위 아전절제술 후 소화관 재건 방법에 따른 영양상태와 삶의 질의 비교

유완식,정호영,Yu, Wan-Sik,Chung, Ho-Young 대한위암학회 2002 대한위암학회지 Vol.2 No.2

Purpose: We compared the quality of life (QOL) and nutritional outcomes following both Billroth I (BI) and Billroth II (BII) reconstructions after a subtotal gastrectomy in order to identify which reconstruction would produce a better QOL and nutritional outcomes and to provide better follow-up management. Materials and Methods: We studied 273 patients without evidence of recurrent disease following a curative distal subtotal gastrectomy for gastric cancer. Among them, 135 underwent a BI reconstruction and 138 a BII reconstruction. The nutritional status was assessed by using levels of hemoglobin, serum albumin, iron, and vitamin B12 and by calculating the relative body weight, the body mass index, and the percentage of body fat. The QOL was measured by using the Troidl score and by treatment-specific symptoms based on the criteria, somewhat modified by the authors, of Korenaga and others. Results: There was no significant difference in QOL between the BI and the BII groups. More than half of the patients revealed anemia, regardless of the type of reconstruction. The serum vitamin $B_{12}$ level of the BII group was lower than that of the BI group. The BII group showed a tendency toward lower hemoglobin levels and serum iron concentrations than the BI group did. Conclusions: The quality of life was not impaired in most patients after either a BI or a BII reconstruction. However, both resulted in iron deficiency anemia, although the incidence was higher after a BII reconstruction. The patient's serum iron and vitamin B12 should be measured periodically and these must be administered if the measurements reveal a below normal range.

장막 침윤이 있는 위암환자에서 수술 후 조기 복강 내 화학요법의 예후인자로서의 가치

유완식,김태봉,Yu, Wan-Sik,Kim, Tae-Bong 대한위암학회 2004 대한위암학회지 Vol.4 No.2

Purpose: There is no established treatment-related prognostic factor for gastric cancer except a curative tumor resection. This study was done to clarify the prognostic value of early postoperative intraperitoneal chemotherapy (EPIC) in patients with serosa-positive gastric cancer. Materials and Methods: We analyzed retrospectively the postoperative survival data of 209 patients with serosapositive gastric cancer treated by surgery and chemotherapy. The survival period for patients was calculated from the date of resection until cancer-related death or the last date of follow-up; Kaplan-Meier survival curves were plotted and compared by using the log-rank test. A multivariate analysis was done by using the Cox proportional hazards model. Results: Statistically significant differences in survival rates were noted based on gender, depth of invasion, lymph node metastasis, distant metastasis, stage, location of tumor, macroscopic type, extent of gastric resection, curability of surgery, and adjuvant chemotherapy. Five-year survival rates of patients who received EPIC and systemic chemotherapy were 49 per cent and 25 per cent, respectively (P=0.009). A multivariate analysis revealed that invasion of an adjacent organ, lymph node metastasis, total gastrectomy, and palliative surgery were poor independent prognostic factors. Also, EPIC had a marginal prognostic value (P=0.056). Conclusion: Perioperative intraperitoneal chemotherapy can possibly be one of the independent prognostic indicators in case of serosa-positive gastric cancer. (J Korean Gastric Cancer Assoc 2004;4:89-94)

수치예보자료를 이용한 강우 및 홍수 예측 적용성 평가

유완식,윤성심,황의호,채효석,정관수,Yu, Wan-Sik,Yun, Seong-Sim,Hwang, Ui-Ho,Chae, Hyo-Seok,Jeong, Gwan-Su 한국수자원학회 2019 물과 미래(한국수자원학회지) Vol.52 No.2

