Long-term outcomes of single-port laparoscopic myomectomy using a modified suture technique

( Mina Kang ),( Jihye Kim ),( Tae-joong Kim ),( Jeong-won Lee ),( Byoung-gie Kim ),( Duk-soo Bae ),( Chel Hun Choi ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2

Objective To evaluate the long-term outcomes, including the pregnancy outcome and recurrence rate after single-port laparoscopic myomectomy (LM) using a modified suture technique with a Hem-o-lok clip (Choi’s LM) and conventional 4-port LM. Methods A retrospective study of patients who underwent Choi’s LM (n=55) and 4-port LM (n=102) in a single institutional hospital was conducted. Patients with <3 symptomatic myomas sized <10 cm each and operated on by a single surgeon were included. Recurrence was confirmed when a myoma measuring ≥3 cm was detected. Results The patients in both groups had similar demographic characteristics. Single (76.4% vs. 62.7%) and intramural (52.7% vs. 56.9%) tumors were commonly detected in both groups in the mean diameter (6.8±1.5 cm vs. 7.0±1.6 cm; P=0.40). In Choi’s LM, 16 patients (29.1%) needed an additional port; those who were nulliparous and/or had a large leiomyoma more frequently required an additional port (P=0.023 and 0.04, respectively). During a median follow-up period of 69 months, 17 patients (7.1% vs. 14.6%) had recurrence. The size of dominant myomas at recurrence was significantly smaller in patients who underwent Choi’s LM (3.4±0.7 cm vs. 5.7±2.4 cm; P=0.004). All 13 patients in both groups who successfully conceived had a full-term delivery. No major complications occurred during pregnancy. Conclusion Although an additional port was frequently used, the long-term outcomes of patients who experienced recurrence and pregnancy after Choi’s LM were acceptable. Considering its usability, Choi’s LM is feasible for the treatment of uterine leiomyoma.

再生펄프를 利用한 카르복시메틸셀룰로오스의 製造(Ⅱ) : CMC의 物性 測定 Physical Charateristic of CMC

崔正憲,趙炳默,吳正壽 동국대학교 생명자원과학대학 연습림 1993 연습림논문집 Vol.- No.3

Carboxymethylation of recycled pulp was investigated. For both recycled pulp and dissolving pulp was carboxymethylated by the organic solvent method and tested some industrial analyses, water solubles content, low concentration of NaCl solution solubles and acid hydrolysis. The water solubles content depend on degree of substitution, and low concentration of NaCl did not affected solubilities of the CMC. Prehydrolysis of CM groups prior to reaction with L­cystein, we can obtain the residual unsubstitued anhydroglucose(USAG). The lower amount of USAG in recycled pulp, compared to theorecal data, was suggested that the recycled pulp should obtain the more CM group in the same conditions.

한국소방발전을 위한 정책과제 연구 : 소방청 신설에 대응하는 제도·조직개선 구상 Redesigning Institutional and Organizational Improvement for the Establishment of the National Fire Service Agency

최병학,김학수 한국응급구조학회 2002 한국응급구조학회지 Vol.6 No.1

Today, the basic problem of functional safe management of Korean Disaster Control system was separately administrated 33 acts that are relating to safe management in 13 ministries. Because of the facts that the fire service is not provided practically, the control system and risk management for safe administration are not operated, the information can not be shared with each other, and the various laws have the lacks of linkage, the National Safe System was appeared unsteady. The roles and function of fire service have started with restriction to operate structurally and institutionally, which operational structure of fire service is becoming weak. As a result, the federal and local fire organizations have not reached yet to the institutionalization and the local fire service agencies have bias with the task regarding the fire service because of the relation between organizational structure and the local fire agency. With the enforcement of the federal and local fire system, professionality and autonomy for making policy, and dealing with changes of fire service positively, the national fire service on the policy performance can be established. Promotion of research and development and education training to strengthen innovation in technology and competition in fire industry will contribute to the firmly establishment of control system to prevent from fire, flood, terror, and national disaster. This article proposed that (a) the established law and administration, agency are required efforts to effectively operate fire service system: (b) the national fire service agency, national college of fire, national institute of science fire, and national fire service hospital should be early established to make firmly policy to operate effectively and practically. These kinds of innovational acts are known the best ways of operating solid policy of national fire service system.

