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.

18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

An introduction to the recently excavated Chunggang Medical Records and research on their medical value

Kim, Nam-Il,Yun, Seng-Yick,Hong, Sae-Young,Ahn, Sang-Woo,Cha, Wung-Seok Kyung Hee Oriental Medicine Research Center 2007 Oriental pharmacy and experimental medicine Vol.7 No.2

This study is a report on recently discovered medical records based on traditional medicine in the 1900s. First, the contents of the records and their significance are described in detail. Next, a simple example of the research follows, in order to explain the medical and historical significance the records contain and to answer the question of how this historical document can contribute to future medical and historical studies. The documents dealt with in this study, the Chunggang Medical Records, are medical records compiled by a Korean doctor of oriental medicine by the name of Younghun Kim who practiced in the center of Seoul for a period of over 60 years. The records, which eventually amounted to over 1,500 books, were made known to the academic world when the descendents recently donated them to Kyunghee University. The reason these medical records attract so much attention from academic circles, even though they are the work of one individual, is that they contain abundant information on general public medical health at the time, in addition to the fact that Kim Younghun was a well known figure among Oriental Medicine doctors in Korea. The medical records start in 1915 and continue until Kim Younhun's death in 1974, though they have some damaged or missing parts. Kim's medical records are a gold mine not only for scholars studying the medical history of the early 1900s, but also for doctors trying to emulate the techniques embedded in a great predecessor's medical practice.

고속 마이크로 외팔보 공진시험을 통한 나노스케일 티타늄 박막의 탄성계수 평가

김윤영(Yun Young Kim) 한국표면공학회 2017 한국표면공학회지 Vol.50 No.5

The Young’s modulus of a nanoscale titanium (Ti) thin-film was evaluated using a high-speed microcantilever resonating at the megahertz frequency in the present study. A 350 nm thick Ti film was deposited on the surface of a silicon microcantilever, and the morphology of the film was analyzed using the atomic force microscopy. The microcantilever was excited to resonate using an ultrasonic pulser that generates tone burst signals and the resonance frequency shift induced by the deposition of Ti was measured using a Michelson interferometer. The Young’s modulus was determined through a modal analysis using the finite element method and the result was validated by the nanoindentation testing, showing good agreement within a relative error of 1.0%. The present study proposes a nanomechanical characterization technique with enhanced accuracy and sensitivity.

Original Articles : Clinical significance of occult hepatitis B virus infection in chronic hepatitis C patients

( Jae Young Jang ),( Soung Won Jeong ),( Sung Ran Cheon1 ),( Sae Hwan Lee1 ),( Sang Gyune Kim ),( Young Koog Cheon ),( Young Seok Kim1 ),( Young Deok Cho1 ),( Hong Soo Kim ),( So Young Jin ),( Yun Soo 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3

Background/Aims: We investigated the frequency of occult hepatitis B virus (HBV) infection in anti-hepatitis C virus (HCV)-positive individuals and the effects of occult HBV infection on the severity of liver disease. Methods: Seventy-one hepatitis B virus surface-antigen (HBsAg)-negative patients were divided according to their HBV serological status into groups A (anti-HBc positive, anti-HBs negative; n=18), B (anti-HBc positive, anti-HBs positive; n=34), and C (anti-HBc negative, anti-HBs positive/negative; n=19), and by anti-HCV positivity (anti-HCV positive; n=32 vs. anti-HCV negative; n=39). Liver biopsy samples were taken, and HBV DNA was quantified by real-time PCR. Results: Intrahepatic HBV DNA was detected in 32.4% (23/71) of the entire cohort, and HBV DNA levels were invariably low in the different groups. Occult HBV infection was detected more frequently in the anti-HBc-positive patients. Intrahepatic HBV DNA was detected in 28.1% (9/32) of the anti-HCV-positive and 35.9% (14/39) of the anti-HCV-negative subjects. The HCV genotype did not affect the detection rate of intrahepatic HBV DNA. In anti-HCV-positive cases, occult HBV infection did not affect liver disease severity. Conclusions: Low levels of intrahepatic HBV DNA were detected frequently in both HBsAg-negative and anti-HCV-positive cases. However, the frequency of occult HBV infection was not affected by the presence of hepatitis C, and occult HBV infection did not have a significant effect on the disease severity of hepatitis C. (Korean J Hepatol 2011;17:206-212)

