Effects of Post Biopsy Digital Rectal Compression on Improving Prostate Cancer Staging Using Magnetic Resonance Imaging in Localized Prostate Cancer

박경기,정문수,정수윤,김주희,정병하 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.1

Purpose: To evaluate the effectiveness of digital rectal-compression immediately after transrectal prostate biopsy (P-bx) for improving the accuracy of prostate cancer (PCa) staging. Materials and Methods: Between July 2008 and June 2010, 94 consecutive patients who had a radical prostatectomy were included in our retrospective analysis. The exclusion criteria included a history of previous P-bx and surgery, a biopsy performed in another hospital, a number of biopsy cores different from 12, or a condition interfering with bleeding assessment. The subjects were divided into two groups, compression and non-compression. All enrolled patients took magnetic resonance imaging (MRI) for PCa staging. Results:The compression and non-compression groups were comparable with respect to several baseline characteristics. However, the total hemorrhage score of intraprostatic bleeding was significantly different between the groups, even with adjustment for the time from biopsy to MRI (compression:15.4±2.32, non-compression:24.9±2.43, p<0.001). The intra-prostatic cancer location matching rate was higher in the compression group (78.0%) than in the non-compression group (70.2%) (p=0.011). Overall accuracy of staging in compression and non-compression groups was 84.7% and 77.3%, respectively. Conclusion: Our results demonstrate that digital rectal compression performed immediately after prostate biopsy to reduce intraprostatic hemorrhage improves the accuracy for detection of PCa using MRI.

입방체 점토시료에 대한 압밀 비배수 삼축압축 및 평면변헝률 시험

박경기,이강일 한국지반공학회 1994 지반 : 한국지반공학회지 Vol.10 No.3

본 문은 입방체 삼축시험기에 의한 점토지반의 특성을 연구하기 위하여 Lade형의 삼축시험기를 시험제작하여 그 특성을 논하고 이 시험기를 이용하여 점성토에 대해서 압밀 비배수 시험과 평면변형률의 실험결과를 바탕으로 입방체 시료와 평면변형률 상태의 시료에 대해서 축차응력, 간극수압, 응력경로 등에 대해서 상호 비교한 것이다. This study aims at investigating the mechanism and operation of cubical triaxial test developed by Lade in order to obtain analysis on the clayey foundation deformation. A comparison on deviator stress, pore water pressure and stress path is made between test results of clay using the cubical consolidated undrained test as well as plane strain test.

Antibiotic Sensitivity of Bacterial Strains from Prostate Abscess Pus Aspirated Using Ultrasound Guidance

박경기,Sung Dae Kim,Young-Joo Kim,Jung Sik Huh 대한요로생식기감염학회 2022 Urogenital Tract Infection Vol.17 No.1

Purpose: A prostate abscess is a rare occurrence often caused by immune dysfunction. The diagnostic modality for a prostate abscess is computed tomography or transrectal ultrasound. Transrectal ultrasound-guided aspiration is one such method. If treatment is dependent on the abscess size. This study examined the bacterial strains drained under transrectal ultrasound and their antibiotic sensitivity. Materials and Methods: The medical records of eight patients diagnosed with a prostatic abscess and treated by transrectal ultrasound-guided aspiration from March 2009 to December 2020 were reviewed retrospectively. The general characteristics, associated diseases, and bacterial strains and their antibiotic sensitivities were identified in blood, urine, and pus cultures. Results: Eight patients were hospitalized. The average age was 59.5±6.05 years, and the average length of hospitalization was 16.88±5.49 days; 75% had diabetes. No patients had catheterization, spinal injury, or prostate biopsy prior to diagnosis. The mean prostate volume was 47.05±27.3 ml, and the mean prostate abscess size was 2.08±0.83 ml. Under transrectal ultrasonography, the prostate abscess size was 5.43±5.31 ml, and catheters were inserted for treatment in four cases (50%). In the abscess culture test, Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus were found in four, three, and one case, respectively. E. coli and K. pneumoniae responded well to amikacin treatment, while seven cases responded well to Piperacillin/Tazobactam treatment. Conclusions: Prostate abscesses occur mainly in diabetic patients. The most common cultures are E. coli and K. pneumoniae. Intravenous injection of amikacin or Piperacillin/Tazobactam may be helpful as a treatment prior to bacterial identification.

