Endoscopic submucosal tunnel dissection salvage technique for ulcerative early gastric cancer.

Choi, Hyuk Soon,Chun, Hoon Jai,Seo, Min Ho,Kim, Eun Sun,Keum, Bora,Seo, Yeon Seok,Jeen, Yoon Tae,Lee, Hong Sik,Um, Soon Ho,Kim, Chang Duck,Ryu, Ho Sang WJG Press 2014 WORLD JOURNAL OF GASTROENTEROLOGY Vol.20 No.27

<P>Endoscopic submucosal dissection is an effective treatment modality for early gastric cancer (EGC), though the submucosal fibrosis found in ulcerative EGC is an obstacle for successful treatment. This report presents two cases of ulcerative EGC in two males, 73- and 80-year-old, with severe fibrosis. As endoscopic ultrasonography suggested that the EGCs had invaded the submucosal layer, the endoscopic submucosal tunnel dissection salvage technique was utilized for complete resection of the lesions. Although surgical gastrectomy was originally scheduled, the two patients had severe coronary heart disease, and surgeries were refused because of the risks associated with their heart conditions. The endoscopic submucosal tunnel dissection salvage technique procedures described in these cases were performed under conscious sedation, and were completed within 30 min. The complete en bloc resection of EGC using endoscopic submucosal tunnel dissection salvage technique was possible with a free resection margin, and no other complications were noted during the procedure. This is the first known report concerning the use of the endoscopic submucosal tunnel dissection salvage technique salvage technique for treatment of ulcerative EGC. We demonstrate that endoscopic submucosal tunnel dissection salvage technique it is a feasible method showing several advantages over endoscopic submucosal dissection for cases of EGC with fibrosis. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.</P>

선인장 양심실 보조장치의 설계 및 임상적용을 위한 평가

민병구,박찬영,최재순,이혁수,황창모,김삼성,윤걸중,김종원,선경,이경갑,정종태,김원곤 제주대학교 인공심장이식연구소 2001 인공심장 연구 Vol.2 No.1

현재 개발되고 있는 맥동형 이식형 인공심장은 완전이식형 인공심장과 좌심실보조장치 뿐이다. 좌심실보조장치를 장착한 환자의 10~15%가 우심실의 보조를 필요로하고 완전이식형 인공심장의 장착을 위해서는 자연심장을 제거해야하는 상황에서 이식형 양심실보조장치에 대한 필요성이 대두되고 있다. 본 연구진은 완전이식형 인공심장으로 개발된 한국형 인공심장을 개선하여 양심 실 보조장치를 개발하였다. 양심실보조장치는 이동형 작동기식 미케니즘을 이용하고 있으며 에너지 변환장치와 감속기로 구성된 작동기와 혈액주머니, 그리고 내장형 제어기로 구성되어 있다. 선인장 펌프로 명명된 KAH350은 캐뉼라의 연결을 위한 커넥터를 포함하여 길이 177mm, 폭 164mm, 높이 67 이고 무게 780g이며 최대 심박출량은 5L/min 이다. 양심실보조장치로 개발된 선인장펌프는 좌심실보조장치로도 응용이 가능하다. 이식적합성과 생체적합성을 평가하기 위하여 좌심실보조장치로 5회, 양싱실보조장치로 6회의 동물실험을 수행하였다. 각각 최장 28일간 생존하였으며 11회의 동물실험중 장치의 결함에 의한 것이 3회 있었는데 이들은 모두 전자장치의 결함과 방수처리문제였다. 현재 이식적합성과 일박출량을 향상시킨 KAH400모델이 개발중이다. The types of pulsatile implantable artificial hearts that are on the way of development and have been developed are totally implantable artificial heart and implantable left ventricular assist device (LVAD). Approximately 10% to 15% of all patients Implanted with wearable VADs have required right heart support with another device. And it is reluctant to patient who should remove his or her own heart to be implanted with total artificial heart. These situations drive the development of implantable bi-ventricular assist device (BVAD). The Korean BVAD was develophed by modifying the moving actuator type Korean artificial heart. This electro-mechanical BVAD comprises actuator including energy converter and reduction gear train, blood sacs, and internal motor and energy controllers. The KAH350 which is named as 'Cactus Pump' is 177mm in length, 164mm in width, and 67mm in thickness including connectors and nuts. The weight and maximum cardiac output of Cactus Pump is 780g and 5L/min, respectively. The Cactus Pump that was developed as BVAD could be used as LVAD by attaching compliance caps on the 2 ports of one ventricle. The animal experiments were undergone 5 times for LVAD, and 6 times for BVAD. The best records were 28 days survival in both applications. There were 3 times of device failure and they were all associated with electrical connection and hermetic sealing. The KAH400 that has improved anatomical fitting characterisitcs and stroke volume is on development.

