Robotic single-site staging operation for early-stage endometrial cancer: initial experience at a single institution

정혜원,장태규,남승협,권상훈,신소진,조치흠 대한산부인과학회 2019 Obstetrics & Gynecology Science Vol.62 No.3

ObjectiveThe aims of this study were to introduce surgical guidelines, and to evaluate the feasibility and safety of a roboticsingle-site staging (RSSS) operation for early-stage endometrial cancer. MethodsPatients with a preoperative diagnosis of endometrial cancer (International Federation of Gynecology and Obstetricsstages IA to IB) from endometrial curettage and preoperative imaging studies were selected at Dongsan MedicalCenter from March 2014 to November 2015. All surgical procedures, including hysterectomy, salpingo-oophorectomy,bilateral pelvic node dissection, and cytology aspiration, were performed by robotic single-site instruments (da VinciSi® surgical system; Intuitive Surgical, Sunnyvale, CA, USA). ResultsA total of 15 women with early-stage endometrial cancer underwent the RSSS operation. The median patient ageand body mass index were 53 years (range, 37–70 years) and 25.4 kg/m2 (range, 18.3–46.4 kg/m2). The median dockingtime, console time, and total operative time were 8 minutes (range, 4–15 minutes), 75 minutes (range, 55–115minutes), and 155 minutes (range, 125–190 minutes), respectively. The median retrieval of both pelvic lymph nodeswas 9 (range, 6–15). There were no conversions to laparoscopy or laparotomy. ConclusionThe RSSS operation is feasible and safe in patients with early-stage endometrial cancer. In this study, operative timeswere reasonable, and the surgical procedure was well-tolerated by the patients. Further evaluation of patients withearly-stage endometrial cancer should be performed in large-scale comparative studies using the laparoendoscopic,single-site staging operation to confirm the safety and benefits of the RSSS operation for early-stage endometrialcancer.

거대 뇌동정맥기형에 대한 이단계 수술법

김진기,김수천,김형동,김수휴,심재홍 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.3

This report describes three cases of large arteriovenous malformations which were removed totally with two stage operation. When a large arteriovenous malformation had to be removed, prediction of profuse bleeding and brain swelling could be made. We clipped large feeding arteries and made a cleft around the AVM during the first operation, and the progressive reduction of the shunt flow by clipping the dominant peduncles one after the other diminished the risk of profuse bleeding and brain swelling. 7 to 10 days later, we removed AVM totally as the second operation. All three lesions were resected by microsurgical techniques, and the results were excellent. The rationale for the two stage operation for large cerebral AVM is discussed.

