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Background@#Surgical techniques for small kidney tumors have been developed for decades, from open to robotic surgery. There are two approaches for partial nephrectomy: transperitoneal and retroperitoneal. We divided robotic partial nephrectomy cases into transperitoneal robotic partial nephrectomy (TRPN) and retroperitoneal robotic partial nephrectomy (RRPN) and compared the outcomes. @*Methods@#We retrospectively evaluated patients who underwent robotic partial nephrectomy at our hospital between November 2019 and May 2022. We reviewed patients’ demographic and perioperative data. @*Results@#Seventy robotic partial nephrectomies were performed (35 TRPN and 35 RRPN). There were significant differences in operation time, estimated blood loss (EBL), tumor size, and the RENAL Nephrometry Score (RNS) between those who underwent TRPN and those who underwent RRPN. Larger tumors were noted in the TRPN group, and the RNS was higher. In contrast, the operation time was shorter, EBL was lower, and tumors were more likely to be located in the posterior and lower portions in the RRPN group than in the TRPN group. @*Conclusions@#In our study, RRPN had advantages over TRPN in terms of operation time and EBL. However, TRPN tended to be performed rather than RRPN for tumors that were more complex in terms of size or RNS. Although the choice between RRPN and TRPN depends on the surgeon's preference, RRPN seems effective for treating small kidney tumors if selected appropriately.
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Background@#Benign bladder tumors are rare disease entities, and insufficient studies have assessed their epidemiological characteristics. The authors investigated the prevalence of benign bladder tumors by retrospectively investigating pathology reports of transurethral resection of bladder tumor (TURBT) procedures over the past 20 years. @*Methods@#We analyzed 1,674 pathology reports of TURBT conducted in 1,160 patients from January 1, 2000, to April 30, 2022. The prevalence of benign tumors and histological classification according to the presence of primary (group 1) and recurrent (group 2) bladder lesions were retrospectively investigated. @*Results@#The mean age of patients was 65.2±11.5 years, and 1,284 cases (79.1%) were in men. Benign bladder tumors comprised 278 cases (248 patients) accounting for about 17.1% of the total TURBT cases (278/1,624). Furthermore, 184 patients (16.0%, 184/1,147) belonged to group 1 and 78 patients (27.4%, 78/285) belonged to group 2. Among all benign lesions that underwent TURBT, cystitis was the most common (41.0%, 114/278), and this rate was higher in group 2 (64/184 [34.8%] vs. 50/94 [53.2%], p<0.001). The prevalence of non-neoplastic lesions was higher in group 1 (44/184 [23.9] vs. 11/94 [11.7%], p<0.001). There was no difference in the prevalence of noninvasive urothelial neoplasms between the two groups (22/184 [12.0%] vs. 8/94 [8.5%], p=0.86). @*Conclusions@#The probability of benign lesions in TURBT was 17.1%, among which cystitis was the most common. When TURBT was performed for recurrent lesions, the frequency of benign tumors was higher than that of primary benign bladder tumors.
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OBJECTIVES: We designed the study to compare the oncologic and renal function outcomes of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional laparoscopic partial nephrectomy (HCLPN) for renal tumors. METHODS: Between March 2008 and July 2015, 114 patients who underwent laparoscopic partial nephrectomy (LPN) of a renal neoplasm were studied. We performed LPN without hilar clamp on 40 patients (OCLPN, Group 1), and conventional LPN with hilar control and renorrhaphy on another 40 patients (HCLPN, Group 2). We retrospectively reviewed the medical records of each patient's age, sex, R.E.N.A.L. nephrometry score (RNS), operation time, complications, hospitalization period, tumor size, positive resection margin, histologic classification of tumor, pathologic stage, Fuhrman grade, estimated blood loss (EBL), warm ischemic time (WIT), and estimated glomerular filtration rate (eGFR) before and one year after surgery. RESULTS: There were no significant differences in age, sex, preoperative eGFR, EBL, surgical (anesthesia) time, and tumor size between the two groups. The mean eGFR was not significantly different between the OCLPN and HCLPN groups 1 month (95 and 86.2 mL/min/1.73 m², respectively; P = 0.106), 6 months (92.9 and 83.6 mL/min/1.73 m², respectively; P = 0.151) and 12 months (93.8 and 84.7 mL/min/1.73 m², respectively; P = 0.077) postoperatively. The change in eGFR after one year was 3.9% in the OCLPN group and −7.9% in the HCLPN group. CONCLUSIONS: OCLPN was superior to HCLPN in preserving renal function one year after surgery, and there was no statistically significant difference in tumor treatment results.
