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근막 결손의 복원과 자궁천골인대 고정을 통한 전자궁적출술 후 질탈출의 성공적 교정
문화숙(Hwa Sook Moon),최진국(Jin Koo Choi),김경서(Kyung Seo Kim),박근식(Kyun Sik Park),황지영(Ji Young Hwang),문성은(Sung Eun Moon),한지원(Ji Won Han),김상국(Sang Gook Kim),김상갑(Sang Gap Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7
목적 : 본 연구는 전자궁적출술 후 질탈출을 부위-특이적인 결함의 개념에 입각하여 치골경부 근막과 직장질 격막의 연결을 통한 골반내 근막의 복원과 자궁천골인대 고정술을 이용한 질탈출의 성공적인 수술적 교정의 방법과 결과를 보고하고자 한다. 연구 방법 : 1999년부터 2001년 8월까지 자궁적출술 후 질궁탈출 증상으로 문화병원 산부인과를 내원, 탈출된 질의 근막을 재건시킨 다음, 이를 자궁천골인대에 고정시킴으로써 질의 부위-특이적인 교정술을 받은 3명의 환자를 대상으로 하였다. 3명중 1명은 개복술을 하였고 2명은 내시경 수술을 하였다. 결과 : 환자의 연령 분포는 49-67세였으며, 수술시간은 평균 113분 (105-125)이었다. 세 환자 모두 수술 후 질의 상태가 해부학 및 기능적으로 정상이었으며, 9일째 특이사항 없이 퇴원하였다. 수술 후 HRT를 시행한 1명을 포함한 3명 모두 각각 24개월, 12개월, 7개월간의 추적 검사에서도 특이한 합병증이나 재발 없이 좋은 경과를 보였다. 결론 : 골반 근막 결손의 복원과 자궁천골인대 고정술은 전자궁적출술 후 질탈출의 교정에 매우 안전하고 효과적이며, 기능적인 방법으로 사료되며, 자궁천골인대를 질탈출 교정에 이용한 연구는 본 연구가 국내에서 처음이다. Objective : To report the method and efficacy of the site specific-defects repair in the endopelvic fascia and uterosacral ligament suspension for the correction of posthysterectomy vaginal vault prolapse. Methods : This study was performed in 3 patients with posthyterectomy vaginal vault prolapse who underwent the surgery for the reconstruction of endopelvic fascia and the correction of vault prolapsed vagina by using uterosacral ligament suspension at the department of Obstetrics and Gynecology in Moon-Hwa Hospital. Among them, 1 patient was treated by laparotomy, and 2 patients were treated by laparoscope. Results : The age of patients ranged from 49 to 67 years. The mean operation time was 111 minutes (105-120 minutes). The status of postoperative vagina was normal in all 3 patients, who were discharged 9 days after operation without symptoms. No complication or recurrence were found in them despite long-term follow-up for 24 months, 12 months, 7 months, respectively after operation. One patient has been treated with HRT therapy. Conclusion : The reconstruction of the defect of endopelvic fascia and uterosacral ligament fixation may be very safe, effective, and functional in the correction of vaginal vault prolapse. This study reports the treatment of vaginal vault prolapse using uterosacral ligament within Korea for the first time.
Effects of fibrin glue on bone formation in combination with deproteinized bone xenografts in humans
Moon-Su Kim,Su-Gwan Kim,Sung-Chul Lim,Hak-Kyun Kim,Seong-Young Moon 대한구강악안면외과학회 2008 대한구강악안면외과학회지 Vol.34 No.1
Thirty-six sinus grafts were performed in 34 patients with an alveolar crest bone height in the posterior maxilla of 3 to 5 mm before grafting. The sinuses were grafted using Bio-Oss alone or mixed with fibrin glue. Group 1 was the control group and included 25 patients who received a xenograft mixed in saline. Group 2 comprised 9 patients who received a xenograft and fibrin glue. The study was further subdivided at the time of 9 months. This histologic study evaluated by hematoxylin-eosin (H&E) and histomorphometric analysis whether fibrin glue in combination with Bio-Oss enhances bone regeneration in sinus floor elevation in humans. The new bone formation was better in Group 2 than in Group 1, but the difference was not significant. The absorption of the graft material was faster in Group 2 than in Group 1, in the short term, but better in Group 1 over the long term, although the difference was not significant. Lamellar bone was formed earlier in Group 1 compared to Group 2, but the difference was not significant. Overall, the surgery site stabilized earlier with new bone formation in Group 2 than in Group 1, but the difference was not significant. Combining a fibrin sealant and Bio-Oss could lead to improved scaffolds for bone tissue engineering based on the synergistic effects of the biomaterials. Therefore, Bio-Oss or Bio-Oss plus Tisseel may be used depending on the situation.