절제 가능한 위암 환자에서 수술 전 혈청 알파태아단백치 측정의 의의

유완식,김태봉,Yu, Wan-Sik,Kim, Tae-Bong 대한위암학회 2003 대한위암학회지 Vol.3 No.1

Purpose: Alpha-fetoprotein (AFP) is widely accepted as a useful tumor marker for diagnosis of hepatocellular carcinomas. On rare occasions, however, an abnormal elevation of serum AFP also has been reported in an adenocarcinoma of the gastrointestinal tract. We evaluated the influence of preoperative abnormal elevation of serum AFP (AFP positivity) on the prognosis of resectable gastric cancers. Materials and Methods: 812 gastric cancer patients, who were investigated for serum AFP before their operations and who underwent gastric resections with D2 or more extended lymph node dissection, were enrolled in the study. The survival rates were calculated by using the Kaplan-Meier method and were compared by using the log-rank test. A multivariate analysis was performed using the Cox proportional hazards model. Results: Fifty patients ($6.2\%$) were AFP positive (10.1. 4322.6 ng/ml). The survival rate of the AFP positive group was significantly lower than that of the AFP negative group ( $46.6\%\;vs.\;67.0\%$; P=0.0002). The depth of tumor invasion, the degree of regional lymph node metastasis, distant metastases, the TNM stage, the gross type, differentiation, the extent of gastric resection, and the curability of the surgery also significantly influenced survival. Multivariate analysis revealed that the depth of tumor invasion, the degree of regional lymph node metastasis, the curability of the surgery, and AFP positivity were independent prognostic indicators. Conclusion: Preoperative serum AFP can be used as an independent prognostic factor of resectable gastric cancer.

若年者 胃癌 21例의 檢討

兪完植(Wan-Sik Yu),李煐夏(Young-Ha Lee),黃一愚(Il-Woo Whang) 대한외과학회 1980 Annals of Surgical Treatment and Research Vol.22 No.6

성인 서혜부탈장에서 Shouldice 복원술

유완식(Wan-Sik Yu),이영하(Young-Ha Lee),황일우(Il-Woo Whang) 대한외과학회 1986 Annals of Surgical Treatment and Research Vol.30 No.5

입ㆍ출력 관계에서 언어적 퍼지모델의 추출

유완식(Wan-Sik Yu),김성락(Sung-Rak Kim),김종성(Jong-Sung Kim),변증남(Zeungnam Bien),박동조(Dong-Jo Park) 한국지능시스템학회 1992 한국지능시스템학회논문지 Vol.2 No.3

체력단련(體力鍛練)이 심전도파고(心電圖波高)와 QRS벡타에 미치는 효과(效果)

유완식(Yu, Wan-Sik),황수관(Hwang, Soo-Kwan),김형진(Kim, Hyeong-Jin),주영은(Choo, Young-Eun) 대한생리학회 1984 대한생리학회지 Vol.18 No.1

