Ten-year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) of a superficial esophageal neoplasm (SEN) is a technically difficult procedure. We investigated the clinical outcomes of ESD to determine its feasibility and effectiveness for the treatment of SEN. METHODS: Patients who underwent ESD for SEN between August 2005 and June 2014 were eligible for this study. The clinical features of patients and tumors, histopathologic characteristics, adverse events, results of endoscopic resection, and survival were investigated. RESULTS: ESD was performed in 225 patients with 261 lesions, including 70 cases (26.8%) of dysplasias and 191 cases (73.2%) of squamous cell carcinomas. The median age was 65 years (range, 44 to 86), and the male to female ratio was 21.5:1. Median tumor size was 37 mm (range, 5 to 85) and median procedure time was 45 minutes (range, 9 to 160). En bloc resection was performed in 245 of 261 lesions (93.9%), with complete resection in 234 lesions (89.7%) and curative resection in 201 lesions (77.0%). Adverse events occurred in 33 cases (12.6%), including bleeding (1.5%), perforation (4.6%), and stricture (6.5%). During a median follow-up period of 35.0 months (interquartile range, 18 to 62), none of the patients showed local recurrence. The 5-year overall and disease-specific survival rates were 89.7% and 100%, respectively. CONCLUSIONS: ESD is a feasible and effective procedure for the treatment of SEN based on our 10-year experience, which showed favorable outcomes.

Endoscopic Ultrasonographic Characteristics of Gastric Schwannoma Distinguished from Gastrointestinal Stromal Tumor / 대한소화기학회지

BACKGROUND/AIMS: Gastric schwannoma (GS), a rare neurogenic mesenchymal tumor, is usually benign, slow-growing, and asymptomatic. However, GS is often misdiagnosed as gastrointestinal stromal tumors (GIST) on endoscopic and radiological examinations. The purpose of this study was to evaluate EUS characteristics of GS distinguished from GIST. METHODS: A total of 119 gastric subepithelial lesions, including 31 GSs and 88 GISTs, who were histologically identified and underwent EUS, were enrolled in this study. We evaluated the EUS characteristics, including location, size, gross morphology, mucosal lesion, layer of origin, border, echogenic pattern, marginal halo, and presence of an internal echoic lesion by retrospective review of the medical records. RESULTS: GS patients comprised nine males and 22 females, indicating female predominance. In the gross morphology according to Yamada's classification, type I was predominant in GS and type III was predominant in GIST. In location, GSs were predominantly located in the gastric body and GISTs were predominantly located in the cardia or fundus. The frequency of 4th layer origin and isoechogenicity as compared to the echogenicity of proper muscle layer was significantly more common in GS than GIST. Although not statistically significant, marginal halo was more frequent in GS than GIST. The presence of an internal echoic lesion was significantly more common in GIST than GS. CONCLUSIONS: The EUS characteristics, including tumor location, gross morphology, layer of origin, echogenicity in comparison with the normal muscle layer, and presence of an internal echoic lesion may be useful in distinguishing between GS and GIST.

Coexistence of Solitary Rectal Ulcer Syndrome and Ulcerative Colitis: A Case Report and Literature Review

Solitary rectal ulcer syndrome (SRUS) is an uncommon benign disease that is misdiagnosed as malignancy or inflammatory bowel disease because of similarities in clinical and endoscopic manifestations. Furthermore, SRUS with ulcerative colitis (UC) is extremely rare. To date, two cases have been reported in the medical literature. We report an additional case of SRUS with UC that was misdiagnosed as rectal cancer. A 61-year-old man was admitted to our hospital with rectal bleeding. Colonoscopy showed a well-demarcated, shallow, ulcerative lesion with polypoidal growth involving the entire circumference of the rectal lumen. Findings from imaging studies, including abdominal computed tomography (CT) and positron emission tomography (PET)/CT resembled those of rectal cancer. Surgical resection was performed because clinical symptoms persisted despite medical treatment and because occult rectal cancer could not be ruled out. Histopathological examination of the resected specimen revealed fibromuscular obliteration of the lamina propria and crypt abscesses, characteristics compatible with SRUS and UC.

