• Title/Summary/Keyword: urology

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Comparative Analysis of Pregnancy Outcomes after In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF-ICSI) between Obstructive and Non-obstructive Azoospermia (폐쇄성 무정자증과 비폐쇄성 무정자증에서 체외수정시술 후의 임신 결과 비교)

  • Park, Chan-Woo;Koong, Mi-Kyoung;Yang, Kwang-Moon;Kim, Jin-Young;Yoo, Keun-Jai;Seo, Ju-Tae;Song, Sang-Jin;Park, Yong-Seog;Kang, Inn-Soo;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.3
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    • pp.207-215
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    • 2003
  • Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

Effect of Testicular Histopathology on Pregnancy Outcomes in Non-Obstructive Azoospermia (비폐쇄성 무정자증 환자에서 고환의 조직병리학적 진단에 따른 체외수정시술 결과의 비교)

  • Park, Chan-Woo;Seo, Ju-Tae;Park, Yong-Seog;Kim, Hye-Ok;Yang, Kwang-Moon;Kim, Jin-Young;Koong, Mi-Kyoung;Kang, Inn-Soo;Song, In-Ok
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.4
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    • pp.293-301
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    • 2008
  • Objective: To evaluate outcomes of patients with non-obstructive azoospermia (NOA) undergoing the testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection (ICSI) with different histopathologic subgroups. Method: A total of 122 embryo-transferred TESE/ICSI cycles were compared among NOA subgroups; Germ-cell aplasia (GA, 40 cycles), Maturation arrest (MA, 32 cycles) and severe hypospermatogenesis (S-HS, 50 cycles). Obstructive azoospermia (OA, 667 cycles) patients were served as a control. TESE/ICSI outcomes such as fertilization rate (FR), clinical pregnancy rate (CPR) and live birth rate (LBR) were evaluated. Results: The 2PN FR of embryo-transferred TESE/ICSI cycle was 58.1% in GA, 42.2% in MA and 48.0% in S-HS, which was significantly lower than that of OA (72.9 %, p<0.001). For ICSI-spermatozoa cycles, there were no significant differences in CPR (22.6%, 29.4% and 26.1%) and LBR (16.1%, 29.4% and 19.6%) among NOA subgroups. The CPR of ICSI-spermatid cycles was 0.0%, 9.1% and 0.0% without a live birth. For ICSI-spermatocyte cycles, no clinical pregnancies occurred in any group. Conclusion: There was no significant difference in the FR of embryo-transferred TESE/ICSI cycles among NOA subgroups. The FR among all NOA subgroups was significantly lower than that of OA. Testicular histopathology in NOA did not affect successful pregnancy if spermatozoa extraction from the testis is successful and embryo transfer is possible.

BCR/ABL mRNA Targeting Small Interfering RNA Effects on Proliferation and Apoptosis in Chronic Myeloid Leukemia

