Historical Study of the Etymological Form and Translational Process of Gout (Tongfeng) / 의사학

This study aims to address questions regarding the translation of 'gout' into 'tongfeng' in East Asia. To this end, the formation process of the origins, 'gout' from Western medicine and 'tongfeng' from Oriental medicine, and the translational process were investigated through the relevant records and literature dating from the 16th century on. Symptoms associated with gout were originally mentioned in ancient Egypt and various terminologies were used to refer to gout, such as podagra, cheiragra and gonogra. The word 'gout', which is derived from Latin, was used for the first time in the 13th century. The reason for this linguistic alteration is thought to be the need for a comprehensive term to cover the various terms for gout in symptomatic body parts, since it can occur concurrently in many joints. However, it took hundreds of years before gout was independently established as a medical term. In oriental medicine, terms describing diseases with features similar to gout include bibing, lijiefeng, baihufeng and tongfeng. Among them, the concept of 'tongfeng' has been established since the Jin and Yuan dynasties. The cause, prevention and various treatments for tongfeng were proposed throughout the Ming and Qing dynasties. The early translation of gout and tongfeng in East Asia, respectively, is estimated to have occurred in the 18th century. The first literature translating gout in China was 'An English and Chinese Vocabulary in the Court Dialect (yinghua yunfu lijie)'. From the publication of this book until the late 19th century, gout was translated into an unfamiliar Chinese character 'Jiu feng jiao', likely because the translation was done mostly by foreign missionaries at the time, and they created a new word on the basis of Western medicine instead of researching and translating similar diseases in oriental medicine. In Japan, the first book translating gout was 'A Pocket Dictionary of the English and Japanese Language (Eiwa taiyaku shuchin jisho)', Japan's the first English-Japanese translation dictionary. In this book, gout was translated into tongfeng, a word adopted from oriental medicine. These differences from China are thought to be caused by Rangaku doctors, who, influenced by oriental medicine in the Jin and Yuan dynasties, played an important role in translating medical terminology at that time.

Bispectral index monitoring to assess the level of consciousness in patients with brain injury / 대한마취과학회지

BACKGROUND: It is important to assess the level of consciousness in patients with brain injuries to determine modes of treatment and prognosis. We evaluated the Bispectral Index (BIS) to determine if it could be used as an objective tool for evaluation of the level of consciousness in brain-injured patients. We also compared the BIS values to clinical sedation scales such as the Glasgow Coma Scale (GCS), Richmond Agitation-Sedation Scale (RASS), and the Reaction Level Scale (RLS). METHODS: Thirty eight patients with brain injuries that were admitted to the neurosurgery intensive care unit (NSICU) were enrolled in this study. An investigator evaluated the clinical sedation scales (GCS, RASS, RLS), while a blind observer noted the BIS in the same patient. The BIS score was obtained three times at an interval of 5 hours. The BISs were measured for 1 minute at 5 min prior to the nursing assessment, during the nursing assessment, and at 5 min after the nursing assessment. The BISs used in the data analysis were the maximal, minimal, and mean values obtained during 1 min, which were defined as BISmax, BISmin, and BISmean. A Spearman's rank correlation coefficient was used to determine if the clinical sedation scales were correlated with the BIS scores. RESULTS: In 38 patients, the BISmax, BISmin, and BISmean were found to be significantly correlated with the GCS, RASS, and RLS. The BISmean had the highest correlation with GCS (r = 0.445, P < 0.01), while the BIS min had the lowest correlation with RLS (r = -0.278, P < 0.01). CONCLUSIONS: The results of BIS monitoring were found to be significantly correlated with sedation scales in patients with brain injuries. These findings suggest that BIS can be used as an objective and continuous method for assessment of the level of consciousness in patients with brain injury.

