Single-Port Robotic Cholecystectomy: Early Experience from 8 Cases

( Hyung Jun Kwon ),( Horyon Kong ),( Sang Geol Kim ),( Yun Jin Hwang ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Single-port laparoscopic cholecystectomy (SPLC) is a technical concept to reduced pain and improve cosmetic results when compared to multi-port cholecystectomy. However, SPLC is associated with technical limitation due to the enhanced complexity of the approach and limited number of specialized instruments or platforms. On the other hand, using a robotic platform may overcome these problems and enable more precise surgical actions by increasing freedom of movement and by restoring intuitive instrument control. In this presentation, we report the early clinical experience of our first 8 sing-port robotic cholecystectomy (SPRC) cases. Methods: Between November 2016 and February 2017, eight patients underwent SPRC with the da Vinci Xi robot and single-site instrumentation. We retrospectively reviewed clinical data on those patients. Results: All of 8 patients had completion of SPRC. Seven patients were female and one was male. Average patient age was 43.3±11.8 years and BMI was 22.4±1.4 kg/m2. Three patients (37.5%) were diagnosed with chronic calculous cholecystitis. Three patients (37.5%) underwent operation for polypoid lesions of the gallbladder. One patient (12.5%) was diagnosed with acute calculous cholecystitis. The mean operation time (skin-to-skin) was 83.9±30.7 min, docking time was 13.25±8.1 min, and console time was 42.1±26.4 min. The intraoperative blood loss was negligible. The mean Visual Analog Pain Scale score 6hr after the surgery was 2.9±0.4. The mean length of hospital stay average postoperative hospital stay was 2.3±1.0 day. There were no intraoperative complication and one patient developed seroma on port site. Conclusions: Robotic single-port cholecystectomy appears feasible and safe in our early experience.

Power density of various light curing units through resin inlays with modified layer thickness

Sung-Ok Hong,Yonghui Oh,Jeong-Bum Min,Jin-Woo Kim,Bin-Na Lee,Yun-Chan Hwang,In-Nam Hwang,Won-Mann Oh,Hoon-Sang Chang 大韓齒科保存學會 2012 Restorative Dentistry & Endodontics Vol.37 No.3

Objectives: The purpose of this study was to enhance curing light penetration through resin inlays by modifying the thicknesses of the dentin, enamel, and translucent layers. Materials and Methods: To investigate the layer dominantly affecting the power density of light curing units, resin wafers of each layer with 0.5 mm thickness were prepared and power density through resin wafers was measured with a dental radiometer (Cure Rite, Kerr). The dentin layer, which had the dominant effect on power density reduction, was decreased in thickness from 0.5 to 0.1 mm while thickness of the enamel layer was kept unchanged at 0.5 mm and thickness of the translucent layer was increased from 0.5 to 0.9 mm and vice versa, in order to maintain the total thickness of 1.5 mm of the resin inlay. Power density of various light curing units through resin inlays was measured. Results: Power density measured through 0.5 mm resin wafers decreased more significantly with the dentin layer than with the enamel and translucent layers (p < 0.05). Power density through 1.5 mm resin inlays increased when the dentin layer thickness was reduced and the enamel or translucent layer thickness was increased. The highest power density was recorded with dentin layer thickness of 0.1 mm and increased translucent layer thickness in all light curing units. Conclusions: To enhance the power density through resin inlays, reducing the dentin layer thickness and increasing the translucent layer thickness would be recommendable when fabricating resin inlays. (Restor Dent Endod 2012;37(3):130-135)

Relationship between disease stage and renal function in bisphosphonate-related osteonecrosis of the jaw

Yun Ho Kim,Han Kyul Park,Na Rae Choi,Seong Won Kim,Gyoo Cheon Kim,Dae Seok Hwang,Yong Deok Kim,Sang Hun Shin,Uk Kyu Kim 대한구강악안면외과학회 2017 대한구강악안면외과학회지 Vol.43 No.1

Objectives: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ. Materials and Methods: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient’s medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level. Results: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and ‘responder group’ and ‘non-responder group,’ but there was no significant difference with the ‘worsened group.’ In addition, the age of the patients was a relative factor with BRONJ stage. Conclusion: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.

