Molecular Biological Analysis of the Collagen Changes by Interferon Gamma Following Partial Unilateral Ureteral Obstruction / 대한비뇨기과학회지

No abstract available.

The Outcome of TRUS-guided Sextant Biopsy According to Prostate Volume / 대한비뇨기과학회지

No abstract available.

Urodynamic Analysis Incontinence in children with Myelodysplasia / 대한비뇨기과학회지

No abstract available.

Effects of Interferon Gamma on Collagen Expression in the Partially Obstructed Urinary Bladder of Rat / 대한비뇨기과학회지

PURPOSE: Recent studies have proved that bladder compliance is closely related to the collagen content of the bladder. It has been shown through human fibroblast, condrocyte, and rat myofibroblasts that interferon(IFN)-gammadecreased collagen synthesis. The objective of this study was to investigate the alteration of collagen deposition and gene expressions in collagen types I and III by partial bladder outlet obstruction and to compare the changes during IFN-gamma treatment. MATERIALS AND METHODS: Following 4 weeks of partial bladder outlet obstruction in 200-250gm. SD rats, the bladder tissues were evaluated for collagen deposition by an immunohistochemical staining using the polyclonal antibodies and the messenger ribonucleic acid(mRNA) contents of the collagen type I and III were evaluated by Northern hybridization. Recombinant IFN-gamma(100,000 units) was administered once a day for 4 weeks by subcutaneous injection. RESULTS: In the control bladders, the immunohistochemical staining for type I and type III collagen protein showed an intense localization in the lamina propria with modest localization in the inter-fascicular region. With obstruction type I and type III collagen staining intensified, especially in the inter-fascicular region. The IFN-gamma administration reduced the inter-fascicular deposition of collagen type I and III. There was an up-regulation of collagen type I and III gene expression after the obstruction. In the obstructed bladders proalpha1(I) and proalpha1(III) collagen mRNA intensity was increased 3.4 and 5.1 folds than the control groups, respectively. This up-regulation was down-regulated by IFN-gamma administration. CONCLUSIONS: The down regulation of collagen types I and III gene expression, and decreased protein deposition after IFN-gamma treatment demonstrated that the effect of IFN-gamma was, in part, transcriptionally regulated. These results suggest that the recombinant IFN-gamma may be beneficial in the treatment of patients with poorly compliant bladder.

Morphometric Analysis of the Collagen Changes Induced by Subcutaneous Injection of Interferon-gamma following Partial Unilateral Ureteral Obstruction in the Rat Kidney / 대한비뇨기과학회지

PURPOSE: Interfenon-gamma(IFN-gamma) has been tried to decrease fibrosis in liver cirrhosis in the human and animals. To decrease collagen content in the partially obstructed kidney, we examined collagen changes by IFN-gamma after creating partial ureteral obstruction in the rat. We applied IFN-gammato the partially obstructed kidney and examined collagen contents in the renal cortex by morphometric analysis. MATERIALS AND METHODS: In a total of 50 Sprague Dawley adult male rats(300-350gm), we created partial unilateral ureteral obstruction(PUUO). We divided rats into 5 groups(n=10 in each group): normal control, sham operation group, sham operation with IFN-gamma 4 weeks, PUUO 4 weeks, PUUO with IFN-gamma 4 weeks. IFN-gamma(LG Chemical, Korea) 100,000 IU was subcutaneously injected daily for 4 weeks from operation day 1 in the treated groups. The rats were sacrificed on the expected day and renal cortex was prepared for Masson`s trichrome special staining. With the image analyser, we calculated the relative ratio of collagen to renal cortex area randomly in each kidney. RESULTS: Relative percent of collagen content of the normal control, sham-operation, and sham-operation with IFN-gamma treated groups were 2.42+/-0.53%(n=10), 2.62+/-0.53%(n=10), and 2.22+/-0.65%(n=10), respectively. While relative percent of collagen content of PUUO group, and PUUO with IFN-gamma treated group were 12.25+/-2.41%(n=5) and 7.14+/-3.43%(n=9) respectively. There was significant difference between those of last two groups.(p<0.05, Wilcoxon-rank sum test) CONCLUSIONS: We applied interferon-gamma to the partially obstructed kidney and examined collagen contents in the kidney by morphometric analysis. From the above data, IFN-gammaseems to have a decreasing effect upon collagen content in the partially obstructed rat kidney.

