새로운 기법을 이용한 요도하열의 수술

윤율로 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

We have treated nine hypospadias patients, who were admitted from April, 1996 to November, 1966 using several modified operation techniques : plastic catheter instead of urethral stent and suprapubic diversion, preservation of urethral plate, pedicled subcutaneous tissue covering over new maden urethral tube, glandular fixation with supporting lever, and double diaper dressing. We experienced a significantly lower complication rate(11%) compared to previous techniques. So we recommend the onlay island flap urethroplasty which preserves the urethral plate in the mid and posterior hypospadias repair with above mentioned techniques.

Mycoplasma가 정자운동성에 미치는 영향

윤율로,윤능수 大韓泌尿器科學會 1983 Korean Journal of Urology Vol.24 No.2

장관을 이용한 비뇨기과적 수술 30례에 대한 임상적 관찰

윤율로,윤능수 大韓泌尿器科學會 1982 Korean Journal of Urology Vol.23 No.6

요도하열 20례에 대한 수술적 방법

윤율로 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

The urethroplasties were performed on 20 patients with hypospadias who had been admitted to the Department of Urology Chungnam National University Hospital from January, 1990 to March, 1993. After chordectomy the most common type of hypospadias was penoscrotal type(9 cases,45%). And the combined anomalies were 40% and the scrotal transposition was the most common. Of the 12 one-stage urethroplasties 7 were performed as Duckett method,1 as MAGPI method, 2 as Hodgson I method,1 as Hodgson II method and 1 as augmented Duckett method. Of the 8 two-stage urethroplasties 4 underwent as modified augmented Duckett method, 1 as modified Duckett method with scrotal flap, 1 as Broadbent method, 1 as Rochet method and 1 as modified Rochet method with inguinal flap. The complication rate was 50%,in which the most common complication was urethrocutaneous fistula(7 cases,35%). The complication rates by year were 71%, 50%, 43%, 0% from 1.990 to 1993, respectively. Thus, it is thought that the advance in operation technique may be very important factor for successful operation. The methods of Duckett and augmented Duckett were used in minimal and moderate severe urethral defect and school age and modified two-staged Duckett method were performed in severe urethral defect and preschool age without significant complications. So these results suggests that the methods using dorsal inner prepuce, which is adjacent to operation field, rich blood supply,good elasticity, no contracture after surgery, cosmetic advantage and hairless, are recommended for choice of urethroplasty of hypospadias if possible.

대전지역 유치원생의 무증상세균뇨의 빈도에 관한 연구

윤율로,김영수 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

Asymptomatic bacteriuria, of covert bacteriuira occurs more frequently than symptomatic urinary tract infection at all ages during childhood. However the true prevalence is difficult to ascertain owing to nonspecific and vague symptoms. We evaluated 269 preschool children(male: female=126:143, average age: 4.86 years old) with questionnaire, urine stick test, urine culture and radiologic examinations. The results were as follows: Daytime incontinence was noted in 5.2% of the male and 2.65 of the female, nocturnal enuresis in 10% of the male and 8.2% of the female. Pyuria was present in 2.4% of the male and 14% of the female. Asymptomatic bacteriuria was found in 1.6% of the male and 9% of the female. The most common organism encountered was Escherichia coli(60%). The radiologic evaluations(all in IVP and 3 in VCUG) showed negative in all children who were culture-positive. Conclusively the screening test of the covert bacteriuria for the preschool children is not helpful until other good method can be devised.

요도 손상의 임상적 고찰

윤율로 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

A clinical study was made or 93 patients with uethral injury treated in the Depart. of Urology, Chungnam University Hospital, during the period from Jan. 1980 to Oct. 1990. The results were as follows 1. Of 262 patients with genitourinary trauma among 3608 urologic inpatients during the period, 93 patients sustained urethral injury. 2. The age ranged from 2 to 84 with average 38 years. 3. The most common cause of urethral injury was traffic accident (36.6%) which is followed by straddle injury(34.4%), blunt trauma(10.7%), fall down(8.6%), iatrogenic(7.5%), penile fracture(1.1%) and laceration(1.1%) in decreasing order. 4. Most of cases caused by traffic accident were associated with pelvic bone fracture, which sustained membranous urethal injury. 5. The primary managements were suprapubic cystostomy in 46 cases, urethral catheter only in 17 cases, urethral realignment in 13 cases and the secondary operations were urethroplasty only in 21 cases, urethroplsty with VIU(visual internal urethrotomy) in 13 cases and VIU only in 18 cases. 6. Of the 46 cases treated with primary cystostomy, urethral stricture developed in 33 cases(71.7%), impotence in 4 cases(8.7%), incontinence in 1 case(2.2%), urethrocutaneous fistula in 2 cases(4.3%), and epididymitis in 1 case(2.2%). 7. Of the 13 cases treated with primary realignment, urethral stricture developed in 7 cases(53.8%), incontinence in 1 case, urethrocutanous fistula in 1 case and epididymitis in 1 case(each 7.7%). 8. In the male posterior urethral injury, complete injury were 19 cases and partial injury were 13 cases. Of the 19 cases of complete injury, urethral stricture developed in 16 cases(84.2%), impotence in 5 cases(26.3%), incontinence in 2 cases(10.5%), urethrocutaneous fistula in 1 case and epididymitis in 1 case(each 5.3%). Of the 13 cases of partial injury, urethral stricture were developed in 11 cases(84.6%), impotence in 1 case and incontinence in 1 case(each 7.7%).

