조기 위암의 최신 치료 방법 : 복강경 원위부 위절제술, Hand-Assisted 복강경 원위부 위절제술과 소개복 원위부 위절제술의 비교

윤기영,이상호,Yoon, Ki-Young,Gagner, Michel,Lee, Sang-Ho 대한위암학회 2004 대한위암학회지 Vol.4 No.2

Recently detection of early gastric cancer (EGC) has been increasing and the treatment strategies for gastric cancer have been changing. The purpose of this study was to compare clinical outcomes between laparoscopically assisted (LADG) and hand-assisted laparoscopic gastrectomy (HALDG) and open distal gastrectomy for early gastric cancer. This review is directed toward providing gastric surgeons with recent advances in the treatment of EGC. We investigated the English language literature for the past 12 years through computer searches which focused on : 1) Patient demographics, 2) Operation time, 3) Intra-operative blood loss, 4) Depth of invasion, 5) CBC, 6)Weight loss, 7) Analgesic requirement, 8)Time NPO, 9) Length of hospital stay, 10) Tumor stage, 11) Lymph node (LN) dissection, 12) Position of LN resected, 13) Complications. Improved operative techniques and surgical instrumentation have facilitated the development of minimally invasive gastric cancer surgery. The short-term benefits of laparoscopic gastrectomy included less surgical trauma, less pain, rapid return of gastrointestinal function, and shorter hospital stay, with no change in operative outcome. Laparoscopic gastrectomy was better accepted by the patients as a good procedure and promptly brought the patients back to their previous lifestyle and activities of daily living. But the advantages of HALDG for gastric cancer, extended lymph node dissection and intracorporeal anastomosis are feasible and easier with the presence of the internal hand. The hand-assisted laparoscopic (HALDG) method reported the best results in lymph node dissection.This method is an alternative to total laparoscopic radical gastrectomy. LADG and HALDG, when compared with conventional open gastrectomy, have several advantages. When performed by a skilled surgeon, LADG and HALDG are safe and useful techniques for patients with early-stage gastric cancer. Their appropriateness for gastric cancer surgery require further study.

위 절제술 후 발생한 위 폴립의 임상 병리학적 특징

윤기영,조성진,김정훈,김영식,이상호,Yoon, Ki-Young,Cho, Sung-Jin,Kim, Jeong-Hon,Kim, Young-Sik,Lee, Sang-Ho 대한위암학회 2005 대한위암학회지 Vol.5 No.3

