Protective Effect of Coriolus versicolor Cultivated in Citrus Extract Against Nitric Oxide-Induced Apoptosis in Human Neuroblastoma SK-N-MC Cells

Nitric oxide (NO) is a reactive free radical and a messenger molecule in many physiological functions. However, excessive NO is believed to be a mediator of neurotoxicity. The medicinal plant Coriolus versicolor is known to possess anti-tumor and immune-potentiating activities. In this study, we investigated whether Coriolus versicolor possesses a protective effect against NO donor sodium nitroprusside (SNP)-induced apoptosis in the human neuroblastoma cell line SK-N-MC. We utilized 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, flow cytometry, 4,6-diamidino-2-phenylindole (DAPI) staining, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay, DNA fragmentation assay, reverse transcription-polymerase chain reaction (RT-PCR), Western blot analysis, and caspase-3 enzyme activity assay in SK-N-MC cells. MTT assay showed that SNP treatment significantly reduces the viability of cells, and the viabilities of cells pre-treated with the aqueous extract of Coriolus versicolor cultivated in citrus extract (CVEcitrus) was increased. However, aqueous extract of Coriolus versicolor cultivated in synthetic medium (CVEsynthetic) showed no protective effect and aqueous citrus extract (CE) had a little protective effect. The cell treated with SNP exhibited several apoptotic features, while those pre-treated for 1 h with CVEcitrus prior to SNP expose showed reduced apoptotic features. The cells pre-treated for 1 h with CVEcitrus prior to SNP expose inhibited p53 and Bax expressions and caspase-3 enzyme activity up-regulated by SNP. We showed that CVEcitrus exerts a protective effect against SNP-induced apoptosis in SK-N-MC cells. Our study suggests that CVEcitrus has therapeutic value in the treatment of a variety of NO-induced brain diseases.

Evaluation of Possible Predictive Variables for the Outcome of Shock Wave Lithotripsy of Renal Stones

PURPOSE: The aim of this study was to evaluate possible predictive variables for the outcome of shock wave lithotripsy (SWL) of renal stones in a single center. MATERIALS AND METHODS: Between March 2008 and March 2010, a retrospective review was performed of 115 patients who underwent SWL for solitary renal stones. The patients' characteristics and stone size, location, skin-to-stone distance (SSD), and Hounsfield units (HU) of stone were reviewed. The impact of the possible predictors on the disintegration of the stones was evaluated by logistic regression analysis. Receiver operator characteristic (ROC) curves were generated to compare the predictive powers of the variables. RESULTS: Seventy-nine patients (68.7%) had successful outcomes, whereas 36 patients (31.3%) had residual stones. Significant differences were found in the mean size and mean HU of the stones (size: 8.34+/-3.58 mm vs. 13.57+/-5.41 mm, p<0.001; HU: 675.29+/-254.34 vs. 1,075.00+/-290.41, p<0.001). In the unadjusted model, age, stone size, and stone density were significant predictors. In the reduced model, stone density and size were significant predictors for the outcome of SWL. The area under the ROC curve (AUC) was significantly higher for stone density and size than for the other parameters, but the AUC between stone density and size did not differ significantly (stone density: 0.874, stone size: 0.827, p=0.388). CONCLUSIONS: Stone density and size were significant predictors of the outcome of SWL for renal stones less than 2.0 cm in diameter. We should consider HU and stone size when making decisions on the treatment of renal stones.

Staghorn Stones Combined with Transitional Cell Carcinoma of the Renal Pelvis

Longstanding, unrecognized staghorn stones remain a major cause of morbidity in the form of pain, infection, and functional impairment of the affected kidney. Squamous cell carcinoma of the upper urinary tract is associated with stone disease and chronic infection, but the association with transitional cell carcinoma (TCC) has not been proven. We report a case of a 73-year-old man presenting with right flank pain with episodes of total gross hematuria for 1 year. An abdominopelvic computed tomography scan showed decreased parenchymal enhancement and staghorn stones in the right renal pelvis and multiple tiny calyceal stones with severe hydronephrosis. The patient underwent a simple nephrectomy. Histopathologic analysis revealed staghorn stones combined with high-grade papillary TCC of the renal pelvis. The tumor was extended into the peripelvic fat and renal parenchyme (pT3NoMo).

