Testicular Volume of Korean Young Adult Men as Measured by Ultrasonography: Relationship with Body Mass Index

PURPOSE: Testicular volume is one of the important indices that represent the reproductive ability of adult males. In previous studies, however, testicular volume was measured by manual palpation or orchidometer, resulting in inaccuracy or subjectivity. Accordingly, the need for accurate data on the size of the testes is increasing, and we conducted testicular volume measurements by using scrotal ultrasonography. We investigated the relationship between testicular volume and body weight, height, and body mass index (BMI). MATERIALS AND METHODS: The testicular volumes of 1,002 young adult Korean men were measured for length, width, and thickness with ultrasonography, and data on BMI were collected conventionally. The correlation between testicular volume and BMI was analyzed with one-way ANOVA and Student's t-test. RESULTS: The mean age of the young men was 23.02+/-2.53 years. The mean testicular volume was 18.09+/-3.79 cc on the left and 18.26+/-3.21 cc on the right. Testicular volume was directly proportional to body weight, height, and body mass index. CONCLUSIONS: The testicular volume of Korean young adult men was about 18.17 cc. Testicular volume has a weak direct correlation with body weight, height, and body mass index.

Study of Prostate of Korean Young Adult Using Transrectal Ultrasonography / 대한비뇨기과학회지

PURPOSE: The prostate of the young adult is not a subject which has received much attention, and the vast majority of prostate studies have placed their emphasis predominantly on elderly patients. It seems, then, that an investigation of the prostate in younger patients is warranted, and perhaps long past due. Thus, we attempted to determine the mean prostate volume in Koreans in their 20's. We also reported on the relationships between prostate size and body mass index, as well as body surface area, and compared the prostates of normal Korean youths with those of chronic prostatitis patients. MATERIALS AND METHODS: Between March 2002 and February 2008, we chronicled 583 cases of transrectal ultrasonography(control group: 271, chronic prostatitis group: 314) and calculated prostate volumes via the biplane method. 178 of the cases in the chronic prostatitis group were again examined after treatment. In all of the cases, body mass index and body surface area were assessed. RESULTS: The mean age of the patient was 22.83+/-2.46 years. The mean prostate volume of the 583 young adults was 15.58+/-3.11ml(control group: 15.61+/-3.16ml, chronic prostatitis group: 15.56+/-3.07ml). We ensured that there were no differences between the normal group and the chronic prostatitis group. The prostate volumes of the chronic prostatitis patients made no odds with the treated prostates. Additionally, prostate volume was directly proportional to the body mass index and the body surface area. CONCLUSIONS: The prostate volume of young Korean adults in their 20's was approximately 15.6ml. The development of chronic prostatitis in young men had no appreciable effect on prostate size, but was shown to induce a variety of histologic changes in the prostate, and these changes were similar to those observed in older patients.

Gonadotropin Releasing Hormone (GnRH) and GnRH Receptor in Normal Bladder Epithelia and Their Role in Bladder Epithelial Proliferation / 대한비뇨기과학회지

PURPOSE: To confirm the production of extra-hypothalamic gonadotropin releasing hormone (GnRH) and GnRH receptor in bladder mucosal epithelia, and a potential role of GnRH on the bladder, normal human bladder tissues, and primary cultured dog bladder mucosal epithelia were studied. MATERIALS AND METHODS: For this study, normal human bladder tissue from 4 patients and primary cultured normal bladder mucosal epithelial cells from 2 dogs were used. For localization of extra-hypothalamic GnRH and the extra-pituitary GnRH receptor, in situ hybridization and immunohistochemical staining were done. To evaluate the roles of exogenous GnRH in bladder mucosal cells, the culture media were supplemented with charcoal stripped serum and 4 different concentrations of GnRH (0, 10(-3), 10(-5) and 10(-7)M). The effect of exogenous GnRH was evaluated using a hemocytometer and fluorescence activated cell sorter (FACS). RESULTS: GnRH and GnRH receptors, and their mRNA signals were localized in most of the both human bladder mucosal epithelia and dog bladder mucosal epithelia, but not in a few cells. There were no significant GnRH effects on cellular proliferation and cell cycle changes (p<0.05). CONCLISIONS: Bladder mucosal epithelium produces GnRH and GnRH receptors, but they do not effect either the proliferation or cell cycle changes. Although the exact function of extra-hypothalamic bladder GnRH is unknown, GnRH and GnRH receptors would be assumed to have unknown autocrine or paracrine relationships with each other.

