Penile Augmentation Using Superficial External Pudendal Artery Pedicle and Adipose Tissue / 대한남성과학회지

PURPOSE: Many men are to some degree unsatisfied with the size of their penis, whether it is normal in size and appearance or not. We report a novel surgical technique for penile augmentation using a superficial external pudendal artery pedicle. MATERIALS AND METHODS: In total, 8 patients underwent penile augmentation from March 2003 to February 2004. Their mean age was 37.3 years. Five patients were unsatisfied about the size of their penis, and three patients had complications after insertion of foreign material. This penile augmentation technique was developed by using a low abdominal fat-flap where blood is supplied from the external pudendal artery. Spinal or epidural anesthesia was done during the operation, and the fat-flap was elevated and transpositioned to the site of lesion. RESULTS: All cases of patients were performed successfully by autografting using adipose tissue where blood flow was supplied from the external pudendal artery. There were no complications except one case of hematoma after the operation. The mean operative time was 80 min. The mean follow-up period after operation was about 6 months and all patients had a normal sexual life and no voiding dysfunctions. CONCLUSIONS: This novel surgical technique has several advantages. First, reconstruction without skin necrosis was possible even though the defect was large, because the blood supply was favorable. Second, there was no size limitation in augmentation with dermoplasty. Third, there was no evidence of atrophy of the flap.

Comparison of Techniques for Laparoscopic Radical Nephrectomy in a Single Center: Transperitoneal vs. Retroperitoneal vs. Hand-Assisted

PURPOSE: Laparoscopic surgery has become the standard method of radical nephrectomy within the urological community. We compared the safety and efficacy of different techniques for laparoscopic radical nephrectomy (LRN) in a single medical center. MATERIALS AND METHODS: Between June 2002 and August 2007, we performed LRN for renal cell cancer in 45 cases by a transperitoneal approach (TLRN), in 21 cases by a retroperitoneal approach (RLRN), and in 32 cases by a hand-assisted approach (HLRN), and the results of each approach were compared. Surgical results such as operative time, estimated blood loss (EBL), transfusion rate, hospital stay, complications, and pathologic results were reviewed retrospectively and analyzed by one-way ANOVA. RESULTS: There were no significant differences in demographic data among the 3 groups. The pathologic reports showed clear cell type in 97 cases and chromophobe type in 1 case. For each group (TLRN vs. RLRN vs. HLRN), the mean operative time was 207.9+/-57.06 vs. 211.8+/-52.85 vs. 184.4+/-49.43 minutes, respectively (p=0.03); the EBL was 135.0+/-29.40 vs. 153.8+/-45.59 vs. 183.4+/-89.25 ml, respectively (p=0.14); time to oral intake was 2.3+/-0.79 vs. 1.2+/-0.54 vs. 2.6+/-0.84 days, respectively (p<0.01); and the hospital stay was 6.7+/-0.77 vs. 5.4+/-0.73 vs. 8.2+/-1.51 days, respectively (p<0.01). There were no severe complications. The pathologic surgical margins were all negative. CONCLUSIONS: LRN can be performed efficiently and effectively with the transperitoneal, retroperitoneal, and hand-assisted techniques. Operators may select the technique for LRN according to their own preferences. In our experience, RLRN may protect the organ from injury and promote the recovery of lifestyle because of the early recovery of bowel movement.

Bacillus Calmette-Guerin Intravesical Therapy in Superficial Bladder Cancer: The Early Experience of Comparison of 6 Week Course and Modified 6 3 Maintenance Therapy / 대한비뇨기과학회지

