• Journal of Chest Surgery
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• 제34권11호
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• pp.865-869
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• 2001

광범위한 대동맥류의 수술은 주로 elephant trunk 술식을 이용한 단계적인 수술로 이루어 지고 있다. 그러나 elephant trunk 술식을 적용하기 힘든 경우 동시 치환을 고려하여야 한다. 과거 급성 대동맥박리로 상행대동맥 수술을 받은 과거력이 있는, 마르팡 증후군이 의심되는 35세 환자에서 대동맥 근위부의 대동맥류 및 하행대동맥류 파열이 발생하여 대동맥 판막에서부터 횡격막에까지 전 흉부대동맥 동시치환술을 성공적으로 시행하였기에 문헌 고찰과 함께 보고한다.

• 지식경영연구
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• 제11권2호
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• pp.133-152
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• 2010

This paper suggests a typology of the modes of collaboration for scientific and technological knowledge production and sharing (STKPS) based on knowledge communication types, including organizational factors, communication channel, intensity, and decision-making, that affect STKPS processes. It is mainly designed to rearrange ideas about collaboration drawn from the literature in order to develop a conceptual framework for categorizing modes of collaboration based on how communication patterns shape four modes of collaboration. In the conclusion and discussion part, practical implications, limitations of this study, and further studies are discussed. In particular, the practical implications propose communication patterns suitable for five stages of collaboration processes. As the collaboration initiation or set-up stage is critical, extensive face-to-face communication is recommended in the auditing stage. In the execution stage, media-based communication can be actively utilized, because collaborators will mostly exchange explicit codified knowledge supported by IT. The evaluation and reinforcement stages concentrate on tacit knowledge exchange and explicit knowledge evaluation, which requires intensive face-to-face communication including negotiations for evaluating collaboration outcomes and partnership.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1082-1086
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• 1992

Adenosquamous carcinoma of the lung is a rare disease entity and its clinical characteristics, treatment, and prognosis are poorly described. Stage I disease are amenable to operation as in bronchogenic carcinoma of non-small cell type, but stage III adenosquamous carcinoma shows highly aggressive behavior with rapid progression. We have experienced a case of stage III adenosquamous carcinoma of the lung in a 38-year-old male with a large mass in the right upper lobe with multiple metastasis in the mediastinal lymph nodes. Interestingly, all of the metastatic lymph nodes proved to be adenous component histologically. After right pneumonectomy and extensive lymph node dissection, the patient had received one cycle of chemotherapy. However, clinical signs of distant metastasis to bone and brain were discovered within 5 months postoperatively.

• 한국경영과학회지
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• 제29권1호
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• pp.43-56
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• 2004

The purpose of clustering is to partition a set of objects into several clusters based on some appropriate similarity measure. In most cases, clustering is considered without any prior information on the number of clusters or the structure of the given data, which makes clustering is one example of very complicated combinatorial optimization problems. In this paper we propose a general-purpose clustering method that can determine the proper number of clusters as well as efficiently carry out clustering analysis for various types of data. The method is composed of two stages. In the first stage, two different hierarchical clustering methods are used to get a reasonably good clustering result, which is improved In the second stage by ASA(accelerated simulated annealing) algorithm equipped with specially designed perturbation schemes. Extensive experimental results are given to demonstrate the apparent usefulness of our ASA clustering method.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.667-670
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• 2010

