Penile Augmentation Using Superficial External Pudendal Artery Pedicle and Adipose Tissue / 대한남성과학회지

PURPOSE: Many men are to some degree unsatisfied with the size of their penis, whether it is normal in size and appearance or not. We report a novel surgical technique for penile augmentation using a superficial external pudendal artery pedicle. MATERIALS AND METHODS: In total, 8 patients underwent penile augmentation from March 2003 to February 2004. Their mean age was 37.3 years. Five patients were unsatisfied about the size of their penis, and three patients had complications after insertion of foreign material. This penile augmentation technique was developed by using a low abdominal fat-flap where blood is supplied from the external pudendal artery. Spinal or epidural anesthesia was done during the operation, and the fat-flap was elevated and transpositioned to the site of lesion. RESULTS: All cases of patients were performed successfully by autografting using adipose tissue where blood flow was supplied from the external pudendal artery. There were no complications except one case of hematoma after the operation. The mean operative time was 80 min. The mean follow-up period after operation was about 6 months and all patients had a normal sexual life and no voiding dysfunctions. CONCLUSIONS: This novel surgical technique has several advantages. First, reconstruction without skin necrosis was possible even though the defect was large, because the blood supply was favorable. Second, there was no size limitation in augmentation with dermoplasty. Third, there was no evidence of atrophy of the flap.

A case of gastric strongyloidiasis in a Korean patient

A 69-year-old Korean man was admitted to emergency room with complaints of abdominal pain, vomiting, and diarrhea. Laboratory tests revealed eosinophilia, anemia, hypoproteinemia, and hyponatremia. The gastric mucosa showed whitish mottled and slightly elevated lesions on the body angle of antrum. Microscopically, chronic gastritis with incomplete intestinal metaplasia was observed. Many adult worms, larvae, and eggs in cross sections were located in the crypts. Furthermore, the filariform larvae of Strongyloides stercoralis with a notched tail were detected through the culture.

Effects of Ginseng Alkaloid on the Tension of Rabbit Corpus Cavernosum / 대한남성과학회지

PURPOSE: To evaluate the effects of Ginseng alkaloid on the tension regulation of corpus cavernosum, changes of tension of rabbit corpus cavernosum in vitro were studied after administration of Adaptagen(R) that is extract of Ginseng alkaloid. And changes of tension of rat aorta in vitro and rat blood pressure and heart rate in vivo were studied after administration of the same agent to evaluate systemic cardiovascular side effects. MATERIALS AND METHODS: Rabbit corpus cavernosal strips and rat aorta rings were prepared. Strips and rings were mounted in an organ bath and isometric tensions were recorded after administration of agents contracting or relaxing vascular smooth muscle and Adaptagen(R). RESULTS: Adaptagen(R) relaxed rabbit corpus cavernosal strip and rat aorta ring contracted by phenylephrine in a dose-dependent manner. Pretreatment of L-nitroarginine inhibited the relaxing effect of Adaptagen(R) on phenylephrine-induced contraction of these tissues. In vivo, intraperitonealy administered Adaptagen(R) transiently decreased systemic blood pressure and heart rate of rat. CONCLUSIONS: According to above RESULTS, Ginseng alkaloid relaxes corpus cavernosum in a dose-dependent manner without significant systemic side effects. Therefore, it is suggested that Ginseng alkaloid could enhance erectile function but further studies are required for clinical application.

Clinical Characteristics of Frequency-Anxiety Syndrome / 대한비뇨기과학회지

PURPOSE: Lower urinary tract symptom in elderly person leads to their psychological anxiety and stress in their travel and further, loss of self esteem that can set limitation during their social activities and their lives. we coined a frequency-anxiety syndrome (FAS) for the patients with lower urinary tract symptom and anxiety. This study was performed to characterize the clinical characteristics of FAS. MATERIALS AND METHODS: 24 FAS patients and 20 controls were included in this study. For the analysis and comparisons, we investigated frequency, urgency, i-nternational prostate symptom score (I-PSS), cystoscopy, and urodynamic study in both groups. We also performed semi-structured psychiatric interview and state-Trait Anxiety Inventory (STAI). RESULTS: In the average I-PSS, FAS group had significantly higher score of 22.9+/-10.9 than control group of 10.6+/-6.5 (p<0.001). The control group had significantly higher quality of life herving problems (QOL) value of 1.8+/-1.2 as compared to FAS group of 5.1+/-0.1 (p<0.005). In STAI, FAS group had significantiy higher score than control group. CONCLUSIONS: There were significant differences between FAS group and control group in regard to lower urinary tract symptom, I-PSS, QOL, and anxiety. The above results suggest that FAS could be considered as independent syndrome.

