Relationship between Hypogonadal Symptoms, Sexual Dysfunction and Chronic Prostatitis in Middle-Aged Men by Self-Reported Questionnaires, even without Biochemical Testosterone Deficiency

PURPOSE: To investigate the association of erectile dysfunction (ED), premature ejaculation (PE), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men with late-onset hypogonadism (LOH).MATERIALS AND METHODS: We reviewed the data of 408 enrolled men between January 2014 and January 2019. All participants completed the Androgen Deficiency in the Aging Male (ADAM), international index of erectile function-5 (IIEF-5), National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and premature ejaculation diagnostic tool (PEDT) questionnaires. Participants were divided by ADAM positive (ADAM+: Group 1) and ADAM negative (ADAM−: Group 2).RESULTS: Total of 289 subjects were in Group 1 and 119 were in Group 2. The mean age was 53.8±7.8 years. The mean total testosterone was 4.8±1.2 ng/dL and showed no differences between the groups (p=0.839). In Groups 1 and 2, ED (IIEF≤21) was identified in 233 (80.6%) versus 37 (31.1%), respectively (p<0.001). The prevalence of PE (PEDT≥9) was 112 (38.7%) versus 13 (10.9%) in Groups 1 and 2, respectively (p<0.001). However, PE (intravaginal ejaculation latency time<5 minutes) showed no differences between the groups (p=0.863). The incidence of chronic prostatitis (NIH-CPSI pain score≥4) showed significant differences with 49 (17.0%) versus 8 (6.7%) in Groups 1 and 2, respectively (p=0.007). IIEF-5 total score showed the significantly highest negative correlation (r=−0.313, p<0.001).CONCLUSIONS: Those who complained of LOH symptoms and positive results in the ADAM questionnaire need to be assessed concurrently with the above questionnaires. This could aid useful to detect of ED, PE, and chronic prostatitis co-occurrence.

Metabolic Syndrome Is an Independent Risk Factor for Acquired Premature Ejaculation

PURPOSE: To determine the role of metabolic syndrome (MetS) as a risk factor for acquired premature ejaculation (PE) after considering the various risk factors, such as lower urinary tract symptoms, erectile dysfunction, hypogonadism, and prostatitis. MATERIALS AND METHODS: From January 2012 to January 2017, records of 1,029 men were analyzed. We performed multivariate analysis to identify risk factors for PE, including the covariate of age, marital status, International Prostate Symptom Score, International Index of Erectile Function (IIEF) score, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score, serum testosterone levels, and all components of MetS. Acquired PE was defined as self-reported intravaginal ejaculation latency time ≤3 minutes, and MetS was diagnosed using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS: Of 1,029 men, 74 subjects (7.2%) had acquired PE and 111 (10.8%) had MetS. Multivariate analysis showed that the IIEF overall satisfaction score (odds ratio [OR]=0.67, p<0.001), NIH-CPSI pain score (OR=1.07, p=0.035), NIH-CPSI voiding score (OR=1.17, p=0.032), and presence of MetS (OR=2.20, p=0.022) were significantly correlated with the prevalence of acquired PE. In addition, the Male Sexual Health Questionnaire for Ejaculatory Dysfunction scores and ejaculation anxiety scores progressively decreased as the number of components of MetS increased. CONCLUSIONS: MetS may be an independent predisposing factor for the development of acquired PE. Effective prevention and treatment of MetS could also be important for the prevention and treatment of acquired PE.

Unilateral Multifocal Type 2 Papillary Renal Cell Carcinoma in Adolescence. A Case Report

Papillary renal cell carcinomas (RCCs) can be classified into 2 subtypes (types 1 and 2), depending on their characteristic cytogenetics, immunostaining profiles, and gene-expression profiles. Compared with type 1 papillary RCCs, type 2 papillary RCCs are relatively rare and show more aggressive features. For those reasons, they are associated with a worse prognosis. A 13-year-old patient was admitted to the hospital with right kidney mass. A laparoscopic radical nephrectomy was performed, and results of the histopathologic examination confirmed it to be type 2 papillary RCC. Type 2 papillary RCCs are rarely found in unilateral and multifocal forms, especially in adolescence. Here, we report the unique case of papillary RCC at a young age.

