94 research outputs found

    ROS2๊ธฐ๋ฐ˜์˜ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ์„ ์œ„ํ•œ ๊ธฐ๋Šฅ์ /์‹œ๊ฐ„์  ์ •ํ™•์„ฑ์„ ๋ณด์žฅํ•˜๋Š” ์‹ค์‹œ๊ฐ„ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ธฐ๋ฒ•

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ) -- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ๊ณต๊ณผ๋Œ€ํ•™ ์ปดํ“จํ„ฐ๊ณตํ•™๋ถ€, 2021. 2. ์ด์ฐฝ๊ฑด.This dissertation proposes an approach for functionally and temporally correct simulation of cyber system based on ROS2 framework. In the previous work, the simulation approach was proposed that overcomes the limitations, which only guaranteeing the functional correctness of the existing simulation approach by guaranteeing the temporal correctness and simultaneously performs the task efficiently by reordering jobs. Recognizing that the ROS2 cyber system differs from the traditional automotive cyber systems, this dissertation can be applied to the ROS2 cyber system while maintaining the key idea of the previous simulation approach. In the proposed approach, a system model for ROS2 cyber system is defined. Based on this, the cyber systems schedule is predicted, and a precedence relationship graph is generated so that the existing simulation technique can be applied. The proposed method measures the simulation capacity, together with other simulation algorithms, through a randomly generated workload, and it is shown that the proposed approach has the highest simulation capacity in a single core simulator. Therefore, the existing functional/ temporally correct simulation approach can be applied to the cyber system of automotive system based on ROS2 framework, and by utilizing this, it is possible to correctly and effectively simulate the ROS2 cyber system.๋ณธ ๋…ผ๋ฌธ์€ ROS2๋ฅผ ๊ธฐ๋ฐ˜์œผ๋กœ ์„ค๊ณ„๋œ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ์„ ๊ธฐ๋Šฅ์ /์‹œ๊ฐ„์ ์œผ๋กœ ์ •ํ™•ํ•˜๊ฒŒ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ํ•˜๋Š” ๋ฐฉ๋ฒ•๋ก ์„ ์ œ์•ˆํ•œ๋‹ค. ์•ž์„  ์—ฐ๊ตฌ์—์„œ๋Š” ๊ธฐ์กด์˜ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ธฐ๋ฒ•๋“ค์˜ ๊ธฐ๋Šฅ์ ์ธ ์ •ํ™•์„ฑ๋งŒ ๋ณด์žฅํ•˜๋Š” ๋ฌธ์ œ์—์„œ ๋ฐœ์ƒํ•˜๋Š” ํ•œ๊ณ„์ ์„ ๊ทน๋ณตํ•˜๊ณ  ๋™์‹œ์— ํšจ์œจ์ ์œผ๋กœ ์ž‘์—…์„ ์ˆ˜ํ–‰ํ•˜๋Š” ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ธฐ๋ฒ•์ด ์ œ์•ˆ๋˜์—ˆ๋‹ค. ROS2 ๊ธฐ๋ฐ˜์˜ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ์—์„œ๋Š” ๊ธฐ๋Šฅ ์ˆ˜ํ–‰์˜ ํ–‰ํƒœ๊ฐ€ ๊ธฐ์กด์˜ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ๊ณผ๋Š” ๋‹ค๋ฅด๋‹ค๋Š” ๊ฒƒ์„ ์ธ์ง€ํ•˜์—ฌ ๋ณธ ๋…ผ๋ฌธ์—์„œ๋Š” ์•ž์„  ์—ฐ๊ตฌ์—์„œ ์ œ์•ˆํ•˜๋Š” ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ธฐ๋ฒ•์˜ ํ•ต์‹ฌ ์•„์ด๋””์–ด๊ฐ€ ์œ ์ง€๋˜๋ฉด์„œ ROS2 ๊ธฐ๋ฐ˜์˜ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ์— ์ ์šฉ์ด ๋  ์ˆ˜ ์žˆ๋„๋ก ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ธฐ๋ฒ•์„ ์ œ์•ˆํ•œ๋‹ค. ์ œ์•ˆํ•˜๋Š” ๋ฐฉ๋ฒ•์—์„œ๋Š” ROS2 ์Šค์ผ€์ค„๋ง์„ ๊ณ ๋ คํ•œ ์‹œ์Šคํ…œ ๋ชจ๋ธ์„ ์ •์˜ํ•˜๊ณ  ์ด๋ฅผ ๊ธฐ๋ฐ˜์œผ๋กœ ์‹ค์ œ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ์˜ ์Šค์ผ€์ค„์„ ์˜ˆ์ธกํ•˜๊ณ  ์„ ํ–‰ ๊ด€๊ณ„ ๊ทธ๋ž˜ํ”„๋ฅผ ์ƒ์„ฑํ•˜์—ฌ ๊ธฐ์กด์˜ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ธฐ๋ฒ•์ด ๊ทธ๋Œ€๋กœ ์ ์šฉ๋  ์ˆ˜ ์žˆ๋„๋ก ํ•œ๋‹ค. ์ œ์•ˆํ•˜๋Š” ๋ฐฉ๋ฒ•์€ ์ž„์˜์ ์œผ๋กœ ์ƒ์„ฑ๋œ ์›Œํฌ๋กœ๋“œ๋ฅผ ํ†ตํ•ด ๋‹ค๋ฅธ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ์•Œ๊ณ ๋ฆฌ์ฆ˜๊ณผ ํ•จ๊ป˜ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ์šฉ๋Ÿ‰์„ ์ธก์ •ํ•˜๊ณ , ์ œ์•ˆํ•˜๋Š” ๋ฐฉ๋ฒ•์ด ์‹ฑ๊ธ€์ฝ”์–ด ์‹œ๋ฎฌ๋ ˆ์ดํ„ฐ์—์„œ ๊ฐ€์žฅ ๋†’์€ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ์šฉ๋Ÿ‰์„ ๊ฐ€์ง€๋Š” ๊ฒƒ์„ ๋ณด์ธ๋‹ค. ๋”ฐ๋ผ์„œ, ๊ธฐ์กด์˜ ๊ธฐ๋Šฅ์ /์‹œ๊ฐ„์ ์œผ๋กœ ์ •ํ™•ํ•œ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ธฐ๋ฒ•์ด ROS2 ๊ธฐ๋ฐ˜์˜ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ์—์„œ๋„ ์ ์šฉ์ด ๊ฐ€๋Šฅํ•˜๋ฉฐ, ์ด๋ฅผ ํ™œ์šฉํ•˜์—ฌ ๊ธฐ์กด์˜ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ROS2 ๊ธฐ๋ฐ˜์˜ ์ž๋™์ฐจ ์‚ฌ์ด๋ฒ„ ์‹œ์Šคํ…œ์„ ํšจ๊ณผ์ ์œผ๋กœ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ ํ•  ์ˆ˜ ์žˆ๋‹ค.1 Introduction 1 1.1 Motivation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 Backgrounds 4 2.1 Overview of Functionally and Temporally Correct Simulation . . . 4 2.2 ROS2 Scheduling . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3 Proposed Approach 10 3.1 System Model for ROS2 Cyber System . . . . . . . . . . . . . . . 10 3.2 Offline Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3.3 Online Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4 Evaluation 18 4.1 Experimental Setup . . . . . . . . . . . . . . . . . . . . . . . . . . 18 4.2 Simulation Results . . . . . . . . . . . . . . . . . . . . . . . . . . 19 5 Conclusion 21 References 23Maste