방광 이행상피암에서 argyrophilic nucleolar organizer regions의 의의

윤율로,송규상 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

Using a silver staining technique, nucleolar organizer regions(AgNORs) were identified in routinely processed paraffin sections of transitional carcinoma of baldder which were selected from the 37 patients diagnosed in the Depart. of Urology, Changnam University Hospital, during the period July 1986 to July 1992. The technique showed as follows. 1. Argyrophilic nucleolar organizer regions(AgNORs) were seen as sharply defined dark brownish dots in the almost all nuclei of tumor cells. The nuclei were stained as brownish color and cytoplasms as more light brown color. 2. The Mean scores of AgNORs were 1.07 ± 0.04 in Chronic cystitis, 1.52 ± 0.31 in Grade Ⅰ, 1.99 ± 0.04 in Grade Ⅱ, 3.21 ± 1.20 in Grade Ⅲ, 5.24 ± 1.20 in Grade Ⅳ of the transitional carcinoma of the bladder. Using Kruskal-Wallis test the mean scores of AgNORs among each group showed a statistically significant differences(P value < 0.001). 3. The mean scores of AgNORs of each stage of tumor 2.61 ± 1.44 in Stage Ⅰ, 2.56 ± 1.20 in Stage Ⅱ, 3.40 ± 1.99 in Stage Ⅲ, 3.76 ± 1.37. There was no statistical significant differences among the each group of stage(P value > 0.5). 4. No significant correlation was obtained between AgNORs and tumor size or number. 5. The well defined inverse relationship was observed between AgNORs numbers and their sizes. The numbers of AgNORs rises with decreasing differences and increasing malignancy. Thus, the standardized assessement of argyrophilic nucleolar organizer regions can be easily performed by any surgical pathology laboratory without specialized equipment and may be useful as an good indicator of proliferative activity of tumor cell or biological behavior.

소아에 있어서 정계정맥류의 치료방침에 관한 임상적 연구

윤율로 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

A varicocele is the most common identifiable cause of male infertility, but the management of a childhood and adolescent with a varicocels is still controversial. We evaluated the surgical indications and the adequate was of operation in 26 boys 6 to 18 years old(mean age 13.5 years) between April 1992 and October 1997. The operative indications were testicular asymmetry, positive GnRH stimulation test, pain, increase in varicocele size and give up for observation. The two most frequent indications were testicular asymmetry(17 patients, 67%) and positive GnRH stimulation test(6 PATIENTS, 23%). The inguinal Palomo technique did not show any recurrence or complication. Left testis volume in 26 patients increased from 72% of normal right testis preoperatively to 87.6% postoperatively. And our data suggest that the inguinal Palomo technique seems to be tim-saving, afforded catch up growth and less risky for recurrence, so it should be the preferred technique for varicocele in the childhood.

Estrogen과 Androgen이 웅성 백서의 신장에 미치는 영향에 대한 병리학적 연구

윤율로,이충식,강대영 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

A pathologic study was performed to study the effects of estrogen and androgen on kidney, which was thought to induce benign prostatic hyperplasia in the human and the dog. Forty male Sprague Dawley rats were castrated via a scrotal incision. The remaining 10 rats served as normal controls. A two week period was allowed for the sex accessory tissues of castrated rats to involute after which the rats received 25 daily intramuscular injections of 2mg testosterone only, 0.02mg of estradiol only, or a combination of both steroids, each dissolved in 0.2m1 of propylene glycol. Normal and castrate control groups were injected with 0.2m1 of propylene glycol only. Twenty four hours after the last injection, rats were killed and weighed, and then both kidneys were removed and weighed. Light microscopic and electron microscopic studies of the kidneys were performed. The results were as follows: 1. There was a significant increase in the average weight of the kindeys of the groups treated with testosterone plus estradiol when compared to control group (p<0.01). 2. The average weight of the groups treated with testosterone plus estradiol showed a significant decrease compared to those of castrated controls (p<0.05). 3. In the castrate controls, the kidneys were microscopically unremarkable, but the kidneys of the groups treated with testosterone only and estradiol only showed mild vesicle formation in the cytoplasm. The groups treated with testosterone plus estradiol showed enlargement of convoluted tubules and severe vesicle formation. 4. Electron microscopically, the kidneys of the groups treated with testosterone only and estradiol only showed mild edematous change in the cytoplasm, but the groups treated with testosterone plus estradiol showed severe edematous change in mitochondrias and increase of polyribosomes. The above results suggest that the increased weight of the kidney and tubular er largement of The groups treated with testosterone plus estradiol is caused by water accumulationin the cytoplasm.

소아 비뇨기과 영역에서의 HCG

윤율로,권칠규 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Purpose: Although human chorionic gonadotropin(HCG) is used in the HCG stimulation test, for the treatment of male infertility, tumor markers for bladder cancer and testis tumors and some cryptorchism patients, its indication and treatment methods are still controversial. The objectives of this study are to clarify the indication and methods of HCG treatment in the pediatric urologic field through our clinical experiences. Materials and Methods: Between 1994 and 1997, 51 patients were selected retrospectively for this study. Eight retractile testes, 31 cryptorchisms, seven Kallmann syndromes, two micropenis, two hypospadias, and one XYY syndrome. Each patient was treated with HCG according to the protocol of each of the different disease entities. Results: All eight retractile testis patients were treated successfully. Nine intracanalicular type cryptorchism patients were responded partially and four intracanalicular cryptochid patients completely. As for the Kallmann syndrome patients, all seven improved in their secondary sexual characteristics, but did not improve in sperm quality. We also have had good outcomes for micropenis, hypospadias and XYY syndrome. Conclusions: Our experience indicates that HCG in pediatric urology can be treated safely in selected cases.