http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
정재현,곽철,김현회,구자현 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.12
Purpose: There are only a few reports of extramammary Paget disease (EMPD) of the external genitalia because it is a rare malignancy. We investigated patients with EMPD of the penis and scrotum and report the outcome of surgical management. Materials and Methods: From 2000 to 2012, a total of 19 patients diagnosed as having penile and scrotal EMPD underwent wide local excision with or without intraoperative frozen biopsy or preoperative mapping biopsy. The medical charts of these patients were reviewed and analyzed retrospectively. Mean follow-up was 22.5 months (range, 1 to 60 months). Results: The mean age of the patients was 68 years (range, 57 to 82 years). In some patients, the lesions were misdiagnosed as either eczema or some other benign skin lesion at outside institutions, with a mean delay in diagnosis of 43.5 months (range, 1 to 198 months). Intraoperative frozen biopsy or preoperative mapping biopsy was performed in 18 patients. The resection margin was negative in 9 patients (47.4%) and positive in 10 patients (57.6%). Intraepithelial EMPD without dermis invasion was observed in 5 patients (26.3%), whereas diseases with dermis invasion were noted in 14 patients (73.7%). During the follow-up period, recurrences occurred in four patients, and two patients with dermis invasion and recurrence died from the disease. Conclusions: Diagnosis of EMPD should not be delayed to allow for prompt management. Our findings suggest that intraoperative frozen biopsy or preoperative mapping biopsy cannot guarantee negative margins on final pathology. However, preoperative mapping biopsy and wide local excision with intraoperative frozen biopsy demonstrates good prognosis of EMPD, especially in those cases without dermal invasion.
서준교,정재현,곽철,김현회,구자현 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.4
Purpose: The current stratification of risk groups regarding recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) is problematic. We aimed to assess the long-term outcome and risk of multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors after transurethral resection of the bladder tumor (TURBT). Materials and Methods: We categorized 1,621 patients with NMIBC who underwent TURBT into four risk groups according to the European Association of Urology (EAU) guidelines as follows: low-risk, intermediate-risk, high-risk, and study group. The overall, cancer-specific, disease recurrence-free, and disease progression-free survival rates were estimated by using the Kaplan–Meier method. Then, the impact of risk group was assessed by using a multivariable Cox regression model. Results: The study group comprised 52 patients (3.2%) within a mean follow-up of 64.8 months. The disease recurred and progressed in 41 (78.8%) and 7 (13.5%) patients, respectively. Among the four groups, the study group showed the highest risk for 10-year recurrence after TURBT. The disease progression risk in the study group was between that of the intermediate- and high-risk groups. Cancer-specific and all-cause deaths occurred in one and four patients in the study group, respectively. The study group had a higher risk for disease recurrence than did the high-risk group; however, it did not have a higher risk for disease progression than in the high-risk group. Conclusions: Multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors carry a higher risk for disease recurrence, but not progression, than in the EAU high-risk group of NMIBC.
서준교,정재현,정창욱,이상은,이은식,구자현,김현회,곽철 대한비뇨의학회 2020 Investigative and Clinical Urology Vol.61 No.3
Purpose: The clinical behavior of prostate cancer differs by race and ethnicity; however, data on the Korean population are scarce. We assessed the long-term oncologic outcomes of clinically localized prostate cancer after radical prostatectomy in Korean men. Materials and Methods: We analyzed 786 clinically localized prostate cancer patients who underwent radical prostatectomy, from June 1993 to June 2008. Kaplan–Meier survival curve analysis and log-rank test were used to assess the oncologic outcomes. Results: The mean age of the patients was 64.9±6.6 years. Pelvic lymph node dissection was performed in 373 patients. Pathologic T and N stage cancer with local advancement and invasion were detected by radical prostatectomy in 307 and 22 patients, respectively. In total, 38 patients who underwent adjuvant therapy were excluded from the analysis of progression after biochemical recurrence (BCR), which occurred in 261 men. In total, 219 patients underwent salvage treatment. Local recurrence and distant metastasis occurred in 109 and 42 patients, respectively; 36 patients experienced metastasis with local recurrence. Castration-resistant prostate cancer developed in 22 patients, and overall and disease-specific mortality was noted in 148 and 23 patients, respectively. The median duration from operation to BCR, BCR to metastasis, and metastasis to disease-specific death was 25, 40, and 22 months, respectively. Conclusions: We demonstrated the long-term prognosis of localized prostate cancer after radical prostatectomy among Koreans. Our results differ from those reported in the Western literature, with a lower prevalence of distant metastasis and shorter time to metastasis after BCR.
