방사선학적으로 진단이 어려웠던 신혈관근지방종

박임찬(Im Chan Park),정영범(Young Beom Jeong),김주헌(Joo Heon Kim),김형진(Hyung Jin Kim) 대한비뇨기종양학회 2003 대한비뇨기종양학회지 Vol.1 No.1

전립선비대증 환자에서 경요도전립선절제술 후 요도협착의 발생에 영향을 주는 예측인자들

박봉희 ( Bong Hee Park ),정영범 ( Young Beom Jeong ),박영경 ( Young Kyung Park ) 전북대학교 의과학연구소 2005 全北醫大論文集 Vol.29 No.2

Purpose: To evaluate possible factors affecting urethral stricture development after TURP in patients with BPH. Materials and Methods: We reviewed retrospectively medical records of patients who underwent TURP due to BPH for past 5 years. All operations were performed by 2 experienced doctors who have minimum 200 practices. Patients were classified into 2 groups. Group A included patients with urethral stricture required periodic urethral dilation in outpatient basis postoperatively. Group B included those without urethral stricture development after TURP. We analyzed all possible factors such as resection time, prostate volume, resection volume, resectoscope size, preoperative catheterization duration due to AUR, postoperative catheterization duration, preoperative and postoperative pyuria, prostate needle biopsy performed preoperatively and PSA level, age and co-morbid systemic diseases. We also compared patients with narrow urethral caliber preoperatively (Group I) those who were inserted 22Fr resectoscope without resistance (Group II) in terms of aforementioned factors. Results: 518 patients underwent TURP between 2000 and 2004. 69 of them were categorized into group I and 449 into group II. And Of the group II 100 were categorized into group A and 349 into group B. There was no statistical difference between group A and B with respect to age, preoperative catheterization duration in patients with AUR, postoperative catheterization duration, prostate volume, resection volume, preoperative PSA level, preoperative pyuria, postoperative pyuria, preoperative biopsy history, resectoscope size (22F vs 24F) and anesthesia method (general vs spinal), respectively. However, there is significant difference between group A and B in comparison of resection time (58.5±21.6min vs 50.5±23.2min, p=0.02) There was no statistical difference between group I and II with respect to all factors, except urethral stricture development (p<0.05). Conclusions: Our data suggest that the shortening of resection time is the most important single factor to decrease urethral stricture formation after TURP in patients with BPH. Also, we think that the innate urethral caliber is a significant factor about urethral stricture development after TUR-P.

재발성 신결석환자에서 24시간 요중 생화학적 위험요인 및 물리화학적 성상의 분석

김형진(Hyung Jin Kim),김영곤(Young Gon Kim),정영범(Young Beom Jeong),김진홍,박종관(Jong Kwan Park) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2

N/A Purpose : We examined a 24-h urine to evaluate the important biochemical risk factors and relative supersaturation in patients with recurrent nephrolithiasis. Methods: A total of 17 patients with recurrent nephrolithiasis were analyzed for urinary biochernical stone risk factors and relative supersaturation. They were evaluated using a single 24-h urine specimen with StoneRisk Diagnostic Profile on a random diet. Urinary stone risk factors are calcium, oxalate, citrate, magnesium, uric acid, pH, 24-h urine volume, sodium, phosphorous. Relative supersaturation with respect to stone-forming salts such as calcium oxalate, brushite, monosodium urate and uric acid were calculated. These factors were classified one or more etiologic categories in each patient. Results: Of 17 patients 16 patients(94.2%) had abnormal urinary biochemistry that placed them into one or more of 15 etiologic categories. A single abnormality was documented in only one patient. One patient had no diagnostic abnormality. High urinary sodium encountered in 13(76.5%) of the patients. Hypercalciuria and hyperuricosuria accounted for 9 (52.9%) and 7(41.1%) of the patients, respectively. The acquired problem of low urine volume(< 2L/d) was found in 8(47.1%) of the patients and hypoci-traturia affected in 4(23.5%). But hypomagnesiuria was not detected. The relative supersaturation with respect to monosodium urate was highest and in- creased in 70.6Yo of patients. Conclusion: The StoneRisk Diagnostic Profile using a single 24-h urine specimen is a very useful tool not only in detecting metabolic, environmental and physicochemical abnormalities but also in pro- viding specific therapeutic or preventive guidelines of patients with recurrent nephrolithiasis. In our study the most important biochemical risk factor of recurrent stone former is a high urinary sodium. Furthermore, there is a distinct evidence of high relative supersaturation with respect to monosodium urate. High sodium intake is probably the most important risk factor in patient who develop recurrent stone formation. Therefore, dietary sodium restriction would reduce probability of recurrent nephrolithiasis.

