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( Miseon Kim ),( Young-han Kim ),( Yong Beom Kim ),( Jayeon Kim ),( Jae-weon Kim ),( Mi Hye Park ),( Joo Hyun Park ),( Jeong Ho Rhee ),( Myong Cheol Lim ),( Joon-seok Hong ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.5
Based on the current understanding of a preventive effect of bilateral salpingectomy on ovarian/fallopian/peritoneal cancers, the Korean Society of Obstetrics and Gynecology, Korean Society of Gynecologic Endocrinology, Korean Society of Gynecologic Oncology, Korean Society of Maternal Fetal Medicine, and Korean Society for Reproductive Medicine support the following recommendations: · Women scheduled for hysterectomy for benign gynecologic disease should be informed that bilateral salpingectomy reduces the risk of ovarian/fallopian/peritoneal cancer, and they should be counseled regarding this procedure at the time of hysterectomy. · Although salpingectomy is generally considered as a safe procedure in terms of preserving ovarian reserve, there is a lack of evidences representing its long-term outcomes. Therefore, patients should be informed about the minimal potential of this procedure for decreasing ovarian reserve. · Prophylactic salpingectomy during vaginal hysterectomy is favorable in terms of prevention of ovarian/fallopian/ peritoneal cancer, although operation-related complications minimally increase with this procedure, compared to the complications associated with vaginal hysterectomy alone. Conversion to open or laparoscopic approach from vaginal approach to perform prophylactic salpingectomy is not recommended. · Women who desire permanent sterilization at the time of cesarean delivery could be counseled for prophylactic salpingectomy before surgery on an individual basis.
( Miseon Kim ),( Jeong-yeol Park ),( E Sun Baik ),( Hee Seung Kim ),( Sunghoon Kim ),( Dong Hoon Suh ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
목적: To evaluate the survival impact of low anterior resection (LAR) in patients with epithelial ovarian cancer (EOC) grossly confined to pelvis. 방법: A total of 397 patients who underwent primary staging operation for the treatment of stage II-IIIA EOC was retrospectively reviewed: 116 (29.2%) IIA, 212 (53.4%) IIB, 30 (7.6%) IIIA1, and 39 (9.8%) IIIA2. Patients who had grossly enlarged retroperitoneal lymph nodes positive for metastatic carcinoma were excluded. Total study population comprised three groups according to the presence of gross tumor on intrapelvic rectosigmoid colon and bowel resection: no-tumor/non-LAR group (n=305, 76.8%), tumor/non-LAR group (n=68, 17.1%), and tumor/LAR group (n=24, 6.1%). Survival rates were compared between the groups. 결과: Median follow-up was 36 months (range 0-260 months). Five-year progression-free survival (PFS) of stage IIA, IIB, IIIA1, and IIIA2 were 65.1%, 61.0%, 50.4%, and 45.5%, respectively. There was no survival difference between no-tumor (n=305) and tumor (n=92) groups. All patients of tumor/non-LAR group underwent tumorectomy and/or electrocoagulation. Survival difference was not observed between no-tumor/non-LAR group and tumor/non-LAR group (5-yr PFS, 60.4% vs.58.3%; p=0.530 and 5-yr overall survival [OS], 81.2% vs. 88.0%; p=0.985) even though complete cytoreduction rate was significantly higher in no-tumor/non-LAR group than tumor/non-LAR group (p<0.001). There was no significant survival difference between tumor/LAR and tumor/non-LAR groups (5-yr PFS, 62.5% vs. 58.3%; p=0.787 and 5-yr OS, 63.5% vs. 88.0%; p=0.078). Age, histologic type, optimal cytoreduction rate (residual tumor size≤1cm), and cycle number of adjuvant chemotherapy were not different between the groups of comparisons. Postoperative ileus ≥grade 2 was more frequently observed in LAR group than non-LAR group (13.6% vs. 3.2%; p=0.013). 결론: Survival benefit of LAR does not appear to be significant in the patients with grossly pelvis-confined EOC where post-tumorectomy site on intrapelvic rectosigmoid colon might not be considered as residual tumor.
