• 제목/요약/키워드: Unstable bladder

검색결과 5건 처리시간 0.019초

항콜린제(옥시부티닌)가 원발성 방광요관역류의 자연 소실에 미치는 영향 (The Effect of an Anticholinergic Agent(Oxybutynin) on Spontaneous Resolution of Primary Vesicoureteral Reflux)

  • 안소현;심소연;이정원;조수진;이승주
    • Childhood Kidney Diseases
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    • 제7권2호
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    • pp.174-180
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    • 2003
  • 목적 : 불안정 방광은 소아에서 원발성 방광 요관역류를 생성하고 지속시키는 원인으로 알려져 있다. 따라서 불안정 방광의 치료제인 항콜린제의 사용은 일차성 방광요관역류의 자연 소실율을 증가시킬 수 있으나 논쟁의 여지가 있어왔다. 저자들은 항콜린제인 옥시부티닌이 소변 가리기 훈련과 배뇨 증상이 각기 다른 소아에서 원발성 방광요관역류의 소실에 미치는 영향을 조사하고자 하였다. 방법 : 1996년 10월부터 2002년 4월까지 이화의대 목동병원에 요로 감염으로 입원한 후 방광요관역류가 발견되고 1년 후 추적 검사에서도 소실되지 않은 152명을 대상으로 하였다. 옥시부티닌군(59명)은 옥시부티닌과 trimethoprim-sulfamethoxazole을, 대조군(93명)은 trimethoprim-sulfamethoxazole만을 투약했다. 방광요관역류의 소실율을 나이, 소변 가리기 및 배뇨 장애 유무에 따라 구분하여 분석하였다. 통계 분석은 Chisquare test를 이용하였고 P-값이 0.05 미만을 유의한 것으로 간주하였다. 결과 : 방광요관역류의 변화는 옥시부티닌군(59명)에서 소실 49.2%, 호전 20.3%, 무변화 30.5%로 대조군(93명)의 45.2%, 16.1%, 38.7%와 비교해 유의한 차이는 없었다. 소변을 가리지 못하는 영유아에서 방광요관역류의 변화는 옥시부티닌군(34명)에서 소실 50.0%, 호전 23.5%, 무변화 26.5%로 대조군(52명)의 44.2%, 19.2%, 36.6%와 비교해 유의한 차이는 없었다. 소변을 가리는 소아에서 방광요관역류의 변화는 옥시부티닌군(25명)에서는 소실 48.0%, 호전 16.0%, 무변화 36.0%로 대조군(41명)의 46.3%, 12.2%, 41.5%와 비교해 유의한 차이는 없었다. 소변을 가리고 배뇨 장애도 없는 연장아에서 방광요관역류의 변화는 옥시부티닌군(9명)에서 소실 33.3%, 호전11.1%, 무변화 55.6%로 대조군(28명)의 53.6%, 10.7%, 35.7%와 비교해 유의한 차이는 없었다. 소변을 가리나 배뇨 장애를 보이는 연장아에서 방광요관역류의 변화는 옥시부티닌군(16명)에서는 소실 56.3%, 호전 18.7%, 무변화 25.0%로 대조군(13명)의 30.7%, 15.4%, 53.9%와 비교해 소실되는 경향이나 유의한 차이는 없었다. 결론 : 옥시부티닌은 소변 가리기나 배뇨 장애와 관계없이 모든 소아에서 역류의 소실율에 미치는 치료 효과가 없었다. 배뇨 장애를 보이는 연장아에서는 역류의 소실율이 약간 증가되는 경향이 있었으나 유의하지 않았다. 원발성 방광요관역류에서 옥시부티닌은 배뇨 장애를 보이는 일부 연장아에서 신중하게 사용되어져야 할 것으로 생각된다.

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Incidence and Clinical Features of Urethral Injuries with Pelvic Fractures in Males: A 6-Year Retrospective Cohort Study at a Single Institution in South Korea

  • Sun, Hyun Woo;Kim, Hohyun;Jeon, Chang Ho;Jang, Jae Hoon;Kim, Gil Hwan;Park, Chan Ik;Park, Sung Jin;Kim, Jae Hun;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • 제34권2호
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    • pp.98-104
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    • 2021
  • Purpose: Severe pelvic fractures are associated with genitourinary injuries, but the relationship between pelvic trauma and concomitant urethral injuries has yet to be elucidated. This study evaluated the incidence, mechanism, site, and extent of urethral injuries in male patients with pelvic fractures. Methods: A retrospective cohort study was performed involving patients with urethral injuries accompanying pelvic fractures who visited Pusan National University Hospital from January 1, 2014 to December 31, 2019. Demographics, mechanisms of injury, clinical features of the urethral injuries, concomitant bladder injuries, methods of management, and the configuration of the pelvic fractures were analyzed. Results: The final study population included 24 patients. The overall incidence of urethral injury with pelvic fracture was 2.6%, with the most common mechanism of urethral injury being traffic accidents (62.5%). Complete urethral disruption (16/24, 66.7%) was more common than partial urethral injuries (8/24, 33.3%), and unstable pelvic fractures were the most common type of pelvic fracture observed (70.8%). There was no definitive relationship between the extent of urethral injury and pelvic ring stability. Conclusions: The present study provides a 6-year retrospective review characterizing the incidence, mechanism, and clinical features of urethral injury-associated pelvic fractures. This study suggests that the possibility of urethral injury must be considered, especially in unstable pelvic fracture patients, and that treatment should be chosen based on the clinical findings.

