전립선 비대증 및 전립선암에 있어서 경직장 초음파 소견

설종구,강순구 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

Transrectal ultrasonography can provide a precise image of the prostate, seminal vesicles and adjacent structure. It can play a valuable role in the diagnosis of prostatic diseases, particulary in the detection, staging and monitoring after treatment of prostatic cancer. Transrectal ultrasonography was taken in 51 patients with prostatism (34 cases of benign prostatic hyperplasia and 17 cases of prostatic cancer), and the results were compared with the pathologic results of prostatic tissue obtained by digitally guided biopsy or surgical specimens. The results were as follows: 1. The sensitivity, specificity, positive predictive value, and dectation rate of trasrectal ultrasonography for prostatic cancer were 88.2%, 97.1%, 93.8%, and 29.4%, and in digital rectal examination, sensitivity, specificity, positive predictive value and dectation rate were 64.7%, 97.1%, 91.7% and 21.6%, respectively. 2. Echogenecity of prostatic ultrasonography in prostatic cancer were hypoechoic in 12 cases(70.5%), hyperchoic in 3 cases(17.7%) and isoechoic in 2 cases(11.8%), and in benign prostatic hyperplasia, isoechoic in 33 cases(97.1%) and hyperechoic in 1 case(2.9%).

Modulith SL-20 體外衝擊波碎石機를 利用한 尿路結石의 治療

薛鍾求,羅容吉 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Extracoporeal shock wave lithotripsy monotherapy was performed in 111 patients with Modulith SL-20 electromagnetic lithotriptor from January, 1994, to November, 1994, in our Department of Urology. Most of stones were distributed between 4th and 6th decades(67.4%), and male to female ratio was 1.3 : 1, and 111 patients have 117 stones, which were 76 cases of ureteral stone(65.0%), 28 cases of renal(23.9%), 11 cases of ureteropelvic junction(9.4%) and 2 cases of bladder(1.7%), 6 bilateral cases, and 0.6cm to 5.0cm in diameter. Of the 0.6cm to 5.0cm in diameter, stones were 1.0cm-1.9cm 54 cases(46.2%), 0.6cm-0.9cm 43 cases(36.8%), 2.0cm-2.9cm 12 cases(10.2%) and 8 cases (6.8%) in longer than 3cm. And treatment session was needed more and more in longer than 1.0cm. Complications were colicky pain(16 cases, 13.7%), severe gross hematuria(9 cases, 7.7%), fever and chill(2 cases, 1.7%), renal subcapsular hematoma(2 cases, 1.7%), residual stone(2 cases, 1.7%o), and steinstrasse(1 case, 0.9%). Therefore extracoporeal shock wave lithotripsy monotherapy is considered as a safety and non-invasive treatment method for all urinary stones.

표재성 방광 이행상피세포암에 있어서 방광내 항암제주입요법 밀 면역요법

설종구,신보현,하용원,김윤종,노안식,손성용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

Intravesical chemotherapy and immunotherapy will commonly eradicate residual papillary transitional cell carcinoma or carcinoma in situ(CIS) and clearly reduce the short-term incidence and rate of tumor recurrence. So I reviewed the effects and complications of different therapeutic agents(thiotepa, mitomycin-C, epirubicin, adriamycin, bacillus Cal mette-Cue'rin(BCG)) in superficial bladder cancer confirmed with histopathology, with the literatures. Bladder cancer were recurred more commonly in multiple tumors(50.6-56.3%), high grade tumors(52.6%) rather than in single(30.9%) and low grade(31.6%). And recurrence rates according to therapeutic agents were 83.3% in mitomycin-C, 71.4% in thiotepa, 50.0% in epirubicin, 46.6% in adriamycin and 32.6% in BCG. But incidence of complications were highest in BCG(50.5%). So sufficient preventive manuevers should be needed before intravesical theraphy, especially in BCG immunotherapy.