  • Zhu, Xi-Shan;Lin, Zi-Ying;Du, Jing;Cao, Guang-Xin;Liu, Gang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4773-4780
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    • 2014
  • Background: To investigate the effects of small interference RNA (siRNA) targeting BCR/ABL mRNA on proliferation and apoptosis in the K562 human chronic myeloid leukemia (CML) cell line and to provide a theoretical rationale and experimental evidence for its potential clinical application for anti-CML treatment. Materials and Methods: The gene sequence for BCR/ABL mRNA was found from the GeneBank. The target gene site on the BCR/ABL mRNA were selected according to Max-Planck-Institute (MPI) and rational siRNA design rules, the secondary structure of the candidate targeted mRNA was predicted, the relevant thermodynamic parameters were analyzed, and the targeted gene sequences were compared with BLAST to eliminate any sequences with significant homology. Inhibition of proliferation was evaluated by MTT assay and colony-formation inhibiting test. Apoptosis was determined by flow cytometry (FCM) and the morphology of apoptotic cells was identified by Giemsa-Wright staining. Western blotting was used to analyze the expression of BCR/ABL fusion protein in K562 cells after siRNA treatment. Results: The mRNA local secondary structure calculated by RNA structure software, and the optimal design of specific siRNA were contributed by bioinformatics rules. Five sequences of BCR/ABL siRNAs were designed and synthesized in vitro. Three sequences, siRNA1384, siRNA1276 and siRNA1786, which showed the most effective inhibition of K562 cell growth, were identified among the five candidate siRNAs, with a cell proliferative inhibitory rate nearly 50% after exposure to 12.5nmol/L~50nmol/L siRNA1384 for 24,48 and 72 hours. The 50% inhibitory concentrations ($IC_{50}$) of siRNA1384, siRNA1276 and siRNA1786 for 24hours were 46.6 nmol/L, 59.3 nmol/L and 62.6 nmol/L, respectively, and 65.668 nmol/L, 76.6 nmol/L, 74.4 nmol/L for 72 hours. The colony-formation inhibiting test also indicated that, compared with control, cell growth of siRNA treated group was inhibited. FCM results showed that the rate of cell apoptosis increased 24 hours after transfecting siRNA. The results of annexinV/PI staining indicated that the rate of apoptosis imcreased (1.53%, 15.3%, 64.5%, 57.5% and 21.5%) following treamtne with siRNAs (siRNA34, siRNA372, siRNA1384, siRNA1276 and siRNA1786). Morphological analysis showed td typical morphologic changes of apoptosis such as shrunken, fragmentation nucleus as well as "apoptotic bodies" after K562 cell exposure to siRNA. Western blot analysis showed that BCR/ABL protein was reduced sharply after a single dose of 50nmol/L siRNA transfection. Conclusions: Proliferation of K562 cells was remarkbly inhibited by siRNAs (siRNA1384, siRNA1276 and siRNA1786) in a concentration-dependent manner in vitro, with effective induction of apoptosis at a concentration of 50 nmol/L. One anti-leukemia mechanism in K562 cells appeared that BCR/ABL targeted protein was highly down-regulated. The siRNAs (siRNA1384, siRNA1276 and siRNA1786) may prove valuable in the treatment of CML.

The Influence of Urinary Incontinence and Depression in Elderly on the Quality of the Life (노인의 요실금과 우울증이 삶의 질에 미치는 영향)

  • Kim, Jihyun;Lee, Joongsuk;Nam, Beomwoo;Choi, Jin-Yong;Yang, Sang-Kuk;Yim, Hyeon Woo;Jo, Sun-jin;Jeong, Hyunsuk
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.129-135
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    • 2017
  • Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

A Study on the cost allocation method of the operating room in the hospital (수술실의 원가배부기준 설정연구)

