Capillary Hemangioma of the Testis / 대한비뇨기과학회지

Capillary hemangioma of the testis is extremely rare. Because it is difficult to differentiate from malignant testicular tumors clinically and radiologically, radical orchiectomy is usually performed. Although the fate of hemangiomas of the testis left untreated is unknown, there is no evidence that hemangiomas become malignant. We report a case of a 2-year-old child with capillary hemangioma of the testis which was diagnosed as a malignant tumor preoperatively.

Relationship of Androgen Receptor and p53 Protein Expession to HormonalTherapy in Advanced Prostatic Cancer / 대한비뇨기과학회지

No abstract available.

A Case of Micropapillary Transitional Cell Carcinoma of the Urinary Bladder / 대한비뇨기과학회지

More than 90% of bladder cancers are transitional cell carcinomas. Transitional cell carcinoma of the urinary bladder ordinarily does not pose diagnostic difficulties and is well known its clinical behavior. However, variation from the classic histology can cause problems in recognition. Recently several variants of transitional cell carcinoma of the urinary bladder have been described to promote the recognition of, or to draw attention to, possible differences in clinical behavior. The presence of a micropapillary component in transitional cell carcinoma is associated with high-stage and high-grade transitional cell carcinoma with a tendency of vascular invasion, and with poor prognostic histologic feature. We report a case of micropapillary transitional cell carcinoma of the urinary bladder.

Relation of alpha-1-antichymotrypsin and p53 Protein Expression to Bony Metastasis in Advanced Prostate Cancer / 대한비뇨기과학회지

PURPOSE: The purpose of this study was to investigate whether the expressions of alpha-1 -antichymotrypsin(ACT) and/or p53 protein in advanced prostate cancer were related with bony metastases. MATERIALS AND METHODS: The immunohistochemical study with ACT and p53 included 7 archival transurethral resection and 14 prostate biopsy specimens from patients with prostate cancer who showed high serum PSA level(>10ng/ml) and periprostatic or lymph node involvement on imaging study. Whole body bone scan was perfomed to detect bony metastatis in all patients. RESULTS: Four out of 5 cases showing strong expression patterns with ACT protein showed abnormal hot uptakes on whole body bone scan. ACT proteins were weakly expressed in seven out of eight cases without bony metastases. p53 protein was expressed in 13 cases, but there was no statistically significant relation between the expression of p53 protein and bony metastasis. Either, there was no significant relation between ACT and p53 protein expression patterns. CONCLUSIONS: Our results suggested that the strong expression of ACT protein combined with high serum PSA level(>10ng/ml) and whole body bone scan could be the useful method for confirming bony metastasis although not adequate for screening test. The expression of p53 protein appears to be associated with progression of prostate cancer, but there was no statistically significant relation with bony metastasis.

A Case of True Hermaphroditism Masquerading as Testicular Tumor / 대한비뇨기과학회지

True hermaphroditism represents the rarest of all intersex disorders. The condition is defined by the presence of both ovarian and testicular tissue in the same individual. True hermaphroditism is usually diagnosed during the newborn period in the course of evaluating ambiguous genitalia. We present an unusual case of a 15-year-old boy with phenotypically normal male genitalia and bilaterally descended ovotestis, who was seen for evalution of intermittent scrotal swelling and pain.

Prognostic Significance of Heat Shock Protein 70 Expression in Bladder Tumor / 대한비뇨기과학회지