Incidence of Paresthesia Related to the Insertion Length of Catheter during the Epidural Catheterization / 대한통증학회지

BACKGROUND: Continuous epidural catheterization is a popular and effective procedure for postoperative analgesia. However, continuous epidural catheterization has associated complications such as venous puncture, dural puncture, subarachnoid cannulation, suboptimal catheter placement, and paresthesia because the tip of the epidural catheter touches thenerves of the dura in the epidural space. In this study, we compared the incidence of paresthesia in two different lengths of epidural catheter insertion. METHODS: One hundred women undergoing gynecologic or orthopedic surgery were enrolled in this prospective, double-blinded, randomized study. All patients were randomly divided into two groups based on the insertion length of the epidural catheter 2 cm (group A) or 4 cm (group B). A Tuohy needle was inserted in the lumbarspinal region with a bevel directed cephalad by use of the median approach, and then the epidural space was confirmed by the loss of resistance technique with air. While the practitioner inserted an epidural catheter into the epidural space, a blind observer checked for paresthesia or withdrawal movement. RESULTS: In 97 included patients, 30.6% of the patients in group A (n = 49) had paresthesia, versus 31.3% in group B (n = 48). Withdrawal movements were represented in 2% and 6% of the patients in group A and group B, respectively. There was no difference in the incidence of paresthesia and withdrawal movement between the two groups. CONCLUSIONS: There is no clear relationship for the incidence of catheter-related paresthesia according to the catheter length inserted into the epidural space for epidural analgesia.

Spontaneous Rupture of Native Kidney in a Patient Receiving Kidney Transplantation : A case report / 대한마취과학회지

Spontaneous rupture of a kidney can occur as a complication of an acquired cystic kidney lesion. Herein, one case of a spontaneous rupture of a contralateral native kidney, due to the rupture of a cystic lesion during kidney transplantation surgery, is described. The patient was a 24 year old female admitted for left kidney transplantation due to chronic renal failure. During the operation, her arterial blood pressure and central venous pressure gradually decreased after anastomosis of the renal vessel, but without significant bleeding in the operative field or any suspected cause of the decreasing arterial blood pressure. On the first postoperative day, she underwent an abdominal CT, where a retroperitoneal hematoma was found. Therefore, a right nephrectomy was performed. She also had a right perirenal hematoma due to the rupture of cystic lesion in the native kidney. While a spontaneous rupture of the kidney is very rare, especially during the perioperative period, it is important to consider this complication when evaluating the corresponding clinical picture.

Perineal Recurrence of Langerhans Cell Histiocytosis / 대한비뇨기과학회지

Langerhans cell histiocytosis (LCH) is a rare disorder, characterized by abnormal proliferation of Langerhans cells, which can affect various organ systems. The most common clinical findings are localized bone lesions, with eosinophilic granuloma, which occur at any age, although most patients present under the age of 15 years. We experienced a case of recurrent LCH, invading the bulbous urethra, in the perineal area of a 16-year-old boy. The primary tumor developed in the mastoid bone, and recurred in the ureter, maxillary sinus mucosa and perineum, in the order. The perineal lesion and part of bulbous urethra were surgically removed, through a perineal approach, and the urethra primarily reconstructed.

Sarcomatoid Carcinoma of the Renal Pelvis / 대한비뇨기과학회지

A sarcomatoid carcinoma of the urinary system is a rare malignant tumor, composed of both epithelial and stromal cells, is regarded as a similar disease entity to a carcinosarcoma. In Korea, only 1 case of primary sarcomatoid carcinoma and 4 cases of carcinosarcoma involving the bladder have been reported, but to date, no case of primary sarcomatoid carcinoma involving the renal pelvis has been reported. Recently, we experienced a case of sarcomatoid carcinoma involving the right renal pelvis in a 67-year-old male patient with intermittent gross hematuria. A CT scan demonstrated a 5x4cm sized mass in the right renal pelvis. Under the diagnosis of a right renal pelvic tumor, a right nephroureterectomy, with bladder cuff excision, was performed. The tumor was composed mostly of pleomorphic spindle cells, and in the peripheral part of the tumor and renal pelvis, a high grade transitional cell carcinoma and adenocarcinoma was also found. The tumor was pathologically confirmed as a primary sarcomatoid carcinoma of the renal pelvis.