    Mycobacterium tuberculosis์—์„œ ์œ ๋ž˜ํ•œ MazE2์˜ DNA binding์— ๋Œ€ํ•œ ๊ตฌ์กฐ์ , ๊ธฐ๋Šฅ์  ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› ์•ฝํ•™๋Œ€ํ•™ ์•ฝํ•™๊ณผ, 2017. 8. ์ด๋ด‰์ง„.Mycobacterium tuberculosis was first discovered by Robert Koch in 1882 and is a human infectious strain that causes lung disease through the respiratory tract. M. tuberculosis differs from ordinary bacteria in that it has thick membranes on the cell surface and does not stain Gram stain. However, when stained with Ziehl-Neelsen, it is difficult to decolorize by acid, alcohol and boiling, and this property is called acid-fast. Gram staining is negative, but they do not have external membranes and are classified as acid-fast gram-positive bacteria. Treatment of patients infected with M. tuberculosis is mainly medication. Isoniazid, rifampin, and pyrazinamide are used, and streptomycin is also used. Mycobacterium tuberculosis has the largest number of Toxin-Antitoxin system pairs among bacteria. The Toxin-Antitoxin system is classified into six types according to antitoxin properties. The target protein Rv0660c of this study is MazE, an antitoxin of MazEF system, which is one of Type2 Toxin-Antitoxin system. The Toxin-Antitoxin system plays a role in inhibiting the growth of bacteria or leading to death by external stimuli-activated toxins. Antitoxin normally binds to toxin and inhibits the activity of toxin. but it breaks down in extreme situations. Thus, dissociated toxin induces growth inhibition and death. This also induces latency and lowers susceptibility to antibiotics. We overexpress the N1-44 construct of Rv0660c to characterize the tertiary structure of this Rv0660c protein. His-tagged Rv0660c protein was purified using Immobilized Metal Affinity Chromatography (IMAC), and the His-tag was removed through thrombin cutting to further increase the protein purity. As a result, the crystal could be made and the structure could be obtained with a high resolution of 1.69 ร…. The DNA binding experiments of Rv0660c were carried out by NMR and EMSA. Rv0660c was labeled with 13C and 15N isotopes. Heteronuclear multidimensional NMR spectra were measured and backbone assignments were made through HNCO, HNCA, HNCACO, HNCOCA, HNCOCACB and HNCACB spectra. The TALOS program was used to predict the secondary structure and identify the parts which interact DNA through DNA titration. We confirmed the binding of Rv0660c with DNA in vitro from Electrophoretic Mobility Shift Assay (EMSA).I. Introduction 1 1.1 Structure Based Drug Design (SBDD) 1 1.2 Characteristics of Mycobacterium tuberculosis 2 1.3 Epidemiology of Mycobacterium tuberculosis 2 1.4 Toxinโ€“Antitoxin System 3 1.5 Characteristics of Rv0660c 4 1.6 Purpose of the study 5 โ…ก. Materials and Methods 6 2.1 Materials 6 2.1.1 Reagents 6 2.1.2 Apparatus 7 2.2. Methods 7 2.2.1 Cloning of target protein 8 2.2.2 Protein over-expression and purification 9 2.2.3 Crystallization 10 2.2.4. X-ray data collection and structure determination 11 2.3 Structural and Functional studies by NMR spectroscopy 11 2.3.1 NMR data collection 12 2.3.2 Backbone assignment . 12 2.3.3 Secondary structure prediction based on TALOS 13 2.3.4 DNA synthesis and preparation 13 2.4 Electrophoretic Mobility Shift Assay (EMSA) 14 โ…ข. Result 15 3.1 Protein preparation 15 3.1.1 Cloning, overexpression and purification 15 3.1.2 Crystallization 18 3.2 Crystal structure of Rv0660c1-44 19 3.3 NMR studies of 15N or15N-13C labeled Rv0660c1-44 20 3.3.1 2D 1H-15N HSQC 20 3.3.2 Sequential backbone assignment 21 3.3.3 Predicted secondary structure of Rv0660c1-44 22 3.4 Functional study 24 3.4.1 Protein-DNA binding 24 3.4.2 Comprehensive result of protein-DNA binding 27 3.4.3 Electrophoretic Mobility Shift Assay (EMSA) 29 โ…ฃ. Disussion 30 โ…ค. Referenece 31 ๊ตญ๋ฌธ์ดˆ๋ก 35Maste