PURPOSE: Bacillus Calmette-Guerin(BCG) immunotherapy is the treatment of choice for adjuvant therapy of superficial bladder cancer. The outcomes of a 6 week course of BCG immunotherapy was compared with those of a modified 6 3 maintenance therapy. MATERIALS AND METHODS: Between January 2001 and June 2007, 123 patients with a superficial bladder cancer were treated with a transurethral resection of the bladder tumor(TURBT) and intravesical BCG. For the 93 patients, BCG was administered over a six week course. For the remaining 30 patients, BCG was administered for six weeks followed by three weekly instillations at 3, 6, 12, 18, 24 and 36 months. The recurrence rate, time to recurrence and progression rate were assessed and analyzed. RESULTS: In the six week therapy group, the overall recurrence rate, mean recurrence interval and median follow up was 31.2%(29/93), 15.9 months and 19.4 months, respectively. The recurrence rate according to stage and grade was 27.6%(8/29), 33.9%(21/62) and 0%(0/2) on Ta, T1 and carcinoma in situ(CIS), respectively, and 29.6%(21/71), 40%(8/20) in low grade and high grade, respectively. Five cases in the T1 high grade and 1 case in T1 low grade group progressed to T2. In maintenance therapy, the overall recurrence rate, mean recurrence interval and median follow up was 16.7%(5/30), 16.4 months and 24.8 months, respectively. The recurrence rate according to stage and grade was 14.3%(1/7), 14.3%(3/21) and 50%(1/2) on Ta, T1, CIS, respectively, and 15.0%(3/20), 12.5%(1/8) in low grade and high grade, respectively. One case in the CIS sub group progressed to T4a. CONCULSIONS: These results show a lower recurrence rate in the modified 6 3 maintenance therapy group than in the 6 week therapy group. Therefore, modified 6 3 maintenance therapy is more effective for preventing a recurrence in a superficial bladder cancer than 6 week therapy.

Radiofrequency Ablation of Unilateral Kidney VX2 Tumors in the Rabbit Model / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate the effectiveness and indication of radiofrequency ablation(RFA) using renal VX2 tumors by implantation of VX2 tumor cells under the renal capsule in rabbits. MATERIALS AND METHODS: Ten rabbits were injected with 30-40microliter VX2 tumor cells(1.2x10(7) viable cells/ml) under the renal capsule of the right kidney by right subcostal incision. On the 14th day after the tumor cells were implanted, we checked for the development of renal tumors, and the sizes and shapes(exophytic or central) of the tumors by the use of computed tomography. We performed RFA in the renal VX2 tumors with a 17G StarBurst electrode through kidney exposure. After the first and third day following RFA, renal function was checked. On the third day, we performed CT and harvested the kidneys for gross and microscopic evaluation. RESULTS: We confirmed the development of renal VX2 tumors in nine cases. Tumor shapes were exophytic in seven cases and central in two cases; the mean size of the tumors was 2.1 cm(range, 1.1-3.8cm). In all tumors, RFA was performed. From the use of enhanced CT after RFA on the third day, all of the lesions treated with RFA showed no enhancement. From the pathological findings, coagulative necroses were seen on all of the lesions treated with RFA. The necrotized tumor size after RFA was not different statistically as measured by CT and a pathological examination (p=0.833) CONCLUSIONS:: In centrally located renal tumors, we experienced thermal injury in pelvocalyceal systems. RFA is an effective method for nephron sparing surgery as the tumor cells completely disappear and there is preserved renal function and the procedure is easy to apply. We suggest that the RFA method for exophytic renal tumors is more effective than other procedures.

Changes in Semen Parameters After Varicocelectomy: a Comparative Study of the Laparoscopic and Microsurgical Inguinal Approach / 대한남성과학회지

PURPOSE: The purpose of this study was to compare the surgical outcomes of two different surgical methods for varicocelectomy, and to assess the effects of varicocelectomy on semen parameters in subinfertile men. MATERIALS AND METHODS: This study included 63 patients with clinically palpable varicocele and abnormal semen parameters who underwent varicocelectomy. Thirty-three patients underwent laparoscopic varicocelectomy, and 30 received microsurgical inguinal varicocelectomy. Semen analyses were performed 5.3 months later, and compared with the pre-operative data. RESULTS: The mean age of patients was 32.1+/-1.3 years old. Comparison of the semen parameters between pre and post-varicocelectomy revealed significant improvement in the sperm count (p<0.05). In laparoscopic and microsurgical inguinal varicocelectomy, the sperm counts were increased from 16.2+/-4.3 to 30.6+/-7.5 and from 15.4+/-3.8 to 37.5+/-7.7, respectively. Sperm motility also tended to improve. CONCLUSIONS: Varicocelectomy enhanced semen parameters after both laparoscopic and microsurgical methods. In subfertile men, early varicocelectomy is recommended.

