The Change of Histologic Features and Eicosanoids Level in Rat Testicular Ischemia-Reperfusion Injury / 대한비뇨기과학회지

PURPOSE: It has been suggested that prostaglandins (PGs) play an important role in ischemia-reperfusion (IR) organ injury. However, the significance of PGs is not well documented for a testicular IR injury. The purpose of this study was to assess the potential role of PGs in rat testicular ischemia and IR injury MATERIALS AND METHODS: Sprague-Dawley male rats were divided into 7 groups, each containing 7 rats. The right spermatic cord was clamped with vascular clamps for 30 minute (group B, C), 90 minute (D, E) and 240 minute (F, G). Groups B, D, and F were ischemia groups and the group C, E, and G were reperfusion groups. Reperfusion was carried out after ischemia lasting 30, 90 and 240 min. The levels of thromboxane B2 (TxB2), 6-keto-PGF1alpha and prostaglandins E2 (PGE2) were measured using High-Performance Liquid Chromatography (HPLC). RESULTS: The levels of TxB2 were significantly elevated in groups D, E, F, and G than in the controls (p<0.05, each group). The TxB2 levels in the ischemia group F were significantly decreased compared to that of group D (p<0.05). The histological features shown in groups D, and F were typical ischemic changes, but atypical in groups B, and C. The most severe damage was noted in group G. These features were well matched with the changes of TxB2 in testicular ischemia and IR injury. The levels of 6-keto-PGF1alpha were significantly elevated in all the ischemia and IR groups compared to that of the controls (p<0.05). CONCLUSIONS: These results suggested that TxB2 might have an active role in testicular IR injury, although PGE2 and 6-keto-PGF1alpha seemed not to have an active role.

A Clinical Analysis of Primary Intracranial Germ Cell Tumors

Primary intracranial germ cell tumors(GCTs) are relatively rare brain tumors that show a diverse range of histologic features from benign to highly malignant conditions. To determine their clinical findings, pathology, treatment and outcome, we analyzed the medical records of 45 patients with primary intracranial GCTs treated at our hospital between June 1989 and December 1996. Thirty-two were males and 13 were females, and their ages ranged from three to 43 years. Fifteen cases were located in the pineal region and 13 in the suprasellar. The remaining locations were the basal ganglia in eight cases, both the pineal and suprasellar region in five, and others in four. In the pineal region, there was a male predominance(13:2), but in the suprasellar region, more cases(ten of 13) involved females. Of the 15 patients with tumors of the pineal region, increased intracranial pressure(IICP) was evident in 12 and six had Parinaud's syndrome. Of the 13 patients with tumors of suprasellar region, nine had diabetes insipidus; seven, visual deficit; and six, hypopituitarism. Germinoma was the most common histologic type. Other types of histology were two teratomas, three embryonal carcinomas, one endodermal sinus tumor, one choriocarcinoma, and five mixed GCTs. All patients except those with a teratoma underwent whole craniospinal irradiation. We performed gross total or subtotal removal in cases of non-germinomatous GCTs(NGGCTs) and mixed tumors, but biopsy or partial removal was preferred for the germinomas. Thirteen of 45 patients received adjuvant chemotherapy. All malignant NGGCT and mixed tumor patients were treated with adjuvant chemotherapy, as well as three of 33 germinoma patients. Three of five malignant NGGCT patients and two of five mixed tumor patients died of tumor progression. Two of 33 germinoma patients died not of disease progression but of other causes. Actuarial survival records showed that overall two-year and five-year survival rates were 89.9% and 71.9%, respectively. There were no statistically significant differences with regard to patient's age, sex, or tumor location. With regard to their histology and surgical extent, malignant NGGCTs and mixed tumors showed statistically significant differences. Five-year surival rates of germinoma and malignant NGGCT patients were 83.1% and 53.3%, respectively. We suppose that the appropriate combination of chemotherapy and surgery, with or without radiation therapy, remains to be defined, and that to determine the appropriate management protocol for malignant NGGCTs and mixed tumors, larger series of patients must be analyzed.