목적: 위폴립은 위장에 발생하는 흔한 양성 신생물로서, 증식폴립과 샘종폴립으로 크게 나눈다. 대개의 위폴립은 증식폴립이며 아직 정확한 병인은 밝혀져 있지 않다. 샘종폴립의 경우 보통 장화생 현상을 동반한 미성숙 상피세포로 변화할 수 있어, 악성 변화를 나타낼 수 있는 것으로 알려져 있다. 따라서 샘종폴립에 비해 증식폴립에서는 악성으로 잘 이행하지 않는다고 하는, 지금까지 알려진 위폴립의 지식을 바탕으로 하여 저자들은 위절제술 후 생긴 위 폴립 병변의 특성을 알아보고자 하였다. 대상 및 방법: 1995년 1월부터 2004년 1월까지 위암으로 위절제술을 받은 환자 중 6개월 또는 1년을 단위로 하여 내시경 경과관찰을 한 환자의 잔위에서 생긴 위 폴립을 병리조직 학적 분류와 빈도, 내시경적 크기와 Yamada형 소견, 수술 방법에 따른 차이를 보이는지를 비교 관찰하였다. 결과: 전체 대상 환자는 138명, 정상 위에서 발생한 폴립은 115예, 위절제술 후에 발생한 폴립은 23예였다. 정상 위에서의 폴립의 발생 부위를 보면 전정부에서의 발생이 가장 많았으나, 위절제술 후에는 수술 후 문합부위에서 가장 높은 빈도를 보였다. 정상 위에서의 폴립의 조직학적 분류는 증식폴립 86예(75%), 샘종폴립 24예(21%), 염증폴립 4예(3%), 장피 화생 1예(0.8%)의 발생빈도를 보였다. 위절제술 후의 폴립의 조직학적 분류는 위십이지장 문합술 후 증식폴립 3예(18%), 샘종폴립 1예(6%), 염증폴립 13예(76%)였고 위공장 문합술 후 증식폴립 3예(50%), 샘종폴립 1예(17%), 염증폴립 2예(23%)였다. 위절제 수술 후 폴립의 크기는 정상 위의 폴립의 크기보다 작은 양상을 보였다. 정상 위에서 폴립의 Yamada 형태의 분류는 위절제 수술 후에는 I, IV형이 정상 위의 폴립에 비하여 적은 빈도로 생기는 양상을 보였다. 결론: 위절제 수술 후의 폴립은 수술 문합부에서의 발생빈도가 높았고, 주로 염증폴립 이 대부분을 차지하였으며, 자주 내시경 관찰을 하는 이유로 정상 위에서 보다 일찍 발견되어 크기는 작았으며, 육안적으로 폴립의 Yamada 형태의 분류는 II, III의 형태를 띠고 있었다. Background: Gastric polyps encompass a wide variety of lesions that most commonly arise from the gastric epithelium. However, coincidental gastric carcinomas have rarely been reported, being found in $1.5{\sim}2.1%$ of patients with hyperplastic polyps. The sizes and the pathologies of polyps seem to be important in the application of treatment. Therefore, it is necessary to classily gastric polypoid lesions after a gastrectomy. Materials and Methods: During a follow-up endoscopy study, 23 patients were found to have developed gastric polyps after a gastrectomy. Most of those polyps were removed by using an endoscopic polypectomy. We performed clinical and pathologic evaluations of the gastric polyps in the remainding in the stomach after a gastrectomy, Results: The mean age of the patients was 64.5 years old with the incidence of polyps remainding in the stomach after a gastrectomy increasing after the first year following the gastrectomy. The sizes of the polyps ranged from 0.3cm to 3.5cm in diameter and the numbers of polyps below 1.0cm were 19 (82.6%). The anastomotic site was the most prevalent place 10 (43.2%), followed by the cardia 6 (26.0%) and the body 4 (17.3%). Among 23 gastric polypoid lesions Yamada types of gastric polyps in the remainding in the stomach were as follows: 1 case in type I, 12 cases in type II, 9 cases in type III, 1 case in type IV. The pathologic diagnoses of the polyps were hyperplastic polyps in 6 cases, tubular adenomas in 2 cases and inflammatory polyps in 15 cases. Conclusion: Endoscopic polypectomy is believed to be important in assessing the precise diagnosis of gastric polyps remainding in the stomach. In this study, hyperplastic polyps were found to have no malignant potential, despite their sizes. As a result aggressive biopsy with a polypectomy of gastric polyp afier gastrectomy is recommended and frequent follow-up be performed.

유주비장

윤기영(Ki-Young Yoon),천홍진(Hong-Jin Chun),최경현(Kyung-Hyun Choi) 대한외과학회 1995 Annals of Surgical Treatment and Research Vol.48 No.2

차량용 블루투스 스피커를 위한 EMC를 고려한 4층 PCB 설계

윤기영(Ki-Young Yoon),김부균(Boo-Gyoun Kim),이성수(Seongsoo Lee) 한국전기전자학회 2021 전기전자학회논문지 Vol.25 No.4