    '๊ธฐ์—…์˜ ์‚ฌํšŒ์  ์ฑ…์ž„' ๊ตญ์ œ๊ทœ๊ฒฉ (ISO 26000)์˜ ๋™ํ–ฅ๊ณผ ๊ณ ์ฐฐ

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    ๊ธฐ์—…์˜ ์‚ฌํšŒ์  ์ฑ…์ž„(Corporate Social Responsibility (CSR))์ด ์ตœ๊ทผ ๊ธฐ์—…๊ฒฝ์˜์˜ ํ™”๋‘๊ฐ€ ๋˜๊ณ  ์žˆ์œผ๋ฉฐ, ๊ตญ์ œํ‘œ์ค€ํ™”๊ธฐ๊ตฌ(Organization for International Standardization (ISO))์—์„œ๋„ ๊ธฐ์—…์˜ ์‚ฌํšŒ์  ์ฑ…์ž„์— ๋Œ€ํ•œ ๊ตญ์ œ์  ํ‘œ์ค€ ์ œ์ • ์ž‘์—…์„ ์„œ๋‘๋ฅด๊ณ  ์žˆ๋‹ค. ๋ณธ ๋…ผ๋ฌธ์—์„œ๋Š” CSR์˜ ํƒœ๋™๊ณผ์ •์„ ์‚ดํŽด๋ณด๊ณ , CSR์ด ๋‹ด๊ณ  ์žˆ๋Š” ๊ทผ๋ณธ์ ์ธ ๊ฐœ๋…์„ ๋จผ์ € ์†Œ๊ฐœํ•œ๋‹ค. ISO๋Š” CSR์— ๊ด€๋ จ๋œ ํ‘œ์ค€์„ ISO 26000์œผ๋กœ ๋ช…๋ช…ํ•  ์˜ˆ์ •์ด๋ฉฐ, ISO 26000์— ๋‹ด๊ฒจ์งˆ ๋‚ด์šฉ์€ ์–ด๋–ค ๊ฒƒ๋“ค์ด ์žˆ์„๊นŒ์— ๋Œ€ํ•˜์—ฌ ์˜ˆ์ธกํ•˜์—ฌ ์„ค๋ช…ํ•˜๊ธฐ๋กœ ํ•œ๋‹ค. ์ง€๊ตฌ์ดŒ์€ ๊ธ‰๊ฒฉํžˆ ๊ตญ์ œํ™”๋˜์–ด ๊ฐ€๊ณ  ์žˆ์œผ๋ฉฐ, ์ด๋Ÿฌํ•œ ๊ตญ์ œ์  ํ‘œ์ค€์ด ๊ธฐ์—…์˜ ๊ฒฝ์˜ํ™œ๋™์— ์ฃผ๋Š” ์˜ํ–ฅ์„ ๋ง‰๋Œ€ํ•  ๊ฒƒ์œผ๋กœ ๋ณด์ธ๋‹ค. ๋”ฐ๋ผ์„œ ๊ธฐ์—…๋“ค์€ ์ด๋Ÿฌํ•œ ๊ตญ์ œ์  ํ‘œ์ค€์— ๋Œ€๋น„ํ•œ ํ‘œ์ค€๊ฒฝ์˜์„ ํ•˜๋ฃจ ๋นจ๋ฆฌ ์ค€๋น„ํ•  ๋•Œ์ด๋‹ค. ์ด ๊ธ€์ด ISO 26000์— ๊ด€์‹ฌ์„ ๊ฐ€์ง€๊ณ  ์žˆ๊ฑฐ๋‚˜ ์ค€๋น„ํ•˜๋Š” ์กฐ์ง์—๊ฒŒ ์œ ์šฉํ•œ ๊ฒฝ์˜์ •๋ณด๋ฅผ ์ œ๊ณตํ•  ์ˆ˜ ์žˆ๊ธฐ๋ฅผ ๊ธฐ๋Œ€ํ•œ๋‹ค

