Functional, Morphologic, and Molecular Biological Changes in the Bladder of OLETF Diabetic Rats according to Duration of Diabetes Mellitus

PURPOSE: Our study was undertaken to investigate changes in the bladder according to duration of diabetes mellitus in the Otsuka Long Evans Tokushima Fatty (OLETF) rat model, which is similar to type 2 diabetes. MATERIALS AND METHODS: OLETF rats (n=14) and Long Evans Tokushima Otsuka (LETO, n=14) rats were used. LETO is a normal control of OLETF. The animals were assigned to 4 groups: L-40 group, LETO rats 40 weeks after birth (n=7); O-40 group, OLETF rats 40 weeks after birth (n=7); L-60 group, LETO rats 60 weeks after birth (n=7); and O-60 group, OLETF rats 60 weeks after birth (n=7). At 40 weeks or 60 weeks after birth, blood glucose, cystometry, bladder weight, detrusor contractility, and mRNA expression of nerve growth factor (NGF) were assessed. RESULTS: Cystometry showed that diabetic bladders had increased compliance compared with the control groups at 40 and 60 weeks, and the O-60 group had greater compliance than the O-40 group. Contractile responses to electrical stimulation, bethanecol (250microM), and ATP (10 mM) were decreased in the experimental groups compared with the control groups at 40 and 60 weeks, and the O-60 group had a lower contractile response than the O-40 group. The mRNA expression of NGF was decreased in the experimental groups compared with the control groups, and the O-60 group had lower expression than the O-40 group. Changes in NGF were identified through immunohistochemical staining. CONCLUSIONS: The degree of diabetic cystopathy in OLETF rats was changed by duration of type 2 diabetes mellitus. Our results showed that the changes in the bladder in type 2 diabetes mellitus can be identified through a new rat model.

Outcome after relapse in childhood and adolescent osteosarcoma: single institution experience in Korea / 소아과

PURPOSE: Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Although survival rate of osteosarcoma patients has markedly improved, about 20-30% of patients still have a relapse. This study was aimed to find factors that influence postrelapse survival of osteosarcoma in childhood and adolescents. METHODS: Between 1985 and 2004, of 461 patients who were diagnosed and treated as osteosarcoma in Korean Cancer Center Hospital, 180 patients with recurrent osteosarcoma were retrospectively reviewed. We examined survival rates and analyzed prognostic factors, such as relapse site, post-relapse treatment methods, pathologic response to neoadjuvnat chemotherapy, metastasis at first diagnosis, and relapse free interval. RESULTS: The overall recurrence rate of patients with osteosarcoma was 39%. The 5-year and 10-year postrelapse survival rates in the recurrent osteosarcoma were 13% and 4%, respectively. The 5-year post-relapse survival rate was influenced by site of relapse (lung, 39%; local, 0%; lung & bone, 25%; others, 12%; P or =12 months, 44%, P<0.05), and post-relapse treatment methods (with surgery, 38%; without surgery, 11%; P<0.05). CONCLUSION: The survival rate of recurrent case is very low after 10 years, so new second-line chemotherapy and active treatment is needed to increase survival. Aggressive surgery with the removal of recurrence sites combined with multi-agent chemotherapy could either cure patients with recurrent osteosarcoma or significantly prolong their survival.

