혈액투석 중인 말기신부전 환자에서 발생한 양측 신장의 자발성 파열

정사라 ( Sa Rah Chung ),최대은 ( Dae Eun Choi ),나기량 ( Ki Ryang Na ),설종구 ( Chong Koo Sul ),이강욱 ( Kang Wook Lee ),신영태 ( Young Tai Shin ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5

Bilateral spontaneous renal rupture is a rare event that has been documented in only a few reports. We report a spontaneous, but not simultaneous rupture of both kidneys in a 64-year-old man with end-stage renal disease who had been treated with hemodialysis for 78 months. He complained of sudden left flank pain. Abdominal computed tomography (CT) revealed a huge perirenal hematoma with multiple renal cysts. The patient underwent an urgent left nephrectomy and was diagnosed as multiple acquired renal cysts with rupture and focal incidental papillary renal cell carcinoma. Twentytwo days after the left nephrectomy, he complained of sudden right flank pain and abdominal CT showed another massive perirenal hematoma. The patient underwent a right nephrectomy and was diagnosed as renal cyst rupture with perirenal hemorrhage. However, there was no evidence of renal cell carcinoma in the right kidney. Postural hypotension and frequent hypotensive episodes developed during hemodialysis several months after both nephrectomies. He was diagnosed as primary adrenal insufficiency with rapid adrenocorticotropic hormone (ACTH) stimulation test and the level of plasma ACTH and was treated with prednisolone and fludrocortisone. The patient died of acute myocardial infarction 32 months after bilateral nephrectomies.

신 이식 직후 신장 스캔 소견과 이식신 장기 생존의 관계

소영(Young So),이강욱(Kang Wook Lee),신영태(Young Tai Shin),안문상(Moon Sang Ahn),배진선(Jin Sun Bae),설종구(Chong Koo Sul),정인목(In Mok Jung) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.4

N/A Purpose: We investigated the possibility of early postoperative Tc-99m DTPA scintigraphy in predicting long-term renal transplant survival. Materials and Methods: 64 living donor (LD) grafts were divided into two groups according to the graft function on early post-operative renal scintigraphy. Survival analysis was performed using Kaplan-Meier method and Cox proportional hazard model. Chi-square test was performed to evaluate the difference in the frequency of acute rejection. Results: Cumulative renal transplant survival was decreased in 11 patients with abnormal renal scintigraphy, but it was not statistically significant. Decreased graft function on early post-operative renal scintigraphy was not a predictor of long-term graft survival. The frequency of acute rejection was higher in abnormal scintigraphy group, and the difference was statistically significant. Conclusion: Decreased graft function on early post-operative renal scintigraphy has no direct effect on long-term renal transplant survival in LD transplantation. But it may have an indirect effect through increasing the frequency of acute rejection. (Korean J Nucl Med 200135-251-257)

전립선 암의 다발성 기관지내전이

이정은 ( Jeong Eun Lee ),이유진 ( You Jin Lee ),정미경 ( Mi Kyong Jeong ),박희선 ( Hee Sun Park ),정성수 ( Sung Soo Jung ),김주옥 ( Ju Ock Kim ),강대영 ( Dae Young Kang ),설종구 ( Chong Koo Sul ),김선영 ( Sun Young Kim ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.2

The lung is the most common site for the metastasis of extrapulmonary malignant tumors. However, endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are the breast, renal and colorectal carcinomas. Lung metastasis from prostate cancer is often encountered but EBM is rare. We report a 74-year old man with endobronchial metastases from prostatic carcinoma presented with cough. The diagnosis of prostatic cancer and the endobronchial metastasis were confirmed by immunohistological staining with the prostate specific antigen. Hormonal therapy (lutenizing hormone releasing hormone agonist) was applied to this patient. (Tuberc Respir Dis 2006; 61: 162-166)

표재성 방광암 환자에서 방광내 BCG 주입치료 후 발생한 폐합병증 2예

이계성 ( Gyeoi Seong Lee ),이기용 ( Gi Yong Lee ),윤재철 ( Jae Cheol Yoon ),나동집 ( Dong Jib Na ),정성수 ( Seong Su Jeong ),설종구 ( Chong Koo Sul ),김선영 ( Sun Young Kim ),김주옥 ( Ju Ock Kim ) 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.6

Expression of Fas-associated Factor 1 in the Developing Testis

An Sik Noh(노안식),Su Hee Kim(김수희),Young Jin Choi(최영진),Soo Il Kim(김수일),Yong Gil Na(나용길),Chong Koo Sul(설종구),Young Ho Lee(이영호) 대한체질인류학회 2009 해부·생물인류학 (Anat Biol Anthropol) Vol.22 No.2

Fas-associated factor 1 (FAF1)은 Fas 관련 물질로서, Fas 매개 세포사멸을 유도한다. FAF1 유전자는 생쥐의 여러 기관 중 고환에서 가장 많이 발현된다. 본 연구의 목적은 생쥐의 발생 또는 발달 중인 고환에서 FAF1의 발현과 그 역할을 규명하고자 하였다. C59/BL6 15.5일과 생후 1, 2 및 8주령의 C57/BL6 생쥐 고환에서 H-E 염색과 FAF1에 대한 면역조직화학염색을 시행하였다. FAF1은 생쥐 15.5 태자부터 8주령의 생쥐까지 모두 발현되었다. 고환에서 FAF1 양성세포는 발생 및 발육단계별로 달랐다. 더욱이 FAF1의 세포 내(세포질 또는 핵) 발현양상은 고환의 발생 또는 발달 단계별로 달랐다. 특히, 세포분화가 활발히 진행되는 1주령 및 8주령 생쥐의 생식세포에서는 FAF1이 주로 핵에 발현되었으며, 세포사멸이 최대로 일어나는 2주령의 생식세포에서는 주로 세포질에서 FAF1이 발현되었다. 이를 종합하면, FAF1은 생쥐 고환의 생식세포에서 주로 발현되며, 정자형성 시 세포기능을 조절하여 세포분화와 세포사멸에 관여하고 있음을 보여주었다. FAS associated factor 1 (FAF1) is a Fas-associating molecule, which enhances Fas mediated apoptosis. FAF1 gene is expressed most abundantly in the testis among the mouse organs. The aim of this study was to reveal the expression and the role of FAF1 in the developing testis. H-E stain and FAF1 immunohistochemistry were performed in the testis and epididymis of the E15.5 embryo, and 1, 2, and 8 week-old C57/BL6 mice. FAF1 was expressed in the testis from E 15.5 embryo to 8 week-old mice. Cell type of FAF1 positive cells was different among the developmental stage. Furthermore, cellular (cytoplasmic or nuclear) localization of FAF1 in the male germ cells was different during the developmental stage. FAF1 was expressed mainly in the nuclei of the germ cells 1 and 8 weeks after birth, when cell differentiation occurs actively in the testis. However, FAF1 was expressed in the cytoplasms of germ cells 2 weeks after birth, when apoptosis occurs maximally in the testis. Taken together, it can be suggested FAF1 expressed in male germ cells in the testis. FAF1 might be involved in regulation of the cellular function during spermatogenic cell differentiation and apoptosis in the testis.

요도하열의 임상적 고찰

설종구,나용길 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

A clinical observation was made on 60 patients with hypospadia who had been admitted to the Department of Urology Chungnam National University Hospital during 10 years and 10 monthes from January, 1979 to October, 1988. The results were as follows: 1. Incidence of the age group under 5 years old was 35.0%(21 cases). 2. The most common type of hypospadia was penoscrotal type(23 cases, 38.3%). 3. Associated anomalies were noted in 33.3% (20 cases)of hypospadia, and cryptorchism was the most common anomaly. 4. One-staged operative procedure was performed hypospadia and two-stag In one-staged operative procedure, Duckett's method, Hodgson's method and Hortone-Devine's method were used, and in two-staged operative procedure, Denis-Brown method was used. 5. The total incidence of operative complications was 40.0%(24 cases)and types of operative complication according to the operative procedures were 4 cases of urethrocutaneous fistula (14.3%)and 4 cases of urethral stricture(14.3%)in one-staged operative procedure(8 cases, 28.6%), and 15 cases of urtehrocutaneous fistular (46.9%) and 1 case of urethral stricture (3.1%) in two-staged operative procedure(16 cases, 50.0%). 6. Incidence of the operative complications according to the type of urinary diversion in one staged operative procedure was 29.3%(5 cases) in diversion group and 27.3%(3 cases) in urethral stent catheter group, and in two-staged operative procedure, incidence of operative complications was 50.0% (11 cases) in diversion group and 50.0%(5 cases) in urethral stent catheter group.

Modulith SL-20 體外衝擊波碎石機를 利用한 尿路結石의 治療

薛鍾求,羅容吉 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Extracoporeal shock wave lithotripsy monotherapy was performed in 111 patients with Modulith SL-20 electromagnetic lithotriptor from January, 1994, to November, 1994, in our Department of Urology. Most of stones were distributed between 4th and 6th decades(67.4%), and male to female ratio was 1.3 : 1, and 111 patients have 117 stones, which were 76 cases of ureteral stone(65.0%), 28 cases of renal(23.9%), 11 cases of ureteropelvic junction(9.4%) and 2 cases of bladder(1.7%), 6 bilateral cases, and 0.6cm to 5.0cm in diameter. Of the 0.6cm to 5.0cm in diameter, stones were 1.0cm-1.9cm 54 cases(46.2%), 0.6cm-0.9cm 43 cases(36.8%), 2.0cm-2.9cm 12 cases(10.2%) and 8 cases (6.8%) in longer than 3cm. And treatment session was needed more and more in longer than 1.0cm. Complications were colicky pain(16 cases, 13.7%), severe gross hematuria(9 cases, 7.7%), fever and chill(2 cases, 1.7%), renal subcapsular hematoma(2 cases, 1.7%), residual stone(2 cases, 1.7%o), and steinstrasse(1 case, 0.9%). Therefore extracoporeal shock wave lithotripsy monotherapy is considered as a safety and non-invasive treatment method for all urinary stones.

