Prevalence and Risk Factors for Extended Spectrum Beta-Lactamase-Producing Uropathogens in Patients with Urinary Tract Infection

PURPOSE: The aim of this study was to determine the prevalence and risk factors of extended spectrum beta-lactamase (ESBL)-producing microorganisms in urinary tract infection. MATERIALS AND METHODS: total of 2,312 patients older than 25 years and diagnosed from January 2007 to December 2009 as having urinary tract infection were studied. The prevalence of ESBL-producing microorganisms including Escherichia coli and the antimicrobial susceptibility of E. coli were examined. Univariate analyses were performed with gender, age, inpatient status, previous hospitalization, recent history of urinary catheterization, recent exposure to specific antibiotics, and past history of urogenital organ operation as risk factors for the emergence of ESBL-producing microorganisms. Then, multivariate analysis was performed with all significant variables. RESULTS: In outpatient urinary tract infection, the antimicrobial susceptibility of E. coli to each of the third-generation cephalosporins, cefotaxime, ceftazidime, and ceftriaxone, was 87.6%, 93.4%, and 87.7%, respectively, and the prevalence of ESBL-producing E. coli was 12.1%. In inpatient urinary tract infection, the susceptibility of E. coli was 78%, 84.5%, and 76.9%, respectively, and the prevalence was 23.1%. CONCLUSIONS: The overall prevalence of ESBL-producing microorganism was 12.6% and the risk appeared to be increased in cases with a previous hospitalization, a recent history of urinary catheterization, inpatient status, cefaclor medication, cefminox administration, and female gender.

Prevalence and Risk Factors for Extended Spectrum Beta-Lactamase-Producing Uropathogens in Patients with Urinary Tract Infection

PURPOSE: The aim of this study was to determine the prevalence and risk factors of extended spectrum beta-lactamase (ESBL)-producing microorganisms in urinary tract infection. MATERIALS AND METHODS: total of 2,312 patients older than 25 years and diagnosed from January 2007 to December 2009 as having urinary tract infection were studied. The prevalence of ESBL-producing microorganisms including Escherichia coli and the antimicrobial susceptibility of E. coli were examined. Univariate analyses were performed with gender, age, inpatient status, previous hospitalization, recent history of urinary catheterization, recent exposure to specific antibiotics, and past history of urogenital organ operation as risk factors for the emergence of ESBL-producing microorganisms. Then, multivariate analysis was performed with all significant variables. RESULTS: In outpatient urinary tract infection, the antimicrobial susceptibility of E. coli to each of the third-generation cephalosporins, cefotaxime, ceftazidime, and ceftriaxone, was 87.6%, 93.4%, and 87.7%, respectively, and the prevalence of ESBL-producing E. coli was 12.1%. In inpatient urinary tract infection, the susceptibility of E. coli was 78%, 84.5%, and 76.9%, respectively, and the prevalence was 23.1%. CONCLUSIONS: The overall prevalence of ESBL-producing microorganism was 12.6% and the risk appeared to be increased in cases with a previous hospitalization, a recent history of urinary catheterization, inpatient status, cefaclor medication, cefminox administration, and female gender.

Efficacy of Bicalutamide Monotherapy in Locally Advanced Prostate Cancer / 대한비뇨기과학회지

PURPOSE: Nonsteroidal antiandrogen monotherapy may be a treatment option for some patients with locally advanced prostate cancer. We report the efficacy, advantage, and adverse events of bicalutamide monotherapy in patients with locally advanced prostate cancer. MATERIALS AND METHODS: We retrospectively reviewed 13 patients with locally advanced prostate cancer who were treated with bicalutamide 150mg monotherapy. Serum PSA reduction was evaluated with periodic PSA follow-ups. If clinical progression was suspected, pelvic CT or bone scan was performed for the evaluation of disease progression. The changes of sexual function were assessed with the IIEF questionnaires prior to treatment and after 6 months of medication. RESULTS: Serum PSA declined to less than 2ng/ml within 3 months after treatment in most patients. A high serum PSA level was maintained in only 1 patient, and this patient showed disease progression. There were no significant differences between the mean scores of the pretreatment and post-treatment erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction (p>0.05). Of the 13 patients, 2 patients (15.5%) showed adverse events, such as breast pain and gynecomastia. However, the symptoms were mild to moderate. There was no withdrawal to medication due to drug-related adverse events. CONCLUSIONS: From the viewpoint of the fall in serum PSA levels after 3 months, bicalutamide monotherapy was effective in the treatment of locally advanced prostate cancer. There were benefits to the patients in terms of the quality of life parameters, sexual function, and tolerability, which make bicalutamide monotherapy an attractive treatment option for patients with locally advanced prostate cancer. (Korean J Urol 2004;45: 108-113)