The Efficacy of Repeated Sclerotherapy after Percutaneous Aspiration of the Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: Percutaneous aspiration with sclerotherapy is widely used as a treatment for simple symptomatic renal cysts because percutaneous aspiration with sclerotherapy is minimally invasive and cost-effective. Sclerotherapy is usually performed in combination with aspiration due to the high recurrence rate, 30-70%, for the simple aspiration. We conducted an analysis of percutaneous aspiration with repeated sclerotherapy, and we report the results of sclerotherapy after percutaneous aspiration of simple renal cysts and we also review the results of the other previous studies. MATERIALS AND METHODS: Between January 2001 and April 2004, the results of percutaneous aspiration with repeated sclerotherapy in 39 cases of simple renal cysts were evaluated. We evaluated the operation time, the hospital stay, the success rate, the complication rate and the follow-up period. All patients were available for follow-up over a period of 3 months by conducting ultrasound exams and computed tomography (CT) scans. RESULTS: Complete collapse, partial collapse and recurrence of the renal cysts occurred in 24/39 (61.5%), 13/39 (33.3%), and 2/39 (5.1%) cases, respectively. The mean operative time was 50.3 minutes and the mean hospital stay was 4.5 days. The cost of two sessions of sclerotherapy was about 240,000 won and that of three sessions of sclerotherapy was about 300,000 won. The size of the cyst was not related to the rate of collapse. Any complication related to percutaneous aspiration with repeated sclerotherapy were not noted. CONCLUSIONS: With regard for the success rate and cost-effectiveness, percutaneous aspiration with repeated sclerotherapy is considered a primary treatment for simple symptomatic renal cysts.

Laparoscopic Radical Nephrectomy: Results and Oncological Outcome / 대한비뇨기과학회지

Purpose: A laparoscopic radical nephrectomy is known to cause less morbidity than a traditional open radical nephrectomy. In our institution, the laparoscopic approach, with intact specimen removal, has become the standard technique for radical nephrectomies. Herein, we report the results and oncological outcome of the experience of a single center. Materials and Methods: We reviewed 68 transperitoneal laparoscopic radical nephrectomies, performed for suspected renal cell carcinoma between December 1999 and June 2006. All data were collected from the patient's medical records. Results: The mean tumor size, surgical time and estimated blood loss were 4.82cm (1.7-14), 228.5 min (120-480) and 409.1cc (32-1,312), respectively. Conversion to open surgery was required in one case due to Endo-GIA malfunction, and conversion to hand-assisted surgery was performed in one case. The histological findings were pT1, pT2 and pT3 in 40 (59.7%), 9 (13.4%) and 18 patients (26.9%), respectively. In one case, the histology confirmed a non-malignant disease. The follow-up period was from 3 to 80 months (median 18). Distant metastasis was observed in 2 cases, but there was no local recurrence or port metastasis. Conclusions: A laparoscopic radical nephrectomy is a safe and feasible treatment for localized renal cell carcinomas. Longer follow-up and large scale studies are necessary to evaluate the long-term survival and disease- free rates, and confirm the effectiveness of performing a radical laparoscopic nephrectomy.

The Characteristics of Voiding Difficulty in Women and the Effect of Tamsulosin / 대한비뇨기과학회지

PURPOSE: The aim of this study was to define the characteristics of female voiding difficulty, and evaluate the effects of the alpha-blocker, tamsulosin, on the symptoms in those patients. MATERIAL AND METHODS: 148 patients, who complained of voiding difficulty between March 2002 and September 2004, were retrospectively evaluated. 32 patients with anatomical and neuropathic causes were excluded, with the remaining 116 assigned to 4 groups from their urodynamic evaluations: group I, bladder outlet obstruction (BOO) only; group II, BOO plus an overactive bladder (OAB); group III, detrusor underactivity (DU) only; and group IV, DU plus an OAB. After 2 weeks of observation, tamsulosin, 0.2mg/d, was prescribed in all groups, with the patients re-evaluated after 3 months. RESULTS: 58 (50%), 23 (19.8%), 20 (17.3%) and 15 (12.9%) of the 116 study subjects were placed into groups I, II, III and IV, respectively. In group I, 45 (77.5%) had symptomatic improvement after taking tamsulosin for 3 months, and in group II improvement was observed in 73.9% (17/23) of patients. In groups III and IV; however, improvements were seen in only 25 (5/20) and 13.3% (2/15) of cases, respectively. Dizziness, postural hypotension and urinary incontinence occurred in some patients, but these disappeared after the medication was discontinued. CONCLUSIONS: 81 patients (69.8%) had a bladder outlet obstruction, without detrusor underactivity, and 62 (76.5%) of these exhibited a voiding improvement after taking tamsulosin for three months. However, in patients with detrusor underactivity, the response rate was very low (20%).