Changes in Semen Parameters After Varicocelectomy: a Comparative Study of the Laparoscopic and Microsurgical Inguinal Approach / 대한남성과학회지

PURPOSE: The purpose of this study was to compare the surgical outcomes of two different surgical methods for varicocelectomy, and to assess the effects of varicocelectomy on semen parameters in subinfertile men. MATERIALS AND METHODS: This study included 63 patients with clinically palpable varicocele and abnormal semen parameters who underwent varicocelectomy. Thirty-three patients underwent laparoscopic varicocelectomy, and 30 received microsurgical inguinal varicocelectomy. Semen analyses were performed 5.3 months later, and compared with the pre-operative data. RESULTS: The mean age of patients was 32.1+/-1.3 years old. Comparison of the semen parameters between pre and post-varicocelectomy revealed significant improvement in the sperm count (p<0.05). In laparoscopic and microsurgical inguinal varicocelectomy, the sperm counts were increased from 16.2+/-4.3 to 30.6+/-7.5 and from 15.4+/-3.8 to 37.5+/-7.7, respectively. Sperm motility also tended to improve. CONCLUSIONS: Varicocelectomy enhanced semen parameters after both laparoscopic and microsurgical methods. In subfertile men, early varicocelectomy is recommended.

Efficacy of Tamsulosin 0.2 mg/day in Female Patients with Lower Urinary Tract Symptoms

PURPOSE: The study of lower urinary tact symptoms(LUTS) in women is rare except urinary incontinence, and there were even no diagnostic or therapeutic guidelines for female bladder outlet obstruction. The objective of this study was to determine the efficacy of tamsulosin 0.2 mg/day single therapy for the female patients with LUTS. MATERIALS AND METHODS: A total 71 patients were evaluable. Tamsulosin 0.2 mg/day was administered orally in a nonblind design for 8 weeks. The efficacy parameters were International Prostate Symptom Score(IPSS), quality of life(QOL) score, frequency in daytime and night, maximal flow rate(Qmax), post-void residual urine volume(PVR), and changes in blood pressure and pulse rates. Changes in parameters between baseline and 8 weeks were assessed using Student's paired t-test. RESULTS: Statistically significant changes in the total, obstructive and irritative IPSS, QOL score, daytime and night time frequency, Qmax and PVR were observed at week 8. Adverse events included dizziness in 2 patients and increased nocturia in 1 patient. There were no withdrawals resulting from adverse events. There were significant differences in systolic blood pressure, but did not cause significant hypotension events. CONCLUSION: Treatment with tamsulosin 0.2 mg/day in female patients with LUTS was effective and well tolerated in improving LUTS and QOL.

The Influence of Chlormadinone Acetate on the Total and Free Serum Prostate Specific Antigen Levels in Men with Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Chlormadinone acetate (CMA) therapy for benign prostatic hyperplasia (BPH) may lower the serum prostate specific antigen (PSA) level. However, little is known about the effect of CMA on the total or free serum PSA levels of PSA. Such information would be important since PSA testing is useful for prostate cancer screening. Thus, we prospectively studied the effect of CMA therapy on the total and free serum PSA levels. MATERIALS AND METHODS: The patients with lower urinary tract symptoms (LUTS) and BPH who were aged over 50 years were treated with 50mg CMA for 6 months. Men with a PSA level greater than 10ng/ml were excluded to reduce the likelihood of including cases of occult prostate cancer. Those with suspicious findings on the digital rectal examination and serum PSA testing were biopsied to rule out prostate cancer. alpha- blocking agents were permitted to treat the men with LUTS. Serum levels of the total and free PSA were measured at the study baseline and after approximately 3 and 6 months. The prostate volume (PV) was assessed by transrectal ultrasonography. RESULTS: The analysis included 170 patients with a mean age of 67.9 years, a baseline PV of 47.3ml and a baseline total PSA of 4.1ng/ml. The total PSA levels declined from 4.1ng/ml at baseline to 2.0ng/ml after 6 months of treatment (50.7% decrease, p<0.01). The mean percent free PSA (21% to 22% at baseline) was not significantly altered by CMA treatment. The PSA levels and PV at baseline did not affect the rate of decline of PSA. CONCLUSIONS: The total PSA serum levels decreased by an average of 50% during CMA therapy, but the percent free PSA did not change significantly. This information is potentially useful in the interpretation of the PSA data that's used for early detection of prostate cancer in the men receiving CMA.

