담낭암, 간문부암 및 말단 담도암의 새로운 AJCC 7<SUP>th</SUP> 병기

임진홍(Jin Hong Lim),김성훈(Sung Hoon Kim),김경식(Kyung Sik Kim) 한국간담췌외과학회 2010 한국간담췌외과학회지 Vol.14 No.2

The American Joint Committee on Cancer (AJCC) Cancer staging system has been revised every 6∼8 years since the first edition of the cancer staging system was introduced in 1977. The latest edition, the 7th, was published in 2009 and has been used since January, 2010. In case of gallbladder cancer, perihilar cancer and distal common bile duct cancer, there are several changes compared to the 6th edition (revised in 2002). In gallbladder cancer, there is no difference in lymph node location from the 6th edition, but in the 7th edition disease is divided into hilar nodes and other regional lymph nodes. This has been reclassified in terms of the possibility of surgical resection and patient outcome. In perihilar cancer, we had to follow cancer staging for extrahepatic bile duct cancer because there was no classification previously ; but now a new staging guideline has been introduced. There is no difference from the 6th edition in cancer staging of the distal common bile duct. However, the classification of the primary site has changed according to involvement of the celiac axis or superior mesenteric artery in invasion of adjacent organs. Explanations for the differences between the 5th, 6th and 7th editions are introduced and the helpfulness of the new system in clinical applications is examined.

내압 방폭형 LED 작업등 부피 및 설계에 따른 방폭성능에 관한 연구

임진홍(Jin-Hong Lim),유민욱(Min-Uk Yoo),이선권(Sun-Kwon Lee),강규홍(Gyu-Hong Kang) 한국가스학회 2018 한국가스학회 학술대회논문집 Vol.2018 No.5

수술 증 절개창 보호 방법이 수술 후 절개창 합병증에 미치는 영향

임진홍,김성수,최원혁,오성진,형우진,최승호,노성훈,Lim, Jin-Hong,Kim, Sung-Soo,Choi, Won-Hyuk,Oh, Sung-Jin,Hyung, Woo-Jin,Choi, Seung-Ho,Noh, Sung-Hoon 대한위암학회 2007 대한위암학회지 Vol.7 No.4

목적: 수술 절개창 합병증은 의료진 및 환자에게 많은 노력과 비용을 발생 시킨다. 수술 절개창 합병증을 줄이기 위한 노력중 하나로 수술 시 절개창 보호 방법에 대한 연구가 있어왔으나 주로 절개창 감염에 국한된 연구였기 때문에 절개창 보호 방법이 절개창 합병증에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법: 위 절제술을 시행받은 295예의 위선암 환자를 대상으로 하였으며 연구기간은 2006년 5월부터 2006년 9월까지로 하였다. 수술 전 성별, 나이, body mass index, 음주 및 흡연력, ASA 분류를 조사한 후 환자의 동의를 얻어 무작위로 절개창 보호 방법을 결정하였다. 수술중 절개창을 보호를 하지 않은 비보호군(137명)과 폴리에틸렌(polyethylene) 보호막으로 절개창을 보호하는 보호군(432명)으로 분류하였으며, 발생한 합병증과 합병증 치료 기간을 조사 하였다. 결과: 수술 중 절개창을 보호하지 않은 비보호군과 절개창을 보호한 보호군 간에 환자의 기본 인자 및 수술 관련인자의 차이는 없었다. 전체 절개창 합병증은 비보호군에서는 42예, 보호군에서는 12예가 발생하여 통계학상으로 유의한 차이를 보였다(P=0.001). 장액종은 비보호군에서 29예, 보호군에서 6예(P=0.001), 감염은 비보호군에서 13예, 보호군에서 4예(p=0.030), 열개는 비보호군에서 6예와 보호군에서 2예(P=0.282)가 발생하였다. 재원기간은 절개창 비보호군에서 $12.3{\pm}9.7$일, 절개창 보호군에서 $10.3{\pm}5.4$일로 유의한 차이가 있었다(P=0.040). 결론: 본 연구를 통해 폴리에틸렌 보호막을 이용해 절개창을 보호하였을 때 전체 절개창 합병증이 감소하는 것을 확인하였다. 따라서 수술 중 보호막을 이용하여 절개창을 보호하여 절개창 합병증의 발생을 감소시킬 수 있으며, 나아가 불필요한 치료 기간의 연장을 줄일 수 있다. Purpose: Surgical wound complications remain a cause of morbidity and mortality among postoperative patients, and the cost of caring for patients with a surgical wound complication is substantial. The purpose of this study was to evaluate the ability of a vinyl wound protector to reduce the rate of wound complications when used in clean-contaminated surgery. Materials and Methods: Between May 2006 and September 2006, 295 patients with a gastric cancer that underwent gastric surgery were studied prospectively, and the patients were randomized into one of two groups: the no wound protector group (n=137) or the polyethylene protector group (n=132). Results: The demographics and operation type and operation time were similar for patients in both groups. The rate of wound complication was different between patients in the no protector group (n=42) and the polyethylene protector group (n=12) (P=0.001) and the rates of seroma (P=0.001), infection (P=0.030) and dehiscence (P=0.282) were different for the two groups. The postoperative hospital stay was significantly shorter in the polyethylene protector group of patients (P=0.040). Conclusion: The use of a polyethylene protector resulted in a reduction of the surgical wound complication rate, and the cost of caring for patients, and morbidity and mortality among postoperative patients could be reduced.

