Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

Time-evolving genetic networks reveal a NAC troika that negatively regulates leaf senescence in <i>Arabidopsis</i>

Kim, Hyo Jung,Park, Ji-Hwan,Kim, Jingil,Kim, Jung Ju,Hong, Sunghyun,Kim, Jeongsik,Kim, Jin Hee,Woo, Hye Ryun,Hyeon, Changbong,Lim, Pyung Ok,Nam, Hong Gil,Hwang, Daehee National Academy of Sciences 2018 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.115 No.21

<▼1><P><B>Significance</B></P><P>Leaf senescence is regulated in a complex manner, involving time-dependent interactions with developmental and environmental signals. Genetic screens have identified key regulators of senescence, particularly late-stage senescence regulators. Recently, time-course gene-expression and network analyses, mostly analyses of static networks, have predicted many senescence regulators. However, senescence is defined by time-evolving networks, involving the temporal transition of interactions among senescence regulators. Here, we present time-evolving networks of NAM/ATAF/CUC (NAC) transcription factors, central regulators of leaf senescence in <I>Arabidopsis</I>, via time-course gene-expression analysis of NACs in their mutants. These time-evolving networks revealed a unique regulatory module of NACs that controls the timely induction of senescence-promoting processes at a presenescent stage of leaf aging.</P></▼1><▼2><P>Senescence is controlled by time-evolving networks that describe the temporal transition of interactions among senescence regulators. Here, we present time-evolving networks for NAM/ATAF/CUC (NAC) transcription factors in <I>Arabidopsis</I> during leaf aging. The most evident characteristic of these time-dependent networks was a shift from positive to negative regulation among NACs at a presenescent stage. ANAC017, ANAC082, and ANAC090, referred to as a “NAC troika,” govern the positive-to-negative regulatory shift. Knockout of the NAC troika accelerated senescence and the induction of other <I>NAC</I>s, whereas overexpression of the NAC troika had the opposite effects. Transcriptome and molecular analyses revealed shared suppression of senescence-promoting processes by the NAC troika, including salicylic acid (SA) and reactive oxygen species (ROS) responses, but with predominant regulation of SA and ROS responses by ANAC090 and ANAC017, respectively. Our time-evolving networks provide a unique regulatory module of presenescent repressors that direct the timely induction of senescence-promoting processes at the presenescent stage of leaf aging.</P></▼2>

Identification of a sensitive urinary biomarker, selenium-binding protein 1, for early detection of acute kidney injury

Kim, Kyeong Seok,Yang, Hun Yong,Song, Hosup,Kang, Ye Rim,Kwon, JiHoon,An, JiHye,Son, Ji Yeon,Kwack, Seung Jun,Kim, Young-Mi,Bae, Ok-Nam,Ahn, Mee-Young,Lee, Jaewon,Yoon, Sungpil,Lee, Byung μ,Kim, Hyung TAYLOR & FRANCIS 2017 Journal of Toxicology and Environmental Health Vol.80 No.9

<P>Acute kidney injury (AKI) is associated with increased mortality rate in patients but clinically available biomarkers for disease detection are currently not available. Recently, a new biomarker, selenium-binding protein 1 (SBP1), was identified for detection of nephrotoxicity using proteomic analysis. The aim of this study was to assess the sensitivity of urinary SBP1 levels as an early detection of AKI using animal models such as cisplatin or ischemia/reperfusion (I/R). Sprague-Dawley rats were injected with cisplatin (6 mg/kg, once i.p.) and sacrificed at 1, 3, or 5 days after treatment. Ischemia was achieved by bilaterally occluding both kidneys with a microvascular clamp for 45 min and verified visually by a change in tissue color. After post-reperfusion, urine samples were collected at 9, 24, and 48 hr intervals. Urinary excretion of protein-based biomarkers was measured by Western blot analysis. In cisplatin-treated rats, mild histopathologic alterations were noted at day 1 which became severe at day 3. Blood urea nitrogen (BUN) and serum creatinine (SCr) levels were significantly increased at day 3. Levels of urinary excretion of SBP1, neutrophil gelatinase-associated lipocalin (NGAL), and a tissue inhibitor of metalloproteinase-1 (TIMP-1) were markedly elevated at day 3 and 5 following drug treatment. In the vehicle-treated I/R group, serum levels of BUN and SCr and AST activity were significantly increased compared to sham. Urinary excretion of SBP1 and NGAL rose markedly following I/R. The urinary levels of SBP1, NGAL, TIMP-1, and KIM-1 proteins excreted by AKI patients and normal subjects were compared. Among these proteins, a marked rise in SBP1 was observed in urine of patients with AKI compared to normal subjects. Based upon receiver-operator curves (ROC), SBP1 displayed a higher area under the curve (AUC) scores than levels of SCr, BUN, total protein, and glucose. In particular, SBP1 protein was readily detected in small amounts of urine without purification. Data thus indicate that urinary excretion of SBP1 may be useful as a reliable biomarker for early diagnosis of AKI in patients.</P>

