Invasive Extramammary Paget's disease of the vulva

( Eunwook Joo ),( Eun-joo Son ),( Yeonseong Jeong ),( Yunjin Bang ),( Jeongmin Song ),( Kyung-do Ki ),( Seonkyung Lee ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Extramammary Pagets disease is a rare, slow-growing skin neoplasm. Extramammary Pagets disease of the vulva (EPDV) counts less than 1% of all vulvar malignancies. Because of its rarity and unpredictable disease course, diagnosis is delayed. The deep invasion (≥1mm depth) has been reported as poor prognosis because spread through the epidermal basal membrane results in a high percentage of nodal metastasis and a low survival rate. Thus, patients with invasive EMPD can be treated less successful than in situ tumor. Although reports of EPDV have been reported often in dermatology, they have rarely been reported as gynecologic papers in Korea. In order to identify in the clinical course and treatment of EMPD in Korean patients, we present here a case of a 69-year-old woman with DM and HTN, admitted to the gynecological department because of right side of vulvar itching sensation. Prior to our hospital visit, the patient underwent right vulvar lesion biopsy on August 19, 2017 at local gynecology hospital. Histopathologic result of her skin biopsy was reported as compound nevus and there was no evidence of malignancy. At the time of our hospital on June 26, 2018, her Right vulvar lesion was entirely involved and had erythematous patches and nodules with erosion and discolored lesion. Right vulvar lesion excision under general anesthesia was performed again on July 06, 2018. Unlike the previous biopsy, histologic result was reported extramammary Paget disease with 5mm invasion depth. Surgical treatment was performed on July 23, 2018: bilateral vulvectomy without pelvic lymphadenectomy using frozen section analysis of excision margins. The final histopathologic examination revealed an Extra-mammary Paget's disease with focal stromal invasion at right vulva. We are currently undergoing outpatient follow-up due to improved symptoms.

Delayed interval delivery in twin pregnancies with spontaneous delivery before viability:The role of cervical cerclage combined with adjuvant broad-spectrum antibiotics and natural progesterone

( Eunwook Joo ),( Kwanghee Ahn ),( Hyeon Ji Kim ),( Jee Yoon Park ),( Kyung Joon Oh ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: The aim of this study was to evaluate the proportion eligible for delayed interval delivery, and the efficacy of cervical cerclage combined with adjuvant broad-spectrum antibiotics and natural progesterone in prolonging the gestation in twin pregnancies with spontaneous delivery before viability. Methods: This was a retrospective study including 17 consecutive dichorionic twins of which presenting fetus had been spontaneously delivered before viability(15.0-22.9 weeks) from January 2015 to June 2020. Cases without active labor pain within 6 hours after delivery of the first fetus were considered to be eligible for delayed interval delivery. Cervical cerclage combined with adjuvant broad-spectrum antibiotics and vaginal natural progesterone was performed in eligible cases. Obstetric outcomes and neonatal outcomes of the remaining fetus were analyzed. Results: About 41% of patients(7/17) were not delivered within 6 hours after delivery of the first fetus. Among the 7 patients undelivered within 6 hours, two patients did not undergo cervical cerclage because of suspected chorioamnionitis(n=1) or preterm premature rupture of membrane(n=1). Five cases(29.4%) underwent cervical cerclage combined with adjuvant broad-spectrum antibiotics and natural progesterone use. The median interval from cervical cerclage to delivery was 111 days (range: 39-119 days) and the median gestational age at delivery was 34.9 weeks (range: 27.6-37.0 weeks). The rate of patients undelivered at 32, 34 and 36 weeks was 80%(4/5), 60%(3/5), and 40%(2/5). All the 5 neonates survived without major morbidity except mild chronic lung disease in one case born at 27.6 weeks. Conclusion: About 29% of twin pregnancies with spontaneous delivery of the first fetus before 23 weeks were eligible for delayed interval delivery. Cervical cerclage combined with adjuvant broad-spectrum antibiotics and natural progesterone use seems to help maintain the pregnancy of remaining fetus after spontaneous delivery before 23 weeks in twin pregnancies.

