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열공망막박리에서 공막돌륭술 후 발생한 중심와앞색소증식 1예
박수환,박성후,이지은,변익수,이승민 대한안과학회 2020 대한안과학회지 Vol.61 No.4
목적: 공막돌륭술 후 중심와에 발생한 망막앞색소증식 1예를 경험하여 이를 보고하고자 한다. 증례요약: 49세 여자 환자가 5일간 지속된 우안 시야장애를 주소로 내원하였다. 최대교정시력은 0.8이었다. 안저검사에서 중심와를 침범하지 않은 열공망막박리가 관찰되었고 11와 11시 30분 방향에 열공이 있었다. 공막돌륭술, 망막하액배출술, 냉동망막유착술을 시행하였다. 술 후 4일에는 망막하액이 거의 감소하였으나 시력이 0.2로 감소하였다. 안저검사에서 갈색의 색소 덩어리가 중심와앞을 덮고 있었다. 빛간섭단층촬영에서 고반사의 신호를 보이는 증식성 조직이 중심와 오목앞을 덮고 있었다. 경구 스테로이드를 투여하였고 술 후 2주부터 색소증식은 감소하였으며 3개월 이후에는 거의 소실되었다. 교정시력도 0.8로 회복되었다. 결론: 열공망막박리로 공막돌륭술을 시행한 환자에서 중심와에서 색소증식이 관찰될 수 있으며, 다른 증식질환과 감별을 위해 주의깊게 경과 관찰하는 것이 필요하다. Purpose: To report a case of preretinal pigmentary proliferation on the fovea after scleral buckling for rhegmatogenous retinal detachment. Case summary: A 49-year-old female visited out clinic complaining of a visual field defect in the right eye for 5 days. The best-corrected visual acuity (BCVA) was 0.8 in her right eye. Fundus examination of the right eye revealed an upper rhegmatogenous retinal detachment without macular involvement and retinal breaks were found at 11 o’clock and 11’ 30” direction. She underwent scleral buckling, subretinal fluid drainage, and cryoretinopexy under general anesthesia. At postoperative day 4, the subretinal fluid was reduced, but the BCVA decreased to 0.2. The fovea was covered with a brownish pigmentary clump and preretinal hyperreflective proliferative tissue was observed on the fovea by optical coherence tomography. Oral steroid was administered and a decrease of pigmentary proliferation was observed at 2 weeks after surgery. At 3 months postoperatively, the pigmentary proliferation had almost disappeared and the BCVA recovered to 0.8. Conclusions: Pigmentary proliferation on the fovea may be observed in patients treated with scleral buckling for rhegmatogenous retinal detachment, so careful observation is needed to differentiate this process from other proliferative diseases.
박수환,Park, Su-Hwan 한국설비기술협회 1994 설비 : 공조ㆍ냉동ㆍ위생 Vol.11 No.9
리엔지니어링은 분석적 사고에서 벗어나 논리의 규칙에 따라 필요한 결론을 도출해 내는 결과상정형(IE)발상법이다. 도요다 생산방식에서는 이를 공정분해라 한다. 공정분해는 리프로세스 디자인(Reprocess design)즉, 공정재설계를 의미한다. 공정분해기법을 제조부문이 아닌 조직의 슬림(slim)화, 간접업무의 합리화 등에 응용한 것이 리엔지니어링이다. 발상법이 동일하므로 여기서는 그에 대한 실증방법, 내용의 명확화를 설명하고자 한다.
전립선 침 생검 결과에 따른 전립선암의 피막 침범 여부 예측
박수환,박종연,안한종 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.7
Purpose: To assess the ability of multiple variables to predict the extracapsular extension and lateralities of the extension on ten-core prostate needle biopsies. Materials and Methods: Eighty-five ten-core prostate biopsies and corresponding radical prostatectomy specimens were studied. Using univariate and multivariate regression analyses, variables, such as Gleason score, preoperative PSA, bilaterality of cancer, number of positive cores, total length of cancer, maximum length and percent of cancer on one core and maximum percent of cancer on one site were determined for their prediction of extracapsular extension. Results: Thirty-seven of the 85 patients(44%) showed extracapsular extension. In a univariate analysis, all variables, with the exception of the PSA, were significant. The number of positive cores was the only independent predictive factor in a multivariate analysis(p=0.0007). Nineteen (39.6%) of the 48 unilateral cancers cases on biopsy showed ipsilateral extracapsular extension, including 3 bilateral extensions on prostatectomy specimens. Significant differences in the Gleason score and number of positive cores were noted between organ confined and extracapsular tumors on the prostatectomy specimens. Among 37 bilateral cancers on biopsy, the probability of organ confined, unilateral extracapsular and bilateral extracapsular diseases were 51, 16 and 32%, respectively. The number of positive cores had a significant impact on the extension of tumors, with a dominant number of positive cores on the ipsilateral side. Conclusions: The number of positive cores is the most important predictive factor for the extracapsular extension. The laterality of the extracapsular extension can be predicted by the laterality and dominance of positive cores on biopsies. (Korean J Urol 2004;45:647-652)
박수환,장태정,정병욱,김대곤,이경섭,서영진 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.9
A ganglioneuroma is a rare benign tumor that originates in the neural crest, and is found along the path of the sympathetic chain, from the base of the skull to the pelvic cavity. It is characterized histologically by the composition of mature ganglion cells and nerve fibers. Due to the slow growth of the tumor, it may be incidentally found or detected by the pressure effects on adjacent structures. Herein, a case of a ganglioneuroma arising from the retroperitoneal sympathetic chain is reported in a 45-year-old female patient with a review of the literature. (Korean J Urol 2004;45:951-953)