How Serious Is Erectile Dysfunction in Men’s Lives? Comparative Data From Korean Adults

지윤섭,최지웅,고영휘,송필현,정희창,문기학 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.7

Purpose: Whereas sexual function has long been assumed to be an important component of adult men’s lives, the impact of sexual dysfunction has not been estimated in parallel to other modern disease entities. We compared the seriousness of erectile dysfunction (ED) with that of other diseases by use of self-administered questionnaires. Materials and Methods: Between January 2012 and July 2012, 434 healthy male volunteers (group 1) and 263 ED patients (group 2) were enrolled. The questionnaire consisted of the following: “If you must undergo only one disease in all your life, which disease could you select among these items or ED?” The comparative disease entities included hypertension, diabetes mellitus (oral hypoglycemic agent/insulin injection), hemodialysis, myocardial infarction, herpes zoster, chronic sinusitis, chronic otitis media,gastric cancer (early/late), lung cancer (early/late), liver cancer (early/late), and dementia. Results: Group 1 recognized ED as being a more serious disease than hypertension,diabetes mellitus (oral hypoglycemic agent), herpes zoster, chronic sinusitis, and chronic otitis media. In comparison, group 2 recognized ED as being a more serious condition than diabetes mellitus (insulin injection) and dementia (p<0.001 and p<0.001, respectively). In particular, ED was deemed to be more serious than hemodialysis, gastric cancer (early), lung cancer (early), and liver cancer (early) by men in group 2 in their 30s to 40s, and these results were statistically significant compared with the same age subgroups in group 1 (p<0.001, p<0.007, p<0.02, and p<0.007, respectively). Conclusions: In contrast with their healthy counterparts, Korean men with ED recognized ED as being as serious as hemodialysis, dementia, and early stage cancer, which reflects the severe bother of ED in Korean patients.

Long-term survival and patient satisfaction with inflatable penile prosthesis for the treatment of erectile dysfunction

지윤섭,고영휘,송필현,문기학 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.6

Purpose: We investigated the long-term survival and patient satisfaction with an inflatable penile prosthesis as a treatment forrefractory erectile dysfunction (ED). Materials and Methods: Between July 1997 and September 2014, a total of 74 patients underwent implantation of an inflatablepenile prosthesis. The present mechanical status of the prosthesis was ascertained by telephone interview and review of medicalrecords, and related clinical factors were analyzed by using Cox proportional hazard regression model. To investigate current statusand satisfaction with the devices, novel questionnaires consisting of eight items were administered. Results: The mean (±standard deviation) age and follow-up period were 57.0±12.2 years and 105.5±64.0 months, respectively. Sixteen patients (21.6%) experienced a mechanical failure and 4 patients (5.4%) experienced a nonmechanical failure at a medianfollow-up of 98.0 months. Mechanical and overall survival rates of the inflatable penile prosthesis at 5, 10, and 15 years were93.3%, 76.5%, and 64.8% and 89.1%, 71.4%, and 60.5%, respectively, without a statistically significant correlation with host factorsincluding age, cause of ED, and presence of obesity, hypertension, and diabetes mellitus. Overall, 53 patients (71.6%) completedthe questionnaires. The overall patient satisfaction rate was 86.8%, and 83.0% of the patients replied that they intended to repeatthe same procedure. Among the 8 items asked, satisfaction with the rigidity of the device received the highest score (90.6%). Incontrast, only 60.4% of subjects experienced orgasm. Conclusions: The results of our study suggest that excellent long-term reliability and high patient satisfaction rates make the implantationof an inflatable penile prosthesis a recommendable surgical treatment for refractory ED.

서울 교육현장의 무질서 심각한 수준 교육활동 보호장치 마련 시급

지윤섭 대한사립학교장회(구 대한사립중고등학교장회) 2011 私學 Vol.129 No.-

α-phenyl-N-iso-propylnitrone유도체에 대한 1-propanethiol의 친핵성 첨가반응에 관한 연구

이광일(Lee Kwang Il)(李光一),곽천근(Kwak Chun Geun)(郭仟根),장병만(Jang Byung Man)(張炳萬),김영주(Kim Young Ju)(金榮珠),지윤섭(Ji Yun Seup)(池允燮),이기창(Lee Ki Chang)(李基昌) 한국유화학회 1995 한국응용과학기술학회지 Vol.12 No.2

The rate constant of the nucleophilic addition of 1-propanethiol to α-phenyl-N-iso-propylnitrone derivatives were determined at various pH and a rate equation which can be applied over wide pH range is obtained. Final product of the addition reaction was α-thiopropyl-p-phenylbenzylideneamine. Base on the rate equation, general base effect, substituent effect and final product, plausible mechanism of addition reaction have been proposed. Below pH 3.0, the reaction was initiated by the addition of 1-propanthiol, and in the range of pH 3.0-10.0, proceeded by the competitive addition of 1-propanethiol and propanethiolate. Above the pH 10.0, the reaction proceeded through the addition of propanethiolate.

