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.

충남방언 활용에서의 음성모음화

김정태(Jeong-tae Kim) 어문연구학회 2006 어문연구 Vol.51 No.-

The vowel harmony is one of the phonological phenomena which is represented by connecting to similar series of vowels. In these days, this vowel harmony has remained as a type of fossilization in modern Korean. That is the "-아/어’ alternation, adverb conjunctive endings as a result of diachronic variation. This variation is regarded to diachronic vowel harmony and also is described as a kind of assimilation. However, Lee Byeong-geun(1976), Kim Ju-won(1999), Lee Mun-Gyu(2004) described that vowel harmony is not an assimilation in modern Korean any more. So this study assumed that there are positive and negative ending synchronically. That is, it is considered being fossilized as vowel harmony in diachronic phonology. For example, they have the formation like this: stem-final positive vowels of Korean verb "ㅏ, ㅗ + ending 아" and "negative vowels + ending 어". In fact, although /먹어/-〉*[머가] is not realized, /잡아/-〉[자버] is realized in modern Korean. That is, it has no variation in "negative vowels+negative vowels", but it has variation into "positive vowels+positive vowels" in "posive vowels+negative vowels". We intend to call this negative vowelization. The purpose of this paper is to propose that this negative vowelization could be one of characteristics in Chungnam dialect. We cannot see the negative vowelization in conjugation of "negative vowels+negative vowels". It shows us itself the realization of negative vowel forms in the formation like this: negative vowels + C]vst+어, such as "넘+어-〉[너머], 뜯+어-〉[뜨더]". The cases of ‘끄+어→[꺼], 서+어→[서], 가리+어→[개려]’ are under the circumstance of hiatus avoidance. There is no variation of negative vowel, only deletion and gliding are existed. In this paper, ‘아→어’ is negative vowelization. In "ending positive vowel + ending positive vowel" structure, "아’ changes to "어’. However, "가+아서→[가서], 빻+아→[빠:]’ is a deletion from hiatus avoidance phenomena. It turns out that hiatus avoidance is prior to negative vowelization. In case that final sound is a sonorant consonant as ‘갈+아→[가러], 말+아서→[마러서], 감+아→[가머], 많+아→[마너], 앓+았지→[아?찌]’, we can see negative vowelization like "아→어". At the same time, even in case that final sound is a obstruent like ‘옭+아서→[올거서], 솎+아서→[소꺼서], 맞+아→[마저], 쫓+아→[쪼처]’, vowelization is shown. This" 아-->어’ is very negative vowelization. Then, what is a mechanism of negative vowelization? Because bac k·low-vowel "/a/" is changed to back·middle-vowel "/?/", it could be named as a vowel rising in Korean vowel system. But, "아→어’ is not the Vowel rising in this case. According to Kim Jeong-tae(2003:57), vowel rising is a unconditional alternation which is not affected by adjacent sound. 아→어’ as a negative vowelization is a conditional alternation, because of stem positive vowel and word-final consonant, circumstance of ‘V+C+_____’. That is the reason we can say that ‘아→어’ negative vowelization is one of characteristics in Chungnam dialect, due to vowel rising of common pronunciation tendency in Korean. This paper analysed the only utterances of the old in rural area. Because generational and individual differences are existed in actual language use, negative vowelization is optionally applied to speakers of modern Korean.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

맨드라미(Celosia cristata L.) 꽃 메탄올 추출물로부터 용매분획된 분획물의 항산화활성

김현영(Hyun Young Kim),고지연(Jee Yeon Ko),송석보(Seuk Bo Song),김정인(Jung In Kim),서혜인(Hye In Seo),이재생(Jae Saeng Lee),곽도연(Do Yeon Kwak),정태욱(Tae Wook Jung),김기영(Ki Young Kim),오인석(In Seok Oh),정헌상(Heon Sang Jeong),우 한국식품영양과학회 2012 한국식품영양과학회지 Vol.41 No.11

