The bone formation around anodic oxidized titanium implants in the tinbiae of ovarectomized rats

Anodic spark deposition method(ASD) surface treated titanium implant possesses a considerable osteoconductive potential that promoting a high level of implant osseointegration in normal bone. The purpose of this study was to observe the ASD implant's osseointegration in the osteoporosis-induced animal model. Twenty four rats, 10 weeks of age, were ovarectomized and 5 weeks later divided into two groups : ASD implant group and control implant group. Titanium screw implants (diameter; 2.0 mm, length, 3.5 mm; pitch-height, 0.4 mm) were designed for this study. Experimental implants were ASD treated and no treatment on control implants. ASD implants and control implants were placed in to left tibiae of rats. The rats were sacrificed at different time interval(1, 2, 4 and 8 weeks after implantation) for histopathologic observation and immunohisto -chemistrical observation, with collagen type I, fibronectin, integrin alpha2beta1 and integrin alpha5beta1 antibodies. The results obtained from this study were as follow: 1. Histopathologic findings, overall tissue response and the pattern of bone formation in both groups were similar. In ASD group, more newly formed bone was seen at 1 week and 2weeks than control group. 2. The levels of type I collagen and fibronectin expression were the most abundant at 2weeks and decreased gradually in both groups. Fibronectin and type I collagen expression in ASD group were stronger than control group but no significance. 3. The levels of integrin alpha2beta1 and Integrin alpha5beta1 expression were most abundant at 2 weeks and decreased gradually in both groups. No significant difference was observed in both groups. From this results, anodic oxidized titanium implants were more advantages in early stage of bone formation than control group, but have no significance in tissue responses and late bone formations. It could be stated that although anodic oxidized titanium implant possesses considerable osteoconductive potential but in osteoporotic bone condition dental implant procedure should performed after improving or treating the osteoporotic bone condition.

Short Term Follow Up of Whiplash-associated Disorder Patients Treated with Pulsed Radiofrequency Thermocoagulation / 대한마취과학회지

BACKGROUND: Whiplash associated disorder (WAD) is one of the most common causes of neck pain and cervicogenic headache. One proposed method of treating neck pain and cervicogenic headache is the ablation of cervical medial branch with pulsed radiofrequency thermocoagulation (PRFT). This study was a retrospective evaluation of the effect of the PRFT in patients with WAD who did not show any responses to the various conservative treatments. METHODS: Short term outcome was ascertained among 7 patients with the PRFT of cervical medial branches, who had shown positive response to the diagnostic block. During the PRFT under the guidance of C-arm image, impedance and sensory electrical nerve stimulation threshold were assessed. After obtaining appropriate stimulation, PRFT was performed to the cervical medial branches at 42degreesC for 120 seconds. Three out of 7 patients were treated unilaterally. For the assessment of short term outcome, the 4 point Likert scale was adopted. The result was regarded as favorable if pain reduction were more than 50% on the scale. RESULTS: Mean duration of pain was 415.3 +/- 233.4 days. Average follow-up interval was 76.4 +/- 10.1 days. Two patients did not respond favorably to the PRFT. In 5 patients who showed favorable response to the PRFT, the effect lasted on average 76.4 +/- 10.1 days. CONCLUSIONS: The PRFT of cervical medial branches might be an effective treatment modality in patients with WAD and who did not show any responses to the conservative managements.

The Effect of Cycolooxygenase (COX-1 and COX-2) on the Bacterial Toxin Formyl Methionyl Leucyl Phenylalanine (fMLP) Induced Contraction of the Rabbit Bladder Muscle / 대한비뇨기과학회지

No abstract available.

Expression of Heat Shock Protein 70 m-RNA in Rat Bladder Overdistended by Diuresis

No abstract available.

