Yonsei Experience in Robotic Urologic Surgery - Application in Various Urological Procedures

PURPOSE: The da Vinci robot system has been used to perform complex reconstructive procedures in a minimally invasive fashion. Robot-assisted laparoscopic radical prostatectomy has recently established as one of the standard cares. Based on experience with the robotic prostatectomy, its use is naturally expanding into other urologic surgeries. We examine our practical pattern and application of da Vinci robot system in urologic field. PATIENTS AND METHODS: Robotic urologic surgery has been performed during a period from July 2005 to August 2008 in a total of 708 cases. Surgery was performed by 7 operators. In our series, radical prostatectomy was performed in 623 cases, partial nephrectomy in 43 cases, radical cystectomy in 11 cases, nephroureterectomy in 18 cases and other surgeries in 15 cases. RESULTS: In the first year, robotic urologic surgery was performed in 43 cases. However, in the second year, it was performed in 164 cases, and it was performed in 407 cases in the third year. In the first year, only prostatectomy was performed. In the second year, partial nephrectomy (2 cases), nephroureterectomy (3 cases) and cystectomy (1 case) were performed. In the third year, other urologic surgeries than prostatectomy were performed in 64 cases. The first robotic surgery was performed with long operative time. For instance, the operative time of prostatectomy, partial nephrectomy, cystectomy and nephroureterectomy was 418, 222, 340 and 320 minutes, respectively. Overall, the mean operative time of prostatectomy, partial nephrectomy, cystectomy and nephrourectectomy was 179, 173, 309, and 206 minutes, respectively. CONCLUSION: Based on our experience at a single-institution, robot system can be used both safely and efficiently in many areas of urologic surgeries including prostatectomy. Once this system is familiar to surgeons, it will be used in a wide range of urologic surgeryope

Molecular characterization and genogrouping of VP1 of aquatic birnavirus GC1 isolated from rockfish Sebastes schlegeli in Korea

The cDNA nucleotide sequence of genome segment B encoding the VP1 protein was determined for the aquatic birnavirus GC1 isolated from the rockfish Sebastes schlegeli in Korea. The VP1 protein of GC1 contains a 2,538 bp open reading frame, which encodes a protein comprising 846 amino acid residues that has a predicted MW of 94 kDa. The sequence contains 6 potential Asn-X-Ser/Thr motifs. Eight potential Ser phosphorylation sites and 1 potential Tyr phophorylation site were also identified. GC1 contains the Leu-Lys-Asn (LKN) motif instead of the typical Gly-Asp-Asp (GDD) motif found in other aquatic birnaviruses. We also identified the GLPYIGKT motif, the putative GTP-binding site at amino acid position 248. In total, the VP1 regions of 22 birnavirus strains were compared for analyzing the genetic relationship among the family Birnaviridae. Based on the deduced amino acid sequences, GC1 was observed to be more closely related to the infectious pancreatic necrosis virus (IPNV) from the USA, Japan, and Korea than the IPNV from Europe. Further, aquatic birnaviruses containing GC1 and IPNV have genogroups that are distinct from those in the genus Avibirnaviruses and Entomo-birnaviruses. The birnavirusstrains were clustered into 5 genogroups based on their amino acid sequences. The marine aquatic birnaviruses (MABVs) containing GC1 were included in the MABV genogroup; the IPNV strains isolated from Korea, Japan, and the USA were included in genogroup 1 and the IPNV strains isolated primarily from Europe were included in genogroup 2. Avibirnaviruses and entomobirnaviruses were included in genogroup 3 and 4, respectively

Stability of the Maxillary and Mandibular Total Arch Distalization Using Temporary Anchorage Devices (TADs) in Adults

Distalization with temporary anchorage devices (TADs) is commonly used to resolve crowding and to correct molar relationships in non-extraction cases. The purpose of this study was to quantify the treatment effects and post-treatment stability of total arch distalization with TADs in adults and thereby elucidate the clinical effect of this treatment modality. The subjects of the study were 39 adult orthodontic patients treated with total arch distalization with TADs. Lateral cephalograms and dental casts were taken at pretreatment (T0), post-treatment (T1), and the retention period (T2, 29.3 ± 12.8 months) to evaluate the vertical and horizontal movement of teeth, changes of arch width and molar rotation. It was concluded that even though there was a little relapse in the anteroposterior position of the maxillary and mandibular teeth during retention, there was no obvious relapse in the facial profile. Therefore, the total arch distalization can be used in patients with a moderate amount of arch length discrepancy effectively with stable retention

Stability of the Maxillary and Mandibular Total Arch Distalization Using Temporary Anchorage Devices (TADs) in Adults