Heat Shock Protein (HSP) is a genetic product reacting on stress. HSP is increased by physiological or environmental stress and expressed at gastrointestinal tumors such as stomach cancer, pancreatic cancer and large intestinal cancer, and at other various tumors such as lymphoma and breast cancer. The role of HSP is to interrupt the process of apoptosis interfering with formation of tumors, and weaken function of tumor control beyond that of immune surveillance. In case of causing the normal p53 to be mutated, it leads to morphological change of p53 protein and combine with HSP. But, it has not been clarified yet. We intend to examine the meaning of HSP 70 in bladder tumor by investigating the relations among HSP expression and tumor stage, tumor grade, P-gp (glycoprotein) expression as a product of multi-drug resistant gene, and p53 expression in 59 cases of bladder tumor. 1) There were HSP expressions of 8 cases (22%) among 36 superficial bladder tumors and of 9 cases (39%) among 23 invasive bladder tumors. 2) HSP positive reactions were observed in 1 case (8%) of 13 Grade I, and 6 cases (29%) of 21 Grade II and 10 cases (40%) of 25 Grade III. 3) Positive reactions of HSP were showed in 10 cases (40%) among 25 P-gp expression, and in 7 cases (21%) among 34 P-gp non-expression. 4) The p53 proteins were expressed in 12 cases (29%) among 42 ones of HSP non-expression and in 8 cases (47%) among 17 ones of HSP expression. 5) Positive reactions of HSP were showed in 9 cases (23%) among 39 ones of p53 non-expression, and in 8 cases (40%) among 20 ones of p53 expression. 6) 5 patients of 6 with negative expression of HSP and strong positive expression of p53 had poorly differentiated transitional cells, in which one of the patients accompanied with lung metastasis. In view of above study, HSP expression has no correlation with P-gp and stage in bladder tumor, but it has probable pertaining to tumor grade and p53. As it were, tumor cellular differentiation and p53 expression have weak correlations with HSP 70 expression. Meanwhile, judging from poor differentiation, in most cases of HSP non-expressed but p53 strongly expressed, HSP is insufficient to be a prognostic factor of bladder tumor independently, however, in case of using it, as supplementary one, concurrently with p53, it would be valuable prognostic factor in bladder tumor.

Significance of p53 and P-glycoprotein Expression and its Relationship in Bladder Cancer / 대한비뇨기과학회지

Overexpression of the MDR1 gene product, P-glycoprotein (Pgp), has been shown to be one of the mechanism underlying the development of mutidrug resistance in bladder cancer. Recently, mutant p53 has been shown to stimulate the P-glycoprotein and to being strongly associated with tumor progression and malignant biological behavior, whereas wild-type p53 repressed this activity. To evaluate the correlation of p53 expression with P-glycoprotein, to study expression pattern of two parameters according to histologic grade, tumor stage and recurrence, we examined expression of p53 and Pgp in paraffin-embedded tissues from 59 transitional cell carcinoma of bladder. Expressions of p53 and Pgp Protein were detected by immunohistochemical analysis using the monoclonal antibody BP53.12 and JSB-1. Among the cases of 59 patients, 36 were from patients of superficial bladder cancer, 23 were from invasive bladder cancer. Median follow-up duration was 31.8 months (1~55 months). The results were as follow: 1. p53 was detected in 34% (20/59), and Pgp in 42% (25/59) of the bladder cancer. 2. Eight out of the 20 specimens with p53 positive stain expressed positive Pgp expression, as compared to 17 out of the 39 specimens without p53 positive stain. This result showed that Pgp expression was not associated with p53 expression (p=0.98), suggesting that mutant p53 does not induce Pgp expression in bladder cancer. 3. Seven of 12 patients with p53 positive stain revealed tumor recurrence, whereas 2 of 24 patients without p53 positive stain showed recurrence in superficial bladder cancer. There ia s significant correlation between p53 expression and recurrence (p=0.0025). 4. Expression of p53 and Pgp showed enhanced positive tendency according to higher clinicopathological stage, but difference was not statistically significant. Also positivity of Pgp expression according to histologic grade was observed significantly higher in case with high grade tumors (14/25, 56%) than in case with low grade tumors (10/34, 29%) (p=0.03). These results show that superficial bladder cancers exhibiting expression of p53 protein are associated with a higher rate of recurrence. This study also suggests that Pgp expression is significantly more common in higher grade, and mutant p53 does not induce Pgp expression in bladder cancer.

Two Cases of Blind Ending Duplication of Ureter / 대한비뇨기과학회지

The blind ending duplication of ureter represents a rare anomaly in development of ureteric bud, and may almost be asymptomatic. We report two cases of blind ending duplication of ureter, that were detected incidentally.

Two Cases of Inverted Papilloma of the Ureter / 대한비뇨기과학회지

Although inverted papillomas of urinary tract have been reported, the lesion of the ureter is rare and peculiar tumor characterized by unique microscopic finding. The prognosis of ureteral inverted papilloma is very favorable, only small number progress to higher grade tumor. We report 2 cases of ureteral inverted papilloma which were treated by segmental resection with end-to-end anastomosis of ureter.

A Case of Ureteral Nephrogenic Adenoma / 대한비뇨기과학회지

Nephrogenic adenoma is a rare proliferative response of urothelium to chronic irritation or infection. It has been reported in the bladder, ureter, renal pelvis and urethra, but to date there have been only 15 reports, of its occurrence in the ureter. We present a further case of this lesion in this unusual location.

