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RISS 인기검색어
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- 저자 : ( Ga Won Yim ) (검색결과 114 건)
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Film Session Q&A 1 : Transumbilical Glove Port Placement Techniques for Single Port Laparoscopy
( Ga Won Yim ),( Sang Wun Kim ),( Eun Ji Nam ),( Sung Hoon Kim ),( Young Tae Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
Demonstrate a new instrument, technique or procedure Single port access laparoscopic surgery is being widely applied in the gynecologic field. There are various commercial or home-made port systems available. This video introduces Glove Port (Nelis, Seoul, Korea) and the method of port placement. Glove Port is easy to use due to its all-in-one design, where additional trocar placement is unnecessary. The port is composed of two rings (inner ring and outer ring to fix the port on the abdominal wall) and three to four trocar channels with gas insufflation and exsufflation lines. The trocar channel of the Glove port enables the entry of 10 mm laparoscope camera without gas leakage, due to elastic opening of trocar channels. This port system can be safely used within 1.5 cm sized incision in the umbilicus and therefore is cosmetically advantageous.
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( Ga Won Yim ),( Sang Wun Kim ),( Sung Hoon Kim ),( Eun Ji Nam ),( Young Tae Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-
목적: The aim of this study was to evaluate perioperative complications of robot-assisted laparoscopic surgery in gynecology. 방법: Patients who underwent elective robot-assisted laparoscopic surgery at the Department of Obstetrics and Gynecology, Severance Hospital between February 2006 and December 2013 were identified. Robotic procedures were performed using the da Vinci robotic system. Patient demographic data and operative outcomes were prospectively collected in a computerized database and extracted for this study. 결과: Two hundred and ninety eight patients were identified during the study period. One case was converted to conventional laparoscopy due to mechanical failure of the robot system and excluded from review. The median age and body mass index of patients were 48 years and 23.0 kg/m2, respectively. The majority (n=130, 43.6%) of operative procedures was radical hysterectomy, followed by endometrial cancer staging (n=112, 37.6%), total hysterectomy (n=39, 13.1%), and myomectomy (n=17, 5.7%). The median operative time, estimated blood loss, and postoperative hospital stays were 208.5 min, 184.8 mL, and 8.9 days, respectively. The overall complication rate was 18.8% and that for only the oncologic cases was 16.1%. Intraoperative complications (n=5, 1.7%) consisted of 3 vessel injury and 1 bowel content leakage during appendectomy during endometrial cancer staging and one case of bladder injury during radical hysterectomy. Early and late postoperative complications were 14.4% and 2.7%, respectively. Five patients (1.7%) experienced grade 3 complications according to Clavien-Dindo classification and therefore needed further intervention. 결론: Robot-assisted laparoscopic surgery is a feasible approach in gynecology with acceptable complications.
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( Ga Won Yim ),( Hee Jung Kim ),( Mi Ri Hyun ),( Sunghoon Kim ),( Sang Wun Kim ),( Eun Ji Nam ),( Young Tae Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-
목적: The functions of many long non-coding RNAs (ncRNAs) in human cancers are not well understood. Homeobox A11 (HOXA11) genes, which normally regulate mullerian duct differentiation, are not expressed in normal ovarian epithelium. The aim of this study was to examine the expression of HOXA11 antisense (HOXA11as) in patients with ovarian cancer. 방법: HOXA11as expression was determined in ovarian cancer tissues (n=142) and normal tissues (n=40) and ovarian cancer cell line by using real-time polymerase chain reaction. Its correlation with clinical parameters and survival were analyzed. 결과: The expression level of HOXA11as in ovarian cancer tissue was significantly higher than in noncancerous tissues by more than 8 fold (p=0.001). High HOXA11as expression (HOXA11as/GAPDH > 400 fold) among cancer tissues was not correlated with stage and lymph node metastasis, however associated with cell type and reduced recurrence-free survival. Median recurrence-free survival was 24 vs. 18 months in low and high expression group, respectively (Log rank p= 0.044). Knockdown of HOXA11as (siHOXA11as) reduced cell proliferation and invasion by in vitro assays using the OVCAR429 cell line. Hoxa11as knockdown also demonstrated inhibition of migration by wound healing migration assay. 결론: The results suggest that HOXA11as may represent a novel biomarker for epithelial ovarian cancer progression and prognosis.