Ectopic Ureter Associated with Ipsilateral Renal Dysgenesis / 대한비뇨기과학회지

An ectopic ureter inserts at a point other than the normal trigonal position of the bladder and its association with ectopic renal dysgenesis is extraordinarily rare. We report two cases of ectopic ureter associated with ipsilateral ectopic renal dysgenesis. One was a 44-year-old man whose right ureteral opening was identified at the right seminal vesicle and who was treated successfully by nephroureterectomy and ipsilateral seminal vesiculectomy. The kidney drained by the ectopic ureter was dysplastic. The other was a 32-year-old woman whose right ureter drained into the right anterior vaginal wall and who was also treated successfully by nephroureterectomy. On pathologic examination, there was no renal tissue in the postoperative specimen. From the marked dilatation of the right ureter, this condition was interpreted as an acquired form of renal agenesis, in which renal tissue developed but atrophied during development or during childhood because of an associated ureteral obstruction rather than true renal agenesis which is defined as the complete congenital absence of renal tissue.

Effective Intervals of Serum Prostate Specific Antigen (PSA) Test for Screening of Prostate Cancer in Men with Initial Serum PSA Level below 2ng/ml / 대한비뇨기과학회지

PURPOSE: The aim of this study was to estimate the effective intervals of the serum prostate specific antigen (PSA) test in men aged over 50 years, with an initial PSA value below 2ng/ml, no palpable nodule at digital rectal examination (DRE) and no abnormal findings on transrectal ultrasonography (TRUS). MATERIALS AND METHODS: 209 men, with initial serum PSA levels below 4ng/ml, who had checked their PSA more than twice, with a minimal interval of 4 months, taking no BPH medication and with no lesion suspicious of malignancy on DRE and TRUS, were enrolled. The factors influencing the changes in the PSA were analyzed, and the rate of conversion of PSA over the cut-off level of 4ng/ml, or age specific reference level of PSA, calculated. Another group of 24 patients, with initial PSA levels below 4ng/ml, but showing no lesion suspicious of malignancy on DRE or TRUS, underwent transrectal biopsies, and their PSA velocities (PSAV) calculated. RESULTS: Of the 209 patients, a PSA conversion, over the age specific reference level of PSA, was not observed over a 4 years period in the group with an initial PSA below 1ng/ml. In the group with initial PSA levels between 1 and 2ng/ml, a PSA conversion of over 4ng/ml was observed in only 3.4% of patients over a 2 year period. Among 24 biopsies, 5 prostate cancers and one high grade PIN were detected, with the calculated PSAV from these patients being 0.75ng/ml/year. When this PSAV was applied as a cut-off value, the sensitivity and specificity were 33.3 and 11.1%, respectively. CONCLUSIONS: The PSAV did not effectively predict the presence of prostate cancer in men with an initial PSA below 4ng/ml. Therefore, in men over 50, and without a lesion suspicious of malignancy on DRE and TRUS, the suggested effective intervals for screening of prostate cancer, for men with an initial PSA below 1ng/ml and between 1 and 2ng/ml, should be 4 and 2 years, respectively.

Effect of Sulfated Glycoprotein-2 (Clusterin) on Apoptosis of PC3 Cell Induced by Docetaxel / 대한비뇨기과학회지

PURPOSE: Sulfated glycoprotein-2 (SGP-2) is a glycoprotein that is secreted by mature mammalian Sertoli and epididymal epithelial cells, and has been previously identified as an apoptosis inhibitor. This study was undertaken to determine, whether anti-SGP-2 antibodies in combination with a chemotherapeutic agent improves the therapeutic outcome. MATERIALS AND METHODS: Western blot analysis was performed to detect the changes in SGP-2 secretion from PC-3 cells after treating them with docetaxel (Taxotere ). The PC-3 cells were cultured and treated with various concentrations of docetaxel with 40 microgram/ml of anti-SGP-2 antibodies. In addition, the cultured PC-3 cells were treated with TNF-alpha at 10ng/ml with the SGP-2 antibodies. The number of viable cells was assessed by a trypan blue dye extraction assay after 24 hours. Using flowcytometric analysis, the exact extent of and changes in apoptosis after treatment with the anti-SGP-2 antibodies were assessed. RESULTS: The percentage of viable PC-3 cells treated with docetaxel decreased with increasing docetaxel concentration. The percentage of viable PC-3 cells treated with docetaxel and anti-SGP-2 antibodies was lower in proportion to the docetaxel concentration. However these two groups were not statistically different. The percentage of viable PC-3 cells incubated with 10ng/ml TNF-alpha and the anti-SGP-2 antibodies were significantly lower compared to that for TNF-alpha alone (p<0.05). In the FACScan analysis, the number of apoptotic cells was not higher in the PC3 cells treated with docetaxel and anti SGP-2 antibodies compared to those treated with docetaxel alone. CONCLUSIONS: These results showed that SGP-2 prevents TNF-alpha induced apoptosis primarily. However no difference in apoptosis between the docetaxel treated PC-3 cells and the docetaxel with the anti-SGP-2 antibodies treated PC-3 cells was observed. Therefore, the treatment outcome may not be improved by the combined therapy, involving blocking SGP-2 with Taxane based chemotherapy with the same cytotoxic mechanism as docetaxel.

