• 대한수학회보
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• 제52권2호
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• pp.679-684
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• 2015

In this paper we discuss bounds for the total curvature of nonparametric minimal surfaces by using the properties of planar harmonic mappings.

• 대한수학회논문집
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• 제35권4호
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• pp.1299-1307
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• 2020

We show that the Liechti-Strenner's example for the closed nonorientable surface in [13] minimizes the dilatation within the class of pseudo-Anosov homeomorphisms with an orientable invariant foliation and all but the first coefficient of the characteristic polynomial of the action induced on the first cohomology nonpositive. We also show that the Liechti-Strenner's example of orientation-reversing homeomorphism for the closed orientable surface in [13] minimizes the dilatation within the class of pseudo-Anosov homeomorphisms with an orientable invariant foliation and all but the first coefficient of the characteristic polynomial p(x) of the action induced on the first cohomology nonpositive or all but the first coefficient of p(x)(x ± 1)², p(x)(x² ± 1), or p(x)(x² ± x + 1) nonpositive.

• Journal of Chest Surgery
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• 제35권2호
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• pp.157-160
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• 2002

식도이완불능증 환자의 수술은 내시경을 이용한 최소 절개술로써 개복술에 상응하는 성적을 거두고 있다. 최근에는 복강경을 이용한 식도근절개술과 위저부성형술을 통해 기존에 시행되던 흉강경을 사용한 식도근 절개술보다 환자의 만족도에서 좋은 결과를 보이는 경우가 보고된 바 있다. 이 증례에서는 풍선확장술로써 치유되지 않는 식도이완불능증을 가지고 있는 15세의 남자 환자에서 5개의 작은 절개창을 통한 복부내시경을 이용하여 식도근절제술과 위저부성형술을 시행하여 증상을 현저히 개선하고 방사선적, 임상적 객관적 치료효과를 성공적으로 치험하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권12호
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• pp.4971-4975
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• 2015

Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

• 대한영상의학회지
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• 제85권2호
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• pp.372-380
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• 2024

목적 콜레스테롤 식이 및 기계적 혈관 내막 손상 유발을 통한 토끼 장골동맥 협착 모델을 개발하고 서로 다른 내막 손상 방법에 따른 협착 유발 정도를 평가하고자 한다. 대상과 방법 18마리의 토끼를 콜레스테롤 식이 후 풍선으로 당김 손상(pullover injury)을 가한 군(group A, 6마리), 콜레스테롤 식이 후 국소 확장 손상(localized balloon dilatation) 군(group B, 6마리), 일반 사료 식이 후 당김 손상을 가한 군(group C, 6마리)로 나누었다. 모든 군에서 혈관조영술을 시행하고 좌측 장골동맥에 직경 3 mm, 길이 10 mm의 비순응성(noncompliant) 풍선 카테터를 이용하여 당김 손상(group A, C) 또는 국소 확장 손상(group B)를 가하였다. 실험 시작 후 9주째 추적 혈관조영술을 시행하여 혈관조영술상 장골동맥의 협착 정도(후기 내강 손실, 협착 비율)을 정량적으로 비교 평가하였다. 결과 A군이 9주째 추적 혈관조영술에서 가장 심한 후기 내강 손실을 보였고 32.02% ± 6.54%의 협착이 확인되었다(A군 vs. B군: 0.67 ± 0.13 mm vs. 0.04 ± 0.13 mm, p < 0.0001; A군 vs. C군: 0.67 ± 0.13 mm vs. 0.26 ± 0.29 mm, p < 0.05). B군에서는 혈관조영술상 협착이 1.75% ± 6.55%로 매우 낮게 나타났다. 결론 콜레스테롤 식이 및 당김 손상 기법을 이용한 기계적 내막 손상이 토끼 장골 동맥에서 유의한 협착을 유발함을 확인하였다. 이 전임상 모델은 전임상 말초동맥 질환의 질병 모델로 사용될 수 있을 것으로 예상된다.

