단일공법 복강경하 질식자궁절제술 110예의 고찰 및 다공법과의 비교

박병준 ( Byung Joon Park ),김용욱 ( Yong Wook Kim ),노덕영 ( Duck Yeong Ro ),김태응 ( Tae Eung Kim ),류기성 ( Ki Sung Ryu ),김장흡 ( Jang Heup Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.7

목적: 통상적인 복강경기구만을 사용한 단일공법 복강경하 질식자궁절제술을 다공법 복강경하 질식자궁절제술과 비교하여 안전성 및 유용성을 평가하고자 하였다. 연구 방법: 2007년 4월부터 2009년 11월까지 인천성모병원에서 자궁근종 또는 자궁샘근증의 질환으로 단일공법 복강경하 질식 자궁절제술을 시행받은 환자 110명과 다공법 복강경하 질식자궁절제술을 시행받은 환자 110명, 총 220명의 환자를 대상으로 하였다. 우리는 모든 수술에서 통상적으로 사용되는 구부러지지 않는 일직선의 복강경기구를 사용하였다. 또한 단일공법 및 다공법 복강경하 질식자궁절제술 둘 다에서 수술자 (Kim, YW)의 이름을 따서 명명한 새로운 질단부 봉합 방법인 김씨 질구개 현수법 (Kim`s Vaginal Vault Suspension Method)을 사용하였다. 결과: 환자 나이, 수술 시간, 자궁의 무게, 혈색소 수치의 변화, 수혈 빈도, 수술 후 발열에서 두 군 간에 유의한 차이를 보이지 않았다. 환자들의 평균 나이는 46.7±7.0세(단일공법)와 45.5±6.3세(다공법)이었다. 평균 수술 시간은 87.2±21.0분(단일공법)과 83.3±20.3분(다공법), 평균 자궁의 무게는 261.4±139.7 g(단일공법)과 257.8±132.9 g(다공법), 평균 혈색소 수치의 변화는 1.1±0.7 g/dL(단일공법)와 1.2±0.6 g/dL(다공법)이었다. 두 군 모두에서 수술 중 장 또는 요로의 손상은 없었다. 두 군 모두에서 각각 한 건의 개복수술로의 전환이 있었다. 단일공법을 시행한 군에서 입원 기간이 유의하게 짧았다(2.6±0.6일 [단일공법], 3.3±0.7일 [다공법], P<0.05). 결론: 통상적으로 사용하는 구부러지지 않는 일직선의 복강경기구를 이용한 단일공법 복강경하 질식자궁절제술은 다공법 복강경하 질식자궁절제술에 대한 안전하고 유용한 대체 수술이 될 수 있다. Objective: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). Methods: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary`s Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim`s Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. Results: There was no significant difference in patients` age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients` mean age was 46.1±7.0 years (SPA-LAVH) and 45.5±6.3 years (MPA-LAVH). The mean operating time was 87.2±21.0 minutes (SPA-LAVH) and 83.3±20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4±139.7 g (SPA-LAVH) and 257.8±132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1±0.7 g/dL (SPA-LAVH) and 1.2±0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6±0.6 days [SPA-LAVH] and 3.3±0.7 days [MPA-LAVH], P<0.05). Conclusion: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.

결장 직장암 환자에서 근치적 절제술 후 혈청 CEA치의 변화에 대한 임상적 의의

김영훈,배병노,김기환,한세환,김홍주,김영덕,김홍용 대한대장항문학회 2003 Annals of Coloproctolgy Vol.19 No.6

자기장 저속 냉동보관법을 이용한 쥐 치아 치주인대세포의 활성도 검사

안현정,김의성,김진,김덕원,김기열,이찬영,이승종 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.4