Effects of Lipopolysaccharide on Inflammation within the Bladder Muscle and Muscle Contractility in the Rats / 대한비뇨기과학회지

PURPOSE: The mechanisms, which alter urinary bladder muscle function during infectious cystitis, are poorly understood. The objective of this study was to identify potential resident targets for endotoxin lipopolysaccharide(LPS) within normal bladder smooth muscle and test the hypothesis that LPS induces an inflammatory response within the bladder muscle and that this is associated with a decrease in muscle contractility. MATERIALS AND METHODS: Male rats were studied 24 hours after a single bolus i.p. injection of LPS(15mg/kg). Whole-mount preparations of the bladder muscle were immunohistochemically stained for neutrophils(myeloperoxidase), macrophages(ED2), activated leukocytes(LFA-1) and mast cells(FITC-Avidin). Contractile activity was assessed from muscle strips of the bladder in response to bethanechol(0.3-300microM). Voiding frequency and urine volume for 24 hours were measured using metabolic cage. Cystometry was performed to measure the intravesical bladder pressure. RESULTS: Using the resident macrophage marker ED2, dense network of macrophages were observed within the bladder muscle of control and LPS treated rats. Few neutrophils(myeloperoxidase-positive cells, 2.3 +/- 0.38 cells, x200) were detected in whole-mounts of bladder muscle of control rats, while LPS pretreatment resulted in a significant increase in the number of neutrophils which demonstrate inflammatory response(10.8 +/- 1.70 cells, x200, p<0.001). LFA-1 immunohistochemistry demonstrated an increased presence of LFA-1 positive cells in bladder muscle of LPS treated rats, which had a morphology similar to both neutrophils and resident macrophages. The expression of LFA-1 is known as a marker of cells that are in an activated state. LPS pretreatment resulted in a significant reduction in bladder muscle contractions in response to bethanechol(i.e. control = 0.049 +/- 0.010 vs. LPS= 0.029 +/- 0.003 gr/mm2/sec, 100microM, p<0.05). Voiding frequency of LPS treated rats was significantly increased compared to that of control rats. In LPS treated rats, voiding phase representing bladder contractility in cystometry was observed. CONCLUSIONS: These data demonstrate that a single intraperitoneal injection of LPS initiates an inflammatory response within the bladder muscle that is associated with a decrease in the functional activity of the bladder. We hypothesize that secretions from the resident macrophages and extravasated leukocytes within the muscle cause the observed suppression in bladder muscle activity in vitro.

Urethral Afferent Nerve Activity Affects the Micturition Reflex; Implication for the Relationship between Stress Incontinence and Detrusor Instability

No abstract available.

Malignant Ureteral Obstruction secondary to Stomach Cancer / 대한비뇨기과학회지

PURPOSE: Metastasis from primary malignancies anywhere in the body can spread to the retroperitoneum and lead to ureteral obstruction. We evaluated the correlation between pathologic stages of stomach cancer and ureteral obstruction, and their urologic manifestations. MATERIALS AND METHODS: Ten patients who had ureteral obstructions caused by stomach cancer were retrospectively analysed. Medical records associated with stomach cancer, urologic symptoms and signs, and methods of urinary diversion were reviewed. RESULTS: Pathologic stages of stomach cancer(UICC & AJC classification) at the time of primary surgery were stage III in 1 and IV in 8 patients. Mean time inteval between the diagnosis of stomach cancer and subsequent ureteral obstruction was 26.6 months(range: 2months-10years) and ureteral obstruction of 6 patients(60.0%) was discovered within 2 years. Urologic symptoms and signs were gross or microscopic hematuria(50.0%), elevated Cr(40.0%) and flank pain(40.0%). Nine out of 10 patients had one of these findings. Ureteral involvements were bilateral in 7(70.0%) and unilateral in 3 patients(30.0%). Sites of ureteral obstruction were upper ureter in 5 and midureter in 5 patients. 14 out of 17 obstructed kidneys were managed by double-J stent(7 kidneys) or percutaneous nephrostomy(7 kidneys). CONCLUSIONS: We believe that we should take into account the possibility of ureteral obstruction by direct invasion or lymph node metastasis in patients who had advanced stomach cancer. If such patients show hematuria, uremia or flank pain, secondary ureteral obstruction should be suspected. And malignant ureteral obstruction should be detected and managed as early as possible to preserve renal function.