맨드라미꽃의 식품학적 이용가능성을 확인해 보고자 항산화성분 및 항산화활성에 대해 검토하였다. 맨드라미꽃의 항산화성분과 활성은 메탄올 추출물과 순차적 용매분획물에 대해 측정하였으며, 메탄올 추출물과 hexane, chloroform, ethyl acetate, butanol 및 물 분획물의 추출수율은 각각 23.33, 10.27, 20.00, 13.63, 17.55 및 38.54%였다. 맨드라미 꽃 메탄올 추출물의 총 polyphenol, flavonoid 및 tannin 함량은 각각 6.80 ㎎ GAE/g ME, 2.34 ㎎ CE/g ME 및 6.23 ㎎ TAE/g ME였다. 순차적 용매분획물 중 butanol 분획에서 각각 14.92 ㎎ GAE/g SF, 5.44 ㎎ CE/g SF 및 13.38 ㎎ TAE/g SF로 함량이 높았다. 총 proanthocyanidin 함량은 44.72 ㎍ CE/g ME였고 순차적 용매분획물은 각각 42.47, 44.43, 50.03, 49.12 및 41.80 ㎍ CE/g ER로 용매간 유의적인 차이를 보이지 않았다. 맨드라미꽃의 메탄올 추출물의 DPPH 및 ABTS radical 소거활성은 각각 5.24 및 10.70 ㎎ TE/g ME였고 butanol 분획에서 각각 12.53 및 21.09 ㎎ TE/g SF로 활성이 높았다. 메탄올 추출물의 SOD 유사활성은 7.96 unit/mL로 나타났고 hexane, chloroform, ethyl acetate, butanol 및 물 분획물은 각각 4.56, 6.15, 8.07, 12.36 및 5.21 unit/mL로 butanol 분획의 활성이 높았다. 맨드라미꽃 추출물의 항산화성분과 항산화활성 간에 높은 정의 상관관계를 보였고 맨드라미꽃 추출물이 체내 및 식품에서 유익한 도움을 줄 수 있을 것으로 생각된다. The purpose of this study was to evaluate the antioxidant contents and activities of solvent fractions from methanolic extracts of cockscome flowers. The yield of methanolic extracts from cockscome flowers was 23.33%, whereas those of its solvent fractions (hexane, chloroform, ethyl acetate, butanol, and water) were 10.27, 20.00, 13.63, 17.55, and 38.54%, respectively. Total polyphenolic, flavonoid, tannin, and proanthocyanidin contents of methanolic extracts (ME) were 6.80 ㎎ gallic acid equivalent (GAE)/g ME, 2.34 ㎎ catechin equivalent (CE)/g ME, 6.23 ㎎ tannic acid equivalent (TAE)/g ME, and 44.72 ㎍ CE/g ME, respectively. The highest total polyphenolic, flavonoid, and tannin contents of solvent fractions were 14.92 ㎎ GAE/g solvent fraction (SF), 5.44 ㎎ CE/g SF, and 13.38 ㎎ TAE/g SF in the butanol fraction, respectively. The total proanthocyanidin contents were 42.47, 44.43, 50.03, 49.12, and 41.80 ㎍ CE/g SF, respectively. The DPPH and ABTS radical scavenging activities from cockscome flowers were 5.24 and 10.70 ㎎ Trolox equivalent (TE)/g ME, respectively. The highest DPPH and ABTS radical scavenging activities of the solvent fractions were 12.53 and 21.09 ㎎ TE/g SF in the butanol fraction, respectively. SOD-like activities of methanolic extracts from cockscome flowers were 7.96 units/mL, whereas those of its solvent fractions were 4.56, 6.15, 8.07, 12.36, and 5.21 units/mL, respectively. The results of this study show that notable antioxidant activities in cockscome flowers have significant health benefits.

Clinicopathological role of kidney injury molecule-1 in immunoglobulin A nephropathy

( Yu Ho Lee ),( Yang-gyun Kim ),( Sang-ho Lee ),( Ju-young Moon ),( Kyung-hwan Jeong ),( Tae-won Lee ),( Chun-gyoo Ihm ) 대한신장학회 2014 Kidney Research and Clinical Practice Vol.33 No.3

Background: Urinary kidney injury molecule-1 (KIM-1) is an early and sensitivebiomarker of acute kidney injury, but it is unclear if it is a biomarker of chronicglomerulonephritis. We evaluated whether urinary KIM-1 levels in patients withimmunoglobulin A (IgA) nephropathy can be a marker to reflect clinicopathologicalseverity and predict the prognosis. Methods: We measured urinary KIM-1 levels in 40 patients (15 males; mean age36.6712.9 years) with IgA nephropathy and 10 healthy people (5 males; mean age37.379.6 years) as controls. The correlation of urinary KIM-1 levels with patients’clinical parameters, histological grades, and follow-up data were analyzed using themodified H. S. Lee grading system and tubulointerstitial change scores. Results: Urinary KIM-1 levels were higher in patients with IgA nephropathy thanhealthy controls (P¼0.001). Univariate and multivariate regression analyses showedthat urinary KIM-1 levels had a direct correlation with H. S. Lee grade andtubulointerstitial inflammation (P¼0.004 and P¼0.011, respectively). Conclusion: In patients with IgA nephropathy, urinary KIM-1 has a significantcorrelation with histopathologic severity.