본 논문에서는 전자파 방출을 줄이기 위해 필터나 디커플링 캐패시터를 사용하는 대신에 PCB 내의 칩 배치, 배선 모양 등을 변경하여 위험신호의 배선 길이와 귀환경로를 짧게 하는 EMC 고려 PCB 설계 기법을 제안하였다. 제안하는 기법에서는 PCB 상의 여러 가지 신호에 대해 신호속도를 계산하고, 신호속도가 가장 높은 위험신호에 대해 선로를 가능한 짧게 하도록 가장 먼저 칩의 위치를 선정하고 배선도 가장 먼저 수행해야 한다. 또 위험신호의 귀환경로에 불연속이 발생하지 않도록 설계하며 귀환경로의 기준이 되는 전원판과 접지판이 분할되어 있지 않도록 한다. CISPR-32, CISPR-25 등의 전자파 적합성 시험을 통과하지 못했던 차량용 블루투스 지향성 스피커에 이 기법을 적용하여 PCB를 재설계한 후 EMC 측정을 수행하였더니 해당 전자파 적합성 시험을 수월하게 통과할 수 있었다. 제안하는 기법은 EMC 특성이 중요한 전자기기에 유용하게 쓰일 수 있다. This paper proposes an EMC-aware PCB design method to reduce electromagnetic emission, where trace length and teturn path of critical signal are shortened by changing chip location and trace layout on the PCB, while additional filters or decoupling capacitors are not required. In the proposed method, signal velocity is calculated for various signals on the PCB. Critical signal with the fastest signal velocity is determined and its return path is shortened as much as possible by placing chip location and trace routing first. Return path of critical signal should be carefully designed not to have discontinuity. Power plane and ground plane should be carefully designed not to be divided, since these planes are the reference of return path. The proposed method was applied to automotive directional Bluetooth speaker which failed to pass CISPR 32 and CISPR 25 EMC tests. Its PCB was redesigned based on the proposed method and it easily passed the EMC tests. The proposed method is useful to EMC-sensitive electronic equipments.

‘유치원 교육활동 지도자료’ 통일교육내용 분석

윤기영(Yoon Ki-young) 한국열린유아교육학회 2006 열린유아교육연구 Vol.11 No.6

개정되는 현행 6차 유치원 교육과정 및 지도자료 제작에 도움을 주고자 ‘유치원 교육활동 지도자료’에 제시된 교육활동 중에서 유아통일교육 내용체계를 기준으로 통일교육 관련활동을 추출하여 교육목표 및 내용별, 생활주제별, 수준별로 그 활동을 분류, 분석하였다. 그 결과, 493개의 활동 중 명시된 교육목표 관점에서 보면 한 활동만이 제시되어 있고, 내용체계에 비추어보면 다섯 번째 목표에 편중된 470개의 활동이 각 생활주제에 고루 분포되어 있었지만, 첫째 목표에 관련된 23개의 활동은 2개 생활주제에 편중되어 있었다. 따라서 현재 유치원에서 사용되고 있는 ‘유치원 교육활동 지도자료’는 유아를 위한 직접적 통일교육 활동 자료로 활용하기에는 미흡하고, 일부 목표는 연계 체제만 적절하게 정립된다면 생활주제별 교육활동에서 간접적으로 다루어질 수 있다고 결론지을 수 있다. The purpose of this study was to know the proportion of reunification education activities presented in the National Standard Guideline for the Kindergarten Curriculumpublished by Ministry of Education & Human Resources Development, and to recommend ideas in order to update the national standard kindergarten curriculum and the "National Standard Guideline for the Kindergarten Curriculum". To achieve this purpose, an analysis of the literaturewas conducted, and reunification education was researched. The results of this study are as follows; First, 493 activities are related to reunification education for young children in the National Standard Guideline for the Kindergarten Curriculum. Second, 470 activities related with fifth object shown in the NationalStandard Guideline for the Kindergarten Curriculumare equally distributed according to educational themes. Third, 23 activities related with the first object shown in the National Standard Guideline for the Kindergarten Curriculum are not equally distributed according to educational themes. Fourth, only one activity is fitted to the national standard kindergarten curriculum. Therefore we must carefully consider that the categories of the reunification education fitness when updating the national standard kindergarten curriculum and National Standard Guideline for the Kindergarten Curriculum. To be more useful, the guidebook should change edition styles and some content.

빙쇄굴 모델에 의한 극지 해저 파이프라인의 매설깊이 산정

윤기영(Ki-Young Yoon),최경식(Kyung-Sik Choi) 한국해양공학회 1997 韓國海洋工學會誌 Vol.11 No.2

The interaction of grounded-ice features with underlying seabed is one of the major considerations in the design of Arctic pipeline systems. Regarding the development of offshore gas fields near Sakhalin Island, which is an ice-infested area, in this paper an ice scour model to determine the burial depth of Arctic offshore pipeline is studied. Using a simplified ice-seabed interaction process, ice scour depth is easily estimated. This nonlinear numerical model can simulate the scouring process for various environmental parameters such as ice mass, incoming velocity, soil strength. This study also deals with interacting forces during the scouring process in sloping seabed conditions and discusses the ice loads that are transmitted through the seabed soil.