신극 단체 ‘극예술연구회(1931.7.8~1938.3)’의 운영 구조와 제작 체제 및 구성원에 관한 고찰: 당대의 언론 자료 및 사료에 기반하여

성명현 역사문화학회 2022 지방사와 지방문화 Vol.25 No.1

This study aims not only to examine the operational system, organization composition and members of the Shingeuk troupe Geukyesulyeonguhoe (hereinafter referred to as ‘Geukyeon’) but also to discuss the formation process of both directing and production systems according to the trend of the Geukyeon, thereby elucidating the landscape in production of plays at that time. As a result of the study, Geukyeon started with the coterie system (1931.7.8~1932.12), which shares the responsibilities and obligations by all members, in its operational scheme and then switched to a membership system(1933.1~1938.3), the organization structure was changed over five times. The department in charge of directing and production, in particular, went through a revision process from the Business department (during the period of coterie system) to the Practice department (during the period of membership system), then changed back to the Directing department. The purpose of such changes was to equip with a professional theater group system and to perform the Shingeuk. The organization structure of operation in Geukyeon was established with ‘General affairs bureau and its sub-departments including Directing department, Literary department, Stage Arts department, and Accounting department(1936.7~1936.6). Moreover, each department had several sections. Under such a structural system, the ‘Movie Department (1937.6~1938.3)’ was newly established as a special case in order to address the financial pressures. However, it was revealed that the acting system in terms of the acting domain was still weak position because of staying at ‘Acting section’ under the Directing department. Geukyeon introduced the ‘formation system of both stage-director and stage-management & -manager’ in the first demonstration of the coterie system period. This was a pioneering attempt that drives the division of labor in theater production together with securing the independence of directing (or a director). Afterward, the directing system of Geukyeon consisted of ‘stage-director, assistant stage-director, stage-manager & -management, stage-manager & -management assistant, and prompter’, and most of founding members and members typically took a path to debut as a stage-director after passing through stage-manager & -management or assistant stage-director. However, no boundary and authority of tasks have been established between stage-director and their assistants until the Geukyeon was dispersed. Accordingly, the division of their labors was not implemented and the assistants of a stage-director were just in a position to follow the instruction of a stage-director. In the case of stage production in Geukyeon, a division of labor system in which each individual takes responsibility in all domains such as devices, lighting, effects, costumes, and small and medium tools was established. In particular, as a result of efforts to recruit practical experts from outside in the device and lighting domains, a tendency of the ‘dedicated experts and skilled people’ was very prominent. It is, however, still questionable to what extent the collaboration system in each domain has been implemented and how much the effectiveness has been achieved. This is a task to be discussed based on the performance cases in a future study. 본 연구는 신극 단체 극예술연구회(1931.7.8~1938.3, 이하 ‘극연’)의 운영 제도와 조직 구성(원) 및 그 추이에 따른 연출 체제와 제작 체계를 고찰하고 당시에 형성된 제작 판도를 파악하는 데 목적을 두었다. 연구 결과, 극연은 운영상 동인제(1931.7.8~1932.12)로 시작하여 회원제(1933.1~1938.3)로 전환하였고 조직의 구조는 그 동안 네 차례 이상 변경하였다. 특히 연출과 제작을 관할한 부처는 사업부(동인제 시기)에서 실천부(회원제 전반기)로 개정한 후에 다시 연출부(회원제 후반기)로 개편하는 도정을 거쳤다. 그 목적은 전문적 극단 체제를 갖추며 ‘우리 신극’을 상연하기 위함이었다. 결과적으로, 극연은 회원제 후반기(1936.7~1938.3)에 조직체를 ‘총무국과 산하의 연출부, 문예부, 미술부, 경리부 및 산하의 반’의 구조로 수립하였다. 그 중 연기 부문은 연출부 산하의 연기반으로 두어 당시까지 연기 체계가 미약한 실정을 노정하였다. 그 후 극연은 자금난 해소를 위해 영화부(1937.6~1938.3)를 추가로 특설하기도 했다. 극연은 첫 시연부터 ‘연출(자)와 다른 직무의 무대감독’을 기용하면서 연출(자)의 독립성과 제작 부문의 분업화를 도모하였다. 그 후 연출 부문은 ‘연출자, 연출보, 무대감독, 무대감독 조수, 프롬프터’의 구성(원) 체제를 갖추었다. 그 가운데 동인(회원)은 무대감독 또는 연출보를 거쳐서 연출자로 데뷔하는 경로를 이루었다. 그러나 연출자와 연출의 조력자들 간에 직무 권한과 경계는 확립되지 않았다. 따라서 실무적 분업화는 실현되지 않았고 무대감독을 비롯한 조력자들은 연출자의 지시를 추종하는 입장에 있었다. 무대미술 부문은 장치, 조명, 효과, 의상, 대․소도구 등 제반 분야에서 구체적인 개인에게 구체적인 책임을 맡기는 분업 체제를 수립하였다. 특히 장치와 조명 부문은 외부의 실기 전문가를 영입하는 노력의 결과로 해당 분야의 전공자와 숙련자가 전담하는 추세를 보였다. 하지만 무대 부문에서도 분업 체제와 그 실천 사이에 적잖은 간극이 실재하였다.

다발성 뇌동맥류의 임상적 분석

류성근,이제혁,정신,박종근,김재휴,김수한,강삼석 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.6