Pelvic Hematoma following a Transobturator Vaginal Tape Surgery for Treating Stress Urinary Incontinence

The transobturator tape surgery is the most recent minimally invasive midurethral sling procedure. This technique is introduced with the expect of decreasing some of the complications such as bladder, bowel and blood vessel injury that is associated with retropubic passage of needles. Reported is a 48-year-old woman who underwent a transobturator tape(TVT-O) procedure and who developed a retropubic hematoma at the pelvic cavity.

Development of Data Acquisition System for Quantification of Autonomic Nervous System Activity and It's Clinic Use / 영남의대학술지

BACKGROUND: Power spectrum analysis method is a powerful noninvasive tool for quantifying autonomic nervous system activity. In this paper, we developed a data acquistion system for estimating the activity of the autonomic nervous system by the analysis of heart rate and respiratory rate variability using power spectrum analysis. MATERIALS AND METHODS: For the detection of QRS peak and measurement of respiratory rate from patient's ECG, we used low-pass filter and impedence method respectively. This system adopt an isolated power for patient's safety. In this system, two output signnals can be obtained: R-R interval(heart rate) and respiration rate time series. Experimental ranges are 30-240 BPM for ECG and 15-80 BPM for respiration. RESULTS: The system can acquire two signals accurately both in the experimental test using simulator and in real clinical setting. CONCLUSION: The system developed in this paper if efficient for the acquisition of heart rate and respiration signals. The system will play a role in research area for improving our understanding of the pathophysiologic involvement of the autonomic nervous system in various disease states.

Embryonal Rhabdomyosarcoma of the Posterior Mediastinum: A Case Report

A rhabdomysarcoma originating during childhood is an easily-detected soft tissue sarcoma which frequently occurs in the head, and neck, or genitourinary system. It has been reported that in the mediastinum its rate of occurrence is 1 percent, though the rate at which it occurs in the posterior mediastinumhas not been reported. We recently encountered a case of embryonal rhabdomyosarcoma of the posterior mediastinum in a 12-year-old girl with neurofibromatosis type 1. Initial chest X-rays revealed a well-marginated round mass, with destruction of the right posterior rib. CT scans indicated the presence of an iso-dense mass which after contrast infusion showed heterogeneous enhancement. T1-and T2-weighted MR images showed, respectively, slight and heterogenous hyperintensity, with invasion of the thoracic spine and compression of the spinal cord. After surgery, embryonal rhabdomyosarcoma of the posterior mediastinum was pathologically confirmed.

Squamous Cell Carcinoma of Temporal Bone: Four Case Reports

We report the CT findings of four cases of squamous cell carcinoma, paying special attention to the epicenter of the lesion and the pattern of bony destruction. All four patients had a past history of chronic otitis media. Squamous cell carcinoma affected mainly the hypotympanum and inferior wall of the external auditary canal, and in all cases revealed an irregular pattern of bony destruction. Irregular destruction of the tegmen tympani occurred in two cases. In cases of squamous cell carcinoma, CT findings suggesting involvement of the promontary are usually noted.

Surface Modification of Stent Material: Experimental Study of Adhesion and Migration of Human AorticEndothelial Cells on Stent Material

PURPOSE: To evaluate the relative adhesion and migration rate of cultured human aortic endothelial cells onto modified stent material in vitro. MATERIALS AND METHODS: Flat 1 x 1cm square, stainless steel 316 L pieces(600 micrometer thick) were initially glow dis-charged to increase the polarity of the metal and were coated with 1 %polyhydroxyethylmethacrylate to which two different amino acid peptide sequences (GRGDY, GREDVY) were covalentlylinked via an amide to an amino-terminus, thus providing a known orientation of these covalently bound peptides.To stimulate implantation of a stent onto the intact arterial wall, human aortic endothelial cells were seeded andgrown to confluence on thick, firm collagen gel. The peptide coated steel pieces were then implanted on thisendothe-lialized surface and migration of HAEC to the surface was monitored and measured for ten days. The contactangle of steel was measured before and after glow-discharge treatment. RESULTS: Our results indicate that themigration and adhesion rate of HAEC to surfaces bearing either GRGDY or GREDVY adhesive peptide sequences wassignificantly higher than that of uncoated stainless steel. The contact angles of glow-discharged steel (eitherpositive or negative charge) were significantly lower, and this in-dicates the increased wettability of steel. Furthermore, migration to a GREDVY-coated surface was greater than to one coated with GRGDY. CONCLUSION: Theseresults indicate that a specific peptide sequence (GREDVY), together with positive glow-discharge treatment ofsteel can selectively enhance endothelial cell migration to metallic stent material.