Usefulness of Urine Cytology as a Routine Work-up in the Detection of Recurrence in Patients With Prior Non–Muscle-Invasive Bladder Cancer: Practicality and Cost-Effectiveness

옥봉기,지윤섭,고영휘,송필현 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.10

Purpose: To investigate the usefulness of urine cytology in the detection of tumor recurrencein terms of practicality and cost-effectiveness. Materials and Methods: We retrospectively analyzed 393 patients who underwent transurethralresection of bladder tumor (TURBT) for non–muscle-invasive bladder cancer(NMIBC) from January 2010 to June 2013. All patients underwent cystoscopy, urinecytology, urinalysis, and computed tomography (CT) at 3 and 6 months after TURBT. In 62 cases, abnormal bladder lesions were identified on cystoscopy within 6 months. Suspicious lesions were confirmed pathologically by TURBT or biopsy. Patients weregrouped by modalities: group I, urine cytology; group II, CT; group III, urinalysis; groupIV, urine cytology plus CT; group V, urine cytology plus urinalysis; group VI, CT plusurinalysis; group VII, combination of all three modalities. Each group was comparedby cost per cancer detected. Results: Forty-nine patients were confirmed to have tumor recurrence and 13 patientswere confirmed to have inflammation by pathology. The overall tumor recurrence ratewas 12.5% (49/393) and recurrent cases were revealed as NMIBC. Sensitivity in groupI (24.5%) was lower than in group II (55.1%, p=0.001) and group III (57.1%, p<0.001). However, in group VII (77.6%), the sensitivity was statistically similar to that of groupVI (75.5%, p=0.872). Under the Korean insurance system, total cost per cancer detectedfor group VII was almost double that of group VI (p=0.041). Conclusions: Routine urine cytology may not be useful for follow-up of bladder cancerin terms of practicality and cost-effectiveness. Application of urine cytology needs tobe adjusted according to each patient.

후복막섬유화증에서 동반된 양측 요관폐색에서 Memokath 스텐트 삽입술

송필현,지윤섭,김종민,정희창 대한요로생식기감염학회 2012 Urogenital Tract Infection Vol.7 No.1

Retroperitoneal fibrosis is a rare disease characterized by the presence of a retroperitoneal tissue, consisting of chronic inflammation and marked fibrosis, which often causes ureteral obstruction. Surgical approach is necessary to preserve the renal function, and this is achieved by ureteral stent. The Memokath stent is a new thermo-expandable shape-memory metallic stent. Herein, we report our recent experience of a patient with retroperitoneal fibrosis, which involves bilateral ureter, who underwent successful bilateral Memokath stent insertion.

Effect of patient position on pain scales during transrectal ultrasound-guided prostate biopsy

김영욱,지윤섭,고영휘,송필현 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.6

Purpose: Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer;however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient’s positionon pain scales during TRUS-guided prostate biopsy. Materials and Methods: Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guidedprostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by aurologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzedthe correlation between pain scale score and clinical variables with a focus on patient position. Results: No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria,pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLDgroups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position(p<0.05). In the multiple linear regression model, VAS score showed a significant correlation with lithotomy position (β=–0.772,p=0.003) and diabetes mellitus (β=–0.803, p=0.033). Conclusions: We suggest that the lithotomy position may be the proper way to reduce pain during TRUS-guided prostate biopsy.

학생인권조례의 현황과 쟁점: 경기도 학생인권조례를 중심으로

오동석,천희완,지윤섭,이종근 한국법과인권교육학회 2011 한국법과인권교육학회 학술대회 Vol.2011 No.1

전립선비대증 환자에서 경요도전립선절제술 후 급성요폐 발생에 영향을 미치는 인자

양소전,문기학,지윤섭,송필현,김현태 대한남성과학회 2011 The World Journal of Men's Health Vol.29 No.2

Purpose: Urologists occasionally experience some cases of voiding failure after transurethral resection of prostate (TURP). Preoperative and postoperative factors attributable to acute urine retention (AUR) after catheter removal in post-TURP patients were evaluated and analyzed to determine the causative factors for AUR. Materials and Methods: From June 2004 to May 2008, a total of 172 patients who underwent TURP due to symptomatic benign prostatic hyperplasia (BPH) were divided into the AUR group (n=21) and the control group (n=151). The AUR group was defined as patients with voiding difficulty within 24 hours and whose residual urine volume was above 400 ml after catheter removal. The control group was defined as patients without AUR. Age, duration of symptoms, International prostate symptom score (IPSS), Quality of life score (QoL), uroflowmetry, post-void residual urine volume, preoperative serum prostate specific antigen (PSA) level, preoperative prostate volume, resected prostate volume, rate of prostate resection [resected prostate volume/preoperative prostate volume×100], operative time and duration of catheter were retrospectively analyzed to identify which of these were the factors related with AUR after catheter removal in post-TURP patients. Results: Preoperative prostate volume was higher (90.7±50.4 vs 64.4±32.7, p=0.002) and rate of prostate resection was lower (38.8±8.1 vs 50.5±12.4, p<0.001) in AUR group compared to control group. And age, duration of symptoms, IPSS, QoL, uroflowmetry, post-void residual urine volume, preoperative serum PSA level, resected prostate volume, operative time and duration of catheter were not statistically significant in both groups. The multivariate analysis subsequently showed that preoperative prostate volume (p=0.010, OR=1.040) and rate of prostate resection (p=0.001, OR=0.901) were independent factors related with AUR after catheter removal in post-TURP patients. Conclusions: The incidence of AUR after catheter removal was higher in post-TURP patients with high preoperative prostate volume and low rate of prostate resection. Therefore the surgeon’s effort to increase the rate of prostate resection, especially in patients with large prostate volume, may lower the incidence of postoperative AUR.