Congenital Renal Arteriovenous Malformation in Pregnancy / 대한비뇨기과학회지

Congenital arteriovenous malformation of the kidney is a rare condition and there have been few reported cases that were detected during pregnancy because of a fistula. Of the 7 such cases in the literature, either a nephrectomy or partial nephrectomy was done during pregnancy, or an abortion was induced. We report here on a case of arteriovenous malformation that was treated successfully by therapeutic embolization. The patient's convalescence was unremarkable and a healthy newborn was delivered without any complications.

Application of the Clinical Pathway for Transurethral Resection of Prostate / 대한비뇨기과학회지

PURPOSE: The purpose of a clinical pathway(CP) is to standardize the clinical practice of specialists to optimize the medical care. The objective of this study is to develop CP for transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia(BPH) and to evaluate the results of the CP. MATERIALS AND METHODS: 18 patients with BPH and who were managed according to the CP between November 2006 and April 2007 were compared with 38 patients, for whom this pathway had not been used between the period of November 2005 to October 2006. The patients had no other disease except benign prostatic hyperplasia. The results such as the operative time, the resection volume, the length of the hospital stay, the complication rates, the catheter indwelling time and the maximal flow rate were compared between the CP group and the non-CP group. RESULTS: There were no statistically significant differences between both groups for the postoperative complication rates(p=0.683). With the application of the clinical pathway, the mean duration of the hospital stay and the catheter indwelling time were significantly lower for the CP group than that for the non-CP group(p<0.001). Statistically, there were no significant differences of the maximal flow rate and International Prostate Symptom Score(IPSS) between the two groups. All members of the CP group were satisfied with the application of the CP. CONCLUSIONS: The application of the clinical pathway for patients undergoing transurethral resection of prostate has reduced the catheter indwelling time and the length of the hospital stay. This improves the bed use and hospital efficiency while it also results in a higher level of patient satisfaction. Furthermore, reducing the variability of medical care has improved its quality.

A Case of Trichoblastic Fibroma in Scrotum / 대한비뇨기과학회지

We report a case of trichoblastic fibroma involving the scrotum in a 60-year-old man. Trichoblastic fibroma is very rare and benign trichogenic tumor that has both epithelial and mesenchymal components and histologically recount the embryologic development of the hair follicle. The diagnosis was confirmed by histopathologic examination.

Clinical Results of Transurethral Electro-Vaporization of the Prostate for Treatment of Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: We compared the outcome of transurethral electro-vaporization of the prostate (TVP) with that of transurethral resection of the prostate (TURP) in patient with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Fifty-four patients with BPH were treated with TVP (Group I) and sixty-two with TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urinary flow rate (Qmax) and post-void residual urine volume (ml). Safety parameters evaluated included incidence of side effects, operative time, postoperative catheterization time, change in hematocrit and serum sodium. RESULTS: The mean prostate size was 28.4+/-4.8gm in GroupI and 37.1+/-5.3gm in Group II. The mean operation time was shorter in Group I (48.2+/-10.5min) than in Group II (75.2+/-32.6min) (p<0.05). The change of hematocrit (%) was lower in Group I (from 40.2+/-4.1 to 38.7+/-4.1) than in Group II (from 40.3+/-3.8 to 34.9+/-5.5), (p<0.05). The mean catheterization time was 3.2+/-1.2 days and 4.9+/-1.9 days (p<0.05). The change of peak urinary flow rate, post-void residual urine volume, AUA symptom score, incidence of postoperative complications was not significantly different between each group. CONCLUSIONS: Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, significant morbidities are associated with this procedure. Our early clinical experience highlights several advantages of electro-vaporization, particulary the low incidence of postoperative morbidity.

