The Role of Clusterin in Apoptosis Induced by Testicular Torsion / 대한비뇨기과학회지

PURPOSE: This study examined the histological changes and apoptosis in contralateral rat testes after testicular torsion or the repair of torsion, and investigated the functional role of clusterin in the pathogenesis for the injury of the contralateral testes after testicular torsion. MATERIALS AND METHODS: H&E staining and TUNEL assay were performed in contralateral testes following torsion or repair of torsion. The mean numbers of spermatids per tubule and apoptotic germ cells per tubule were calculated in each group with respect to time. The expression of clusterin after torsion or the repair of torsion was observed by RT-PCR and Western blot analysis. RESULTS: Following the repair of torsion, significant germ cell injuries and abnormal spermatogenesis were observed in the contralateral testes compared to those without repair. The expressions of clusterin mRNA and protein after testicular torsion were no different from those in the control testes. However, in the contralateral testes, the clusterin mRNA and clusterin protein expressions in the contralateral testes were increased 8 hours after the repair of torsion. The appearance of apoptosis in the contralateral testes after the repair of torsion appeared to correlate with the clusterin protein expression. CONCLUSIONS: The injury to contralateral testes during testicular torsion seems to be caused by the apoptosis induced by reperfusion of ischemic torsioned testis. Clusterin appears to play an antiapoptotic role in the apoptotic process in the injury to the contralateral testis due to the repair of testicular torsion.

The Expression of Vascular Endothelial Growth Factor and Thrombospondin-1 in Wilms' Tumor / 대한비뇨기과학회지

PURPOSE: With the process of neoangiogenesis being linked to the growth and metastasis of various tumors, anticancer therapeutics with a basis in the suppression of neoangiogenesis has recently been receiving attention. In this study, we tried to clarify the immunoreactivities of vascular endothelial growth factor (VEGF), major angiogenic inducer and thrombospondin-1 (TSP-1), major angiogenic inhibitor in human Wilms' tumor and its clinicopathological significance. MATERAILS AND METHODS: Utilizing immunohistochemical staining, we assessed the immunoreactivities of VEGF and TSP-1 in archival tissues of 29 Wilms' tumors and 25 normal kidneys. Also, we assessed the relationship between expression of each factor and clinicopathological parameters in 29 cases of Wilms' tumors. RESULTS: Immunoreactivities of VEGF and TSP-1 were detected mainly in the cytoplasm of the tubular cells in normal kidneys. In Wilms' tumors, whereas VEGF was detected in the cytoplasm of the tumor cells and peritumoral stromal tissues, but TSP-1 only in the peritumoral stromal tissues. Immunohistochemical expression patterns of each factor were divided into two groups according to the area of immunoreactivity (negative: OR =10%). VEGF immunoreactivity was detected in 25 (100%) normal kidneys and in 20 (69%) Wilms' tumors. However, TSP-1 immunoreactivity was detected in 24 (97%) normal kidneys and in 3 (10%) Wilms' tumors. Therefore, although no significant difference was observed between the expressions of VEGF and TSP-1 in normal kidney, the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors. A relatively higher rate of positive expression of TSP-1 was observed in the patients with no demonstrable lymph node metastasis. Also, as for the VEGF, maximal diameter of the tumor was larger in the positive expression group. However, it proved otherwise for TSP-1 as the negative expression group demonstrated tumors with larger maximal diameters. CONCLUSIONS: Our study demonstrated that the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors, and disease progression has a tendency to be found in the VEGF-positive cases and TSP-1 negative cases. We suggest that the growth and metastasis of Wilms' tumor may be influenced mainly by TSP-1 decrease rather than VEGF increase.

The Long Term Results of Augmentation Cystoplasty in Contracted Bladder / 대한비뇨기과학회지

PURPOSE: In contracted bladder of various etiologies, if many of conservative managements fail, a surgical treatment seems to be the only therapeutic approach. We tried to evaluate the long term results of aug mentation cystoplasty including the postoperative complication and the degree of satisfaction in patients. MATERIALS AND METHODS: From 1989 to 1988, augmentation cystoplasties had been performed in 11 patients with contracted bladder of various etiologies. We reviewed the patients' medical records including the result of urodynamic examinations, retrospectively. Postoperative follow-up periods were 9 to 114months (mean:61months). Patients were interviewed by telephone. RESULTS: Urinary frequency, nocturia, dysuria and suprapubic pain were improved in all patients, but dysuria persisted in one patient with tuberculous cystitis. Clean intermittent catheterization (CIC) was done in there of 11 patients due to large volume of residual urine. The volume of residual urine was 200-300ml in one with hyperreflexic neurogenic bladder, and 100-200ml in two with interstitial cystitis. Self voiding was possible in 8 patients with residual urine volume less than 90ml. Almost all patients were very satisfied symptomatically in the telephone survey. There were no significant complications which required surgical revision. CONCLUSIONS: It is concluded that augmentation cystoplasty could be an excellent method of treatment for selective patients with contracted bladder, who have not improved symtomatically by medication or conservative management.

