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      • KCI등재

        Eleven-year Cumulative Incidence and Estimated Lifetime Prevalence of Urolithiasis in Korea: a National Health Insurance Service-National Sample Cohort Based Study

        태범식,Ulanbek Balpukov,조성용,정창욱 대한의학회 2018 Journal of Korean medical science Vol.33 No.2

        Background: The purpose of this study was estimation of the cumulative incidence and lifetime prevalence of urolithiasis in Korea. Methods: We used a National Health Insurance Service (NHIS) sample cohort dataset that included approximately 1 million individuals from Korea. Data from January 2002 to December 2013 were collected. We calculated the annual prevalence, recurrence rate, and estimate lifetime prevalence of urolithiasis. Multivariate logistic regression analysis was used to identify risk factors associated with urolithiasis. Results: There were 57,921 diagnosed urolithiasis cases in the NHIS database over the 11 years studied. The annual incidence of urolithiasis increased every year (Poisson regression; hazard ratio, 1.025; P < 0.001). Of the patients with urolithiasis, 21.3% experienced disease recurrence within 5 years. The 11-year cumulative incidence was 5.71%, and the incidence in men was higher than that seen in women (7.07% vs. 4.34%, respectively). The 11-year cumulative incidence in the 60- to 69-year-old group (9.08%) was higher than that seen in any other age group. The overall standardized lifetime prevalence rate was estimated to be 11.5%: 12.9% in men and 9.8% in women. Meanwhile, age (> 60 years), income level, diabetes, body mass index, hypertension, and cancer history were identified as contributing factors to urolithiasis. Conclusion: This study demonstrates that the annual incidence of urolithiasis in Korea is increasing. The overall standardized lifetime prevalence rate was higher than that reported in a previous report. This study is significant in that it is the first retrospective cohort study to estimate the lifetime prevalence of urolithiasis using a large national retrospective cohort.

      • Evaluation of the Learning Curve of Hand-Assisted Laparoscopic Donor Nephrectomy

        Tae, Bum Sik,Balpukov, Ulanbek,Kim, Hyeon Hoe,Jeong, Chang Wook International Scientific Literature, Inc. 2018 Annals of transplantation Vol.23 No.-

        <P><B>Background</B></P><P>In this study, we analyzed the learning curve of hand-assisted laparoscopic donor nephrectomy (HALDN).</P><P><B>Material/Methods</B></P><P>The first 198 consecutive donors (110 cases by expert surgeon and 88 cases by newbie surgeon) operated on using HALDN were included in this study. The primary outcome measures were warm ischemic time (WIT), total operation time and estimated blood loss (EBL). The secondary outcome measures included length of hospital stay (LOS), graft outcome, and surgery-related complications. We used the cumulative sum (CUSUM) method to generate learning curves.</P><P><B>Results</B></P><P>Except for WIT, all operative and convalescence parameters of donors and graft outcomes were similar for the 2 groups, including the total operation time (174.13 minutes <I>vs.</I> 171.75 minutes, <I>P</I>=0.140), EBL (108.27 cc <I>vs.</I> 116.82 cc, <I>P</I>=0.494), LOS (4.80 days <I>vs.</I> 4.92 days, <I>P</I>=0.144), and overall rates of intraoperative and postoperative complications (<I>P</I>>0.05). A significant difference was observed in WIT between the 2 groups (140.59 sec <I>vs.</I> 106.85 sec, <I>P</I>=0.027). Upon visual assessment of the CUSUM plots, a downward inflexion point for decreasing WIT was observed in 4 cases, total operation time in 12 cases, and EBL in 15 cases.</P><P><B>Conclusions</B></P><P>HALDN has a relatively short learning curve and similar results may be expected from newbie urologists who are trained in minimally invasive surgery fellowship.</P>

      • KCI등재

        Clinical Usefulness and Predictability of Seoul National University Prostate Cancer Risk Calculator (SNU-PCRC)

        Hyuk-Dal Jung(정혁달),Hyeong Dong Yuk(육형동),Ulanbek Balpukov,Ja Hyeon Ku(구자현),Cheol Kwak(곽철),Hyeon Hoe Kim(김현회),Chang Wook Jeong(정창욱) 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.3

        Purpose: To evaluate the clinical usefulness of the Seoul National University Prostate Cancer Risk Calculator (SNU-PCRC) to reduce unnecessary prostate biopsy and to increase the detection rate of high-risk cancer. Materials and Methods: We retrospectively analyzed 546 patients who underwent prostate biopsy between 2014 and 2016. The subjects were divided into 2 groups based on the type of risk calculator used: conventional and SNU-PCRC group. In the SNU-PCRC group, prostate biopsy was recommended when the probability of SNU-PCRC was more than 30%. Results: The SNU-PCRC group had significantly smaller prostate volume (p=0.010) and significantly more digital rectal examination and transrectal ultrasonography (TRUS) abnormalities (p=0.011 and p=0.010, respectively). Overall detection (71.9% vs. 32.1%) and high-risk cancer detection rates (40.6% vs. 19.3%) were significantly higher in the gray zone (prostate-specific antigen=4-10 ng/mL) (p<0.001 and p=0.006). The group with prostate cancer risk ≥30% on the SNU-PCRC compared to <30% group, overall detection rate of 72.3% versus 30.2% and high-risk detection rate of 60.6% versus 18.3% were significantly different (p<0.001 and p<0.001). Applying the SNU-PCRC to the conventional group could avoid unnecessary prostate biopsy in 50.6%. Conclusions: SNU-PCRC is clinically useful to reduce unnecessary prostate biopsy and increase overall detection rate and high-risk cancer detection rate.

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