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Assessment of Erectile and Ejaculatory Function after Penile Prosthesis Implantation
배장호,송필현,김현태,문기학 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.3
Purpose: We investigated erectile and ejaculatory function after penile prosthesis implantation. Materials and Methods: A total of 121 patients were enrolled in the surgery group (SG) and 120 patients in the nonsurgery group (NSG). All subjects were evaluated by use of the following questionnaires: the erection function and intercourse satisfaction domains of the International Index of Erectile Function (IIEF) and the ejaculation domain of the Male Sexual Health Questionnaire (MSHQ-EjD). Comparisons were made between the SG and the NSG, by prosthesis types, and of postoperative periods and complication rates for each prosthesis type. Results: Differences in the erection function and intercourse satisfaction domains of the International Index of Erectile Function (IIEF-EF and IIEF-IS) between before and after treatment were significantly higher in the SG group than in the NSG group (p=0.02, 0.03, respectively). When comparing prosthesis types, differences in the erection confidence and intercourse satisfaction items between before and after surgery were significantly higher in the SG group (p=0.03, 0.04, respectively). In the comparison of each prosthesis type by postoperative period, differences in the IIEF-EF and IIEF-IS between before and after surgery were not statistically significant but the MSHQ-EjD domain after surgery was significantly lower in cases of >5 years (p=0.02, 0.03, respectively). Conclusions: Subjective symptoms such as erectile confidence and erectile function were improved more in the SG group than in the NSG group, especially in the inflatable group. It appeared that there was no significant difference in improvement in ejaculatory function depending on the treatment method, but that ejaculatory function decreased as time passed.
급성 관동맥 증후군에서 생체내 관상동맥 경화반 조직 소견: 심혈관 초음파 연구
배장호,권택근,김기홍,현대우,김기영,김동식 대한심장학회 2007 Korean Circulation Journal Vol.37 No.9
Background and Objectives:Rupture-prone plaque, characterized by a large necrotic core, thin fibrous cap and large number of inflammatory cells, is known to be associated with acute coronary syndrome (ACS) from several autopsy and animal studies. We sought to assess in-vivo lesion characteristics of culprit lesions in patients with ACS. Subjects and Methods:One hundred consecutive patients (mean age 60.4 years, 70 males), who underwent percutaneous coronary intervention, were analyzed for intravascular ultrasound (IVUS) radiofrequency information using IVUS-virtual histology (VH) software. Results:Patients with ACS (n=44, mean 59.7 years, 34 males) had a lower prevalence of hypertension (45.5% vs. 67.9%, p=0.024), higher level of high-sensitivity C-reactive protein (0.36±0.36 mg/dL vs. 0.22±0.27, p=0.043), longer lesion length (22.6±8.6 mm vs. 19.3±6.9 mm, p=0.036), and more plaque rupture (63.6% vs. 10.7%, p<0.001) than those without ACS (mean 61.0 years 36 males). The lesion analysis, at a minimal luminal area, revealed that patients with ACS had a larger plaque area (12.5±5.8 mm2 vs. 10.3±4.8 mm2, p=0.043) and necrotic core (1.7±1.4mm2 vs. 1.1±0.9 mm2, p=0.013) than those patients without ACS. Volumetric analysis over the lesion length showed that patients with ACS had larger plaque volume (9.9±4.0 mm3/mm vs. 8.3±3.4 mm3/mm, p=0.031) and necrotic core volume (1.3±1.0 mm3/mm vs. 0.8±0.6 mm3/mm, p=0.002) than those without ACS. The necrotic core volume was associated with the presence of ACS (β=0.662, p=0.041) by the IVUS-VH findings. Conclusion:The results of this study suggest that the overall necrotic core volume, not the necrotic core area at the minimal luminal area, is associated with the clinical presentation of ACS. (Korean Circulation J 2007;37:437-442) 배경 및 목적:급성 관동맥 증후군과 관련이 있는 고위험 경화반은 내부 괴사 조직이 크고 경화반을 둘러 싸는 섬유막이 얇으며 염증 세포가 많다는 것이 부검 연구 등을 통해 알려져 있다. 