준선형 비동차 방정식에 대한 정칙성

학위논문 (박사) -- 서울대학교 대학원 : 자연과학대학 수리과학부, 2021. 2. 변순식.We establish local higher integrability and local Calderón-Zygmund type estimate for p-Laplacian type parabolic systems with divergence data and nondivergence data. Firstly, we investigate local higher integrability. We prove scaling invariant estimate for parabolic p-Laplacian type systems. Secondly, we study the Calderón-Zygmund theory. We find scaling invariant local Calderón-Zygmund type estimate for parabolic p-Laplacian systems by adopting technique developed in higher integrability.이 학위논문에서는 포물형 비발산 데이터를 포함한 비동차 p-라플라스 형태 방정식에 대하여 연구한다. 에너지 추정이 가능한 최소의 비발산 데이터에 대해 약해의 자기 개량 성질과 그에 연관된 추정값을 제시한다. 우리는 이 추정값이 방정식의 척도변환에 불변임을 확인하고 활용을 알아본다. 또한, 자기 개량의 추정값을 증명하는데 사용된 기술들을 칼데론-지그문트 이론에 적용하여 그에 연관된 추정값을 제시한다.1 Introduction 1 1.1 Nondivergence data in parabolic problem 2 1.2 Higher integrability 3 1.3 Calderón-Zygmund theory 5 2 Preliminaries 7 2.1 Notations 7 2.2 Existence of p-Laplacian type parabolic systems 8 2.3 Mollification in time 17 2.4 Technical lemma 18 3 Higher integrability 19 3.1 Caccioppoli type inequality 20 3.2 Poincaré type inequality 25 3.3 Reverse Hölder inequality 30 3.4 Stopping time argument 38 3.5 Vitali's covering argument and Fubini's Theorem 39 4 Calderón-Zygmund theory 47 4.1 Comparison estimates 48 4.2 Vitali's covering argument and Fubini's Theorem 55Docto

Prostate size correlates with fasting blood glucose in non-diabetic benign prostatic hyperplasia patients with normal testosterone levels

We evaluated the correlations between BMI, fasting glucose, insulin, testosterone level, insulin resistance, and prostate size in non-diabetic benign prostatic hyperplasia (BPH) patients with normal testosterone levels. Data from 212 non-diabetic BPH patients with normal testosterone levels, who underwent transurethral resection of the prostate (TURP) due to medical treatment failure, were evaluated retrospectively. Patients with prostate specific antigen (PSA) levels of ≥ 3 ng/mL underwent multicore transrectal prostate biopsy before TURP to rule out prostate cancer. Patients with diabetes mellitus (DM) or serum testosterone levels of 0.05). Testosterone level inversely correlated with BMI (r = -0.327, P 0.05). Upon multiple adjusted linear regression analysis, prostate size correlated with elevated PSA (P < 0.001) and increased fasting glucose levels (P = 0.023). In non-DM BPH patients with normal testosterone levels, fasting glucose level is an independent risk factor for prostate hyperplasia.ope

Role of 1,25-dihydroxy vitamin D3 and parathyroid hormone in urinary calcium excretion in calcium stone formers.

PURPOSE: To find out the possible role of 1,25(OH)₂ vitamin D₃ [1,25(OH)₂D₃] and parathyroid hormone (PTH) as intrinsic factors in urinary calcium stone formers (SFs), we investigated their relationship with serum and urinary biochemical parameters. MATERIALS AND METHODS: A total of 326 calcium SFs (male: 204, female: 122) were enrolled and underwent outpatient metabolic evaluations including 1,25(OH)₂D₃ and PTH as well as serum and 24-hour urinary biochemical parameters. As control, 163 age- and sex-matched (2:1) individuals (non-SFs) who have never urinary stone episode were included. RESULTS: 1,25(OH)₂D₃ level was positively correlated with urinary calcium excretion (r=0.347, p<0.001). The hypercalciuric group and recurrent SFs had higher serum 1,25(OH)₂D₃ levels than the normocalciuric group (p<0.001) and first SFs (p=0.050). In the adjusted multiple linear regression analysis, serum 1,25(OH)₂D₃ level (β=0.259, p<0.001) and serum PTH level (β=-0.160, p<0.001) were significantly correlated with urinary calcium excretion. The patients in highest tertile of 1,25(OH)₂D₃ had a more than 3.1 fold risk of hypercalciuria than those in the lowest tertile (odds ratio=3.14, 95% confidence interval: 1.431-6.888, p=0.004). No correlation was observed between PTH and 1,25(OH)₂D₃ (R=0.005, p=0.929) in calcium SFs, while a negative correlation was found in controls (R=-0.269, p=0.001). CONCLUSION: 1,25(OH)₂D₃ was closely correlated with urinary calcium excretion, and high 1,25(OH)₂D₃ levels were detected in the hypercalciuric group and in recurrent SFs. However, 1,25(OH)₂D₃ was not correlated with PTH in calcium SFs. These findings suggest that 1,25(OH)₂D₃ might be important intrinsic factor for altered calcium regulation in SFs.ope

