Establishment of Neurotoxicity Assessment Using Microelectrode Array (MEA) with hiPSC-Derived Neurons and Evaluation of New Psychoactive Substances (NPS)

Background and Objectives@#Currently, safety pharmacological tests for the central nervous system depend on animal behavioral analysis. However, due to the subjectivity of behavioral analysis and differences between species, there is a limit to appropriate nervous system toxicity assessment, therefore a new neurotoxicity assessment that can simulate the human central nervous system is required. @*Methods@#and Results: In our study, we developed an in vitro neurotoxicity assessment focusing on neuronal function. To minimize the differences between species and fast screening, hiPSC-derived neurons and a microelectrode array (MEA) that could simultaneously measure the action potentials of the neuronal networks were used. After analyzing the molecular and electrophysiological characters of our neuronal network, we conducted a neurotoxicity assessment on neurotransmitters, neurotoxicants, illicit drugs, and new psychoactive substances (NPS). We found that most substances used in our experiments responded more sensitively to our MEA-based neurotoxicity assessment than to the conventional neurotoxicity assessment. Also, this is the first paper that evaluates various illicit drugs and NPS using MEA-based neurotoxicity assessment using hiPSC-derived neurons. @*Conclusions@#Our study expanded the scope of application of neurotoxicity assessment using hiPSC-derived neurons to NPS, and accumulated evaluation data of various toxic substances for hiPSC-derived neurons.

Clinical Variables and Genetic Risk Factors Associated with the Acute Outcome of Ischemic Stroke: A Systematic Review / 대한뇌졸중학회지

Stroke is a complex disease and one of the main causes of morbidity and mortality among the adult population. A huge variety of factors is known to influence patient outcome, including demographic variables, comorbidities or genetics. In this review, we expound what is known about the influence of clinical variables and related genetic risk factors on ischemic stroke outcome, focusing on acute and subacute outcome (within 24 to 48 hours after stroke and until day 10, respectively), as they are the first indicators of stroke damage. We searched the PubMed data base for articles that investigated the interaction between clinical variables or genetic factors and acute or subacute stroke outcome. A total of 61 studies were finally included in this review. Regarding the data collected, the variables consistently associated with acute stroke outcome are: glucose levels, blood pressure, presence of atrial fibrillation, prior statin treatment, stroke severity, type of acute treatment performed, severe neurological complications, leukocyte levels, and genetic risk factors. Further research and international efforts are required in this field, which should include genome-wide association studies.

Clinical Experience of Nonseminomatous Germ Cell Testicular Tumor: Risk Factors and Survival Rate / 대한비뇨기과학회지

PURPOSE: We reviewed clinical features and survival rates of nonseminomatous germ cell testicular tumors(NSGCTs) and analyzed pathological risk factors of relapse in stage I group under surveillance program. MATERIALS AND METHODS: Forty one patients were treated for primary NSGCTs from February 1983 to April 1998. 20(48.8%) patients were stage I and 19 of them were followed up under surveillance program after orchiectomy and 1 underwent orchiectomy and adjuvant therapy(RPLND and PVB chemotherapy). 11(26.8%) were stage II and 10(24.4%) stage III and all stage II and III patients underwent orchiectomy and adjuvant therapy. Statistical analysis with Fisher`s exact test was performed to identify that pathological risk factors affected relapse rate. RESULTS: Mean age at diagnosis was 26 years(range 16-47) and mean follow-up period was 58 months(range 5-163). According to histopathological types, embryonal carcinoma, teratoma, teratocarcinoma and mixed type represented 19.5%, 26.8%, 7.3% and 46.3%, respectively. Among 41 patients, 33 showed significant elevation of tumor markers at diagnosis. The 5-year survival rates of stage I, II and III were 95%, 80% and 56%, respectively and overall 5-year survival rate was 82%. Among stage I patients under surveillance program, there was statistically significant increase of relapse rate in the patients with pathological risk factors(presence of embryonal elements, local stage T2 or higher, presence of lymphovascular invasion) as compared to those without. CONCLUSIONS: In stage I NSGCT patients, if there are pathological risk factors after orchiectomy, aggressive therapy such as early retroperitoneal lymph node dissection or chemotherapy is selectively needed.