Extracorporeal Shockwave Lithotripsy vs Ureteroscopy in the Treatment of Lower Ureteral Stones / 대한비뇨기과학회지

PURPOSE: To determine the efficacy and outcome of extracorporeal shock-wave lithotripsy (SWL) compared with ureteroscopy (URS) in the treatment of lower ureteric calculi. MATERIALS AND METHODS: The records of patients treated primarily by SWL and URS were analysed retrospectively. Treatment with SWL included 198 patients (103 men and 95 women). All patients received 2500-3000 shocks waves at a mean energy setting of 16-20kV. URS was used in 194 patients (91 men and 103 women), with 7Fr, 8Fr, 9.5Fr rigid Storz ureteroscope. All ureteroscopies were performed with the patient under general or spinal anesthesia. The outcome was assessed by stone-free rates, retreatment rates, auxiliary treatment, Efficiency quotient (EQ), complications. RESULTS: SWL and URS for lower ureteric calculi resulted in a success rate 75.3% and 95.8%, respectively. Including the number of auxiliary procedures, we calculated the Efficiency Quotient (EQ) as 66.6 for SWL and 72.3 for URS. The mean treatment time for SWL was 30 minutes and for URS 38.1 minutes. General anesthesia was more frequently needed in URS patients. Complications occurred more often in the URS group. These were mostly mild, and all could be treated with a double-J stent, antibiotics, or analgesics. A lower stone-free rate was achieved in patients with larger(> OR = 10mm) stones (56.9% vs 82.9%) for smaller stones (<10mm) in the SWL group and 90.0% vs 97.9% for smaller stones in the URS group. Compared with SWL, URS was more time consuming; entailed placement of a ureteral stent and more often led to hospitalization. On the other hand, stone clearance was rapid after URS. CONCLUSIONS: The stone-free rate after URS is much higher than after SWL. Our study demonstrates that URS is highly effective treatment option for lower ureteral stones.

Gene Amplification and Overexpression in BPH by Means of One-step Real Time Quantitative PCR / 대한남성과학회지

PURPOSE: Gene amplification/overexpression of c-erbB2/neu is controversy in BPH by conventional detecting methods. To evaluate the amplification and overexpression of c-erbB2/neu gene in BPH we have used and validated a one-step real time PCR and quantitative reverse transcription PCR assay based on fluorescent TaqMan methodology. MATERIALS AND METHODS: Using one-step real time PCR assay, we have assesed the amplification and overexpression of c-erbB2/neu gene in 30 prostate samples from patients with BPH as well as from 10 normal blood sample. Real time PCR and RT-PCR were performed on an iCycler (Bio-Rad Co., USA) and we used TaqMan probes to detect c-erbB2/neu transcripts amplified. All experiments were performed in duplicate using 96 well-PCR plate. The GAPDH housekeeping gene was used for normalization of c-erbB2/neu amplification and overexpression. RESULTS: In a series of 30 BPH samples c-erbB2/neu normalized amplification was found to range from 3.16 10(-3) to 7.16 10(-2) and overexpression to range from 7.72 10(-3) to 1.57 10. Sixteen cases of BPH (53.3%) showed c-erbB2/neu overexpression and only two cases (6.7%) showed amplification of c-erbB2/neu. Except 2 cases, no correlation was found between the results of amplification and overexpression of c-erbB2/neu (p=0.183). CONCLUSIONS: Our results using of one-step real time quantitative PCR assay suggest that a role of c-erbB2/neu overexpression in the development of BPH and the use of this new semi-automated technique will make molecular analysis of gene simpler and more reliable.

Two Cases of Congenital Scrotal Anomalies: Ectopic Scrotum, Accessory Scrotum / 대한비뇨기과학회지

The three major scrotal anomalies are bifid scrotum, penoscrotal transposition, and ectopic or accessory scrotum. Bifid scrotum occurs if the genital swellings fail to fuse at the scrotal septum. Penoscrotal transposition results from abnormal genital tubercle development. This is associated with delay in the midline fusion of the urethral folds. Ectopic and accessory scrotum result from cleavage or abnormal migration of the genital swellings. Ectopic scrotum is extremely rare. His right scrotum was normal in position and size, and contained a normal palpable testis. The penis was showed externally normal appearance. At operation it was possible to excise the scrotal wall, preserving the vas deferens and the testicular vessels. Accessory scrotum has not been recorded in Korea. We experienced a case of unilateral ectopic scrotum and a case of accessory scrotum.

