Usefulness of the NMP22BladderChek Test for Screening and Follow-up of Bladder Cancer

PURPOSE: We evaluated the usefulness of the nuclear matrix protein 22 BladderChek (NMP22BC) test for the screening and follow-up of bladder cancer. MATERIALS AND METHODS: From February 2006 to September 2009, we enrolled 1,070 patients who had hematuria or who were being followed up for bladder cancer. We compared the sensitivity and specificity of the NMP22BC test with those of urine cytology. RESULTS: The sensitivity of the NMP22BC test (77.5%) was significantly higher than that of urine cytology (46.3%). The specificity of the NMP22BC test was 88.8%, compared with 97.9% for urine cytology. The sensitivity of the NMP22BC test (81.8%) in non-muscle-invasive bladder cancer was higher than that of cytology (36.4%). However, the sensitivity of the NMP22BC test and of urine cytology in invasive bladder cancer were 57.1% and 92.9%, respectively. The sensitivity of the NMP22BC test was higher for low-grade bladder cancer (83.9%) than for high-grade (62.5%), and the sensitivity of cytology was higher for high-grade bladder cancer (66.7%) than for low-grade (37.5%). Follow-up bladder cancer was detected in 262 patients. The sensitivity of the NMP22BC test in that group (72.7%) was decreased and the specificity (91.7%) was increased. The sensitivity of cytology (54.5%) in the follow-up group was increased and the specificity (95.6%) was decreased. The presence of pyuria was significantly associated with the lower specificity of the NMP22BC test. CONCLUSIONS: The greater sensitivity of the NMP22BC test may be more useful for the diagnosis of non-muscle-invasive bladder cancer and low-grade bladder cancer than for the diagnosis of invasive or high-grade bladder cancer. If the NMP22BC test is performed in the absence of pyuria, it may play a compensatory role for urine cytology.

Effect of Tamsulosin and Dichlozid on the Expected Treatment of Ureteral Calculi

PURPOSE: We evaluated the effect of tamsulosin and hydrochlorothiazide (Dichlozid) on the expulsion of ureteral stones. MATERIALS AND METHODS: A total of 132 patients with a single ureteral calculi less than 10 mm in diameter were enrolled and divided into 3 groups: group 1 (n=40) received tamsulosin (0.2 mg/day), group 2 (n=35) received Dichlozid (25 mg/day) and tamsulosin (0.2 mg/day), and group 3 (n=57) was the control. Proximal and distal ureteral stones were evaluated separately. Efficacy was evaluated in terms of the rate and duration of expulsion according to stone size ( or =5 mm) for a maximum period of 4 weeks. RESULTS: The mean stone diameters were 4.9+/-1.7 mm (group 1), 4.8+/-1.6 mm (group 2), and 5.3+/-1.8 mm (group 3). The overall expulsion rates were 70%, 74.3%, and 52.6%, respectively, and showed statistical significance. The mean durations of expulsion were 14.7+/-1.6, 12.8+/-1.5, and 18.0+/-2.0 days, respectively, and group 2 showed a significant decrease in the duration. There were no significant differences in the expulsion rate of proximal and distal ureteral stones in any group. Distal ureteral stones in groups 1 and 2 showed a significant reduction in the mean expulsion time ( or =5 mm: 15.0+/-1.4, 13.0+/-0.6, and 17.8+/-0.4 days in groups 1, 2, and 3, respectively). The mean expulsion time for smaller proximal stones (<5 mm) in groups 1 and 2 was reduced significantly (17+/-0.6, 15.2+/-0.8, and 19.3+/-0.6 days in groups 1, 2, and 3, respectively). CONCLUSIONS: Medical therapy with tamsulosin is time-saving and effective for treating ureteral calculi. In addition, adjunctive treatment with Dichlozid may reduce the duration of expulsion.