The Analysis of Lymph Node Metastases and Survival Rates in Transitional Cell Carcinoma of Urinary Bladder / 대한비뇨기과학회지

PURPOSE: The incidence of lymph node metastases in patients undergoing radical cystectomy varies between 15% and 25%, and is related to the depth of invasion of primary tumor. Pelvic lymphadenectomy provides accurate staging information as well as therapeutic benefit in a selected group of patients without increased morbidity. We analyzed the incidence of lymph node metastases and survival rates in the patients with pathologically proven lymph node metastases to reassess the role of pelvic lymphadenectomy in the patients with transitional cell carcinoma of urinary bladder. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 215 patients with transitional cell carcinoma treated by radical cystectomy and pelvic lymphadenectomy from 1976 to 1996 who were followed for a mean 31.7 months and analyzed the incidence of pathologically proven lymph node metastases and survival rates according to pathological stage, histologic grade and cell morphology. RESULTS: Patient distribution according to pathological stage was 18 for pTa, 51 pT1, 44 pT2 36 pT3a, 42 pT3b, and 24 pT4. Mean follow up was 31.7 months. The overall 5-year survival rate was 67.9%. The 5-year survival rates according to pathological stage were 93.6% for pTa and pT1, 72.4% pT2, 47.2% pT3a, 52.2% pT3b, 49.6% pT4 The 5-year survival rates according to histologic grade were 100.0% for grade l, 80.1% grade ll, 57.0% grade lll. The overall incidence of lymph node metastases was 14%(30/215). The 5-year survival rates according to lymph nodes metastases were 72.5% for pN0, 30.3% pN1 and the 2-year survival rate was 41.5% for pN2. The incidence of lymph node metastases was 0% for pTa and pT1, 2.3% pT2, 11.1% pT3a, 38.1% pT3b, 37.5% pT4 and 0% for grade l, 7.2% grade ll, 19.0% grade lll. The 5-year survival rates according to pathological stage and lymph nodes metastases were 75.9% for pT3a or less with pN0,58.4% for pT3b or more with pN0, 26.7% for pT3b or more with pN1 or pN2. CONCLUSIONS: Lymph node metastases was a significant prognostic factor for transitional cell carcinoma of the urinary bladder. The incidence of lymph node metastases increased as pathological stage and histologic grade increased. Radical cystectomy with pelvic lymphadenectomy might be beneficial for a few patients with bladder confined tumor with lymph node metastases. Adjuvant therapy is recommended for transitional cell carcinoma of the urinary bladder with lymph node metastases for improved survival.

Evaluation of Appropriateness of Radical Cystectomy Using p53 and nm23-H1 Protein Expression in Grade III, Muscle Invasive Transitional Cell Carcinoma of Bladder / 대한비뇨기과학회지

