간ㆍ담도ㆍ췌장 수술에서 간동맥의 안전한 처리지침 수립을 위한 연구

양성훈(Sung Hoon Yang),인용후(Yong Hu Yin),장진영(Jin-Young Jang),이승은(Seung Eun Lee),정진욱(Jin Wook Chung),서경석(Kyung-Suk Suh),이건욱(Kuhn Uk Lee),김선회(Sun-Whe Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.2

Purpose: Hepato-pancreatico-biliary (HPB) surgeons often must make decisions regarding hepatic artery (HA) resection while performing major HPB surgery. The purpose of this report was to review and summarize HA resection experience with a focus on vascular preservation during major HPB surgery and to develop a useful algorithm in dealing with these needs. Methods: We reviewed 1,324 cases that had available computed tomographic and angiographic findings and summarized the problematic HA variations encountered in major HPB surgery. In reviewing our series and previous studies, we have created a set of guidelines that enables a pragmatic approach to the unique variations in HA and the risks of cancer invasion. Results: Challenging HA variations during major HPB surgery were found in 25.7% of the cases and included variations of common HA from superior mesenteric artery (SMA), gastroduodenal artery (GDA), aorta, celiaco-mesenteric (CM) trunk or left gastric artery (LGA) (3.70%), the variations of the right HA from SMA, GDA, aorta, celiac axis (CA) including CM trunk or LGA (12.76%), the variations of the left HA from LGA, CA or GDA (4.46%), and the mixed types of the aberrant left medial HA and/or left lateral HA and/or right anterior HA and/or right posterior HA (2.11%). Conclusion: Surgeons should have knowledge of the anatomically variable vasculature of the HA when planning for major HPB surgery. Preoperative imaging studies can aid and should be performed in anticipation of potential HA variations during major HPB surgery.

4개의 칩이 적층된 FBGA 패키지의 휨 현상 및 응력 특성에 관한 연구

김경호,이혁,정진욱,김주형,좌성훈,Kim, Kyoung-Ho,Lee, Hyouk,Jeong, Jin-Wook,Kim, Ju-Hyung,Choa, Sung-Hoon 한국마이크로전자및패키징학회 2012 마이크로전자 및 패키징학회지 Vol.19 No.2

Semiconductor packages are increasingly moving toward miniaturization, lighter and multi-functions for mobile application, which requires highly integrated multi-stack package. To meet the industrial demand, the package and silicon chip become thinner, and ultra-thin packages will show serious reliability problems such as warpage, crack and other failures. These problems are mainly caused by the mismatch of various package materials and geometric dimensions. In this study we perform the numerical analysis of the warpage deformation and thermal stress of 4-layer stacked FBGA package after EMC molding and reflow process, respectively. After EMC molding and reflow process, the package exhibits the different warpage characteristics due to the temperature-dependent material properties. Key material properties which affect the warpage of package are investigated such as the elastic moduli and CTEs of EMC and PCB. It is found that CTE of EMC material is the dominant factor which controls the warpage. The results of RSM optimization of the material properties demonstrate that warpage can be reduced by $28{\mu}m$. As the silicon die becomes thinner, the maximum stress of each die is increased. In particular, the stress of the top die is substantially increased at the outer edge of the die. This stress concentration will lead to the failure of the package. Therefore, proper selection of package material and structural design are essential for the ultra-thin die packages. 최근 모바일 기기에 적용되는 반도체 패키지는 초소형, 초박형 및 다기능을 요구하고 있기 때문에 다양한 실리콘 칩들이 다층으로 수직 적층된 패키지의 개발이 필요하다. 패키지 및 실리콘 칩의 두께가 계속 얇아지면서 휨 현상, 크랙 및 여러 다른 형태의 파괴가 발생될 가능성이 많다. 이러한 문제는 패키지 재료들의 열팽창계수의 차 및 패키지의 구조적인 설계로 인하여 발생된다. 본 연구에서는 4층으로 적층된 FBGA 패키지의 휨 현상 및 응력을 수치해석을 통하여 상온과 리플로우 온도 조건에서 각각 분석하였다. 상온에서 가장 적은 휨을 보여준 경우가 리플로우 공정 조건에서는 오히려 가장 큰 휨을 보여 주고 있다. 본 연구의 물성 조건에서 패키지의 휨에 가장 큰 영향을 미치는 인자는 EMC의 열팽창계수, EMC의 탄성계수, 다이의 두께, PCB의 열팽창계수 순이었다. 휨을 최소화하기 위하여 패키지 재료들의 물성들을 RMS 기법으로 최적화한 결과 패키지의 휨을 약 $28{\mu}m$ 감소시킬 수 있었다. 다이의 두께가 얇아지게 되면 다이의 최대 응력은 증가한다. 특히 최상부에 위치한 다이의 끝 부분에서 응력이 급격히 증가하기 시작한다. 이러한 응력의 급격한 변화 및 응력 집중은 실리콘 다이의 파괴를 유발시킬 가능성이 많다. 따라서 다이의 두께가 얇아질수록 적절한 재료의 선택 및 구조 설계가 중요함을 알 수 있다.

