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Extrahepatic recurrence of hepatocellular carcinoma after curative hepatic resection
Jangmoo Byeon,Eung-Ho Cho,Sang Bum Kim,Dong Wook Choi 한국간담췌외과학회 2012 한국간담췌외과학회지 Vol.16 No.3
Backgrounds/Aims: This study was designed to compare the recurrence patterns after curative hepatectomy, to compare the prognosis according to the initial site of metastasis, and to investigate the independent predictive factors associated with extrahepatic recurrence in hepatocellular carcinoma (HCC) patients after curative hepatectomy. Methods: From January 2000 to July 2009, 307 patients underwent curative hepatectomies for HCC at our institution; 152 patients showed recurrences. Patients were divided into 2 groups according to their initial recurrence site: the intrahepatic recurrence (IHR) group and extrahepatic recurrence (EHR) group. The IHR group was comprised of 111 patients and the EHR group was comprised of 41 patients. The study investigated the preoperative, intraoperative, and postoperative factors related to the recurrence pattern retrospectively and compared the prognoses of the patients. Results: A five-year survival rate after an initial recurrence was lower in the EHR group (21.5%) than the IHR group (36.3%) (p<0.001). The preoperative alpha-fetoprotein (AFP) level was an independent risk factor for extrahepatic recurrence (p=0.014). Conclusions: Patients with a preoperative AFP level greater than 200 ng/ml have a higher incidence of extrahepatic metastases after a curative resection of HCC. Increased level of preoperative AFP is an indication for a short-term follow up hepatectomy.
Ku Sang Kim,Jangmoo Byeon,Jinhyuk Choi,Sungui Jung,Yeonwoo Kim,Junyong Jekal,Chang-Wan Jeon 대한종양외과학회 2021 대한임상종양학회 학술대회지 Vol.2021 No.6
Background/Aims Digital breast tomosynthesis (DBT)-guided stereotactic biopsy is increasingly used in practice. It is important to know usefulness of this innovative practice in procedure time, anesthesia, reoperation rates, and incision size compared with conventional surgical excision under digital mammography (DM)-guided hook wire localization. To compare biopsy procedure time, pathologic results, and reoperation rates for 2 years preceding of surgical excision and 6 months following implementation of DBT-guided stereotactic biopsy. Methods All conventional surgical excision under DM-guided hook wire localization from a single university hospital breast center from July 2018 to August 2020 from DBT-guided 9-gauge vacuum-assisted stereotactic biopsies from October 2020 to March 2021 were retrospectively reviewed. All procedures were done by breast surgeons not radiologist. All mammographic examinations were performed with DBT. Patient demographics, biopsy target type, pathologic reports, procedure time, type of anesthesia, surgical excision specimens when available, imaging follow-up results were recorded. Pathologic findings, procedure time, and reoperation rates between two different procedures were compared. Results A total of 42 women underwent breast biopsies: 22 by conventional surgical excision under DM-guided hook wire localization (July 2018 to August 2020) (median age, 52 years; interquartile range, 49–66 years) and 20 by DBT-guided 9-gauge vacuum-assisted stereotactic biopsies (October 2020 to March 2021) (median age, 48 years; interquartile range, 40–57 years), (P = .58). Microcalcifications were the most common biopsy target for both groups, constituting 92% (20 of 22) conventional surgical excision under DM-guided hook wire localization and 100% (20 of 20) of DBT-guided 9-gauge vacuum-assisted stereotactic biopsies (P = .32). The rate of architectural distortion biopsies was 8.0% (2 of 22) with conventional surgical excision under DM-guided hook wire localization and no case with DBT-guided 9-gauge vacuum-assisted stereotactic biopsies. Although overall malignancy rate was similar for conventional surgical excision under DM-guided hook wire localization (31.8% [7 of 22]) and DBT-guided 9-gauge vacuum-assisted stereotactic biopsies (25% [5 of 20], P = .54), Procedure time was different for conventional surgical excision under DM-guided hook wire localization (mean 95 minutes for surgery time 62 minutes, and hook wire localization time 33 minutes) and DBT-guided 9-gauge vacuum-assisted stereotactic biopsies (mean 16 minutes). Reoperation rate for malignant lesion were 29% (2/7) in conventional surgical excision under DM-guided hook wire localization but 0% (0/5) in DBT-guided 9-gauge vacuum-assisted stereotactic biopsies. And conventional surgical excision under DM-guided hook wire localization was performed under general anesthesia but, DBT-guided 9-gauge vacuum-assisted stereotactic biopsies was performed under local anesthesia. Omission rate for surgery was 70% (14/20) in DBT-guided 9-gauge vacuum-assisted stereotactic biopsies. Conclusions With the transition to digital breast tomosynthesis–guided stereotactic biopsy, procedure time was enormously decreased and procedure was possible in local anesthesia. DBT-guided 9-gauge vacuum-assisted stereotactic biopsies was accurate, minimally invasive and simple procedure with merits for short procedure time and local anesthesia furthermore omission of surgery.