Relationship among risk factors related to Human Papillomavirus infection among youth / 한국역학회지

PURPOSE: To investigate the prevalence and related risk factors of infection with human papillomavirus(HPV) in young adults, and the interrelationships among the risk factors, school-based survey was conducted in Busan. METHODS: A total of 1,430 male and female students(aged 16~25) participated in the survey that included self-administered questionnaire and, for males, physician-performed collection of exfoliated genital cells, for females, self-collection of vaginal cells. The prevalences of 25 HPV types were evaluated by a polymerase chain reaction-based assay. RESULTS: HPV DNA detected more frequently in female students(15.2%) than in male students(8.7%). In female students, currently smoking cigarettes(OR=3.8, 95% CI=1.7~8.3) and having had penetrative sexual intercourse(OR=12.7, 95% CI=7.2~22.2) were the significant risk factors for HPV infection; in male students, there was nothing to show statistical significance. Smoking rate was 53.8% in males and 17.7% in females, and 55.6% of male students and 25.9% of female students reported having had a sexual intercourse. Smokers were more likely to have had a sexual intercourse than nonsmokers(OR=4.0, 95% CI=2.5~6.2, males; OR=9.1, 95% CI=5.6~14.7, females). CONCLUSIONS: According to the strong interrelationship between sexual intercourse and smoking, multilateral behavioral intervention is needed to prevent infection with HPV.

Novel Surgical Technique for Orthotopic Testicular Transplantation in Rats / 대한남성과학회지

PURPOSE: This study was performed to evaluate the functional and histological changes following orthotopic testicular transplantation. A new microsurgical technique was used for the transplantation. MATERIALS AND METHODS: Recipient rats were castrated, and microsurgically-removed testes from adult rats were utilized for orthotopic transplantation. Animals were divided into three groups:(1) the control group(n=6);(2) the castrated group(n=6);(3) the orthotopic testis transplantation group (n=12). In order to identify the survival of the testis after transplantation, testicular scans and histopathological examinations were performed. RESULTS: The following results were obtained from examination of transplanted testes: 1. Histopathologic findings. Excluding 2 transplanted rats which demonstrated ischemic necrosis, the testes of the other 10 transplantated rats showed almost normal histologic findings. 2. Testicular scan. Testicular scan was effective to differentiate the successfully transplanted testes from the testes with ischemic necrosis. CONCLUSIONS: These results demonstrate that orthotopic transplantation has a higher possibility of graft survival, and testicular scan is aneffective method to confirm the survival of transplanted testes. In addition, newly-developed orthotopic transplantation animal models could be used for research on the hypothalamus-pituitary-testis axis. The orthotopic transplantation technique could alsobe used as a new therapeutic method for congenital and acquired hypogonadism patients.

The Usefulness of the UBC(TM)(Urinary Bladder Cancer) Test for Screening of Transitional Cell Carcinoma of the Bladder in Patients with Hematuria / 대한비뇨기과학회지

PURPOSE: A new quantitative tumor marker, based on the combined measurement of urinary fragments of cytokeratins 8 and 18, namely the urinary bladder cancer antigen(UBC(TM)) test, has been proposed for the detection of bladder transitional cell carcinoma(TCC). We evaluated the diagnostic efficacy of UBC(TM) test in comparison with that of urinary cytology to establish UBC(TM) test for the diagnosis of TCC. MATERIALS AND METHODS: One-hundred ninety-six patients with hematuria were included in this study. Forty patients were diagnosed histologically as TCC by transurethral resection or radical cystectomy(group A), while the others had various benign urinary tract conditions(group B). RESULTS: UBC(TM) levels were significantly different between groups A (1851.39+/-4627microgram/l) and B (19.28+/-107.03microgram/l) (p<0.001). Sensitivity for diagnosis of TCC was 89.7%(36/40) in UBC(TM) test and 45%(18/40) in cytology(p<0.05). Specificity for diagnosis of TCC was 84.6%(132/156) in UBC(TM) test and 100%(156/156) in cytology. UBC(TM) test was significantly more sensitive than cytology in stage Ta(85.7% vs. 0%, p<0.05), T1 tumors(89.4% vs. 31.5%, p<0.05), and in Grades 1(83.3% vs. 25%, p<0.05) and 2(90.4% vs. 52.3%, p<0.05) tumors. UBC(TM) test was more sensitive in higher Grade(83.3% in Grade 1, 90.4% in Grade 2 and 100% in Grade 3). CONCLUSIONS: In comparison with urinary cytology, UBC(TM) test could be a valuable marker for diagnosis of TCC in patients with early stage and low grade TCC. Therefore, UBC(TM) test in association with cytology may be useful as a screening test for TCC of the bladder.

