증례 : 갑상샘항진증에서 우심부전을 동반한 중증 삼첨판 폐쇄부전증 1예

장원일 ( Won Il Jang ),김은미 ( Eun Mi Kim ),안계택 ( Kye Taek Ahn ),박재형 ( Jae Hyeong Park ),최시완 ( Si Wan Choi ) 대한내과학회 2007 대한내과학회지 Vol.73 No.2

결론적으로 갑상샘항진증과 연관된 좌심부전의 소견이 없이 우심부전을 동반한 삼첨판 폐쇄 부전증을 보였던 예에서 항갑상샘제제 및 소량의 이뇨제 치료로 호전되었다. 폐동맥 고혈압을 동반한 우심부전과 삼첨판 폐쇄부전이 있을 경우 갑상샘항진증은 이의 가능한 원인으로서 고려되어야 한다. Left-sided heart failure can be complicated in the patient suffering with thyrotoxicosis; however, predominantly right heart failure in thyrotoxic patients is a rare condition. We present here a case of reversible right-heart failure with severe tricuspid regurgitation associated with thyrotoxicosis. A 71-year-old woman was admitted to the hospital because of a 10-day history of shortness of breath and indigestion. On echocardiography, there was a normal-sized left ventricle with preserved systolic and diastolic function. However, the right atrium and ventricle were dilated, and there was incomplete systolic coaptation of the tricuspid leaflets, resulted in severe tricuspid regurgitation. The maximal velocity of tricuspid regurgitation was 3.7 m/sec and the estimated pressure gradient between the right two chambers was 55 mmHg. After treatment that included diuretics and antithyroid drug (methimazole), the symptoms of right heart failure resolved. Four weeks later, a second echocardiogram was obtained revealing a normalized right atrium and ventricle, trivial tricuspid regurgitation and the resting pulmonary hypertension had disappeared.(Korean J Med 73:206-209, 2007)

Management of Regional Lymph Nodes in Localized Vulvar Carcinoma

Won Il Jang(장원일),Hong-Gyun Wu(우홍균),Charn Il Park(박찬일),Sung Whan Ha(하성환),Hyo Pyo Lee(이효표),Soon Beom Kang(강순범),Yong Sang Song(송용상) 대한방사선종양학회 2008 Radiation Oncology Journal Vol.26 No.1

목 적: 외음부 암환자에서 국소영역 치료실패에 대한 수술 후 방사선치료의 영향을 평가하고 임상적으로 림프절이 전 이가 없는 환자들에서 서혜부 림프절에 대한 치료방침을 결정해 보고자 하였다. 대상 및 방법: 1979년 10월부터 2004년 6월까지 서울대학교병원에서 일차성 외음부 암으로 치료를 받은 환자 66명에 대해 후향적 분석을 시행하였다. 이들 중에서 원격전이가 있는 2명, 고식적 목적으로 치료를 받은 6명, 이전에 골반부위 방사선 치료의 병력이 있는 3명, 추적관찰이 탈락된 4명, 의무기록이 불충분한 1명을 포함하여 16명의 환자들은 이번 분석에서 제외되었다. 50 명 중에 수술만 받은 환자가 35명, 수술과 방사선 치료를 받은 환자가 10명, 방사선 치료만을 받은 환자가 5명이었다. 결 과: 5년 전체 생존율과 무병 생존율은 각각 91%, 78%였다. 12명(26%)에서 치료 실패를 보였으며, 국소 실패가 8명, 영역림프절 전이가 3명, 원격 전이가 1명이었다. 수술과 방사선치료를 같이 받은 환자들이 수술만을 받은 환자들보다 위험요인을 더 많이 가지고 있었지만, 무병 생존율은 두 집단에서 통계적으로 유의한 차이를 보이지 않았다(5년무병 생존율 78% vs. 83%, p=0.66). 잠재성 림프절 전이의 빈도는 10%였다. 임상적으로 림프절 전이가 없었던 31명의 환자들 중에서 10명은 서혜부 림프절 절제술을 받지 않았지만, 이들 중에서 영역림프절 전이를 경험한 사람은 아무도 없었다. 결 론: 치료실패의 위험요인을 가진 외음부 암자들에게 수술 후 방사선 치료는 잠재적인 이점을 가지고 있다. 임상적으로 림프절 전이가 없는 위험도가 낮은 환자들에게는 서혜부 림프절 절제술을 하지 않는 것이나 서혜부 림프절에 대해 예방적 방사선치료를 하는 것에 대해서 고려해 볼 수 있겠다. Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone (S), ten were treated with surgery followed by radiotherapy (S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival (OS) and disease-free survival (DFS) rates of all patients were 91% and 78%, respectively. Twelve patients (26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients (p <0.05), the DFS rates were similar for the two groups (5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

