Effects of Diabetes Mellitus on the Relaxation of Rabbit Vaginal Smooth Muscle / 대한비뇨기과학회지

PURPOSE: Diabetic women commonly reported decreased sexual arousal and a lack of vaginal lubrication. Genital arousal depends on the vaginal blood flow and the vaginal smooth muscle tone. The aim of this study was to investigate the effect of diabetes mellitus on the relaxation of the vaginal smooth muscles in the rabbit models. MATERIALS AND METHODS: New Zealand White female rabbits (3-3.5kg) were divided into two groups: control (n=5) and experimental (n=20). The experimental group received an intravenous injection of alloxan (100mg/kg). The development of diabetes was verified by measuring the body weight and blood glucose levels. After 12 weeks, the reactivity of the vaginal tissue from the control and diabetic animals was studied examined in the organ chambers. Vaginal The vaginal tissue was also processed immunohistochemically to determine the presence of the neuronal NOS isoform (n-NOS) in similar groups of rabbits. RESULTS: By After 12 weeks, five 5 of the 20 animals developed diabetes mellitus. The mean blood glucose level was significantly increased higher in the experimental group (340.8+/-116.9 mg/dl) compared to the control group (81.3+/-6.2mg/dl) (p=0.004). There was no significant difference in terms of the rRelaxation of vaginal tissue to electrical stimulation of the autonomic nerves, to the endothelium-dependent vasodilator acetylcholine and to the endothelium-independent vasodilator nitroprruside was not significantly different between the control and diabetic group. n-NOS immunoreactivity was also similar in both the control and diabetic groups. CONCLUSIONS: This The results suggest that diabetes mellitus may does not impair the neurogenic and endothelium-dependent relaxation of the rabbit vaginal smooth muscle. However, further intensive studies areinvestigation is needed to verify these results.

Effect of Intravesical BCG Instillation on the Expression of Inducible Nitric Oxide Synthase in Mouse / 대한비뇨기과학회지

PURPOSE: Bacillus Calmette-Guerin(BCG) therapy for superficial bladders carcinoma and carcinoma in situ is believed to exert its antitumor effects through immune mechanisms when BCG is instilled into the bladder, but its detail mechanisms are poorly understood. Recently, intravesical BCG instillation is known to induce nitric oxide(NO) which is revealed to be tumoricidal . This experiment was performed to determine the intravesical localization and alteration of expression of inducible nitric oxide synthase(iNOS) after BCG instillation. MATERIALS AND METHODS: Normal saline(0.85m1/kg, control group) and BCG(6mg/kg, experimental group) were instilled intravesically in fifty four female mice. After 2 hours, each mouse urinated after removal of urethral ligature, and was sacrificed at 6th, 12th, 18th hour, 1st day, 1.5th, 2th, 3th, 7th and 14th day, respectively. Immunohistochemistry was performed on paraffin embedded bladder tissue using anti-inducible NOS antibody(Transduction Labaratories, USA.). RESULTS: Inflammatory cells were infiltrated in the bladder wall in the BCG-treated group, but not in the control group. Number of inflammatory cells among BCG-treated group, was the highest in the 18th hour group and was reduced gradually with time elapse thereafter In the control group, immunoreactivity of iNOS to be positive in the all intermediate cell layer and a few basal cell layer of bladder transitional epithelium, which did not change as time passed. In the BCG-treated group, immunoreactivity of iNOS increased from 6 hours after BCG instillation, and gradually decreased from 7 days to restore to the level of the control group. However, some cells of transitional epithelium showed reduced immunoreactivity, focally. CONCLUSIONS: These results suggest that iNOS is tonically expressed in transitional epithelium of mouse bladder which is further induced by BCG instillation. Also, NOS-mediated NO production is supposed to be one of factors to induce tumoricidal erect by BCG instillation.

Role of Reactive Oxygen Species in Motility of Human Spermatozoa / 대한남성과학회지

PURPOSE: To determine whether seminal malondialdehyde and carbonyl group have any relation to sperm motility. MATERIALS AND METHODS: Human semen samples were obtained by masturbation after 3 days of abstinence from patients consulting an infertility clinic. Using conventional semen analysis, samples were divided into two groups according to sperm motility (group 1: motility > OR =50%, group 2: motility <50%). Malondialdehyde and carbonyl group were measured in whole semen. RESULTS: The amount of malondialdehyde and carbonyl group was slightly lower in group 1 than group 2. CONCLUSIONS: Although the difference between the groups was not statistically significant, it seems possible that malondialdehyde and carbonyl group, which are produced from reactive oxygen, are negatively correlated with sperm motility.