안티몬 제거를 위한 킬레이트 막의 합성 및 흡착특성

최혁준,김민 한국공업화학회 2005 응용화학 Vol.9 No.1

Chelating forming groups were introduced into the polymer chains grafted onto a porous hollow-fiber membrane for Sb ion remove in waters by radiation-induced graft polymerization and subsequent functionalization of a monomer containing an epoxy group. Moreover adsorption characteristic and different pH of Sb ion by n-MG membrane were researched. The breakthrough curves overlapped independent of the permeation pressure, residence time. This indicates a negligible diffusional nass-transfer resistance of Sb ion to the chelating forming groups. Moreover the adsorption capacity of each n-MG membrane appeared the highest around pH 7.

젊은 여성 유방암 환자에서 스테로이드 호르몬 수용체 상태와 싸이클린 D1 과발현의 예후 분석

최두호,이민혁 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background and Objects : The purpose of this study was to determine the prognostic significance of estrogen receptor (ER) and progesterone receptor (PR) status and cyclin D1 overexpression in Korean women with early-onset breast cancer. Materials and Methods : Sixty women diagnosed and treated with breast cancer at the age of 45 or younger at Soonchunhyang University Hospital were entered for this study. The median age was 37years and follow-up periods were between 80 and 30 months. Paraffin embedded blocks of the primary tumor were processed for immunohistochemical staining of ER, PR and cyclin D1. Close follow-up data were entered in the database for analysis of the prognostic signifinance. Results : The proportion of the tumors staining positive for ER, PR and cyclin D1 were 45.7%, 44.1% 40.7%, respectively. No association was found between immunoreactivity of these markes and axiliary lymph node metastais. The expression of ER correlated with expression of PR and cyclin D1(p<0.001). Lymph node metastasis revealed a poor prognostic factor, but these 3 markers were not prognostic factors in these cohorts of patients, although trends toward poor outcome were observed among patients with negative staining. Conclusions : Cyclin D1 and steroid hormone receptor status were not significant prognostic factors in young women with breast cancer. Large-scaled studies are needed for evaluation of prognostic significance of these immunohistochemical markers in Korean women with early-onset breast cancer.

전자기형 충격파 발생기의 전자기력 특성 해석

최민주,이승환,이종혁,이헌주 제주대학교 공과대학 첨단기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.2

임상용 체외 충격파 쇄석술에서 최근 우수한 성능이 입증되고 있는 솔레노이드를 이용한 전자기학적 충격파 발생기의 전자기학 및 역학적인 특성을 분석하였다. 10kV로 충전된 콘덴서(1㎌)가 솔레노이드 (직경 40mm, 길이 110mm, 구리선의 직경 1mm)를 통하여 순간적으로 방전되면, 솔레노이드 주변을 감싸고 있는 금속판이 진동하여 원통형으로 방사하는 충격파가 발생한다. 소프트웨어 Flux2D를 사용하여 전류의 파형, 금속판 주변의 자속의 세기 및 금속판에 떨림을 야기시키는 전자기력을 계산하였다. 금속판의 두께, 코일의 저항 및 권선수가 금속판에 가하는 전자기력의 효과에 대해 분석하였다.

