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.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

말초염증에 의한 등족뿌리신경절의 brain-derived neurotrophic factor 합성의 변화

김상열,김정기,김효신,이상지,하선옥,홍해숙,김동선 대한해부학회 1998 Anatomy & Cell Biology Vol.31 No.3

한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

반어법의 예술적 변용 : 해학 , Ironie le Hai-Hac et l'ironie

김상숙 프랑스문화학회 1998 프랑스 문화읽기 Vol.4 No.1

1. Alle´goire et antiphrase Essayons d'abord de de´finir une langue critique qui se trouvera dans l' oeuvre me^me, et qui serait un moyen de communication intellectuelle, aussi bien en Occident qu'en Extre^me-Orient, qu'en France ou en Core´e. Gette langue critique serait mobile, et devrait e^tre une expression antiphrastique, qui vivrait ainsi comme un certain e´nigme tre`s intime de l'oeuvre. Notre esprit tombe parfois dans le pie`ge antiphrastique de l'oeuvre quand il se contente de l'apparence et ne´glige la re´-expression antiphrastique qui re´ve`le $quot;la parole$quot; me´tonymique et me´taphorique de l'oeuvre, c'est-a`-dire , sa $quot;parole symbolique$quot;. Il serait ne´cessaire d'observer et d'analyser la fonction critique de l'oeuvre par le langage rhetorique et antiphrastique du Hai-Hac coreen et l'ironie occidentale, et e´galement de trouver le point comrnun de ces deux expressions en comparant leurs receptions. Car, s'il y a un point commun, ceci montre certanement un moyen de communication quelconque, c'est a`-dire, une alle´goire ne´e dons la rhe´torique, inhe´rente a` toute oeuvre artstique. Autrement dit, alle´goire instaure un dialogue indirect, et rythme une critique existant dons l'oeuvre meme. Le Hai-Hac se compose des deux mots $quot;Hai$quot; et $quot;Hoc$quot; qui sont deux caracte`res chinos. Il se signifient pas seulement ironie mais aussi rire, plaisanterie, satire, humour, paradoxe ou encore me´taphore. Il insiste sur la bonne humeur ne´e de plaisanteries ou jeux exempts de toute me´chancete´. Mais le Hai-Hac, c'est aussi un certain regard, $quot;une manie`re de regarder$quot;, c'est a dire, $quot;des yeux qui s'amusent$quot;, que ce soit par la description ou par l'e´mfltian sur un fait. Par exemple, paemi les caracte´ristiques des oeuvres artistiques en Core´e, en particulier, dons les tableaux de moeurs ou ceux du peuple, si on parle du Hai-Hac, I'oeuvre doit sublimer l'envirenement de l'auteur, c'est-a`-dire, atteindre a` $quot;un esprit du vide$quot;. Il est e´vident que le Hai-Hac s'enracine dons l'instinct du jeu, qu'il suit l'ordre de la nature et en meme temps, qu'il surpasse les souffrances de la vie. Indepe´ndement de cela, il peut aussi e^tre un moyen de de´passer des conditions de vie pe´nibles. Si on recheche l'origine du Hai-Hac dons $quot;l'esprit du vide$quot;, on voit que fart core´en y a grandi et qu'il y a cache´ quelque chose de re´ve´lateur. Autrement dit, il signifie une rencontre toujaurs possible aver $quot;un vide$quot;. $quot;Lesr paroles$quot; et $quot;les gestes$quot; d'un homme vers le vide re´vle`lent une certaine intimite´ invisible a` la surface. C'est un effort de re´conciliation aver la vie. L'ironie signifie une certaine $quot;re´sonance coope´rative$quot; sur un objet que l'on regarde a` travers une re´flexion savante elle peut montrer aussi pre´sciosite´, taquinerie, parabole, me´taphore, persiflage, bizarrerie, discordance... ; elle reunit ce qui se montre et ce qui ne se montre pas, c'est-a`-dire qu'elle pane des rapports de l'imagination et de la re´alite´, de la ve´rite´ et du mensonge. L' ironie pent devenir $quot;aigre$quot; par sa force destructrice. La pense´e ironique pent vite nourir toutes les pense´es et prendre plaisir a re´veiller la cole`re qui est en chacun de nous. L'ironie signifie alors une errance de l'esprit et, a` la fois, une activite´ essentielle de celui-c. Cette activite´ se concentre dans la critique, et peut re´vele´r le myste`lre de l'oeuvre. 2. Repre´sentation et antiphrase L'aspect expressif de l'antiphrase se devise en deux parties dons son oeuvre. L'une est une expression indirecte qui transmet doucement par la vigueur de l'inverse la force d'un the`me puissant. L'autre est une expression plus brutale, une influence directe, par le retour de certaines intentions fortes. Comment e´tudier alors le Hai-Hac et l'ironie antiphrastiques? Il faudrait analyser concre`tement les caracte´ristiques de l'antiphrase a` travers plusieurs oeuvres : A) parabole B) paradigme C) paradoxe. Les aspects interieurs rendent possible la perspective des fonctions critiques a` l'inte´rieur de l'oeuvre. En premier lieu, In situ, le travail de Daniel Buren montre le mouvement