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.

Mechanical meibomian gland squeezing combined with eyelid scrubs and warm compresses for the treatment of meibomian gland dysfunction : Meibomian gland squeezing for MGD<i>Lee, Kim, Park, Kim, Seo and Kim</i>

Lee, Hun,Kim, Minseo,Park, Si Yoon,Kim, Eung Kweon,Seo, Kyoung Yul,Kim, Tae-im Wiley Blackwell (Blackwell Publishing) 2017 Clinical & experimental optometry Vol.100 No.6

직장암 수술 후 국소재발과 예후

김태윤,백무준,김성용,신응진,박내경,이문수,김창호,송옥평 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Locally recurrent rectal cancer is a difficult clinical problem. Local recurrence following treatment for rectal cancer is a major cause of morbidity and mortality. The reported range of local recurrence rates following surgical treatment for rectal cancer has varied from 4% to 50%. We retrospectively reviewed the charts of 142 rectal cancer patients from January 1991 to December 1999. Analysis of patients factors included age, gender, type of surgery, and adjuvant therapy. Tumors were assessed for level, stage, and grade. Local recurrence and distant metastases were also documented. Variables influencing local recurrence in this group were identified and disease-free survival is determined. Of the 142 patients(74 males, 68 females; mean age 62.6 years), 137 consecutive patients operated on for rectal cancer and followed up to December 2000 (range 23-118months) were analyzed. Local recurrence rate was 18.3%. Age and sex of patients, type of surgery, location of tumor in the rectum, size, morphology and grading of the tumor were all unrelated to the event under investigation. At Cox regression, the Dukes stage and the postoperative radiotherapy were the only independent prognostic factors for local recurrence, and Dukes stage (Hazard ratio=2.89, p<0.001) and local recurrence (Hazard ratio=3.31, p<0.01) were the only independent factors associated with improved survival.

동북아시아 지역의 국가적 월경환경오염 분석과 대처방안에 관한 연구

김태응,정원문,조남운,임봉수 대전대학교 산업기술연구소 1999 산업기술연구소 論文集 Vol.10 No.1

Recently, social agreement on the environment pollution has gradually increased in the national and global scope. Also in the last one decades fast industrialism in China has caused to the nations concerns and anxiety on the environmental problems of the North-East Asia including Japan. Korea located mostly close to China has been effected directly on the pollutant products produced from China and many environmental co-work problems of both nations has become to delayed objects anymore. The purpose of this study is to investigate cases and problems of the national overflowing environment pollution and describe answerings.

대전광역시 상수도 원단위 조사 및 장래 용수수요량 예측

김태응,임봉수,허재영,이길영 大田大學校 環境問題硏究所 1999 환경문제연구소 논문집 Vol.4 No.-

This study was carried out examine per capita demand and forecast water demand until 2031 in Taejon City. These data can be used as the basis for the desgn and maintenance of water supply system. Future water demand including industrial water supply in Taejon City was predicted about 1,488,000m3/day in 2011, about 1,876,000 m3/day in 2021, about 2,275,000m3/day in 2031.

人工衛星 데이터를 이용한 솔잎혹파리와 산성우의 상관관계 분석

金應南,後薦惠之後薦惠之端,楊寅台 江原大學校 附設 環境硏究所 1998 環境硏究 Vol.15 No.-

솔잎혹파리에 의한 송림피해는 그 대상지역이 매우 넓고 지속적으로 증가하면서 위치를 옮겨가고 있다. 또한 송림피해는 약 7년이 경과하면 회복되는 것으로 보고되고 있으나 일부지역에서는 그대로 고사하고회생하지 못하고 있는데 이것은 산성우와 밀접한 관계가 있는 것으로 추측된다. 따라서 이 연구에서는1990년대에 들어서 강원도 지역 중에서도 송림고사 피해가 가장 심하게 발생 하고 있는 평창권을 대상으로 하여, 1984년과 1993년의 인공위성자료로부터 식물의 활 In this study, an attempt was done to analyze the damaged areas by pine gall midge in PYONGCHANG county by using the LANDSAT/TM data observed on Nov.12, 1984 and Oct.20. 1993. This county has suffered most serious damage in the forest areas caused by pine gall midge in KANGWON prefecture, KOREA. The method of Normalized Difference Vegetation Index is used to detect the damage situation for the passed 10 years. A normal recovery of the damaged areas was observed 7 years after the first damage has occurred. But, there was a lot of pines died and never resurrect again in some areas. The reason of this phenomenon may due mainly to the acid rain in that areas. Therefore the relationship between the damaged areas and the acid rain is considered in this study. As a result of this study the damage state and the distribution pattern of the damaged areas in PYONGCHANG county are clearly understood. The acid rain (pH less than 5.6)is observed on the whole KANGWON prefecture in the 1990's and also the Rainfall intensity of pH less than 5.0 is increased by 10 times in 1995 compared with rainfall intensity of the same pH observed in 1991

Landsat TM data로부터 수질인자 추출을 위한 상대적 대기 보정 방법

김응남,양인태,최윤관 江原大學校 産業技術硏究所 1998 産業技術硏究 Vol.18 No.-

Recently there are a lot of studies to use a satelite image data in order to investigate a simultaneous change of a wide range area as a lake . However, many cases of a water quality research occur as problem when we try to extracty the water quality factros from the stelite image data, because of the atmosphere scattering exert as bad influence on a result of analysis. In this study, and attempt was made to select the relative atmospheric correction method for the water quality factors extraction from the satelite image data. And also, the time -series analysis of the water quality factors extraction from the satelite image data. And also, the time-series analysis of the water quality factors was performed by using the multi-temporal image data.