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Humanos , Classificação , Seguimentos , Taxa de Filtração Glomerular , Hospitalização , Neoplasias Renais , Prontuários Médicos , Nefrectomia , Estudos Retrospectivos , Isquemia QuenteRESUMO
OBJECTIVES: The standard metrics used to monitor the progression of acute kidney injury (AKI) include markers such as serum creatinine, blood urea nitrogen, and estimated glomerular filtration rate (eGFR). Moreover, neutrophil gelatinase-associated lipocalin (NGAL) expression has been reported to modulate oxidative stress. METHODS: We aimed to evaluate the usefulness of serum NGAL levels for monitoring renal function after radical nephrectomy (RN). We prospectively collected data from 30 patients who underwent RN. We analyzed serum NGAL and creatinine at 6 time points: preoperative day 1, right after surgery, 6 hours after surgery, postoperative day (POD) 1, POD 3, and POD 5. We compared these measurements according to the eGFR values (classified as chronic kidney disease stage III; CKD III or not) using data obtained 3 months after surgery. RESULTS: The mean age was 65.5 years (range, 45–77 years), and the male-to-female ratio was 2:1. At the last follow-up examination, there were 12 patients (40%) with CKD III. Using receiver operating characteristic analysis, we found that serum creatinine on POD 5 (area under the curve [AUC], 0.887; P= 0.000) and NGAL at 6 hours after LRN (AUC, 0.743, P= 0.026) were significant predictors of CKD III. The development of CKD III after LRN was associated with the serum creatinine level on POD 5 and the NGAL at 6 hours after surgery. CONCLUSIONS: Compared to serum creatinine, serum NGAL enabled earlier prediction of postoperative CKD III. Therefore, serum NGAL measured 6 hours after surgery could be a useful marker for managing patients after RN.
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Humanos , Injúria Renal Aguda , Nitrogênio da Ureia Sanguínea , Creatinina , Diagnóstico Precoce , Seguimentos , Taxa de Filtração Glomerular , Rim , Lipocalinas , Nefrectomia , Neutrófilos , Estresse Oxidativo , Estudos Prospectivos , Insuficiência Renal Crônica , Curva ROCRESUMO
No abstract available.
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Linhagem Celular , Neoplasias da Bexiga Urinária , Bexiga UrináriaRESUMO
PURPOSE: The aim of this study was to assess the clinicopathologic characteristics of penile cancer, including patterns of therapy, oncologic results, and survival. MATERIALS AND METHODS: Between January 2005 and July 2015, 71 patients at 6 institutions who had undergone penectomy or penile biopsy were enrolled. Their medical records were reviewed to identify the mode of therapy, pathology reports, and cancer-specific survival (CSS) rate. RESULTS: Clinicopathologic and outcome information was available for 52 male patients (mean age, 64.3 years; mean follow-up, 61.4 months). At presentation, 17 patients were node-positive, and 4 had metastatic disease. Management was partial penectomy in 34 patients, total penectomy in 12 patients, and chemotherapy or radiotherapy in 6 patients. The pathology reports were squamous cell carcinoma in 50 patients and other types of carcinoma in the remaining 2 patients. Kaplan-Meier survival analysis showed a 5-year CSS rate of 84.0%. In univariate and multivariate analyses, the American Joint Committee on Cancer (AJCC) stage and pathologic grade were associated with survival. CONCLUSIONS: Partial penectomy was the most common treatment of penile lesions. The oncologic outcomes were good, with a 5-year CSS of 84.0%. The AJCC stage and pathologic grade were independent prognostic factors for survival.