Effect of muscle relaxant on entropy during propofol anesthesia / 대한마취과학회지

BACKGROUND: The purpose of this study was to investigate whether muscle relaxant affect the values of Entropy, response entropy (RE) or state entropy (SE) during propofol anesthesia. METHODS: Eighty patients (ASA I) scheduled for elective surgery under general anesthesia were randomly assigned to four groups. Anesthesia was maintained at a SE value of 80 (80 +/- 2) using target controlled infusion (TCI) of propofol. After maintaining SE 80 for 5 min, vecuronium 0.1 mg/kg was injected intravenously in group I and same volume of normal saline was intravenously injected in group II. After maintaining SE 60 for 5 min, vecuronium 0.1 mg/kg was injected intravenously in group III and same volume of normal saline was injected intravenously in group IV. The mean arterial pressure, heart rate, SE and RE were measured before anesthetic induction and up to 5 min after vecuronium or normal saline injection in each group. RESULTS: SE and RE were not changed in group II, but significantly decreased in group I (P < 0.05, respectively). In group III and IV, SE and RE were not changed in both groups. There were no significant hemodynamic changes among the four groups. CONCLUSIONS: These results suggest that the effect of muscle relaxant on Entropy vary according to the baseline values of RE or SE during propofol anesthesia.

Tracheal laceration detected by high end-tidal CO2 during endoscopic thyroidectomy / 대한마취과학회지

Endoscopic thyroidectomy is frequently used for cosmetic reasons, such as reducing cervical scarring. Subcutaneous gas insufflation with CO2 is needed to maintain the surgical space, and optimal surgical techniques and careful attention are required when conducting this procedure due to the limited space available for the endoscopic instruments. We report here a case of a tracheal laceration with a tear in the cuff of a reinforced tube, which was detected by an abrupt increase in end-tidal CO2 to 90 mmHg. Reintubation was achieved using a tube exchanger and the patient was effectively ventilated without complications.

Predicting Factors for Spontaneous Passage of Ureteral Calculi Based on Unenhanced Helical CT Findings / 대한비뇨기과학회지

PURPOSE: We performed a prospective study to determine whether unenhanced helical computed tomography(UHCT) findings predict the spontaneous passage of ureteral calculi. MATERIALS AND METHODS: Between April 2006 and June 2007, 175 patients with a single ureteral calculus <1cm in diameter were enrolled in this study, and a UHCT was performed. All of the patients were managed conservatively for 2 weeks. Patients without spontaneous passage of ureteral calculi within 2 weeks were treated by ureteroscopy or extracorporeal shock wave lithotripsy(ESWL). The secondary signs (hydronephrosis, perinephric edema, and the tissue rim sign) were graded on a scale of 0-3. We evaluated whether spontaneous passage of ureteral calculi was associated with stone diameter, location, Hounsfield units(HU), and the degree of secondary signs. RESULTS: Ninety-two patients(52.6%) had spontaneous passage of ureteral calculi. The mean stone diameter was significantly smaller in the passage group than the non-passage group(4.28mm vs. 6.73mm, p=0.002). The rate of spontaneous passage was significantly higher involving distal ureteral calculi(66.1%) than proximal ureteral calculi(30.3%, p<0.001). The incidences of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(8.7% vs. 73.5% and 5.4% vs. 69.9%, respectively). The grades of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(p=0.001). Although there was a tendency toward increasing grades of hydronephrosis and perinephric edema with increasing stone size, the grades were more frequent and severe in the non-passage group in patients with similarly sized stones. CONCLUSIONS: The degree of hydronephrosis and perinephric edema are useful ancillary signs in predicting the likelihood of spontaneous passage of ureteral calculi.

Vaginal Erosion and Pelvic Abscess after Anterior Intravaginal Slingplasty (IVS) in Patient with Stress Urinary Incontinence

Midurethral slings are increasingly popular for the surgical treatment of stress urinary incontinence. They are relatively simple to implant and shorten operating time, hospital stay, and recovery time. Tension free vaginal tape (TVT) and Intravaginal slingplasty (IVS) mesh are both polypropylene mesh. TVT is a type I totally macroporous mesh which, because of pores larger than 75 microns, admits bacteria, macrophages, and fibroblasts into the pores. IVS is a type III mesh with microporous components which admits bacteria but not macrophages. So anterior IVS appear to be more at risk of infection or vaginal erosion than other monofilament mesh. We report our experience with a patient who underwent anterior IVS and developed erosion of the mesh through vagina, creating pelvic abscess.

