Growth Inhibition After Exposure to Transforming Growth Factor-beta1 in Human Bladder Cancer Cell Lines

PURPOSE: Transforming growth factor-beta1 (TGF-beta1) plays a dual role in apoptosis and in proapoptotic responses in the support of survival in a variety of cells. The aim of this study was to determine the function of TGF-beta1 in bladder cancer cells. MATERIALS AND METHODS: The role of TGF-beta1 in bladder cancer cells was examined by observing cell viability by using the tetrazolium dye (MTT) assay after treating the bladder cancer cell lines 253J, 5637, T24, J82, HT1197, and HT1376 with TGF-beta1. Among these cell lines, the 253J and T24 cell lines were coincubated with TGF-beta1 and the pan anti-TGF-beta antibody. Fluorescence-activated cell sorter (FACS) analysis was performed to determine the mechanism involved after TGF-beta1 treatment in 253J cells. RESULTS: All six cell lines showed inhibited cellular growth after TGF-beta1 treatment. Although the T24 and J82 cell lines also showed inhibited cellular growth, the growth inhibition was less than that observed in the other 4 cell lines. The addition of pan anti-TGF-beta antibodies to the culture media restored the growth properties that had been inhibited by TGF-beta1. FACS analysis was performed in the 253J cells and the 253J cells with TGF-beta1. There were no significant differences in the cell cycle between the two treatments. However, there were more apoptotic cells in the TGF-beta1-treated 253J cells. CONCLUSIONS: TGF-beta1 did not stimulate cellular proliferation but was a growth inhibitory factor in bladder cancer cells. However, the pattern of its effects depended on the cell line. TGF-beta1 achieved growth inhibition by enhancing the level of apoptosis.

Altered Gene Expression Profile After Exposure to Transforming Growth Factor beta1 in the 253J Human Bladder Cancer Cell Line

PURPOSE: Transforming growth factor beta1 (TGF-beta1) inhibits the growth of bladder cancer cells and this effect is prominent and constant in 253J bladder cancer cells. We performed a microarray analysis to search for genes that were altered after TGF-beta1 treatment to understand the growth inhibitory action of TGF-beta1. MATERIALS AND METHODS: 253J bladder cancer cells were exposed to TGF-beta1 and total RNA was extracted at 6, 24, and 48 hours after exposure. The RNA was hybridized onto a human 22K oligonucleotide microarray and the data were analyzed by using GeneSpring 7.1. RESULTS: In the microarray analysis, a total of 1,974 genes showing changes of more than 2.0 fold were selected. The selected genes were further subdivided into five highly cohesive clusters with high probability according to the time-dependent expression pattern. A total of 310 genes showing changes of more than 2.0 fold in repeated arrays were identified by use of simple t-tests. Of these genes, those having a known function were listed according to clusters. Microarray analysis showed increased expression of molecules known to be related to Smad-dependent signal transduction, such as SARA and Smad4, and also those known to be related to the mitogen-activated protein kinase (MAPK) pathway, such as MAPKK1 and MAPKK4. CONCLUSIONS: A list of genes showing significantly altered expression profiles after TGF-beta1 treatment was made according to five highly cohesive clusters. The data suggest that the growth inhibitory effect of TGF-beta1 in bladder cancer may occur through the Smad-dependent pathway, possibly via activation of the extracellular signal-related kinase 1 and Jun amino-terminal kinases Mitogen-activated protein kinase pathway.