Distalization with temporary anchorage devices (TADs) is commonly used to resolve crowding and to correct molar relationships in non-extraction cases. The purpose of this study was to quantify the treatment effects and post-treatment stability of total arch distalization with TADs in adults and thereby elucidate the clinical effect of this treatment modality. The subjects of the study were 39 adult orthodontic patients treated with total arch distalization with TADs. Lateral cephalograms and dental casts were taken at pretreatment (T0), post-treatment (T1), and the retention period (T2, 29.3 ± 12.8 months) to evaluate the vertical and horizontal movement of teeth, changes of arch width and molar rotation. It was concluded that even though there was a little relapse in the anteroposterior position of the maxillary and mandibular teeth during retention, there was no obvious relapse in the facial profile. Therefore, the total arch distalization can be used in patients with a moderate amount of arch length discrepancy effectively with stable retention

Suppressed Formation of Conductive Phases in One-Pot Electrodeposited CuInSe₂ by Tuning Se Concentration in Aqueous Electrolyte

The single-bath electrochemical deposition of CuInSe₂ often leads to short-circuit behavior of the resulting solar cells due to the high shunt conductance. In this study, in an attempt to resolve this problem, the influence of the Se precursor concentration (<i>C</i>_Se) on electrodeposited CuInSe₂ films and solar cell devices is examined in the <i>C</i>_Se range of 4.8 to 12.0 mM in selenite-based aqueous solutions containing Cu and In chlorides along with sulfamic acid (H₃NSO₃) and potassium hydrogen phthalate (C₈H₅KO₄) additives. As <i>C</i>_Se increases, the CuInSe₂ layers become porous, and the grain growth of the CuInSe₂ phase is restricted, while the parasitic shunting problem was markedly alleviated, as unambiguously demonstrated by measurements of the local current distribution. Due to these ambivalent influences, an optimal value of <i>C</i>_Se that achieves the best quality of the films for high-efficiency solar cells is identified. Thus, the device prepared with 5.2 mM Se exhibits a power-conversion efficiency exceeding 10% with greatly improved device parameters, such as the shunt conductance and the reverse saturation current. The rationale of the present approach along with the physicochemical origin of its conspicuous impact on the resulting devices is discussed in conjunction with the electro-crystallization mechanism of the CuInSe₂ compound

Daily Collection of Self-Reporting Sleep Disturbance Data via a Smartphone App in Breast Cancer Patients Receiving Chemotherapy: A Feasibility Study

Background Improvements in mobile telecommunication technologies have enabled clinicians to collect patient-reported outcome (PRO) data more frequently, but there is as yet limited evidence regarding the frequency with which PRO data can be collected via smartphone applications (apps) in breast cancer patients receiving chemotherapy. Objective The primary objective of this study was to determine the feasibility of an app for sleep disturbance-related data collection from breast cancer patients receiving chemotherapy. A secondary objective was to identify the variables associated with better compliance in order to identify the optimal subgroups to include in future studies of smartphone-based interventions. Methods Between March 2013 and July 2013, patients who planned to receive neoadjuvant chemotherapy for breast cancer at Asan Medical Center who had access to a smartphone app were enrolled just before the start of their chemotherapy and asked to self-report their sleep patterns, anxiety severity, and mood status via a smartphone app on a daily basis during the 90-day study period. Push notifications were sent to participants daily at 9 am and 7 pm. Data regarding the patients demographics, interval from enrollment to first self-report, baseline Becks Depression Inventory (BDI) score, and health-related quality of life score (as assessed using the EuroQol Five Dimensional [EQ5D-3L] questionnaire) were collected to ascertain the factors associated with compliance with the self-reporting process. Results A total of 30 participants (mean age 45 years, SD 6; range 35-65 years) were analyzed in this study. In total, 2700 daily push notifications were sent to these 30 participants over the 90-day study period via their smartphones, resulting in the collection of 1215 self-reporting sleep-disturbance data items (overall compliance rate=45.0%, 1215/2700). The median value of individual patient-level reporting rates was 41.1% (range 6.7-95.6%). The longitudinal day-level compliance curve fell to 50.0% at day 34 and reached a nadir of 13.3% at day 90. The cumulative longitudinal compliance curve exhibited a steady decrease by about 50% at day 70 and continued to fall to 45% on day 90. Women without any form of employment exhibited the higher compliance rate. There was no association between any of the other patient characteristics (ie, demographics, and BDI and EQ5D-3L scores) and compliance. The mean individual patient-level reporting rate was higher for the subgroup with a 1-day lag time, defined as starting to self-report on the day immediately after enrollment, than for those with a lag of 2 or more days (51.6%, SD 24.0 and 29.6%, SD 25.3, respectively; P=.03). Conclusions The 90-day longitudinal collection of daily self-reporting sleep-disturbance data via a smartphone app was found to be feasible. Further research should focus on how to sustain compliance with this self-reporting for a longer time and select subpopulations with higher rates of compliance for mobile health care.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000040632/5ADJUST_YN:YEMP_ID:A077602DEPT_CD:901CITE_RATE:3.428FILENAME:5.daily collection of self-reporting sleep disturbance data via a smartphone app_0.pdfDEPT_NM:보건학과SCOPUS_YN:YCONFIRM:YCONFIRM: