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RISS 인기검색어
- 검색키워드
- 저자 : Seung-Hyuk Shim (검색결과 108 건)
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( Seung Hyuk Shim ),( Shin Wha Lee ),( Jeong Yeol Park ),( Jong Hyeok Kim ),( Yong Man Kim ),( Young Tak Kim ),( Joo Hyun Nam ),( Dae Yeon Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
The aim of this study was to compare the surgical outcomes between single-port versus three-port laparoscopic myomectomy. This was a retrospective matched cohort study. We included patients who underwent single-port or three-port laparoscopic myomectomy between 2009 and 2011. We matched all cases of single-port laparoscopic myomectomy (SLM) 1:2 with three-port laparoscopic myomectomy (TLM) based on age, body mass index, diameter of largest myoma, and number of removed myoma. Clinicopathologic data of these patients were reviewed by medical records. During study period, 20 cases of SLM were performed. There were no statistically significant differences between the SLM and TLM groups in age, body mass index, diameter of largest myoma, and number of removed myoma. Mean age was 33.6±7.9 years versus 34.1±8.1 years, mean body mass index was 22.6±3.9 kg/m2 versus 22.9±4.3 kg/m2, and mean myoma diameter was 6.54±2.1 cm versus 7.08±2.49 cm, respectively. There were no differences in operating time (101.1±29.1 min vs. 105.8±25.3 min, p=0.545), estimated blood loss (202.8±161.3 mL vs. 195.2±161.3 mL, p=0.865), postoperative drop of hemoglobin level (2.1±1.6 mg/dL vs. 2.0±1.4 mg/dL, p=0.614), and transfusion requirement (5.56% vs. 6% p=0.596). However, single-port group had significantly shorter postoperative hospital stay (2.11±0.32 vs. 2.48±0.68, p<0.05), lower postoperative pain scores at POD 0 (3.9±0.9 vs. 4.5±0.9, p<0.05) and less postoperative opioids requirement (24.8% vs. 50.0%, p<0.05). Operation related complications occurred in 1 (5%) and 2 (4%) patients of single-port and three-port laparoscopic myomectomy group, respectively (p=0.371). This is the first matched cohort study to compare the surgical outcomes between single-port versus three-port laparoscopic myomectomy. Single-port laparoscopic myomectomy appeared to be as feasible and safe as three-port laparoscopic myomectomy. It was more minimally invasive surgery with more favorable operative outcomes in terms of postoperative pain, analgesics requirement and cosmetic outcome.
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( Seung-hyuk Shim ),( Dae-yeon Kim ),( Young Hee Hong ),( Sun Joo Lee ),( Soo-nyung Kim ),( Soon-beom Kang ),( Shin-wha Lee ),( Jeong-yeol Park ),( Dae-shik Suh ),( Jong-hyeok Kim ),( Yong-man Kim ),( 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
목적: Concurrent chemoradiotherapy is usually administered to patients with locally advanced cervical cancer (LACC). Extended-field chemoradiotherapy is required if para-aortic lymph node (PALN) metastasis is detected. This study aimed to construct a prediction model for PALN metastasis in patients with LACC before definitive treatment. 방법: Between 2009 and 2015, all consecutive patients with LACC who underwent para-aortic lymphadenectomy at two tertiary centers were retrospectively analyzed. A multivariate logistic model was constructed, from which a prediction model for PALN metastasis was developed and internally validated. Before analysis, risk grouping was predefined based on the likelihood ratio. 결과: In total, 245 patients satisfied the eligibility criteria. Thirty-four patients (13.9%) had pathologically proven PALN metastases. Additionally, 16/222 (7.2%) patients with negative PALNs on positron emission tomography/computed tomography (PET/CT) had PALN metastasis. Moreover, 11/105 (10.5%) patients with both negative PALNs and positive pelvic lymph nodes on PET/CT had PALN metastasis. Tumor size on magnetic resonance imaging and PALN status on PET/CT were independent predictors of PALN metastasis. The model incorporating these two predictors displayed good discrimination and calibration (bootstrap-corrected concordance index = 0.886; 95% confidence interval = 0.825-0.947). The model categorized 169 (69%), 52 (22%), and 23 (9%) patients into low-, intermediate-, and high-risk groups, respectively. The predicted probabilities of PALN metastasis for these groups were 2.9, 20.8, and 76.2%, respectively. 결론: We constructed a robust model predicting PALN metastasis in patients with LACC that may improve clinical trial design and help clinicians determine whether para-aortic lymphadenectomy should be performed.