크론병에 대한 CoPPLX의 방어효과에 대한 연구

이호학,김유림,문창기,이재일,양병윤,김종수,이정민,정재혁,안석진,박상준,김윤권,김소연,김영중,조민구,최영자,장성조 圓光大學校 醫科學硏究所 2005 圓光醫科學 Vol.20 No.1

항암화학요법 관련 오심과 구토 완화를 위한 비약물요법에 관한 연구동향

소향숙,최자윤,조인숙,김영재,김지영,김애숙,김옥미,김춘심,김현오,설영애,안정옥,이애리,이영자 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. Method: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. Result: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group: 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. Conclusion: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.

일자리 참여 프로그램이 노인의 자아존중감과 생활만족도에 미치는 영향

민순 ( Soon Min ),주리애 ( Ree Aie Ju ),정현필 ( Hyon Pil Jung ),정영주 ( Young Ju Jung ),김미란 ( Mi Ran Kim ),김윤경 ( Yun Gyung Kim ) 경희대학교 동서의학연구소 2008 동서간호학연구지 Vol.14 No.2

본 연구는 G시 D복지관에 있는 60세 이상 된 노인 70명을 대상으로 일자리 참여 프로그램이 노인들의 자아존중감과 생활만족도에 미치는 영향을 파악하고자 한다. 단일군 전후 원시실험설계로 노인들의 대조군이 없는 현실적인 문제를 갖고 있어 비교할 수 없는 제한점을 갖고 있지만 노인들에게 일자리를 참여시키므로 그들을 돕는데 의미를 두고 있으며, 본 프로그램에서 얻어진 결과를 토대로 논의하고자 한다. 일자리 프로그램에 참여하기 전 자아인식의 평균이 참여 전3.31에서 참여 후 3.50으로, 자아가치는 참여 전 평균이 3.04에서 참여 후 3.46으로, 자아존중 정도도 참여 전 평균 3.31에 참여 후 3.48로 모두 유의하게 향상되었다. 이는 저소득 노인의 자아존중감이 낮다는 Shim (2005)의 연구결과와 일치했고, 월 사용 지출액에 따라 자아존중감이 차이가 있다는 Kim2003)의 연구 결과와 월수입이 많은 사람 즉 경제적으로 나은사람이 자아존중감이 높다는 Kim (2002)의 연구 결과 및 일자프로그램 참여를 여가활동으로 여겨 이에 참여하는 사람이참여하지 않는 경우보다 자아존중감이 높다고 한 Kim (2007)연구 결과와도 유사한 결과를 보였다. 노인에게 자아존중감은 정신건강을 결정짓는데 중요한 요소로, 자아존중감은 노인의 우울과 역상관관계가 있는데(Park,1993), 본 연구에서 노인들이 일자리에 참여하므로 자존감 향상에 긍정적인 영향을 미치는 것으로 나타난 바, 이는 노후에노인 대상자들에게 여가활동과 소정의 수익을 통해 용돈이나기초생활에 필요한 경비를 조달받게 된 것이 자아존중감을 높인 것으로 사료된다.그러므로, 본 연구에서도 일자리 참여 프로그램이 노인들의 자아존중감을 향상시키는 점을 볼 때, 노인의 일자리 참여는 자신들의 소득을 확보하려는 경제적인 측면뿐 아니라 사회참여의 욕구도 포함하고 있어 노인에게 일자리 참여는 매우 중요한 의미를 지니고 있고, 소일거리와 여가선용 차원에서도 노인에게 일자리 참여의 기회를 제공해주는 것은 노후의 경제적인 자립생활은 물론 사회적으로도 바람직한 방안이라 할 수 있어 일을 통해 보람도 얻고, 단체 활동을 통한 소속감을 가지고 경제활동도 할 수 있는 방안도 모색해야 할 것이다.일자리 참여 프로그램 전과 후의 생활만족도의 변화에서, 일자리 프로그램에 참여하기 전 평균 3.04점이었고, 일자리 프로그램에 참여한 후 평균 3.24점으로 유의하게 향상하였는데, 이는 일자리 참여자와 비참여자들을 비교 연구한 Kim (2007)과Seo (2007)의 연구 결과와 일치하였고, 시니어클럽에 참여하고 있는 노인이 참여하지 않고 있는 노인보다 생활만족도가 유의하게 높게 나타난 Bang (2005)의 연구 결과와도 일치하였다.노인들의 생활만족도에 관한 선행연구를 고찰한 결과 노인의 생활만족도는 배우자가 있는 경우, 주관적 건강상태가 좋을수록, 경제수준이 높을수록, 교육정도가 높을수록 생활만족도가 높다고 보고되고 있으며, 노인의 사회적 지지나 자아존중감이 높을수록 생활만족도가 높다고 하였다(Jang, 2006; Kim,2005; Park & Lee, 2006).