전립선암의 진단에서 12군데 경직장 전립선 조직 생검의 한계성

차재성 ( Jai Seong Cha ),최만수 ( Wan Sou Cui ),정영범 ( Young Beom Jeong ),박영경 ( Young Kyung Park ),박종관 ( Jong Kwan Park ) 전북대학교 의과학연구소 2006 全北醫大論文集 Vol.30 No.2

혈청 PSA의 상승 시 초음파를 이용한 경직장 12군데 전립선 조직 생검과 전립선절제술 시 채취한 조직에서 전립선암으로 진단되었던 11명의 환자에서 12군데 전립선 조직 생검의 진당율은 9.1%의 한계성을 보이고 있었다. 따라서 전립선암 환자를 선별하기 위하여 12군데 조직검사 외에 더많은 생검 수 (core)와 영역을 넓히는 방법이 시도되어야 할 것으로 생각된다. Purpose: This report describes the limitation of transrectal prostate needle biopsy with 12 biopsy cores taken to diagnosis prostate cancer. Material and Methods: We retrospectively analyzed the 11 patients (2.56%) in 430 patients included in the study, who had transurethral resection of prostate (TUR-P) due to benign prostate hyperplasia (BPH) but pathologic results were prostate adenocarcinoma in the period from January 1998 till July 2004. All patients with over 4 ng/mL of prostate specific antigen (PSA) were undertaken the 1st transrectal ultrasono guided prostatic needle biopsy to rule out prostatic adenocarcinoma from BPH. The patients who were received TUR-P were undertaken the 2nd transrectal prostate needle biopsy blindly just before TUR-P under anesthesia. Results: In 11 patients, the mean age was 74.0 years and the mean volume of the prostate was 46.0 gm. The pre-operative mean serum prostate specific antigen (PSA) and free PSA was 19.5 ng/mL. There was no patient with below 4 ng/mL at serum PSA. In 9 of 11 patients the 1st biopsy showed BPH, but pathological results after TUR-P was confirmed to prostate adenocarcinoma. Adenocarcinoma was only detected on one core in the one patient (9.1%) at TRUS guided biopsy at 12 sites on operation room. Conclusions: Our result suggest that more biopsy core number and area were needed for increasing detection rates of prostate adenocarcinoma.

한국인 전립선암 환자에서 술 전 중등도위험군에서 술 후 고위험군으로 이행할 수 있는 인자

유제국(Je Guk Ryu),황인상(Insang Hwang),임동훈(Dong Hun Im),정영범(Young Beom Jeong),박승철(Seung Chol Park),노준화(Joonwha Noh),권동득(Dong Deuk Kwon),강택원(Taek Won Kang) 대한비뇨기종양학회 2013 대한비뇨기종양학회지 Vol.11 No.3

Purpose: We aimed to examine a change and relevant predictors in intermediate-risk prostate cancer which have a wide range of treatment options from active surveillance to radical prostatectomy (RP). Materials and Methods: Of 1,159 patients who underwent RP in multi-institution between January 2009 and December 2012, 390 patients who were classified as intermediate-risk prostate cancer group by preoperative evaluation according to NCCN guideline were enrolled in this retrospective study. The rates of Gleason score upgrading, upstaging and migrating to high-risk prostate cancer group at final pathology and there risk factors were assessed. Results: The mean age of enrolled patients were 67.33±6.17 years with mean PSA level of 9.34±4.34 ng/ml. The number of patients with worsening upgrading, worsening upstaging and worsening prognosis were 42 (10.77%), 83 (21.28%) and 108 (27.7%), respectively. In analysis compared between upgrading group and non-upgrading group, there was no difference in patient’s features. However, in analysis on upstaging and worsening prognosis, serum PSA (p=0.029, p=0.042) and %positive biopsy core (p=0.010, p=0.013) showed significant difference. In univariable analysis, serum PSA (p=0.030, p=0.042) and %positive biopsy core (p=0.004, p=0.014) were predictive of upstaging and worsening prognosis, also, in multivariable analysis, serum PSA (p=0.016) and %positive biopsy core (p=0.042) were statistically relevant factors of worsening upstaging. Conclusions: In this study, 27.7% of patients with preoperative intermediate-risk prostate cancer were re-stratified into high-risk prostate cancer group after RP. Serum PSA and %positive biopsy core were the predictive factors for migrating to high risk group.

Case Reports : Organized urethral hematoma confused with tumor

김환 ( Hwan Kim ),최만수 ( Wan Shou Cui ),정명자 ( Myoung Ja Chung ),정영범 ( Young Beom Jeong ),박영경 ( Young Kyung Park ),박종관 ( Jong Kwan Park ) 전북대학교 의과학연구소 2006 全北醫大論文集 Vol.30 No.2

Posterior male urethral mass is a rare. Urethral mass presented with hematuria, obstructive voiding symptoms or urinary retention is usually suggested to malignant. We present a rare case of organized hematoma occurred after trans urethral surgery, which was confused with carcinoma.