Purpose: The management of urethral defect represents one of the most challenging clinical problems in uroplastic surgery. Especially for defect after Fournier's Gangrene, optimal management is still a hard problem. During extensive urethral reconstruction, to overcome the poor vascularity due to periurethral scarred tissue and limitation of the choice of local flap, we report our experience with one-stage reconstruction of urethral defect using a longitudinal tubed flap of scrotal skin. Methods: A 72-year-old man with several years of diabetes mellitus history visited for swelling and pain of scrotal area. After diagnosis of Fournier's Gangrene, radical debridement was performed and 6 cm of urethral defect on border of penile-scrotal ventral area was made. Rectangular scrotal skin flap ($6{\times}2.5\;cm$) based on external spermatic fascia was elevated and tubed longitudinally. After transfer the flap to the defect area, end-to-end anastomosis was performed bilaterally. Results: 4 weeks after the operation, the patient started voiding him-self and urethrography showed good fluence of contrast agent. Long term evaluation reveals stable performance characteristics without any complications. Conclusion: We suggest a one-stage reconstruction of extensive urethral defect using a longitudinal tubed flap of scrotal skin. Advantages of this procedures are simple, one-stage reconstruction with the reliable scrotal skin flap based on external spermatic fascial vasculature, and no donor morbidity.

• Tuberculosis and Respiratory Diseases
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• 제43권4호
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• pp.527-535
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• 1996

연구배경 : 내피세포와 백혈구 및 상피세포에서 주로 발견되는 sICAM-1은 백혈구 표면의 배위자인 (ligand)인 LFA-1과 결합함으로서 염증성 질환 이외에 악성 종양의 전이와 진행에 중요한 역할을 하는 것으로 알려졌다. 최근에는 혈청내 sICAM-1의 농도가 악성 흑세포종의 전이와 비례하여 증가되는 것으로 보고되었으며, 또한 sICAM-1의 이형이 여러 질환에서 발견되고 이들의 혈청 농도의 증가는 위암, 대장암, 담낭암, 췌장암의 간전이와 관련되며, 악성 흑세포종 환자의 생존율의 감소와 관련되는 것으로 보고하였으나 폐암에서는 이에 대한 보고는 거의 없다. 이에 저자들은 폐암 환자의 혈청에서 sICAM-1을 측정하여 폐암의 조직학적 분류와 진행 및 전이의 정도에 따른 변화를 알아보고 폐암의 진단적 가치에 대하여 알아 보고자 하였다. 방법 : 1995년 1월부터 1996년 3월까지 전북대학교병원 내과에 입원하여 폐암을 진단 받은 환자 38명을 대상으로 하였으며, 정상 대조군은 비슷한 연령의 다른 질환을 갖고 있지 않은 8명을 대상으로 하였으며, 기관지 내시경을 통한 조직 생검이나 경피적 세침 흡입술을 이용하여 확진을 하였으며, 각 조직학적 분류에 따른 진행정도를 알기 위하여 TNM system 을 이용하여 분류하였고, 소세포 폐암은 limited stage와 extensive stage로 분류하였다. Genzyme사의 Predicts sICAM-1 ELISA kit를 이용하여 혈청 sICAM-1농도를 측정하였다. 결과 : 1. 소세포 폐암군에서 혈청 sICAM-1은 정상 대조군에 비해 유의한 증가가 없었으나, extensive stage군에서 limited stage군에 비해 유의한 증가를 보였다. 2. 편평상피암군에서 혈청 sICAM-1은 정상 대조군에 비해 유의한 증가를 보였으며, stage IIIa기 이하군에 비해 stage IIIb기 이상군에서 유의한 증가를 보였다. 3. 선폐암 환자군에서 혈청내 sICAM-1은 정상 대조군에 비해 유의한 증가를 보였다. 결론 : 혈청 sICAM-1농도의 변화는 폐암의 조직학적 분류에 따라 다르게 나타나며, 폐암의 전이 및 진행과 관련이 있을 것으로 보인다. 폐암 환자에서 혈청 sICAM-1농도의 측정은 폐암에서 진행의 정도를 평가하는 데 지표로서 이용될 수 있을 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6783-6787
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• 2015

