Robot assisted laparoscopic myomectomy, an alternative to laparotomy for numerous myomas (over 10)

( Hyun-kyung Kim ),( Min-kyung Lee ),( Yoon-jee Cheung ),( Hyun-hee Cho ),( Jang-heub Kim ),( Mee-ran Kim ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: To evaluate the feasibility of robot-assisted laparoscopic myomectomy in multiple myomas over 10 in number and to compare outcomes with open myomectomy. 방법: This study is a retrospective chart review of 216 patients who underwent robot assisted laparoscopic myomectomy by a single operator at St. Mary's Fibroid Center in Seoul between October 1, 2010 and January 31, 2014; in the selected patients, 10 or more uterine myomas were removed. We reported the characteristics of the removed myomas including the with maximum diameter of the myomas, the sum of the diameter of each myoma, and the types of the combined surgeries. we organized surgical outcomes that were measured including the operative time, estimated intraoperative blood loss, length of hospital stay, and perioperative complications. And we compared these surgical outcomes with cases of open myomectomy. 결과: A total of 13 women underwent the removal of 10 or more uterine myomas by robotics. The patient age was 37.6±3.6 years, and all of the patients were nulliparous. The operation time was 389.8±100.6 min. The number of removed myomas for each case was 13.1±3.8 (range 10-20). The myoma with the maximum diameter was 6.5±0.7 centimeters (range 5.0-8.0 centimeters). The sum of the diameters was 34.9 ±9.6 centimeters (range 20.0-54.5 centimeter. The Estimated blood loss during operation was 219.2±158 milliliter. . The postoperative hospital stay was 2.6±0.6 days. Compared to laparotomic adenomyomectomy, robotic surgery has strengths that enables less blood loss, shorter hospital stay and decreasing risk of blood transfusion although it takes more operation time. 결론: This report is the first to describe the feasibility of robot-assisted laparoscopic myomectomy in multiple myomas over 10 in number. In robot- assisted laparoscopic myomectomies, supplementary techniques including preoperative MRI assessment, intraoperative sonographic navigation, and palpation by an assistant to localize the myomas are helpful in overcoming the absence of haptic perception. This technique is considered to be an alternative to laparotomy for more than 10 myomas.

간경변 환자에서 Oro-cecal Transit Time의 측정

원경준,이준,변유미,조민근,조주연,서정균,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Background: Neurotransmitter like substances in the gut have been proposed to contribute to the overall portal systemic encephalopathy (PSE). The source of the ammonia in patients with PSE is mainly the small bowel, as a result of the conversion of glutamine in the diet to glutamate and ammonia. PSE is highly responsive to changes in diet, to antibiotic therapy and to ingestion of nondigestible disaccharides such as lactulose. This study was performed to evaluate the relationship between PSE and oro-cecal transit time. In addition, performed to evaluate the effect of severity, cause, complications of liver cirrhosis on oro-cecal transit time. Methods: Between August 2006 and February 2007, 48 cirrhotic patients consecutively was enrolled in study their oro-cecal transit time after informed consent was obtained. A non-invasive hydrogen breath test was used to study oro-cecal transit time (OCTT). Result: The OCTT were delayed in cirrhotic patients with PSE compared without PSE (123.3 ± 42.7 min vs 170.0 ± 58.3 min, p<0.05). OCTT tended to prolongate further as the damage in the liver got worse, nevertheless the result was statistically meaningless (p<0.111). Neither presence of ascites or cause of PSE had any influence on gastrointestinal transit. Conclusions: Cirrhotic patients with PSE have more delayed OCTT than without PSE. Further research is needed to find out the relationship between OCTT and severity of liver cirrhosis.

