Oncologic and Functional Outcomes after Partial Nephrectomy Versus Radical Nephrectomy in T1b Renal Cell Carcinoma: A Multicenter, Matched Case-Control Study in Korean Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The study was to compare the oncologic and functional outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for pathologically proven T1b renal cell carcinoma using pair-matched groups. MATERIALS AND METHODS: We reviewed our prospectively maintained database for RN and PN in T1b renal tumors surgically treated between 1999 and 2011 at five institutions in Korea. Of 611 patients treated with PN or RN for a solitary and NX/N0 M0 renal mass (4-7 cm), 577 (PN, 100; RN, 477) patients with pathologically confirmed pT1b remained for analysis. Study subjects were grouped by PN or RN, then matched by age, sex, comorbidities, body mass index, tumor size and depth, histologic type, and preoperative estimated glomerular filtration rate (eGFR) using propensities score. To evaluate oncologic outcomes, overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were analyzed. The functional outcomes were evaluated by postoperative eGFR. RESULTS: The median follow-up in the RN group was 48.1 and 42.6 months in the PN group. The estimated 10-year CSS rate (PN 85.7% vs. RN 84.4%, p=0.52) and 5- and estimated 10-year PFS rates (PN: 86.4% and 79.2% vs. RN: 86.0% and 66.1%, p=0.66) did not differ significantly between groups. The estimated 10-year OS rate was significantly higher in the PN group (85.7%) compared to the RN group (73.3%) (p=0.003). PN was less likely to induce new-onset chronic kidney disease (CKD) and end-stage CKD compared with RN. CONCLUSION: Our study suggests that patients treated with PN demonstrate a superior OS rate and postoperative renal function with analogous CSS and PFS rates compared with pair-matched patients treated with RN.

Effect of Ixeris dentata Nakai Extract on Nitric Oxide Production and Prostaglandin E2 Generation in LPS-stimulated RAW264.7 Cells

Inflammation is the basis of severe acute and chronic diseases. This study investigated the anti-inflammatory property of a crude methanol extract (MeOH-ex) and the solvent fractions of Ixeris dentata Nakai (IDN) in LPS-stimulated murine macrophage-like cell line RAW264.7. Here, we showed that the ethyl acetate fraction (EtOAc-fr) had the most potent inhibitory activity on LPS-induced nitric oxide (NO) production among the tested samples, i.e., IDN MeOH-ex and the three different solvent fractions (chloroform, n-hexane, and EtOAc). We further found that the EtOAc-fr significantly inhibited LPS-induced prostaglandin PGE2 (PGE2) generation in RAW264.7 cells. Furthermore, the treatment with EtOAc-fr effectively suppressed the expression of inducible NO synthase (iNOS) and cyclooxygenase 2 (COX-2). These results suggest that the EtOAc-fr of IDN MeOH-ex exhibits an anti-inflammatory activity in vitro by inhibiting LPS-induced NO production and PGE2 generation via suppression of iNOS and COX-2 expression.

Chronic Aircraft Noise Exposure and Sustained Attention, Continuous Performance and Cognition in Children

OBJECTIVES: This study was focused on the influence of chronic aircraft noise exposure on children's continuous performance, intelligence and reading skill. METHODS: We enrolled 586 children in 4-6th grade of 7 primary schools near air base in Korea. Continuous performance was measured using the computerized ADS program. We analyzed 477-512 children on the visual continuous performance test, auditory continuous performance test, intelligence test, and reading and the vocabulary test. Intelligence was measured using vocabulary, digit span, block design, and digit symbol tests of K-WISC-III. RESULTS: The commission error and variability deviation of auditory continuous performance test and reading test were significantly higher among children in schools with the helicopter noise and the fighting plane noise compared to children in the low noised schools. CONCLUSION: There was a possibility that chronic aircraft noise exposure was associated with impairment of the school performance. The result of our study also shows chronic aircraft noise was associated with reading ability.