The Need for Second-Look Endoscopy to Prevent Delayed Bleeding after Endoscopic Submucosal Dissection for Gastric Neoplasms: A Prospective Randomized Trial

BACKGROUND/AIMS: Many authors recommend performing a second-look endoscopy (SLE) to reduce the frequency of delayed bleeding after endoscopic submucosal dissection (ESD) for gastric neoplasms, but these recommendations have been made despite a lack of reliable evidence supporting the effectiveness of SLE. METHODS: From January 2012 to May 2013, we investigated 441 gastric neoplasms treated by ESD to assess the risk factors for delayed bleeding. Delayed bleeding occurred in four of these lesions within 1 postoperation day. Therefore, we enrolled the patients with the remaining 437 lesions to determine the utility of SLE performed on the morning of postoperative day 2. All lesions were randomly assigned to SLE (220 lesions) groups or non-SLE (217 lesions) groups. RESULTS: Delayed bleeding occurred in 18 lesions (4.1%). A large tumor size (>20 mm) was the only independent risk factor for delayed bleeding (p=0.007). The chance of delayed bleeding was not significantly different between the patients receiving a SLE (eight cases) and those patients not receiving a SLE (six cases, p=0.787). Furthermore, SLE for lesions with a large tumor size did not significantly decrease delayed bleeding (p=0.670). CONCLUSIONS: SLE had little or no influence on the prevention of delayed bleeding, irrespective of the risk factors.

Acute Obstructive Cholangitis Complicated by Tumor Migration after Transarterial Chemoembolization: A Case Report and Literature Review / 대한소화기학회지

Intraductal tumor invasion of hepatocellular carcinoma (HCC) is considered rare. Transarterial chemoembolization (TACE) is effective for tumor thrombus of HCC in the bile duct. However, a few cases of obstructive jaundice caused by migration of a tumor fragment after TACE have recently been reported. The aim of this study was to identify factors that affect tumor migration after TACE. At this writing, a review of the medical literature disclosed seven reported cases of biliary obstruction caused by migration of a necrotic tumor cast after TACE. We, herein, report on an additional case of acute obstructive cholangitis complicated by migration of a necrotic tumor cast after TACE for intrabile duct invasion of HCC, in a 71-year-old man. The tumor cast in the common bile duct was removed successfully using a basket during ERCP and was pathologically confirmed to be a completely necrotic fragment of HCC. The patient's symptoms showed dramatic improvement. In summary, physicians should be aware of acute obstructive cholangitis complicated by tumor migration in a patient undergoing TACE. We suggest that an intrabile duct invasion would be a major predisposing factor of tumor migration after TACE and drainage procedures such as ERCP or percutaneous transbiliary drainage could be effective treatment modalities in these patients.

Benign Teratoma of the Thyroid Gland

Although pathology reports of thyroid tissue in ovarian teratomas are abundant, benign teratomas of the thyroid are extremely rare in adolescents and adults. Therefore, their clinical characteristics are still not well characterized. We report a case of a 54-year-old woman with a growing mass in her neck. Left lobectomy of the thyroid revealed it to be a benign thyroid teratoma composed of tissues from all three germ layers. Preoperative evaluations included thyroid ultrasonography (US), ultrasound-guided fine needle aspiration cytology (FNAC), and computed tomography (CT) of the neck. A 4.7-cm, well defined, predominantly hypoechoic mass intermingled with hyperechoic internal lesions, was observed in the inferior portion of the left thyroid lobe with substernal extension on US. The posterior extent of the nodule was not visualized due to deep attenuation of the echo. US-guided FNAC failed to reveal any thyroid follicular cells, but suggested a benign cystic tumor. Neck CT hinted at the diagnosis of teratoma because the mass contained large amounts of fat, and the margin was well defined. Extrathyroidal extension and cervical lymphadenopathy were not seen. She underwent left thyroid lobectomy, and histologic examination confirmed benign thyroid teratoma. To the best of our knowledge, this is the first case report of benign thyroid teratoma in Korea.