Effect of Deuterium Oxide on Urological Cancer Cells / 대한비뇨기과학회지

PURPOSE: To evaluate the antiproliferative activity of deuterium oxide (D2O) on urological cancer cells for the application of D2O in the treatment of urological cancer. MATERIALS AND METHODS: Urological cancer cell A-498 (kidney), T-24 (bladder) and DU 145 (prostate) were used in this study. The changes in cellular proliferation and the expressions of the bcl-2 and bax genes, according to changes in the D2O concentrationand exposure time were measured. The changes in cellular proliferation were measured using a hemocytometer and the MTT assay, and the changes in gene expression by Western hybridization. RESULTS: D2O had antiproliferative effects, DU-145 was most resistant and T-24 was most sensitive to D2O. The proliferation of cells in T-24, as measured by the MTT assay, showed a reduced growth rate, which was the inverse of the increased D2O concentration and exposure time. The expression of bcl-2 was reduced with increasing exposure time and D2O concentration, and that of bax was increased with increasing exposure time and D2O concentration. CONCLUSIONS: From this study, the authors believe D2O has antiproliferative effects on urological cancers, and the effect on bladder cancer cells suggests that D2O shows potential as an agent for the treatment of early small bladder cancer or the prevention of superficial bladder cancer recurrence following transurethral resection.

Down-regulation of Dopamine D1 Receptor in Rat Penile Tissue after Cavernous Neurotomy / 대한비뇨기과학회지

PURPOSE: Dopamine plays a critical role in promoting sexual drive and penile erection through dopamine receptors. This study was performed to investigate whether the cavernousal nerve controls the expression of peripheral dopamine D1 receptors in rat penile tissues after cavernousal nerve injury. MATERIALS AND METHODS: Male rats (n=20) were divided into two groups: a control group consisting of sham-operated rats (n=10) and an experimental group consisting of rats that underwent incision of the bilateral cavernous nerve (n=10). Three months later, the intracavernous pressure response was monitored using an intracavernous papaverine injection of 300 microgram. The expression of dopamine D1 receptor mRNA were studied using an RT-PCR method, and dopamine D1 receptor protein expression by Western blot analysis and immuno-histochemical staining in each group. The expressed band density of the RT-PCR and Western blot were measured by a densitometer. RESULTS: Erectile functions, as studied by intracavernosal papaverine injection at three months, were similar in both groups. The dopamine D1 receptor mRNA and protein expressions were significantly lower in the neurotomy group. The immuno-histochemical staining also showed a reduction in the dopamine D1 receptor expression in the neurotomy group compared with the control group. CONCLUSIONS: Our results show that dopamine D1 receptors in penile tissues were down-regulated following cavernousal nerve injury. These findings suggest that cavernousal nerve injury affects directly the reduction of dopamine D1 receptor expression, and that the action of dopamine on the cavernousal dopamine receptor will be affected in cavernousal nerve injured rats.

Study for the Ureteral Reconstruction with Tissue Engineering Using Poly (glycolide/epsilon-caprolactone) Scaffold-1 / 대한비뇨기과학회지

PURPOSE: Transplantation is one modality saving human life. But not only lack of the living or cadaveric human organs but also immunologic problems or some ethical situations limit transplantation in terminal stage patients. Recent research for escaping from those problems resulted in the reconstruction of the artificial organ using patients' own cells with tissue engineering. The goal of this study is, for the better reconstruction of urinary system using tissue engineering, to perform basic researches on techniques related with seeding and viability of cells. MATERIALS AND METHODS: We used 16 adult dogs, 4 female and 12 male, for primary culture of the dog bladder mucosal cell and muscle cell. The scaffold we used was made of absorbable substance polyglycolide/epsilon-caprolactone (GL/CL) in thin sponge like shape. Fibroblast 3T3 cell was used for control and 16 primary cultured mucosal cell and smooth muscle cells were used. For dynamic culture, rocker was adapted with for 5 hours. Attached cells were evaluated by 562nm ELISA reader using BCA method and scanning electron microscope. RESULTS: Successful primary culture was achieved with cells from dog bladder, and results were much better by using male dog. The dynamic culture increased attachment of the cell in scaffold and the cell attached at deeper portion of the scaffold. Long term culture showed formation of the cellular sheets on the surface of scaffold preventing inner passage of the suggesting disadvantageous condition for cells in core of the scaffold. CONCLUSIONS: We conclude that for the better attachment of the cultured cells on scaffolds, dynamic culture would be desirable. And for the better in vivo reconstruction of the organ with primary cultured cell attached scaffold, evaluation of culture state with repeated in vitro experiments are necessary.

