요역동학검사를 통한 여성요도증후군의 원인 분류

진명헌,이정구 대한비뇨의학회 2003 Investigative and Clinical Urology Vol.44 No.1

소아에서 발생한 기능성 부신피질암

진명헌,윤덕기,고영수,조재흥,김동선 大韓泌尿器科學會 2002 Korean Journal of Urology Vol.43 No.7

한국 남성에서 ICS-남성설문지를 이용한 하부요로증상과 방광폐색지표와의 연관성 분석

진명헌,고영수,이정구,박홍석,박원희,정희창,김덕윤,김형지,권동덕,나영길 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.1

소아에서 발생한 기능성 부신피질암

진명헌,윤덕기,고영수,조재흥,김동선 대한비뇨의학회 2002 Investigative and Clinical Urology Vol.43 No.7

한국 남성에서 ICS-남성설문지를 이용한 하부요로증상과 방광폐색지표와의 연관성 분석

진명헌,고영수,이정구,박홍석,박원희,정희창,김덕윤,김형지,권동덕,나영길 대한비뇨의학회 2003 Investigative and Clinical Urology Vol.44 No.1

요역동학검사를 통한 여성요도증후군의 원인 분류

진명헌,이정구 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.1

성욕감퇴가 있으나 정상 혈청 테스토스테론치를 가진 발기부전 환자에서 PDE5 차단제 단독요법과 Trazodone과의 병합요법의 비교

박민구,진명헌,배재현,김제종,문두건 대한남성과학회 2008 The World Journal of Men's Health Vol.26 No.1

Purpose: This study was done to assess the therapeutic effect of trazodone, an antidepressant agent in combination with sildenafil in patients with erectile dysfunction (ED) and decreased libido with normal serum testosterone level. Materials and Methods: From March 2005 to February 2006, 90 patients with ED complaining of decreased libido but whose serum testosterone level was within normal range were screened and enrolled in this study. The subjects were randomly treated by sildenafil only (group 1) and combination of sildenafil with trazodone (group 2). Patients received trazodone for at least 3 consecutive months, with daily doses starting at 50 mg. By intention-to-treat basis, the period of study was extended by 9 month. The intention-to-treat population included 39 sildenafil recipients and 35 sildenafil with trazodone recipients. The patients were asked to make up two questions, Q1: ‘Did you experience improvement of erection after treatment?’ and Q2: ‘Did you experience improvement of libido after treatment?’ and the change of International index of erectile function (IIEF) scores before and after the treatment were analyzed to assess the efficacy of treatment. Results: After 3 month treatment period, 70% of group 1 and group 2 answered ‘yes’ to Q1. Twenty seven percents of group 1 and 51% of group 2 answered ‘yes’ to Q2 and 20% of group 1 and 24% of group 2 answered ‘yes’ to both Q1 and Q2. In the intention-to-treat population, seventy-two percents of group 1 and 71% of group 2 answered ‘yes’ to Q1 and 28% of group 1 and 52% of group 2 answered ‘yes’ to Q2, 21% of group 1 and 26% of group 2 answered ‘yes’to both Q1 and Q2. The change of IIEF scores before and after the treatment at 3 month and 9 month showed similar results. Both group 1 and group 2 showed significant improvement on scores of IIEF-5 and question 15 of IIEF after treatment (p<0.01). Meanwhile, only group 2 showed significant improvement on question 11 and 13 of IIEF after the treatment compared to group 1 (p<0.05). Two patients with high dose of trazodone complained of headache and drowsiness, but the symptoms disappeared by dose reduction. Conclusions: The combination therapy of trazodone with sildenafil increased libido and sexual satisfaction on patients with ED. Therefore, combination of trazodone with sildenafil might be considered in ED patients of decreased libido with normal serum testosterone level rather than sildenafil monotherapy.