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Role of Robot-Assisted Surgery in Cervical Cancer
Yim, Ga Won,Kim, Sang Wun,Nam, Eun Ji,Kim, Young Tae BMJ 2011 International journal of gynecological cancer Vol.21 No.1
<B>Background:</B><P>The development of robotic technology has facilitated the application of minimally invasive techniques for complex operations in gynecologic oncology.</P><B>Objectives:</B><P>The objective of the study was to assess and summarize the current literature on the role of robot-assisted surgery in cervical cancer in terms of its utility and outcome.</P><B>Methods:</B><P>Literature review concerning the use of robot-assisted technology in the management of cervical cancer, including radical hysterectomy, trachelectomy, parametrectomy, pelvic and aortic lymphadenectomy, and pelvic exenteration, was performed.</P><B>Results:</B><P>To date, 12 articles addressing radical hysterectomy, 5 articles of radical trachelectomy, and 6 articles of surgical procedure in advanced or recurrent cervical cancer, all performed robotically, are published in the literature. The advantages of the robotic system include 3-dimensional vision, tremor reduction, motion downscaling, improved ergonomics, and greater dexterity with instrument articulation. Because of these benefits, the robotic technology seems to facilitate the surgical approach for technically challenging operations performed to treat primary, early or advanced, and recurrent cervical cancer as evidenced by the current literature.</P><B>Conclusions:</B><P>Surgical management of cervical cancer may be one of the gynecologic oncology surgeries that can take full advantage of robotic assistance in a minimally invasive manner. Continued research and clinical trials are needed to further elucidate the equivalence or superiority of robot-assisted surgery to conventional methods in terms of oncological outcome and patient's quality of life.</P>
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( Ga Won Yim ),( Eun Ji Nam ),( Sung Hoon Kim ),( Sang Wun Kim ),( Jae Wook Kim ),( Young Tae Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
Ovarian cancer is a chronic and wasting disease. Nutritional Risk Index (NRI) has been reported as a simple and accurate tool to assess nutritional status of patients with chronic disease. This study is to explore the association between pre/post-chemotherapy nutritional risk and survival using NRI. Also, the impact of weight change and body mass index (BMI) on cancer outcomes was analyzed. A retrospective data review was conducted of 214 advanced ovarian cancer patients who received primary surgical staging with 6 cycles of paclitaxel plus platinum postoperative adjuvant chemotherapy. NRI was calculated with patient`s body weight, ideal body weight, and serum albumin level. BMI was categorized by WHO criteria for Asians; underweight (<18.5 kg/m2), normal (18.5-22.9 kg/m2), and overweight (≥23.0 kg/m2). Weight change was defined as the ratio of body weight at the last course of chemotherapy to pre-surgery body weight. Overall survival (OS) and recurrence-free survival (RFS), classified by NRI were estimated by Kaplan-Meier, and associations were assessed using a Cox proportional hazards analysis, adjusted for known prognostic variables (age, histology, tumor grade, residual tumor). Mean age of patients was 54 years. Mean BMI was 23.1 kg/m2 and 22.5 kg/m2 before and after chemotherapy, respectively. Most (48.0%) of patients experienced 1-9.9% of weight loss after chemotherapy. Twenty-eight percent of patients were moderate to severely malnourished before treatment according to Nutritional Risk Index. During 10 years of follow up, 117 patients recurred and 67 patients died. The median survival time was 80 months. The 5-yr OS and RFS was 58.9% and 37.8%, respectively. Nutritional risk index was significantly associated with both OS and RFS. Moderate to severely malnourished patients before treatment had lower OS (48 months) compared to normal to mild group (80 months), respectively(p=0.014). Adjusted for covariates, the relative risk of death was 3.6 times higher in moderate/severely malnourished group (HR=3.6, 95% CI=1.63-7.96, p=0.002) compared with normal/mildly malnourished patients. Similarly, post-treatment NRI less than 97.5 (moderate risk) was associated with shorter PFS (median survival 12 months) compared with normal to mild risk group (17 months, p=0.006). There was no association between weight change and OS. Nutritional risk index is a simplified nutritional screening index that may be used as a potential predictor for mortality. Since weight change may not necessarily reflect patient`s nutritional status, NRI would be a clinically useful marker for the assessment of nutritional status as well as survival in ovarian cancer patients.