The Significance of Uroflowmetry after Repair of Hypospadias / 대한비뇨기과학회지

PURPOSE: To determine the role of uroflowmetry in the evaluation of the functional results of hypospadias repair we reviewed the asymptomatic patients who underwent hypospadias repair. MATERIALS AND METHODS: A total of the 34 patients was available for this study. Age of patient were ranged from 3 to 14 years(mean; 8.8+/-4.67 years) at the time of uroflowmetry and followup ranged from 7 months to 3.5 years(mean; 2.4+/-0.88 years) after repair of hypospadias. The peak uroflow were compared to age dependent nomograms that indicate the normal range of peak flows according to the voided volumes. Flow rates were defined as low if they decreased below 90 percentile of the expected normal range. RESULTS: The peak urine flow in hypospadias repair patients(12.1 +/-8.74m1/sec) was not significantly different from normal control(12.9+/-5.10 ml/sec). Five of the 34 patients had peak flow below the normal ranges. One of the 17 patients with chordee and one of the 11 without chordee showed low peak urine flow. One of the 14 patients with anterior hypospadias, one of the 8 with posterior hypospadias and none with mid hypospadias showed low peak urine flow. According to the methods of repair one of the 12 patients with onlay island flap, one of the 5 with pyramidal procedure and three of the 6 who had undergone previous attempts at hypospadias in other hospital showed low peak urine flow Two of the 5 patients who revealed low peak uroflow rate were managed with periodic meatal dilatation and the 3 were managed with internal urethrotomy for proximal urethral stricture. CONCLUSIONS: The uroflowmetry is an easy and noninvasive method to detect asymptomatic urethral stricture In hypospadias repair patients.

Ureteral Obstruction Caused by Uterine Prolapse: 5 Cases

No abstract available.

The Pharmacological and Histological Comparison Between Detubularized and Tubularized Cystoplasty Ileum in the Rat / 대한비뇨기과학회지

Bowel segments are used either in a tubular or detubular configuration in bladder augmentation and substitutions. The majority of urologists agree that detubularized segments give better clinical results,but detailed studies were not investigated in animals. The present study compared the contractile response of autonomic agonists including carbachol, isoproterenol,alpha, beta-methylene ATP on detubularized and tubularized cystoplastic ileal segments. In addition, histological examinations of cystoplastic ileal segments were performed. Five rats underwent Sham operation as control and eight rats underwent detubularized ileocystoplasty and seven rats underwent tubularized ileocystoplasty. Analysis was done six weeks after surgery. The contractile responses of detubularized cystoplasty ileum to carbachol, alpha, beta-methylene ATP were significantly increased when compared to the responses of tubularized ileum and control ileum. The relaxation responses of detubularized cystoplasty ileum to isoproterenol were significantly higher than control ileum. However, in tubularized ileum, the responses to carbachol, alpha, beta-methylene ATP, isoproterenol were similar for control ileum. The responses of detubularized cystoplasty ileum to carbachol, alpha, beta -methylene ATP were significantly different from control bladder, but detubularized cystoplasty ileum showed responses that resemble control bladder more closely when compared to the responses of tubularized ileum.The histological examination showed urothelialization of cystoplastic ileum with transitional epithelium extending over and covering the junction margin of the cystoplastic ileum. These results suggest detubularized ileocystoplasty induced closer pharmacological changes in the ileal segment towards the bladder than tubularized ileocystoplasty and so we can expect detubularized ileocystoplasty gives better clinical outcome.

Impaired Endothelium-Dependent Relaxation by Alternating Protein Kinase C and Na+-K+ ATPase in Isolated Rabbit Corpus Cavernosum Exposed to Elevated Glucose / 대한비뇨기과학회지