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( Seung-hyuk Shim ),( Soo-nyung Kim ),( Young Hee Hong ),( Jung Eun Kim ),( Sun Joo Lee ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
목적: To quantify the effect of adjuvant hysterectomy (AH) on prognosis in locally advanced cervical cancer (LACC) patients treated with definitive chemoradiation through a meta- analysis. 방법: We systematically reviewed published studies comparing AH with no AH in LACC patients through April 2016. Endpoints were recurrence and mortality rates. Study design features that possibly affected participant selection, recurrence/death detection, and manuscript publication were assessed. For pooled estimates of the effect of AH on recurrence/death, random- or fixed-effects meta-analytical models were used after assessing cross-study heterogeneity. 결과: Two randomized trials and six observational studies (AH, 630 patients; no AH, 585 patients) met our search criteria. Fixed-effects model-based meta-analysis indicated a reduced recurrence risk among AH patients (odds ratio [OR]=0.64; 95% confidence interval [CI]: 0.47-0.87, p<0.05, I2=25.6), whereas its efficacy was not shown in two randomized controlled trials (hazard ratio, 1.05; 95% confidence interval, 0.84-1.31). Furthermore, no significant between-group difference in mortality was observed (OR=0.98; 95% CI: 0.42-2.29, p=0.97, I2=0). This pattern was observed in the subgroup analysis for stage, type of hysterectomy undergone, type of radiotherapy, chemotherapeutic regimen, and residual disease after CCRT. There was no evidence of publication bias. 결론: In this meta-analysis mainly based on observational studies, AH appeared to significantly reduce recurrence among LACC patients after CCRT. No survival impact was observed. Future research should verify this relationship through randomized controlled trials with large-sample size over a longer term.
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( Seung Hyuk Shim ),( Dong Yun Lee ),( Shin Wha Lee ),( Jeong Yeol Park ),( Jong Jin Lee ),( Jong Hyeok Kim ),( Yong Man Kim ),( Young Tak Kim ),( Joo Hyun Nam ),( Dae Yeon Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are functional tumor parameters which determine the metabolic activity of tumors with increased 18 fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography/computed tomography(PET/CT). The goal of this study was to evaluate whether these parameters have prognostic value in patients with endometrial cancer. Between 2004 and 2009, 84 patients with endometrial cancer who had undergone preoperative 18F-FDG PET/CT were included in this study. We measured the SUVmax, SUVavg, MTV, and TLG of the primary tumor. Patients` clinicopathologic characteristics and follow-up information were collected from hospital charts and clinic records retrospectively. Cox proportional hazards analysis and Kaplan-Meier method were used to identify the predictors for recurrence. Receiver operating curve (ROC) analysis was used to determine the cutoff value of continuous variables for predicting recurrence. The median age was 51 (range 24-76) years. The median follow-up period was 49 (range 3-85) months. International Federation of Gynecology and Obstetrics (FIGO) stage included: I (58), II (11), III (13), and IV (2). Histology included: endometrioid (63), papillary serous (10), carcinosarcoma (9), clear cell (1), and adenocarcinoma (1). There were 12 cases of recurrence and 9 cases of disease-specific death. The median progression free survival (PFS) duration was 48 (1-85) months. In univariate analysis, factors predicting for recurrence were myometrial invasion (p=0.012), lymphovascular space invasion (p=0.029), lymph node metastasis (p<0.001), non-endometrioid histology (p=0.002), advanced FIGO stage (p<0.001), MTV (p=0.001), and TLG (p=0.052) while SUVmax and SUVavg were not. However, multivariate analysis showed that only lymph node metastasis (p=0.001 , hazard ratio [HR] 9.286, 95% confidence interval [CI] 2.614-32.986), and MTV (p=0.009 , HR 1.007, 95% CI 1.002-1.013) remained as independent risk factors for recurrence. The area under the ROC plot for discriminating recurrence of MTV using the cutoff value of 17.15 was 0.679. The Kaplan-Meier survival graph showed that patients with a high MTV (≥17.15) had a significantly lower PFS rate than those with a low MTV (<17.15; p=0.034, log-rank test). MTV measured by preoperative 18F-FDG PET/CT was a significant independent prognostic factor predicting for recurrence in patients with endometrial cancer. This functional tumor parameter may be considered to plan further treatment and follow-up after operation.
