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전립선 침 생검 결과에 따른 전립선암의 피막 침범 여부 예측
박수환,박종연,안한종 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.7
Purpose: To assess the ability of multiple variables to predict the extracapsular extension and lateralities of the extension on ten-core prostate needle biopsies. Materials and Methods: Eighty-five ten-core prostate biopsies and corresponding radical prostatectomy specimens were studied. Using univariate and multivariate regression analyses, variables, such as Gleason score, preoperative PSA, bilaterality of cancer, number of positive cores, total length of cancer, maximum length and percent of cancer on one core and maximum percent of cancer on one site were determined for their prediction of extracapsular extension. Results: Thirty-seven of the 85 patients(44%) showed extracapsular extension. In a univariate analysis, all variables, with the exception of the PSA, were significant. The number of positive cores was the only independent predictive factor in a multivariate analysis(p=0.0007). Nineteen (39.6%) of the 48 unilateral cancers cases on biopsy showed ipsilateral extracapsular extension, including 3 bilateral extensions on prostatectomy specimens. Significant differences in the Gleason score and number of positive cores were noted between organ confined and extracapsular tumors on the prostatectomy specimens. Among 37 bilateral cancers on biopsy, the probability of organ confined, unilateral extracapsular and bilateral extracapsular diseases were 51, 16 and 32%, respectively. The number of positive cores had a significant impact on the extension of tumors, with a dominant number of positive cores on the ipsilateral side. Conclusions: The number of positive cores is the most important predictive factor for the extracapsular extension. The laterality of the extracapsular extension can be predicted by the laterality and dominance of positive cores on biopsies. (Korean J Urol 2004;45:647-652)
박수환,Park, Su-Hwan 한국설비기술협회 1994 설비 : 공조ㆍ냉동ㆍ위생 Vol.11 No.9
리엔지니어링은 분석적 사고에서 벗어나 논리의 규칙에 따라 필요한 결론을 도출해 내는 결과상정형(IE)발상법이다. 도요다 생산방식에서는 이를 공정분해라 한다. 공정분해는 리프로세스 디자인(Reprocess design)즉, 공정재설계를 의미한다. 공정분해기법을 제조부문이 아닌 조직의 슬림(slim)화, 간접업무의 합리화 등에 응용한 것이 리엔지니어링이다. 발상법이 동일하므로 여기서는 그에 대한 실증방법, 내용의 명확화를 설명하고자 한다.
박수환,안정효 대한안과학회 2020 대한안과학회지 Vol.61 No.4
Purpose: To report two cases of periorbital necrotizing fasciitis in immunocompromised patients. Case Summary: (Case 1) A 55-year-old female with a history of diabetes and hepatic liver resection visited our clinic complaining of periorbital edema in her left eye 4 days prior to her visit. The visual acuity of the left eye was no light perception. Erythematous edema of the periorbital area and a black necrotic lesion in the left eye were observed. Periorbital necrotizing fasciitis was diagnosed and broad-spectrum antibiotics were injected. Urgent debridement was recommended but the patient went to another hospital and orbital exenteration was performed. K. pneumoniae was isolated in her blood culture. (Case 2) A 56-year-old female with a history of ovarian cancer chemotherapy visited our clinic complaining of periorbital pain and skin necrosis in her right eye 3 days prior to her visit. The visual acuity of the right eye could not be measured because of severe lid edema. Periorbital necrotizing fasciitis was diagnosed and antibiotic injection and urgent debridement were performed. P. aeruginosa was isolated in her blood culture. Postoperative infection progression and recurrence were not observed and eyelid reconstruction was performed. Conclusions: Early detection and treatment of periorbital necrotizing fasciitis is important in immunocompromised patients. Proper antibiotic therapy and necrotic debridement are needed to remove the periorbital inflammation. 목적: 면역저하환자에서 안와주위에 발생한 괴사근막염 2예를 보고하고자 한다. 증례요약: (증례 1) 당뇨 및 간암 간절제술 과거력이 있는 55세 여자 환자가 4일 전부터 발생한 좌측 안와주위 부종을 주요 소견으로 내원하였다. 좌안 시력은 광각이 없었고, 홍반성 부종 및 검은색의 괴사 병변이 관찰되었다. 안와주위 괴사근막염으로 진단하여 항생제를 투여하고, 괴사조직제거술을 권유하였다. 타 병원에 전원한 후 눈확내용물제거술을 시행하였으며, K. pneumoniae가 배양되었다. (증례 2) 난소암 항암치료 과거력이 있는 56세 여자 환자가 3일 전부터 발생한 우측 안쪽눈구석 부위 통증 및 피부괴사를 주소로 내원하였다. 우안 시력은 부종으로 측정이 불가능하였다. 안와주위 괴사근막염을 진단하여 항생제를 투여하고 괴사조직제거술을 시행하였으며, P. aeruginosa가 배양되었다. 술 후 감염 진행 및 재발은 관찰되지 않았고, 우안 눈꺼풀재건술 이후 발생한 노출성 각막염으로 경과 관찰 중이다. 결론: 면역저하환자에서 안와주위 괴사근막염은 조기 발견과 치료가 중요하며, 적절한 항생제 치료 및 괴사조직제거술로 안와주위염증을 제거해 주는 것이 필요하다.
체질량지수가 복압성요실금 환자의 Tension-free Vaginal Tape 수술 결과에 미치는 영향
박수환,이경섭,김대곤 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.4
Purpose: The aim of the study was to evaluate the clinical outcome, according to the body mass index(BMI), of tension-free vaginal tape(TVT) for the surgical treatment of stress urinary incontinence. Materials and Methods: Women were classified as being of normal weight (BMI 20-25), overweight(BMI 26-30) or obese(BMI>30). The patients characteristics and clinical outcomes of the operation were analyzed according to the BMI. Results: There were no significant differences in the patients characteristics, with the exception of the pre-operative posterior urethrovesical angle(PUVA). The subjective cure rate, satisfaction rate and complications of the normal BMI patients did not significantly differ from the women with the high BMI. Conclusions: The TVT procedure in stress urinary incontinence patient's results in similar subjective cure rates, satisfaction rates and post-operative complications, irrespective of the BMI, which makes it safe for overweight and obese women, and would appear to be an adequate treatment for future use. (Korean J Urol 2004;45:337-340)