Association of Urinary Urgency and Delay Time of Micturition in Women With Overactive Bladder

박경기,허정식 대한배뇨장애요실금학회 2014 International Neurourology Journal Vol.18 No.3

Purpose: Accurately measuring urinary urgency is important for diagnosing overactive bladder (OAB) and quantifying improvements in treatment outcome. Various methods have been recommended for evaluating urinary urgency, but these methods assess individual perceptions and preferences. To overcome the subjectivity in measuring urinary urgency, we evaluated the relationship between uroflowmetric parameters and urinary urgency in women with OAB. Methods: Consecutive female patients with lower urinary tract symptoms (n=110) were prospectively enrolled in this study between April 2011 and September 2012. Individuals with a history of using medications that are known to affect bladder function were excluded. All enrolled patients completed uroflowmetry with a delayed time to voiding (T2V). After urination was completed, patients were asked whether they experienced any urinary hesitancy or urgency at that time. Results: The mean patient age was 56.1 years; 70 out of 110 patients reported some degree of urinary urgency. T2V decreased with increased urgency. Several uroflowmetric parameters were observed to have a significant correlation with urinary urgency. T2V had a meaningful correlation coefficient for individuals with urgency, regardless of the voided volume. There was no significant correlation between the presence of urinary hesitancy and T2V. Conclusions: We believe that T2V would be a complementary tool for diagnosing and determining the degree of urinary urgency in women with OAB.

Easily Removable Ureteral Catheters for Internal Drainage in Children: A Preliminary Report

박경기,김명업,정문수,이동훈,홍창희 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.2

Purpose: We review our experience using a new and easily removable ureteral catheter in patients who underwent complicated ureteral reimplantation. Our goal was to shorten hospital stay and lower anxiety during catheter removal without fear of postoperative ureteral obstruction. Materials and Methods: Between April 2009 and September 2010, nine patients who underwent our new method of catheter removal after ureteral reimplantation were enrolled. Patients who underwent simple ureteral reimplantation were excluded from the study. Following ureteral reimplantation,a combined drainage system consisting of a suprapubic cystostomy catheter and a ureteral catheter was installed. Proximal external tubing was clamped with a Hem-o-lok clamp and the rest of the external tubing was eliminated. Data concerning the age and sex of each patient, reason for operation, method of ureteral reimplantation, and postoperative parameters such as length of hospital stay and complications were recorded. Results: Of the nine patients, four had refluxing megaureter, four had a solitary or non-functional contralateral kidney and one had ureteral stricture due to a previous anti-reflux operation. The catheter was removed at postoperative week one. The mean postoperative hospital stay was 2.4 days (range 1-4 days), and the mean follow-up was 9.8 months. None of the patients had postoperative ureteral obstructions, and there were no cases of migration or dislodgement of the catheter. Conclusion: Our new method for removing the ureteral catheter would shorten hospital stays and lower levels of anxiety when removing ureteral catheters in patients with a high risk of postoperative ureteral obstruction.