Conservative Management of the Renal and Perirenal Abscesses / 대한비뇨기과학회지

PURPOSE: We critically evaluated the most appropriate management of renal and perirenal abscess and identified the set of patients who had benefited from conservative management. MATERIALS AND METHODS: Between May 1995 and June 1999, fifteen patients with renal (10 cases) and perirenal abscess (5 cases) were treated in our hospital. Among the fifteen patients, six patients were managed by antibiotics alone, the other nine patients were managed by percutaneous aspiration and antibiotics. Percutaneous abscess aspiration and drainage was done under ultrasound guidance and local anesthesia. RESULTS: On the urine culture, 4 cases had positive urine culture (27%); E. coli was in 3 cases, Klebsiella in 1 case respectively. On the blood culture, E. coli was in 2 cases. On the abscess culture (9 cases were performed), the organisms were identified in 8 cases (89%); E. coli was in 6 cases, S. aureus was in 1 case, S. epidermidis in 1 case respectively. CONCLUSIONS: We suggest that proper antibiotic therapy alone or combined with ultrasound guided percutaneous drainage of renal and perirenal abscesses is a choice of reasonable, safe and effective management in selected patients.

A case of Plexiform Neurofibroma of the Bladder / 대한비뇨기과학회지

No abstract available.

A Case of Sparganosis In the Spermatic Cord / 대한비뇨기과학회지

Sparganosis is a parasite infestation caused by the larval stage of Spirometra erinacei. Ingestion of raw or undercooked flesh of numerous intermediate hosts results in human infection. Sparganum infestation of human body was reported over 120 cases including urogenital lesions in Korean literatures since 1924. But, no case of sparganosis in the spermatic cord was reported until now. We experienced a case of sparganosis in the spermatic cord.

Clinical Experience of Symptomatic Management of BPH with Terazosin, Doxazosin or Combination of Terazosin and Finasteride / 대한비뇨기과학회지

PURPOSE: We evaluated and compared the efficacy of terazosin, doxazosin and terazosin(alpha-1 adrenoreceptor antagonist) with finasteride(5-alpha reductase inhibitor) in the treatment of patient with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The study was single-blind design. The patients were divided 3 groups(terazosin group, doxazosin group, terazosin with finasteride group). Terazosin was administrated with escalating dose of 1 to 5mg once daily for 12 weeks. Doxasosin, fixed dose of 2mg was taken once daily for 12 weeks. Finasteride was taken 5mg once daily with terazosin for 12 weeks. The study enrolled 69 patients, and 60 patients were included in the analyses. RESULTS: The parameters used to assess the effectiveness included international Prostatic Symptom Score(1-PSS), Quality of Life(QOL) index and peak urinary flow rate(Qmax). At baseline, 1-PSS, QOL index and Qmax were 18.8+/-4.3, 3.7+/-1.0, 8.6+/-1.7 in terazosin group, 19.3+/-3.9, 3.6+/-1.0, 7.8+/-1.8 in doxazosin group, 20.1+/-4.4, 3.8+/-1.0, 72 +/-1.6 in combination group, respectively. After 12 weeks trial, 1-PSS, QOL index and Qmax were 12.0+/-2.8, 1.9+/-0.9, 11.4+/-2.8 respectively in terazosin group, 11.3+/-3.0, 1.7+/- 0.7, 10.6+/-2.6 in doxazosin group, 10.9+/-4.0, 1.8+/-0.9, 9.8+/-1.0 in combination group, respectively. CONCLUSIONS: There was clear evidence for the efficacy of alpha-1 blocker in treating patients with bladder outlet obstruction due to BPH. There was no significant difference between alpha-1 blocker therapy alone and combination therapy with finasteride. This study showed beneficial short term results for the safety and efficacy of long acting selective alpha-1 blocker and finasteride in the management of symptomatic BPH, but if symptom and quality of life for patient were not improved, we are 1ikely to consider that early surgical therapy will be required.

Clinical Observation of Decrease of Prostatic Volume in Men with Voiding Symptoms by Means of TRUS / 대한비뇨기과학회지

PURPOSE: It has been generally known that prostatic volume is increased related to aging process and changing in hormonal environment, so lower urinary tract symptoms develops. But, our experience has revealed the decrease of prostatic volume in many cases with lower urinary tract symptoms despite aging. MATERIALS AND METHODS: The numbers of patient underwent TRUS were 301 cases. Among the patients who had visited urologic outpatient clinic from march, 1993 to march, 1996, transrectal ultrasonography of prostate was applied to patient with following conditions. 1) over 8 in IPSS with or without enlarged evidence from digital rectal examination 2) enlarged evidence from digital rectal examination 3) no symptomatic relief after 2weeks therapy with alpha blocker 4) when the patient wants more evaluation. RESULTS: Decrease of prostatic volume were shown in 66cases(22%) despite lower urinary tract symptoms. CONCLUSIONS: In our experience, many patients with lower urinary tract symptoms showed decrease of prostatic volume. So, we expect that many more cases of decrease of prostatic volume can be seen among asymptomatic cases with age. Because we can guess that prostatic volume can be influenced by racial differences and dietary habit, we also believe that further evaluation and investigation of this nature is needed.