Functioning Adrenocortical Carcinoma in a Child / 대한비뇨기과학회지

Adrenocortical carcinoma is a rare tumor in children. This tumor is more likely to be hormonally active in children than in adults and tends to cause a variety of symptoms. These tumors are usually diagnosed at the advanced stages and have a dismal prognosis. Here we report a case of a functioning adrenocortical carcinoma in a child with a review of the relevant literature.

The Relationship between Prostate-specific Antigen, Invasiveness and Vascular Endothelial Growth Factor in Human Prostatic Cancer / 대한비뇨기과학회지

PURPOSE: Vascular endothelial growth factor (VEGF) known as an angiogenic factor is a potent inducer of pathologic neovascularization. The purpose of this study is identifying the relationship between serum PSA, invasiveness and VEGF expression in prostatic cancer. MATERIALS AND METHODS: Ex-vivo study with immunohistochemical stain analysis for VEGF expression was performed on 18 paraffin embedded specimens of prostatic cancer patients who were treated with radical prostatectomy. VEGF expressions were classified by three groups (1+ , 2+ , 3+ ) according to the degree of staining of cancer cell. Biochemical failure and recurrence were determined by Takayama's IMx PSA assay criterion (>0.1ng/ml) following radical prostatectomy. RESULTS: Immunohistochemical studies demonstrated that each group contained 1, 2, 8 patients in advanced disease (n=11), and 3, 2, 2 patients in localized disease (n=7), respectively. All cases in strong positive (3+ ) group had Gleason sum higher than 7 and nadir PSA values were lower than 0.1ng/ml except one case. We found no correlation between initial PSA and VEGF expression (p=0.361). Three biochemical recurrent patients were identified as strong positive VEGF expression. CONCLUSIONS: Our study indicates that patients with advanced stage and higher Gleason sum have a trend with more VEGF expression than patients with localized disease. Identifying the angiogenesis factors especially, VEGF involved in prostatic cancer growth and understanding their regulation will lead to the developement of anti-angiogenic strategies useful for diagnostic studies and therapeutic interventions.

A Case of No Residual Cancer in Radical Prostatectomy Specimens Despite Biopsy-proven Prostate Cancer / 대한비뇨기과학회지

In prostate cancer patients without local invasion and metastasis, radical prostatectomy is performed as a rule for the resection of residual cancer. In a few cases, little amount of cancer volume is identified in radical prostatectomy specimens. This finding has been described as 'minimal residual cancer' or 'vanishing cancer phenomenon' and some reports have demonstrated an increase in the incidence of minimal residual prostate cancer. However, only few cases with 'minimal residual cancer' or 'no residual cancer' despite efforts searching for other possibilites have been reported. We report a case of no residual cancer in radical prostatectomy specimens of biopsy-proven prostate cancer.