    - ์ง€๋‹ˆ๊ณ„์ˆ˜์™€ ์‹ค์—…๋ฅ ์„ ์ค‘์‹ฌ์œผ๋กœ-

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ) -- ์„œ์šธ๋Œ€ํ•™๊ต๋Œ€ํ•™์› : ์‚ฌํšŒ๊ณผํ•™๋Œ€ํ•™ ๊ฒฝ์ œํ•™๋ถ€, 2022.2. ๊น€์˜์‹.๋ณธ ์—ฐ๊ตฌ๋Š” ๊ฒฝ๊ธฐ๋ณ€๋™์— ๋”ฐ๋ฅธ ์ •๋ถ€์˜ ์ •์ฑ…ํšจ๊ณผ๋ฅผ ๊ฒฝ๊ธฐ๋ณ€๋™์ง€์ˆ˜์ธ ์‹ค์—…๋ฅ , ์†Œ๋น„์ž๋ฌผ๊ฐ€์ƒ์Šน๋ฅ , ๊ฒฝ์ œ์„ฑ์žฅ๋ฅ ๊ณผ ์†Œ๋“๋ถˆํ‰๋“ฑ์˜ ์ •๋„๋ฅผ ์ธก์ •ํ•  ์ˆ˜ ์žˆ๋Š” ์ง€๋‹ˆ๊ณ„์ˆ˜๋ฅผ ํ†ตํ•ด ๋ถ„์„ํ•˜๊ณ  ์ •๋ฆฌํ•ด๋ณธ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์ง€๋‹ˆ๊ณ„์ˆ˜๋ฅผ ์„ธ์ „, ์„ธํ›„๋กœ ๋ถ„๋ฆฌํ•˜์—ฌ ๊ฐ๊ฐ์˜ ์—ฐ๋„๋ณ„ ์ฐจ์ด๋ฅผ ๊ตฌํ•œ ๋’ค, ์ด๋ฅผ ์ •๋ถ€์˜ ์กฐ์„ธ ์ •์ฑ…์— ์˜ํ•œ ์†Œ๋“๋ถˆํ‰๋“ฑ ๊ฐœ์„ ๋„๋กœ ์ธก์ •ํ•˜์—ฌ ์ด๋ฅผ ๋ถ„์„๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค. ์ฃผ์š” ๋ถ„์„ ๊ฒฐ๊ณผ๋กœ๋Š” ์‹ค์—…๋ฅ ์ด ์˜ฌ๋ผ๊ฐˆ์ˆ˜๋ก ์ฆ‰ ๊ฒฝ๊ธฐ๊ฐ€ ์•…ํ™”๋  ๋•Œ ์†Œ๋“ ๋ถˆํ‰๋“ฑ์˜ ์ •๋„๋Š” ์ •๋ถ€์˜ ์กฐ์„ธ์ •์ฑ…์„ ํ†ตํ•œ ๊ฐœ์ž… ์ „๋ณด๋‹ค ๊ฐœ์ž… ํ›„๊ฐ€ ๋”์šฑ ์ข‹์ง€ ๋ชปํ•œ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด๋Š” ์‹ค์—…๋ฅ ์˜ ๋ณ€๋™์œผ๋กœ ์‚ดํŽด๋ณธ ๊ฒฝ๊ธฐ๋ณ€๋™์— ๋”ฐ๋ฅธ ์ •๋ถ€์˜ ๊ฐœ์ž…์ด ๊ฒฝ๊ธฐ ํšŒ๋ณต๊ณผ ์•…ํ™”์˜ ์‹œ์ ์— ๋”ฐ๋ผ ๊ฐœ์ž… ์˜๋„์™€๋Š” ๋‹ค๋ฅด๊ฒŒ ์†Œ๋“๋ถˆํ‰๋“ฑ์„ ๋˜๋ ค ์•…ํ™”์‹œํ‚ค๋Š” ๊ฒฐ๊ณผ๋ฅผ ์ดˆ๋ž˜ํ•  ์ˆ˜ ์žˆ๋‹ค๊ณ  ์ •๋ฆฌํ•  ์ˆ˜ ์žˆ๋‹ค.This study analyzes and summarizes the government's progressive tax policy effects on income inequality which can measure by the Gini coefficient through economic indexes (unemployment rate, inflation rate, economic growth rate). In this study, the Gini coefficient was separated into pre-tax and post-tax categories to find the difference for each year, and this was measured as the improvement in income inequality by the government's tax policy, and this was used as an analysis target. The result of the main analysis, the unemployment rate rises, that is, when the economy deteriorates, the degree of income inequality is worse after the intervention than before the intervention through the government's tax policy. This can be summarized that governmentโ€™s intervention in response to economic fluctuations, which was examined by fluctuations in the unemployment rate, could lead to aggravating income inequality differently from the intention of the intervention, depending on the timing of economic recovery and deterioration.1. ์„œ ๋ก  1 2. ์„ ํ–‰์—ฐ๊ตฌ 3 3. ์—ฐ๊ตฌ๋ฐฉ๋ฒ• ์„ค๊ณ„ 7 3.1 ์—ฐ๊ตฌ ๋ชจํ˜• 7 3.2 ์ •๋ถ€ ์ •์ฑ…ํšจ๊ณผ์˜ ์ธก์ • 8 3.3 ๊ฒฝ๊ธฐ๋ณ€๋™์ง€์ˆ˜ 12 3.4 ํ†ต์ œ๋ณ€์ˆ˜ (๊ฒฝ์ƒ์กฐ์„ธ ์‹ค๋ถ€๋‹ด๋ฅ ) 14 4. ์‹ค์ฆ๋ถ„์„ ๊ฒฐ๊ณผ 18 5. ๊ฒฐ ๋ก  20 ์ฐธ๊ณ ๋ฌธํ—Œ 22 Abstract 24 ํ‘œ ๋ชฉ์ฐจ [ํ‘œ2-1] 4 [ํ‘œ2-2] 5 [ํ‘œ3-1] 8 [ํ‘œ3-2] 10 [ํ‘œ3-3] 13 [ํ‘œ3-4] 17 ๊ทธ๋ฆผ ๋ชฉ์ฐจ [๊ทธ๋ฆผ3-1] 11 [๊ทธ๋ฆผ3-2] 11 [๊ทธ๋ฆผ3-3] 12์„

