Journal of Yeungnam Medical Science

Hee Chang Jung

12 Articles

Current Trend of the Primary Treatment in Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia.: Hee Chang Jung; Yeungnam Univ J Med. 2009;26(2):85-92. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.85

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Clinical benign prostatic hyperplasia (BPH) is a multifaceted phenomenon that is due to prostatic and bladder influences as well as nonurological causes. It is also important to differentiate between the more common voiding or obstructive symptoms as well as the more bothersome storage or irritative symptoms. Lower urinary tract symptoms (LUTS) and BPH may be two separate conditions with different underlying pathologies. However, they are often treated incorrectly as one entity. Both conditions are very common and they represent chronic conditions of the aging male. They are often associated with a significant reduction in the patients' quality of life. Although these are not new conditions, there have been enormous changes in the methods of assessing and managing the patients with these conditions. This review describes some of the influential studies in this area and the current trends of the primary treatment for LUTS/BPH.

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Image Analysis of Computer Aided Diagnosis using Gray Level Co-occurrence Matrix in the Ultrasonography for Benign Prostate Hyperplasia
Jin-Young Cho, Chang-Soo Kim, Se-Sik Kang, Seong-Jin Ko, Soo-Young Ye
The Journal of the Korea Contents Association.2015; 15(3): 184. CrossRef

A Case of Bladder Stone and Vesicovaginal Fistula after McDonald Operation.: Chang Jun Yoon, Ki Hak Moon, Hee Chang Jung; Yeungnam Univ J Med. 2006;23(1):108-112. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.108

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Abstract PDF: The frequency of a bladder foreign body in the female is lower than in the male, and bladder stones attached to foreign bodies such as non-absorbable suture material are not common. Moreover, vesicovaginal fistulas due to migration or puncture of suture materials into the bladder are rare. In this report, we present a case of bladder stone and vesicovaginal fistula formation in a 29-year-old female patient who had been treated with the McDonald operation for an incompetent internal os of the cervix (IIOC) during pregnancy. The patient was successfully treated by cystoscopic removal of the bladder stone with suture material and conservative treatment for the vesicovaginal fistula.

The Effects of Ginseng Saponin on Relaxation of Smooth Muscle in the Lower Urinary Tract and the Corpus Cavernosum.: Hee Chang Jung, Tae Hee Oh; Yeungnam Univ J Med. 2006;23(1):52-61. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.52

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Abstract PDF: BACKGROUND
Korean ginseng (KG) has been used as a general tonic, and for voiding dysfunction for a long time in oriental society. However, scientific basic studies on the use of KG, have been rare, especially for voiding and erectile dysfunction. This study was performed to investigate the effects of KG on voiding and erectile function by examining the effects of total saponin (TS) on the bladder, urethral and penile cavernosal smooth muscle. MATERILAS AND METHODS: To examine the effects of TS, NewZeland white rabbits were used to obtain tissue strips from the smooth muscle of the bladder, proximal urethra and corpus cavernosum. Adult Sprague Dawley rats were used to examine the changes in urodynamic findings and penile erection after administration of TS. RESULTS: In proximal urethral strips, the rate of relaxation of the proximal urethra was increased from 9.0+/-2.9 to 33.7+/-4.8% in a dose-dependent manner when the concentration of TS was added accumulatively from 0.25 mg/ml to 4.0 mg/ml (p<0.05). However, no significant response was observed in the bladder strips within these concentration ranges. For the corpus cavernosal strips, the rate of relaxation ranged from 5.8+/-2.1 to 36.7+/-5.8%, increasing in a dose-dependent manner when TS was increased from 1.0 mg/ml to 4.0 mg/ml (p<0.05). After administration of 0.1 ml of TS (32 mg/ml) in the rat, the bladder pressure was 37.5+/-8.5 mmHg at 52.1+/-7.0 sec. during isovolumetric bladder contraction, showing no significant differences from 35.7+/-7.8 mmHg and 50.7+/-7.2 sec, respectively, before treatment. However, when 0.1 ml of TS (32 mg/ml) was administered, the relative reduction of urethral pressure was 6.9+/-0.5 mmHg at 62+/-7.5 sec, which was significantly higher compared to 4.6+/-1.1 mmHg at 45+/-10 sec before treatment (p<0.05). For the cavernosal injection study, the change in intracavernosal pressure (delta ICP) was examined after administering 0.1 ml of TS. The cumulative additions of TS at concentrations from 0.5 mg/ml to 32 mg/ml increased delta ICP from 1.3+/-0.5 to 21.3+/-7.8 mmHg in a dose-dependent manner (p<0.05). The duration of tumescence was from 0.3+/-0.1 to 5.2+/-0.2 min, showing dose-dependent increase (p<0.05). Furthermore, the cumulative addition of TS at concentrations from 0.5 mg/ml upto 32 mg/ml did not cause any significant change in systemic blood pressure. CONCLUSION: These results suggest that ginseng improves voiding functions, which is mainly achieved by TS relaxing the proximal urethra, the most important part of the bladder outlet function. In addition, ginseng safely induced a penile erection hemodynamically by relaxing the corpus cavernosum.