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Humanos , Masculino , Biópsia , Carcinoma de Células Escamosas , Tratamento Farmacológico , Seguimentos , Articulações , Prontuários Médicos , Análise Multivariada , Patologia , Neoplasias Penianas , Prognóstico , Radioterapia , Resultado do TratamentoRESUMO
Prostate cancer is increasing in frequency in Korea. Among them, ductal adenocarcinoma (DCP) has a more aggressive and poor prognosis than acinar adenocarcinoma (ACP), despite its low incidence. Patients usually present with symptoms of lower urinary tract symptoms and hematuria due to increasing tumor mass within the lumen of the prostatic urethra, making diagnosis of DCP by the transrectal prostate biopsy difficult. DCP is often metastasized at the time of diagnosis. DCP is transferable to most other organs but the metastasis to the anterior urethra is rare. There is no doubt that localized DCP requires radical prostatectomy (RP) but the guidelines for adjuvant therapy after RP have not yet been established. Methods of the treatment are confounded by individual differences, and arriving at a consensus is challenging due to insufficient data. We report a case of DCP and urethral metastasis after RP, thus aiding in the determination of treatment guidelines.
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Humanos , Adenocarcinoma , Biópsia , Consenso , Diagnóstico , Hematúria , Incidência , Individualidade , Coreia (Geográfico) , Sintomas do Trato Urinário Inferior , Metástase Neoplásica , Prognóstico , Próstata , Prostatectomia , Neoplasias da Próstata , UretraRESUMO
PURPOSE: To evaluate the relationship between RENAL nephrometry score (RNS) and operative approach for renal masses. MATERIALS AND METHODS: This study included 206 consecutive patients who underwent renal tumor surgery between January 2008 and October 2012. We divided the patients into four groups by surgical approach: open radical nephrectomy (ORN, 53 patients), laparoscopic radical nephrectomy (LRN, 83 patients), open partial nephrectomy (OPN, 31 patients), and laparoscopic partial nephrectomy (LPN, 39 patients). We retrospectively assessed the RNS for each surgery group and evaluated the relationship between this score and operative approach. RESULTS: The mean RNSs of the ORN, LRN, OPN, and LPN groups were 9.75, 8.35, 6.72, and 5.76, respectively. When the RNS was analyzed according to nephron-sparing, the mean RNSs of the RN groups (ORN and LRN) and the PN groups (OPN and LPN) were significantly different (8.89 and 6.09, respectively; p<0.001). All the individual components of the RNS were significantly different between RN and PN. In the RN groups, the criteria for open versus laparoscopic surgery were based on tumor size ('R' score=2.43 for open, 1.54 for laparoscopic, p<0.001) and tumor location relative to the polar line ('L' score=2.55 for open, 2.09 for laparoscopic, p=0.006). In the PN groups, the criteria for open or laparoscopic surgery were based only on exophytic/endophytic property ('E' score=1.87 for open, 1.41 for laparoscopic, p=0.046). CONCLUSIONS: The RNS was significantly different in all surgery groups. The decision to take a laparoscopic approach was primarily influenced by the R and L scores for RN and by the E score for PN.
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Humanos , Rim , Laparoscopia , Nefrectomia , Estudos RetrospectivosRESUMO
PURPOSE: To evaluate alterations in renal function after laparoscopic radical nephrectomy (LRN) and laparoscopic partial nephrectomy (LPN) for renal tumors. MATERIALS AND METHODS: From March 2008 to August 2011, we performed 175 cases of laparoscopic kidney resection. Among these, we excluded patients who received perioperative immunotherapy or target therapy and also patients with a preoperative estimated glomerular filtration rate (eGFR) <60 mL/min. A total of 32 patients undergoing LPN and 92 patients undergoing LRN were enrolled. We retrospectively reviewed the changes in eGFR (by the modification of diet in renal disease method) at the following time points: preoperative, postoperative 1 week, and postoperative 1, 3, 6, and 12 months. RESULTS: The mean warm ischemia time of the LPN group was 22 minutes (range, 0 to 47 minutes). Mean eGFR values (mL/min/1.73 m2) during postoperative week 1 and 1, 3, 6, and 12 months were 70.8, 71.5, 76.7, 76.0, and 75.3 in the LPN group and 52.1, 50.6, 52.8, 53.4, and 52.4 in the LRN group, respectively. One year after the operation, 6.3% (2 patients) of LPN patients and 68.5% (63 patients) of LRN patients had progressed to chronic renal insufficiency (eGFR<60 mL/min/1.73 m2). CONCLUSIONS: Renal function recovered slightly after LPN and LRN and was maintained constantly after 3 months. However, renal function showed different patterns of decrease. Despite the concern for warm ischemia, LPN can preserve renal function better than can LRN. LPN should be considered for selected patients to prevent chronic renal insufficiency.