Effect of Sulfated Glycoprotein-2 (Clusterin) on the Apoptosis of Prostatic Cancer / 대한비뇨기과학회지

PURPOSE: This study was performed to evaluate anti-apoptotic mechanism of Sulfated Glycoprotein-2 (SGP-2) in tumor necrosis factor-alpha (TNF-alpha) induced apoptosis of prostatic cancer cell. MATERIALS AND METHODS: To suppress the activity of natively secreted SGP-2 by prostatic cancer cells, varying amount of the blocking antibody to SGP-2 (anti-SGP-2 antibody, 1.25~2.0microgram/ml) was applied. Then TNF-alpha or agonistic antibody to type I TNF-alpha receptor (agonistic-TNFR1 antibody) were applied for the induction of apop tosis. The changes of cell number and cytotoxicity were assessed by trypan blue dye exclusion assay. The exact amount of early and late apoptosis were analyzed and compared by flowcytometric analysis. RESULTS: By blocking SGP-2 with anti-SGP-2 antibody (2.0microgram/ml), apoptosis was signi ficantly increased in both TNF-alpha (96.8 +/- 1.4%) and agonistic-TNFR1 antibody treated PC3 cells (95.2 +/- 0.9%) compared to control group (41.4 +/- 4.7%), especially after 36 hours incubation (p<0.05). The more suppressed the activity of SGP-2 by anti-SGP-2 antibody, significantly the more apoptosis was happened (p<0.05). After 24 hours incubation, the increase of apoptosis by the suppression of SGP-2 was significantly greater in TNF-alpha treated PC3 cells (45.6 +/- 27.6%) than in agonistic- TNFR1 antibody treated ones (28.6 +/- 4.7%). However after 36 hours the difference in degree of apop tosis between two groups disappeared. CONCLUSIONS: We found that SGP-2 blocked the apoptosis which was induced by agonistic-TNFR1 antibody as like TNF-alpha induced one. These results implies the possi bility of the direct action of SGP-2 on type I TNF-alpha receptor. However the difference between two groups in the degree of apoptosis after 24 hours incubation period sug gest the more efficient blocking effect of SGP-2 on agonistic-TNFR1 induced apoptosis than on TNF-alpha induced one. For clarification of these difference, further research about other influencing factors such as type II TNF-alpha receptor activation is essential.

An Immunohistochemical Study of Vascular Endothelial Growth Factor as a Predictor of Progression in Bladder Cancer / 대한비뇨기과학회지

No abstract available.

A Long Term Effect of Single 6 -Week Intravesical BCG Therapy for the Recurrence and Progression of Stage T1 Bladder Cancer / 대한비뇨기과학회지

No abstract available.

Analysis of Postoperative Results According to the Types of Urinary Diversionafter Radical Cystectomy / 대한비뇨기과학회지

No abstract available.

Significance of E-cadherin Expression in the Tissue of Bladder Cancer / 대한비뇨기과학회지

PURPOSE: Cadherins are a family of transmembranous glycoproteins involved in intercellular adhesion. E-cadherin, an epithelium specific cadherin, plays a major role in the maintenance of epithelial tissue and therefore in neoplastic progression of many human carcinomas. In order to search for more accurate prognostic factors, we investigated the relationship between decreased E-cadherin expression and tumor grade, stage, recurrence and progression in bladder tumors. MATERIALS AND METHODS: 62 formalin fixed paraffin embedded specimens which were taken from 34 patients with transitional cell carcinoma who underwent TURB, partial cystectomy, radical cystectomy were retrospectively analyzed with E-cadherin immunohistochemical staining from January 1989 to December 1997. Correlations were evaluated between E-cadherin immunohistochemical staining and grade, stage, recurrence and progression. RESULTS: Decreased E-cadherin expression correlated with both increased grade and stage(x2=25.6, p<0.01 and x2=26.7, p<0.01 respectively). Also, abnormal E-cadherin expression correlated with recurrence and progression of superficial bladder tumors(Fisher Exact test: p=0.008 and x2=6.6, p=0.01 respectively). In multiple linear regression analysis controling the effects of other factors, only the tumor grade showed weak correlation with E-cadherin expression(coefficient=-0.25, r2=40.1%, p<0.001). CONCLUSIONS: The results suggest that decreased expression of E-cadherin is correlated with higher grade, advanced stage, recurrence and progression respectively. But, E-cadherin could not be used as an independent prognostic marker in bladder cancer.

A Case of Iatrogenic High Flow Priapism / 대한남성과학회지

High-flow priapism is caused by sustained arterial inflow into the spaces from a lacerated cavernosal artery. This typically follows perineal trauma. Iatrogenic high-flow priapism occasionally follows the treatment of low-flow priapism and is a diagnostic and therapeutic challenge. Herein, we reported a case of iatrogenic high-flow priapism which developed after treatment of-flow priapism.