방광암 조직에서 Insulin-like Growth Factors (IGFs)와 Insulin-like Growth Factor Binding Proteins (IGFBPs)의 발현

이민우(Min Woo Lee),강명재(Myoung Jae Kang),황평한(Pyoung Han Hwang),정영범(Young Beom Jeong),김형진(Hyung Jin Kim) 대한비뇨기종양학회 2004 대한비뇨기종양학회지 Vol.2 No.2

症例(증례) : 자궁내막 증에 의한 물요관콩팥증 1예

이태환 ( Tae Hwan Lee ),박호성 ( Ho Seong Park ),김명기 ( Myung Ki Kim ),정영범 ( Young Beom Jeong ) 전북대학교 의과학연구소 2008 全北醫大論文集 Vol.32 No.1

Hydroureteronephrosis caused by endometriosis is rare and timely diagosis is important to prevent loss of renal function. A 49-year-old woman was referred to our hospital for left flank pain. Enhanced computed tomography demonstrated severe hydroureteronephrosis on left kidney and 1.5 cm-sized mass around left ureter on the level of crossing iliac vessel. The mass compressed distal ureter externally. And there were no other mass lesion or enlarged lymph nodes. For obtaining the character of the mass, an image of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) was taken. It showed also severe hydroureteronephrosis caused by nodular mass in left distal ureter but there was no hypermetabolic lesion. Retrograde pyelography showed narrowing of distal ureter with difficulty of upstream of dye. In this case, excision of mass and adhesiolysis, placement of ureteral stent for stricted site were performed by open surgery. The pathologic exam of resected tissue revealed that it was endometriosis. So gonadotropins were administered immediately. In conclusion, hydroureteronephrosis caused by endometriosis should be included in the differential diagnosis of obstructive uropathy in women. Awareness of clinical features and high index of suspicion can help in early detection and proper management and convincing that associated mass is not malignant, it is possible to avoid open surgery in certain cases

Laparoscopic Partial Adrenalectomy: Surgical Technique and Outcome

Oh Seok Ko(고오석),Ji Yong Kim(김지용),Hyung Jin Kim(김형진),Young Beom Jeong(정영범) 대한비뇨기종양학회 2019 대한비뇨기종양학회지 Vol.17 No.2

Purpose: To examine the perioperative surgical and long-term outcomes of laparoscopic partial adrenalectomy (LPA) by comparing the results of laparoscopic total adrenalectomy (LTA) Materials and Methods: A total of 132 transperitoneal laparoscopic adrenalectomies were performed for adrenal gland tumor between May 2006 and April 2019. All surgeries were performed by a single surgeon. Seventy patients underwent LTAs and 54 underwent LPAs. The data were collected retrospectively through review of the medical charts. We compared the perioperative and long-term outcomes between the 2 surgical methods. Results: A total of 70 patients, including 4 patients with bilateral tumors, underwent LTA. In contrast, 54 patients, including 4 patients with bilateral masses, underwent LPA. There were no differences between the 2 groups with regard to mean age at presentation, mean tumor size, or postoperative stay. However, the mean operating time was significantly shorter in the LPA group than that of the LTA group. The mean estimated blood loss in the LPA group was significantly higher than that in the LTA group. However, none of the LPA patients required blood transfusion. The biochemical markers and laboratory values normalized postoperatively in all patients with functional adrenal tumors. There was no local recurrence during the follow-up period. Conclusions: Our data demonstrate that the surgical outcomes and perioperative complications in LPA group are similar to those of LTA. When LPA is performed for small adrenal lesions, most patients remain steroid independent, as well as recurrence-free at long-term follow-up.

요석환자에서 유로시트라®의 생리학적 효과

정영범,김영곤,황태곤,김동선,이정주,김현희,전성수,박영요,임정식,문영태,박광성,이춘용 大韓泌尿器科學會 2002 Korean Journal of Urology Vol.43 No.6

PURPOSE: To investigate the biochemical change in serum and 24-hour urine after therapy with Urocitra® in patients affected by urolithiasis, who had hypocitraturia alone or associated with other metabolic disorder.<br> MATERIALS AND METHODS: One hundred eighteen patients with evidence of 1 or more stone attacks within the last 3 years participated in the present study. They were 78 men and 40 women (6 to 78 years old, with a mean age of 47.01±12.95 years). All of the patients received 15 to 20㎖ of Urocitra®-solution or 5 g of Urocitra®-C powder, three or four times daily for 3 months. Before treatment, 24-hour urine and venous blood samples were obtained, while patients were maintained on a random diet, and analyzed for various stone risk factors. After 1 week, 1 month and 3 months of treatment, samples were again obtained and analyzed in the same manner. Thereafter, we compared the biochemical values before and after treatment.<br> RESULTS: In all three follow-up periods Urocitra® induced a significant increase in urinary citrate (p<0.001) level. Urinary potassium (p<0.001), pH (p<0.001) and total volume (p<0.05) also increased significantly after 1 and 3 months of therapy, as did urinary citrate excretion in patients with hypocitraturia and normocitraturia. Urocitra® did not alter calcium, sodium or phosphorus urinary excretion. There was no significant change of serum chemistry after administration.<br> CONCLUSIONS: Urocitra® was effective in increasing urinary pH and citrate. Furthermore, it was relatively free of side effects, except for minor gastrointestinal distress. Thus, our study provides physiological and clinical validation for the use of Urocitra® in patients affected by urolithiasis, who have hypocitraturia alone or associated with another metabolic disorder.