정적 부하의 비대칭적 적용에 따른 등 근육의 근전도 분석

김태영,박은영,이응상 한국전문물리치료학회 1997 한국전문물리치료학회지 Vol.4 No.1

씨름선수에서 체중 감량과 회복기의 Leptin과 PAI-1 변화

김용운,도경오,권태동,박덕일,장응찬,박소영,김종연,이석강 대한스포츠의학회 2000 대한스포츠의학회지 Vol.18 No.2

Obesity which is defined as accumulation of excess body fat, is central factor of insulin resistance syndrome. Recently, it is revealed tat adipose tissue is not simply an energy storage organ but it also secretes a variety of molecules which affect the metabolism of the whole body, those are leptin and plasminogen activator inhibitor-1(PAI-1). Therefore, leptin and PAI-1 are increased in the obese state. Leptin regulates energy homeostasis and satiety and PAI-1 regulates fibrinolytic system. For these reasons, elevated levels of leptin and PAI-1 are considered as link factors between obesity and insulin resistance syndrome. However, the exact regulating mechanism for serum levels of leptin and PAI-1 is not fully understood yet. In this study, to evaluate the regulating mechanisms of serum levels of leptin and PAI-1 according to the weight changes, we measured leptin, PAI-1, physical, metabolic, and endocrine parameters during 10 days of weight reduction and 10 days of regain period in 7 young athletes. The mean body weight change was -4.7 kg(5.0%) in the weight reduction period and -2.4 kg(2.5%) in the weight regain period compared to baseline value. Baseline level of leptin in athletes was 1.7±0.66 ng/ml, which was significantly correlated with body weight, BMI, percent body fat, body fat mass, triglyceride, insulin, and PAI-1. Baseline level of PAI-1 in athletes was 16.6±5.26 ng/ml, which was significantly correlated with body weight, BMI, triglyceride, insulin, and leptin. Leptin was decreased to 0.7±0.39(44% of the basaline value) in the weight reduction period, and increased to 1.9±0.64(119% of the baseline value) in the regain period. PAI-1 was decreased to 7.4±2.72(44% of the basaline value) in the weight reduction period, and increased to 22.8±7.33(138% of the baseline value) in the regain period. The changes of leptin during weight reduction period were significantly correlated with the changes of insulin(r=0.890, P<0.01) and triglycerides(r=0.874, P<0.01). The changes of PAI-1 during weight reduction period were significantly correlated with the changes of FFA(r=0.889, P<0.01) and triglycerides(r=0.869, P<0.05). The changes of both leptin and AAI-1 during weight regain period were significantly correlated with the changes of insulin(r=0.755 and 0.849, P<0.05, respectively). In summary, these results suggest that serum levels of leptin and PAI-1 were affected by weight cycling, the percentages of change were more greater than that of weight change, and rebound phenomena were occurred during weight regain period.

제4형 가족성 고중성지방혈증 임산부에서 발생한 급성 췌장염 1례

박관응,윤채중,김영학,진영기,윤성호,권용은,김태원,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

Plasma levels of cholesterol (TC) and triglyceride(TG) physiologically increase during pregnancy. The lipid increment is 23-53% above the pregravidic level for TC and 2- to 3-fold of the prepregnancy level for TG. If the TC and TG are higher than normal values in pregnancy, the patient must be carefully monitored. Acute pancreatitis is the main consequence of hyperlipidemia and occurs either during pregnancy, in the third trimester, or in the puerperium. Mortality is high both for the mother (21%) and the fetus (20%). We report a case of 28 year-old pregnant woman at 29 weeks gestation with hypercholesterolemia (TC = 357 ㎎/dl) and severe hypertriglyceridemia (TG = 1300 ㎎/dl). The patient was admitted to the hospital because of severe epigastric pain, nausea and vomiting. Total serum cholesterol was increased and trigyleride was markedly increased. The electroporesis pattern of serum lipoprotein showed increase in pre-beta lipoprotein fraction, suggesting IV hypertriglyceridemia pattern. According to a review of the literature, the incidence of pancreatitis during pregnancy is 1 in 1000 to 3000 pregnancies. Severe hypertriglyceridemia in pregnancy should be treated with a careful restriction of calories and fat: for preventing acute pancreatitis, hospitalization for intravenous fluid therapy and plasma exchange must be required.