Impact of Prostate Size on Pathologic Outcomes and Prognosis after Radical Prostatectomy

민선호,박용현,이승배,구자현,곽철,김현회 대한비뇨의학회 2012 Investigative and Clinical Urology Vol.53 No.7

Purpose: We investigated prostate size and its correlation with final pathologic outcomes and prognosis. Materials and Methods: From 1993 to 2009, 830 consecutive patients who underwent radical prostatectomy with follow-up duration of 12 months or more were included in this study. Patients were categorized according to prostate size as follows: group 1, prostate size ≤40 g (n=458), and group 2, prostate size >40 g (n=472). Preoperative parameters and postoperative pathologic outcomes were compared between groups. Multivariate analysis with Cox proportional hazards regression model was used to identify the pathologic and clinical factors affecting biochemical recurrence. Results: Patients in group 1 had higher pathologic T stage (pT2a=17.7% vs. 23.9%, pT2b=1.1% vs. 0%, pT2c=40.4% vs. 39.8%, pT3a=29.5% vs. 21.0%, pT3b=10.7% vs. 13.2%, p=0.003) and higher positive surgical margin (40.3% vs. 33.1%, p=0.033) than did patients in group 2. Pathologic Gleason score was not significantly different between the two groups. The 5-year biochemical-recurrence-free survival was 62.3% for patients in group 1 and 73.2% for patients in group 2 (p=0.005). Multivariate Cox regression analysis showed that prostate size of 40 g or less (hazard ratio [HR], 1.378; 95% confidence interval [CI], 1.027 to 1.848; p=0.032), extracapsular extension (HR, 1.592; 95% CI, 1.147 to 2.209; p=0.005), positive surgical margin (HR, 2.348; 95% CI, 1.701 to 3.242; p<0.001), and pathologic Gleason sum (HR, 1.507; 95% CI, 1.292 to 1.758; p<0.001) were independent predictors of biochemical recurrence. Conclusions: Smaller prostate size was associated with increased risk of higher pT stage and positive surgical margin after radical prostatectomy. Also, prostate size less than 40 g was an independent prognostic factor for biochemical recurrence. Purpose: We investigated prostate size and its correlation with final pathologic outcomes and prognosis. Materials and Methods: From 1993 to 2009, 830 consecutive patients who underwent radical prostatectomy with follow-up duration of 12 months or more were included in this study. Patients were categorized according to prostate size as follows: group 1, prostate size ≤40 g (n=458), and group 2, prostate size >40 g (n=472). Preoperative parameters and postoperative pathologic outcomes were compared between groups. Multivariate analysis with Cox proportional hazards regression model was used to identify the pathologic and clinical factors affecting biochemical recurrence. Results: Patients in group 1 had higher pathologic T stage (pT2a=17.7% vs. 23.9%, pT2b=1.1% vs. 0%, pT2c=40.4% vs. 39.8%, pT3a=29.5% vs. 21.0%, pT3b=10.7% vs. 13.2%, p=0.003) and higher positive surgical margin (40.3% vs. 33.1%, p=0.033) than did patients in group 2. Pathologic Gleason score was not significantly different between the two groups. The 5-year biochemical-recurrence-free survival was 62.3% for patients in group 1 and 73.2% for patients in group 2 (p=0.005). Multivariate Cox regression analysis showed that prostate size of 40 g or less (hazard ratio [HR], 1.378; 95% confidence interval [CI], 1.027 to 1.848; p=0.032), extracapsular extension (HR, 1.592; 95% CI, 1.147 to 2.209; p=0.005), positive surgical margin (HR, 2.348; 95% CI, 1.701 to 3.242; p<0.001), and pathologic Gleason sum (HR, 1.507; 95% CI, 1.292 to 1.758; p<0.001) were independent predictors of biochemical recurrence. Conclusions: Smaller prostate size was associated with increased risk of higher pT stage and positive surgical margin after radical prostatectomy. Also, prostate size less than 40 g was an independent prognostic factor for biochemical recurrence.

Acacia ( Pseudo - acacia , Lin ) 꽃향기 성분분석

노택우,민선호,양해주 한국공업화학회 1990 한국공업화학회 연구논문 초록집 Vol.1990 No.0

Analysis of Octyl-2-Cyanoacrylate as a Dressing Material after Pediatric Urological Procedures

이한이,민선호,김광명,Lee, Hahn-Ey,Min, Sun Ho,Kim, Kwang Myung Korean Society of Pediatric Nephrology 2012 Childhood kidney diseases Vol.16 No.2

목적: 소아비뇨기과 관혈적 수술 시 피부봉합제로 사용된 Octyl-2-Cyanoacrylate (Dermabond$^{TM}$)의 효용성에 대해 알아보고자 하였다. 방법: 2010년 8월부터 2011년 8월까지 1년 동안 서울대학교 어린이병원 소아비뇨기과에서 단일 술자에 의해 음낭수종절제술, 고환고정술, 음경성형술을 시행받은 환자들을 대상으로 상처 합병증 발생율을 후향적으로 비교분석하였다. 총 128명을 대상으로 210개의 절개 창에서 시행되었으며, 피부 봉합에 Dermabond$^{TM}$을 사용하였다. 모든 절 개창은 Dermabond$^{TM}$을 사용하기 전 흡수사를 이용하여 표피 밑 봉합 혹은 몇 개의 단순 봉합을 시행하였다. Dermabond$^{TM}$는 4 mm 너비로 얇게 두 번 사용되었으며, 건조시키는 과정이 포함되었다. 추가적인 붕대나 드레싱은 적용되지 않았다. 결과: 128명의 환자들을 수술 종류에 따라 세 그룹으로 나누었다(Group 1: 음낭수종 절제술, 55례, 41.3%; Group 2: 고환고정술, 43례, 32.3%; Group 3: 음경성형술, 35례, 26.4%). 수술 후 외래에서 추적 관찰한 210개의 절개창 중에서 총 5개(2.3%)에서 상처 합병증이 발생하였고, 이를 그룹별로 다시 분석해 보면 Group 1에서 0개(0/55, 0%), Group 2에서 1개(1/43, 2.3%), Group 3에서 4개(4/35, 11.4%)가 각각 발생하였다. 상처 부위별로 다시 분석해 보면 서혜부 상처 1개(1/120, 0.83%), 고환 상처 0개(0/55, 0%), 음경 상처 4개(4/35, 11.4%)가 각각 발생하였다. Group 3의 음경 상처에서 다른 군에 비해 통계적으로 의미 있게 증가되었다(P=0.008). Group 2와 3에서 상처 합병증이 발생한 환자들의 평균 나이는 각각 1세, 9.50세 이었고 상처 합병증이 없는 환자들의 평균 나이는 2.34세, 5.61세 였지만 통계적으로 의미는 없었다(P=0.639, 0.122). 5개의 상처 합병증은 모두 가벼운 염증반응이었으며, 항생제 연고만을 적용 후 술 후 평균 13.8일(13-15일) 후 모두 치료되었다. 결론: Dermabond$^{TM}$는 소아비뇨기과에서 음낭수종절제술과 고환고정술 시 피부봉합제로서 기존의 피부 봉합에 대한 대안으로 안전한 방법으로 사료된다. 하지만 음경성형술에서는 향후 더 많은 연구가 필요하다. Purpose: We aimed to evaluate the efficacy of Octyl-2-cyanoacrylate (Dermabond$^{TM}$) as a topical skin adhesive for pediatric urologic open surgery. Methods: From August 2010 to August 2011, we retrospectively evaluated pediatric patients who underwent urologic open surgery at our institution. A total of 128 pediatric patients with 210 incisions used Dermabond$^{TM}$ for skin closure. Results: We divided the 128 patients into 3 groups according to type of surgery. Group 1 underwent hydrocelectomy (55 cases, 41.3%), Group 2 underwent orchiopexy (43 cases, 32.3%), Group 3 underwent penoplasty (35 cases, 26.4%). One hundred and twenty eight patients who underwent 133 surgeries in total, with a total of 210 incisions visited our outpatient department postoperatively, and a total of 5 wound complications (2.3%) occurred, but were simple inflammations and no dehiscence was observed. When analyzed according to groups, no wound problems occurred in Group 1 (0/55, 0%), one occurred in Group 2 (1/43, 2.3%) and four cases occurred in Group 3 (4/35, 11.4%) respectively. When re-analyzed according to wound locations, one occurred in an inguinal wound (1/120, 0.83%), none occurred in scrotal wounds (0/55, 0%), and four occurred in penile wounds (4/35, 11.4%). In Group 3, the incidence of penile wounds was significantly increased compared to other groups (P=0.008). All 5 wound problems were inflammatory and healed at an average of 13.8 days (13-15 days) with antibiotic ointment application only. Conclusion: Dermabond$^{TM}$ is feasible and safe topical skin adhesive alternative to standard skin suture in pediatric urologic surgery. However, further research about its efficacy and safety could be valuable in the future.

