Prevalence and Determinants of High-Risk Human Papillomavirus Infection in Male Genital Warts

PURPOSE: To evaluate the prevalence and type distribution of high-risk human papillomavirus (HPV) infection in genital warts of Korean men, and for the first time, to describe the risk factors associated with high-risk HPV infection in male genital warts. MATERIALS AND METHODS: In a single private clinic, 150 consecutive male patients with histopathologic-confirmed genital warts who underwent HPV genotyping by use of polymerase chain reaction (PCR) were included in this study. We detected HPV DNA in male genital warts and evaluated HPV type distribution, especially high-risk HPV types, by use of PCR. The associations between HPV prevalence and various characteristics, such as age, circumcision status, type of genital warts diagnosis (new vs. recurrent), number of lesions, site of lesions, and gross morphology, were assessed by use of unconditional multiple logistic regression. RESULTS: High-risk HPV types were detected in 31 cases (23.5%), and of these, 27 cases (20.5%) contained both high-risk and low-risk HPV types. The most frequently detected high-risk HPV types were HPV16 (6.8%), HPV33 (4.5%), HPV18 (2.3%), and HPV68 (2.3%). In particular, the prevalence of infection with HPV16 and/or HPV18 was 8.3% (11 of 132). In the multivariate analysis, lesions located at sites including the base of the penis or the pubic area, papular or mixed genital warts, and lack of circumcision significantly increased the association with high-risk HPV infection in male genital warts. CONCLUSIONS: The prevalence of high-risk HPV infection was substantial in male genital warts. The site and morphology of lesions and circumcision status were significantly associated with the prevalence of high-risk HPV infection.

Photoselective Vaporization of the Prostate(PVP) using KTP Laser for Treatment of Benign Prostatic Hyperplasia(BPH) / 대한남성과학회지

PURPOSE: PVP using a high-power potassium-titanly-phosphate(KTP) laser offers safe and efficacious surgical therapy for men with symptomatic BPH. To demonstrate its efficacy, safety and durability, we present the results of PVP for treatment of BPH with 12 month follow-up. MATERIALS AND METHODS: 104 consecutive men with symptomatic BPH underwent PVP with an 80 W KTP laser (Laserscope) between July 2003 and August 2004. All underwent preoperative and postoperative evaluation, including assessments of international prostate symptom score(IPSS), quality of life(QOL), peak urinary flow rate(Qmax), post-void residual volume(PVR), prostate specific antigen(PSA), and ultrasound prostate volume(PV). Secondary outcome parameters included surgical time, anesthesia, and length of catheterization. Follow-up assessment occurred at 1, 3, 6, and 12 months. Data were analyzed using the Wilcoxon signed rank test. RESULTS: Preoperative mean PV was 57.2+/-4.2 ml. PV decreased to 38.9, 35.4, 32.8 and 35.8 at 1, 3, 6 and 12 months (p <0.01 versus preoperative value). Mean improvements in IPSS, QOL, Qmax, and PVR at 12 months were 67%, 81%, 138% and 94%, respectively(p <0.001). Mean operative time was 26.3+/-15.0 minutes. Anesthesia included pudendal and prostatic block(n=102) and spinal anesthesia(n=2). Ninety-nine(95%) patients were treated as outpatients( <12 hrs) and the remaining 5 patients were admitted for 1 or 2 hospital days. Mean catheterization times were 9.8+/-3.1 hours(range 0~72), with 28(27%) patients not requiring a catheter post-operatively. Minor complications included mild hematuria lasting 3 weeks(3.8%), transient post-operative retention(2.9%), urge incontinence(1.9%), transient dysuria(25%), frequency(21.2%), urgency(17.3%) and retrograde ejaculation(41%). CONCLUSIONS: These results demonstrate that PVP is safe and efficacious for the treatment of symptomatic BPH. Long follow-up will further validate this new modality as the standard for surgical treatment of BPH.