[동력전달계] 무단변속기 장착 차량의 커플링 기부별 발진 성능 해석
김정윤(Jungyun Kim),조형준(Hyoungjun Cho),이장무(Jangmoo Lee),임원식(Won Sik Lim) 한국자동차공학회 1999 한국자동차공학회 춘 추계 학술대회 논문집 Vol.1999 No.11_2
To reduce the drive-line torsional vibration, some torsional coupling devices were used for the passenger car equipped a CVT with the wet type multi-plate clutch as a starting device. This paper describes the behaviors of a passenger car using a Belt-type CVT (Continuously Variable Transmission) that has different torsional coupling devices: a solid mass flywheel with torsional damper and a dual mass flywheel, focusing in the launching characteristics. The launching characteristics, considered here, are the acceleration performance and the creep characteristic. By using the mathematical models of this systems, the launching characteristics for different types of torsional coupling devices were investigated through the driving simulation, which developed in the previous study.
최장훈(JangHoon Choi),강상욱(SangWook Kang),이장무(JangMoo Lee) 대한기계학회 2005 대한기계학회 춘추학술대회 Vol.2005 No.11
Free vibraton Analysis by Non-dimensional Influence Function (or NDIF) is extended from circular shaped plates to arbitrarily shaped plates. The indefinite normal direction and concentrated forces at the corner of rectangular plates make it difficult to apply NDIF to rectangular. Besides, the straight edges make the use of local polar coordinate impossible. This problem is solved by a new method that uses Cartesian coordinate and new boundary conditions at corner .The proposed method provides reliable natural frequencies and mode shapes for various polygons which accord with those given by an exact method or FEM(ANSYS).
김정훈(Junghoon Kim),이호원(Howon Lee),이장무(Jangmoo Lee),유동호(Dongho Yoo) 한국자동차공학회 2005 한국자동차공학회 춘 추계 학술대회 논문집 Vol.2005 No.5_2
For shimmy vibration analysis, a mathematical theory model has been considered and the dynamic characteristics of full vehicle has not been considered in most researches. In this study, based on the results obtained from the quasi-static analysis of 10 dof suspension theoretical model, multi-body dynamic analysis considering shimmy vibration of the steering wheel is performed and compared with the results of MSC/ADAMS. Also, modal analysis results using front suspension system of 32 dof theoretical model agree with modal test results. Based on the results obtained from the modal test using CADA-X program, several design parameter have been found. Through simulations using MSC/ADAMS, it has been found that the shimmy vibration can be improved by changing the bush stiffness of the front suspension. In the end, the design process on the steering/suspension development is suggested for the analysis of shimmy vibration.
[동력전달계부문] 구면무단변속기를 장착한 하이브리드 차량의 개발
조형준(Hyoungjun Cho),김정윤(Jungyun Kim),전순일(Soonil Jeon),이장무(Jangmoo Lee),김재열(Jaeyu Kim),박영일(Yeongil Park) 한국자동차공학회 2000 한국자동차공학회 춘 추계 학술대회 논문집 Vol.- No.-
In this paper, we introduce the Semi-Spherical CVT(SS-CVT), which is characterized by its simple structure, infinite torque multiplication feature, and specific operating principles, with a kinematic analysis. The SS-CVT transmits the power using the rolling resistance between the metal on metal currently and realizes the smooth transitions between the forward/ neutral/ reverse states of output shaft by manipulating only one shifting actuator without a clutch. Using these special features of SS-CVT, we propose a prototype Hybrid vehicle equipped with a DC motor as a complementary power source. To build the prototype vehicle, we present the design processes and numerical investigations of its capabilities in this study.