전립선 비대증 남성의 건강관련 삶의 질 예측요인

문희남(Hee Nam Moon) 학습자중심교과교육학회 2022 학습자중심교과교육연구 Vol.22 No.15

목적 본 연구는 대상자 본인이 지각하는 하부요로 증상과 질병관련 특성이 전립선 비대증 남성의 건강관련 삶의 질에 미치는 예측 요인을 확인하기 위한 서술적 상관관계 연구이다. 방법 본 연구는 경기도 U시 소재 종합병원 비뇨의학과 외래에 내원하는 전립선 비대증으로 진단을 받은 남성으로, 설문지 내용을 이해하고, 응답하며 의사소통이 가능한 45세 이상 환자를 대상으로 하였고, 총 113명을 대상으로 설문지를 작성하였다. 수집된 자료는 SPSS/WIN 23.0으로 분석하였다. 결과 대상자의 건강관련 삶의 질의 예측요인을 탐색하기 위하여 단계적 회귀분석 시행 결과 전립선 비대증 남성의 건강관련 삶의 질에 영향을 주는 예측인자로 하부요로 증상(β=-.65, p<.000)이 가장 높게 나타났고, 그 다음은 예측인자로는 수면시간(β=.17, p<.008)으로 확인되었다(Adjusted R2=.57). 결론 본 연구 결과 전립선 비대증 남성의 건강관련 삶의 질에 영향을 주는 예측요인은 하부요로 증상과 수면시간으로 조사되었다. 전립선 비대증 낭성의 건강관련 삶의 질을 증진시키기 위해서는 하부요로 증상 관리를 위한 중재와 교육 프로그램이 개발되어야 할 것으로 사료된다. 또한, 하부요로 증상 완화 및 개선에 도움을 주는 전립선 비대증 남성의 증상, 질환 예방에 대한 자가관리 역량 향상에 대한 접근이 필요하다 하겠다. Objectives This study is a descriptive correlation study to confirm the predictive factors of lower urinary tract symptoms and disease-related characteristics perceived by the subject on the health-related quality of life of men with Benign prostate hypertrophy. Methods This study was conducted on a total of 113 patients aged 45 or older who were diagnosed with prostate hypertrophy at a general hospital urology out patient department in U-si, Gyeonggi-do, who could understand, respond to, and communicate with the questionnaire. The collected data were analyzed with SPSS/WIN 23.0. Results As a result of a Stepwise regression analysis to explore predictors of health-related quality of life of subjects, lower urinary tract symptoms (==-.65, p<000) as a predictor of health-related quality of life in men with Benign prostate hypertrophy was the highest, followed by sleep time (==.17 p<008). It was identified as (Adjusted R2=.57). Conclusions As a result of this study, the predictive factors affecting the health-related quality of life of men with prostate hypertrophy were investigated as lower urinary tract symptoms and sleep time. In order to improve the health-related quality of life of prostate hypertrophy cyst, it is believed that intervention and education programs for the management of lower urinary tract symptoms should be developed. In addition, it is necessary to approach the improvement of self-management capabilities for the prevention of symptoms and diseases of prostate hypertrophy men who help alleviate and improve lower urinary tract symptoms.

Sprague Dawley 흰쥐에서 테스토스테론에 의하여 유발된 전립선 비대증에 미치는 산수유 추출물의 영향

권다혜(Da He Kwon),황보현(Hyun Hwangbo),최은옥(Eun Ok Choi),김민영(Min Yeong Kim),지선영(Seon Yeong Ji),김경일(Kyung-Il Kim),박노진(No-Jin Park),김성옥(Sung Ok Kim),홍수현(Su-Hyun Hong),박철(Cheo Park),황혜진(Hye-Jin Hwang),정지숙(Ji-S 한국생명과학회 2018 생명과학회지 Vol.28 No.12