본 연구의 목적은 흰쥐 상악 대구치를 발거하여 자기장 저속 냉동보관법을 이용하여 냉동 시 치주인대세포의 활성도 및 세포 사멸도를 MTT검색법과 TUNEL검사를 이용하여 측정하고자 하였다. 4주령의 암컷 Sprague-Dawley계 된 쥐의 상악 좌우 제1,2대 구치를 발거하여 각군 당 12개의 쥐 치아를MTT검색에 이용하였고 6개의 치아를 TUNEL 검사에 이용하였다. 실험군은 5개군으로 대조군은 즉시 발치군이며 4℃냉장고에서 1주일간 보관한 냉장군, 발치 후 동해방지제 처리과정을 거쳐 -196℃의 액화질소에 넣어 급속 냉동한 액화질소군, 21.7 ㎃, 60 ㎐, 1 G의 자기장을 이용하여 -0.3℃/min 의 속도로 -20℃까지 냉동 후 -196℃로 급속 냉동한 자기장군, -0.3℃/min의 속도로 -20℃까지 냉동 후 -196℃에 급속 냉동한 저속 냉동군으로 나누었다. 보존액은 F medium을 사용했으며 동해방지제로 10% dimethyl sulfoxide (DMSO)를 사용하였다. 치근면을 단위면적으로 표준화하기 위해 MTT측정값을 Eosin 염색 후 530 ㎜에서 측정한 흡광도 값으로 나누었다. TUNEL 검사 시 각 조직슬라이드에서 400배 크기의 현미경 시야에서 임의로 세 부분을 지정하여 정상 세포수와 양성 세포수를 세어 그 비율을 계산하여 각 실험군 당 평균치를 구하였다. 통계 분석을 위해 one way ANOVA를 시행하였으며 사후검정으로 Scheffe와 Tukey HSD방법을 썼으며 결과는 다음과 같다. MTT검색에 의한 흡광도를 Eosin염색 후 측정한 흡광도로 나눈 값에서는 자기장군은 즉시 발치군보다 낮은 세포활성을 보였고 (p < 0.05) 액화질소군, 저속 냉동군과는 통계적으로 유의성 있는 차이를 보이지 않았다. 그러나 자기장군은 액화질소군, 저속 냉동군과 함께 냉장군보다는 높은 세포 활성도를 보였다 (p<0.05).TUNEL검사 결과도 자기장군은 즉시 발치군보다 치주인대의 세포사멸도가 높았으나 (p < 0.05) 저속 냉동군과 액화 질소군과는 통계적으로 유의한 차이를 보이지 않았다. 자기장군은 냉장군보다 세포사멸도가 낮았으며 냉장군은 모든 군 중에서 세포 사멸도가 가장 높았다 (p<0.05). The purpose of this study was to evaluate the viability of periodontal ligament cell in rat teeth using slow cryopreservation method with magnetic field through MTT assay and TUNEL test. For each group, 12 teeth of 4 weeks old white female Sprague-Dawley rat were used for MTT assay, and 6 teeth in TUNEL test. The Maxillary left and right, first and second molars were extracted as atraumatically as possible under tiletamine anesthesia. The experimental groups were groupl (immediately extraction), group 2 (cold preservation at 4℃ for 1 week), group 3 (rapid Cryopreservation in liquid nitrogen), group 4 (slow cryopreservation with magnetic field of 1 G), and group 5 (slow cryopreservation). F medium was used as preservation medium and 10% DMSO as cryoprotectant. After preservation and thawing, the MTT assay and TUNEL test were processed. One way ANOVA and Scheffe method were performed at the 95 % level of confidence. The value of optical density obtained after MTT analysis was divided by the value of eosin staining for tissue volume standardization. In both MTT assay and TUNEL test, it had showed no significant difference among group 3,4, and 5. And group 3 had showed higher viability of periodontal ligament cell than group 2. From this study, slow cryopreservation method with magnetic field can be used as one of cryopreservation methods.

Interrelation of Cyclin D1, Cyclin E, and p27Kip1 Expression on Tissue Arrays of Breast Cancer

Sehwan Han,Young-Duck Kim,Hong-Yong Kim,Hong-Joo Kim,Kyeongmee Park,Byung-Noe Bae,Suk Yong Ryu,Ki Hwan Kim 대한암학회 2002 Cancer Research and Treatment Vol.34 No.5

Purpose: To evaluate the clinical impact of the alteredexpression of cell cycle regulators in stage I and II breastcancers.Materials and Methods: The interaction between cyclinD1/E and p27Kip1 expressions were analyzed usingtissue microarray (TMA) technology in 133 breast cancers.Data from the immunohistochemical assays of 3molecules were merged, and analyzed, with a Ki67labeling index of the same tumors.Results: Cyclin D1 was expressed in 72 breast carcinomas(54.1%) and cyclin E in 60 (45.1%) out of the 133breast carcinomas. Expressions of cyclin D1 and cyclinE were inversely related to each other, and significantlyassociated with the estrogen receptor (ER) expressionand differentiation of the breast carcinoma. The expressionof cyclin E was significantly decreased in tumorsexpressing cyclin D1 (p=0.022). There was a trend forcyclin D1 expression to increase in tumors expressingp27Kip1 (p=0.053), but the expression of cyclin E didnot correlate with p27Kip1 expression. The Ki67 labelingindex was markedly increased in tumors expressing cyclinE, whereas it was significantly decreased in the cyclin D1or p27Kip1 expressing-tumors. From survival analysis,cyclin E expression was the only significant variable forthe prediction of poor survival.Conclusion: The abnormal expressions of cell cycleregulatory molecules are prevalent, and interrelated witheach other in breast cancer. Integration of TMA technologyallowed a high-throughput analysis for correlating molecularthe in situ findings, with the clinico-pathologicinformation. Among the three molecules studied, thecyclin E had a prognostic implication for stage I and IIbreast cancer. (Cancer Res Treat. 2002;34:388-393)

