Film Session Q&A 2 : 05 ; How to remove a huge ovarian tumor in single port laparoscopic surgery using XXXL endopouch

( Jin Hwa Lee ),( Ga Won Yim ),( Eun Ji Nam ),( Sung Hoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: Demonstrate a new instrument, technique or procedure 방법: In this video, we showed how to remove huge ovarian tumors in sinlgel port laparoscopic surgery by SW KIM`s method. SW KIM`s method is the technique to put a huge ovarian tumor into a specially designed extremely large endopouch (XXXL: 30x30㎠sized) using two conventional laparoscopic needle holders and one laparoscopic grasper and gravity by changing the patient`s position. After identifying the infundibulopelvic and uteroovarian ligaments salpingooophorectomy including huge ovarian tumor was performed by LigaSure. And then ovarian tumor was located in the pelvic cavity by changing the patient`s position into reverse-trendelenberg position and a XXXL endopouch was inserted and un-rolled inside the abdominal cavity. To insert a huge tumor into the XXXL endopouch, the endopouch was opened in triangular shape. Bilateral apex of baseline of trianglular opening of the endopouch was hold by two needle holders and then the upper apex was hold by a grasper. After holding three point of endopouch opeing, the patient`s position was changed into deep trendelenberg postion, then the tumor came into the endopouch by gravity. While changing the patient`s position, 2 needle holders and a graspers were moved into the pelvic cavity from the abdominal cavity. Aftere identifying the tumor inside the endopouch, tumors could be removed through the single port opening site or transvaginally in laparoscopic hysterectomy case without spillage of ovarian tumor. 결과: The advantage of SW KIM`s method is to remove ovarian tumor without spillage in a single port laparoscopic surgery by putting it into the large endoscopic bag despite narrow space. 결론: Using a specially designed 30×30 cm sized XXXL Endopouch and SW Kim`s technique, huge ovarian tumors could be removed without spillage in single port laparoscopic surgery.

백서 척수후근절로부터 슈반세포의 효과적인 체외 배양법

김성민,이종호,김남열,안강민,최원재,최시호,차미주,이주영,황순정,장정원,명훈,최진영,서병무,정필훈,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Schwann cells(SCs), an important component of the peripheral nervous system, intract with nerous to mutually support growth and replication for the peripheral nerve regentation. Recently, ading SCs to the lumen of guidance channel is widely tried to improve regeneration or to make regeneration possible over otherwise irreparable gaps. however, it is not easy to isolate and multiplicate SCs as much as enough to help the axonal regeneration. For the allogeneic SCs source for tubular nerve guidance, we developed a little bit improved technique of harvesting and multiplicating SCs. by culturing dispersed dorsal root ganglia in specially designed medium with growth factors and serial processing, we repeatedlly generate relatively homogenous SC cultures. Our technique was compared with other methods of literature using immunostaining methods such as GFAP, S100, BDNF and the total SC count assessment at different time interval after primary culture.

여성노인의 저항운동 시 세트구성 방법의 차이가 Myokine에 미치는 영향

김명수 ( Kim¸ Myung-soo ),이승환 ( Lee¸ Sung-hwan ),민병남 ( Min¸ Byung-nam ),김재훈 ( Kim¸ Jae-hoon1 ),방현석 ( Bang¸ Hyun-seok ),김성희 ( Kim¸ Sung-hee ) 한국융합과학회(구 한국시큐리티융합경영학회) 2020 한국융합과학회지 Vol.9 No.4

