A comparison of survival outcome of open, total laparoscopic and laparoscopy-assisted vaginal radical hysterectomy in patients with early cervical cancer of stage IB2

( Sul Lee ),( Hyung Joon Yoon ),( Eun Hye Jeon ),( Juseok Yang ),( Yong Jung Song ),( Hyun Jin Roh ),( Sang Hun Lee ),( Byung Su Kwon ),( Ki Hyung Kim ),( Dong Soo Suh ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: The aim of this study is to evaluate oncologic outcomes of total abdominal radical hysterectomy (TARH), total laparoscopic radical hysterectomy (TLRH) and laparoscopic-assisted radical vaginal hysterectomy (LARVH) in early cervical cancer patients (stage IB2-3, tumor size≥2cm), analyzing the risk factors that may affect the clinical results. Methods: A total of 756 patients underwent radical hysterectomy between 2000 and 2019 from three university hospitals (Pusan National University Hospital, Yang-san Pusan National University Hospital, Ulsan University Hospital) were enrolled. Among them, 172 patients with stage IB2-3 were analyzed retrospectively. Results: Seventy-seven patients were treated with TARH, and 95 were managed via minimally invasive surgery (MIS), consisting of 35 with TLRH and 60 with LARVH. TARH group had better disease five-year disease free survival (DFS) and overall survival (OS) compared with MIS group (86.4% vs. 73.4 for DFS and 91.7 vs. 82.2 for OS), but not statistically significant in both (p=0.058 for DFS and p=0.119 for OS). When TARH and the LARVH group were compared, both five-year DFS and OS were not significant different (86.4 vs 82.2%; p=0.288 for DFS and 91.7 vs 84.4%; p=0.206 for OS). However, when TARH and the TLRH group were compared, TLRH group had significantly worse five-year DFS than TARH (86.4 vs 54.5%; p=0.008), but five-year OS was not significant different (91.7 vs 77.5%; p=0.127). Multivariate analysis showed that LN metastasis and TLRH surgical approaches were an independent prognostic factor for DFS in IB2-3 cervical cancers. Conclusion: Our findings provided the evidence that TLRH surgical approach was associated with worse DFS in IB2-3 cervical cancers but that of LARVH was not. Such results may have important implications of colpotomy method for MIS in cervical cancer.

Adverse perinatal outcomes of abnormal cord insertion in twin pregnancies

( Juseok Yang ),( Mi-young Lee ),( Hye-sung Won ),( Jin Hoon Chung ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: The aim of this study was to evaluate the relationship between abnormal cord insertion and adverse perinatal outcomes in twin pregnancies. Methods: This retrospective cohort study was conducted at a single tertiary center. Cases with major structural anomalies were excluded. The chorionicity and diagnosis of abnormal cord insertion were confirmed by the placental pathology. Perinatal parameters including duration of pregnancy, birth weight discordance, and admission to neonatal intensive care unit (NICU), presence of selective fetal growth restriction (sFGR) were compared between the normal cord insertion group (group 1), the marginal cord insertion group (group 2), and the velamentous cord insertion group (group 3). Results: A total of 299 cohorts were included for the analysis: 110 cases in the group 1; 61 in the group 2; and 51 in the group 3 were MCDA twin pregnancies. Duration of pregnancy was significantly shorter in the group 3 (33.5±3.6 weeks) than in the group 1 or group 2 (34.5±3.2 weeks and 35.1±2.5 weeks). The birth weight discordance between the twins was significantly higher in the group 3 (22.5±20.2%) than in group 1 or group 2 (14.4±12.8% and 17.6±12.3%). The NICU admission rate was also significantly higher in the group 3 than in the group 1 or group 2. There were no significant differences in pregnancy duration, birth weight discordance, and NICU admission rate between the group 1 and 2. sFGR was most prevalent in the group 2 (31.1%), followed by the group 3 (23.5%), and the group 1 (10.9%). In DCDA twin pregnancies there were 56 and 21 case in group 1 and 2, respectively. No significant differences were shown between group 1 and 2 in the duration of pregnancy (36.3±2.1 weeks and 35.1±3.9 weeks), the birth weight discordance (286.3±259.4g and 348.1±262.8g) and the NICU admission rate. Conclusion: MCDA twins with velamentous cord insertion have increased risk of shorter duration of pregnancy, higher birth weight discordance, and are more susceptible to NICU admission.