본 연구의 목적은 급성 관동맥 증후군 환자에서 원인 병변의 조직 소견을 생체내에서 분석해 보는데 있다.방 법:관상동맥 중재술과 Virtual Histology(VH)-혈관내 초음파를 시행받은 100명의 비선택적 연속적인 환자를(평균 60.4세, 남자 70명) 대상으로 하였다. VH-혈관내 초음파는 심혈관 무선 초음파의 스펙트럼 분석을 통해 관상동맥 경화반의 조직 소견을 네가지로(섬유, 지방 섬유, 괴사, 석회화 부위) 분류하여 정보를 제공해 준다. 결 과: 급성 관동맥 증후군이 있는 환자에서 (n=44, 평균 59.7세, 남자 34명) 안정형 협심증 환자보다(평균 61.0세, 남자 36명) 고혈압의 빈도는 낮았고(45.5% vs 67.9%, p=0.024) high-sensitivity C-reactive protein은 높았다(0.36±0.36 mg/dL vs 0.22±0.27 mg/dL, p=0.043). 심혈관 초음파 검사상 급성 관동맥 증후군 환자에서 병변 길이가 길었고(22.6±8.6 mm vs 19.3±6.9 mm, p=0.036) 경화반 파열이 흔하였다(63.6% vs 10.7%, p<0.001). 협착 부위가 가장 심한 부위 분석에서 급성 관동맥 증후군 환자에서 경화반 면적과(12.5±5.8 mm2 vs 10.3±4.8 mm2, p=0.043) 괴사 부위의 면적이(1.7±1.4 mm2 vs 1.1±0.9 mm2, p=0.013) 안정형 협심증 환자보다 컸다. 병변 전체의 부피 분석에서는 급성 관동맥 증후군 환자에서 안정형 협심증 환자보다 경화반 부피가 크고(9.9±4.0 mm3/mm vs 8.3±3.4 mm3/mm, p=0.031) 괴사 조직 부피도 컸다(1.3±1.0 mm3/mm vs 0.8±0.6 mm3/mm, p=0.002). 병변 전체에서의 괴사 조직 부피는 급성 관동맥 증후군과 독립적인 상관 관계가 있었다(β=0.662, p=0.041). 결 론: 본 연구의 결과로 보아 협착이 심한 부위의 조직 소견보다는 병변 전체에서의 조직 소견, 특히 괴사 조직의 부피가 급성 관동맥 증후군의 임상 양상과 관련이 있음을 알 수 있다.
외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경강압 및 기구고정술
배장호 영남대학교 의과대학 1996 Yeungnam University Journal of Medicine Vol.13 No.2
Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and bone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient are remained back pain. According to above results we concluded that anterolateral internal fixation combined.with bone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level
OLETF 쥐에서 날록손의 MTII에 의한 식욕억제 증가효과
배장호,박용훈,김성호,박소영,김종연,손조영,허정윤,원규장,김용운 대한내분비학회 2008 Endocrinology and metabolism Vol.23 No.1
Background: Leptin, an adipocyte-derived hormone, inhibits obesity in lean subjects, but is not widely used because of leptin resistance. Thus, circumventing the arcuate nucleus of the hypothalamus, the site responsible for leptin resistance, has been evaluated for treatment of obesity. However, chronic treatment of melanotan II (MTII), a synthetic agonist of the melanocortin 3/4 receptor, induces tachyphylaxis. Here, we evaluated whether naloxone, a non-specific agouti-related peptide (AgRP) antagonist, increases the anorexic effect of MTII in Otsuka Long-Evans Tokushima Fatty (OLETF) rats. Methods: We measured food intake following intracerebroventricular (i.c.v.) infusion of MTII and/or naloxone in OLETF rats. Sprague-Dawley rats were used as a normal control group. Results: The anorexic effect of i.c.v. MTII infusion decreased with time in OLETF rats, indicating the development of tachyphylaxis. In normal control rats, naloxone alone decreased AgRP expression in the hypothalamus but failed to induce anorexia. Moreover, there was no additional anorexic effect with co-treatment of naloxone and MTII. In OLETF rats, naloxone alone did not show an anorexic effect despite increased POMC expression in the hypothalamus. However, naloxone sensitized the anorexic effect of MTII when treated together. Conclusion: These results suggest that naloxone augmented the anorexic effect of MTII when treated together in OLETF rats, but had no effect alone. These results suggest that a combination therapy of naloxone and a melanocortin receptor activator would be an effective modality for treatment of obesity. (J Kor Endocr Soc 23:18~26 2008)
Tissue Characterization of Coronary Plaques Using IntravascularUltrasound/Virtual Histology
배장호 대한심장학회 2006 Korean Circulation Journal Vol.36 No.8