AlGaN/GaN HEMT의 채널폭 스케일링에 따른 협폭효과

임진홍,김정진,심규환,양전욱,Lim, Jin Hong,Kim, Jeong Jin,Shim, Kyu Hwan,Yang, Jeon Wook 한국전기전자학회 2013 전기전자학회논문지 Vol.17 No.1

본 연구에서는 AlGaN/GaN HEMT (High electron mobility transistor)를 제작하고 채널폭의 감소에 따른 특성의 변화를 고찰하였다. AlGaN/GaN 이종접합구조 기반의 기판 위에 채널의 길이는 $1{\mu}m$, 채널 폭은 각각 $0.5{\sim}9{\mu}m$가 되도록 전자선 리소그라피 방법으로 트랜지스터를 제작하였다. 게이트를 형성하지 않은 상태에서 채널의 면저항을 측정한 결과 sub-${\mu}m$ 크기로 채널폭이 작아짐에 따라 채널의 면저항이 급격히 증가하였으며, 트랜지스터의 문턱전압은 $1.6{\mu}m$와 $9{\mu}m$의 채널폭에서 -2.85 V 이었으며 $0.9{\mu}m$의 채널폭에서 50 mV의 변화, $0.5{\mu}m$에서는 350 mV로 더욱 큰 변화를 보였다. 트랜스컨덕턴스는 250 mS/mm 내외의 값으로부터 sub-${\mu}m$ 채널에서 150 mS/mm로 채널폭에 따라 감소하였다. 또한, 게이트의 역방향 누설전류는 채널폭에 따라 감소하였으나 sub-${\mu}m$ 크기에서는 감소가 둔화되었는데 채널폭이 작아짐에 따라 나타는 이와 같은 일련의 현상들은 AlGaN 층의 strain 감소로 인한 압전분극 감소가 원인이 되는 것으로 사료된다. AlGaN/GaN HEMTs (High electron mobility transistors) with narrow channel were fabricated and the effect of channel scaling on the device were investigated. The devices were fabricated using e-beam lithography to have same channel length of $1{\mu}m$ and various channel width from 0.5 to $9{\mu}m$. The sheet resistance of the channel was increased corresponding to the decrease of channel width and the increase was larger at the width of sub-${\mu}m$. The threshold voltage of the HEMT with $1.6{\mu}m$ and $9{\mu}m$ channel width was -2.85 V. The transistor showed a variation of 50 mV at the width of $0.9{\mu}m$ and the variation 350 mV at $0.5{\mu}m$. The transconductance of 250 mS/mm was decreased to 150 mS/mm corresponding to the decrease of channel width. Also, the gate leakage current of the HEMT decreased with channel width. But the degree of was reduced at the width of sub-${\mu}m$. It was thought that the variation of the electrical characteristics of the HEMT corresponding to the channel width came from the reduced Piezoelectric field of the AlGaN/GaN structure by the strain relief.

담도유두종 환자에서 광역학치료 후 간용적 보존 수술

정진옥 ( Chin Ock Cheong ),임진홍 ( Jin Hong Lim ),박준성 ( Joon Seung Park ),박승우 ( Seung Woo Park ),김현기 ( Hyun Ki Kim ),김경식 ( Kyung Sik Kim ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.1

Biliary papillomatosis is rare, and its pathogenic mechanisms are not yet clear. Because of its high risk for malignancy transformation, surgical resection is regarded as a standard treatment. Photodynamic therapy (PDT) has been used by the intravenous administration of hematoporphyrin derivative followed by laser exposure. A photochemical process causes disturbance of the microvascular structure and degradation of membrane. Cholangitis is a major complication after PDT. A healthy 56-year-old man was diagnosed with biliary papillomatosis involving the common hepatic duct, both proximal intrahepatic bile ducts (IHD), and the right posterior IHD. After biliary decompression by endoscopic nasobiliary drainage, PDT was performed to avoid extensive liver resection and recurrence using endoscopic retrograde cholangiographic guidance. After portal vein embolization, the patient underwent extended right hemihepatectomy. Following administration of chemoradiation therapy with tegafur-uracil and 45 Gy due to local recurrence at postoperative 13 months, there was no local recurrence or distant metastases. This is the first case report on PDT for biliary papillomatosis in Korea. Preoperative PDT is beneficial for reducing the lesion in diffuse or multifocal biliary papillomatosis and may lead to curative and volume reserving surgery. Thus, PDT could improve the quality of life and prolong life expectation for biliary papillomatosis patients. (Korean J Gastroenterol 2015;66:55-58)