Sang Kyun Sohn,Joon Ho Moon,Yoo Jin Lee,Sung Woo Park,Ji Yoon Kim 대한혈액학회 2016 Blood Research Vol.51 No.1
BackgroundMost hypomethylating agent (HMA) responders with myelodysplastic syndrome (MDS) eventually need allogeneic stem cell transplantation (SCT) because they often acquire re-sistance to HMAs within two years of treatment. Considering the nature of MDS and the poor outcomes of SCT when performed after confirming the progression of MDS to acute myeloid leukemia (AML), allogeneic SCT should be performed with caution in patients with low-risk MDS.MethodsTo address low-risk MDS, the Korean AML/MDS working party group designed a survey for 34 MDS experts in Korea on therapeutic HMA and allogeneic SCT policies for low-risk MDS. The level of consensus was defined as the percentage of agreement among the experts.ResultsWith regard to the optimal time for allogeneic SCT for HMA responders with MDS-RA, 76% experts agreed that allogeneic SCT should be performed when a patient has a low platelet count. With regard to the relapse pattern that was most commonly found during HMA treatment in responding patients with MDS-RA, 54% experts agreed that the most common pattern that indicated HMA failure was the gradual worsening of cytopenia. ConclusionThe optimal time to perform allogeneic SCT in RA patients who achieved hematologic complete remission during HMA treatment is when the platelet count decreases. However, these suggestions need to be evaluated in larger future studies. Therefore, care-ful decisions should be taken at each step of allogeneic SCT to maximize the outcomes for patients with MDS-RA and iron overload.
The Effects of Passive Static Posterior Compression on the Spine of Growing Dogs
Moon, Myung-Sang,Woo, Young-Kyun,Ha, Kee-Yong,Lee, Young-Soo CATHOLIC MEDICAL CENTER 1988 Bulletin of the Clinical Research Institute Vol.16/17 No.1
Spinal instrumentation such as Harrington or Luque rod has been recommended frequently for surgical correction of the various deformities and maintenance of the correction. Authors tried to find out the effect of passive posterior static compression with hooked rods on growing spine of dogs. The results were as follows: 1. Radiologically the immobilized bony vertebrae grew less than the mobilized vertebrae above and below. 2. Narrowing of the intervertebral disc space in the immobilized segments occurred in all dogs. 3. The A-P diameter of the spinal canal in the immobilized segments increased up to 14% in comparsion with the mobilized vertebrae above and below. 4. Narrowing of the facet joint space and degenerative changes of the facet joint developed gradually after passive compressive immobilization. 5. From 16 weeks onward, microscopically the growth plate cartilage of compressed vertebrae developed degeneration. These areas were sharply demarcated from the remaining normal growth plate cartilage layer. 6. The direction of horizontally arranged fibers of annulus fibrosus began to distort and all the fibers of the annulus were vertically arranged completely at the end. 7. The vertebral end-plate cartilage gradually became thinner and lastly there were profoundly degenerative changes in the cartilage.