  • Kim, Hwi-Jung;Jung, Key-Sun;Choi, Sung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.1
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    • pp.135-164
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    • 2003
  • The operating room is the major facility that costs the highest investment per unit area in a hospital. It requires commitment of hospital resources such as manpower, equipments and material. The quantity of these resources committed actually differs from one type of operation to another. Because of this, it is not an easy task to allocate the operating cost to individual clinical departments that share the operating room. A practical way to do so may be to collect and add the operating costs incurred by each clinical department and charge the net cost to the account of the corresponding clinical department. It has been customary to allocate the cost of the operating room to the account of each individual department on the basis of the ratio of the number of operations of the department or the total revenue by each operating room. In an attempt to set up more rational cost allocation method than the customary method, this study proposes a new cost allocation method that calls for itemizing the operation cost into its constituent expenses in detail and adding them up for the operating cost incurred by each individual department. For comparison of the new method with the conventional method, the operating room in the main building of hospital A near Seoul is chosen as a study object. It is selected because it is the biggest operating room in hospital A and most of operations in this hospital are conducted in this room. For this study the one-month operation record performed in January 2001 in this operating room is analyzed to allocate the per-month operation cost to six clinical departments that used this operating room; the departments of general surgery, orthopedic surgery, neuro-surgery, dental surgery, urology, and obstetrics & gynecology. In the new method(or method 1), each operation cost is categorized into three major expenses; personnel expense, material expense, and overhead expense and is allocated into the account of the clinical department that used the operating room. The method 1 shows that, among the total one-month operating cost of 814,054 thousand wons in this hospital, 163,714 thousand won is allocated to GS, 335,084 thousand won to as, 202,772 thousand won to NS, 42,265 thousand won to uno, 33,423 thousand won to OB/GY, and 36.796 thousand won to DS. The allocation of the operating cost to six departments by the new method is quite different from that by the conventional method. According to one conventional allocation method based on the ratio of the number of operations of a department to the total number of operations in the operating room(method 2 hereafter), 329,692 thousand won are allocated to GS, 262,125 thousand won to as, 87,104 thousand won to NS, 59,426 thousand won to URO, 51.285 thousand won to OB/GY, and 24,422 thousand won to DS. According to the other conventional allocation method based on the ratio of the revenue of a department(method 3 hereafter), 148,158 thousand won are allocated to GS, 272,708 thousand won to as, 268.638 thousand won to NS, 45,587 thousand won to uno, 51.285 thousand won to OB/GY, and 27.678 thousand won to DS. As can be noted from these results, the cost allocation to six departments by method 1 is strikingly different from those by method 2 and method 3. The operating cost allocated to GS by method 2 is about twice by method 1. Method 3 makes allocations of the operating cost to individual departments very similarly as method 1. However, there are still discrepancies between the two methods. In particular the cost allocations to OB/GY by the two methods have roughly 53.4% discrepancy. The conventional methods 2 and 3 fail to take into account properly the fact that the average time spent for the operation is different and dependent on the clinical department, whether or not to use expensive clinical material dictate the operating cost, and there is difference between the official operating cost and the actual operating cost. This is why the conventional methods turn out to be inappropriate as the operating cost allocation methods. In conclusion, the new method here may be laborious and cause a complexity in bookkeeping because it requires detailed bookkeeping of the operation cost by its constituent expenses and also by individual clinical department, treating each department as an independent accounting unit. But the method is worth adopting because it will allow the concerned hospital to estimate the operating cost as accurately as practicable. The cost data used in this study such as personnel expense, material cost, overhead cost may not be correct ones. Therefore, the operating cost estimated in the main text may not be the same as the actual cost. Also, the study is focused on the case of only hospital A, which is hardly claimed to represent the hospitals across the nation. In spite of these deficiencies, this study is noteworthy from the standpoint that it proposes a practical allocation method of the operating cost to each individual clinical department.

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An epidemiological study on enuresis in children of two elementary schools in Suwon (야뇨증 역학조사 보고: 2개 초등학교 학생 대상)

  • Lee, Hyun Jung;Lee, Kang Gyoon;Kim, Eun Jin;Pai, Ki-Soo;Lee, Sang Don
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.518-522
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    • 2008
  • Purpose : The purpose of this study was to investigate the prevalence of enuresis in association with voiding habits and socioeconomic status in elementary school children. Methods : A dynamic survey was done of 1,514 students from two elementary schools in Suwon, Korea in December 2006. Data regarding gender, age, height and weight, voiding habits, and monthly family incomes were gathered and analyzed to discover any correlation with the incidence of enuresis. The percentile value of height or weight was extrapolated from the standard population curve. Results : Among 1,514 children, 1,063 (70.2%) answered and returned the questionnaires. Overall, the prevalence of enuresis was 8.7% and there was no difference between the public (8.8%) and private school (8.7%). The family incomes of the students from the two schools differed greatly from each other, but there was no difference in the prevalence of enuresis between the two schools. Children with a habit of void-holding showed a higher prevalence of enuresis. No significant correlation was found between the prevalence of enuresis and the height and weight percentile of children. Experience with hospital visits was low among enuretic children (20.8%), suggesting that Korean parents tend to neglect treatment of enuresis for their children. The prevalence of enuresis decreased by 2.0% each year, as school children aged. Conclusion : The overall prevalence of enuresis among elementary school children in Suwon district was 8.7%. The 12.1% prevalence of enuresis at the seven years came down gradually, to be nil at the age of 13. Infrequent urination or void-holding was assumed to be one of the important factors causing enuresis in elementary school children.