Ureteral Submucosal Macroplastique Injection in the Treatmenet of vesicoureteral Reflux

No abstract available.

Long-term Followup Results of Desmopressin-based Combined Drug Therapy in the Nocturnal Enuretic Children / 대한비뇨기과학회지

PURPOSE: This study was designed to evaluate the effectiveness of desmopressin-based combined drug therapy in nocturnal enuretic children who had been followed at least 6 months. MATERIALS AND METHODS: Thirthy eight patients(5 to 16 years old) with 4 or more wet nights per week were studied. We used desmopressin-based combined drug therapy(imipramine or/and oxybutynin chloride) depending upon associated daytime voiding symptom. Patient response to treatment was categorized as complete(0 to 1 wet night per month), near complete(2 to 4 wet nights per month), intermediate(5 to 7 wet nights per month) and poor(more than 7 wet nights per month). We evaluated the results at the initial 6 week and at the last follow-up visit on medication. RESULTS: After 6 weeks, 13(34.2%) patients were complete responder, 13(34.2%) near complete responder, 7(18.4%) intermediate responder and 5(13.1%) poor responder, respectively. The response rate in this period was 86.8%. At the last follow-up visit on medication, 20(52.6%) patients were classified as complete responder, 13(34.2%) as near complete responder, 4(10.5%) as intermediate responder and 1(2.6%) as poor responder. Therefore, overall response rate was 97.3%. There was no obvious side effect that made discontinue drug therapy. CONCLUSIONS: From the above data, we think that longterm desmopressin-based combined drug therapy is the highly successful and safe treatment method for enuretic children.

Biochemical Analysis of the Changes of Collagen Types following Bladder Outlet Obstruction in the Rat / 대한비뇨기과학회지

PURPOSE: We observed the ratio of collagen type III to type I by biochemical analysis in the adult rat bladder with chronic partial bladder outlet obstruction. MATERIALS AND METHODS: Female adult(20-wk-old, 200-250gm) Sprague-Dawley rats were divided into 3 groups: control group. 6-wk obstruction group, and 12-wk-obstruction group(n=7 in each group), Collagen samples, extracted from the whole bladders by pepsin digestion followed by salt precipitation, were analysed by SDS-PAGE on 5% or 8% polyacrylamide slab gels with in situ reduction or pre-reduction. Collagen polypeptides were wisualized by Coomassie blue staining and quantitated with a scanning densitometer. Collagen types were confirmed y Western blots. RESULTS: The ratio of collagen type III to type I increased gradually alona the obstructed period and the highest value was found in 12-wk-obstruction group(sontrol 0.29+/-0.023, 6-wk-obstruction 0.332+/-0.026, and 12-wk-obstruction0.395+/-0.047, mean+/- standard error). This change was statistically significant in the 12-wk-obstruction group compared to that of control. (p<0.05; by Wilcoxon signed rank test) CONCLUSIONS: Increasing type III collagen compared to type I collagen is a unique feature in the obstructed bladder.

Urodynamic Evaluation of Neurosurgical Effect in Myelodysplasia / 대한비뇨기과학회지

PURPOSE: To evaluate neurosurgical effect in the pediatric patients with myelodysplasia we reviewed preoperative and postoperative videourodynamic results. MATERIALS AND METHODS: All the 24 patients received untethering of spinal cord. Twenty postoperative urodynamic studies were performed between 6 months and 1 year, and 4 were performed at 3 months after operation. Uninhibited contraction and detrusor-sphincter dyssynergia(DSD) were checked in the patients having detrusor contraction and leak pressure was measured in areflexic bladder. RESULTS: Preoperative normal urodynamic finding was found in 6 patients. Among them one patient showed hyperreflexia with synergic voiding after operation. Normal detrusor contraction with DSD was found in 2 patients preoperatively One of these patients changed to high pressure areflexia Nine patients showed hyperreflexia preoperatively. Four patients among them had DSD. Five hyperreflexic bladders without DSD showed normoreflexia without 858 in one, low pressure areflexia in 3 and no change in one after operation. Out of four patients with hyperreflexia having DSD 2 showed high pressure areflexia, 1 showed atomic bladder and no change was seen in one. Seven patients had areflexia preoperatively. One patient with low pressure areflexia preoperatively showed high pressure areflexia postoperatively and 6 patients with high pressure areflexia preoperatively showed hyperreflexia with DSD in two and atonic bladder in one and no changes in 3 patients. CONCLUSIONS: From the above data we think that main urodynamic effect by neurosurgical treatment is decreasing detrusor activity. Although this effect on detrusor contraction is likely to be beneficial to myelodysplastic patients, more durable sphincteric activity may offset this profit.

Morphometric Analysis of the Collagen Changes Induced by Subcutaneous Injection of Interferon-gamma following Bladder Outlet Obstruction in the Rat / 대한비뇨기과학회지

PURPOSE: Recent studies of bladder outlet obstruction have provided evidence that poor bladder compliance is closely related to collagen content in the bladder wall. To decrease collagen content in the obstructed bladder, we examined the collagen changes by interferon gamma after creating partial bladder outlet obstruction in the rat. Experimental studies of interferon-gamma(IFN-gamma)have been tried to decrease fibrosis in liver disease. We applied interferon-gamma to the obstructed bladder and observed its effect on collagen changes in the bladder wall by morphometric analysis. MATERIALS AND METHODS: In a total of 50 Sprague-Dawley adult female rats(200- 220gm), we created partial bladder outlet obstruction by placing metal rod (diameter 1 mm). We divided the rats Into 5 groups(n=10 in each group): normal control(N), sham operation(5), sham operation and IFN-gamma4 weeks(S+IFN), bladder outlet obstruction 4 weeks(BOO), and bladder outlet obstruction and IFN-gamma4 weeks(BOO+IFN) groups. IFN- gamma(LG Chemical, Korea) was injected daily(100,000IU) for 4 weeks through subcutaneous route from obstruction day 1 in the injection groups. The rats in each group were sacrificed at 4 weeks of the experimental day and bladder body was prepared for Masson's trichrome special staining. With the image analyser, we calculated the percent collagen area(collagen/collagen muscle) in each bladder. RESULTS: With obstruction, bladder weights of BOO group and BOO+IFN group were increased 4.6 and 4.4 times, respectively, compared to S group. The percent collagen area in each group was 40.7 1.6% in N group, 38.2 +/-2.0% in S group, 26.6 +/-3.8% in S+IFN group, 19.9 +/-2.5% in BOO group, and 12.4 +/-2.0% in BOO+IFN group(mean+/-standard error). There was no significant statistical difference between N group and S group(p>0.05 by Wilcoxon's rank sum test). On the contrary, there were significant statistical differences between N group and S+IFN group and between S group and S+IFN group. Also there was significant statistical difference between BOO group and BO0+1FN group(p<0.05). CONCLUSIONS: From the above results, IFN-gamma seems to have the effect to decrease collagen content in the obstructed rat bladder. However, furthers investigations are required to evaluate the therapeutic relevance of IFN-gamma on bladder outlet obstruction patients.