A Study of Clinical Predictors Associated With Intrinsic Sphincter Deficiency in Women With Stress Urinary Incontinence

박경기,김성대,허정식,김영주 대한배뇨장애요실금학회 2017 International Neurourology Journal Vol.21 No.2

Purpose: Recently, intrinsic sphincter deficiency (ISD) has been identified as one important factor in the outcome of stress urinary incontinence (SUI) related surgery. Clinical factors that can predict ISD are uncommon. The aim of this study was to determine predictive clinical factors for ISD in female patients with SUI. Methods: The patients were classified into 3 groups according to the value of Valsalva leak point pressure (VLPP)>90 cm H2O (anatomical incontinence, AI), between 61 and 90 cm H2O (equivocal, EV), and <60 cm H2O (ISD). All groups underwent a full examination, history evaluation, physical examination, uroflowmetry, and complete urodynamic study. Univariate analysis was performed by chi-square or t-test for categorical variables, respectively. A multivariate study was performed by Pearson correlation analysis in order to get clinical predictors of VLPP<60 cm H2O. Statistical significance was set at P<0.05. Results: There were 3 groups with a total of 189 patients: 56 patients (AI, 29.7%), 64 patients (EV, 33.8%), and 69 patients (ISD, 36.5%). The univariate analysis revealed a significant difference associated with maximal urethral closing pressure (P=0.03) and Stamey classification (P=0.006) between ISD and AI. The more severe the urinary symptom grade, the higher the frequency of ISD. However, the multivariate analysis showed the independent predictor of ISD is only present in grades II and III symptoms in the Stamey classification (P=0.001). Conclusions: It was found that the more severe the symptoms of urinary incontinence, the higher the possibility of ISD. In other words, the degree of urinary incontinence was found to be one relevant clinical factor in predicting ISD. This finding may help in evaluating and identifying the appropriate surgical technique for EV. Currently, absolute cutoff value to diagnose ISD has not yet been determined. More research is needed to identify clinical factors that can predict ISD.

음이온 계면활성 물질에 의한 구리의 흡착분리에 관한 연구

박경기,신정호,정갑섭 한국화학공학회 1997 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.35 No.3

음이온 계면활성 물질로서 sodium dioctylsulfosuccinate(SDSS라 약함)와 구리의 기포-포말 흡착분리 특성을 고찰하였다. 이상용액과 단분자 흡착의 가정하에 Gibbs식에 의한 정적방법으로 SDSS수용액의 표면과잉농도를 구하고 흡착모델을 고찰하였으며, 회분식 흡착실험으로 SDSS의 기액계면 흡착열을 구하였다. 또한 SDSS와 구리의 제거속도 및 포집효율(분리인자) 등을 검토하였으며, 구리 및 그 수산화물의 용해도적과 평형상수를 이용하여 수용액 중의 화학종의 분리 가능한 pH한계를 구하였다. 흡착모델은 3×10^7 ㏖/ℓ 이하의 희박농도에서는 Langmuir 흡착식을 따르지만 그 이상의 농도에서는 Freundlich식으로 나타낼 수 있었다. SDSS의 기액계면 흡착열은 1.92 ㎉/㏖로 얻어졌고, SDSS에 의한 구리의 효과적인 분리 pH범위는 5-6이었으며, 분리효율은 3ℓ/min이하의 범위에서 공기유량에 비례하였다. To investigate the characteristics of the adsorptive separation of copper by an anion surfactant, sodium dioctylsulfosuccinate(SDSS), the surface excess concentration of SDSS was determined by the static method, and the adsorption heat of SDSS at the gas-liquid interface was also determined under the assumption of ideal solution and mono-layer adsorption. The removal rate and the collection efficiency of SDSS and copper were determined, and the effect of pH was discussed from the solubility products and equilibrium constants of copper and its hydroxides. The Langmuir adsorption equation was adequate at very low concentration below 3×10^7 ㏖/ℓ of SDSS, but above this concentration the Freundlich equation worked well. Copper was effectively separated at pH 5-6.

