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여성 성기능 장애의 진단에서 외음부 체감각 측정의 유용성과 임상적 의의
변동원,박성재,윤하나,심봉석,홍재엽 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.6
Purpose: It is thought that neurological disorders are one of the main causes of organic female sexual dysfunction. However, it is difficult to diagnose due to the lack of measuring tools for assessing genital neural function. Sensory nerve tests on external genitalia is a new challenge for diagnosing female sexual dysfunction. In this study, we aimed to evaluate the clinical significance of the quantitative measurement of the genital sensory threshold in female sexual dysfunction. Materials and Methods: Forty women with complaints of sexual dysfunction were evaluated with physical and vagina examination, serum hormonal tests, routine urinalysis and a questionnaire(the brief index of sexual function for women). A genitosensory analyzer(GAS, Medoc, Israel) was used to quantitative measure the vaginal and clitoral warm, cold and vibratory sensory thresholds. Results: Of the 40 women, an arousal disorder was reported in 40%, orgasmic disorder in 82.5%, sexual pain disorder in 17.5% and a decreased libido in 17.5%. Of the 40 women, 86.4 and 91.2% showed impairment of vaginal cold(A-δ fiber) and warm(unmyelinated C fiber) sensations, respectively. However, the touch and vibratory sensations(A-β fiber) showed relatively lower impairments; vagina and clitoris in 20.0 and 89.2% of the patients, respectively. Conclusions: In this study, most of the patients with sexual problems had significant vaginal and clitoral sensory nerve fiber impairments. The results support the significance of organic origins in female sexual dysfunction and the usefulness of quantitative analysis of genital sensation in diagnosing the etiology.
일차성 부갑상선 기능항진증으로 인한 모든 합병증이 동반된 부갑상선 종양 1예
변동원 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Most of the primary hyperparathyroidism is resulted from parathyroid adenoma and is characterized by hypercalcemia, reduced bone density, frequent renal stone, gastric ulcer, duodenal ulcer, muscle weakness, depression, hypertension, anemia and rarely causing brown tumor. Author experienced a case of 81-year-old man showing all complications of primary hyperparathyroidism. The patient presented with decreased mentality, acute gastric ulcer, acute duodenal ulcer, GB stones with cholecystitis, renal insufficiency, previous history of 3 times of renal stones, depression and osteoporoid Serum calcium level was 16.7㎎/dl and intact parathyroid hormone level was 3,901pg/ml. Parathyroid mass was detected by neck CT and 99mTc-tetrofosmin parathyroid scan. Parathyroid tumor was removed and confirmed as a parathyroid adenoma by pathologic finding. After operation, the patient was treated with vitamin D and calcium because hungry bone syndrome was occured, Intact PTH level was also returned to normal ranges after of parathyroid adenoma.