In this retrospective clinical analysis for 143 patients who underwent operation due to multiple intracrarial aneurysms during the last 12 years(1983-1994), we intended to find out the clinical characteristics, the significant signs for the differentiation between ruptured and unruptured aneurysm, and to compare the results of one-stage operations with those of two-stage operations. The results were as follows : Of 864 patients operated on due to intracranial aneurysms. 143 patients(16.6%) had two or more intracranial aneurysms. Multiple aneurysms were more common in females, with a female to male ratio of 2.4:1 as compared with 1.3 to 1 for patients with single aneurysm. Common locations of the aneurysms were the middle cerebral artery, and posterior communicating artery, anterior communicating artery, and the anterior choroidal artery, in that order, in identifying the site of rupture, the focal hematoma in brain CT scan, segmental vasospasm, irregularity and sizes of aneurysmal sacs on angiograms were helpful. Aneurysms 3mm or less were less prone to rupture. However, for those with a diameter of more than 4mm, the frequency of rupture increased with the size of aneurysm. Eighty eight percent of patients who underwent operations had a favorable outcome and the operation mortality rate was 7.7%. In patients of Grade Ⅰ and Ⅱ, surgical results of the one-stage operation group and two-stage operation group did not differ. In Grade Ⅲ patients, the results were better for the two-stage operation group, without statistical significance. From our studies we have come to the conclusion that incidental aneurysms found in patients with low risk should be treated at the same time when ruptured aneurysms are clipped.

A Performance Evaluation System for PPP Sewage Treatment Plants at the Operation-maintenance Stage

Xiaojuan Li,Yishu Liu,Mengmeng Li,Chi Yung Jim 대한토목학회 2023 KSCE Journal of Civil Engineering Vol.27 No.4

Sewage treatment plants are essential in improving the quality of receiving water bodies, contributing to healthy and sustainable urban development. The increasingly common public-private partnership (PPP) model of sewage treatment facilities may not yield the expected benefits, often compromised by inadequacies in the complex operation-maintenance stage. Holistic criteria and methods to define and judge a plant’s performance are lacking. To fill the knowledge gap, this study established a performance evaluation system applicable to the critical operation-maintenance stage of China's PPP sewage-treatment industry. First, the range of quantitative and qualitative indicators was surveyed by literature review, and an appropriate subset was selected according to expert judgment. Second, the multilevel extension principle of matter-element analysis was combined with the analytic hierarchy process to determine the performance level and establish a comprehensive, efficient and practical evaluation system. The proposed method was tested on two PPP plants to confirm its applicability and reliability in assessing operation-maintenance functions. The study identified the diagnostic criteria to refine the design, operation and maintenance parameters to optimize plant performance. The findings provided an assured and comprehensive quality control scheme and a practical tool for governments and other parties to assess the service delivery quality of PPP plants.

다발성 뇌동맥류 환자의 수술적 치료 결과에 대한 고찰

이녹영,김재민,백광흠,신형식,김영수,고용,오성훈,오석전,김남규,김광명 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

From January 1990 to January 1996, we analyzed outcome according to the distribution of aneurysms the type of surgical treatment the timing of operation, and the patient's pre-operative status in a total of 54 cases of multiple intracranial aneurysms. The frequency of multiple intracranial aneurysms was 13.4% and the sex ratio was 1 : 2 with female being predominant. The frequency of aneurysmal location was MCA(35.0%), P-comm, artery(25.0%) and A-comm artery (15.0%) in that order. The number of ruptured aneurysms was in the order of MCA aneurysms A-comm aneurysms, and F-comm aneurysms. The size of ruptured aneurysms was 6-10mm if 34 cases(64.2%). The unilateral distribution of aneurysms was 31 cases(57.4%) and the bilateral was f8 cases(42.6%). Depending on how many times the patient had the operation, there were 29(57.4%) cases of complete single operation, 17 cases(31.5%) of complete two-stage operation, and 8 cases(14.8%) of partial operation. Surgical outcome was good(GOS≤4) in 42 cases(77.8%). and six patients(11.1%) expired. Based on the results of the above study we have concluded that initial Hunt-Hess grade has a close relationship with the outcome, but the operation type, the timing of operation, the number and distribution of aneurysms do not significantly effect the outcome.

지역주택조합사업의 성공요인에 관한 연구

조진희(Cho JinHee),이주형(Lee JooHyung) 한국주거환경학회 2016 주거환경(한국주거환경학회논문집) Vol.14 No.2

This study intended to derive the success factors of the local housing association business to suggest objective and fair success factors to a company that wishes to promote a local housing association business or a customer. By summarizing the result of empirical analysis, it was possible to recognize the order of importance of local housing association operation stage, local housing association business planning stage, local housing association establishment stage, business plan approval stage, construction stage, and local housing association liquidation stage, in respective order, considering the importance by area. Considering the importance by factor, the importance of thorough area analysis appeared prominently in the business planning stage and the importance of the decision maker’s will, in the local housing association steering committee stage. The importance of the marketability of the association apartment was prominent in the local housing association establishment stage, the importance of ethics of the operating agent in the local housing association operation stage, the importance of the construction company’s capability of executing the construction in the business plan approval stage, the administrative procedure for construction in the construction stage, and the administrative procedure for liquidation in the local housing association liquidation stage.