OBJECTIVE: About 50% of patients undergoing radical cystectomy for muscle invasive bladder cancer have occult distant micrometastasis. Most of these patients have clinical manifestations of distant metastasis within 1 year of operation, and not likely to achieve 2-year survival. But in other words, the remaining half of patients can expect definite survival benefit from radical surgery. Therefore if those who have micrometastasis can be selected preoperatively, unnecessary cystectomies can be avoided, and bladder preservation by anticancer chemotherapy, radiotherapy, and partial cystectomy can be employedinstead. MATERIALS AND METHODS: From 1985 to 1993, 45 patients diagnosed with high grade muscle invasive transitional cell carcinoma at transurethral resection of bladder (TURB) who later confirmed to have stage T2, T3a, and T3b rumors after radical cystectomy were selected. Patients with double primary tumor, early death, follow up period under 2 years, and poor quality of paraffinized tissue presentation were excluded.Immunostaining of tumor suppressor gene p53 (DO7 and PAb1801; both wild and mutant type) and antimetastatic gene nm23-H1(NM301) were performed and the survival function was analysed. Stainings were interpreted as positive when more than heterogenous pattern for p53, and stronger than moderately stained for nm23-H1 were seen. RESULTS: Pathological nodal status (pN stage), combination of p53 and nm23-Hl expression, and p53 expression were correlated with survival. Pathological rumor stage (pT stage), nm23-H1 expression alone were not correlated with survival. Expression of p53 was 44.4% (20/45) and nm23-H1 expression was seen in 55.6% (25/45). Combinations of p53 negative plus nm23-H1 negative, p53 negative plus nm23-H1 positive, p53 positive plus nm23-H1 negative, and p53 positive plus nm23-H1 positive were 12, 13, 8, and 12 cases, respectively. Cases when both proteins were expressed poor survival was observed. Detection time elapsed from cystectomy to metastasis and duration from detection of metastasis to death was only related with N stage. CONCLUSION: 1. When cellular grade of TURB specimen is III, muscle invasive, and positive for both p53 and nm23-H1, the chance of surgical cure by radical cystectomy is significantly reduced. 2. In high grade tumors, the degree of muscle invasion does not affect survival, but might affect the detection time elapsed from cystectomy to metastasis and the duration from detection of metastasis to death. 3. Lymph node metastasis is related to survival, and especially p53 expression is related to survival.

Analysis of nm23 expression as a prognostic parameter in renal cell carcinoma

To identify the clinicopathological events including nm23 expression that underlies progression in renal cell carcinoma, a retrospective analysis of patients with renal cell carcinoma was performed. Ninety-eight cases of radical nephrectomies with extensive regional or para-aortic lymph node dissection were assessed for clinicopathological variables, and eighty-five cases underwent nm23/NDPK-A protein immunohistochemical staining. Significant parameters in survival were tumor size, histologic pattern, Fuhrman's nuclear grade, pathologic T(pT) stage, pathologic N stage, M stage, tumor thrombi, location of metastasis, and nm23 staining intensity. To assess the relationship with survival, the tumors with low and high nm23 expressions were compared. The fifty-nine patients with a high staining intensity had a significantly worse survival than did the twenty-six with a low staining intensity (p = 0.0015). Additionally nm23 staining intensity was correlated with tumor size, Fuhrman's nuclear grade, pT, and distant metastasis. Therefore, the immunostaining intensity of nm23 protein could be used as a prognostic parameter with an inverse correlation.

Laparoscopic extraperitoneal bladder neck suspension (LEBNS) for stress urinary incontinence

Seventy-nine patients of bladder neck suspension using an extraperitoneal variation of laparoscopic surgery were performed for the treatment of stress urinary incontinence. Using a balloon dissector the anterior vesical pelvic space is secured. The bladder neck suspension similar to the Burch operation was performed through a laparoscopic procedure. Symptoms of patients were assessed preoperatively and at one and six months following surgery. Operative times and complications were also evaluated. Success rate was 89.8% at six months. Complications such as bladder perforations were observed. Laparoscopic extraperitoneal bladder neck suspension-(LEBNS) is a viable option to the conventional methods of suspension, it has definite cosmetic advantages, is devoid of intraperitoneal dissection and adhesion, and has a comparable success rate.

Two Cases of Extragonadal Embryonal Carcinoma Originating in Unusual Sites / 대한비뇨기과학회지

Primary germ cell tumor of extragonadal origin are rare, accounting for approximately 3 to 5 percent of all germ tumors. Extragonadal germ cell tumors usually originate in midline body structures. We report a case of extragonadal germ cell tumor from the left superficial inguinal area, a nonmidline structure and a case of from the superficial suprapubic area unusual site of extragonadal germ cell tumor-with brief of the literature.

Two Cases or Primary Small Cell Carcinoma of the Prostate / 대한비뇨기과학회지

Small cell carcinoma of the prostate is rare, accounting for approximately 1% of all prostatic cancer. However the identification of small cell carcinoma of the prostate has increased in recent years, probably reflecting the increasing use of the electron microscope and immunohistochemistry. We report a case of pure small cell carcinoma and a case of small cell carcinoma mixed with adenocarcinoma of the prostate.

