The Current Status of Metastatic Castration-Naïve Prostate Cancer Management

During last many decades, androgen deprivation therapy (ADT) was the main treatment of choice for metastatic castration-naïve prostate cancer (mCNPC). However, there are now more possible treatment options for mCNPC. In CHAARTED, GETUG-AFU 15, and STAMPEDE trial, docetaxel added to ADT improved overall survival compared to ADT alone in mCNPC. Also, STAMPEDE and LATITUDE trial revealed that abiraterone added to ADT improved overall survival compared to ADT alone for mCNPC patient. Furthermore, ARCHES and ENZAMET trial showed that enzalutamide added to ADT also can be a treatment option for mCNPC. Apalutamide added to ADT also improved survival compared to ADT alone in castration resistant prostate cancer patient. The usefulness of radiation therapy to primary tumor in mCNPC has also been studied in HORRAD and STAMPEDE trial. There are many ongoing trials for mCNPC setting. The aim of this paper is to review the current status of mCNPC management options. (Korean J Urol Oncol 2020;18:11-17)

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.

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.

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.

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.

Diagnosis and Treatment of Premature Ejaculation by Urologists in South Korea

PURPOSE: This study discusses the treatment of premature ejaculation (PE) using various approaches with the goal of evaluating the methods of diagnosis and treatment of PE in clinical practice in 2014 in South Korea. MATERIALS AND METHODS: We surveyed 200 urologists and andrologists who treated patients with PE from July 1, 2014 to July 29, 2014 using an online questionnaire. The questionnaire was composed of 4 parts: disease, comorbidities, diagnosis, and treatment. Using the answers to this survey, current trends in the diagnosis and treatment of PE were investigated using weighted averages. RESULTS: The median number per month of patients who were diagnosed with PE was 14 patients (interquartile range, 7~24). The time to ejaculation necessary for a diagnosis of PE was considered to be <1 minute by 12% of respondents, <2 minutes by 27%, <3 minutes by 28%, <5 minutes by 13%, and 20% stated that diagnosis was based on a patient's subjective complaint. The treatment methods preferred by PE patients were reported to be pharmacological treatment (87%), surgical treatment (9.5%), and behavioral management (3.5%). The treatment methods used by respondents were pharmacological treatment (77%), surgical treatment (15%), and behavioral management (14%). The most commonly used pharmacological treatment was the oral administration of dapoxetine (97%). CONCLUSIONS: In 2014 in South Korea, various methods were used to diagnose and treat PE. The most commonly used treatment for PE was the oral administration of dapoxetine. It was also found that surgical treatment was applied in some cases.

Metabolic effects of androgen deprivation therapy

The therapeutic effects and side effects of androgen deprivation therapy (ADT), which is a main treatment method for metastatic prostate cancer, are well known, but the metabolic effects have only recently been studied. This review describes the effects of ADT on body habitus, insulin resistance, lipid profiles, diabetes, metabolic syndrome, and cardiovascular morbidity and mortality. The review was done by using KoreaMed and PubMed to search the medical literature related to prostate cancer, ADT, body habitus, lipid profile, diabetes, insulin resistance, metabolic syndrome, and cardiovascular disease. ADT increases fat mass and decreases lean body mass. Fat mostly accumulates in the subcutaneous area. ADT increases total cholesterol, triglycerides, and high-density lipoprotein, as well as the risk for insulin resistance and diabetes. ADT also increases the risk for cardiovascular events, but insufficient evidence is available for a correlation with mortality. ADT changes body habitus and lipid profiles and has different characteristics than those of classic metabolic syndrome, but it is related to insulin resistance and diabetes. ADT increases the risk for cardiovascular events. No consistent guidelines have been proposed for treating the metabolic effects of ADT, but the generally recommended treatment methods for lowering the risk of diabetes and cardiovascular disease should be fully understood. Additional studies are necessary.

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.

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.

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.

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.

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.

Efficacy and Safety of a Herbal Formula that Mainly Consists of Cornus Officinalis for Erectile Dysfunction: A Double-blind, Placebo-controlled Study / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate the efficacy and safety of a herbal formula that mainly consists of Cornus officinalis for treating erectile dysfunction. MATERIALS AND METHODS: Eighty patients suffering with erectile dysfunction were enrolled in this randomized, double-blinded, placebo-controlled study. The average duration of erectile dysfunction of the herbal formula group(n=40) vs. the placebo group(n=40) were 19.33+/-18.13 months vs. 19.33+/-25.62 months, respectively. The safety variables we examined were the history, physical examination, vital signs, EKG, clinical laboratory tests and hormonal tests. Efficacy assessments included the International Index of Erectile Function(IIEF), the sexual encounter profile(SEP) diary and Global Assessment Questions(GAQ). RESULTS: No significant changes in the laboratory values, hormone tests and blood pressure were observed in both groups. In comparison with the placebo group(6.57+/-11.72), the herbal formula group experienced a significant improvement of the IIEF(11.13+/-11.83)(por=50) of the herbal formula group significantly improved their IIEF score(p<0.05). The herbal formula group significantly improved their GAQ score(p<0.05). The herbal formula was well tolerated. The common adverse events were headache(2.5%) and nausea(5%). CONCLUSIONS: In conclusion, the herbal formula that mainly consists Cornus officinalis was not only effective at improving erectile function, but it was also safe for the treatment of erectile dysfunction.

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.

Location of Brain Electrical Source Activation according to Visually Stimulated Sexual Arousal: A Cross Spectral Analysis using Low Resolution Brain Electromagnetic Tomography (LORETA) / 대한비뇨기과학회지

PURPOSE: Low resolution brain electromagnetic tomography (LORETA) is a kind of functional imaging technique and it is also an up-to-date technique for conducting electroencephalography (EEG) analysis. We tried to investigate the locations on the cerebral cortex that are activated by visually stimulated sexual arousal. MATERIALS AND METHODS: Thirty-three male volunteers (age range: 24.7+/-1.7 years) among all the right-handed medical students at our university were enrolled in this study. The EEGs included the segments recorded during resting, watching a music-video, intermission and watching a porno-video. The LORETA images of the cross-spectral analysis were obtained with using segments of LORETA-KEY (KEY Institute for Brain-Mind Research, Switzerland) software. RESULTS: In the statistical nonparametric maps (SnPM) of each spectrum and the delta, theta and alpha waves did not show the increased current density. The beta 1, 2 and 3 activity showed the point of maximal current densities in the anterior parahippocampal gyrus of the left limbic lobe and the superior temporal gyrus of both temporal lobes, the superior temporal gyrus of the right temporal lobe, the precuneus of the right parietal lobe, the medial frontal gyrus of the left frontal lobe, the middle occipital gyrus of the right occipital lobe, the superior temporal gyrus of both temporal lobes and the superior frontal gyrus of the right frontal lobe. CONCLUSIONS: The sexual arousal by visual stimulation may activate the anterior parahippocampal gyrus of the left limbic lobe, the superior temporal gyrus of both temporal lobes, the precuneus of the right parietal lobe, the medial frontal gyrus of the left frontal gyrus, and the middle occipital gyrus of the right occipital lobe.

Schwannoma Originated from Obturator Nerve of Pelvic Cavity in Patient with Urinary Frequency / 대한비뇨기과학회지

A Schwannoma is a tumor originating from the neural sheath of Schwann cells, and is also known as a neurilemmoma, neurinoma or fibroblastoma. It can be either a benign or malignant tumor arising from the associated nerve sheath. Here, a case of a Schwannoma, originated from the obturator nerve of the pelvic cavity, in a patient with urinary frequency is reported, with a brief review of the literature.