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( Ga Won Yim ),( Sung Hong Joo ),( Anna Choi ),( Eui Shik Jung ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-
Objective: To analyze knowledge and perception of female nurses on cervical cancer and the role of education and related factors on cancer prevention and screening. Methods: A total of 201 nurses were recruited from a single institution and 156 nurses were included in the study. Web-based surveys were given out which contained questionnaires covering sociodemographic factors, knowledge, and perception on cervical cancer and screening. Then, subjects were randomized into 3 groups according to education type (paper, group 1; email, group 2; or social network service, group 3). Education proceeded for 2 weeks and follow up surveys were given immediately after and 6 weeks post education. Perception was measured using a revised form of the Health Belief Model questionnaires. Logistic regression analysis was performed to identify factors related to receiving cervical cancer screening. Results: Fifty-two subjects were randomized to each education method group. Median age was 30.9 years (range 22-60). Baseline characteristics did not differ significantly among the 3 groups. The baseline knowledge (percent of correct answer) on cervical cancer was 69% within 15-point questions. Significant improvements in knowledge (10.43 vs 11.39 vs 11.23 points, P < .0001 for groups 1,2, and 3, respectively) were shown in Paper and SNS group both immediately and 6 weeks after education. Perception on cervical cancer was low (scale 1-2 out of 4), however, perception on benefit (2.2 vs 2.44 vs 2.53, P = .0053), motivation (2.42 vs 2.72 vs 2.61, P = .0027), and intention (2.31 vs 2.64 vs 2.57, P = .0053) were improved after education. Logistic regression analysis showed career years, non-marital status, HPV vaccination, and health motivation as related factors for regular cervical screening. Conclusion: Education improved both knowledge and perception, however no differences were identified by education type. Perception related to the HBM model may be important for adoption of regular cervical cancer screening. Acknowledgements: This work was supported by a grant of the National Medical Center, Republic of Korea. (NMC2016-PR-06)
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( Ga Won Yim ),( Hoon Kim ),( Young Min Choi ),( Seok Hyun Kim ),( Yong Sang Song ),( Noh Hyun Park ),( Chang Suk Suh ),( Jae Won Kim ),( Joong Shin Park ),( Seung Yup Koo ),( Hyun Hoon Chung ),( Myun 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-
Objective: To identify the impact of care given by gynecologic hospitalist on waiting time prior to final disposition in the emergency department. Methods: Since September 2016, the government adopted a pilot program to introduce hospitalist system in Korea. Gynecologic hospitalist system was implemented at a high-volume hospital since May 2018 for the first time in Korea. The hospitalist provided acute and/or palliative medical care in the emergency department (ED), intensive care unit (ICU), and at the general ward. Three-month data before and after the implementation of hospitalist system on the waiting time at the ED was analyzed. Waiting time was defined as the time of referral for gynecologic consultation by the ED staff to the time of final plan (disposition) given by the hospitalist formally through the consultation reply. Patients that were given care during the daytime (9AM - 6PM) were included for analysis. Results: The number of monthly gynecologic consultation during daytime at the ED were 11, 4, and 18 on February, March, and April (group 1), respectively. The number increased gradually after the implementation of the hospitalist system; 13, 21, and 22 patients in May, June, and July (group 2), respectively. The proportion of patients with conditions related to oncologic treatment (neutropenic fever, septic shock, bowel obstruction, etc.) was 60.7%. The number of patients with extended length of stay (> 12 hours) at the ED were 5 vs. 1 in group 1 and 2, respectively. The median waiting time prior to final deposition was 142 min (range 45 - 492 min) in group 1 (before hospitalist system) and 81 min (range 17 - 212 min) in group 2 (after hospitalist system). Conclusion: The waiting time of gynecologic patients upon ED admission was significantly decreased after the establishment of the hospitalist system. Further related to patient mortality and patient / staff satisfaction are needed.
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Yim, Ga Won,Kim, Hee Jung,Kim, Lee Kyung,Kim, Sang Wun,Kim, Sunghoon,Nam, Eun Ji,Kim, Young Tae Korean Cancer Association 2017 Cancer Research and Treatment Vol.49 No.3
<P><B>Purpose</B></P><P>The biological function of long non-coding RNAs (lncRNAs) is only partially understood; therefore, in this study, we investigated the expression of the novel <I>HOXA11</I> antisense (<I>HOXA11as</I>) lncRNA and its oncogenic role in serous ovarian cancer (SOC).</P><P><B>Materials and Methods</B></P><P><I>HOXA11as</I> expression was examined in 129 SOC tissue samples by real time reverse transcription polymerase chain reaction. Clinicopathological factors and patient survival were compared between the high (n=27) and low <I>HOXA11as</I> expression group (n=102). To investigate the role of <I>HOXA11as</I> in cell proliferation, invasion, and migration, <I>HOXA11as</I> expression in ovarian cancer cells was knocked down using RNA interference.</P><P><B>Results</B></P><P><I>HOXA11as</I> expression in cancer tissue was 77-fold higher than that of noncancerous tissue (p < 0.05). Higher <I>HOXA11as</I> expression was significantly correlated with histological grade (p=0.017) and preoperative cancer antigen 125 (p=0.048). <I>HOXA11as</I> overexpression in SOC cells led to increased cell proliferation, invasion, and migration. Moreover, <I>HOXA11as</I> was associated with the expression of genes involved in cell invasion, migration, and epithelial-mesenchymal transition (EMT), including vascular endothelial growth factor, matrix metalloproteinase 9 (MMP-9), B-catenin, E-cadherin, Snail, Twist, and vimentin. Multivariate analysis revealed that <I>HOXA11as</I> was a prognostic factor of progressive disease and mortality (hazard ratio [HR], 1.730; p=0.043 and HR, 2.170; p=0.033, respectively). Progression-free and overall survival were significantly shorter in patients with high <I>HOXA11as</I> expression.</P><P><B>Conclusion</B></P><P>These findings highlight the clinical significance of <I>HOXA11as</I> to predicting the prognosis of SOC patients and suggest its potential in promoting tumor aggressiveness via regulation of vascular endothelial growth factor (VEGF), MMP-9, and EMT-related mechanisms.</P>
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