Effect of hydroxy groups in natural flavones on ocular blood flow of rabbits and retinal function recovery after ischemia insult in rat eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine the effect of hydroxy (OH) group on the ocular blood flow and retinal function recovery.METHODS: Colored microsphere technique was used to determine the ocular blood flow in rabbit eyes and electroretinography was used to measure the retinal function recovery.RESULTS: Flavones with four free OH groups seemed to produce the optimal effects in ocular blood flow increase and retinal function recovery. When there were 3OH groups (Apigenin), rapid increment in ocular blood flow and retinal function recovery was found. When the number of OH groups was below two (7-Hydroxyfiavone,Chrysin), no effect was observed on the ocular blood flow. The attachment of rutinose group in the fiavone (Diosmin) with two free OH groups and methoxy group did not affect the ocular blood flow or retinal function recovery, but the attachment of glucose group in the fiavone (Luteolin-7-glycoside) with catechol group affected the ocular blood flow one way or the other. The attachment of methoxy group in the fiavone (Acacetin)with two free OH groups affected ocular blood flow and retinal function recovery after ischemic insult.CONCLUSION: Ocular blood flow and retinal function recovery are increased significantly with the increase in the number of OH groups attached in the flavone molecule, with the 7-OH group and the catechol group in the B ring the most efficient to enhance the ocular blood flow and retinal function recovery after ischemic insult.

Mutations of DPC4/Smad4 Gene in Gallbladder Carcinoma

PURPOSE: The DPC4/Smad4 gene is known to perform a key role in the TGF-beta group protein signaling pathway, which regulates cell proliferation, differentiation and death. DPC4/ Smad4 gene mutation has been studied in cancers of the breast, ovary, esophagus, colo-rectum, bile duct, as well as the pancreas. The mutation rates depend on the kind of carcinoma sites, and range from 10% to around 50%, but no study has been performed on gallbladder carcinomas. This study was performed to search for mutation of the DPC4/Smad4 gene in the gallbladder carcinomas. METHODS: Eighteen surgically resected gallbladder cancers were screened for mutation of the exons; 8, 9, 10 and 11 of the DPC4/Smad4 gene using dideoxyfingerprinting (ddF), and single strand conformational polymorphism (SSCP). The results were confirmed using automatic DNA sequencing, and the expressions examined by immunohistochemical staining with the monoclonal anti-DPC4/Smad4 protein antibody, B8. RESULTS: DdF revealed 3 mutations in two of the exons, which were confirmed by direct sequencing. In one case, a single-base substitution mutation existed in exon 11 with codon change (missense mutation), whereas in two cases such mutations were detected in exon 9 without codon change (silent mutation). Immunohistochemical staining showed negative to weakly positive expression for all three mutated cases, but had high false-positive rates (7/11). CONCLUSION: DPC4/Smad4 gene mutation exists in a certain proportion of gallbladder carcinomas, but the mutation rate seems to be low compared to organogenetically related pancreas or bile duct carcinomas. This suggests somewhat different mechanisms may operate on the carcinogenesis of these organs.

A Case Report of Inflammatory Pseudotumor in the Spleen / 한국간담췌외과학회지

Inflammatory pseudotumor is a benign lesion mainly developed in respiratory system. It is difficult to distinguish from malignant lesions, so surgical biopsy is necessary. Of the extrarespiratory system, the inflammatory pseusotumor is rarely developed in the spleen, and first reported by Cotelingam and Jaffe in 1984. We report a case of the inflammatory pseudotumor in the spleen. A 59-years old woman has visited with a splenic mass detected on routine check. She denied the history of abdominal trauma or other diseases except urinary stone and had no subjective symptoms. Tumor markers were all within normal limits. For the differential diagnosis of the splenic mass, splenectomy was done. Grossly, 6x5x4.5 cm sized yellow, hard, well-demarcated mass was seen, and microscopically, prominent fibrosis and collagenation and partial infiltration of plasma cells and neutrophils were found. And the postoperative course was uneventable.

Treatment for Painful Bipartite Patella Using Vastus Lateralis Tendon Release / 대한정형외과학회잡지

Nine patients, who had ten painful bipartite patellae, were managed with a new operative tech nique in which the vastus lateralis insertion to the painful patellar fragment is detached subpe riosteally while the continuity of the tendon-periosteum complex to the main portion of the patella is preserved. A grossly mobile patellar fragment was removed in 3, fragment that showed minimum mobility was left in situ in 5 and fragment that had significant articular component was fixed with 4.0 mm cancellous screw in one. All of the patients had prompt relief of pain and returned to full sports activity within three months of the operation, 2 of 5 patellas that had not been removed united by bone to the main portion of the patella within 2 years post-operatively. Overall, 10 knees had excellent results at an average of four years post-operatively.

Alpha-Fetoprotein-Producing Carcinoma of the Gallbladder: A case report

We experienced a case of a gallbladder carcinoma detected incidentally by elevated serum alpha- fetoprotein. The patient had a symptom of mild intermittent indigestion, and a routine medical examination revealed elevation of serum alpha-fetoprotein. A mass, 4 cm 3 cm, was located in the gallbladder and it had not infiltrated the liver. The serum level of alpha-fetoprotein decreased after a cholecystectomy. The gallbladder mass was an adenocarcinoma of hepatoid differentiation. Cytoplasms of the tumor cells had positive reactivity to immunohistochemical staining of alpha-fetoprotein. In the course of postoperative follow up, the serum alpha-fetoprotein level increased continuously, and abdominal CT scanning proved multiple intrahepatic metastases.