re´trograde de la vision optique et oblige le regard a` une strate´gie de de´tour. C'est-a`-dire que le ro^le de l'instrument optique de´fnit l'espace circulaire par I'indication. Dans le sens linguistique, par exemple, l'instrument visuel appartient a` une relation du type : $quot;Ceci est cela$quot;, Ceci est A et B$quot;. $quot;Ceci et cela$quot;est un geste, c'est-a`-dire, un terme de transformation indicative. En tant que ro^le indicatif, l'instrument visuel (les motifs des lignes de Buren) ne vise plus son objet lui-me^me, mail indique l'espace par le jugement de la personne qui les regarde. De la`, ce jugement de la personne qui les regarde se porte sur l'espace de l'oeuvre. Le travail de Buren nous re´ve`le la possibilite´ du $quot;retour$quot;(de l'inverse) de $quot;voir$quot; et il de´crit l'espace de la vision optique par la me´taphore, la parabole, la comparaison ou l'antiphrase. Bref, il cre´e une vision critique dans la ligne´e sociale comme un domaine autonome de fart. Pourquoi la capacite´ de lire l'exte´rieur de l'objet, la promenade des $quot;yeux$quot; duns l'espace, l'activite´ revenue a` la realite´, et 1$quot;antiphrase visuelle du travail existent-ils dans In situ? La re´ponse se trouverait probablement dans $quot;l'efficacite´ de l'art$quot;. Deuxie`mement, In transit de Sang-Sook KIM utilise les conditionnements re´els du syste`me inte´rieur et de l'espace. La distinction de bonnes ou mauvaises conditions d'exposition n'est pas un phe´nome`ne pour l'oeuvre. Car, l'e´le´ment topographique de la sculpture architecturale incarne toutes les images qui $quot;s'erigent, demeurent et pensent$quot;. Le travail prend toute sa valeur, place´ dans un endroit visite´ par des spectateurs. Les pieds rencontrent d'abord la moquette, e´tale´e sur le sol de la galerie, gra^ce a` des trous dans la moquette pose´e sur le sol des parties de´coupe´es, des formes diverses, les places vides se rencontrent ; les pie`ces de la moquette se de´placent parfois sur les mars ou l'inverse. Le couteau et les ciseaux remplacent le crayon et le pinceau, apanage de l'art pictural. Mais cet acte ressemble au travail dune surface plate $quot;car il cherche a` e^tre reconnu en taut que peinture$quot;. D'une part, il e´largit l'espace, transformant la surface plate en cube. Dans ce travail, l'horizon (le sol) et la perpendicularite´ (le mar) se trouvent l'un avec l'autre en rapport de compre´hension. De la moquette, du mar au sol, du sol au mar, entre l' absence et la pre´0sence, entre le vide et le plein, entre monter et descendre, entre vidanger et remplir : des e´changes re´ciproques font comme un mouvement de va-et-vient, un dialogue du mouvement, entre les possessions inde´termine´es, entre certains pre´sages... Quel effet serait-ce de marcher sur la moquette? La sensibilite´ des spectateurs nai^t des pieds, fait appel a` leur perception par le sol puffs veut changer leur cadre de pense´e. Leurs marches continuent a` les faire entrer pea a` pea dans le travail de cre´ation. $quot;N'allons tout de me^me pas trop vite en besogne dans notre de´couverte des lieux. Reprenons plus pe´sdestrement le fil de nos actions. Pour ce faire, quittons le seuil. Hasardons davantage nos pas en tous sens dans cet espace. Attardons-nous cependant sur l'exercice me^me de la marche.$quot;( Jean Lancri, dans la critique de In transit) Le toucher par nos pieds avant la vision repre´sente plus $quot;les pieds$quot; que $quot;les yeux$quot;. Le sentiment de liberte´ par le toucher peut e^tre obtenu par sa propre $quot;expe´rience$quot;, Nous voudrians que les spectateurs lisent la moquette, le sol, l'horizon par leurs $quot;pieds$quot;, $quot;But secret de In Transit (ou encore, si l'on nous passe une me´taphore emprunte´e au vocabulare de l'escrime, sa botte secre`te, une butte en manie`re de coup bas qui nous affecte d'abord a` notre insu au niveau du pied, avant de s'en prendre, de`s que nous en aeons conscience, a` notre t^ete), but secret de l'installation, sa butte secre`te : amener pas a pas le visiteur a` changer ses appuis au sdcle de sa pense´e, au sol de ses certitudes, puisque le rnonde, ici, se re´ve`le pour le moms mis a` l'envers, et le plein s'ave`re intimement me^le´ au vide$quot;(ibid) Le sol servait au travail cubique et le mur au tableau jusqu'a` aujourd'hui. Il s'agit donc d'un essai pour changer la pense´e en ce qui concerne le ro^le et la reconnaissance de I'espace. Autrement dit, l'ide´e pre´conc¿ue de l'oeuvre artistique peut e^tre bouleverse¿e par le de¿placement ce ehoc correspond a` la re-re¿sception du Hai-Hac qui vise la de¿viation