Experience of Ultrasonography-Guided Percutaneous Core Biopsy for Renal Masses

PURPOSE: We evaluated the safety and accuracy of ultrasonography-guided percutaneous core biopsy collection in patients with renal masses. MATERIALS AND METHODS: From June 2008 to August 2012, 30 percutaneous core biopsies of renal masses were performed. The biopsies obtained were small tumors (<4 cm) with ambiguous radiologic findings or that met classic renal biopsy indications. The biopsy results were compared with the final pathological results after definitive surgical treatment. Ultrasonography was performed on the day after biopsy collection to rule out any complications. RESULTS: The mean age of the patients was 57.7 years, and the mean tumor size was 3.39 cm. Twelve of the lesions were in the left kidney, and 18 were in the right kidney. All but one core biopsy contained sufficient material for histopathological analysis. The biopsy results showed 17 renal cell carcinomas (56.7%), 3 angiomyolipomas (10.0%), 2 oncocytomas (6.7%), 1 adenocarcinoma (3.3%), and 7 benign lesions (23.3%). A total of 18 cases underwent surgery, and the pathological results confirmed the initial biopsy diagnosis for 17 of 18 cases (94.4%). The one (5.9%) inaccurate biopsy result was found to be a urothelial carcinoma of the kidney. No needle tract seeding was found in the pathological specimens or on follow-up imaging. A small perinephric hematoma (1-2 cm) was seen in 5 cases (16.7%), but all patients remained hemodynamically stable. CONCLUSIONS: Ultrasonography-guided renal biopsy is a safe, effective, and accurate method for evaluating small renal masses. This procedure may help in selecting treatment modalities for small renal masses.

Use of Cystoscopic Tattooing in Laparoscopic Partial Cystectomy

PURPOSE: During laparoscopic partial cystectomy (LPC), lesion identification is essential to help to determine the appropriate bladder incisions required to maintain adequate resection margins. The inability to use tactile senses makes it difficult for surgeons to locate lesions during laparoscopic surgery. Endoscopic India ink marking techniques are often used in laparoscopic gastroenterological surgery. We present our experience with performing LPC with India ink during the surgical resection of various bladder lesions. MATERIALS AND METHODS: LPC with cystoscopic fine needle tattooing was performed on 10 patients at our institute. Tattooing was performed at 1- to 2-cm intervals approximately 1 cm away from the outer margin of the lesion with enough depth (the deep muscle layer) under cystoscopic guidance. LPC was performed by the transperitoneal approach. The clinical courses and pathologic results were analyzed. RESULTS: All LPC with cystoscopic tattooing cases were performed successfully. The mean patient age was 39.1 years. The mean operative time was 130.5 minutes, and the mean estimated blood loss was 93 ml. The mean hospital stay was 13.1 days, and the mean duration of indwelling Foley catheterization was 10.7 days. There were no significant intraoperative or postoperative complications except 1 case of delayed urinary leak and 1 case of delayed wound healing. The pathological diagnosis included 1 urachal cancer, 1 urachal remnant, 4 urachal cysts, 2 pheochromocytomas, and 2 inflammatory masses. All specimens showed adequate surgical margins. CONCLUSIONS: Cystoscopic tattooing in LPC is a simple and effective technique to assist in locating pathological bladder lesions intraoperatively. This technique can help to determine appropriate resection margins during LPC without incurring additional complicated procedures.

Anterior Urethral Valve and Diverticulum in a Neonate with Febrile Urinary Tract Infection

Anterior urethral valve is a rare congenital anomaly that can cause obstructive uropathy. Herein, we report a case of an anterior urethral valve that led to the development of febrile urinary tract infection in a neonate.

The Efficacy, Safety and Effectiveness of the Laparoscopic Varicocelectomy: Comparative Study of 2 Trocars and 3 Trocars

OBJECTIVE: Varicocelectomy can be accomplished using a variety of approaches, including retroperitoneal, transinguinal, subinguinal or scrotal approach and there are advantage and disadvatage, respectively. The goal of this study is to evaluate the efficacy, safety and effect of the laparoscopic varicocelectomy and compare 2 trocars laparoscopic technique with 3 trocars. METHODS: Between March 2003 and December 2007, 46 patients with varicocele were treated using 3 trocars (group A) or 2 trocars (group B) laparoscopic varicocelectomy. Data regarding operative time, time of vein ligation, hospital stay, recurrence rate and complications of each procedure were retrospectively evaluated. RESULTS: Of the 46 patients 39 with left side varicocele constituted the population of the present study; the others, with bilateral varicocele, were excluded. No significant differences were found in terms of mean operative time, mean time of vein ligation, mean hospital stay and morbidity between group A and B. CONCLUSION: Laparoscopic varicocelectomy is feasible, safety and effective surgical technique. Compared with 3 trocars, 2 trocars laparoscopic varicocelctomy results in similar operative and postoperative outcomes. In addition, it is cost-effective and cosmetic.

