Complication of Intraoperative Radiation Therapy (IORT) in Gastric Cancer

김명세(Myung Se Kim),김성규(Sung Kyu Kim),송선교(Sung Kyo Song),김홍진(Hong Jin Kim),권굉보(Koing Bo Kwan),김흥대(Heung Dae Kim) 대한방사선종양학회 1992 Radiation Oncology Journal Vol.10 No.2

영남대학교 의료원 치료방사선과에서 1988년 6월 15일에 위함 환자의 수술중 방사선치료를 시작한 이래 1992년 8월 30일까지 총 58예에서 시도하여 그중 53예에서 IORT를 실시하였으며, 정기적인 추적검사에서 한명의 국소개발 환자도 보고되지 않고 있다. 출혈(3예), 장관폐쇄(3예), 폐혈증(2예), 골수기능저차(1예)를 포함한 총 9예(17%)의 합병증이 보고되었고, 이중 6예(13%)가 사망하였다. IORT(1500cGy), 외부 방사선치료 (-4500cGy)와 강한 항암제를 병합치료 하였음에도 불구하고 주등(수술과 항암제 치료)의 25.2%, 김등(수술 불가능한 환자에서 항암제 투여)의 18%, 리등(수술)의 18.5%, Kraming등(IORT 2800-3500cGy)의 35.3%에 비해 낮은 합병증을 보여 IORT가 위암의 치료에 공헌할 수 있음을 시사하였다. 그러나 비교적 높은 치사율(11.3%)은 더욱 세심한 수술수기 및 수술 후 환자의 치료가 필요하며 외부 방사선치료와 항암제치료의 적절한 시기 조절 및 치료선량의 가감이 필요할 것으로 생각된다. Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and increase distant metastasis free survival. IORT is the modality which could increase local control without increasing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988 and performed 53 IORT in patients with gastric cancer. No local failure had been reported including interstinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's 25.2% (chemotherapy + operation), Kim's 18% (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500cGy), external irradiation (--4500cGy) and extensive chemotherapy (FAM, 5FU + MMC, BACOP). Our data encouraged us to re-inforce further IORT in stomach cancer treatment.

초음속 흡입구 블리드 출구 유동특성 연구

김보환(Bo-Hwan Kim),이경태(Kyung-Tae Lee),김해동(Hae-Dong Kim),유진선(Jin-Sun Yoo) 한국추진공학회 2018 한국추진공학회 학술대회논문집 Vol.2018 No.5

초음속 흡입구에 사용되는 블리드 출구의 유동특성을 알아보기 위해 30°와 15° 각도를 갖는 루버 형상에 대해 수치해석을 수행하였다. 본 논문에서는 plenum chamber의 압력비에 따른 유량비 데이터를 확인하였고, 전산유체해석을 위해 상용소프트웨어인 Fluent v18.0을 사용하였다. 해석결과, 루버 주변에 충격파와 팽창파 등의 복잡한 유동패턴을 확인하였으며, 15° 루버의 경우에서 이러한 물리적 현상들이 완화되는 것을 확인하였다. Numerical simulations of the flow through the louver structure with 30° and 15° angles were conducted to investigate the flow characteristics of the bleed exit louvers used in supersonic inlet. In this paper, the sonic flow coefficient according to the pressure ratio of the plenum chamber was confirmed, and the commercial software Fluent v18.0 was used for computational fluid dynamics analysis. As a result of the analysis, complex flow patterns such as shock and expansion wave were confirmed around the louvers, and it was confirmed that these physical phenomena were alleviated in the case of the 15° louvers.

카프카의 소설 ‘변신’ 에서 나타난 ‘소외’ 개념과 낯설게 하기를 통한 서울 구의 취수장 재생방안

김파(Jin, Bo),구영민(Koo, Young-Min) 대한건축학회 2015 대한건축학회 학술발표대회 논문집 Vol.35 No.1

전 비경구적 영양요법시 휴지기(Resting period)설정의 의의

김홍진(Hong Jin Kim),김상운(Sang Woon Kim),박태준(Tae Joon Park),송선교(Sun Kyo Song),서보양(Bo Yang Suh),권굉보(Koing Bo Kwun),이석강(Suck Kang Lee) 대한외과학회 1987 Annals of Surgical Treatment and Research Vol.33 No.1

