• The Korean Journal of Pain
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• 제33권2호
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• pp.176-182
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• 2020

Background: Catheter-related bladder discomfort (CRBD) has been observed in many patients undergoing a urethral catheterization. CRBD may be so severe that the patients require additional analgesics. Muscarinic receptors are involved in the mechanism of CRBD. The aim of this study is to determine the effects of the antimuscarinic properties of atropine, which is frequently used in current practice on CRBD, by comparing it with sugammadex which has no antimuscarinic effects. Methods: Sixty patients selected for transurethral resection due to bladder tumors were randomized into 2 groups: an atropine group and a sugammadex group, with no antimuscarinic effect. The patients were given rocuronium (0.6 mg/kg) as a neuromuscular-blocker. In addition to the frequency and severity of CRBD postoperatively at 0, 1, 6, 12, and 24 hours, postoperative numeric rating scale (NRS) scores, and postoperative nausea and vomiting were examined. Results: The incidence of CRBD was significantly lower in the atropine group in all postoperative measurements. The score was found to be significantly lower in the atropine group when NRS measurements were performed at all time periods (P < 0.01). There was no difference between the groups in terms of nausea and vomiting (P > 0.05). Conclusions: Atropine is a cheap, easy-to-access, safe-to-use drug for reducing CRBD symptoms, without any observed adverse effects. Since it not only reduces CRBD symptoms but also has a positive effect on postoperative pain, it can be used safely to increase patient comfort in patients receiving general anesthesia and a urinary catheter.

• 대한영상의학회지
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• 제82권3호
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• pp.715-720
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• 2021

방광암의 경요도절제술은 비근침윤성 방광암의 1차 치료 방법이다. 첫 번째 경요도절제술 이후 약 절반가량의 방광암 환자에서 재발을 보인다. 대부분의 방광암 재발은 방광점막에서 방광내막 쪽으로 자라는 용종 모양의 종괴로 나타난다. 지금까지 알려진 바에 의하면, 재발한 방광암이 상피하종양의 형태로 보고된 증례는 없다. 근육내층에 국한된 재발암은 방광경에서 발견하기가 쉽지 않고, 또한 수술적으로 완전히 제거하는 것 역시 쉽지 않다. 근육내층에 재발한 방광암을 진단하는 데에 있어서 영상 검사가 가장 중요한 정보를 제공할 수 있다. 이 증례에서는 영상 검사에서 진단할 수 있는 아주 드문 상피하 재발 방광암에 대해 보고하고자 한다.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.101-104
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• 1988

외요도구를 통한 Foley catheter의 유치는 거의 대부분의 경뇨도적 내시경 수술 후 필수적으로 행하는 술기이다. 그러나 가끔, 특히 심한 요도손상을 입힌 경우나 요도에 false tract가 생긴 때에는 통상의 방법으로 Foley catheter의 외요도구를 통한 방광내로의 유치가 곤란하며 또한 심한 손상을 초래할 위험이 많다. 저자는 guide wire를 이용한 새롭고 안전한 요도 catheter의 유치방법을 고안하여 1986년 9월부터 1988년 6월 까지 요도협착으로 입원하여 internal urethrotomy를 받은 후 Foley catheter의 유치가 곤란하였던 7명의 환자 및 경뇨도전립선절제술후 Foley catheter의 삽입이 곤란하였던 3명의 환자에게 각각 시행하여 전례에서 성공하였다.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2001년도 International Symposium on Dietary and Medicinal Antimutgens and Anticarcinogens
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• pp.203-204
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• 2001

Background and Aim: Transitional cell carcinoma (TCC) of the bladder represents the fifth most prevalent malignancy in Western population, with peak incidence found in males of the 50- to 70-year-old age group. A major problem in the management of bladder cancer is the low sensitivity of a large proportion (approximately 40%) among bladder tumors to chemotherapy and the high risk for recurrence of bladder tumors after transurethral resection.(omitted)

