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.

Brucella abortus 국내 분리주의 36kDa 외막단백을 암호하는 omp2b 유전자의 염기 분석

허지연,김지영,송근호,김명철,박창식,김태용,김정화,전무형 한국수의공중보건학회 2003 예방수의학회지 Vol.27 No.1

B. abortus 국내 분리주의 분자유전학적 성상을 규명하고 분자역학적 연구에 필요한 기초자료를 얻기위해 36kDa OMP를 암호하는 omp2b 유전자를 PCR법으로 확인하고, 그리고 omp2b 유전자의 핵염기 서열과 아미노산 서열을 결정하고 이 결과를 Brucella 표준균주 및 여러 동물에서 분리된 Brucella 분리주와 상호 비교 분석하였던 바 다음과 같은 결과를 얻었다 1. B. abortus 분리주 (7주)에 대해 omp2b primers를 이용하여 PCR을 수행 한 바 공시한 참조균주와 분리균주 모두에서 1,251bp의 특이한 DNA 절편이 각각 증폭되었다 2. omp2b 유전자의 1,089bp에 대한 염기서열과 이에 대한 362개의 아미노산 서열을 결정하였다. 분리균주의 omp2b 유전자의 염기서열을 참조균주와 비교 분석한 결과 B. abortus 2308 (biovar 1) 및 B. abortus B3196 (biovar 5)과는 99.6%~l00% 및99.5%~99.9%의 매우 높은 상품성을 나타내었고, B. abortus 45/20 (biovar 1)과는 97.1%~97.4%의 상품성을 나타내었다. 또한 362개의 아미노산 서열에 대해 분석하였던 바, 분리균주들은 B. abortustus 2308 (biovar 1) 및 B. abortus B3196 (biovar 5)과는 99.2%~l00%의 매우 높은 상품성을 보였으며, B. abortus 45/20 (biovar 1)과는 96.4%~97.2%의 상품성을 보였다. 3. 본 시험에 공시된 브루셀라균주의 omp2b 유전자서열과 여러 동물에서 분리된 브루셀라 분리주의자료를 바탕으로 phylogenetic tree를 작성 한 바, 국내 분리주는 B. abortus 2308 (biovar 1), B. abortus B3196 (blovar 5), B. abortus 45/20 (biovar 1), B. suis 1330 (biovar 1), B. melitensis 16M (biovar 1), B. canis NCTC 01854, B. neotomae 5k33과 97.3%이상의 높은 근연성을 보이며 동일한 cluster에 소속되었으며, omp2b 유전자는 매우 잘 보존됨을 알 수 있었다. omp2b gene of Brucella abortus isolates encoding 36kDa outer membrane protein (OW) was amplified by polymerase chain reaction (PCR) and the sequences of nucleotide and amino acid were determined and analyzed to obtain the basic data for molecular epidemiological features of brucellosis in Korea. In PCR using omp2b primers for the gene of 36kDa OMP, the specific signals at 1,251bp were demonstrated, The nucleotide sequences of omp2b gene of 1,089bp were sequenced by dye terminator cycle sequencing method, and 362 amino acid sequences were predicted. As compared the nucleotide sequences with those of B. abortus reference strains, the isolates showed the very high homology to the reference strains ranging 97.1%-100%. The similar results were also obtained in the analysis of the amino acid sequences. In the phylogenetic tree, the isolates clustered with the reference strains and the majority of strains originated from pig, dog, wood rat and cattle.

Brucella abortus 국내 분리주의 36kDa 외막단백을 암호하는 omp2b 유전자의 염기 분석

허지연,김지영,송근호,김명철,박창식,김태용,김정화,전무형 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