Cosmetic outcomes of cesarean section scar; subcuticular suture versus intradermal buried suture

( Juseok Yang ),( Ki Hyung Kim ),( Yong Jung Song ),( Seung-Chul Kim ),( Nayoung Sung ),( Haneul Kim ),( Dong Hyung Lee ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.1

Objective The objective of the study was to compare cosmetic outcomes and overall satisfaction rate of cesarean section scar between conventional subcuticular suture and intradermal buried vertical mattress Methods Patients were enrolled to the study by chart review. A scar assessment was obtained retrospectively through a telephone survey. The patient component of the patient and observer scar assessment scale (POSAS) was utilized along with the overall satisfaction of the patient regarding their cesarean section scar and their willingness to choose the same skin closure technique when anticipating their next cesarean section. Results A total of 303 cases of cesarean section was recruited, 102 finished telephone surveys were calculated for the analyses. Subcuticular suture was regarded as control group (n=52) and intradermal buried suture as test group (n=50). The PSAS score of the test group (mean, 21.8) was lower than that of the control group (mean, 28), with a statistical significance (P=0.02). Overall satisfaction rate did not differ between the two groups. Two parameters of the PSAS score and the level of overall satisfaction showed significant correlation (Pearson’s r, -0.63; P<0.01). Conclusion We suggested the use of intradermal buried vertical mattress as a cosmetically superior skin closure method for application in cesarean sections over subcuticular stitch.

비행 시뮬레이터를 위한 임무 디브리핑 시스템 설계

윤성민(Seongmin Yun),양주석(Juseok Yang),류민주(Minju Yoo),김혜진(Hyejin Kim) 한국정보과학회 2011 한국정보과학회 학술발표논문집 Vol.38 No.2B

비행임무에서는 사전 계획과 더불어 임무수행 결과에 대한 사후 분석도 중요하며 이를 위해 비행 후 디브리핑 과정을 수행한다. 최근 비행 시뮬레이터 기술이 발전함에 따라 공군에서는 시뮬레이터를 이용한 모의훈련의 비중이 점차 증가하고 있다. 이에 따라 비행 시뮬레이터를 이용한 모의비행훈련 후 임무결과를 분석하기 위한 효과적인 디브리핑 시스템이 요구되고 있다. 하지만 국내에서 운용중인 비행 시뮬레이터를 위한 디브리핑 시스템은 전무한 실정이다. 본 논문에서는 국내에서 처음으로 연구·개발되고 있는 비행 시뮬레이터용 임무 디브리핑 시스템을 소개한다. 본 시스템은 비행임무 결과에 대한 효과적인 분석기능을 통해 정확한 피드백을 제공함으로써 비행훈련 효과 향상에 기여할 수 있다. 또한 국내기술로 시스템을 구현함에 따른 국방예산 절감을 기대할 수 있다.

Non-puerperal Uterine Inversion Presented with Hypovolemic Shock

( Yong Jung Song ),( Juseok Yang ),( Hyun Sil Yun ),( Sun Kyung Lee ),( Hwi Gon Kim ),( Dong Hyung Lee ),( Ook Hwan Choi ),( Yong Jin Na ) 대한폐경학회 2016 대한폐경학회지 Vol.22 No.3

We report a non-puerperal uterine inversion with nulliparous women caused by huge pedunculated submucosal fibroid. Massive bleeding from protruding mass through vagina brought the heart to stop in 42-year-old nulliparous woman. She became cardiopulmonary resuscitation survivor in emergency room and then underwent laparotomy which ended in successful myomectomy rather than hysterectomy considering her demand for future fertility. Meticulous and adequate fluid therapy and transfusion was also administered to recover from hypovolemic status. Pathologic report confirmed benign submucosal fibroid with degeneration, necrosis and abscess formation. Thus, clinician should be aware of uterine inversion when encountered with huge protruding vaginal mass and consider uterus-preserving management as surgical option when the future fertility is concerned. (J Menopausal Med 2016;22:184-187)

A comparison of two- and three-port laparoscopic myomectomy

( Hwi Gon Kim ),( Juseok Yang ),( Ji Hyun Ahn ),( Yong Jung Song ),( Ook Hwan Choi ),( Yong Jin Na ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: 2 years ago, FDA announced its safety communication in respect to laparoscopic power morcellation used for hysterectomy or myomectomy in women with uterine fibroids that it poses a risk of spreading unsuspected cancerous tissue. In awareness of that recommendation, we aimed to evaluate the surgical outcomes of two-port laparoscopic myomectomy removing uterine fibroids within confined tissue-retrieval bag manually in comparison of conventional laparoscopic myomectomy undergoing power morcellation. 방법: Design: Retrospective chart review study Setting: Tertiary teaching university hospital Patients: We examined 300 women who underwent myomectomy for symptomatic uterine fibroids from January 2010 to December 2015. 결과: 2 study group showed no statistically significant difference in terms of operation time including elapsed time for fibroid morcellation and major surgical complications. 결론: We analyzed the feasibility and safety of two-port laparoscopic myomectomy without performing power morcellation in terms of surgical outcomes and operating times. It might be a safe treatment option for power morcellation having benefits of minimally invasive surgery at the same time.