The Effects of Electrical Stimulation Therapy with Microchip for the Treatment of Bladder Irritability Symptoms in Stress Urinary Incontinent Women.: Hee Chang Jung, Yeun Ho Chung, Hyoun Jin Shin; Yeungnam Univ J Med. 2004;21(2):207-214. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.207

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Abstract PDF

PURPOSE: This study was carried out to evaluate the efficacy of intravaginal pelvic floor electrical stimulation (FES) therapy on bladder irritability symptoms in stress urinary incontinent women. MATERIALS AND METHODS: The evaluation before and after treatment included the Blaivas's female Bladder Questionnaire, the quality of life questionnaires and the overall satisfaction with present voiding state using visual analogue test (VAT). All patient were treated for 20 minutes, twice a week for 6 weeks, using a new intravaginal electrical stimulator with microchip (PIC16C74). RESULTS: After the FES therapy, the overall success rate of the SUI was 50.4.% at 9 months. The bladder irritability symptoms such as frequency, nocturia, urgency, residual urine sensation and lower abdominal discomfort were improved. In particular, the symptoms of frequency, urge incontinence, dysuria were significantly improved after the FES therapy at 9 months. The VAT score of the overall satisfaction with the present voiding state was significantly lower after the FES therapy. 73.7% of patients were satisfied with the FES therapy and complications such as hemorrhage, vaginitis, urinary tract infection and pain were not encountered. CONCLUSION: These results suggest that FES therapy with microchip improves some bladder irritability in SUI women. Therefore, electrical stimulation therapy should be considered as a first line therapy in SUI women with bladder irritability symptoms.

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Effect of Spiritual Well-being on Mental Health in Nursing Students
Nae-Young Lee, Ji-Young Han
Journal of Korean Academy of Psychiatric and Mental Health Nursing.2014; 23(1): 21. CrossRef

Malignant Fibrous Histiocytoma of the Spermatic Cord: A Case Report.: Ji Yoon Kim, Seong Ho Lee, Hee Chang Jung, Dong Sug Kim, Jae Ho Cho; Yeungnam Univ J Med. 2003;20(1):85-91. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.85

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Abstract PDF: Malignant fibrous histiocytoma (MFH) of the spermatic cord represents an uncommon location for the most common soft tissue tumor in adults. MFH of the spermatic cord is extremely rare. No case report has been described in the Korean literature. We report a case of malignant fibrous histiocytoma, myxoid type, arising from left spermatic cord. A 77-year-old male presented with a painless left upper scrotal mass for 5 months. Simple mass excision was performed for a diagnosis. Grossly, the mass closely contacted with the left spermatic cord. Since a myxoid type of malignant fibrous histiocytoma was diagnosed from histopathological findings, left radical orchiectomy with high ligation of the spermatic cord was performed additionally. There were no evidence of local recurrence or metastasis at 6 months after surgery.