Epigallocatechin-3-gallate Inhibits the Expression of Adhesion Molecules by Blocking Nuclear Factor Kappa B Signaling in Intestinal Epithelial Cells

BACKGROUND/AIMS: Epigallocatechin-3-gallate (EGCG) is the main polyphenol in green tea and has anti-inflammatory and anti-oxidative effects. The aim of this study was to determine the impact of EGCG on the expression of adhesion molecules and lipopolysaccharide (LPS)-induced nuclear factor-kappa B (NF-kappaB) signaling in rat intestinal epithelial (RIE) cells. METHODS: The effect of EGCG on LPS-induced NF-kappaB signaling and expression of intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 was examined by reverse transcription polymerase chain reaction, western blotting, immunofluorescence and electrophoretic mobility shift assay. RESULTS: LPS-induced expression of ICAM-1 and VCAM-1 mRNA was inhibited by EGCG treatment in RIE cells. LPS-induced inhibitor of kappa B alpha degradation and NF-kappaB nuclear translocation were blocked by EGCG in RIE cells. EGCG blocked LPS-induced NF-kappaB DNA-binding activity in RIE cells. The pharmacological NF-kappaB inhibitor Bay11-7082 suppressed the LPS-induced expression of ICAM-1 and VCAM-1 mRNA in RIE cells. CONCLUSIONS: These results indicate that EGCG inhibits LPS-induced ICAM-1 and VCAM-1 expression by blocking NF-kappaB signaling in intestinal epithelial cells.

Fatal Interstitial Pneumonitis Rapidly Developed after the First Cycle of CHOP with Etoposide Combination Chemotherapy in a Patient with Lymphoma / 결핵및호흡기질환

Several chemotherapeutic agents are known to develop pulmonary toxicities in cancer patients, although the frequency of incidence varies. Cyclophosphamide is a commonly encountered agent that is toxic to the lung. Additionally, granulocyte colony-stimulating factor (G-CSF) being used for the recovery from neutropenia can exacerbate lung injury. However, most of the patients reported previously that the drug-induced interstitial pneumonitis were developed after three to four cycles of chemotherapy. Hereby, we report a case of peripheral T cell lymphoma which rapidly developed a fatal interstitial pneumonitis after the first cycle of combined chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisolone, and etoposide and the patient had also treated with G-CSF during neutropenic period.

Visual outcomes and operative complications following cataract surgery in Sorokdo Hansen patients / 나학회지

PURPOSE: To evaluate the visual outcomes and operative complications following cataract surgery in Sorokdo leprosy patients. METHODS: Forty three eyes of 35 leprosy patients with cataract underwent phacoemulsification and posterior chamber intraocular lens implantation surgeries. Eyes with small pupil and insufficient pupildilatation were treated with iris retractor and iris sphincterotmy. RESULTS: The mean age of patients was 71.0 +/- 8.2 years and the mean follow up was 4.5 +/- 2.0 months. The mean visual acuity significantly increased from 0.34 +/- 0.23 to 0.73 +/- 0.21 (p<0.05). Sixteen eyes (38%) gain 5 or more lines and 35 eyes (83%) gain 2 or more lines in corrected visual acuity. Common intraoperative events were 8 (19%) iris retractor use and 6 (14%) posterior capsular tear. CONCLUSIONS: Phacoemulsification and posterior chamber intraocular lens implantation surgeries in aged Sorokdo Hansen patients were safe and efficient to improve visual quality and life expectations.

Fludarabine-containing chemotherapy for patients with previously untreated low-grade non-Hodgkin's lymphoma

BACKGROUND: The clinical efficacy and safety of fludarabine combination chemotherapy was investigated for the treatment of previously untreated patients with low-grade (NHL). METHODS: Twenty-five patients who were newly diagnosed as low-grade NHL were treated with fludarabine combination chemotherapy. Fludarabine combination regimens consisted of fludarabine, mitoxantrone and dexamethasone or fludarabine, cyclophosphamide and mitoxantrone with or without rituximab and repeated every 4 weeks. RESULTS: The median age was 60 years (range, 35-77 years), with 13 of 25 patients (52%) > or =60 years of age. Seven of 25 patients (28%) with an intermediate risk follicular lymphoma international prognostic index (FLIPI) and 9 of 25 patients (36%) with a high risk FLIPI were enrolled in this study. The delivered median number of chemotherapy was six (range, 2-9 cycles). The overall response rate with fludarabine-based treatment was 88%, including 52% complete remission and 36% partial remission. During the median follow-up of 19 months, the estimated 2-year event-free survival was 63+/-10% (95% CI, 43-83) and the 2-year overall survival was 78+/-9% (95% CI, 60-96). Fludarabine combination chemotherapy was frequently associated with grade 3 or 4 neutropenia in 84% patients. However, neutropenic infection was observed in only one (4%) patient. Four patients (16%) showed grade 3 or more non-hematologic toxicities, such as acute coronary syndrome, intracranial hemorrhage, anaphylaxis and gastric cancer. CONCLUSION: Fludarabine-combination treatment was a highly active regimen with well toleration in untreated low-grade NHL.