구자윤,구휘모,유성현,황의창,한미아,정재흥,이현주,김명하,곽철,김선일 대한비뇨기종양학회 2023 대한비뇨기종양학회지 Vol.21 No.2
Purpose: There is a lack of guidelines for using angioembolization to manage renal cell carcinoma (RCC) patients with intractable symptoms. Therefore, the Korean Urologic Oncology Society (KUOS) developed a set of recommendations for angioembolization for RCC patients with intractable symptoms who are unfit for surgery. Materials and Methods: A rigorous systematic review was performed and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology was used to rate the certainty of the evidence for the patient outcomes and to develop the evidence into recommendations. The steering group, guidelines development group, systematic review team, and external review group consisted of KUOS members involved in the guideline development process. Results: The guidelines address the benefits, harms, patients’ values and preferences, costs, and resources related to angioembolization by using a single clinical question: Does angioembolization improve the quality of life for RCC patients with intractable symptoms who are unfit for surgery? Conclusions: The guideline development panel suggests angioembolization for RCC patients with intractable symptoms compared with supportive therapies, including systemic treatment (very low certainty of evidence, weak recommendation).
99mTc - HMPAO 뇌 SPECT 에서 시각자극에 의한 국소 뇌 혈류변화의 정량적 검증
주라형(Ra Hyeong Juh),서태석(Tae Suk Suh),곽철은(Chul Eun Kwark),최보영(Bo Young Choe),이형구(Hyoung Koo Lee),정용안(Yong An Chung),김성훈(Sung Hoon Kim),정수교(Soo Kyo Chung) 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.3
목적: 이 연구의 목적은 시각 활성 자극에 의한 뇌활성영역을 확인하고 국소 뇌 혈류량을 정량적으로 분석하는데 그 목적이 있다. ^8F-fluoro-2-deoxy glucose (FDG) PET과 ^15O-water PET에서 시각 자극을 가하는 동안 시각피질에서의 기전이 확인되었으며 PET에 비해 적은 비용으로 널리 사용되고 있는 ^99mTc-HMPAO Brain SPECT를 이용하여 시각자극을 주었을 때 대뇌 후두엽의 일차시각피질과 시각연합 피질에서의 국소 뇌 혈류 변화율을 정량적으로 분석하고자 하였다. 대상 및 방법: 오른손을 주로 사용하는 25세에서 33세의 나이 분포를 갖는 남자 3, 여자 3명(평균나이 26.7세)의 정상인을 대상으로 ^99mTc-HMPAO Brain SPECT (925 MBq)를 시행 하였고 8 Hz의 발광다이오드를 이용하여 4∼5분 동안 시각활성 자극을 주었을 때와 대조군으로 자극을 가하지 않은 비 활성상태에서의 경우로 나누어 스캔하고 해부학적 기준정보를 제공하기위해 MR영상과 융합하였으면 관심영역을 설정하여 혈류량을 정량적으로 분석하였다, 결과: 정량적인 분석을 위해 대뇌의 전체 용적과 계수율을 계산하고 관심영역을 설정하여 관심영역에 대한 복셀 당 평균 계수율을 측정하여 각 대상의 시각 활성자극을 가한 영상에서 정상 상태의 영상을 픽셀 당 픽셀로 감산 하여 통계적 파라미터를 이용한 뇌 지도를 구성하였으며 뇌 활성이 Brodmann 영역의 시각피질(Ba17)과 시각연합피질(Ba 18,19)에서 활성화되어있음을 Talairach 좌표를 통해 확인하였고 regional index를 계산하여 국소 뇌혈류 변화율을 측정하였다. 결론:^99mTc-HMPAO Brain SPECT에서 8 Hz의 발광다이오드로 시각 자극을 주었을 때 후두엽의 일차시각피질과 시각 연합 피질에서 뇌 활성화를 확인 하였고 통계적 파라미터를 이용한 SPM99에서 뇌지도를 작성하여 시각자극에 의한 활성영역을 Talairach 좌표와 Brodmann 분류에 의해 확인하여 Tl 강조 MR 영상에 융합하였다. 후두엽의 일차시각피질에서 시각 활성자극에 의해 국소 뇌 혈류량이 32.50±5.67% 증가하고 있음을 정량적으로 분석하였다. Purpose: The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of ^99mTc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. Materials and Merhods: The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRl and ^99mTc-HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). Results: The mean regional cerevral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipotal lobe was 32.50±5.67%. The sifnificant activation sites using a statistical parameter of vrain constructed a rendering image and image fusion with SPECT and MRI. Conclusion: Visual activation was revealed sifnificant increase through quantitative anaysis in visual cortex. Activation refion was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area(Ba18,19) of Brodmann. (Korean J Nucl Med 2002;36;166-76)