Journal of Yeungnam Medical Science

Tong Choon Park

17 Articles

Diagnosis of Malignant Lesion in Patients with Lower Urinary Tract Symptoms: Tong Choon Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S1-11. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S1

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Abstract PDF: Some patients, especially with chronic disease such as diabetes, who suffer from lower urinary tract symptoms (LUTS) just want to take prolonged oral medication (anticholinergics or alpha blockers) without proper evaluation for basic causes. LUTS is commonly occurred by urinary tract infection, several chronic diseases and/or aging itself. However, we should not pass over the fact that LUTS also can be evoked by malignancy. Because there is a higher detection rate of malignancy in patients with microscopic hematuria, urine cytology must be done with ultrasonography, IVP and cystoscopy. In those patients aged over 50 years or high risk group for urothelial carcinoma, it is mandatory to undergo ultrasonography and cystoscopy, even if there is no abnormalities on their urinalysis and urine cytology.

Analysis of Matrix Metalloproteinase-9 Expression in Renal Cell Carcinoma.: Ji Yoon Kim, Tong Choon Park; Yeungnam Univ J Med. 2006;23(1):82-89. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.82

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Abstract PDF: BACKGROUND
Matrix metalloproteinases (MMPs) are involved in the degradation of the extracellular matrix, which is an important step in tumor invasion and metastasis. A positive correlation between the expression of MMP-9 and aggressive behavior of renal cell carcinomas (RCCs) has been reported. MMP-9 expression in RCCs and adjacent normal kidney tissues were examined in this study. MATERILAS AND METHODS: Twenty-five patients pathologically diagnosed as clear cell RCCs, from specimens obtained at radical nephrectomy, between May 2003 and December 2004 were enrolled in this study. MMP-9 activity was estimated using gelatin zymography, and quantified using a laser densitometer. The results were compared with clinicopathological characteristics. RESULTS: The expression of MMP-9 was significantly elevated in the RCC compared with non-tumor kidney specimens (p<0.01). The levels of MMP-9 expression in the RCC patients with large tumors (>4 cm) or vascular invasion were significantly higher than in those without these clinical manifestations (p<0.01). There were also significant differences in the expression of MMP-9 among T stages (p<0.01). The tissue MMP-9 level was the highest in nuclear grade 4, but there was no statistical significance between the histological grades (p=0.17). CONCLUSIONS: These results suggest that enhanced MMP-9 expression contributes to carcinogenesis and tumor progression in the later stages of RCC.

Association between Obesity and Prostate Cancer.: Chang Jun Yoon, Ki Hak Moon, Tong Choon Park; Yeungnam Univ J Med. 2005;22(2):199-210. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.199

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Abstract PDF: BACKGROUND
The role of obesity in prostate cancer etiology remains controversial. The aim of this study was to evaluate the relationship between obesity and prostate cancer risk. MATERIALS AND METHODS: Between January 2000 and June 2005, 286 patients suspected of having prostate cancer underwent prostate biopsy. The clinical records of the 286 study patients were retrospectively reviewed with regard to age, Body Mass Index (BMI), serum PSA, TRUS, and prostate biopsy results. They were stratified by BMI into three groups according to the cutoffs recommended for Asian populations: normal, BMI less than 23 kg/m2; overweight, BMI 23 to 25 kg/m2; and obese, BMI greater than 25 kg/m2. RESULTS: As for BMIs, 132 (46.2%) were normal, 95 (33.2%) overweight and 59 (20.6%) were obese. A total of 99 (34.6%) patients were diagnosed as having prostate cancer. In multivariate logistic regression analyses, no significant association was observed between BMI and prostate cancer detection. CONCLUSION: We initially hypothesized that obesity may be biologically associated with increased prostate cancer development. However, our study did not show a significant association between BMI and prostate cancer.

A Case of Infected Huge Lymphangioma in Pelvic cavity.: Woo Seok Choi, Seong Ho Lee, Seok Young Chung, Phil Hyun Song, Un Gi Baek, Chul Kyu Cho, Tong Choon Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2002;19(1):63-67. Published online June 30, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.1.63

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Abstract PDF: Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developed at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma arising from pelvic cavity and involving bladder wall.

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.

2 cases of male urethral diverticulum combined with stone.: Hyun Chul Shin, Young Soo Kim, Tong Choon Park; Yeungnam Univ J Med. 1992;9(2):416-421. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.416

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Abstract PDF: Male urethral diverticulum is uncommon lesion, furthermore calculus formation within the male urethral diverticulum is very rare. Generally, urethral diverticula are classified as congenital and acquired. The majority of male urethral diverticula are acquired and approximately 10 to 20 per cent are congenital. Acquired urethral diverticula in the male may arise from many sources, including infection (prostatic abscess, infection of periurethral glands, hematoma or schistosomiasis), obstruction (stricture, impacted stone, Cunningham clamp or condom catheter) and trauma (instrumentation, external injury and pelvic fracture). Calculi formation is more common in the acquired diverticulum owing to stagnation of urine and infection. These calculi in the diverticulum usually are solitary and may attain considerable size with predisposing factors, 1) a ureteral or bladder calculus that is lodged in the urethra 2) urethral trauma or stricture, 3) calcification around a foreign body or hair. The treatment of urethral diverticulum combined with stone is excision of the diverticula with removal of stone. We treated two cases of urethral diverticulum combined with stone in the male, and report with review of literature.