A Case of Idiopathic Calcinosis of the Scrotum / 대한비뇨기과학회지

The idiopathic calcinosis of the scrotum is multiple and asymptomatic nodules of scrotal skin which can onset either in childhood or early adulthood. It increases in size and number, while breakingdown to discharge chalky contents on occasions. We report a case of a 68-year-old-man who was effectively treated with a simple excision of the affected skin with an idiopathic scrotal calcinosis. There is no family history of scrotal calcification. Histopathologically, multiple nodules showed the epidermal cyst with partially degenerated wall and calcium deposits with a foreign body reaction in the dermis in this case. In most reported cases, some intact epidermal cysts are also present, and dystrophic calcification, and possible inflammation and rupture of epidermal cysts regarded as be the main pathogenetic mechanism of the disease.

Assessment of Quality of Life after Cystectomy: Comparison of Orthotopic Neobladder Versus Ileal Conduit / 대한비뇨기과학회지

No abstract available.

Change of Collagen after Partial Ureteral Obstruction in Rat Kidney / 대한비뇨기과학회지

PURPOSE: Chronic ureteral obstruction results in changes in renal hemodynamics, tubular function, and subsequently fibrosis of the tubulointerstitium. The pathologic marker of irreversible renal injury is interstitial fibrosis. The degree of interstitial fibrosis is the most useful measure of the degree of renal injury. This study in rats with partial ureteral obstruction was performed to describe and quantify the changes in collagen deposition. MATERIALS AND METHODS: Female Sprague-Dawley rats weighing 300-400g were used. Individual kidneys were obtained from rats at 1, 2, 3, 4 weeks after partial ureteral obstruction and sham operation. The total amount of collagen was measured from its contents of hydroxyproline by assuming that hydroxyproline is 14% in weight of the collagen. Collagen types I, III, and IV were localized by immunohistochemical staining and the distribution of each collagen type was analized using differences of their staining densities. RESULTS: After 2 weeks of partial ureteral obstruction, the total amount of collagen in affected kidney was significantly increased compared to control and 1 week groups(P<0.05). All of the collagen types in the interstitium of the affected kidney was gradually increased parallel to the duration of partial ureteral obstruction. Collagen type IV was increased significantly in tubular basement membrane and interstitium after 2 weeks of partial obstruction compared to control and 1 week groups. CONCLUSIONS: The partial ureteral obstruction causes progressive increase of amount of collagen according to the duration of obstruction, especially after 2 weeks, and tubulointerstitial fibrosis of obstructive nephropathy is closely related to collagen type I, III, and IV. Infiltration of collagen type IV in tubular basement membrane may play a major role in obstructive nephropathy.

Change of Collagen after Partial Ureteral Obstruction in Rat Kidney / 대한비뇨기과학회지

PURPOSE: Chronic ureteral obstruction results in changes in renal hemodynamics, tubular function, and subsequently fibrosis of the tubulointerstitium. The pathologic marker of irreversible renal injury is interstitial fibrosis. The degree of interstitial fibrosis is the most useful measure of the degree of renal injury. This study in rats with partial ureteral obstruction was performed to describe and quantify the changes in collagen deposition. MATERIALS AND METHODS: Female Sprague-Dawley rats weighing 300-400g were used. Individual kidneys were obtained from rats at 1, 2, 3, 4 weeks after partial ureteral obstruction and sham operation. The total amount of collagen was measured from its contents of hydroxyproline by assuming that hydroxyproline is 14% in weight of the collagen. Collagen types I, III, and IV were localized by immunohistochemical staining and the distribution of each collagen type was analized using differences of their staining densities. RESULTS: After 2 weeks of partial ureteral obstruction, the total amount of collagen in affected kidney was significantly increased compared to control and 1 week groups(P<0.05). All of the collagen types in the interstitium of the affected kidney was gradually increased parallel to the duration of partial ureteral obstruction. Collagen type IV was increased significantly in tubular basement membrane and interstitium after 2 weeks of partial obstruction compared to control and 1 week groups. CONCLUSIONS: The partial ureteral obstruction causes progressive increase of amount of collagen according to the duration of obstruction, especially after 2 weeks, and tubulointerstitial fibrosis of obstructive nephropathy is closely related to collagen type I, III, and IV. Infiltration of collagen type IV in tubular basement membrane may play a major role in obstructive nephropathy.

A Case or Unilateral Ureteral Triplication Associated with Ipsilateral Vesicoureteral reflux / 대한비뇨기과학회지

We report one case of ureteral triplication associated with ipsilateral vesicoureteral reflux and the relevant literatures are reviewed. A 26-year-old female was referred to our hospital with a history of fever, chilling and recurrent left flank pain. Referral was prompted by documentation of urinary tract infection. Intravenous pyelogram showed 3 ureters, which were drained into bladder separately and cystoscopy revealed only two ureteral orifices in left side. It can be classified as type I according to Smith's classification. Vesicoureteral reflux (Grade I) was found on voiding cystourethrogram.