Effect of Prostate Specific Membrane Antigen on Angiogenesis / 대한비뇨기과학회지

PURPOSE: PSMA (prostate specific membrane antigen) is a transmembrane glycoprotein, which is isolated from LNCaP. It is reported that PSMA is expressed in the vascular endothelium of various tumor. It has been suggested that PSMA can be related to angiogenesis. Herein, the effect of PSMA on angiogenesis was investigated with the HUVEC (human umbilical vein endothelial cell) line transfected with PSMA. MATERIALS AND METHODS: mRNA was extracted from LNCaP. RT-PCR for PSMA ORF (open reading frame) was performed. PSMA ORF cDNA was subcloned into PcDNA 3.1(-) (BamH1 and Xba1 site) and transfection of PSMA on HUVEC was performed. HUVEC was plated onto a Matrigel coated 6 well plate and incubated at 37oC in a CO2 incubator for 18 hours. The HUVEC tube formation was observed every 2 hours using an inverted microscope. HUVEC cell protein was extracted immediately, and 3 and 6 hours after transfection. Western blot for VEGF (vascular endothelial growth factor) was performed. RESULTS: The tube formation stage of HUVEC transfected with PSMA was observed 10 hours after incubation on Matrigel coating, whereas in the control HUVEC, the cord formation stage was observed after up to 10 hours incubation. The HUVEC transfected with PSMA showed an earlier tube formation stage than the control. Western blot analysis showed that PSMA transfection on HUVEC increased the expression of VEGF 2.5 fold in 3 hours and 1.89 fold in 6, as measured by densitometry. CONCLUSIONS: PSMA transfection on the HUVEC cell line induced an initial increase in the expression of VEGF, and subsequently stimulated an earlier tube formation in the HUVEC cell line. These data suggest PSMA is related to angiogenesis.

Effect of Prostate Specific Membrane Antigen on Angiogenesis / 대한비뇨기과학회지

PURPOSE: PSMA (prostate specific membrane antigen) is a transmembrane glycoprotein, which is isolated from LNCaP. It is reported that PSMA is expressed in the vascular endothelium of various tumor. It has been suggested that PSMA can be related to angiogenesis. Herein, the effect of PSMA on angiogenesis was investigated with the HUVEC (human umbilical vein endothelial cell) line transfected with PSMA. MATERIALS AND METHODS: mRNA was extracted from LNCaP. RT-PCR for PSMA ORF (open reading frame) was performed. PSMA ORF cDNA was subcloned into PcDNA 3.1(-) (BamH1 and Xba1 site) and transfection of PSMA on HUVEC was performed. HUVEC was plated onto a Matrigel coated 6 well plate and incubated at 37oC in a CO2 incubator for 18 hours. The HUVEC tube formation was observed every 2 hours using an inverted microscope. HUVEC cell protein was extracted immediately, and 3 and 6 hours after transfection. Western blot for VEGF (vascular endothelial growth factor) was performed. RESULTS: The tube formation stage of HUVEC transfected with PSMA was observed 10 hours after incubation on Matrigel coating, whereas in the control HUVEC, the cord formation stage was observed after up to 10 hours incubation. The HUVEC transfected with PSMA showed an earlier tube formation stage than the control. Western blot analysis showed that PSMA transfection on HUVEC increased the expression of VEGF 2.5 fold in 3 hours and 1.89 fold in 6, as measured by densitometry. CONCLUSIONS: PSMA transfection on the HUVEC cell line induced an initial increase in the expression of VEGF, and subsequently stimulated an earlier tube formation in the HUVEC cell line. These data suggest PSMA is related to angiogenesis.

Vascular Injury Following Tension-Free Vaginal Tape in Stress Incontinence

Tension-free vaginal tape (TVT) has been accepted for a therapeutic modality of stress incontinence and presented as easy, safe, effective, and time-saving procedure with cure rate of more than 86% and another 11% significantly improved with no serious complication. However, there is not always safe without severe complications, because the TVT needle has to pass blindly through the pelvic cavity. Furthermore, it may be very serious once it happened. We, herein, present a case who bled to shock following TVT procedure but was controlled conservatively, and review its complications in the literatures.