The reduction of the rate of uterine fundal pressure maneuvers by an inflatable obstetric belt in nulliparous women: A preliminary study

( Eunwook Joo ),( Ji Young Park ),( Gwan Hee Han ),( Do Youn Kwon ),( Jungsoo Chae ),( Eunjoo Son ),( Yeonseong Jeong ),( Hyun-joo Seol ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: Uterine fundal pressure maneuver has been frequently used in laboring women to help pushing the baby with doubtful efficacy and safety. The inflatable obstetric belt is synchronized to adapt consistent fundal pressure during a uterine contraction. Its efficacy of decreasing the duration of the second stage of labor without remarkable complications in nulliparous women has been proven. The aim of this study was to determine whether or not the inflatable obstetric belt reduces the rate of uterine fundal pressure in the management of the second stage of labor in nulliparous women. 방법: Thirteen nulliparous women with a singleton cephalic pregnancy above 37+0 weeks gestation in the second stage of labor were enrolled. The control cohort group was 29 primiparous women who underwent the same criteria with standard care. All participants in the active group wore the belt (Baidy M-600/Curexo, Inc., Seoul, Korea) at the end of the first stage of labor and the inflatable belt was started at the beginning of the second stage and maintained until delivery of a baby. The primary outcome was the rate of fundal pressure maneuvers in the second stage of labor. The secondary outcomes were the duration of labor, rates of cesarean section, perineal laceration, and perinatal outcomes. 결과: There were no significant differences between the active group and the control group according to the maternal and fetal demographic variables. The active group showed a significantly decreased the rate of fundal pressure maneuvers as compared to the control group (23.07% vs. 100.00%, p=0.02). Duration of the second stage of labor was shorter in the active group than in the control group (43.23±19.02 min vs. 67.51±32.80 min, p=0.008). There was no difference in the rates of cesarean section, perineal laceration, and perinatal outcomes between the two groups. 결론: The results of the preliminary study demonstrate that the use of the inflatable obstetric belt significantly decreases the rate of fundal pressure maneuvers during the second stage of labor in nulliparous women.

Simultaneous improvements in self-cleaning and light-trapping abilities of polymer substrates for flexible organic solar cells

Jeong, Eunwook,Zhao, Guoquing,Song, Myungkwan,Yu, Seung Min,Rha, Jongjoo,Shin, Jongmoon,Cho, Young-Rae,Yun, Jungheum The Royal Society of Chemistry 2018 Journal of Materials Chemistry A Vol.6 No.5

<P>Organic solar cells (OSCs) supported on mechanically flexible and optically transparent polymer substrates have been receiving increased attention owing to their noticeable merits of low cost, light weight, and flexible design that are unattainable by their existing counterparts supported on rigid glass substrates. However, technical issues such as relatively low photon-to-electron conversion efficiencies and long-term stabilities of OSCs on polymer substrates require the enhancement and maintenance of the efficiency of OSCs. In this study, a simple, direct vacuum deposition strategy was used to fabricate a multifunctional silica nanoparticle array (SNA) layer on polymer substrates for improving and maintaining the light harvesting efficiencies of OSCs; this induces simultaneous and significant enhancements in the light-scattering and contaminant-repelling (or self-cleaning) properties of the substrate. The SNA layer led to improved light scattering features, representing haze transmittances ranging from 3.4% to 80.4% in the visible spectral range with strong influences of its geometrical features on the hydrophobic/oleophobic characteristics of the substrate. Any contaminant-induced reduction in the performance of OSCs could be successfully prevented by the strong contaminant-repelling feature, characterized by high contact angles (>150°) and low sliding angles (<15°) for water and ethylene glycol, without compromising the optical transparency of the polymer substrate. A combination of the SNA layer and oxide/metal/oxide (OMO) electrode coating on each side of the polymer substrate provides a promising solution to improve the performance of OSCs. The power conversion efficiency was enhanced by 13.31% compared to that of an OSC based on the same polymer substrate without the SNA layer.</P>