Maximum standard uptake value as a clinical biomarker for detecting loss of SMAD4 expression and early systemic tumor recurrence in resected left-sided pancreatic cancer

Sung Whan Cha,Chang Moo Kang,Ho Kyoung Hwang,Jiae Park,Changsoo Kim,Seong-Kyoung Cho,Mijin Yun,Woo Jung Lee 한국간담췌외과학회 2016 한국간담췌외과학회 학술대회지 Vol.2016 No.4

Optimal Conditions of Mycelial Growth and Exopolysaccharide Production in Submerged Culture of Phellinus baumii

Hwang, Hye-Jin,Kim, Sang-Woo,Yun, Jong-Won,Park, Jang-Won Korean Society of Life Science 2004 생명과학회지 Vol.14 No.1

장수상황버섯(Phellinus baumii)의 균사체 성장 및 세포외 다당체(exopolysaccharides) 생산을 위한 액체배양의 최적 배지 및 배양조건에 관한 실험을 수행한 결과, 최적배양 온도와 초기 pH는 각각 3$0^{\circ}C$와 5.0으로 결정되었다. 탄소원의 경우, cellobiose와 maltose가 균사체 성장에는 양호하였으나 저조한 세포외 다당체 생산을 보였으며, 반면에 fructose 와 mannitol 은 상대적으로 높은 수율의 세포외 다당체 생산과 균사체 성장 또한 양호하였다. 최적 질소원으로는 yeast extract가 균사체 성장뿐만 아니라 세포외 다당체 생산에 효과적인 것으로 결정되었다. 최적 배지의 조성은 fructose 20 g/L, yeast extract 20 g/L 및 $CaCl_2$ 0.55 g/L이었으며, 최적 배양조건 하에서 5-L 교반 발효조를 운전한 결과, 최대 균사체 성장(17.43 g/L)과 최대 세포외 다당체 생산(3.6 g/L)을 얻을 수 있었다. 회수된 세포외 다당체는 glycoprotein이었으며 그 조성은 amino acid분석 결과 주로 arginine (14.1%)과 glycin (12.0%)이었으며, cabohydrate의 경우는 mannose (48.7%)와 arabinose (38.4%)이 주성분이었다. The polysaccharide isolated from Phellinus species has been known as a folk remedy, including antitumor and immune-stimulating activities. However, there are lacks of knowledge about mycelial growth and exopolysaccharide (EH) production in its submerged culture. We investigated the optimal conditions on mycelial growth and EPS production in Phellinus baumii. The optimal temperature and initial pH for mycelial growth and EPS production in shake flask culture of P. baumii were proved to be 3$0^{\circ}C$ and pH 5.0, respectively. In case of carbon source, cellobiose and maltose were highly efficient for mycelial growth and fructose and mannitol were also relatively favorable for EPS production. Yeast extract was the most suitable nitrogen source for mycelial growth and EPS production. The composition of optimal culture medium was determined to be fructose 20 g/L, yeast extract 20 g/L, and $CaCl_2$ 0.55 g/L, respectively. Under the optimal culture condition, the maximum mycelial biomass and EPS achieved in a 5-L stirred-tank fermenter were 17.43 g/L and 3.6 g/L, respectively. It was found that the EPS was a glycoprotein onsisted of mainly arginine (14.1%) and glycine (12.0 %) in protein moiety and mainly mannose (48.7%) and arabinose (38.4%) in carbohydrate moiety.