연구목적: 본 연구는 여성노인을 대상으로 저항운동 시 사용되는 set구성 방법에 중 ascending set, descending set, drop set를 각각 적용시켜 Myokine의 변화를 알아보고자 하였다. 연구방법: 연구대상은 노인복지시설을 이용하고 있는 만 65-72세 사이의 여성노인 32명을 대상으로 ascending set, 8명, descending set 8명, drop set 8명, control group 8명으로 구분하였다. 자료처리는 반복측정에 의한 이원변량분석(two-way ANOVA with repeated measure)을 사용하였으며, 유의도는 .05로 하였다. 결론: 운동프로그램은 12주간 주 3회 실시하였으며, 신체구성과 IL-15, BDNF, VEGF, Irisin의 변화를 관찰하였다. 연구결과 신체구성의 체중, 체지방률, 제지방량 모두 유의한 차이가 없었다. IL-15와 BDNF는 운동 전·후의 비교결과 Descending set와 Drop set에서 운동 후 유의하게 증가하였고, 집단 간의 차이에서 Descending set와 Drop set 집단이 대조집단에 비하여 높게 나타났다. VEGF는 운동 전·후의 비교결과 Descending set와 Drop set 집단이 유의하게 증가하였으며, 집단 간의 차이에서 Descending set와 Drop set가 Ascending set와 control group 보다 높게 나타났다. Irisin은 집단 간 차이는 없었지만 Ascending, Descending, Drop set집단에서 운동 전에 비하여 운동 후 유의한 차이로 증가하였다.. Purpose: The purpose of this study is to identify the change of Myokine by applying ascending set, descending set, and drop set which are set composition used during elderly women’s resistance training. Method: 32 participants aged 65 to 72 who were users of welfare facilities for the aged were divided into 4 groups. They were ascending set group of 8, descending set group of 8, drop set group of 8, and control group of 8. The training program was conducted 3 times a week for 12 weeks and the change of body composition, IL-15(interleukin-15), BDNF(brain derived neurotrophic factor), VEGF(Vascular endothelial growth factor) and Irisin was observed. Two-way ANOVA with repeated measure was used for data processing. Result: The result of this study is as follows. Weight, %fat, and LBM(lean body mass) without fat showed no significant change. IL-15 and BDNF increased significantly after training in Descending set group(p<.05; p<.01)and Drop set group(p<.01; p<.05). VEGF significantly increased in descending set group(p<.01) and drop set group(p<.05). Among groups, VEGF was higher in descending set and drop set groups than ascending set and control groups. Irisin showed no difference between groups, but it showed significant increase after training in ascending(p<.05), descending(p<.05), and drop set groups(p<.05).

자가 면역성 간염에서 자가항체의 발현 양상과 스테로이드 치료의 효과

박기오,채경훈,허원석,강윤세,정재훈,김연수,문희석,이엄석,김선문,이병석,김남재,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 최근 8년간 본원에서 경험한 자기면역성 간염의 혈액학적 특징과 스테로이드의 치료효과를 알아보고자 본 연구를 시행하였다. 방법 : 1996년 이후부터 2002년까지 충남대학교 병원에서 1999년 International Autoimmune Hepatitis Group(LAHG)에서 제시한 수정 진단 기준안에 의거하여 총 진단점수가 probable 이상에 해당하는 환자들을 대상으로 임상적 특징, 검사실 및 조직 소견과 스테로이드와 azathioprine의 치료 효과를 후향적으로 조사하였다. 결과 : 9예의 환자들은 여성이 78%, 40대가 많았고, 급성 발병이 33.3%, 피로감, 식욕부진 및 황달 등이 나타났으며, 항핵항체가 55.6%에서 그리고 항평활근 항체가 77.8%에서 양성이었고, 동반 질환은 류마치스 관절염이 2예, 특발성 혈소판 감소증 1예, Henoch-Sch nlein 자반증 및 그레브스병이 각각 1예 씩이었다. 7예에 대해서 스테로이드와 azathioprine으로 치료하여 생화학적 임상적 완해가 이루어져서 유효한 치료 결과를 얻었다. 결론 : 자가면역성 간염은 우리 나라에서 원인을 찾을 수 없는 만성 간질환의 경우, 특히 중년여성에서 다른 자가면역성 질환이 동반되었을 때 자가면역성 간염을 의심하여 자가항체 선별검사를 시행해 보아야 할 것으로 생각된다. 향후 다기관 연구를 통하여 좀 더 많은 증례를 모으고 전향적인 연구를 시행하여야 할 필요가 있다. Although autoimmune hepatitis(AIH) is common in western contries, some studties have been reported in Korea. The aim of the study was to analyze the clinical and histological features and expression pattern of the autoantibody and to examine clinical course of AIH in Korea. For 9 patients diagnosed as having AIH in our hospital since 1996, we reviewed medical records and analyzed clinical and laboratory findings retrospectively. They had a probable or definite AIH according to the revised criteria of International AIH group. The mean age was 42.7(21∼68)years and 7(77.8%) were female. Three of them(33.3%) showed acute hepatitis and five of them showed cirrhosis. Fatigue and anorexia were the most frequently complained symptoms(55.6%). Four patients(44.4%) were accompanied with other autoimmune diseases. Antinuclear antibody was detected in 5(55.6%) and anti-smooth muscle antibody was detected in 7(77.8%). Three patients showed focal picemeal necrosis and four showed periportal fibrosis. Among 7 patients who received immunosuppressive therapy, six patients(85.7%) showed initial response. and biochemical and serologic remission were achived in 5(71.4%) and 3(42.8%) patients, AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. AIH should be suspected in female patients with unknown chronic liver disease of unknown etiolgy, especially accompanied with other autoimmune disease. The clinical characteristics of AIH may not be quite different from those of Western countries.