Role of Intracellular Ca++ in Contraction and Relaxation of Rabbit Corpus Cavernosal Smooth Muscle / 대한비뇨기과학회지

PURPOSE: To elucidate the role of intracellular Ca++ stores in rabbit corpus cavernosal tissue, we performed organ bath study using strips from rabbit corpus cavernosum. MATERIALS AND METHODS: The corpus cavernosal strips of New Zealand white rabbit (3.0-3.5kg) were mounted in organ chambers to measure isometric tension. Each rabbit corporal strips of 3x10mm in size was incubated for 12 hours to reduce spontaneous contractions. The effects of Ca++ free Tyrode solution and TMB-8 (intracellular Ca++ blocker) on electrically and adrenergically induced contractions were evaluated. And the effects of ATP, bethanechol, sodium nitroprusside(SNP) and electrical stimulation(ES) in the presence of phenylephrine(PE) prestimulation were determined prior to and following preincubation with TMB-8. The responses were monitored via an FT03 force transducer and recorded on a Grass 7D polygraph and expressed as the g tension per 100mg of tissue in contractile response and percent of maximum contraction in relaxation response. RESULTS: PE and ES induced contractions were reduced depending on time but were not disappeared in the Ca++ free solution after 30minutes. Preincubation for 15minutes with 20uM TMB-8 significantly reduced contractile response of corporal smooth muscle (p<0.05). Relaxation responses to bethanechol and ES in TMB-8 preincubated group were significantly reduced in comparison with non-preincubated group (p<0.05). But there is no statistical differences between responses to ATP and SNP in TMB-8 preincubated and non-preincubated group. CONCLUSIONS: PE and ES induced contraction and NO mediated relaxation(bethanechol, ES) of corporal smooth muscle depend, in part, on the bioavailability of intracellular Ca++ via release through TMB-8 sensitive channels.

Contractile Response of the Rat Vas Deferens to Electrical Field Stimulation, Phenylephrine and Acetylcholine under Hypoxia / 대한비뇨기과학회지

PURPOSE: The proper functioning of all smooth muscle structures depends on the ability of normal blood to deliver oxygen and nutrients to the muscles. In addition, hypoxia has been shown to inhibit the contractile response to various forms of stimulation. The contractile response of the vas deferens can be divided into two phases: an initial rapid increase in tension(phasic contraction) and prolonged period of sustained tension(tonic contraction). The aim of this study was to determine the effect of hypoxia on the ability of the vas deferens to sustain tension . MATERIALS AND METHODS: The isolated strips of rat vas deferens were studied for Isometric tension measurement under normoxia and hypoxia in the organ chamber. Effects of phenylephrine(Phe) and acetylcholine(Ach) on the rat vas deferens tissue were monitored under normoxia and hypoxia. RESULTS: The results of these studies can be summerized as follows; (1) hypoxia induced time dependent decrease in both phasic and tonic contraction in response to electrical field stimulation(4 and 32Hz). The rate of inhibition of the tonic contraction was significantly and immediatly greater than that of the phasic contraction in both the prostatic and epididymal vas deferens, which was much prominent. (2) hypoxia(5min) increased the basal tension of prostatic vas deferens only to Phe(10(-3)M) and Ach(10(-3)M). But In the response of epididymal vas deferens to Phe(10(-3)M) and Ach(10(-3)M), rhythmic contractions disappeared. CONCLUSIONS: In conclusion, the contractile response of rat Vas deferens to electrical field stimulation under hypoxia were decreased and basal tension of prostatic vats deferens to Phe(10(-3)M) or Ach(10(-3)M) was increased This effect can interfere the sperm expulsion by changing normal contractability of the vas deferens.

Four Cases of Conservative Surgical Management in Major Renal Injury / 대한비뇨기과학회지

A review is presented in 4 patients with major renal injury seen in our hospital. All patients underwent conservative surgical management. A conservative surgical management to major renal injury is emphasized.

A Case of the Bilateral Testicular Infiltration of the Leukemia Patient / 대한비뇨기과학회지

Testicular infiltration is less common than CNS leukemia and is manifested by painless, progressive enlargement of the testis, This complication may also occur during a period of hematologic remission. We report a case of testicular infiltration developed in a 14yrs old man old man and the relevant literature has been reviewed.