대기 중 휘발성 유기화합물의 Advanced Technology에 대한 실험비교

최금찬,안병주,김석택,김찬훈,정창훈,서정민,유수영 동아대학교 환경문제연구소 2000 硏究報告 Vol.23 No.1

Nowaday, Advanced technology has been applied to organic destruction technologies that are alternatives to incineration. Plasma, photolysis, and Photocatalytic oxidation processes are an emerging advanced technologies for the abatement of volatile organic compounds(VOCs) in atmospheric pressure air streams, so we has been used these technologies for destruction of VOCs. TCE, Benzene, Toluene, and Xylene were selected as objective materials. We have been studied each process and found many types of reaction parameters which effect on treatment efficiency. So combination processes, which are plasma-photocatalytic oxidation process and photolysis-photocatalytic oxidation process, have been used to increase destruction efficiency. Analysis of above materials and byproducts was carried out by GC-FID.

선인장 양심실 보조장치의 설계 및 임상적용을 위한 평가

민병구,박찬영,최재순,이혁수,황창모,김삼성,윤걸중,김종원,선경,이경갑,정종태,김원곤 제주대학교 인공심장이식연구소 2001 인공심장 연구 Vol.2 No.1

현재 개발되고 있는 맥동형 이식형 인공심장은 완전이식형 인공심장과 좌심실보조장치 뿐이다. 좌심실보조장치를 장착한 환자의 10~15%가 우심실의 보조를 필요로하고 완전이식형 인공심장의 장착을 위해서는 자연심장을 제거해야하는 상황에서 이식형 양심실보조장치에 대한 필요성이 대두되고 있다. 본 연구진은 완전이식형 인공심장으로 개발된 한국형 인공심장을 개선하여 양심 실 보조장치를 개발하였다. 양심실보조장치는 이동형 작동기식 미케니즘을 이용하고 있으며 에너지 변환장치와 감속기로 구성된 작동기와 혈액주머니, 그리고 내장형 제어기로 구성되어 있다. 선인장 펌프로 명명된 KAH350은 캐뉼라의 연결을 위한 커넥터를 포함하여 길이 177mm, 폭 164mm, 높이 67 이고 무게 780g이며 최대 심박출량은 5L/min 이다. 양심실보조장치로 개발된 선인장펌프는 좌심실보조장치로도 응용이 가능하다. 이식적합성과 생체적합성을 평가하기 위하여 좌심실보조장치로 5회, 양싱실보조장치로 6회의 동물실험을 수행하였다. 각각 최장 28일간 생존하였으며 11회의 동물실험중 장치의 결함에 의한 것이 3회 있었는데 이들은 모두 전자장치의 결함과 방수처리문제였다. 현재 이식적합성과 일박출량을 향상시킨 KAH400모델이 개발중이다. The types of pulsatile implantable artificial hearts that are on the way of development and have been developed are totally implantable artificial heart and implantable left ventricular assist device (LVAD). Approximately 10% to 15% of all patients Implanted with wearable VADs have required right heart support with another device. And it is reluctant to patient who should remove his or her own heart to be implanted with total artificial heart. These situations drive the development of implantable bi-ventricular assist device (BVAD). The Korean BVAD was develophed by modifying the moving actuator type Korean artificial heart. This electro-mechanical BVAD comprises actuator including energy converter and reduction gear train, blood sacs, and internal motor and energy controllers. The KAH350 which is named as 'Cactus Pump' is 177mm in length, 164mm in width, and 67mm in thickness including connectors and nuts. The weight and maximum cardiac output of Cactus Pump is 780g and 5L/min, respectively. The Cactus Pump that was developed as BVAD could be used as LVAD by attaching compliance caps on the 2 ports of one ventricle. The animal experiments were undergone 5 times for LVAD, and 6 times for BVAD. The best records were 28 days survival in both applications. There were 3 times of device failure and they were all associated with electrical connection and hermetic sealing. The KAH400 that has improved anatomical fitting characterisitcs and stroke volume is on development.

급성 충수돌기염의 조기 진단을 위한 초음파검사의 의의

오병연,임경수,이영주,김원,최옥경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. Methods: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gently. When the blind loop was found at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-appendiceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. Results: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by Us, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tendemess on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tendemess were observed for 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. Conclusions: In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an accurate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal CT scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.

