• Title/Summary/Keyword: Urology

Search Result 998, Processing Time 0.027 seconds

Prognostic Significance of Nestin Expression in pT1 High-Grade Bladder Urothelial Carcinoma Patients Treated with Intravesical BCG

  • Sen, Volkan;Bozkurt, Ozan;Demir, Omer;Tuna, Burcin;Yorukoglu, Kutsal;Ellidokuz, Hulya;Mungan, Ugur
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.24
    • /
    • pp.10813-10817
    • /
    • 2015
  • Background: Possible roles of nestin expression in terms of predicting intravesical BCG therapy response in T1 high grade bladder cancer patients were investigated. Materials and Methods: T1 high grade bladder cancer patients who were treated with intravesical BCG between 1990-2009 were included. Immunohistochemical staining for nestin expression was performed. Nestin(+) and nestin(-) patients were compared in terms of recurrence and progression rates. Results: Sixty-three patients were included and median follow-up time was twenty-five months. After staining; 33 patients (52.4%) were classified as nestin (+) and 30 (47.6%) as (-). Nestin (+) patients were more likely to recur compared to nestin (-) patients (60.6% vs. 30%, p<0.05). Progression rates were also higher in nestin (+) patients, although this result did not reach statistical significance (15.2 % vs. 10 %, p=0.710). Conclusions: Nestin expression, which seems effective in predicting recurrence, appears to have a potential role in the urothelial carcinoma tumorigenesis. Patients with high grade bladder cancer and positive nestin expression need close follow-up and might be informed about more tendency to recur. Further comprehensive studies including larger patient cohorts may clarify the role of nestin in bladder cancer.

Two Cases of Duplicated Collecting System with Lower Pole Ureteropelvic Juncton Obstruction (하극 신우요관이행부 폐색을 동반한 중복요관 치험 2례)

  • Ko Woo Jin;Hong Chang Hee;Chang Soo Yeon;Han Sang Won
    • Childhood Kidney Diseases
    • /
    • v.4 no.2
    • /
    • pp.170-174
    • /
    • 2000
  • Ureteropelvic junction obstruction and duplicated collecting system are common urologic anomalies in upper urinary system, but they seldom occur in combination. These obstruction can occur in both partial or complete duplicated collecting system. Complete duplication of the ureter may be asymptomatic or recognized when complications develop as a result of reflux into the lower pole ureter or obstruction of the upper pole with an ectopic ureterocele. It is difficult to choose an optimal therapy due to the high variability in function, degree of obsturction, damage and potential fir regeneration in growing kidney. We report our experience of successful surgical interventions in the ureteropelvic junction obstruction of the lower pole with complete duplicated collecting system.

  • PDF

Nicotine in High Concentration Causes Contraction of Isolated Strips of Rabbit Corpus Cavernosum

  • Nguyen, Hoai Bac;Lee, Shin Young;Park, Soo Hyun;Han, Jun Hyun;Lee, Moo Yeol;Myung, Soon Chul
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.19 no.3
    • /
    • pp.257-262
    • /
    • 2015
  • It is well known that cigarette smoke can cause erectile dysfunction by affecting the penile vascular system. However, the exact effects of nicotine on the corpus cavernosum remains poorly understood. Nicotine has been reported to cause relaxation of the corpus cavernosum; it has also been reported to cause both contraction and relaxation. Therefore, high concentrations of nicotine were studied in strips from the rabbit corpus cavernosum to better understand its effects. The proximal penile corpus cavernosal strips from male rabbits weighing approximately 4 kg were used in organ bath studies. Nicotine in high concentrations ($10^{-5}{\sim}10^{-4}M$) produced dose-dependent contractions of the corpus cavernosal strips. The incubation with $10^{-5}M$ hexamethonium (nicotinic receptor antagonist) significantly inhibited the magnitude of the nicotine associated contractions. The nicotine-induced contractions were not only significantly inhibited by pretreatment with $10^{-5}M$ indomethacin (nonspecific cyclooxygenase inhibitor) and with $10^{-6}M$ NS-398 (selective cyclooxygenase inhibitor), but also with $10^{-6}M$ Y-27632 (Rho kinase inhibitor). Ozagrel (thromboxane $A_2$ synthase inhibitor) and SQ-29548 (highly selective TP receptor antagonist) pretreatments significantly reduced the nicotine-induced contractile amplitude of the strips. High concentrations of nicotine caused contraction of isolated rabbit corpus cavernosal strips. This contraction appeared to be mediated by activation of nicotinic receptors. Rho-kinase and cyclooxygenase pathways, especially cyclooxygenase-2 and thromboxane $A_2$, might play a pivotal role in the mechanism associated with nicotine-induced contraction of the rabbit corpus cavernosum.

