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      • KCI등재

        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.

      • 항암제 처리한 백혈병 세포주에서의 Apoptosis 발현

        김삼용,윤소현,김현수,김종숙,윤환중,김진경,조덕연 충남대학교 암연구소 1998 癌共同硏究所 硏究誌 Vol.2 No.1

        The bcl-2 proto-oncogene encodes a 26 kD protein that promotes cell survival by blocking apoptosis. The bax protein is a member of the bcl-2 familly, now known to form heterodimers with the bcl-2 protein. The ratio of bax to bcl-2 is be critical in determining the fate of the cell in response to stimuli that can induce apoptosis. Extract of Pulsatilla Koreana (SB-31) showed promising antitumor activity in vitro with Topo I inhibitory action. In the present study, the relationship between apoptosis and the apoptosis related proteins, bcl-2 and bax were investigated in human leukemic cell lines HL-60, U-937 and CEM-CM3. All anticancer drugs(adriamycin, etoposide, camptothecin, SB-31) induced extensive apoptosis in HL-60, U-937 cells and CEM-CM3 cells. The expression of bcl-2 and bax protein were determined in cell lines by western blotting before and after incubation with anticancer drugs at different time points. 1) In HL-60 or U-937 cell lines, down regulation of bcl-2 and up-regulation of bax were found after incubation with ADR, VP-16 or camptothecin. 2) In HL-60 or U-937 cell lines, no significant change in bcl-2 or bax protein expression resulted after incubation with SB-31. 3) In CEM-CM3 cells, virtually no change was noted in bcl-2/bax expression after incubation with ADR, VP-16, camptothecin or SB-31. It is suggested that different leukemic cell lines use different pathways of apoptosis activation and a given cell may utilize different pathways of apoptosis activation in response to different cytotoxic agents.

      • 항암제 처리한 백혈병 세포주에서의 Apoptosis 발현

        김삼용,윤소현,김현수,김종숙,윤환중,김진경,조덕연 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        The bcl-2 proto-oncogene encodes a 26 kD protein that promotes cell survival by blocking apoptosis. The bax protein is a member of the bcl-2 familly, now known to form heterodimers with the bcl-2 protein. The ratio of bax to bcl-2 is be critical in determining the fate of the cell in response to stimuli that can induce apoptosis. Extract of Pulsatilla Koreana (SB-31) showed promising antitumor activity in vitro with Topo I inhibitory action. In the present study, the relationship between apoptosis and the apoptosis related proteins, bcl-2 and bax were investigated in human leukemic cell lines HL-60, U-937 and CEM-CM3. All anticancer drugs(adriamycin, etoposide, camptothecin, SB-31) induced extensive apoptosis in HL-60, U-937 cells and CEM-CM3 cells. The expression of bcl-2 and bax protein were determined in cell lines by western blotting before and after incubation with anticancer drugs at different time points. 1) In HL-60 or U-937 cell lines, down regulation of bcl-2 and up-regulation of bax were found after incubation with ADR, VP-16 or camptothecin. 2) In HL-60 or U-937 cell lines, no significant change in bcl-2 or bax protein expression resulted after incubation with SB-31. 3) In CEM-CM3 cells, virtually no change was noted in bcl-2/bax expression after incubation with ADR, VP-16, camptothecin or SB-31. It is suggested that different leukemic cell lines use different pathways of apoptosis activation and a given cell may utilize different pathways of apoptosis activation in response to different cytotoxic agents.

      • KCI등재

        두경부 마사지가 중환자실 환자의 수면과 불안에 미치는 효과

        김미용,전선영,송윤희,최은진,김재희,김미성,주명순,김남선 병원간호사회 2006 임상간호연구 Vol.11 No.2

        Purpose: This study was to apply head and neck massage to patients in intensive care unit and to inventigate the effect of that massage on sleep and state anxiety. Method: The subjects in this study were 27 patients who were admitted in medical intensive care unit. The study was performed from June thru September of 2005 on the One-group pretest-posttest design and the sleep, state anxiety of the subjects were measured before and after head and neck massage. For data analysis, paired t-test and Pearson correlation coefficient were utilized. Result: The first hypothesis that the subjects might have a better sleep after being exposed to head and neck massage was accepted. The second hypothesis that the subjects might feel less state anxiety afrer being exposed to head and neck massage was accepted. The third hypothesis that the sleep of the ICU patients maight be correlated to their anxiety was accepted, as there appeared correlation between their sleep and anxiety. Conclusion: Head and neck massage is identified as one of independent nursing interwentions to improve the sleep of ICU patients and ease their anxiety, and it is necessary to apply it to clinical practices.