Continent Ileal Diversion과 Noncontinent Ileal Diversion에 관한 임상적 연구

설종구 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

We records of the continent ileal diversion(12 cases) and noncontinent ileal diversion(31 cases) at/ the Chungnam National University Hospital were reviewed. The results were as followings; 1. There were 10 males and 2 females(ratio of 5 : 1) with the peak incidence in the 6 decades (7 cases) in the continent ileal diversion, and 24 males and 7 females(ratio of 3.4 : 1) with the peak incidences in the 6 decades(9 cases) and 7 decades (9cases) in the noncontinent ileal divers on. 2. The most common disease was bladder cancer in the continent and noncontinent ileal diversion. 3. The mean of the operating times, amounts of transfused blood and postoperative hospital dates were measured as 9.5 hours, 5.1 pints and 27.7 dates in the continent ileal diversion, and 5.4 hours, 3.5 pints and 22.2 dates in the noncontinent ileal diversion. 4. The postoperative complications were 2 urine leaks, 1 fecal fistular and 1 wound infection in the continent ileal diversion, and 5 fecal fistulars, 3 wound infections, 2 urine leaks and 1 intestinal obstruction in the noncontinent ileal diversion. 5. The incidences of the complication and death were 33.3% and 8.3% in the continent ileal diversion, and 35.3% and 9.7% in the noncontinent ileal diversion.

신결석에 대한 임상적 고찰

설종구,윤능수 大韓泌尿器科學會 1981 Korean Journal of Urology Vol.22 No.4

급성 음낭증에 대한 임상적 고찰

설종구 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

The acute scrotum can be defined as any conditions of the scrotum or intrascrotal contents that requires emergency medical or surgical intervention. Although rarely fatal, acute scrotal pathology can result in testicular loss, infertility, or significant short or long-term morbidity. The correct dignosis of the acute scrotum is not always evident on history, physical examination, or routine laboratory testing. For this reason, classical urological teaching has held that these patients should, with few exceptions, undergo surgical exploration. This policy results in a large number of patients undergoing unnecessary operations, and does not provide optimal therapy in all cases. Sixty cases of acute scrotum were studied in the Department of Urology, Chungnam National University Hospital, during the period from January 1981 to October 1986. The following results were obtained. 1. Acute scrotum was noted most frequently in 4th decade and the incidence was (30.0%, 18 cases). The incidence in 4th and 5th decade was 56.7%. 2. The most frequent disease was trauma, of which incidence was 41.7%, (25 cases). And the incidences of acute epididymitis, testicular torsion, scrotal abscess and testicular tumor were 33.3%(20 cases), 11.7%(7 cases), 8.3%(5 cases), and 5.0%(3 cases), respectively. 3. The acute epididymitis was noted most frequently in 4th decade, and its incidence was 40.0%(8 cases). 4. Of the scrotal trauma, scrotal hematoma was most common(16 cases, 64.0%), and testicular rupture was 7 cases(28.0%), laceration and burn was 1 case(4.0%), respectively. Scrotal trauma was most frequent in 3rd decade (12 caes, 48.0%). 5. The types of treatment of acute, scrotum were conservative(28 cases) and surgical method (33 cases).

가토에 있어서 편측 요관 폐색시 환측, 반대측 요관에 대한 변화 : 조직학적 소견을 중심으로

설종구,김용웅,육승모,노안식,김홍식,김상현,이충식 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

This study was designed to clarify histological changes in the experimental rabbit ureter after unilateral prartial or complete ureteral obstruction. A total of 20 adult white rabbits were divided into 4 subgroups in the partial obstruction followed by 2 weeks, partial obstruction followed by 4 weeks, complete obstruction followed by 2 weeks, complete obstruction followed by 4 weeks. The normal control group consisted of 5 adult white rabbits. The H & E stain. light microscopy were used. Abnormal histological fingings were showed in ipsilateral ureter of all subgroups; dilatation of ureter, epithelial cell atrophy or loss, interstitial fibrosis, interstitial inflammation. These findings were most severe in the complete-obstructed ureter for 4 weeks. There were no significant changes in contralateral ureter of all subgroups. Despite of progressive histological changes in ipsilateral ureter no abnormal findings were showed in contralateral ureter. We suggest that long term experimental investigation for histological changes in ipsilateral ureter and compensatory changes in contralateral ureter should be done.