무스위치 정합 네트워크를 이용한 900 MHz ZigBee CMOS RF 송수신기

장원일(Won Il Jang),어윤성(Yun Seong Eo),박형철(Hyung Chul Park) 한국전자파학회 2017 한국전자파학회논문지 Vol.28 No.8

본 논문에서는 868/915 MHz 대역의 CMOS ZigBee RF 송수신기를 설계, 제작하였다. 무스위치 정합 네트워크를 이용하여 외부 스위치를 사용하지 않아 저가격화 실현이 가능하게 하였고, 스위치의 삽입 손실을 없애 RF 수신기의 잡음지수와 송신기의 출력전력 대비 전력소모에 이득을 가져올 수 있었다. 수신기는 저잡음 증폭기와 믹서, 기저대역 아날로그 회로로 구성되었고, 송신기는 기저대역 아날로그 회로, 믹서, 드라이버 증폭기로 구성되었으며, 주파수 합성기는 정수분주기 구조이다. 제안된 ZigBee RF 송수신기는 0.18 μm CMOS 공정 기술을 이용하여 단일칩 full transceiver 형태로 설계, 제작하었다. 측정 결과, 수신기의 최대 이득은 97.6 dB이고, 잡음지수는 6.8 dB이다. 수신 모드의 전류소모는 32mA, 송신 모드의 전류소모는 33 mA이다. This paper presents a 868/915 MHz CMOS RF transceiver for the ZigBee application. Using a switchless matching network, the off chip switch is removed to achieve the low cost RF transceiver, and by the elimination of the switch"s insertion loss we can achieve the benefits for the RF receiver"s noise figure and transmitter"s power efficiency at the given output power. The receiver is composed of low-noise amplifier, mixer, and baseband analog(BBA) circuit. The transmitter is composed of BBA, mixer, and driver amplifier. And, the integer N type frequency synthesizer is designed. The proposed ZigBee RF full transceiver is implemented on the 0.18 μm CMOS technology. Measurement results show that the maximum gain and the noise figure of the receiver are 97.6 dB and 6.8 dB, respectively. The receiver consumes 32 mA in the receiver mode and the transmitter 33 mA in the transmission mode.

논문 및 방사선치료 현황을 통해 본 한국 20년의 간담도계 암 방사선치료

장원일 ( Won Il Jang ),서영석 ( Young Seok Seo ),김미숙 ( Mi Sook Kim ),김희진 ( Heejin Kim ) 대한간암학회 2015 대한간암학회지 Vol.15 No.2

Background/Aims: To analyze the future trends through the status of radiotherapy in the hepatobiliary cancer in Korea and related articles published in the world. Methods: Science citation index (SCI) and science citation index expanded (SCIE) articles, published in the 20 years from 1995 until 2014, were searched that contain the keywords related hepatobiliary cancer and radiotherapy using the Scopus. The incidence of hepatobiliary cancer was analyzed using annual reports from the Korea Central Cancer Registry. The status of radiotherapy was analyzed using data obtained form the Korean Society for Radiation Oncology and the National Health Insurance Service. Results: Total 2,302 papers related radiotherapy for hepatobiliary cancer were searched in the world. By 2014, the cumulative number of papers published by domestic authors was a total 221 pieces. In 1999, total 16,305 hepatobiliary cancer patients were developed, of which 729 patients have been treated with radiotherapy. In 2013, it was expected that total 22,482 hepatobiliary cancer patients would be developed, of which 3,075 patients have been treated with radiotherapy. Conclusions: Over the past 20 years, South Korea has made clinically and academically remarkable advances in the area of radiotherapy for hepatobiliary cancer. The researchers will continue to announce the results such as an objective status data and published papers in the future. (J Liver Cancer 2015;15:100-105)

