Biological Variation of Serum Prostate Specific Antigen Levels in Men Aged 50 or Older without Prostate Cancer / 대한비뇨기과학회지

PURPOSE: To evaluated the effect of the intra-individual variation in the serum prostate specific antigen (PSA) level in men without prostate cancer to decide on the requirement of a prostate biopsy. MATERIALS AND METHODS: Patients, aged between 50 and 80 years, were screened for prostate cancer or lower urinary tract symptoms at least 2 times within 3 months using PSA or free PSA measurements. Patients with an initial PSA level between 2.0 and 10.0ng/ml were included. Those with prostate cancer, urinary tract infection or 5-alpha reductase inhibitor medication were excluded. The coefficient of variation (CV) was evaluated in each PSA range. RESULTS: The analysis included 139 patients, with a mean age 62.1 years. The level of free PSA was measured in 56 patients. The mean interval between the two PSA measurements was 36.6 days. The mean CVs for the total PSA and % free PSA were 21.5 and 22.2%, respectively. 20% of patients show a CV of more than 30%, implying a large variation. In our study, the 95% confidence interval of initial PSA levels between 3.0 and 4.9ng/ml included the PSA cut-off point (4.0ng/ml) in the visit results. CONCLUSIONS: The variation the PSA level was relatively small, but some patients showed a CV greater than 30%. Therefore, the intra-individual PSA variation should become part of interpreting the PSA test results, especially for men with a PSA value near the cut-off point.

Nocturnal Hypercalciuria for Enuresis Subtypes: Prospective Controlled Study / 대한비뇨기과학회지

PURPOSE: The aim of this study was to determine whether the enuresis subtype, on the basis of nocturnal hypercalciuria, can be generally accepted. MATERIALS AND METHODS: Since 2003, 58 children visited our clinic for nocturnal enuresis, and were enrolled in this study. Patients were followed to evaluate the treatment response after three months medical treatment. Patients were divided into 3 groups; group 1 had nocturnal polyuria, group 2 had non-nocturnal polyuria and group 3 did not have nocturnal enuresis. The urine creatinine, osmolarity and calcium were measured in urine obtained both during the day and night. Hypercalciuria was defined as a urinary calcium to urinary creatinine ratio greater than 0.20. The treatment response was measured as a full, partial or non-response in the nocturnal hypercalciuria and non-nocturnal hypercalciuric groups. Statistical evaluation was performed using Pearson correlation, chi-squared, Student's t-test (paired) and ANOVA tests. RESULTS: There were no significant differences in the calciuria to urinary creatinine ratios between the groups in the urine obtained during the night. There were no significant differences in urinary Ca/kg/12 hours between the groups, with the exception of a significant increase at night in group 1. There were no statistically significant correlations between nocturnal polyuria and nocturnal calciuria between the three groups. During the 3 months after medical therapy, there were no significant differences in the response rates between the nocturnal hyperclaciuria and non-nocturnal hypercalciuria groups. CONCLUSIONS: In this study, no evidence could be for hypercalciuria affecting nocturnal polyuria, including the treatment response results. Therefore, as the first diagnostic method of enuresis, the hypercalciuria measurement can not be recommended. Further study is necessary to classify the enuresis subtype on the basis of nocturnal hypercalciuria.

Suprarenal Filter Placement in the Inferior Vena Cava to Prevent Tumor Emboli During Radical Nephrectomy in Renal Cell Carcinoma Invading the Inferior Vena Cava / 대한비뇨기과학회지

A renal cell carcinoma with tumor thrombus extension into the inferior vena cava occurs in approximately 5 percent of cases. Despite invasion of the inferior vena cava, an aggressive surgical approach for these neoplasms is recommended, but pulmonary and tumor embolisms have been common complications. Therefore, the prevention of tumor emboli during operation is necessary. Placement of a suprarenal filter in the inferior vena cava has become the procedure of choice for preventing tumor emboli during a radical nephrectomy.