Predictors of PSA Screening Among Men Over 40 Years of Age Who Had Ever Heard about PSA

PURPOSE: The purpose of this study was to investigate social and behavioral factors associated with prostate-specific antigen (PSA) screening in men in California, United States, who were over 40 years of age and had ever heard about PSA screening. MATERIALS AND METHODS: This survey was administered as a random-digit-dialing telephone survey to produce reliable estimates of medium-sized counties. It surveyed 42,000 households and interviewed 58,407 people randomly. It considered socioeconomic status and health behavior as affecting PSA screening. Access to health care was measured as having regular health care access. The main outcome measure was self-report of ever having undergone PSA screening at least once in the respondent's lifetime. RESULTS: Of 8,864 respondents, 82.2% were White, 7.7% were Latin, 4.2% were African American, and 5.9% were Asian. The respondents' mean age was 60.13 years. Age was the significant factor for PSA screening. Respondents aged 50-59 years were 3.5 times as likely to have undergone PSA screening as were those aged 40-49 years (OR=3.49, p< or =0.001). Race was not statistically significant after considering other factors. People who had never married had statistically significantly lower screening than did people who were married (OR=0.71, p=0.001). Poverty levels were statistically significant in both the unadjusted and the adjusted analysis. People who had no regular health care access were much less likely to have undergone PSA screening than were people who had regular health care access (OR=0.22, p=0.001). CONCLUSIONS: The likelihood of PSA screening was positively associated with increased age, marital status (married), higher socioeconomic status (higher federal poverty level and higher educational attainment), and health care access. However, there was no statistically significant association of PSA screening with race, employment, exercise, smoking, or drinking status.

Prognosis Associated with Thrombocytosis in Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: Thrombocytosis has been reported in many types of malignancies and it has been studied as a prognostic factor. To better define the relationship between the platelet count and survival, we performed a retrospective analysis of patients with thrombocytosis and renal cell carcinoma, and some of whom had a lower survival rate than those with a normal platelet count. MATERIALS AND METHODS: We reviewed the medical records of patients with renal cell carcinoma and who had undergone radical nephrectomy between January, 1995 and December, 2004. A total of 112 patients were treated by radical nephrectomy for renal cell carcinoma. Among them, 67 patients without primary thrombocytosis, no familial history of renal cell carcinoma and no history of adjuvant therapy were enrolled in this study. The patients were divided into a normal platelet count group and a thrombocytosis group(greater than 400,000/microliter) according to the peri-operative platelet count. The two groups were compared pathologically and clinically, including comparing the prognosis. RESULTS: The mean follow-up was 55.8 months(range: 21 to 80). Thrombocytosis was present in 19 patients. The mean survival for the normal platelet count group was 67.8+/-39.36 months, compared with 41.4+/-30.65 months for the thrombocytosis group(p<0.05). The difference of survival between the 2 groups remained significant when controlling for the established prognostic indicators like the pathological stage, nuclear grade and cell types. CONCLUSIONS: This study documents the association of thrombocytosis with decreased survival in patients with renal cell carcinoma. The peri-operative platelet count appears to be a significant independent predictor for determining the prognosis for patients with renal cell carcinoma.