B. abortus 국내 분리주의 분자유전학적 성상을 규명하고 분자역학적 연구에 필요한 기초자료를 얻기 위해 36kDa OMP를 암호하는 omp2b 유전자를 PCR법으로 확인하고,그리고 omp2b 유전자의 핵염기 서열과 아미노산 서열을 결정하고 이 결과를 Brucella 표준균주 및 여러 동물에서 분리된 Brucella 분리주와 상호 비교 분석하였던 바 다음과 같은 결과를 얻었다. 1. B. abortus 분리 주 (7주)에 대해 omp2b primers를 이용하여 PCR을 수행한 바 공시한 참조균주와 분 리균주 모두에서 1,251bp의 특이한 DNA 절편이 각각 증폭되었다. 2. omp2b 유전자의 1,089bp에 대한 염기서열과 이에 대한 362개의 아미노산 서열을 결정하였다. 분리 균주의 omp2b 유전자의 염기서열을 참조균주와 비교 분석한 결과 B. abortus 2308 (biovar 1) 및 B abortus B3196 (biovar 5)과는 99.6%∼100% 및 99.5%∼99.9%의 매우 높은 상동성을 나타내었고,B. abortus 45/20 (biovar 1)과는 97.1%~97.4%의 상동성을 나타내었다. 또한 362개의 아미노산 서열에 대해 분석하였던 바,분리균주들은 B.abortustus 2308 (biovar 1) 및 B. abortus B3196 (biovar 5)과는 99.2%∼100%의 매우 높은 상동성을 보였으며,B. abortus 45/20 (biovar 1)과는 96.4%∼ 97.2%의 상동성을 보였다. 3. 본 시험에 공사된 브루셈라균주의 omp2b 유전자 서열과 여러 동물에서 분리된 브루셀라 분리주의 자료를 바탕으로 phylogenetic tree를 작성 한 바,국내 분리주는 B. abortus 2308 (biovar 1),B. abortus B3196 (biovar 5),B. abortus 45/20 (biovar 1),B. suis 1330 (biovar 1),B. melitensis 16M (biovar 1),B. canis NCTC 01854,B. neotomae 5K33과 97.3% 이상의 높은 근연성을 보이며 동일한 cluster에 소속되었으며,omp2b 유전자는 매우 잘 보존됨을 알 수 있었다. omp2b gene of Brucella abortus isolates encoding 36kDa outer membrane protein (OMP) was amplified by polymerase chain reaction (PCR) and the sequences of nucleotide and amino acid were determined and analyzed to obtain the basic data for molecular epidemiological features of brucellosis in Korea. In PCR using omp2b primers for the gene of 36kDa aMP, the specific signals at 1,251bp were demonstrated, The nucleotide sequences of omp2b gene of 1,089bp were sequenced by dye terminator cycle sequencing method, and 362 amino acid sequences were predicted. As compared the nucleotide sequences with those of B. abortus reference strains, the isolates showed the very high homology to the reference strains ranging 97.1%∼100%. The similar results were also obtained in the analysis of the amino acid sequences. In the phylogenetic tree, the isolates clustered with the reference strains and the majority of strains originated from pig, dog, wood rat and cattle.

급성 심근경색 : Gd-DTPA 조영증강 자기공명영상 Gd-DTPA Enhanced Magnetic Resonance Imaging

정경일,김제현,이창호,이영주,김한수,소동문,이영돈,박경주,왕희정,탁승제,이철주,김선용,김옥화,임태환,문창현,최병일,서정호 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

This study was undertaken to determine the value of gadolinium dimeglumine (Gd-DTPA) enhanced MRI in the diagnosis of acute myocardial infarction. Seven cats were subjected to 2 hours of left anterior descending coronary arteryocclusion (group 1) and 8 cats to 1 hour of occlusion (group 2). Reperfusion was followed by taking Tl-weighted MR images at 5, 15, 30, 45, 60 minutes after Gd-DTPA (0.2 mmol/kg) injection. Myocardial enhancement patterns were categorized into three zones (central ischemic, peripheral ischemic, and normal) or two zones (ischemic and normal) and the presence of injured myocardium in each zone was confirmed by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Signal intensity (SI) of each zone was evaluated relative to back muscle in regard to its chronological changes and difference among the zones. Group 1 displayed three zones of enhancement in 6 cats whereas 1 cat in group 1 and all in group 2 showed two zones of enhancement. Intermediate SI central zone was compatible but smaller than TTC nonstained area, and determined to be a persistently occlusive injury. High SI peripheral zone in group 1 and high SI ischemic zone in group 2 were stained and determined as reperfused injury although reversibility was not definite. The peak SI, occurring 15 minutes after Gd-DTPA injection, of 2.47±0.48 at peripheral zone was greater than that of 1.66±0.36 at central zone in group 1 and of 1.81±0.41 at ischemic zone in group 2 (p < 0.05). SI of injured myocardium increased more rapidly and decreased more gradually than that of normal myocardium. That the features of SI change with time in injured myocardium was compatible with the results of other studies using different contrast agents. Gd-DTPA enhanced MRI differentiated persistently occlusive injury as central intermediate SI, and reperfused injury as homogenous high SI, with the maximal contrast between the two at 15 minutes after contrast injection, thus indicating the value of Gd-DTPA enhanced MRI in the diagnosis of acute myocardial infarction.