보완대체의학에 대한 간호학과 학생의 주관성 연구

박은영 ( Eun Young Park ),이은남 ( Eun Nam Lee ),강지연 ( Ji Yeon Kang ),주현옥 ( Hyeon Ok Ju ),김삼숙 ( Sam Sook Kim ),최은정 ( Eun Jung Choi ),김학선 ( Hack Sun Kim ) 경희대학교 동서의학연구소 2011 동서간호학연구지 Vol.17 No.1

보완대체의학은 건강증진과 질병예방을 위한 총체적인 접근법의 하나로 환자뿐 아니라 일반인들 사이에서도 이용률이 증가하고 있고, 교육에 있어서도 보완대체요법 관련 교과목을 의학이나 간호학의 정규 교과과정 내에 포함시키는 대학이 늘어남에 따라 미래의 건강관리 제공자인 간호학생들의 보완대체의학에 대한 인식이나 태도를 파악하는 것은 중요하다. 이에 본 연구는 Q방법론을 이용하여 보완대체의학에 대한 간호학생의 반응을 유형화하고 구체적인 특성을 파악하고자 시도되었다. 보완대체의학에 대한 간호학생의 반응은 4개로 유형화되었으며, 각 유형은 실용적 확신형, 견제형, 가치 인정형, 제한적 수용형으로 명명하였다. 각 유형의 명명에서 볼 수 있듯이 간호학생들은 인식에서 약간씩은 차이가 있지만 보완대 체의학에 대해 비교적 긍정적인 태도를 갖고 있는 것으로 나타났다. 이러한 결과는 간호학생들이 보완대체요법에 대해 긍정적인 태도를 보였음을 보고한 Kim (2004), Kim, Erlen, Kim 과 Sok (2006), Uzun과 Tan (2004)의 연구결과와 일치한다고 할 수 있다. 제1유형은 ‘실용적 확신형’으로 보완대체요법의 효과를 단순히 인정하기보다는 실용성에 초점을 맞춘 유형이다. 보완대체요법의 문제점으로 많이 지적되는 것 중의 하나가 사람마다 효과가 다르기 때문에 일률적으로 적용하기 어렵다는 것인데, 제1유형의 대상자들은 이를 오히려 실용적인 측면으로 인식하여, 보완대체요법의 효과는 사람마다 결과가 다르게 나타날 수 있기 때문에 어떤 치료법을 일률적으로 적용하기보다는 자신한테 맞는 보완대체요법을 찾아야 한다고 인식하는 것이다. 또한 제1유형의 대상자들은 보완대체요법에 대해 효과가 없거나 의미 없는 행위이며 의학적 치료를 방해하거나 효과를 믿을 수 없다는 데는 강하게 반대를 했다. 간호학생의 보완요법에 대한 태도를 조사한 Kim (2004)의 연구에서도 보완대체요법이 엉터리 치료법이라는 데에 대해 가장 부정적인 태도를 보임으로써 본 연구결과와 일치한다. 간호학생의 주관성을 조사한 Hwang (2004)의 연구에서는 간호학생의 인식이 세 가지로 유형화되었는데 ‘긍정적 인정형’으로 명명된 사람들은 보완대체요법이 건강의 유지와 증진에 도움이 되며, 면역력을 향상시키고 심리적 지지를 제공하고 몸을 보호하며 안위를 증진시키는 것으로 인식하고, 엉터리 치료법이고 환자의 치유에 방해가 되므로 사용을 피해야 하고 과학적인 근거를 설명할 수 없으므로 신뢰할 수 없다는 데대해서는 강한 반대의 의사를 표함으로써 본 연구에서 ‘실용적 확신형’으로 명명된 대상자들과 유사한 인식양상을 보였다. 본 연구에서의 ‘실용적 확신형’의 사람은 보완대체요법에 대해 쉽게 접근할 수 있고 여러 가지 효과를 한꺼번에 기대할 수 있다는 점에서 좀 더실용적인 면을 강조한 점이 차이라고 할 수 있다. 제2유형은 ‘견제형’으로 보완대체의학의 부작용에 대한 염려와 효과에 대한 정확한 작용기전의 뒷받침을 요구하는 유형으로, Hwang (2004)의 연구에서 보완대체요법은 체계적인 검증 후에 정통적인 치료와 병행해서 사용해야 효과가 있다고 하여 ‘객관적 수용형’으로 명명한 것과 매우 유사하다. 또한 간호사를 대상으로 한Son (2002)의 연구에서 보완대체요법을 현대의학을 보완해주는 치료법으로 고려하면서 과학적인 근거를 확립하는 일이 필요하다고 제시한 것과 일치한다. Ernst (2000)도 보완대체요법을 이용하는 대상자들은 보완대체요법의 안전성과 효율성에 대해서 알고자 하며, 보완대체요법에 대해 건강관리자와 개방적으로 의사소통할 때 안정성이 확립된다고 하여 본 연구의 ‘견제형’ 유형과 유사한 것을 볼 수 있다. ‘견제형’의 사람들은 보완대체요법에 대한 효과가 사람마다 다르게 나타나므로 보완대체요법을 무조건적으로 받아들이기 이전에 임상적인 효율성에 대한 정확한 근거와 과학적인 검증에 관한 많은 연구들이 이루어져야 할 것을 강조한 유형이다. 이러한 견해는 최근 의학이나 간호학 교육에서 근거중심의 행위를 강조하고 있는 것을 반영하는 것이라 할 수 있다. 