Poland씨 흉근 異狀의 유방재건 치험례 : Case Report

조인창,최준,박병윤,유재덕 中央醫學社 1983 中央醫學 Vol.45 No.4

Poland's syndrome means a congenital unilateral pectoralis muscle defect, often accompanied by the deformity of the ipsilateral upper extremity. Besides the pectoralis major muscle defect, the defects of deltoid, supra-and infra-supinatus, latissimus dorsi, rectus abdominis, teres major & minor etc. may occur as muscle deformity. And also breast tissue, nipple and areolar, subcutan-eous fat deficiency and abnormality of costal cartilage and anterior ends of ribs may be associa-ted. In the ipsilateral upper extremity, various abnormality including syndactly, brachydactyly may be associated. This paper describes an experience of Poland's pectoralis muscle anomaly, which was corrected with latissimus muscular island flap transposition and silastic prosthesis augmentation.

Prostate Volume has Prognostic Value Only in Pathologic T2 Radical Prostatectomy Specimens

조인창,권휘안,김정은,정재영,서호경,정진수,박원서,이강현 대한의학회 2011 Journal of Korean medical science Vol.26 No.6

The objective of this study was to evaluate the prognostic roles of the prostate volume,tumor volume, and tumor percentage as a function of the pathologic T stage in radical prostatectomy specimens. This study included 259 patients who underwent radical prostatectomy between 2005 and 2010. The mean follow-up period was 41.2 months. In all of the specimens, prostate volume (P = 0.021), the Gleason score (P = 0.035), and seminal vesicle invasion (P = 0.012) were independent predictors of biochemical recurrence (BCR). In the T2 group, multivariate analysis showed that the BCR was significantly associated with prostate specific antigen (PSA) (P = 0.028), a lower prostate volume (P =0.004), and the Gleason score (P = 0.040). The Kaplan-Meier survival curve showed that a smaller prostate volume was significantly associated with a greater risk of BCR (< 30 vs ≥ 30 mL; P = 0.010). In the T3 group, patients with seminal vesicle invasion had a significantly shorter mean BCR-free survival (P = 0.030). In this study, tumor volume and tumor percentage did not predict BCR. Notably, a lower prostate volume is an independent predictor for BCR only in the organ-confined radical prostatectomy specimens. But,prostate volume could not predict BCR in most locally advanced tumors.

대사증후군과 만성 신질환과의 연관성

조인창,김영원,채윤병,김동욱,윤석중,이상철,김원재,김용준 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.3

Purpose: Metabolic syndrome (MS) has been identified as a causal risk factor for cardiovascular disease, stroke, and cardiovascular mortality. Recent studies have suggested a possible relation between MS and renal function. The aim of this study was to evaluate the influence of MS on renal function. Materials and Methods: We analyzed 12,348 healthy Koreans who underwent a general health checkup. MS was defined as 3 or more of the criteria according to the National Cholesterol Education Program Adult Treatment Panel guidelines III (NCEP ATP III). The glomerular filtration rate (GFR) was estimated by the redefined Modification of Diet in Renal Disease formula. Chronic kidney disease (CKD) was categorized into 3 categories according to the Kidney Disease: Improving Global Outcomes guidelines; I: GFR≥90 ml/min, II: 60-89 ml/min, III: 30-59 ml/min. Results: The overall proportion with MS was 19.3%. Compared with populations without MS, those with MS showed a significantly decreased GFR. The prevalence of CKD increased with the number of MS components, and it was prominent in the group of males over 40 years of age. In multivariate analyses using age, sex, and individual MS components, age (odds ratio [OR]=20.40; 95% CI: 10.81-38.49), sex (OR=1.98; 95% CI: 1.51-2.60), and obesity (OR=1.48; 95% CI: 1.13-1.93) were strongly associated with CKD. Conclusions: This study showed that MS is a significant determinant of CKD. Handling of correctable factors such as obesity may be considered one of the preventive modalities against the development of CKD. Purpose: Metabolic syndrome (MS) has been identified as a causal risk factor for cardiovascular disease, stroke, and cardiovascular mortality. Recent studies have suggested a possible relation between MS and renal function. The aim of this study was to evaluate the influence of MS on renal function. Materials and Methods: We analyzed 12,348 healthy Koreans who underwent a general health checkup. MS was defined as 3 or more of the criteria according to the National Cholesterol Education Program Adult Treatment Panel guidelines III (NCEP ATP III). The glomerular filtration rate (GFR) was estimated by the redefined Modification of Diet in Renal Disease formula. Chronic kidney disease (CKD) was categorized into 3 categories according to the Kidney Disease: Improving Global Outcomes guidelines; I: GFR≥90 ml/min, II: 60-89 ml/min, III: 30-59 ml/min. Results: The overall proportion with MS was 19.3%. Compared with populations without MS, those with MS showed a significantly decreased GFR. The prevalence of CKD increased with the number of MS components, and it was prominent in the group of males over 40 years of age. In multivariate analyses using age, sex, and individual MS components, age (odds ratio [OR]=20.40; 95% CI: 10.81-38.49), sex (OR=1.98; 95% CI: 1.51-2.60), and obesity (OR=1.48; 95% CI: 1.13-1.93) were strongly associated with CKD. Conclusions: This study showed that MS is a significant determinant of CKD. Handling of correctable factors such as obesity may be considered one of the preventive modalities against the development of CKD.