Morphology and Function of Testis in Growth Deprived Mature and Immature Male Rats / 대한비뇨기과학회지

Growth hormone(GH) plays a major role in growth and its effects are mainly mediated by insulin like growth factor-I ( IGF-I). However the role of GH in the regulation of testicular function especially in spermatogenesis is still under debate. Though there were several studies using GH-deficient mutant mice, results are conflicting. Furthermore they are not proper to find out any exact role of GH in normal adults. We have therefore used somatostatin analogue (Sandostatin) for 1 week to block the effect of GH and it's mediator IGF-I, in mature and immature Sprague-Dawley male rats. In immature rats the delayed maturation was recovered after ceasing somatostatin in several weeks and the testicular parameters became normal after maturation. Post-pubertal rats showed diminished spermatogenesis especially in the number of pachytene spermatocytes and round spermatids of stage VII. These results seems to be associated with decreased systemic IGF-I. But the Leydig cell function in other words, testosterone production, remained normal. Somatostatin administered Leydig cells showed strong positive reactions like normal control on IGF-I immunohistochemical stain. We concluded that GH mediated IGF-I plays a major role in spermatogenesis especially on pachytene spermatocytes of post-pubertal male rats and there are GH independent IGF-I actions in Leydig cells.

Major Factors Influencing on the Success of Extracorporeal Shock Wave Lithotripsy / 대한비뇨기과학회지

This study is performed to extend the indication of Extracorporeal Shock Wave Lithotripsy (ESWL) and to help the improvement of treatment results. We analysed the results of urinary stone disintegration for the 345 urinary stones of 271 patients to whom the ESWL had been undergone by Siemens Lithostar from March, 1992 to September, l993, of which the complete data for stone volume, shape, location, catheterization, and intravenous urographic findings were obtained. Also, using the specially devised instrument, we dipped stones of several components that our department have in the solution differentiated by pH, shot a little shock wave and observed the differences of urinary stone destruction. The results of study are as follows. l. The results of stone destruction according to the volume of stone showed the significant differences. 2. Destruction results according to the location of renal stone or ureteral stone did not show the differences. 3. In the destruction of ureteral stone, there are no differences according to the existence of ureteral catheter. 4. It showed a tendency to resist disintegrating in the case of accompanying severe hydronephrosis with stone, however, the destruction results according to the degree of hydronephrosis did not show the differences. 5. The destruction effect in the differentiated pH solution, there is an effect in the uric acid stone and in the struvite stone a little effect but there is no effect in the calcium oxalate and calcium phosphate stone. As the result above, in the view of destruction itself of stone, we can say that the stone destruction is the most influenced by the volume of stone and we cannot expect to be succeeded by one time ESWL in case of the greater than 1,016.691mm3 in stone volume, therefore, it is necessary for us to operate the volume-reductive procedure such as percutaneous nephrolithotripsy, to plan the retreatment of ESWL prior to the first operation. Neither the location of stone nor the ureteral catheterization have particular effects the stone destruction. Effect of hydronephrosis is necessary to make more study. Even though we use the irrigating solution in order to increase the treatment effect of stone, regulating pH, There seems no much help to the treatment except uric acid stone.

Effects of IFN-r on Human Bladder Tumor Cell Lines / 대한비뇨기과학회지

The purpose of this study is to analyze the effects of IFN-r(interferon-r) on HLA-DR and ICAM-l(intercellular adhesion molecule 1) expression, a measure of cancer progression. We uses human bladder tumor cell lines of RT4(GI) and T24(GIII), a part of each type of cultured cells were treated by 200U/m IFN-r and divided into 3 groups( 24-hour, 48-hour, 72-hour) according to the time after the IFN-r treatment. Each cell was then indirectly immunofluorescence stained and analyzed using the Fluorescence Activated Cell Sorter(FACS). We founded that bladder cancer cells, when they are not treated by IFN-r, do not seem to show much HLA-DR constitutive expression. When bladder cancer cells are treated by IFN-r, the effects of IFN-r on HLA-DR expression rate seem to depend on the degree of differentiation of bladder cancer cells : well-differentiated bladder cancer cell shows higher HLA-DR expression rate when it is treated by IFN-r, while poorly-differentiated bladder cancer cell does not show much changes in HLA-DR expression rate even after it is treated by IFN-r. Bladder cancer cells of higher degree of malignancy show higher ICAM-1 constitutive expression rate and enhanced expression by IFN-r.

