• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.303-303
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• 2009

• 한국임상수의학회지
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• 제26권6호
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• pp.647-649
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• 2009

양측성 잠복고환을 가진 18개월 연령의 잉글리쉬 불독에서 고환하강고정술을 실시하였고 수술 1달 후 GnRH를 투여하였다. 수술 전후 정액검사를 실시하였으며 인공수정을 통해 생식능력을 검증하였다. 수술 전과 수술 2달 후 정액검사 결과, 무정자증으로 판단되었으나 수술 4개월 경과 후 6마리의 정자가 관찰되었다. 수술 7개월 후 정자수를 제외한 나머지 정자 소견에서 정상을 나타내었으며 수술 8개월 후 채취된 정액을 암컷 불독에게 인공수정한 결과 6마리의 건강한 산자를 생산하였다. 양측성 잠복고환견에서 성성숙 이후라 할지라도 고환하강고정술과 GnRH 투여를 통해 정자형성과 수정능력이 회복 가능함을 알 수 있었다.

• Advances in pediatric surgery
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• 제14권1호
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• pp.58-66
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• 2008

Untreated cryptorchidism contributes to infertility and may play a role in increasing the risk of malignancy. The appropriate time of operation was considered before school age in 1970s, 2 years of age in 1980s, and between 1 and 2 years of age from 1990s to present time. Orchiopexy is the most common operation for congenital urological problem of children. We analyze our experience of orchiopexies to evaluate the results and to identify the role of the pediatric surgeon. We reviewed the medical records of 91 patients who underwent orchiopexy from January 1996 to December 2007. The patient age at orchiopexy were as follows: 48 cases (52.7 %) under 2 years of age, 24 cases (26.4 %) between 3 and 5 years, 16 cases (17.6 %) between 6 and 10 years, and 3 cases (3.3 %) over 11 years. Location of testes was preperitoneum in all 91 cases. There were 84 unilateral and 7 bilateral cases. Among the unilateral cases, the undescended testes were on right side in 54 cases and on the left side in 30 cases. The surgical procedure employed in all cases was trans-inguinal orchiopexies. Seventy-nine patients had excellent results. There were 12 complications; 5 cases of wound infection and 7 cases of temporary incomplete descent. Seven cases of incomplete descent have become normal from 3 to 6 months after orchiopexy. According to our results, 43 cases (47.3 %) underwent orchiopexies over 2 years of age. In conclusion, orchiopexies were successful in most cases of cryptorchidism in terms of testicular position and growth. We suggest that pediatric surgeons should educate their primary care physicians and parents concerning the potential complications of cryptorchidism and the appropriate time of operation.

• Clinical and Experimental Pediatrics
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• 제63권11호
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• pp.415-421
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• 2020

Cryptorchidism or undescended testis is the single most common genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%-2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, undescended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treatment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to protect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intra-abdominal undescended testis, or who underwent delayed orchiopexy. Patients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general population. Self-examination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.

• The Korean Journal of Pain
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• 제9권1호
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• pp.145-150
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• 1996

The purpose of this study was to evaluate and compare the effectiveness of ilioinguinal-hypogastric nerve blocks(IHNB) and caudal block in producing post-orchiopexy and post-heniorrhaphy analgesia in children. Forty consenting healthy children, ages 3~10yr, were randomly assigned to receive caudal bupitvacaine (0.125%, 0.5ml/kg), or IHNB bupivacaine (0.25%, 0.3 ml/kg). Blocks were performed following the induction of general anesthesia, be fore the operation. Pre-anesthetic medication in form of atropine 0.01 mg/kg, droperidol 0.05 mg/kg were given intramuscularly one hour before induction to 40 children. Children were induced with thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg intravenously. Anesthesia was maintained with oxygen-nitrous oxide ($FiO_2$ 0.3) and ethrane. When the patients stabilized after induction. IHNB was done in the supine position and caudal block was done in the lateral position. The local anaesthetic was injected after negative aspiration. Postoperative pain was assessed with face pain rating scale (RPRS) at rest on discharge of recovery room, and 5 hours after discharge of recovery room, and the "red and white" visual analogue scale (VAS) at rest and mobilization from supine to sitting position on discharge of recovery room, and 5 hours after discharge of recovery room. Post-operative recovery was quiet and comfortable, without side effect. Relief of ain was complete in both IHNB group and caudal group. Surgeons, parents and recovery room personnel were satisfied. There were no surgical or anesthetic complications. In our study, the postpoerative pain scores were similar in both IHNB group and caudal group. IN conclusion, we found that both IHNB and caudal blocks before the start of surgery for orchiopexy & herniorrhaphy are safe and effective in controlling the postoperative pain of children.

• Journal of Chest Surgery
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• 제33권5호
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• pp.419-421
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• 2000

Noonan syndrome is characterized by typical facies, congenital heart defect, and some clinical features similar to Turner syndrome, but with normal chromosomes. The most commonly associated cardiac defects are pulmonary valvular stenosis and strial septal defect. We experienced a case of Nonan syndrome associated with pulmonay valve stenosis with double-chambered right ventricle and atrial septal defect and cryptorchidism. Pulmonary valvotomy was done through transannular incision. Hypertrophied muscle bundles were excised. Atrial septal defect was closed directly. RVOT was reconstructed with pericardial transannular patch. Orchiopexy was performed simultaneously without any problem.

• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.852-854
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• 2010

Testicular torsion is rare in newborn infants. However, its frequency has increased, most of which are reported in full-term infants. We diagnosed and treated testicular torsion in an extremely low birth weight infant (ELBWI). A $2{\times}2cm$ red mass was palpable in the left groin of a 24-week-old, 745 g, male newborn at 23 days of age. Left testicular torsion was diagnosed, and emergent orchiopexy was performed. Careful physical examination is needed in cases suspicious of testicular torsion in ELBWIs with cryptorchidism. Moreover, early diagnosis and emergent exploration are necessary to prevent complications such as the risk of anorchia.

• Advances in pediatric surgery
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• 제15권1호
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• pp.44-51
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• 2009

This study is a retrospective analysis of 1244 cases of the inguinal hernia in children under the age of fifteen years who were operated at the department of pediatric surgery, Inje University Busan Paik Hospital from March, 1997 to February, 2007. The ratio of male to female was 3.6:1. The type of hernia was indirect in all of the cases. The hernia was on the right side in 656 cases (53.9 %), left side in 467 cases (37.5 %), and bilateral in 121 cases (9.7 %). The hernia presented most frequently in infants under age 12 months; 364 cases (29.2 %). Fifty-nine cases (21.7 %) were in female and 305 cases (31.3 %) in male. There were 428 cases (33.6 %) in 1-3 years age group, 295 cases (23.7 %) in 4-6 years, 112 cases (9.0 %) in 7-9 years, 39 cases (3.1 %) in 10-12 years and 16 (1.2 %) in 13-15 years. The content of hernia sac was small bowel (59 %), omentum (31 %) in males and the ovary and tube (54 %) and small bowel (26 %) in female. The incidence of combined operation at the time was 3.2 %, and consisting of orchiopexy (67.5 %), frenulotomy (12.5 %), appendectomy (10 %), circumcision (5 %), and fistulotomy (5%). The incidence of combined disease was 2.8 % and consisting of undescended testis, Hirschsprung's disease, idiopathic hypertrophic pyloric stenosis, imperforate anus, and congenital heart disease. After unilateral inguinal hernia repairs, contralateral hernias developed in 34 patients. The laterality of the primary site of hernias were left in 19 cases (55.8 %), and right 15 cases (44.1 %). The 936 cases (75.2 %) were operated under general anesthesia; Mask bagging 663 cases (53.2 %), endotrachea intubation 257 cases (20.6 %), and laryngeal mask 16 cases (1.2 %). The remainder 308 cases (24.7 %) were operated under regional caudal anesthesia.

• Childhood Kidney Diseases
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• 제16권2호
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• pp.115-120
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• 2012

목적: 소아비뇨기과 관혈적 수술 시 피부봉합제로 사용된 Octyl-2-Cyanoacrylate (Dermabond$^{TM}$)의 효용성에 대해 알아보고자 하였다. 방법: 2010년 8월부터 2011년 8월까지 1년 동안 서울대학교 어린이병원 소아비뇨기과에서 단일 술자에 의해 음낭수종절제술, 고환고정술, 음경성형술을 시행받은 환자들을 대상으로 상처 합병증 발생율을 후향적으로 비교분석하였다. 총 128명을 대상으로 210개의 절개 창에서 시행되었으며, 피부 봉합에 Dermabond$^{TM}$을 사용하였다. 모든 절 개창은 Dermabond$^{TM}$을 사용하기 전 흡수사를 이용하여 표피 밑 봉합 혹은 몇 개의 단순 봉합을 시행하였다. Dermabond$^{TM}$는 4 mm 너비로 얇게 두 번 사용되었으며, 건조시키는 과정이 포함되었다. 추가적인 붕대나 드레싱은 적용되지 않았다. 결과: 128명의 환자들을 수술 종류에 따라 세 그룹으로 나누었다(Group 1: 음낭수종 절제술, 55례, 41.3%; Group 2: 고환고정술, 43례, 32.3%; Group 3: 음경성형술, 35례, 26.4%). 수술 후 외래에서 추적 관찰한 210개의 절개창 중에서 총 5개(2.3%)에서 상처 합병증이 발생하였고, 이를 그룹별로 다시 분석해 보면 Group 1에서 0개(0/55, 0%), Group 2에서 1개(1/43, 2.3%), Group 3에서 4개(4/35, 11.4%)가 각각 발생하였다. 상처 부위별로 다시 분석해 보면 서혜부 상처 1개(1/120, 0.83%), 고환 상처 0개(0/55, 0%), 음경 상처 4개(4/35, 11.4%)가 각각 발생하였다. Group 3의 음경 상처에서 다른 군에 비해 통계적으로 의미 있게 증가되었다(P=0.008). Group 2와 3에서 상처 합병증이 발생한 환자들의 평균 나이는 각각 1세, 9.50세 이었고 상처 합병증이 없는 환자들의 평균 나이는 2.34세, 5.61세 였지만 통계적으로 의미는 없었다(P=0.639, 0.122). 5개의 상처 합병증은 모두 가벼운 염증반응이었으며, 항생제 연고만을 적용 후 술 후 평균 13.8일(13-15일) 후 모두 치료되었다. 결론: Dermabond$^{TM}$는 소아비뇨기과에서 음낭수종절제술과 고환고정술 시 피부봉합제로서 기존의 피부 봉합에 대한 대안으로 안전한 방법으로 사료된다. 하지만 음경성형술에서는 향후 더 많은 연구가 필요하다.