Anterior Vaginal Wall Sling for Female Stress Urinary Incontinence.: Hong Seok Shin, Jin Wook Yoo, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 2001;18(1):59-66. Published online June 30, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.1.59

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Abstract PDF: BACKGROUND
The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. MATERIALS AND METHODS: From January 1998 to December1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication, success rate and patient's satisfaction were evaluated. RESULTS: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication, bladder perforation occurred in one patient(2.4%), residual urine sensation developed in seven patients(16.7%). and suprapubic pain was complained in five patients(11.9%). which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instablility were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. CONCLUSION: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence. but a longer follow-up is necessary to determine long term effect.

Suprameatal Transvaginal Urethrolysis in Urethral Obstruction Associated with Anti-incontinence Surgery: A Case Report.: Jin Wook Yoo, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1999;16(2):376-379. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.376

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Abstract PDF: We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.

Clinical Experience of Nephron Sparing Surgery for Renal Tumor with a Normal Opposite Kidney.: Jun Young Lee, Jung Hyun Kim, Kang Min Lee, Ki Hak Moon, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1999;16(1):94-100. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.94

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Abstract PDF: The aims of this retrospective study were to determine whether a nephron sparing surgery might be feasible in patients with a small solid renal tumor. Materials and methods: Between 1988 and 1999, 21 patients with radiologically detectable small solid renal tumor underwent enucleoresection, wedge resection and polar segmental nephrectomy. The mean age of the 11 men and 10 women in this study was 43 years (range 14 to 68). According to the preoperative radiological diagnosis, 15 among the 21 patients were considered to have renal cell carcinoma, 4 were considered to have angiomyolipoma, and the remaining 2 patients were difficult to differentiate as renal tumors radiologically. Among 15 patients considered to have renal cell carcinoma, 14 were found to have renal cell carcinoma and the remaining one patient was diagnosed as having oncocytoma on pathologic examination. Radiological determination of angiomyolipoma in four patients was confirmed to be correct on pathological examination. The 2 patients whose radiological diagnose wasdificult were founf to have cavernous hemangioma and angiomyolipoma. One patient with renal cell carcinoma developed arteriocaliceal fistula, the only immediate complication in this series, and underwent nephrectomy on postoperative 10th day. The mean follow-up duration for the 14 patients with renal cell carcinoma was 18.6 months(range:1-103). There were no other tumor involvement in the resection margins following the nephron sparing surgery. These results suggest that nephron sparing surgery provides an effective treatment for patients with a single, small, unilateral, localized renal tumor. Longer follow-up is suggested for more definite verification of the role of nephron sparing surgery.

Comparison OF Northgate SD-3 and Modulith SLX Lithotriptors: Treatment Results with 2,000 Renal and Ureteral Stones.: Jun Young Lee, Hee Chang Jung, Ki Hak Moon, Chul Kyu Cho, Tong Choon Park; Yeungnam Univ J Med. 1999;16(1):85-93. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.85

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Abstract PDF: Some reports have shown a decreased effectiveness of extracorporeal shock wave lithotripsy(ESWL) with newer lithotriptors. We compared the treatment results of ESWL with a second generation Northgate SD-3 and a third generation Modulith SLX device. A total of 2,000 patients underwent ESWL treatments for single urinary calculus between September, 1988 and July, 1998. The 1,241 patients were treated with Northgate SD-3 between September, 1988 and December, 1995. The 759 patients were treated with Modulith SLX between January, 1996 and July 1998. The treatment results were compared using the chi-square test to determine statistical significance. The overall success rate, success rate according to the location and size, the mean number of sessions, complication rate and retreatment rate were obtained, according to lithotriptor. The overall success rate was 90.6% with Northgate SD-3 and 89.1% with Modulith SLX. With Northgate SD-3 and modulith SLX. the success rate according to the location was 91.0%(579/636), 88.1%(236/268) in the kidney, 93.2%(517/555), 89.9%(258/287) in upper ureter; 83.3%(10/12) and 94.4%(167/177) in middle and lower ureter; 47.4%(18/38) and 55.6%(15/27) in staghorn stone, respectively, The success rate According to the size of stone with Northgate SD-3 and Modulith SLX for stone with the size under 10mm was 96.1% (612/637) and 93.1%(470/505); from 11mm to 20mm was 87.3%(421/482) and 86.4%(165/191); from 21mm to 30mm, 77.5%(62/80) and 67.5%(23/34); and for stone larger then 31mm was 69%(29/42) and 62.1%(18/29), respectively, Mean number of sessions for successful fragmentation was 1.21 and 1.69, respectively, with Northgate SD-3 and Modulith SLX. Retreatment rate was 16.7% and 17.5%, respectively. The complications after treatment were severe pain(6.2% with Northgate SD-3 vs. 2.0% with Modulith SLX), steinstrasse(3.4% vs. 1.9%), fever(1.2% vs. 0.5%) and perirenal hematoma(0.2% vs. 0%) in order of frequency. There was no significant difference in the effectiveness between of Northgate SD-3 and Modulith SLX. However, a statistically significant difference was observed between the two lithotriptors. We concluded that ESWL with Modulith SLX is more safe compared to Northgate SD-3.

