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      • KCI등재후보
      • KCI등재

        대장암 예방을 위한 대장 용종에 대한 이해

        양동훈 대한의사협회 2023 대한의사협회지 Vol.66 No.11

        Background: Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. Most CRCs arise through carcinogenesis pathways from precancerous lesions, such as adenoma and sessile serrated lesions (SSLs). Understanding the characteristics of such precancerous colorectal polyps and the carcinogenesis pathways helps to develop CRC preventive strategies via screening, colonoscopic polypectomy, and surveillance. Current Concepts: Benign colorectal tumors can be classified as conventional adenomatous and serrated polyps. Conventional adenoma is one of the most prevalent precancerous polyps detected on screening colonoscopy, but most are small. Small colorectal adenomas are less likely to contain advanced histology, such as villous features, high-grade dysplasia, or invasive cancer. A small adenoma may progress slowly over 10 years to become an invasive cancer via the chromosomal instability pathway. SSL is a recently established precancerous lesion and is estimated to account for approximately 15% of sporadic CRC. Most SSLs are not dysplastic and progress very slowly through the serrated carcinogenesis pathway. Conversely, SSL with dysplasia (SSLD) may progress more rapidly, as a mismatch repair gene product is defective. According to colonoscopy studies, SSLD comprises only 4% to 8% of SSLs, with a prevalence of 0.1% to 0.9%. Most precancerous lesions detected on colonoscopy progress slowly to CRC and are appropriate targets for colonoscopic polypectomy for the prevention of CRC. Discussion and Conclusion: Colorectal adenoma and SSL are representative precancerous lesions of CRC and most are slow progressing enough to be detected and removed via colonoscopy before CRC development.

      • KCI등재
      • KCI등재
      • KCI등재
      • KCI등재후보

        실물옵션을 이용한 가치평가와 투자의사 결정:IT 프로젝트 사례를 중심으로

        양동훈,이준서,남찬기,박기재,곽명재 한국경영학회 2006 Korea Business Review Vol.10 No.1

        Under traditional analysis of the capital budgeting, it is assume that management cannot react to deviation from the expected scenario of cash flows. In practice, however, it is less likely that the expected scenario will come true when new information arrives and uncertainty is resolved. Uncertainty and risk can be influenced through ‘managerial flexibility’, which becomes a central instrument for value creation. Real option framework takes this managerial flexibility into account. Therefore, it is more appropriate to use real option method to evaluate the project than the traditional DCF (discounted cash flow) tool if the firm has high volatility of the expected returns. In this study, we analyze the project evaluation using real option through case study about an IT firm that considers the investment of a project called as portal ASP(Application Service Provider). We use replicating portfolio approach, one of the applied binomial option pricing model, for option pricing and employ Monte Carlo simulation to estimate the standard deviation of rate of returns. This study finds the project that is rejected by DCF tool can be accepted if we use real option methodology. This result suggests that real option can be appropriate tool to evaluate the project if the firm has managerial flexibility under the uncertainty. 전통적인 자본예산 분석에서는 사업분석 시 현금흐름이 이미 결정되어 수행기간동안 변하지 않는다고 가정한다. 하지만 현실적으로 볼 때 새로운 정보가 유입되고 그에 따른 불확실성이 해소되면 기업은 경영상의 유연성을 가지게 되며 예상된 현금흐름의 시나리오는 변할 수 있다. 이러한 경영상의 유연성(managerial flexibility)은 기업들에게 회피하려고만 했던 불확실성이 투자기회의 가치를 증대 시킬 수도 있다는 새로운 인식을 하게했다. 이 같은 경영상의 유연성을 측정할 수 있는 수단이 실물옵션(real options)이며 기초자산의 변동성(volatility)이 높은 기업일수록 전통적인 순현가법(DCF: discounted cash flow)보다 실물옵션을 이용한 투자의사결정 방법이 보다 논리적일 수 있다. 이에 따라 본 연구에서는 실물옵션을 활용한 가치평가 방식이 어떻게 기업의 투자의사 결정에 적용될 수 있는가를 실제 사례분석을 통해 알아 보았다. 즉, 실물옵션분석 기법을 인터넷 포털 ASP(Application Service Provider) 사업에 진출하고자 하는 IT기업의 사례에 적용해 보았다. 실물옵션 가격결정 모델로는 이항옵션 모델의 하나인 복제 포트폴리오 방법 (replicating portfolio approach)을 사용했으며 몬테카를로 시뮬레이션을 이용해 기대가치의 변동성에 대한 추정치를 얻었다. 분석결과, 전통적인 순 현가법을 적용했다면 기각될 수 있는 프로젝트가 실물옵션 투자의사결정 방법을 사용할 경우 채택될 수 있음을 보여주었다. 이 같은 결과는 불확실성 하에서 유연한 단계적 의사결정이 가능한 경우 실물옵션은 경영의사결정의 유용한 대안이 될 수 있다는 것을 의미한다고 할 수 있다.

      • KCI등재

        Korean Guidelines for Postpolypectomy Colonoscopy Surveillance

        양동훈,Sung Noh Hong,Young Ho Kim,홍성필,Sung Jae Shin,김성은,Bo-In Lee,이석호,박동일,Hyun Soo Kim,양석균,김효종,김세형,김현정 대한소화기내시경학회 2012 Clinical Endoscopy Vol.45 No.1

        Postpolypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. In this report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy and we elucidated the high risk findings of the index colonoscopy as follows: 3 or more adenomas, any adenoma larger than 10 mm, any tubulovillous or villous adenoma, any adenoma with high-grade dysplasia, and any serrated polyps larger than 10 mm. Surveillance colonoscopy should be performed five years after the index colonoscopy for those without any high-risk findings and three years after the index colonoscopy for those with one or more high risk findings. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polypectomy, the patient’s general condition, and family and medical history.

      • KCI등재

        견관절의 임상적 평가도구에 관한 고찰

        양동훈,김건형,김행범,최양식,박영배,Yang, Dong-Hoon,Kim, Kun-Hyung,Kim, Haeng-Beom,Choi, Yang-Sik,Park, Young-Bae 대한침구의학회 2007 대한침구의학회지 Vol.24 No.6

        Objectives : A number of instruments have been developed to measure the quality of life in patients with various shoulder disorders. Much progress has been made in this area, and currently an appropriate instrument exists for each shoulder state. The purpose of this study is to review the instruments that are currently in use for assessing the shoulder joint. Methods : A literature research was performed to choose appropriate scales for assessment of function and the disability of the shoulder. Theoretically based scales were selected for review. Therefore, 11 scales were reviewed. The status of scales involved in shoulder treatment of acupuncture throughout several countries was evaluated. Results : 11 scales: The American shoulder and elbow surgeons evaluation form(ASES), Constant Shoulder Score, The disabilities of the arm, shoulder and hand(DASH), Shoulder Disability Questionnaire (SDQ), The Shoulder Pain And Disability index(SPADI), The simple shoulder test(SST), Oxford Shoulder Questionnaire(OSQ), The Rotator Cuff quality-of-life Measure(RC-QoL), Western Ontario Shoulder Instability Index(WOSI), Western Ontario Osteoarthritis of the Shoulder Index(WOOS), Western Ontario Rotator Cuff Index(WORC), wereevaluated. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 3 domestic and 10 overseas papers about shoulder treatments using acupuncture assessed with shoulder scales. Conclusions : In clinical research, the selection of the measurement scale should take account of the condition of disease, the patient's traits and the characteristics of the research. Moreover, appropriate scales, which havevalidity, reliability, responsiveness and practical characteristics, are needed to enhance the quality of research.

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