Effects of Combined Drug Therapy in the Nocturnal Enuretic Patients / 대한비뇨기과학회지

PURPOSE: Recently there have been arguments about the exact nature of pathophysiology of nocturnal enuresis. Desmopressin and imipramine have been used for drug therapy. Also oxybutynin chloride has been used to treat the children having nocturnal enuresis and diurnal voiding symptoms. Practically most nocturnal enuretic patients who visit outpatient clinic really want to quit their enuretic episode quickly and durably without side effect of drug therapy. We evaluated the effectiveness of combined drug therapy in the primary nocturnal enuretic patients who had 7 times episodes in a week. MATERIALS AND METHODS: In a total of 36 nocturnal enuretic patients(male:female=24:12) whose ages ranged from 4- to 12-year-old(mean; 7.9-year-old), we initially used two or three drugs among oxybutynin chloride(O) t.i.d., imipramine(I) h.s. and desmopressin(D) h.5. for the 24 patients who have urgency and/or daytime enuresis(DE): O+l for 8 patients, O+D for 4,1+D for 4 and 0+1+D for 8. For 12 monosymptomatic enuretic(ME) patients without having diurnal symptoms,0 h.s.+1 h.s.(in 5 patients) or 1 h.s.+D h.s.(in 7 patients) were used. Usual doses in a time are as follows: 2.5mg p.o. for 0,25mg p.o. for 1,20mg intranasally for D or 0.2mg p.o. for 8. RESULTS: At the first follow-up visit(2 weeks later), 14 patients had up to 3 enuretic episodes in a 2 weeks period(judged as success) in the 24 DE patients. Among the successful patients, 2 used O+l, 2 used O+D, 4 used 1+D and 6 used 0+1+D at the start. In the 12 ME patients,5 had success. Four of the 5 successful patients had used 1+D. At the second visit(6 weeks later from the beginning), 16 patients who had not showed success at the first follow-up visit were analysed. Ten(6 DE and 4 ME) of the 16 patients became success. Five DE and 3 ME patients among the 10 successful patients had newly used D or increased D dose during the second period. Three patients (1+D in 1 DE,0+1+D in 1 DE and 1+D in 1 ME)who had showed success at 2 week visit became worse at 6-week visit after dose reduction in 1(12.5mg). CONCLUSIONS: From the above data, we think that combined use of imipramine and desmopressin is effective for initial treatment in the enuretic patients regardless of diurnal symptom. To improve success rate, desmopressin dose needs to be increased.

The Value of Prostate Specific Antigen Density in the Diagnosis of Prostate Adenocarcinoma / 대한비뇨기과학회지

PURPOSE: Most studies have shown considerable overlap between benign prostatic hyperplasia(BPH) and cancer, using a prostate specific antigen(PSA) cut-off point of 4.0ng/ml. Because of lack of sensitivity and specificity, the value of PSA measurement in the diagnosis of prostate cancer has been questioned. The concept of PSA density(PSAD) was introduced to enhance the specificity of serum PSA. To determine the value of PSAD in the diagnosis of prostate cancer, we investigated whether PSAD-based clinical guidelines could help in the diagnosis of prostate cancer and assist in avoiding a significant number of biopsies. MATERIALS AND METHODS: Retrospective data were analysed from a selected population of 130 patients(mean age 66 years, range 42-86), 54 with histopathologically diagnosed prostate cancer and 76 with BPH. DRE(digital rectal examination) and TRUS(transrectal ultrasonography) were performed and PSA and PSAD were determined for each patient. RESULTS: The median PSA level was 7.0ng/ml(range 0.6-87ng/m1) in the patients with a benign diagnosis and 25.5ng/ml(range 2.2-736ng/m1) in those with malignancies. Also, the median PSAD was 0.18ng/m1/cm3(range 0.02-2.56ng/ml/cm3) in the benign group and 0.75ng/m1/cm3(range 0.06-22.3ng/m1/cm3) in the malignant group. Both PSA and PSAD discriminated BPH from cancer in a whole range of PSA level and were statistically significant. Of the 130 patients, 49(377 %) had a PSA level in the intermediate range(4.0-10.0ng/ml). In these patients, the median PSA was 6.5ng/ml(range 4.2-10ng/m1) In the benign group and 5.2ng/ml(range 4.1-9.8ng/ml) in the malignant group. Also, the median PSAD was 0.16ng/m1/cm3(range 0.07-0.39ng/m1/cm3) in the benign group and 0.17ng/m1/cm3 (range 0.08-0.27ng/m1/cm3) in the malignant group Both PSA and PSAD had no discriminating ability between BPH arid cancer in the Intermediate PSA range(4.0-10.0ng/ml). CONCLUSIONS: PSAD was of no additional value over serum PSA measurement in discriminating BPH from cancer for the population with intermediate PSA levels.

