Single-Port Robotic Cholecystectomy: Early Experience from 8 Cases

( Hyung Jun Kwon ),( Horyon Kong ),( Sang Geol Kim ),( Yun Jin Hwang ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Single-port laparoscopic cholecystectomy (SPLC) is a technical concept to reduced pain and improve cosmetic results when compared to multi-port cholecystectomy. However, SPLC is associated with technical limitation due to the enhanced complexity of the approach and limited number of specialized instruments or platforms. On the other hand, using a robotic platform may overcome these problems and enable more precise surgical actions by increasing freedom of movement and by restoring intuitive instrument control. In this presentation, we report the early clinical experience of our first 8 sing-port robotic cholecystectomy (SPRC) cases. Methods: Between November 2016 and February 2017, eight patients underwent SPRC with the da Vinci Xi robot and single-site instrumentation. We retrospectively reviewed clinical data on those patients. Results: All of 8 patients had completion of SPRC. Seven patients were female and one was male. Average patient age was 43.3±11.8 years and BMI was 22.4±1.4 kg/m2. Three patients (37.5%) were diagnosed with chronic calculous cholecystitis. Three patients (37.5%) underwent operation for polypoid lesions of the gallbladder. One patient (12.5%) was diagnosed with acute calculous cholecystitis. The mean operation time (skin-to-skin) was 83.9±30.7 min, docking time was 13.25±8.1 min, and console time was 42.1±26.4 min. The intraoperative blood loss was negligible. The mean Visual Analog Pain Scale score 6hr after the surgery was 2.9±0.4. The mean length of hospital stay average postoperative hospital stay was 2.3±1.0 day. There were no intraoperative complication and one patient developed seroma on port site. Conclusions: Robotic single-port cholecystectomy appears feasible and safe in our early experience.

Pretreatment with Lycopene Attenuates Oxidative Stress-Induced Apoptosis in Human Mesenchymal Stem Cells

( Ji Yong Kim ),( Jai Sung Lee ),( Yong Seok Han ),( Jun Hee Lee ),( Inhyu Bae ),( Yeo Min Yoon ),( Sang Mo Kwon ),( Sang Hun Lee ) 한국응용약물학회 2015 Biomolecules & Therapeutics(구 응용약물학회지) Vol.23 No.6

Human mesenchymal stem cells (MSCs) have been used in cell-based therapy to promote revascularization after peripheral or myocardial ischemia. High levels of reactive oxygen species (ROS) are involved in the senescence and apoptosis of MSCs, causing defective neovascularization. Here, we examined the effect of the natural antioxidant lycopene on oxidative stress-induced apoptosis in MSCs. Although H2O2 (200 mM) increased intracellular ROS levels in human MSCs, lycopene (10 μmM) pretreatment suppressed H2O2-induced ROS generation and increased survival. H2O2-induced ROS increased the levels of phosphorylated p38 mitogen activated protein kinase (MAPK), Jun-N-terminal kinase (JNK), ataxia telangiectasia mutated (ATM), and p53, which were inhibited by lycopene pretreatment. Furthermore, lycopene pretreatment decreased the expression of cleaved poly (ADP ribose) polymerase-1 (PARP-1) and caspase-3 and increased the expression of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax), which were induced by H2O2 treatment. Moreover, lycopene significantly increased manganese superoxide dismutase (MnSOD) expression and decreased cellular ROS levels via the PI3K-Akt pathway. Our findings show that lycopene pretreatment prevents ischemic injury by suppressing apoptosis-associated signal pathway and enhancing anti-oxidant protein, suggesting that lycopene could be developed as a beneficial broad-spectrum agent for the successful MSC transplantation in ischemic diseases.