Treatment of Upper and Mid Ureter Stones: Comparison of Semirigid Ureteroscopic Lithotripsy with Holmium: YAG Laser and Shock Wave Lithotripsy / 대한비뇨기과학회지

PURPOSE: To compare the success rates, complications and cost effectiveness of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URS) using a Holmium: YAG laser to establish the more effective treatment for upper and mid ureter stones. MATERIALS AND METHODS: This retrospective study included 83 and 286 patients treated with URS and ESWL, respectively, for upper and mid ureter stones. URS was performed with a 7.5Fr semi-rigid ureterorenoscope and Holmium: YAG laser. ESWL was performed with Stonelith V.5 (PCK, Turkey). The stone sizes, success rates, postoperative complications and cost effectiveness were analyzed for each group. RESULTS: The overall success rates of the URS and ESWL were 97.6 and 82.5%, respectively. Success rates of URS were 98.4 and 95.2% when the stones were smaller and larger than 10mm, respectively. In the ESWL group, the success rates after the third session were 86.3 and 65.4% with stones smaller and larger than 10mm, respectively. The complication rates associated with URS and ESWL were 6 and 4.2%, respectively. The average cost of URS was lower than that of ESWL. CONCLISIONS: In our study, URS with Holmium: YAG laser was more efficacious than ESWL. Considering both the success rate and cost effectiveness, URS should remain the recommended first-line treatment for upper and mid ureter stones.

Clinical Outcome of the Tension-free Vaginal Tape Procedure for Treating Women with Urinary Incontinence (the 2-year Follow Up): Comparison between Stress Urinary Incontinence and Mixed Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: We evaluated and compared the outcomes between stress urinary incontinence(SUI) and mixed urinary incontinence(MUI) for those patients who had undergone a tension-free vaginal tape(TVT) procedure. MATERIALS AND METHODS: Patients were categorized into the SUI(43 patients) and MUI(28 patients) groups. The preoperative evaluations included a comprehensive medical history, physical examination and urodynamic study that included determining the Valsalva leak point pressure(VLPP). Further, we asked about lower urianry tract symptoms (LUTSs) with using a female bladder questionnaire. After treatment, the same questionnaires were repeated. The objective and subjective success rate were evaluated during the postoperative period. RESULTS: For the operation outcome results, in SUI group there were 37 cases of cure(86.0%) and 4 cases of improvement(9.3%), and in MUI group there were 21 cases of cure(75.0%) and 4 cases of improvement(14.3%) (p>0.05). The operation satisfaction rate of patients was 88.4% in the SUI group and 82.2% in the MUI group(p>0.05). The objective success rate and satisfaction rate of the SUI patients did not significantly differ from the women with MUI. Also, these results show that the TVT procedure improves some LUTSs in both groups of patients. CONCLUSIONS: We consider the TVT procedure to be an effective treatment not only for SUI, but also for MUI.

Mixed Hemangioma of the Epididymis / 대한비뇨기과학회지

A hemangioma is a benign tumor arising in the vessels, but an intrascrotal hemangioma is rare, and a hemangioma of the epididymis is extremely rare. Ultrasound and MRI (magnetic resonance imaging) are mainly used for the diagnosis of an intrascrotal hemangioma, with surgical excision being the appropriate treatment. We report on the case of a 24 year- old-man with a mixed hemangioma of the epididymis.

The Early Experience of Sling Procedure Used Remnant Anterior Vaginal Wall Tissue with Grade III Cystocele / 대한비뇨기과학회지

PURPOSE: In patient with grade III cystocele, to determine whether the anterior vaginal wall tissue, remnant at the anterior colporrhaphy, is an appropriate sling material, we retrospectively reviewed the outcomes of sling operations that used remnant anterior vaginal wall tissue. MATERIALS AND METHODS: An anterior colporrhaphy and sling operation using remnant vaginal wall tissue was undertaken in 21 patients. The preoperative evaluation included the patients' history, a physical examination, urinalysis, an urodynamic test, a voiding cystourethrogram and incontinence staging with Stamey grade. The surgical outcomes and stress- related leakage, emptying ability, anatomy, protection, inhibition (SEAPI) were assessed. RESULTS: The mean follow-up period, operation time and hospital stay were 18 months (12-36), 45.4 minutes and 8.6 days, respectively. 18 patients (85.7%) were cured and 3 (14.3%) improved. The total subjective SEAPI score of 8.48 decreased postoperatively to 1.78. The pre- and post-operative complications were unremarkable. CONCLUSIONS: The remnant anterior vaginal wall sling was helpful in minimizing the postoperative complications and cost effectiveness. Although long-term follow-up data might be required, this technique could be a good alternative method to replace conventional fascial or synthetic pubovaginal slings with grade III cystocele.