Clinical Analysis of Testicular Seminoma: A Review of 27 Cases / 대한비뇨기과학회지

We reviewed 82 testicular tumors (78 germ cell tumors and 4 non-germ cell tumors) from 1972 to 1991 retrospectively. Among them, the pure testicular seminomas were 27(24 typical seminoma and 3 anaplastic seminoma). The mean age at the time of diagnosis was 39.0 years(20-60). There were 15 stage I, 10 stage II and 2 stage III at the initial diagnosis. The number of patients with either present or history of cryptorchidism were 10(37.0%) and all being pathologically typical seminoma. The hCG was elevated in 30% (6/20), but either AFP(0/20) or LDH(0/8) were not elevated at all. Among the 15 stage I seminoma, 8 out of 9 cases followed-up more than 3 years were tumor free. One patient with anaplastic histology progressed at 6 month follow-up. Among the 10 cases of stage II, 7 cases were followed-up average 54.8 months. 6 out of 7 cases showed no progression and one case developed metastasis to the lung, and expired at the 13 months after initial diagnosis. In the 2 cases of stage III, patients expired each at 13 and at 18 months after initial management. The overall cumulative 5 year survival rates were 100% for stage I , 88.9% for stage II and none for stage III (p<0.05) respectively. Elevated hCG combined with history of cryptorchidism showed significant correlation with the tumor stage.

Production of tumor necrosis factor by intravesical administration of bacillus Calmette Guerin in patients with superficial bladder cancer

Although an immune response to bacillus Calmette Guerin (BCG) has often been associated with antitumor activity, the action mechanism(s) of intravesical BCG therapy for prophylaxis and treatment of superficial bladder cancer is not clearly understood. In an attempt to evaluate the roles of tumor necrosis factor (TNF)-alpha and lymphotoxin (LT) in the antitumor activity, TNF-alpha productivities by peripheral blood monocytes, serum levels of TNF-alpha, and LT productivities by peripheral blood lymphocytes were studied in superficial bladder cancer patients after six intravesical administrations of BCG. TNF-alpha productivities by peritoneal macrophages of guinea pigs were also studied after six intravesical administrations of BCG. The maximum TNF-alpha productivities by peripheral blood monocytes of superficial bladder cancer patients were seen after the fourth week of administration of BCG, and the serum TNF-alpha levels were also slightly increased after intravesical BCG administration in the superficial bladder cancer patients. LT productivities by peripheral blood lymphocytes of superficial bladder cancer patients were significantly enhanced and the maximum LT productivity was also seen after the third or fifth BCG administration. TNF-alpha productivities by peritoneal macrophages of guinea pigs were significantly enhanced and the maximum TNF-alpha productivity was seen after the second or third BCG administration. Our data might suggest that six consecutive intravesical BCG administrations could induce the increased productions of TNF-alpha and LT, which might play an important role in the antitumor activity in superficial bladder cancer.Although an immune response to bacillus Calmette Guerin (BCG) has often been associated with antitumor activity, the action mechanism(s) of intravesical BCG therapy for prophylaxis and treatment of superficial bladder cancer is not clearly understood. In an attempt to evaluate the roles of tumor necrosis factor (TNF)-alpha and lymphotoxin (LT) in the antitumor activity, TNF-alpha productivities by peripheral blood monocytes, serum levels of TNF-alpha, and LT productivities by peripheral blood lymphocytes were studied in superficial bladder cancer patients after six intravesical administrations of BCG. TNF-alpha productivities by peritoneal macrophages of guinea pigs were also studied after six intravesical administrations of BCG. The maximum TNF-alpha productivities by peripheral blood monocytes of superficial bladder cancer patients were seen after the fourth week of administration of BCG, and the serum TNF-alpha levels were also slightly increased after intravesical BCG administration in the superficial bladder cancer patients. LT productivities by peripheral blood lymphocytes of superficial bladder cancer patients were significantly enhanced and the maximum LT productivity was also seen after the third or fifth BCG administration. TNF-alpha productivities by peritoneal macrophages of guinea pigs were significantly enhanced and the maximum TNF-alpha productivity was seen after the second or third BCG administration. Our data might suggest that six consecutive intravesical BCG administrations could induce the increased productions of TNF-alpha and LT, which might play an important role in the antitumor activity in superficial bladder cancer.

