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남종길(Jong Kil Nam),정석근(Suk Gun Jung),김태남(Tae Nam Kim),박성우(Sung Woo Park),정문기(Moon Kee Chung) 대한비뇨기종양학회 2011 대한비뇨기종양학회지 Vol.9 No.1
Purpose: We evaluated lymphovascular invasion (LVI) as a prognostic factor and the outcome in patients with transitional cell carcinoma of the upper urinary tract. Materials and Methods: Between 1996 and 2009, we retrospectively reviewed the series of 136 patients who underwent nephroureterectomy with bladder cuff resection for transitional cell carcinoma of the upper urinary tract. Among 136 patients, those who had distant metastasis (2 patients), concomitant invasive bladder cancer (20 patients), incomplete resection or positive surgical margin (12 patinets) and follow up loss or unavailable data (n=18) were excluded in this study. 84 patients were selected to evaluate the 5 year survival rate and 5 year disease free rate by using log rank test of Kaplan-Meier according to the factor of the lymphovascular invasion. We evaluated the prognostic factors by using Cox regression. The prognostic factors were age, Sex, T stage, N stage, grade, location of the cancer (pelvis and ureter) and lymphovascular invasion. Results: The mean age of the patients when the operation performed was 66.6 year-old and the mean period of follow-up study was 42.2 months (7-161 months). Male patients are 56 and female patients were 28. The Ta/T1 and T2-4 stage was 40 and 44. The N0 and N1-3 were 72 and 12. The grade I-II and III were 45 and 39. Cancer in pelvis and ureter were 29 and 54. 24 patients were diagnosed with LVI. The 5 year survival rate in LVI positive and negative were 59% and 84.5% (p=0.014), and the 5 year disease free rate were 28.4% and 74.3% (p=0.004), respectively. T stage, N stage and LVI were significant prognostic factors in 5 year survival rate and 5 year disease free rate. However, tumor location was not an independent predictor for recurrence, and there was no difference in the probability of disease recurrence between ureteral and renal pelvic tumor. Conclusions: LVI regarded as a prognostic factor in 30% of patients of transitional cell carcinoma in upper urinary tract and could be independent prognostic factor of disease free rate and survival rate.
근치적방광적출 후 회장도관을 이용한 방광대치술의 장기간의 배뇨기능 분석
남종길(Jong Kil Nam),이동훈(Dong Hoon Lee),박성우(Sung Woo Park),정문기(Moon Kee Chung) 대한비뇨기종양학회 2017 대한비뇨기종양학회지 Vol.15 No.1
Purpose: The aim of this study is to compare clinical and urodynamic parameters among patients undergoing orthotopic neobladder substitution with ileal segment. Materials and Methods: Between 1991 and 2015 orthotopic bladder replacement with an ileal segment was performed 158 patients. All data were recorded retrospectively from medical records. For neobladder function, at 1-year follow-up we checked abdominal computed tomography, voiding cystourethrography, and voiding diary. Twenty-eight patients underwent urodynamic evaluation. Urodynamic data were divided into 4 groups based on follow-up duration. Preoperative (17 patients), 6 months (24 patients), 1–5 years (20 patients) and above 5 years (15 patients) after surgery evaluations were performed by urodynamic study. Results: All patients were men. Mean age is 61.7 years (range, 40–72 years). Mean follow-up period is 86.7 months (range, 7–182 months). Maximum bladder capacity, maximum detrusor pressure (Pdet), and maximum urethral closure pressure improve over the time. Maximum flow rate (Qmax) is constant during the follow-up. There was vesico-ureteric reflux during voiding in 5 renal units. At day time, 23 of 28 substitution patients were completely continent. Thirteen of 28 substitutions have night time continence. Of neobladder-related complications, the most common was acute pyelonephritis. Conclusions: Long-term functional outcomes with the ileal neobladder have acceptable. The urodynamic parameters without Qmax tended to improve with the lapse of time. However, the number of patients in each group was relatively small in comparison to the numbers of orthotopic diversion. Our results support the good functional outcomes of radical cystectomy with Studer ileal neobladder.
정문용,민성길,강홍조 大韓神經精神醫學會 1986 신경정신의학 Vol.25 No.1
Thyroid function tests including measuring blood triiodothyronine(T₃), thyroxine(T₄) and free thyroxine(FT₄) were done in 29 patients with panic disorder and compared with the data from normal control group of 86 persons. Only the value of FT₄in panic patients was significantly higher than those of control group, but it was within normal limit. The values of T₃ and T₄in panic patients were higher, too but without statistical significance. The scores of each items and total score of Hamilton's anxiety scale were not significantly correlated with the values of T₃,T₄and FT₄, but only depression score was significantly correlated with T₃value.