Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

Film Session Q&A 2 : 05 ; How to remove a huge ovarian tumor in single port laparoscopic surgery using XXXL endopouch

( Jin Hwa Lee ),( Ga Won Yim ),( Eun Ji Nam ),( Sung Hoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: Demonstrate a new instrument, technique or procedure 방법: In this video, we showed how to remove huge ovarian tumors in sinlgel port laparoscopic surgery by SW KIM`s method. SW KIM`s method is the technique to put a huge ovarian tumor into a specially designed extremely large endopouch (XXXL: 30x30㎠sized) using two conventional laparoscopic needle holders and one laparoscopic grasper and gravity by changing the patient`s position. After identifying the infundibulopelvic and uteroovarian ligaments salpingooophorectomy including huge ovarian tumor was performed by LigaSure. And then ovarian tumor was located in the pelvic cavity by changing the patient`s position into reverse-trendelenberg position and a XXXL endopouch was inserted and un-rolled inside the abdominal cavity. To insert a huge tumor into the XXXL endopouch, the endopouch was opened in triangular shape. Bilateral apex of baseline of trianglular opening of the endopouch was hold by two needle holders and then the upper apex was hold by a grasper. After holding three point of endopouch opeing, the patient`s position was changed into deep trendelenberg postion, then the tumor came into the endopouch by gravity. While changing the patient`s position, 2 needle holders and a graspers were moved into the pelvic cavity from the abdominal cavity. Aftere identifying the tumor inside the endopouch, tumors could be removed through the single port opening site or transvaginally in laparoscopic hysterectomy case without spillage of ovarian tumor. 결과: The advantage of SW KIM`s method is to remove ovarian tumor without spillage in a single port laparoscopic surgery by putting it into the large endoscopic bag despite narrow space. 결론: Using a specially designed 30×30 cm sized XXXL Endopouch and SW Kim`s technique, huge ovarian tumors could be removed without spillage in single port laparoscopic surgery.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

Assessment of In Vitro Assay System for Thyroid HormoneDisruptors Using Rat Pituitary GH3 Cells

Hee Jin Kim1,Hae Young Park1,Jeonga Kim1,Il Hyun Kang2,Tae Sung Kim2,Soon Young Han2,Tae Seok Kang2,Kui Lea Park2,Hyung Sik Kim1 한국독성학회 2006 Toxicological Research Vol.22 No.4

The development of in vitro assays has been recommended to screening and test-ing the potential endocrine disruptors (EDs). These assay systems focus only on identifying thethe thyroid hormone (TH) disruptors. The aim of this study was to evaluate a test system to detectTH disruptors using rat pituitary tumor GH3 cells. The test system is based on the TH-dependentincrease in growth rate. As expected, L-3,5,3-triiodothyronine (T3) markedly induced a morphologicalchange in GH 3 cells from flattened fibroblastic types to rounded or spindle-shaped types. T3 stimu-lated GH3 cell growth in a dose-dependent manner with the maximum growth-stimulating effect9 M. In addition, T3 increased the release of growth hor-mone and prolactin into the medium of the GH3 cells culture. Using this assay system, the TH-dis-rupting activities of bisphenol A (BPA) and its related compounds were examined. BPA,dimethylbisphenol A (DMBPA), and TCI-EP significantly enhanced the growth of GH3 cells in therange of 1 × 10-5M to 1 × 10-6M concentrations. In conclusion, this in vitro assay system might bestandardization before it can be used as a broad-based screening tool.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

ZnO:In 가스 감지막의 특성 및 응용

김영범,박종아,김진해,김권태,김정규,마대영,박기철 경상대학교 생산기술연구소 2001 工學硏究院論文集 Vol.1 No.-

The microsensors to detect NH3 gas were fabricated by continous deposition of In film by evaporation and ZnO film by rf magnetron sputtering onto the Si3N4 diaphragm that was prepared by MEMS technology. The sensors were heat-treated to dope In into the ZnO thin film. The electrical characteristics of sensitive films were studied as a function of heat-temperature by 4-point probing method and electrometer. The dependence of the sensitivity, selectivity and time response of sensor on heat-treatment temperature was investigated. The microsensor heat-treated at 400℃ that 3000 A ZnO:In film was chosen as gas sensitive film, showed the highest sensitivity 23% at 350ppm NH3 under 366mW heater power. The time response was 90sec. The sensitivity for CO and NOx was not observed.