Impaired endothelium dependent relaxation occurs in diabetic rabbit corpus cavernosum and normal corpus cavernosum exposed to elevated glucose. Elevation of glucose can change the activities of two key enzymes, protein kinase C (PKC) and Na+-K+ ATPase. This study addresses the question of whether impaired endothelium dependent relaxation in isolated corpus cavernosum from normal rabbit exposed to elevated glucose is related to PKC and Na+-K+ ATPase activities and, if so, whether it is associated with altered ouabain sensitive 86-Rb uptake, an index of Na+-K+ ATPase activity, and contractile response of corpus cavernosum tissue to ouabain. Corpus cavernosal tissue suspended for measurement of isometric tension were incubated for 6 hours in control (5.5mM) or elevated glucose (44mM) to mimic euglycemic and hyperglycemic conditions. Relaxations of corpus cavernosum tissue in response to the endothelium-dependent vasodilator acetylcholine (ACh)were unaffected in control groups while significantly inhibited in the elevated glucose group. Relaxations of corporeal tissue to endothelium-independent vasodilators, sodium nitroprusside (SNP) were similar in the control and elevated glucose groups. Corporeal tissue treated with 4-phorbol 12-myristate 13-acetate (PMA), a PKC activator, showed decreased relaxations to ACh, similar to normal corporeal tissue exposed to elevated glucose. Relaxations in response to SNP were unaffected by treatment with PMA or exposure to elevated glucose. 1(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7), PKC inhibitor, restored the abnormal Ach-induced relaxation in corporeal tissue exposed to elevated glucose. The contractions caused by ouabain, Na+-K+ ATPase inhibitor, were smaller in elevated glucose groups than control and elevated glucose groups treated with H-7. Ouabain sensitive 86-Rb uptake of elevated glucose groups was significantly less than that of control groups but ouabain sensitive 86-Rb uptake of elevated glucose groups treated with H-7 was similar to those of control groups. These results suggest that activation in PKC activity and inhibition in Na+-K+ ATPase activity caused by elevated glucose contribute to impaired endothelium dependent relaxation in corpus cavernosum smooth muscle.

Expression of Heat Shock Protein 70 m-RNA in Non-obstructed Bladder Tissue in Rats with Diuresis

No abstract available.

The Effect of Free Radical Scavengers on Reperfusion Injury after Testicular Torsion / 대한비뇨기과학회지

The free radicals generated during the ischemic/reperfusion period have been suggested as a possible cause for tissue damage in organs. This state was conducted to investigate protective effects of free radical scavengers through changes in the lipid peroxide content of the testis when administered before reperfusion of testicular torsion. These protective agents include superoxide dismutase(SOD), an oxygen radical scavenger and dimethylthiourea(DMTU), a hydroxyl radical scavenger. Forty five Sprague-Dawley rats were divided into 9 groups, each containing 5 rats. Group 1 served to determine basal values of the lipid peroxide content of the testis ; group 2 underwent sham operation as a control ; group 3 was subjected to unilateral testicular torsion lasting 3 hours; group 4, 5 were subjected to the detorsion lasting 1 hour and 2 hours following torsion for 3 hours; group 6, 7, 8, 9 were treated with SOD or DMTU before detorsion following torsion lasting 3 hours. The measurement of thiobarbituric acid reactive products of lipid peroxidation(TBAR) were employed to assess the extent of lipid peroxidation in testicular tissues. TBAR from sham operation control groups did not differ significantly from basal groups (p>0.05). Testicular torsion caused a significant increase in TBAR in the testis (p<0.05) when compared with basal values and detorsion caused a further significant increase when compared with values obtained after torsion. But TBAR after 1 hr detorsion did not change significantly compared with values obtained after 2 hours detorsion. The pretreatment with SOD prevented this further increase but the pretreatment with DMTU didn't. In conclusion, biochemically, reperfusion injury occurs in testis following detorsion after testicular torsion of 720 lasting 3 hours. The pretreatment with SOD, an oxygen radical scavenger, is effective in preventing reperfusion injury.

Bilateral Xanthogranulomatous Pyelonephritis in a Child / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis is a chronic inflammatory condition that can only be diagnosed by histological examination, and is often associated with renal calculi, obstruction and urinary tract infection. We report a case of bilateral xanthogranulomatous pyelonephritis in a child with end stage renal disease, which was misdiagnosed as renal cell carcinoma preoperatively.

The Diagnostic Usefulness of Computed Tomography of Transitional Cell Carcinoma of the Renal Pelvis and Ureter / 대한비뇨기과학회지

We evaluated the usefulness of preoperative computed tomography (CT) in 26 patients with transitional cell carcinoma (TCC) of the renal pelvis or ureter. Also we had comparative analysis between CT and conventional urography in diagnosis. The conventional imaging methods such as excretory urography and retrograde pyelography are helpful in localizing the lesions but usually cannot detect extension into the peripelvic and/or periureteral fat or metastasis to the lymph nodes. Of 17 patients who were thought localized by CT, 16 were localized in the mucosa or muscle layer and 1 was invasive to periureteral or peripelvic tissue pathologically. Of 8 patients who were thought invasive to periureteral or peripelvic tissue by CT, 5 were identical and 3 were metastatic to lymph nodes pathologically In conclusion, preoperative CT is thought to be useful tool for the diagnosis and staging in TCC of the pelvis or ureter and the sensitivity and specificity of CT were higher in localized diseases than in advanced diseases.