Pretreatment with Lycopene Attenuates Oxidative Stress-Induced Apoptosis in Human Mesenchymal Stem Cells

Kim, Ji Yong,Lee, Jai-Sung,Han, Yong-Seok,Lee, Jun Hee,Bae, Inhyu,Yoon, Yeo Min,Kwon, Sang Mo,Lee, Sang Hun The Korean Society of Applied Pharmacology 2015 Biomolecules & Therapeutics(구 응용약물학회지) Vol.23 No.6

Human mesenchymal stem cells (MSCs) have been used in cell-based therapy to promote revascularization after peripheral or myocardial ischemia. High levels of reactive oxygen species (ROS) are involved in the senescence and apoptosis of MSCs, causing defective neovascularization. Here, we examined the effect of the natural antioxidant lycopene on oxidative stress-induced apoptosis in MSCs. Although $H_2O_2$ ($200{\mu}M$) increased intracellular ROS levels in human MSCs, lycopene ($10{\mu}M$) pretreatment suppressed $H_2O_2$-induced ROS generation and increased survival. $H_2O_2$-induced ROS increased the levels of phosphorylated p38 mitogen activated protein kinase (MAPK), Jun-N-terminal kinase (JNK), ataxia telangiectasia mutated (ATM), and p53, which were inhibited by lycopene pretreatment. Furthermore, lycopene pretreatment decreased the expression of cleaved poly (ADP ribose) polymerase-1 (PARP-1) and caspase-3 and increased the expression of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax), which were induced by $H_2O_2$ treatment. Moreover, lycopene significantly increased manganese superoxide dismutase (MnSOD) expression and decreased cellular ROS levels via the PI3K-Akt pathway. Our findings show that lycopene pretreatment prevents ischemic injury by suppressing apoptosis-associated signal pathway and enhancing anti-oxidant protein, suggesting that lycopene could be developed as a beneficial broad-spectrum agent for the successful MSC transplantation in ischemic diseases.

Relationship between Transferable Embryos and Major Metabolite Concentrations in Holstein Donor Cows

Jun-Kyu Son,Yeon-Sub Jung,Sang-Rae Cho,Kwang-Soo Baek,윤호백,Hyun-Joo Lim,Eung Gi Kwon,Sang-Bum Kim,Chang Yong Choe 사단법인 한국동물생명공학회 2012 한국동물생명공학회지 Vol.27 No.4

This research was investigated the relationship, in high-producing Holstein donor cows, between the number of the transferable embryos and the blood serum concentrations of Blood Urea Nitrogen (BUN), glucose and cholesterol,which affect the nutritional state of cows. CIDRs were inserted into the vaginas of twenty two heads of Holstein cows, regardless of estrous cycle. Superovulation was induced using folliclar stimulating hormone (FSH). For artificial insemination, donor cows were injected with PGF2α and estrus was checked about 48 hours after the injection. Then they were treated with 4 straws of semen 3 times, with 12-hour intervals. Embryos were collected by a non-surgical method 7 days after the first artificial insemination. The total numbers of ova collected from 3 experimental groups whose blood BUN concentrations were <10 mg/dl, 11~18 mg/dl and ≥19 mg/dl were 8.9, 12.5 and 19.0, respectively; whereas the numbers of transferable embryos were 5.8 + 1.9, 7.9 + 2.8 and 5.2 + 1.4, respectively. When glucose concentration was <60 mg/dl, the total number of collected ova was 9.9, which was smaller than when the concentration was 60~70 mg/dl or ≥70 mg/dl. When glucose concentration was 60~70 mg/dl, the number of transferable embryos was 7.1 + 2.4, which was slightly larger than the numbers 6.4 + 2.1 and 6.1 + 1.7 that were obtained when the concentrations were <60 mg/dl and ≥70 mg/dl, respectively ; however, the differences were not significant (p>0.05). When cholesterol concentrations were <150 mg/dl, 150~200 mg/dl and ≥200 mg/dl, the total numbers of collected ova were 11.2, 11.3 and 8.6, respectively. Whereas the numbers of transferable embryos were 7.1 + 2.1, 7.3 +1.9 and 5.6 + 1.3, respectively ; however, the differences were again not significant (p>0.05). The result of this research showed no significant difference in ovum recovery rate and the number of transferable embryos according to major metabolite concentrations in high-producing Holstein donor cows. However, it is considered that the failure of maintaining proper nutritional status would cause the fall in in vivo embryo productivity.

