Experimental Urinary Stone Formation by Sex Hormones in Rats and Analysis of Composition of the Stones / 대한비뇨기과학회지

PURPOSE: The incidence of renal stones is three times higher in men than women due to sex hormones, and most are calcium oxalate stones. Therefore, the effects of testosterone and estrogen in the formation of urinary stones were investigated. MATERIALS AND METHODS: One hundred female Sprague-Dawley rats were divided into seven groups. The first was the control group; the second was injected with testosterone cypionate into the muscle, every week; the third was fed tamoxifen only, everyday; the fourth was oophorectomized; the fifth was fed tamoxifen after an oophorectomy; the sixth was treated with testosterone after an oophorectomy; and the seventh was injected with testosterone, weekly, and fed tamoxifen everyday after an oophorectomy. The bladder stone formation and degree of renal crystal deposition of the control group was compared with those of the other groups. The composition of the bladder stones was analyzed by SEM (scanning electron microscopy)-EDX (energy dispersive X-ray microanalysis). RESULTS: Bladder stones were found in 9 rats from group 6 only, which also showed the most predominant renal crystal deposition rate (65.5%). There was a statistical significance in the renal crystal deposition rate only between groups 6 and 1. According to SEM-EDX analysis of the bladder stones, they were composed of struvite and apatite. CONCLUSIONS: It is suggested that testosterone and estrogen influenced the formation of struvite and apatite stones.

The Therapeutic Effect of Monotherapy and Combined Therapy for Androgen Blockade in Patients with Metastatic Prostate Cancer / 대한비뇨기과학회지

PURPOSE: We evaluated the therapeutic effect of combined androgen blockade (CAB) compared with that of medical, or surgical, castration monotherapy, in the treatment of the metastatic prostate cancer. MATERIALS AND METHODS: Of 53 patients with metastatic prostate cancer, we compared the overall survival between CAB and monotherapy groups, using a Kaplan-Meier survival curve. We also compared the therapeutic effect of flutamide and bicalutamide in the CAB group. RESULTS: There were no differences in known prognostic factors between the CAB and monotherapy groups. The mean survival after treatment were 43 months in the CAB group, and 38 months in monotherapy group, with no significant difference (p=0.470). There were also no differences in the survival rates between the flutamide and bicalutamide groups (p=0.158). CONCLUSIONS: These results implicate that the CAB was no better than medical, or surgical, castration monotherapy in patients with metastatic prostate cancer, and that flutamide or bicalutamide, in CAB, resulted in similar efficacies and tolerabilities.

The Therapeutic Effect of Monotherapy and Combined Therapy for Androgen Blockade in Patients with Metastatic Prostate Cancer / 대한비뇨기과학회지

PURPOSE: We evaluated the therapeutic effect of combined androgen blockade (CAB) compared with that of medical, or surgical, castration monotherapy, in the treatment of the metastatic prostate cancer. MATERIALS AND METHODS: Of 53 patients with metastatic prostate cancer, we compared the overall survival between CAB and monotherapy groups, using a Kaplan-Meier survival curve. We also compared the therapeutic effect of flutamide and bicalutamide in the CAB group. RESULTS: There were no differences in known prognostic factors between the CAB and monotherapy groups. The mean survival after treatment were 43 months in the CAB group, and 38 months in monotherapy group, with no significant difference (p=0.470). There were also no differences in the survival rates between the flutamide and bicalutamide groups (p=0.158). CONCLUSIONS: These results implicate that the CAB was no better than medical, or surgical, castration monotherapy in patients with metastatic prostate cancer, and that flutamide or bicalutamide, in CAB, resulted in similar efficacies and tolerabilities.

Retroperitoneal Gossypiboma / 대한비뇨기과학회지

Gossypiboma is the term used to describe a mass within the body composed of a non-absorbable surgical material involving a cotton matrix. Surgical sponges with radiopaque markers are easily recognized on plain radiographs, but foreign bodies retained in the body without such markers present a diagnostic problem. Gossypiboma should be differentiated from a hematoma, abscess, cyst or tumor. Here we report a case of Gossypiboma in a 60-year-old male patient who had undergone a ureterolithotomy for a right ureteral stone 30 years earlier.

Primary T Cell Lymphoma of the Testis / 대한비뇨기과학회지

Primary malignant lymphoma of the testis is an uncommon tumor, accounting for only 1 to 9% of all testicular neoplasms and 1% of all non-Hodgkin's lymphoma. Especially, T cell lymphoma of the testis is very rare. However, it is the most common testicular malignancy in the elderly. It has a propensity for extranodal spread to the skin, subcutaneous tissue, CNS and lung. Immunohistochemical studies of testicular lymphoma have showed that the majority of these are B cell lymphomas, with rare reports of T cell lymphomas. Given the rarity of this disease, treatment has not been standardized. However, there is universal agreement that orchiectomy is the initial treatment. Although excellent results with a doxorubicin-containing chemotherapy regimen have been achieved in early stage disease, most patients have relapse of disease and a grave prognosis. We experienced the primary T cell lymphoma of the testis that was developed in 41 year-old-man.