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Humanos , Dieta , Taxa de Filtração Glomerular , Imunoterapia , Rim , Laparoscopia , Nefrectomia , Insuficiência Renal Crônica , Estudos Retrospectivos , Isquemia QuenteRESUMO
Recently, nephron-sparing, minimally invasive surgery of small renal masses has become popular. The most typical surgery is laparoscopic partial nephrectomy (LPN). However, due to technical difficulties, the indications for LPN had been limited to small, exophytic, and peripheral tumors. This paper introduces current status of oncological outcomes and technical considerations.
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Rim , Laparoscopia , NefrectomiaRESUMO
PURPOSE: HER-2/neu overexpression is documented in some bladder cancers. To our knowledge, there are no current studies evaluating urine HER-2/neu levels. Therefore, we examined the clinical significance of serum and urine HER-2/neu protein in bladder cancer. MATERIALS AND METHODS: Urothelial bladder carcinoma patients (n=38, including 31 men and 7 women) and healthy controls (n=25, including 20 men and 5 women) were included in the study. Urine cytology and serum and urine HER-2/neu levels were measured before the transurethral resection of bladder tumor procedure. Prognostic factors including tumor stage, histologic grade, tumor size, multiplicity, and preoperative urine cytology and their association with urinary HER-2/neu were analyzed by simple and multiple regression analyses. RESULTS: There was no significant difference in serum HER-2/neu between the two groups (p=0.489). The mean urinary HER-2/neu was 7,586.82 relative luminescence unit (RLU) in bladder cancer patients and 4,245.84 RLU in healthy controls. The mean RLU values of urinary HER-2/neu in the bladder cancer patient group were significantly higher than in healthy controls (p=0.012). An receiver operating characteristic curve was generated, and using the cutoff value of > or =4,800 RLU of urinary HER-2/neu, 71.1% sensitivity and 84.0% specificity were obtained. Among the clinical factors, only positive preoperative urine cytology samples were associated with urinary HER-2/neu levels by both simple and multiple regression analyses. CONCLUSIONS: Bladder cancer patients demonstrated significantly higher urinary HER-2/neu than did healthy controls. These findings suggest that urinary HER-2/neu may be valuable as a new urinary marker. The application of urinary HER-2/neu needs additional investigation.
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Humanos , Masculino , Luminescência , Projetos Piloto , Curva ROC , Sensibilidade e Especificidade , Bexiga Urinária , Neoplasias da Bexiga UrináriaRESUMO
PURPOSE: The purpose of this study was to evaluate the characteristics of patients who received primary androgen deprivation therapy (PADT) for clinically localized prostate cancer and the clinical efficacy of this treatment. MATERIALS AND METHODS: Between January 1998 and August 2007, patients who underwent PADT for clinically localized prostate adenocarcinoma were analyzed. The patients studied could not receive definitive therapy owing to old age or medical comorbidities. All patients' Gleason score, pretreatment prostate-specific antigen (PSA) value, time to PSA progression, and D'Amico's risk criteria were analyzed. RESULTS: A total of 72 patients were analyzed. The patients' mean age was 75.29 years (range, 57-92 years) and their median pretreatment PSA was 13.52 ng/ml (range, 1.27-74.82 ng/ml). The median follow-up duration was 39 months (range, 18-115 months). Thirteen patients (18.57%) had PSA progression after reaching a PSA nadir. The mean time to PSA progression was 14 months (range, 7-55 months). Among these 13 patients, 2 patients had low-risk prostate cancer and 11 patients had high-risk prostate cancer by D'Amico's risk criteria. Three of the 13 patients are now receiving chemotherapy, 2 patients died from cancer progression, 3 patients died of a non-cancer cause, and 5 patients are now being conservatively managed. Of the total 72 patients, 70.83% of the patients are still receiving PADT. A total of 11 patients died; however, only 2 deaths were caused by prostate cancer. CONCLUSIONS: In patients with localized prostate cancer who could not receive definitive therapy for several reasons, the cancer-caused death rate was very low, even in patients with PSA progression. PADT is an effective therapeutic option in patients with localized prostate cancer.
