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      • KCI등재
      • KCI등재

        Comparison of Laparoscopic and Open Partial Nephrectomies in T1a Renal Cell Carcinoma: A Korean Multicenter Experience

        박홍주,변석수,김현회,이승배,권태균,전승현,강석호,서성일,오태희,전윤수,이완,황태곤,나군호,서일영,권동득,김용준,최윤희,박수경 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.7

        Purpose: We analyzed a series of patients who had undergone laparoscopic partial nephrectomies (LPNs) and open partial nephrectomies (OPNs) to compare outcomes of the two procedures in patients with pathologic T1a renal cell carcinomas (RCCs). Materials and Methods: From January 1998 to May 2009, 417 LPNs and 345 OPNs were performed on patients with small renal tumors in 15 institutions in Korea. Of the patients, 273 and 279 patients, respectively, were confirmed to have pT1a RCC. The cohorts were compared with respect to demographics, peri-operative data, and oncologic and functional outcomes. Results: The demographic data were similar between the groups. Although the tumor location was more exophytic (51% vs. 44%, p=0.047) and smaller (2.1 cm vs. 2.3 cm, p=0.026) in the LPN cohort, the OPN cohort demonstrated shorter ischemia times (23.4 min vs. 33.3 min, p<0.001). The LPN cohort was associated with less blood loss than the OPN cohort (293 ml vs. 418 ml, p<0.001). Of note, two patients who underwent LPNs had open conversions and nephrectomies were performed because of intra-operative hemorrhage. The decline in the glomerular filtration rate at the last available follow-up (LPN, 10.9%; and OPN, 10.6%) was similar in both groups (p=0.8). Kaplan- Meier estimates of 5-year local recurrence-free survival (RFS) were 96% after LPN and 94% after OPN (p=0.8). Conclusions: The LPN group demonstrated similar rates of recurrence-free survival, complications, and postoperative GFR change compared with OPN group. The LPN may be an acceptable surgical option in patients with small RCC in Korea. Purpose: We analyzed a series of patients who had undergone laparoscopic partial nephrectomies (LPNs) and open partial nephrectomies (OPNs) to compare outcomes of the two procedures in patients with pathologic T1a renal cell carcinomas (RCCs). Materials and Methods: From January 1998 to May 2009, 417 LPNs and 345 OPNs were performed on patients with small renal tumors in 15 institutions in Korea. Of the patients, 273 and 279 patients, respectively, were confirmed to have pT1a RCC. The cohorts were compared with respect to demographics, peri-operative data, and oncologic and functional outcomes. Results: The demographic data were similar between the groups. Although the tumor location was more exophytic (51% vs. 44%, p=0.047) and smaller (2.1 cm vs. 2.3 cm, p=0.026) in the LPN cohort, the OPN cohort demonstrated shorter ischemia times (23.4 min vs. 33.3 min, p<0.001). The LPN cohort was associated with less blood loss than the OPN cohort (293 ml vs. 418 ml, p<0.001). Of note, two patients who underwent LPNs had open conversions and nephrectomies were performed because of intra-operative hemorrhage. The decline in the glomerular filtration rate at the last available follow-up (LPN, 10.9%; and OPN, 10.6%) was similar in both groups (p=0.8). Kaplan- Meier estimates of 5-year local recurrence-free survival (RFS) were 96% after LPN and 94% after OPN (p=0.8). Conclusions: The LPN group demonstrated similar rates of recurrence-free survival, complications, and postoperative GFR change compared with OPN group. The LPN may be an acceptable surgical option in patients with small RCC in Korea.