Effects of Histamine and Hydroxyzine on the Bladder Contraction of Rat / 대한비뇨기과학회지

No abstract available.

The Factors Influencing the Percentage of Free Serum Prostate Specific Antigen Levels in Men without Clinically Detectable Prostate Cance / 대한비뇨기과학회지

No abstract available.

The Effect of Venous Extension on the prognosis of Renal Cell Carcinoma / 대한비뇨기과학회지

No abstract available.

The Factors Influencing the Percentage of Free Serum Prostate Specific Antigen Levels in Men without Clinically Detectable Prostate Cance / 대한비뇨기과학회지

No abstract available.

The Effect of Venous Extension on the prognosis of Renal Cell Carcinoma / 대한비뇨기과학회지

No abstract available.

A Clinical Study Following Macrosurgical Procedures for Tubal REversal / 대한산부인과학회잡지

From January 1989 to December 1994, 105 cases of Macrosugical tubal reversal were performed and 87 cases of them were followed up for more than 1 year postoperatively in the Department of Obstetrics and Gynecology, Pohang St. Mary's Hospital. The result were as follows;1. The mean age of the patients was 31.7 years and 93.1% of them had been sterilized by laparoscopic sterilization. 2. Average inteval between sterilization and tubal reversal was 43.3 months. 3. The reasons for requesting reversal of sterilization were remarrigae 41.5%, chagne of attitude 33.3%, loss of children 25.2%. 4. The distributions of the site of tubal anastomosis were isthmic-ampullar 58.6%, isthmic-isthmic 24.1%, cornual-isthmic 8.1%. 5. The postoperative tubal length was 5.0 cm or more in 78.0%. 6. The overall pregnancy rate after tubal reversal was 68.9% and the outcome of the pregnancy was as follows; term pregnancy 74.6%, premature delivery 1.8%, opontaneous abortion 10.9%, ectopic pregnancy 9.1%, pregnancy state 3.3%.

Ureteroscopic Manipulation for Ureteral Calculi: Comparison with ESWL / 대한비뇨기과학회지

Ureteroscopy has been used widely to remove ureteral calculi, especially distal ureter stones. Also extracorporeal shock wave lithotripsy (ESWL) has widened its applicability to ureter stones including distal ureter stones. In this study we tried to evaluate the exact role of ureteroscopic manipulation to get rid of ureter stones in the era of ESWL. Success rates and complications of 111 ureteroscopic stone removal procedures performed from December 1986 to May 1995 and those of another 369 patients managed with ESWL from May 1989 to May 1995 were analyzed. Success was defined as complete removal of the stones or residual stones less than 2 mm, immediate postoperatively in ureteroscopic manipulation and 2 weeks after ESWL. The success rate of the ureteroscopic manipulation was 38.9% (7/18), 46.2% (6/13) and 67.5% (54/80) in upper, middle and lower ureter stones, respectively. According to the size of the stone, success rate was 72.4% (21/29), 63.5% (40/63) and 14.3% (9/63) when it was less than 5 mm, 6 to 10 mm and larger than 10 mm. So the overall immediate postoperative success rate of ureteroscopic stone removal was 60.4%, and in another 8.9% of the patients the residual fragmented stones were expelled spontaneously in one month after the procedure. Complications were found in 9.9% of the procedures, including 5 mucosal avulsions and 2 ureteral strictures Success rate of the single session of ESWL was 64% without any differences regardless of the location of the stones in ureter, and it increased up to 88% when another 2 more sessions were tried. Success rate of the single session of ESWL according to the size of the stone was 91.7% (22/24), 67.9% (144/215) and 53.89S (70/130) in stones less than 5 mm, 6 to 10 mm and more than 10 mm, respectively. Complications were found in 3.4% of the patients, including 1.7% of steinstrasse and 1.4% of severe nausea and vomiting. From these observations we can conclude that it seems to be mandatory to renovate the indications of the ureteroscopic stone removal procedures in the era of ESWL.

The Value of Radionuclide Bone Scan in Renal Cell Carcinoma / 대한비뇨기과학회지

The need for routine radionuclide bone scan as part of the preoperative metastatic work-up in patients with renal cell carcinoma has been debated by several investigators more than 10 years. To investigate the value of radionuclide bone scan, radionuclide bone scans were performed preoperatively as part of staging procedures in 79 patients of 91 patients with renal cell carcinoma from 1989 to 1994. We analyzed the findings of bone scan according to the clinical and laboratory variables. When hot uptake was detected on the preoperative bone scan, it was interpreted positive if there was no history of trauma or absence of bone and joint disease such as degenerative Joint disease or arthritis. The bone scans were positive in 21 cases ( 26.6%) and negative in 58 cases (73.4%). The bone scans were neither correlated with the clinical variables such as incidentaloma, age of the patient, performance status, bone pain, the size of the tumor, T category of the tumor, thrombosis of renal vein or IVC, lymph node metastasis and extraskeletal metastasis nor with laboratory variables such as serum alkaline phosphatase, hemoglobin, serum calcium and ESR. We also analyzed positive scan according to the number of bony lesions. There was no correlation between the number of lesions on bone scan and clinica1 and laboratory variables. In conclusion, there was no clinical and laboratory parameters predicting positivity of bone scan. This suggests that all patients with renal cell carcinoma should be staged routinely with preoperative bone scan as the part of the initial clinical work up.