입원중인 암환자에 대한 통증관리의 적절성평가 - 한 3차 의료기관 내과 전공의를 대상으로 -

김국회,장원일,조요한,최인실,박숙련,이상윤,김지현,김도연,이세훈,김태유,방영주,김노경,허대석,Kim, Kuk-Hyoe,Jang, Won-Il,Joh, Yo-Han,Choi, In-Sil,Park, Sook-Ryun,Lee, Sang-Yoon,Kim, Jee-Hyun,Kim, Do-Yeun,Lee, Se-Hoon,Kim, Tae-You,Bang, Yung-J 한국호스피스완화의료학회 2001 한국호스피스.완화의료학회지 Vol.4 No.2

목적 : 암환자에서 가장 흔히 겪게 되고, 심각한 증세는 통증이다. 진행성 암인 경우 $60{\sim}90%$의 환자들이 통증으로 고상하게 되며, WHO통계에 따르면 전세계적으로 4백만 정도의 암환자들이 통증으로 고생하고 있다. 통증관리원칙에 따르면 환자 $70{\sim}90%$이상에서 적절한 통증조절이 이루어질 수 있음에도 불구하고 이들 중 $60{\sim}70%$의 암환자들이 적절한 통증치료를 받지 못하고 있다. 본 연구는 1) 암환자의 통증 빈도 2) 환자와 담당전공의에서 통증인지의 일치 여부 3) 암환자의 통증치료에서 진통제 투약의 적절성 등을 조사함으로써, 암환자 통증에 대한 이해와 통증관리에 대한 지침을 마련하는데 기초자료를 제공하고자 하였다. 대상 및 방법 : 서울대학교병원 내과병동에 입원한 암환자들의 통증 빈도, 담당전공의와 환자의 통증인지 일치도, 통증 관리의 적절성 등을 평가하기 위해서 환자와 담당전공의를 대상으로 설문조사를 시행하고, 진료기록을 평가하였다. 결과 : 7일 이상 내과병동에 입원해 있는 암환자 59명중 43명(62.8%)이 통증을 호소하였다. 전공의들은 담당 암환자들의 통증을 실제보다 과소평가하고 있었으며, 진통제 투약 원칙이 지켜지지 않은 경우도 상당수 있었고, 환자의 통증이 심해질수록 통증에 대한 치료가 더 불충분한 경향이 있었다. 결론 : 암환자에 있어서 통증은 아직까지 낮게 평가되고 있으며 통증 치료는 여전히 불충분하다, 이와 같은 점을 고려할 때, 통증의 평가 및 치료에 대한 더 많은 교육이 필요할 것으로 생각된다. Purpose : Pain is the most serious symptom that cancer patients experience. About $60{\sim}90%$ of advanced cancer patients and four million patients worldwide, according to the WHO statistics, are reported to suffer from cancer pain. Although about $70{\sim}80%$ of the pain could be controlled according to the pain control principles, to our regret, only $30{\sim}40%$ are managed appropriately. This research was aimed to (1) investigates the prevalence of pain among cancer patients, (2) compare patients' perception of pain with physician's recognition and (3) evaluate appropriateness of the doctor's prescription of analgesic. Materials and Methods : Patients with advanced or terminal cancers admitted at department of internal medicine of Seoul National University Hospital for at least 7 days were enrolled. A questionnaire for the patients and the physicians in charge were given and the answers were compared for each other. We also examined their medical records and the physician's orders. Results : Total 59 patients were enrolled. Among them, 43 patients answered the questionnaire, and 27 patients (62.8%) suffered hem cancer pain. The survey also showed that physicians underestimated the severity of pain, overlooked frequently analgesic prescription principle, and that as the patients' pain became severe, the less adequate was pain managements. Conclusion : For cancer patients, pain was frequently overlooked, and treatment still inadequate. Based on this evidence, it seemed that more active practice and education about evaluation and management of cancer pain are needed.