    ๋ถ€๋™์‚ฐ์—…์˜ ๊ฒฝ์˜ํ˜์‹ : 6์‹œ๊ทธ๋งˆ ๋ฐฉ๋ฒ•๋ก ์„ ํ™œ์šฉํ•œ ์‚ฌ๋ก€ ์—ฐ๊ตฌ

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    ๋งˆ์ดํฌ๋กœ์†Œํ”„ํŠธํšŒ์‚ฌ์˜ Bill Gates(l999) ํšŒ์žฅ์€ ๋น„์ฆˆ๋‹ˆ์Šค๋Š” ๋‹ค๊ฐ€์˜ฌ 10 ๋…„ ๋™์•ˆ์— ์ง€๋‚œ 50๋…„ ๋ณด๋‹ค ํ›จ์”ฌ ๋” ํฐ ๋ณ€ํ™”๋ฅผ ๊ฒช๊ฒŒ ๋  ๊ฒƒ์ด๋‹ค๋ผ๊ณ  ๋งํ•˜์˜€๋‹ค. ๊ทธ์˜ ๋ง์ฒ˜๋Ÿผ ์ง€๊ธˆ์€ ๊ธฐ์—… ํ™˜๊ฒฝ์ด ๊ธ‰์†ํžˆ ๋ณ€ํ™”ํ•˜๊ณ  ์žˆ์œผ๋ฉฐ, ์‹œ์žฅ์˜ ๊ธ€๋กœ๋ฒŒํ™”์™€ ๊ฒฝ์˜ํŒจ๋Ÿฌ๋‹ค์ž„์˜ ๋ณ€ํ™”๋Š” ๊ฐœ๋ณ„๊ธฐ์—… ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ํ•œ๊ตญ์‚ฐ์—… ์ „์ฒด์— ์ƒˆ๋กœ์šด ์ „๋žต์  ๋Œ€์‘์„ ์š”๊ตฌํ•˜๊ณ  ์žˆ๋‹ค. ๋ถ€๋™์‚ฐ ์‹œ์žฅ ์—ญ์‹œ ์™ธ๊ตญ๊ณ„ ๋ถ€๋™์‚ฐ๊ธฐ์—…์ด ์ง€์‹๊ณผ ์ž๋ณธ์„ ์•ž์„ธ์›Œ ๊ตญ๋‚ด์— ์ด๋ฏธ ์ง„์ถœํ•ด ์žˆ๋Š” ์‹ค์ •์ด๋‚˜, ๋‹ค๋ฅธ ์—…์ข…์— ๋น„ํ•˜์—ฌ ๊ตญ๋‚ด ๋ถ€๋™์‚ฐ๊ธฐ์—…์€ ๊ฒฝ์˜ํŒจ๋Ÿฌ๋‹ค์ž„์˜ ๋ณ€ํ™”์— ๋Œ€ํ•œ ์ ์‘์ด ํ›จ์”ฌ ๋Š๋ฆฐ ํŽธ์ด๋‹ค. ์‚ฌ์—… ์ถ”์ง„์˜ ์ „๋ฌธํ™”์™€ ์—…๋ฌดํ”„๋กœ์„ธ์Šค์˜ ํ‘œ์ค€ํ™”๊ฐ€ ๋ฏธํกํ•œ ์šฐ๋ฆฌ๋‚˜๋ผ ๋ถ€๋™์‚ฐ ๊ธฐ์—…์ด ์ด๋Ÿฌํ•œ ์‹œ์žฅ ๋ณ€ํ™”๋ฅผ ์ขŒ์‹œํ•˜๊ณ ๋งŒ ์žˆ๊ฑฐ๋‚˜ ์„ ์ง„๋ถ€๋™์‚ฐ ์‹œ์Šคํ…œ ๋„์ž…์„ ๋“ฑํ•œ์‹œ ํ•˜๋Š” ๊ฒฝ์šฐ ๊ฒฝ์Ÿ๋ ฅ์ด ๋’ค์ณ์งˆ ์ˆ˜๋ฐ–์— ์—†๋Š” ์ƒํ™ฉ์— ์ง๋ฉดํ•˜๊ฒŒ ๋  ๊ฒƒ์ด๋‹ค. ๋ณธ ๋…ผ๋ฌธ์€ ๊ตญ๋‚ด ๋ถ€๋™์‚ฐ์‹œ์žฅ์˜ ํ† ์–‘์œ„์— ์„ ์ง„๋ถ€๋™์‚ฐ ์‹œ์Šคํ…œ์„ ๋„์ž…ํ•˜์—ฌ ๊ฒฝ์˜์ฒด์งˆ์„ ๊ฐœ์„ ํ•˜๊ณ  ๊ฒฝ์Ÿ๋ ฅ์„ ๊ฐ•ํ™”ํ•˜๊ณ ์ž ๋…ธ๋ ฅํ•˜๊ณ  ์žˆ๋Š” ERA-Korea์‚ฌ๋ฅผ ์กฐ์‚ฌ ๊ธฐ์—…์œผ๋กœ ์„ ์ •ํ•˜์—ฌ, ์šฐ๋ฆฌ๋‚˜๋ผ ๋ถ€๋™์‚ฐ ๊ธฐ์—…์˜ ๊ฒฝ์˜ํ™œ๋™์— ๊ฒฝ์˜ํŒจ๋Ÿฌ๋‹ค์ž„์˜ ๋ณ€ํ™”๋ฅผ ์ ์‘์‹œํ‚ค๊ณ , ๊ฒฝ์˜ํ’ˆ์งˆ์„ ๋†’์ด๊ธฐ ์œ„ํ•˜์—ฌ ๊ณผํ•™์  ๊ฒฝ์˜ํ˜์‹  ๊ธฐ๋ฒ•์ธ 6์‹œ๊ทธ๋งˆ ๊ฒฝ์˜ํ˜์‹  ๊ธฐ๋ฒ•์„ ์ ์šฉํ•˜์—ฌ ๋ด„์œผ๋กœ์จ ๋ถ€๋™์‚ฐ ๊ธฐ์—…์— ์ƒˆ๋กœ์šด ๊ฒฝ์˜ํ’ˆ์งˆ๊ด€๋ฆฌ ๋ชจ๋ธ์„ ์ œ์‹œํ•˜๊ณ  ๊ถ๊ทน์ ์œผ๋กœ ๊ตญ๋‚ด ๋ถ€๋™์‚ฐ๊ธฐ์—…์˜ ๊ฒฝ์Ÿ๋ ฅ ๊ฐ•ํ™”๋ฅผ ์œ„ํ•œ ๋ถ€๋™์‚ฐ ๊ฒฝ์˜์˜ ๊ณผํ•™ํ™” ๋ฐฉ๋ฒ•์„ ์—ฐ๊ตฌํ•˜๋Š”๋ฐ ๊ทธ ๋ชฉ์ ์ด ์žˆ๋‹ค

    Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance

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    Introduction: Abdominal computed tomography (CT) can accurately demonstrate organs and vascular structures around the stomach, and its potential role for image guidance is becoming increasingly established. However, solely using two-dimensional CT images to identify critical anatomical structures is undeniably challenging and not surgeon-friendly. To validate the feasibility of a patient-specific 3-D surgical navigation system for preoperative planning and intraoperative guidance during robotic gastric cancer surgery. Materials and methods: A prospective single-arm open-label observational study was conducted. Thirty participants underwent robotic distal gastrectomy for gastric cancer using a virtual surgical navigation system that provides patient-specific 3-D anatomical information with a pneumoperitoneum model using preoperative CT-angiography. Turnaround time and the accuracy of detecting vascular anatomy with its variations were measured, and perioperative outcomes were compared with a control group after propensity-score matching during the same study period. Results: Among 36 registered patients, 6 were excluded from the study. Patient-specific 3-D anatomy reconstruction was successfully implemented without any problems in all 30 patients using preoperative CT. All vessels encountered during gastric cancer surgery were successfully reconstructed, and all vascular origins and variations were identical to operative findings. The operative data and short-term outcomes between the experimental and control group were comparable. The experimental group showed shorter anesthesia time (218.6 min vs. 230.3 min; P=0.299), operative time (177.1 min vs. 193.9 min; P=0.137), and console time (129.3 min vs. 147.4 min; P=0.101) than the control group, although the differences were not statistically significant. Conclusions: Patient-specific 3-D surgical navigation system for robotic gastrectomy for gastric cancer is clinically feasible and applicable with an acceptable turnaround time. This system enables patient-specific preoperative planning and intraoperative navigation by visualizing all the anatomy required for gastrectomy in 3-D models without any error. Clinical trial registration: Clinicaltrials.gov, identifier NCT05039333.ope

    Chylous Ascites After Gastric Cancer Surgery: Risk Factors and Treatment Results

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    Purpose: Although chylous ascites is a frequent complication of radical gastrectomy for gastric cancer, proper diagnostic criteria and optimal treatment strategies have not been established. This study aimed to identify the clinical features of chylous ascites and evaluate the treatment outcomes. Materials and methods: We retrospectively analyzed the data of patients who underwent radical gastrectomy between 2013 and 2019. Diagnosis was made when milky fluid or elevated triglyceride levels (โ‰ฅ100 mg/dL) appeared in the drains without a preceding infection. The clinical features, risk factors, and treatment outcomes were assessed according to the initial treatment modalities for fasting and non-fasting groups. Results: Among the 7,388 patients who underwent radical gastrectomy for gastric cancer, 156 (2.1%) experienced chylous ascites. The median length of hospital stay was longer in patients with chylous ascites than in those without (median [interquartile range]: 8.0 [6.0-12.0] vs. 6.0 [5.0-8.0], P<0.001). Low body mass index (adjusted odds ratio [aOR]=0.9; P<0.001), advanced gastric cancer (aOR=1.51, P=0.024), open surgery (reference: laparoscopic surgery; aOR=1.87, P=0.003), and extent of surgical resection (reference: subtotal gastrectomy, total gastrectomy, aOR=1.5, P=0.029; proximal gastrectomy, aOR=2.93, P=0.002) were associated with the occurrence of chylous ascites. The fasting group (n=12) was hospitalized for a longer period than the non-fasting group (n=144) (15.0 [12.5-19.5] vs. 8.0 [6.0-10.0], P<0.001). There was no difference in grade III complication rate (16.7% vs. 4.2%, P=0.117) or readmission rate (16.7% vs. 11.1%, P=0.632) between the groups. Conclusions: A fat-controlled diet and medication without fasting provided adequate initial treatment for chylous ascites after radical gastrectomy for gastric cancer.ope

    Changes in failure to rescue after gastrectomy at a large-volume center with a 16-year experience in Korea