비혈연간 동종조혈모세포이식의 단일기관성적 : Single Center Experience

김유진,김동욱,이석,이동건,박윤희,김희제,김태규,민우성,김춘추 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.2

연구배경: 비혈연간 조혈모세포이식은 HLA체계에 대한 이해의 증진과 새로운 검사법의 개발, 그리고 기증자 수의 증가에 힘입어 최근 빠르게 증가하고 있다. 방법: 가톨릭조혈모세포이식센터에서 1995년 10월부터 2001년 12월까지 비혈연간 이식을 받은 138명의 성인 환자를 대상으로 후향적 분석을 하였다. 결과: 질환별로 만성골수성백혈병 66예, 급성림프구성백혈병 23예, 급성골수성백혈병 16예, 재생불량성빈혈 21예, 골수이형성증후군 9예, 비호지킨림프종 2예, 그리고 발작성야간혈색소뇨증이 1예였다. 일차 생차부전은 분석가능한 136예 중 4예(2.9%)에서 발생하였다. Ⅱ도 이상의 급성이식편대숙주병의 발생률은 48.1%였고, 만성이식편대숙주병은 49.5%였다. 재발 이외의 사망원인 중 가장 높은 빈도를 보인 것은 폐렴으로, 독성사망 64예 중 36예(52.3%)에서 관찰 되었다. 만성골수성백혈병의 경우(n=66), 무병생존율, 재발률, 비재발성 사망률이 각각 45.7%, 11.4%, 49.2%였다. 무병생존율은 표준위험군이 고위험군에 비해 통계적으로 유의하게 높았다(50.3% vs 32.0%, p=0.03). 급성림프구성백혈병의 경우(n=23), 무병생존율, 재발률, 비재발성 사망률이 각각 30.0%와 49.4%, 44.8%였던 반면, 급성골수성백혈병에서는(n=16) 28.6%, 39.4%, 52.9%였다. 이들 급성백혈병에서는 표준위험군에 비해 고위험군에서 재발률과 비재발성 사망이 모두 높게 관찰되었다. 중증재생불량성빈혈의 경우(n=21), 무병생존율과 비재발성 사망이 37.3%와 62.7%였다. 결론: 본 연구의 결과 비혈연간 이식은 HLA적합 형제가 없는 혈액질환 환자들에게 유용한 치료법의 하나임을 알 수 있었다. 낮은 병기에서의 조기 이식과 분자생물학적 방법을 사용한 HLA 적합도의 개선이 이식관련 사망을 최소화시켜 비혈연간 이식의 효과를 더욱 확대시킬 수 있을 것으로 생각된다. Background: Unrelated allogeneic stem cell transplantation (U-SCT) is recently on a increasing trend supported by better understanding of HLA system, development of new HLA typing, and increase of donor pool. Methods: We retrospectively analyzed 138 adult patients who underwent U-SCT between October 1995 and December 2001 at Catholic Hematopoietic Stem Cell Transplantation Center. Results: Diagnoses were chronic myeloid leukemia (CML, n=66), acute lymphoblastic leukemia (ALL, n=23), acute myeloid leukemia (AML, n=16), severe aplastic anemia (SAA, n=21), myelodysplastic syndrome (MDS, n=9), non-Hodgkin lymphoma (NHL, n=2), and paroxysmal nocturnal hemoglobinuria (PNH, n=1). Primary engraftment failure was observed in 4 (2.9%) of 136 evaluable patients. Acute GVHD (≥grade II) occurred in 48.1% and chronic GVHD occurred in 49.5%. The most common cause of death other than relapse was pneumonia, which occurred 36 (52.3%) of 64 toxic deaths. In CML, disease-free survival (DFS), relapse rate, and non-relapse mortality (NRM) was 45.7%, 11.4%, and 49.2%. DFS of the standard-risk group (SR) was significantly better than that of high- risk group (HR) (50.3% vs 32.0%, P=0.03). In ALL, DFS, relapse rate, and NRM was 30.0%, 49.4%, and 44.8%, whereas corresponding figures for AML were 28.6%, 39.4%, and 52.9%. NRM and relapse rate were higher in HR compared to SR in acute leukemia. In SAA, DFS and NRM was 37.3% and 62.7%. Conclusion: We concluded that U-SCT is a feasible therapeutic option for patients lacking a HLA-matched sibling donor. Transplantation at earlier phase of disease with more accurate HLA matching by molecular typing can minimize treatment-related toxicity and could extend the benefit of U-SCT.

分散制御 시스템에서 開放化 構造說計

김내진,김진태,최진석 건국대학교 1996 대학원 학술논문집 Vol.43 No.-

최근 각종 제어시스템에 분산제어 시스템을 이용하는 경우가 늘고 있는데, 각 플랫폼에 따른 호환성 결여로 인하여 여러 가지 문제가 야기되고 있다. 본 논문에서는 이러한 어려움을 극복하기 위하여 사용 환경에 관계없이 각 분산제어 시스템을 연결하고자 개방구조를 설계하였다. 이를 위하여 OSI 7 layer model을 따른 protocal을 개발하였으며, 이것을 RPC와 XDR을 이용하여 구현하였다. 전체 시스템은 속도와 호환성을 모두 고려하였지만, 속도와 호환성이 모두 문제가 되는 것은 호환성을 위주로 설계하였다. Recently, many kind of control system is implemented by DCS(Distributed Control System). But that situation the compatible problem between different flatform system is arised. In this paper, we are about to describe the design of the system that makes a user to satisfy scalability, portablility, interoperability which is the characteristic of the open structure in DCS using real time control theory and microprocessor applicable technique. For this, we developed a protocal that followed OSI 7 layer model, and implemented this protocol using RPC and XDR. The system is considered the speed and the compatibility, but in the case of some problems in compatibility and speed, out design is intented to choose compatibility.