The Effect of Alcohol Administration on the Corpus Cavernosum

PURPOSE: We studied the effects of alcohol administration on the corpus cavernosum (CC) using an animal model. MATERIALS AND METHODS: CC sections and the aortic ring of rabbits were used in an organ bath study. After acute alcohol administration, changes in blood alcohol concentration and electrical stimulation induced intracavernosal pressure/mean arterial pressure (ICP/MAP) percentage were compared in rats. Cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) levels in the CC were measured using immunoassays. After chronic alcohol administration, ICP/MAP percentage, cAMP and cGMP were compared in rats. Histological changes were examined using the Masson trichrome stain and the Sircol collagen assay. Endothelial nitric oxide synthase (eNOS) expression was examined using immunohistochemistry and Western blotting. RESULTS: Alcohol relaxed the CC in a dose-dependent manner, and the relaxation response was suppressed when pretreated with propranolol, indomethacin, glibenclamide, and 4-aminopyridine. In rats with acute alcohol exposure, the cAMP level in the CC was significantly greater than was observed in the control group (p<0.05). In rats with chronic alcohol exposure, however, changes in cAMP and cGMP levels were insignificant, and the CC showed markedly smaller areas of smooth muscle, greater amounts of dense collagen (p<0.05). Immunohistochemical analysis of eNOS showed a less intense response, and western blotting showed that eNOS expression was significantly lower in this group (p<0.05). CONCLUSIONS: Acute alcohol administration activated the cAMP pathway with positive effects on erectile function. In contrast, chronic alcohol administration changed the ultrastructures of the CC and suppressed eNOS expression, thereby leading to erectile dysfunction.

The Correlation between Body Mass Index and Routine Parameters in Men Over Fifty

PURPOSE: This study aimed to investigate the relationships between body mass index (BMI) and prostate-specific antigen (PSA) levels, international prostate symptom score (IPSS), quality of life (QoL), and prostate volume (PV). MATERIALS AND METHODS: Height, weight, PSA levels, PV, and IPSS were analyzed in 15,435 patients who underwent a prostate examination between 2001 and 2014. Patients aged <50 years or with a PSA level ≥10 ng/mL were excluded. The relationships between BMI and PSA, IPSS, QoL, and PV were analyzed by a scatter plot, one-way analysis of variance, and the Pearson correlation coefficient. RESULTS: The mean age was 71.95±7.63 years, the mean BMI was 23.59±3.08 kg/m2, the mean PSA level was 1.45±1.45 ng/mL, the mean IPSS was 15.53±8.31, the mean QoL score was 3.48±1.25, and the mean PV was 29.72±14.02 mL. PSA, IPSS, and QoL showed a tendency to decrease with increasing BMI, and there were statistically significant differences for each parameter (p≤0.001). PV showed a significant tendency to increase with BMI (p < 0.001). In the correlation analysis, BMI showed a statistically significant correlation (p < 0.001) with PSA, IPSS, and QoL, although the correlations were very weak. In contrast, BMI showed a significant correlation with PV (p < 0.001), with a meaningful Pearson correlation coefficient of 0.124. CONCLUSIONS: Higher BMI was associated with lower PSA levels and higher IPSS and QoL scores. Meanwhile, PV increased with BMI. Although obese individuals had a greater PV, obesity did not aggravate lower urinary tract symptoms.

Proteomic analysis of novel targets associated with the enhancement of TrkA-induced SK-N-MC cancer cell death caused by NGF

Nerve growth factor (NGF) is known to regulate both cancer cell survival and death signaling, depending on the cellular circumstances, in various cell types. In this study, we showed that NGF strongly upregulated the protein level of tropomyosin-related kinase A (TrkA) in TrkA-inducible SK-N-MC cancer cells, resulting in increases in various TrkA-dependent cellular processes, including the phosphorylation of c-Jun N-terminal kinase (JNK) and caspase-8 cleavage. In addition, NGF enhanced TrkA-induced morphological changes and cell death, and this effect was significantly suppressed by the JNK inhibitor SP600125, but not by the phosphatidylinositol 3-kinase (PI3K) inhibitor wortmannin. To investigate novel targets associated with the enhancement of TrkA-induced SK-N-MC cell death caused by NGF, we performed Coomassie Brilliant Blue staining and two-dimensional (2D) proteomic analysis in TrkA-inducible SK-N-MC cells. We identified 31 protein spots that were either greatly upregulated or downregulated by TrkA during NGF treatment using matrix-associated laser desorption/ionization time of flight/time of flight mass spectrometry, and we analyzed the effects of SP600125 and wortmannin on the spots. Interestingly, 11 protein spots, including heterogeneous nuclear ribonucleoprotein K (hnRNP K), lamin B1 and TAR DNA-binding protein (TDP43), were significantly influenced by SP600125, but not by wortmannin. Moreover, the NGF/TrkA-dependent inhibition of cell viability was significantly enhanced by knockdown of hnRNP K using small interfering RNA, demonstrating that hnRNP K is a novel target associated with the regulation of TrkA-dependent SK-N-MC cancer cell death enhanced by NGF.

