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.

교정용 선재와 브라켓 사이의 마찰력에 관한 연구

김철위,박영준,이용근 大韓齒科器材學會 1995 대한치과재료학회지 Vol.22 No.2

Mechanical friction makes the orthodontic tooth movement require greater force than the biological tooth movement. Friction is affected by the size, shape, and material of both the bracket and the wire. This study was designed to investigate the effect of material or size of orthodontic brackets and orthodontic wires on the amount of frictional forces generated during simulated tooth movement. A testing apparatus was designed to simulate the clinical situation in which the center of resistance of a tooth is not on the same plane as that of bracket, thereby resulting in some tipping of the bracket slot relative to orthodontic wire (100 gram weight was suspended). In angulated and non-angulated experimental condition, the orthodontic wires were drawn through the testing apparatus with the speed of 2mm/minute. The results were as follows : 1. In both of the cases of the metal bracket and ceramic bracket, the frictional forces were greater in angulated experimental group than non-angulated group. In both of the non-angulated and angulated experimental group, the frictional forces of ceramic brackets were greater than those of metal brackets. In most of cases, these differences were statistically significant(p<0.05) with a few exceptions. 2. In general, the frictional forces of orthodontic wires with circular cross-cut surface were lower than those wires with rectangular cross-cut surfaces. But there was no statistically significant correlation between the size of orthodontic wire and frictional forces. 3. There was no difference between the frictional of the stainless-steel orthodontic wires and those of the cobalt-chromium orthodontic wires, but the frictional forces varied depending on the measuring condition or brand of the wires. 4. The frictional forces of β-titanium orthodontic wires were significantly higher than those of stainless-steel orthodontic wires were cobalt-chromium orthodontic wires.

L-(+)-Diisopropyl tartrate로부터 유도된 lithium azide 착물의 에폭시드 및 α,β-불포화 카르보닐 화합물과의 반응

金鎭演,金榮俊 충남대학교 기초과학연구소 2005 忠南科學硏究誌 Vol.32 No.1

Several azido alcohols and azido ketones were obtained in moderate yields by an efficient transferring azido group from an organoboron compound. (4R,5R)-2-allyl-1,3,2-dioxaborolane-4,5-dicarboxylic acid diisopropylester lithium azide reagent(3), which was readily prepared from L-tartrate.

티타늄의 산화 조건에 따른 산화막의 특성 및 인산칼슘 생성에 미치는 영향

김인,양홍서,박연준,송호준,이용렬 전남대학교 치의학연구소 2003 구강과학 Vol.15 No.3

The objective of this study was to evaluate the changes of micro morphology, roughness and crystalline structure of titanium surface after various oxidation treatments. Moreover, the effect of titanium surface oxide characteristics on the formation of calcium phosphate in Eagle's MEM. Commercially pure Ti disks were treated at various thermal conditions of 530℃ (Ti-530), 600℃(Ti-600), 700℃(Ti-700), 800℃(Ti-800), 900℃(Ti-900), and 1000℃(Ti-1000), respectively, and as received cp Ti (AS-R) and passivated cp Ti (PAS) were used as comparison groups. Surface characteristics were investigated using FE-SEM, profilometer and XRD. After immersing each sample in MEM for 7days, calcium phosphate (Ca-P) formation was evaluated using FE-SEM and EDS. Crystallites of 10~30nm-size were observed on the surface of Ti-530 and Ti-600 samples. Needle-like crystals were formed on Ti-700 samples, and the crystal grain size was increased dramatically as the temperature increased higher than 800℃. The roughness of Ti-530 was higher comparing to AS-R and PAS, and the roughness decreased in the treatment range of 530-700 with dense crystalline oxide formation. However, at treatment temperatures higher than 800℃, the roughness increased and its degree was depended to the size of the crystals. The anatase structures were observed in Ti-530 and Ti-600, and anatase and rutile structures were co-existed in Ti-700 specimen. Only rutile TiO_(2) were observed in Ti-800, Ti-900 and Ti-1000 specimens. The Ca-P formation on AS-R and PAS specimens was low in MEM solution. However, the Ca-P formation was well observed on heat-treatedgroups, and its degree of formation and micro-morphology was different by the specimen groups. The crystalline and chemical structure, micro-morphology, and surface roughness of titanium were various by the conditions of heat treatments, and the grain size and crystal structure of titanium oxide affected on the degree of Ca-P formation on Ti samples in MEM solution