多面評價制度의 效用的 構築方案 硏究 : K社를 中心으로

최교원,정민혁 東新大學校 2003 論文集 Vol.13 No.-

The objectives of this study are to investigate current status and problems about multilateral evaluation system. The researcher focused on the public Corporation ( K public Corporation) and evaluated the formation of evaluator's group, selection method of evaluator, evaluation method, evaluation items, and security devices such as objectiveness and fairness, feedback of evaluation results, and assistance of updating problems. Research target area is limited on the abstract of "K" public Corporation, and results of 2001 year evaluation, and evaluation feedback of this system. The summary of this study is as follows; First of all, the safety of evaluation should be considered. Social emotion, organization's particularity, the degree of evaluator's preparation should be considered. The design phase should be consisted of introduction period, extension period, and stable period so that trial and error could be minimized. Secondly, the necessity and objectiveness should be cleared. Temporary social phenomena and system acceptance of outside influence may bring about negative influence. Thirdly, accepted system should be carried out consistently. One time of multilateral evaluation cannot get general support afterwards. At fourth, the outcome of multilateral evaluation should be applied effectively. Fifthly, the maintenance of evaluator and system should be well preserved. Evaluator's anonymity should be guaranteed. Training for the evaluator should be provided to minimize the evaluation's error. Sixthly, evaluation items and the composers of evaluator should be balanced. Evaluation items should be focused according to one's ability in case of promotion while items should be carried out according to one's ability and accomplishment in case of monetary compensation Seventhly, multilateral evaluation system should be recognized widely. Without understanding of this system may bring about unnecessary disharmony and anxiety so that advertizement and education about the importance of carrying this system should be well informed.

상아질 접착제 사용 여부에 따른 근관 밀폐효과의 비교

이민조,박상혁,최기운 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.1

이 연구의 목적은 상아질 접착제의 사용 여부에 따른 근관 밀폐효과를 비교 평가하기 위해 40개의 단근치를 근관 성형 후 20개씩 두군으로 나누었다. 1군은 근관 충전시에 상아질 접착제를 사용하지 않았으며 2군은 상아질 접착제를 사용하였다. 근첨에서 1.5 mm (Level 1), 2.0 mm (Level 2), 2.5 mm (Level 3) 떨어진 부위의 평균 누출률을 측정하였다. 1. 두군의 평균 누출률은 치경부로 향하면서 감소하였다. 2. Level 1에서 1군과 2군의 평균 누출률은 차이가 없었다 (p > 0.05) .3. Level 2와 3에서 2군의 평균 누출률은 1군보다 낮았으며, 통계학적으로 유의차를 나타내었다 (p < 0.05) .연구결과 상아질 접착제를 사용하여 근관 충전하는 경우 치근단 누출을 감소시킬 수 있을 것으로 판단된다. The purpose of this study was to compare the sealing ability of root canal obturation with or without the use of dentin adhesive system. Forty extracted human teeth with one canal were selected and decoronated. The teeth were divided into two Groups. The obturation procedure of Group 1 was the same as that of Group 2 with the exception of dentin adhesive system. Group 2 were obturated with dentin adhesive system, AH-26, and gutta-percha. After obturation, the teeth were immersed in methylene blue solution for 84 hours. The teeth were sectioned horizontally at 1.5 mm (Level 1), 2.0 mm (Level 2) 2.5 mm (Level 3) from the root apex using a low speed microtome. Distance of dye-penetrated surface and total dentinal surface were measured using SigmaScan Pro 5.0, and the ratio of dye-penetrated distance to the total dentinal distance was analyzed statistically by Mann-Whitney U-test. 1. In both groups, the mean leakage ratio was decreased cervically. 2. At level 1, there was no significant difference between group 1 and group 2 (p > 0.05). 3. At level 2 and 3, group 1 showed significantly higher mean leakage ratio than group 2 (p < 0.05). The results suggest that using dentin adhesive system in root canal obturation procedure reduces the apical microleakage.