Clinical Outcome of IVF-ET using Testicular Sperm Retrieved from Patients with Obstructive Azoospermia or Hypospermatogenesis (폐쇄성 무정자증 환자와 정자형성저하증 환자의 고환정자를 이용한 체외수정 및 배아이식술의 결과)

  • Han, Sang-Chul;Park, Yong-Seog;Choi, Su-Jin;Lee, Sun-Hee;Hong, Seung-Bum;Lee, Hyoung-Song;Lim, Chun-Kyu;Song, In-Ok;Seo, Ju-Tae
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.1
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    • pp.55-61
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    • 2009
  • Objective: To compare the clinical outcomes of ICSI with sperm retrieved from testicular tissue in patients with obstructive azoospermia (OA) or hypospermatogenesis (HS). Methods: From January 2003 through December 2006, 155 patients with OA (241 cycles) and 28 patients with HS (34 cycles) were included in this study. We compared clinical outcomes of ICSI with testicular sperm such as fertilization rate, implantation rate, clinical pregnancy rate and delivery rate. Data were statistically analyzed using t-test and ${\chi}^2$-test. Results: Testicular spermatozoa could not be retrieved in 1 out of the 21 cycles where fresh testicular sperm extraction in HS patients. Fertilization rate (FR) was significantly higher in OA than HS (75.6 % vs. 62.6%, p<0.001). Cleavage rate (CR) per fertilized zygote was also significantly higher in OA than that in HS (66.8% vs. 54.8% p<0.001). However, there were no significant differences in good embryo rate (GER), clinical pregnancy rate (CPR), implantation rate (IR) and delivery rate (DR). Conclusion: Our results show that testicular sperm of HS does not affect CPR, IR, and DR although it has shown reduced FR and CR.

Prevalence of Lower Urinary Tract Symptoms and Association of Hypertension with I-PSS (국제 전립선 증상 점수(I-PSS)를 이용한 하부요로증상의 유병률 및 고혈압과의 관계)

  • Ha, Jee-Young;Cho, Dong-Young;Yang, Sang-Kuk;Chang, Soung-Hoon;Lee, Kun-Sei;Lee, Won-Jin;Yu, Byung-Yeon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.265-273
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    • 2000
  • Benign prostatic hyperplasia (BPH) is a highly prevalent, age-related disorder in men which place a considerable burden on health care resources worldwide. While BPH and hypertension are apparently diverse disease processes, they have some features in common(e.g. underlying etiology of the sympathetic nervous system). The purpose of this study is to estimate the prevalence of lower urinary tract symptoms using I-PSS(international prostate symptom score) and to investigate the association of hypertension with I-PSS. This study was carried out to 390 men(40~86 year old) at 3 Myun in Chungju City from July to August, 1997. Subjects answered on questionnaire for I-PSS and were checked age, education, marital status, annual income, blood pressure. The mean age of subjects was 59.8 year old. The mean of I-PSS were increased by age decades(40~49, 50~59, 60~69, 70~86) and it's scores were 4.4, 7.0, 8.2, 12.3 respectively. Strong correlations were observed between the I-PSS and the QUL(quality of life)(P=0.0001). I-PSS(mean-value) were 7.85 in hypertensive group and 8.39 in normotensive group but there was no statistically significance between the two groups(P>0.05). The proportion of mean scoring greater than 8 was 42.5%. There have been reports of association between lower urinary tract symptoms and hypertension, but there was no consistent suggestion that such an association could be casual. The need for high-quality epidemiological information and consequent increased prospects for prevention is obvious.