Dedifferentiated Liposarcoma of the Retroperitoneum / Journal of the Korean Cancer Association, 대한암학회지

A dedifferentiated liposarcoma of the retroperitoneum is an extremely rare tumor. A 51-year old man was admitted to our department because a retroperitoneal mass was seen on abdominal computed tomography at another hospital. Computed tomography of the abdomen and magnetic resonance imaging showed a large pelvic mass located in the right hemipelvis, and it was pushing the right ureter and invading the right kidney, duodenum, colon and inferior vena cava. The patient underwent right radical nephrectomy, pylorus preserving pancreatoduodenectomy, right hemicolectomy and artificial blood vessel replacement for the inferior vena cava. The histopathological diagnosis was dedifferentiated liposarcoma and the patient was free from recurrence on the computed tomography that was done 6 months after the operation.

Obesity and the Metabolic Syndrome in Korean Adolescents

This study evaluated the prevalence of metabolic syndrome and investigated its association with being overweight in Korean adolescents. Data were obtained from 1,393 students between 12 and 13 yr of age in a cross-sectional survey. We defined the metabolic syndrome using criteria analogous to the Third Report of the Adult Treatment Panel (ATP III) as having at least three of the following: fasting triglycerides > or =100 mg/dL; HDL or =110 mg/dL; waist circumference >75th percentile for age and gender; and systolic blood pressure >90th percentile for age, gender, and height. Weight status was assessed using the age- and gender-specific body mass index (BMI), and a BMI > or =85th percentile was classified as overweight. Of the adolescents, 5.5% met the criteria for the metabolic syndrome, and the prevalence increased with weight status; it was 1.6% for normal weight and 22.3% in overweight (p<0.001). In multivariate logistic regression analyses among adolescents, overweight status was independently associated with the metabolic syndrome (odds ratio, 17.7; 95% confidence interval, 10.0-31.2). Since childhood metabolic syndrome and obesity likely persist into adulthood, early identification helps target interventions to improve future cardiovascular health.

Mucinous Adenocarcinoma of the Colon and Rectum

PURPOSE: This study was to evaluate and compare the clinical characteristics of a mucinous adenocarcinoma with those of a non-mucinous adenocarcinoma in colorectal cancer patients. METHODS: Data were retrospectively reviewed on 3,232 colorectal cancer patients, including 221 mucinous adenocarcinoma patients (6.1%), who received surgery between 1990 and 2003. RESULTS: The mean tumor size (6.5 cm) of the mucinous adenocarcinomas was bigger than that (5.2 cm) of the non-mucinous adenocarcinomas. The locations of the mucinous adenocarcinomas were 95 (48.2%) in the proximal colon, 35 (17.8%) in the distal colon, and 67 (34.0%) in the rectum whereas those of the non-mucinous adenocarcinomas were 559 (18.9%) in the proximal colon, 861 (29.2%) in the distal colon, and 1,533 (51.9%) in the rectum. Stage distribution was as follows: In mucinous adenocarcinomas, 7 stage A (3.3%), 84 stage B (39.3%), 76 stage C (35.5%), and 47 stage D (21.9%). In non-mucinous adenocarcinomas, 447 stage A (15.2%), 1,036 stage B (35.1%), 997 stage C (33.8%), and 469 stage D (15.9%). In the univariate analysis, the overall 5-year survival rate of patients with a mucinous adenocarcinoma was lower than that of patients with a non-mucinous adenocarcinoma (60% vs. 65%, P=0.016), but survival rates for each stage were not significantly different. The difference in recurrence rates was not statistically significant (33.3% vs. 24.2%, P=0.258). A multivariate analysis showed that the mucinous histologic type was not useful as an independent prognostic factor. CONCLUSIONS: Mucinous colorectal adenocarcinomas tend to be large, exist in a proximal location, have an advanced stage at diagnosis. The difference in survival rates for each stage was not statistically significant. A mucinous histologic type was not an independent prognostic factor.