de notion accepte´e et de re`gles existantes et le changement des conceptions habituelles. En troisie`me lieu, la base de l'autonomie de la sculpture est le sol, et le contact minimal avec celui-ci s'etablit par le socle daps le cas de Didier Vermeiren. C'est-a`-dire que l'oeuvre part de l'offre du socle et arrive en son inte´rieur. Ce jeu est une re´ponse des socles qui sont faits de la me^me matie`re, analogue au jeu entre le volume de la sculpture et le de´placement de surface. Regardons son oeuvre Sans titre(1994). Quatres roues se trouvent ensemble sur quatre sods. Place(1993), son autre oeuvre montre sur un grand marbre, un socle de quatre fers dont chacun comporte quatre roues. Ce genre de travail cre´e un certain choc paradoxal compare´ a` la sculpture traditionnelle. De´fier ses aspects, indirectement rnais essentiellement devient une question fondamentale pour la sculpture. Son travail insiste sur le socle, et egalement sur le sol(...), La matie`re qui est pose´e sur le socle devient la sculpture ; cette matie`re devient donc sculpture par le socle. Le ro^le des roues est d'e^tre les points de contact minimum entre la sculpture et le sol ; ces rows, ici de´signent un mouvement. Mais le mouvement nest pas re´el. Ces rous ne sont pas inte´gre´es dans la sculpture pour leur fonction, mais pour ne pas cacher le socle au sol ; elles assument le ro^le de la force, de´place´e au sol. Le travail de Vermeiren repre´sente une importance cruciale dans le processus de changement historique. Sa vision pre´sence un espace d'interpre´tation paradoxale du socle daps la sculpture. L'antiphrase est comme un dard quagit sur la parole mysterieuse d'une oeuvre. L'humour et l'ironie se re´ve`lent e^tre comme une finesse d'esprit, un paradoxe et un gou^t aigre dans l'oeuvre. En fin de compte, la question de l'antiphrase rejoint celle de l'essence de l'oeuvre. Voir n'est pas seulement une activite´ oculaire, mais surtout une faculte´ cognitive. L' antiphrase est une invitation a` voir non seulement la forme, mais aussi la fonction de l'oeuvre. Car l'antiphrase oblige a` une activite´ cognitive daps le domaine de l'image et daps l'expe´rience artistique, et elle est une strate´gie derive´e de la faculte´ cognitive. En me^me temps, l'expression antiphrastique, dans la tactique de l'artiste, de´voile, affirme, de´montre la faculte´ cognitive et s'en moque. 3. Cri culturel de l'antiphrase Pourquoi abordons-nous ce sujet? Pourquoi nous y inte´ressons-noun seulement aujourd'hui? Que veulent dire l'Hai-Hac, l'irorue et l'expression antiphrastique? A propose de la prernie`re question notre conscience attire toujours l'enigme que contient l'oeuvre. L'enigme, c'est comme une parole rnyste´rieuse ou inde´finie. La critique, elle, de´livre celle-ci. En d'autres termes, elle attaque la parole que contient l'oeuvre. L' antiphrase d' une expression agit comme un dard sur la parole myste´rieuse de l'oeuvre. Parmi les caracte´ristiques du mystere et de la libe´ration, le Hai-Hac et l'ironie se manifestent au travers de leur choc. Il se manifestent en tart que gou^t aigre, esprit et paradoxe. En fin de compte, la question de l'antiphrase revient a` celle de l'mmanence de l'oeuvre. A propos de la deuxie`me question les caracte´ristiques de l'antiphrase font ressortir la fontion critique inhe´rente a` l'oeuvre. Cette fonction ame`ne une nouvelle question et entrai^ne une conversation esthe´tique sur l'oeuvre. Elle estun changement d'un syste`me critique qui laisse parler l'oeuvre, elle-me^me. De nos fours, la production de l'artiste et la critique ne sont pas se´pare´es, mais la continuation de l'oeuvre. C'est-a`-dire, l'art est quelque chose d'historique qui n'est pas se´parable de la critique. Car, l'art est un phe´nome`ne de re´flexion dans lequel sont implique´es la politique, la socie´te´, l'conomie, la culture, etc... Bref, la faculte´ critique de l'oeuvre est sous tous les aspects la cognition et la productian automatiques. A propos de la troisieme question ; si l'on veut parler clairement, voir, ce n'est pas 1`activite des yeux, mais celle de la faeulte´ cognitive. La signification de l'antiphrase est l'invitation a` voir selon la forme et la fonction de l'oeuvre. Car l'antiphrase est une activite cognitive´ dons le domaine de l'image et dons l'expe´rience artistique et elle est une strate´gic derive´e de la faculte´ cognitive. En me^me temps, l'expression antiphrastique, dons la tactique de l'artiste, de´voile, affirme, de´monte la faculte´ cognitive et s'en moque. Elle est une utilisation artistique madihe´e qui crie dons le contexte culturel.