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최승혁(Seung Hyuk Choi),심원흠(Won Heum Shim),윤영섭(Young Sup Yoon),편욱범(Wook Bum Pyun),최동훈(Dong Hoon Choi),장양수(Yang Soo Jang),김동익(Dong Ik Kim),장병철(Byung Chul Chang),조승연(Seung Yun Cho) 대한내과학회 2000 대한내과학회지 Vol.59 No.1
Background : The goal of percutaneous transluminal angioplasty(PTA) is recanalization of the arterial stenosis or occlusion. The low incidence of serious complications makes PTA an attractive form of treatment for selected patients, especially if the lesions are not severe enough to warrant surgery or the patient is at high operative risk. The purpose of this study was to assess the feasibility, safety, and efficacy of PTA as an alternative or primary therapy for whole body arterial occlusive disease. Methods : PTA was performed in 397 patients(male 342, female 55 : mean age 58.9±12.4 yr) with arterial occlusive disease. The patients were followed after PTA for a mean period of 22±11months. The information on restenosis, recurrence of symptom, redo-PTA, bypass surgery and amputation was obtained by follow-up angiography, plethysmography and self-administered questionnaire. Results : In the 313 patients who underwent PTA for low extremity vascular disease, the overall success rate was 80.6%. Technical success rate for the iliac lesions was 84.7%, for the femoropopliteal lesions 74.8%, and for the infrapopliteal lesions 78.6% respectively. These results showed that outcome for iliac lesions were significantly better than those for femoropopliteal lesions(p<0.001). The technical success rate for the low extremity vessels was greater in the stenting group than in the ballooning group(98.2% vs 68.9%, p<0.001). In 260 lesions followed after PTA for low extremity vascular disease, cumulative patency rate at 3 years was greater in the iliac artery group than in the femoropopliteal artery group(84.6% vs 50.8%, p<0.001). In femoropopliteal lesions, cumulative patency rate at 3 year was greater for intervention of stenotic lesions compared to occlusive lesions(60.3% vs 38.1%, p<0.05). Carotid artery stenting in 25 patients(35 lesions) was successful in all lesions. Angiography and/or duplex sonography which was performed at 5.5±2.6 months in 18 patients(24 lesions) followed after carotid stenting revealed no evidence of restenosis. Subclavian artery stenting in the 16 patients(17 lesions) was successful in 16 lesions(94%). Renal artery stenting in the 17 patients(18 lesions) was successful in all lesions. Angiography at 8.5±3.5 months in 6 patients(6 lesions) followed after renal stenting revealed no evidence of restenosis. PTA for total occlusion of abdominal aorta was successful in 11 lesions(84.6%) of the 13 lesions. Angiography at 13±12 months in 7 patients(7 lesions) followed after PTA for abdominal aorta revealed significant restenosis in 2 patients. Minor complications during the PTA for peripheral disease occurred in 25 patients of 397 patients. Conclusion : PTA for whole body arterial occlusive disease can be performed with an excellent technical success rate and minimal morbidity and mortality. PTA for carotid, subclavian, renal, iliac artery or abdominal aorta represents a true alternative to vascular surgery as a first-line treatment. Despite acceptable initial success rate, PTA for femoropopliteal or infrapopliteal artery warrants further validation because it has high incidence of clinical restenosis during the follow-up periods. (Korean J Med 59:5-19, 2000)
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심승혁 ( Seung-hyuk Shim ),( Dae-yeon Kim ),( Sun Joo Lee ),( Soo-nyung Kim ),( Soon-beom Kang ),( Shin-wha Lee ),( Jeong-yeol Park ),( Dae-shik Suh ),( Jong-hyeok Kim ),( Yong-man Kim ),( Young-tak Kim 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-