Real-Time Audio-Visual Sexual Stimulation with Eyeglasses-Type Monitor Improves Quality of Drug-Induced Erection during Penile Duplex Doppler Ultrasonography / 대한남성과학회지

PURPOSE: Intracavernosal injection subsequent vibrotactile or audiovisual sexual stimulation (AVSS) have frequently been utilized to produce al maximal erectile response during penile Doppler ultrasonography. However, several studies have shown that erectile quality often decreases following the placement of the sonographic probe. We examined whether real-time AVSS with an eyeglasses-type monitor enhances quality during penile duplex color Doppler ultrasonography. PATIENTS AND METHODS: A total of 32 impotent patients underwent penile duplex color Doppler ultrasonography of the cavernosal arteries after intracavernosal injection of 10 to 20 microgram of prostaglandin E1 and subsequent manual stimulation. Real-time AVSS sas used when the patient failed to achieve a rigid erection or showed abnomal arterial blood flow. The clinical erectile response was assessed by visual inspection and palpation and graded from I to V. Peak blood flow velocities and resistance index of the both cavernosal arteries were monitored continuously. After AVSS, the sexual drive was assessed as grade I (poor), II (moderate), or III (good). RESULTS: After intracavernosal injection and genital stimulation, 3 patients (9%) had a Grade II erection, 2 (6%) a Grade III, 16 (50%) a Grade IV, and 11 (34%) a Grade V. During duplex ultrasonography, 4 patients (13%) had a Grade II erection, 7 (22%) a Grade III, 16 (50%) a Grade IV, and 5 (16%) an arade V. During real-time AVSS, 22 patients (69%) showed better drectile quality. Initial Doppler ultrasonographic scanning showed arteriogenic impotence in 9 patients (28%), veno-occlusive disease in 5 (16%), and mixed arteriogenic and venogenic impotence in 18 (25%), veno-occlusive in 9 (28%), and mixed type in 2 (6%). Therefore, the initial diagnosis turned to be different after AVSS in 26 patients (81%). The sexual drive was rated grade I in 9 (28%), grade II in 11(34%), and grade III in 12 (38%). CONCLUSION: Real-time AVSS with an eyeglasses-type monitor remarkably enhances the quality of pharmacologically induced erections. Such stimulation may be useful during penile color Doppler ultrasonography to help in making the ccorrect diagnosis of the cause of erectile dysfunction.

Paradoxical Hyperfunctioning Kidney on the Renal Scan in Patients with Ureteropelvic Junction Obstruction / 대한비뇨기과학회지

PURPOSE: We evaluated whether increased split renal function ratio (%) on the renal scan with Tc-99m diethylenetriamine pinta-acetic acid (DTPA) represent elevated renal function in the obstructed kidney. MATERIALS AND METHODS: From 1994 to 1995, we evaluated 36 patients with unilateral hydronephrosis due to ureteropelvic junction (UPJ) obstruction and split renal function ratios of the affected kidneys were calculated using Tc-99m DTPA renal scan. RESULTS: Of the 36 patients, 7 patients showed that split renal function ratios of the affected kidneys were all over 52%. To assess the significance of the split renal function ratio on the Tc-99m DTPA renal scan, we performed Tc-99m mercaptoacetyltriglycine (MAG3) renal scan with the time interval of 3 days and calculated the split renal function ratios of the affected kidneys on the MAG3 renal scan in all 7 patients. The split renal function ratios of the affected kidneys on the MAG3 renal scan were also higher than those of the normal kidney. And the split renal function ratios of the affected kidneys on the MAG3 renal scan were well correlated with those of DTPA renal scan (r=0.83). CONCLUSIONS: Our results suggest that the increased split renal function ratio in affected kidney due to UPJ obstruction is not an artifact of the DTPA renogram.

Two Cases of Renal Angiomyolipomas with Tuberous Sclerosis / 대한비뇨기과학회지

We report two cases of bilateral renal angiomyolipoma with tuberous sclerosis who had skin lesions like butterfly shaped adenoma sebaceum on face, shagreen patch on back, leaf-shaped hypopigmented spot on both extremities, mental retardation, and seizure, which they are treated unilateral simple nephrectomy and selective arterial embolization, each other.

Detection of Human Papillomavirus DNA in Invasive Squamous Cell Carcinoma of the Penis Using Polymerase Chain Reaction and in Situ Hybridization / 대한비뇨기과학회지

PURPOSE: Infection of the external urogenital system with human papillomavirus (HPV) has been implicated in the development of genital cancer. We evaluated the prevalence of HPV types 6/11, 16 and 18 deoxyribonucleic acid (DNA) by polymerase chain reaction (PCR) and the localization of HPV DNA by in situ hybridization. MATERIAL AND METHOD: A total of 22 formalin-fixed, paraffin-embedded specimens of invasive squamous cell carcinoma of the penis were analyzed. We used the PCR technique to evaluate type specific DNA sequences of unique E6 to E7 transforming regions of HPV. Also, we investigated the localization of HPV DNA by in situ hybridization in PCR positive cases. RESULTS: Overall, by PCR technique the detection rate for HPV DNA were 50% (11 of 22 cases). HPV DNA type 16 was detected in all positive specimen and type 6/11 in 5 cases, whereas type 18 could not be detected. All of HPV DNA type 6/11 positive specimens were also HPV DNA type 16 positive. Using in situ hybridization HPV DNA type 16 was detected in 2 (18.2%) from 11 specimens in which HPV DNA had already been detected by PCR, and HPV DNA type 16 was localized in the nuclei of scattered carcinoma cells. But, HPV DNA type 6/11 were not detected by in situ hybridization. CONCLUSIONS: These findings suggest that HPV DNA type 16 is the type most commonly associated with penile carcinoma. But the result of high detection rate for HPV DNA type 6/11 seems to require further investigations.