CT Findings of the Angiomatous Polyp in the Nasal Cavity and Paranasal Sinus

PURPOSE: To assess the characteristic CT findings of the angiomatous polyp. MATERIALS AND METHODS: Fivecases of pathologically-proven angiomatous polyp were retrospectively evaluated. All underwent CT scanning, butin only four cases were postcontrast CT scans obtained. In analysing CT findings we focused on adjacent bonychange, and the extent and enhancement pattern of the mass. RESULTS: All but one case involved the maxillarysinus, showing thickening of the posterolateral wall and erosion or destruction of the medial wall. As forinvolvement of the anterior wall of this sinus, bony destruction was seen in one case, and thickening in three. Infour cases the tumor involved the maxillary sinus and nasal cavity, and two cases showed nasopharyngeal extension.No case involved the pterygopalatine fossa, however. On contrast enhanced CT scans(n=4), all cases showedenhancement as strong as blood vessels, and a multiple focal punctate or tubular pattern. CONCLUSION: Angiomatouspolyp tends to show bone thickening rather than bone destruction, not to involve the pterygopalatine fossa, and toreveal a strong punctate or tubular enhancement pattern. These findings may be helpful in the differentialdiagnosis of angiomatous polyp from other tumors such as maxillary cancer, angiofibroma and nasal polyp

Hormonal(Cortisol, Growth Hormone, Lutenizing Hormone, Thyroid Stimulting Hormone Changes of Rabbits Exposed to Microwaves

Following irradiation with 2.45GHz microwave, pituitary hormonal changes in rabbits were observed. A 30 rabbits (New Zealand, White, Male) were used for the experiments, 10 for each experiment immediately following one two and four weeks after irradiation with amount of 2.4 Joule/cm2, 4.8 Joule/cm2 and 7.2 Joule/cm2 respectively. The following are the results of the study as a conclusion. The secretion of cortisol hormone increased immediately after the exposure and then decrease to below that of the control group until two weeks afterwards, followed by recovery phase with secretion level approaching that of the central group in 4 weeks. Lutenizing hormone showed a tendency of increase from the first week of exposure, rather than immediately after, lasting up to over four weeks, In the irradiation group for 30 min, however, the increase began immediately after the exposure. The secretion of of growth hormone showed an insignificant, increase after the second and fourth weeks over the control group. The duration of exposure did not have much effect on the hormonal secretion. Thyroid stimulating hormone showed a different pattern changes: increase of immediately after exposure, decreased in two weeks, and then approaching the level of the control group after four weeks.

The Protective Effect of Intravenous Adenosine on Myocardial Reperfusion Injury in Feline Heart Model