Effect of polysaccharides from a Korean ginseng berry on the immunosenescence of aged mice
Kim, Miseon,Yi, Young-Su,Kim, Juewon,Han, Sang Yun,Kim, Su Hwan,Seo, Dae Bang,Cho, Jae Youl,Shin, Song Seok The Korean Society of Ginseng 2018 Journal of Ginseng Research Vol.42 No.4
Background: Korean ginseng has been widely evaluated to treat human diseases; however, most studies on Korean ginseng have focused on its root. In this study, polysaccharides [acidic-polysaccharide-linked glycopeptide (APGP) extracted with 90% ethanol and hot water] were prepared from Korean ginseng berries, and their effect on immunosenescence was explored. Methods: The effect of APGP on thymic involution was evaluated by measuring the size of thymi dissected from aged mice. The effect of APGP on populations of immune cells, including natural killer (NK) cells, dendritic cells, age-correlated CD11c-positive B cells, and several subtypes of T cells [CD4-positive, CD8-positive, and regulatory (Treg) T cells] in the thymi and spleens of aged mice was analyzed by fluorescence-activated cell sorting analysis. Serum levels of interleukin (IL)-2 and IL-6 were evaluated by enzyme-linked immunosorbent assay analysis. Profiles of APGP components were evaluated by high-performance liquid chromatography (HPLC) analysis. Results: APGP suppressed thymic involution by increasing the weight and areas of thymi in aged mice. APGP increased the population of NK cells, but showed no effect on the population of dendritic cells in the thymi and spleens of aged mice. APGP decreased the population of age-correlated CD11c-positive B cells in the spleens of aged mice. APGP showed no effect on the populations of CD4- and CD8-positive T cells in the thymi of aged mice, whereas it increased the population of Treg cells in the spleens of aged mice. APGP further decreased the reduced serum levels of IL-2 in aged mice, but serum levels of IL-6 were not statistically changed by APGP in aged mice. Finally, HPLC analysis showed that APGP had one major peak at 15 min (a main type of polysaccharide) and a long tail up to 35 min (a mixture of a variety of types of polysaccharides). Conclusion: These results suggested that APGP exerted an anti-immunosenescent effect by suppressing thymic involution and modulating several types of immune cells.
Ovarian reserve as a predicting factor for successful pregnancy after adenomyomectomy
( Sohyun Kim ),( Seyeon Won ),( Ji Young Hwang ),( Nara Lee ),( Miseon Kim ),( Mikyoung Kim ),( Mi-la Kim ),( Bo Sung Yun ),( Seok Ju Seong ),( Yong Wook Jung ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-
Objective: To compile the fertility outcomes of adenomyomectomy and to evaluate which demographic factors predict a successful pregnancy in patients who have undergone adenomyomectomy. Methods: We retrospectively reviewed the patient data between January 2017 and April 2020. Possible causes for infertility were excluded by hysterosalpingography, blood tests, karyotyping, hormonal assay, and semen analysis before the surgery. Candidates were selected for surgery based on the following criteria: 1) patients aged ≤45 years, 2) patients who consented to proceed with the surgery after being informed about the possibility of recurrence of the disease and operative blood loss, and 3) patients desiring pregnancy in the future. Patients were followed up monthly for 3 months. The subsequent follow-ups were conducted every 3-6 months. Patients who wanted to get pregnant could try for pregnancy 3 months after the surgery. We defined pregnancy success as the presence of fetal heartbeat at 6-7 weeks of gestation. The number of pregnancy trials was defined as the number of embryos transferred. Results: Forty-three patients were divided into two groups: the pregnancy failure group (n=28) and the pregnancy success group (n=15). The age of patients was higher (39.0 [32.046.0] vs. 37.0 [33.042.0] years, P=0.006) and the level of anti-Mllerian hormone (AMH) (0.54 [0.018.54] vs. 2.91 [0.347.92] ng/mL, P=0.002) was lower in the pregnancy failure group than in the pregnancy success group. The operative time was longer (220.0 [68.0440.0] vs. 175.0 [65.0305.0] minutes, P=0.048) and the estimated blood loss was higher (750 [1002500] vs. 500 [502000] ml, P=0.016) in the pregnancy failure group than in the pregnancy success group. No significant difference was observed in body mass index, symptoms, cancer antigen 125, preoperative uterine volume, and type of adenomyosis. In the multivariate analysis, age and AMH were significant predictive factors for successful pregnancy. Conclusion: Ovarian reserve (age and AMH) and disease severity might be predictive factors for successful pregnancy in patients who have undergone adenomyomectomy. Adenomyomectomy should be positively considered for women desiring pregnancy and having appropriate ovarian reserve. This information will be beneficial for patients and clinicians before the decision about adenomyomectomy. Larger prospective studies are needed to confirm our findings.