Experimental Study of Growth Factors on Regeneration of Cavernosal Nerves in the Rats / 대한남성과학회지

PURPOSE: Nitric oxide (NO) has recently been identified as the main neurotransmitter involved in the nonadrenergic-noncholinergic (NANC) pathway and is responsible for penile erection. Nitric oxide synthase (NOS)-containing nerve regeneration can be seen 6 months after unilateral cavernosal nerve neurotomy in rats. However its molecular mechanism is still unknown. It is believe that growth factors are involved in this phenomenon. In this study I investigated the change of NOS containing nerve fibers and the RNA expression of insulin like growth factor (IGF)-I, nerve growth factor (NGF), transforming growth factor (TGF)-alpha, TGF-beta 1, TGF-beta 2, TGF-beta 3, vascular endothelial growth factor(VEGF), nNOS and eNOS on the penis after cavernosal neurotomy in rats. MATERIALS AND METHODS: Male rats were divided into three groups: sham operation (n=12); unilateral neurotomy of a 5-mm segment of the cavernosal nerve (n=18); and bilateral neurotomy (n=18). Electrostimulation of the cavernosal nerve of pelvic ganglion was performed at 1,3 and 6 months. Nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining was used to identify NOS in the penile nerve fibers. The gene expressions for growth factors, nNOS and eNOS were investigated in corporal tissue by reverse transcriptase-polymerase chain reaction (RT-PCR) using specific oligonucleotide primers. RESULTS: One month after neurotomy, both unilateral and bilateral neurotomy groups showed significant decreases in NOS-containing nerve fibers on the dorsal and intracavernosal nerves on the side of neurotomy and significantly lower mRNA expressions of nNOs, IGF-I and TGF-beta 2, and the unilateral neurotomy group showed higher mRNA expression of eNOS and VEGF189. At 3 months, the number of NOS-containing nerve fibers in the unilateral neurotomy group increased only slightly but at 6 months, those in the intracavernosal nerve increased in a significant amount (p<0.0001),however mRNA expressions of nNOs, IGF-I and TGF-beta . , showed significant increases as early as at 3 months, After bilateral neurotomy, the NOS-positive nerve fibers in the dorsal and intracavernosal nerve were significantly decreased at 1 month and remained so at 6 months; no erectile response could be elicited by pelvic ganglion stimulation. In the unilateral neurotomy group at 6 months, more NOS-positive neurons in the pelvic ganglia were found on the intact side than on the side of the neurotomy (p<0.005), indicating that the regeneration derived from pelvic ganglion neurons on the intact side. Furthermore, electrostimulation in the unilateral neurotomy group revealed a greater maximal intracavernosal pressure and a shorter latency period at 6 months than at 1 month (p<0.001, p<0.001, respectively). CONCLUSION: These data suggest that IGF-I and TGF-beta 2, may play a key role in regeneration of NOS-containing nerve fibers in the dorsal and intracavernosal nerves, and eNOS increases temporarily in the intracavernosum involving VEGF189 after unilateral cavernosal nerve injury.

Detection of Mycobactrium tuberculosis by in situ hybridization / 결핵

BACKGROUND: A presumptive histopathologic diagnosis of tuberculosis is commonly based on the finding of acid- fast bacilli upon microscopic examination of a diagnostic specimens. Although this traditional histochemical staining methodis satisfactory, it is time-consuming and not species-specific. For more specific assessment, in situ hybridization assay with oligonucleotide probes is introduced. METHODS: The human surgical specimens were obtained from tuberculosis patients(,)and experimental specimens were made by injecting fresh rat liver with cultured M. tuberculosis organisms into fresh rat liver. Oligonucleotide probes complementary to ribosomal RNA portion were synthesized and labeled with multiple biotin molecules. For a rapid detection, all procedures were carried out using manual capillary action technology on the Microprobe staining system. RESULTS: The in situ hybridization assay produced a positive reaction in experimental specimens (80-90% sensitivity) after pepsin- HCl pre-treatment for a good permeabilization of probes, but reliable result was not obtained from human surgical specimens. CONCLUSION: It is, therefore, suggested that biotin- labeled oligonucleotide probes have considerable potential for identification and in situ detection of M. tuberculosis but, there are some barriers to overcome for the diagnostic use of this method.