국소 전립선암에서 복강경 술기를 이용한 소절개창 근치적 후치골 전립선적출술(LaMRRP)

박경기,고우진 대한비뇨의학회 2007 Investigative and Clinical Urology Vol.48 No.6

Bacillus Calmette Guerin 주입요법 이후 생긴 가종양에 대한 경구 Prednisolone의 효과

박경기,방우진,서주완,김영식,이석영,고우진 대한비뇨의학회 2007 Investigative and Clinical Urology Vol.48 No.4

비뇨기과의 영역에서 산업재해보상과 장애평가에 대한 의학적 고찰 : 최근 판례의 분석을 중심으로

박경기,허정식 한국의료법학회 2017 한국의료법학회지 Vol.25 No.2

Although the relationship between the patient and the doctor is a legal contraction, doctor is making a great effort to cure the disease with the best of the patient's disease. In the medical practice, complications related to treatment occur, resulting in obstacles to the patient, which are increasingly being compensated for the disability. The compensation system for industrial accidents among the compensation system in Korea is a system in which the system has been established along with the economic growth in Korea and a system for compensating for the obstacles that occur during the work of the workers. Disability can be temporary or permanent due to damage during work, and reimbursement can also have a significant impact on patients and companies in the event of a permanent disability. Compensation takes physical defects as priority, and the degree of impairment is weak against the functional impairment of organs. In each hospital, modifications are made in consideration of the patient's name and age through forms such as reimbursement-related cost estimates and medical certificate of injury, so that estimates are different for each hospital even for the same specialized courses. This study examines the difference between the judgments of damages related to industrial accidents and the medical indemnification standards that should be considered at the medical field. In many cases, when an industrial accident is confined to the urology area, a large number of bladder dysfunction and male sexual dysfunction become a problem. In the case of incontinence, which is a problem of the quality of life, it is not possible to take into consideration the grade or to provide objective data to identify the subjective symptoms such as incontinence. There is a more objective and predictable compensation system using the guideline, so it would be better to reduce time and economic waste to each other in patients and compensating organizations. 환자와 의사와의 관계는 법적으로 계약관계이지만, 의사는 전문화된 의학적인 지식과 숙련된 의료술기를 통하여 환자가 처해 있는 질환과 질병을 완치하려고 많은 노력을 경주하고 있다. 그러나 의료현장에서는 치료와 관련된 합병증 등이 발생이 되고 이로 인해 환자에게는 장애가 발생되고 이로 인해 장해에 대한 보상을 받는 경우가 늘고 있다. 우리나라 보상제도 중 산업재해보상제도는 우리나라 경제성장과 더불어 체계가 확립되었고 근로자의 작업 중 발생되는 장해에 대하여 보상하는 제도이다. 작업 중 발생되는 손상으로 인해 장해는 일시적인 경우와 영구적인 경우가 있으며 영구적인 장해의 경우 보상은 환자와 기업에게도 많은 영향을 미친다. 배상은 신체적인 결함을 우선으로 하고 있으며 장기의 기능상의 장해에 대하여 장해등급이 약한 편이다. 각 병원마다 배상과 관련된 치료비 추정서, 상해 진단서 등의 양식을 통하여 환자의 성명과 나이 등을 고려하여 변경을 하는 경우가 많아 같은 전문과목이라도 각 병원마다 추정이 다르게 나타나고 있다. 이 연구는 비뇨기계영역 중 산업재해와 관련된 손해배상의 판결과 실제로 의료현장에서 고려되어야 할 의학적인 배상 기준과의 차이에 대하여 검토하였다. 산업재해 중에 비뇨기과 영역에 국한 되어 있는 경우 많은 부분이 방광의 기능장애와 남성의 성기능장애가 문제가 되는 경우가 많다. 방광기능장해의 경우 각 등급간의 폭이 너무 크고 자세하게 기술되지 못하는 경우가 많아 실제적으로 삶의 질에 문제가 되는 요실금 등의 경우는 등급에도 고려하지 못하거나 배뇨통 등 주관적인 증상을 파악하는 객관적인 자료를 제시할 수 없는 경우가 많다. 신뢰할 수 있는 기관의 기준지침서를 이용하여 보다 객관적이고 예측이 가능한 보상시스템이 있어 환자와 보상을 하는 단체에서도 서로에게 시간과 경제적인 낭비를 줄이는 것이 좋을 것으로 판단된다.