개원의의 진료의뢰시 기대요인 및 만족도에 관한 연구 : 협력병원체제 여부를 중심으로

김동일,김해준,윤석준,문영배 한국의료QA학회 2002 한국의료질향상학회지 Vol.9 No.2

Background : This research, as a part of improving management process of college hospital in this rapidly changing circumstances, is searching for the actual state of private clinics referring patients to referral center including college hospitals. Methods : This research examined the sense of satisfaction and requesting degree in using referral center and by analyzing the correlation and differences among factors such as primary factors regarded as selecting ones in referring patients to a referral center in college hospital and expecting factors expected to be supported to patients and cooperative hospitals. Results : The main researched results are as follows. First, as for the primary factors, the differences between cooperative and uncooperative hospitals revealed the fact that choosing target hospital in accordance with cooperative relation and convenient process in referring patients are important. Second, satisfaction rates, analyzed from the paired t-test revealed kindness and convenience as the top priorities, while sending patients back again and benefit of supporting such as the use of facilities were revealed as the least satisfactory aspects, despite the fact that they should be fulfilled through actual service. Conclusion : The recognition of the practitioner is examined and analyzed in this research by examining primary factors in selecting college hospitals, expecting factors expected to be supported to patients and satisfaction degree, which are expected to be used as basic materials for the development of referral center of college hospitals.

방광의 염증성 가종양 1례

정영봉,배준,권명훈,김상익,김경수 大韓泌尿器科學會 2001 Korean Journal of Urology Vol.42 No.3

치과주조용 Ti-Zr-Cr계 합금에서 Cr 함량변화가 부식저항성에 미치는 영향

박영준,강후원,이용렬,송호준,김민강 大韓齒科器材學會 2004 대한치과재료학회지 Vol.31 No.4

The purpose of this study was to develop new dental casting titanium (Ti) alloys having an excellent mechanical properties and good corrosion resistance as a substitute for c.p Ti and Ti-6Al-4V alloy (control groups). Ti-20Cr, Ti-2OZr and Ti-20Zr-XCr (X=2, 5, 10, 15) alloys (experimental groups) were designed for dental casting Ti alloys. Prior to casting prccedure, mother alloys were prepared by using vacuum arc melting with skull melting method. Argon-arc melting and argon/vacuum-pressure casting machine were used for making the specimens. The hardness, microstructure, and corrosion resistance were evaluated by using Vickers microhardness measurement, FE-SEM, and anodic polarization test. The results were as follows: 1. The Vickers microhardness (Hv) of Ti and Ti-6Al-4V alloy showed the values of 210 and 352, and Ti-20Cr and Ti-20Zr alloys showed the values of 341 and 259, respectively. As the Cr content increased from 0 to 15 % in Ti-20Zr-XCr (X=0, 2, 5, 10, 15) alloys, the Hv increased from 259 to 298, 457, 344, and 351, respectively. The microstructure of Ti-20Zr-XCr specimens showed significant difference by the concentration changes of Cr content showing acicular crystalline structure for Ti-20Zr-2Cr and Ti-20Zr-5Cr, and equiaxed crystalline structure for Ti-20Zr-10Cr and Ti-20Zr-15Cr. 2. Open-circuit potentials (E_(∝)) were rapidly decreased followed by steadiness as time elapse in all experimental groups except in Ti-20Z group. Ti-2OZr group showed an increase in E_(∝), from the first. 3. In potentiodynamic anodic polarization tests, all experimental groups showed more noble corrosion potential (E_(corr) than that of Ti-6Al-4V, and more basic E_(corr) than that of Ti. Especially, Ti-20Zr-10Cr alloy showed most favorable corrosion resistance among Ti-Zr-Cr alloys. 4. For Ti-20Zr-10Cr, Ti-20Zr-15Cr, and Ti-20Cr groups, which have more than 10% Cr content, the secondary corrosion potential shifted to noble direction in larger amounts than in the cases of control and other experimental groups. From these results, it was concluded that newly formulated Ti-20Zr-10Cr experimental alloy have adequate hardness and high corrosion resistance, and this alloy is promising candidate for a successful dental casting alloy.