      • KCI등재

        Serous-lined Extramural Tunnel 방법의 Ileal W-neobladder의 종양학적, 기능적 결과

        박홍주,유창희,김청수 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.9

        Purpose: We wanted to analyze the oncologic and functional outcomes of radical cystectomy and creation of an orthotopic ileal neobladder with a serous-lined extramural tunnel. Materials and Methods: There were 110 patients and 101 patients were male(mean age: 58.7 years, age range: 35-78 years). All these patients underwent radical cystectomy and creation of a ileal W-shaped neobladder with a serous-lined extramural tunnel, and all the procedures were done by one surgeon. The median period of follow-up was 28.9(range: 6-95) months. The Assessing the patients’ clinical history, physical examinations, complete laboratory tests, CT scans and bone scans were performed postoperatively for the evaluation of recurrence and complications. The voiding patterns of 77 patients of the 110 patients were surveyed. Results: Five-year-overall survival was 56% and the median survival period was 66.1 months. The tumor recurrence rate was 39.1%(43 patients) and 21(19.1%) patients died due to progression of cancer. The daytime and nighttime urinary continence rates at postoperative 1 year were 87% and 79%, respectively. Sixty three(81%) patients among the 77 patients had no voiding problems after the procedures. Nine patients still had severe incontinence and 5 patients still suffered from voiding difficulty. Renal functional deterioration developed in 3 patients(2.8%); however, no patients were on dialysis. Acute pyelonephritis was observed in 12 patients and recurrent pyelonephritis occurred in 6 patients. Ureter-ileal anastomosis site stricture was occurred in 5 renal units. No reflux from the ileal bladder into the ureter was observed. Conclusions: Radical cystectomy and an orthotopic ileal neobladder using a serous-lined extramural tunnel for patients with invasive bladder cancer were effective and durable procedures in terms of the oncologic and functional outcomes. Purpose: We wanted to analyze the oncologic and functional outcomes of radical cystectomy and creation of an orthotopic ileal neobladder with a serous-lined extramural tunnel. Materials and Methods: There were 110 patients and 101 patients were male(mean age: 58.7 years, age range: 35-78 years). All these patients underwent radical cystectomy and creation of a ileal W-shaped neobladder with a serous-lined extramural tunnel, and all the procedures were done by one surgeon. The median period of follow-up was 28.9(range: 6-95) months. The Assessing the patients’ clinical history, physical examinations, complete laboratory tests, CT scans and bone scans were performed postoperatively for the evaluation of recurrence and complications. The voiding patterns of 77 patients of the 110 patients were surveyed. Results: Five-year-overall survival was 56% and the median survival period was 66.1 months. The tumor recurrence rate was 39.1%(43 patients) and 21(19.1%) patients died due to progression of cancer. The daytime and nighttime urinary continence rates at postoperative 1 year were 87% and 79%, respectively. Sixty three(81%) patients among the 77 patients had no voiding problems after the procedures. Nine patients still had severe incontinence and 5 patients still suffered from voiding difficulty. Renal functional deterioration developed in 3 patients(2.8%); however, no patients were on dialysis. Acute pyelonephritis was observed in 12 patients and recurrent pyelonephritis occurred in 6 patients. Ureter-ileal anastomosis site stricture was occurred in 5 renal units. No reflux from the ileal bladder into the ureter was observed. Conclusions: Radical cystectomy and an orthotopic ileal neobladder using a serous-lined extramural tunnel for patients with invasive bladder cancer were effective and durable procedures in terms of the oncologic and functional outcomes.

      • 토피라메이트에 의하여 치료된 편두통을 동반한 메니에르병 2예

        박홍주,박문수,유진석 대한평형의학회 2008 Research in Vestibular Science Vol.7 No.1

        Objective: To investigate the effects of topiramate on vestibular symptoms in patients with Meniere’s disease and migraine Case Reports: We present two patients with Meniere’s disease and migraine, who did not respond to the salt reduction diet and diuretics. Topiramate was given and maintained for several months. Frequency and severity of headache and vestibular symptoms decreased after initiation of the topiramate. Conclusions: Topiramate can be used satisfactorily for the patients with Meniere’s disease and migraine, who are refractory to regular conservative treatment for Meniere’s disease, when vertigo attacks are accompanied by migraine. Objective: To investigate the effects of topiramate on vestibular symptoms in patients with Meniere’s disease and migraine Case Reports: We present two patients with Meniere’s disease and migraine, who did not respond to the salt reduction diet and diuretics. Topiramate was given and maintained for several months. Frequency and severity of headache and vestibular symptoms decreased after initiation of the topiramate. Conclusions: Topiramate can be used satisfactorily for the patients with Meniere’s disease and migraine, who are refractory to regular conservative treatment for Meniere’s disease, when vertigo attacks are accompanied by migraine.

      • KCI등재

        발치 후 즉시 매식된 서로 다른 두종의 RBM표면 처리된 임플란트에 대한 다기관 후향적 임상연구

        박홍주,국민석,김수관,김영균,조용석,최갑림,오영학,오희균,Park, Hong-Ju,Kook, Min-Suk,Kim, Su-Gwan,Kim, Young-Kyun,Cho, Yong-Seok,Choi, Gab-Lim,Oh, Young-Hak,Oh, Hee-Kyun 대한악안면성형재건외과학회 2008 Maxillofacial Plastic Reconstructive Surgery Vol.30 No.3

