Long-term outcomes of single-port laparoscopic myomectomy using a modified suture technique

( Mina Kang ),( Jihye Kim ),( Tae-joong Kim ),( Jeong-won Lee ),( Byoung-gie Kim ),( Duk-soo Bae ),( Chel Hun Choi ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2

Objective To evaluate the long-term outcomes, including the pregnancy outcome and recurrence rate after single-port laparoscopic myomectomy (LM) using a modified suture technique with a Hem-o-lok clip (Choi’s LM) and conventional 4-port LM. Methods A retrospective study of patients who underwent Choi’s LM (n=55) and 4-port LM (n=102) in a single institutional hospital was conducted. Patients with <3 symptomatic myomas sized <10 cm each and operated on by a single surgeon were included. Recurrence was confirmed when a myoma measuring ≥3 cm was detected. Results The patients in both groups had similar demographic characteristics. Single (76.4% vs. 62.7%) and intramural (52.7% vs. 56.9%) tumors were commonly detected in both groups in the mean diameter (6.8±1.5 cm vs. 7.0±1.6 cm; P=0.40). In Choi’s LM, 16 patients (29.1%) needed an additional port; those who were nulliparous and/or had a large leiomyoma more frequently required an additional port (P=0.023 and 0.04, respectively). During a median follow-up period of 69 months, 17 patients (7.1% vs. 14.6%) had recurrence. The size of dominant myomas at recurrence was significantly smaller in patients who underwent Choi’s LM (3.4±0.7 cm vs. 5.7±2.4 cm; P=0.004). All 13 patients in both groups who successfully conceived had a full-term delivery. No major complications occurred during pregnancy. Conclusion Although an additional port was frequently used, the long-term outcomes of patients who experienced recurrence and pregnancy after Choi’s LM were acceptable. Considering its usability, Choi’s LM is feasible for the treatment of uterine leiomyoma.

우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계

강혜영,강대룡,장영화,박성은,최원정,문성환,양규현,Kang, Hye-Young,Kang, Dae-Ryong,Jang, Young-Hwa,Park, Sung-Eun,Choi, Won-Jung,Moon, Seong-Hwan,Yang, Kyu-Hyun 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

Productivity Loss of Rheumatoid Arthritis Patients according to the Their Stages of the Disease Activity Score

( Sang-Cheol Bae ),( Jin-Hye Cha ),( Jung-Yoon Choe ),( Sung Jae Choi ),( Soo-Kyung Cho ),( Won-Tae Chung ),( Chung-Il Joung ),( Young-Ok Jung ),( Young Mo Kang ),( Dong-Wook Kim ),( Jinseok Kim ),( Y 대한류마티스학회 2018 대한류마티스학회지 Vol.25 No.2

Objective. Productivity loss was compared by 3-stage of disease activity and associations between higher disease activity and high productivity loss were identified. Methods. Data were extracted from Rheumatoid Arthritis (RA) Patient-reported Outcomes Research, which enrolled 2,000 RA patients (>20-year) on disease-modifying-antirheumatic-drugs (DMARDs) (≥ 6-month) from December 2012 to June 2013. This included 1,457 RA patients with the disease activity score (DAS-28-ESR) in their medical charts. Productivity loss in time and indirect cost was estimated using The World Health Organization Health and Work Performance Questionnaire (HPQ). Baseline characteristics and productivity loss outcomes were compared according to DAS-28-ESR groups. Results. 84.4% were females, 54.2% had low DAS-28-ESR (<3.2), and 38.2% and 7.6% had moderate (3.2∼5.1) and high DAS-28-ESR (>5.1). Patients with moderate to high DAS-28-ESR had higher lost productivity time (LPT) and monthly costs of LPT than those with low DAS-28-ESR (time in hours: 110.0±58.4 vs. 132.4±57.2 vs. 71.5±52.0, p<0.0001; monthly costs of LPT in 1,000 Korean won: 1,097±607 vs. 1,302±554 vs. 741±531, p<0.0001). Multiple regression analyses revealed significant associations with high LPT in high (adjusted odds ratio [OR]=3.87, 95% confidence interval [CI]: 2.18∼6.87) and moderate DAS-28-ESR (adjusted OR=1.88, 95% CI: 1.41∼2.52) compared to low DAS-28-ESR. In addition, positive associations with high monthly costs of LPT were observed in high (adjusted OR=3.45, 95% CI: 1.98∼5.99) and moderate DAS-28-ESR (adjusted OR=1.93, 95% CI: 1.43∼2.54) compared to low DAS-28-ESR. Conclusion. Timely therapeutic strategies should be taken into consideration given that the RA patients with moderate to high DAS-28-ESR showed strong associations with high productivity loss for effective management of RA. (J Rheum Dis 2018;25:122-130)

