Expression of Nitric Oxide Synthase and Aquaporin-3 in Cyclophosphamide Treated Rat Bladder / 대한배뇨장애요실금학회지

PURPOSE: The expression of Nitric oxide Synthase (NOS) and aquaporin (AQP) water channels in rat bladder is recently reported. The aim of this study is to evaluate the expression of inducible NOS (iNOS), aquaporin-3 (AQP-3) in cyclophosphamide (CYP) induced rat bladder. MATERIALS AND METHODS: The 32 Sprague-Dawley rats were divided into cystitis group (n=20) and control group (n=12). In cystitis group, 100mg/kg CYP was injected every second day for 1 week whereas in control group, normal saline was injected. After extracting of the bladder and dividing dome, body and trigone of the bladder, independently H&E staining and immunohistochemical staining for iNOS and AQP-3 were performed. Expressions of iNOS and AQP-3 were analyzed with a confocal laser scanning microscope and an image analyzer. RESULTS: The expression of iNOS significantly increased in the mucosa, submucosa layer of dome in cystitis group (p<0.05). The expression of AQP-3 significantly increased in the mucosa, submucosa, vessel layer of dome in cystitis group (p<0.05). CONCLUSIONS: These results suggest that inflammatory change activates NOS and AQP-3 expression in the bladder tissue of rats. These may imply that NOS and AQP-3 have a pathophyiological role in the cyclophophamide induced interstitial cystitis. Further study on the NOS and AQP-3 in bladder is needed for clinical application.

The Effect of Finasteride on Microvessel Density and Expression of Vascular Endothelial Growth Factor and 5alpha-Reductase in Prostatic Hyperplasia

PURPOSE: Vascular endothelial growth factor (VEGF), a potent stimulator of angiogenesis and microvessel density (MVD), which is an important indicator of neoangiogenesis, were independently evaluated to elucidate the mechanism of decreased bleeding observed in patients treated with finasteride, an inhibitor of 5alpha-reductase (5AR). We evaluated MVD and the expression of VEGF and 5AR type II in patients with benign prostatic hyperplasia (BPH) treated with finasteride. MATERIALS AND METHODS: The study included 61 patients undergoing transurethral prostatectomy (TURP) for BPH. Among these patients, 29 had well-preserved paraffin blocks, 13 of whom were given finasteride for a minimum of 3 weeks before surgery; the remaining 16 patients served as controls. MVD was calculated by counting the number of positively stained blood vessels on 5 random, high-power fields within the prostatic section. Expressions of VEGF and 5AR type II were analyzed with a confocal laser scanning microscope and an image analyzer. RESULTS: Prostatic MVD was significantly lower in the finasteride-treated group (p<0.05). The expression of VEGF and 5AR type II at the level of the prostatic glandular epithelium and stroma was not significantly different between the 2 groups. VEGF and 5AR type II were more strongly expressed in the epithelium of both groups than in stromal smooth cells (p<0.05). CONCLUSIONS: Finasteride treatment had no clear effect on the expression of VEGF or 5AR type II. It is possible, however, that finasteride improves blood loss after TURP and BPH-induced hematuria by reducing MVD. Further study on the mechanism of MVD reduction is needed.

Effect of 5alpha-reductase Inhibitor (Finasteride) on Bleeding during Transurethral Resection of Prostate

PUROPOSE: The efficacy of finasteride in the treatment of hematuria associated with benign prostatic hyperplasia (BPH) is well known. Recent studies have also shown that finasteride reduce angiogenesis and prostatic bleeding associated with BPH. We evaluated that pretreatment with finasteride could decrease perioperative bleeding associated with transurethral resectrion of prostate (TURP) in this way. MATERIAL AND METHODS: A total of 56 patients who underwent TURP due to BPH between January 2004 and August 2006 were evaluated. Of the patients, 30 recieved pretreatment with finasteride 5mg daily (group 1) while 26 did not undergo any pretreatment (control group). In the group 1, 17 had pretreatment period of 3months or more (group 2). In all patients we evaluated the degree of perioperative bleeding, intended as a reduction tendency in hemoglobin (Hb) and hematocrit (Hct) value in the 24 h following TURP. Also, we evaluated the correlation of the preoperative factor and postoperative change of Hb and Hct. RESULTS: Difference of reduction tendency in Hb and Hct between group 1 and control group was not significant (p=0.86, 0.95, respectively). Difference between group 2 and control was not significant (p=0.56, 0.29, respectively). The change of Hb and Hct correlated with prostate volume, significantly (p=0.006, 0.010). Also, operation time was correlated with the change of Hb and Hct (p=0.006, 0.011). CONCLUSIONS: There were no significant difference of the perioperative bleeding according to finasteride medication or medication duration.