Maternal Plasma and Amniotic Fluid LBP, Pentraxin 3, Resistin, and IGFBP-3: Biomarkers of Microbial Invasion of Amniotic Cavity and/or Intra-amniotic Inflammation in Women with Preterm Premature Rupture of Membranes

Joo Eunwook,Park Kyo Hoon,Kim Yu Mi,Ahn Kwanghee,Hong Subeen 대한의학회 2021 Journal of Korean medical science Vol.36 No.44

Background: We sought to determine whether lipopolysaccharide binding protein (LBP), pentraxin 3, resistin, and insulin-like growth factor binding protein (IGFBP)-3 in plasma and amniotic fluid (AF) can predict microbial invasion of the amniotic cavity (MIAC), intra-amniotic inflammation (IAI), and microbial-associated IAI in women with preterm premature rupture of membranes (PPROM). Methods: This was a retrospective cohort study involving 168 singleton pregnant women with PPROM. AF obtained via amniocentesis was cultured and assayed for interleukin (IL)-6 to define IAI and for IL-8 to compare with AF biomarkers. Plasma samples were collected at the time of amniocentesis, and C-reactive protein (CRP) levels in serum were compared with plasma biomarkers. The stored plasma and AF samples were assayed for LBP, pentraxin 3 (PTX3), resistin, and IGFBP-3 by ELISA. Results: Multivariate logistic regression analysis revealed that: 1) elevated plasma and AF levels of LBP were independently associated with increased risks of MIAC, IAI, and microbial-associated IAI; 2) elevated AF, but not plasma, PTX3, and resistin levels were independently associated with increased risks of MIAC, IAI, and microbial-associated IAI; 3) decreased IGFBP-3 levels in the plasma were independently associated with only IAI, whereas those in the AF were associated with only microbial-associated IAI. Among the tested biomarkers, AF PTX3 and resistin had the highest predictive performance for MIAC, IAI, and microbial-associated IAI (area under the curves [AUC] = 0.85–0.95), which is similar to the performance of AF IL-8. The AUCs of the plasma LBP and IGFBP-3 were similar to that of serum CRP with respect to IAI. Conclusion: Maternal plasma LBP and IGFBP-3 are potential biomarkers for the non-invasive identification of IAI in women with PPROM, with a similar accuracy to the serum CRP level. AF LBP, PTX3, resistin, and IGFBP-3 may be involved in the intra-amniotic inflammatory responses in PPROM complicated by MIAC.

대학생의 배근력 차이에 따른 척추변형 정도

이은욱 ( Lee Eunwook ),김규완 ( Kim Kewwan ),전경규 ( Jeon Kyoungkyu ) 인천대학교 스포츠과학연구소 2018 스포츠科學硏究誌 Vol.31 No.0