오공약침의 안전성에 대한 임상적 연구

소기숙,최회강,박소영,고강훈,김성남,이옥자,윤민영,문형철,김성철,이정훈,나원경,So, Ki-suk,Choi, Hoi-kang,Park, So-young,Koh, Kang-hun,Kim, Sung-nam,Lee, Ok-ja,Yun, Min-young,Mun, Hyung-chul,Kim, Sung-chul,Lee, Jung-hun,Na, Won-kyung 대한침구의학회 2004 대한침구의학회지 Vol.21 No.1

Objective: Recently scolopendrid aquacupuncture has been a good effect on pain control but it has not been known about clinical safety. So, In order to prove the clinical safety of scolopendrid aquacupuncture, We have observed the physical reac-tion and clinical pathology test after scolopendrid aquacupuncture treatment. Methods: We analyzed physical reaction and clinical pathology test before and after Scolopendrid aquacupuncture treatment of 30 patients suffering from pain, who admitted department of Acupunture and Moxibustion, College of Oriental Medicine, Won-Kwang University Kwangju hospital. Results & Conclusions: The results were summarized as follows. 1) The distribution of sex was 14 males and 16 females, and the average of patients age was 46.2 years. 2) The distribution of symptom was lumbago, lumbago with radiating pain, nuchal pain and knee joint pain. 3) In the 30 patients treated with Scolopendrid aquacupuncture, hematologic test did not show remarkable change. 4) In the 30 patients treated with Scolopendrid aquacupuncture, Liver function test(AST, ALT, ALP) showed a slight decrease on the contrary, and abnormal rate showed a decrease of 1.0%(from 3.3% to 2.3%) compared with previous study. 5) In the 30 patients treated with Scolopendrid aquacupuncture, Renal function test(BUN, Cr) and abnormal rate(from 2.5% to 2.0%) showed a slight decrease on the contrary. 6) In the 30 patients treated with Scolopendrid aquacupuncture. Electrolyte were normal range before & after treatment. 7) In the results of the Urine analysis of 30 patients, Leukocyte, Protein. Glucose, Keton, Bilirubin, U-bilinogen were not detected before and after Scolopendrid aquacupuncture treatment, and the rest almost made no difference. 8) In the Physical reactions, all of the patients complained of pain of body partially, only one patient showed reddish and itch, but symptoms like those were entirely disappeared within 24 hours and whole body pain, swelling, headache, dizziness, fatigue and nausea was not observed.

Simplified Screening Method for Rice Cultivars with Adaptability to Flooded Paddy

Lee, Kang Soo,Choi, Sun Young,Choi, Won Yul 전북대학교 농업과학기술연구소 2000 農大論文集 Vol.31 No.1