Early Experience of Transperineal Prostatic Biopsy under Transrectal Ultrasound Guidance / 대한비뇨기과학회지

To evaluate the role of digital rectal examination(DRE), prostate specific antigen(PSA), transrectal ultrasound(TRUS) and prostate specific antigen density(PSAD) and the effectiveness of TRUS-guided perineal prostatic biopsy in the diagnosis of prostate cancer, the clinical data were reviewed from the 78 patients who were suggested to have prostate cancer with DRE, PSA or TRUS, and pathologically confirmed by TRUS-guided six systematic biopsy between May 1993 and February 1995. Of 78 patients, 15 patients(19.2%) had prostate cancer, 60 patients(76.9%) BPH, 2 patients (2.6%) chronic prostatitis and 1 patient(1.3%) prostatic metastasis from transitional cell carcinoma of the bladder. Only 2 of 15 cancers (13.3%) were localized cancer, while 10 of 15 cancers(66.7%) had distant metastasis. Although 35 patients received TURP among 60 patients with BPH, and their specimens were investigated pathologically whether prostate cancer was present, there was no prostate cancer. Of 34 patients whose PSA levels were below 10ng/ml, none had prostate cancer regardless of the results of DRE and TRUS. PSA had the highest sensitivity(100%) and DRE the highest specificity (79.4%) among the modalities. The positive predictive value of DRE, PSA and TRUS was 48.0%, 22.1% and 36.1% respectively. DRE and TRUS had 54.5% and 44.8% Positive predictive value in patients with elevated PSA level in contrast to 0% positive predictive value in patients with normal PSA level. Because 3 patients of prostate cancer with negative DRE and positive TRUS had elevated PSA level(>20ng/ml), the addition of TRUS to PSA and DRE was not helpful in early detection of prostate cancer. Although PSAD of prostate cancer group and non-prostate cancer group was 1.312+/-0.155(S.E.) and 0.279+/-0.036 respectively(p<0.05), we could not found any superiority of PSAD to PSA in early diagnosis of prostate cancer. In conclusion, these results suggest that PSA and DRE should be used as the first line modality in early diagnosis of prostate cancer, TRUS-guided prostatic biopsy may be considered as a confirmative modality in patients with elevated PSA level or abnormal DRE and the clinical.trials for standardization of the upper normal limit of PSA should be followed.

A Case of Urethral Perforation by Foreign Body / 대한비뇨기과학회지

Urethral foreign body extended to bladder and scrotum is very rare. We report a case of urethral perforation by plastic tube extended to bladder and scrotum with brief review of literature.

Early Experience of Transurethral Laser Induced Thermotherapy for Benign Prostatic Hyperplasia / 대한비뇨기과학회지

Transurethral laser induced thermotherapy by Prostalase is a new modality being evaluated for the treatment of BPH. We performed transurethral laser induced thermotherapies on 30 patients from April 1993 to December 1993. After treatment, 27 patients of them were followed up (urinary retention in 13 cases, non-urinary retention in 14 cases). Mean age of patients was 72 year-old. Prostalase in system was run for 40 minutes with single session without anesthesia. We evaluated patients with Boyarsky symptom score, urine flow rate. volume of residual urine, prostatic volume. Mean Boyarsky symptom score decreased from 16.5 to 7.8 for a 52.7% improvement on non-retention group, mean Boyarsky symptom score decreased from 16.7 to 6. 2 for a 62.8% improvement on retention group at 6 months after treatment. Mean peak flow rate increased 84.7% from a preoperative average of 7.2ml/s to 13.3ml/s at 6 months on non- retention group, mean peak flow rate increased 61.7 % from a postoperative 1-month average of 10.2ml/s to 16.5ml/s at 6 months on retention group. Prostatic volume decreased 22.4 % from a preoperative average of 37.5gm to 29.1 gm at 3 months on non-retention group, prostatic volume decreased 23.5% from a preoperative average of 42.0gm to 32.1gm at 3 months on retention group. There have been no urinary tract infection or retrograde ejaculation. Acute urinary retention occurred in 2 patients, gross hematuria in 1, urinary incontinence in 1. Our study number is small, but we think transurethral laser thermotherapy (Prostalase) to be a safe and less morbid alternative to transurethral resection of prostate.