박테리아에 대한 나노 입자의 항균 특성 평가

윤기영(Ki-Young Yoon),이승재(Seung Jae Lee),이정은(Jung-Eun Lee),배귀남(Gwi-Nam Bae),지준호(Jun-Ho Ji),황정호(Jungho Hwang),정효일(Hyo-Il Jung) 한국실내환경학회 2005 한국실내환경학회지 Vol.2 No.1

The antimicrobial activity of metallic nanoparticles against bacteria was investigated. Silver, copper, and titania nanoparticles were tested. The bacteria species E. coli and B. subtilis were selected as models for Gram-negative and Gram-positive bacteria, respectively. Bacteriological tests were performed in Luria-Bertani (LB) medium or Nutrient (NT) medium on solid agar plates containing different concentrations of nanoparticles in the range of 0 to 150 ㎍/㎖. Silver and copper nanoparticles were shown to be an effective bactericide. However, titania nanoparticles were found to be ineffective as an antimicrobial agent. It appears that E. coli cells are more sensitive to the copper nanoparticles than to silver nanoparticles and B. subtilis cells have similar sensitivity against both copper and silver nanoparticles.

근위부 위암과 원위부 위암의 비교 연구

윤기영(Ki Young Yoon),이상호(Sang Ho Lee),최경현(Kyung Hyun Choi) 대한소화기학회 2002 대한소화기학회지 Vol.40 No.4

Background/Aims: Proximal gastric cancer (PGC) has been known to have a poor prognosis compared to distal gastric cancer (DGC), but the reasons have not been fully explained yet. We compared the clinical characteristics, prognosis, and outcome of PGC and DGC. Methods: The 1187 cases were divided into the PGC group and the DGC group based on the location of primary tumor. We reviewed reterospectively the medical records of the patients who underwent gastrectomy at Kosin Medical Center between 1989 and 1998. The PGC group included 156 patients and the DGC group included 1,031 patients. Results: The PGC group showed more advanced tumor T stages (p<0.05), and more lymph-node metastasis (p<0.05). The resectability was 83.5% in PGC group and 88.4% in DGC group, but these were not statistically different (p>0.05). In the tumor stage I, II, IV, the two groups showed no statistical difference in 5-year survival rates. However, in stage III, the overall 5-year survival rate was higher in the DGC group. Conclusions: In survival of PGC group and DGC group, there was no statistical difference between tumor stage I, II, and IV. Patients with PGC were diagnosed at more advanced stage, which might be the reason for the poor prognosis. Therefore, if early diagnosis can be made and adequate therapy is performed, the prognosis of PGC will be improved. (Korean J Gastroenterol 2002;40:241-246)

[기술자료] 상용 항균 필터 여재의 바이오에어로졸 저감 특성

윤기영(Ki Young Yoon)⋅김양선(Yang Seon Kim)⋅박재홍(Jae Hong Park)⋅황정호(Jungho Hwang) 한국실내환경학회 2008 한국실내환경학회지 Vol.5 No.4

Characteristics of commercial antimicrobial filter media for bioaerosol removal were estimated. A chitoasn/ medium filter, a catechin/HEPA filter, a silver/HEPA filter, a copper/pre filter, a electret cabin filter and a non-electret cabin filter were used for estimation. Filtration efficiency and antimicrobial efficiency was tested using Escherichia coli and Staphylococcus epidermidis. The electret cabin filter and the chitosan/medium filter showed the highest filtration and antimicrobial efficiency, respectively.

소심낭(Bovine Pericardial Patch)과 인공 풀(Indermil<SUP>®</SUP>)을 사용한 복강내의 수술이 가능한가에 대한 실험적 연구

윤기영(Ki Young Yoon),이충한(Chung Han Lee),Michel Gagner 대한외과학회 2005 Annals of Surgical Treatment and Research(ASRT) Vol.69 No.3