Theoretical and experimental investigation of the pressure ratio distribution and the regulation strategy of a two-stage turbocharging system for various altitudes operation

Huiyan Zhang,Xuyang Tang,Liansong Mu,Lei Shi,Kangyao Deng 대한기계학회 2021 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.35 No.3

Fixed two-stage turbocharging system matched at high altitude leads to engine performance deterioration at low altitudes due to unreasonable pressure ratio distribution between two stages. In this paper, a thermodynamic model of regulated two-stage turbocharging system is established. Theoretical analysis shows the pressure ratio distribution should lean towards a turbocharger with greater efficiency, and the high-altitude operation intensifies the role of HP stage. Experiments are conducted on an environment simulation test bench. Then, the optimal pressure ratio distribution and ETAR at various altitudes are proposed. Experiment results demonstrate that the turbocharging system boosts sufficient intake air with the optimal ETAR. Compared to that with the fixed turbocharging system, the maximum increment of the overall efficiency is 9.3 % at 0 m and attains 1.5 % at 3000 m. Consequently, the output torque is 100 % recovered below 3000 m, and it exceeds 91 % at 4500 m. Moreover, the optimal ETAR reduces the BSFC under low altitude conditions.

Theoretical and experimental dynamic characteristics of a RC building model for construction stages

Temel Turker,Alemdar Bayraktar 사단법인 한국계산역학회 2016 Computers and Concrete, An International Journal Vol.17 No.4

Dynamic characteristics, named as natural frequencies, damping ratios and mode shapes, affect the dynamic behavior of buildings and they vary depending on the construction stages. It is aimed to present the effects of construction stages on the dynamic characteristics of reinforced concrete (RC) buildings considering theoretical and experimental investigations. For this purpose, a three-storey RC building model with a 1/2 scale was constructed in the laboratory of Civil Engineering Department at Karadeniz Technical University. The modal testing measurements were performed by using Operational Modal Analysis (OMA) method for the bare frame, brick walled and coated cases of the building model. Randomly generated loads by impact hammer were used to vibrate the building model; the responses were measured by uni-axial seismic accelerometers as acceleration. The building’s modal parameters at these construction stages were extracted from the processed signals using the Enhanced Frequency Domain Decomposition (EFDD) technique. Also, the finite element models of each case were developed and modal analyses were performed. It was observed from the experimental and theoretical investigations that the natural frequencies of the building model varied depending on the construction stages considerably.

뇌동정맥기형에 대한 임상적 고찰

심재홍 인제대학교 1988 仁濟醫學 Vol.9 No.1

1981년 1월부터 1986년 12월까지 인제대학 부산백병원 신경외과에 입원하여 뇌혈관 기형으로 진단받고 수술요법을 시행한 36례를 임상적 분석과 함께 그 결과를 보고하고저 한다. From January 1981, to December. 1986, the medical records and angiograms of 36 patients with intracranial arteriovenous malformations (AVMs) treated under the surgical microscope were reviewed. Followings are the results : The patients ranged in age from 2 to 56 years, with peak incidence in second grade (39%). Of the 36 patients in this series, 23 were males and 13 were females. The sex incidence ws higher in men than in women (1.8 times). The location was parietal (25%), basal ganglia(19%), temporoparietal (14%), and occipital (14%) in order of frequency. The common symptoms were hemorrhage (72%), seizure (17%), and headache (6%) in order of frequency. In small intracranial AVM, 92% was presented with hemorrhage and in large intracranial AVM, 56% with hemorrhage. Total excision of AVM was performed in 25 cases, partial excision in 4 cases, feeding artery ligation in 3 cases, hematoma evacuation in 2 cases, and EVD in 2 cases. In 25 cases of total excision, 15 cases were performed in one stage operation, 9 cases in second stage operation and 1 case in third stage operation. The postoperative complications were brain infaction (17%), brain swelling (6%), infection (6%), and hemorrhage (3%). The postoperative results were good (53%), fair (22%), poor (14%), and death (11%).