• Radiation Oncology Journal
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• 제9권2호
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• pp.311-317
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• 1991

1989년 2월부터 1990년 6월까지 조선대학교 부속병원 치료방사선과에서 침윤성 방광암으로 경요도적절제술 및 Cisplatin과 방사선을 병용하여 치료를 받았던 10예에 대하여 저자는 후향적으로 국소관해율, 생존기간, 치료실패양상 및 부작용을 분석하였다. 이들은 원발병소가 근치적방광절제술이 불가능하였거나, 환자의 전신상태 또는 고령의 나이나 합병된 내과적인 질환때문에 근치적수술을 할 수 없었던 경우였다. 원발병소의 병기는 T3a-T4b였고, N병기는 NO가 9예이고 N1가 1예였으며, 10예 모두 MO 였다. 추적기간은 $16\~32$개월이었다. 수술요법은 경요도적절제술, 화학요법은 Cisplatin $1\~5$회, 방사선치료는 골반부위에 $3960\~5400$ cGy의 선량으로 치료하였다. 원발병소의 병기에 따른 완전관해율은 cT3a에서 80$\%$, cT3b에서 67$\%$ 그리고 cT4b에서 0$\%$였고 전체적으로 60$\%$의 완전관해율을 보였다. 부분관해율은 20$\%$이어서 전체의 국소관해율은 80$\%$였다. 조직학적 검사상모두 이행상피암이었고 조직학적 등급에 따른 완전관해의 차이를보면 I, II등급인 6예에서는 모두 완전관해를 보였고 III, IV등급인 4예에서는 부분관해가 2예이고 무반응이 2예였다. 완전관해를 보였던 6예는 모두 생존하여 있고 이중 1예에서만 치료후 10개월후에 국소재발을 보였다. 완전관해를 보이지 않았던 4예는 모두 조직학적 등급이 III, IV등급으로 방광암으로 사망하였다. 원격전이는 3예에서 보였으며 2예 (cT4b)는 폐, 1예(cT3b)는 척추부위였다. 방사선치료후 부작용은 설사가 가장 심한 부작용으로 1예에서 나타났으나 보존요법으로 호전되었다. 따라서 침윤성방광암에 있어서 방광기능의 보존측면에서 병용치료는 심한 부작용없이 치료가 가능하며 완전관해율을 높이기위하여 방사선선량을 높이고, T4b병기에서는 원격전이 가 큰 문제이므로 효과적인 복합화학요법을 시도하는 것이 필요하다고 사료된다.

• Journal of Yeungnam Medical Science
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• 제9권1호
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• pp.110-120
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• 1992

경뇨도 전립선 절제술을 시행한 환자 30명을 대상으로 하여 furosemide부여에 따른 혈중 나트륨치와 삼투질 농도를 비교 관찰한 결과 다음과 같은 결론을 얻었다. 1. 혈중 나트륨치는 대조군에서 술전에 비해 10분, 20분, 30분, 수술직후에 의의있는 감소(p<0.05)가 있었으나 실험군에서는 변화가 없었다. 2. 혈장 삼투질농도와 유효 삼투질농도는 대조군에서 술전치와 비교시 술중 30분과 수술직후에 의의있는 감소(p<0.05)가 있었으나 실험군에서는 잘 유지가 되었다. 이상의 결과로 보아 술중 흡수된 관류액의 영향을 줄일 목적으로 furosemide를 투여한 실험군에서 대조군에 비해 혈중나트륨치와 삼투질농도를 잘 유지시키기에 그 예방적 투여가 의의있다고 사료되며 특히 울혈성 심부전이나 신부전이 있는 환자의 수술시 furosemide를 투여하면 그 의의가 더 클 것으로 사료된다.

