• Journal of Chest Surgery
• /
• 제54권4호
• /
• pp.239-245
• /
• 2021

Video-assisted thoracoscopic surgery (VATS) has been established as the surgical approach of choice for lobectomy in patients with early-stage non-small cell lung cancer (NSCLC). Patients with clinical stage I NSCLC with no lymph node metastasis are considered candidates for VATS lobectomy. To rule out the presence of metastasis to lymph nodes or distant organs, patients should undergo meticulous clinical staging. Assessing patients' functional status is required to ensure that there are no medical contraindications, such as impaired pulmonary function or cardiac comorbidities. Although various combinations of the number, size, and location of ports are available, finding the best method of port placement for each surgeon is fundamental to maximize the efficiency of the surgical procedure. When conducting VATS lobectomy, it is always necessary to comply with the following oncological principles: (1) the vessels and bronchus of the target lobe should be individually divided, (2) systematic lymph node dissection is mandatory, and (3) touching the lymph node itself and rupturing the capsule of the lymph node should be minimized. Most surgeons conduct the procedure in the following sequence: (1) dissection along the hilar structure, (2) fissure division, (3) perivascular and peribronchial dissection, (4) individual division of the vessels and bronchus, (5) specimen retrieval, and (6) mediastinal lymph node dissection. Surgeons should obtain experience in enhancing the exposure of the dissection target and facilitating dissection. This review article provides the basic principles of the surgical techniques and practical maneuvers for performing VATS lobectomy easily, safely, and efficiently.

• 대한두경부종양학회지
• /
• 제16권2호
• /
• pp.206-211
• /
• 2000

Objectives: Any uptake of I-131 after total thyroidectomy means the remant thyroid tissue or distant metastasis of the thyroid cancer. However diffuse hepatic uptake of I-131 without abnormal uptake was showen in many cases on I-131 whole body scan. The aim of this study was to classify the liver uptake after I-131 scan and to evaluate the analysis of this finding. Materials and Methods: Between 1982 and 1998, 104 patients(l4 males, 90 females) with normal liver function underwent I-131 scan after total thyroidectomy. Prospectively we reviewed the films of the whole body scan and analysed the correlations between results of radioiodine uptake, pathologic diagnosis, prognostic factors, lymphatic metastasis, and thyroid function test. Result: Diffuse hepatic uptake was found in 44 of 104(42%) patients. 10 of 39(26%) patients on I-131 100mCi, and 34 of 63(54%) on I-131 150mCi showed hepatic uptake. 52 of 104(50%) patients was locally invasive thyroid cancer. The rate of the hepatic uptake was no significant differences with the thyroid hormone levels(T3, Free T4) and thyroglobulin between uptake group and non-uptake group. Conclusion: The rate of I-131 uptake was high in high-dose radioiodine treatment group. However, we can not find any correlation among the thyroid functions, the extent of metastasis or the extent of local invasion. We need further study to find out the causes of the hepatic uptake of I-131 after total thyroidectomy, besides liver metabolism of I-131 attached thyroid hormones.

• 대한전자공학회논문지TC
• /
• 제47권3호
• /
• pp.39-49
• /
• 2010

애드혹(Ad hoc)네트워크는 각 노드에 의하여 네트워크의 토폴로지가 구성되는 인프라스트럭처래스(infrastructureless) 네트워크이다. 전용의 네트워크 디바이스가 없기 때문에 각 노드들이 디바이스 기능 즉, 네트워크 제어와 관리기능을 수행한다. 애드혹 네트워크는 어떤 노드가 네트워크 토폴로지에 참여하거나 탈퇴하는 것이 임의적이기 때문에 토폴로지의 확장이 용이하고, 트래픽이 먼 거리를 가는 경우에는 중간 노드들의 경로를 경유해야 하는데, 이러한 요인들이 성능변동에 영향을 준다. 따라서 각 노드들은 자신의 트래픽을 안정적으로 유지하기 위하여 주변의 트래픽, 네트워크를 구성하는 경로들의 상태, 자신의 트래픽야 경유할 노드에서 트래픽 몇 혼잡제어 등을 고려할 필요가 있다. 본 논문은 경로의 대역을 유한자원으로 가정하고 경로를 점유하기 위하여 발생하는 트혜픽 경쟁이 전송성능에 미치는 영향과 이러항 경쟁모델을 구성하는 인자가 성능에 미치는 영향을 분석하고 그 결과를 제시하였다. 이러한 결과는 네트워크에서 관리정책과 기법 등에 기여할 것으로 기대한다.