Stereotactic Body Radiation Therapy for Low- to Intermediate-risk Prostate Adenocarcinoma

The aim of the present study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) for low- to intermediate-risk prostate adenocarcinoma. Thirty-nine patients were retrospectively reviewed. The SBRT was delivered using the CyberKnife with the fiducial tracking method combined with In-tempo imaging. The gross target volume, which included the prostate only, was delineated on the fused CT/MRI scans. The prescription dose was delivered every other day as 5 fractions of 7.5 Gy. Venous blood was obtained before and after SBRT to assess the prostate-specific antigen (PSA) level. Toxicity was evaluated using the CTCAE, v4.03. The median follow-up time was 30.0 months. The median initial PSA level was 7.7 ng/mL. PSA levels decreased in all patients treated with SBRT, and after 5 months, the median PSA was less than 2 ng/mL. The rate of overall 3-yr actuarial biochemical failure free survival was 93.9%. Acute side effects were generally comparable with those of previous studies. The PSA change and toxicity after SBRT for low- to intermediate-risk prostate adenocarcinoma indicates favorable biochemical responses and tolerable levels of toxicity. Additionally short course treatment may produce cost benefit and convenience to patients.

Complications of Transrectal Ultrasound-Guided Prostate Biopsy: Impact of Prebiopsy Enema

PURPOSE: Transrectal ultrasound (TRUS)-guided biopsy of the prostate is usually safe. However, some patients are hospitalized owing to complications from TRUS biopsy. We identified the risk factors for complications and effective preventive measures for treating complications after TRUS biopsy. MATERIALS AND METHODS: Medical records and radiological images of 1,083 patients who underwent TRUS biopsy of the prostate over 10 years in Gyeongsang National University Hospital were examined retrospectively to investigate the correlation between complications after TRUS biopsy and preventive antibiotics, prebiopsy enema, number of biopsy cores, and pathological findings. RESULTS: Complications occurred in 69 patients (6.4%). The complication rates of the 1,008 patients who received antibiotics and the 75 patients who did not were 6.3% and 8.0%, respectively (p=0.469). Complication rates of the pre-biopsy enema group (n=658) and the group without prebiopsy enema (n=425) were 4.7% and 8.9%, respectively (p=0.007). Complication rates of the 6-core biopsy group (n=41) and the 12-core biopsy group (n=955) were 7.3% and 6.3%, respectively (p=0.891). Complication rates of the prostate cancer group (n=306) and the no prostate cancer group (n=713) were 6.2% and 6.6%, respectively (p=0.740). CONCLUSIONS: A prebiopsy enema was associated with a reduced risk of complications after TRUS biopsy. Preventive antibiotics, number of biopsy cores, and pathological findings did not significantly influence the complication rate.

Efficacy of Long-Term Daily Dosage of Alfuzosin 10 mg upon Sexual Function of Benign Prostatic Hypertrophy Patients: Two-Year Prospective Observational Study

