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상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교
노승무,정현용,이병석,조준식,신경숙,송규상,이태용,Noh Seung-Moo,Jeong Hyun-Yong,Lee Byong-Seok,Cho June-Sik,Shin Kyung-Sook,Song Kyu-Sang,Lee Tae-yong 대한위암학회 2002 대한위암학회지 Vol.2 No.3
Purpose: The aim of this study was to evaluate the shortterm outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pyloruspreserving proximal gastrectomy is a common problem to be solved in the future.
노승무(Seung-Moo Noh) 한국의학교육학회 2000 Korean journal of medical education Vol.12 No.1
가상강의는 수강자가 원하는 시간에, 지역적인 제약없이 강의자료에 접할 수 있어서 대학원 의학과 교육의 새로운 방법이 될 수 있음을 확인하였다. 교실에서 하는 수업보다도 더 다양하고 많은 정보를 제공할 수 있으며, 동영상, 음성서비스 등의 multimedia 기술을 이용하면 더 효과적인 교육이 가능하므로, 적극적으로 첨단의 통신기술을 도입하여야 할 것으로 생각된다. 또한 가상강의의 부수적인 효과로는 정보의 홍수시대라고 일컫는 현대사회에서 필요한 정보를 찾고, 가공하고, 이용하는 방법을 알려주는 기능도 있었다. 현재로서는 수강신청시에 충분한 사전 고지가 필요하며, 경우에 따라서는 가상강의의 수강에 필요한 교육이 선행되어야 한다고 생각되었다. 가상강의는 여러 가지의 문제점에도 불구하고 대학원 의학과 과정, 특히 공통과목의 경우에 적용하기 좋은 방법이라고 생각되었다 Changes in education and technology have influenced medical education and have altered many traditional concepts of teaching & learning skills. We are familiar with the traditional lecture in the classroom, but there are a lot of limitations to this method. In order to overcome geographical and time constraints of the limitations, I have tried implementing a cyber class using the internet lectures, homework, discussions, and even examination for the graduate medical course. The purpose of this study was to find alternatives for improvement of teaching and learning methods in medical education, especially in graduate courses. The cyber class was conducted on the internet with 69 medical graduate students in a course on the pre- & postoperative management of the surgical patient. Each student used his/her personal computer, and he/she entered the cyber classroom of the server computer of Chungnam National University (http://cyber.chungnam.ac.kr), connected to the auther s homepage. The computer program consisted of several menus and the system was also able to automatically check the student s contact number and duration, submission of homework, examination and discussion. I believe that the cyber class using internet is a useful tool for graduate medical course.
노승무(Seung-Moo Noh) 한국의학교육학회 2002 Korean journal of medical education Vol.14 No.1
The purposes of this study are to describe some of the basic and practical services available on the internet, and to evaluate the efficacy of a lecture using the internet together with a traditional classroom lecture. Growing demands for better education and increasing amount of knowledge have brought up the need to use new methods in learning. Information and communication technology has given new opportunities and challenges in the field of education. Especially, the internet is creating information and communication spaces that are removing the traditional boundaries of time and location. It offers new ways to learn and communicate in the field of medical education. Medicine is a very suitable area to use WWW-based teaching, because a great part of it is based on visually learned topics. The internet carries vast quantities of information in all different formats and modalities such as text, figures, video and audio. Teaching and learning are complex processes, and a wide variety of techniques and facilities are needed for each student and subject, which may vary at different times. The internet will not, and should not, replace traditional classroom lectures or tutorials, but it dose have the ability to add value to these traditional teaching techniques and to make the life of the student and teacher a little easier, more varied and possibly more interesting. Preliminary results show that this kind of lecture is useful in teaching medicine, especially in self-oriented learning, but cannot replace totally a clinical teacher s share in the learning process. Feedback from the users shows that this education is widely used and needed. The internet is likely to play more important roles in many aspects of medicine in the future.
명암값 분포를 이용한 자동화된 간과 비장의 정교한 추출
유승화(Seung Wha Yoo),성윤창(Yun Chang Sung),조준식(June Sik Cho),노승무(Seung Moo Noh),신경숙(Kyung Suk Shin),박종원(Jong Won Park) 한국정보과학회 2001 정보과학회논문지 : 시스템 및 이론 Vol.28 No.1·2
Because each organ has a gray value range of its own and its different ratio, in this study, we segmented the organ from the noise part with this gray value portion. We represented the organ with mesh images and made a template that is the rough outline of the organ. In the location searching process, that is to find the organs location, we traced not only the organ itself but also the separated organ. To represent the outline of the organ, we used the subtraction method from the binary image, so that even the tip of the organ could be represented minutely. With the proposed opening and closing methods in this paper, we reduced the runtime of the process in comparison with the existing algorithm. We computed the volume calculation from the segmented organ size and presented a clinical demonstration with the animal experiment. 각 장기는 고유한 명암값의 범위와 각 명암값에 대한 서로 다른 비율을 지니고 있으므로 제안된 연구에서는 이러한 명암값의 비율을 이용하여 장기의 영역과 노이즈를 구분할 수 있도록 하였다. 장기의 영역을 세 종류의 메쉬영상으로 표현하여 이들의 유니온 영상으로 장기의 전반적인 형태인 템플리트를 생성하였다. 템플리트 방식은 기존의 방식에서 명암값의 범위가 같은 노이즈의 제거가 어려운 단점을 해결하여 장기의 영역만을 분리할 수 있었다. 장기의 위치를 탐색하기 위한 위치탐색과정에서는 장기의 존재여부의 파악과 함께 분리된 장기까지 추적할 수 있도록 하였다. 외곽선 표현을 위해서는 템플리트로 이진영상에서 서브트랙션(subtraction)하는 방법을 사용하여 장기의 말단부위까지 세밀하게 표현하였다. 제안된 연구에서 사용된 오프닝과 클로징 방법으로 기존의 structuring element를 사용하는 방법에 비해 처리 속도를 단축시킬 수 있었다. 추출된 장기의 면적을 토대로 체적계산을 시행하였고 동물실험을 통하여 임상실험치를 제시하였다.