난소암에서 CA125의 임상적 의의

윤병일,김수녕,손인숙,유연웅,최원석 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

The concentration of the tumor marker CA125 in serum from patients with ovarian tumor was measured to define the usefulness of them in differentiating malignant ovarian tumor from benign ovarian mass. In the study of 105 patients with gynecologic neoplasm, of whom 38 were myoma uteri, 42 benign ovarian tumor, and 25 ovarian cancer, the level of serum CA125 were measured. CA125 was greater than 35 U/ml in 2.6% of myoma uteri, in 2.4% of benign ovarian tumors and 68.0% of ovarian cancers. Using a cut-off level of 35 U/ml, the results can be characterized by a 68.0% of sensitivity and 97.5% of specificity in detecting an ovarian cancer. Among 25 patients with ovarian cancer, 11 of 14 (78.6%) patients with serous cystadenocarcinoma, 4 of 6 (66.7%) patients with mucinous cystadenocarcinoma and 2 of 5 (40.0%) patients with endometrioid carcinoma had CA125 values greater than 35 U/ml. In relation to a higher tumor stage, there was an increasing incidence of elevated levels of CA125. As a result, it is likely that the measurement of CA125 is useful for early diagnosis of ovarian cancer.

자유곡면 NC 가공에서의 공구간섭 방지

전차수,최병규 한국경영과학회 1989 한국경영과학회 학술대회논문집 Vol.- No.1

Cutter interference (or part surface gouging) is one of the most critical problems in NC machining of sculptured surfaces. Developed in this study is an algorithmic procedure for cutter interference handling that converts CC-data(cutter contact data; pairs of point and unit normal vector) into interference-free CL-data(cutter location data).

1996년과 1999년 경기지역 초등학교 학생들에서 유행성이하선염에 대한 면역도 조사

나병국,이주영,고운영,이진수,신구철,이주연,최보율,기모란,양병국,강춘,김우주,김지희 대한감염학회 2001 감염 Vol.33 No.3

Background : Although massive use of live attenuated mumps virus vaccines successfully reduced the incidence of mumps virus infection worldwide, mumps outbreaks have not been completely eliminated, even in vaccinated populations. In recent years, the incidence of mumps has been remarkably increased in Korea. This study was designed to evaluate the recent seroprevalence rate of mumps IgG among children in Kyonggi province at 1996 and 1999. Methods : Study population included students from 8 elementary schools in Kyonggi province. Serum samples were collected twice at 1996 and 1999 and tested for mumps-specific antibody by enzyme-linked immunosorbent assay (ELISA). We also conducted a questionnaire survey on the parents and collected the records including history of vaccination and mumps infection. Results : The seropositive rates against mumps were 89.47% and 89.74% at 1996 and 1999, respectively, and they were not significantly different when compared to age, sex, and region. Although the first vaccination rates were 92.17% and 92.25% at 1996 and 1999, respectively, the second vaccination rates were only 37.89% and 38.03% at 1996 and 1999, respectively. Infection rate showed no significant difference between vaccinated groups and nonvaccinated gropus. Seropositive rate of infected group was higher than that of noninfected group but it was not significantly different between the vaccinated and the nonvaccinated. Conclusions : This study showed the seropositive rate and vaccination against mumps in children. There were no significant relationships between vaccination and infection. Therefore, it seems likely that the vaccination is not fully protective against mumps infection. This study will be helpful for the establishment of guideline for prevention and treatment of mumps in Korea. (Korean J Infect Dis 33: 157∼164, 2001)

Carbamoylethyl Starch의 製造와 종이 製造時 添加效果에 관한 硏究

尹世永,崔正箕,鄭文箕,趙炳默,吳正壽 동국대학교 생명자원과학대학 연습림 1995 연습림논문집 Vol.- No.4

Recently, paper strength properties come up to be lowered by increasing ratio of utilization of recycling paper. In order to overcome these problems, strengthening agents which may cause enviromental problems have been used. Therefore, acrylamide was added to starch which is a cheap natural polymer, carbamoylethyl starch(CES) with high activity was prepared, and so the applicability as a paper additive was examined. The results are following; FT-IR spectra of CES of which degree of substitution was 0.25 showed strong C=O band at 1680㎝^-1 which corresponds the carbonyl group n amides(amide Ⅰ). Analysis of bravender viscosity showed that cooking start point of CES is 60℃ and instant viscosity is 830 B.U.(bravender unit). Effect of carbamoylethl DS on strength properties was resulted that CES of DS 0.20 appeared to be the best choice for making handsheets from KOCC with good overall strength properties, and it was selected as standard sample. Effect of pH on strength properties was obvious for their increasing values as decreasing pH. Also, a 5-fold increase in size rate as well as significant increase in wet-tensile strength were obtained in handsheets from KOCC by 3% wet-end addition of CES.