장기간(長期間) 체력단련(體力鍛鍊)이 심전도파고(心電圖波高) 및 심전도(心電圖) vector에 미치는 효과(效果)를 구명(究明)하고자 10명(名)의 운동선수군(運動選手群)과 13명(名)의 비운동선수군(非運動選手群)에서 rebounder운동전후(運動前後)의 심전도파고(心電圖波高)와 QRS vector의 길이를 측정(測定)하여 분절(分折)한 결과(結果)는 다음과 같다. 심전도파고(心電圖波高)에서 R파고(波高)는 선수군(選手群)이 23.38±1.14 mm로서 비선수군(非選手群)의 17.91±2.00 mm에 비(比)해 유의(有意)하게 높았고, 운동후(運動後)에도 선수군(選手群)이 계속(繼續) 유의(有意)하게 높았다. S파고(波高)는 양군(兩群) 모두 운동후(運動後)는 안정시(安靜時)에 비(比)해 유의(有意)하게 높았으며, T파고(波高)는 운동후(運動後) 감소(減少)하였다. P파고(波高)는 양군(兩群) 모두 운동후(運動後) 증가(增加)하였으며 선수군(選手群)이 다소 낮았다. PQ분절(分節)의 파고(波高)는 선수군(選手群)은 0인데 비(比)해 비선수군(非選手群)은 negative를 나타냈으며 운동후(運動後)에 유의(有意)하게 감소(減少)하였다. J점(點)은 양군(兩群) 모두 안정시(安靜時) positive에서 운동후(運動後) 유의(有意)하게 감소(減少)하여 negative를 나타냈고, J+0.08초(秒)도 운동후(運動後) 양군(兩群) 모두 감소(減少)하였으며 선수군(選手群)이 다소 높았다. 그러므로 ST분절(分節)은 운동후(運動後) 감소(減少)함을 알 수 있다. Rv₅와 Sv₁의 합(合)은 선수군(選手群)이 38.74±2.71 mm로서 비선수군(非選手群)의 32.28±2.90 mm에 비(比)해 높았으며 운동후(運動後)에도 선수군(選手群)이 유의(有意)하게 높았다. QRS vector 각도(角度)에서 Frontal plane에서 선수군(選手群)이 62.7±7.36˚로서 비선수군(非選手群)과 별(別) 차이(差異)가 없었고, horizontalplane에서는 선수군(選手群)이 -23.5±7.2˚로서 비선수군(非選手群)의 -38.8±8.2˚에 비(比)해 유의(有意)하게 높았으며 운동후(運動後) 양군(兩群) 모두 유의(有意)하게 높았다. QRS vector 길이에서 Frontal plane에서 선수군(選手群)이 13.86±1.44 mm로서 비선수군(非選手群)의 9.62±0.97 mm에 비(比)해 유의(有意)하게 높았으며 운동후(運動後)에도 유의(有意)하게 높았다. Horizontal plane에서도 선수군(選手群)이 19.82±2.10 mm로서 비선수군(非選手群)의 16.90±1.39 mm에 비(比)해 유의(有意)하게 높았고 운동후(運動後)에도 선수군(選手群)이 유의(有意)하게 높았다. 이상(以上)을 종합(綜合)해 보면 선수군(選手群)의 R파고(波高)가 비선수군(非選手群)에 비(比)해 운동후(運動後) 계속(繼續) 유의(有意)하게 높았고, Rv₅와 Sv₁파고(波高)의 합(合)이 38.74mm정도(程度)로 좌심실(左心室)이 비대(肥大)함을 알 수 있으며, 선수군(選手群)의 PQ분절파고(分節波高)와 ST분절(分節) 파고(波高)가 비선수군(非選手群)에 비(比)해 높고 운동후(運動後)에 양군(兩群) 모두 감소(減少)한 점(點)은 주목(注目)할만한 사실(事實)이며, 특(特)히 선수군(選手群)의 QRS vector의 길이가 모두 비선수군(非選手群)에 비(比)해 유의(有意)하게 긴점등(點等)으로 좌심실기능(左心室機能)이 우수(優秀)한 스포츠심장(心臟)임을 알 수 있으며, 선수군(選手群)과 비선수군(非選手群)을 평가(評價)할 수 있는 중요(重要)한 지표(指標)가 될 것으로 사료(思料)되는 바이다. In an effort to elucidate the effect of physical training on the electrocardiographic amplitudes, QRS vector, axis and QRS vector amplitude, electrocardiograms were recorded before and 1, 5 and 10 minutes after 3 minute rebounder exercise in 23 healthy male students aged between 18 and 21 years in two groups of athletes and non-athletes. ECG amplitudes were measured from lead I, V₁ and V₅ and axis and amplitudes of QRS vectors were measured from lead I and III in frontal plane, from lead V₂ and lead V₆ in horizontal plane. The results obtained are summarized as follows. ECG amplitudes: The R wave amplitude was 23.38±1.14 mm in athletes which was higher than 17.91±2.00 mm in non-athletes. After exercise, the difference in two groups remained significant throughout the recovery period. The S wave amplitude was increased significantly, and the T wave amplitude was decreased in both groups after exercise. The P wave amplitude was increased in both groups after exercise, and it was lower in athletes than in non-athletes. The PQ segment amplitude was zero in athletes but negative in non-athletes than in the resting state. The J point amplitude was positive in resting state and was negative after exercise in both groups. J+0.08 sec point amplitude was also lowered after exercise, and it was higher in athletes than in non-athletes. Therefore the whole ST segment was proved to be decreased after exercise. The summated amplitude of R in V₅ plus S in V₁ was 38.74±2.71 mm in athletes which was higher than 32.82±2.90 mm in non-athletes. After exercise, it was also significantly higher in athletes than in non-athletes. Axis of QRS vector: In frontal plane, axis of QRS vector was 62.7±7.36˚ in athletes, it showed no significant difference between the two groups. In horizontal plane, axis of QRS vector was -23.5±7.2˚ in athletes which was significantly higher than -38.8±8.2˚ in non-athletes. After exercise, it was significantly higher than the resting state in both groups. Amplitude of QRS vector : In frontal plane, amplitude of QRS vector was 13.86±1.44 mm in athletes which was significantly higher than 9.62±0.97 mm in non-athletes. After exercise, it was also significantly higher in athletes than in non-athletes. In horizontal plane, amplitude of QRS vector was 19.82±2.10 mm in athletes which was significantly higher than 16.90±1.39 mm in non-athletes. After exercise, it was also significantly higher in athletes than in non-athletes. From the above, these results indicate that R wave amplitude in athletes was significantly higher than in non-athletes before and after exercise, and that the summated amplitude of R in V₅ plus S in V₁ in athletes was also 38.74±2.71 mm suggesting a left ventricular hypertrophy We should note that the PQ segment and ST segment amplitude were higher in athletes than in non-athletes, and they were decreased with exercise in both groups. In particular, the fact that amplitudes of QRS vector in frontal plane or in horizontal plane were significantly greater in athletes than in non-athletes may be an index in evaluating athletes.

