Inaccuracy in Ultrasonographic Measurement of the Testicular Volume in Children / 대한비뇨기과학회지

PURPOSE: For the measurement of testicular volume, we tried to evaluate the differences between the 1) ultrasonographic and intraoperative ruler measurements, 2) the performances by a radiologist and urologic residents and also 3) the difference among the various formulas for volume calculation. MATERIALS AND METHODS: The sizes of 108 testes of 96 children (mean age: 4) were measured preoperatively for the length (L) and width (W) with using ultrasonography by a radiologist. These testes were also measured intraoperatively for the L, W and thickness (T) with using a ruler. Of the 108 testes, 57 testes were also scanned with using ultrasonography by urologic residents to measure the L, W and T. The testicular volumes were calculated with three different formulas: LxW2x0.52 (F1), LxWxTx0.52 (F2) and LxWxTx0.71 (F3). RESULTS: The mean volumes of the 108 testes measured with ultrasonography by the radiologist and with a ruler were 0.27+/-0.2ml vs. 0.87+/-0.56ml, respectively (p<0.001). The mean difference between the volumes measured with ultrasonography and a ruler was 0.61+/-0.47ml. The mean volume of 57 testes measured with ultrasonography by the urologic residents was not significantly different from that measured by a radiologist (p=0.235), and it was also smaller than the volume measured with an intraoperative ruler (p<0.001). CONCLUSIONS: The testicular volume in children was much underestimated by ultrasonography with statistical significance. Therefore, the possibility of underestimation must be considered in clinical settings. The testicular volumes measured with ultrasonography by the radiologist and by the urologic residents had no significant difference.

Correlation of Caveolin-1 Expression on Tissue Microarray with Prognosis in Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: We investigated the relationship between the expression of caveolin-1, using a tissue microarray (TMA), and the prognosis of patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: TMA sections of formalin-fixed, paraffin-embedded tissues of RCC from 82 patients, who had undergone radical nephrectomy, were stained immunohistochemically with specific antibodies against caveolin-1. The caveolin-1 immunostaining was semi-quantitatively estimated based on intensity. The expression pattern of caveolin-1 was compared with the clinicopathological variables. RESULTS: The expression of caveolin-1 was significantly correlated with tumor size (p=0.002), TNM stage (p<0.001), T stage (p=0.001), M stage (p=0.004), grade (p=0.028) and metastasis (p<0.001), and was also significantly higher in clear cell than non-clear cell RCC (p<0.001). The survival of patients with higher caveolin-1 expression was significantly worse than that of patients with lower caveolin-1 expression (p=0.001). Univariate analyses were able to identify all variables, including caveolin-1 expression as significant prognostic factors for cancer-specific survival; multivariate analyses indicated that TNM stage, M stage and grade were independent prognostic factors. Caveolin-1 expression was not an independent factor. CONCLUSIONS: The increased expression of caveolin-1 is associated with tumor size, stage, grade, metastasis and a worse prognosis in RCC, which suggests that caveolin-1 may be important in the progression of RCC.

Localized Amyloidosis of the Prostate / 대한비뇨기과학회지

The increasing number of prostatic biopsies, performed for the investigation of patients at risk of prostate cancer, will result in the more frequent identification of uncommon forms of prostatic pathology. Amyloidosis is a disease characterized by the extracellular deposition of insoluble amyloid fibrils, and may be either systemic or localized. Localized amyloidosis of the prostate is very rare. Herein, we report the case of a 34-year-old man with localized amyloidosis of the prostate, which was found via a transrectal ultrasound-guided prostatic biopsy due to an increased serum prostate-specific antigen level.

Analysis of Heart Rate Variability in Patients BPH

PURPOSE: To characterize autonomic dysfunction in patients with benign prostatic hyperplasia(BPH), we measured heart rate variability(HRV) and analyzed them compared with those of normal population. MATERIALS AND METHODS: ECG signals were obtained from 11 male patients(mean age, 63.1 years) and 23 healthy male controls(mean age, 57.0 years) in resting state. We analyzed their parameters of HRV and compared them between groups. RESULTS: Time domain analysis including standard deviation of NN interval(SDNN), square root of mean of sum of squares of differences between adjacent NN intervals(RMSSD) in patients with BPH were not significantly different with those of controls. There were suggested evidence of decreased total power(TP), high frequency (HF) in patients with BPH(p<0.05) while no significant difference in other frequency domain such as very low frequency(VLF), low frequency(LF) and LF/HF ratio. CONCLUSION: This preliminary study shows that patients with BPH have different results on HRV study comparing to controls. With the exception of LF and LF/HF ratio, all parameters of HRV in patients with BPH lower than normal controls. TP, HF in patients with BPH significantly lower than that of normal controls. The decreased values of HRV study means that they may have some kinds of disease or imbalance in autonomic nervous system(ANS). So we suggest that HRV study may be a tool to describe the possibility of altered ANS activity in patients with BPH.