피질골 절제술을 응용한 견치 및 대구치의 후방 견인

김상철,김선영,김현숙,정혜승,김현태,조진우 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.2

빠르며 정확하고 안전한 치아이동을 목표로 삼고 있는 교정치료에서 최근 새로이 도입된 피질골 절제술과 견인 골형성술을 응용한 치아이동에 대하여 알아보았다. 특히 견치나 대구치의 후방이동은 기존의 치아 이동 양식으로는 조절이 어렵고, 장기적인 기간에 불가피한 치아이동이다. 피질골 절제술과 견인 골형성술을 동반하여 상당히 효과적인 원심이동을 기할 수 있었던 증례를 통하여 적용 술식, 견인 장치 등을 논하고 그효과를 파악하였다. 이런 술식을 통해 빠른 치아 이동과 이에 따른 전반적인 치료기간의 감소가 가능하였으며, 무리한 치아이동에서 발생할 수 있는 고정원 소실이나 치근흡수, 치주조직의 파괴 같은 부작용도 줄일 수 있었다. Tooth movement facilitated by corticotomy and distraction osteogenesis was discussed. In this study, a portion of cortical bone which can provide resistance to tooth movement in alveolar bone was removed. Active bone deposition was then possible in the tension side. Teeth moved at such a speedy rate as we could not imagine from conventional orthodontic treatment, which lead to the reduction of the total treatment period. Posterior movement of the canine or molar teeth was possible without any side effects such as anchorage loss, root resorption or periodontal breakdown.