Coincidental occurrence of renal cell carcinoma and angiomyolipoma in the same kidney : a case report / 대한비뇨기과학회지

Coincidental occurrence of the renal cell carcinoma and renal angiomyolipoma in the same kidney is exceedingly rare, and it is usually presented as separated masses or nodules in cage of its occurrence. However, our case which has occurred in a 37-year-old-man without any stigmata of tuberous sclerosis is different because the angiomyolipoma and renal cell carcinoma are admixed in the same mass. To our knowledge, only 2 cases or combination of this tumors have been reported previously.

A case of asynchromous bilateral nonfunctioning adrenal cortical carcinoma / 대한비뇨기과학회지

Bilateral nonfunctioning adrenal cortical carcinoma is an extremely rare disease with poor prognosis. We report a case of asynchronous bilateral nonfunctioning adrenal cotical carcinoma. The patient was a 55 year-old man who had complained of discomfort in the right upper quadrant and flank area. There was no endocrinological abnomaliries. Abdominal CT revealed about 9.5 x 7.0 cm sized right adrenal mass. Under the impression of nonfunctioning adrenal cortical carcinorna, right radical adrenalectomy was performed. After 1 year from operation, 5.0 x 7.0 x 6.0 cm sized new mass was detected in the left adrenal gland with metastasis to the peritoneum.

Clinical evaluation of 12 cases of pheochromocytoma / 대한비뇨기과학회지

Between 1980 and 1991, we managed 12 cases of pheochromocytoma which consisted of 1 case of vesical pheochromocytoma, 1 case of malignant adrenal pheochromocytoma and 10 cases of benign adrenal pheochromocytoma including one case of bilateral pheochromocytoma. There were 6 men and 6 women and their mean are was 47 ranging from 17 to 67. Eleven patients complained of hypertension and headache. and one symptom free patient had nonfunctioning vesical pheochromocytoma. After diagnosis. various surgical management were proceeded in 11 patients. 1 patient who had bilateral tumor refused any operation`. Mean duration of follow-up after operation was 40.5 months (ranging from 8 to 127). Ten surgically mats were alive during follow up but one died of malignant adrenal pheochromocytoma 9 months after operation. One patient who received nonsurgical treatment had hypertension and headache despite of continued medical therapy.

Two cases of urethral polyp / 대한비뇨기과학회지

The urethral polyp is relatively unusual lesion but recently, has been reported more frequently Polyps of the anterior urethra are less common than those of the posterior urethra. The lesion is usually encountered in the young child but has occurred in the adult. Recently, we found two cases of urethral polyp. So, we report these with a brief review of the literature.

The usefulness of herniography on the hydrocele in pediatric age / 대한비뇨기과학회지

The incomplete obliteration of the processus vaginalis leads to the development of inguinal hernia in pediatric age, and its management is principally surgical repair. This study was a review and analysis of the usefulness of herniography on the hydrocele in pediatric age. From January 1985 to June 1989, 117 patients with unilateral hydrocele were studied to evaluate incomplete obliteration of the processus vaginalis. The over-all incidence of open processus vaginalis on the opposite side was 6.9% (8 of 117 cases), but the rate of patients who had past history of a palpable or visualized mass on the opposite side was 5%(3 of 12 cases). This finding would suggest that the herniogram is needed for the patients whose history is suspicious for hydrocele testis.

Primary Signet Ring Cell Adenocarcinoma of the Prostate / 대한비뇨기과학회지

A 61-year old man visited to our hospital due to gross hematuria and voiding difficulty. Microscopic examination of the prostatic tissue revealed a tumor composed predominantly of signet ring cells. Signet ring cell adenocarcinoma of the prostate is extremely rare disease. Recently we have experienced a case of signet ring cell adenocarcinoma of the prostate and report it with brief review of literature.

A Case of Nonfunctioning Pheochromocytoma of the Bladder / 대한비뇨기과학회지

Pheochromocytoma originate from chromaffin cells and occur in the adrenal medulla in majority. About 10 per cent of pheochromocytomas can occur in the ectopic or extra-adrenal sites, anywhere along the fetal route of the chromaffin tissues. Pheochromocytoma of the bladder is a rare neoplasm that often occurs with the unique symptom complex of micturitional attacks, such as headache, palpitation, hypertension of sweating due to increased catecholamine secretion during detrusor activity. We report a very rare case of nonfunctioning pheochromocytoma of the bladder in a 67- year-old woman without typical symptoms. Preoperatively elevated urine catecholamines and their metabolites returned to normal after removal of the tumor.