노년기 비뇨기 계통에 가장 흔한 증상의 하나인 전립선 비대증은 요도를 둘러싼 전립선의 주위의 평활근과 상피세포의 과다 증식에 의한 것이다. 산수유는 강력한 항산화 효과로 인하여 다양한 질병의 예방 및 치료에 효과적이라고 보고되었지만 전립선 비대증에 대한 효능은 아직 알려지지 않았다. 본 연구에서는 산수유 열수 추출물이 testosterone에 의하여 유도되는 전립선 비대증에 미치는 영향을 조사하였다. 실험동물 내재성 testosterone의 영향을 배제하기 위해 거세를 하였으며, 전립선 비대증을 유도하기 위해, testosterone propionate (TP)를 피하 주사하였다. 산수유 추출물은 TP 주입과 함께 매일 경구 투여하였고, 5α-reductase type 2의 선택적 억제제인 finasteride를 양성 대조군으로 사용하였다. 본 연구의 결과에 의하면, 산수유 추출물 투여군에서는 finasteride 처리군에서와 마찬가지로 혈청 내 dihydrotestosterone 농도가 억제되었으며 전립선 무게 증가와 조직병리학적 변화가 유의하게 감소되었다. 산수유 추출물은 또한 전립선 조직 및 혈청에서 각각 TP에 의해 증가된 5α-reductase type2의 발현 및 농도를 유의적으로 억제하였다. 아울러 산수유 추출물은 TP에 의하여 유도된 AR, AR의 co-activator 및 세포증식 마커 단백질들의 발현 증가뿐 만 아니라 prostate-specific antigen의 수치와 발현도 감소시켰다. 결론적으로 산수유 추출물은 전립선 비대억제를 위한 식의약 소재로서의 개발 가능성이 매우 높음을 의미한다. Benign prostatic hyperplasia (BPH) is characterized by prostatic hypertrophy mainly in the elderly. Corni Fructus is reportedly effective in the prevention and treatment of various diseases, but its efficacy on BPH has not been previously studied. In the present study, we investigated whether or not a Corni Fructus water extract (CF) could prevent testosterone-induced prostatic hyperplasia in rats. To induce BPH, castrated rats were subcutaneously injected with testosterone propionate (TP). CF was administered daily by oral gavage, along with the TP injections, and finasteride, a selective inhibitor of 5α-reductase type 2, was used as a positive control. The results show that CF significantly reduces prostate weight and histopathologic changes while also decreasing levels of serum dihydrotestosterone, similar to the finasteride-treated group. CF also suppresses TP-induced 5α-reductase expression and concentration in prostate tissue and serum, respectively. Furthermore, CF markedly inhibited TPinduced expression of the androgen receptor (AR) and the steroid receptor coactivator 1, an AR coactivator, which was associated with a decrease in prostate-specific antigen levels in both serum and prostate tissue. In conclusion, the results of this study indicate that CF weakens BPH status by inactivation of 5α-reductase and AR.

전립선 진단을 위한 특징 파라미터 추출 프로그램

최환용(Hwan-Yong Choi),이대종(Dae-Jong Lee),차은종(Eun-Jong Cha),조영임(Young-Im Cho),전명근(Myung Geun Chun) 한국지능시스템학회 2008 한국지능시스템학회논문지 Vol.18 No.5

전립선 비대증은 고령 남성의 대표적 만성질환으로서 간단하면서도 비침습적인 방법인 요류검사를 수행하여 진단한다. 이러한 전립선 비대증을 진단하기 위한 제품들이 사용되고 있으나, 기존 제품은 특징되는 파라미터의 결과만 제공할 뿐 시간에 따른 요류의 변화, 데이터베이스 기능 등 환자의 정보를 제공하지 못하는 단점이 있다. 이에 본 논문에서는 유비쿼터스 환경을 고려한 무선모듈과 LabVIEW 기반의 윈도우 프로그램을 이용하여 전립선 진단을 위한 특징 파라미터 추출 프로그램의 개발뿐만 아니라 환자 정보의 데이터베이스가 가능한 시스템을 개발하였다. Uroflowmetry is a non-invasive and easily performed method to diagnose the benign hypertrophy(BPH) which is frequently found in the aged men. There are some manufactures to provide a diagnosis tool for the benign prostate hypertrophy. Conventional products, however, render only the result of parameters related with prostate hypertrophy, not additional information such as the uroflowmetry variation and related personal information. In this paper, we developed an effective system for feature extraction of prostate hypertrophy as well as online program for wireless networked database management which can be used under ubiquitous environments and Labview based Window program.

