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고콜레스테롤 식이 흰쥐의 과민성방광에서 Aspirin과 Arginine의 병용투여가 방광내압검사와 방광근수축에 미치는 영향
손환철,양지현,김수웅,백재승,구자현,박관진 대한배뇨장애요실금학회 2005 International Neurourology Journal Vol.9 No.1
Purpose: The purpose of this study was to show the effects of aspirin and arginine on hyperactive bladder of hypercholesterol diet rats. Materials and Methods: We used 40, 3-month-old Sprague-Dawley rats. Ten of them received the 2% cholesterol diet for 8 weeks and 10 received cholesterol diet and aspirin treatment and 10 received cholesterol diet, aspirin and arginine treatment. The remaining 10 served as control and were fed a normal diet. Cystometry and bladder muscle strips study were evaluated in each group. Results: Compared with normal control, mean serum cholesterol and body weight significantly elevated in the cholesterol group. Aspirin +/- arginine treatment lessened the increase of body weight and serum cholesterol level. Compared to control, the cholesterol group showed a shorter voiding interval and smaller functional bladder capacity in cystometrogram, however, aspirin +/- arginine treatment group showed no difference in voiding interval and functional bladder capacity. In detrusor muscle strip study, the increase in the proportion of purinergic components and the decrease in the proportion of cholinergic components were observed in the cholesterol group, however, not in aspirin +/- arginine treatment group. Overall, additional effect of arginine on aspirin treatment was negligible. Conclusion: Treatments of aspirin +/- arginine showed significant protective effect on the bladder overactivity induced by hypercholesterol diet in rats. In patients with heart diseases and overactive bladder, aspirin could be a useful treatment for protection and treatment. (J. Korean Continence Society 2005;9:6-12)
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Current Laser Treatments for Benign Prostatic Hyperplasia
손환철,송상훈,백재승 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.11
The latest technical improvements in the surgical armamentarium are remarkable. In particular, advancements in the urologic field are so exceptional that we could observe the flare-up of robot-assisted laparoscopic radical prostatectomy for prostate cancer and laser prostatectomy for benign prostatic hyperplasia (BPH). Photoselective vaporization of the prostate (PVP) and holmium laser prostatectomy are the most generalized options for laser surgery of BPH, and both modalities have shown good postoperative results. In comparison to transurethral prostatectomy (TURP), they showed similar efficacy and a much lower complication rate in randomized prospective clinical trials. Even in cases of large prostates, laser prostatectomy showed comparable efficacy and safety profiles compared to open prostatectomy. From a technical point of view, PVP is considered to be an easier technique for the urologist to master. Furthermore, patients can be safely followed up in an outpatient clinic. Holmium laser enucleation of the prostate (HoLEP) mimics open prostatectomy because the adenomatous tissue is peeled off the surgical capsule in both procedures. Therefore, HoLEP shows notable volume reduction of the prostate similar to open prostatectomy with fewer blood transfusions, shorter hospital stay, and cost reduction regardless of prostate size. Outcomes of laser prostatectomy for BPH are encouraging but sometimes are unbalanced because safety and feasibility studies were reported mainly for PVP, whereas long-term data are mostly available for HoLEP. We need longer-term randomized clinical data to identify the reoperation rate of PVP and to determine which procedure is the ideal alternative to TURP and open prostatectomy for each patient.
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손환철,정유진,장진숙,김선형,홍성규,오승준,C. Lowell Parsons,이규성 대한배뇨장애요실금학회 2010 International Neurourology Journal Vol.14 No.2
Purpose: The objective of this study was to achieve a linguistic adaptation of the original version of the Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale into Korean. Materials and Methods: Between June 2008 and December 2008, a linguistic adaptation was carried out by 2 native Korean speakers who were also fluent in English. First, the original English version of the PUF was translated into Korean. A panel, which included the 2 translators, reviewed the translations to form a single reconciled forward translation of the Korean version. Then, another bilingual translator, having never seen the original version, back-translated the first draft of the Korean version of the PUF into English, and this back-translation was subsequently assessed for equivalence to the original. The panel discussed all discrepancies and produced a second version. After revising the 2nd version, 10 participants [5 interstitial cystitis (IC) patients and 5 persons from the general population], stratified variously by age, sex, and educational level, answered the PUF and were systematically debriefed afterwards. A summary of the changes from the patient interviews were incorporated into the third version. After the spelling, grammar, layout, and formatting were checked, the third version was verified as the final Korean version of the PUF, without modifications. Results: The multi-step process of forward translation, reconciliation, back-translation, cognitive debriefing, and proofreading of the Korean version of the PUF was completed. Conclusions: The Korean version of the PUF scale may be helpful for screening IC patients in the Korean population and can now be used in Korea.
