Diagnosing Acute Pyelonephritis with CT, 99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

유제모,고준성,한창희,이수림,하유신,강성학,정윤석,이용석 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.4

Purpose: With growing interest in early imaging, the aim of our study was to define the most practical modality for routine clinical use for the diagnosis of acute pyelonephritis (APN). We compared the sensitivity of enhanced computerized tomography (CT), dimercaptosuccinic acid (DMSA) scintigraphy, and Doppler ultrasonography (DUS) by using clinical findings as the standard of reference. Materials and Methods: A total of 207 APN patients (191 women, 16 men; mean age, 49.4 years; range, 17-88 years) were enrolled in this study. All the patients underwent imaging modalities during hospitalization. SPECT images were obtained 4 hours after injection of 99mTc-DMSA. Transverse and coronary CT images were obtained before and after injection of the contrast agent. DUS was performed in the longitudinal, transverse, and coronal planes. All the images were read independently by a single radiologist and a nuclear medicine specialist. The sensitivity of each modality for detecting APN was compared. Results: CT showed significantly superior sensitivity compared with that of DUS (81.0% vs. 33.3%, respectively, n=147). DMSA scintigraphy also showed significantly superior sensitivity compared with that of DUS (74.7% vs. 33.3%, respectively, n=150). Compared with DMSA scintigraphy, CT showed superior sensitivity, but the difference was not statistically significant (81.0% vs. 74.8%, respectively, n=147, p=0.163). Conclusions: For cases of clinically suspected APN, CT and DMSA scintigraphy appear to be equally sensitive and reliable for detecting APN, although CT is more practical in various fields. DUS was significantly less sensitive. Purpose: With growing interest in early imaging, the aim of our study was to define the most practical modality for routine clinical use for the diagnosis of acute pyelonephritis (APN). We compared the sensitivity of enhanced computerized tomography (CT), dimercaptosuccinic acid (DMSA) scintigraphy, and Doppler ultrasonography (DUS) by using clinical findings as the standard of reference. Materials and Methods: A total of 207 APN patients (191 women, 16 men; mean age, 49.4 years; range, 17-88 years) were enrolled in this study. All the patients underwent imaging modalities during hospitalization. SPECT images were obtained 4 hours after injection of 99mTc-DMSA. Transverse and coronary CT images were obtained before and after injection of the contrast agent. DUS was performed in the longitudinal, transverse, and coronal planes. All the images were read independently by a single radiologist and a nuclear medicine specialist. The sensitivity of each modality for detecting APN was compared. Results: CT showed significantly superior sensitivity compared with that of DUS (81.0% vs. 33.3%, respectively, n=147). DMSA scintigraphy also showed significantly superior sensitivity compared with that of DUS (74.7% vs. 33.3%, respectively, n=150). Compared with DMSA scintigraphy, CT showed superior sensitivity, but the difference was not statistically significant (81.0% vs. 74.8%, respectively, n=147, p=0.163). Conclusions: For cases of clinically suspected APN, CT and DMSA scintigraphy appear to be equally sensitive and reliable for detecting APN, although CT is more practical in various fields. DUS was significantly less sensitive.

Urolithiasis in Patients Suffering from Malignant Hematologic Diseases

손동완,김세웅,김성대,유제모,조용현 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.2

Purpose: We performed this study in order to evaluate the incidence and characteristics of urolithiasis in patients with malignant hematologic diseases. Materials and Methods: Nine hundred one patients who underwent medical treatment for malignant hematologic disease and 40,543 patients who visited the emergency room and without malignant hematologic diseases were included in our study. The patients with malignant hematologic diseases were divided into two groups depending on their primary treatment. Group I included patients with acute and chronic leukemia (AML, ALL, CML, CLL) for which chemotherapy and steroid therapy was necessary, and group II included patients with anaplastic anemia and myelodysplastic syndrome and who had undergone repeated transfusion for treatment. Comparisons were made between the two groups in respect to the incidence of urolithiasis and the stones’ radiopacity. Results: Twenty nine patients (3.2%) of the 901 malignant hematologic patients were diagnosed with urolithiasis, compared to 575 patients (1.4%) of 40,543 emergency room patients. There was a significant increase of the incidence of urolithiasis in the malignant hematologic group. Compared to the general patients, the patients with malignant hematologic diseases had a higher rate of radiolucent stones (46.6%versus 16.3%, respectively), and the difference was significant. Conclusion: The incidence of urolithiasis for malignant hematologic patients was significantly higher than that for the control group.

쥐에서 생체이식 방광용적센서를 활용한 실시간 방광용적의 측정

이동섭,김수진,손동완,유제모,최범규,이문규,이승준,김세웅 대한남성과학회 2010 The World Journal of Men's Health Vol.28 No.3

Purpose: Real-time monitoring of urinary bladder volume can not only provide information on urinary bladder function more precisely in laboratories and in the setting of intravesical pressure monitoring, but can also help areflexic neurogenic bladder patients have notice of the timing for optimal urination to prevent secondary complications. Thus we introduce a new implantable bladder volume monitoring device and its usefulness. Materials and Methods: Ten male Sprague-Dawley rats were used under intraperitoneal anesthesia. Two microelectrodes produced by a micro-electrical-mechanical systems (MEMS) process were stitched onto each side wall of the urinary bladder and 25 G needles were inserted through the bladder dome. The distances between two microelectrodes converted from capacitances recorded by LCR meter were monitored in real-time during cystometry. Urinary bladder volume was estimated with its shape approximated as a sphere. Results: Estimated bladder volume correlated well statistically with infused volume in (p<0.05 regression analysis). Since the urinary bladder was filled with over 0.6 cc normal saline in each rat, estimated urinary volume was not different than infused saline volume (p>0.05, repeated measures ANOVA). Conclusions: In our animal model, an implantable volume-monitoring device produced reliable data. Therefore, we expect that it should be an excellent tool for detecting urinary bladder volume and producing more accurate and useful information during urodynamic laboratory studies with small animals. Furthermore, we expect that this study will be the foundation of research for the clinical application of bladder volume monitoring devices to areflexic neurogenic bladder patients.

Sexual behavior and sexually transmitted infection in the elderly population of South Korea

김희연,최현섭,이동섭,유제모,이승주 대한비뇨의학회 2019 Investigative and Clinical Urology Vol.60 No.3

Purpose: To study the sexual behavior and status of sexually transmitted urethritis (STU) in the elderly population of South Korea. Materials and Methods: Congregating places for elderly population, which were selected on the expected risk of sexually transmitted infections, were visited to study their sexual behavior, awareness on sexually transmitted diseases (STDs), and STU status using a specially developed survey and urine polymerase chain reaction (PCR) test. In addition, analysis of the Health Insurance Review & Assessment Service (HIRA) database was done to study the nationwide status and trends of STU of the elderly population. Results: The study found that approximately 42% of elderly South Koreans were sexually active. Elderlies in the high-risk group showed a higher percentage of multiple sexual partners and prostitution than elderlies in the low-risk group. Only 3% and 14% in the low-risk group and high-risk group used condoms, showing a very low rate of condom use. Both the urine PCR results and HIRA database analysis showed that the prevalence of STU was not high and it remained stable in recent years, implying that currently, STU is not a significant burden on public health in the elderly population of South Korea. Conclusions: The current study presented the sexual behavior in the elderly population of South Korea, as well as the recent prevalence and trend of STU in the elderly population. These results may be used as baseline data for future study, education, prevention and public campaign plan for STDs in the elderly population.