Multicenter Study on the Efficacy and Safety of Intracavernous 'TM' (Standro(R)) for the Treatment of Erectile Dysfunction in Korean / 대한비뇨기과학회지

PURPOSE: To evaluate the efficacy and safety of an intracavernous injection of lyophilized papaverine/phentolamine/alprostadil (Standro(R)) for the treatment of erectile dysfunction (ED) in Koreans. MATERIALS AND METHODS: 249 men (>20 years old), with ED (>6 month duration), were enrolled from 14 clinical centers. The intracavernous 'TMs' were titrated in a stepwise fashion at the clinic, from 0.05-0.25ml (17.64mg papaverine, 0.6mg phentolamine, and 6mug alprostadil per ml), with increment of 0.02-0.05ml, according to the etiology and severity of the ED and the patients' ages. RESULTS: Of the 249 men, 238 completed the dose titration, and progressed to home treatment of 3 months duration. Of these 238, 193 (psychogenic 13.0%, organic 75.5%, mixed 11.5%) completed the home treatment (4 or more self-injections), with the other 45 dropping out (lost to follow-up in 24, patient refusal in 9, no chance to have intercourse in 7 and omitted recording of patient diary in 2). The success rate per trial (a total number of sufficient erection for vaginal intromission/a total number of injections) and per patient (number of patients who had one or more sufficient erections for vaginal intromission/the enrolled patients at beginning or 193 patients), and the satisfaction rate per patient (number of patients who had both patient and partner satisfaction with erection/193 patients) were 74.1, or 91.2 and 75.1%, respectively. The adverse reactions were prolonged erections in 3, urethral pain in 1 and penile skin edema in 2. Three patients complained of penile pain during an erection, but there was no dropout due to the pain. No significant changes in laboratory tests were found after the home treatment. CONCLUSIONS: A 'TM' seems to be effective and safe for an intracavernous injection for the treatment of men with erectile dysfunction.

Outcome of Tubularized Incised Plate Urethroplasty for Correction of Hypospadias / 대한비뇨기과학회지

PURPOSE: The outcome of a tubularized incised plate (TIP) urethroplasty for hypospadias was reviewed retrospectively, and compared with other procedures with respected to the success rate, complications and satisfaction. MATERIALS AND METHODS: Between April, 1994 and July, 2001, 51 patients underwent a repair for hypospadias, by the same operator, using a transverse preputial island flap (TPIF; 7), an onlay island flap (OIF; 3), Mathieu (7) and tubularized incised plate (34) procedures. The operation time, period of catheterization, postoperative hospital days and complication rates for each procedure were also compared. RESULTS: The mean operation time in the TIP group was 140 minutes, compared to 230 220 and 160 minutes in the TPIF, OIF and Mathieu groups, respectively. The mean admission periods in the TPIF, OIF, Mathieu and TIP group, were 14, 17, 11 and 10 days, respectively. The mean operation time and admission period was shorter in the TIP group than those of the other procedures. The incidence rate of an urethrocutaneous fistula was lower in the TIP group (23%: 8/34) than in the TPIF (43%: 3/7), OIF (66%: 2/3) and Mathieu groups (57%: 4/7). Postoperative satisfaction for the penis and meatus shapes was highest in the TIP group. CONCLUSIONS: The TIP urethroplasty had better outcomes than the TPIF, OIF and Mathieu procedures with regard to the operation time, catheterization period, admission period and complication rates following the operations. TIP urethroplasty is thought to be the most economic method for the repair of hypospadias, and can be recommended as the first choice for its repair.

Effects of Ginseng Alkaloid on the Tension of Rabbit Corpus Cavernosum / 대한남성과학회지