Clinical Characteristics of Nontraumatic Acute Renal Infarction / 대한비뇨기과학회지

Purpose: Early diagnosis and treatment are essential features to save the kidney in patients with an acute renal infarction. To reduce the delay in diagnosis, the clinical features and treatments of an acute renal infarction were evaluated. Materials and Methods: The medical records of 19 patients (14 men and 5 women) diagnosed with an acute renal infarction were retrospectively analyzed. Symptoms, findings of a cardiologic evaluation, laboratory findings, presumptive diagnosis and treatments were evaluated. Results: All patients complained of flank or abdominal pain. Fifty-three percent of the patients had a history of cardiovascular disease and 37% had no history of specific illnesses. The level of serum LDH was markedly elevated in all patients that performed the test. Initially, only 4 patients were diagnosed as acute renal infarction. In the others, the presumptive diagnoses were urinary stone, acute abdomen, aortic dissection and so forth. Seven patients were managed with conservative care due to the delay in diagnosis or poor general condition. Nine patients were managed with systemic anticoagulation and 3 with intra-arterial thrombolytic therapy. Conclusions: An acute renal infarction must be considered as one of the presumptive diagnoses in patients presenting with flank or abdominal pain and a history of cardiovascular diseases. Prompt CT scanning and testing of the serum LDH level will help in the accurate and immediate diagnosis of an acute renal infarction.

Retroperitoneal Cystic Lymphangioma Simultaneously Diagnosed with Bladder Cancer / 대한비뇨기과학회지

Lymphangiomas are rare benign tumors of the lymphatic system. They usually occur in the neck or axillary region, whereas the retroperitoneum is one of the least frequent sites. The treatment of choice is complete surgical excision. We report a case of a 56-year-old man who had a retroperitoneal cystic lymphangioma in combination with bladder cancer. After complete surgical excision of the retroperitoneal lymphangioma with transurethral resection of the bladder tumor followed by intravesical BCG immunotherapy, the patient remained free of recurrence at 1 year after treatment.

Primary Malignant Fibrous Histiocytoma of the Kidney

Primary renal malignant fibrous histiocytoma is a rare tumor of the kidney. It is clinically and radiologically indistinguishable from a renal cell carcinoma. Even following radical surgery, the tumor shows a strong predilection for local recurrence and the prognosis is generally poor. We report on a 32-year-old man with malignant fibrous histiocytoma of the kidney who remained free of recurrence for 1 year after radical nephrectomy.

Primary Malignant Fibrous Histiocytoma of the Kidney

Primary renal malignant fibrous histiocytoma is a rare tumor of the kidney. It is clinically and radiologically indistinguishable from a renal cell carcinoma. Even following radical surgery, the tumor shows a strong predilection for local recurrence and the prognosis is generally poor. We report on a 32-year-old man with malignant fibrous histiocytoma of the kidney who remained free of recurrence for 1 year after radical nephrectomy.

Endoscopic Observation of Gastric Varices / 대한소화기내시경학회지

We observed the gastric varices in l89 variceal patients with liver cirrhosis and in 129 patients with UGI bleeding by endoscopy. Gastric varices was found in 27 cases(14.2%) amoag 189 variceal cases. There was variceal bleeding in 74 cases(57.4%) beieg the toy cause of UGI: bleeding among l29 cases with UGI bleeding and 6(4.7%) had endoscopically proved gastric Variceal bleeding. Cardiac and fundic varices were observed in l8 and 12 cases, respectively end 12 cases of cardiac varices were mainly observed on the lesser curvature side. The incidence of isolated gastric varices being 30 % amoag gastric varices was far less than that of esophagogastric varices. There was no significant relations between the severity of liver cirrhosis and the kinds of varices These results suggest that gastric varices are not infrequent cause of UGI bleeding cases. Therefore all must have attention in gastric intestinal fiberscopic examination in portal hypertensive patients.