중소규모 SW개발 프로젝트를 위한 시각화 기반의 Tool-Chain 품질관리 방법 제안

김정보(Jung-Bo Kim),정진영(Jin-Young Jung),김정인(Jung-In Kim) 한국멀티미디어학회 2015 멀티미디어학회논문지 Vol.18 No.4

간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 단순 담낭 절제술 후 배액술의 필요성

김홍진(Hong Jin Kim),심민철(Min Chul Shim),권굉보(Koing Bo Kwun),노진우(Jin Woo Roh),김재황(Jae Hwang Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3

N/A A retrospective review is undertaken to evaluate the effects of drainage versus nondrainage of the gallbladder bed after elective cholecystectomy. Ninety one charts of patients who underwent elective cholecystectomy without choledochotomy were reviewed. Patient selection was based upon following criteria: 1) No evidence of empyema, pericholecystic abscess or cholangitis 2) No bleeding or leakage of bile from the bed of the gallbladder after cholecystectomy 3) Lack of exploration of the common bile duct. Two groups were analyzed. Those who had postoperative drainage of the subhepatic space and those who didn't have drainage. The results are as follows. Postoperative length of hospital stay was longer in the drainage group (p<0.05). The average days of hospital stay were 7.75 (+- 1.20) in nondrainage group and 8.16 (+- 1.21) in drainage group. Maximum postoperative temperature elevation was higher in the drainage group (p<0.05). The average maximum postoperative temperature were 37.20 (+- 0.33)C in nondrainage group and 37.94 (+- 0.42)C in drainage group. There was no significant difference in the duration of the postoperative fever between the drainage and nondrainage group. The average druation of the postoperative fever were 1.91 (+- 1.44) days in the nondrainage group and 2.27 (+- 1.47) days in the drainage group. There was no significant difference in the dose of the postoperative analgesics between the drainage and nondrainage group. The average dose of the postoperative analgesics were 4.45 (+- l. 47) in the nondrainage group and 4.98 (+- 2.12) in the drainage group. There was no significant difference in the complication rate between the drainage and nondrainage group. It is concluded that routine drainage of the subhepatic space after elective cholecystectomy without choledochotomy is unnecessary and contributes to increased length of postoperative hospotal stay and a higher rate of patients discomfort.

소화성궤양 환자에 있어서 Latarjet Nerve 영역의 전정부와 체부의 조직학적인 경계

김홍진(Hong Jin Kim),구자일(Ja Ill Koo),심민철(Min Chul Shim),권굉보(Koing Bo Kwun),이수정(Soo Jung Lee),서보양(Bo Yang Suh),최원희(Won Hee Choi),이태숙(Tae Sook Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1

In highly selective vagotomy, one of the main problem is to find out antrum-corpus boundary and which branch of Crows foot must be sectioned in order to obtain a complete vagotomy to reduce incidence of the recurrence. This report was done to investigate the interrelationship between Crow s foot branches of Latarjet nerve and histologic antrum-corpus boundary determined by intraoper- ative biopsies. Studies were done on 22 patients of peptic ulcer who underwent vagotomy and antrectomy at YUH between September, 1987 and June, 1989. The results were as follows 1) The proximal, middle and distal branches were found to be located at a mean distance of 7.6cm (7~9), 6.6cm (6~8cm) and 5.6cm (5~6.cm) from the pylorus respectively. 2) At the level of proximal branch, oxintic mucosa was found in 45.5% and tranzitional mucosa was found in 50%. At the level of middle Branch, oxintic mucosa was found in 22.3% and transitional mucosa was identified in 68.2% to 72.7%, but antral mucosa was not seen. At the level of distal branch, oxintic mucosa was not seen, transitional mucosa was seen in 54.5% and antral mucosa was found in 45.5%. 3) There was no correlation between the distance from the pylorus to each of the terminal branches and the type of mucosa found on the lesser curvature at the level of the nervous branches is given.