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Humanos , Adenocarcinoma , Androgênios , Comorbidade , Seguimentos , Gradação de Tumores , Próstata , Antígeno Prostático Específico , Neoplasias da PróstataRESUMO
PURPOSE: We reviewed the records of renal cell carcinoma (RCC) patients with brain metastases, analyzed about survival and prognosis after several palliative management. MATERIALS AND METHODS: Between June 1998 and January 2008, 22 patients diagnosed to have brain metastases from RCC. We retrospectively reviewed their medical records, and analyzed clinical properties. RESULTS: Of 278 patients with RCC, 22 patients (7.9%) diagnosed to have brain metastases. The pathological T stages and Fuhrman nuclear grade of RCC at the time of initial diagnosis were various (T1: 1 patient, T2: 5, T3: 8, T4: 3, Fuhrman grade 1: 0, 2: 4, 3: 10, 4: 6, unknown: 2). Most of RCC was clear cell carcinoma (17/22). Most symptoms suggesting brain metastases were neurologic. Median cancer specific survival (CSS) of WBRT, radiosurgery, or surgery group (13/22) was 4 months, conservative management group (9/22) was 1.5 months and CSS of the former group was significantly better. Median duration of development of brain metastasis after diagnosis of RCC was 28 month (1-120). There was no difference in CSS between patients with brain metastasis developed before and after 28 month (p=0.361). CONCLUSIONS: Brain metastases of RCC have poor prognostic course. Development interval of brain metastases did not affect survival. WBRT, radiosurgery or surgery group showed better survival. Active intervention may improve survival.
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Humanos , Encéfalo , Carcinoma de Células Renais , Seguimentos , Prontuários Médicos , Metástase Neoplásica , Prognóstico , Radiocirurgia , Estudos RetrospectivosRESUMO
PURPOSE: This study was undertaken to investigate the outcomes associated with docetaxel treatment of Korean patients with hormone-refractory prostate cancer (HRPC) and to compare its clinical efficacies in 1st and 2nd-line settings. PATIENTS AND METHODS: This study was retrospectively performed and included 47 patients with HRPC. The 1st-line group consisted of 19 patients who had not undergone prior chemotherapy, and the 2nd-line group consisted of 28 patients who underwent prior chemotherapy. All patients were treated with 75mg/m2 IV docetaxel every 3 weeks and 5mg of prednisone twice daily with a continuous androgen blockade. RESULTS: Of 47 study subjects, 14 patients (29.8%) had > or = 50% PSA decline from baseline. PSA response was more common in the 1st-line group, but this was not statistically different (42.1% vs. 21.4%, p = 0.114). After a median follow up of 11 months (range, 6-24 months), the 1st-line group showed a longer time to PSA progression (4 vs. 2 months, p = 0.015) and survival (17 vs. 10 months, p = 0.037) than the 2nd-line group. In terms of toxicities, no difference was apparent between the 2 groups. CONCLUSION: In a 1st-line setting, docetaxel is an effective and tolerable agent for Korean HRPC patients, and that its efficacy is limited, although 2nd-line docetaxel is tolerable.
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Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Antineoplásicos/administração & dosagem , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/tratamento farmacológico , Estudos Retrospectivos , Taxoides/administração & dosagem , Resultado do TratamentoRESUMO
The authors designed this study to determine the clinical effectiveness of trimodality treatment, i.e., transurethral resection of a bladder tumor (TURBT) and concurrent chemoradiotherapy (CRT). Twenty patients with a muscle-invasive bladder cancer were treated by TURBT followed by concurrent cisplatin (75 mg/m(2) day), administered on weeks 1 and 4 of radiotherapy. According to residual tumor status after TURBT, patients were classified into patients with a complete TURBT group and incomplete TURBT group. Response to treatment was evaluated by restaging TURBT at 4 weeks after completing CRT (post-CRT). Fifteen patients (75%) achieved complete remission (CR) at restaging; 10 patients (50%) remained continuously free of tumor recurrence. Disease-specific and overall survivals were 51.1% and 38.6% at 5 yr post-CRT, respectively. Of 16 patients in the complete TURBT group, 14 patients (87.5%) achieved CR, which was significantly different from that observed in the incomplete TURBT group, in which only 1 (25%) of 4 patients achieved CR (p=0.032). Five- year disease-specific and overall survivals were 71.6% and 53.5%, respectively. Ten patients (90.9%) maintained their own bladder among the 11 surviving patients. Trimodality treatment was found to be an effective treatment in patients who underwent complete TURBT for a muscle-invasive bladder cancer.
