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        • KCI등재

          Natural 10-year history of simple renal cysts

          박홍주,김종수 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.5

          Purpose: To carry out long-term follow-up of patients diagnosed with asymptomatic simple renal cysts (SRCs). Materials and Methods: One hundred fifty-eight adult patients in whom SRCs were incidentally diagnosed by abdominal ultrasonography or abdominopelvic computed tomography between August 1994 and June 2004 were followed up for over 10 years. The retrospective analysis investigated sequential changes in the size, shape, and Bosniak classification of the renal cyst and analyzed risk factors for increased size and growth rate of the cysts. Results: The median follow-up period was 13.9 years (range, 10.0–19.8 years). Median patient age was 54.1 years (range, 22–86 years). Mean maximal cyst size was 33 mm (range, 2–90 mm). Among all patients, 120 (76%) showed a mean increase in maximum renal cyst diameter of 1.4 mm (6.4%) per year. Age at initial diagnosis was a risk factor for increased renal cyst maximum diameter. The probability of an increase in maximum diameter of an SRC was 7.1 times greater in patients aged 50 years or older at diagnosis than in those aged less than 50 years. However, among patients with an increased maximum diameter, the mean growth rate was lower in patients aged ≥50 years than in those aged <50 years. Conclusions: About three-quarters of adult patients with accidentally diagnosed SRCs presented with an increased maximum diameter. The only risk factor for an increase in maximum diameter was age. In patients with an increase in the maximum diameter, the growth rate of the maximum diameter was 6.4% per year during 10 years and decreased with age.

        • KCI등재

          Osteoclast-Like Giant Cell Carcinoma of the Distal Ureter

          박홍주 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.1

          Extraskeletal osteoclast-like giant cell (OGC) tumors are uncommon and have mainly been found in the breast and pancreas. OGC neoplasms of the urinary tract are extremely rare. Most cases found in the renal pelvis and bladder are associated with either an in situ urothelial malignancy or a conventional high-grade urothelial carcinoma. These malignancies tend to be associated with a poor prognosis and disease course. To our knowledge, no cases of OGC tumors of the distal ureter only have been published. Here, we present the case of a 76-year-old man who underwent hand-assisted laparoscopic nephroureterectomy because of painless gross hematuria with right flank pain. Pathologic examination showed OGC carcinoma of the right distal ureter. No local tumor recurrence or distant metastasis was found at the 5-month follow-up.

        • KCI등재

          경부에 발생한 2새열낭종 2례

          박홍주,박세찬,손영휘,윤천주,유선열 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4

          Developmental anomalies arising from the branchial apparatus include cysts, external sinuses, internal sinuses, and complete fistulas. Second branchial cleft cysts are by far the most common among these anomalies. It may occur at any age, being most common in the third decade, and more frequent in the male than in the female. It usually presents a smooth, round, nontender fluctuant mass located between the level of the tragus and the clavicle along the anteromedial border of the sternocleidomastoid muscle. It is lined by respiratory or squamous epithelium unless inflammation is present. The considerable amount of lymphoid tissue may be found beneath the epithelium. The treatment of choice of branchial cleft cyst is surgical excision. If the lesion is acutely infected, however, it is essential to relieve the infection prior to the surgery This report deals with two cases of second branchial cleft cyst. In case 1, the cyst had rapidly increased in size over pregnant period. In case 2, the patient presented the swelling in the left neck, and had the history of incision and drainage because of misdiagnosis as submandibular space abscess. The infection was treated by antibiotic therapy in the first place, and then complete surgical excision was made. There was no evidence of any recurrence or complications for these 3∼4 years.

        • 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.

        • KCI등재

          국소 전립선암 환자에 대한 능동적 감시의 결과

          박홍주,김정현 대한비뇨기종양학회 2017 대한비뇨기종양학회지 Vol.15 No.3

          Active surveillance (AS) is currently accepted as a good management option for men with low-risk prostate cancer (PCa). Moreover, given the grade migration following the 2005 International Society of Urologic Pathology consensus conference, AS may be appropriate for men presenting with favorable intermediate-risk PCa. Three contemporary experiences of AS for men with intermediate-risk features suggest that although these men are at higher risk for radical treatment, most of them are not significantly compromising chances for long-term cure. From the long-term randomized ProtectT trial, 10-year outcomes after active monitoring, surgery, or radiotherapy for localized PCa revealed that PCa specific mortality was low irrespective of the treatment assigned, with no significant difference among treatments. Multiparametric magnetic resonance imaging, molecular biomarkers, and new Gleason grading system could enhance diagnostic accuracy and decrease the demerits of current AS protocols. Particularly, uniform recording of the percentage pattern 4 in Gleason 7 cancers will enable better understanding of prognostic risks and consideration of careful expansion of AS to populations with minimal Gleason pattern 4 disease.

        • KCI등재후보
        • 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

          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.

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