불만족스런 상안검의 조기 교정술

조인창 대한미용성형외과학회 2006 Archives of Aesthetic Plastic Surgery Vol.12 No.2

Double eyelidplasty is one of the most common esthetic surgical procedures in Asia. However the incidence of complications is not rare, even by the hands of much experienced plastic surgeons. The most common serious complication is high fold, deep fold or ectropion, triple fold, ptosis and retraction. These occur single or complexed. The proper time of secondary revision is usually accepted at least 6 months after primary operation. It means that revision should be delayed until wound maturation. However when the complications are too severe for patient to manage his or her normal life, early revision should be taken into consideration. Moreover early revision can get better result in certain cases especially such as ptosis and retraction.A total 23 patients were treated early revisions between December 2004 and June 2006. All of the patients had their initial surgery done at another hospital or clinic. Early revsion was performed differently according to the various problems. Dissection was carried out with two forceps traction each other. Metzem was not used. Previous adhesion was detached also with two forceps and high fixation was lowed. And in ptosis and retracction cases, levator advancement was adjusted according to the eye fissue size. The successful early correction of complicated double eyelidplasty could be accomplished by accurate identification of the problem based on established surgical principles.

안검하수렐낫保*

조인창 釜山醫師會 1984 釜山醫師會誌 Vol.20 No.1

대한민국 40-50대 남성에서 만성전립선염 증상점수 (NIH-CPSI)와 국제 발기능 지수 (IIEF-5)의 관계 분석

조인창,김성빈,김유석,최재영,민승기 대한요로생식기감염학회 2012 Urogenital Tract Infection Vol.7 No.2

Purpose: Analyzed the correlation between the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and International Index of Erectile Function (IIEF-5) from questionnaires among Korean 40-50s male. Materials and Methods: From September 1, 2011 to December 31 2012, we conducted a survey targeting 1032 Korean males who were had medical examinations in National Police Hospital, Using NIH-CPSI and IIEF-5. After explaining the content of the NIH-CPSI and IIEF-5, the paper was checked by volunteers in person, and the results were then collected. The subjects were limited to Korean males in their 40-50s. We analyzed the collected questionnaires. Results: The average age of 1032 volunteers was 50 years old (42-59), and the average of NIH-CPSI total scores was 7.1±5.5. The average of IIEF-5 total scores was 17.4±6.5. IIEF-5 category was divided into Normal 385 (37.3%), Mild 296 (38.7%), Mild-Moderate 215 (20.8%), Moderate 98 (9.5%), and Severe 38persons (3.7%). Among total volunteers, 72 persons were Chronic prostatitis like symptom patients (6.9%),and whose NIH-CPSI average of pain score (total 21), voiding score (total 10), quality of life score (total 12)and total scores were 7.6±3.1, 4.3±2.5, 5.8±2.3, and 17.8±6.7, respectively. There were moderate correlations of pain score, voiding score, quality of life score, but not significant (Pearson's coefficient of correlations <0.501). An average of total IIEF-5 scores in chronic prostatitis - like symptoms in the present group was 14.0±6.8. It was significantly lower than in the in the absent group. Prostatitis-like symptoms in the present group had more severe degrees of erectile dysfunction than absent group (p=0.002). Assessing each NIH-CPSI category score and total score affected to total IIEF-5 score, we analyzed the correlation between NIH-CPSI and IIEF-5 using regression analysis. There were all negative correlations between IIEF-5 and Pain score (t=-6.199, r2=0.036, p=0.000), voiding score (t=-0.157, r2=0.025, p=0.000), QOL score (t=-7.845, r2=0.056,p=0.000), and total score (t=-9.366, r2=0.078, p=0.000). Having analyzed correlations between each score of NIH-CPSI groups and IIEF-5 score by using multiple regression analysis, there were statistically significant difference negative correlations between pain score and IIEF-5 (t=-2.646, p=0.008), QOLscore (t=-4.219,p=0.000), and age (t=-3.135, p=0.002), but not to voiding score (t=0.628, p=0.530). Conclusions: The higher the NIH-CPSI score, especially for pain and QOL scores play a larger role,and adversely affects erectile function of chronic prostatitis like symptom patients in Korean males aged 40-50s