여성노인의 허약에 대한 체력 분별점 제시: 국민체력100 노인기 체력검사항목을 중심으로

박세정 ( Sae Jong Park ),고병구 ( Byoung Goo Ko ),김상훈 ( Jin Wook Chung ),정진욱 ( Sang Hoon Kim ),박수현 ( Soo Hyun Park ),이미현 ( Mi Hyun Lee ),김성호 ( Sung Ho Kim ),박채희 ( Chae Hee Park ),최규환 ( Kyu Hwan Choi ) 한국스포츠정책과학원(구 한국스포츠개발원) 2015 체육과학연구 Vol.26 No.2

본 연구의 목적은 여성노인을 대상으로 허약과 관련된 체력요인을 알아보고 그 체력의 분별점을 제시하는 것이다. 연구대상은 2014년(1차년도) ‘국민체력100 한국인 건강체력 기준개발’ 사업에 참여한 65세 이상 여성노인 444명(72.29±5.29세)으로 하였다. 측정변인으로 신체적 특성, 혈압, 그리고 국민체력100 노인기 체력검사항목을 측정하였으며, 허약노인과 정상노인의 분류는 ‘Kihon Checklist’를 이용하였다. 연구결과, 허약노인은 19.1%(85명)로 나타났으며, 허약노인이 정상노인에 비해 연령, 체중, 그리고 비만지표(체질량지수, 체지방량, 허리둘레)가 유의하게 높은 것으로 나타났다. 허약유무에 따른 체력 비교에서 연령과 체질량지수를 보정한 후에도 허약노인이 정상노인에 비해 상대악력, 의자에앉았다일어서기, 의자에앉아3m표적돌아오기, 8자보행, 2분제자리걷기의 체력수준이 유의하게 낮은 것으로 나타났다. ROC curve를 이용한 각각의 체력 분별점은 상대악력 34.13%, 의자에앉았다일어서기 14회, 의자에앉아3m표적돌아오기 7.09초, 8자보행 30.88초, 2분제자리걷기 93회로 나타났다. 또한 각각의 분별점을 기준으로 체력수준이 낮은 집단은 높은 집단에 비해 허약의 위험(odds ratio)이 연령과 체질량지수를 보정한 후에도 1.86-2.77배 높은 것으로 나타났다. 결론적으로 본 연구에서 제시된 체력의 분별점은 국내 여성노인의 허약예방을 위한 적정체력수준인 것으로 사료되며, 추후 성별 및 연령대별로 세분화된 체력의 분별점 제시를 위한 후속 연구가 이루어져야 한다. Frailty in older adults is related to an increased risk for poor health outcomes including falls, disability, hospitalization and mortality. The purpose of this study was to determine the thresholds of a functional fitness associated with frailty for community-dwelling woman aged 65 or older. In this study, the National Fitness Award(NFA) items for elderly were utilized as the physical function and fitness testing for korean elderly women. The total of 444 community-dwelling woman completed the testings. Frailty status was classified by the Japan LTCI system ‘Kihon Checklist’ in the study. The prevalence of the frailty was 19.1% in the study. The frail elderly were older and showed higher obesity index such as weight, body mass index (BMI), percent body fat and waist circumference than the normal elderly. After adjusting for age and BMI which was related to frailty, fitness testing items were compared depending on frailty. As the result, the frail elderly showed significantly lower fitness levels in grip strength, 30-second chair stand test, timed up and go, figure-of-8 walk around two cones, and 2-minute step test than the normal elderly. When the fitness cut-off values were analyzed using the ROC curve, also, grip strength: 34.13%, 30-second chair stand test: 14 reps, timed up and go: 7.09 seconds, figure-of-8 walk around two cones: 30.88 seconds, and 2-minute step test: 93 reps. In addition, based on the cut-off values of each fitness item, the group with a low fitness level showed a 1.86 to 3.09 higher odds ratio of frailty than the group with a high fitness level, even after age and BMI were adjusted. In conclusion, these findings indicate that the fitness cut-off values in this study are fitness levels for preventing frailty of Korean elderly women and there will be a need for a large-scale study including subdivided fitness cut-off values for each age group and targets elderly men as well.

경동맥 색전술에 초기 반응을 보인 간세포암 환자의 생존율 및 예후인자

박재형,이효석,김정룡,이준성,신경한,우광훈,정진욱,장동경 대한간학회 1998 Clinical and Molecular Hepatology(대한간학회지) Vol.4 No.3

Focal nodular hyperplasia (FNH) is a benig nepithelial tumor of the liver. The etiology of FNH is unknown, but recent evidence suggests that FNH may represent a localized, hyperplastic response to a pre-existing vascular malformat ion. There is a high probability of as sociat edlesions , most commonly hepatic hemangiomas , meningioma, as trocytoma, and arterial dysplasia in various organs . In the present report we describe a FNH with aberrant lymphatics in a 24-year-old woman. In operation field, lymphatics were located on the site of falciform ligament . Histologically, aberrant lymphatics were composed of well vas cularized complex lymphatic channels and the mass were typical FNH. In this case, the role of aberrant lymphatics in the development of FNH was unclear . But as the FNH frequently as sociated with ot her anomalies , we think the aberrant lymphatic as such anomaly that have not been reported. (Korean J Hepa tol 1998;4:278 282)