      • KCI우수등재
      • RISS 인기논문

        수면량과 집중력의 상관관계

        김병우,류지근,박우진,박계원,김미정,임지은,백대현,최재덕,최윤호,이가현,이관,김덕수 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

        수면, 기억 그리고 학습의 연관성은 실제 매우 복잡하다. 많은 연구에도 불구하고 명확한 연구결과는 아직 없다. 우리는 이 연구에서 평소와는 달리 시험 전날 수면 변화 양상이 집중력에 어느 정도 영향력을 미치는지 알아보고자 하였고, 이를 이용해 효율적인 수면 관리를 할 수 있는 기초자료로 삼고자 하였다. 동국대 의대 본과 1학년생 중 지원자 30명과 본과 2학년생 10명을 대상으로 평상시 상태와 시험 직후 수면이 부족한 상태에서 각각 K-PES TEST를 실시하여 총 8항목에 걸쳐 암기력, 판단력, 단순반응의 변화정도를 검사하였다. 또 설문조사를 병행하여 결과에 영향을 미칠 수 있는 다른 인자들도 파악하였다. 수면량에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 인간의 최대 생리학적 기능은 꼭 수면부족에 의해 좌우되는 것은 아니다. 그러나, 수면감소는 피로를 증가시키고, 동기부여를 감소시키나 단, 새로운 사실을 학습하는 데에는 큰 영향을 끼치지 않는다. 즉, 수면부족으로 장시간 깨어있는 것은 정확성과 반응성을 떨어뜨린다. 흡연에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 니코틴의 수면에 대한 상호관계는 알려지지 않았고, 인간의 감정이나 의식, 인식에 영향을 주는 것으로 알고있지만, 장기적은 측면에서 흡연이나 알코올은 인식능력과 무관한 것 같다. 카페인에 대한 숫자 외우기(암기력)검사 결과, 카페인은 spacial selective attention에는 특별한 영향을 주지 않지만 지각과정이나 주의 집중에 큰 효과를 주며, 인간의 의식 수행에 긍정적인 효과를 준다. 즉 카페인은 활력, 혼란, 피로상태를 변화시키고 visual analog scales에서 휴식상태에 가까운 양상을 나타낸다. 또 48시간 동안 수면을 취하지 않은 사람에게 카페인은 집중력과 장시간의 좋은 기분을 유지하게 하였다. 그러나 규칙적, 비규칙적으로 먹는 사람간에는 인지수행력의 차이를 보이지 않으며 상용자에서는 상당한 내성이 보인다. 수면패턴에 대한 숫자 더하기(순간 판단력)검사 결과, 집중력은 수면패턴에 의해서도 영향을 받고, 수면패턴이 바뀌게 되면 순간판단력을 저하시킨다. This study was performed to evaluate relationship of sleep and attention, and to control sleep effectively. We conducted a K-PES test of 40 medical students. K-PES contains eight elements, for example, simple response, selective response, color pairing, OddEven discrimination, number addition, number-symbol matching, memory, right-tapping, left tapping. Through these, we tested changes of memory, judgement, simple response. And we conducted a questionnaire survey to exclude bias. Results are as follows. As a results of number-symbol matching test, we know that sleeplessness is not complete responsible for physiologic function for humans. But, decreased sleep increases fatigue and decreases motivation, but no influence on learning new materials. So, long term sleeplessness decreases precision and responsibility. As a results of number-symbol matching test on smoking, a relationship of nicotine and sleep is not certain. A point of view in long term period, smoking and drinking is not related cognition, even if we know that those influence mood, consciousness and cognition. As a results of memory work test on caffeine, caffeine does not influence spacial selective attention, but mainly does perception, attention and consiousness process. Namely caffeine changes energetic activities, chaos, fatigue states and shows resting state in visual analog scales In sleeplessness for 48 hours, caffeine produced attention and good mood for a long time. But, in case of cognitive process no significance shows in regular or irregular diet. Regular diet shows high resistance. As a results of number addition test on sleep patterns, seep patterns influence attention, changes of sleep patterns decrease a moment judgement.

      • Sheehan 증후군 발생한 Torsades de Pointes

        김승환,김남호,김용철,최준호,박은미,이상재,이은미,유남진,윤경호,오석규,정진원 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.1

        재발하는 심실 빈맥으로 내원한 환자에서 Sheehan 증후군을 진단하였고, 적절한 호르몬 보충 치료 후 심전도 이상이 정상으로 회복된 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Torsades de Pointes is a form of polymorphic ventricular tachycardia that is associated with prolongation of QT intervals, characterized by QRS complexes of progressively changing ampulitude and cyclic length, giving the appearance of oscillations around the baseline. A 77 years-old woman was presented with hypotention and arrhythmia. Twenty four-hour ECG showed typical episodes of torsades de pointes with QT prolongation. This arrhythmia was controlled by isoproterenol and magnesium infusion, but it was not disappeared. She was diagnosed as Sheehan's syndrome by past history, anterior pituitary stimulation test and empty sella on CT scan. After hormone replacement treatment, Prolonged QT interval was normalized and polymorphic ventricular tachycardia has not recurred. We report a case of torsades de pointes associated with Sheehan's syndrome

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