Epidemiological Study for Urologic Cancer in Korea (1998-2002) / 대한비뇨기과학회지

PURPOSE: To evaluate the incidence of urologic cancer in Korea. MATERIALS AND METHODS: Between January 1998 and December 2002 the Korean Urologic Oncology Society (KUOS) decided to evaluate the incidence of Korean urologic cancer. The URO-DMS data obtained by 86 training hospital was analyzed. First, the disease code was simplified; for example, renal cell carcinoma (C64), and thereafter, evaluated for incidence and prevalence, etc. RESULTS: A total of 35,480 patients were newly diagnosed over this period. Bladder cancer was the most common (42.9%) urologic cancer, followed by prostate (26.4%), kidney (22.4%), ureter (3.7%), renal pelvis (3.0%), testis (2.8%), penile (0.2%), urethral (0.1%) and scrotal cancers (0.1%). Male patients outnumbered the females by a ratio of 4.4:1. The incidence rates per 100,000 males for prostate and testicular cancers were 7.73 and 0.81, respectively. The incidence rates per 100,000 persons for bladder, renal, ureter and renal pelvis cancers were 6.36, 3.30, 0.55 and 0.44, respectively. Cancers of the prostate and kidney increased rapidly, but the others increased steadily. CONCLUSIONS: It is hoped that these results would contribute to cancer research and control of cancers in Korea.

A Multicenter Study of Antimicrobial Susceptibility of Uropathogens Causing Acute Uncomplicated Cystitis in Woman / 대한비뇨기과학회지

PURPOSE: Worldwide data shows that there is an increasing resistance among urinary tract pathogens to the first-line antimicrobial agents used in domestic areas. The objective of this study was to obtain data on the susceptibility patterns of the pathogens responsible for acute uncomplicated cystitis to currently used antimicrobial agents. MATERIALS AND METHODS: This study was carried out with the participation of fifteen hospitals in South Korea. A total of 239 isolates were obtained from female outpatients with acute uncomplicated cystitis. The antimicrobial susceptibilities to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, trimethoprim/sulfamethoxazole(TMP/SMX) and tobramycin were determined by Vitek(R) antimicrobial susceptibility test systems. RESULTS: The most prevalent causative organism was Escherichia coli(79.9%), followed by coagulase negative Staphylococcus(4.2%), and a combination of other species of Enterobacteriaceae(8.2%). The mean rates of susceptibility were 35.5, 45.0, 85.7, 81.5, 62.1 and 85.3% to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, TMP/ SMX and tobramycin, respectively. No significant differences were detected in the resistance rates between the results from 4 regional groups. CONCLUSIONS: The high prevalence of resistance to ampicillin, ampicillin/sulbactam, and TMP/SMX suggest these drugs would not provide adequate initial therapy, and therapies other than TMP/SMX may need to be considered. The relatively high prevalence of resistance to ciprofloxacin, compared with other countries, also requires on going surveillance to identify further changes among urinary tract isolates.

The Comparison of Therapeutic Effectiveness According to the Location of Tension-free Vaginal Tape (TVT) Procedure for Stress Urinary Incontinence in Females / 대한비뇨기과학회지

PURPOSE: A sling operation using tension-free vaginal tape (TVT) has been recently developed and popularized. In order to overcome the problem that the location of the TVT procedure is limited to the mid-urethra, the therapeutic effectiveness of the TVT sling through bladder neck approach was investigated and compared with that through the mid-urethra approach. MATERIALS AND METHODS: Out of 127 stress urinary incontinence patients, 78 patients were assigned to Group A (the mid-urethra approach) and 49 patients were assigned to Group B (the bladder neck approach). The data was analyzed according to age, grade, time of operation, postvoiding residual urine volume, postoperative complications, success rate and the patient's satisfaction. RESULTS: Both groups were mainly Grade I in Stamey grade. There was no significant difference in the surgery time between the two groups, with an average of 23 minutes and 24 minutes, respectively. Of the total number of SUI patients, 12% of Group B patients had a postvoiding residual urine volume larger than 100ml while 6% of Group A patients had a similar residual urine volume. In both groups, severe complications and discomfort were very rare. The success rates of the two groups were similar, 95% versus 96% respectively, and similar results were shown in the patients' satisfaction. Overall, there was no significant difference between two groups. CONCLUSIONS: In the TVT sling operation, the mid-urethra approach is the standard for SUI treatment. However, bladder neck approach has an equivalent effect. Therefore, it is believed that this site for the TVT will lead to more surgical approaches.