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Classification of Congenital Urinary Tract Anomalies Diagnosed by Antenatal Ultrasonogram (산전 초음파로 발견된 선천성 요로계 기형의 분류)

  • Choi Jin-Ho;Hahn Hye-Won;Won Hye-Sung;Kim Kun-Suk;Yoon Chong-Hyun;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.227-236
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    • 2002
  • Purpose : A study was done to assess the incidence and classification of congenital urinary tract anomalies detected by antenatal ultrasonogram. Methods : We reviewed 558 cases of urinary tract anomaly which were detected by antenatal ultrasonogram and postnatally confirmed between June 1989 and May 2002. We investigated the incidence and classified congenital urinary tract anomalies by review of medical records, antenatal and postnatal radiologic studies retrospectively. Results : In 558 cases of congenital urinary tract anomalies, 292 cases of hydronephrosis were found and the most common. Another anomalies were composed of 65 cases of multicystic dysplastic kidney, 32 cases of hydroureteronephrosis, 31 cases of duplication of kidney, 25 cases of renal agenesis, 21 cases of simple renal cyst, 20 cases of polycystic disease, 13 cases of ureterocele, 11 cases of renal hypoplasia, 10 cases of horseshoe kidney, 9 cases of vesicoureteral reflux, 8 cases of posterior urethral valve, 7 cases of bladder diverticulum, 6 casts of megaureter, 5 cases of ectopia, 2 cases of megacystis, and 1 case of medullary cystic disease. In 82 of the 558 cases, there were two or more combined urinary tract anomalies. Associated diseases other than urinary tract were observed in 13 cases, of which the congenital heart disease was the most common. Conclusion : The congenital urinary tract anomaly is frequently found and diverse during the antenatal ultrasonography. The multicenter study is needed to investigate precise incidence and distribution of each anomalies in general population.

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Contralateral Vesicoureteral Reflux in Children with Abnormal Unilateral Renal Development (일측성 신발생이상 환아에 동반된 반대측 방광요관역류)

  • Oh Sung-Wook;Lee Jae-Seung;Kim Myoung-Jun;Han Sang-Won;Bae Ki-Soo
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.53-59
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    • 1997
  • There have been many recent reports that unilateral renal agenesis and multicystic dysplastic kidneys are accompanied by contralateral vesicoureteral reflux leading to its injury. We grouped the children with unilateral renal agenesis, renal hypoplasia, multicystic dysplastic kidney into abnormal unilateral renal development and investigated whether it was accompanied with contralateral vesicoureteral reflux. We retrospectively reviewed 96 pediatric cases of unilateral renal agenesis, hypoplasia, multicystic dysplastic kidney diagnosed at Shinchon Severance Hospital, Yongdong Severance Hospital from 1987 to 1996 and Ajou University Hospital from 1994 to 1996. Diagnosis was based on radiological findings, renal hypoplasia being defined as small renal size with no apparent renal scarring and no irregularity of the calyceopelvic system on abdominal sonography or intravenous pyelography. Among the 96 cases,48 cases carried out voiding cystourethrography. 58 cases were male(60%) and 38 cases were female(40%). The cases of abnormal unilateral development on the left side were 45(47%) and that on the right side were 51(53%). Although there were diverse reasons leading to diagnosis, the major ones included were prenatal sonography, urinary tract infection, and other congenital anomalies. In cases of unilateral renal agenesis & hypoplasia the leading factors were urinary tract infection & other congenital anomalies and in cases of multicystic dysplastic kidney that was prenatal sonography. There was a chronological gap between the mean age of diagnosis(1.8 year) and voiding cystouerthrography(2.5 year, P < 0.01). 9 of the 18 unilateral renal agenesis cases, 5 of the 11 unilateral renal hypoplasia cases, and 3 of the 19 unilateral multicystic dysplastic kidney cases showed contralateral vesicoureteral reflux. Average reflux grade was above G III.Among the 17 children who had contralateral vesicoureteral reflux, 3 children had chronic renal failure and ureteroneocystostomy was carried out in 6 children. From the above results we conclude that screening voiding cystourethrography should be performed in children with abnormal unilateral renal development for early detection of vesicoureteral reflux in the contralateral kidney.

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