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최상지,최은경,박성찬,박규주 대한대장항문학회 2008 Annals of Coloproctolgy Vol.24 No.6
Purpose: We sought to determine the long-term outcome of surgical management for gastrointestinal Crohns’s disease (CD) and to find out whether there is any improvement over the time period. Methods: We analyzed the records of the 102 patients who underwent surgery for gastrointestinal CD excluding perianal CDbetween 1978 and 2007. A cumulative surgical recurrence rate was analyzed by Kaplan-Meier plots and log-rank tests. Results: The main sites of CD were ileocecal area in 54.5%, followed by small bowel (29.7%) and large bowel (7.9%). Common indications for operation were obstruction (25.7%), diagnostic purpose (20.8%), and failure of medical treatment (12.9%). The operation performed were ileocolectomy including right hemicolectomy in 53 cases (45.3%), small bowel resection in 38 cases (31.7%), and strictureplasty 12 cases (10.0%, including 11 cases combined with bowel resection). The average follow-up period after operation was 6.4years (range: 0.5∼29 yr, median: 5.3 yr). Among all patients, 22 (21.6%) underwent operations for recurrence. The re-operation rate was higher in the younger patients group (age at diagnosis less than 25 years) (34.1% vs. 12.1%, P<0.05), and in case of the patients whose length of initial intestinal resection was less than 40 cm (27.9% vs. 7.7%, P<0.05). The overall cumulative re-operation rates at 5years, 10years and 15years were 15%, 25%, and 60%, respectively. Conclusions: Despite recent advances in medical therapy, the cumulative re-operation rate of patients operated for gastrointestinal CD remains similar to our previous report in 1997. Purpose: We sought to determine the long-term outcome of surgical management for gastrointestinal Crohns’s disease (CD) and to find out whether there is any improvement over the time period. Methods: We analyzed the records of the 102 patients who underwent surgery for gastrointestinal CD excluding perianal CDbetween 1978 and 2007. A cumulative surgical recurrence rate was analyzed by Kaplan-Meier plots and log-rank tests. Results: The main sites of CD were ileocecal area in 54.5%, followed by small bowel (29.7%) and large bowel (7.9%). Common indications for operation were obstruction (25.7%), diagnostic purpose (20.8%), and failure of medical treatment (12.9%). The operation performed were ileocolectomy including right hemicolectomy in 53 cases (45.3%), small bowel resection in 38 cases (31.7%), and strictureplasty 12 cases (10.0%, including 11 cases combined with bowel resection). The average follow-up period after operation was 6.4years (range: 0.5∼29 yr, median: 5.3 yr). Among all patients, 22 (21.6%) underwent operations for recurrence. The re-operation rate was higher in the younger patients group (age at diagnosis less than 25 years) (34.1% vs. 12.1%, P<0.05), and in case of the patients whose length of initial intestinal resection was less than 40 cm (27.9% vs. 7.7%, P<0.05). The overall cumulative re-operation rates at 5years, 10years and 15years were 15%, 25%, and 60%, respectively. Conclusions: Despite recent advances in medical therapy, the cumulative re-operation rate of patients operated for gastrointestinal CD remains similar to our previous report in 1997.
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일반화 공간 변조 시스템에서 타부 탐색을 이용한 신호 검출
최상지(Sangji Choi),이경천(Kyungchun Lee) 대한전기학회 2021 대한전기학회 학술대회 논문집 Vol.2021 No.10
본 논문은 일반화 공간 변조 시스템을 위한 QR 분해를 적용한 타부 탐색(Tabu Search) 신호 검출 방식을 제안한다. 제안된 수신 방식에서는 QR 분해 후의 신호 모델을 이용함으로써 비용 함수 계산량을 낮추며 이를 통해 타부 탐색의 전체 복잡도를 줄인다. 또한 비용함수 계산에서 순서화를 적용하여 복잡도를 추가로 최적화 한다. 모의실험을 통해 제안한 QR 분해 기반의 타부 탐색 수신기의 성능 및 계산 복잡도를 평가하였으며, 기존 방식들과 비교하여 낮은 계산량으로도 유사한 BER(Bit Error Rate, 비트오류율) 성능을 갖는 것을 확인하였다.
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Rectourethral Fistula: Systemic Review of and Experiences With Various Surgical Treatment Methods
최지혜,전병건,최상지,한언철,하헌균,오흥권,최은경,문상희,유승범,박규주 대한대장항문학회 2014 Annals of Coloproctolgy Vol.30 No.1
Purpose: A rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation or trauma. Although various surgical procedures for the treatment of an RUF have been described, none has gained acceptance as the procedure of choice. The aim of this study was to review our experience with surgical management of RUF. Methods: The outcomes of 6 male patients (mean age, 51 years) with an RUF who were operated on by a single surgeon between May 2005 and July 2012 were assessed. Results: The causes of the RUF were iatrogenic in four cases (two after radiation therapy for rectal cancer, one after brachytherapy for prostate cancer, and one after surgery for a bladder stone) and traumatic in two cases. Fecal diversion was the initial treatment in five patients. In one patient, fecal diversion was performed simultaneously with definitive repair. Four patients underwent staged repair after a mean of 12 months. Rectal advancement flaps were done for simple, small fistula (n = 2), and flap interpositions (gracilis muscle flap, n = 2; omental flap, n = 1) were done for complex or recurrent fistulae. Urinary strictures and incontinence were observed in patients after gracilis muscle flap interposition, but they were resolved with simple treatments. The mean follow-up period was 28 months, and closure of the fistula was achieved in all five patients (100%) who underwent definitive repairs. The fistula persisted in one patient who refused further definitive surgery after receiving only a fecal diversion. Conclusion: Depending on the severity and the recurrence status of RUF, a relatively simple rectal advancement flap repair or a more complex gracilis muscle or omental flap interposition can be used to achieve closure of the fistula.
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