Clinical Significance of GnRH Stimulation Test in Adolescent Varicocele / 대한비뇨기과학회지

We measured the gonadotropin responses to the intravenous injection of gonadotropin releasing hormone(GnRH) in 16 adolescent varicocele patients and the results were compared with those of normal control group. After GnRH stimulation, LH response was very exaggerated in all the adolescent varicocele patients compared to the response of normal control but FSH response was not different from that of normal control. Testicular size and size difference were not correlated with GnRH stimulation test. We suggest that GnRH stimulation test may detect testicular dysfunction before the change in testicular size and early treatment may reduce the potential risk for infertility in adolescent varicocele patients, but long term follow up will be required to confirm our data.

Assessment of Surgical Methods for Impalpable Cryptorchid Testis / 대한비뇨기과학회지

Management of the impalpable testis is one of the controversial issues in cryptorchidism. So we studied to evaluate the usefulness of laparoscopy and surgical methods for impalpable testis. From January 1992 to December 1993, a total of 36 patients with impalpable cryptorchid was admitted to Seoul National University Children's Hospital. All the patients were examined by laparoscopy under general anesthesia. According to laparoscopic finding, in 15 patients with high abdominal testis, we performed 5 microscopic testicular autotransplantations and 10 testicular vessels transsections(Fowler-Stephens method). In other cases, We performed 9 standard orchiopexies and 6 orchiectomies. Complication of laparoscopy was not experienced. During mean follow up period of 12 months, success rate was 80% in microscopic testicular autotransplantation, 80% in testicular vessels transsection and 91% in standard orchiopexy. Therefore, we think that laparoscopy can be used safely to assess the accurate location of impalpable testis and that surgical methods including testicular autotransplantation are acceptable to high abdominal testis.

In Situ Extracorporeal Shock Wave Lithotripsy for Ureteral Calculi: Investigation of the Factors Influencing on Stone Fragmentation and the Appropriate Session for Changing Treatment Modality / 대한비뇨기과학회지

To determine the factors influencing on stone fragmentation and the appropriate session for changing treatment modality of ureteral calculi refractory to in situ ESWL, we analyzed 369 patients with ureteral calculi primarily treated by second-generation lithotripter, Siemens Lithostar from March,1989 to December, 1993. The results obtained were as follows: 1.Three hundred and forty two(92.7%) of the total 369 patients were ultimately free of stones by repetitive performance of in situ ESWL ranging from the first session to the tenth session. 2. The cumulative stone-free rates of the first, second and third session were 64%, 81% and 88%, respectively, and the increment of cumulative stone-free rate thereafter with further repeated in situ ESWL was minimal(p0.05). 4. According to the size of stone, the cumulative stone-free rate at third session was 100%, 90%, 87%, 70%, 67%, 50% in stones less than 5 mm, 6-10 mm, 11-15 mm, 16-20 mm, 21-25 mm and above 25 mm, respectively(p<0.001). 5. According to the radio-opacity of stone, the cumulative stone-free rate at third session was 96% in stones with minimal opacity, 94% with moderate opacity and 70% in highly opaque stones(p<0.001). 6. According to the degree of ureteral obstruction due to stone, the cumulative stone-free rate at third session was l00% without ureteral obstruction, 80% with mild, 57% with moderate, 67% with severe ureteral obstruction, and it was 50% in patients with non-visualization of the kidney(p<0.05). From these observations, it could be concluded that the factors influencing on stone fragmentation were the size of calculi, radio-opacity and the degree of ureteral obstruction, whereas the location of the ureteral calculi did not influence on the cumulative success rate of repetitive in situ ESWL. Also, it is preferable to restrict the repetitive sessions of in situ ESWL within third session in patients with the ureteral calculi refractory to in situ ESWL, and early change of surgery would be retreatment modality either to ureteroscopic manipulation or to open commended if there are risk factors listed above.

Therapy and Outcome in 47 Cases of Wilms' Tumor / 대한비뇨기과학회지

We studied to know The prognostic factors of Wilms' tumor who admitted to the Seoul National University Children's Hospital from May 1985 to July 1992. We treated Wilms' tumor with surgery, anticancer chemotherapy and radiation therapy according to National Wilms' Tumor Study protocol and analysed survival or relapse rate versus prognostic factors (age at diagnosis, histology, lymph node involvement and stage). As a result, during median follow-up period of 31 months, two year relapse free survival rate was 64% and 2-year overall survival rate was 79%. Two year overall survival rate was 100% in stage I, 83% in stage II and III, 60% in stage IV. This tumor stage was statistically significantly correlated with survival rate(P 0.05). We concluded that stage is more valuable prognostic factor than age, histology and lymph node involvement.