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Feminino , Humanos , Masculino , Cisplatino/uso terapêutico , Terapia Combinada , Neoplasias Musculares/patologia , Invasividade Neoplásica , Terapia de Salvação , Neoplasias da Bexiga Urinária/mortalidadeRESUMO
PURPOSE: We wanted to compare the treatment outcome, safety, efficacy and complications of transurethral resection of the prostate (TURP), interstitial laser coagulation (ILC), transurethral needle ablation (TUNA) and transurethral ethanol ablation of the prostate (TEAP) for the treatment of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: In this prospective, randomized study, a total of 403 patients with symptomatic BPH were treated by TURP, ILC, TUNA or TEAP from January 1998 to December 2002. ILC was performed using the Indigo 830e LaserOptic(TM) System with a specially designed interstitial thermotherapy light guide, TUNA was performed using the VidaMed TUNA System and TEAP was performed using the Prostaject(TM) device. The treatment outcomes were evaluated at 3 months, 6 months and 1 year with the International Prostate Symptom Score (IPSS), the prostate volume, the maximal urinary flow rate (Qmax), the post-void residual urine (PVR), and the quality of life (QoL) assessment score. RESULTS: All the patients in the four groups showed significant improvement for all the parameters. After 1 year, the four groups showed significant improvement in the clinical and voiding parameters (IPSS, Qmax, PVR, prostate volume and QoL). Our results did not show significant differences in the IPSS, prostate volume and QoL among the four groups. However, the TURP group showed a higher Qmax, and the TEAP group showed a less reduced prostate volume than the other groups during the follow-up period (p<0.05). The period of hospital admission showed no significant difference between the ILC, TUNA and TEAP groups, but the TURP group showed a longer hospital admission period compared to the other groups. The TURP group was markedly associated with more complications than the other groups. CONCLUSIONS: These early results indicate that ILC, TUNA and TEAP are safe, effective and useful alternative therapies to TURP for the patients with symptomatic BPH.
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Humanos , Terapias Complementares , Etanol , Seguimentos , Hipertermia Induzida , Índigo Carmim , Fotocoagulação a Laser , Agulhas , Estudos Prospectivos , Próstata , Hiperplasia Prostática , Qualidade de Vida , Ressecção Transuretral da Próstata , Resultado do Tratamento , AtumRESUMO
Since the procedure of a full thickness vaginal wall sling for stress urinary incontinence was first described, concern has been raised regarding the potential formation of inclusion cysts due to buried vaginal mucosa. Recently, two female patients, who underwent an in-situ vaginal wall sling procedure, visited our department presenting with painless large anterior vaginal wall masses. The masses were cystic, and cyst excisions performed. The cyst fluid was aseptic and the cyst wall lined with stratified squamous epithelium. At the 1 year follow up, the patient remained continent and the cyst had not reformed. To our knowledge, this is the first reported case of inclusion cyst formation after an in-situ vaginal wall sling procedure in Korea. An epithelial inclusion cyst is an under-recognized complication of the in-situ advancing vaginal wall sling. The vaginal surgeon should be aware of the potential for an epithelial inclusion cyst and actively search for their formation at the postoperative examination following an in-situ sling placement.