이 연구는 대학생의 배근력의 차이가 어느 정도 척추변형의 차이를 가져오는지 탐색하고자 하였다. 연구의 목적을 달성하기 위하여 인천광역시 소재 I대학교의 재학생 142명을 임의 표집 하여 이들을 배근력이 높은 집단과 낮은 집단으로 구분하였고, 이들을 대상으로 척추구조분석 및 배근력을 측정하였다. 이 연구에서 척추변형 정도를 알아보기 위해 분석한 변인은 체간의 길이, 정중면상 체간의 길이와 각도, 전후면상 체간의 길이와 각도, 골반 각도, 척추 만곡 각도이다. 변인의 측정을 위하여 Formetric 4D(척추구조분석기)와 배근력 측정기를 사용하였다. 수집한 자료의 처리는 Window용 SPSS 23.0을 이용하였으며 배근력의 크기에 따른 척추변형의 차이를 알아보기 위하여 독립표본 t-test를 사용하였다. 이 연구의 결과 체간길이는 배근력이 높은 남자 집단에서 유의하게 작게 나타났고 골반의 각도는 배근력이 높은 남자 집단에서 유의하게 크게 나타났다. 척추측만각도는 배근력이 높은 여자 집단에서 측만각도가 유의하게 낮은 것으로 나타났다. 이와는 반대로 전만각도는 배근력이 낮은 여자 집단에서 유의하게 낮은 것으로 나타났다. 따라서 배근력의 차이에 따라 척추의 변형정도 차이가 나타난 것을 알 수 있었다. The purpose of this study was to investigate the effect of back muscle strength on spinal deformity in college students. We recruited 142 university students, and divided into four groups based on the level of back muscle strength: (a) male with higher back muscle strength, (b) male with lower back muscle strength, (c) female with higher back muscle strength, and (d) female with lower back muscle strength. Using Formetric 4D, we measured trunk length, sagittal imbalance, coronal imbalance, pelvic angle, and curvature of the spine angle. Independent t-tests were used for statistical analysis using SPSS 23.0. The findings revealed that trunk length was significantly smaller in the male with higher back muscle strength than with the male with lower back muscle strength. Pelvic angle was significantly greater in the male students with higher back muscle strength than the male with lower back muscle strength. Scoliosis angle was significantly smaller in the female with higher back muscle strength than the female with lower back muscle strength. However, lordotic angle was significantly smaller in the female with lower back muscle strength than the female with higher back muscle strength. These findings indicated that back muscle strength may influence the deformation of the spine, however these patterns were inconsistent across male and female groups.

朝鮮後期 白瓷食器의 종류와 쓰임새

이은욱,윤용이,이종미 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.5

The aim of this thesis is to study how tableware china has developed, on the basis of social and cultural changes, during the latter period of Chosun Dynasty. First, general sociological background of Chosun Dynasty has been reviewed. To examine the kinds of tableware china and their use during this period, this thesis is based on Asakawa Dakumis "A ceramic ware of Chosun Dynasty" one of the most thorough references available in the field. Various antiques and remains of different periods were compared to study the changes in tableware china types and uses. In conclusion, the development in food culture brought the changes in tableware china. Tableware china and food has developed together complementarily throughout the latter period of Chosun Dynasty.

Rearfoot and Tibial Motion during Gait Associated with Medial Tibial Stress Syndrome: A Systematic Review

( Hyung-pil Jun ),( Eunwook Chang ) 한국운동생리학회(구 한국운동과학회) 2020 운동과학 Vol.29 No.2

PURPOSE: The purpose of this study was to confirm the kinematic characteristics of overuse leg injuries during gait through a systematic review. METHODS: Electronic databases from 1960 to 2018 were used to search studies. Physiotherapy Evidence Database Scale was used for quality of studies. Effect sizes (ES) of between-groups and its 95% confidence intervals were calculated. RESULTS: Seven studies were selected for review. The average Physiotherapy Evidence Database Scale score was 4.3 of 10-point scale. The ES for maximum rearfoot eversion from 5 studies ranged from -0.34 to 0.67 with 3 of 5 studies statistically significant. The ES of eversion excursion from 4 studies ranged from -0.24 to 2.37 and 3 of 4 studies showed statistically significant. The ES of maximum eversion velocity ranged from 0.29 to 0.38 from all of 2 studies. With abduction, the ES for abduction excursion ranged from -0.04 to 0.35, and 2 of 3 studies revealed statistically significant. The ES of maximum abduction velocity showed statistically significant with the ES of 0.23 and 0.61. However, maximum abduction from 3 studies showed non-significant with ES ranges from 0.00 to 0.62. CONCLUSIONS: The rearfoot motion (eversion) associates with overuse leg injuries during gait more than tibial motion (internal rotation).

