섬모원주상피로 피복된 고환내 단순낭 1례

김지윤 ( Ji Yoon Kim ),임화수 ( Hwa Soo Lim ),문기학 ( Ki Hak Moon ),김미진 ( Mi Jin Kim ),조재호 ( Jae Ho Cho ) 영남대학교 기초/임상의학연구소 2005 Yeungnam University Journal of Medicine Vol.22 No.2

An intratesticular simple cyst is a rare lesion. The pathogenesis of such lesions is uncertain. Clinically, an intratesticular simple cyst may be difficult to differentiate from a cystic neoplasm. However, preoperative diagnosis is possible using ultrasonography (US). Testis-sparing surgery with simple enucleation of the cyst has a favorable outcome. We report an intratesticular simple cyst in a 48-year-old male who had a non-tender cystic mass in the right testis for 2 years. The diagnosis was made by preoperative US. The patient underwent a testis-sparing surgery. After simple excision of the cyst, histological examination revealed a simple cyst lined by ciliated cuboidal and columnar epithelium.

당뇨 흰쥐에서 음경발기 양상과 신경원성 Nitric Oxide Synthase의 관계

문기학,정희창,박동춘,이융창,허근,박종민,서준규 영남대학교 약품개발연구소 1997 영남대학교 약품개발연구소 연구업적집 Vol.7 No.-

Diabetes mellitus (DM) is an important cause of organic impotence in man. The exact pathogenesis remains debatable although it has been focused on cavemosal neuropathy and/or endothelial dysfunction. This study was designed to investigate the effect of DM on penile erection, especially in association with nitric oxide synthase (NOS) in corpus cavrnosum of diabetic rats. Nos studies of rat penis were performed in diabetic (DM was induced for 3, 6, 9, 12 weeks, respectively, by intraperitoneal administration of streptozotocin, 60mg/kg), in control and neurotomy group (3 weeks after bilateral cavrnous nerve transection). The experiments consisted of nicotinamide dinucleotide phosphate (NADPH) diaphorase activity with spectrophotometric assay for NOS catalytic activity, NADPH diaphorase staining for the identification of NOS containing nerve fibers, and Western blotting analysis with anti-brain NOS antibody for the expression of neuronal NOS. Finally, these results were compared with erectile response to cavemous nerve stimulation in diabetic and in control rats. In assay of NADPH diaphorase activity, NOS activity decreased significantly in penis of diabetic rat as compared to that of controls. Between the diabetic groups, NOS activity was not seen significantly different, and in neurotomy groups it was similar to that of diabetic groups. On histochemical staining of penile tissues, the number of NADPH-positive nerve fibers in control group (a mean of 127±6 fibers recorded in 4 random fields on each corporal side) contrasted significantly with that of the bilateral cavernous nerve ablation group (a mean of 12±2). In diabetic group, the number of NOS-containing nerve fibers was gradually reduced along with duration of diabetes (from 92±3 at 3 weeks to 28±3 at 12 weeks). In addition, analysis of blot density of neuronal NOS by Western blotting showed similar findings: 16% at 3 weeks and 8% at 12 weeks in diabetic group, 5% in neurotomy group and 27% in controls, based on the density of the rat cerebellum. Furthermore, erection response to cavernous nerve stimulation was also decreased in diabetic rats along with DM duration. The results indicated that reduction of cavernous NOS, particularly, its neuronal form at the level of NO production plays an important role on the pathogenesis of erectile impotence in diabetic rats although the role of endothelial NOS in DM remains to be elucidated. Furthermore, cavernosal NADPH diaphorase staining and/or NOS activity may allow to characterize certain pathological condition, which comprise neurogenic impotence.

하부 요로계 이물 : 4례 증례보고

박동춘,유진욱,정희창,문기학 영남대학교의과대학 1998 Yeungnam University Journal of Medicine Vol.15 No.2

Foreign bodies in genitourinary tract are common and almost of them are within the bladder. These foreign bodies were inserted of applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Foreign bodies(a thermometer and a piece of cloth) in the bladder were inserted as a mean of masturbation in two cases, and a cooper wire in the posterior urethra was introduced by iatrogenic causes in one case. In one case, four magnets were inserted into the bladder for the purpose of forceful penile erection. Clinical history, symptom, radiologic study, and endoscopic examination were required to diagnose foreign body. They were easily removed by endoscopic manipulation or open surgical procedure.