흰쥐 뇌에서 Tyrosine Hydroxylase분비세포의 출현시기 및 분포에 관한 면역조직화학적 연구

정윤영,선희매,김영택,김남훈,안계훈,장인엽,김종중,문정석,강양수 조선대학교 부설 의학연구소 1999 The Medical Journal of Chosun University Vol.24 No.1

The immunohistochemical (ABC method) studies on the ontogeny and localization of the catecholamine-synthesizing enzyme tyrosine hydroxylase (TH) were examined in rat brain from the 12th fetal day until the 9th postnatal day. The results obtained were as follows : 1. Tyrosine hydroxylase was first detected immunohistochemically at embryonic day 13(E13). At this stage, the TH-containing neurons were still migrating and cytologically immature. 2. The changes occuring from the early to the late prenatal stages of development appeared to be the result of an increase in the number and size of the TH-containing cells and in the length of nerve fibers. 3. The distribution of the TH-containing neurons at embryonic day 19(E19) more closely resembled catecholaminergic neurons in the adult rat brain : 1) a rhombencephalic group became the A1-7 ; 2) a ventral mesencephalic group became A8-10 ; 3) a ventral prosencephalic group and a few neurons ventral to the striatum became A11-14 ; and 4) the cells of the olfactory bulb corresponded to the A15. 4. The cytodifferentiation of the TH-immunoreactive neurons was accompanied by continued migration to form the collective catecholaminergic groups during ontogenesis. In addition, the morphology of the TH-immunoreactive neurons in the late prenatal stage resembled in the adult rat brain.

유해화학물질의 계통분석

박성우,박유신,이진훈,유재훈,김유나,오세진,이진숙,김남이,박종신,남금문,노동석 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

림프구성 간질을 동반한 위선암종의 임상-병리학적 및 면역조직화학적 연구

김종만,김남훈,이중달 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.1

Various clinicopathologic and immunologic parameters to determine the prognosis of gastric adenocarcinoma have been proposed. It has been reported that lymphocytes around tumor cells may play a role in determination of the prognosis. Among them gastric adenocarcinoma with lymphoid stroma(GALS), which is characterized by 1) a sparese population of small nests consisting of poorly differentiasted carcinoma cells widely separated by the intervening lymphocytic infiltration, and 2) the presence of a nondesmoplastic stroma infiltrated uniformly iwth abundant lymphocytes throughout the tumor frequently accompanied by lymph follicles, has been proven to show good prognosis. To evaluate the correlation between the pathologic patterns and immunologic expression of lymphocytes, the author reviewed clinical data and pathologic specimens from 13 cases of GALS. Immunohistochemical study on lymphocytes in GALS was performed. In comparison with ordinary gastric carcinomas GALS had the growth pattern of Borrmann type Ⅱ in 7 of 13(54%), and occured predominantly in the body. No correlation between the degree of lymphocytic infiltration and the metastases to the regional lymph nodes was noted. The less invasive tumors had a tendency to the more expanding in growth pattern, and more invasive tumor, more infiltrative. Immunohistochemical study revealed stromal lymphocytes of predominantly T-cell expression. T-cells were frequently seen in intimate contact with individual carcinoma cells. In contrast, B-cellls was sparsely scattered throughout apart from carcinoma cell nests.

생물전극 반응조를 이용한 영양물질 제거

김성완,윤철종,최성우,김성우,우성훈,신남철,박승조 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.2

We have investigated a performance of bio-electrode reactor for removal of nutrient like a nitrogen, phosphorus and organic substrate. Lab scale of bio-electrode reactor was operated with synthetic and tannery wastewater. Iron bar and stainless steel used for anode and cathode respectively. In experiment with synthetic wastewater, we were able to obtain the optimal current density range of 2.4-40 mA/dm² after 48 hrs operating time. And in that experiment, about 70~73% of ammonia nitrogen and 54~64% of phosphorus were removed. In experiment with tannery wastewater at 2.4-4.0 mA/dm², the removal rate of ammonia nitrogen, phosphorus and organic substract were about 62-69%, 45~59% and beyond 79% respectively.