각성수준 및 여러가지 향이 P300에 미치는 영향

윤영화,민선호 한국심리학회 한국심리학회지 생물 및 생리 Vol.4 No.1

본연구에서는 각성상태나 졸린상태 또는 향이 제시되는 조건등을 사용하여 이러한 요인이 사건관련 뇌전위의 일종인 P300반응에 어떤 영향을 주는가 보고자 하였다. 그러기 위하여 피험자에게 일련의 비교적 낮은 소리를 제시하는 가운데 간혹 높은 소리를 제시하면서 드물게 제시되는 높은 소리를 탐지하여 세게 하는 과제를 사용하였다. 실험1에서는 P300반응이 각성수준과 관련되는가 살펴보기 위하여 피험자에게 잠깐 낮잠을 자게 하다가 깨운 직후나 커피를 마시고 쉬게 한 후에 P300반응을 측정하였다. 그 결과, 졸린 상태에서는 P300반응의 진폭이 감소하였고, 커피를 마시고 각성된 상태에서는 P300반응의 진폭이 도로 증가하였음을 발견하였다. 그러나 그런 조작이 P300반응의 잠재기에는 영향을 미치지 않았다. 실험2에서는 향이 지닌 각성효과나 진정효과가 P300반응의 진폭에 반영되리라 생각되어 천연향의 정유나 천연향의 정유에서 조향한 몇가지 개발한 향의 정유를 선택하여 실험1에서와 동일한 과제를 사용하여 향 제시가 P300반응에 미치는 영향을 살펴보았다. 실험2의 결과, 여러가지 향이 P300의 진폭에 유의미한 영향을 미쳤다. 즉 쟈스민과 로오즈는 P300반응의 진폭을 증가시켰으며 라벤더와 캐모마일은 P300의 진폭을 감소시켰으며 개발한 향 역시 P300의 진폭에 유의미한 영향을 미쳤다. 따라서 본연구자들은 P300반응이 향이 뇌전기활동에 미치는 영향을 측정하는데 사용될 수 있는 민감한 측정치라 제안한다. Present study was conducted to investigate the effects of arousal level and odour on the P300 amplitude. To obtain P300, subjects were requested to detect and count infrequent high-pitched tones interspersed frequent low-pitched tones(odd-ball paradigm). In experiment 1, in order to examine the effects of drousiness and arousal on the P300, amplitude P300 was obtained immediately after subjects took a nap or drank a coffee and rested. The result showed drowsiness decreased and arousal increased the P300 amplitude. Experiment 2 was conducted to examine whether the P300 was sensitive to the stimulating or sedative effects of some odours with odd-ball paradigm. The results of experiment 2 showed odours affected the P300 amplitude, that is, jasmine and rose increased while lavender and chamomile decreased the P300 amplitude. We suggest that P300 is a sensitive measure of the effects of odour on the brain electrical activities.

연구논문 - 유기공업화학 : Acacia ( Pseudo - acacia , Lin ) 꽃향기 성분분석

노택우,민선호,양해주 한국공업화학회 1990 한국공업화학회 연구논문 초록집 Vol.1990 No.3

고혈압 환자들은 자신이 복용하고 있는 혈압 약의 이름을 얼마나 알고 있는가?