Expression of Bcl-2 Gene in Human Renal Cell Carcinoma Associated with Drug Resistance and Metastatic Potential / 대한비뇨기과학회지

PURPOSE: To investigate whether the up-regulation of Bcl-2 gene expression may be associated with chemotherapy resistance and malignant progression in human renal cell carcinomas (HRCC). MATERIALS AND METHODS: The HRCC cell line, SN12C, was cultured in MEM medium, supplemented with 10% FBS. Full length of Bcl-2 cDNA was obtained using the sense primer (5'-ATGGCGCACGCTGGGAGAACGG-3') and the antisense primer (5'-TCACTTGTGGCTCAGATAGG-3') and inserted into SN12C cells to establish stable cells expressing the Bcl-2 gene (SN12C/smcb2). To investigate the response to doxorubicin in orthotropic organs, SN12C/smcb2 and parental cells were implanted into the subcapsular renal tissue of nude mice (n=5). The mice were treated with doxorubicin (8mg/kg) on days 8 and 15 following tumor cell implantation. Tumor tissues, obtained from the kidneys and lungs, were ex vivo cultured (SN12C/smcb2-kidney and SN12C/smcb2-lung, respectively). To compare the metastatic potential in these cell lines, the gelatinolytic activity was measured by zymogram and the expression of type IV collagenase (MMP-9) examined by western blot. RESULTS: In the in vitro study, the SN12C/smcb2 was more resistant to doxorubicin than the parental cells, and treatment and those cells produced a higher rate of tumor formation and metastasis. The SN12C/ smcb2-kidney showed higher gelatinolytic activity than the parental cells. Higher expression levels of type IV collagenase were detected in the SN12C/smcb2-lung and SN12C/smcb2-kidney, but barely detected in SN12C. CONCLUSIONS: The up-regulation of Bcl-2 gene expression in HRCC cells induces drug resistance to doxorubicin and increases the metastatic potential. Although the drug resistance induced by Bcl-2 over-expression enhances distant metastasis (lung), the up-regulation of Bcl-2 may enhance the malignant potential of tumor cells and produce distant metastasis.

Clinical Experience of Holmium:YAG Laser in Ureteroscopic Removal of Ureteral Calculi / 대한비뇨기과학회지

PURPOSE: We report our experience to assess the effectiveness and safety of Holmium:YAG laser lithotripsy for managing ureteral calculi. MATERIALS AND METHODS: Ureteroscopic Holmium:YAG laser lithotripsy was performed in 116 cases from November 1999 to October 2003. Calculi were located at the upper ureter in 9%, mid ureter in 19% and lower ureter in 72%. The mean stone size was 1.2cm. A 8Fr semirigid ureterorenoscope, 7.5Fr flexible ureterorenoscope and holmium:YAG laser (Trimedyne, Irvine, USA) with 365mul laser fiber were used. RESULTS: Stones were completely cleared in 113 cases among 116 cases. Stone-free rates according to stone position were 97.6% in the lower ureter, 100% in the mid ureter and 90.9% in the upper ureter. Stone-free rates according to stone size were 100%, 100% and 85.7% in the cases of which diameter is below 10mm, between 10mm and 15mm and above 15mm respectively. Fragmentation was incomplete in 3 cases, so ESWL was performed in 2 cases and repeated procedure in on case. Ureteral perforation was developed in 1 case. CONCLUSIONS: The Holmium:YAG laser lithotripsy was highly effective and safe in managing ureteral calculi irrespective of their location.

Up-Regulation of Differentiation Related Gene-1 Expression in the Androgen Independent Prostate Cancer / 대한비뇨기과학회지

PURPOSE: To determine whether the up-regulation of the differentiation related gene (Drg-1) enhances the progression of prostate cancer into the androgen independent phenotype, via escaping androgen signal transduction. MATERIALS AND METHODS: A full length of Drg-1 cDNA was obtained using the Drg-1 primer, which was inserted into LNCaP cells. The sensitivities of dihydrotestosterone and bicalutamide were then examined. In addition, the level of the Drg-1 gene expression was examined in derivatives of the LNCaP cell lines obtained from the orthotopic animal model. RESULTS: The Drg-1 transfected LNCaP cells, which highly expressed the Drg-1, were established (LNCaP/D2). The LNCaP/D2 slowly grew in a culture medium, supplemented with 10% charcoal stripped fetal bovine serum, whereas the control cells did not. When the sensitivities of DHT and bicalutamide were examined, the PC-3 and LNCaP/D2 cells were not sensitive to either. The metastatic androgen independent prostate cancer cells (LNCaP-AI-Lung), which were obtained from the orthotopic animal model, showed higher levels of Drg-1 expression than the parental cells. CONCLUSIONS: Androgen dependent prostate cancer cells, expressing high levels of the Drg-1 gene, behave like androgen independent prostate cancer cells. This finding suggest that the Drg-1 gene may play an important role in the initiation of an androgen-independent state.