Outcomes and recurrence pattern after non-anatomic liver resection for solitary hepatocellular carcinomas

Sung Hoon Cho,Jae Min Chun,Hyung Jun Kwon,Young Seok Han,Sang Geol Kim,Yoon Jin Hwang 한국간담췌외과학회 2016 한국간담췌외과학회지 Vol.20 No.1

Backgrounds/Aims: Anatomic resection (AR) is preferred for eradicating portal tributaries in patients with hepatocellular carcinoma (HCC). However, the extent of resection is influenced by underlying liver disease and tumor location. We compared the surgical outcomes and recurrence pattern between non-anatomic resection (NR) and AR. Methods: From March 2009 to February 2012, 184 patients underwent surgical resection for HCC. Among these, 79 patients who were primarily treated for a single tumor without rupture or macroscopic vascular invasion were enrolled. The patients were divided into 2 groups based on the extent of resection: AR (n=31) or NR (n=48). We compared the clinical characteristics, overall survival, disease-free survival, pattern of recurrence, and biochemical liver functions during the perioperative period between the two groups. Results: The extent of resection had no significant effect on overall or disease-free survival rates. The overall 1- and 3-year survival rates were 97% and 82% in the AR group, and 96% and 89% in the NR group, respectively (p=0.49). In addition, the respective 1- and 3-year disease-free survival rates for the AR and NR groups were 84% and 63%, and 85% and 65%, respectively (p=0.94). On the other hand, the presence of hepatic cirrhosis and a tumor size of >5 cm were significant risk factors for recurrence according to multivariate analysis (p<0.001 and p=0.003, respectively). The frequency of early recurrence, the first site of recurrence, and the pattern of intrahepatic recurrence were similar between the 2 groups (p=0.419, p=0.210, and p=0.734, respectively); in addition, the frequency of marginal recurrence did not differ between the 2 groups (1 patient in the AR group and 2 in the NR group). The NR group showed better postoperative liver function than the AR group. Conclusions: Non-anatomic liver resection can be a safe and efficient treatment for patients with a solitary HCC without rupture or gross vascular invasion.

Visceral Fat as a Useful Parameter in the Differential Diagnosis of Crohn`s Disease and Intestinal Tuberculosis

( Jun Kwon Ko ),( Hang Lak Lee ),( Jin Ok Kim ),( Soon Young Song ),( Kang Nyeong Lee ),( Dae Won Jun ),( Oh Young Lee ),( Dong Soo Han ),( Byung Chul Yoon ),( Ho Soon Choi ),( Joon Soo Hahm ),( Sang 대한장연구학회 2014 Intestinal Research Vol.12 No.1

Background/Aims: Because of the similarities in the clinical presentations of Crohn`s disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB. Methods: We conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT. Results: The ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively. Conclusion: Measurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB. (Intest Res 2014;12:42-47)

DNA Analysis by Flow Cytometry in Early Gastric Cancer

( Jun Myeong Kim ),( Dong Ki Lee ),( Young Kyung Kim ),( Soon Koo Baik ),( Chong In Lee ),( Sang Ok Kwon ),( Soon Hee Jung ) 대한내과학회 1997 The Korean Journal of Internal Medicine Vol.12 No.2

A New Version of the Plasma Database for Plasma Physics in the Data Center for Plasma Properties

Jun-Hyoung Park,Heechol Choi,Won-Seok Chang,Sang Young Chung,Deuk-Chul Kwon,Mi-Young Song,Jung-Sik Yoon 한국진공학회(ASCT) 2020 Applied Science and Convergence Technology Vol.29 No.1