Transurethral Resection of Prostate in Benign Prostatic Hyperplasia Patients with Large Prostate Volume

PURPOSE: We investigated the safety and efficacy of transurethral resection of the prostate(TURP) in benign prostatic hyperplasia(BPH) more than 60cc by single surgeon for the relief of infravesical obstruction. MATERIALS AND METHODS: We evaluated 211 patients treated with TURP in BPH with large prostate by single surgeon. Each group was divided by prostate volume(group 1; 60-69.9, group 2; 70-79.9, group 3; 80-89.9, group 4; 90-99.9, group 5; >100cc of prostate volume). Various parameters such as International Prostate Symptom Score(IPSS), maximal flow rate(Qmax.), postvoid residual volume(PVR), prostate volume, adenoma volume, resection time, resection prostate volume, irrigation fluid volume and complications were evaluated and compared. RESULTS: Age of each group was not significantly different. Prostate volume, adenoma volume, resection time, Resection volume, irrigation volume of each groups were different significantly. But, resection volume/resection time and irrigation volume/resection time were not different significantly. Mean resection volume/resection time was 1.34g/min, and mean irrigation volume/resection time was 315.8ml/min. And intraoperative and postoperative complications of each group were not different. Mean postoperative change of Hb was 2.0+/-1.1g/dl. Postoperative parameters(IPSS, Qmax, PVR) were improved significantly. Only 2 patients needed transfusion in group 5. No urinary incontinence and TUR syndrome in each group was observed. CONCLUSIONS: TURP by experienced surgeon is a safe and effective treatment in BPH patients with large prostates for relief of infravesical obstructionope

Recent Concepts of Premature Ejaculation

Premature ejaculation(PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin(5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors(SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine(hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neurotransmission, it has been suggested that on-demand selective serotonin reuptake inhibitor(SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.ope

The Significance of Simultaneous Transurethral Resection of Bladder Tumor and the Prostate in Patient who have Superficial Bladder Cancer with Bladder Outlet Obstruction.

PURPOSE: We evaluated the clinical significance of simultaneous transurethral resection of bladder tumor(TURB) and the prostate(TURP) in patients who have superficial bladder cancer with bladder outlet obstruction. MATERIALS AND METHODS: Between April 1997 to April 2006, 213 patients with superficial bladder cancer were included in this study. The patients were treated with TURB only(n=107, Group I) or TURB with TURP (n=106, Group II). Bladder cancer recurrence was observed by performing cystoscopy and urine cytology. Uroflowmetry was performed three months after surgery. RESULTS: There were no significant differences in age, the tumor size or the number of tumors between groups I and II. There was no evidence of cancer implantation where TURP was applied. The recurrence rate of group II was significantly lower than that of group I(p=0.044), and the time to recurrence was longer for group II than for group I(p=0.026). There was no significant difference in the progression rate between the two groups(p=0.788). Three months after surgery, the mean residual urine volume was lower for group II(7.9ml) than that for group I(21.7ml). CONCLUSIONS: For superficial bladder cancer patients with bladder outlet obstruction, simultaneous TURB and TURP may help reduce the bladder cancer recurrence rate and delay the time to recurrence without the risk of cancer implantation at the site where TURP is applied.ope

Efficacy and Safety of Red Ginseng Extract Powder in Patients with Erectile Dysfunction: Multicenter, Randomized, Double-Blind, Placebo-Controlled Study

PURPOSE: To evaluate the safety and efficacy of red ginseng extract powder (OKBT) for treating erectile dysfunction. MATERIALS AND METHODS: Sixty-nine adult patients with mild to moderate erectile dysfunction of various etiologies were randomized to receive placebo or red ginseng extract powder. The red ginseng extract powder used in the present study was named OKBT. The primary efficacy parameter was response to the International Index of Erectile Function (IIEF) erectile function domain at baseline and week 8. Other IIEF domain scores were evaluated as secondary parameters. For safety evaluation, we performed history taking, physical examination, clinical laboratory tests, and hormonal tests at baseline and week 8. RESULTS: There were no significant differences in the patients' characteristics between the 2 groups. After 8 weeks of administration, primary efficacy (erectile function domain) and all secondary efficacy domains were significantly improved in the OKBT group compared with the placebo group (p<0.05). Notably, even the domain related to sexual desire, frequency and degree of sexual desire, was also improved in the OKBT group (p<0.001). There were no significant adverse reactions with OKBT administration, and there were also no significant differences in the results of laboratory tests between the 2 groups after administration. CONCLUSIONS: Our data show that red ginseng extract powder can be used as an alternative remedy for Korean men suffering from mild to moderate erectile dysfunctionope