Increased Expression of Hypoxia-Inducible Factor-1alpha in Castrated Rat Penile Tissue / 대한남성과학회지

PURPOSE: Hypoxia-inducible factor 1(HIF-1) is a transcriptional activator of genes whose products are involved in systemic, local, and cellular responses to hypoxia. We investigated the effect of androgen deprivation on the expression of HIF-1alpha and related proteins in the penile corpus cavernosum of castrated rat. MATERIALS AND METHODS: Thirty adult male Sprague-Dawley rats(250~350 gm) were divided into 3 groups of 10 each: sham operation(group 1), bilateral orchiectomy(group 2), and bilateral orchiectomy plus hormone replacement(group 3). Testosterone propionate(2 mg/day for 4 weeks) was used for hormone replacement. At 4 weeks after surgery, serum testosterone and erythropoietin were measured, and the expression of HIF-1alpha and VEGF were examined by immunohistochemical staining and Western blot of corpus cavernosum. RESULTS: There was no significant change in serum erythropoietin among the three groups. HIF-1alpha and VEGF immuno-positive cells were dense in vascular endothelium and cavernosal smooth muscle and showed more intense staining in the orchiectomy group compared with the control and sham operation groups. The amount of HIF-1alpha and VEGF proteins detected by Western blot were also increased in the orchiectomy group compared with the control and sham operation groups. CONCLUSIONS: These results suggest that increased HIF-1alpha expression in the penile tissue of castrated rat results from adaptive responses to hypoxia, and testosterone deprivation may contribute to hypoxic injury in the cavernosal microenvironment.

Primary Retroperitoneal Cyst Presented as Simple Renal Cyst / 대한비뇨기과학회지

Primary retroperitoneal cysts are rare. Symptoms may be absent, or only an increased abdominal size observed. However, some patients present with complaints associated with pressure or displacement of an abdominal organ due to the cyst. Most patients display some chronic symptoms that necessitate therapeutic intervention. These cysts may occur at any age, with the highest incidence being the fourth decade, but one-third of patients present at less than 10 years of age. A case of a retroperitoneal cyst, which presented as a simple renal cyst, and removed with a laparoscopy, is reported in a sixty one-year-old woman.

Estrogen Producing Adrenocortical Carcinoma / 대한비뇨기과학회지

An estrogen producing adrenocortical carcinoma is a rare, highly malignant tumor. Fewer than 100 cases of feminizing adrenocortical carcinomas in men have been reported. These tumors are usually large in size and show high levels of serum total estrogen and estradiol. Recently, two cases of estrogen producing adrenocortical carcinoma were experienced by our selves during in year. A unilateral adrenalectomy, with mass excision, was performed in both patients, with an ipsilateral nephrectomy performed in just one. Mitotane or cisplatin based adjuvant chemotherapy was also performed.

Retroperitoneal Ancient Schwannoma / 대한비뇨기과학회지

The term 'ancient' schwannoma was proposed for a group of neural tumors showing degenerative changes and marked nuclear atypia. The findings from abdominal ultrasound and computed tomography, in a patient with a retroperitoneal ancient schwannoma, are presented, and the histological features of this unusual type of tumor are reviewed. The presence of a large, well-delineated complex cystic mass in the deep soft tissues should raise the possibility of an ancient schwannoma. The treatment of choice for an ancient schwannoma is complete excision. It is important to recognize these tumors as benign, with excellent prognosis, so as to avoid unnecessary radical surgery. A recurrence, or persistence, seems to be associated with incomplete resection, which occurred in 10% of the reported cases.

Penoplasty with a Sensate Radial Forearm Free Flap after Removal of Paraffinoma / 대한비뇨기과학회지

A 33-year-old man who self injected paraffin into his penis to facilitate an erection and increase his potency suffered from diffuse ulceration and a wide defect on the penile skin involving the proximal glans to the penopubic junction with a high fever. The compromised skin and subcutaneous tissue had to be completely removed and a sensate radial forearm free flap was performed around the penile shaft. This method gave the patient excellent satisfaction in both cosmetic and sexual function. Therefore, this method might be a good therapeutic alternative, especially for young adults indulging in active sexual activity and suffer from wide skin defects even though this operation is expensive and not easy.

A Case of Leiomyoma of Testicular Tunica Albuginea / 대한비뇨기과학회지

Leiomyoma is an uncommon lesion which may originate anywhere including the genitourinary system where smooth muscle is present. Five cases of leiomyoma of the testicular tunica albuginea were reported in the world literature. A case of leiomyoma of testicular tunica albuginea in a 58 year old male is presented. We preserved the testis with tumor resection. This is the first report of leiomyoma of testicular tunica albuginea in Korea.

Complications of Various Genital Procedures Performed by Non-medical Personnel / 대한비뇨기과학회지

