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소아비뇨기과 통원수술 환자에서 예방적 항생제 사용의 임상지침 확립을 위한 연구
남형종,정승찬,공미연,이금섭,이상돈 대한요로생식기감염학회 2012 Urogenital Tract Infection Vol.7 No.1
Purpose: Proper use of antibiotics is essential in the clinical field. The overuse of antibiotics can be one of the causes for resistance. However, there is a lack of guideline to a valid method of prophylactic antibiotics in surgery. We evaluated the evidence on the suitable prophylactic antibiotics usage to prevent perioperative infection, when performing pediatric urologic outpatient surgery. Materials and Methods: From December 2010 to may 2011, 70 cases (mean age was 3.5±3.23 years)who underwent outpatient operation approached inguinal or scrotal incision were evaluated. In group 1, intravenous antibiotic prophylaxis was done only preoperatively. In group 2, intravenous antibiotics were administrated pre- and post-operative, each. In group 3, beside pre- and post-operative intravenous antibiotic prophylaxis, additional oral antibiotics were medicated for 3 days after discharge from the hospital. Further, in group 4, beside pre- and post-operative intravenous antibiotic prophylaxis, oral medication was administered until 7 days after discharge. Skin redness, pain, wound dehiscence, fever, gastrointestinal disturbance,and etc., were examined postoperatively. Results: Slight skin redness was observed in 4 cases (23.5%), 2 cases (10.5%), 1 case (7.1%), and 0case (0.0%) in each group, but there is no need to treatment. There is no case who feels pain on the incision site of each group. Wound dehiscence occurred in one case in group 1 (5.9%) and group 3 (7.1%),respectively. There were no association with wound infection between each group, and wound infection was recovered spontaneously. Two cases (11.8%), 1 case (5.3%), 0 case(0.0%), and 3 cases (15.0%) complained with fever in each group. Diarrhea was observed in 2 cases (13.3%) and 4 cases (20.0%) in group 3 and 4, respectively. Conclusions: There were no differences in prophylactic effect to prevent infection in each group. Group 1 showed a lower incidence of diarrhea than group 3 or 4, but other adverse effects were not different among the groups. Therefore, it is sufficient to use antibiotics preoperatively for prophylactic purpose in pediatric urologic outpatient surgery.
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요로감염 환자에서 소아 및 성인의 원인균주 및 항생제내성의 차이점
남형종,정승찬,이종윤,이상돈 대한요로생식기감염학회 2012 Urogenital Tract Infection Vol.7 No.2
Purpose: Urinary tract infection (UTI) is one of the most common infectious diseases in children and adults. It is widely known that most UTI is caused by E. coli. In most cases for those who underwent UTIs,empirical antibiotics were treatment of choice. But resistance of empirical antibiotics is increasing gradually. The proper use of antibiotics is essential in the clinical field. We evaluated the antibiotic resistance of organisms causing UTIs in children and adults patients to provide the proper use of empirical antibiotics. Materials and Methods: From January 2011 to December 2011, 749 cases (mean age was 27.9±30.2years) who underwent positive urinary culture tests were evaluated. The age, sex, results of urine dipstick and microscopic tests, urine culture, and antibiotics resistance were reviewed. Results: 460 men and 289 women were evaluated. Adults were 310 cases (41.4%) and children were 439 cases (58.6%). Pathogens from the results of urine culture were E. coli (35.7%), Enterococcus species (25.8%), Klepsiella (12.9%). Antibiotics resistance rate of all pathogens was 29.8% and Pseudomonas (36.1%), with E. coli (32.8%) having the highest resistance rate of all. Ampicillin (61.8%), trimethoprim/sulfamethoxazole (42.6%), and penicillin (39.4%) showed higher resistance rates than other antibiotics. The multi-drug resistance rate was 17.8% in total, adults were 17.4%, and children were 18.1%. Female urine RBC and urine WBC counts were associated with UTIs from a pathogen which has resistance at to at least one of the antibiotics in adults. On the other hand, older age, urine leukocyte esterase and urine RBC count was associated with antibiotics resistance in children. Conclusions: Gram positive microorganisms including E. coli were the most common pathogen of UTIs both in adults and children. Therefore, quinolones and cephalosporins are widely used in UTIs, however antibiotic sensitivity was reduced in this study and there was no difference in adults and children. The sensitivity and drug resistance were changing steadily, affecting many factors and various pathogens gave rise to UTIs. Therefore considerations of many factors of sensitivity to antibiotics are needed.
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박현준,남형종,최만수,최경운,박남철 대한남성과학회 2008 The World Journal of Men's Health Vol.26 No.2
Idiopathic scrotal calcinosis is a rare benign disease of scrotal skin, characterized by multiple asymptomatic nodules on the scrotum. The lesions are asymptomatic, round, firm, and yellowish nodules with variable size. Herein, we report a case of idiopathic scrotal calcinosis and a short review of the literature. A 42-year old man presented multiple painless, firm, nodules on his scrotum for about ten years. After excision of the nodules, mixture of calcified material was observed as a typical histological feature of idiopathic scrotal calcinosis.
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정계정맥류 흰쥐 모델에서 정계정맥류 유발기간과 고환손상의 연관성
박창수,박현준,박남철,남형종 대한남성과학회 2009 The World Journal of Men's Health Vol.27 No.1
Purpose: The aim of this study was to evaluate the damage to the testicles caused by a varicocele over time with using an experimental varicocele rat model and by measuring the testicular weight, the status of oxidative stress, the hormonal changes and the degeneration of the tubules. Materials and Methods: Thirty male Sprague-Dawley white rats, 10 weeks old, weighing 350-360g each, had experimentally induced left varicoceles; 30 rats of the same age were used as a control group. All rats in the varicocele and control groups were sacrificed at 2, 4 and 8 weeks after surgery. The testicular weight, the levels of serum reactive oxygen species, serum testosterone, LH and FSH, as well as the degenerative changes of the tubules were measured. Statistical analyses for comparisons between the two groups were performed using the Mann-Whitney U test; probability values of less than 0.05 were considered significant. Results: Degenerative changes of the tubules on H-E stain and the testicular weight loss were observed 4 weeks after surgery. There was a significant difference in the serum ROS between the varicocele group and the control group at eight weeks after surgery. However, there were no significant differences found in the serum testosterone, LH or FSH. Conclusions: The results of this study with using a rat model showed that a varicocele may cause progression of the testicular damage that induced by the varicocele over time. If a further study shows that this damage can be reversed, then there may be a critical period for treatment of men before infertility develops.
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