Rice direct seeding on flooded paddy has a shortcoming of instability of seedling establishment due to hypoxia. This study was conducted to clarify the interrelationship between seeding rate and seedling growth in flooded condition and find out a optimum screening condition for anaerobic tolerant cultivars. The germinated seeds were sown in 250 ml flasks containing 150 ml (in water) and 5 ml distilled water(in air) at 25℃ respectively. The number of seeds sown (seeding rate) were 5, 15, 25, and 35 seeds per 250 ml flask. The characteristics measured, length of shoot and root, fresh weight of shoot and root and chlorophyll content, were not affected by seeding rate and cultivars in air while those in water were decreased as seeding rate increased. The dissolved oxygen in the soak water were affected by seeding rate and cultivars. The difference between the two cultivars in the characteristics were greatest when seeding rate was35 seeds in 250 ml flask containing 150 ml water. The characteristics at seeding rate of 35 seeds in 250 ml flask containing 150 ml water would be used in the screening of anaerobic tolerant cultivars for direct seeding.

Huge Perirenal Hematoma which Caused Renal Dysfunction after Percutaneous Needle Biopsy in Transplanted Kidney

( Won Ik Jang ),( Hyun Jun Ju ),( Dae Eun Choi ),( Ki Ryang Na ),( Kang Wook Lee ),( Young Tai Shin ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1

Introduction: Percutaneous biopsy of the kidney is a standard procedure to evaluate renal parenchymal disease in native kidneys and in renal transplants. The percutaneous approach using real-time ultrasound guidance and automated biopsy device is the standard method of obtaining tissue in patients without complications. This procedure remains safe with a few risks to the patients and provides adequate tissue for diagnosis in at least 95% of cases. However, serious complications, although rare, may occur in 2.7% of the patients and the majority of these are related to bleeding. We report a case of huge perirenal hematoma with renal dysfunction after percutaneous needle renal biopsy in transplanted kidney. Case: A 63-year old man presented with fever, chill, rhinorrhea from 3 days ago. He underwent a kidney transplant operation donated from his wife last year. He had been on regular hemodialysis for 3 years due to hypertensive ESRD.He was diagnosed upper respiratory tract infection and had been taken conservative management. Ultrasound sonograghy revealed no structural abnormality in transplanted kidney. The CBC showed WBC 13,270 /uL,Hb13.5 g/dl, platelet 135,000 cells/uL. The coagulation profile was normal. The blood chemistry revealed a serum creatinine level of 3.0 mg/dL from 1.1 mg/dL last 1 month. His urine output was good. He was performed a percutaneous ultrasound-guided allograft renal biopsy on the 3rd day in hospital. We had used 16G automated gun needle and gotten 5 pieces of tissue. The histologic diagnosis was acute rejection type IA. On 4 days after biopsy, his serum creatinine elevated up to 8.2 mg/dL and his urine output decreased to 300 ml/day. Abdominal computed tomography angiography showed a 8.5 X 2.8 cm hematoma at lateral aspect of transplanted kidney. Tc-99m DTPA Renal Perfusion &Renogram showed marked decreased perfusion and excretion in transplanted kidney. We intended radiologic intervention of drainage catheter insertion to perirenal hematoma, but the procedure failed. He performed acute hemodialysis two days. His serum creatinine decreased to 1.7 mg/dL and urine output increased to 2,700 ml/day after 5 days from acute hemodialysis. On the 22nd day in hospital, He was discharged.

Comparative Study of Gene Expression Profiles in Posterior Silk Glands of the Silkworm, Bombyx mori L.

Choi, Kwang-Ho,Goo, Tae-Won,Kang, Seok-Woo,Kang, Min-Uk,Yun, Eun-Young,Hwang, Jae-Sam Korean Society of Sericultural Science 2008 International Journal of Industrial Entomology Vol.17 No.2