Toward a Scientific Nutritional Supplement Combination for Prostatism and Erectile Dysfunction I: From Known Pharmacology to Clinical Testing

Robert E. Pyke, MD, PhD 한국식품영양과학회 2019 Journal of medicinal food Vol.22 No.5

Prostatism and erectile dysfunction (ED) are highly prevalent and closely comorbid. Prescription treatments are limitingly expensive but robust in mechanisms of action (MoA). Nutritional supplements (NS) are low-cost but inadequately supported by evidence. Do any NS use robust MoA? Could their efficacy be amplified via dosing, concentration of active principles, and/or use in combination? The goal is to develop an effective NS for prostatism and ED using the MoA of prescription treatments. Literature reviews were conducted on dietary supplements for prostatism or ED and MoA of relevant drugs. The most promising NS employing these MoA were chosen. A pilot study of a prototype combination was conducted. A protocol was created for an adequate dose-response trial to test the NS combination in men with ED and prostatism. The main measures were response rates, International Prostate Symptom Score, and International Index of Erectile Function. For drugs, the MoAs best proven for prostatism and ED were nitric oxide augmentation, mild androgen inhibition, and anti-inflammatory effects. The following NS best simulate these MoA and are best supported for efficacy; for prostatism: beta sitosterol; for ED: panax ginseng, arginine, and citrulline. Pilot clinical data provided support. A plan for a formal dose-response clinical trial was approved by a central institutional review board. NS using effective MoA might suffice for prostatism and ED. Pilot testing of a combination NS with the best-supported MoA supported further development. A dose-response trial should be conducted using adequate doses of L-citrulline, beta-sitosterol, ginseng, and vitamin D3.

Prostate Volume Measurement by TRUS Using Heights Obtained by Transaxial and Midsagittal Scanning: Comparison with Specimen Volume Following Radical Prostatectomy

Sung Bin Park,Jae Kyun Kim,Sung Hoon Choi,Han Na Noh,Eun Kyung Ji,Kyoung Sik Cho The Korean Society of Radiology 2000 Korean Journal of Radiology Vol.1 No.2

Objective: The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. Materials and Methods: Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height × length × width × 𝜋/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. Results: Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). Conclusion: Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning.

전립선암의 진단에서 12군데 경직장 전립선 조직 생검의 한계성

차재성 ( Jai Seong Cha ),최만수 ( Wan Sou Cui ),정영범 ( Young Beom Jeong ),박영경 ( Young Kyung Park ),박종관 ( Jong Kwan Park ) 전북대학교 의과학연구소 2006 全北醫大論文集 Vol.30 No.2

혈청 PSA의 상승 시 초음파를 이용한 경직장 12군데 전립선 조직 생검과 전립선절제술 시 채취한 조직에서 전립선암으로 진단되었던 11명의 환자에서 12군데 전립선 조직 생검의 진당율은 9.1%의 한계성을 보이고 있었다. 따라서 전립선암 환자를 선별하기 위하여 12군데 조직검사 외에 더많은 생검 수 (core)와 영역을 넓히는 방법이 시도되어야 할 것으로 생각된다. Purpose: This report describes the limitation of transrectal prostate needle biopsy with 12 biopsy cores taken to diagnosis prostate cancer. Material and Methods: We retrospectively analyzed the 11 patients (2.56%) in 430 patients included in the study, who had transurethral resection of prostate (TUR-P) due to benign prostate hyperplasia (BPH) but pathologic results were prostate adenocarcinoma in the period from January 1998 till July 2004. All patients with over 4 ng/mL of prostate specific antigen (PSA) were undertaken the 1st transrectal ultrasono guided prostatic needle biopsy to rule out prostatic adenocarcinoma from BPH. The patients who were received TUR-P were undertaken the 2nd transrectal prostate needle biopsy blindly just before TUR-P under anesthesia. Results: In 11 patients, the mean age was 74.0 years and the mean volume of the prostate was 46.0 gm. The pre-operative mean serum prostate specific antigen (PSA) and free PSA was 19.5 ng/mL. There was no patient with below 4 ng/mL at serum PSA. In 9 of 11 patients the 1st biopsy showed BPH, but pathological results after TUR-P was confirmed to prostate adenocarcinoma. Adenocarcinoma was only detected on one core in the one patient (9.1%) at TRUS guided biopsy at 12 sites on operation room. Conclusions: Our result suggest that more biopsy core number and area were needed for increasing detection rates of prostate adenocarcinoma.