이승연,조홍준,민선호,이홍규 대한가정의학회 2003 Korean Journal of Family Medicine Vol.24 No.5

Background: Doctor shopping is common in Korea. Therefore, if patients are not familiar with the name of the antihypertensive drug they are taking, they may end up taking a drug that previously caused them side effects and may have to start on a new antihypertensive drug. This study was to clarify the factors related to patients' recognition of the name of their antihypertensive medications. Methods: A questionnaire survey was done in June 2002 targeting 607 outpatients who were on antihypertensive medication seeking care at Asan Medical Center, Ulsan University Hospital and a clinic in Gyungju. Out of the 607 patients, 293 patients responded to the questionnaire. Results: Ninety six of the 293 patients (32.8%) were able to accurately name at least one of the antihypertensive drugs they were taking. Women were more familiar with names of antihypertensive drugs than men (39.4% vs 23.6%, odds ratio [O.R], 2.69; 95% confidence interval [CI], 1.39~5.22). The recognition of a drug was greater in subjects who had a higher education level (high school or university) compared to those with a lower education level (elementary school or less) by 4.2 fold (O.R, 4.20; CI, 1.64~10.69). The type of concomitant drug intake was lower in subjects who could name their antihypertensive drugs than for subjects who could not (O.R, 0.78; CI, 0.63~0.98). The patients who could name their antihypertensive drugs had both a lower mean systolic (133.2±11.6 mmHg: mean±standard deviation [S.D] vs 141.3±15.5 mmHg: mean±S.D) and diastolic blood pressure, compared to the patients who could not (84.5±7.2 mmHg: mean±S.D vs 86.8±9.5 mmHg: mean±S.D) when measured twice consecutively during a recent clinic visit. Conclusion: The recognition of a medication was associated with patient's sex, education level and the number of concomitant drug intake. The patients, who could name the antihypertensive drugs they were taking, had a lower mean systolic and diastolic blood pressure. 연구배경: 환자가 여러 의료 기관을 이용하는 ‘의사 장보기’현상이 흔한 우리나라에서 환자들이 자신이 복용하고 있는 약의 이름을 모르고 있는 경우에 부작용이 있던 약도 그대로 복용할 수 있고, 반대로 이전 약으로 혈압이 잘 조절되던 환자도 다시 처음부터 새롭게 약물 치료를 시작해야 되는 경우가 많을 수 있다. 또한 자신이 복용하고 있는 혈압 약의 이름을 알고 있는 환자들이 순응도가 높고 혈압이 더 잘 조절된다는 외국 자료가 있었지만, 우리나라에서는 이에 대한 연구가 거의 없어 혈압 약 이름의 인지율과 관련 인자들을 알아보고자 하였다. 방법: 2002년 6월 1일부터 6월 30일까지 서울아산병원 가정의학과 외래 및 울산대학교 병원, 그리고 경북 경주시 안강읍에 위치한 한 개인 의원 외래를 방문하여 고혈압 약을 복용하고 있는 사람 총 607명 중 설문에 응답한 293명을 대상으로 하였다. 결과: 1개 이상의 고혈압 약 이름을 정확히 알고 있는 사람은 96명(32.8%)이었다. 여성의 인지율(39.4%)이 남자(23.6%)보다 높았다(odds ratio [O.R], 2.69; 95% confidence interval [CI], 1.39~5.22). 초등학교 이하 교육을 받은 사람보다 고등학교 이상 교육을 받은 사람이 4.2배 더 인지율이 높은 것으로 나타났다(O.R, 4.20; CI, 1.64~10.69). 또한 복용하고 있는 다른 약의 종류는 0.78배(O.R, 0.78; [CI], 0.63~0.98) 더 적게 복용하는 것으로 나타났다. 최근 2회 측정한 평균 수축기 혈압은 인지군(133.2±11.6 mmHg: mean±standard deviation [S.D])이 비인지군(141.3±15.5 mmHg: mean±S.D)보다 낮았으며, 이완기 혈압도 인지군(84.5±7.2 mmHg: mean±S.D)이 비인지군(86.8±9.5 mmHg: mean±S.D)보다 더 낮았다. 결론: 이 연구에서 고혈압 약 이름의 인지율과 관련이 있는 인자는 성별과 학력, 그리고 복용 중인 다른 약의 종류로 나왔다. 또한 인지군에서 수축기 혈압과 이완기 혈압이 더 낮게 나타나, 혈압 약 이름을 알고 있는 것이 혈압 조절에도 도움을 줄 수 있을 것으로 생각한다.

두 번의 연속적 뇌경색에 의한 양측성 외측연수증후군 1예

조광덕,이덕희,황정숙,민선호,조아현,조경희 대한노인병학회 2004 대한노인병학회지 Vol.8 No.1

Laparoscopic Stone Surgery With the Aid of Flexible Nephroscopy

정재현,조성용,정창욱,정현,손환철,우승효,김대경,민선호,오승준,김현회,이승배 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.7

Purpose: To report the outcome of laparoscopic pyelo- and ureterolithotomies with theaid of flexible nephroscopy. Materials and Methods: A retrospective analysis was performed in 71 patients withcomplex renal stones or large and impacted proximal ureteral stones. Patients underwentlaparoscopic pyelo- or ureterolithotomies with or without the removal of smallresidual stones by use of flexible nephroscopy between July 2005 and July 2010. Operative success was defined as no residual stones in the intravenous pyelogram at12 weeks postoperatively. Perioperative results and surgical outcomes were analyzed. Results: The patients’ mean age was 54.7±13.7 years, and 53 males (74.6%) and 18 females(25.4%) were included. The mean maximal stone size was 19.4±9.4 mm. A totalof 47 cases were complex renal stones and 24 cases were impacted ureteral stones. Meanoperative time was 139.0±63.7 minutes. Stones were completely removed in 61 cases(85.9%), and no further ancillary treatment was needed for clinically insignificant residualfragments in 7 cases (9.9%). For complex renal stones, the complete stone-freerate and clinically significant stone-free rate were 80.9% and 93.6%, respectively. Multivariate analysis showed that the use of flexible nephroscopy for complex renalstones can reduce the risk of residual stones. A major complication occurred in one case,in which open conversion was performed. Conclusions: Laparoscopic stone surgery is a safe and minimally invasive procedurewith a high success rate, especially with the aid of flexible nephroscopy, and is not associatedwith procedure-specific complications.