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Endovascular Mechanical Thrombectomy in Basilar Artery Occlusion: Initial Experience
박범수,강창우,권현조,최승원,김선환,고현송,염진영,송시헌 대한뇌혈관외과학회 2013 Journal of Cerebrovascular and Endovascular Neuros Vol.15 No.3
Objective:This study was conducted to assess the efficacy and safety of endovascular mechanical thrombectomy (EMT) for patients diagnosed with basilar artery (BA) occlusion. Materials and Methods : We retrospectively analyzed clinical and imaging data of 16 patients diagnosed with BA occlusion who were treated with endovascular intervention from July 2012 to February 2013. Direct suction using the Penumbra system and thrombus retrieval by the Solitaire stent were the main endovascular techniques used to restore BA flow. The outcomes were evaluated based on rate of angiographic recanalization, rate of improvement of National Institutes of Health Stroke Scale (NIHSS) score, rate of modified Rankin Scale (mRS) at discharge and after 3 months, and rate of cerebral hemorrhagic complications. Successful recanalization was defined as achieving Thrombolysis In Cerebral Infarction (TICI) of II or III. Results : Sixteen patients received thrombectomy. The mean age was 67.8 ± 11 years and the mean NIHSS score was 12.3 ± 8.2. Eight patients treated within 6 hours of symptom onset were grouped as A and the other 8 patients treated beyond 6 hours (range, 6-120) were grouped as B. Successful recanalization was met in six patients (75%) for group A and 7 (87.5%) for group B. Favorable outcome occurred in 4 patients (50%) for group A and 5 (62.5%) for group B. Conclusion : Our study supports the effectiveness and safety of endovascular mechanical thrombectomy in treating BA occlusion even 6 hours after symptom onset.
박범수,추설호,전황균,정병창,서성일,전성수,이현무,최한용 대한의학회 2014 Journal of Korean medical science Vol.12 No.12
Traditionally, urologists recommend an interval of at least 4 weeks after prostate biopsybefore radical prostatectomy. The aim of our study was to evaluate whether the intervalfrom prostate biopsy to radical prostatectomy affects immediate operative outcomes, witha focus on differences in surgical approach. The study population of 1,848 radicalprostatectomy patients was divided into two groups according to the surgical approach:open or minimally invasive. Open group included perineal and retropubic approach, andminimally invasive group included laparoscopic and robotic approach. The cut-off of thebiopsy-to-surgery interval was 4 weeks. Positive surgical margin status, operative time andestimated blood loss were evaluated as endpoint parameters. In the open group, therewere significant differences in operative time and estimated blood loss between the< 4-week and ≥ 4-week interval subgroups, but there was no difference in positivemargin rate. In the minimally invasive group, there were no differences in the threeoutcome parameters between the two subgroups. Multivariate analysis revealed that thebiopsy-to-surgery interval was not a significant factor affecting immediate operativeoutcomes in both open and minimally invasive groups, with the exception of the interval< 4 weeks as a significant factor decreasing operative time in the minimally invasive group. In conclusion, performing open or minimally invasive radical prostatectomy within 4 weeksof prostate biopsy is feasible for both approaches, and is even beneficial for minimallyinvasive radical prostatectomy to reduce operative time.
박범수 서울敎育大學校 初等敎育硏究所 2002 한국초등교육 Vol.13 No.2
Many people recommend 'having discussions' as the most effective method for teaching the philosophy-related classes. This paper tries to explore the most significant guidelines for having discussions in the class, while re-examining the COI(Community of Inquiry) model of teaching philosophy which IAPC (the Institute for the Advancement of Philosophy for Children) first proposed. Among other things, the COI model is based upon the belief that one can, through competition and cooperation in the communal inquiry, acquire what one cannot get in the individual inquiries. In this paper the most important guidelines we have to keep in mind when constructing the COI in the class are given as follows : First, we have to try to activate the student-centered discussion. For our original goal has been set upon stimulating the students to develop the ability to think for themselves. Second, the teachers have to take part in the classes not as the leader but as the guide. If the teachers were to predetermine the directions of inquiry by giving questions, it would deny the core ideals of COI. Thus, they should remember that they give questions not to direct the students' inquiry, but to guide provoke and challenge the students' inquisitive instincts. Third, the teachers ought to respect students' rights to choose the inquiry agenda as much as possible. Students will attach themselves much more to the problems which they have found and formulated. Therefore, it is necessary that students think that their own interests and concerns dominate the stage of setting inquiry agenda. Fourth, it is wise to use students' real names when listing their questions. It may be important to respect students' interests, but it does not guarantee that they will participate in the inquiry most positively. In this case, if we are to write their real names following the questions they have given themselves, they will be expected to involve in the inquiry with greater responsibility and spontaneity. Fifth, we cannot put too much emphasis upon enforcing the habits to give and ask for the reasons for their opinions. Whether we will succeed in constructing the COI in the class or not depends upon how much children will value their duties to give to others, and at the same time, their rights to require of others, the reasons for their opinions. Sixth, we have to induce, if possible, the greatest number of members into discussions. We often see that certain members monopolize the opportunities to speak or dominate the directions of discussion. In such cases, the teachers should be prepared to help students to pay attention to the minority opinions by picking out the points children have passed away unnoticed through questioning.