• Archives of Plastic Surgery
• /
• 제40권3호
• /
• pp.238-243
• /
• 2013

Background Primary malignant tumors of the hand, although unusual, may present varied and often complex clinical problems. The main treatment modality of skin cancer of the hand has changed. Methods We retrospectively reviewed the medical records of 43 patients who underwent surgery for malignant skin tumors of the hand during an 18-year period, from September 1994 to February 2012. The characteristics of the tumor, methods of reconstruction, and long-term results were reviewed. Results We had 43 patients with 27 melanomas, 14 squamous cell carcinomas, and 2 sarcomas. Their ages ranged from 19 to 74 years (mean, $53.4{\pm}14.5$ years), from 46 to 79 years (mean, $59.7{\pm}9.6$ years), and from 15 to 43 years (mean, $29{\pm}19.8$ years), respectively. Thirty-four cases occurred on the fingertip (16 of those cases on the thumb), 5 cases occurred on the palm, and 4 cases on the dorsum of the hand. Amputation was most frequently used in early cases, but recently, tissue-sparing excision has been performed frequently. The incidence of local recurrence was 3 cases and distant metastasis was 1 case, and the 5-year survival rate was 100%, except in 4 cases due to follow-up loss. Conclusions The principles of treatment-to be curative and to preserve function and appearance-are important points. "Preservative surgery" preserves function and cosmesis of the involved finger or hand dorsum or palm. Preservative surgery not only emphasizes less resection and surgery of a smaller scale, but also optimal reconstruction of the soft tissue defect of the digit.

• Radiation Oncology Journal
• /
• 제35권1호
• /
• pp.55-64
• /
• 2017

Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

• 한국안광학회지
• /
• 제13권2호
• /
• pp.59-62
• /
• 2008

목적: 알코올 섭취 후 시간경과에 따른 시력변화를 알아보고자 하였다. 방법: 음주 1시간 및 3시간 후의 자각적 타각적 굴절검사, 원거리 대비감도 검사, 그리고 세막대 입체시 검사를 실시하였다. 결과: 혈중 알코올 농도의 상승과 비례하여 평균 -0.25D ~ -0.35D의 근시성 변화를 일으켰고, 동적입체시 기능이 저하되는 것으로 나타났다. 그러나 대비감도는 모든 공간주파수에서 큰 변화가 없는 것으로 나타났다. 결론: 알코올이 일반적인 시력검사 및 기능검사에 영향을 끼친다는 사실을 숙지하고 피검자의 검사 전 알코올 음용에 대해 문진할 필요성이 있다.

• 천문학회보
• /
• 제37권2호
• /
• pp.98.2-98.2
• /
• 2012

We firstly present the unified Far-UV continuum map of the Taurus-Auriga-Perseus (TPA) complex, one of the largest local associations of dark cloud located in (l, b)=([154,180], [-28, -2]), by merging both FIMS and GALEX. The FUV continuum map shows that dust extinction correlate well with the FUV around the complex. It shows strong absorption in FUV toward the dense Taurus cloud while it does not in California cloud. It turned out that it is related to the relative location of each cloud and Perseus OB2 association. We also present some results of dust scattering simulation based on Monte Carlo Radiative Transfer technique (MCRT). Through this dust scattering simulation, we have derived the scattering parameter for this region, albedo(a)=$0.42^{+0.05}{_{-0.05}}$, asymmetry factor(g)=$0.47^{+0.11}{_{-0.27}}$. The optical parameters we obtained seem reasonable compared to the theoretical model values ~0.40 and ~0.65 for the albedo and the phase function though the phase function is rather small. Using the result of simulation, we figured out the geometries of each cloud in the complex region, especially their distances and thicknesses. Our predictions from the results are in good agreement with the previous studies related to the TPA complex. For example, the Taurus cloud is within ~200pc from the Sun and the Perseus seems to be multi-layered, at least two. The California cloud is more distant than the other cloud on average at ~350 pc and Auriga cloud seems to be between the Taurus cloud and the eastern end of the California cloud. We figured out that across the TPA complex region, there might be some correlation between the LSR velocity and the distance to each cloud in the complex.