Bulk and surface chemistry database (DB) are necessary to compute plasma parameters using plasma simulators. As the high quality of the DB is closely related to the accuracy enhancement of simulations, we attempted to gather reliable data from previously published articles. However, previous systems could not accommodate various types of information such as electron collision cross sections, rate coefficients of heavy particle reactions, sticking coefficients on the surfaces, and thermodynamic data. Therefore, we developed a new version of the DB system to provide plasma data for researchers in related fields; this new DB system is designed to retrieve data such as electron collision cross sections, rate coefficient, and thermodynamics data. About 35,000 collision cross sections and 74,000 rate coefficients for 90 chemical species and thermodynamic data for 55 chemicals are provided in the numerical and graphical forms in this DB system.

Thalidomide for Treating Metastatic Hepatocellular Carcinoma: A Pilot Study

( Sang Hoon Han ),( Se Hoon Park ),( Jung Ho Kim ),( Jong Jun Lee ),( So Young Kwon ),( Oh Sang Kwon ),( Sun Suk Kim ),( Ju Hyun Kim ),( Keon Kug Kim ),( Yeon Ho Park ),( Jeong Nam Lee ),( Eun Mi Nam 대한내과학회 2006 The Korean Journal of Internal Medicine Vol.21 No.4

Background: Thalidomide has been reported to have antitumor activity for treating metastatic hepatocellular carcinoma (HCC). We evaluated the safety and efficacy of using thalidomide for treating selected patients with unresectable or metastatic HCC, and their disease was refractory to systemic chemotherapy. Methods: Eight patients with measurable and metastatic HCC that had progressed with prior systemic chemotherapy and who desired further active therapy were enrolled in this study. Thalidomide was given orally at bedtime and it was started at 200 mg/day with no further dose escalation. The response was measured at 2-month intervals. Results: The median age was 44 years (range: 34-52 years) and all the patients had received doxorubicin-based systemic chemotherapy prior to their enrollment. Each patient received thalidomide for a median of 152 days (range: 5-422 days). One partial response was observed (12.5%, 95% CI; 0-42%) along with 4 cases of stable diseases. The most commonly encountered toxicity was somnolence; grade 3 somnolence was noted for one patient, which led to treatment discontinuation. Skin rash was observed in one responding patient. Conclusions: The results indicate that thalidomide may feasibly offer disease stabilization to metastatic HCC patients. Further dose escalation of thalidomide, or its combination with other chemotherapeutic agents, may be of interest and this should be investigated for treating patients with metastatic HCC.

The Effects of Repetitive Transcranial Magnetic Stimulation on Balance Ability in Acute Stroke Patients

( Sang-goo Ji ),( Young-jun Shin ),( Myoung-kwon Kim ) 대한물리의학회 2016 대한물리의학회지 Vol.11 No.3

PURPOSE: The aim of the present study was to determine whether high frequency repetitive transcranial magnetic stimulation (rTMS) can improve balance ability in acute stage stroke patients. METHODS: The study was conducted on 30 subjects diagnosed with hemiparesis caused by stroke. The experimental group consisted of 15 patients that underwent rTMS for 15 mins and the control group consisted of 15 patients that underwent sham rTMS (for 15 minutes). A 70-mm figure 8 coil and a Magstim Rapid stimulator was used in both groups. Patients in the experimental group received 10Hz rTMS applied to the hotspot in the lesioned hemisphere in 10-second trains with 50-second intervals between trains, for 15 minutes (total 2,000 pulses). Both groups received conventional physical therapy for 30 minutes a day, 5 days a week, for 4 weeks. Static balance ability analysis was performed using the Gaitview system to measure pressure rate, postural sway, and total pressure, and dynamic balance ability analysis was performed to measure pressure variables using a balance system. RESULTS: A significant difference was observed in post-training gains for pressure rate, total pressure in static balance, and overall stability index in dynamic balance between the experimental group and the control group (p<.05). CONCLUSION: The results of this study indicate that high frequency rTMS may be beneficial for improving static and dynamic balance recovery in acute stroke patients.