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( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2
Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.
액체소듐속에서 소듐-물반응에 의한 재질의 Wastage현상
정경채,정지영,김병호,김태준,최병해,최종현,김의식 한국공업화학회 2003 응용화학 Vol.7 No.1
In this study we observed and analyzed the corrosion phenomena in leak site and the effect on temperature at the target surface of heat transfer tube material by sodium-water reaction through water leakage in liquid sodium atmosphere. Surrounding of leak hole of the specimen was damaged by the wastage phenomena due to corrosion and erosion of material, and hole size by damage of leak site was extended from 150㎛ to about 200㎛. Also, the damaged size appeared in the target surface was observed to about 1000㎛ diameter. The temperature of target surface increased about 70~80℃ by the heat of sodium-water reaction even with the small leakage of 15㎖ water. From the results of EPMA and EDX analysis, damaged area are found to covered with complex compounds such as (NaOH+Na_2O) FexOy or (NaCrO_2+nA_2CrO4) mixed up with the sodium oxides by sodium-water reaction and the Fe or Cr element by matrix of tube sodium oxides by matrix of tube material.
김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2
Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.
Case Report : Autosomal Translocation Patient Who Experienced Premature Menopause: A Case Report
( Tae-hee Kim ),( Yesol Kim ),( Do-won Jeong ),( Eun-gyeong Lee ),( Dong-su Jeon ),( Jun-mo Kim3 ) 대한폐경학회 2015 대한폐경학회지 Vol.21 No.2
Premature ovarian failure (POF) is a condition in which the ovarian functions of hormone production and oocyte development become impaired before the typical age for menopause. POF and early menopause are present in a broad spectrum of gonad dysgenesis, from a complete cessation of ovarian function to an intermittent follicle maturation failure. Actually POF has been identified as a genetic entity (especially chromosome X), but data on genetic factors of premature menopause are limited. Until now, several cases revealed that inactivation of X chromosomes has an effect on ages of premature menopause and females with balanced or unbalanced X-autosome translocations can have several reproductive problems. On the other hand, there have been a few data that was caused by autosome-autosome translocation can lead. Therefore we report a relevant case of POF with translocation between chromosomes 1 and 4. She had her first menstrual period at the age of 12, and after 7 years she stopped menstruation. Chromosomal analysis showed 46, XX, t (1;4) (p22.3;q31.3). While evaluating this rare case, we could review various causes (especially genetic factors) of POF. To remind clinicians about this disease, we report a case of POF caused by autosomeautosome translocation with a literature review. (J Menopausal Med 2015;21:112-114)
서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)
김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1
In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.
다중음성치료기법(SK-MVTT)이 성대결절 환자의 음성개선에 미치는 효과 : 액센트 기법과의 비교 연구 Comparison with Accent Method
김성태,정옥란 한국음성과학회 2004 음성과학 Vol.11 No.4
Vocal nodule is one of the representative chronic diseases of vocal folds, and it can be cured by voice therapy. However, the existing therapeutic methods about vocal nodule are in great demand. The purpose of this study was to evaluate the effect of therapeutic methods between Accent method and SK-MVTT (Seong-Tae Kim's multiple voice therapy technique), which was designed by the author. We identified 40 females, who diagnosed having vocal nodules, aged from 21 to 52 years (mean age: 40 years). Twenty females were treated by the SK-MVTT and the other 20 females the Accent method. All subjects received 12 sessions of treatment, and were evaluated after finishing the 6th and the 12th session. The results showed that the SK-MVTT produced a better results compared to the Accent method. The SK-MVTT was better especially at the initial stage of voice therapy compared to the Accent method. In this study, we can suggest that SK-MVTT may be useful in improving the voice qualities of vocal nodule patients. However, more data should be collected and evaluated before it can widely be used in other clinics.