대장직장 종양에 대한 내시경 점막하 절제술의 연대순 임상 결과와 학습 곡선

이상민 ( Sang Min Lee ),김은수 ( Eun Soo Kim ),박경식 ( Kyung Sik Park ),조광범 ( Kwang Bum Cho ),김동춘 ( Dong Choon Kim ),강유진 ( Yu Jin Kang ),이유진 ( Yoo Jin Lee ),이정민 ( Jung Min Lee ),최은성 ( Eun Sung Choi ),최재혁 ( Ja 대한소화기학회 2014 대한소화기학회지 Vol.64 No.4

Background/Aims: Endoscopic submucosal dissection (ESD) is an effective procedure for en-bloc curative resection of the colorectal tumor. As it requires high technical skills and experience in therapeutic endoscopy, it is important to understand learning curve of ESD technique. The aim of this study was to retrospectively describe the clinical results of ESD and to evaluate learning curve for the ESD of colorectal tumors. Methods: A total of 90 patients with 90 colorectal neoplasms, who had undergone ESD at a tertiary referral hospital from July 2009 to December 2012, were enrolled. The ESD was performed by a single endoscopist. All ESD cases were divided into three periods: first, cases 1-30; second, cases 31-60; and third, cases 61-90. Results: The en-bloc resection rates in third period (100%) was significantly higher than that of the first (93.3%) and second period (80%) (p=0.025). The perforation rate in third period (0%) also significantly decreased compared with that of the first (13.3%) and second period (20%) (p=0.032). To calibrate the difference of tumor size among periods, proficiency was calculated, as the procedure time per specimen area (min/cm2). The proficiency in third period (4.3) was significantly shorter than that of the first (16.8) and second period (10.2) (p=0.004). Conclusions: The learning curve of colorectal ESD in our study shows that at least 60 cases of ESD have to be conducted to acquire sufficient skill of degree without perforation. (Korean J Gastroenterol 2014;64:198-205)

본태성 고혈압 환자의 적혈구 Na+-Li+ Countertransport 와 적혈구막 지방산 구성에 대한 연구

이영우,고경수,고재준,박경수,김원배,한은경,김성연,조보연,이홍규,고창순,민현기 한국지질학회 1991 韓國脂質學會誌 Vol.1 No.1

Since the changes of Na^+-Li^+ countertransport (SLC) Vmax in essential hypertension have been reported. it has been known that hyperlipidemia could affect SLC independently of blood pressure. To reveal the relation between SLC Vmax and RBC membrane fatty acid conposition in the hypertensive patients, we divided patients into two groups according to their levels of SLC Vmax of erythrocytes(elevated SLC Vmax: n=4, normal SLC Vamx: n=6). The results were as follows: 1) There was no difference in body mate index, waist-hip ratio, blood pressure, serum cholesterol level between two groups. Triglyceride were higher in elevated group (278.0±180.0 ㎎/㎗) than normal group (124.3±60.7 ㎎/㎗) but there was no statistical significance. HDL-cholesterol levels were significantly lower in elevated group (32.0±3.6 vs. 44.8±8.9 ㎎/㎗) and free fatty acid concentrations, intracellular (RBC) Na^+ concentrations were similar between two groups. 2) The results of oral glucose tolerance test showed no differences in the glucose and insulin area, however the incremental insulin areas of elevated group (108.8±31.3, μU. min/㎖×10²) were significantly higher compared with those of normal group (56.3±20.7 μU. min/㎖×10²). 3) In the elevated group, palmitic acid proportions of erythrocytes (22.1±0.7%) were higher than those of normal group (20.1±0.7%) and SLC Vmax showed significant correlation (r=0.81, p$lt;0.01) with palmitic acid proportion. These results suggest that the abnormal lipid metabolism may change the RBC Na^+ transport system through the alterations of RBC membrane fatty acid composition.

N세대의 패션상품 쇼핑동기 및 디스플레이 태도

조지현,민경혜,류덕환 啓明大學校 生活科學硏究所 2002 科學論集 Vol.28 No.-

This study intends to provide a beneficial foundation which can help understanding of how a consumer group can be classified according to the shopping motivation of net generation. And what differences to the store display were shown differences to the store display were shown differently among them and ultimately, some concrete data which can be useful in establishing efficient store display strategies for consumer. The subject of this study were 298 female college students living in Daegu. Model sampling was done by inconvenient sampling. Modified survey based on references and former studies was used, using SPSS packages. The results were as follows. 1. Three kind of factors in the shopping motivations for fashion goods were determined for analysis of consumer groups and by which it was revealed as to be significant to classify them into the following three subdivisions : information pursuit, social & amusement pursuit, and financial & practical pursuit group. 2. N-generation consumer groups were interested in the store display and used it frequently, while they were effected by the satisfied with it positively. 3. It has shown the positive relation between interest and use, interest and effect and use and effect of store display, respectively. 4. N-generation consumer groups were conscious of the necessity and effect of store display highly. And lack of originality o store display and too much goods in display area were indicated to have to be improved.