Male Urethral Diverticulum Combined with Stone and Urethrocutaneous Fistula / 대한비뇨기과학회지

A male urethral diverticulum is a relatively uncommon abnormality. It usually occurs at the penoscrotal junction and most of these lesions develop as secondary disorder after a urethral trauma, obstruction or infection. Here we report a case of a male urethral diverticulum combined with a stone and a urethrocutaneous fistula.

Male Urethral Diverticulum Combined with Stone and Urethrocutaneous Fistula / 대한비뇨기과학회지

A male urethral diverticulum is a relatively uncommon abnormality. It usually occurs at the penoscrotal junction and most of these lesions develop as secondary disorder after a urethral trauma, obstruction or infection. Here we report a case of a male urethral diverticulum combined with a stone and a urethrocutaneous fistula.

Physiologic Role of K+ Channels in Relaxation of Rabbit Corpus Cavernosal Tissue / 대한남성과학회지

PURPOSE: Ion channels play key roles in determining smooth muscle tone by setting the membrane potential and allowing Ca2+ influx. Potassium channels may be important in modulating corporal smooth muscle tone. In this study, we investigated the effects of potassium channels in the rabbit corpus cavernosal smooth muscle by blocking them with various agents. MATERIALS AND METHODS: Strips of rabbit corpus cavernosum were prepared for mounting and isometric tension measurement in an organ bath. On cavernosal strips contracted with phenylephrine (PHE), sodium nitroprusside (SNP) was applied in increasing concentrations from 10(-7)M to 10(-4)M, causing dose-dependent relaxation. The effects of various potassium channel blockers on SNP-induced relaxation were then evaluated by measuring the tension of the cavernosal strips. The potassium channel blockers used were tetraethyl ammonium (TEA), charybdotoxin, gliben clamide, and apamin. RESULTS: The relaxation responses to SNP of the corporal preparations contracted in response to PHE were significantly attenuated by TEA (10(-2)M) and charybdotoxin (10(-7)M), with no significant difference observed between the two drugs. The SNP-induced relaxation responses were not significantly attenuated by glibenclamide (10(-5)M) or apamin (10(-5)M). CONCLUSIONS: These results suggest that maxi-K+ channels play an important role in corpus cavernosal relaxation. The KATP channel and small-conductance KCa channel are thought to be unrelated to corpus cavernosal smooth muscle relaxation.

Preoperative Evaluation of Living Renal Transplant Donors Using Helical CT Angiography: Comparison with Conventional Angiography / 대한비뇨기과학회지

PURPOSE: This study evaluated the accuracy of helical CT angiography (HCTA) in a preoperative evaluation of living renal transplant donors (LRTDs) for visualizing the renal vascular anatomy with an emphasis on identifying the number of renal arteries and the presence of small branches and venous anomalies. MATERIALS AND METHODS: From Jan. 2000 to Feb. 2001, a total of 50 potential LRTDs were evaluated with conventional renal angiography (CRA) and HCTA. All candidates then underwent a donor nephrectomy. The HCTA was done according to a standard HCTA protocol. The intraoperative findings on the number of renal vessels were compared with those of the CRA and HCTA respectively. RESULTS: There was an overall agreement on the number of renal arteries and veins between the CRA findings and 3-D reconstruction of the HCTA (91%, 95%). The overall accuracies for predicting the number of renal arteries and veins relative to the intraoperetive findings were 84%, 94% for CRA and 80%, 94% for HCTA respectively. The CRA missed 8 accessory renal arteries while HCTA missed 10. In HCTA, cases with an accessory renal artery with a diameter < or =5 Fr. (1.65mm) and two cases of an early branching single vessel simulating dual arteries, were misdiagnosed. Despite the misdiagnosed cases, there was no significant intraoperative morbidity. The HCTA revealed another lesion of a renal parenchyme, the urinary collecting system and other viscera. There were no significant complications in the process of both techniques. The cost of HCTA was 48% less than the CRA plus the excretory urography (EU) for imaging the potential LRTDs. CONCLUSIONS: A HCTA appears to be as accurate as a CRA for visualizing the renal vascular anatomy in the preoperative assessment of potential LRTDs. A HCTA has the potential to be a good alternative to a CRA plus EU for assessing potential LRTDs.