Case Reports : Two Cases of Giant Epidermal Cyst Occurring in the Neck
( Sang Gue Kang ),( Chul Han Kim ),( Hong Ki Cho ),( Mi Youn Park ),( Yoon Jin Lee ),( Moon Kyun Cho ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.1S
Epidermal cysts are the most common cysts of the skin. A conventional epidermal cyst rarely reaches a size of more than 5 cm in diameter. We report on two cases of giant epidermal cyst occurring in the neck. One patient had a cyst measuring 12×9×9 cm and the other patient had a non-pulsatile, dome-shaped lesion in the neck, which measured 6×5×3 cm. The lesions were totally excised. Histopathologically, both were confirmed as giant epidermal cysts. (Ann Dermatol 23(S1) S135~S138, 2011)
Clinical Significance of Autoantibody Expression in Allogeneic Stem-Cell Recipients
Moon, Joon-Ho,Lee, Soo-Jung,Kim, Jong-Gwang,Chae, Yee-Soo,Kim, Shi-Nae,Kang, Byung-Woog,Suh, Jang-Soo,Lee, Kun-Soo,Sohn, Sang-Kyun Lippincott Williams Wilkins, Inc. 2009 Transplantation Vol.88 No.2
BACKGROUND.: The occurrence of autoantibodies has been reported in allogeneic stem-cell recipients, but the association of this occurrence with chronic graft-versus-host disease (cGVHD) or survival remains uncertain. METHODS.: A total of 121 consecutive patients who underwent allogeneic stem-cell transplantation from November 2001 to March 2008 and survived at least 3 months after transplantation were included in this study. RESULTS.: Forty-seven patients (38.8%) expressed at least one of various autoantibodies after transplantation. Antinuclear antibody was positive in 22 patients (18.2%), antidouble stranded DNA in seven (5.8%), antismooth muscle antibody in six (5%), rheumatoid factor in 17 (14.0%), and a positive Coombs test recorded for 12 patients (9.9%). cGVHD was more commonly diagnosed in the patients with autoantibody expression (61.7% vs. 43.2%, P=0.048). The patients expressing autoantibodies had a better 5-year overall survival than those without any autoantibody expression: 70.2% and 47.9% for the autoantibody-positive and autoantibody-negative patients, respectively (P=0.002). The cumulative incidence of relapse was 21.5% and 39.3% for the autoantibody-positive and autoantibody-negative patients, respectively (P=0.023). In particular, the patients expressing autoantibodies without cGVHD had a better overall survival (100%) than the patients in the other groups: 63.1% for the autoantibody- and cGVHD-positive patients, 59.6% for the autoantibody-negative and cGVHD-positive patients, and 36.6% for the autoantibody- and cGVHD-negative patients. The multivariate analysis identified autoantibody expression as a good prognostic factor regarding survival (hazard ratio=0.378, 95% confidence interval=0.185–0.775, P=0.008). CONCLUSION.: The occurrence of autoantibodies after allogeneic stem-cell transplantation was found to be related to cGVHD, and patients expressing autoantibodies had a better survival.
Moon, Joon Ho,Kim, Jong Gwang,Sohn, Sang Kyun,Baek, Jin Ho,Cho, Yoon Young,Chae, Yee Soo,Ahn, Byung Min,Kim, Shi Nae,Lee, Soo Jung,Lee, In Taek,Choi, Gyu Seog,Jun, Soo Han KOREAN ACADEMY OF MEDICAL SCIENCE 2007 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.22 No.3
<P>The objectives of the present study were to evaluate the efficacy and safety of an outpatient-basis chemotherapy of oxaliplatin, 5-fluorouracil, and leucovorin as the first-line treatment for patients with advanced colorectal cancer. Forty-three histologically confirmed patients with metastatic or recurrent colorectal cancer were enrolled. The chemotherapy consisted of oxaliplatin 85 mg/m<SUP>2</SUP> as a 2-hr infusion on day 1, plus leucovorin 30 mg/m<SUP>2</SUP> over 10 min, followed by bolus 5-fluorouracil 400 mg/m<SUP>2</SUP> and an 8-hr infusion of 5-fluorouracil 600 mg/m<SUP>2</SUP> on days 1 and 2 (modified FOLFOX4), all of which were administered on an outpatient basis every 2 weeks. The median age was 58 yr (range 33-72 yr), and 25 (58.1%) patients had metastatic diseases. Eventually, 39 patients were assessable for efficacy and all assessable for toxicity. Four (9.3%) complete responses and 11 (25.6%) partial responses were confirmed, giving an overall response rate of 34.9% (95% CI; 20.0-49.7%). The median time to progression and median overall survival for all patients was 6.1 months and 17.4 months, respectively. Grade 3/4 neutropenia occurred in 2 patients (4.7%) and febrile neutropenia was observed in 1 patient (2.3%). Modified FOLFOX4, an outpatient-basis regimen, was found to be well-tolerated and effective as the first-line chemotherapy in patients with advanced colorectal cancer.</P>