대학 부설 환경 연구소의 운영 실태

조병진,오경환,박기민 경상대학교 환경보전연구소 1993 環境保全硏究所報 Vol.1 No.1

The actual administrative conditions of the environment research institutes attached to the universities and colleges were investigated by means of the questionnaire to propose the reference data for the reasonable and effective management of them. The majority of them were established after 1981, and half of them are unregistered. The retention rates of the full-time researchers and the attendants was 55%, and that of the official facilities was high, but the equipments for analysis and measurement were poorly furnished as 15%. Annual mean amounts of the fund for management and research are less than ten million and more than thirty million won, respectively. Therefore their major roles are limited to consultations, supervising academic conferences, and collecting research materials because of the fund limitations. Half of them distribute their own publications, and subscribe for few scientific journals regularly. There are many obstracles in the management of institutes such as lack of funds, deficient administrative support of the college authorities, deficiencies of full-time researchers, attendants, and equipments for analysis and measurement.

면역학적 특성에 따른 yeast cytochrome c의 구조에 관한 연구

조경환,우기민,조만희,이상한,박현경,김창세 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

The antiserum against yeast cytochrome c and horse heart cytochrome c was reacted immunologically with those from various species. The results were as followings; 1. The antiserum against horse heart cytochrome c was reacted immunologically with heart cytochrome c of horse, cow, rabbit, mouse, chicken, pigeon, frog, tuna, and guanaco, and were not with yeast and neurospora cytochrome c. 2. However, antiserum against yeast cytochrome c was only reacted immunologically with yeast cytochrome c, and was not mammals and vertebrates horse, cow, rabbit, mouse, chicken, pigeon, frog, tuna, guanaco, even neurospora 3. CNBr-digested peptides of horse heart cytochrome c were obtained 5 peaks, Ⅰ(1-80), Ⅱ(1-65), Ⅲ(66-104), Ⅳ(81-104), Ⅴ(66-80), and other peptide (1-50). Among them peptides Ⅰ and Ⅱ were weakly reacted immunologically with antiserum against horse heart cytochrome c. CNBr-digested peptides of horse heart cytochrome c were not reacted with antiserum against yeast cytochrome c. 4. From the above, the immunologically positive cross reaction was thought to be related with Ω loop D.

산발성 장형 위선암 환자의 Microsatellite Instability와 병리학적 양상

조창희,홍유찬,안지현,최경현,이상호,신영명,윤기영,정민정,장희경 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Background : Through many researches, microsatellite is expected to be a good diagnositic and prognostic factor in colorectal cancer, endometrial cancer, gastric cancer, and the others. The prevalence of microsatellite instability (MSI) in gastric carcinoma has reported variously, 13~44%. Purpose : We aimed to determine the prevalence of MSI-high and the relationship between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma of stomach. Material and Methods : We analyzed 106 sporadic intestinal type adenocarcinoma specimens excised from patients who were over thirty-five years old to determine the statue of microsatellite by DNA sequencing. The tissues were formalin-fixed and paraffin embedded. DNA were extracted and amplified by polymerase chain reaction (PCR). MSI was determined using five markers recommended by National Cancer Institute (NCI). Specimens were also studied with five patholical factors-differenciation of tumor cells, depth of invasion, lymph node metastasis, vessel invasion, and perineural invasion- to determine pathological state. Result : The microsatellite statue was determined as MSI-High in 5 cases (4.7%), no MSI-low, and MSS (microsatellite stable) in 101 cases (95.3%). Within the frequency, there was no large gap in the distinction of gender in MSI cases, but in MSS cases, there was three-times more cases in male. MSI cases had moderate-to-poor differenciation and trend to invade toward serosa. All MSI cases showed no perineural invasion. But we could not find any statistical significance between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma. Conclusion : Results suggest that MSI can not make any certain pathological significance in sporadic intestinal type adenocarcinoma. Even though less than 5% of sporadic intestinal type adenocarcinoma patients showed MSI, it can be used as a influential prediagnostic factor of gastric cancer. Further study with large scale of cases will be followed to verify these results.