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손환철,이상형,김대용,윤병우,임대정,김광명,백재승,최황 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.5
Purpose: The purpose of this study was to evaluate the active contractile properties of detrusor smooth muscle from bladders of cerebral-infarcted rats(CI rats). Materials and Methods: The cerebral infarction was induced in 8 to 9 week-old male Sprague-Dawley rats by occlusion of the left middle cerebral artery. At 2 and 4 weeks after the operation, bladder muscle strips were evaluated for force development in response to electrical field, 5μM carbachol(Cch) and 60mM KCl stimulation using an isometric transducer. The contractile response to field stimulation on the additions of 1μM atropine and 5μM α,β-methylene ATP(abmATP) were measured, and the contributions of cholinergic and purinergic transmissions determined. Cystometrography(CMG) was also performed in anaesthetized rats. Results: In comparison with sham-operated rats, the CI rats showed a shorter voiding interval, smaller peak voiding pressure, smaller voiding volume and greater residual urine volume on CMG. The CI rats also showed smaller tension at maximum contraction induced by Cch and a quicker response to maximum contraction induced by KCl than the sham operated rats. The CI rats showed time-dependent increases and decreases in the proportions of abmATP-sensitive(purinergic) and atropine-sensitive (cholinergic) components, respectively. Conclusions: CI rats showed changes in detrusor activity, contractility and the proportions of cholinergic and purinergic components. The increase in the purinergic contraction of the detrusor muscle was believed to be related to bladder instability. The results of this study will be useful in explaining detrusor hyperactivity, with impaired contractility(DHIC), in patients with cerebral infarction.
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손환철,박준현,송상훈,강정윤,홍성규,이현문,김선희,박병주,이형래,이경섭 대한의학회 2015 Journal of Korean medical science Vol.30 No.2
Using the Korean public health insurance database, we analyzed patients diagnosed asbenign prostatic hyperplasia (BPH) from 2004 to 2008. Age and year-specific amount andseasonal variation of hospital visits (HV), duration of treatment (DT), the total and percapita amount of insurance payment (TAIP, PCIP) were evaluated. A total of 12,088,995HV were studied. Total HV increased 1.7 times and DT almost doubled in 2008 compared tothose in 2004. HV, DT, and TAIP showed linearly increasing patterns year by year. In a timeseries analysis, HV increased in winter and demonstrated seasonality in a 12-month cycle. In a Poisson regression analysis, the annual variations of HV, DT, TAIP, and PCIP weredifferent by age groups. In patients older than 40 yr, HV significantly increased 1.10-1.16times compared to that of the previous year. DT markedly increased in their 60s and 80spatients. The rate of increase in PCIP was steeper in patients 50 yr and older than in theothers.Health care utilization due to BPH was rapidly increasing in Korea and it wasremarkable in the elderly population. Seasonal variation of HV demonstrated that healthcare utilization increased in winter.
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발기부전치료에서 Phosphodiesterase type 5 inhibitor의 작용시작시간
손환철,김명,박용현,정창욱,김현주,김영주,허정식 대한남성과학회 2008 The World Journal of Men's Health Vol.26 No.4
Purpose: After the market launch of multiple phosphodiesterase type 5 inhibitors (PDE5Is), a considerable amount of information has emerged regarding the efficacy and the time of initiation of these drugs. In clinical situations, however, many patients with erectile dysfunction (ED) have complained about the onset of erection occurring later than expected or desired. We therefore studied the time course for initiating an erection after usage of PDE5Is. Materials and Methods: One hundred forty-one patients who were medicated with PDE5Is > 4 times in the most recent 3 months were included for study. The patients were divided into 3 groups: sildenafil (n=51), vardenafil (n=51), and tadalafil (n=39). The choice of PDE5I was made according to the patient's and/or doctor's preferences. Regardless of the type of drug selected, the patients were recommended to have sexual stimulation 15 minutes after taking the medication. Results: The onset of action of the 3 drug groups were significantly different (sildenafil, 57.0±38.5 min; tadalafil, 79.5±50.6 min; and vardenafil, 44.4±26.6 min; p<0.05). Psychogenic causes of ED resulted in a shorter PDE5I onset of action than organic causes of ED. Other factors, such as body mass index and international index of erectile function erectile function domain score, were shown not to differ with respect to the onset of action of PED5Is. Conclusion: In clinical situations, patients need more time for the onset of erections after taking PDE5Is. For restoration of a healthy sexual life, patients needs more time to achieve an erection after taking PDE5Is.
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