노인들이 일자리 프로그램에 참여하므로 생활만족도에 긍정적인 영향을 미치는 것으로 나타난 바, 이는 노인대상자들에게일자리를 통해 심리적, 경제적 여건에 도움이 된 것으로 여겨지며, 이로 인해 생활만족 정도를 높인 것으로 사료된다. 노후의시간활용 방법에 대한 2004 전국 노인생활실태 및 복지욕구조사 결과에서 가장 선호되는 것이 소득창출 27.8%, 취미활동16.3%, 소일거리 14.5%, 자원봉상활동 3.1%, 자아계발 활동2.4%로 나타났다(Jung et al, 2005). 그러나 노인의 일자리 참여는 여러 가지 문제에 봉착하게 된다. 우선 노인시장에 유입되는 신규 노동력의 과잉과 기업의 인사정체, 그리고 노인취업에 대한 잘못된 인식으로서 기능주의적 사회격리이론은 인간의 노화를 기능주의적으로 이해하려는 사회적 편견인데 노인이 반드시 체계적, 생물학적으로 또는 정신적으로 결함이 있다는 편견으로 인해 노인인력 활용가능성을 근본적으로 저해하는 요인이 된다(Jung, 2007). 또한 본 연구 대상자들에게 연구일자리 프로그램 유형에 따른 생활만족도와 자아존중감 정도를 분석한 결과에서는 유의하지 않았는데 노인들에게 일자리 참여 자체가 생활만족과 자아존중감 정도에 영향을 주는 것이지 유형별로는 큰 의미가 있는 것은 아닌 것으로 보인다. 본 연구 결과를 종합하여 볼 때 어떤 형태이든 간의 노인의 일자리 참여는 고령화 사회에서 나타나는 심각한 노인문제를 해결하고 노후 생활에 대한 적응력을 높이며, 노년기의 역할변화에 따른 적절한 대응을 통해 역할상실에 대한 대비를 할 수 있을 뿐만 아니라 노인 스스로의 자아존중감과 생활만족도 향상을 위해 필요하다. Purpose: The effects of job participation on self-esteem and life satisfaction were investigated. Methods: Seventy residents of D welfare center located in G city who were >60 yr-of-age were selected for the study. The SERS research tool (Nugent and Thomas,1993; modified by Koh, 2002) was used to assess self-esteem before and after a job participation program. The Cronbach`s αvalue-based reliability of this tool was 0.923 and 0.920 before and after the job participation program, respectively. Cronbach`s αvalue-based life satisfaction as measured according to Choi (1986) was 0.932 and 0.933 before and after the job participation program, respectively. Results: The hypothesis that job participation program increases self esteem was supported by the results. The mean self esteem of subjects before and after the job program, 3.31 and 3.48, respectively, represented a significant increase. The hypothesis that the job participation program increases life satisfaction was supported by the results, The mean life satisfaction index of subjects before and after the program, 3.04 and 3.24, respectively, represents a significant increase. Conclusions: Increased job opportunities and income guarantee for adults, particularly the elderly, can increase self-esteem, life satisfaction, and emotional stability.

