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감성철,이상훈,전주홍,서인석,채미리,박종관,이성원 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.4
Purpose: To investigate the effects of cavernous nerve injury (CNI) on gene expression profiles in the cavernosal tissue of a CNI-induced erectile dysfunction (ED) model and to provide a basis for future investigations to discover potential target genes for ED treatment. Materials and Methods: Young adult rats were divided randomly into 2 groups: sham operation and bilateral CN resection. At 12 weeks after CNI we measured erectile responses and performed microarray experiments and gene set enrichment analysis to reveal gene signatures that were enriched in the CNI-induced ED model. Alterations in gene signatures were compared with those in the diabetes-induced ED model. The diabetic-induced ED data is taken from GSE2457. Results: The mean ratio of intracavernosal pressure/blood pressure for the CNI group (0.54±0.4 cmH2O) was significantly lower than that in the sham operation group (0.73±0.8 cmH2O, p<0.05). Supervised and unsupervised clustering analysis showed that the diabetes- and CNI-induced ED cavernous tissues had different gene expression profiles from normal cavernous tissues. We identified 46 genes that were upregulated and 77 genes that were downregulated in both the CNI- and diabetes-induced ED models. Conclusions: Our genome-wide and computational studies provide the groundwork for understanding complex mechanisms and molecular signature changes in ED.
Premature Ejaculation Diagnostic Tool (PEDT) 한국어판의 개발과 타당도에 대한 연구
감성철,한덕현,허정호,이성원 대한남성과학회 2009 The World Journal of Men's Health Vol.27 No.3
Propose: Premature ejaculation (PE) is the most prevalent male ejaculation disorder. The premature ejaculation diagnostic tool (PEDT) was developed to systematically apply the DSM-IV-TR criteria in diagnostic PE. This study was designed to assess the validity of the Korean version of the PEDT as a diagnostic tool for PE. Materials and Methods: The Korean version development of the PDET involved two stages: (1) Development of the initial language version through two independent forward translations and one backward translation. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Discrepancies between the original English form and the Korean translation were reviewed by the panel. (2) For psychometric validation and scoring system development, data was collected from men with and without PE based on clinician diagnosis, using DSM-IV-TR criteria. A total of 98 patients with a DSM-IV-TR defined PE and 100 men without PE were enrolled into the study and requested to complete the PEDT, which was translated into Korean. The PE patients were also requested to measure intravaginal ejaculatory latency time (IELT). The 50 men of no-PE group and all PE group were requested to come for a second visit to assess the PEDT’s retest reliability. The results were analyzed statistically by SPSS version 12. Result: The mean age of the no-PE group and PE group were 43.4±9.2 and 51.6±9.0, respectively. The geometric mean IELT of the PE group was 115.37±78.14s. The number of men reporting IELTs of <1, 1-<2 and >2min were 28 (28.6%), 29 (29.6%) and 41 (41.8%), respectively. The Cronbach's alpha score of the Korean version of PEDT was calculated as 0.93, showing adequate internal consistency. The test-retest correlation coefficients of each item were higher than 0.72 and the correlation coefficients of the total score was 0.88. (P<0.001) Sensitivity and specificity analyses suggested a score of ≤8 indicated no-PE, 9 and 10 probable PE, and ≥11 PE. Conclusions: The Korean version of PEDT was highly effective in detecting the presence of PE. The result of our study supports its validity as a diagnostic instrument in the clinical setting.