고등급 방광요관역류에서 변형된 내시경적 주입술기의 효용성

이태원,오미미,진명헌,문두건 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.11

Purpose: The modified subureteral transurethral injection(STING) has been reported to increase the success of endoscopic treatment of high grade vesicoureteral reflux(VUR). This study was performed to assess the efficacy of the modified STING procedure compared to conventional STING in the setting of high grade VUR. Materials and Methods: We retrospectively reviewed the medical records of 40 consecutive children(46 ureters) with a median age of 5.32 years (range 1 to 10 years) who underwent endoscopic treatment of grade IV to grade V VUR between February 2004 and December 2006. The modified STING was performed by applying a direct pressure stream of irrigation fluid into the ureter in order to define the injection site within the ureteral submucosa. The needle was then placed in the ureteral tunnel, and a dextranomer/hyaluronic acid copolymer(Dx/HA) was injected into the submucosal intraureteral space, tracking along the entire length of the detrusor tunnel. Modified STING was performed in 27 ureters(grade IV: 13, grade V: 14), and conventional STING was performed in 19 ureters (grade IV: 12, grade V: 7). Follow-up voiding cystourethrography(VCUG) was performed 3 months later. Results: Complete resolution occurred in 82%(22/27 ureters) of the patients undergoing modified STING, including 92%(12/13) of grade IV patients and 71%(10/14) of grade V patients. Three ureters required a second injection to correct VUR. Conventional STING had a success rate of 63%(12/19), [75%(9/12) in grade IV and 43%(3/7) in grade V]. The mean injected volume for the modified STING was 1.23±0.3ml, while that for the conventional STING was 0.95±0.2ml(p=0.03). Conclusions: The modified STING was markedly more successful in the treatment of high grade VUR and carried no significant adverse effects. Purpose: The modified subureteral transurethral injection(STING) has been reported to increase the success of endoscopic treatment of high grade vesicoureteral reflux(VUR). This study was performed to assess the efficacy of the modified STING procedure compared to conventional STING in the setting of high grade VUR. Materials and Methods: We retrospectively reviewed the medical records of 40 consecutive children(46 ureters) with a median age of 5.32 years (range 1 to 10 years) who underwent endoscopic treatment of grade IV to grade V VUR between February 2004 and December 2006. The modified STING was performed by applying a direct pressure stream of irrigation fluid into the ureter in order to define the injection site within the ureteral submucosa. The needle was then placed in the ureteral tunnel, and a dextranomer/hyaluronic acid copolymer(Dx/HA) was injected into the submucosal intraureteral space, tracking along the entire length of the detrusor tunnel. Modified STING was performed in 27 ureters(grade IV: 13, grade V: 14), and conventional STING was performed in 19 ureters (grade IV: 12, grade V: 7). Follow-up voiding cystourethrography(VCUG) was performed 3 months later. Results: Complete resolution occurred in 82%(22/27 ureters) of the patients undergoing modified STING, including 92%(12/13) of grade IV patients and 71%(10/14) of grade V patients. Three ureters required a second injection to correct VUR. Conventional STING had a success rate of 63%(12/19), [75%(9/12) in grade IV and 43%(3/7) in grade V]. The mean injected volume for the modified STING was 1.23±0.3ml, while that for the conventional STING was 0.95±0.2ml(p=0.03). Conclusions: The modified STING was markedly more successful in the treatment of high grade VUR and carried no significant adverse effects.

단순 신낭종으로 오인된 이시성 양측 신림프관종증

장훈아,반정현,진명헌,오미미,문두건,윤덕기 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.5

Renal lymphangiomatosis is a rare developmental malformation of the perirenal lymphatic system, and this can result in the development of cystic masses in the peri-pelvic or peri-renal areas. This is difficult to differentiate from other cystic renal disease on imaging studies. We present here a case of metachronous bilateral renal lymphangiomatosis that was falsely diagnosed as a simple renal cyst. A 47 year-old man was referred for a large amount of drainage after right renal cyst marsupialization. The abdominal computed tomography(CT) findings and fluid analysis were compatible with a lymphangiomatosis. After 6 month, he presented with flank pain on his left side and CT showed intracystic hemorrhage on the left renal lymphangiomatosis. Percutaneus drainage and conservative management were done. (Korean J Urol 2008;49:454-456)

경직장 전립선 생검 후 발생한 감염성 합병증의 위험인자와 배양된 균주의 특징

장훈아,강재일,배영대,진명헌,박재영,문두건,윤덕기,김제종 대한남성과학회 2008 The World Journal of Men's Health Vol.26 No.4

Purpose: Transrectal ultrasound-guided prostate needle biopsy (TRUS-PBx) is the standard procedure to diagnose prostate cancer. We evaluated the incidence and risk factors of infectious complications, the species cultured and rates of resistance for antibiotics of microorganism in infectious complications after TRUS-PBx. Materials and Methods: We retrospectively evaluated the medical records of 742 patients who underwent TRUS-PBx from January 2004 to May 2007. All patients were treated with intravenous ciprofloxacin and oral ciprofloxacin for 1 week after discharge. Patients who presented infectious complications were performed chest x-ray, blood analysis, urine analysis and culture studies. Results: Among 742 patients, 15 patients (2.0%) developed infectious complications. There were no significant differences between the complication and non-complications groups in age, PSA, prostate volume, nodule, hypoechoic lesion on transrectal sonography and underlying medical diseases. Twelve cases were performed in outpatient department and 3 cases were in operation room and that suggests high frequency of infectious complication when transrectal prostate biopsy is performed in outpatient department (p=0.007). Six kinds of microorganisms were cultivated in 12 patients (1.9%). E. coli (7/12) was most common. Extended-spectrum β-lactamase suggesting nosocomial infection was positive in 3 cases of outpatient department. On logistic regression analysis, urethral catheter indwelling was a significant risk factor increasing infectious complications. Conclusions: After TRUS-PBx, the rate of severe infectious complications and nosocomial infections were more frequent in outpatient department. And urethral catheter indwelling significantly increased infectious complication rate. So we should sublate the urethral catheter and keep in mind the aseptic technique at outpatient department.