PURPOSE: To evaluate the effects of Ginseng alkaloid on the tension regulation of corpus cavernosum, changes of tension of rabbit corpus cavernosum in vitro were studied after administration of Adaptagen(R) that is extract of Ginseng alkaloid. And changes of tension of rat aorta in vitro and rat blood pressure and heart rate in vivo were studied after administration of the same agent to evaluate systemic cardiovascular side effects. MATERIALS AND METHODS: Rabbit corpus cavernosal strips and rat aorta rings were prepared. Strips and rings were mounted in an organ bath and isometric tensions were recorded after administration of agents contracting or relaxing vascular smooth muscle and Adaptagen(R). RESULTS: Adaptagen(R) relaxed rabbit corpus cavernosal strip and rat aorta ring contracted by phenylephrine in a dose-dependent manner. Pretreatment of L-nitroarginine inhibited the relaxing effect of Adaptagen(R) on phenylephrine-induced contraction of these tissues. In vivo, intraperitonealy administered Adaptagen(R) transiently decreased systemic blood pressure and heart rate of rat. CONCLUSIONS: According to above RESULTS, Ginseng alkaloid relaxes corpus cavernosum in a dose-dependent manner without significant systemic side effects. Therefore, it is suggested that Ginseng alkaloid could enhance erectile function but further studies are required for clinical application.

Clinical Studies of Xanthogranulomatous Pyelonephritis / 대한비뇨기과학회지

PURPOSE: Because the preoperative diagnosis of xanthogranulomatous pyelonephritis (XGP) is difficult due to its similarities to other renal diseases, the diagnosis is made postoperatively in most patients. The aim of this study was to improve preoperative diagnosis of this disease. MATERIALS AND METHODS: We reviewed clinical characteristics, laboratory and radiological findings, preoperative diagnoses, and operative methods of 6 patients with XGP who underwent operation from March 1991 to July 1998. Mean age was 49.8 years (range 28 to 80) and male to female ratio was 1 to 2. RESULTS: All 6 patients had flank pain and urinary tract infection. Among 6 patients, there were 3 patients (50%) with renal staghorn stone and 1 (16.7%) with ureteropelvic junction stricture. No patient was diagnosed as XGP preoperatively. Three patients (50%) diagnosed as pyonephrosis with staghorn stone preopratively underwent simple nephrectomy and 2 patients diagnosed as renal mass preoperatively underwent radical nephrectomy. One patient diagnosed as renal abscess extended to retroperitoneum and psoas muscle preoperatively was diagnosed as XGP through intraoperative frozen section biopsy of renal tissue and underwent partial nephrectomy and drainage. CONCLUSIONS: Preoperative diagnosis of XGP will be raised through better understanding of the clinical characteristics and radiologic findings of this disease.

Two Cases of Prolonged Priapism Caused by Abuse of Intracavernosal Self-injection / 대한남성과학회지

Priapism is a rare disease, but needs early intervention and appropriate management. We present 2 cases of ischemic low-flow priapism after intracavernosal injection of vasoactive drug. 43-year-old man and 61-year-old man visited our clinic complaining of continuous plan and erection persisting for several days after self cavernosal injection for increasing their erectile function. We performed blood gas analysis of cavernosal blood and color doppler ultrasound. And so we confirmed the diagnosis of low-flow priapism. Detumescence was finally achieved after the proximal shunt operation. Their erectile function was not recovered and they became permanent impotence.

Percutaneous Sclerotherapy of Simple Renal Cyst Using Minocycline HCl / 대한비뇨기과학회지

PURPOSE: Sclerotherapy is performed additionally to improve the outcome of aspiration in simple renal cyst. Ethanol has been used most commonly as a sclerosing agent, however, drainage is necessary which complicates the procedure. For this reason, we used minocycline HCl as a sclerosing agent without need to be drained and evaluated the results. MATERIALS AND METHODS: From June 1990 to May 1999, 140 patients who underwent percutaneous minocycline HCl sclerotherapy for simple renal cyst were evaluated. Among them, 10 patients were missed during follow-up and 7 patients had bilateral simple renal cysts. The simple renal cysts were aspirated under ultrasonography, and then minocycline HCl 100mg mixed with 5ml normal saline was injected into the cyst per 50ml of aspirated cyst fluid. The follow-up ultrasonography was performed at posttreatment 3, 6 and 12 months. The recurred cases were retreated with same procedure. RESULTS: Among 137 renal cysts of 130 patients who could be followed up, 70 renal cysts (51.1%) were totally collapsed and 53 renal cysts (38.7%) showed a 50% or more decrease in cyst volume after first treatment. All 14 persistent renal cysts (10.2%) showed a 50% or more decrease in cyst volume after second or third treatment. Catheterization for drainage of the sclerosing agent was not needed. There were only some minor complications such as nausea, vomitting and local pain that subsided within one day with only symptomatic treatment. CONCLUSIONS: These results shows that percutaneous minocycline HCl sclerotherapy is simple, safe and effective and can be a alternative first line therapy of simple renal cyst.