        Purpose. This multicenter retrospective study was performed to evaluate the survival and success rates of immediate placement of USII and SSII Osstem implant (Osstem implant Co, Korea) on the maxillary and mandibular anterior and premolar areas. Materials and methods. Dental records were obtained in 37 patients who were treated with immediate implantation on the maxillary and mandibular anterior and premolar areas in 6 different clinics. The 98 implants were evaluated both clinically and radiographically using predefined success criteria. Results. There was no failed implant in all patients. The mean follow up period was 24.7 months (ranged from 12 to 58 months), and 25.1 months (ranged from 16 to 35 months) in USII and SSII implants, respectively. The crestal bone loss was 3 mm in 3 USII implants during 41 months, and in 1 SSII implant during 22 months. The overall success rate was 94.2% and 97.7% in USII and SSII implants, respectively. The age, gender, diameter, or length of implants, and type of surgery were not influenced to the success rate of immediate implantation. Conclusion. These results suggest that USII and SSII Osstem implant can be used successfully in immediate implantation on the maxillary and mandibular anterior and premolar areas.

      • KCI등재

        하악과두에서 발생한 악성 골육종 환자에서 외과적 절제 후 유리장골이식을 이용한 재건

        박홍주,유민기,국민석,오희균,Park, Hong-Ju,Yu, Min-Gi,Kook, Min-Suk,Oh, Hee-Kyun 대한악안면성형재건외과학회 2008 Maxillofacial Plastic Reconstructive Surgery Vol.30 No.4

        하악골에서 고분화 골육종은 매우 드물게 보고되고 있으며 조직검사상 전형적인 골육종과는 달리 다형성(pleomorphism)을 보이지 않기 때문에 양성종양으로 오진(under-diagnosis) 되기 쉽다. 그러나 정확한 환자의 진단은 적절한 치료와 환자의 예후에 영향을 큰 영향을 미친다. 그러므로 조기에 정확한 진단을 위하여는 의심되는 여러 부위에서 조직검사를 시행하고 임상소견과 방사선소견 등을 병리의사와 공유하여야 한다. 이에 초기에 진단이 어려웠던 하악골에 발생된 고분화 골육종을 경험하여 환자의 사회적 기능적 회복을 위한 수술을 시행하여 바람직한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다. Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.

      • KCI등재후보

        간호대학생의 임상실습 스트레스, 회복탄력성 및 우울과의 관계

        박홍주,김남희 경북대학교 간호과학연구소 2020 경북간호과학지 Vol.24 No.2

        Purpose: This study is to investigate the relationship between clinical practice stress, resilience and depression in nursing students. Methods: The subjects of this study were 3rd and 4th year students in two nursing school. The data collected from June 23rd to July 15th, 2019. Data were analyzed by frequency and percentage, mean and standard deviation, t-test, ANOVA and Pearson correlation coefficients. Results: The mean of clinical practice stress, resilience, and depression were 3.01±0.52, 3.56±0.42, and 2.20±0.61 respectively. Clinical practice stress showed a significantly correlated both with resilience (r=-.18, p=.002) and depression (r=.31, p<.001). Resilience of nursing students was significantly negatively correlated with depression (r=-.36, p<.001). Conclusion: According to the results of this study, it is considered that it is necessary to develop a variety of intervention programs that promote resilience to reduce clinical practice stress and depression in nursing college students.

      • KCI등재

        한국인에서 MRI로 측정한 유양돌기간 간격과 난형낭간 간격

        박홍주,장현종,심대보,신향애,안재윤,신정은 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.8

        Background and Objectives:The distance between the utricles is important in vestibular tests like the unilateral centrifugation test for examining the utricular function. In this test, the axis of rotation crosses precisely through one utricle, thus only theopposite utricle is stimulated. The interutricular distance needs to be known in order to stimulate one utricle maximally for thistest, and it would be better if the distance could be estimated from surface landmarks like intermastoid distance. Subjects andMethod:We investigated the correlation between the interutricular distance (IUD) and the intermastoid distance (IMD),measured on magnetic resonance images. Data were collected from 177 subjects (72 men and 105 women), who suffered fromdizziness, sensorineural hearing loss and facial nerve disorders. Results:We found that IUDs were 7.33±0.42 cm (6.03- 8.75cm) and the maximum difference of IUDs between the subjects was 2.73 cm. There was a significant correlation between IUDand IMD. The IUDs of men (7.57±0.38 cm) and women (7.17±0.38 cm) showed the similar correlation with those of IMD.The correlation was not different from that published for Caucasian subjects. Conclusion:These findings show that there is asignificant correlation between IUD and IMD. IMD can be useful for estimating IUD, which enables exact stimulation to begiven to the unilateral utricle in the unilateral centrifugation test. Moreover, individual assessment of IUD gives more precisestimulation than using a fixed IUD in the unilateral centrifugation test. (Korean J Otolaryngol 2006;49:781-5)

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