골반환 손상과 동반된 고환 탈구 (Testicular Dislocation Associated with Pelvic Ring Injury)

  • 김범수;이호형;김성태;임현규
    • 대한정형외과학회지
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    • 제55권6호
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    • pp.540-544
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    • 2020
  • 불안정성 골반환 손상은 고에너지 외상으로 발생하게 되는데 종종 비뇨기과적인 손상을 동반하기도 한다. 비뇨기과적 손상으로는 방광, 요관, 요도 손상이 흔하다. 고환 탈구는 골반환 손상에 동반될 수 있으나 매우 드문 것으로 보고되고 있다. 이 경우 고환의 탈구로 인한 통증을 환자가 호소하여도 골반환 손상에 의한 통증으로 간과되기가 쉽다. 고환 탈구가 조기에 진단되지 않아 치료가 지연되면 고환 괴사 등과 같은 합병증으로 이어질 수 있어 주의를 요한다. 본 저자들은 골반환 손상에 동반된 고환 탈구환자를 경험하여 이에 대한 증례보고를 하고자 한다

요류검사 시스템의 구현과 요류파라미터의 유용성 평가 (Implementation on the Uroflowmetry System and Usefulness Estimation of the Uroflow Parameters)

  • 한봉효;정도운;김우열;배진우;손정만;김재현;박준모;정문기;전계록
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2002년도 하계종합학술대회 논문집(5)
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    • pp.293-296
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    • 2002
  • In this study, the object is a development on uroflowmetry system to detect a voiding symptom conveniently in home or hospital. The hardware was composed of mechanism and system circuit part, the software was divided into firmware and PC program part. The following experiment was performed to evaluate an ability of classification and fitness. First, the following parameters was calculated in each flow curve pattern. The parameters are MFR, AFR, VOL, VT, FT, and TMF. A significant difference among parameters was examined through a statistical analysis for extracted parameters between normal and abnormal group. In the next work, the following experimentation was performed to classify the voiding symptom. Analysis of congregate rate was examined to find out classification possibility about each symptom of BPH, voiding difficulty, detrusor failure and hyperreflexia, unstable bladder. The uroflow data with the above symptom was divided into normal and abnormal group using fuzzy classifier. and that was performed appending the other group again. Fuzzy classification result using MFR and AFR was superior by 89.6 % more than grouping evaluation including VOL.

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Metoclopramide의 생체내대사(生體內代謝)에 미치는 안정제(安定劑)의 영향에 관한 실험적(實驗的) 연구(硏究) (Experimental Studies on the Metabolism of Metoclopramide: The Effects of a Few Stabilizers)

  • 지웅길
    • Journal of Pharmaceutical Investigation
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    • 제9권2호
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    • pp.11-21
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    • 1979
  • It has been reported from our department that a few agents, such as $K_2S_2O_5,\;NaHSO_3,$ nicotinamide have a marked stabilizing effect in vitro on metoclopramide which is relatively unstable compound. In order to study the effect of these stabilizers on the action of metoclopramide in vitro, the fate of this compound combined with $K_2S_2O_5,\;NaHSO_3$ and nicotinamide, respectively, was studied and furthermore, the change of the biological activity of metoclopramide due to these stabilizers was studied by using the isolated stomach strip of rat. The blood concentration of metoclopramide was measured by using Bakke's method at the various time after intravenous injection of the mixed metoclopramide solution with the stabilizers. In order to study the excretion of the drug, rabbits were anesthesized and catheterized into bladder for withdrawal of urine. After intravenous injection of the mixed metoclopramide solution, urine was collected for 5 hours and the conjugated forms of metoclopramide as well as the free form were determined by using Arita's method. In the biological study of the metoclopramide combined with stabilizers, the contractability of the isolated rat stomach strip was observed by using polygraph recorder. The results were following: 1. When metoclopramide was administered with nicotinamide as stabilizer, the blood concentration of the unchanged from and the rate of the clearance of this compound were very similar to that of metoclopramide alone. On the other hand, other stabilizers, $K_2S_2O_5\;and\;NaHSO_3$, brought about 40% decrease in blood concentration of the unchanged form at 15 min after intravenous injection however, the rate of clearance of metoclopramide with $K_2S_2O_5\;or\;NaHSO_3$ was very slow. 2. In the case of urinary excretion, the excretory pattern of the metabolites of metoclopramide with $NaHSO_3$ or nicotinamide was very similar to that of metoclopramide alone. But metodopramide plus $K_2S_2O_5$ group showed the maked depression of excretion for first 1 hour. 3. In composition of metabolites, when metoclopramide was administered with $K_2S_2O_5$ or $NaHSO_3$, the sulfonate conjugation was predominant. But the glucuronic acid conjugation was predominant in metoclopramide plus nicotinamide gronp. 4. In the experiments on the biological activity of the metoclopramide, this compound exhibited the marked contracting effect in isolatd rat stomach strip. Specially, the meetoclopramide combined with $K_2S_2O_5$ showed the strong contraction of the isolated strip, suggesting the potenciating effect of $K_2S_2O_5$ on the action of metoclopramide in the isolated strip.

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