Background: Despite consistent pharmacogenetic effects of CYP2D6 on tamoxifen exposure, there is considerable controversy regarding the validity of CYP2D6 as a predictor of tamoxifen outcome. Understanding the current state of evidence in this area and its limitations is important for the care of patients who require endocrine therapy for breast cancer. Materials and Methods: A total of 101 patients with breast cancer who received tamoxifen therapy for at least 3 years, were genotyped for common alleles of the CYP2D6 gene by nested-PCR and restriction fragment length polymorphism PCR. Patients were classified as extensive or poor metabolizers (PM) based on CYP2D6*4 alleles in 3 different groups according to the menopause, Her2-neu status, and stage 3. Results: The mean age of the patients with the disease recurrence was $50.8{\pm}6.4$ and in non recurrent patients was $48.2{\pm}6.8$. In this study 63.3% (n=64) patients were extensive metabolizers and 36.6% (n=37) were poor metabolizers. Sixty four of the 101 patients (63.3%) were Her2-neu positive. For tamoxifen-treated patients, no statistically significant difference in rate of recurrence observed between CYP2D6 metabolic variants in stage 3 and post-menopausal patients. However, there was a significant association between CYP2D6 genotype and recurrence in tamoxifen-treated Her2-neu positive patients. Compared with other women with breast cancer, those with Her2-neu positive breast cancer and extensive metabolizer alleles had a decreased likelihood of recurrence. Conclusions: This study for the first time demonstrated significant effects of CYP2D6 extensive metabolizer alleles on risk of recurrence in Her2-neu positive breast cancer patients receiving adjuvant tamoxifen therapy. Therefore, CYP2D6 metabolism, as measured by genetic variation, can be a predictor of breast cancer outcome in Her2-neu positive women receiving tamoxifen.

• Journal of Chest Surgery
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• 제26권3호
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• pp.214-218
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• 1993

Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.

• 융합정보논문지
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• 제11권8호
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• pp.207-211
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• 2021

이 논문은 단계 1에 기계 한 대, 단계 2에 2대의 병렬 기계가 있는 유연 흐름 생산 스케줄링 문제를 다룬다. 목적 함수는 평균 완료 시간을 최소화하는 것이다. 이 문제를 혼합 정수 2차 문제로 정식화하여 혼합 시뮬레이티드 어닐링을 이용하여 풀었다. 혼합 시뮬레이티드 어닐링은 유전자 알고리즘의 탐색 능력을 이용하고 시뮬레이티드 어닐링을 적용하여 너무 이른 수렴 현상을 줄이는 방법이다. 실험을 통하여 혼합 시뮬레이티드 어닐링의 성능을 평가하였다.

• 한국콘텐츠학회논문지
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• 제8권12호
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• pp.207-213
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• 2008

수십 년 동안 우리는 테마파크, 쇼핑몰, 길거리 등에 이를 보완하는 미디어나 이와 경쟁하는 미디어들을 채워왔다. 이런 공간들은 신문과 잡지, 라디오, 텔레비전, 영화를 재매개(remediation)하거나 이것들의 재매개(remediation) 대상이 되어왔다.[5] 하지만, 전통적 연극무대디자인은 재매개(remediation)가 이루어지지 못했다. 그로인해서 관람자에게 현전감(sense of presence)을 느끼게 할 수 없는 많은 문제점들을 수반하고 있다. 전통적 연극무대디자인의 문제점을 해결하기위한 재매개(remediation)의 체계적 연구가 필요한 시점이다. 본 연구는 전통적 연극무대디자인을 재매개(remediation)할 수 있는 해결방안을 제안한다. 이를 위해서 광범위하고 다양한 영역을 형성하고 있는 시각효과(Visual Effects)분야와 연극무대디자인분야의 협업을 중심으로 연구한다. 시각효과(Visual Effects)를 활용한 전통적 연극 무대디자인의 재매개(remediation) 제안은 두 학문 간의 긴밀한 협업의 체계화를 통한 경제적 고부가가치를 창출할 것이다. 또한 두 학문 분야의 협업의 체계화는 전통적 연극 무대디자인분야에서 관객들이 경험할 수 없었던 또 다른 커뮤니케이션의 패러다임을 만들어 나갈 것이다.