A Case of Uncrossed Complete Ureteral Duplication with Upper System Reflux and Caudal Orthotopic Orifice with Ureterocele / 대한비뇨기과학회지

We report a case of uncrossed complete ureteral duplication with the orifice of the upper system ureter opening in the cranial and lateral positionin the bladder. There was reflux only to the upper system of the duplex kidney and the orifice of the lower system ureter in caudal position was associated with a ureterocele, and the lower pole system was large and non-functioning. The patient was treated successfully by lower pole heminephrectomy and ureterectomy.

A comparative study of the brooker-wills and russell-taylor nailing for treatment of patients who have fractures of the distal half of the femur / 대한정형외과학회잡지

No abstract available.

Preliminary results of M-VAC(methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy for advanced trasitional cell carcinoma of the urothelium / 대한비뇨기과학회지

We reviewed retrospectively 23 patients treated with M-VAC (Methotrexate. Vinblastine, Doxorubicin, Cisplatin) from October 1987 to June 1990 at our hospital to evaluate predictive variables for response to chemotherapy and long term survival free of disease. Treatment consisted of monthly cycles of 30mg. per m2 methotrexate, followed 24 hours later by 3mg. per m2. vinblastine, 30mg. per m2. doxorubicin and 70mg. per m2. cisplatin and concluded with repeat vinblastine and methotrexate on days 15 and 22. The Median number of cycles was 3 (range 2 to 5). Complete plus partial remission were observed in 13 of 23 patients (57%) with a median survival or 13 months (range 7+ to 32+ months). Stabilization occurred in 3 patients (14%) and progression in 7 patients (29%) with median survivals of 10 months (range 7+ to 11 months) and 8 months(4 to 12+ months). 1 year survival rate was 77% in complete puls partial remission and 66% in stabilization and 28% in progression. 10 patients with a complete plus partial remission are alive with a median follow up of 15 months ( range 4 to 32+ months), of whom 1 is surviving for more than 2 years. Toxicity included moderately severe myelosuppression that resulted in nadir sepsis in 1 patient mild to moderate anorexia, vomiting, alopecia and renal dysfunction. Though the number of availuable patients are limited, these preliminary results suggest that treatment with M-VAC is effective against disseminated urothelial transitional cell tumors.

Analysis of Urinary Calculi in Voided Urine after ESWL / 대한비뇨기과학회지

Accurate analysis of urinary calculi is fundamental for study of the etiology of stone formation and essential for treatment of urinary stone and its prevention. A total of 600 patients underwent treatments with ESWL for urinary tract calculi between May, 1987 and June, 1989. The stone fragments that were passed with 99 patient's urine and 21 stone calculi required surgical removal, were analyzed by infrared spectrometer. The following results were obtained : 1. Mixed calculus (58.3%) in much more than single calculus (41.7% ), The most common type of calculi is calcium oxalate-calcium phosphate (69 cases-57.5% ). The most common type of components is calcium oxalate (105 cases-87.5%). 2. Uric acid stones are found in acid urine, and most of magnesium ammonium phosphate stones are found in alkaline urine. 3. 17 of 120 cases have bacteriuria on culture and most of them are ureasplitting organisms. 4. 21 calculi of failed ESWL were analyzed and the components were calcium oxalate-calcium phosphate in 14, calcium oxalate in 4, magnesium ammonium phosphate in 2, uric acid in 1. 5. The causes of failed ESWL were stone components in 5 cases, impacted stone in 10 cases and poor stone localization in 6 cases.

1 Case of Transverse Testicular Ectopia / 대한비뇨기과학회지

Transverse testicular ectopia is an uncommon anatomical abnormality in which both gonads migrate toward the same hemiscrotum. A case report, review of the embryology, differential diagnosis and suggested management are detailed witha brief review of literature.