Complications of Transrectal Ultrasound-Guided Prostate Biopsy: Impact of Prebiopsy Enema
감성철,최세민,윤솔,최재휘,이승현,화정석,정기현,현재석 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.11
Purpose: Transrectal ultrasound (TRUS)-guided biopsy of the prostate is usually safe. However, some patients are hospitalized owing to complications from TRUS biopsy. We identified the risk factors for complications and effective preventive measures fortreating complications after TRUS biopsy. Materials and Methods: Medical records and radiological images of 1,083 patients whounderwent TRUS biopsy of the prostate over 10 years in Gyeongsang NationalUniversity Hospital were examined retrospectively to investigate the correlation betweencomplications after TRUS biopsy and preventive antibiotics, prebiopsy enema,number of biopsy cores, and pathological findings. Results: Complications occurred in 69 patients (6.4%). The complication rates of the1,008 patients who received antibiotics and the 75 patients who did not were 6.3% and8.0%, respectively (p=0.469). Complication rates of the pre-biopsy enema group (n=658)and the group without prebiopsy enema (n=425) were 4.7% and 8.9%, respectively(p=0.007). Complication rates of the 6-core biopsy group (n=41) and the 12-core biopsygroup (n=955) were 7.3% and 6.3%, respectively (p=0.891). Complication rates of theprostate cancer group (n=306) and the no prostate cancer group (n=713) were 6.2% and6.6%, respectively (p=0.740). Conclusions: A prebiopsy enema was associated with a reduced risk of complicationsafter TRUS biopsy. Preventive antibiotics, number of biopsy cores, and pathologicalfindings did not significantly influence the complication rate.
Metabolic effects of androgen deprivation therapy
최세민,감성철 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.1
The therapeutic effects and side effects of androgen deprivation therapy (ADT), which is a main treatment method for metastaticprostate cancer, are well known, but the metabolic effects have only recently been studied. This review describes the effects of ADTon body habitus, insulin resistance, lipid profiles, diabetes, metabolic syndrome, and cardiovascular morbidity and mortality. Thereview was done by using KoreaMed and PubMed to search the medical literature related to prostate cancer, ADT, body habitus,lipid profile, diabetes, insulin resistance, metabolic syndrome, and cardiovascular disease. ADT increases fat mass and decreaseslean body mass. Fat mostly accumulates in the subcutaneous area. ADT increases total cholesterol, triglycerides, and high-densitylipoprotein, as well as the risk for insulin resistance and diabetes. ADT also increases the risk for cardiovascular events, but insufficientevidence is available for a correlation with mortality. ADT changes body habitus and lipid profiles and has different characteristicsthan those of classic metabolic syndrome, but it is related to insulin resistance and diabetes. ADT increases the risk forcardiovascular events. No consistent guidelines have been proposed for treating the metabolic effects of ADT, but the generallyrecommended treatment methods for lowering the risk of diabetes and cardiovascular disease should be fully understood. Additionalstudies are necessary.
서덕하,감성철 대한의사협회 2017 대한의사협회지 Vol.60 No.5
Benign prostatic hyperplasia (BPH) is one of the most common urological diseases in men after middle age. The most common surgical treatment of BPH is transurethral prostatectomy. Recently, because of the rapid development of lasers, they have been used for the treatment of BPH. The treatment of BPH using lasers has been shown to lead to significant improvements in symptoms and to have excellent therapeutic effects. It is widely used as a minimally invasive treatment of BPH because of the risk and complications associated with transurethral prostate resection. Currently, 3 kinds of lasers are generally used in the treatment of BPH in Korea: potassium-titanyl-phosphate, holmium, and thulium lasers. With developments in laser technology, surgical procedures have improved continuously. The most common surgical procedures are holmium laser enucleation of the prostate (HoLEP), photoselective vaporization of the prostate (PVP), and thulium laser enucleation of the prostate. HoLEP is an effective surgical procedure for large prostates. PVP is safe for patients who are elderly, are in poor general health, or are taking anticoagulants. Thulium laser enucleation of prostate has advantages over PVP and HoLEP surgery due to specific characteristics of the laser and the surgical method. Compared with transurethral prostate resection, laser-based surgical procedures require shorter hospitalization and Foley catheter insertion periods. HoLEP and PVP are safe and effective methods for the surgical treatment of BPH. Therefore, if more data are accumulated from research into these methods, they will become the standard surgical treatments for prostate hyperplasia.