인공신경망을 이용한 연약지반 침하에 대한 연구

강윤경(Won-Il Jang),장원일(Yoon-Kyung Kang),정진(Jin Jung) 한국마린엔지니어링학회 2010 한국마린엔지니어링학회 학술대회 논문집 Vol.2010 No.4

When industrial structures are constructed on soft ground, ground subsidence is occurred by problems of bearing capacity. To protect ground subsidence have to improve soft ground, and have to predict settlement estimation for reasonable construction. Generally, we predicted and analyzed the settlement estimation of ground by using Asaoka method, Hyperblic method and Hoshino method. This methods are not enough to apply initial design and construction of industrial structures. While Artificial Neural Networks are capable of predicting settlement though accumulated data in the initial design and construction. In the study, Artificial Neural Networks are applied to predict the settlement estimation of initial condition ground and ground improved by D.C.M method. Also, this study compares results of Artificial Neural Networks and results of continuum analysis using Mohr-Coulomb models.

해상풍력시스템의 기초침하에 관한 연구

서동일(Dong-Il Seo),장원일(Won-Yil Jang),신성렬(Sung-Ryul Shin),임종세(Jong-Se Lim),윤지호(Ji-Ho Yoon) 한국마린엔지니어링학회 2007 한국마린엔지니어링학회 학술대회 논문집 Vol.2007 No.-

The wind energy technology which converts kinetic energy into electrical energy has been in the focus of the world's attention. In this study, two-dimensional numerical analyses were conducted to observe subsidence aspects of the sea bottom on differently applied loads and various ground conditions.

해상풍력시스템의 기초침하에 관한 연구

서동일(Dong-Il Seo),장원일(Won-Yil Jang),신성렬(Sung-Ryul Shin),임종세(Jong-Se Lim),윤지호(Ji-Ho Yoon) 한국마린엔지니어링학회 2007 한국마린엔지니어링학회지 Vol.31 No.8

0.18㎛ CMOS 공정을 이용한 WBAN용 고집적 IR-UWB RF 송수신기

박명철(Myung Chul Park),장원일(Won Il Jang),이경학(Kyoung Hak Lee),어윤성(Yun Seong Eo) 대한전자공학회 2015 대한전자공학회 학술대회 Vol.2015 No.6

This paper presents a fully integrated 3-5 GHz IR-UWB(Impulse Radio Ultra Wide Band) RF transceiver for WBAN (Wireless Body Area Network). WBAN transceiver is needed to requirement such as low power consumption and high data rate. To achieve the low power and low complexity, UWB transceiver is designed for OOK(On-off keying) modulation using energy detection. Receiver topology is a non-coherent energy detector and RF notch filter is integrated for the rejection of the undesired interferers below 2.4 GHz. IR-UWB signal is generated by using VCO and switch mechanism which reduce power consumption and VCO leakage. Each channel has same spectral mask and support to 500MHz bandwidth. It is fabricated in 0.18um CMOS and power supply is 1.8v. Sensitivity is - 84.1 dBm at 3.5GHz. Transmitter average and peak power are - 48.71 dBm/MHz and -13.79 dBm/50MHz when PRF is 15.6MHz. Receiver power consumption is 4.1mW and transmitter is 3.3mW.

골수의 육아종을 동반한 ANCA 연관성 혈관염 1예

강현모 ( Hyun Mo Kang ),장원일 ( Won Il Jang ),김주옥 ( Ju Ock Kim ),김선영 ( Sun Young Kim ),김진환 ( Jin Hwan Kim ),이충식 ( Choong Sik Lee ),정성수 ( Sung Soo Jung ) 대한내과학회 2006 대한내과학회지 Vol.70 No.2S