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Feminino , Humanos , Líquido Cístico , Epitélio , Seguimentos , Coreia (Geográfico) , Mucosa , Incontinência Urinária , Incontinência Urinária por Estresse , VaginaRESUMO
BACKGROUND: Production of nitric oxide (NO) by inducible NO synthase (iNOS) has been implicated in the pathology of autoimmune disease. It is unknown whether iNOS expression is increased within testes and whether iNOS and NO have essential roles in the pathogenesis of EAO. METHODS: EAO was induced in guinea pig testes at 17 days after secondary immunization by administration of crude extract (CE) and purified glycoprotein 1 (GP1) from normal guinea pig testes. iNOS gene expression was assessed by RT-PCR and Northern blot analysis in testes. Localization of iNOS and Mac-1 and the indicator of NO-mediated tissue injury, nitrotyrosine, were detected in the testicular lesion by immunohistochemistry. RESULTS: In control testes, inflammation and iNOS gene expression were not detected, whereas, in CE- and GP1-injected testes, inflammation and marked iNOS gene expression were evident at day 17 after secondary immunization. Immunohistochemistry of Mac-1 showed the colocalization with iNOS protein and nitrotyrosyl proteins in intertubules, suggesting that NO produced by infiltrated macrophages may be involved in inflammatory lesions of intertubules. Intraperitoneal administration of aminoguanidine significantly prevented EAO with reduction of inflammation, iNOS expression and nitrotyrosine formation. CONCLUSION: These results suggest that NO production by macrophages may be important in the pathogenesis of CE- and GP1-induced EAO. Furthermore, this study demonstrated the therapeutic potential of iNOS inhibitor in the treatment of inflammatory and autoimmune mediated-diseases.
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Animais , Masculino , Doenças Autoimunes , Northern Blotting , Expressão Gênica , Glicoproteínas , Cobaias , Guiné , Imunização Secundária , Imuno-Histoquímica , Inflamação , Macrófagos , Óxido Nítrico Sintase , Óxido Nítrico , Orquite , Patologia , Ácido Peroxinitroso , TestículoRESUMO
PURPOSE: The main objectives of this work were to characterize the mechanism of resistance to imipenem of Morganella morganii KU158 isolated in Busan, Korea and to analyze the structure of the integron, which carries the resistance gene that confers resistance to imipenem. MATERIALS AND METHODS: Antimicrobial susceptibilities of M. morganii KU158 were tested by using the disk diffusion method. The modified Hodge and EDTA-disk synergy tests were performed for the screening of metallo-beta-lactamase-producing isolates. blaIMP and blaVIM genes were detected using the polymerase chain reaction (PCR) amplification. To detect the presence of the integron, the PCR method was used. The PCR product was cloned through the use of primers, 5'CS-F and 3'CS-R, and it was used to determine the sequence of the integron through the dideoxy-mediated chain termination method. RESULTS: M. morganii KU158 was intermediately resistant to imipenem and showed a positive result for the modified Hodge and EDTA-disk synergy tests, which suggest the production of metallo-beta-lactamase, and also was positive in the PCR result for the detection of blaVIM gene. The genotype of the PCR product from the blaVIM gene was blaVIM-2. Sequencing of the 5,031 bp-cloned fragment revealed the structure of the class I integron, such as the 5'-CS element containing an Intl1 integrase gene with its own promoter region, the attI1 recombination site, and the 3'-CS element containing qacE1. The integron contained insert gene cassettes blaVIM-2, aac(6')-Ib, aadA1, "orfII", and "orfIII". The blaVIM-2 gene was located immediately downstream of the aac(6')-Ib gene. CONCLUSIONS: M. morganii KU158 acquired the resistance to imipenem through the production of metallo-beta-lactamase VIM-2. The gradual increase in the number of VIM-2-producing bacterial species may indicate the highly mobile nature of the blaVIM-2 cassette. The spread of blaVIM-2 could compromise the future usefulness of carbapenem in treating gram-negative bacilli infections.
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beta-Lactamases , Células Clonais , Difusão , Genótipo , Imipenem , Integrases , Integrons , Coreia (Geográfico) , Programas de Rastreamento , Morganella morganii , Morganella , Reação em Cadeia da Polimerase , Regiões Promotoras Genéticas , Recombinação GenéticaRESUMO
Hydatid disease is a parasitic infection that is caused by the larval stage of Echinococcus granulosus. This disease is widely distributed in a temperate and subtropical countries, and it is especially prevalent in sheep and cattle raising countries. The most common infection site is the liver, and the second most common site is the lung. We report here on our experience with Echinococcal hydatid cysts that were found in the bladder of a 38 year old worker from Uzbekistan. The cysts were surgically removed and the patient was managed postoperatively with albendazole.