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유승흠,채수응,김춘배,강명근,송재만,이은식,이정구,이춘용,홍성준,Yu, Seung-Hum,Chai, Soo Eung,Kim, Chun-Bae,Kang, Myung Geun,Song, Jae Mann,Lee, Eun Sik,Lee, Jung Gu,Lee, Tchun Yong,Hong, Sung Joon 한국의료질향상학회 1997 한국의료질향상학회지 Vol.3 No.2
Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.
박두철,이춘용 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.1
Accurate assessment of severity and degree of renal injuries is required because their management if different according to the extent of renal damage. Recently the diagnostic accuracy of determining the severity of renal injury is relatively high, which enables the physician to determine the selection of treatment modality more easily and enhance the possibility of renal preservation. Between 1972 and 1989, a total of 109 patients with renal injury admitted to Department of Urology, Hanyang University Hospital were evaluated to determine the diagnostic accuracy of radiologic studies. There were 87 males and 22 females. The various causes of trauma were traffic accidents (41 patients), falls(36 patients), blow or kick injuries (27 patient), stab injuries (5 patients). Types of renal injuries were contusion(55%), minor injuries (15%), major injuries (26%) and vascular injuries (4%). Associated injuries were present in 45% of the patients and bone fracture (39 patients)was the most common injury. Drip infusion pyelography or intravenous pyelography were underwent in 82 patients, which showed the accuracy of 59% to assess the severity and degree of the renal injury. However the accuracy of the ultrasonography for 21 patients were 71%, and 100% for angiography (18 patients), 100% for computed tomography (14patients), respectively. Nephrectomy was underwent for 19 patients, renorrhyphy for 5 patients and partial nephrectomy for 2 patients. As mentioned above, excretory urography might not fully establish the degree and extent of renal injury, thus next diagnositc methods were needed in many cases. Although angiography proved the accuracy of the renal injury, it is moderately invasive and not required to perform for all patient with renal injury. Computed tomography has provided the clearest morphologic information, both the extent of injury and the vascularization of the injured part of the kidney. Commputed tomography scanning has resulted in a derease in the use of angiography for diagnosis of renal injury. These results suggest that computed tomography is the most effective initial diagnostic method for staging renal injury and the accurate staging with computed tomography will provide the appropriate management and reduce the renal loss.
이춘용 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.1
In Urlogy edndoscopic surgery has been widely used for the prostate and the bladder surgery since Nitze described the combination of telescope and Edison's incandescent light bulb in 1887. Kelling in 1901 described a case report of inspection of the abdominal cavity in the dog using a cystoscope introduced through a small stab wound. The endoscpic equipments has developed along with the electronic instruments development. In 1976 Cortesi and associates initially reported the utility of laparoscopic exploration of locating intra-abdominal tesis, and other laparoscopic applications have been slow to be adopted in clinical urologic practice. Laparoscopy has an inadequacy in teaching methods, unknown long term outcomes and cost concerns have limited its adoption as a diagnostic and therapeutic tool by in the urologic community. Despite relatively low levels of utilization, laparoscopy is a powerful tool offered by several centers throughout the world to perform various ablative and reconstructive procedures on surgical pathology involving urinary tract. The advantages of less post operative pain, shorter convalescence, and minimal disfigurement are well-supported by clinical studies and sought out by many patients. In conclusion, Improved instrumentation and technique continue to spur the urolaparoscopic surgeon forward toward newer and more challenging endeavors. Laparoscopic application in urologic surgery will cover more than 80% of conventional urologic surgery.
Tumor Necrosis Factor와 Interleukin - 2가 신세포암환자의 종양침윤림프구 세포독성 활성화에 미치는 영향
이춘용,최홍용,우영남 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.1
In an attempt to increase the potency of tumor infiltrating lymphocytes(TIL) in immunotherapy, the effect of tumor necrosis factor(TNF) and interleukin-2(IL-2) were investigated in vitro on proliferation and cytotoxic effect of TIL to the vatious kinds of tumor lines and fresh frozen tumor cells from renal cell carcinoma patient. The dosage of TNF was 500 unit/ml and IL-2 was 1000 Cetus unit/ml. The cytotoxicity of TIL was checked with 4 hour Chromium release cytotoxicity of TIL was checked with 4 hour Chromium release cytotoxicity assay and its proliferatio was checked by {³H} thymidine uptake assay. For the target cell of the TIL cytotoxicity was used M-14(melanoma cell line) as a lymphokine activated killer(LAK) cell sensitive cell line for investigation of LAK activity and K562(erythroleukemic cell line) for investigation of natural killer(NK) cell activity. To investigate the specific cytotoxicity on renal cell carcinoma, autologous tumor cell line was used as the autologous target. To investigate the non specific cytotoxicity on renal cell carcinoma, allogeneic fresh frozen renal carcinoma cells and renal cell carcinoma cell line(444) were used as the allogeneic target cells. The proliferation effect of TIL, treated with IL-2 at 20th day of culture was 11486±591 cpm and 23871±1069 cpm with combination of TNF and IL-2. The nonspectific cytotoxicity of TIL for the 444 at 20th day of culture was 8.2 LU in IL-2 only and 19.0 LU with combination of TNF and IL-2. The cytotoicity of TIL for the K562 at 20th day of culture was 37.3 LU in IL-2 only and 60.4 LU with combination of TNF and IL-2. These result suggest that the combination of TNF and IL-2 has a synergistic effect on proliferation and nonspectific cytotoxicity of TIL at 20th day of culture in vitro. THese results bear important practical implication for clinical trials of TIL in adoptive immunotherapy for metastatic renal cell carcinoma.
Prospidin이 Mouse 신 근위요세관 상피세포의 미세구조에 미치는 영향
이춘용,김동한,이규식 한양대학교 의과대학 1987 한양의대 학술지 Vol.7 No.1
Prospidin, a new alkylating agent, is an antineoplastic agent which inhibits various transplantable tumor, Incubation with prospidin increases the stability of DNA and suppresses the incorporation of uridine into RNA by 15-20 percent. Prospidin is cytostatic for suspension culture and cells are blocked percent. Prospidin is cytostatic for suspension culture and cells are blocked in G₂ phase of the cell cycle, but does not affect the proliferation of bone marrow cells in vivo. The author has demonstrated the effect of prospidin on the kidny of the mice obsefving changes in the cytoplasmic organelles of the proximal tubular epithelium. All experimental animals were administered food and wa5ter as libitum. The animals of control group were administered only water for injection. The animals treated with 650 mg per kg of prospidin were sacrified at 12 and 24 hours after drug administration. The kidney specimens, which were fixed in 2% glutaradehyde-2.5% paraformaldehyde phosphate buffer, were stained with uranyl acetate and lead citrate and observed with JEM 100B electron microscop. 1. A lot of pinocytotic vesciles are formed below th vrush border of the epithelium of renal proximal tubule. 2. Dilatation of the cisterane of the rough endoplasmic reticulum associated with detachment of the membrane bounded ribosomes and hypertrophies of cisternae of Golgi comples are observed. 3. The formation of the phagosomes, autophagic vacuoles and residual bodies are recogized in the epithelial cells and some of residual bodies are located in the lumen of the renal proximal tubule. Consequently, it is suggested that intraperitoneal injection of prospiding induces a degenerative changes of the cytoplasmic organelles of the epithelium of renal proximal tubules in the albiono mice.