Effects of pumpkin (Cucurbita maxima Duch.) Fiber on Physicochemical Properties and Sensory Characteristics of Chicken Frankfurters

Yun Sang Choi,Hyun Wook Kim,Ko Eun Hwang,Dong Heon Song,Jae Hyun Park,Soo Yeon Lee,Min Sung Choi,Ji Hun Choi,Cheon Jei Kim 한국축산식품학회 2012 한국축산식품학회지 Vol.32 No.2

The effects of dietary fiber extracted from pumpkin (pumpkin fiber) on physicochemical properties, textural properties, and sensory characteristics of chicken frankfurters were investigated. Chicken frankfurter was supplemented with pumpkin fiber at levels of 0, 1, 2, 3, and 4%. Adding different levels of pumpkin fiber affected the proximate composition of the chicken frankfurters (p

Optimization of Aconitine Production in Suspension Cell Cultures of Aconitum napellus L.

Hwang, Sung-Jin,Kim, Yun-Hee,Pyo, Byoung-Sik The Korean Society of Medicinal Crop Science 2004 韓國藥用作物學會誌 Vol.12 No.5

Aconitine alkaloids produced from cell suspension cultures of Aconitum napellus for the first time. The effects of various culture conditions on cell biomass and aconitine accumulation in cell suspension cultures were investigated. Suspension cell cultures of A. napellus were established by transferring callus tissues from leaf explants onto liquid MS medium supplemented with $1\;mg/l$ NAA and $0.1\;mg/l$ kinetin. Among the culture media tested, MS medium had a pronounced effect on cell growth and aconitine accumulation. The maximum dry cell weight was obtained at inoculum size of 3 g (FCW) per flask and in MS medium supplemented with 5% sucrose after 8 weeks. The addition of salicylic acid (SA) and yeast extract (YE) in the MS medium enhanced aconitine accumulation. Using a proper combination of culture condition and supplements, aconitine content could reach 0.043% (dry weight basis), that was $2.5{\sim}3$ fold higher that detected in control cultures.

Association Between Plaque Thickness of the Thoracic Aorta and Recurrence of Atrial Fibrillation After Ablation

Hwang, Hui-Jeong,Lee, Man-Young,Youn, Ho-Joong,Oh, Yong-Seog,Rho, Tae-Ho,Chung, Wook-Sung,Park, Chul-Soo,Choi, Yun-Seok,Chung, Woo-Baek,Lee, Jae-Beom,Park, Hyun-Keun,Lim, KeunJoon,Lee, Jae Hak The Korean Society of Cardiology 2011 Korean Circulation Journal Vol.41 No.4

<P><B>Background and Objectives</B></P><P>Several predictors of recurrence of atrial fibrillation (AF) after ablation have been identified, including age, type of AF, hypertension, left atrial diameter and impaired left ventricular ejection fraction. The aim of this study was to investigate whether the atherosclerotic plaque thickness of the thoracic aorta is associated with a recurrence of AF after circumferential pulmonary vein ablation (CPVA).</P><P><B>Subjects and Methods</B></P><P>Among patients with drug-refractory paroxysmal or persistent AF, 105 consecutive (mean age 58±11 years, male : female=76 : 29) patients who underwent transesophageal echocardiography and CPVA were studied. The relationships between the recurrence of AF and variables, including clinical characteristics, plaque thickness of the thoracic aorta, laboratory findings and echocardiographic parameters were evaluated.</P><P><B>Results</B></P><P>A univariate analysis showed that the presence of diabetes {hazard ratio (HR)=3.425; 95% confidence interval (CI), 1.422-8.249, p=0.006}, ischemic heart disease (HR=4.549; 95% CI, 1.679-12.322, p=0.003), duration of AF (HR=1.010; 95% CI, 1.001-1.018, p=0.025), type of AF (HR=2.412, 95% CI=1.042-5.584, p=0.040) and aortic plaque thickness with ≥4 mm (HR=9.514; 95% CI, 3.419-26.105, p<0.001) were significantly associated with the recurrence of AF after ablation. In Cox multivariate regression analysis, only the aortic plaque thickness (with ≥4 mm) was an independent predictor of recurrence of AF after ablation (HR=7.250, 95% CI=1.906-27.580, p=0.004).</P><P><B>Conclusion</B></P><P>Significantly increased aortic plaque thickness can be a predictable marker of recurrence of AF after CPVA.</P>