Establishment and charaterization of normal and transformed fetal rat urogenital sinus mesenchymal cells: a comparative study / 대한비뇨기과학회지

Experiment on fetal urogenital sinus mesenchyme is invaluable to investigate the role of which stromal-epithelial interaction plays in the proliferation, differentiation and hormonal dependence of normal epithelial tissue as well as epithelial tumors. Normal and transformed embryonic fibroblast may have different effect on epithelial tumors. We have recently established normal (NUGM) and spontaneously transformed fetal rat urogenital sinus mesenchymal cell (TUGM) lines and herein present comparative characteristics of these cell lines including cytokinetic study, chromosomal study, effect of sex hormones on the growth, immunohistochemical study for intermediate filaments and in vivo tumorigenicity. TUGM has cellular characteristics of transformed fibroblast and shows increased expression of cell surface fibronectin. Addition of different concentration of serum and various sex hormones did not affect the growth of TUGM significantly, whereas in TUGM, The growth was significantly enhanced by increase of serum concentration in medium and dihyrotestosterone at the concentration of 100 ng/ml of medium. NUGM does not show any tumorigenicity in vivo. TUGM shows strong tumorigenicity (19/21) and forms fibrosarcoma when inoculated into nude mouse. The size of tumor was significantly smaller when inoculated into castrated male and female mice compared to non castrated males. In conclusion, NUGM and TUGM have different cellular characteristics and hormonal dependence. NUGM and TUGM may be help to elucidate the relative role of normal and transformed embryonic fibroblast in the mechanism of evolution, invasion and metastasis of epithelial cancer.

Incidence estimation of genitourinary cancer in Korea

A nation-wide study was performed to estimate the incidence of bladder, kidney, renal pelvis and ureter, prostate, testicular and other genitourinary cancer among Koreans in Korea using medical records of the inpatients of the beneficiaries of the Korea Medical Insurance Corporation (KMIC) from Jan. 1, 1989 to Dec. 31, 1989. The crude incidence rate of bladder cancer (ICD-9 188) is estimated to be 4.43 and 0.98 per 100,000 in males and females, respectively. Around 1,093 new cases of bladder cancer (895 male and 198 female) are estimated to occur in a year. The adjusted rate for the world population is 7.76 in males and 1.19 in females which is similar to that of Japanese in Osaka and Chinese in Shanghai, but lower than in American whites and blacks. The crude incidence of kidney, renal pelvis and ureteral cancer (ICD-9 189) is estimated to be 1.61 and 0.87 in males and females, respectively. Around 507 new cases of kidney, renal pelvis and ureteral cancer (332 male and 175 female) are estimated to occur in a year. The adjusted rate for the world population is 2.69 in males and 1.04 in females. In the prostate (ICD-9 185), the crude incidence rate of cancer is estimated to be 1.36. Around 274 new cases of prostate cancer are occurring in a year. The adjusted rate for the world population is 2.98 which is similar to the Chinese rate. The incidence of genitourinary cancer continuously increases with age.