Differential expression of reproductive hormone receptors and contraction associated genes in porcine uterus during the estrous cycle

( Si Eun Han ),( Juseok Yang ),( Dong Hyung Lee ),( Kyu Sup Lee ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Objective: Contraction of uterus tissue frequently occurs throughout the estrous cycle and is regulated by several endogenous factors, including estradiol, progesterone, luteinizing hormone, follicle stimulating hormone, oxytocin (OXT) and contraction associated proteins (CAPs). Contraction activity of uterus tissue according to the estrous cycle is important, due to the fact that it is directly associated with balanced implantation and stable pregnancy. Methods: Uterine tissues were fixed with 10% formalin, embedded in paraffin wax, routinely processed, then sectioned into 4-m-thick slices. Tissue sections were deparaffinized and rehydrated through graded alcohol using standard procedures and then stained with hematoxylin & eosin (H&E; Sigma-Aldrich; Merck Millipore). Images were captured at a magnification of x40 using a model BX50F-3 optical microscope (Olympus Corporation, Tokyo, Japan) and examined for histological analysis. Results: To investigate regulation of contraction associated factors according to the estrous cycle, mRNA and protein expression levels of reproductive hormonal receptors, including estrogen receptors, progesterone receptor and luteinizing hormone/choriogonadotropin receptor in addition to CAPs including OXT, OXT receptor (OXTR), hydroxyprostaglandin dehydrogenase 15 (NAD) and gap junction 1 protein, were examined in the porcine uterus according to the follicular and luteal phases. For the results, hormonal receptors and CAPs were dynamically regulated depending on the estrous cycle. Conclusion: In conclusion, genes associated with uterine contraction and its regulatory hormonal receptors in the porcine uterus were differently regulated in the follicular and luteal phases, suggesting that these genes are critically involved in the remodeling and contraction of uterine tissue and may be required to modulate the physiological status of the uterus.

Prognostic value of preoperative lymphocyte-monocyte ratio in elderly patients with advanced epithelial ovarian cancer

( Byung Su Kwon ),( Hyun Joo Lee ),( Juseok Yang ),( Yong Jung Song ),( Dong Soo Suh ),( Dong Hyung Lee ),( Ki Hyung Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.6

Objective To investigate the prognostic significance of preoperative lymphocyte-monocyte ratio (LMR) in elderly patients with advanced epithelial ovarian cancer (EOC) receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy. Methods A total of 42 elderly patients (≥65 years) diagnosed with EOC who are receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 was included. LMR was calculated from complete blood cell count sampled before operation. Receiver operating characteristic (ROC) curves were used to calculate optimal cut-off values for LMR. Prognostic significance with respect to overall survival (OS) and progression-free survival (PFS) were determined using log-rank test and Cox regression analysis. Results The optimized LMR cut-off value determined by ROC curve analysis was 3.63 for PFS and OS. The high LMR group (LMR ≥3.63) was found to be significantly more associated with optimal debulking (P=0.045) and platinum response (P=0.018) than the low LMR group. In addition, Kaplan-Meier analysis revealed the LMR-high group was significantly more associated with high PFS and OS rates (P=0.023 and P=0.033, respectively), and univariate analysis revealed that a high LMR, histology type, and optimal debulking and platinum responses were significantly associated with prolonged PFS and OS. However, subsequent Cox multivariate analysis showed only optimal debulking and platinum response were independent prognostic factors of PFS or OS. Conclusion This study suggests that LMR might be associated with treatment and survival outcomes in elderly patients with EOC receiving standard oncology treatment.

A Rare Case of an Autoamputated Ovary with Mature Cystic Teratoma

( Hwi Gon Kim ),( Yong Jung Song ),( Yong Jin Na ),( Juseok Yang ),( Ook Hwan Choi ) 대한폐경학회 2017 대한폐경학회지 Vol.23 No.1

Autoamputated ovary with mature cystic teratoma (MCT) is a rarely reported gynecologic entity with an unknown prevalence. A 34-year-old woman referred to our clinic for presumed left ovarian tumor. Pelvic examination, ultrasonography and computed tomography scan revealed a 5-cm, cystic ovarian mass with calcification and fat component, and tumor markers were as follows, cancer antigen (CA) 125; 10.4 U/mL, CA19-9; 2 U/mL. Laparoscopy was performed. The mass was identified in the left adnexal region without any ligamentous or direct connection with the pelvic organs. The right ovary was normal. However, the left ovary and the tube could not be identified in its proper anatomical location. The mass was successfully removed with sharp and blunt dissection. A review of histopathologic study revealed a MCT. The patient became pregnant within seven months and gave birth to a healthy baby by cesarean section. We present a rare case of an autoamputated ovary with MCT. (J Menopausal Med 2017;23:74-76)

Reducing the sprint time of novice runners via the assistance of exosuit

Jungyoung Moon(문준영),Kimoon Nam(남기문),Jaewook Ryu(류재욱),Yoosun Kim(김유선),Juseok Yun(윤주석),Seungtae Yang(양승태),Jaeha Yang(양재하),Giuk Lee(이기욱) 대한기계학회 2023 대한기계학회 춘추학술대회 Vol.2023 No.4