태아 긴박증에서 태아 심장박동의 비선형 동력학 및 카오스 분석

김사진(Sa Jin Kim),신종철(Jong Chul Shin),정대영(Dae Young Chung),심영보(Young Bo Sim),이상훈(Sang Hoon Yi),김창이(Chang Yi Kim),김수평(Soo Pyung Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.6

목적 : 태아의 건강을 평가하기 위한 새로운 분석 방법을 개발하기 위함이다. 방법 : 전자식 태아 감시장치를 이용하여, 긴박증 태아에서 발생되는 심박동 신호를 컴퓨터로 받아들여 데이터 전처리 (low pass filtering; LPF)후에 비선형 분석으로 지연시간 (delay time), 매립차원 (embedding dimension), 상관차원 (correlation dimension), Isoangular return map을 통한 mean crossing, information entropy를 구하였고, 태아 긴박증 소견을 보인 신생아 22명의 출생후 제대 혈액 가스값을 산혈증군 5명과 비산혈증군 17명으로 나누어 비선형 카오스 분석 결과와 비교하였다. 결과 : 1. 데이터 전처리를 거친 지연 시간은 15.73±2.47 이었다. 2. FNN 법으로 계산한 매립 차원은 5.00±0.82 이었다. 3. 산혈증군의 상관차원은 1.41±0.20으로 비산혈증군의 상관차원 1.10±0.38 보다 높았으나 통계적 유의성은 없었다. 4. Isoangular return map 의한 mean crossing값은 산혈증군이 28.80±11.34이었고 비산혈증군은 16.65±7.00으로 통계적으로 유의성이 있었다 (P=0.008). 5. Information entropy에 의한 1-D ED 비교에서 산혈증군은 6.32±0.38, 비산혈증군은 6.20±0.28로 통계적인 의의가 없었다. 또한 2-D ED 값의 비교에서는 산혈증군은 10.20±0.34로 비산혈증군의 9.51±0.44보다 통계적으로 의의있게 높았다(P=0.004). 그러나 2-D EP 값 비교에서는 산혈증군은 8.70±0.90, 비산혈증군 9.22±0.74로 통계적으로 유의성이 없었다 (P=0.281). 또한 2-D ED(DI) 값도 산혈증군은 10.64±0.14, 비산혈증군은 10.51±0.18로 통계적으로 유의성이 없었다 (P=0.141). 결론 : 태아 심박동 자료로 컴퓨터를 이용한 비선형 및 카오스 동력학 분석이 실시간으로 태아의 건강상태를 평가할 수 있는 새로운 진단 방법으로 역할을 할 수 있다는 것을 알 수 있었으나, 임상에 적용하기까지는 향후 더 많은 연구를 통하여 이의 진단 기준 확립과 컴퓨터 프로그래밍화하여 실시간 진단 방법이 임상에 적용되어야 할 것으로 생각된다. Objectives: For estimating the antenatal fetal wellbeing to develop new analysis method of fetal heart rate(FHR) with electronic Fetal Heart Rate Monitoring(eFHRM) and computer.Methods: Heart rate signal is received from distressed fetus using eFHRM. It is necessary to carry out low pass filtering as a preprocess for the nonlinear method. Nonlinear parameters are calculated and classified to investigate the relations between these parameters and values of umbilical cord blood gas.Results: By dividing values of the umbilical cord blood gas into 5 fetuses of acidemic group and 17 fetuses of non-acidemic group after 22 neonates who presented fetal distress were born, the following results as compared with nonlinear chaotic analysis result were obtained. 1. Delay time through AMI for acidemic group was 16.80±3.11, and was higher than 15.41±2.27 for non-acidemic group, and is not significant in statistics.2. Embedding Dimension calculated with FNN method was 5.60±2.07 for acidemic group, and 4.71±1.26 for non-acidemic group, and it was not significant statistically.3. Correlation dimension for acidemic group was 1.41±0.20, and was higher than 1.10±0.38 for non-acidemic group, and is not significant in statistics.4. Mean crossing value by isoangular return map was 28.80±11.34 for acidemic group, and 16.65±7.00 for non-acidemic group, and it was significant statistically(P=0.008).5. In comparison of information entropy in 1-D ED, acidemic group was 6.32±0.38 and non-acidemic group was 6.20±0.28 and it was not significant statistically. Also, in comparison of value in 2-D ED, acidemic group was 10.20±0.34. It was higher than non-acidemic group of 9.51±0.43 significantly in statistics(P=0.004). But, in comparison of value in 2-D EP, acidemic group was 8.78±0.86 and non-acidemic group is of 9.22±0.74 and it wasn't significant statistically. And, 2-D ED(DI) value was 10.64±0.14 for acidemic group and 10.51±0.18 for non-acidemic group, and it wasn't significant statistically.Conclusions: By the above result, nonlinear dynamics and chaotic analysis of heart rate data with computer can serve as a new diagnosis method which may estimate the fetal wellbeing with real time. Through further studies for establishment of diagnosis standard and computer programming, real time diagnosis method shall be applied to clinical practice.