Detection of the Gonadotropin Releasing Hormone (GnRH) and Its Receptor in Cancer Cell HT-1197 and HT-1376, and Effect of GnRH on Cancer Cell Cycle / 대한비뇨기과학회지

Gonadotropin releasing hormone (GnRH) is believed to be pivotal hormone in hypothalamo-pituitary gonadal axis and the hypothalamus is believed as the exclusive organ producing GnRH and pituitary is for GnRH re ceptor until recently. Some reported the exptra-hypothalamic GnRH or extra-pituitary GnRH receptors from decades ago. The aims of this study are to confirm the existence of the GnRH receptor in bladder epithelial cancer cell, HT-1197 and HT-1376, and evaluated the possible role of the GnRH on cell cycle. The GnRH and GnRH receptor were detected by immunohistochemical staining and the effect of GnRH on cell cycle change in both cell line were studied by fluorescence activated cell sorter (FACS). The control cells were cultured at media supplemented with normal serum, and experimental group were cultured at media supplemented with charcoal stripped serum (CSS) which excluding peptide hormones except exogenous GnRH with different concentration. The GnRHs and GnRH receptors were detected at both cell lines and the cell cycle analysis showed that there were little difference in proportion of cell cycle among examined 10,000 cells in both cell lines, neither control nor experimental groups. This study shows that the GnRHs and GnRH receptors exist in bladder cancer cells and GnRH did not influence on the cell cycle progression. With this study, we suppose that the bladder cancer cells produce the GnRH and GnRH receptors and the role of the GnRF produced from the bladder cancer cells might be the autocrine rather than endo-or paracrine factor.

The Changes of the Sensory Perception Threshold to the Vibratory and Electrical Current Stimuli of the External Genitalia according to Age / 대한비뇨기과학회지

PURPOSE: Although the aging process does not mean a morbid state, it is reported that the incidence of male erectile dysfunction is higher in the aged than in the young. One of important causes seems to be the functional changes of hormonal, vascular and nervous system. In addition the functional change of the sensory perception of penis can be another major cause of the erectile dysfunction in the aged male. We investigated the changes of the penile sensory perception function in the aged male. MATERIALS AND METHODS: We selected 90 men from age 20 to 76(average 43.6+/-17.0) who had no neuronal defect in past medical history and physical examination and measured the sensory perception threshold after giving the stimuli of vibration using the Biothesiometer and the stimuli of 5Hz, 250Hz, 2000Hz electrical currents using the Neurometer to the penile glans, penile shaft, scrotum, thigh and the index finger. RESULTS: All sensory perception thresholds of electrical stimuli in penile glans and penile shaft had no significant correlation with age(p>0.05). On the other hand, the sensory perception threshold of vibratory stimuli had a significant correlation with age in all of scrotum(r=0.59, p=0.0001), penile glans(r=0.58, p=0.0001), penile shaft(r=0.54, p=0.0001), thigh(r=0.43, p=0.0002) and index finger(r=0.38, p=0.0015), in which the stimuli threshold increased in proportion to age. The vibratory stimuli threshold had a higher significant correlation with age in penis, scrotum, penile glans than in thigh and index finger. CONCLUSIONS: The sensory perception threshold of vibratory stimuli elevated significant in the penile glans, penile shaft and scrotum. However, the sensory perception threshold of electrical stimuli showed no increase by the age. It is supposed that increased vibratory threshold of penile glans, shaft and scrotum may contribute to the pathophysiology of erectile dysfunction in aging male.