Usefulness of the UBC(TM)(Urinary Bladder Cancer) Test Compared to Urinary Cytology for Transitional Cell Carcinoma of the Bladder in Patients with Hematuria / 대한핵의학회잡지

No abstract available.

Combined Modality Therapy with Selective Bladder Preservation for Muscle Invading Bladder Cancer / 대한방사선종양학회지

PURPOSE: To assess the tolerance, complete response rate, bladder preservation rate and survival rate in patients with muscle-invading bladder cancer treated with selective bladder preservation protocol. METHOD AND MATERIALS: From October 1990 to June 1998, twenty six patients with muscle-invading bladder cancer (clinical stage T2-4, N0-3, M0) were enrolled for the treatment protocol of bladder preservation. They were treated with maximal TURBT (transurethral resection of bladder tumor) and 2 cycles of MCV chemotherapy (methotrexate, crisplatin, and vinblastine) followed by 39.6~45 Gy pelvic irradiation with concomitant cisplatin. After complete urologic evaluation (biopsy or cytology), the patients who achieved complete response were planed for bladder preservation treatment and treated with consolidation cisplatin and radiotherapy (19.8 Gy). The patients who had incomplete response were planed to immediate radical cystectomy. If they refused radical cystectomy, they were treated either with TURBT followed by MCV or cisplatin chemotherapy and radiotherapy. The median follow-up duration is 49.5 months. RESULT: The patients with stage T2-3a and T3b-4a underwent complete removal of tumor or gross tumor removal by TURBT, respectively. Twenty one out of 26 patients (81%) successfully completed the protocol of the planned chemo-radiotherapy. Seven patients had documented complete response. Six of them were treated with additional consolidation cisplatin and radiotherapy. One patient was treated with 2 cycles of MCV chemotherapy due to refusal of chemo-radiotherapy. Five of 7 complete responders had functioning tumor-free bladder. Fourteen patients of incomplete responders were further treated with one of the followings : radical cystectomy (1 patient), or TURBT and 2 cycles of MCV chemotherapy (3 patients), or cisplatin and radiotherapy (10 patients). Thirteen patients of them were not treated with planned radical cystectomy due to patients' refusal (9 patients) or underlying medical problems (4 patients). Among twenty one patients, 12 patients (58%) were alive with their preserved bladder, 8 patients died with the disease, 1 patient died of intercurrent disease. The 5 years actuarial survival rates according to CR and PR after MCV chemotherapy and cisplatin chemoradiotherapy were 80% and 14%, respectively (p=0.001). CONCLUSION: In selected patients with muscle-invading bladder cancer, the bladder preservation could be achieved by MCV chemotherapy and cisplatin chemo-radiotherapy. All patients tolerated well this bladder preservation protoco. The availability of complete TURBT and the responsibility of neoadjuvant chemotherapy and chemoradiotherapy were important predictors for bladder preservation and survival. The patients who had not achieved complete response after neoadjuvant chemotherapy and chemoradiotherapy should be immediate radical cystectomy. A randomized prospective trial might be essential to determine more accurate indications between cystectomy or bladder preservation.