CapSG를 이용한 IoT 서비스 접근제어 플랫폼

김진보 ( Jin Bo Kim ),장데레사 ( Deresa Jang ),김미선 ( Mi Sun Kim ),서재현 ( Jae Hyun Seo ) 한국정보처리학회 2015 정보처리학회논문지. 소프트웨어 및 데이터 공학 Vol.4 No.9

사물인터넷(Internet of Things, IoT) 환경의 다양한 프로토콜, 도메인, 애플리케이션 위에서 유연한 서비스 제공을 위한 효율적인 사용자 권한 관리 방법이 필요하다. 본 논문은 IoT 환경의 다양한 서비스에 대한 효율적인 접근제어를 제공하기 위하여 CapSG(Capability Service Gateway)를 이용한 IoT 서비스 플랫폼을 제안하였다. CapSG는 인증과 접근 권한을 포함하는 토큰을 사용하여, 서비스 주체에 대한 인증 및 접근제어를 수행하여 서비스를 제공한다. 또한, 서비스 토큰 관리를 위한 생성, 위임, 폐기, 거절 등의 기능을 제공한다. 본 논문은 각 도메인에 대한 토큰 그룹을 사용함으로써 도메인별 서비스 접근제어가 가능하며, 토큰 그룹 내의 특정 서비스 토큰을 이용한 접근제어 수행도 가능하도록 설계하여 IoT의 다양한 서비스 요구에 대한 접근제어의 유연성과 효율성을 제공한다. There is great need for efficient user rights management method to provide a flexible service on variety protocols, domains, applications of IoT environments. In this paper, we propose a IoT service platform with CapSG to provide efficient access control for IoT various services of the environment. CapSG uses a token including authentication and access rights to perform authentication and access control service entity providing services. In addition, the generated token for service management, delegation, revocation, and provides a function such as denied. Also, it provides functions such as generation, delegation, disposal and rejection for service token management. In this paper, it provides the flexibility and efficiency of the access control for various services require of the IoT because of it is available to access control specific domain service by using the token group for each domain and is designed to access control using specific service token of tokens group.

간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 약제에 의한 간장의 허혈 및 재관류 손상의 방지

김홍진(Hong Jin Kim),심민철(Min Chul Shim),권굉보(Koing Bo Kwun),박동일(Dong Il Park),노진우(Jin Woo Roh) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3

N/A Several drugs known to be vasodilators and/or membrane stabilizers were studied to evaluate whether these would have protective effects against experimental eschemia-reperfusion induced liver injury in rats. The aninmals were divided into six groups-control, treatment with pentoxifylline, aprotinin, FDP, verapamil, and sham operation. Drugs were administered systemically through IVC 5 minutes before induction of ischemia. The hepatic arterial and portal venous blood supply to the left lateral and median lobes of the liver was interrupted with an surgical clip for 90 minutes to induce hepatic ischemia, and after then the clip was removed for reperfusion. The arterial blood SGOT, SGPT, ALP, LDH, and hepatic MDA were measured before and 90 minutes after ischemia, and at the end of 60 minutes reperfusion. The control group showed sharp elevation of the all liver enzymes following both hepatic ischemia and reperfusion. However the treated groups with pentoxifylline, aprotinin, FDP, and verapamil demonstrated significantly lower level of liver enzymes compare with the values of the control group. Verapamil thought to be most effective in protection of liver from ischemia- reperfusion injury. The hepatic MDA l evel decreased during ischemia-reperfusion procedures, and showed no significant difference between control and treatment groups.