혈액투석을 하기 위한 Shunt 술에 관한 임상적 고찰

설종구 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

Shunt operation for hemodialysis is the mainstem in the treatment of acute and/or chronic renal failure. This study was aimed to investigate the results of the each type of shunt operations in 44 patients from January, 1982, to September, 1985, with the review of the literatures. The results were summerized as followings: 1. Of the 44 patients, male to female ratio was 1.3:1 and 50% of the patients were distributed from 4th decades to 6th decades. 2. The cases of the external and internal shunt were 35 cases in each(total; 70 cases). And 27 cases were recieved one time operation(61.4%), two time operations were 11 cases (25.0%), three times were 4 cases(9.1%), four times and five times were 1 case in each(2.3%). 3. The complication rates were 38.6%(27 cases) in total cases, 48.6%(17 cases) in external shunt and 28.6%(10 cases) in internal shunt. 4. The most common complication was obstruction(20.0%) in total cases of shunt operation and in external shunt(34.3%), and malfunction in internal shunt(22.9%). 5. The types of operations in internal shunt operation were Side-Side(20 cases; 57.0%) End-Side(9 cases; 26.0%), and End-End(6 Cases; 16.0%), and the most common complication in internal shunt was malfunction(6 cases).

전립선 비대증 및 전립선암에 있어서 경직장 초음파 소견

설종구,강순구 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

Transrectal ultrasonography can provide a precise image of the prostate, seminal vesicles and adjacent structure. It can play a valuable role in the diagnosis of prostatic diseases, particulary in the detection, staging and monitoring after treatment of prostatic cancer. Transrectal ultrasonography was taken in 51 patients with prostatism (34 cases of benign prostatic hyperplasia and 17 cases of prostatic cancer), and the results were compared with the pathologic results of prostatic tissue obtained by digitally guided biopsy or surgical specimens. The results were as follows: 1. The sensitivity, specificity, positive predictive value, and dectation rate of trasrectal ultrasonography for prostatic cancer were 88.2%, 97.1%, 93.8%, and 29.4%, and in digital rectal examination, sensitivity, specificity, positive predictive value and dectation rate were 64.7%, 97.1%, 91.7% and 21.6%, respectively. 2. Echogenecity of prostatic ultrasonography in prostatic cancer were hypoechoic in 12 cases(70.5%), hyperchoic in 3 cases(17.7%) and isoechoic in 2 cases(11.8%), and in benign prostatic hyperplasia, isoechoic in 33 cases(97.1%) and hyperechoic in 1 case(2.9%).

급성 음낭증에 대한 임상적 고찰

설종구 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

The acute scrotum can be defined as any conditions of the scrotum or intrascrotal contents that requires emergency medical or surgical intervention. Although rarely fatal, acute scrotal pathology can result in testicular loss, infertility, or significant short or long-term morbidity. The correct dignosis of the acute scrotum is not always evident on history, physical examination, or routine laboratory testing. For this reason, classical urological teaching has held that these patients should, with few exceptions, undergo surgical exploration. This policy results in a large number of patients undergoing unnecessary operations, and does not provide optimal therapy in all cases. Sixty cases of acute scrotum were studied in the Department of Urology, Chungnam National University Hospital, during the period from January 1981 to October 1986. The following results were obtained. 1. Acute scrotum was noted most frequently in 4th decade and the incidence was (30.0%, 18 cases). The incidence in 4th and 5th decade was 56.7%. 2. The most frequent disease was trauma, of which incidence was 41.7%, (25 cases). And the incidences of acute epididymitis, testicular torsion, scrotal abscess and testicular tumor were 33.3%(20 cases), 11.7%(7 cases), 8.3%(5 cases), and 5.0%(3 cases), respectively. 3. The acute epididymitis was noted most frequently in 4th decade, and its incidence was 40.0%(8 cases). 4. Of the scrotal trauma, scrotal hematoma was most common(16 cases, 64.0%), and testicular rupture was 7 cases(28.0%), laceration and burn was 1 case(4.0%), respectively. Scrotal trauma was most frequent in 3rd decade (12 caes, 48.0%). 5. The types of treatment of acute, scrotum were conservative(28 cases) and surgical method (33 cases).