A case of giant lymph node hyperplasia in the spermatic cord.: Hyun Chul Shin, Young Soo Kim, Tong Choon Park, Young Ran Shim; Yeungnam Univ J Med. 1992;9(1):175-180. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.175

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Abstract PDF: Giant lymph node hyperplasia (Castleman's disease) is a rare disease, which represents a peculiar form of lymph node hyperplasia. Generally, it has been considered as benign and localized disease but recently, revealed malignant transformation in some cases of multicentric form. It usually occurs on the mediastinum and occasionally neck, lung, axilla, mesentery, broad ligament, retroperitoneum or soft tissue of extremities. Histopathologically, it is divided into hyaline vascular or plasma cell type and the former is characterized with prominent vascular proliferation and hyalinization in the central portion and tight concentric layering of lymphocytes at the periphery of the follicles (mantle zone) and the latter is characterized by a diffuse plasma cell proliferation in the interfollicular area. From the point of view of clinical presentation, it has been divided into solitary form, which presents as a localized mass located most commonly in the mediastinum, and multicentric form, which occurs multiple location and has systemic manifestation and transformation into malignancy. Herein we report a case of Giant lymph node hyperplasia occurring in the left spermatic cord in a 58-year old male with brief review of literatures.

Anatrophic nephrolithotomy: experience in 55 cases.: Tae Jin Kim, Tong Choon Park; Yeungnam Univ J Med. 1992;9(1):149-155. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.149

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Abstract PDF: 55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients (36 male and 19 female) ranged in age from 3 to 72 years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases (9.4%), atelectasis in 4 (7.5%), transient urine leak in 2 (3.8%), delayed bleeding in 2 (3.8%) and urinary retention in 2 (3.8%). Postoperative residual stones were identified in 15 (27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases (87.3%) became stone free. The recurrence of stone was noted in 2 out of 48 patients during the short follow up period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.

Clinical Experiences of the Ureteroscopic Management for the Lower Ureteral Stone.: Seong Jong Mo, Young Soo Kim, Jun Kyu Suh, Tong Choon Park; Yeungnam Univ J Med. 1990;7(2):97-102. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.97

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Abstract PDF

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62 (83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents (65 cases). Of 57 smaller calculi than 1 cm (radiographic largest diameter) 50 (88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications during or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.

Citations

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A Clinical Case Report of Severe Hematuria Patient after Ureterolith Lithotripsy
Sang Hyun Lee, Ju Yong Jeong, Myoung Rae Cho
Korean Journal of Acupuncture.2015; 32(3): 144. CrossRef

Prostatic Urethral Polyp Causing Lower Urinary Tract Obstruction: Report of a Case.: Dong Heon Lee, Jun Kyu Suh, Young Soo Kim, Tong Choon Park, Hae Joo Nam, Won Hee Choi, Tae Sook Lee, Kyung Chul Lee; Yeungnam Univ J Med. 1985;2(1):249-252. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.249

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Abstract PDF: Polyps of the male urethra are relatively uncommon lesions, They usually arise from the prostatic urethra mostly verumontanum or just lateral to the verumontanum. Posterior urethral polyp often presents with hematuria, hemospermia and sometimes lower urinary tract obstruction. We recently experienced a pedunculated prostatic urethral polyp in a 63-year-old man who complained of gross total hematuria and difficult micturition for several years. On rectal examination the prostate was slightly enlarged with normal consistency. Excretory urogram showed a round filling defect in the right side of the bladder neck measuring about 2×2 cm in size. Cystourethroscopy revealed trabeculation of the vesical wall, mild bilateral prostatic hypertrophy and a round cystic mass with a long stalk arising from the prostatic floor 1cm. Proximal to the verumontanum which caused ball-valve obstruction in the bladder neck. This pedunculated polypoid mass was then resected at its base with resectoscope and was removed transurethrally using Lowsley's grasping forceps. The specimen was proved as fibrous polyp histologically.

Transurethral Dormia Dislodging in Patients with Lower Ureteral Stone.: Eun Gill Kim, Jun Kyu Suh, Young Soo Kim, Tong Choon Park; Yeungnam Univ J Med. 1985;2(1):81-85. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.81

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Abstract PDF: Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial. Herein we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 46 mm, and 33% in 610 mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained in the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And in the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

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