결장직장암에서의 Cyclooxygenase-2와 Inducible Nitric Oxide Synthase의 발현

양근호,배병노,김정연,김기환,한세환,김홍주,김영덕 대한대장항문학회 2003 Annals of Coloproctolgy Vol.19 No.3

페디그리 사료 섭취에 의한 급성신부전증의 치료 1례

김영실,신영지,박정희,김명철,신상태,조종기,김덕환 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

A 4 years old male poodle dog with gastro-intestinal distress was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. The patient was presented with history of vomiting, hemorrhagic diarrhea and inappetence. Laboratory evaluation revealed that WBC (23.8 x 10^(3)/㎕). BUN (87.9 ㎎/㎗), creatinine (7.3 ㎎/㎗) and phosphate (9.6 ㎎/㎗) was elevated, and proteinuria, hematuria and bilirubinuria were detected on urinalysis. Increased renal cortical echogenicity and parenchymal calcification of kidney were observed by ultrasonography. Based on the findings of history, clinical signs, laboratory assessment and ultrasonography, it was diagnosed as acute renal failure. The present patient showed favorable therapeutic response by fluid therapy. diuretics, peritoneal dialysis and blood transfusion.

中學 科學敎育의 探究學習에 대한 評價問項 開發(Ⅰ)

奇宇恒,權炳奎,朴德圭,이병교,鄭遠佑,金裕漢 경북대학교 과학교육연구소 1984 科學敎育硏究誌 Vol.8 No.-

The purpose of this study is to achieve the individualized inquiring learning which is centered on students by improving the method of the evaluation of the inquiry learning in the science class in a multi-student class. Therefore the author made the table of specification for scientific achievements of the abilities of inquiring by analyzing the abilities of inquiring according to the content of science and five basic experiments of each unit inthe first grade of of middle school, ant then made the paper and pencil and performance test items for the evaluation of the abilities of inquiring. The paper and pencil test was taken after the experimental and observational class, and performance test was taken in the way of the students' self evaluation, peer evaluation and Tester evaluation. The results are as follows: 1) In operation of the inquiry learning by two experiments, performance test items and 13 the paper and pencil test items made for evaluation of the abilities of inquiring could be applied usefully. 2) Correlation coefficient between paper and pencil test and performance test is .362 and it is very low. Therefore it is desirable that performance test be used for the evaluation for the abilities of inquiring which cannot be evaluated by paper and pencil test. 3) In evaluation of the abilities of inquiring by performance test on five basic experiments, it is more desirable that 'the use of microscope' is presented in the way of peer evaluation or peer and Tester evaluation, 'the observation on epidermis of onion cell' in the way of peer evaluation, and self-evaluation. 4) Skill of the abilities of inquiring in experimental and observational class can be evaluated correctly through performance test.

2-[(4-Cyanophenyl)amino]-3-chloro-1,4-naphthalenedione(NQ-Y15)의 돌연변이원성

김봉희,정기화,유충규,창동신,이기선,전선덕,소동수,채상호,문창규 한국환경독성학회 2000 환경독성보건학회지 Vol.15 No.4

2-[(4-Cyanophenyl)amino]-3-chloro-1, 4-naphthalenedione (NQ-Y15) was asssayed for its genotoxic potential by using Salmonella typhimurium reversion assay and in vitro chromosome aberration test on Chinese hamster lung cells. In the Ames test, NQ-Y 15 induced his+ revertants of Salmonella typhimurium TA 98 and TA1537, reaching levels twice the negative control values. But, NQ-Y15 induced only his^(+) revertants of Salmonella typhimurium TA1537 more than twice the control values under the condition with metabolic activation system. In the cytogenetic test on chinese hamster lung cells, NQ-Y15 showed significant chromosomal aberrations, but the incidence was significantly reduced in the presence of metabolic activation.

燒死

金基德,金相鉉 大韓法醫學會 1983 대한법의학회지 Vol.7 No.1-2

Death by fire is defined to asphyxial death due to the combination of burn injury, carbon monoxide poisoning and hypoxia, but it differs from burn injury in nature. Not rarely a victim by dry heat may have been overcome by fumes, which usually contain carbon monoxide, produced by the incomplete combustion of wood or paint etc. In consequence, the victim's collapse prevent his escape from the fire or, on some occasions, inhalation of fumes may cause death from carbon monoxide poisoning. But destruction of tissue by the application of dry or moist heat, producing a burn, is usually the result of contact with a naked flame, the heated elements of an electric fire or scalding. The range of damage due to scalding or dry heat is from a negligible but actually painful redding of the skin to gross incineration not only of the soft parts but also of bone., of which the cause of death by burn injury may be the complications of burn injury or systemic disturbances. Therefore, the authors discussed the autopsy finding and medicolegal aspects of burn injury and death by fire.

간헐적 양압호흡기를 이용한 호흡운동치료 후 근 이영양증 환자의 폐기능 변화

김기송,이규완,오덕원 한국전문물리치료학회 1999 한국전문물리치료학회지 Vol.6 No.3