• Parasites, Hosts and Diseases
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• 제48권1호
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• pp.57-59
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• 2010

A 59-year-old Korean man complained of a painless scrotal hard nodule and weak urine stream. The ultrasound scan revealed a 2.2-cm sized round heteroechogenic nodule located in the extratesticular area. Microscopic hematuria was detected in routine laboratory examinations. On scrotal exploration, multiple spargana were incidentally found in the mass and along the left spermatic cord. On cystoscopy, a 10-mm sized mucosal elevation was found in the right side of the bladder dome. After transurethral resection of the covered mucosa, larval tapeworms were removed from inside of the nodule by forceps. Plerocercoids of Spirometra erinacei was confirmed morphologically and also by PCR-sequencing analysis from the extracted tissue of the urinary bladder. So far as the literature is concerned, this is the first worm (PCR)-proven case of sparganosis in the urinary bladder.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.381-384
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• 2014

Background: Evidence indicates that Dickkopf-1 (DKK-1) levels may be a biomarker for cancer risk. The aim of this study was to assess DKK-1 and its correlation with clinic-pathological features in patients with bladder cancer. Materials and Methods: DKK-1 levels were determined in serum samples from 90 patients with bladder cancer before transurethral tumor resection. The concentrations of DKK-1 were determined by using enzyme linked immune-sorbent assay (ELISA). Results: Elevated preoperative DKK-1 levels were associated with tumor stage (p<0.001), grade (p<0.001) and histological grade (p<0.001). Conclusions: The results of our study demonstrated that the level of serum DKK-1 is correlated with both disease progression and increase in the tumor grade. Preoperative serum DKK-1 elevation may thus represent a novel marker for the determination of bladder cancer and the detection of patients with a likely poor clinical outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2871-2877
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• 2015

Background: Urothelial carcinoma (UC) is a malignant neoplasm that most commonly occurs in the urinary bladder. The primary aim of this study was to evaluate the clinicopathologic features, recurrence and progression in patients with bladder urothelial cancer. Materials and Methods: The medical records of patients diagnosed with UC in the state pathology laboratory between January 2006 and July 2014 were retrospectively included. Carcinomas were categorized according to age, gender, histologic grade, tumor configuration, pathologic staging, recurrence status, and progression. Results: A total of 125 (113 men, 12 women) patients were examined. The mean age was 65.9 years and the male-to-female urothelial cancer incidence ratio was 9.4:1. Low-grade UCs were observed in 85 (68%) and high-grade in 40 (32%). A papillary tumor pattern was observed in 67.2% of the UCs. Cases were classified with the following pathological grades: 34 (27.2%) cases of pTa, 70 (56%) of pT1, and 21 (16.8%) of pT2. Recurrence occurred in 27 (21.6%) patients. Ten progressed to a higher stage (pT1 to pT2), and three cases to higher grade (low to high). We also analyzed the results separately for 70 (56%) patients 65 years of age and older. Conclusions: With early detection and diagnosis of precursor lesions in older patients, by methods such as standard urologic evaluation, urinary cytology, ultrasound scanning and contrast urography, and cystoscopy, in addition to coordinated efforts between pathologists and urologists, early diagnosis may reduce the morbidity and mortality of patients with urothelial carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.81-85
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• 2013

Background: Early diagnosis of carcinoma of bladder remains a challenge. Survivin, a member of the inhibitor of apoptosis (IAP) protein family, is frequently activated in bladder carcinoma. The objective of this study was to investigate urinary survivin as a marker for diagnosis of urinary bladder. Materials and Methods: We examined urinary survivin concentration in 28 healthy individuals, 46 positive controls and 117 cases of histologically proven TCC prior to transurethral resection, using ELISA, and compared values with findings for urinary cytology. Results: Survivin was found to be significantly higher in the cancer group (P<0.05). A cut off value of 17.7 pg/ml was proposed, with an approximate sensitivity of 82.9% and specificity of 81.1% (P<0.0001), whereas urine cytology had a sensitivity of 66.7% and a specificity of 96.0%. Conclusions: Urinary survivin can be used as a non-invasive diagnostic biomarker for TCC bladder, both for primary and recurrent disease.