간암 환자에서 간절제술 시행 후 초기 회복기간 중 이용할 수 있는 적합한 영양상태 평가 지표

김상화(Sang Hwa Kim),임진홍(Jin Hong Lim),김성훈(Sung Hoon Kim),이수지(Su Ji Lee),이호선(Ho Sun Lee),이재길(Jae Gill Lee),김충배(Choong Bae Kim),김경식(KyungSik Kim) 대한종양외과학회 2012 Korean Journal of Clinical Oncology Vol.8 No.2

목적 : 간절제술 후에는 간의 합성능력이 저하되고, 복수나 부종이 발생하게 된다. 본 연구에서는 이러한 상황에서 영양상태를 평가할 수 있는 적절한 지표를 검증하고자 하였다. 대상 및 방법 : 간세포암을 진단받고, 간절제술을 시행받은 65명의 환자를 대상으로 후향적으로 의무 기록을 분석하였다. 간절제 전 및 간절제 후 7일째 체중과 신체 체질량 지수, 혈액검사를 통해 영양 평가 지표를 측정하였다. 결과 : 65명의 환자중 남자는 52명, 여자는 13명으로 남녀 비는 4:1이었으며, 평균 연령은 56.2세였다. 수술 전 신체 체질량 지수는 저체중인 18.5 kg/m2 미만이 2명 (3.1%), 18.5-23kg/m2의 정상 범위가 22명(33.8%), 23-27.5 kg/m2의 과체중 상태가 19명(29.2%), 그리고 신체 체질량 지수 27.5 kg/m2 이상의 비만 상태가 22명(33.8%)였다. 수술 전 후의 영양 평가 항목의 변화를 살펴보면, 수술 후 림프구 수, 총 단백질량, 알부민, 혈액 요소 질소(BUN), 콜레스테롤, 프리알부민 수치가 유의하게 감소하였으며, 반면에 백혈구 세포수(5642±1831 vs. 7149±3069)와 CRP(2.98±4.78 vs. 25.69±22.23)는 눈에 띄게 증가하는 소견을 보였다(p=0.00, p=0.00). 수술 전과 후의 신체 체질량 지수와 체중은 통계학적으로 의미있는 변화는 보이지 않았다(p=1.91, p=8.23). 결론 : 간절제술 시행 후 영양 상태를 정확하게 평가하기 위해서, 염증 반응과 외부의 개입에 의한 영향 등을 고려하여, 쉽게 적용 할 수 있는 단일 영양 상태 평가 지표로는 프리알부민이 가장 적합할 것으로 사료된다. After hepatic resection, a synthetic liver function is often deteriorated, and ascites have been occasionally developed. Because of these limitations, this study is designed to validate the optimal nutritional index. We retrospectively reviewed medical records of sixty-five patients who underwent hepatectomy for hepatocellular carcinoma. Body weight, Body Mass Index (BMI) and laboratory parameters were compared at preoperative day and postoperative day 7. Patients consist of fifty-two males and thirteen females and average age is 56.2±9.9 years old. Forty-four patients had resected more than three segments, and twelve had resected 2 segments and nine had resected only one segment or received a wedge resection. According to preoperative BMI, there were two underweight (BMI < 18.5), twenty-two normal, nineteen overweight, and twenty-two obese (BMI>=27.5). After the surgery, lymphocyte count, total protein, albumin, BUN, Cholesterol, Prealbumin statistically significantly increased (p=0.00 & p=0.00). However, BMI and change in Body weight do not show statistically significant data (p=1.91, p=8.23). The degree of inflammation may have a significant influence in nutrition evaluation scale. Therefore, a new method of nutritional evaluation that can adjust degree of inflammation is needed to accurately evaluate the nutrition scale after hepatectomy.