A Case of Transitional Cell Carcinoma Associated with Adult Polycystic Kidney Disease / 대한비뇨기과학회지

Some cases of renal malignancy associated with adult (autosomal dominant) polycystic kidney disease have been reported. Most of these malignancies were diagnosed as renal cell carcinoma. But the case of transitional cell carcinoma has not been reported. We report a case of renal pelvic and urethral transitional cell carcinoma associated with adult polycystic kidney.

A Case of Budd-Chiari Syndrome with IVC Web Treated by Balloon Dilatation / 대한간학회지

Budd-Chiari syndrome is acute or subacute occlusion of the hepatic vein and IVC, The occlusion of hepatic veins often reveals dramatic illness characterized by abdominal pain, ascites, hepatomegaly and a poor prognosis. Several recent reports have suggested that balloon dilatation may be effective in Budd-Chiari syndrome. We experienced a case of Budd-Chiari syndrome with IVC web which was successfully treated with balloon dilatation. We report the case here with a brief review of literature,

Iatrogenic Ureteral Injuries in Pelvic Surgery: A Review of 12 Cases / 대한비뇨기과학회지

We reviewed 12 patients with iatrogenic urethral injuries in pelvic surgery from May 1993 to May 1996. The patients ranged in age from 27 to 52 years (mean age 47). The diagnosis of urethral injury was made intraoperatively in 8 (66.7%) and postoperatively in 4 cases (33.3%). The ureteral injury patterns in intraoperative diagnosis group at recognition were classified into complete transsection in 5, partial transsection in 2 and ligation in 1 case. The clinical findings of postoperative diagnosis group were ureterocutaneous fistula in 1, ureteral obstruction in 2, and ureterovaginal fistula in 1 case. Presenting symptoms were fever in 1, urine leakage in 2, and flank pain in 1 case. The treatments in intraoperative diagnosis group included ureteroureterostomy in 4, ureteroneocystostomy in 2, and simple closure in 2 closes. In postopeative diagnosis group the treatments were initiated soon after establishment of the diagnosis, and consisted of ureteroneocystostomy with psoas hitch in 2, ureteral stunting with ureteroscope in 1, and ureteroureterostomy in 1 case. The RESULTS were good in 7 cases (87.5%) of intraoperative diagnosis group and 2 cases (50.0%) of postopertive diagnosis group. Of the 3 poor resulted cases 2 were managed with percutaneous nephrostomy, and 1 with ureteral stenting. We concluded that prompt recognition of ureteral injuries at occurrence with immediate repair RESULTS in few complications. Injuries detected postoperatively required more complicated procedures to repair the ureter. Because most of the ureteral injuries occurs by the non-urologic surgeon, especially gynecologist or general surgeon, it is important to let them know the fact that immediate repair of the ureter is important and cooperative relationships between urologist and non-urologist are also important during pelvic surgery.

Comparison of Culture Results after Preoperative Chemical Preparation of The Eye in Cataract Surgery