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    Failure to rescue (FTR), the mortality rate among patients with complications, is gaining attention as a hospital quality indicator. However, comprehensive investigation into FTR has rarely been conducted after radical gastrectomy for gastric cancer patients. This study aimed to assess FTR after radical gastrectomy and investigate the associations between FTR and clinicopathologic factors, operative features, and complication types. From 2006 to 2021, 16,851 gastric cancer patients who underwent gastrectomy were retrospectively analyzed. The incidence and risk factors were analyzed for complications, mortality, and FTR. Seventy-six patients had postoperative mortality among 15,984 patients after exclusion. The overall morbidity rate was 10.49% (1676/15,984 = 10.49%), and the FTR rate was 4.53% (76/1676). Risk factor analysis revealed that older age (reference: < 60; vs. 60โ€“79, adjusted odds ratio [OR] 2.07, 95% confidence interval [CI] 1.13โ€“3.79, P = 0.019; vs. โ‰ฅ 80, OR 3.74, 95% CI 1.57โ€“8.91, P = 0.003), high ASA score (vs. 1 or 2, OR 2.79, 95% CI 1.59โ€“4.91, P < 0.001), and serosa exposure in pathologic T stage (vs. T1, OR 2.74, 95% CI 1.51โ€“4.97, P < 0.001) were associated with FTR. Moreover, patients who underwent gastrectomy during 2016โ€“2021 were less likely to die when complications occurred than patients who received the surgery in 2006โ€“2010 (OR 0.35, 95% CI 0.18โ€“0.68, P = 0.002). This investigation of FTR after gastrectomy demonstrated that the risk factors for FTR were old age, high ASA score, serosa exposure, and operation period. FTR varied according to the complication types and the period, even in the same institution. ยฉ 2023, The Author(s).ope

    Determination of Additional Surgery after Non-Curative Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Practically Modified Application of the eCura System

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    Background: Additional surgery after non-curative endoscopic submucosal dissection (ESD) may be excessive as few patients have lymph node metastasis (LNM). It is necessary to develop a risk stratification system for LNM after non-curative ESD, such as the eCura system, which was introduced in the Japanese gastric cancer treatment guidelines. However, the eCura system requires venous and lymphatic invasion to be separately assessed, which is difficult to distinguish without special immunostaining. In this study, we practically modified the eCura system by classifying lymphatic and venous invasion as lymphovascular invasion (LVI). Method: We retrospectively reviewed 543 gastric cancer patients who underwent radical gastrectomy after non-curative ESD between 2006 and 2019. LNM was evaluated according to LVI as well as size >30 mm, submucosal invasion โ‰ฅ500 ยตm, and vertical margin involvement, which were used in the eCura system. Results: LNM was present in 8.1% of patients; 3.6%, 2.3%, 7.4%, 18.3%, and 61.5% of patients with no, one, two, three, and four risk factors had LNM, respectively. The LNM rate in the patients with no risk factors (3.6%) was not significantly different from that in patients with one risk factor (2.3%, p = 0.523). Among patients with two risk factors, the LNM rate without LVI was significantly lower than with LVI (2.4% vs. 10.7%, p = 0.027). Among patients with three risk factors, the LNM rate without LVI was lower than with LVI (0% vs. 20.8%, p = 0.195), although not statistically significantly. Based on LNM rates according to risk factors, patients with LVI and other factors were assigned to the high-risk group (LNM, 17.4%) while other patients as a low-risk group (LNM, 2.4%). Conclusions: Modifying the eCura system by classifying lymphatic and venous invasion as LVI successfully stratified LNM risk after non-curative ESD. Moreover, the high-risk group can be simply identified based on LVI and the presence of other risk factors.ope

    Short-term outcomes and cost-effectiveness of laparoscopic gastrectomy with articulating instruments for gastric cancer compared with the robotic approach

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    To overcome the limitations of laparoscopic surgery, robotic systems have been commonly used in the era of minimally invasive surgery despite their high cost. However, the articulation of instruments can be achieved without a robotic system at lower cost using articulating laparoscopic instruments (ALIs). Between May 2021 and May 2022, perioperative outcomes following laparoscopic gastrectomy using ALIs versus robotic gastrectomy were compared. A total of 88 patients underwent laparoscopic gastrectomy using ALIs, while 96 underwent robotic gastrectomy. Baseline characteristics were similar between the groups except for a higher proportion of patients with a medical history in the ALI group (p = 0.013). Clinicopathologic and perioperative outcomes were not significantly different between the groups. However, the operation time was significantly shorter in the ALI group (p = 0.026). No deaths occurred in either group. In conclusion, laparoscopic gastrectomy using ALIs was associated with comparable perioperative surgical outcomes and a shorter operation time compared to robotic gastrectomy in this prospective cohort study. ยฉ 2023, The Author(s).ope
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