Pathological Characteristics of Neuroendocrine Cell Differentiation in Prostate Cancer / 대한비뇨기과학회지

PURPOSE: Neuroendocrine (NE) cells in a prostate carcinoma may play important roles in tumor growth, proliferation and progression. The aim of this study was to evaluate the relationship between the NE cell differentiation status and pathological characteristics of prostate cancer. MATERIALS AND METHODS: Radical prostatectomy specimens from 215 patients were available for analysis. NE cell were detected by immunohistochemistry, using antibodies to chromogranin A (CgA). Tumor cell proliferation was assessed using the Ki-67 proliferation index (PI) employing the MIB-1 antibody. Staining of CgA was scored as: 0= no staining; 1= staining cell 20. Tumors were classified depending on their staining score, positive staining and growth pattern. RESULTS: NE cell differentiation was present in 25.1% (54/215) of tumors. The amount of NE cells significantly increased; from tumors with solitary scattered NE cells to both small and large clusters (p<0.05). NE cell differentiation and the growth pattern were correlated with the Ki-67 PI (p<0.05). With respect to high-grade tumors, an increased PI was found in tumors with positive NE cells compared with those with negative NE (p<0.05). Pathologically advanced tumors, or those with higher histological grades, were associated with NE cell differentiation and Ki-67 PI (p<0.05). CONCLISIONS: NE cell differentiation in prostate cancer may lead to increased proliferation, high-grade tumors and an advanced stage. The exact prognostic significance of NE still has to be addressed in larger prospective, comparative and highly selective clinical studies.

Functional Paraganglioma of the Pelvic Cavity / 대한비뇨기과학회지

Paraganglioma is one of the pheochromocytomas, and this arises in the extra-adrenal tissue. It is a rare tumor of neural crest origin; it accounts for at least 10% of all the pheochromocytomas. Paragangliomas produce catecholamines and on the basis of this, they are classed as either functional or nonfunctional. We report here on our experience with laparoscopic removal of functional paragangliomas of the pelvic cavity and we include a brief review of literatures.

Expression Pattern of Neuroendocrine Cells and Survivin in the Prostate of Rabbits / 대한비뇨기과학회지

PURPOSE: The neuroendocrine cell (NE cell) is thought to play an important role in the development of hormone-refractory prostate cancer. Survivin is one of the IAPs (inhibitors of apoptosis), and it is expressed in the NE cell and in most of the common cancers, but not in normal tissue. The objective of this study was to investigate the expression pattern of the NE cell and survivin in the prostate of rabbits. MATERIALS AND METHODS: The 9 rabbits underwent orchiectomy and their prostates were removed at 0 weeks (control), 2 weeks and 6 weeks after orchiectomy. Each of the prostatic tissue specimens was stained with H&E; immunohistochemical staining was done for chromogranin A, synaptophysin and survivin, and the tissue specimens were then examined by microscopy. RESULTS: In the prostate of rabbits, most of the NE cells were located between the epithelial gland and the stroma. NE differentiation occurred 6 weeks after orchiectomy. The location of cells that were positive for survivin was almost same as that of the NE cells. CONCLUSIONS: The main location of NE cells in the prostate of rabbits was between the epithelial gland and the stroma, and NE differentiation occurred 6 weeks after orchiectomy, the same as in a human or a dog. The location of survivin positive cells coincided with that of the NE cells. Therefore, a rabbit seems to be a suitable animal model for the study of the NE cell.

Unilateral Renal Agenesis in 2 Siblings / 대한비뇨기과학회지

Unilateral renal agenesis associated with genito-urinary disease was found in 2 siblings of a single family. There are a few reports of familial unilateral renal agenesis. Bilateral renal agenesis is a fetal condition and unilateral renal agenesis or hypoplasia is usually asymptomatic, so investigations for renal anomalies have not been frequently undertaken in healthy members of families in which bilateral agenesis has occurred. The present report suggests that unilateral renal agenesis could occur as a manifestation of a genetic disorder.