Postoperative endophthalmitis is one of the devastating complications following cataract surgery. Ocular flora has been presumed to be a major source of infectious organisms in postoperative endophthalmitis. We compared the efficacies of various chemical preparation methods that decrease or eradicate ocular flora effectively before surgery. 355 eyes undergoing cataract surgery were randomly divided into 4 groups according to chemical preparation methods. 0.3% gentamicin eyedrop was used in group 1, 0.3% ciprofloxacin eyedrop in group 2, 0.3% gentamicin eyedrop and 5.0% povidone-iodine solution in group 3, and 0.3% ciprofloxacin eyedrop and 5.0% povidone-iodine solution were used in group 4 to prepare eye before surgery. Cultures of eyelid-conjunctival swab and aqueous humor were performed just before operation and at the time of wound closure, respectively, and then compared among 4 groups. The culturepositive rate was the lowest in group 4 and increased in group 3, group 2, and group 1 in a order. The culture-positive rate from the eyelid-conjunctiva in group 2 was significantly lower than that in group 1(p<0.05). The culture positive rates in the groups(group 3, 4) using the combination of antibiotics eyedrop and povidone-iodine solution for chemical preparation were significantly lower than those in the groups(group 1, 2) using antibiotics eyedrop only(p<0.05). The culture results of aqueous humor showed similar pattern as those from the eyelid-conjunctival swab. This study suggests that combined use of 0.3% ciprofloxacin eyedrop and 5.0% povidone-iodine solution is an effective and recommendable preoperative chemical preparation.

Experience of the Raz Procedure for Stress Urinary Incontinence / 대한비뇨기과학회지

We retrospectively evaluated the 20 patients who underwent the Raz operation for genuine stress urinary incontinence from January, 1993 to January, 1994. The mean periods of follow-up was 11.1+/-4.3 months. Four patients with grade I stress incontinence, twelve patients with grade II stress incontinence and four patients with grade III stress incontinence underwent the Raz bladder neck suspension. All patients had no previous anti-incontinence operation. Seventeen patients(85%) were cured, while two patients(10%) were significantly improved with only rare episodes of incontinence not requiring protection. One(5%) was failure. When the results were stratified by degree of incontinence preoperatively 4 of 4 patients(100%) with mild, 11 of 12(9l.7%) with moderate and 4 of 4(100%) with severe incontinence had a successful outcome. Namely, 95 percent of the patients were either cured or improved. The complications were not significant except temporary urinary retention of 2 to 20 days, there was no permanent urinary retention. The advantages of a needle suspension procedure, as compared with the abdominal retropubic techniques, include simplicity, less operative time, decreased postoperative morbidity, and a shorter hospital stay, because it avoids an extensive abdominal operation. In addition, the vaginal approach enables the surgeon to perform concomitant pelvic floor surgery for other conditions, such as cystocele, rectocele, enterocele, and uterine prolapse. Therefore, in a relatively short-term follow-up and a small group, Raz bladder neck suspension seems to be the ideal procedure for the woman presenting with stress urinary incontinence.

The Quantitative Analysis of Autofluorescence in the Aging Crystalline Lens

When illuminated by blue light, the human crystalline lens exhibits green autofluorescence. Autofluorescence of the human lens were analyzed quantitatively in vivo as a function of age in 75 healthy individuals{150 eyes) without cataract, ranging in age from 17 to 63 years. Lenses were scanned through the dilated pupil along the optical axis, generating a fluorescence profile consisting of anterior and posterior peaks of lens, using an automated scanning fluorophotometer(Fluorotron master) coupled with a lens system designed for high resolution of the anterior segment structures. Anterior peak autofluorescence increased linearly by 90 ng fluorescein/ml per decade and posterior peak autofluorescence by 70 ng fluorescein/ml per decade. No significant difference between right and left eyes was demonstrated for anterior or posterior peak autofluorescence. We suggest that the quantitative analysis of the autofluorescence of the human lens might be useful to investigate the changes of the aging lens proteins and the pathogenesis of cataract.

Clinical Results of Phacoemulsification Performed by Ophthalmic Resident

The clinical results and complications of 27 phacoemulsification which had been performed by ophthalmic resident during the learning curve were studied retrospectively. Mean postoperative follow-up period was 8.9 weeks and 82%(22 of 27) was followed up for 4 weeks or longer. Posterior chamber intraocular lenses were implanted in all cases. Final best corrected visual acuity of 0.5 or better was obtained in 21 eyes(95.5%) and mean value of the surgically induced astigmatism was -0.47 diopter of the 22 eyes who were followed up for 4 weeks or longer. The incidence of vitreous loss was 11.1 %(3/27). Of these, two cases occurred during nuclear emulsification, while one case during cortex aspiration. With proper patient selection, meticulous technique, and under the faculty's supervision, phacoemulsification performed by residents during the learning curve can be an effective method for cataract surgery procedure.

Gastrointestinal leiomyosarcoma / 대한암학회지

No abstract available.