Pathologic Characteristics and Prognosis of Pathologic T0 Prostate Cancer

PURPOSE: We evaluated the pathologic characteristics and prognosis of pathologic T0 (pT0) prostate cancer (PC). MATERIALS AND METHODS: Of 1,196 consecutive men who underwent radical prostatectomy (RP) between January 1992 and November 2008, 34 patients (mean age, 68.8+/-7.9 years; range, 48-85) had pT0 PC. They were categorized into 4 groups according to neoadjuvant hormone therapy (NHT) and diagnostic methods. The initial PSA, 5 alpha-reductase inhibitor (5alphaRI), Gleason score of prostatic needle biopsy (PNB) or transurethral resection of the prostate (TURP), clinical stage, and presence of high-grade prostatic intraepithelial neoplasia were evaluated. Clinical and biochemical progression were also evaluated. RESULTS: 34 patients were categorized into 4 groups (Group I: 9 without NHT, diagnosed by PNB [1.1%]; Group II: 8 without NHT, diagnosed by TURP [11.3%]; Group III: 16 with NHT, diagnosed by PNB [5.5%]; Group IV: 1 with NHT, diagnosed by TURP [3.8%]). Group I had serum prostate-specific antigen (PSA)<15.0 ng/ml, one positive biopsy core, and a Gleason score< or =7. Group II had serum PSA<10.1 ng/ml, chips involved with cancer<10.0%, and a Gleason score< or =6. There were more patients taking 5alphaRI and high-grade PIN among patients without NHT. None of patients with pathologic pT0 PC had clinical or biochemical progression during follow-up, except 3 patients with NHT (mean, 22 months; range, 2-105 months). CONCLUSIONS: Patients without NHT had more favorable clinical and pathologic results. In our study, except for 3 patients with NHT, all patients had undetectable PSA levels after RP. We need more time for follow-up to conclude whether the prognosis of pT0 PC is favorable.ope

Treatment of Simple Renal Cysts by Percutaneous Aspiration and OK-432 Sclerotherapy

PURPOSE: Percutaneous aspiration with sclerotherapy has been widely used for the treatment of symptomatic or large simple renal cysts. Ethanol has been most commonly used as a sclerosing agent; however, a temporary percutaneous nephrostomy for multiple ethanol injections is necessary to achieve a low recurrence rate. Thus, we used OK-432 as a new sclerosing agent without a temporary percutaneous nephrostomy for multiple injections, and also compared our results with the results of previous studies. MATERIALS AND METHDOS: Between October 2005 and April 2006, 50 patients (63 simple renal cysts) who underwent percutaneous OK-432 sclerotherapy for simple renal cysts were evaluated. The simple renal cysts were aspirated under ultrasonography and fluoroscopy, after which OK-432 was injected into the cyst. Follow-up was performed with ultrasonography or CT scan after 3 months. Regression of the renal cyst or a >70% reduction in size with no symptoms was considered a treatment success. RESULTS: Among 63 renal cysts in 50 patients, complete regression occurred in 17(27.0%). Greater than a 90% reduction in size occurred in 8(12.7%), a 80-90% reduction in size occurred in 21(33.3%), and a 70-80% reduction in size occurred in 15(23.8%); a <70% reduction in size occurred in 2 (3%). The overall efficacies of success were 96.8%. After the procedure, there were only some minor complications, such as mild fever, local pain, and liver function test elevation that subsided with symptomatic treatment. CONCLUSIONS: Percutaneous OK-432 sclerotherapy is simple, safe, and effective and can be an alternative first-line therapy of simple renal cysts.ope

Comparison of Extraperitoneal and Transperitoneal Robot-Assisted Radical Prostatectomy in Prostate Cancer: A Single Surgeon’s Experience

PURPOSE: To evaluate the feasibility and safety of the extraperitoneal robotic radical prostatectomy (ERP), we compared the results of transperitoneal robotic radical prostatectomy (TRP) with those of ERP performed by a single surgeon. MATERIALS AND METHODS: All operation was performed by a single surgeon, who had the experience of more than 150 transperitoneal cases. Recently, 30 cases were performed through transperitoneal approach, and then extraperitoneal approach was applied to next 30 cases. We compared the clinicopathologic parameters and perioperative outcomes between two groups. RESULTS: There were no significant differences in mean age, body mass index (BMI), preoperative prostate-specific antigen (PSA) level, prostatectomy Gleason scores and pathologic T stage between two groups, whereas positive surgical margin rate was significantly lower in ERP. There was no significant difference in total operation time, whereas console time, and vesicourethral anastomosis time significantly decreased in ERP. There were no significant differences in postoperative normal diet start day, the duration of hospital stay and bladder catheterization. There were no significant differences in the amount of estimated blood loss and the number of resected lymph nodes. In both groups, there were no inadvertent organ injury during trocar placement and conversion to open surgery, whereas 1 case of lymphocele in ERP was recovered with conservative care. CONCLUSIONS: ERP showed similar perioperative outcomes compared to TRP. Considering the potential risk of bowel injury in TRP and reduced peritoneal irritation in ERP, ERP may be alternative in robotic radical prostatectomyope