Four Cases of Foreign Body in Lower Urinary Tract.: Jin Wook Yoo, Ki Hak Moon, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1998;15(2):391-396. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.391

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Abstract PDF: Foreign bodies in genitourinary tract are common and almost of then are within the bladder. These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Foreign bodies(a thermometer and a piece of cloth) in the bladder were inserted as a mean of masturbation in two cases, and a cooper wire in the posterior urethra was introduced by iatrogenic causes in one case. In one case, four magnets were inserted into the bladder for the purpose of forceful penile erection. Clinical history, symptom, radiologic study, and endoscopic examination were required to diagnose foreign body. They were easily removed by endoscopic manipulation or open surgical procedure.

Early Clinical Experience with Transurethral Electrovaporization of the Prostate for Benign Prostatic Hyperplasia: Comparison with Transurethral Resection of the Prostate and Visual Laser Ablation of the Prostate.: Jung Hyun Kim, Ki Hak Moon, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1998;15(2):297-305. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.297

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Abstract PDF: Recently, several alternatives have been attempted in the management of benign prostatic hyperplasia (BPH) to reduce morbidity of traditional transurethral resection of the prostate (TURP). Among new modalities, transurethral electrovaporization (TEVP) is considered as a promising alternative. To evaluate the safety and initial efficacy of TEVP using the roller loop electrode (ProSurg Inc. USA) on BPH patients, we compared the results of TEVP with those of TURP and visual laser ablation of the prostate (VLAP). In this study, a total of 115 patients with symptomatic BPH were underwent TEVP (n=17), TURP (n=59) or VLAP (n=39) since 1995. Before treatment, patients were evaluated with an International Prostate Symptom Score (IPSS) and the measurement of maximal uroflow rate (MFR) and postvoid residual urine (PVR). After treatment, the operative and hospital records were reviewed. The uroflowmetry and IPSS were re-evaluated 3-10 months after treatment. In clinical outcome of re-evaluation compared to the preoperative parameters, there was a clinically significant improvement in three procedures. TEVP resulted in 62% reduction in IPSS (TURP, 73% : VLAP, 69%), 84% improvement in MFR (TURP, 113% : VLAP, 91%), and 74% reduction in PVR (TURP, 88% : VLAP, 78%). TEVP had shorter duration of hospitalization and catheterization than the others. TEVP was associated with lower rates of treatment-related complication than TURP. In conclusions, TEVP is considered as a useful procedure to treat symptomatic BPH. And, the advantages of TEVP over TURP include excellent intraoperative hemostasis, lower morbidity, shorter hospital stay and simple technique. In addition to this, the advantages over VLAP include lower cost, shorter duration of catheterization and early symptom improvement.

Embryologic Discission of the Median Raphe Cyst: Two Cases Report.: Sang Ho Bae, Ki Hak Mun, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1996;13(2):367-371. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.367

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Abstract PDF: Median raphe cyst is known as congenital lesion of the perineum and genitalia, but its etiology is unclear. Most investigators believe that the median raphe cyst represent defects in the embryologic developenient bf the male genitalia. Simple surgical excision is effective in most cases. We report our experience with two cases of median raphe cyst without specific symptoms. Even though median raphe cyst is asymptomatic, surgical therapy is worth applicable because it relieve a patient from cosmetic and psychotic problem.

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