요관결석에 대한 요관경하 배석술의 임상경험

정영봉,노준화,김상익 全南大醫大 2000 전남의대학술지 Vol.36 No.4

티타늄 상에 강유전성 barium titanate 박막 형성과 분극처리에 의한 유사체액 내에서의 calcium phosphate 생성 증진

박영준,이용렬,황규석,김은주,임용무,이기헌 대한치과기재학회 2001 대한치과재료학회지 Vol.28 No.2

This study was performed to fabricate a ferroelectric barium titanate (BaTiO₃, BTO) thin film on Ti substrate and to evaluate the effect of poling treatment for the improvement of calcium phosphate (Ca-P) formation. BTO thin-film was spin-coated on Ti substrate by dipping-pyrolysis technique using coating sol obtained by mixing Ba-naphthenate and Ti-naphthenate as starting substances. Pre-heating temperature of the BTO thin film was performed at 500℃ because organic-solvent was completely volatilized without any crystal growth, and the final heat treatment was performed at 600, 650, 700, 750, 800, 850℃, respectively. By repeating the coating and pre-heating procedure gor 20 times, homogeneous thin film of 0.7㎛ thickness could be fabricated, and it performed well during the poling treatment without breakdown. The final heating treatment of the BTO thin film at 750℃ produced a homogeneous crystalline structure without heterogeneous TiO₂formation, which was confirmed by field emission scanning electron microscope (FE-SEM) and X-ray diffraction analyser (XRD). An average grain size of 20∼30 ㎚ were confirmed by SEM observation. The final heat-treated BTO thin-films were polarized (Ep = 5 V/㎛) from 160℃ to 25℃ in heating chamber for 2 h. The negatively poled BTO thin film (N-BTO), non-poled BTO thin film (BTO), Ti substrate (Ti), and 600℃ heat-treated Ti (Ti-O) were immersed in SBF and Eagle's MEM solution for 15 days at 37℃. After the immersion period, the morphological and compositional changes of the surfaces were investigated using a FE-SEM and an energy dispersive X-ray spectrometer (EDX). After immersion in simulated body fluid (SBF), sodium chloride (Nacl) crystals were formed on Ti, Ti-O, and BTO surfaces due to anion adsorption (Cl), while Ca-P crystals were formed on N-BTO surfaces. We assumed that rapidly adsorded cations (Ca²□ ions) on the negatively charged surface at the initial stage acted as nuclei for the formation of Ca-P crystals. In MEM, sodium chloride (NaCl) was formed on Ti, and Ca-P layer including NaCl was formed on Ti-O. Weak and sparse Ca-P layers were formed on BTO, while thick, homogeneous, and dense Ca-P layer was formed on N-BTO, which was confirmed by FE-SEM and EDX. These results demonstrated that introducing a N-BTO on Ti is an effective method for the improvement of Ca-P formation in SBF and MEM. In conclusion, negatively charged ferroelectric BTO thin-film on Ti would improve the possibility of implant osseointegration.

Plyometric Training과 비타민 C 투여가 남고생의 체력, 혈중 젖산, 암모니아 및 젖산탈수소효소에 미치는 영향

장준원,김세종,이현미,서혜림,조현숙,고정림,염종우,예정복,백영호 釜山大學校 附設 體育科學硏究所 2003 體育科學硏究所 論文集 Vol.19 No.-

The purpose of this was to examine the effect of plyometric training and vitamin C ingestion on physical fitness and fatigue substance....