The Change of Telomerase Activity in the Developmental Stages of the Rat Urinary System / 대한비뇨기과학회지

PURPOSE: Telomeres define the natural ends of linear chromosomes and their sequence organization is highly conserved in the majority of eukaryotes. Telomerase is a ribonucleoprotein involved in maintaining telomere length in stem cells and immortal and actively dividing cells. If there lacks telomerase in cell, length of telomere will be shortened, and results in cell death. We investigated the changes of telomerase activity in the developmental stages of rat urinary system. MATERIALS AND METHODS: Organs(kidney, ureter and bladder) were aseptically removed from Sprague-Dawley rats of fetal(17-day-gestation), growing(1, 2, 3, 4, and 6-week-old) and adult period(12-week-old). Samples for telomerase activity were frozen on liquid nitrogen immediately after sacrifice, and stored until the use at -750C for measurement of telomerase activity. Telomerase activity was measured by a PCR-based telomeric repeat amplification protocol(TRAP) assay. Telomerase activity was quantitated with a phosphoimager(GS525 Molecular Imager System, Bio-Rad Laboratories, Hercules, California, USA). RESULTS: Telomerase activities in the kidney were highly expressed at the fetal period, however they were significantly decreased since 1week after birth and maintained weakly until adult period. Telomerase activities of the bladder and ureter showed active expression throughtout whole life. When comparing the telomerase activities of the ureter and bladder to those of the kidney, the ureter and bladder showed higher acitivities than the kidney throughtout whole life except fetal period. CONCLUSIONS: There may be a developmental and tissue-specific regulation of telomerase in the urinary system of rat and an active mechanism for maintaining telomeres in the ureter and bladder after birth.

The Distribution and Concentration of Ofloxacin Contained in Sustained Releasing Microsphere after Intraprostatic Injection / 대한비뇨기과학회지

PURPOSE: Sporadic excellent treatment results of intra-prostatic antibiotic injections against resistant chronic prostatitis were reported without sufficient background. So, for the scientific base of this effective treatment modality, we studied the tissue distribution and concentration of the ofloxacin after intraprostatic injection of formula which is designed for sustained release ofloxacin at least for four weeks. MATERIAL AND METHODS: 28 male dogs aged over 2 and ofloxacin designed to release over four weeks were used. The ofloxacin 12mg and poly(D,L-lactic) acid 28mg were prepared for sustained releasing formula and resolved in 1ml of 1.5% sodium carboxymethyl cellulose solution. Dogs were grouped into two, 8 control and 16 experiments for open injection. For control, oral ofloxacin 100mg was given twice a day for two and four weeks and for experimental groups, the new formula were injected at right lobe of prostate directly. The ofloxacin concentration was measured by high performance liquid chromatography(HPLC). RESULTS: Oral ofloxacin 2,800(2 weeks) and 5,600(4 weeks) were given for control and tissue concentration of ofloxacin were relatively even at all partitions of the prostate, 7.4+/-1.4(2 weeks) and 9.2+/-1.3mg/ml(4 weeks) and the blood level were 3.6-5.1mg/ml. In experimental groups, the only 12mg of ofloxacin was given and tissue concentration were 10.5+/-3.0(1 weeks), 13.8+/-4.5(2 weeks), 7.1+/-0.9(3 weeks) and 7.7+/-3.0mg/ml(4 weeks) in rights and 8.0+/-1.1(1 weeks), 10.2+/-4.2(2 weeks), 5.1+/-1.4(3 weeks) and 7.6+/-0.8(4 weeks)mg/ml in left lobes suggesting communication of blood between two lobes, and blood concentration were 0.16-0.59mg/ml. In histologic examination, the formula were localized between stroma and their size were reduced with time. CONCLUSIONS: Authors conclude that there are free communication of blood between two lobes of prostate and one direct injection of this sustained releasing formula ofloxacin into prostate can be a substitute with local effects without disturbing prostatic tissue level which reducing number or medication in future.

Changes of the p57 and bcl-2 mRNA Expression in Human and Rat Prostates after Castration or 5alpha-reductase Inhibitor Administration / 대한비뇨기과학회지