A Case of Emphysematous Pyelonephritis: Successful Management by Percutaneous Drainage / 대한비뇨기과학회지

Emphysematous pyelonephritis is an uncommon serious suppurative infection characterized by the production of intrarenal and perirenal gas and generally occurs in patient with diabetes mellitus or urinary tract obstruction. We report a case of emphysematous pyelonephritis treated successfully with percutaneous drainage in 61-year-old woman with diabetes mellitus, mitral insufficiency and pleural effusion.

Comparison of Tc-99m MAG, and Tc-99m DTPA Renal Scans in Patients with Upper Urinary Tract Obstruction / 대한비뇨기과학회지

Tc-99m mercaptoacetyltriglycine (MAG3) is a new Tc-99m renal agent that is excreted by tubular function. To evaluate the efficacy of Tc-99m MAG3, renal scans with Tc-99m MAG3 and Tc-99m diethylenetriamine penta-acetic acid(DTPA) were performed in patients with upper urinary tract obstruction within the time interval of 3 days. Of the 36 patients 17 had ureteropelvic junction (UPJ) strictures, 5 had renal stones, 10 had ureteral stones, and 4 had ureterovesical junction (UVJ) strictures. The patient ages were ranged from 1 to 72 years and the numbers of male and female were 22 and 14, respectively. Split renal function ratio(%), time parameters and image quality using target to background ratio of the Tc-99m MAG, renal scan were compared with those of Tc-99m DTPA, in terms of age group (less than 16, 16 or more), obstruction site (UPJ or proximal to UPJ, distal to UPJ) and treatment pre-treatment, post-treatment state). The split rena1 function ratio(%) of Tc-99m MAG, was well correlated with that of Tc-99m DTPA (r=0.92). There was no statistically significant difference between time parameters of Tc-99m MAG, and Tc-99m DTPA. The image quality of Tc-99m MAG, was superior to that of Tc-99m DTPA (p<0.05). In conclusion, Tc-99m MAG, renal scan had a superior image quality to that of Tc-99m DTPA and correlated well with other Tc-99m DTPA parameters. Thus, Tc-99m MAG, renal scan may be considered to replace Tc-99m DTPA in the evaluation of patients with upper urinary tract obstruction.

Role of Endothelium-derived Relaxing and Hyperpolarizing Factors in the Relaxation of the Corpus Cavernosum / 대한비뇨기과학회지

It has been found that acetylcholine releases at least two different substances from the vascular endothelial cells, i.e., relaxing factor and hyperpolarizing factor. The present study was armed to investigate whether and to what extent these factors are involved in the relaxation of the corpus cavernosum. The corpus cavernosum was isolated from male New Zealand white rabbits and suspended longitudinally in an organ bath. The corporal strips were precontracted with phenylephrine, tetraethylammonium (TEA) or potassium chloride, and their responses to electrical field stimulation (EFS) or exogenously-administered acetylcholine were examined. EFS caused a frequency-dependent relaxation of the corpus cavernosum precontracted with phenylephrine, which was significantly inhibited or abolished in the presence of procaine (3.5 x 0.0001mol/L) or ouabain (0.0001mol/L). The corporal preparation precontracted with TEA also showed a frequency-dependent relaxation, however, the degree of which was lower than that precontracted with phenylephrine. EFS was without a significant effect on the corporal preparation precontracted with KCl (3 x 0.01mol/L). Acethylcholine elicted a concentration-dependent relaxation of the corpus cavernosum, the magnitude of which was significantly diminished in the presence of L-NAME (0.0001 mol/L). The relaxation response to EFS of the corporal preparation precontracted with phenylephrine was significantly attenuated in the presence of L-NAME (0.0001 mol/L), in which the residual relaxation was completely abolished by glibenclamide (0.00001mol/L). The relaxation of the corpus cavernosum in response to EFS was reversed into a contraction by methylene blue (0.0001mol/L) or TEA (0.01mol/L). These results suggest that endothelium-derived relaxing and hyperpolarizing factors released upon neural stimulation mediate the relaxation of the corpus cavernosum. It is also suggested that EDRF activates soluble guanylate cyclase and EDHF does ATP-sensitive potassium channels.