제3유형은 ‘가치 인정형’으로 보완대체의학에 대해 과학적 신뢰를 갖고 있지는 않지만 보완대체요법의 건강증진에 대한 가치를 인정하는 유형이다. 의사를 대상으로 보완대체요법의 치료 효과에 대한 태도를 분석한 Jang 과 Park (2003)의 연구에서 62.2%는 ‘설명하기는 어렵지만 보완대체요법은 효과가 있다’고 하여 작용기전에 대한 이론적 근거는 부족하지만 치료효과에 대해서는 비교적 긍정적으로 인식하고 있는 것으로 나타나 본 연구 대상자의 ‘가치 인정형’과유사한 태도를 보였다. 또한 초등학교 보건교사를 대상으로 보완대체요법의 문제점에 대한 인식을 조사한 Kim, Kim과 Cho (2007)의 연구에서 40.5%가 ‘과학적인 검증의 부족으로 치료효과가 의심된다’고 지적하였지만 학교보건실무에서 보완대체요법의 적용가능성에 대한 질문에는 72.1%가 ‘가능하다’고 하였으며, 78%가 보완대체요법의 적용이유로 ‘증상완화, 치료보조의 효과’ 때문이라고 답하여 본 연구결과와 유사한 인식을 보였다. 또한 보완대체요법 교과목을 수강한 간호학생들에게 보완대체요법의 치료적 효과에 대해조사한 Kim (2005)의 연구에서도 ‘건강유지증진을 위해 일반 대중들도 보완대체요법을 많이 적용하고 있다’에 대해 5점 만점에 3.7점으로 응답하여 비교적 긍정적 태도를 보였다. 위의 결과들을 종합해 볼 때 보완대체요법이 체계적인 지식체로 인정하기엔 과학적 근거가 부족하지만 신체의 자연 치유력과 면역력을 증가시켜 건강증진에 영향을 미친다는 본 연구의 ‘가치 인정형’과 유사하다고 할 수있다. 제4유형은 ‘제한적 수용형’으로 보완대체의학이 건강증진에 도움이 되고 심리적 안정감을 주는 여러 가지 효과가 있는 반면 부작용이 있을 수 있고 사람마다 효과가 다르게 나타날 수 있으므로 작용기전에 대한 연구도 더 필요하다고 생각하는 유형으로 무조건적으로 수용하기보다는 제한적으로 수용하는 유형이다. 대학생을 대상으로 보완대체요법의 문제점에 대한 인식을 조사한 Gwon 등(2008)의 연구에서 ‘부작용을 예측할 수 없다’가 37.7%로 가장 높았고, 23.2%가 ‘비과학적이다’라고 응답함으로써 자신에게 맞는 보완대체요법을 찾아 효과를 볼 수는 있지만 부작용에 대한 우려, 효과에 대한 객관성 부족 및 작용기전에 대한 체계적 검증의 필요성을 언급한 본 연구에서의 ‘제한적 수용형’ 대상자와 유사한 인식을 보였다. Purpose: The purpose of this study was to grasp the subjectivity of the nursing students toward CAM and put the outcomes into use as basic facts and figures in developing and applying a curriculum associated with CAM. Methods: Q methodology was employed to explore the nursing students` subjectivity from their rank-order statements. For the Q population, individual in-depth interviews and literature research were conducted. Finally, 30 participants completed 40 Q statements. The data were analyzed using the QUANL software package. Results: The current survey that probed into the subjectivity of the nursing students relative to CAM abstracted four categories, namely, practical and convinced type, keep-under-control/wait-and-see type, merit acknowledging type and limitedly accepting type. Conclusion: It is recommended that various educational programs should be developed to shift the awareness of CAM on the part of the nursing students, based on the findings set forth in the current study.