The Natural History of Simple Renal Cysts in Adults / 대한비뇨기과학회지

PURPOSE: Simple renal cysts are common in older patients and they are usually left untreated, yet only a few studies have been done on the natural history of simple renal cysts. We investigated the sequential changes in their size and number in 103 patients. MATERIALS AND METHODS: From January 1993 to August 2003, we followed 103 patients who were suffering with simple renal cysts. Their mean age was 55.8+/-18.72 years old (M:F=58:51). Using Abdominal USG and CT, the annual changes in renal cysts were analyzed through the follow-up period, and the mean follow-up period was 52.3+/-17.58 months. The values of the parameters were compared with using a 2-tailed Student's t-test, multivariate logistic regression analysis and the chi-square test. RESULTS: At the time of diagnosis, the mean number and size of simple renal cyst were 1.5+/-1.31 cysts per each kidney and 25.3+/-12.42mm, respectively. On the consecutive imaging study, the size of the renal cysts was increased 4.4+/-1.54mm per year. The average size increase was significantly greater in the individuals younger than 50 versus the patients 50 years or older (5.7+/-2.14mm/year vs 3.7+/-1.45mm/year, respectively). The multiple cysts showed a significantly larger size increase than did the single cysts (8.1+/-3.27mm/year vs 3.6+/-1.64mm/year, respectively). The size increase of the bilateral renal cysts was significantly larger than that of the unilateral renal cysts (5.6+/-1.48mm/year vs 4.1+/-1.02mm/year, respectively). No significant difference was observed for the average size increase with regard to gender or the initial cyst size. Only the number of cysts was a significant predictor of aggressiveness on the multivariate logistic regression analysis. CONCLUSIONS: The simple renal cysts progress in size and they appear to grow with aging. They seem to grow more rapidly in patients with a younger age, and for multiple and bilateral renal cysts.

A Case of Lipoleiomyosarcoma in the Spermatic Cord / 대한비뇨기과학회지

A lipoleiomyosarcoma (L-LMS) is an extremely rare tumor, which is a well-differentiated liposarcoma, with leiomyosarcomatous differentiation. Leiomyosarcomatous differentiation may consist of either a well-differentiated liposarcoma, with an intrinsic smooth muscle component, or a dedifferentiated liposarcoma (DL), having smooth muscle differentiation in the dedifferentiated zones. We report an L-LMS appertaining to the latter type, affecting the spermatic cord.

The Effect of Cigarette Smoking on Bladder Cancer in Korean: A Prospective Cohort Study / 대한비뇨기과학회지

PURPOSE: To verify the association between cigarette smoking and bladder cancer in the Korean population, as smoking is well known as a risk factor on bladder cancer. The risk of bladder cancer was compared among never-smokers, ex-smokers and current-smokers using a multivariate adjusted incidence rate and the mortality rate of bladder cancer of Koreans. MATERIALS AND METHODS: A total of 348,010 participants were enrolled in this prospective study between 1993 (to 1994) and 2002. All participants completed a self administered questionnaire on cancer risk factors, including smoking habit. Follow up for incident bladder cancer was established. We classified all participants into three categories: current-smoker, ex-smoker and never-smoker, on the basis of their smoking habits. We confirmed bladder cancer from the data of the Korea National Cancer Registry and National Health Insurance Corporation up to (December?) 2002. The multivariate adjusted incidence and the mortality due to bladder cancer were used for both genders for a statistical analysis using a Cox proportional hazards model. RESULTS: The incidence rate of bladder cancer per 100,000 persons in male never-smokers, ex-smokers and current-smokers were 27, 41 and 48, respectively, and the multivariate adjusted relative risks (RR) were 1.3 (95% confidence interval (CI), 0.9-2.0) and 1.7 (95% CI, 1.2-2.3) in ex- and current smokers, respectively. The incidence rate of bladder cancer in women was 4.7, 8.4 and 13, respectively. There was no significant association between the risk of bladder cancer and the amount and duration of smoking. CONCLUSIONS: We concluded that current smokers have an increased incidence and mortality rate of bladder cancer in both genders in the Korean population, but there was no significant difference in relation to the amount and duration of smoking.