민항기 소음 예측을 위한 데이터베이스구축에 관한 고찰

송혁,송민정,최형욱,김선우 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The prediction of aircraft noise is based on the database of airplane's noise characteristics such as take-off and landing style etc. In this study, to predict the airplane flight noise, airplane which is being used for passengers and cargos currently are surveyed. The airplanes were divided into types and the noise characteristics of take off, flight at constant speed and landing were analyzed to establish database for prediction of aircraft noise. And the result of this study should be connected with GIS(Geographic Information System) to measure the area which is affected by aircraft noise.

全南住民에 있어서 惡性腫瘍의 統計的 觀察 (第2報)

曺圭赫,柳柱容,尹康爀,鄭相愚,梁東旭,李珉撤,崔燦 全南大醫大 1983 전남의대학술지 Vol.20 No.4

골반경수술의 임상적 고찰

강민창,조혜진,최상준,한세준,정혁 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2

Objective: Pelviscopic surgery has been used in the treatment of some gynecologic disease. And now, it is applied in almost all cases of gynecologic disease. This study is performed to evaluate the clinical advantages of pelviscopic surgery and current circumstance of ORGY of chosun university hospital. Methods: From March, 2000 to February 2003, total 437 cases were received laparoscopic surgery on department of ORGY of Chosun University hospital. We reviewed the chart and analyzed these cases according to age, parity, clinical indication, operation type, duration of hospitalization, operation time and complication. Results: The results are summarized as follows, The mean age of patients was 42.5 years old with ranges between 15 and 61 years old and mean parity of the patients was 1.95. The common indications were uterine myoma (45.1%) , ovarian tumor (15.3%) and ectopic pregnancy (7.3%) and frequent types of surgery were laparoscopic assisted vaginal hysterectomy (LAVH) (46.9%) , salpingectomy (8.5%), oophorectomy (8.5%). The operation time was variable according to types of operation and difficulty and the mean duration of hospitalization was 4.27 days. The most frequent complication was hemorrhage at the trocar site. Conclusion: Pelviscopic surgery is useful and recommended for the treatment of gynecologic disease, because this is safe and has many advantages. So, we expect the number and indication of pelviscopic surgery will be increased in future. 목적 : 진단목적으로 시행되어오던 골반경 수술이 부인과 질환의 거의 모든 영역에서 적용되어있다. 이에 골반경 수술의 임상적 이점에 대해 알아보고자 본 연구를 시행하였다. 연구방법 : 2000년 3월부터 2003년 2월가지 조선대학교 병원 산부인과에서 골반경 수술을 시행 받은 437명의 외래 및 입원기록을 검토하여 환자의 연령, 출산력, 골반경수술의 적응증, 수술종류 및 시간, 입원기간, 합병증을 분석하였다. 결과 : 2000년 3월부터 2003년 2월까지 시행한 437예의 골반경수술을 분석하여 다음과 같은 결과를 얻었다. 환자들의 평균연령분포는 15세에서 61세 사이였고 평균 연령은 42.5세이었다. 평균 출산력은 1.95회이었다. 골반경 수술은 LAVH가 205예 (46.9%) 로 가장 많았고, 난관 절제술이 37예 (8.5%), 난소 적출술이 35예 (8.%), 난소부분절제술이 28예(6.4%) 이었다. 골반경 수술의 적응증은 자궁외 임신이 43예(86%), 자궁근종이 197예(61.2%), 난소종양이 82예(52.6%) 이었다. 수술시간은 수술의 종류 및 난이도에 따라 다양하였다. LAVH의 경우 평균 38.2분, 난소난관 절제술의 경우 평균 31.9분, 난관 절제술의 경우 평균 30.7분이 소요 되었다. 평균 실혈량은 LAVH가 1.16g/dl, 난관절제술은 0.94g/dl, 난소난관 절제술의 경우는 0.97g/dl이었다. 입원기간은 대부분 1일에서 5일 사이였으며, 평균 4.27일 이었다. 가장 많은 합병증은 트로카 천공부위 출혈이었다. 결론 : 본 연구의 결과로 골반경 수술은 현재 부인과 질환의 진단과 치료에 있어서 매우 유용하며 개복 수술을 대치하는 상황으로 나아가고 있다.