Metastatic squamous cell carcinoma of the kidney from cholangiocarcinoma.

We present a rare case of a metastatic renal tumor originating from adenosquamous carcinoma of the intrahepatic bile duct. A 64-year-old man treated with bisegmentectomy and extended cholecystectomy for cholangiocarcinoma had a left cystic renal mass, which had irregular wall thickening, heterogeneously low attenuation, and soft tissue infiltration as determined by a computed tomography scan. The first impression was renal abscess. Left nephrectomy was performed and the nonencapsulated mass was gray in color macroscopically. Histological examination of the specimen revealed alveolar proliferation of small cancer cells, which was consistent with the original tumor of the intrahepatic bile duct. The left renal tumor was misdiagnosed as a renal abscess but finally diagnosed as squamous cell carcinoma metastasized from the intrahepatic bile duct. The patient expired because of lung metastasis after 14 months following left nephrectomy. In our opinion, this case would be the first report of a renal metastasis from a cholangiocarcinoma clinically and was treated with nephrectomy.

Effects of Spinal and Peripheral Injection of α1A or α1D Adrenoceptor Antagonists on Bladder Activity in Rat Models with or without Bladder Outlet Obstruction.

PURPOSE: Antagonists of α1-adrenergic receptors (α1ARs) relax prostate smooth muscle and relieve voiding and storage symptoms. Recently, increased expression of α1ARs with change of its subtype expression has been proved in bladder outlet obstruction (BOO). To search for the evidence of changes in α1ARs subtype expression and activity in the peripheral and spinal routes, the effects of spinal and peripheral administration of tamsulosin (an α1A/D-selective AR), naftopidil (an α1A/D-selective AR), and doxazosin (non-selective AR) on bladder activity were investigated in a rat model with or without BOO. METHODS: A total of 65 female Sprague-Dawley rats were divided into the BOO surgery group (n=47) and the sham surgery group (n=18). After 6 weeks, cystometry was assessed before and after intrathecal and intra-arterial administrations of tamsulosin, naftopidil, and doxazosin. RESULTS: After intra-arterial administrations of all three drugs, bladder capacity (BC) was increased and maximal intravesical pressure (Pmax) was decreased in both BOO and the sham rat models (P<0.05). After intrathecal administration of all three drugs, BC was increased and Pmax was decreased in only the BOO group. The episodes of involuntary contraction in the BOO rat models were decreased by intra-arterial administration (P=0.031). The increase of BC after intrathercal and intra-arterial administrations of α1ARs was significantly greater in the BOO group than in the sham group (P=0.023, P=0.041). In the BOO group, the increase of BC and decrease in Pmax were greater by intra-arterial administration than by intrathecal administration (P=0.035). There were no significant differences of the degrees of changes in the cystometric parameters among the three different α1ARs. CONCLUSIONS: Up-regulations of the α1ARs in BOO were observed by the greater increases of BC after α1AR antagonist administrations in the BOO group than in the sham group. However, there were no subtype differences of the α1ARs in functional parameters of bladder activity. In addition, α1ARs also act on the lumbosacral cord which implies that the sensitivity of α1ARs is increased in pathologic models such as BOO. Further evaluation including differential expression of α1ARs in BOO models are need.

Extracorporeal magnetic innervation therapy in children with refractory monosymptomatic nocturnal enuresis.

OBJECTIVES: To evaluate the effect of extracorporeal magnetic innervation (ExMI) therapy in children with refractory monosymptomatic nocturnal enuresis (MNE). METHODS: A total of 55 children (34 boys and 21 girls, median age 8.0 years, range 5 to 13) who wetted the bed more than twice per week because of MNE that was refractory to treatment with desmopressin, anticholinergics, and enuretic alarm were assessed prospectively using a voiding diary before and after ExMI, administered once a week for at least 4 weeks with a size-adjusted magnetic chair (each session lasted 20 minutes). RESULTS: After all sessions of ExMI, the mean frequency of nocturnal enuresis decreased significantly to 2.09 +/- 2.47 in all patients (P = 0.04), and the mean functional bladder capacity increased 1.88 times in all patients (P = 0.00). In total, 63.6% of our patients had a nocturnal enuresis frequency of less than 50% after a mean of 6.62 +/- 4.26 ExMI sessions. CONCLUSIONS: From our results, reduced functional bladder capacity might be the main pathophysiologic cause in children with MNE refractory to established treatment. ExMI might have an acute inhibitory effect in these children with refractory MNE by increasing functional bladder capacity. However, long-term follow-up data and controlled study with a sham-stimulation group are necessary to determine the durability of this new therapy for refractory MNE.

Development of a Korean version of the Female Sexual Distress Scale.

INTRODUCTION: This article presents data based on the responses of more than 100 women who contributed to the development of a Korean version of the Female Sexual Distress Scale (FSDS). AIM: The FSDS was developed to measure sexually related personal distress in women. This article aims to test the usefulness and analyze factors of the 20-item version of the FSDS in a Korean female sample. METHODS: The original two-item FSDS was translated with cultural modifications. A total of 104 healthy, married women were recruited through a survey. A second survey was undertaken after 2 weeks for test-retest reliability. Validity, internal consistency reliability, and test-retest reliability were evaluated. An exploratory factor analysis was also performed. MAIN OUTCOME MEASURES: A Korean version of the FSDS. RESULTS: The test-retest coefficients of stability over a 2-week period was 0.99 (P < 0.01). The 20 items of the FSDS have good internal consistency, with an alpha of 0.96. The FSDS discriminated between women with and without sexually related distress (t = -7.34, P < 0.01). The optimal cut-off score was 20 (sensitivity 71.4%, specificity 92.2%). By principal axis factoring, the Korean version of the FSDS was found to consist of two factors. A 16-item FSDS had good internal consistency with an alpha of 0.97. The test-retest reliability was good (r = 0.99, P < 0.01). The items of the 16-item FSDS were somewhat different from the original 12-item FSDS. CONCLUSIONS: The Korean version of the FSDS (20-item) might be a useful tool for screening sexually distressed women in Korea. Instead of the 12-item version of the original FSDS, the 16-item FSDS was validated in this study. These results could reflect cultural differences between Eastern Asian and Western societies.