Clinical Studies of Xanthogranulomatous Pyelonephritis / 대한비뇨기과학회지

PURPOSE: Because the preoperative diagnosis of xanthogranulomatous pyelonephritis (XGP) is difficult due to its similarities to other renal diseases, the diagnosis is made postoperatively in most patients. The aim of this study was to improve preoperative diagnosis of this disease. MATERIALS AND METHODS: We reviewed clinical characteristics, laboratory and radiological findings, preoperative diagnoses, and operative methods of 6 patients with XGP who underwent operation from March 1991 to July 1998. Mean age was 49.8 years (range 28 to 80) and male to female ratio was 1 to 2. RESULTS: All 6 patients had flank pain and urinary tract infection. Among 6 patients, there were 3 patients (50%) with renal staghorn stone and 1 (16.7%) with ureteropelvic junction stricture. No patient was diagnosed as XGP preoperatively. Three patients (50%) diagnosed as pyonephrosis with staghorn stone preopratively underwent simple nephrectomy and 2 patients diagnosed as renal mass preoperatively underwent radical nephrectomy. One patient diagnosed as renal abscess extended to retroperitoneum and psoas muscle preoperatively was diagnosed as XGP through intraoperative frozen section biopsy of renal tissue and underwent partial nephrectomy and drainage. CONCLUSIONS: Preoperative diagnosis of XGP will be raised through better understanding of the clinical characteristics and radiologic findings of this disease.

The Functional and Histological Changes Following Orthotopic Testicular Transplantation in Castrated Experimental Rats / 대한비뇨기과학회지

PURPOSE: This study was performed to evaluate the functional and histological changes following the orthotopic testicular transplantation. For orthotopic testicular transplantation, a new operative microsurgical techniques were applied. MATERIALS AND METHODS: Forty-eight (24) recipient rats were castrated and microsurgically removed testes from adult rats were utilized for orthotopic transplantation, respectively. These animals were divided into following three groups: 1) the control group (n=6); 2) the castrated group (n=6); 3) the orthotopic testis transplantation group (n=12). The levels of LH, FSH and testosterone were measured using radioimmunoassay. In order to identify the survival of testis, testicular scans were performed. Histopathological examinations were added. RESULTS: The following results were obtained: 1. Histopathologic findings. Excluding 2 transplanted rats which demonstrated ischemic necrosis findings, the testes of other 10 transplantated rats showed almost normal histologic findings. 2. Hormonal levels. There was no significnat statistical difference between the control group and the 10 successfully transplanted animals. 3. Testicular scan. Testicular scan was effective to differentiate the successfully transplanted testis from the testis with ischemic necrosis. CONCLUSIONS: These results demonstrate that orthotopic transplantation has higher possibility of graft survival, and testicular scan is a effective method to confirm the survival of transplanted testis. In addtion, newly developed orthotopic transplantation animal models could be used for hypothalamus-pituitary-testis axis research. The orthotopic transplantation technique would be used for the new therapeutic method for congenital and acquired hypogonadism patients, too.

Identification of Tumor Suppressor Gene in Renal Cell Carcinoma using Arbitrarily Primed-Polymease Chain Reaction (AP-PCR) / 대한비뇨기과학회지

No abstract available.

Correlation between Genetic Polymorphism of CYP2D6 and CYP1A1 and Susceptibility of Renal Cell Carcinoma in Korean / 대한암학회지

PURPOSE: Many of the enzymes handling environmental factors are polymorphic and may confer variable susceptibility to renal cell carcinoma (RCC). Among those, the author studied genetic polymorphisms of CYP2D6 (B & T) and CYP1A1 in RCCs and controls in Korean. MATERIALS AND METHODS: Using 132 RCCs and 94 controls, first PCR products were obtained in 104 RCCs and 94 controls with CYP2D6, and 74 RCCs and 56 controls with CYP1A1. Res triction enzyme - BstN I/EcoN I for CYP2D6 (B & T), and NCo I for CYP1A1-digestion was followed to analyze constitutive DNA. RESULTS: In both RCCs and controls, no mutant allele of CYP2D6 (B & T) was detected and the susceptibility for occurrence of RCC was unable to evaluate. With CYP1A1 RFLP, homozy gous wild type (WW) was seen in 68 (52.3%; 37 RCCs, 31 controls), heterozygous mutant type (WM) in 54 (41.5%; 32 RCCs, 22 controls) and homozygous mutant type (MM) in 8 (6.2%; 5 RCCs, 3 controls). The odds ratios (95% CI) of RCC susceptibility for CYP1A1 genotype were 1.15 for WM and 1.36 for MM. Even though not significant statistically, higher tendency in MM presented. CONCLUSION: There is no association between susceptibility for the occurrence of RCC and genetic polymorphism of CYP2D6 (B & T) and CYP1A1.