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위에 발생한 위장관간질종양의 수술적 치료에서 Computed Tomogrophy Gastrography의 유용성
한동석,이혁준,이민우,김세형,이건욱,양한광,Han, Dong-Seok,Lee, Hyuk-Joon,Lee, Min-Woo,Kim, Se-Hyung,Lee, Kuhn-Uk,Yang, Han-Kwang 대한위암학회 2006 대한위암학회지 Vol.6 No.4
목적 : 위에 발생한 위장관간질종양의 수술적 절제에 있어서, 최근 개발된 3차원 재구성 기술을 이용한 computed tomography (CT) gastrography의 유용성을 알아보고자 본 연구를 시행하였다. 대상 및 방법: 2001년 1월부터 2006년 2월까지 서울대학교병원 외과에서 위장관간질종양으로 수술을 시행받은 환자 중 CT gastrography를 시행하였던 38예를 대상으로 CT상 종양의 크기, 위치, 위식도 접합부위 또는 유문부부터 종양까지의 거리등을 조사하여 내시경, 수술 및 병리학적 소견과 비교하였다. 결과: CT gastrography 및 내시경 소견에서 종양의 종축상 위치는 수술 소견과 전 예에서 일치했으나 횡축상 위치는 CT gastrography 소견의 81.6% (31/38), 내시경 소견의 75.8% (25/33)만이 수술 소견과 일치하였다. 38예증 12예에서 복강경 설상절제술을 시행하였으며 26예에서 개복수술을 시행하였는데, CT gastrography 소견에서 종양의 크기가 5 cm 미만인 경우 42.3% (11/26)에서 복강경 설상절제술이 시행되었고, 5 cm 이상인 경우 8.3%(1/12)에서 복강경 설상절제술을 시행하였다. 종축 위치상 중부 1/3에 위치한 9예 중 8예(88.9%)에서 복강경 설상절제술이 시행된 반면, 상부 1/3이나 하부 1/3에 위치한 경우에는 29예 중 4예(13.8%)에서만 복강경 설상절제술이 시행되었다. 결론: 본 연구 결과 CT gastrography는 수술자에게 정확한 3차원적 정보를 제공함으로써 수술적 치료 방침 결정에 도움을 줄 수 있었다. Purpose: This study was performed to evaluate the usefulness of computed tomography (CT) gastrography in the surgical management of a gastric gastrointestinal stromal tumor (GIST). Materials and Methods: We retrospectively analyzed the clinicopathologic data of 38 patients who had undergone CT gastrography from among patients who had gastric GISTS surgically resected at the Department of Surgery, Seoul National University Hospital, between January 2001 and February 2006. We compared CT gastrography data, including tumor size and location and distance from the gastroesophageal junction or pylorus with endoscopic, surgical and pathologic findings. Results: The longitudinal tumor locations on CT gastrography and endoscopy were identical to the surgical findings. For tumor sizes on CT gastrography of less than 5 cm, we performed 11 (42.3%) laparoscopic wedge resections from among 26 cases. In the 12 cases with tumor sizes of 5 cm or over, only 1 (8.3%) laparoscopic wedge resection was performed. When the tumor was located in the middle third of the stomach, a laparoscopic wedge resection was performed in 88.9% (8/9) of the cases, but when it was located in the upper or lower third, a laparoscopic wedge resection was performed in only 13.8% (4/29) of the cases. Conclusion: Three-dimensional information from CT gastrography allows the surgeon to perform preoperative planning, including accurate localization.
한동석(Dong-Seok Han) 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.1
Surgery plays a key role in gastric cancer treatment without distant metastasis. However, once distant sites are involved, no optimal therapeutic strategy has been established. Because M1 gastric cancer is a heterogeneous disease entity according to the extent and site of metastasis, it is difficult to analyze and interpret the result of study subjected to relative small number of patients. In patients without symptoms, several studies have shown that reductive surgery might have a benefit in terms of survival and quality of life. A randomized controlled trial of reduction surgery plus chemotherapy versus chemotherapy alone for M1 gastric cancer is ongoing (REductive Gastrectomy for Advanced Tumor in Three Asian countries [REGATTA], JCOG0705/KGCA01), and the result would be reported in near future. Currently, as an initial treatment for M1 gastric cancer, chemotherapy is generally used in order to reduce tumor-related symptom and prolong survival. For patients responsive to chemotherapy, some retrospective studies reported that longer survival was observed in resection group after disappearing of distant metastasis. Recently, Japanese group reported that a multimodality treatment consisting of chemotherapy with S-1 and cisplatin followed by gastrectomy with D2+ para-aortic lymph node dissection was found to be promising for metastasis to the 16a1/b2 para-aortic lymph nodes.
한동석 ( Dong Seok Han ),김동기 ( Dong Ki Kim ),이혁준 ( Hyuk Joon Lee ) 한국정맥경장영양학회 2013 한국정맥경장영양학회지 Vol.5 No.2
The kidney is the organ responsible for clearing nitrogenous and metabolic waste from the body as well as for regulating fluid, electrolyte, and acid-base balance in the body. Because of kidney`s important role in the human body, renal insufficiency could exert a significant effect on the nutritional and metabolic status of patients. Renal insufficiency includes a variety of areas of disease. Disease extent can be categorized as acute kidney injury (AKI), chronic kidney disease (CKD), and end-stage renal disease (ESRD) requiring renal replacement therapy (RRT). Most patients with AKI require continuous RRT. Nutritional support in renal insufficiency plays an essential role in improving the survival and quality of life in patients. AKI is a frequent complication affecting many critically ill patients, who are in hypermetabolic state presenting with hyperglycemia, insulin resistance, hypertriglyceridemia and increased protein catabolism. The optimal nutritional management of AKI includes providing adequate macronutrients to correct the underlying conditions and prevent ongoing loss as well as supplementing micronutrients and vitamins during RRT. As a result of the inflammatory mediators, protein-calorie malnutrition may develop in patients with CKD. Uremia also can secondarily worsen protein- calorie malnutrition through the development of anorexia and nausea. The pre-dialysis CKD patients require low-protein diet with caloric supplementation of 35 kcal/kg/day. However, ESRD patients on dialysis should receive 1.2∼1.3 g/kg of protein daily. An appropriate nutrition delivery, tailored to the patient`s clinical presentation, is important to good nutritional care. Energy requirements must be assessed and supplementation of macronutrients and micronutrients based on the disease category and type of RRT must be performed. (JKSPEN 2013;5(2):50-56)
Sobel Edge 기반의 ACB 알고리즘을 적용한 실시간 이미지 회전보정 방법연구
한동석(Dong-Seok Han),정민우(Min-Woo Jeong),김희석(Hi-Seok Kim) 한국정보기술학회 2015 한국정보기술학회논문지 Vol.13 No.6
The latest image processing system does not have only one processor but various processor that works simultaneously. In an optimized memory that includes fast processing speed and high recognition ratio are essential because of recognition ratio is very important for a certain things. In this paper, the proposed ACB (Active Contour Boundary) algorithm can correct rotated image for various real time image recognition system. Basically, for important features of simple expression as an inputted image, SOBEL edge algorithm was used. Then the angle of rotated image can be calculated using ACB, and it can be implemented the ACB using the filtering process within a specific rage. Comparing with the conventional CORDIC algorithm to the proposed ACB algorithm shows the result which is about 17 times much faster that the computed time.