The Etiology and Classification of Nocturia in Adults / 대한비뇨기과학회지

PURPOSE: Nocturia, from which the patients feel the most discomfort, is one of the frequently complained urologic symptoms combined with insomnia. Studying the etiology and classification of nocturia is not enough. In this study, we analyzed the voiding diary and urodynamic study to investigate the etiology of nocturia. We classified the type of nocturia based on the etiology. MATERIALS AND METHODS: We reviewed the urodynamic study (UDS) as well as the three days voiding diary of 152 patients with nocturia. We classified nocturia into three groups based on the voiding diaries and the results of UDS: Pure nocturnal polyuria in which the voided urine volume during the hours of sleep is more than 35% of the 24-hours urine volume, detrusor overactivity defined as existing uninhibited contraction on filling cystometrogram, and mixed (nocturnal polyuria with detrusor overactivity). Polyuria (24-hours urine output >2,500cc) was classified separately. RESULTS: The mean number of nocturia was 3.3 (3.1 for men, 3.4 for women). octurnal polyuria, detrusor overactivity and mixed were 50.0%, 7.9% and 17.1% respectively. Nocturnal polyuria was not related with detrusor overactivity, bladder outlet obstruction and impaired detrusor contractility, but significantly increased with age (p<0.01) and in men (p<0.05). Detrusor overactivity was not related to impaired detrusor contractility, but was significantly related to the bladder outlet obstruction (p<0.05) and increased with age (p<0.01) and in men (p<0.01). Seventeen (11.2%) had polyuria. CONCLUSIONS: In 75% of nocturia patients, there were nocturnal polyuria, detrusor overactivity or mixed type and 11.2% of them had polyuria. Therefore we conclude that these three causes were the main etiology of nocturia, and nocturia could be classified and treated based on these results.

A Case of Rhabdomyolysis in Eosinophilic Polymyositis / 대한신장학회잡지

A 45-year-old man presented with muscle pain, skin nodules and persistent hypereosinophilia over a period of 4 months. Laboratory data excluded the diagnosis of trichinosis or any other parasite infection. The patient's course of the disease over the 9 months was compatible with idiopathic hypereosinophilic syndrome. In a muscle biopsy, eosinophilic and lymphoplasma cells are predominantly infiltrated. Authors report a case of rhabdomyolysis due to eosinophilic polymyositis in idiopathic hypereosinophilic syndrome.

Effects of Long-Term Alcohol Treatment Combined with Vitamins or Piracetam on the Ultrastructure of Rat Hippocampal and Cerebellar Neurons

This study was carried out to investigate the direct neurotoxicity of alcohol on CNS and the effects of piracetam or vitamins on ultrastructural changes of the rat cerebellar and hippocampal neurons during long-term alcohol treatment. To evaluate the results, quantitative analysis were done for light and electronic microscopic findings. On the light microscopy, red degeneration of pyramidal cells and Purkinje cells was found more apparently in the alcohol only treated group than in the control group. On the electron microscopy, increased lipofuscin pigments wee found in cerebellum and hippocampus. In quantitative analysis, vitamins significantly reduced red degeneration in both hippocampus and cerebellum. However, piracetam significantly reduced red degeneration in cerebellum but not in hippocampus. Lipofuscin pigments in Purkinje cells and pyramidal cells were significantly reduced in the alcohol with piracetam treated group than the alcohol only treated group. However, vitamin had no significant reducing effect of lipofuscin pigments in Purkinje cells and pyramidal cells. According to the results, it is concluded that vitamins deficiency might cause red degeneration of pyramidal cell after long-term alcohol treatment, but increment of lipofuscin pigments in pyramidal and Purkinje cell may be caused by alcohol itself or its metabolite rather than vitamins deficiency. Piracetam seems to improve cognitive function impairment caused by alcohol consumption.