Objective Concurrent chemoradiotherapy is usually administered to patients with locally advanced cervical cancer (LACC). Extended-field chemoradiotherapy is required if para-aortic lymph node (PALN) metastasis is detected. This study aimed to construct a predictionmodel for PALNmetastasis in patients with LACC before definitive treatment. Methods Between 2009 and 2016, all consecutive patients with LACC who underwent para-aortic lymphadenectomy at two tertiary centers were retrospectively analyzed. A multivariate logistic model was constructed, from which a prediction model for PALN metastasis was developed and internally validated. Before analysis, risk grouping was predefined based on the likelihood ratio. Results In total, 245 patients satisfied the eligibility criteria. Thirty-four patients (13.9%) had pathologically proven PALN metastases. Additionally, 16/222 (7.2%) patientswith negative PALNs on positron emission tomography/computed tomography (PET/CT) had PALNmetastasis. Moreover, 11/105 (10.5%) patients with both negative PALNs and positive pelvic lymph nodes on PET/CT had PALN metastasis. Tumor size on magnetic resonance imaging and PALN status on PET/CT were independent predictors of PALN metastasis. The model incorporating these two predictors displayed good discrimination and calibration (bootstrap-corrected concordance index = 0.886; 95% confidence interval = 0.825-0.947). The model categorized 169 (69%), 52 (22%), and 23 (9%) patients into low-, intermediate-, and high-risk groups, respectively. The predicted probabilities of PALN metastasis for these groups were 2.9, 20.8, and 76.2%, respectively. Conclusion We constructed a robust model predicting PALN metastasis in patients with LACC that may improve clinical trial design and help clinicians determine whether nodal-staging surgery should be performed.
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Hyuk-Jae You,Il-Woo Shim,Hye-Jin Jo,Hong-Soo Park,Seung-Jin Kim,Young-Geun Kim 한국유화학회 2005 한국응용과학기술학회지 Vol.22 No.1
Chlorine-containing modified polyester polyols were synthesized by two-step condensation reactions. Intermediate was synthesized by the esterification of monochloroacetic acid with trimethylolpropane in the first step. Polycondensation of the intermediate (MCAOs), 1,4-butanediol, and trimethylolpropane with adipic acid was carried out. Two-component polyurethane (PU) coatings were prepared by blending MCAOs and IPDI-isocyanurate. There new flame-retardant coatings showed various properties comparable to other non-flame-retardant coatings. They were superior to flammable coatings from the experimental results showing rapid and 10 to 13 hours of pot-life. Coatings with 30wt% monochloroacetic acid was not flammable by the vertical flame retardancy test.
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Pituicytoma with Significant Tumor Vascularity Mimicking Pituitary Macroadenoma
( Hyuk Ki Shim ),( Seung Heon Cha ),( Won Ho Cho ),( Sung-hye Park ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2017 Brain Tumor Research and Treatment Vol.5 No.2
A 19-year-old man presented with bitemporal hemianopsia and was found to have a large sellar and suprasellar tumor, resembling a pituitary macroadenoma. Emergency transsphenoidal approach was attempted because of rapid visual deterioration with headache. However, the approach was compli-cated and stopped by uncontrolled hemorrhage from the tumor. After conventional cerebral angiogram-phy and recognition of an unusual pathology, transcranial approach was achieved to prevent permanent visual loss. The final pathological diagnosis was pituicytoma with epithelioid features. Pituicytoma is a rare low-grade tumor (WHO Grade I) of pituicytes involving the sellar and suprasellar region, and origi-nating from special glial cells of the neurohypophysis. Because of the high vascularity, the firm consis-tency, and invasion to surrounding neurovascular structures, a pituicytoma should be included in the differential diagnosis of a mass in the sellar and suprasellar area if the tumor shows high enhancement with vascular components. We report a case of rare pituicytoma mimicking a pituitary macroadenoma with massive hemorrhage to disturb surgery.
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