Usefulness of the UBC(TM)(Urinary Bladder Cancer) Test Compared to Urinary Cytology for Transitional Cell Carcinoma of the Bladder in Patients with Hematuria / 대한핵의학회잡지

No abstract available.

PADAM: Practical Approach / 대한남성과학회지

No abstract available.

Experimental Study of Growth Factors on Regeneration of Cavernosal Nerves in the Rats / 대한남성과학회지

PURPOSE: Nitric oxide (NO) has recently been identified as the main neurotransmitter involved in the nonadrenergic-noncholinergic (NANC) pathway and is responsible for penile erection. Nitric oxide synthase (NOS)-containing nerve regeneration can be seen 6 months after unilateral cavernosal nerve neurotomy in rats. However its molecular mechanism is still unknown. It is believe that growth factors are involved in this phenomenon. In this study I investigated the change of NOS containing nerve fibers and the RNA expression of insulin like growth factor (IGF)-I, nerve growth factor (NGF), transforming growth factor (TGF)-alpha, TGF-beta 1, TGF-beta 2, TGF-beta 3, vascular endothelial growth factor(VEGF), nNOS and eNOS on the penis after cavernosal neurotomy in rats. MATERIALS AND METHODS: Male rats were divided into three groups: sham operation (n=12); unilateral neurotomy of a 5-mm segment of the cavernosal nerve (n=18); and bilateral neurotomy (n=18). Electrostimulation of the cavernosal nerve of pelvic ganglion was performed at 1,3 and 6 months. Nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining was used to identify NOS in the penile nerve fibers. The gene expressions for growth factors, nNOS and eNOS were investigated in corporal tissue by reverse transcriptase-polymerase chain reaction (RT-PCR) using specific oligonucleotide primers. RESULTS: One month after neurotomy, both unilateral and bilateral neurotomy groups showed significant decreases in NOS-containing nerve fibers on the dorsal and intracavernosal nerves on the side of neurotomy and significantly lower mRNA expressions of nNOs, IGF-I and TGF-beta 2, and the unilateral neurotomy group showed higher mRNA expression of eNOS and VEGF189. At 3 months, the number of NOS-containing nerve fibers in the unilateral neurotomy group increased only slightly but at 6 months, those in the intracavernosal nerve increased in a significant amount (p<0.0001),however mRNA expressions of nNOs, IGF-I and TGF-beta . , showed significant increases as early as at 3 months, After bilateral neurotomy, the NOS-positive nerve fibers in the dorsal and intracavernosal nerve were significantly decreased at 1 month and remained so at 6 months; no erectile response could be elicited by pelvic ganglion stimulation. In the unilateral neurotomy group at 6 months, more NOS-positive neurons in the pelvic ganglia were found on the intact side than on the side of the neurotomy (p<0.005), indicating that the regeneration derived from pelvic ganglion neurons on the intact side. Furthermore, electrostimulation in the unilateral neurotomy group revealed a greater maximal intracavernosal pressure and a shorter latency period at 6 months than at 1 month (p<0.001, p<0.001, respectively). CONCLUSION: These data suggest that IGF-I and TGF-beta 2, may play a key role in regeneration of NOS-containing nerve fibers in the dorsal and intracavernosal nerves, and eNOS increases temporarily in the intracavernosum involving VEGF189 after unilateral cavernosal nerve injury.