Voiding Pattern in Healthy Korean Children Below 3 Years Old / 대한비뇨기과학회지

PURPOSE: There is little known about the voiding patterns and development of bladder control in healthy Korean children. To obtain a more comprehensive picture of voiding patterns in healthy children during the first 3 years of life children were examined using 4-hour voiding observations. MATERIALS AND METHODS: The 4-hour voiding was observed in 37 healthy children(male:female ratio; 21:16, with a mean age of 18.4 month). The children were divided into 9 groups depending on their 4 month intervals. Observation began between 8:00 and 9:00 a.m., and the diapers checked every 10 minutes. Voiding patterns, including the number of voidings, voided volume, bladder capacity and residual urine were determined for 4 hours. The urine volume was measured by weighing the diaper, and post-void residual urine using a portable ultrasound device(BladderScanTM BVI 3000, Diagnostic Ultrasound, USA). The bladder capacity was defined as the highest voided volume plus the residual urine for 1 occasion during the 4-hour observation. RESULTS: During the 4-hour observation the children voided between 1 and 9 times(mean 3.5 times). The voiding frequency and residual urine decreased with age, while the voiding volume and bladder capacity increased. In all children the residual volume was less than 5ml. at least once during the observation. There were no significant differences between male and female children in the voiding frequency, mean voided volume and mean residual urine. CONCLUSIONS: The 4-hour voiding observation is an easy noninvasive method of characterizing the voiding patterns in infants and non-toilet trained children. During the first 3 years of life the number of voiding episodes and residual urine decreased, while the voiding volume and bladder capacity increased. Our study may be used as reference data for the normal voiding pattern in healthy Korean children aged between 0 and 3 years.

Expression of Neuroendocrine Cells in the Prostate of Rat and Guinea Pig after Orchiectomy / 대한비뇨기과학회지

PURPOSE: Neuroendocrine cells, also referred to as amine precursor uptake and decarboxylation (APUD) cells, in the prostate gland are serotonin and peptide containing cells, which are thought to play an important role in the regulation of growth, cellular differentiation and homeostasis. The expressions of neuroendocrine cells in the prostate differ between species and pathological conditions of the prostate. Androgen is believed to be a major effective material toward the prostate, its role in neuroendocrine cells is uncertain. The objective of this study was to investigate the effects of blockade of androgen on neuroendocrine cells in the prostate of rats and guinea pigs. MATERIALS AND METHODS: Rats and guinea pigs underwent an orchiectomy, and their prostate glands removed at 0 (control), 2 (2-week group) and 6 (6-week group) weeks after the orchiectomy. Each prostate tissue was examined both microscopically and with immunohistochemistry using synaptophysin, chromogranin A and serotonin. RESULTS: In the rat prostate glands, fewer neuroendocrine cells were stained with chromogranin A compared to the other two monoclonal antibodies. Although some atrophy of the glandular structure was presented grossly and microscopically in the castration groups, there was no difference in the chromogranin A immunoreactivity between the control, 2-week and 6-week groups. In the guinea pig prostate glands, few neuroendocrine cells were stained with either synaptophysin or serotonin. Glandular atrophy presented in the castration groups. There was no difference between the control, 2-week and 6-week groups in the immunoreactivities of the synaptophysin and serotonin monoclonal antibodies. CONCLUSIONS: The immunoreactivities of the neuroendocrine cells of rats and guinea pigs were different from those in humans and from each other. Neuroendocrine cells in the prostate of rats and guinea pigs exist only in small numbers, and seem to be independent of androgen.

Expression of Neuroendocrine Cells in the Prostate of Rat and Guinea Pig after Orchiectomy / 대한비뇨기과학회지