A comparison of Modified One Layer Vasovasostomy with Optical Loupe and Microscope (Optical Loupe와 현미경을 이용한 단층정관정관문합술의 비교)

  • Kim, Jong-Gu;Cho, In-Rae;Park, Seok-San;Choi, Hee-Seok
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.27 no.1
    • /
    • pp.99-105
    • /
    • 2000
  • Objective: The objective of this study was to compare results of the macroscopic one-layer vasovasostomy with those of microscopic one-layer vasovasostomy and to analyze the change of semen parameters according to the interval of vasal obstruction. Method and Materials: Between March 1987 and December 1997, we performed 121 vasovasostomies using modified one-layer technique with loupe magnification (macroscopic vasovasostomy) or microscope. Among the 68 could be followed post-operatively, 37 patients were treated by macroscopic technique with loupe, and 31 patients by microscopic technique. We compared rates of anatomical patency (sperm count above than $10{\times}10^{6}$/ml) and pregnancy of macroscopic vasovasotomy with those of microscopic vasovasostomy. Patency and pregnancy rates according to vasal obstructive interval were also examined. Results: The patency rates of macroscopic and microscopic technique were 86.5% and 87.1%, and pregnancy rates of macroscopic and microscopic technique were 64.9% and 67.7%. There was no statistical significance between these two methods (p>0.05). The pregnancy rates and sperm motility were decreased if more than 10 years had elapsed following vasectomy (p<0.05). Conclusion: We found little difference in success rates resulting from macroscopic and microscopic vasovasostomy and the former had the advantage of reduced cost and a lower operator skill level. In post-operative semen analysis, the sperm motility was the most probable factor associated with vasal obstructive interval.

  • PDF

Prostatic Urethral Polyp Causing Lower Urinary Tract Obstruction: Report of A Case (하부요로폐쇄를 일으킨 전립선부 요도폴립 1례)

  • Lee, Dong-Heon;Suh, Jun-Kyu;Kim, Young-Soo;Park, Tong-Choon;Nam, Hae-Joo;Choi, Won-Hee;Lee, Tae-Sook;Lee, Kyung-Chul
    • Journal of Yeungnam Medical Science
    • /
    • v.2 no.1
    • /
    • pp.249-252
    • /
    • 1985
  • Polyps of the male urethra are relatively uncommon lesions. They usually arise from the prostatic urethra mostly verumontanum or Just lateral to the verumontanum. Posterior urethral polyp often presents with hematuria, hemospermia and sometimes lower urinary tract obstruction. We recently experienced a pedunculated prostatic urethral polyp in a 63-year-old man who complained of gross total hematuria and difficult micturition for several years. On rectal examination the prostate was slightly enlarged with normal consistency. Excretory urogram showed a round filling defect in the right side of the bladder neck measuring about $2{\times}2cm.$ in size. Cystourethroscopy revealed trabeculation of the vesical wall, mild bilateral prostatic hypertrophy and a round cystic mass with a long stalk arising from the prostatic floor 1 cm. Proximal to the verumontanum which caused ball-valve obstruction in the bladder neck. This pedunculated polypoid mass was then resected at its base with resectoscope and was removed transurethrally using Lowsley's grasping forceps. The specimen was proved as fibrous polyp histologically.

  • PDF

Relationship between oxidative stress, semen characteristics, and clinical diagnosis in men undergoing infertility investigation