비만과 전립선암의 연관성 분석

윤창준,문기학,박동춘 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: The role of obesity in prostate cancer etiology remains controversial. The aim of this study was to evaluate the relationship between obesity and prostate caner risk Material and methods: Between January 2000 and June 2005, 286 patients suspected of having prostate cancer underwent prostate biopsy. The clinical records of the 286 study patients were retrospectively reviewed with regard to age Body Mass Index (BMI), serum PSA, TRUS, and prostate biopsy results. They were stratified by BMI into three groups according to the cutoffs recommended for Asian population: normal. BMI less than 23 Kg/m^(2), overweight , BMI 23 to 25 Kg/m^(2), and obese, BMI greater than 25 Kg/m^(2). Results: As for BMI, 132 (46.2%) were normal, 95 (33.2%) overweight and 59 (20.6%) were obese. A total of 99 (34.6%) patients were diagnosed as having prostate cancer. In multivariate logistic regression analyses, no significant association was observed between BMI and prostate cancer detection. Conclusion: We initially hypothesized that obesity may be biologically associated with increased prostate cancer development. However, our study did not show a significant association between BMI prostate cancer.

Northgate SD-3와 Modulith SLX 쇄석기를 이용한 체외충격파쇄석술의 비교분석 : Treatment Results with 2,000 Renal and Ureteral Stones 단일신결석 및 요로결석 2,000례의 치료결과 분석

정희창,문기학,박동춘,이준영,조철규 영남대학교 의과대학 1999 Yeungnam University Journal of Medicine Vol.16 No.1

세대 및 특징이 다른 쇄석기종의 치료효과와 안전성을 비교하기 위해 2세대 Northgate사의 SD-3쇄석기와 3세대 Storz사의 Modulith SLX쇄석기로 체외충격과 쇄석술을 시행한 단일요로결석 환자 2000례를 분석한 결과, 치료효과를 판정해 볼 수 있는 요로결석의 위치 및 크기에 따른 성공률과 재시행률에서는 큰 차이가 없는 것으로 분석되어, 제 3세대 쇄석기인 Modulith SLX와 Northgate SD-3의 치료효과는 비슷한 것으로 나타났다. 그리고, 두 쇄석기종 모두에서 심각한 합병증의 발생은 없었으나, Northgate SD-3에서 Modulith SLX보다 합병증으로 인한 입원치료를 받은 환자의 수가 많았다. 이상으로 두 기종 사이의 치료효과에는 큰 차이가 없고, Modulith SLX를 이용한 체외충격파쇄석술이 조금 더 안전한 것으로 나타났지만 두 기종의 장단점을 서로 보완하여 사용한다면 더욱 효과적인 치료방법이 될 것으로 생각된다. Some reports have shown a decreased effectiveness of extracorporeal shock wave lithotripsy(ESWL) with newer lithotriptors. We compared the treatment results of ESWL with a second generation Northgate SD-3 and a third generation Modulith SLX device. A total of 2,000 patients underwent ESWL treatments for single urinary calculus between September, 1988 and July, 1988. 1,241 patients were treated with Northgate SD-3 between September, 1988 and December, 1995. And 759 patients were treated with Modulith SLX between January, 1996 and July 1998. The treatment results were compared using chi-square test to determine statistical significance. The overall success rate, success rate according to the location and size, the mean number of sessions, complication rate and retreatment rate were calculated, according to lithotriptor. The overall success rate was 90.6% with Northgate SD-3 and 89.1% with Modulith SLX. With Northgate SD-3 and Modulith SLX, the success rate according to the location was 91.0%(579/636) and 88.1%(236/268) in kideny; 93.2%(517/555) and 89.9%(258/287) in upper ureter; 83.3%(10/12) and 94.4%(167/177) in middle and lower ureter; 47.4%(18/38) and 55.6%(15/27) in staghorn stone, respectively. The success rate according to the size of stone with Northgate SD-3 and Modulith SLX for stones with the size under 10mm was 96.1%(612/637) and 93.1%(470/505); from 11mm to 20mm was 87.3%(421/482) and 86.4%(165/191); from 21mm to 30mm, 77.5%(62/80) and 67.5%(23/34); and for stones larger than 31mm was 69%(29/42) and 62.1%(18/29), respectively. Mean number of sessions for successful fragmentation was 1.21 and 1.69, respectively with Northgate SD-3 and Modulith SLX. Retreatment rate was 16.7% and 17.5%, respectively. The complications after treatment were severe pain(6.2% with Northgate SD-3 vs. 2.0% with Modulith SLX), steinstrasse(3.4% vs. 1.9%), fever(1.2% vs. 0.5%) and perirenal hematoma(0.2% vs. 0%) in order of frequency. There was no significant difference in the effectiveness of Northgate SD-3 and Modulith SLX. However, a statistically significant difference was observed between the two lithotriptors. We concluded that ESWL with Modulith SLX is more safe compared to Northgate SD-3.

