Informed consent forms for gynecologic cancer surgery: recommendations from the Korean Society of Gynecologic Oncology

장하균,심승혁 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.2

The sociomedical environment is changing. In the traditional physician-patient relationship, the physician was authoritative and the patient was obedient. The contractual relationship featured patient consent to the physician’s decision. Today, the physician must explain fully the planned medical treatment, and any alternative, to the patient, who has the right to choose her treatment after considering the benefits and side-effects. The Korean Society of Gynecologic Oncology (KSGO) thus decided to standardize the surgical consent forms to meet the legal requirements of modern medicine, improve patient understanding of the surgical details, and protect medical staff from legal disputes. To determine the format and content, subcommittees for each cancer type collected and reviewed all relevant articles and the current consent forms of domestic medical institutions. After several meetings, 16 basic items to be included for each type of gynecologic cancer were selected. Also, to help patients understand the surgical details, figures were included. The revised forms were legally reviewed in terms of the appropriateness of the format and content. We also developed English versions to provide adequate information for foreign patients. We hope that these efforts will promote trust between patients and physicians, and contribute to effective treatment by laying a foundation of mutual respect.

Incidence and costs of cervical intraepithelial neoplasia in the Korean population

장하균,서상수,명준표,유예리,변승원 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.3

Objective: The purpose of this study was to assess the incidence rate of cervical intraepithelial neoplasia (CIN) and cervical cancer, and their costs according to age. Methods: We collected data on annual incidence and medical costs of CIN and cervical cancer from 2010 until the end of 2014 from the Health Insurance Review and Assessment (HIRA) service. The CIN was classified into CIN3 (high-grade) requiring conization and CIN1/2 (low-grade) requiring observation. Results: Incidence rates of CIN3 and cervical cancer are reducing over time, whereas CIN1/2 is increasing significantly (p for trend: <0.001). The peak ages of incidence were 25–29, 30–34, and 70–74 years old for CIN1/2, CIN3, and cervical cancer, respectively. The crude incidence of CIN1/2 increased by approximately 30% in 2014 compared to 5 years ago and demonstrated an increasing trend in all age groups. The CIN3 showed a significantly increasing trend in the age group of 30–39 years old, the cervical cancer was significantly reduced in all ages, except the 35–39 years old. The treatment for cervical cancer costs $3,342 per year, whereas the treatment for CIN3 and CIN1/2 cost $467 and $83, respectively. Conclusion: The crude incidence rate of cervical cancer is currently decreasing among Korean women, but the incidence rates and medical costs of CIN and cervical cancer are increasing in women in their 30s in Korea. These findings suggest that different strategies by age will be required for prevention of cervical cancer in Korea.

해외 LED 교통신호등 기술규격 현황

장하균 한국조명전기설비학회 2004 조명.전기설비 Vol.18 No.3

LED교통신호등은 기존 전구식 신호등과 달리 필라맨트 발열부가 없고, 전구식에 사용하는 착색렌즈 사용이 없어 이에 따른 빛 손실이 매우 적으며, 전구식 신호등에 비해 90% 정도의 전력이 절약된다. 또 특정 파장대의 단색광을 발광하며, 소자의 특성상 전원 공급과 동시에 빛을 발광한다. 그러면서 긴 수명으로 인하여 유지보수비용의 절감이 이루어지고, 구조적으로 매우 견고한 특성을 가지고 있다. (중략)

The 5th Shanghai Gynecologic Oncology Group (SGOG)-Korean Gynecologic Oncology Group (KGOG) joint meeting and 2016 Asia-Pacific Ovarian cancer Laparotomy and Laparoscopic Operation (APOLLO) symposium in Shanghai

장하균,김병기,Ting-Yan Shi,Rongyu Zang 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.6

Informed consent forms for gynecologic cancer surgery: recommendations from the Korean Society of Gynecologic Oncology

장하균,심승혁,이마리아,오경진,유헌종,김미경,김민규,이광범,소경아,김영태,이대우,Doo-Yoon Hyun,이종민 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.2

The sociomedical environment is changing. In the traditional physician-patient relationship, the physician wasauthoritative and the patient was obedient. The contractual relationship featured patient consent to the physician’sdecision. Today, the physician must explain fully the planned medical treatment, and any alternative, to the patient,who has the right to choose her treatment after considering the benefits and side-effects. The Korean Societyof Gynecologic Oncology thus decided to standardize the surgical consent forms to meet the legal requirementsof modern medicine, improve patient understanding of the surgical details, and protect medical staff from legaldisputes. To determine the format and content, subcommittees for each cancer type collected and reviewed allrelevant articles and the current consent forms of domestic medical institutions. After several meetings, 16 basicitems to be included for each type of gynecologic cancer were selected. Also, to help patients understand the surgicaldetails, figures were included. The revised forms were legally reviewed in terms of the appropriateness of the formatand content. We also developed English versions to provide adequate information for foreign patients. We hope thatthese efforts will promote trust between patients and physicians, and contribute to effective treatment by laying afoundation of mutual respect.

Refractory fever with pancytopenia in postpartum and SLE-induced pacreatitis (초)

장하균,고현선,박호정,위지선,최세경,신종철 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-

Film Session Q&A 1 : 02 ; Single-port laparoscopic para-aortic lymph nodes dissection

장하균,이윤경,기은영,이근호 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: Teach a new procedure 방법: Single port laparoscopic surgery is gradually adopted in gynecologic oncology. Indicaitons of single port paraaortic lymphadnectomy are in the course of staging of endometrial cancer, early ovarian cancer, and advanced cervical cancer. 결과: Here we performed the single port laparoscopic lymphadenectomy in a case of endometrial cancer stage Ia with suspicious paraaortic lymph node at CT imaging. All the procedures were completed with 10 mm endosocopy, 5 mm grasper and 5 mm working device i.e. biopolar. A 2.5 cm sized trans-umblical skin incision was made and wound retractor was inserted. After peritoneal opening, left and right paraaoritc space was developed around great vessels and ureter. Right and left paraaortic nodes up to renal vein were collected (20 nodes). 결론: Operative time was 95 min and she leave the hospital the next day of operation.