PURPOSE: To identify sexual function improvement associated with alfuzosin (10 mg daily for 2 years). MATERIALS AND METHODS: We enrolled 30 men with lower urinary tract symptom (LUTS) who visited Gyeongsang National University Hospital between 2010 and 2012. At first visit, urinalysis, prostate specific antigen, transrectal ultrasound, and uroflowmetry were performed. The nternational Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculation Function Domain (MSHQ-EjFD) questionnaires were administered, and the subjects answered the same questionnaires at 1 month, 6 months, 1 year, and 2 years of follow-up. RESULTS: Twelve men completed of the entire study. After administration of alfuzosin, the median IPSS at first visit, 1 month, 6 months, 1 year, and 2 years was 18.00 (interquatile range [IQR]: 14.00~29.75), 20.00 (IQR: 11.50~30.00), 15.50 (IQR: 8.50~25.25), 14.50 (IQR: 9.25~19.50), and 11.50 (IQR: 5.00~17.75), respectively, which showed an improvement. The median QoL at the same times was 4.50 (IQR: 4.00~5.00), 4.50 (IQR: 4.00~5.00), 3.00 (IQR: 2.00~4.00), 3.50 (IQR: 2.25~4.00), and 3.00 (IQR: 1.00~3.00), respectively, and also showed improvement. Likewise, the median IIEF was 36.50 (IQR: 24.50~46.75), 37.50 (IQR: 26.75~47.25), 45.50 (IQR: 35.00~59.75), 48.50 (IQR: 34.75~62.75), and 47.50 (IQR: 43.25~61.00), while the median MSHQ-EjFD was 19.00 (IQR: 12.0~24.75), 19.50 (IQR: 13.50~27.75), 23.00 (IQR: 19.25~32.25), 26.50 (IQR: 18.25~34.50), 27.00 (IQR: 21.50~32.50), respectively, with both showing improvement. CONCLUSIONS: After administration of alfuzosin (10 mg daily for 2 years), the IPSS, QoL, IIEF, and MSHQ-EjFD all improved significantly. This means long-term administration of 10 mg of alfuzosin daily would be effective not only for LUTS but also erectile function and ejaculation.

Angiomyofibroblastoma-Like Tumor of the Scrotum

Various tumors can occur in the scrotum. Of them, angiomyofibroblastoma-like tumors are very rare mesenchymal tumors. Angiomyofibroblastoma-like tumors cannot be easily differentially diagnosed from other malignant tumors invading the male genital tract on the basis of clinical characteristics and imaging study. Therefore, surgical removal and a histopathologic diagnosis must also be performed.

Diagnosis of Prostatic Abscess and Utility of Transrectal Ultrasonography Guided Abscess Aspiration / 대한남성과학회지

PURPOSE: Prostatic abscess is a very rare disease whose incidence has been reported to be approximately 0.2% in patients with urologic symptoms. Besides, it cannot be diagnosed by interview and physical examination, for which imaging studies must also be performed. In the current study, we examined the clinical usefulness of imaging studies in making a diagnosis of prostatic abscess and the effect of a fine needle aspiration based on trans-rectal ultrasonography on the treatment outcomes. MATERIALS AND METHODS: In ten patients who were diagnosed with prostatic abscess and then treated during a period ranging from January of 1995 to June of 2008 (mean age: 61.8 years, range: 40-89 years), a past history, clinical symptoms, physical examination findings, laboratory findings, trans-rectal ultrasonography findings, computed tomography findings, treatment modalities and complications were retrospectively analyzed. RESULTS: All patients complained fever and voiding dysfunction as chief complaint. On trans-rectal ultrasonography and computed tomography scans, all the ten patients had abnormal findings. In five patients, there were nonhomogenous hypo-echoic lesions on trans-rectal ultrasonography. All the patients had cystic abscess lesions detected on computed tomography scans. In four patients, in whom the diameter of lesions was greater than 1cm on computed tomography scans, a fine needle aspiration was performed on trans-rectal ultrasonography and antibiotic treatment was performed. In six patients, in whom the diameter of lesions was smaller than 1 cm on computed tomography scans, antibiotic treatment was performed. There were statistically significant differences in the length of hospital stay and the size of prostate gland between the group where a fine needle aspiration was performed using trans-rectal ultrasonography and the group where antibiotic treatment was performed (p0.05). Length of antibiotic therapy was shorter in antibiotic therapy only group, but there was no statistically significant difference (P>0.05). CONCLUSIONS: A computed tomography is a useful diagnostic modality for prostatic abscess. Besides, a fine needle aspiration based on trans-rectal ultrasonography is one of the minimally invasive treatment regimens for prostatic abscess, whose good treatment outcomes have been well documented. Furthermore, there were no severe complications in our series.

Improvement of Lower Urinary Tract Symptoms and Sexual Function after Treatment with Alpha-Blocker