김미선 ( Miseon Kim ),( Dong Hoon Suh ),( Jeong-yeol Park ),( E Sun Paik ),( Seungmee Lee ),( Kyung Jin Eoh ),( Joo-hyun Nam ),( Yoo-young Lee ),( Jae-weon Kim ),( Sunghoon Kim ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-
Objective: To evaluate survival impact of low anterior resection (LAR) in patients with epithelial ovarian cancer (EOC) grossly confined to the pelvis. Methods: We retrospectively reviewed 397 patients who underwent primary staging surgery for treatment of 2014 International Federation of Gynecology and Obstetrics (FIGO) stage II-IIIA EOC: 116 (29.2%) IIA, 212 (53.4%) IIB, and 69 (17.4%) IIIA. Patients with grossly enlarged retroperitoneal lymph nodes positive for metastatic carcinoma were excluded. Of 92 patients (23.2%) with gross tumors at the rectosigmoid colon, 68 (73.9%) underwent tumorectomy and 24 (26.1%), LAR for rectosigmoid lesions. Survival outcomes between patients who underwent tumorectomy and LAR were compared using Kaplan-Meier curves. Results: During the median follow-up of 55 months (range, 1-260), 141 (35.5%) recurrences and 81 (20.4%) deaths occurred. Age (52.8 vs. 54.5 years, p=0.552), optimal debulking (98.5% vs. 95.0%, p=0.405), histologic type (serous, 52.9% vs. 50.0%, p=0.804), FIGO stage (p=0.057), and platinum-based adjuvant chemotherapy ≥6 cycles (85.3% vs. 79.2%, p=0.485) were not different between groups. No significant difference in 5-year progression-free survival (PFS; 57.9% vs. 62.5%, p=0.767) and overall survival (OS; 84.7% vs. 63.8%, p=0.087), respectively, was noted between groups. Postoperative ileus was more frequent in patients subjected to LAR than those who were not (4/24 [16.7%] vs. 11/373 [2.9%], p=0.001). The 5-year PFS (60.3% vs. 57.9%, p=0.523) and OS (81.8% vs. 87.7%, p=0.912) between patients who underwent tumorectomy and those who did not were also similar. Conclusion: Survival benefit of LAR did not appear to be significant in EOC patients with grossly pelvis-confined tumors.
( Hee Seung Kim ),( Jeong Eun Kwon ),( Jeong Ha Kim ),( Anna Kim ),( Na Ra Lee ),( Miseon Kim ),( Maria Lee ),( Dong Hoon Suh ),( Yong Beom Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2
Objective To evaluate the efficacy of loop electrosurgical excision procedure (LEEP) combined with cold coagulation for treating cervical intraepithelial neoplasia (CIN). Methods We reviewed clinic-pathologic data of 498 patients treated with LEEP alone (n=354), and LEEP combined with cold coagulation (n=144) between January 2000 and December 2011. After LEEP, we followed up all patients by using Papanicolaou smear and human papillomavirus (HPV) test, and evaluated abnormal cervical cytology-free interval and high-risk HPV infection-free interval. Moreover, we investigated independent factors affecting abnormal cervical cytology or high-risk HPV infection after LEEP. Results Abnormal cervical cytology-free interval was longer in patients treated with LEEP combined with cold coagulation than in those treated with LEEP alone (mean, 92.4 vs. 84.4 months; P=0.01), and patients treated with LEEP combined with cold coagulation also showed longer high-risk HPV infection-free interval than those treated with LEEP alone (mean, 87.6 vs. 59.1 months; P=0.01). Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1.90 and 0.61; 95% confidence intervals, 1.27 to 2.84 and 0.39 to 0.96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios, 2.07, 4.11, and 0.64; 95% confidence intervals, 1.38 to 3.08, 1.63 to 10.39, and 0.43 to 0.96). When we performed subgroup analyses for patients with CIN 2 or CIN 3, the result were similar. Conclusion LEEP combined with cold coagulation may be more effective for treating CIN than LEEP alone. Moreover, cold coagulation may decrease the risk of potential of recurrence after LEEP.
공공기관 재해경감활동관리체계 구축 지원프로그램 설계 및 개발을 위한 필요기능 연구
Kim, Minji,Kim, Doyeon,Lee, Miseon 한국재난정보학회 2016 한국재난정보학회 논문집 Vol.12 No.1
본 연구에서는 공공기관 대상 재해경감활동관리체계를 구축 및 관리할 수 있는 지원 프로그램을 개발하고자 ISO22301 등 업무연속성관리/기능연속성계획 표준문서와 해외 선진 사례를 분석하여 프로그램에서 필요로 하는 요구기능을 도출하였다. 그 결과 시스템 관리를 위한 기능을 제외하고, 영향분석 리스크 평가 경감활동 대응계획 교육 및 모의훈련 재난대응 문서관리가 도출되었다. 향후 업무연속성관리 및 기능연속성계획의 요구조건을 만족하는 공공기관 재해경감활동관리체계 구축 지원프로그램을 개발할 수 있을 것으로 기대된다. We analyze BCM, COOP and other exotic advanced cases for making supporting programs relates with Disaster mitigation management in Public area. The outcome from this study explains what are requirements for proper activating the programs and what we need. In conclusion, we could understand importances of BIA, RA, Disaster mitigation activities, Contingency plan, Training, Correspond to disaster, Management of document except for system managing functions. It will be helpful to build supporting programs by meeting most of requirements of BCM at the same time.