We used serial analysis of gene expression (SAGE) approach to derive a profile of expressed genes of the posterior silk glands (PSG) and to create a reference for understanding gene cluster related to the mechanism of silk protein synthesis in the silkworm, Bombyx mori. We constructed a 3' SAGE library from the PSG of the fifth instar larvae of the silkworm. In total we obtained 2,406 SAGE tags, of which 682 were unique tags. Sorted by tag count number, 27 (4%) unique tags were significantly more abundant genes (ten or more times), whereas 445 (65%) unique tags were detected as single copies. The annotation of 682 unique SAGE tags revealed that 462 (68%) of the SAGE tag sequences represented known genes, whereas 220 (32%) of the tag sequences had no matches in SAGE map and silkworm EST databases. Of the 682 SAGE tags, the most abundant tag sequences were that of the fibroin light chain gene and the silk protein P25. In addition, we compared two relative abundance results of the SAGE and the EST approaches to verify whether their transcript quantitative aspects are significant or not. The comparative results of relative abundances of the fibroin H-, L- chain and P25 glycoprotein genes indicated that the quantitative approach based on SAGE tags is effective for quantitative cataloging and comparison of expressed genes in same organs. The SAGE tag information reported in this study would be useful for researchers in the field to analyze genes associated with silk processing mechanisms of insects.

Causes and Predictive Factors Associated with "Diagnosis Changed" Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

Kang, Byung Ju,Jo, Kyung-Wook,Park, Tai Sun,Yoo, Jung-Wan,Lee, Sei Won,Choi, Chang-Min,Oh, Yeon-Mok,Lee, Sang-Do,Kim, Woo Sung,Kim, Dong Soon,Shim, Tae Sun The Korean Academy of Tuberculosis and Respiratory 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). Results: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.

A study on balance assessment according to the levels of difficulty in postural control

Kang, Dong-Won,Seo, Jeong-Woo,Kim, Dae-Hyeok,Yang, Seung-Tae,Choi, Jin-Seung,Tack, Gye-Rae The Society of Physical Therapy Science 2016 JOURNAL OF PHYSICAL THERAPY SCIENCE Vol.28 No.6

<P>[Purpose] This study aimed to determine appropriate measures for assessing balance ability according to difficulty level during standing tasks. [Subjects and Methods] The subjects were 56 old (>65 years) and 30 young (20–30 years) adults. By using the Berg balance scale, the subjects were divided into three groups: 29 healthy older (Berg score≥52), 27 impaired older (Berg score≥40), and 30 healthy young (Berg score≥55). One inertial measurement unit sensor was attached at the waist, and the subjects performed standing tasks (1 min/task) with six difficulty levels: eyes open and eyes closed on firm ground, one foam, and two foams. Thirty-nine (24 time-domain, 15 frequency-domain) measures were calculated by using acceleration data. The slope of each derived measure was calculated through the least-squares method. [Results] Five (95% ellipse sway area, root mean squares [anterior-posterior and resultant directions], and mean distance [anterior-posterior and resultant directions] in time domain) of the 39 measures showed significant differences among the groups under specific standing conditions. The slopes of derived measures showed significant differences among the groups and significant correlations with the Berg scores. [Conclusion] The slope according to the difficulty level can be used to assess and discriminate standing balance ability.</P>

Growth Pattern and Content of Tropane Alkaloids of Metabolic Engineered Scopolia parviflora Hairy Root Lines

Kang, Young-Min,Min, Ji-Yun,Kim, Won-Jung,Kim, Yong-Duck,Lee, Byung-Hynn,Choi, Myung-Suk The Korean Society of Medicinal Crop Science 2004 韓國藥用作物學會誌 Vol.12 No.2

Hyoscyamine and scopolamine are two most common tropane alkaloids found in the Solanaceae. The pEB expression vector carrying Nspmt gene was transformed to Agrobacterium rhizogenes. The growth of transgenic hairy roots were approximately to 80% of the wild type root. Transgenic hairy roots are less developed on only their branch roots than those of the wild type root. The extracts from Nspmt transgenic hairy root lines, 3 and 5 contained between 3.52 and 4.23 mg/g dry weight as hyoscyamine and did between 5.23 to 6.40 mg/g dry weight as scopolamine. These results showed that the overexpression of the pmt gene enhanced tropane alkaloids production of S. parviflora transformed roots and this improvement affected both hyoscyamine and scopolamine production.