청심연자탕(淸心蓮子湯)으로 호전된 뇌내출혈에 고혈압이 동반된 태음인 환자 치험 1례

오정민,엄태민,최고은,허종원,유호룡,설인찬,김윤식,Oh, Jeong-Min,Eom, Tae-Min,Choi, Ko-Eun,Heo, Jong-Won,Yoo, Ho-Ryong,Seol, In-Chan,Kim, Yoon-Sik 대한중풍순환신경학회 2014 대한중풍.순환신경학회지 Vol.15 No.1

■ Objectives The purpose of this case study is to report that a hypertension with intracerebral hemorrhage of tae-eumin was treated with 'Cheongsim Yeunja-tang' and then the symptoms were improved and blood pressure was decreased. ■ Methods Although the patient who had hypertension with intracerebral hemorrhage took antihypertension drugs, intermittent increase of blood pressure was shown. We diagnosed him as Tae-eumin and treated with Cheongsim Yeunja-tang. We daily checked blood pressure and evaluated the symptoms. ■ Results After the treatment with Cheongsim Yeunja-tang, blood pressure was decreased and symptoms were improved. ■ Conclusion The result shows Cheongsim Yeunja-tang has antihypertensive effect and improve hypertension symptoms of Tae-eumin patient with intracerebral hemorrhage.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

폐경기여성에서 시청각 교육이 호르몬대체요법의 시행과 골다공증관련 생활습관의 변화에 미치는 효과

정태흠,전태희,김문찬,김영일,전대준,양승오,함수연,고병균,김성률 大韓家庭醫學會 2000 Korean Journal of Family Medicine Vol.21 No.11

Multi-media and multi-pathway aggregate exposure assessment for polycyclic aromatic hydrocarbons to the inhabitant in Tae-an county after Hebei-spirit oil spill

Kim Chan-Kook(김찬국),Woo-Chul Jeong(정우철),Jong-il Hur(허종일),Pan-Soo Park(박판수),Tae-Woo Lee(이태우),Hwi-Soo Seol(설휘수),Jung-hyeon Park(박정현),Jong-Heop Lee(이종협),Jong-Ho Kim(김종호),Byeong-Kyu Kwak(곽병규),Jong-Hyeon Le 한국환경독성학회 2010 한국독성학회 심포지움 및 학술발표회 Vol.2010 No.11

Disruption of rsmA Gene of Pectobacterium carotovorum subsp. carotovorum LY34 and Effect on Pathogenicity

Kim, Min Keun,Kang, Tae Ho,Kim, Sung Kyum,Jeong, Yu Seok,Yun, Han Dae,Kim, Hoon The Korean Society for Applied Biological Chemistr 2012 Applied Biological Chemistry (Appl Biol Chem) Vol.55 No.6

The rsmA gene was cloned from soft-rot bacterium Pectobacterium carotovorum subsp. carotovorum LY34 (Pcc LY34), and its role in pathogenicity was investigated by marker exchange mutagenesis. From a cosmid library of Pcc LY34 genomic DNA, a positive clone carrying the rsmA gene was selected, and the gene was cloned by polymerase chain reaction (PCR) amplification. The gene is 186 bp in size and encodes a protein of 62 amino acids with a predicted molecular mass of 6,839 Da. The calculated pI of the RsmA is 8.16. The phylogenetic tree showed that the RsmA of Pcc LY34 appeared genetically identical to the CsrA of Pectobacterium atrosepticum SCRI1043 (100% identity) and similar to the CsrA of Yersinia pestis KIM10+(98.3%). The gene was disrupted by the $Km^r$ gene, and the cells became mutated (i.e., $RsmA^-$ mutant). The pathogenicity test revealed that the disease rating of the $RsmA^-$ mutant only differed slightly from that of the wild type on a slice of potato tuber and a Chinese cabbage stalk. These results suggest that RsmA is not an essential factor for the pathogenicity of Pcc LY34 and that the rsmA gene of Pcc LY34 is not completely derepressed in the $RsmA^-$ mutant for virulence-related genes, contrary to the results of Erwinia carotovora subsp. carotovora $RsmA^-$ mutant, which proved hypervirulent for celery petioles. These results showed that the microenvironmental conditions of the host and/or strain of pathogen are important for the coordination of virulence gene expression.