腸重量을 利用한 泌尿器科的 手術

薛鍾求,羅容吉 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Urologic operations using bowel segments are urinary diversion, augmentation cystoplasty and ureteral replacement. Among these, urinay diversion and augmentation cystoplasty are most commonly used. But, among the complications, reflux, upper tract infection and metabolic disorders are troublesome for the urologists. So, in order to reduce these problems, intussuscepted bowel surgery is developed and modified. So, we reviewed 25 cases of bowel surgery using intussuscepted bowel segment in our urologic department. The results were as followings; 1. Operative procedures using intussuscepted bowel segments were 19 cases of urinary diversion (12 cases of Kock’s continent ileal reservior and 7 cases of ureteroileocecal sigmoidostomy) and 6 cases of augmentation cystoplasty(4 cases of Hemi-Kock’s ileocystoplasty and 2 cases of ureteroileocecal cystoplasty), and the most common disease was bladder cancer in urinary diversion and was tuberculosis in augmentation systoplasty. 2. The most common postoperative complication was would infection, and most of complications were developed in Kock’s continent ileal reservior, but there was no complication in augmentation cystoplasty. In Kock’s continent ileal reservior, stones and urine extravasations were the main complication, and in Hemi-Kock’s ilecystoplasty and ureteroileocecal cystoplasty, would infection was the main complication. 3. The postoperative BUN was increased significantly in the small bowel, but not in large bowel. And postoperative serum creatinine K^+ and Cl^- were slightly increased without significance. As a above result, intussuscepted bowel surgery in urology would be an effective method with relative low incidience of complications.

혈액투석을 하기 위한 Shunt 술에 관한 임상적 고찰

설종구 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

Shunt operation for hemodialysis is the mainstem in the treatment of acute and/or chronic renal failure. This study was aimed to investigate the results of the each type of shunt operations in 44 patients from January, 1982, to September, 1985, with the review of the literatures. The results were summerized as followings: 1. Of the 44 patients, male to female ratio was 1.3:1 and 50% of the patients were distributed from 4th decades to 6th decades. 2. The cases of the external and internal shunt were 35 cases in each(total; 70 cases). And 27 cases were recieved one time operation(61.4%), two time operations were 11 cases (25.0%), three times were 4 cases(9.1%), four times and five times were 1 case in each(2.3%). 3. The complication rates were 38.6%(27 cases) in total cases, 48.6%(17 cases) in external shunt and 28.6%(10 cases) in internal shunt. 4. The most common complication was obstruction(20.0%) in total cases of shunt operation and in external shunt(34.3%), and malfunction in internal shunt(22.9%). 5. The types of operations in internal shunt operation were Side-Side(20 cases; 57.0%) End-Side(9 cases; 26.0%), and End-End(6 Cases; 16.0%), and the most common complication in internal shunt was malfunction(6 cases).

요도하열의 임상적 고찰

설종구,나용길 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

A clinical observation was made on 60 patients with hypospadia who had been admitted to the Department of Urology Chungnam National University Hospital during 10 years and 10 monthes from January, 1979 to October, 1988. The results were as follows: 1. Incidence of the age group under 5 years old was 35.0%(21 cases). 2. The most common type of hypospadia was penoscrotal type(23 cases, 38.3%). 3. Associated anomalies were noted in 33.3% (20 cases)of hypospadia, and cryptorchism was the most common anomaly. 4. One-staged operative procedure was performed hypospadia and two-stag In one-staged operative procedure, Duckett's method, Hodgson's method and Hortone-Devine's method were used, and in two-staged operative procedure, Denis-Brown method was used. 5. The total incidence of operative complications was 40.0%(24 cases)and types of operative complication according to the operative procedures were 4 cases of urethrocutaneous fistula (14.3%)and 4 cases of urethral stricture(14.3%)in one-staged operative procedure(8 cases, 28.6%), and 15 cases of urtehrocutaneous fistular (46.9%) and 1 case of urethral stricture (3.1%) in two-staged operative procedure(16 cases, 50.0%). 6. Incidence of the operative complications according to the type of urinary diversion in one staged operative procedure was 29.3%(5 cases) in diversion group and 27.3%(3 cases) in urethral stent catheter group, and in two-staged operative procedure, incidence of operative complications was 50.0% (11 cases) in diversion group and 50.0%(5 cases) in urethral stent catheter group.