Neoadjuvant chemotherapy with a combination of vinblastine, bleomycin, and cisplatin(VBP) followed by surgery in locally advanced squamous cell carcinoma of the vulva : A case report

( Eun-joo Son ),( Eunwook Joo ),( Yeonseong Jeong ),( Yunjin Bang ),( Jeongmin Song ),( Eun-hee Yoo ),( Seon Kyung Lee ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

A 56-year-old female was referred to our gynecological department for evaluation of the vulvar ulceration. The patient suffered from vulvar burning sensation. Physical examination revealed an approximately 7 cm in diameter exophytic cauliflower-like mass with ulcerative growth that involved the both labia minor and the perineum. And both enlarged inguinal lymph nodes were palpable. The serum squamous cell carcinoma antigen level was 4.3 ng/ml. Punch biopsy was performed and the result was reported as SCC of the vulva. Computed tomography showed an enlarged (>5mm) lymph nodes metastasis in the both groin. Due to bulky mass in the vulva, the patient underwent neoadjuvant chemotherapy(NACT) with VBP(vinblastine 4 mg/m2 plus bleomycin 25 mg and cisplatin 50 mg/m2). After the three courses of chemotherapy, the vulvar lesion was greatly reduced in size, while the both groin lymphadenopathy remained unchanged. Subsequently, a radical vulvectomy with bilateral inguinofemoral lymphenectomy was performed. The final histopathological reports of the surgical specimen demonstrated a moderately-differentiated invasive squamous cell carcinoma with negative resection margin. Lymph nodes were positive for metastasis (right inguinal: 3/8, left inguinal: 1/7). 2 month later the surgery, the patient received adjuvant radiotherapy of the vulvar and inguinal regions bilaterally. (external-beam irradiation, 1.8 Gy/day in 25 fractions over 5 weeks ; total radiation dose, 45.0 Gy) Optimal treatment of locally advanced, inoperable vulvar cancer is still debatable. Our case illustrates that NACT with VBP showed significantly decreasing in tumor burden with manageable toxicity. In conclusion, NACT with VBP may increase surgical feasibility in initially unresectable tumor, decrease the deleterious side effect of radiotherapy. Therefore, the use of neoadjuvant chemotherapy followed by surgery could be considered as a therapeutic option for locally advanced vulvar cancer.

건강한 성인의 대퇴사두근과 햄스트링에 대한 휴대용 초음파기기의 측정자 간 신뢰도

천소울 ( Soul Cheon ),장은욱 ( Eunwook Chang ) 한국운동생리학회(구 한국운동과학회) 2020 운동과학 Vol.29 No.1

PURPOSE: The purpose of this study was to examine the inter-rater reliability of a portable ultrasound device for measuring the muscle thickness of the quadriceps and hamstrings in healthy subjects. METHODS: Thirty-six subjects (20 males, 16 females, age 22.2±2.0 years, mass 67.4±11.3 kg, height 171.7±9.6 cm) participated as subjects and two examiners attended. The thickness of the quadriceps was measured in order of rectus femoris (RF), vastus intermedius (VI), vastus lateralis (VL), vastus medialis (VM), and vastus medialis oblique (VMO). The hamstring thickness was measured in order of biceps femoris (BF), semitendinosus (ST), and semimembranosus (SM). Three measurements were taken for each muscle by one examiner. Using image J software, the average thickness was calculated from the measured image. Pearson’s correlation coefficient was used in order to identify inter-rater reliability, and the statistical significance level was set to p<.05. RESULTS: Pearson correlation coefficient for inter-examiner reliability of ultrasound showed moderate-to-high level for all assessed muscle. In quadriceps, the values were significantly correlated ranged from 0.62 to 0.90 and in hamstrings the value were relatively low with values of 0.57 to 0.68. CONCLUSIONS: The findings of this study indicated that portable ultrasound was a reliable method for measuring the quadriceps and hamstring muscle thickness. Therefore, it could be used as a useful assessment tool in future studies to assess various skeletal muscle thicknesses.