The Establishment of Sperm Penetration Assay Using Cryopreserved Hamster Oocyte / 대한비뇨기과학회지

To establish sperm penetrating assay (SPA) with using cryopreserved hamster oocyte, we performed the stepwise SPA with 1) fresh hamster oocyte and hamster sperm, 2) cryopreserved hamster oocyte and hamster sperm, 3) fresh hamster oocyte and human sperm, and 4) cryopreserved hamster oocyte and human sperm, in 4 cases of male hamster and 12 cases of fertile human. In SPA of hamster sperm with fresh hamster oocyte, the oocyte penetration rate (PR) were 100+0%, and the penetration index(mean penetration per oocyte, PI) was 22.4 +/- 1.8. In SPA of hamster sperm with cryopreserved hamster oocyte, the PR were 100 +/- 0%, and the Pl was 14.1 +/- 2.9 (p<0.01). When the oocytes were examined at 1, 2, 3, and 6 hour post insemination, hamster sperm penetration was 1 hour slower in cryopreserved oocytes than in fresh ones. In SPA of human sperm with fresh hamster oocyte, the PR was 79.5 +/- 10%, and the Pl was 2.78 +/- 2.6. In SPA of hamster sperm with cryopreserved hamster oocyte, the PR was 73.9+/- 16%, and the PI was 2.82 +/- 2.7. There`s no significant difference in SPA using human sperm. These results suggest that them may be some functional damages on cryopreserved oocyte, because Pl of fresh oocytes is higher than that of cryopreserved oocytes. However in sperm of human, it dose not make significant difference in Pl between fresh and cryopreserved oocytes. The SPA using cryopreserved hamster oocyte would appear to have wide application of the evaluation of infertility, the assessment of the treatment of infertility and the experiment in infertility field.

Evaluation of the Augmentation Cystoplasty in the Pediatric Neurogenic Bladder / 대한비뇨기과학회지

From 1985 to 1995, 13 children with neurogenic bladder underwent augmentation cystoplasty. Diagnosis in these 13 children included Meningomyelocele in 11 and unknown origin in 2. Indications for augmentation cystoplasty were persists incontinence in 6 patients and progressive upper urinary tract deterioration in Bowel segments were used for augmentation included sigmoid colon in 1 patient, ileocecal segments incontinence in 6 patients stomach in 3. Dilated ureter also was used in 1 patient. Postoperatively, all the patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 12 require clean intermittent catheterization to empty bladder and 10 are completely continent. After operation, bladder capacity increased from 155 ml to 305 ml and there were significant increases in bladder compliance. Hypereflexia was present in 5 patients before operation and in 3 patients after operation. There has been no surgical mortality. Postoperative complications occurred in 4 patients included mild ileus in 2 patients, mucus obstruction in 1, mild hematuria in 1, metabolic alkalosis in 1 and superficial wound infection in All complications were transient and managed medically. the kind of bowel segments did not seem to influence results. We think that augmentation cystoplasty is a therapeutic modality that should be considered as a viable treatment option in selected patients with neurogenic bladder dysfunction.