우리나라 사람면역결핍바이러스(Human Immunodeficiency Virus) 감염환자에서 발병한 악성종양

최평균,송진수,조재현,김성한,박경화,방지환,박완범,김홍빈,김동완,김태유,허대석,오명돈,김남중,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : Since highly active antiretroviral therapy has lengthened the life span of individuals infected with human immunodeficiency virus (HIV), the importance of malignancy associated with HIV has been increased. The relative frequencies of malignancies in HIV infected patients may vary in different race and region. The aim of this study is to determine the prevalence and characteristics of malignancies in patients with HIV infection in South Korea. Materials and Methods : To identify HIV patients with malignancy, we reviewed the electronic database of pathological reports for all HIV-infected patients seen from January 1986 to December 2005 at the Seoul National University Hospital. We retrospectively reviewed the medical records of them. Results : Among 850 patients infected with HIV, 33 episodes of malignant diseases were diagnosed in 32 patients (3.76%). Thirty were males, and median age was 46 years (range 29-70). At the time of the diagnosis of malignancy, median CD4^(+) lymphocytes count was 100/uL (range 5-620) and in 27 (82%) patients, CD4^(+) lymphocytes count were less than 200/uL. For 13 patients (40%), malignancy was initial presentation of HIV infection. Excluding patients initially diagnosed as malignancy, median follow-up duration from the first visit to diagnosis of malignancy was 36 months (range 3-96). Non-Hodgkin's lymphoma was the most frequent malignancy (13 patients), followed by Kaposi's sarcoma (7), Hodgkin‘s disease (3), acute myeloid leukemia (1), and other solid cancer (9) including one case of anal cancer associated with human papillomavirus. Among 13 patients with non- Hodgkin's lymphoma, 4(31%) achieved the complete remission after chemotherapy and/or radiation therapy, and had been followed without evidence of recurrence. Conclusion : Malignancy was diagnosed in 3.76% of patients infected with HIV. Non-Hodgkin‘s lymphoma is the most prevalent malignancy in HIV patients in South Korea. 목적 : 효과적인 항레트로바이러스 다제요법이 도입됨에 따라, HIV 감염환자들의 수명이 증가되었고, 이에 따라 HIV 감염환자에서 악성종양의 중요성 또한 증가하고 있다. 본 연구의 목적은 우리나라 HIV 감염환자에서 악성종양의 유병률과 호발하는 악성종양의 특성을 밝히는 것이다. 재료 및 방법 : 1986년부터 2005년까지 서울대학교병원에서 치료를 받은 HIV 감염환자의 의무기록을 후향적으로 분석하였고, 병리학적 검사 결과를 검토하여 악성종양이 진단된 환자들을 대상으로 연구를 시행하였다. 결과 : 총 850명의 환자 중, 32명(3.76%)에서 33예의 악성종양이 진단되어, 악성종양의 발병률은 1,000인년 당13.0명(95% 신뢰구간: 8.6∼17.4명)이었다. 그 중 남자는 30명이었고, 악성종양 진단 당시 연령의 중간값은 46 (29-70)세이었다. 악성종양 진단받을 당시, CD4 림프구 수의 중간값은 lOO/uL (5-620 uL) 이었고, CD4 림프구수가 200/ uL 미만인 환자가 27명(82%)이었다. 악성종양에 대한 검사 도중에 HIV 감염사실이 밝혀진 환자가 13명(40%)이었다. HIV를 진단 받은 후 악성종양이 발병한 환자들에서, HIV 진단 후 악성종양의 발병까지는 평균 36개월(3-96개월)이 걸렸다. 13명의 HIV 감염 환자에서 진단된 비호지킨림프종이 가장 흔한 악성종양이었고, 이외에 카포시육종이 7명, 호지킨병이 3명, HPV와 연관된 항문암이 1명의 HIV 환자에서 진단되었다. 그 밖에 급성백혈병, 방광암, 췌장장, 폐암, 진행성위암, 갑상선암, 간세포암, 후두암이 각각 1예씩 진단되었다. 비호지킨림프종이 진단된13명 환자 중, 4명(31%)은 항암치료 및 방사선치료를 받아 완전관해가 되었고, 현재 재발의 증거 없이 외래에서 경과 관찰 중이다. 결론 : 우리나라 HIV 감염환자에서 악성종양의 유병률은 3.76%이었고, 비호지킨림프종이 가장 흔한 악성종양이었다.

腦死者 臟器移植에 관한 法律上의 問題點

김태홍,김경화 동의공업대학 1998 論文集 Vol.24 No.1

The brain-death theory is the most debating point before and after legislation so called「Organ Transplantation Law」. The thesis emphasized positive aspects of the brain-death theory that Organ Transplantation Law theoretically based on. Brain-death theory also have some defacts bringing on trends of belittlement of human life and incorrect judgement of brain-death. The purposes of this study are giving logic basis to establish legal system preventing will-be problems and making how to control all about transplantation procedure within moral consensus. Even though 「Organ Transplantation Law」 permits the brain-death, it should be allowed under strict limitation. 「Human dignity first, all others after」. The organization that will control transplantation procedure ought to be formed objectively, fairly and closely. There is no need to hurry to make something extra. Only well-organized system guarantees rooting out illegal organ transplantation and fair and reasonable organ-transplantation procedure.