Anatomic and Histologic Changes of the Testis after Long-Term Estrogen Exposure in Transsexuals / 대한남성과학회지

PURPOSE: To investigate the anatomic and histologic changes of testis as a result of long-term estrogen exposure on male MATERIALS AND METHODS: Fourteen testes were harvested from 14 consecutive male-to-female transsexuals who had sex reassignment operation in Dong-A University Hospital from March 1991 to March 1997. Age at inception of estrogen therapy was 16 years to 24 years. The duration of estrogen therapy was 2-12 years (mean 7.4 years). The dose and method of estrogen treatment regimen was variable, but about 20 mg (intravenous) monthly during first year. Sperm analysis, volume of testis and histologic change of testis were compared to the duration of estrogen therapy. RESULTS: The mean volume of semen was 1.8 ml(0.5~3 ml), and oligozoospermia, azoospermia or asthenospermia were observed in 12 cases (85.7%) by means of sperm analysis. The mean volume of testis was 17.3 ml(15~23ml). In light microscopic examination of the testis, near-normal histologic finding was noted in 3 cases(21.4%), spermatocytic arrest in 8 cases(57.2%) and geminal cell aplasia in 3 cases (21.4%). CONCLUSION: As the duration of estrogen therapy was longer, there was a tendency that volume of semen, sperm count and motility were reduced and the histologic change of seminiferous tubules was severe. It was considered that the negative feedback of estrogen on hypothalamic-pituitary-gonadal axis, the down regulation of estrogen receptors and the direct effect of estrogen might produce the adverse effect on male reproductive system by testicular change with maturation arrest, germ cell aplasia, end-stage testis and peritubular fibrosis and reduced fertility after long-term estrogen exposure.

The Effect of Treatment of Erectile Dysfunction with Electrical Stimulation / 대한남성과학회지

PURPOSE: In recent year, erectile dysfunction patients are increasing, and some of them want to increase their erectile function without using medication or surgical methods, In this study we attempted to find the value of electrical stimulation with electrical stimulation machine Hi-DREAM 328(TM) made in Korea as a treatment method of no definite underling disease caused erectile dysfunction patients. MATERIALS AND METHODS: In 22 cases erectile dysfunction patients we treated them two times per week for 4 weeks totally 8 times above mentioned machine, each session was spent for 1 hour 48 minutes. We checked IIEF-5 (International Index of Erectile Function-5) score repeatedly for comparing the change of IIEF-5 score pretreatment, 1 month after treatment and 3 month after treatment. And we compared the effect of treatment as comparing the IIEF-5 score changing each time. RESULTS: Total IIEF-5 score of pretreatment was 9.6+/-5.5, 1 month and 3 month after electrical stimulation were 17.9+/-2.9, 16.2+/-2.9, respectively. In the patients with venous leakage, IIEF-5 score was no increase definitely following electrical stimulation. But in the case of abnormal SPACE, pretreatment of IIEF-5 score was 12.1+/-5.2, 1 month and 3 month after electrical stimulation were 18.1+/-7.6, 16.5+/-7.4, respectively. We found that IIEF-5 score were increased in no definite organic caused erectile dysfunction patients, and there was significant correlation statistically (p<0.05) in erectile function, maintenance of erection, intercourse satisfaction, overall satisfaction. The remaining effect after treatment was decreased in time follow up. But the erectile function was preserved at comparing before treatment. CONCLUSIONS: We suggest that electrical stimulation is one of the treatment modalities in the treatment of no definite underling disease caused erectile dysfunction patients rather than vascular abnormalities as like venous leakage.

Intracavernosal Needle breakage developed during Self-injection of Vasoactive Agent : Two case reports / 대한남성과학회지

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.

Correlation between Genetic Polymorphism of CYP2D6 and CYP1A1 and Susceptibility of Renal Cell Carcinoma in Korean / 대한암학회지