Small Bowel Obstruction in Patients without a Previous History of Abdominal Operation

PURPOSE: Intra-abdominal adhesion related to prior abdominal surgery is the most common cause of small bowel obstruction (SBO). However, there are subsets of patients with SBO without a history of previous operation. We studied the characteristics of these patients. METHODS: The medical records of 311 patients underwent operations at Seoul National University Hospital between Jan. 1994 and Oct. 2005 were reviewed. A retrospective analysis of the incidence, etiology, diagnostic method, preoperative hospital stay, operative findings and methods, complication rates, postoperative hospital stay, re-admission rate, and reoperation rate of SBO was performed, and the results were compared with those of patients with a history of previous operation. RESULTS: Among the 311 patients (54.4 +/- 14.7 yr, M:F=1.5:1), 48 patients (15.3%) had no history of operation. The etiologies of SBO without a history of operation were malignancy (23.0%), bezoar (14.5%), adhesion (10.4%), Crohn's disease (10.4%), tuberculosis (8.3%), and appendicitis (8.3%). SBO without prior abdominal surgery showed a longer preoperative hospital stay, which was not statistically significant. The accuracies of CT and small bowel series among patients without a history of operation were 68.4% and 54.5%, respectively. SBO without prior abdominal surgery showed a lower complication rate (8.3% vs. 26.6%, P=0.006) and shorter postoperative hospital stays (12.7 +/- 6.9 days vs. 16.1 +/- 10.4 days, P=0.032). CONCLUSIONS: Among the patients who underwent an operation for SBO, 15.3% had no history of previous operation. The most common cause of SBO without a history of operation was malignancy. SBO without a history of operation showed a lower complication rate and a shorter postoperative hospital stay compared with SBO with a history of operation.

Identification of Proteins Differentially Expressed in the Conventional Renal Cell Carcinoma by Proteomic Analysis

Renal cell carcinoma (RCC) is one of the most malignant tumors in urology, and due to its insidious onset patients frequently have advanced disease at the time of clinical presentation. Thus, early detection is crucial in management of RCC. To identify tumor specific proteins of RCC, we employed proteomic analysis. We prepared proteins from conventional RCC and the corresponding normal kidney tissues from seven patients with conventional RCC. The expression of proteins was determined by silver stain after two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). The overall protein expression patterns in the RCC and the normal kidney tissues were quite similar except some areas. Of 66 differentially expressed protein spots (p<0.05 by Student t-test), 8 different proteins from 11 spots were identified by MALDI-TOF-MS. The expression of the following proteins was repressed (p<0.05); aminoacylase-1, enoyl-CoA hydratase, aldehyde reductase, tropomyosin alpha-4 chain, agmatinase and ketohexokinase. Two proteins, vimentin and alpha-1 antitrypsin precursor, were dominantly expressed in RCC (p<0.05).

A Case of Primary Malignant Melanoma on the Glans Penis / 대한남성과학회지

Malignant melanomas of the genitourinary tract are uncommon, accounting for less than 1% of all cases of melanoma and only a small percentage of penile carcinoma. In industrialized counties, penile cancer is an uncommon malignancy, with a reported annual incidence of 1 per 100,000 men. Malignant melanoma of the penis is a rare lesion and will be encountered infrequently during urological practice. Here in, we report a case of primary malignant melanoma of the penis and a brief review of the literature.

A case of Torsion of the Undescended Testis in the Infant / 대한비뇨기과학회지

No abstract available.

The Distribution and Concentration of Ofloxacin Contained in Sustained Releasing Microsphere after Intraprostatic Injection / 대한비뇨기과학회지

PURPOSE: Sporadic excellent treatment results of intra-prostatic antibiotic injections against resistant chronic prostatitis were reported without sufficient background. So, for the scientific base of this effective treatment modality, we studied the tissue distribution and concentration of the ofloxacin after intraprostatic injection of formula which is designed for sustained release ofloxacin at least for four weeks. MATERIAL AND METHODS: 28 male dogs aged over 2 and ofloxacin designed to release over four weeks were used. The ofloxacin 12mg and poly(D,L-lactic) acid 28mg were prepared for sustained releasing formula and resolved in 1ml of 1.5% sodium carboxymethyl cellulose solution. Dogs were grouped into two, 8 control and 16 experiments for open injection. For control, oral ofloxacin 100mg was given twice a day for two and four weeks and for experimental groups, the new formula were injected at right lobe of prostate directly. The ofloxacin concentration was measured by high performance liquid chromatography(HPLC). RESULTS: Oral ofloxacin 2,800(2 weeks) and 5,600(4 weeks) were given for control and tissue concentration of ofloxacin were relatively even at all partitions of the prostate, 7.4+/-1.4(2 weeks) and 9.2+/-1.3mg/ml(4 weeks) and the blood level were 3.6-5.1mg/ml. In experimental groups, the only 12mg of ofloxacin was given and tissue concentration were 10.5+/-3.0(1 weeks), 13.8+/-4.5(2 weeks), 7.1+/-0.9(3 weeks) and 7.7+/-3.0mg/ml(4 weeks) in rights and 8.0+/-1.1(1 weeks), 10.2+/-4.2(2 weeks), 5.1+/-1.4(3 weeks) and 7.6+/-0.8(4 weeks)mg/ml in left lobes suggesting communication of blood between two lobes, and blood concentration were 0.16-0.59mg/ml. In histologic examination, the formula were localized between stroma and their size were reduced with time. CONCLUSIONS: Authors conclude that there are free communication of blood between two lobes of prostate and one direct injection of this sustained releasing formula ofloxacin into prostate can be a substitute with local effects without disturbing prostatic tissue level which reducing number or medication in future.