기능성척추측만증에 근막이완요법 및 전침치료 증례

김성욱,강영화,이상훈,권혜연,조태성,송춘호,안창범 동의대학교 한의학연구소 2001 동의한의연구 Vol.5 No.-

목적 : 우리는 신체를 근막의 통합된 전체로 보는 근막이완요법과 TrP를 파괴하는 전침요법을 기능성 척추측만증에 적용시킬수 있는지 알아보았다. 방법 : 22세의 기능성 척추측만증을 가진 남성에게 다양한 형태의 근막이완요법을 적용하였고, 중둔근, 요방형근, 슬괵근에 전침요법을 적용하였다. 결과 : 3주시술후 다리길이차이, 근막구축, Cobb's 각과 척추회전변위가 감소되었고 흉부압박감 같은 전신적증상이 호전되었다. 결론 : 근막이완요법과 전침병행치료가 신체를 근막의 일체로 보는 관점으로 인체의 구조적불균형을 바로 잡아줄수 있는 새로운 치료법의 기능성을 찾았다. Objective: We investigated this study in order to see the adaptation capability of myofascial release that translating the body being integrated fascial totality and electroacupuncture treatment that breaking trigger points in functional scoliosis. Methods: We applied myofascial relase by three patterns and electroacupuncture in TrPs of gluteus medius, Quadratus lumborum and Hamstring muscle to 22 year-old who have had functional scoliosis. Results: After 3 weeks, The leg length, fascial restriction. Cobb's angle and rotation scoliosis are decreased. Systemic symptoms, for example; chest discomfort are improved. conclusion: Myofascial release and electroacupuncture treatment is new methods that treating the sturctural unbalance in view of body's fascial network.

乳牛에서 驅蟲效果가 泌乳量과 乳脂率에 미치는 效果에 관한 觀察

金泰鍾,李元暢,尹和重,金世寧 건국대학교 1995 學術誌 Vol.39 No.2

The purpose of this study was make an observation on effects of anthelmintics such as Albendazole, Ivomec-F and Nilzan for amount of milk production and milk fat levels before and after administration on Nematoda, Trematoda and Cestoda in helminths infestated from 218 heads of dairy cattle in Gyongi province. The results are summerizied as follows : Infestation and distribution rate in percent of helminths among the collected fecal samples from dairy cattle are Bunostomum species(spp.) 1.3%, Strongyloides spp. 4.5%, Tricostrongylus spp. 0.8%, Ostertagia spp. 7.3%, Cooperia spp. 4.7%, Nematodrius spp. 1.6%, Haemonchus spp. 5.7% and Oesphagostumum spp. 6.5% in Nematoda, and that of Eurytrema app. 2.1%, Fascioloa spp. 11.8% and Pharamphistomum spp. 51.3% in Trematoda, and that of Moniezia spp. in Cestoda, respectively. After administration for three kinds of anthelminthics infestated dairy cattle, high level of efficacy were confirmed against Nematodes and Cestodes. The average values tend to be incresed amount of milk production and its fat levels after anthelmintics administration on helminths infestated dairy cattle were 1.8 kg and 0.14 % per daily, respectively (p<0.01). Key word : Infestation of helminths in dairy cattle, Effects of milk products.

여성 청각 ·언어장애인의 취업욕구에 관한 조사 연구 : 부산 ·경남지역을 중심으로

김기태,박병현,서화정 釜山大學校 社會福祉硏究所 1999 社會福祉硏究 Vol.9 No.-

醫療行爲와 刑法上의 問題點

김태홍,김경화 동의공업대학 2000 論文集 Vol.26 No.1

One difficulty in dealing with the concept of medical treatment in criminal law is to reconcile some of the dictates of the Criminal Code, which have ancient origins. with the reality of modern medicine. Such a situation arises when we ask whether a surgical operation is prima facie legal or illegal. This may be considered a rather narrow and esoteric question, but it has and will become increasingly important with the development of modern medical technology. The initial presumption of legality or illegality may determine the final characterization of a given medical intervention as lawful or unlawful. This is particularly important in such areas as non-therapeutic human medical research and live-donor organ transplantation. Medical malpractice is just ordinary negligence by a healthcare provider which causes injury. It is no different in theory than negligence by a motorist who does not pay attention to and runs a red light causing an injury. Some people incorrectly believe that "malpractice" connotes conduct that is worse or more serious than simple "negligence", but that is not normally the case.