일 대학병원에 입원한 노년기 양극성 장애 환자의 인구학적 및 임상적 특징

조숙현(Sook Hyun Cho),정한용(Han Yong Jung),권영준(Young Jun Kwon),이소영(So Young Lee),김양래(Yang Rae Kim),김윤정(Yun Jung Kim) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

Objectives : As the elderly population is continuing to increase, psychiatric diseases of the elderly are becoming an important social issue. This study looks into the demographical and clinical features of the elderly patients diagnosed with bipolar disorder in a University hospital. Methods : The study subjects include patients admissioned in the closed wards of Soonchunhyang Seoul hospital and Cheonan hospital from March, 2000 to February, 2005 who met the DSM-IV-TR criteria for bipolar disorder at the time of discharge. A total of 146 patients (76 men, 70 women) medical records were studied retrospectively. Subjects older than the age of 50 at time of admission were grouped as the old age group, whereas those who were younger than 50 as the young age group. Also among the old age group, those who had the first onset of episode under the age of 50 were grouped as the early onset group, whereas those who had the first onset after the age 50 were grouped as the late onset group. Results : The number of bipolar disorder patients in the young age group and old age group were 73 and 73 respectively. The number of early onset group and late onset group were 46 and 23 respectively. The old age group had a relatively higher incidence of bipolar II disorder than the young age group. Also in the old age group there was a higher incidence of hypomanic or depressive episode rather than manic episode compared to the young age group. And in the old age group psychotic symptoms were less common and the mean admission length shorter than the young age group. Additionally in the old age group treatment with Lithium monotherapy or with no mood stabilizers at all were relatively common. Among the old age group, late onset group had a higher rate of bipolar II disorder than the early onset group. Conclusion : This study shows differences in the demographical and clinical features among different age groups. But additional research would be required to determine whether the bipolar disorders in the elderly or late onset group are actually a different type of disorder from those of the young.

비침습적 검사를 이용한 수술후 하지 심부 정맥 혈전증의 감시

김영욱,정한준,윤봉호,김신윤,이상국,변경환,김태헌 경북대학교 병원 1997 경북대학교병원의학연구소논문집 Vol.1 No.1

Deep vein thrombosis is recognized as a common complication in surgical patients in western countries especially in patients with high risk factors. The purposes of this study were to detect leg DVTs in early postoperative period by non-invasive surveillance and to analyze the risk factors of DVT. One hundred seventy one patients who underwent major operations(67 curative resection of colorectal cancer, 64 total hip replacement, 38 femur operation for fracture, and 2 colon resections for benign colon disease) were included for the prospective surveillance of leg DVT within 2 weeks after the operations. For the surveillance of leg DVT, strain gauge plethysmography(SPG) and Duplex scanning of both legs were completed for all patients except 10 patients. These 10 patients were examined in only one leg. The patients with past history of leg DVT or under prophylactic anticoagulant therapy were excluded from this study. To determine the risk factors related with leg DVT formation, age and sex of the patients, indication of surgery or surgical procedures, duration of operation, position during the operation, duration of postoperative immobilization, and preoperative serum level of antithrombin III (AT- III) were analyzed using Chi-square test. After performing SPG of 342 legs, 38 legs, showed abnormal on venous outflow/venous capacitance discriminant line chart, and 13 legs of 12 patients showed the finding(s) suggesting DVT on duplex scanning. Among the patients with abnormal duplex findings, 7 limbs(53.8%) were symptomatic, but the remaining 6 legs were silent. In 6 (15.8%) patients of 36 femur operations, 3(4.7%) of 64 total hip replacements and 3(4.5%) of 67 curative resections of colorectal cancer developed DVT by duplex scanning in the iliac(5), femoral-popliteal(6), and isolated calf(2) veins. After analyzing the risk factors, we could not find any statistically significant(p<0.05) factor related with leg DVT.