• Journal of Chest Surgery
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• 제2권2호
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• pp.155-166
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• 1969

Heterotopic abdominal homograft of canine heart was carried out in 20 pairs of dogs. Of these 12 cases were subjected as a control and 8 were subjected to immunosuppressive group. The dosage of immunosuppressive agent was 5mg/kg/day of Imuran [Azathioprine] for 3 days preoperatively, 10mg/kg on operative day and 5mg/kg/day postoperatively. For reducing the metabolic demand, the donor heart was preserved in 4degree heparinized saline solution for approximately I4 minutes. In the most of the cases, transplantation was performed with the technique of end-to-side aorto-aortic anastomosis and end-to-side pulmonary artery-inferior vena cava anastomosis at the infrarenal portion. Five out of 20 grafted dogs were survived more than one day. The longest survived 18 days in the control group and survive more than 60 days in the treated group. The survival cases were 3 out of 8[37. 5%] in the group of dogs treated with lmuran and 2`out of 12 [16.6%] in the group of non-treated. A prominent gross findings of the grafted heart was a minimal to moderate degree of dilatation of the heart with or without thrombosis in the cardiac chambers and/or anastomotic site. The case number 10, 15, and 19 showed moderate hypertrophy in grossly. The microscopic findings were as follows; 1. There were early hypersensitive histologic reactions such as interstitial edema, cellular infiltrations and early degenerative changes in the myocardium in the cases of 3 hour survival. 2. In the cases of more than 6 hours survival, organizing thrombosis of myocardial vessels, vasculitis,myocardial necrosis and lymphocyte, plasma cell, round cell infiltrations were noted. In the cases of more than 12 hours survival, the degree of these histologic changes especially in the non-treated group were more intensified than in the treated. 3. In the cases which survived more than one day, so called homograft specific histologic changes were milder in the immunosuppressive group compared with the control. 4. All the host hearts showed no evidence of pathologic findings histologically. Among the homologous canine cardiac transplantation tissue reaction, was milder and suvival time longer in the group treated with immunosuppressive drug.

• Radiation Oncology Journal
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• 제17권4호
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• pp.314-320
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• 1999

목적 : Paclitaxel(Toxol)은 미소관의 집합을 촉진시키고 분해를 방지하는 미소관 억제제로서 이 작용은 세포주기 중 방사선에 예민한 G2fM 시기에 일어나기 때문에 방사선조사와 병용할 경우 방사선감작제 가능성이 있다. Paclitaxel과 방사선조사를 병용하여 흰쥐의 위점막에서 paclitaxe이 방사선의 효과에 미치는 영향을 파악하기 위하여 본 연구를 시행하였다. 대상 및 방법 : 실험군은 paclitaxel 단독군, 방사선조사 단독군 및 paclitaxel과 방사선조사 병용군의 세 군으로 분류하여 paclltaxel 단독군은 paclitaxel (10 mg/kg)을 복강내 1회 주입하였고, 방사조사 단독군은 8 Gy를 전복부에 단일 조사하였으며, paclitaxel과 방사선조사 병용군은 paclitaxel (10 mg/kg)을 복강내 주입 후 24시간에 방사선조사 단독군과 동일한 방법으로 방사선조사하였다. 실험 완료 후 위점막 내 유사분열수, apoptosis와 기타 점막의 변화를 시간별로(6, 24시간, 3일 및 5일) 비교관찰하였다. 결과 : Paclitaxel 주입 후 위점막 내 유사분열은 증가하지 않았고 apoptosis는 6시간에 $5.75\%$였고 3일까지 비슷하게 지속되었다. Paclitaxel 주입 후 경미한 위선의 확장이 24시간에 관찰되었고, 세포의 비정형이 24시간과 3일에 보였으나 5일에는 정상으로 회복되었다. 방사선조사 단독군에서 apoptosis는 6시간에 $6.0\%$로 가장 많았으며 24시간에 $1.25\%$로 감소되었고 5일까지 지속되었다. 위선의 확장과 세포의 비정형은 방사선조사 후 6시간부터 5일까지 계속해서 경미하게 보였다. Paclltaxei과 방사선조사 병용군은 apoptosis가 6, 24시간, 3일 및 5일에 각각 5.5, 4.5, 4.0, $4.0\%$로 방사선조사 단독군에 비하여 24시간부터 많아졌고 3일에는 통계학적으로 유의한 차이가 있었다. 위선의 확장과 세포의 비정형은 Paclitaxel과 방사선조사 병용군에서 방사선조사 단독군에 비하여 증가되지 않았다. 결론 : 흰쥐의 위점막은 paclitaxel 주입 후 24시간에 방사선조사를 시행한 결과 apoptosis를 종말점으로 볼 때 paclitaxel의 첨가효과만을 보여 주었다.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.831-834
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• 2010