  • Pasqualotto, Fabio F.;Sharma, Rakesh K.;Nelson, David R.;Thomas, Jr, Anthony J.;Agarwal, Ashok
    • 대한생식의학회:학술대회논문집
    • /
    • 2000.06a
    • /
    • pp.37-42
    • /
    • 2000
  • Objective: To determine whether particular semen characteristics in various clinical diagnoses of infertility are associated with high oxidative stress and whether any group of infertile men is more likely to have high seminal oxidative stress. Reactive oxygen species (ROS) play an important role in sperm physiological functions, but elevated levels of ROS or oxidative stress are related to male infertility. Design: Measurement of sperm concentration, motility, morphology, seminal ROS, and total antioxidant capacity (TAC) in patients seeking infertility treatment and controls. Setting: Male infertility clinic of a tertiary care center. Patient(s): One hundred sixty-seven infertile patients and 19 controls. Intervention(s): None. Main Outcome Measure(s): Semen characteristics, seminal ROS, and TAC in samples from patients with various clinical diagnoses and controls. Result(s): Fifteen patients (9.0%) were Endtz positive and 152(91.0%) Endtz negative. Sperm concentration, motility, and morphology were significantly reduced in all groups compared with the controls (P = .02), except in varicocele associated With infection group. Mean (${\pm}$SD) ROS levels in patient groups ranged from 2.2 ${\pm}$ 0.13 to 3.2 ${\pm}$ 0.35, signilicantly higher than controls (1.3 ${\pm}$ 0.3; P<.005). Patient groups had a significantly lower mean (${\pm}$SD) TAC from 1014.75 ${\pm}$ 79.22 to 1173.05 ${\pm}$ 58.07 than controls (1653 ${\pm}$ 115.28, P<.001), except ill the vaseclony reversal group (1532.02 ${\pm}$ 74.24). Sperm concentration was negatively correlated with ROS both overall and within all groups (P${\leq}$.007), with the exception of idiopathic infertility. Conclusion(s): Irrespective of the clinical diagnosis and semen characteristics, the presence of seminal oxidative stress in infertile men suggests its role in the pathophysiology of infertility. Medical or surgical treatments for infertility in these men should include strategies to reduce oxidative stress.

  • PDF

Efficacy of Pancreatic Kallikrein on Semen Parameters of Men with Varicocele (정계정맥류로 인한 불임증에 대한 췌장성 Kallikrein의 효능)

  • Lee, Hee-Yong;Lee, Sang-Kon;Kim, Choung-Soo;Lee, Seung-Won
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.13 no.2
    • /
    • pp.175-180
    • /
    • 1986
  • It has been reported that oral kallikrein therapy exerts a favourable effect on sperm motility in asthenozoospermic patients. In order to evaluate the efficacy of kallikrein on asthenozoospermia, a total of 20 subfertile male patients with varicocele, whose sperm counts were less than $40{\times}10^6/ml$ and sperm motility was less than 30%, was subjected to this clinical study (Table 1). They were divided into 2 study groups: 1) Varicocelectomy group consisted of 10 patients with varicocele (grade II-III) who underwent varicocelectomy. 2) Kallikrein group was composed of 10 patients with varicocele (grade I) who were given kallikrein orally 600 KU (kallikrein unit) daily divided 3 times after meal for 3 to 9 months. Semen analyses were repeated twice before the study, once a month during the study and twice after the study. Effective results designate that sperm parameters improved more than 30% from the basical levels after varicocelectomy or kallikrein exposure. Sperm counts increased from $32.5{\times}10^5/ml$ to $45.5{\times}10^6/ml$ after varicocelectomy in 3 patients and sperm motility increased from 25% to 38.5% after varicocelectomy in 3 patients. Pregnancy occurred in 2 patients of 3 responders and 1 patient of 7 non-responders 3 to 6 months after varicocelectomy in Varicocelectomy group. Sperm motility increased from 28% to 40.2% after kallikrein treatment in 3 patients. Pregnancy occurred in 2 patients of the 3 responders in Kallikrein group (Tables 2-3). There were no significant changes in volume and morphology in Varicocelectomy group before after varicocelectomy and no significant changes in volume, counts, and morphology before and after kallikrein exposure. No remarkable side effects were noted with kallikrein treatment.

  • PDF

The reactive oxygen species-total antioxidant capacity score is a new measure of oxidative stress to predict male infertility

  • Sharma, Rakesh K.;Pasqualotto, Fabio F.;Nelson, David R.;Thomas Jr, Anthony J.;Agarwal, Ashok
    • 대한생식의학회:학술대회논문집
    • /
    • 2000.06a
    • /
    • pp.29-35
    • /
    • 2000
  • The imbalance between reactive oxygen species (ROS) production and total antioxidant capacity (TAC) in seminal fluid indicates oxidative stress and is correlated with male infertility. A composite ROS-TAC score may be more strongly correlated with infertility than ROS or TAC alone. We measured ROS, TAC, and ROS-TAC scores in semen from 127 patients and 24 healthy controls. Of the patients, 56 had varicocele, eight had varicocele with prostatitis, 35 had vasectomy reversals, and 28 had Idiopathic infertility. ROS levels were higher among infertile men, especially those with varicocele with prostatitis (mean ${\pm}$ SE, 3.25 ${\pm}$ 0.89) and vasectomy reversals (2.65 ${\pm}$ 1.01). All infertility groups had significantly lower ROS-TAC scores than control. ROS-TAC score identified 80% of patients and was significantly better than ROS at identifying varicocele and idiopathic infertility. The 13 patients whose partners later achieved pregnancies had a mean ROS-TAC score of 47.7 ${\pm}$ 13.2, similar to controls but significantly higher than the 39 patients who remained infertile (35.8 ${\pm}$ 15.0; P < 0.01). ROS-TAC score is a novel measure of oxidative stress and Is superior to ROS or TAC alone in discriminating between fertile and infertile men. Infertile men with male factor or idiopathic diagnoses had significantly lower ROS-TAC scores than controls, and men with male factor diagnoses that eventually were able to initiate a successful pregnancy had significantly higher ROS-TAC scores than those who failed.

