여성 복합성요실금의 치료에 있어서 치골질식 근말실링 술식의 장기추적 결과

노안식,나용길,설종구 大韓泌尿器科學會 2002 Korean Journal of Urology Vol.43 No.5

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.

만성전립선염의 약물치료에 따른 임상경과와 전립선특이항원 간의 연관성

김도완,노안식,박석산 대한비뇨의학회 2006 Investigative and Clinical Urology Vol.47 No.9

전립선 비대증 진단에 있어서 전립선 이행대 용적 지수의 유용성

임재성,노안식,김용웅,육승모 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Purpose : Prostate volume has been poorly correlated to various parameters used to assess benign prostatic hyperplasia (BPH), including symptom score, peak urine flow and detrusor pressure at peak urine flow. The purpose of this study was 2-fold: 1) to determine if transrectal ultrasound measurement of the transition zone of the prostate served as a better proxy for determining prostate size and correlated better with IPSS, peak urine flow and detrusor pressure and 2) if the parameter transition zone index (the ratio between transition zone volume and prostate volume) was useful in evaluating clinical prostatism. Materials and Methods: We prospectively evaluated 30 men with symptomatic BPH (mean age 65.4 years) according to symptom sore, peak urine flow, pressure/flow study, transrectal ultrasound volume of the entire prostate and the transition zone and calculation of the transition zone index. Results : There was a week correlation between prostate volume and symptom score, peak urine flow and detrusor pressure at peak urine flow: a stronger correlation between volume of transition zone and symptom score (r=0.679 p=0.03), and peak urine flow (r=-0.672 p=0.05) and a significant correlation (p=0.001) between transition zone index and symptom score (r=0.868), and peak urine flow(r=-0.870). Conclusion : Transition zone index is a parameter that correlates siginificantly with parameters of BPH and may serve as a useful proxy for evaluating worsening obstruction. Studies are underway to determine whether transtion zone index can be used prospectively to predict and correlate response with therapies designed to ablate prostatic tissue medically or surgically.

요로조영상에서 요관폐색 및 음영결손을 보인 환자에서의 요관경검사

염규영,하용원,노안식,손성용,김진겸,설종구 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Purpose: To evaluate the clinical value of ureteroscopy for the ureteral filling defect or obstruction on the excretory or retrograde pyelogram(RGP). Materials and Methods: The 72 patients with filling defect or intrinsic obstruction ureteral lesion on the excretory urogram or RGP underwent ureteroscopy to examine and treat the lesions. We used the 9.5Fr. or 11.5Fr. rigid ureteroscope with 5Fr. working channel. Results: The results were as follows; I. Among the 72 patients, 39 were male and 33were female. The mean age of patient was 45.7 years. 2. Ureteroscopy was successfully performed in 70 cases(97%) out of 72. In 2 cases, the advance of ureteroscope was failed. 3. Among 70 successful cases, ureteroscopy revealed 45 radiolucent stones, 9 ureteral stricture, 2 ureteral TCC. I metastatic tumor, 3 blood clot, each case of ureteral polyp, epithelial hyperplasia and Von-Brunn's nest. In 7 cases, no causative lesions were identified. 4. 41 out of 45 radiolucent stones were successfully removed by ureteroscopic procedure and 9 ureteral strictures were dilated. 6 cases of ureteral mass were successfully biopsied for pathological diagnosis. 5. 23 cases of post-operative or fever were treated conservatively and 10 cases of mucosal tearing and 1 case of ureteral perforation were treated with double-J stent indwelling. Conclusions: The ureteroscopy is effective modality to evaluate and treat in the ureteral filling defect or obstruction on the excretory urogram.

가토에서 일측 요관 부분 및 완전폐색시 신장과 요관의 조직학적 변화

김상현,김용웅,육승모,한동석,노안식,임재성,김홍식,나용길,설종구 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

This study was designed to clarify histologic changes in the experimental rabbit kidney and ureter after unilateral partial or complete ureteral obstruction. A total of 20 adult white rabbits were divided into 4 subgroups in the partial obstruction followed by 2 weeks, the partial obstruction followed by 4 weeks, the complete obstruction followed by 2 weeks, and the complete obstruction followed by 4 weeks. The normal control group was consisted of 5 adult white rabbits. The kidneys and ureters for light microscopy were fixed in 10% neutral formalin, embedded in paraffin and stained with hematoxylin and eosin. Abnormal histologic fingings showed in ipsilateral kidney and ureter of all subgroups(such as dilatation of uriniferous tubule, focal necrosis and desquamation of epithelium, interstitial fibrosis, glomerular congestion, widening of Bowman's space, dilatation of ureter, epithelial cell atrophy or loss, interstitial fibrosis and interstitial inflammation). These findings were most severe in the group of the complete-obstructed ureter for 4 weeks. No significant changes showed in contralateral ureter of all subgroups. The degree of obstruction was severe and period of obstruction was long, the histological changes in ipsilateral side were severe. Despite of changes in ipsilateral side no abnormal findings showed in contralateral side. We suggest that long term experimental investigation of histologic changes in ipsilateral side and compensatory changes in contralateral side have to be studied.