The Changes of the Sensory Perception Threshold to the Vibratory and Electrical Current Stimuli of the External Genitalia according to Age / 대한비뇨기과학회지

PURPOSE: Although the aging process does not mean a morbid state, it is reported that the incidence of male erectile dysfunction is higher in the aged than in the young. One of important causes seems to be the functional changes of hormonal, vascular and nervous system. In addition the functional change of the sensory perception of penis can be another major cause of the erectile dysfunction in the aged male. We investigated the changes of the penile sensory perception function in the aged male. MATERIALS AND METHODS: We selected 90 men from age 20 to 76(average 43.6+/-17.0) who had no neuronal defect in past medical history and physical examination and measured the sensory perception threshold after giving the stimuli of vibration using the Biothesiometer and the stimuli of 5Hz, 250Hz, 2000Hz electrical currents using the Neurometer to the penile glans, penile shaft, scrotum, thigh and the index finger. RESULTS: All sensory perception thresholds of electrical stimuli in penile glans and penile shaft had no significant correlation with age(p>0.05). On the other hand, the sensory perception threshold of vibratory stimuli had a significant correlation with age in all of scrotum(r=0.59, p=0.0001), penile glans(r=0.58, p=0.0001), penile shaft(r=0.54, p=0.0001), thigh(r=0.43, p=0.0002) and index finger(r=0.38, p=0.0015), in which the stimuli threshold increased in proportion to age. The vibratory stimuli threshold had a higher significant correlation with age in penis, scrotum, penile glans than in thigh and index finger. CONCLUSIONS: The sensory perception threshold of vibratory stimuli elevated significant in the penile glans, penile shaft and scrotum. However, the sensory perception threshold of electrical stimuli showed no increase by the age. It is supposed that increased vibratory threshold of penile glans, shaft and scrotum may contribute to the pathophysiology of erectile dysfunction in aging male.

Changes of Dorsal Nerve Conduction Velocity and Sensory Threshold of Glans Penis before and after Pharmacological Erection Using PGE1 / 대한남성과학회지

PURPOSE: We performed this study to determine the value of pharmacoerection with PGE1 for measurement of conduction velocity in the dorsal penile nerve and to identify the change in sensation in the glans penis between th pre-erection and posterection state. MATERIALS AND METHODS: We studied 14 patients with psychogenic impotence and premature ejaculation (mean age 45.2+/-6.5 years) who had no evidence of neurologic deficit and responded with a full erection lasting more than 1 hour to PGE1 injection. We measured penile length, penile temperature, sensory threshold of the glans penis to electrical stimulation, BCRL, pudendal sensory evoked potential (SEP), and dorsal nerve conduction velocity and amplitude before, directly after, and 1 hour after erection induced using PGE1(15~20 microgram). RESULTS: Neither PGE1 nor prolonged erection had any effect on the sensory threshold of glans penis, BCRL, pudendal SEP, or amplitude of the dorsal verve. Only the dorsal nerve conduction velocity changed. We could check the conduction velocity after erection in therr cases in which these values were not available at rest. CONCLUSIONS: Given the absence of change in the sensory condition of the glans penis, pharmacoerection using PGE1 has no effect on premature ejaculation except to prolong the erection state. Pharmacoerection seems to be the best method of calculating dorsal nerve sensory conduction velocity and amplitude, It can replace th normal erection state and also help in obtaining a recordable potential when this measurement is technically difficult at rest.