PURPOSE: Many of the enzymes handling environmental factors are polymorphic and may confer variable susceptibility to renal cell carcinoma (RCC). Among those, the author studied genetic polymorphisms of CYP2D6 (B & T) and CYP1A1 in RCCs and controls in Korean. MATERIALS AND METHODS: Using 132 RCCs and 94 controls, first PCR products were obtained in 104 RCCs and 94 controls with CYP2D6, and 74 RCCs and 56 controls with CYP1A1. Res triction enzyme - BstN I/EcoN I for CYP2D6 (B & T), and NCo I for CYP1A1-digestion was followed to analyze constitutive DNA. RESULTS: In both RCCs and controls, no mutant allele of CYP2D6 (B & T) was detected and the susceptibility for occurrence of RCC was unable to evaluate. With CYP1A1 RFLP, homozy gous wild type (WW) was seen in 68 (52.3%; 37 RCCs, 31 controls), heterozygous mutant type (WM) in 54 (41.5%; 32 RCCs, 22 controls) and homozygous mutant type (MM) in 8 (6.2%; 5 RCCs, 3 controls). The odds ratios (95% CI) of RCC susceptibility for CYP1A1 genotype were 1.15 for WM and 1.36 for MM. Even though not significant statistically, higher tendency in MM presented. CONCLUSION: There is no association between susceptibility for the occurrence of RCC and genetic polymorphism of CYP2D6 (B & T) and CYP1A1.

The Results of Microscopic Vasovasostomies with Different Methods in the Vasectomized Patients / 대한비뇨기과학회지

PURPOSE: Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patient requiring vasectomy reversal. Recently, many authors have reported high success rates of vasovasostomy using microsurgical techniques. The purpose of this study was to compare patency and pregnancy rates and operation time of a new method for vasovasostomy developed at the Department of Urology, Dong-A University Hospital with those of other methods, and to find out other factors influencing patency and pregnancy rates. MATERIALS AND METHODS: Microscopic vasovasostomy was performed in 149 patients from June 1990 to September 1997 at our department. Among 89 patients who could be followed up post-operatively, standard two layer vasovasostomy was performed in 22 patients, modified one layer vasovasostomy with 4 full thickness sutures in 32 patients and modified one layer vasovasostomy with 5 full thickness sutures developed at our department in 35 patients. We compared mean operation times and patency and pregnancy rates between the techniques and examined patency and pregnancy rates according to age, vasal obstruction interval, presence of sperm in vas fluid and sperm granuloma. RESULTS: Success rates were 95.5% for patency and 68.2% for pregnancy in standard two layer vasovasostomy, 87.5% for patency and 59.42% for pregnancy in modified one layer vasovasostomy with 4 full thickness sutures and 97.1% for patency and 65.7% for pregnancy in modified one layer vasovasostomy with 5 full thickness sutures and there was statistical significance in the patency rates between each method (p0.05) and significantly lower in case of longer vasal obstruction interval (p<0.0005). CONCLUSIONS: We found little difference in success rates between standard double layer vasovasostomy and modified one layer vasovasostomy with 5 full thikness sutures and the latter was easier and more time saving technique.

Clinical Study of SS-cream in Patients with Primary Premature Ejaculation / 대한비뇨기과학회지

PURPOSE: To determine the clinical efficacy of SS-cream, the topical agent made from the extracts of natural products for treating premature ejaculation(PE), a double blind, randomized placebo controlled phase III study on the patients with primary PE was performed in three medical centers. MATERIALS AND METHODS: Mean age of patient with primary PE was 38.7+/-0.6 years and duration of suffer from PE was 15.8+/-0.4 years. We investigated the ejaculatory latency calculated by stop watch and sexual satisfaction rate after the treatment(1 placebo and 5 SS-cream 0.2gm). Patients were instructed to apply the cream on the glans penis 1 hour before sexual intercourse in double blind randomized fashion. Clinical efficacy was compared with the prolongation of ejaculatory latency and improvement of sexual satisfaction rate. RESULTS: 106 patients with primary premature ejaculation completed this study. Mean ejaculatory latency tested at screening period was 1.37+/-0.1 min and both of patient and partner were not satisfied with their sexual lives. The mean ejaculatory latency was significantly prolonged as 10.92+/-1.0 min with SS-cream, while 2.45+/-0.3 min with placebo. In 79.8%, there was prolongation of ejaculatory latency longer than 2 minutes with SS-cream, while in 15.1% with placebo. The sexual satisfaction rate was also significantly improved as 82.2% with SS-cream, while 12.6% with placebo. 103 (16.2%) out of 636 trials of SS-cream showed mild local irritation including 82 mild burning senses and 21 mild pain, which disappeared in less than 1 hour. No adverse effect on sexual function and partner and no systemic side effects were observed. CONCLUSIONS: With these results, SS-cream is effective and safe in the treatment PE with mild local side effect.