PURPOSE: The penis has been attracted to everyone associated with various diseases and sexual activity. Lots of materials and instruments has been applied to the penis for sexual arousal. Furthermore, those ar e usually made and applied in inappropriate ways by non-medical personnel. This resulted in lots of complications in various degrees. So, we investigated the real problems concerning various procedures performed on the genitalia by non-medical personnel. MATERIALS AND METHODS: We reviewed retrospectively medical records of 32 male and one female patients having complications which had been developed following some procedures on the genitalia by non-medical personnel from January 1995 to December 1999. These patients were analyzed according to characteristics of the patients, the methods, purposes, complications and treatments. RESULTS: Their age at first visit was various from 12 years to 70 years (mean, 35.8 years). At that time when procedures had been performed, their age were 12 years to 56 yeats (mean, 30.8 years) in 26 cases whose ages were identified. Among them 22cases (66.7%) were the married and 11 (33.3%) were the unmarried. Occupations were various and out-of-work were 10 (30.4%), commerce 8 (24.2%), firm worker 6(18.2%), student 5 (15.2%), and private job manager and the not-identified 2 (6.1%). according to the school career, the high school graduates were 18 (54.6%), the college graduates 7 (21.2%), middle school graduates 4 (12.1%), and 4 were under middle school. These procedures were performed for sexual satisfaction in 29 cases (87.9%) and for cheap and easy circumcision in 4 cases (12.1%), of which 26 cases (78.8%) had been performed by other person and 7 cases (21.2%) by himself. According to the materials used, 22 (66.7%) cases had been injected vaseline or paraffin in to the penis and one (3.0%) into the vulva, and one (3.0%) plicated his penile skin with rubber band using sewing needle, which 24 cases (72.7%) were for enlargement of the genitalia. 2 (6.0%) cases inserted plastic balls into the penile skin for sexual arousal of partner. 3 (9.1%) cases put a metallic ring, a ceramic ring, and a vacuum device over their penis for improving erection quality, respectively. 4(12.1%) cases had applied the commercially-maid self-circumcision devices over their prepuce, Complications were foreign body sensation, pain at erection, inflammation, skin necrosis, and septic condition, which were variable case by case. Treatments were removal of foreign materials and devices, necrotic tissue, and primary repair of defected skin, for that, in 2 (6.0%) cases, skin flap and graft were needed. CONCLUSIONS: Lots of complications, severe in some cases, had been developed on external genitalia following various procedures performed by medically unauthorized person. So, we have to strongly for their purpose and it would be rather harmful. At the same time, we have to strongly recommend the government to control strictly such materials and instruments not to be sold and used inappropriately.

A Case of Renal Leiomyosarcoma / 대한비뇨기과학회지

No abstract available.

Shock Wave Lithotripsy in a Hemophilia Patient / 대한비뇨기과학회지

Shock wave lithotripsy(SWL) has been considered as a contraindication in a patient with bleeding diathesis. However, appropriate pre-treatment made it possible recently. We present a case of ureteral stone patient with hemophilia A which was resolved successfully using SWL and this would be the first report concerning SWL in a hemophilia A patient in our country.

Clinical Characteristics of Acute Epididymitis in Children and Adults / 대한비뇨기과학회지

PURPOSE: We investigated if there are some differences in clinical charecteristics of acute epididymitis between child and adult and if ordinary therapeutic regimen based on antibiotics is the most appropriate one. MATERIALS AND METHODS: We reviewed medical records of 64 patients with acute epididymitis retrospectively, who took admission treatment from July, 1996 to June, 1998 at our hospital. These patients were divided into two groups, child and adult group, younger and older than 16 years respectively. The diagnosis of acute epididymitis was made by symptoms, physical examinations, doppler sonography, and/or radionuclide scan. Chronic epididymitis, recurrent epididymitis, patients taken antibiotics before admission, and surgical epididymis were excluded from this study. We investigated the age of the patients, symptoms, symptom duration and signs. Complete blood count, urinalysis, and urine culture were performed. Independent-samples T-test was used for the comparative analysis of the results. RESULTS: Symptoms including scrotal swelling and pain were not different between two groups significantly. Signs including scrotal tenderness, fever, and leucocytosis were not different between two groups significantly. However, there were statistically significant differences between two groups in studies of urine. Pyuria or positive urine culture were 20.8%(5 of 24) in child group and 52.5%(21 of 40) in adult group(p<0.001). CONCLUSIONS: In acute epididymitis, evidences of urinary tract infection were significantly lower in children than in adults. So, although further studies are needed to find out the exact cause of acute epididymitis, at least ordinary therapeutic regimen based on antibiotics would not be the best one for the majority of children without evidence of urinary tract infection.