The Study of Expression of p53 and Apoptosis in Prostatic Cancer / 대한비뇨기과학회지

PURPOSE: Mutation of the p53 gene in one of the most common genetic abnormalities found in solid human tumors. p53 gene is related to the cell cycle and concerned with the control of cellular proliferation or cell death by mediating ?programmed cell death (Apoptosis)?. The objective of this study is to evauate the expression of p53 mutations and apoptosis with metastatic prostatic adenocarcinoma. MATERIALS AND METHODS: We examined 31 paraffin-embedded tissues and compared with the tumor grade, survival estimates. Nuclear expression of p53 could be detected using the monoclonal antibody DO-7 and the expression of apoptosis could be detected using Apotag by in situ hybridization method. The study group was divided by Gleason sum score into low score group (score 2-7, 16cases) and high score group (score 8-10, 15cases). RESULTS: Positive staining for p53 was found in three of sixteen low score group(19%), eight of fifteen high grade group(53%). Diffuse(>20%) staining was considered as positive for p53 expression. Positive expression of p53 showed more frequent in high Gleason score group than low score group(p=0.044). And more expression for p53 was related to more short survival time than negative p53 group(p=0.041). Mean expression for apoptosis in thirty one cases was 32%. In low Gleason score group mean expression for apoptosis was 35% and 28% was found in high Gleason score group. No significant relationship between low and high group in expressing for apoptosis(p=0.2526). No difference was found for survival time between two groups(p=0.96). And no specific relationship was found between the expression of p53 and apoptosis in low and high Gleason score group each other(p=0.275). CONCLUSIONS: p53 mutations play an important role as aggressive biological properties in the metastatic prostate cancer in relation to Gleason grade. Therefore we might use the extent of p53 expression as an usuful prognostic factor in clinical aspects. But the expression of apoptosis cannot reveal any specific features with tumor grade, survival time.

Comparison of Microvessel Densities (MVD) between Needle Biopsies and Prostatectomy Specimens in the Patients with Prostate Carcinoma / 대한비뇨기과학회지

PURPOSE: We compared neovascularity with needle biopsies and definitive prostatectomy specimens to examine whether the measurement of microvessel density(MVD) has an ability to predict extracapsular extension with limited tissue sample. MATERIALS AND METHODS: We evaluated total 11 pathologically proven stage T3 lesions. The paraffin embedded tissues from needle biopsies and definitive prostatectomy specimens were sectioned serially. Of the serial sections obtained from prostatectomy specimens 2 showing a relatively uniform histology grade; one identical grade with biopsy sample, another the worst grade within the tumor or different grade from biopsy, and 2 from specific sites of the tumor; center and periphery, selected for examination. MVD determinations were performed immunohistochemically using monoclonal antibodies directed at the CD34 antigens. RESULTS: MVD of total 11 needle biopsies with grade 2-5 (score 4-8) ranged from 73.7 to 170.8 (median 106.7 +/- 10.6). The grade (score 5-9) distributions of prostatectomy specimens were different from those of needle biopsies and the MVD obtained from definitive prostatectomy specimens exhibited a heterogeneity within the individual tumor. The variation in densities between different grade group proved statistically different (p< 0.01, paired t-test). Also, the MVD count in the center of the tumor was higher than that in the periphery of the tumor and the difference between two group of the specific sites was statistically significant (p = 0.015, paired t-test). Finally, although MVD of biopsy sample did not correlated exclusively to that of definitive prostatectomy specimen, there would be a significant correlation of MVD between two groups if their distribution of histological grade were identical (p< 0.01, r2 = 0.889). CONCLUSIONS: Prior to surgical extirpation in the patients of clinically localized prostatic carcinomas, MVD determination of needle biopsies of the prostate would not correlate with that of definitive prostatectomy specimen. Given the limited tissue sampling from a biopsy, understanding of the site specificity of vasculature and analyzing the relationship of angiogenesis and other biologic factors of which histologic grade seems to be involved most importantly, are critical to developing a consistent and effective methodology of microvessel quantification.