BACKGROUND: Among the various mechanisms of Myocardial reperfusion injuries, neutrophil is thought to be one of them. Endogenous coronary vasodilator adenosine is known to have myocardial protective effect through variable pharmacologic action, influencing the function of several cell types involved in the pathogenesis of myocardial reperfusion injury. This study was designed to determine the beneficial effect of adenosine on the left ventricular function during reperfusion and whether this effect is due to the adenosine on the role of neutrophil. METHODS: 27 open-chest cats were randomly divided into 3 groups. 6 cats received ischemic injury without reperfusion(group 1). 21 cats were subjected to 60 minutes of proximal left anterior descending coronary artery occlusion followed by a 60-minute reperfusion. 11 of 21 cats received intravenous adenosine(0.15mg/Kg/min) infusion starting 5 minutes before reperfusion throughout the entire period(group 3). 10 cats received equal volume of saline instead of adenosine(group 2). RESULTS: 1) During the experimental period, significant decrease of heart rate, blood pressure, RPI, negative dP/dT and increase of LVEDP were noted in group 2 and 3 with no difference between the two groups. The reduction of positve dP/dT was more significant in group 2 at 30 and 60 minute of reperfusion than the preocclusion value(1404+/-111, 1631+/-161 vs 1832+/-169mmHg/sec at baseline, p<0.05). In contrast, positive dP/dT in group 3 at 30 and 60 minute of reperfusion were similar to baseline values(1890+/-92, 2052+/-112 vs 2025+/-227mmHg/sec at baseline, p=NS). These were significantly higher(p<0.05) than untreated group 2. 2) Infarct size was significantly reduced in adenosine-treated group 3, when expressed as a percentage of the area at risk(28.4+/-3.3% vs 44.5+/-3.2% of group 2, p<0.05). The significant increase in myeloperoxidase activity observed after reperfusion was not detected in adenosine treated group 3.(0.18+/-0.05 vs 0.46+/-0.09 unit/100mg wet tissue weight, p<0.05). A significant correlation was present between infarct size (% of left ventricle) and myeloperoxidase activity(r=0.72, p<0.01). 3) Light microscopic examination demonstrated the decreased acute interstitial and intra vascular inflammatory infiltration and capillary plugging together with decreased tendency of incidence of contraction band necrosis in adenosine treated group 3. CONCLUSION: These findings suggest that intravenous administration of adenosine during the early reperfusion period significantly reduces infarct size, improving the early recovery of global ventricular function. The probable cause is the effect of adenosine on neutrophil as one of the various protective mechanisms of adenosine in feline heart model subjected to coronary occlusion and reperfusion, 60 minutes each.

Problems with interpretation of primary diagnostic tests for impotence / 대한비뇨기과학회지

We analyzed the practical problems and factors which affect making the correct differential diagnosis in the interpretation or test results from the nocturnal penile tumescence (NPT) test and erotic stimulation test (EST). This was done to provide better information for higher diagnostic accuracy in the clinical application of these tests. The followings are the results of NPT tests and EST identifying the factors affecting correct differential diagnosis by comparison the other differential diagnostic methods. The overall sensitivity of NPT test (Number: 114 total patients) was 82%. 21 cases (18%) could not be diagnosed correctly due to traction of the sensor (12 cases, 10%) and sleep disturbance (9 cases, 8%). The overall sensitivity of EST (Number: 174 total patients) without considering the degree of patient`s sexual drive to erotic stimulation was 77%. 40 cases (23%) could not be diagnosed correctly due to tolerance to pornographic film (17 cases, 10 %), discomfort by the body attachments (14 cases, 8%) and traction of the sensor (9 cases, 5%). However, higher sensitivity (90%) and lower rate of incorrect diagnosis (10% ) were observed in 119 patients who showed Grade II or III (moderate to good) sexual drive to erotic stimulation. The results suggest that undesirable factors in the primary screening methods, traction of sensor, sleep disturbance in NPT test, and tolerance to pornographic film, discomfort by the body attachments, traction of sensor in EST must be taken into consideration when interpretation of test results is being performed.

Polysomnographic Nocturnal Penile Tumescence Monitoring / 대한비뇨기과학회지

Nocturnal penile tumescence is a well-documented normal occurrence associated with rapid eye movement sleep and clinically important in differentiating between psychogenic and organic impotence. The failure, however, to differentiate true increases in tumescence from movement artifact would lead to overestimation of NPT magnitude when portable home-monitoring is used. This can be overcome only by monitoring sleep polygraphically including electroencephalography, electooculography and electromyography. Recently, polysomnographic NPT testing was undertaken in normal potent men and in patients with erectile impotence, which suegests its clinical applicability in diagnosis of erectile impotence and possibly contributes toward understanding the characteristics of penile erection. Herein, we introduce our initial experience of polysomnographic NPTM including methodology, advantages and disadvantages with some literature.