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음경골절의 임상상과 치료: 한국에서의 다기관 연구 결과
이종복 ( Jong Bouk Lee ),이재현 ( Jae Hyun Lee ),류범상 ( Bum Sang Ryu ),최종보 ( Jong Bo Choi ),이경섭 ( Kyung Sup Lee ),김홍섭 ( Hong Sup Kim ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.1
Backgrounds: Penile fracture is the traumatic injury of the tunica albuginea of the corpus carvernosum in erectile state. This study was designed to evaluate clinical manifestations, diagnostic and therapeutic modalities. Methods: Between December 1992 and July 2003, 72 patients were evaluated after penile injury. History taking and physical examination were performed in each patient and if needed, radiologic examination and operation was undergone. Results: The mean age of patients was 42 years old (18-72 years old), and causes of penile fracture were sexual intercourse (44 cases: 61.1%), masturbation (8 cases: 20.8%), and fingerpressure (4 cases: 5.6%) in order. As a preoperative radiologic examination, penile sonography was performed in 30 cases and carvernosogram in 20 cases. In each group, 4 and 3 cases who showed no sign of penile fracture underwent an operation, and it revealed carvernosal rupture in 1 case in both groups. Among 57 patients (79.1%) who had an early operation, 52 patients were found to have rupture of corpus carvernosum. The most common site of penile fracture was proximal shaft (28 cases: 53.9%) and then midshaft (15 cases: 28.9%) and distal shaft (5 cases:9.6%). Injury involved unilateral and bilateral corporeal rupture in 49 cases (Rt.:35, Lt.:14) and 3 cases. The overall complication rate in patients who had an early operation was 8.9% (4 of 45 cases) in compare to 66.7% (8 of 12 cases) in patients who did not. Conclusions: Our experience demonstrates that the most common cause and site of penile injury are sexual intercourse and right proximal shaft respectively, and an early operation would be an effective treatment to prevent complications. When penile fracture is not clinically definite, radiologic examination, such as carvernosogram or penile sonography, can be helpful in making diagnostic and therapeutic plan.
Extramammary Paget's Disease의 CO₂Laser를 이용한 치험례
김우경,윤을식,최종보,한승규 大韓成形外科學會 2000 Archives of Plastic Surgery Vol.27 No.2
Since Paget's first description in 1874 of what is presently known as Paget's disease of the nipple, similar lesions have been reported rarely on the penis and scrotum, vulva, perineum, axilla and the eyelids. Because it is often associated with a subjacent or visceral malignancy and recurrence, extramammary Patget's disease (EPD) is considered as malignant condition. This case report describes two patients with extramammary Paget's disease of the penoscrotal area. One of them had renal cell carcinoma in left kidney and was managed by radical nephrectomy in urology. A skin lesion with extramammary Paget's of the penis and scrotum was treated using the CO₂ laser. The lesion showed a temporary improvement but a relapse was experienced again, and then we excised the lesion widely and closed primarily with local advancement flaps on scrotum and split thickness skin graft on penis. We suggest that it is not sufficient to treat the extramammary paget's disease only with the CO₂laser, although no definitive conclusion can be drawn yet due to the rarity of the disease.