Study of the Duration of Pyuria after Transurethral Prostatectomy / 대한비뇨기과학회지

PURPOSE: Persistent pyuria is one of the common complications after transurethral prostatectomy (TURP). Postoperative pyuria has an effect on postoperative voiding symptoms. Thus, postoperative urinalysis and urine culture are reliable indicators when following up voiding symptoms. In our study, possible preoperative, intraoperative and postoperative factors influencing the development and duration of pyuria and bacteriuria after TURP were evaluated. MATERIALS AND METHODS: Between January 2004 and November 2005, 82 patients who underwent TURP due to benign prostatic hyperplasia (BPH) were evaluated. The risk factors of the duration of the postoperative pyuria were divided into preoperative, intraoperative postoperative, and evaluated the differences and correlations according to these risk factors. RESULTS: The average durations of pyuria of 26 and 23 patients under and over the age of 70 were 4.12+/-2.69 and 6.61+/-4.51 weeks, respectively (p= 0.03). The average duration of pyuria of 12 patients with no preoperative pyuria and 37 with preoperative pyuria were 4.97+/-3.12 and 6.25+/-5.55 weeks, respectively (p=0.04). Separating patients according to the resected volume of prostate, the average duration of pyuria of 16 and 33 patients with resected prostate volumes greater than and less than 7g were 3.56+/-2.16 and 6.12+/-4.20 weeks, respectively (p=0.03). The age and average duration of pyuria showed a positive correlation (p=0.031). CONCLISIONS: Significant differences were observed in the duration of pyuria according to age, preoperative pyuria and resected volume of prostate.

Primary Leiomyosarcoma of the Ureter / 대한비뇨기과학회지

An 82-year-old woman was admitted to our hospital with a palpable mass in her right lower abdomen. The mass was enlarged and tender for the previous 3 months. Abdomen-pelvic computed tomographic scan demonstrated severe right hydroureteronephrosis and about an 8x8x9cm sized huge irregular shaped pelvic mass. Retrograde pyelography showed complete obstruction of the right middle ureter. En bloc resection of the mass and segmental resection of the ureter was performed. Pathologically, it was diagnosed primary leiomyosarcoma of the ureter. At 3 month postoperatively, there has been no recurrence or metastasis.

Thoracic Actinomycosis: A Case Report / 대한흉부외과학회지

Actinomycosis of the lung is a chronic, suppurative granulomatous infection which is caused by Actinomyces israelii. It is believed to enter the thorax by way of the bronchial tree, by aspiration of contaminated aerosol particles in the upper digestive tract. Symptoms of chronic cough, sputum, hemoptysis, low grade fever, chest pain, and weight loss are common. Chest X-ray shows mass like lesion, pulmonary infiltration, abscess, and tuberculosis like lesion, which makes differential diagnosis from lung cancer very difficult. Surgical intervention is needed for the diagnosis and treatment, and diagnosis of actinomycosis is achieved when histologic examination reveals sulfur granules containing filamentous organisms. Penicillin is the drug of choice. Two or three months of penicillin treatment is recommended to treat the oropharyngeal or dental abscess to avoid recurrences. We present a case of actinomycosis which is suspected to malignant with review of literatures.

Benign Metastasizing Leiomyoma of Lung: A case report / 대한흉부외과학회지

We performed thoracoscopic resection for diagnosis in a 41 year-old-female presenting with multiple pulmonary nodules in both lung fields, which was detected incidentally on routine chest x-ray and followed by additional exmaminations including chest CT scan and percutaneous needle aspiration biopsy under the presumptive diagnosis of metastatic cancer. During thoracoscopy, the result of the frozen section analysis of multiple masses revealed strong evidence of leiomyoma. In her past medical history, she had undergone myomectomy, and hysterectomy, 7 years ago and 10 years ago, respectively. Based on permanent, special staining of specimen, estrogen receptor assay and review of past specimen of uterine myoma, the final diagnosis was benign metastasizing leiomyomata from uterine myoma, the report was very uncommon in Korean and English literatures. The patient has been followed up for 2 years without special therapy, such as hormonal therapy.

Survival Rate after Pulmonary Metastasectomy in Bone and Soft Tissue Sarcoma / 대한정형외과학회잡지

We investigated the overall survival rate after pulmonary metastasectomy in the bone and soft tissue sarcoma and the available prognostic factors related with the survival rate after pulmonary metastasectomy. Between 1986 and 1995, 9 patients (median age 32) with bone and soft tissue sarcoma with pulmonary metastasis were managed in the Catholic University of Korea. Until the final follow-up in May 1996, 6 patients have died of disease and their mean survival period was 28 months (9- 58months). The actual 5-year survival rate by Kaplan-Meier method was 33%. Prognostic factors such as tumor free interval, number of metastatic lesion, postoperative chemotherapy and histologic grade were analyzed. Three patients who had the tumor free interval over 3 years were alive (mean survival period: 52.6 months), whereas six patients who had the tumor free interval less than 3 years were dead (mean survival period: 19 months). Out of four patients with low grade tumor, three patients were alive with average 39.2 months survival period, whereas five patients with high grade tumor were all dead with average 19.2 months survival period. These results suggested that pulmonary metastasectomy in bone and soft tissue sarcoma may prolong the survival rate. The long tumor free interval, histological low grade and soft tissue sarcoma may influenced on prolonged survival rate. However, number of metastatic lesion or postoperative chemotherapy has not influenced on the survival rate.