敎科書 읽기 技術 訓練이 學習 習慣 및 學業成績에 미치는 效果

金楠玉 경북대학교 학생생활연구소 1985 學生指導硏究 Vol.18 No.1

The purpose of this study was to verify the effect of Text Reading Skills Training program on academic achievement and study habits. The subjects were 80 seventh-grade male students. They were randomly assigned to one of two groups. Half of the subjects (experimental group) were trained with Text Reading Training program, and the other half (control group) received no training. After and before the training, the subjects of two groups were administered the study Habit Inventory and then academic achievenment scores were obtained. Training procedure was divided into five periods; (1) (1) Reading Skills, (2) Reading Skills Training, (3) Text Readng, Skills, (4) Text Reading Skills Training(I) and (5) Text Reading Skills Training(Ⅱ). A 2×2 analysis of variance was carried out to test statistical significance of the main and interaction effects of Study Habit scores. There is to significant main effect but significant interaction effect. So post-hoc test was conducted to test the difference of two mean scores of experimental and control group. And t-test was conducted to test statistical significance of mean difference in academic achievement scores between the two groups. Based upon the findings of the present study, the following conclusions were made; (1) There is a singnificant difference in reading habits and technique factors scores between experimental and control group. (2) There is no significant difference, but a little enhancement in motivation factors and total study Habit scores for experimental group's subjects, (3) There is no significant difference, but quiet a little enhancement in the mean scores of total academic achievenlent for the experimental groups subjects. But there is a significant difference in the mean scores of social subjects among the academic achievement. (4) It is clarified that the Text Reading Skills Training program which was used in this study is more effective in social subjects than others ; it seems that the development and appliance of the Text Reading Skills Training program should include the comprehensive and flexible content of the training, considering the trait of each subject and individual student.

손씻기 교육이 간호사의 손씻기 행위와 중환자의 호흡기로의 MRSA 분리율 감소에 미치는 영향

김남초,최경옥 성인간호학회 2002 성인간호학회지 Vol.14 No.1

Purpose: This is a clinical experimental study aimed to provide basic data to ensure quality care. The propose of this study is to increase nurses hand washing behavior and decrease respiratory isolation rate of MRSA. Method: This study was conducted in Kangnam St. Marys hospital. The subjects included 5 nurses working at the NS ICU and 165 specimen for nasal swabs and 46 specimen for sputum cultures from 106 patients admitted to the NS ICU. The data were collected from June to September 2000. Results: 1. The percentage of the nurses hand washing was 15.6percent but was improved to 46.5 percent after the educational intervention. In particular, hand washing behavior was increased in situations such as after suctioning, before parenteral nutrition, and after providing hygiene care. 2. Results of nasal swab showed that MRSA isolation rate was reduced from 42.8 percent before the education to 18.6percent after the education. The sputum culture results also showed that the MRSA rate was reduced from 40.7percent before the education to 34.6percent after the education. Conclusion: The findings showed the nurses' strict hand washing behavior and use of disposable gloves and paper towers as well as use of hand sterilization spray by visitors or families can decrease the MRSA isolation rate in the NS ICR patients. Since the NS ICU patients may have respiratory complications due to long-term hospitalization, the nurses regular hand washing is important enough to be emphsized. Future research should be focused on the impact of nurses' hand washing behavior on the incidence of pneumonia, an iatrogenic infection.