Bupivacaine과 ropivacaine이 Xenopus oocyte에 발현된 HERG 전류에 미치는 영향

김국성,이규승,김효신,손숙진,이상도,김광진,전병화,김윤희,박진봉 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Bupivacaine is an amide-type local anesthetic widely used for regional anesthesia. Ropivacaine is developed as a less cardiotoxic alternatives to bupivacaine. In the present study, we have analyzed the effects of bupivacaine and ropivacaine on HERG currents expressed in Xenopus oocytes. Bupivacaine and ropivacaine(3∼1,000μM) blocked HERG currents in a concentration dependent manner. EC_(50) was 26.1±3.1μM(n_(R) 0.65±0.04) and 43.5±7.9μM(n_(H) 0.99±0.13) in bupivacaine and ropivacaine, respectively. Bupivacaine and ropivacaine did not affect the activation and deactivation kinetics of HERG channels. However, the drugs decreased the slope conductance measured from fully activated current-voltage relationship curves. These results suggest that bupivacaine and ropivacaine have a similarinhibitory effect on HERG channels, which could be a possible cellular mechanism of LQT or ventricular arrythmia by the drugs.

한국인 여성에서 비타민 D 수용체 유전자 , 에스트로겐 수용체 유전자 및 제 1 형 콜라겐 α1유전자의 다형성과 최대골량의 연관성에 관한 연구

김은숙,김상욱,김기수,김홍규 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.1

Background: Genetic suggest that strongest effect is observed in the premenopausal peak bone mass, which become less with age. However, the evaluation of candidate genes polymorphisms has been most frequently done in postmenopausal women and the results have been controversial. Therefore, we studied the possible association of the peak bone mass and candidate for osteoporosis genes polymorphism in premenopausal women. Methods: The associations between BMD and polymorphisms of the vitamin D receptor (3'-end region by BsmI restriction enzyme and start codon by FokI restriction enzyme), estrogen receptor (by PvuII and XbaI restriction enzyme), and type I collagen al (Spl binding site by MscI and Ball restriction enzyme) genes were examined in 100 healthy young Korean women who had a peak bone mass (age 20 35 years). Bone mineral densities were measured by dual energy X-ray absorptiometry (DEXA). Dietary calcium intake was also measured using a food frequency questionnaire. Results: The frequencies of the B allele of the vitamin D receptor gene BsmI polymorphism and the X allele in the estrogen receptor gene, XbaI polymorphisms were lower in Koreans than those in Caucasians. The allelic frequencies of the vitamin vitamin D receptor gene Fokl polymorphism and the estrogen receptor gene PvuII polymorphism were similar to those of Caucasians. No significant association was found between BMD and the vitamin D receptor genotype according to Bsml or FokI polymorphisms. There was also no significant relation between the PvuII or XbaI polymorphisms of the estrogen receptor gene and BMD. The associations between BMD and cross-genotypes combining the vitamin D receptor gene (BsmI and FokI) and estrogen receptor gene (PvuII and XbaI) polymorphisms were also analyzed. Among the subjects who lacked the Bf haplotype of the vitamin D receptor gene, the BMD of the femoral neck area was significantly higher in subjects lacking Px haplotypes of the estrogen receptor gene than in those having Px haplotype (p $lt; 0.05). When dietary calcium intake was taken into consideration, there were significant differences in BMD according to the cross-genotype in the group having a low calcium intake ($lt; 500 mg/day). The subjects that lacked the Bf and Px haplotypes had a significantly higher BMD in the femoral neck (p $lt; 0.01), Wards triangle (p $lt; 0.0~5), and in the trochanteric area (p $lt; 0.05) than those who lacked Bf but a Px haplo~type. We did not find a polymorphism in the Spl bindi~ng site of the type I ~collagen ~al gene in our subjects. Conclusion: These data suggest that a complex interaction of vitamin D and the estrogen receptor gene with the dietary calcium intake, rather than a polymorphism of a sing~le gene, may influence peak bone mass in healthy young Korean women (J Kor Soc Endocrinol 16:97-114, 2001).