난소난관농양으로 복강경수술한 환자의 임상적 고찰

장하균 ( Ha Kyun Chang ),이희중 ( Hee Joong Lee ),박태철 ( Tae Chul Park ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.9

목적: 난소난관농양 의심하에 진단적 복강경을 시행한 경우 수술 소견상 급성 골반염의 소견만 보인 군과 난소난관 농양이 발견된 두 군간에 역학적 요인과 혈액학적 검사 소견 및 임상양상, 수술적 치료 소견 등을 비교 분석하여 난소난관농양으로 발전하는 요인들을 분석하고자 하였다. 방법: 2005년 1월부터 2008년 3월까지 가톨릭대학교병원에서 시행한 초음파 및 내진 소견상 난소난관농양 의심으로 입원하여 진단적 복강경수술을 시행받은 130명을 대상으로, 골반 및 난소난관농양이 발견된 군과 급성 골반염 소견만을 보이고 복강경수술 소견상 농양은 발견되지 않은 두 군으로 분류하여 역학적 요인과 임상 양상, 수술적 치료 등을 조사하여 각 군별로 비교 분석하였다. 결과: 골반 및 난소난관농양이 발견된 군을 급성 골반염만을 보인 군과 비교하였을 때 자궁내 피임장치를 사용하고 있는 경우가 많았으며 C-반응성 단백질 및 적혈구 침강계수가 높은 경우가 많았고 통계적으로 두 군간의 체온 및 백혈구 증가에서 유의한 차이가 있었고 나이, 출산력 유산력 및 기왕 골반염의 과거력 등의 인자들은 의미 있는 차이가 없었다. 결론: 상기 수술적 소견에 의거한 결과는 자궁내 피임장치를 사용하고 있는 경우나 C-반응성 단백질 및 적혈구 침강계수가 높은 경우에는 난소난관농양의 빈도가 상대적으로 급성 골반염만의 소견을 보인 군보다 높았다. 이에 근거하여 난소난관농양의 진단 시 특이도나 민감도 혹은 양성 및 음성 예측도를 평가할 수 있는 연구 방법이 이루어지면 급성 골반염 환자에서 난소난관농양이 병발된 경우를 예측하여 수술적 중재를 통해 합병증을 미리 예방하는데 도움이 될 것으로 사료된다. Objective: To evaluate the clinical characteristics between patients with tuboovarian abscess and those presenting with non-tuboovarian abscess in acute pelvic inflammatory disease according to the operation findings. Methods: The patients were divided into 2 groups based on the operation findings at laparoscopic surgery; 56 patients diagnosed with evidence of tuboovarian abscess and 74 patients diagnosed with acute pelvic inflammatory disease without tuboovarian abscess. Those were compared with respect to patient characteristics, clinical and laboratory findings depending on the significant differences. Results: There were no significant differences between the two groups considering the percentage of age, parity, mean abortion rate and rate of the history of previous pelvic inflammatory disease. But there were differences in mean white blood cell count, erythrocyte sedimentation rate and C-reactive protein level. A higher number of patients having intrauterine devices were observed in the tuboovarian abscess group than in the non-tuboovarian abscess group. Also, statistical significance was noted in hospital stay after operation but there was no difference in number of sick days prior to operation. Conclusion: Our results suggest that some variables noted between the tuboovarian abscess group and acute pelvic inflammatory disease group. These results make easier to calculate diagnostic accuracy of patients prone to developing tuboovarian abscess and prevent subsequent complications from the delay of treatment if sensitivity, specificity, negative and positive predictive values were assessed.

Surgical patterns in management of uterine sarcoma; CMC experiences (초)

장하균 ( Ha Kyun Chang ),( Yoon Ji Jung ),( Keun Ho Lee ),( Soo Yong Hur ),( Jong Sup Park ) 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-

산업용 백열전구 대체 LED조명등 설계

장하균(Ha-Gyoon Chang),여인권(In-Kwon Yeo),장우진(Woojin Jang) 한국조명·전기설비학회 2008 한국조명·전기설비학회 학술대회논문집 Vol.2008 No.5월

수은이 함유된 방전등과 같은 조명기구의 사용이 제한되는 특수구역의 산업용 조명설비로 200 W 이상의 높은 소비전력의 백열등기구들이 사용되고 있다. 인공광원으로 백열전구는 매우 낮은 발광효율로 전력소모가 많고, 높은 방사열로 인해 화재의 염려가 있어 램프보호유리구를 장착하므로 낮은 조명률로 광 손실이 높게 발생한다. 또한 산업지역 내에서는 일반적으로 각종 전동기 및 공기조화 설비의 가동으로 진동이 심하며 여기에 백열전구 사용 시 당초 예상되는 수명보다 더욱 단축되고 있다. 이러한 지역에 설치된 백열등을 조명등기구 효율(Luminaire Efficacy)이 높은 친환경 에너지 절감형 차세대 광원인 LED조명등으로 대체하여 산업설비 지역 내 공급되는 조명용 소비전력을 크게 줄여 에너지 절약효과를 높임과 동시에 양호한 조명율의 LED등기구를 사용함으로써 실내조도를 향상 시키며, 백열전구 대비 색온도가 높은 LED광원을 사용함으로써 조명환경 개선에 따른 작업능률을 높이기 위해 특수지역의 산업용 LED조명등을 개발하였다.