경요도전립선전기기화술이 초기 임상경험 : 경요도전립선절제술 및 레이저 전립선절제술과의 비교

김정현,문기학,정희창,박동춘 영남대학교의과대학 1998 Yeungnam University Journal of Medicine Vol.15 No.2

최근에 Roller loop electrode를 이용한 경요도전립선전기기화술에 관심이 집중되고 있다. 저자들은 전립선비대중에서 전립선전기기화술의 가치를 알아보기 위해 Roller loop electrode를 이용한 전립선전기기화술(TEVP, 17례)을 레이저전립선절제술(VLAP, 39례)과 전통적 경요도전립선절제술(TURP, 59례)과 비교 분석해 보았다. TEVP는 효과 면에서는 전통적인 경요도전립선절제술에는 미치진 못하지만 VLAP과는 유사한 효과를 보였으며 안전성면과 경제적인 면에서는 VLAP을 능가하는 치료법으로 사료된다. 본 연구가 적은 환자를 대상으로 10개월까지 관찰한 결과이고 경요도전립선전기기화술의 초기 경험이라 명확한 결론을 내리기에는 다소 성급한 면이 있으나 전통적인 전립선절제술에 비해 짧은 입원기간, 짧은 요도관유치기간 및 적은 출혈 등을 보여주며 레이저 시술의 단점인 고가장비가 필요 없다는 점에서는 전통적 전립선절제술의 대체 술기로 높이 평가되어진다. Recently, several alternatives have been attempted in the management of benign prostatic hyperplasia (BPH) to reduce morbidity of traditional transurethral resection of the prostate (TURP). Among new modalities, transurethral electrovaporization (TEVP) is considered as a promising altermative. To evaluate the safety and initial efficacy of TEVP using the roller loop electrode (ProSurg Inc. USA) on BPH patients, we compared the results of TEVP with those of TURP and visual laser ablation of the prostate (VLAP). In this study, a total of 115 patients with symptomatic BPH were underwent TEVP (n=17), TURP (n=59) or VLAP (n=39) since 1995. Before treatment, patients were evaluated with an International Prostate Symptom Score (IPSS) and the measurement of maximal uroflow rate (MFR) and postvoid residual urine (PVR). After treatment, the operative and hospital records were reviewed. The uroflowmetry and IPSS were re-evaluated 3-10 months after treatment. In clinical outcome of re-evaluation compared to the preoperative parameters, there was a clinically significant improvement in three procedures. TEVP resulted in 62% reduction in IPSS (TURP, 73% : VLAP, 69%), 84% improvement in MFR (TURP, 113% : VLAP, 91%), and 74% reduction in PVR (TURP, 88% : VLAP, 78%). TEVP had shorter duration of hospitalization and catheterization than the others. TEVP was associated with lower rates of treatment-related complication than TURP. In conclusions, TEVP is considered as a useful procedure to treat symptomatic BPH. And, the advantages of TEVP over TURP include excellent intraoperative hemostasis, lower morbidity, shorter hospital stay and simple technique. In addition the advantages over VLAP include lower cost, shorter duration of catheterization and early symptom improvement.

자궁경부봉축술 후 발생한 방광석 및 방광질루 1예

윤창준,문기학,정희창 영남대학교 의과대학 2006 Yeungnam University Journal of Medicine Vol.23 No.1

The frequency of a bladder foreign body in the female is lower than in the male, and bladder stones attached to foreign bodies such as non-absorbable suture material are not common. Moreover, vesicovaginal fistulas due to migration of puncture of suture materials into the bladder are rare. In this report, we present a case of bladder stone and vesicovaginal fistula formation in a 29-year-old female patient who had been treated with the McDonald operation for an incompetent internal os of the cervix (IIOC) during pregnancy. The patient was successfully treated by cystoscopic removal of the bladder stone with suture material and conservative treatment for the vesicovaginal fistula.

건강진단 수진자를 대상으로 한 성기능의 평가: IIEF (International Index of Erectile Function) 한국어 번역본을 이용한 설문조사

이준영,문기학,박동춘 大韓泌尿器科學會 2001 Korean Journal of Urology Vol.42 No.3

원발성 조루증 환자에서 SS-cream의 임상시험 평가

최형기,정경우,문기학,신종성,최영득,이웅희,김동기 大韓泌尿器科學會 1999 Korean Journal of Urology Vol.40 No.4

흰쥐에서 연령에 따른 고환염전이 대측 고환의 조직학적 소견 및 세포고사에 미치는 영향

신홍석,조철규,문기학 大韓泌尿器科學會 2002 Korean Journal of Urology Vol.43 No.8