bcl-2 and bax Expression in Prostate Carcinoma / 대한비뇨기과학회지

PURPOSE: Proteins encoded by bcl-2 family as regulators of apoptosis appear to have significant cellular effects such that when abnormally expressed, they may render certain cells more susceptible to aberrant proliferation. The ratio of anti-apoptotic to pro-apoptotic bcl-2 family proteins appears to control the relative sensitivity or resistance of cells to apoptotic stimuli. The primary goal of this study is to determine the expression pattern of bcl-2 and bax in prostate carcinoma and to correlate them with Gleason score, T stage, and PSA to determine their prognostic potential. MATERIALS AND METHODS: We examined the cellular expression of bcl-2 and bax proteins using immunohistochemical metod in a total 35 patients with untreated prostatic carcinoma. All tissues were scored for overall tissue expression as follows: bcl-2(0,50%), bax(1+,75%). RESULTS: Of the 35 cases, 16(45.7%) contained at least 1% bcl-2 positive tumor cells. The bcl-2 positive cases included 1(7.7%) Gleason 2 to 4 grade tumors, 8(66.7%) Gleason 5 to 7 tumors, 7(70.0%) Gleason 8 to 10 tumors. bcl-2 protein expressed more frequently in higher grade(p<0.05) and in higher PSA level(p<0.05) of tumors. bax immunostaining was positive for all 35(100%) and 1+ was 16(45.7%), 2+ was 14(40.0%), 3+ was 5(14.3%). But statistically significant differences in bax expression among grade, T stage, and PSA were not observed. The bcl-2 protein was present mainly in the basal cells, but bax was in both basal and secretory cells of prostate. CONCLUSIONS: bcl-2 protein have some potential role in progression of prostate carcinoma. Therefore, studies that evaluate the expression of these bcl-2 family genes in varoius time during progression of tumors correlate with the state of hormone dependency, response to therapy and duration of response are needed.

A Foreign Body in Renal Parenchyme / 대한비뇨기과학회지

Foreign bodies in the renal pelvis or calyx are not rare and the majority of them are iatrogenic in origin. However, a renal parenchymal foreign body is not common. We present a case of an unusual renal foreign body considered to be a needle which had broken due to corrosion in the kidney which was completely removed via open surgery.

A Case of Liposarcoma of the Spermatic Cord / 대한비뇨기과학회지

We report a case of a spermatic cord liposarcoma in a 67-year-old male. His chief complaint was painless mass in the right hemiscrotum for about two years, which was firm and solid in nature and 20 x 11 x 10 cm. in demension. The mass did not transmit light. Scrotal ultrasonography showed huge, homogenous, echogenic mass on right spermatic cord with intact testicle and epididymis. Radical inguinal orchiectomy was performed. Postoperative abdominal computerized topography (CT) excluded the presence of nodal involvement He has been free of disease, until eights months after surgery.

Ileocolovesical Fistula Caused by Crohn's Disease: Report of a Case / 대한비뇨기과학회지

Enterovesical fistula is a relatively rare disease and usually caused by primary intestinal disease (diverticulitis, colon cancer and inflammatory bowel disease including Crohn's disease etc.). We experienced a rare case of ileocolovesical fistula caused by Crohn's disease. The 34 year old man had had chronic dysuria, lower abdominal pain and turbid urine for 3 years. Contrast studies including cystography, small bowel series, barium enema and abdominal Of showed ileocolovesical fistula. Small bowel segmental resection, Hartmann's colostomy and suprapubic cystostomy were performed. Histological examination of operative specimen showed a granulomatous inflammation caused by Crohn's disease. Our case suggests that Crohn's disease may be a rare cause of enterovesicalfistula in Korean.

Correlation Between Actual and Estimated Prostate Weight by Transrectal Ultrasonography with 14 Separate Methods of Volume Estimation in Patients with Benign Prostate Hyperplasia / 대한비뇨기과학회지

A precise estimation of prostate volume with transrectal ultrasound would help to determine the appropriate therapy. To determine the most accurate means of volume estimation 39 patients underwent transrectal ultrasound with 14 separate methods of volume estimation. All patients underwent subsequent suprapubic prostatectomy. Prostate specimen weights were compared with the results of each volume estimation method. The most accurate method to estimate prostate weight (r = 0.94) was the ellipsoid volume formula, widely used as an alternative to planimetry, which overestimated the weight of the prostate in 33 of 39 cases (84.5%) with an average error of 7.5 gm. (13.6%). A large portion of the error in the application of this ellipsoid volume formula was the inclusion of transverse dimension.

An unusual infected hydrocele: a case report

Of acute scrotal lesions in the neonates, cases needing emergent exploration are quite rare and differential diagnosis of them is not easy. Only a few cases of inflamed hydroceles occurring in young boys have been reported to have been caused by bacterial infection in the literature. We couldn't find any case concerning simultaneous bacterial infection in urine and hydrocele by the same organisms. We present an unusual case of infected hydrocele in a neonate with bacteriuria.

Sclerosing lymphangitis of the penis: a case report

Sclerosing lymphangitis of the penis occurs as a skin-colored or dusty red, cord-like thickening of tissue at the corona or within the coronal sulcus. The thickened, elongated lesion is firm and relatively nontender. The cause is unknown: because it occurs primarily in those who are sexually very active, however, it is likely that chronic trauma plays an important etiologic role. We experienced a case of pathologically proven sclerosing lymphangitis in a 31 year-old man. Ultrasonographic finding showed circumferential cord like hypoechoic band with irregular, but well demarcated margin.