Treatment of Ejaculatory Disorder

No abstract available.

The Action Mechanism of Growth Hormone on Regeneration of Nitiric Oxide Synthase(NOS)-containing Nerves after Cavernous Neurotomy in the Rat / 대한비뇨기과학회지

PURPOSE: As growth hormone was reported to improve cavernosal nerve regeneration, we studied the action mechanism of growth hormone(GH) on the regeneration of nitric oxide synthase(NOS)-containing penile nerves after unilateral cavernous nerve neurotomy in rats. MATERIALS AND METHODS: Male rats were divided into three groups: sham operation(n=10); unilateral neurotomy of a 5mm segment of the cavernous nerve(n=10) and unilateral neurotomy with GH injection(n=10). Electrostimulation of the intact cavernous nerve was performed at 1 and 3 months after operation. Nicotinamide adenine dinucleotide phosphate(NADPH) diaphorase staining was used to identify nNOS in penile nerve fibers of the mid-shaft segment. The gene expression for nNOS, insulin like growth factor(IGF)-I and nerve growth factor(NGF) were investigated in corporal tissue by reverse transcriptase-polymerase chain reaction(RT-PCR) using specific oligonucleotide primers. RESULTS: Electrostimulation in the GH-treated group revealed a greater maximal intracavernosal pressure and a shorter latency period than in those given neurotomy alone at 3 months after operation. One month after unilateral neurotomy, both neurotomy alone and the GH-treated groups showed a significant decrease in NOS-containing nerve fibers in the dorsal and intracavernosal nerves on the side of neurotomy, however mRNA expression of nNOS and IGF-I showed a significant increase in GH-treated group. At 3 months, the number of NOS-containing nerve fibers in the neurotomy alone group did not increase while the GH-treated group showed a significant increase. CONCLUSIONS: These results show that GH significantly enhances the regeneration of NOS-containing fibers in the dorsal and intracavernosal nerves after unilateral cavernous nerve injury via IGF-I.

Estimation of Prostatic Cancer Prevalence in Korea: An Epidemiological Survey in Kangseo-Gu, Pusan / 대한비뇨기과학회지

PURPOSE: The prostate cancer is one of the most prevalent disease in the Western world. Recently, with the increase of old-aged population and the westernized diet, prostate cancer patients have increased in Korea. We have studied the prevalence of prostate cancer in Kangseo-Gu, Pusan. MATERIAL AND METHODS: From September to November 1996, a representative sample of 433 volunteers were chosen randomly and were monitored. Of these, 393 participants were older than 50 years and were not within the urological practice. Screening programs used here are international prostatic symptom score(1-PSS), digital rectal examination(DRE) and serum prostate specific antigen(PSA) with an immunoenzymatic assay(Tandem-E). The transrectal ultrasonography(TRUS) is reserved for the cases with an abnormal finding on the rectal examination or the elevated PSA value. Transrectal biopsy of prostate was recommended in the cases of PSA greater than 4ng/ml, suspicious nodules on DRE or TRUS, or when more than two of these findings were discovered. RESULTS: The detection rates and the positive predictive values for the DRE were 1.02% and 7.7%, TRUS were 1.27% and 15.2%, and PSA were 1.02% and 16.7% respectively. When the TRUS and PSA tests were combined, the positive predictive value was increased to 33.3% and when all three tests were combined, the predictive value increased further to 57.1%. However, the detection rate did not change with combinations of these tests. When the PSA cut-off value was increased from 4.0ng/ml to 10.0ng/ml, the positive predictive value increased from 11.1% to 33.3%. CONCLUSIONS: From the above examinations, 5 of the 393 samples had prostate cancer, yielding detection rate of 1.27%. The results of our community-based study suggest that there are about 4,5000 people suffering from the prostate cancer, with the prevalence of 1.27%. This value of prevalence of prostate cancer in Korean population is much lower than the western world.