멀티미디어를 기반으로 하는 정보통신 분야 자격시험 학습 자료 개발

민경일,정기석,조용석,황재효 永同工科大學校 1996 硏究論叢 Vol.2 No.1

저작 도구를 사용하여 정보통신분야 1, 2급 멀티미디어 CD 타이틀을 제작하였다. 유제 문제는 STC 교과목 학습을 통하여 엄선하여 데이터 베이스화 하였다. 또한, 정보통신공학을 전공한 학생들이 CD 타이틀 제작에 참여하므로 멀티미디어 시스템 실무 능력을 배양하는 계기가 되었고, 전공에 대한 실질적인 학습 효과가 있었다. 학생들이 제작된 CD 타이틀을 이용하면 자기 학습과 반복 학습이 가능하므로 학습 능률이 극대화되어 기사 자격 시험을 준비하는 학습을 효과적으로 할 수 있을 것이다. A multimedia CD title has constructed for qualifying test of information and communication engineering. Similar problems have been selected during STC lectures and have been databased. Furthermore, the students majored in information and communication engineering participated in the process of constructing the CD title, and as the results, they could obtain practical abilities on the multimedia systems. Using the CD title, they can be able to study for the qualifying test efficiently.

측방가압충전시 Nickel-Titanium spreader의 사용유무가 근관충전효과에 미치는 영향

민경산,홍찬의,조용범 대한치과보존학회 2000 Restorative Dentistry & Endodontics Vol.25 No.3

Lateral condensation with gutta-percha and sealer has been shown to provide an excellent apical seal: however, the lateral condensation technique has demonstrated less favorable apical leakage results in curved canals when compared with straight canals. Placement of endodontic spreaders to within 1 to 2mm of the root canal working length has been advocated for Optimum gutta-percha obduration. Due to their stiffness, stainless-steel(SS) spreaders will often fail to achieve this position in curved canals. Newly marketed nickel-titanium (NT) spreaders may offer an advantage in this regard due to the increased flexibility of these instruments. The purpose of this study was to evaluate the effect of NT finger spreader on the sealing ability in lateral condensation technique, compared with conventional SS finger spreader. Twenty four standardized resin models simulating curved canals(30 degree) were groups and instrumented to a #30 master apical ale size with Ni-Ti Profile .04 taper series using step down technique. Each groups was obdurated with pique using SS finger spreader, NT finger spreader. And then, each model was sectioned horizontally with microtome at 1, 2, 3, 4, smm levels from the apex. At each of 5 levels, ratio of the area of gutta-percha was obtained by calculating the area of Ntta-percha to the total area of the canal. The data collected were then analyzed statistically using a t test for indepent samples. The results as follows: 1.The total mean ratio of area of gutta-percha was 89.20±7.00(%) for SS sprender group. 99.20±5.17(%) for NT spreader group.There was statistically significant difference between each group(p〈0.05). 2.At 3mm level, the mean ratio of area of Ntta-percha was 88.32±5.41(%) for SS spreader group, 95.25±2.60(%) for NT spreader group. There was statistically significant difference between each group(p〈0.05) . At 1,2,4mm levels, NT spreader group showed greater mean ratio of area of gutta-percha than SS spreader group, too. But there was no statistically significant difference. 3.At 5mm level, the mean ratio of area of Ntta-percha was 91.83±3.42(%) for SS spreader group. 87.91±3.68(%) for NT spreader group. There was statistically significant difference between each group(p〈0.05). This study concluded that the NT spreader demonstrated somewhat favorable apical sealing efffct than 55 spreader in prepared curved canals. The clinical use of NT spreaders may enhance our ability to create better apical seals in curved canals, but further studies in this area will help clarify some of fhe remainingareas with which practitioners are concerned, such as compaction forces exerted by NT spreaders.