Responses of prostate carcinoma cell line to fibroblast conditioned medium treated with serum and dihydrotestosterone / 대한비뇨기과학회지

To investigate the biological effect of fibroblast conditioned medium on the proliferation of epithelial cancer cell in vitro with serum and/or dihyrotestosterone(DHT), media conditioned with 3 normal fibroblast cell lines(NUGM, HPF and 3T3) and 1 transformed fibroblast(TUGM) were assayed on the growth of hormone-independent prostate epithelial cancer cell line, PC-3 and quantified by cell counting. The results demonstrated that the TUGM conditioned medium significantly enhanced the proliferation of PC-3 more than the other normal fibroblasts conditioned media in case of not contained serum. But in contrast, normal fibroblasts conditioned media. cultured with 0.4% charcoal stripped calf serum showed marked stimulation of PC-3 proliferation, and TUGM conditioned medium treated with 5% serum. Addition of DHT revealed significant growth enhancement only in case of conditioned medium obtained from NUGM and HPF without serum. These suggest the possibilities that the addition of serum can elicit the production of different growth factors, either stimulating or inhibiting in one cell type of fibroblast and the proliferation of androgen-independent prostate cancer cells in vitro can be regulated by androgenic stimulation via androgen-responsive fibroblast.

The relationship between histologic content and clinical variables in benign prostatic hypertrophy / 대한비뇨기과학회지

To maximize the therapeutic efficacy of non-surgical management in patients with benign prostatic hypertrophy (BPH). the prediction of major histologic type in each patient before treatment would be very important. In order to determine if such patients might be identified prospectively we investigated the relationship between clinical variables such as age, prostate weight (PWt). symptom score. clinical point, total (TAP) and prostatic acid phosphatase (PAP) and volume density of prostate glandular lumen (PGL) determined by computer interactive image analysis. Histologic specimens were obtained on 17 patients who underwent open prostatectomy with BPH. The mean age was 71 years (range 55-84). mean PGL 18.6 % (range 7.9-35.7). mean PWt 47 gram (range 14-100). mean symptom score 16 (range 9-23), clinical point 22 (range 12-42). TAP 8.8 unit/L (range 6.5-13.3) and PAP 1.9 unit/L (range 0.5-4.8). Multivariate regression analysis between these variables and univariate regression analysis according to PGL and prostate weight revealed as no significant relationships and there also were no significance between two groups divided by median value of PGL (14.8%) or PWt (38 gram.) except the inverted correlation between weight of prostate and symptom score (p<0.05). But univariate regression analysis between PGL and PWt in 12 patients with less than 70 grams in weight revealed significant relationship: PGL=0.49S PWt+3.32 (r=0.81, p=0.0015). We could divide another 5 patients into two different groups according to the PGL: mean 10.9 % (range 9.3-13.7) in 3 patients and 33.2 % (range 29.0-34.8) in 2 patients respectively. The predominant histologic feature in low PGL, heavy PWt group represented uniformly muscular hyperplasia. In conclusion, we could not find any significant correlations between PGL and other clinical variables used in the study. Even there was a statistical significance between PGL and PWt under the limited condition, but we should not overlook the possibility that the difference in PGL upto three folds can be exist in patients with similar PWt.

Clinical review of pheochromocytoma / 대한내분비학회지

No abstract available.

Clinicopathologic prognostic factors in renal cell carcinoma / 대한비뇨기과학회지

From 1980 to 1989, 144 patients underwent radical nephrectomy for renal cell carcinoma. Survival was analyzed in terms of pathologic stage and histologic grade. Data revealed that M category was the most important prognostic factor followed by, in order of importance, T category, N category, and grade. But grade as prognostic factor in renal cell carcinoma needs additional investigation. Stage pT1 and pT2 showed similar survival rate. The separation of pT1 and pT2 according to size of the primary tumor may not be a meaningful prognostic variable. Because vascular invasion may occur with tumors of various size, separating components into a description of the tumor (T), nodes (N), metastases (M) and renal vein involvements (V) makes good sense. The prognostic value of lymphadenectomy is limited by the fact that the tumor metastasizes through the blood stream and the lymphatic system with equal frequency.