PURPOSE: Neuroendocrine cells, also referred to as amine precursor uptake and decarboxylation (APUD) cells, in the prostate gland are serotonin and peptide containing cells, which are thought to play an important role in the regulation of growth, cellular differentiation and homeostasis. The expressions of neuroendocrine cells in the prostate differ between species and pathological conditions of the prostate. Androgen is believed to be a major effective material toward the prostate, its role in neuroendocrine cells is uncertain. The objective of this study was to investigate the effects of blockade of androgen on neuroendocrine cells in the prostate of rats and guinea pigs. MATERIALS AND METHODS: Rats and guinea pigs underwent an orchiectomy, and their prostate glands removed at 0 (control), 2 (2-week group) and 6 (6-week group) weeks after the orchiectomy. Each prostate tissue was examined both microscopically and with immunohistochemistry using synaptophysin, chromogranin A and serotonin. RESULTS: In the rat prostate glands, fewer neuroendocrine cells were stained with chromogranin A compared to the other two monoclonal antibodies. Although some atrophy of the glandular structure was presented grossly and microscopically in the castration groups, there was no difference in the chromogranin A immunoreactivity between the control, 2-week and 6-week groups. In the guinea pig prostate glands, few neuroendocrine cells were stained with either synaptophysin or serotonin. Glandular atrophy presented in the castration groups. There was no difference between the control, 2-week and 6-week groups in the immunoreactivities of the synaptophysin and serotonin monoclonal antibodies. CONCLUSIONS: The immunoreactivities of the neuroendocrine cells of rats and guinea pigs were different from those in humans and from each other. Neuroendocrine cells in the prostate of rats and guinea pigs exist only in small numbers, and seem to be independent of androgen.

Is There Any Relationship between Upper Urinary Tract Stone Development and Sleep Posture? / 대한비뇨기과학회지

PURPOSE: Recurrent stone formers are usually presented with calculi on the ipsilateral side. It has been postulated that sleep posture may alter renal hemodynamics and urinary flow during sleep and promote stone formation. We investigated the correlation of sleep posture with unilateral stone formation and the influence of body position on renal hemodynamics and urinary flow. MATERIALS AND METHODS: We prospectively evaluated the sleep posture of 106 patients with unilateral urolithiasis. A questionnaire was used to evaluate sleep posture of the patients. Sixteen normal volunteers were studied. They were evaluated in the supine, left and right lateral decubitus positions with separate diuretic renograms spaced one week apart. Renal scans were obtained using diethylenetriamine-pentaacetic acid (99mTc- DTPA) after the patient was equilibrated in the specific body position for 30 minutes. RESULTS: Of the patients, 66 slept consistently with 1 side in a dependent position, and the side of the stone was identical to the dependent sleep side in 80.2% (p<0.01). Renal perfusion and the T1/2 for clearances in the dependent kidney in the left and right decubitus positions were significantly increased when compared to the same kidney in the supine position (p<0.01). CONCLUSIONS: Specific sleeping position has significant effects on renal perfusion and urinary flow as measured by nuclear renal scintigraphy. This finding may help explain the correlation of sleep posture with unilateral urolithiasis. Even though this observation needs further investigation, it should be factored into the evaluation and prevention of unilateral stone disease.

The Effect of the Cryptorchidism on the Testicular Volume and Gender Identity after Adolescence / 대한비뇨기과학회지

PURPOSE: To investigate the influence of cryptorchidism on the testicular volume and gender identity of young men within a community. MATERIALS AND METHODS: Of 27,202 men, aged 20 years, within the community, a 10% sampling fraction was randomly selected, of which 2,080 (a response rate 77.0%) agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. To evaluate the influence of cryptorchidism on gender identity, we used the Bem Sex Role Inventory (BSRI) in the men without testicular disease, but who were observed to have cryptorchidism on physical examination, or had a history of operation for cryptorchidism. RESULTS: Of the participants, 38 (1.8%) were observed to have cryptorchidism, or had a history of operation for cryptorchidism (right; 15, left; 21, bilateral; 2). Of these patients, 29 had a history of operation, with a mean age at the time of operation of 8.9+/-3.9 years, ranging from 2 to 19 years. Of the 36 patients with unilateral cryptorchidism, the contralateral testicular volume of the men that underwent an orchiopexy was no different to that of those that underwent an orchiectomy or that had no operation at all. Comparing the masculinity and femininity scores, using the BSRI between the orchiopexy and normal groups, the masculinity score of the orchiopexy group was lower than that of the normal group. CONCLUSIONS: Our results demonstrate that a delayed orchiopexy does not improve the growth of the testicular volume on the affected side, or the masculine identity, in men with unilateral cryptorchidism. In addition, these findings suggest that there is a need to increase the awareness related to cryptorchidism amongst all parties involved in the health care of children.