}15kW/m^2$). The micro-fin tube showed higher heat transfer coefficients compared with those of the smooth tube. The difference increased as the vapor quality increased. Surface tension force acting on the micro-fin surface at the high vapor quality is believed to be responsible. Different from the trends of the smooth tube, where the heat transfer coefficient increased as the mass flux increased, the heat transfer coefficient of the micro-fin tube was independent of the mass flux at high vapor quality, which implies that the surface tension effect on the fin overwhelms the vapor shear effect at the high vapor quality. Present data(except those at low mass flux and high quality) were well correlated by equivalent Reynolds number, Existing correlations overpredicted the present data at high mass flux.

      • KCI등재
      • KCI등재후보

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