Current Status of Targeted Therapy for Advanced Renal Cell Carcinoma

조인창,정진수 대한비뇨의학회 2012 Investigative and Clinical Urology Vol.53 No.4

The treatment of metastatic renal cell carcinoma (mRCC) has recently evolved from being predominantly cytokine-based treatment to the use of targeted agents, which include sorafenib, sunitinib, bevacizumab (plus interferon alpha [IFN-a]), temsirolimus, everolimus, pazopanib, and most recently, axitinib. Improved understanding of the molecular pathways implicated in the pathogenesis of RCC has led to the development of specific targeted therapies for treating the disease. In Korea, it has been 5 years since targeted therapy became available for mRCC. Thus, we now have broader and better therapeutic options at hand, leading to a significantly improved prognosis for patients with mRCC. However, the treatment of mRCC remains a challenge and a major health problem. Many questions remain on the efficacy of combination treatments and on the best methods for achieving complete remission. Additional studies are needed to optimize the use of these agents by identifying those patients who would most benefit and by elucidating the best means of delivering these agents, either in combination or as sequential single agents. Furthermore, numerous ongoing research activities aim at improving the benefits of the new compounds in the metastatic situation or their application in the early phase of the disease. This review introduces what is currently known regarding the fundamental biology that underlies clear cell RCC, summarizes the clinical evidence supporting the benefits of targeted agents in mRCC treatment, discusses survival endpoints used in pivotal clinical trials, and outlines future research directions.

하안검 퇴축 교정술 치험례

조인창 대한미용성형외과학회 2007 Archives of Aesthetic Plastic Surgery Vol.13 No.2

With the average life expectancy increasing and a larger percent of the population aging, more patients of an older demographics are undergoing periocular facial rejuvenation procedures. One of the most common procedures performed for periocular rejuvenation is the lower lid blepharoplasty. As interest in this type of surgery increases however, we are seeing more complications associated with this procedure. One of the most common and challenging postoperative complication after this procedure is lower lid retraction. The degree of lower lid retraction can present in a varying range from lateral canthal rounding and scleral show to cicatricial ectropion. Causes of lower eyelid retraction seem to be multifactorial and there are a variety of surgical approaches for correction of lower eyelid retraction. According to the cause and degree of lower lid retraction, the author must incorporate a customized approach for each deformity. In this study, 33 patients had corrective surgery to treat lower eyelid retraction between July 2004 and June 2006. Of these, only one patient presented for primary correction all others were secondary cases. Techniques used to correct lower lid retraction included a midface lift, a lateral canthopexy or canthoplasty, an oculi muscle suspension, or a spacer graft. There was noted improvement in all cases performed, however a mild degree of recurrence was noted in 6 cases. To effectively correct lower lid retraction, the surgeon must have a sound understanding of the anatomy of the lower eyelid. Technically, key essential fundamentals to correcting lower lid retraction include: knowledge of elevating the mid face, anchoring the lateral canthal tendon securely, and proper insertion of the spacer graft. This article presents multiple techniques to correct significant postsurgical lower lid malposition without the use of skin grafts.

비만한 요석 환자에서 대사 이상과 재발의 위험

조인창,김용준,이상철 대한비뇨의학회 2007 Investigative and Clinical Urology Vol.48 No.7

Purpose: Recent studies have suggested an increased prevalence of urolithiasis with obesity. This study aimed to assess the influence of obesity on urinary metabolic abnormalities and the recurrence of stone. Materials and Methods: We analyzed 802 consecutive stone formers(SF: first-time SF=501, recurrent SF=291) who underwent a comprehensive metabolic evaluation that included blood chemistry tests and a 24-hour urinary examination, as well as determining the body mass index(BMI). The BMI was categorized into the non-obese(BMI<25kg/m2) and obese(BMI≥25kg/m2) according to the re-defined Western Pacific Region WHO criteria on obesity(WPRO). All possible risk factors such as age, gender, BMI, the clinical characteristics and the metabolic parameters were compared between both groups. Among them, 184(22.9%) patients had been followed up for more than 24 months or they recurred during the follow up(mean: 56.0, median: 58.5, range: 7.0-140.0) and they were examined for the risk of stone recurrence by performing multivariate Cox regression analysis. Results: Obesity was significantly associated with the increased urinary excretion of sodium, calcium and oxalate(p<0.05, respectively). The urinary pH value showed inverse correlation with obesity(p=0.012). Urinary metabolic abnormalities were more common in the obese SF patients than the non-obese SF patients(p=0.003). Obesity was significantly associated with the stone recurrence rate(p=0.009). Cox regression analysis revealed that obesity was a strong predictor for recurrent stone formation(adjusted HR=2.384 95% CI: 1.372-4.143, p=0.002). Conclusions: Our results reveal that obesity is highly associated with metabolic alterations and urinary stone recurrence. Therefore, weight control might be considered as one of the preventive measures against recurrent stone formation.

開發負擔金制度가 住宅事業의 收益性에 미치는 影響에 關한 硏究

趙寅昌 건국대학교 행정대학원 1993 建國大學校 行政大學院 硏究論叢 Vol.21 No.-