유역발전 시나리오 영향에 따른 캄보디아 톤레삽 지역의 수문학적 평가

유완식(Yu, Wan Sik),김연수(Kim, Yeon Su),임소망(Lim, So Mang),황의호(Hwang, Eui Ho),채효석(Chae, Hyo Sok) 대한토목학회 2018 대한토목학회 학술대회 Vol.2018 No.10

수치예보의 공간예측 불확실성을 고려한 강우 앙상블 추정 및 홍수 예측

유완식(Yu Wan sik),최미경(Choi Mi kyoung),정안철(Jeong An chul),문혜진(Moon Hye jin),정관수(Jung Kwan sue) 한국방재학회 2017 한국방재학회논문집 Vol.17 No.5

본 연구에서는 일본 기상청에서 제공하고 있는 중규모모델(MSM)의 수치예보자료를 이용하여 태풍 및 정체전선 등 3개의 강우사상에 대해 강우 및 홍수 예측 정확도를 평가하였다. 또한 수치예보자료의 공간이동을 통해 생성된 앙상블 강우분포를 이용하여 공간예측 변위를 평가하였다. 그 결과, 태풍과 같은 광역적 범위에 대한 예측에 대해서는 높은 정확도를 나타냈으나, 정체전선과 같이 국지적으로 발생하는 강우사상에 대해서는 공간예측의 오차가 많이 발생하였다. 앙상블 강우 및 홍수예측결과 전체적으로 관측값의 패턴과 유사한 예측결과를 보였으며, 과소예측되는 구간에 대해서는 앙상블 범위가 관측값을 포함하는 결과를 나타냈다. 이를 통해 수치예보의 공간이동기법을 이용한 앙상블 강우 및 홍수예측 적용 가능성을 확인할 수 있었다. This study evaluated the accuracy of rainfall and flood forecasts with three rainfall events such as typhoon and stationary front by using MSM provided by Janpan Meteorology Agency. In addition, prediction misplacement was estimated using ensemble rainfall distribution generated by spatial shift of original MSM rainfall field. As a result, the wide-area prediction such as typhoon event showed high forecast accuracy, and the local-area prediction such as stationary front event has a limitation to quantitative precipitation forecast (QPF) due to spatial prediction error. The ensemble rainfall and flood forecasts showed similar pattern to the observed value, and the forecast accuracy was improved in the under-predicted area because the ensemble range included the observed value. From these results, it could confirm the applicability of ensemble rainfall and flood forecasts by using spatial shift of numerical weather prediction.