全國主要 地方의 日射量 分析

김병철,김진흥,하옥남 조선대학교 동력자원연구소 1987 動力資源硏究所誌 Vol.9 No.2

The insolation and meteorological data which were measured in the meteorological observatory in several locations were examined and analysed. Also mean air temperature, wind speed and amount of cloud were examined. Monthly average insolation, clear sky solar radiation, diffuse, direct, global solar radiation and the ratio of the horizontal solar radiation and extraterrestrial solar radiation were observed and analysed to be a useful data in using the solar energy.

축냉재 포접화합물의 열물성에 관한 실험적 연구(Ⅱ) : 충전량 변화 Variations of Charging Conditions

김진흥,정낙규,고강옥,임재경,하옥남 朝鮮大學校 機械技術硏究所 1999 機械技術硏究 Vol.2 No.2

본 연구에서는 에너지의 합리적 이용을 위한 건물공조용 축냉시스템에 적용 가능한 축냉재로서 TMA-물계 포접화합물의 농도와 충전량의 변화에 따른 상변화온도, 비열 및 과냉도 실험을 통하여 다음과 같은 결론을 얻었다. 1. 충전량이 많을수록 전 실헐과정에서 열물성의 안정성이 높게 나타났다. 2. TMA-물계 포접화합물의 비열은 순수한 물에 대하여 86% ∼ 96% 정도를 나타내었다. 위의 실험결과로부터 TMA-포접화합물은 건물공조용 축냉재로서의 열물성을 갖는다고 판단된다 The objective of this Paper is to investigate the thermal properties of TMA-clathrate compound applicable to cold storage system for residential air-conditioning in order to use energy reasonably. Especially, the test tube experiments are performed to compare and analyze the concentration of TMA-clathrate compound, the temperature of heat source, and the phase change temperature, specific heat and subcooling characteristics according to the variation of charge capacity. The result is summarized as follows: the phase change temperature appears higher as the charge capacity is larger. Thus, it appears that TMA-clathrate compound has thermal properties as the cold storage medium for residential air-conditioning.

효율적인 자동차 배출가스 측정방법에 관한 연구

김선옥,김진흥,하옥남 朝鮮大學校 機械技術硏究所 2000 機械技術硏究 Vol.3 No.1

For this study, we focused on deficiencies in the inspection methods used to measure the idling exhaust emissions of vehicles using gasoline or LPG. For the test, we adapted the inspection method, commonly used in advanced countries. This method was able to let us compare the amounts of exhaust gas emission and other factors, including the age and milage of the vehicles involved. By using the ASM2525 and ASM5015 methods, we reached the following conclusions 1. For the CO, HC and NOX emission tests, each method produced the same result. Vehicles produced prior to 1992 and having travelled over 110,000Km produced more gas. In case of non-business sedans, the same trend appeared for cars over 7 years old. 2. Although there were no big differences detected in the tests for CO and HC emissions involving the idle inspection method and the load inspection method, there were significant differences in the case of the NOX tests. 3. Because the current idle inspection does not reflect the condition of a vehicle when it is being driven, it is difficult to determine which vehicles are emitting excessive exhust. Therefore it would seem a more effective to adapt the load inspection method ASM2525, which takes vehicles milage into account

경희대학교 수원캠퍼스 노천극장 기본계획

김동찬,이윤수,장동주,강남욱,민창기,김용옥 경희대학교 디자인연구원 2003 예술· 디자인학연구 Vol.6 No.1

The aim of this study is to design an open-air theatre to satisfy the demand of students about a place for events in Kyunghee University, Suwon campus. Furthermore, rapid growth of Suwon campus has been requested a suitable place for outdoor amphitheatre. The entire design of Kyunghee University campuses pursuit renaissance style, hence Greek and Roman styles were considered in this study. To make the open-air theater as a useful and distinctive place, the following design elements have to be considered: aesthetic, functional, subjective, symbolic and practical use of the theatre.