False Negative of Doppler Ultrasonography During Testis Torsion in Animal Model / 대한비뇨기과학회지

PURPOSE: Our aim is to identify the false negative rate of doppler ultrasonography and to compare color doppler ultrasonography with pathologic findings during testis torsion in animal model. MATERIALS AND METHODS: Seventeen male house rabbits weighted 1.9-2.6kg were examined with doppler ultrasonography as control group and 1 rabbit was orchiectomized as pathologic control group. In 16 rabbits, right spermatic cord was torqued 720o count-clockwise and placed back into the scrotum, and 1, 3, 6, 9, 12, 18, 24, 48 hours after torsion, doppler ultrasonographic and pathologic findings were examined at twisted testicles. RESULTS: In 1 hour and 3 hours group, false negative rate of doppler ultrasonography were 100% and 6 hours after torsion false nagative rate was 63%. Nine hours after torsion false negative rate was 50%, 12 hours after torsion false negative rate was 25%. But after 18 hours group, all had decreased or disappeared blood flow. Before 9 hours after torsion, there was no pathologic changes in seminiferous tubules. In seminiferous tubules, number of spermatid decreased in 12 hours group and spermatid was absent and spermatocyte were markedly degenerated in 18 hours group. In 48 hours group, spermatid and spermatocyte were absent, number of Sertoli cell decreased markedly and diffuse infarction were seen. CONCLUSIONS: As time goes by, false negative rate of doppler ultrasonography was decreased. So if blood flow have been normal when doppler ultrasonography was done before 12 hours after torsion, doppler ultrasonography should be re-examined in suspected testis before 12 hours after torsion because of spermatocytes are degenerated after 12 hours.

A case of Renal Angiomyolipoma in a Child without Evidence of Tuberous Sclerosis / 대한비뇨기과학회지

Angiomyolipoma is a rare benign tumor and approximately 20 to 50% of patients with the diagnosis of angiomyolipoma have some or all of the other stigma of tuberous sclerosis. Patients with tuberous sclerosis tend to be younger, more likely to have multifocal and bilateral disease. Angiomyolipoma which is not associated with tuberous sclerosis mostly affects middle aged women. According to literature data, angiomyolipoma is very rare in child and almost exclusively associated with tuberous sclerosis. We report a case of 14 year-old girl who has a renal angiomyolipoma without clinical evidence of tuberous sclerosis.

Prognostic Value of TGF-beta1, TGF-beta2 Expression and Ki-67 Labelling Index in Prostate Cancer / 대한비뇨기과학회지

PURPOSE: Transforming growth factor-beta(TGF-beta) is a potent modulator of cell proliferation, differentiation, angiogenesis and immune system. We evaluate the significance of the expression of TGF-beta1 and TGF-beta2 and correlation with Ki-67 as prognostic factors in prostate cancer. MATERIALS AND METHODS: In order to investigate the expression of TGF-beta1, TGF-beta2 and Ki-67, we analyzed immunohistochemical staining from paraffin blocks of 22 cases of the prostate carcinoma and adjacent normal prostate. RESULTS: The TGF-beta1 staining scores of the tumor cells were higher than those of the adjacent normal epithelial cells(p=0.001). The TGF-beta2 staining scores of the tumor cells were also higher than those of the adjacent normal epithelial cells(p=0.003). However no correlation was observed between tumor surrounding stroma and normal stroma in TGF-beta1 and TGF-beta2 staining scores. The serum PSA level, the clinical stage, the Gleason score and the lymph node metastasis of the tumor was not correlated with the staining score of TGF-beta1 and TGF-beta2. Ki-67 labelling index(LI) was significantly associated with the histologic grade, while no relationship was observed between Ki-67 LI and clinical stage. TGF-beta1 and TGF-beta2 staining score was not statistically correlated with the Ki-67 LI. CONCLUSIONS: These results indicate that the prostatic cancer was associated with alteration of TGF-beta1 and TGF-beta2 expression by prostatic epithelial cells which may be biologically important in the development of prostate cancer and TGF-beta1 and TGF-beta2 expression may be new target of treatment of prostate cancer. Prognostic value of TGF-beta1 and TGF-beta2 expression was not statistically significant but Ki-67 LI was significantly associated with Gleason score.

A Case of Primary Amyloidosis of the Bladder / 대한비뇨기과학회지

Amyloidosis is characterized by deposition of homogenous, eosinophilic, hyaline material in various tissues. Presently, most cases occur in a generalized form as a manifestation of an underlying plasma cell neoplasm(myeloma) or plasmacytic dyscrasia. On the other hand, most cases of symptomatic amyloid disease in the urinary bladder has occurred as an apparently solitary, localized tumefactive process and mimicks invasive bladder tumor. We report a case of primary amyloidosis of the bladder which was diagnosed after transurethral resection in a 65-year-old man with chronic renal failure.

Effects of Electrohydraulic Lithotripsy on the Rabbit Bladder According to the Distance / 대한비뇨기과학회지

Currently many modalities are available for intracorporeal stone fragmentation. Among them electrohydraulic lithotripsy destructs stone by the effects produced when An electric discharges occurs in a liquid medium. Though electrohydraulic lithotripsy fragments all kinds of urinary calculi effectively, the major limitation of electrohydraulic lithotripsy remains the potential for urothelial injury. The objective of the present study is to evaluate the possible acute and long-term tissue effects of this instrument on the rabbit bladder. The tissue effects produced by a electrohydraulic lithotripsy were examined and compared. In all acute animals, visible mucosal lesions were seen at the site of probe firing in the bladder except the minor of 3millimeter-distance group. No significant long-term tissue effects were noted either grossly or pathologically in the 3-week animals. This study confirms our clinical impression that electrohydraulic lithotripsy can provide an efficient and safe modality of intracorporeal lithotripsy through proper patient selection and careful attention to technique.