다양한 센서 기반의 침입체 탐지, 분류 및 추적 알고리즘 개발

김원철(Wonchul Kim),임진홍(Jinhong Lim),김태완(Taewan Kim),손영동(Youngdong Son),김현진(H. Jin Kim),김진영(Jinyoung Kim),홍수연(Sooyoun Hong),김한동(Handong Kim) 제어로봇시스템학회 2017 제어·로봇·시스템학회 논문지 Vol.23 No.11

Surveillance is one of the major applications in wireless sensor network areas, and it is important to detect, classify and localize the targets. In this paper, we divide the research into two sections: (1) detecting and classifying the targets and (2) localizing them. To detect and classify multiple moving targets, we use acoustic and seismic sensors, and we analyze raw data from the sensors in both time and frequency domains. In this process, we must decide which features are useful for the classification to improve the performance and make it work in real time. Thus, we exploit Weibull likelihood and short-time Fourier transform (STFT) to extract the features as a sampling method. Then, we implement a support vector machine (SVM) and a neural network to classify the type of targets based on those features. Using the suggested algorithms, the proposed classifiers provide more accurate performance than the method that analyzes the raw data from only the frequency or time domain. For localization, Gaussian Process Regression (GPR) is used to estimate the relative location that corresponds to the received signal strength indication (RSSI) data. We also demonstrate the simultaneous localization with the process of detection and classification in real time. Finally, experimental results validate the suggested algorithm.

비보상성 간경화를 가진 간세포암 환자에서 간 절제와 비장 절제를 동시에 시행한

김성훈 ( Sung Hoon Kim ),임진홍 ( Jin Hong Lim ),안상훈 ( Sang Hoon Ahn ),김경식 ( Kyung Sik Kim ) 대한간암학회 2011 대한간암학회지 Vol.11 No.2

Hepatocellular carcinoma (HCC) develops on chronic liver disease and often accompanies portal hyperternsion. Portal hypertension induces hypersplenism with splenomegaly. Because hypersplenism results in pancytopenia, especially thrombocytopenia, it is not easy to decide the hepatic resection for many surgeons in patients with HCC and hypersplenism. Although liver transplantation is the most ideal treatment for HCC and hypersplenism, liver resection has been performed commonly because of donor shortage. Splenectomy has performed to control intractable varices as a Hassab`s operation (=decongestion of upper gastric marginal veins and splenectomy). Recently, as a development of surgical techniques and equipments, especially laparoscopic surgery, splenectomy has been performed safely and easily. Some studies reported that splenectomy improved the liver function. Splenectomy in patients with HCC expanded the indication of liver resection and increased disease free survival (DFS). However, portal vein thrombosis (PVT) is a one of well-recognized complications of splenectomy and recent prospective study reported the 50% rate of PVT in non-cirrhotic splenectomized patients. Some studies reported that splenectomy with simultaneously or staged liver resection was performed safely without a significant complication and operative mortality. We experienced a case that underwent simultaneously liver resection and splenectomy and then recovered without complication. The further study may be needed to evaluate the role of splenectomy in patients with HCC and hypersplenism.

선박용 액체수소 저장탱크 시험평가절차 ISO 국제표준 개발 연구

정지현(Ji Hyun Jung),전주영(Joo Yeong Jeon),임진홍(Jin Hong Lim),손승민(Seong Min Son),김소정(So Jeong Kim),전보미(Bomi Jeon),김명진(Myung Jin Kim),최주형(Ju Hyung Choi) 대한기계학회 2022 대한기계학회 춘추학술대회 Vol.2022 No.6

마이크로와이어 기반 nitric oxide 가스 측정 센서의 개발 및 그 유용성에 대한 기초연구

이상우(Sang Woo Lee),민선옥(Seon Ok Min),이경훈(Kyoung Hoon Lee),권대성(Dae-Sung Kwon),임진홍(Jin Hong Lim),남기창(Ki-Chang Nam),김종백(Jongbaeg Kim),김경식(Kyung Sik Kim) 대한종양외과학회 2013 Korean Journal of Clinical Oncology Vol.9 No.2

Purpose: Although nitric oxide (NO) is considered one of the initial signals that promote postsurgery liver regeneration, NO’s exact role in the liver regeneration mechanism is still not clear. Therefore, developing a practical gas sensor and testing it in a clinical setting through basic research will lay the groundwork for advanced clinical research on the action mechanism of NO. Methods: A thin nano wire NO sensor was made by wrapping a pair of parlyene-coated gold wires around a needle. The NO blood concentration determined by measuring the potential difference across the oscilloscope using electrical conductivity. In order to measure changes in NO level before and after the surgery, the NO sensor was inserted in the hepatic portal vein and a 75 percent partial hepatectomy was performed. The NO blood concentration was measured regularly with both the NO kit and the sensor. Results: One significant challenge was separation of the wire upon insertion into the hepatic portal vein. Despite separation, the constant measurements of the wire-type sensor were similar to those measured by the NO measurement kit. Conclusion: The development of a needle-type sensor allowed for easier insertion. In the future, using difference in electric potential, as used in the NO sensor, may be a more effective method of measuring blood ion concentration.