PURPOSE: The association of lower urinary tract symptoms (LUTS) and erectile dysfunction has not been investigated comprehensively concerning which LUTS are associated with sexual function. Therefore, we investigated the association of each domain of the International Prostate Symptom Score (IPSS), nocturia, prostate volume, and uroflowmetry with each domain of the International Index of Erectile Function (IIEF)-5. MATERIALS AND METHODS: The correlation of sexual function and LUTS was investigated in 365 men with benign prostatic hyperplasia. To measure the level of LUTS, the IPSS was calculated; uroflowmetry, residual urine measurement, and transrectal ultrasonography (TRUS) were performed; and the level of erectile dysfunction was assessed by the IIEF-5. Three months after treatment with alpha-blocker (tamsulosin 0.2 mg/day), IPSS, uroflowmetry, residual urine, nocturia, and IIEF-5 were assessed again to evaluate the effectiveness of treatment. RESULTS: Erectile function deteriorated more in individuals with severe LUTS (IPSS>20) than in those with mild LUTS (IPSS<8), and IPSS, age, and nocturia correlated significantly with all IIEF-5 domains. The maximal urine velocity and the average urine velocity on uroflowmetry correlated significantly with all IIEF domains. After the administration of alpha-blocker for 3 months, the changed rates of the IPSS-obst domain, average uroflow, and quality of life (QoL) correlated significantly with the improvement in the total IIEF-5. CONCLUSIONS: Changes in the IPSS-obst domain, QoL, and average uroflow rate correlated significantly with changes in the total IIEF-5. Thus, it is expected that the improvement of obstructive symptoms could effectively improve erectile function.

Effect of Cocoa Extract on Tension of the Corpus Cavernosal Tissue in Rat / 대한남성과학회지

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.

Effect of Cocoa Extract on Tension of the Corpus Cavernosal Tissue in Rat / 대한남성과학회지

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.

Clinical Course of Prenatally-detected Hydronephrosis: Focus on Ureteropelvic Junction Obstruction / 대한비뇨기과학회지

PURPOSE: The diagnosis and treatment of prenatally-diagnosed hydronephrosis remain controversial. We have conducted a retrospective study to examine the clinical characteristics and course of prenatally-diagnosed hydronephrosis, especially when in the presence of ureteropelvic junction obstruction(UPJO). MATERIALS AND METHODS: Among all pediatric patients diagnosed with hydronephrosis by prenatal ultrasonography between September 2002 and June 2008, the study was performed on 103 patients(126 renal units), and the mean follow-up period was 19.2 months(range, 6-24 months). Ultrasonography was performed 2-3 days after birth, and after 1, 3, 6, and 12 months, and annually thereafter. Hydronephrosis was graded according to the Society for Fetal Urology(SFU) classification guidelines. RESULTS: On ultrasonography performed 2-3 days after birth hydronephrosis was graded as follows: grade 1, 45(35.7%); grade 2, 49(38.9%); grade 3, 23(18.3%); and grade 4, 9(7.1%) renal units. In cases with UPJO complete improvement of hydronephrosis was detected in 16 renal units(40%); the renal units and rate of complete improvement in grades 1, 2, 3, and 4 were 12(75%), 3(17.6%), 1(16.7%), and 0(0%), respectively. The anticipated times of complete improvement of hydronephrosis in UPJO grades 1, 2, and 3 were 22.0, 31.3, and 50.4 months, respectively. CONCLUSIONS: In UPJO, the possibility of improvement of hydronephrosis lower than grade 2 was high, and thus follow-up for approximately 30 months may be needed. In patients with hydronephrosis >grade 3, the rate of improvement was low, thus compulsive follow-up is required.

Effects of Administration of Tadalafil for 24 Weeks on Lower Urinary Tract Symptoms and Erectile Dysfunction / 대한남성과학회지

PURPOSE: Numerous studies of the effect of tadalafil on sexual function have been performed. However, its effects on lower urinary tract symptoms (LUTS) are unclear. Therefore, the long-term effects of tadalafil on the improvement of LUTS as well as erectile dysfunction were examined. MATERIALS AND METHODS: 69 patients who visited our hospital reporting LUTS and erectile dysfunction as chief complaints were divided into 3 groups. Group 1 received 10 mg/day alfuzosin (39 patients, age: 61.36+/-8.69), group 2 received 10 mg/day alfuzosin and 5 mg/2 day tadalafil (15 patients, age: 58.00+/-7.91), and group 3 received 5 mg/2day tadalafil (15 patients, age: 54.70+/-10.01). Drugs were administered for 24 weeks. At before and 12 weeks and 24 weeks after drug administration, maximum flow rate, IPSS, quality of life, IIEF-5, and self satisfaction were measured and analyzed. The SPSS 14.0 was used as statistical software, and the data were validated using ANOVA. RESULTS: Between pre- and post-administration, the maximum flow rate significantly increased in all groups (p<0.05). The IPSS of groups 1 and 2 were significantly reduced (p<0.05). Quality of life significantly decreased in group 3 (p<0.05). IIEF-5 for groups 2 and 3 significantly increased (p<0.05). Self satisfaction significantly decreased in groups 2 and 3 (p<0.05). CONCLUSIONS: When alfuzosin and tadalafil were administered together for 24 weeks, both LUTS and erectile dysfunction improved significantly. In the group administered tadalafil alone, LUTS improved. Thus, administration of tadalafil for 24 weeks is able to improve not only erectile dysfunction but also LUTS.