Most studies related with plaque histopathology and/or morphology are based on the gray scale intravascularultrasound (IVUS) and autopsy findings, although IVUS is limited for differentiating echolucent areas, andtissue shrinkage almost always occur during tissue fixation. In addition, autopsy studies can not establish the causalrelationship between the autopsy findings and the clinical findings. Spectral analysis of the IVUS radiofrequencydata may be a new and useful tool because it allows detailed assessment of plaque composition in vivo,with a high predictive accuracy of 87.1% to 96.5% in fibrous, fibrofatty, calcified and necrotic core regions withperforming tissue mapping and geometric assessment like that for classic gray scale IVUS. This new imagingtechnique offers clear benefits compared with the results of classic IVUS and autopsy studies. This review willbriefly discuss the methodology of spectral analysis of the IVUS radiofrequency data, the recent clinical studiesthat have used this technique and the future perspectives. (Korean Circulation J 2006;36:553-558)
관상동맥 질환자에서 좌심실 구혈율이 내피세포 기능과 경동맥 내중막 두께에 미치는 영향
배장호,김기영 대한심장학회 2005 Korean Circulation Journal Vol.35 No.5
Background and Objectives:The endothelial function and carotid arteries intima-media thicknes (IMT) are abnormal in patients with coronary artery disease (CAD). We performed this study to evaluate the impact of the ejection fraction on the endothelial function and carotid IMT in patients with CAD. Subjects and Methods:(mean age; 59 years, 176 males). The endothelial function and the carotid IMT were asesed by measuring the flow-mediated vasodi-lation (FMD) of the brachial artery and semi-automatically using high-resolution ultrasound, respectively. Results:Patients (n= 236) with an ejection fraction (EF) (5% on routine echocardiogram were younger (mean age; 58 vs. 62 years), showed a lower prevalence of diabetes (15 vs. 38%) (13 vs. 66%), a hig-her FMD (4.8± 2.4 vs. 4.0± 2.0%, p<0.05) and a lower carotid IMT (0.85± 0.15 vs. 0.91± 0.17 mm, p<0.05) than patients (n=47) with an EF <5%. The correlation coefficients between the EF and FMD, and the EF and the carotid IMT were 0.149 (p<0.02) and -0.156 (p<0.02), respectively, in the entire study population. However, there was no significant correlation between the FMD and carotid IMT in the study patients. A multivariate ana-lysis showed the EF still to be an independent factor of the FMD, but not of the carotid IMT. Conclusion:The EF was the only significant independent factor of the endothelial function, although it was asociated with the FMD and carotid IMT in patients with CAD. These results suport the view that the endothelial function is an important prognostic factor in patients with CAD. 배경 및 목적: 관상동맥 질환 환자에서 내피세포 기능과 경동맥 내중막 두 께(IMT: intima-media thickness)는 이상 소견을 보이는데, 이들 두 지표가 좌심실 구혈율과 상관 관계가 있는지 알아 보고, 내피세포 기능과 경동맥 내중막 두께간에도 상관 관계 가 있는지 알아보고자 이 연구를 시행하였다. 방 법: 대상 환자는 관동맥 조영술을 시행한 283명(평균 연령: 59 세, 남자: 176명)으로 하였다. 내피세포 기능과 경동맥 내중 막 두께는 고해상도 초음파를 이용하여 측정하였고, 내피세 포 기능은 과혈류에 대한 상완동맥의 확장능으로 표시하였 고 경동맥 내중막 두께는 반자동화 방법으로 총경동맥, 경동 맥 팽대부, 내경동맥부위에서 각각 측정하였으며, 경화반 유 무도 확인하였다. 결 과: 좌심실 구혈율이 55% 이상인 경우(n=236)는 55%미만인 경우(n=47) 보다 연령이 낮았고(58세 vs. 62세, p<0.05), 당 뇨병 빈도도 낮았고(15% vs. 38%, p<0.001), 심근 경색의 유병율이 낮았으며(13% vs. 66%, p<0.001), 내피세포 기능 은 높았으며(4.8±2.4 vs. 4.0±2.0%, p<0.05) 총경동맥 내 중막 두께는 낮았다(0.85±0.15 mm vs. 0.91±0.17 mm, p<0.05). 또한 전체 환자군에서 내피세포 기능은 좌심실 구 혈율이 증가할수록 호전되는 양상을 보였고(r=0.149, p<0.05), 총경동맥 내중막 두께는 좌심실 구혈율이 증가할수록 감소하 는 양상을 보였다(r=-0.156, p<0.05). 그러나 내피세포 기 능과 총경동맥 내중막 두께사이에는 유의한 상관 관계를 보 이지 않았다. 다변수 분석에서는 좌심실 구혈율은 내피세포 기능과는 독립적인 상관 관계를 보였으나 총경동맥 내중막 두께에서는 의미가 없었다. 결 론: 관상동맥 질환 환자에서 내피세포 기능과 총경동맥 내중막 두께는 좌심실 구혈율과 유의한 상관 관계가 있었으나, 내피 세포 기능은 좌심실 구혈율과 독립적인 상관 관계가 있었다. 이 결과는 내피세포 기능이 이들 환자군에서 예후 예측인자 라는 점을 뒷받침해준다.