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폐쇄성 좌측 대장암에서 스텐트 삽입 후 단단계 복강경 대장 절제술의 단기 예후: 비폐쇄성 좌측 대장암의 복강경 대장 절제술군과의 비교
김현실,김성근,안창혁,강원경,이윤석,이인규,김형진,이상철,조현민,박종경,오승택,김준기 대한대장항문학회 2009 Annals of Coloproctolgy Vol.25 No.6
Purpose: Laparoscopic surgery has been considered to be contraindicated for treating malignant colorectal obstruction. Stent insertion for obstructive colorectal cancer has recently allowed laparoscopic surgery to be performed by means of preoperative bowel decompression and bowel preparation. The aim of this study is to evaluate the safety and the feasibility of a one-stage laparoscopic resection for obstructive left-sided colon cancer after stent insertion by comparing the results to those for nonobstructive left-sided colon cancer. Methods: Between May 2006 and January 2009, a laparoscopic colorectal operation was performed on 18 consecutive patients with obstructive left-sided colon cancer after placement of a self-expandable stent by one colorectal surgeon, and the results were compared retrospectively to those for 43 patients with non-obstructive left-sided colon cancer who had undergone a laparoscopic procedure with the same surgeon. The collected data were the clinicopathologic characteristics, the perioperative complications, the oncologic outcomes, the postoperative recovery results, and the survival rate. Results: The obstructive left-sided colon cancer group had significant benefits in retrieved lymph nodes (18.8±5.3 vs. 14.0± 8.7, P=0.036), and distal resection margin (5.5±3.0 cm vs. 3.6±2.4 cm, P=0.011). There were no significant differences in other clinicopathological characteristics and oncologic outcomes, including the overall 3-yr survival rate, between the two groups. Conclusion: Preoperative stent decompression followed by a laparoscopic colorectal resection is a safe and feasible option for treating obstructive left-sided colon cancer. A further large-scale prospective study should be performed to evaluate the long-term outcome of a one-stage laparoscopic resection using stent insertion in cases of obstructive left-sided colon cancer. Purpose: Laparoscopic surgery has been considered to be contraindicated for treating malignant colorectal obstruction. Stent insertion for obstructive colorectal cancer has recently allowed laparoscopic surgery to be performed by means of preoperative bowel decompression and bowel preparation. The aim of this study is to evaluate the safety and the feasibility of a one-stage laparoscopic resection for obstructive left-sided colon cancer after stent insertion by comparing the results to those for nonobstructive left-sided colon cancer. Methods: Between May 2006 and January 2009, a laparoscopic colorectal operation was performed on 18 consecutive patients with obstructive left-sided colon cancer after placement of a self-expandable stent by one colorectal surgeon, and the results were compared retrospectively to those for 43 patients with non-obstructive left-sided colon cancer who had undergone a laparoscopic procedure with the same surgeon. The collected data were the clinicopathologic characteristics, the perioperative complications, the oncologic outcomes, the postoperative recovery results, and the survival rate. Results: The obstructive left-sided colon cancer group had significant benefits in retrieved lymph nodes (18.8±5.3 vs. 14.0± 8.7, P=0.036), and distal resection margin (5.5±3.0 cm vs. 3.6±2.4 cm, P=0.011). There were no significant differences in other clinicopathological characteristics and oncologic outcomes, including the overall 3-yr survival rate, between the two groups. Conclusion: Preoperative stent decompression followed by a laparoscopic colorectal resection is a safe and feasible option for treating obstructive left-sided colon cancer. A further large-scale prospective study should be performed to evaluate the long-term outcome of a one-stage laparoscopic resection using stent insertion in cases of obstructive left-sided colon cancer.
김현실,김재승,이성현,서윤호 대한조선학회 2014 International Journal of Naval Architecture and Oc Vol.6 No.4
Insertion loss prediction of large acoustical enclosures using Statistical Energy Analysis (SEA) method ispresented. The SEA model consists of three elements: sound field inside the enclosure, vibration energy of the enclosurepanel, and sound field outside the enclosure. It is assumed that the space surrounding the enclosure is sufficiently largeso that there is no energy flow from the outside to the wall panel or to air cavity inside the enclosure. The comparison ofthe predicted insertion loss to the measured data for typical large acoustical enclosures shows good agreements. It isfound that if the critical frequency of the wall panel falls above the frequency region of interest, insertion loss isdominated by the sound transmission loss of the wall panel and averaged sound absorption coefficient inside theenclosure. However, if the critical frequency of the wall panel falls into the frequency region of interest, acoustic powerfrom the sound radiation by the wall panel must be added to the acoustic power from transmission through the panel.
김현실,김남희,한선희,차인호,서동준,박원서,육종인,김형준,Kim, Hyun-Sil,Kim, Nam-Hee,Han, Seon-Hui,Cha, In-Ho,Seo, Dong-Jun,Park, Won-Se,Yook, Jong-In,Kim, Hyung-Jun The Korean Association of Oral and Maxillofacial S 2010 대한구강악안면외과학회지 Vol.36 No.3
Postirradiation extraosseous osteogenic sarcomas are uncommon in the head and neck, despite the extensive use of high-dose radiation. It has been described as de novo radiation-induced neoplasm. We present a 73-year-old male who had been treated by radiotherapy for gingival cancer 7 years earlier and later developed extraosseous osteogenic sarcomas (EOSs) of the neck. Microscopically, the neck mass was composed with mesenchymal malignant cells with cartilaginous and osteogenic differentiation. Immunohistochemical stain demonstrated strong positivity of tumor cells for Snail, the one of major epithelial-mesenchymal transition (EMT) inducer. The E-cadherin expression was scarce, showing inverse relationship to Snail expression. Compared with previous squamous cell carcinoma (SCC) of the gingiva, the present EOS sample revealed the remained epithelial cells on cytokeratin immunohistochemistry, suggesting the tumor arise from the cells of epithelial origin. We have also reviewed the previous 6 cases of head and neck EOSs carefully. The clinicopathologic features of the unusual lesion suggest that it is an incomplete EMT of precedent epithelial malignancy rather than de novo pathology.
A Study on Mount Performance for Structure-Borne Noise Reduction in Resiliently Mounted System
김현실,김재승,김봉기,Kim, Hyun-Sil,Kim, Jae-Seung,Kim, Bong-Ki The Acoustical Society of Korea 2007 韓國音響學會誌 Vol.26 No.e2
SBN (Structure-Borne Noise) reduction in resiliently mounted machineries are predicted by using mass-spring model and wave model. In mass-spring model, mount is modeled as a spring, while in wave model, mount is considered as an equivalent elastic rod for taking account into longitudinal wave propagation. The predictions for SBN reduction through mounts are compared to the measurements for four different pumps. It is found that the mass-spring model is valid only in low frequency range below few hundred Hz, while for high frequency ranges longitudinal wave propagation in the mount must be considered to explain the measurements. It is also shown that impedance of the floor slightly affects low frequency behaviour in mass-spring and wave model below 50 Hz - 80 Hz, so that in engineering practice the effect of floor impedance may be neglected in computing mount performance.