Mucinous Adenocarcinoma of the Renal Pelvis with Giant Hydronephrosis / 대한비뇨기과학회지

Mucinous adenocarcinoma of the renal pelvis is a rare tumor, and this is associated with renal stone, hydronephrosis and pyelonephritis. We report here on a case of mucinous adenocarcinoma of the renal pelvis with a review of the relevant literatures. The patient was a 74 year-old woman who had left giant hydronephrosis with multiple renal stones.

Clinical Experience of Extracorporeal Shock Wave Lithotripsy (ESWL) using a Dornier Compact S / 대한비뇨기과학회지

Purpose: We analyzed the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) for treating patient with urinary tract calculi with using a Dornier Compact S(R)lithotriptor. Materials and Methods: We retrospectively reviewed the records of all the patient who had urinary calculi and who were treated by ESWL between August 1, 1996 and August 1, 2001. The location and sizes of the stones, the number of sessions, the success rate, the causes of failure and the complications of ESWL were analyzed. The definition of successful treatment was no calcification on the X-ray (plain film, KUB) or residual fragments 31mm, respectively. Conclusions: The results showed that ESWL is a highly effective and minimally invasive treatment modality as the 1st therapeutic option for urinary stones. The Dornier Compact S(R)is an efficient and safe lithotripter that's capable of treating stones in the kidney and throughout the ureter.

Identification of Proteins Differentially Expressed in the Conventional Renal Cell Carcinoma by Proteomic Analysis

Renal cell carcinoma (RCC) is one of the most malignant tumors in urology, and due to its insidious onset patients frequently have advanced disease at the time of clinical presentation. Thus, early detection is crucial in management of RCC. To identify tumor specific proteins of RCC, we employed proteomic analysis. We prepared proteins from conventional RCC and the corresponding normal kidney tissues from seven patients with conventional RCC. The expression of proteins was determined by silver stain after two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). The overall protein expression patterns in the RCC and the normal kidney tissues were quite similar except some areas. Of 66 differentially expressed protein spots (p<0.05 by Student t-test), 8 different proteins from 11 spots were identified by MALDI-TOF-MS. The expression of the following proteins was repressed (p<0.05); aminoacylase-1, enoyl-CoA hydratase, aldehyde reductase, tropomyosin alpha-4 chain, agmatinase and ketohexokinase. Two proteins, vimentin and alpha-1 antitrypsin precursor, were dominantly expressed in RCC (p<0.05).

Histology of Upper Pole Kidney in Patients with Ureterocele / 대한비뇨기과학회지

PURPOSE: The histological changes in the upper pole of excised duplex kidneys with ureterocele were reviewed and the histological variations with respect to age and ureterocele position were assessed. MATERIALS AND METHODS: During the last ten years, 10 patients with duplex system ureterocele underwent an upper pole nephrectomy. A total of 10 specimens, of which 4 and 6 were diagnosed at younger than 1 year old and older than 1 year old, and 5 each involving intravesical and ectopic locations, respectively, were available for independent review by a single pathologist. Histological lesions were classified into the 5 categories; chronic interstitial inflammation, interstitial fibrosis, tubular atrophy, glomerulosclerosis and dysplasia. Each category was divided into moderate/severe histological lesions (greater than 25% involvement) and minimal/mild lesions (25% or less involvement). RESULTS: Chronic interstitial inflammation, interstitial fibrosis, tubular atrophy, glomerulosclerosis and dysplasia in each of the specimens were graded as moderate/severe (greater than 25% involved) in 50, 50, 60, 10 and 80% of the subjects, respectively. The ureteroceles detected at an early stage were not associated with less severe upper pole histological lesions. Also, no pathological differences were observed when comparing specimens according to the ureteroceles positions. CONCLUSIONS: It appears that the histological lesions observed may not be progressive or reversible. Therefore, it is suggested that enhancement of the upper pole renal function seems unjustified in the light of the histological evidence, and the goals of clinical management should focus on preventing complications and secondary procedures.