표재성 방광암에서 Bacillus Calmette-Guerin 방광 내 주입요법 : 장기적 추적결과 Long-term Follow up Results

김용웅,왕세환,육승모,한동석,노안식,나용길,설종구 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

To evaluated the results of long-term follow up of superficial bladder cancer patients who were treated with transurethral resection and intravesical BCG therapy. Between April 1989 and December 1997, 65 patients with superficial bladder cancer were treated with TUR-B(Transurethral resection of bladder tumor) and intravesical BCG instillation, and follow-up was performed for 5 years longer, and the mean follow-up duration was 82 months. Of 65 patients, pathologic stage were Ta in 17 cases and T1 in 48 cases and grade were G Ⅰ in 22 cases, G Ⅱ in 35 cases and G Ⅲ in 8 cases. The tumor recurred in 22(33.8%) at the median of 21.8 months and the tumor progressed in 9(13.8%) at the median of 20.8 months. Most of the recurrences and progression were within 3 year(838 and 77%). Progression is more likely in higher grade(G Ⅱ, G Ⅲ) and higher stage(T1). The complete response rate after first and second courses of BCG therapy were 53% and 73% and the 5 and 10 year disease specific survival rates were 89.5 and 78% respectively. The complete response rate after first and second courses of BCG therapywere 53% and 73%. Most of recurrences and progressions were within 3 years of the BCG therapy, but some cases occured after 5 years. Therefore, close long-term follow up is needed.

표재성 방광 이행상피세포암에 있어서 방광내 항암제주입요법 밀 면역요법

설종구,신보현,하용원,김윤종,노안식,손성용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

Intravesical chemotherapy and immunotherapy will commonly eradicate residual papillary transitional cell carcinoma or carcinoma in situ(CIS) and clearly reduce the short-term incidence and rate of tumor recurrence. So I reviewed the effects and complications of different therapeutic agents(thiotepa, mitomycin-C, epirubicin, adriamycin, bacillus Cal mette-Cue'rin(BCG)) in superficial bladder cancer confirmed with histopathology, with the literatures. Bladder cancer were recurred more commonly in multiple tumors(50.6-56.3%), high grade tumors(52.6%) rather than in single(30.9%) and low grade(31.6%). And recurrence rates according to therapeutic agents were 83.3% in mitomycin-C, 71.4% in thiotepa, 50.0% in epirubicin, 46.6% in adriamycin and 32.6% in BCG. But incidence of complications were highest in BCG(50.5%). So sufficient preventive manuevers should be needed before intravesical theraphy, especially in BCG immunotherapy.

가토에 있어서 편측 요관 폐색시 환측, 반대측 요관에 대한 변화 : 조직학적 소견을 중심으로

설종구,김용웅,육승모,노안식,김홍식,김상현,이충식 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

This study was designed to clarify histological changes in the experimental rabbit ureter after unilateral prartial or complete ureteral obstruction. A total of 20 adult white rabbits were divided into 4 subgroups in the partial obstruction followed by 2 weeks, partial obstruction followed by 4 weeks, complete obstruction followed by 2 weeks, complete obstruction followed by 4 weeks. The normal control group consisted of 5 adult white rabbits. The H & E stain. light microscopy were used. Abnormal histological fingings were showed in ipsilateral ureter of all subgroups; dilatation of ureter, epithelial cell atrophy or loss, interstitial fibrosis, interstitial inflammation. These findings were most severe in the complete-obstructed ureter for 4 weeks. There were no significant changes in contralateral ureter of all subgroups. Despite of progressive histological changes in ipsilateral ureter no abnormal findings were showed in contralateral ureter. We suggest that long term experimental investigation for histological changes in ipsilateral ureter and compensatory changes in contralateral ureter should be done.

여성요도구협착의 수술적 교정

오범석,김도완,오철규,노안식,박석산 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: We describe various clinical presentations of female urethral meatal stricture, which may mimic other pelvic floor disorders and result in diagnostic delay. Diagnosis, management, and outcome results are reported Materials and Methods: We reviewed retrospectively 26 consecutive cases of female urethral meatal stricture. Patient characteristics, history, clinical presentation, symptom score, maximal flow rate, residual urine, diagnosis, management and short-term follow up are reported. Results: Mean patient age plus or minus standard deviation was 54 years. Most 21 (81%) cases were referred as diagnostic dilemmas with symptoms present for 1 month to 30 years. Mean interval between onset of symptoms to diagnosis was 5.8 years. The most common symptoms were residual urine sensation (77% of cases), frequency (54%), pelvic pain (46%), dysuria (46%), weak stream urine (27%), urgency (15%) and 17 patients (65%) have combined symptoms. 16 patients (62%) had been treated with oral and/or vaginal medication and/or psychotherapy. The female urethral meatal stricture was visible on physical examination in 21 patients (81%) and cystoscopy in 5 patients (19%). Of these visible urethral meatal stricture, 11 patients (45%) contained recurrent urinary tract infection, 9 patients (35%) contained urethral mucosal prolapse, 7 patients (27%) contained urethral diverticulum, and 3 patients (12%) contained stress urinary incontinence. 18 patients (69%) who has been treated with oral and/or vaginal medication or psychotherapy was not successfully improved. Treatment consist of urethral meatal excision and/or everted urethral mucosal excision and/or urethral diverticulum excision and/or anti-incontinence surgery when indicated. Subsequently 24 patients (92%) had improved symptom score, but 2 patient was not changed. In 9 patients new symptom developed. Conclusions: Female urethral meatal stricture have several urinary symptoms and may mimic other pelvic floor disorders. This condition should be considered in women with frequency, residual urine sensation, pelvic pain, dysuria and etc. Medical treatment is not sufficient but surgical treatment is usually simple, safe and effective in alleviation associated symptoms.