Purpose: Congenital absence of the vagina is a rare case. It occurs as a result of Mullerian duct aplasia or complete androgen insensitivity syndrome. The reconstructive modality includes skin graft, use of intestine and various methods of flap. We report a patient who underwent vulvoperineal fasciocutaneous flap to reconstruct congenital absence of the vagina, while the external genitalia and ovaries are normal. Methods: A 26-year-old woman presented with vaginal agenesis. Under general anesthesia, a U-shaped incision was made between the urethral meatus and the anus. The new vaginal pocket was created up to the level of the peritoneal reflection between the urinary structures and the rectum. Next, the vulvoperineal fasciocutaneous flaps were designed in a rectangular fashion. Flap elevation was begun at the lateral margin which the adductor longus fascia was incised and elevated, and the superficial perineal neurovascular pedicle was invested by the fascial layer. The medial border was then elevated. A subcutaneous tunnel was created beneath the inferior of the labia to rotate the flaps. The left vulvoperineal flap was rotated counterclockwise and the right was rotated clockwise. The neovaginal pouch was formed by approximating the medial and lateral borders. The tubed neovagina was then transposed into the cavity. Results: In 3 weeks, the vaginal canal remained supple After 6 weeks, the physical examination showed normalappearing labia majora and perineum with an adequate vaginal depth. A year after the operation, the patient had a 7 cm vagina of sufficient width with no evidence of contractures nor fibrous scar formation. The patient was sexually active without difficulty. Conclusion: Although many methods were described for reconstruction of vaginal absence, there is not a method yet to be approved as a perfect solution. We used the vulvoperineal fasciocutaneous flap to reconstruct a neovagina. This method had a following merits: a single-stage procedure, excellent flap reliability, the potential for normal function, minimal donor site morbidity and no need for subsequent dilatation, stents, or obturators. We thought that this operation has a good anatomic and functional results for reconstruction of the vagina.

• Journal of Chest Surgery
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• 제42권1호
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• pp.28-33
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• 2009

배경: 경도이상의 기능성 삼첨판막 폐쇄부전이 있는 경우 삼첨판 성형술이 널리 시행되고 있으며, 판륜링을 이용한 성형술이 우수한 성적을 나타내고 있다. 우리는 새로운 삼차원적 모양의 삼첨판륜링(Edwards $MC^3$ annuloplasty system [Edward LifeSciences, Irvine, CA])을 이용한 삼첨판 성형술의 조기성적을 보고하고자 한다. 대상 및 방법: 2004년 11월부터 2006년 7월까지 삼첨판륜의 확장 및 경도이상의 삼첨판막 폐쇄부전이 있는 72명의 환자에서 Edwards $MC^3$ annuloplasty ring을 이용한 삼첨판 성형술을 시행하였다. 72명의 환자 중, 68명에서 정중흉골절개술을 하였고 4명에서 로봇팔을 이용한 최소절개 개흉술을 시행하였다. 남녀비는 21 : 51이었고 평균 나이는 $53.9{\pm}12.3$세였다. 수술 전 삼첨판막 폐쇄부전은 평균 $2.2{\pm}1.0$도였으며 평균 NYHA functional class는 $3.1{\pm}0.8$, 평균 좌심실박출계수는 $57.0{\pm}9.9$%였다. 결과: 삼첨판막 폐쇄부전과 NYHA functional class는 각각 $0.4{\pm}0.6$, $2.0{\pm}0.7$으로 의미있게 감소하였고 삼첨판막 협착은 없었다(p<0.001). 병원 사망은 1명이 있었으며 술 후 합병증은 3도 블록이 발생하여 영구적 인공심박동기 삽입을 한 경우가 1명이 있었다. 결론: 3차원적 모양의 삼첨판륜링은 장착하기 용이하며 임상적, 심초음파 검사상 단기성적은 우수한 것으로 판단된다. 그러나 이 판막륜링의 장기 성적에 대하여는 연구 대상환자에 대한 정기적인 추적관찰 및 검사가 필요하고 더 많은 임상 적용 및 경험이 필요할 것으로 판단된다.