국내에서 분리된 Vancomycin 내성 장구균에 대한 분자역학적 연구

김수정,이남용,배직현,이경원,이위교,김의종,최명식,백경란,김성민,송재훈 대한감염학회 1998 감염 Vol.30 No.1

목 적 : 장구균은 병원 감염의 원인균으로서 최근 그 빈도와 중요성이 증가하고 있다. 특히 vancomycin에 내성을 보이는 장구균(VRE)은 효과적인 치료약제가 드물고, 그 내성 유전자가 vancomycin에 감수성을 보이는 다른 장구균이나 그람양성 구균에 전달될 수 있어 임상적인 중요도가 더욱 크다. 본 연구에서는 국내 5개 병원에서 분리된 VRE 균주의 표현형과 유전형을 결정하고, 분자역학적 방법을 이용하여 유전적 연관성 여부를 밝히고자 하였다. 방 법 : 각 병원에서 수집된 균주는 환자의 임상 검체에서 또는 VRE 집락화에 대한 선별검사에서 분리된 균주였다. 이들을 대상으로 vancomycin과 teicoplanin의 MIC를 측정하여 표현형을 결정하였으며, PCR로 vancomycin 내성 유전자를 증폭하여 유전형을 결정하였다. 또한 이들중 vanA와 vanB 유전자를 갖는 균주들을 대상으로 플라스미드 분석과 PFGE를 시행하였다. 결 과 : VRE로 최종 동정된 균주들은 42균주(E. faecium 21주, E. faecalis 6주, E. avium 2주, E. casseliflavus 13주)였으며, 항균제 감수성 양상으로 결정한 표현형은 VanA, VanB, VanC형이 각각 14주(33%), 7주(17%), 21주(50%)였다. PCR로 결정한 유전형은 vanA 12주(E. faecium), vanC 16주 였으며, 이중 VanA의 표현형을 보인 E. faecium 2주가 VanB의 유전형으로 판명된 것을 제외하면 표현형과 유전형은 모두 일치하였다. 플라스미드 분석과 PFGE 결과, 병원내 동일 균주의 전파 가능성이 5개 병원중 3병원에서 증명되었다. 결 론 : 국내 병원에서도 vancomycin 내성 유전자를 갖는 VRE가 다수 분리되고 있음을 확인할 수 있었으며, 연구 결과 일부 병원에서 내성균주의 병원내 전파 가능성을 시사하였다. 아직까지 국내에서 VRE로 인한 감여보고는 적지만 곧 임상적으로 문제가 될 것으로 판단되며, 따러서 내성균의 발생이나 확산을 억제하기 위한 노력과 감시가 필요할 것으로 생각된다. Background : Enterococci have emerged in recent years as a frequent cause of life-threatening nosocomial infections. The emergence of vancomycin-resistant enterococci(VRE) presents as an increasingly important problem particularly in the treatment and the potential dissemination of vancomycin-resistance. The purpose of this study is to determine the phenotypes and genotypes of VRE isolated from five hospitals and to study the genetic relatedness among them. Methods : Antimicrobial susceptibility patterns and amplification of vancomycin resistance genes were used for phenotyping and genotyping of 42 VRE isolates respectively. For 21 isolates with vanA or vanB gene, plasmid profiles and pulsed field gel electrophoresis(PFGE) patterns were analyzed for molecular epidemiologic study. Results : Out of 42 isolates, 21 were identified as E. faecium, 6 as E. faecalis, 2 as E. avium, and 13 as E. casseliflavus. Phenotyping showed 14 isolates as VanA(33%), 7 as VanB(17%) and 21 as VanC(50%). Genotyping resulted in 12 isolates as VanV(5 of E. faecalis and 7 of e. faecium) and 9 as VanB(all E. faecium). Genotyping results were concordant with phenotyping results except for the two E. faecium isolates of VanA which had VanB genotype. Intrahospital spread of the same strains was proven in three hospitals by plasmid profiles and PFGE analysis. Conclusion : The study demonstrated a considerable number of VRE isolates in Korea and intrahospital spread proven by molecular epidemiologic methods. Although VRE infection has been considered very are in Korea, practical guidelines including restriction of vancomycin usage and surveillance, are warranted to prevent infection and dissemination of VRE.