양성 전립선 질환이 혈청 전립선 특이항원치에 미치는 영향

임진동,이상곤 大韓泌尿器科學會 2001 Korean Journal of Urology Vol.42 No.11

전립선(前立腺) 비대증(肥大症)의 동서의학적(東西醫學的) 비교고찰(比較考察)

김도년 ( Do Nyoen Kim ),강석봉 ( Seok Bong Kang ) 대구한의대학교 제한동의학술원 2009 제한동의학술원논문집 Vol.7 No.1

운동이 전립선 비대 유도 마우스의 혈중 염증반응 지표 및 전립선 조직의 IL-6, NF-kb, COX-2 mRNA 발현에 미치는 영향

윤은정 ( Eun-jung Yoon ),박세환 ( Se-hwan Park ),임은미 ( Eun-mi Lim ) 한국운동생리학회 2021 운동과학 Vol.30 No.4

PURPOSE: Benign prostatic hypertrophy (BPH) is a common finding in older men and a frequent cause of lower urinary tract symptoms. The efficacy of exercise in the management of BPH-related inflammation is not fully understood. Thus, we investigated the effects of exercise on inflammatory markers in a mouse model of BPH. METHODS: A total of 36 male C57BL/6 mice were divided into three groups; CON (sham control, n=12), BPH-CON (received testosterone propionate [TP] control, n=12), and BPH-EXE (TP+aerobic exercise group, n=12). For BPH induction, mice were castrated and testosterone propionate (3 mg/kg/day) was administered by subcutaneous injection. The exercise group was forced to run on a treadmill for 30 minutes 3 times per week for 12 weeks. RESULTS: The BPH-CON group showed significantly increased blood pro-inflammatory cytokines such as interleukin-6, -1β, and TNF-α compared with CON (p<.05). Furthermore, NF-kb and COX-2 mRNA expression were significantly increased in prostate tissue (p<.05). In contrast, the BPH-EXE group exhibited a significant decrease in IL-1β and TNF-α cytokines and NF-kb and COX-2 mRNA, but a significant increase in SOD activity when compared to the BPH-CON group (p<.05). CONCLUSIONS: These results suggest that inflammation may be an important factor for the prevention and management of BPH, and that exercise may contribute to the alleviation of inflammation in the blood and prostate tissues of men with BPH.

Anti-Inflammatory Effects of Graviola Stem Bark Extracts on the Testosterone-induced Benign Prostatic Hyperplasia Model in Rats

Hong Gwan Ui,Choi Minji,Chung Myung-Hee,노재열 건강기능식품미래포럼 2021 건강기능식품미래포럼 학술지 Vol.1 No.2

Pathophysiology for the development of benign prostatic hyperplasia (BPH) is not clearly known yet but it is suggested that inflammation plays a critical role. Graviola as a traditional medicine has been used for inflammatory disorders. This study aims to investigate the ameliorative effects of graviola extract against the development of BPH. BPH was induced in male Wistar rats by subcutaneous injection of testosterone propionate (TP; 5 mg/kg) once per day for 4 weeks, and graviola stem bark (GV) extract (70, 150, 300 mg/kg) or finasteride (1 mg/kg) as a positive control were administrated by gavage feeding once per day concomitantly with TP. GV extract attenuated the prostatic index (ratio prostatic tissue weight to body weight), epithelial thickness, the amounts of target molecules (dihydrotestosterone, prostate specific antigen, prostatic acid phosphatase, cyclooxygenase [COX]-2) in the sera or prostate tissues, the mRNA expression of androgen receptor (AR), 5α-reductase, COX-2, inflammatory cytokines (interleukin [IL]-6, IL-8), growth factors (insulin-like growth factor, epidermal growth factor), transforming growth factor (TGF)-β, CCL2 and CCR2, the protein expression of AR and TGF-β, and the mast cell population in prostatic tissues. Finasteride reduced all the responses like or less than those by GV extract. The data suggest that GV extract may attenuate the development of BPH through inhibiting the release of inflammatory cytokines, growth factors and COX-2 secreted/synthetized from mast cell infiltrated into stromal area of prostatic tissues.