  • PDF

Comparison of Surgical Outcomes of Laparoscopic Adrenalectomy Between Patients With Nonfunctioning Adrenal Adenomas and Subclinical Cushing Syndrome: A Single-Center Experience

  • Kang, Minyong;Baek, Minki;Lee, Jonghoon;Jeong, Byong Chang
    • The Korean Journal of Urological Oncology
    • /
    • 제15권3호
    • /
    • pp.137-142
    • /
    • 2017
  • Purpose: To examine and compare the perioperative outcomes of laparoscopic adrenalectomy (LA) and to determine its efficacy in patients with nonfunctioning adrenal adenomas (NFA) and subclinical Cushing syndrome (SCS). Materials and Methods: We retrospectively analyzed the clinical data obtained from 79 consecutive patients who underwent LA for the treatment of either NFA (n=35) or SCS (n=44) between 2011 and 2016. All patients had undergone computed tomography, as well as endocrinological tests to confirm the diagnosis prior to the adrenalectomy. The primary endpoint was improved metabolic parameters relating to diabetes, hypertension, dyslipidemia, and obesity. Results: Patients with SCS compared to those with NFA showed a higher occurrence of diabetes (29.5% vs. 11.4%), hypertension (59.1% vs. 34.3%), and dyslipidemia (43.2% vs. 14.3%). Patients with SCS showed a smaller median tumor size compared to those with NFA (2.5 cm vs. 5 cm). No significant perioperative complications ${\geq}$ Clavien-Dindo classification grade III were observed in any patient (SCS or NFA group). In terms of their metabolic profile, patients with SCS showed a significant postoperative improvement in hypertension (50.0%), diabetes (53.9%), dyslipidemia (31.6%), and obesity (29.2%). However, patients with NFA showed a postoperative improvement only in dyslipidemia (40.0%) and obesity (4.8%). Conclusions: Owing to absence of significant perioperative complications and the marked postoperative improvement in metabolic impairment, LA is a useful treatment strategy in patients diagnosed with SCS. In contrast, LA was not observed to show beneficial effects in correcting/improving the metabolic profile in patients presenting with NFA.

Relationship of Prostate-Specific Antigen Level With Obesity Indices in Korean Middle-Aged Population

  • Min, Seung Ki;Choi, Kwibok;Kim, Byoung Hoon;Cho, In-Chang
    • The Korean Journal of Urological Oncology
    • /
    • v.16 no.3
    • /
    • pp.103-109
    • /
    • 2018
  • Purpose: We evaluated the relationship of prostate-specific antigen (PSA) and obesity indices (weight, body mass index [BMI] and waist circumference [WC]) in Korean middle-aged men. Materials and Methods: From February to September 2013, 1,900 police men under 60 years old who participated in a prostate health screening program were included this cross-sectional study. All subjects underwent clinical examinations including weight, height, BMI, WC, fasting blood sugar, lipid profiles, estimated glomerular filtration rate (GFR), and PSA. Total prostate volume (TPV) was assessed clinically. Spearman correlation and multiple linear regression tests were performed to evaluate the obesity indices and PSA relationships. Results: The mean age was $52.0{\pm}4.7years$, and the mean PSA was $0.97{\pm}0.99ng/mL$. The PSA showed a significant positive correlation with the age (r=0.108, p<0.01), TPV (r=0.349, p<0.01), height (r=-0.052, p<0.05), weight (r=0.186, p<0.05), low-density lipoprotein cholesterol (r=0.056, p<0.05), and GFR (r=-0.096, p<0.01). All obesity indices including weight, BMI, and WC showed negative correlations with PSA (beta=-0.013, p<0.001; beta=-0.039, p<0.001; and beta=-0.010, p=0.005; respectively) in age and TPV-adjusted model. Conclusions: Common obesity indices (weight, BMI, and WC) were associated with lower PSA in Korean middle-aged population. Thus, an individual's degree of obesity should be considered when PSA is checked in the first prostate cancer screening of life.