Molecular Characterization of a Defensin-like Peptide from Larvae of a Beetle, Protaetia brevitarsis

Hwang, Jae-Sam,Kang, Bo-Ram,Kim, Seong-Ryul,Yun, Eun-Young,Park, Kwan-Ho,Jeon, Jae-Pil,Nam, Sung-Hee,Suh, Hwa-Jin,Hong, Mee-Yeon,Kim, Ik-Soo Korean Society of Sericultural Science 2008 International Journal of Industrial Entomology Vol.17 No.1

A cDNA encoding a defensin-like peptide (Protaetiamycine) from the larvae of a beetle, Protaetia brevitarsis was cloned. The DNAs encoded the deduced propeptide of 79 amino acid residues with the predicted molecular weight of 8.4 kDa and PI of 8.24. Overall amino acid sequence of this protein has 39% similarity to that of Rhodnius prolixus defensin, 43% similarity to that of Acalolepta luxuriosa defensin, and 72% similarity to that of Oryctes rhinoceros defensin, suggesting that this gene is an insect defensin. In an attempt to apply the anti-bacterial peptide to the development of therapeutic agents, a 12-mer peptide amidated at its C-terminus, ACAAHCLAIGRG-$NH_2$ (Ala55-Lys66-$NH_2$, 12Pbn) was synthesized. This peptide showed some antifungal activity against Candida albicans. To increase antifungal activity, six 9-mer peptides were synthesized by modifying amino acid sequences of 12Pbn fragment. Among these peptides, 9Pbm3-9Pbm6 exhibited strong activity compared with Cecropin B and mellitin.

Predictors of upper trapezius pain with myofascial trigger points in food service workers : The STROBE study

Hwang, Ui-Jae,Kwon, Oh-Yun,Yi, Chung-Hwi,Jeon, Hye-Seon,Weon, Jong-Hyuck,Ha, Sung-Min Wolters Kluwer Health 2017 Medicine Vol.96 No.26

<P><B>Abstract</B></P><P>Shoulder pain occurs commonly in food service workers (FSWs) who repetitively perform motions of the upper limbs. Myofascial trigger points (MTrPs) on the upper trapezius (UT) are among the most common musculoskeletal shoulder pain syndromes. This study determined the psychological, posture, mobility, and strength factors associated with pain severity in FSWs with UT pain due to MTrPs.</P><P>In this cross-sectional study, we measured 17 variables in 163 FSWs with UT pain due to MTrPs: a visual analog scale (VAS) pain score, age, sex, Borg rating of perceived exertion (BRPE) scale, beck depression inventory, forward head posture angle, rounded shoulder angle (RSA), shoulder slope angle, scapular downward rotation ratio, cervical lateral-bending side difference angle, cervical rotation side difference angle, glenohumeral internal rotation angle, shoulder horizontal adduction angle, serratus anterior (SA) strength, lower trapezius (LT) strength, bicep strength, and glenohumeral external rotator strength, in 163 FSWs with UT pain due to MTrPs.</P><P>The model for factors influencing UT pain with MTrPs included SA strength, age, BRPE, LT strength, and RSA as predictor variables that accounted for 68.7% of the variance in VAS (<I>P</I> < .001) in multiple regression models with a stepwise selection procedure. The following were independent variables influencing the VAS in the order of standardized coefficients: SA strength (β = −0.380), age (β = 0.287), BRPE (β = 0.239), LT strength (β = −0.195), and RSA (β = 0.125).</P><P>SA strength, age, BRPE, LT strength, and RSA variables should be considered when evaluating and intervening in UT pain with MTrPs in FSWs.</P>