• Journal of Microbiology and Biotechnology
• /
• 제29권1호
• /
• pp.141-150
• /
• 2019

The spatial landmark protein Bud8 plays a crucial role in bipolar budding in the budding yeast Saccharomyces cerevisiae. The unconventional yeast Yarrowia lipolytica can also bud in a bipolar pattern, but is evolutionarily distant from S. cerevisiae. It encodes the protein YALI0F12738p, which shares the highest amino acid sequence homology with S. cerevisiae Bud8, sharing a conserved transmembrane domain at the C-terminus. Therefore, we named it YlBud8. Deletion of YlBud8 in Y. lipolytica causes cellular separation defects, resulting in budded cells remaining linked with one another as cell chains or multiple buds from a single cell, which suggests that YlBud8 may play an important role in cell separation, which is distinct from the function of Bud8 in S. cerevisiae. We also show that the YlBud8-GFP fusion protein is located at the cell membrane and enriched in the bud cortex, which would be consistent with a role in the regulation of cell separation. The coiled-coil domain at the N-terminus of YlBud8 is important to the correct localization and function of YlBud8, as truncated proteins that do not contain the coiled-coil domain cannot rescue the defects observed in $Ylbud8{\Delta}$. This finding suggests that a new signaling pathway controlled by YlBud8 via regulation of cell separation may exist in Y. lipolytica.

• 대한골관절종양학회지
• /
• 제1권2호
• /
• pp.154-163
• /
• 1995

1986년 3월부터 1993년 12월까지 연세대학교 의과대학 정형외과학 교실에서 상지에 발생한 악성 및 침윤성 양성 골종양에 대하여 사지구제술을 시행하여 다음과 같은 결과를 얻었다. 1. 총 13명의 상지에 발생한 악성 및 침윤성 양성골종양 환자에 대해 사지 구제술을 시술 하였다. 2. 사지 구제 술의 내용은 8 례가 Tikhoff -Linberg 수술, 2 례가 분절절제 및 재접합술, 2 례가 종양삽입물 치환술 그리고 1 례가 분절절제술 및 유리혈관부착 생비골이식술이었다. 3. 13 례중 3 례가 골육종, 4 례가 연골육종, 3 례가 거대세포종, 1 례가 병적 골절을 동반한 유잉육종, 1 례가 연골아세포종, 1 례가 전완부 건 및 근육과 원위요골 및 척골을 동시에 침범한 평활근 육종이었다. 4. 추시기간은 술수 1년에서부터 7년 5개월로 평균 4년 5개월이었다. 5. 총 13명의 환자 중 1 례의 상완골에 발생한 병적 골절을 동반한 유잉 육종의 환자에서 국소재발 및 다발성 골전이가 나타나 수술 후 4년 4개월만에 사망하였고 나머지 12 례의 환자는 국소재발이나 원격전이의 소견은 없었다. 6. 상지에 발생한 악성 및 침윤성 양성 골종양의 치료로 여러방법의 사지구제술은 병의 치료 면이나 기능적인 면에서 만족스런 결과를 가져왔다.

• 대한토목학회논문집
• /
• 제34권4호
• /
• pp.1125-1138
• /
• 2014

본 연구는 광동댐 유역을 대상으로 RCPs (Representative Concentration Pathways) 기후변화 시나리오의 Arc-SWAT 적용으로 평균유출량과 저유량 계열을 구축하고 경계핵함수(Boundary Kernel)를 이용하여 비매개변수적 갈수빈도 해석을 수행하였다. 분석결과, RCPs 시나리오 하에서 가까운 미래의 유출량 감소로 인한 가뭄발생빈도가 증가하였으며, RCP8.5에서 저유량 계열의 변동폭이 크게 나타났다. Median flow의 갈수량 빈도해석결과 가까운 미래(2030s)의 30년 빈도 갈수량의 경우 Historic 기간에 비하여 증가(RCP4.5: +22.4%, RCP8.5: +40.4%)하였으나, 먼 미래(2080s)에는 갈수량 감소(RCP4.5: -4.7%, RCP8.5: -52.9%)로 인한 가뭄발생빈도가 커지는 것으로 분석되었다. 또한 Quantile 25% flow 저유량 계열의 경우 먼 미래에 빈도별 갈수량이 감소(RCP4.5: -20.8% ~ -60.0%, RCP8.5: -30.4% ~ -96.0%)하여 극심한 가뭄의 발생빈도가 커질 것으로 분석되었다. RCPs 시나리오 적용에 따른 비매개변수적 갈수빈도 해석 결과는 한반도 중권역별 수자원개발계획 수립과 기후변화 대응책 마련을 위한 기초자료로 활용이 가능할 것이다.