PURPOSE: The voiding difficulty in aged people is usually caused by prostate tumor and these tumors are influenced by the androgen. The purpose of this research was to study the prostatic genetic change caused by changes of hormonal mileu and evaluate the pattern of the changes of p57 and bcl-2 mRNA in human and rat prostate at different biological condition. MATERIALS AND METHODS: This study was performed in two ways, with animal model and human prostate. As animal model, the rats were castrated surgically or chemically(5-alpha reductase inhibitor) and their prostates were collected according to the schedule. Pattern of expression changes in p57 and bcl-2 mRNA was observed. In human prostate, three normal prostates from young 30th, five benign hyperplastic prostates and five cancerous prostates were collected for evaluation of p57 mRNA expression. The evaluation of the expression of those genes was done by in situ hybridization. RESULTS: The expression of the p57 mRNA was observed at the cytoplasm in all three types of the prostate tissues. The expressions of mRNA message were increased from the post-orchiectomy three days group up to postorchiectomy two weeks. After two weeks, there were little change in expression of the p57 mRNA. Compared with normal prostate group, the expressions of p57 mRNA were reduced in BPH and prostate cancer groups without treatment. The expression of bcl-2 was increased in expression upto postorchiectomy 4th week and reduced. In BPH and prostate cancer, the expression of the bcl-2 mRNA was increased in comparison with normal prostate. CONCLUSIONS: With above experiment, the expression patterns of p57 and bcl-2 mRNAs reversed and the prostate cancer showed reduced expression. This result suggests that p57 and bcl-2 may play important roles in differentiation of BPH and prostatic cancer. The differentiation of BPH and prostate cancer by p57 and bcl-2 were impossible.

Detection of the Expression of GnRH and GnRH Receptor mRNAs and Effect of GnRH on Prostate Cancer Cell Proliferation / 대한비뇨기과학회지

Prostatic cancer is the typical hormone dependant cancer and several kinds of hormones are used for the treatment of prostate cancer. Since Harris had proposed the hypothalamo-pituitary gonadal axis, the hypothalamus is believed the exclusive organ producing GnRH. According to the recent researches, several organs were proved to be the extrahypothalamic GnRH sources in human and animal. In this research, the expression of the GnRH and GnRH receptor mRNA, detection of the GnRH which prostate cancer cell produced and effect of the GnRH on the prostate cancer cell proliferation using three human prostate cancer cell lines, ALVA 41, ALVA 101 and DU-145 were studied. In Situ Hybridization method was used for the detection of the expression of the GnRH and GnRH receptor mRNA. The charcoal stripped serum and high performance liquid chromatography were used for the detection of the GnRH produced from prostate cancer cells. Thymidine incorporation assay was used for the evaluation of the effect of the GnRH on the prostate cancer cell proliferation. The GnRH mRNA were detected in 96.7% of ALVA 41, 91.5% of ALVA 101 and 95.3% of DU-145 and GnRH receptor mRNA expression signals were detected in almost all of the examined prostate cancer cells, more than 95%, in three cell lines. The number of signals of the GnRH receptor mRNA were more than GnRH mRNA. The GnRH produced from the rostate cancer cell was detected at culture medium with retention time 19.40 minutes. The cancer cells cultured with peptide hormone deficient medium using charcoal stripped serum showed more than 20% growth retardation to the cancer cells grown at the medium used normal serum. The treatment of the GnRH on the cancer cells growing at the peptide hormone deficient medium showed statistically insignificant dose dependant growth retardation. The RESULTS of our research showed that the human prostate cancer cells, including two hormone refractory prostate cancer cell lines, produce the GnRH and the GnRH receptor in the same cell which could be suggest that the role of GnRH produced from the prostate cancer cell would be autocrine action. And the prostate cancer cell growth was down regulated by unknown complex of various peptide hormones and the GnRH does not has the significant effect on the proliferations of the prostate cancer cells. With those RESULTS we obtained in this research and other's data, it seems that there is a system that contains production of GnRH and GnRH receptor and metabolic mechinary within prostate cancer cell. And there should be the some changes in the hypothalamo-pituitary gonadal axis and the mechanism using GnRH analogues for the treatment of prostate cancer aside from central mechanism.

Factors Affecting on the Invasiveness of the Prostate Cancer Cell on In Vitro Model of Basement Membrane / 대한비뇨기과학회지

This study was aimed to examine whether biological characteristics of the cancer cell lines have any correlation with distinctive movement of the reconstituted basement membrane in modified Boyden chamber. The in vitro model consists of a chamber and basement membrane filter. Matrigel was applied on the upper surface of the filter and type IV collagen, fibronectin and laminin were also applied to the lower surface of the filter, respectively. The cancer invasiveness was measured by the number of the moved cells through basement membrane differing in component, thickness and incubation time. For chemoattractant study, serum free medium, medium supplemented with 10% fetal bovine serum and medium supplemented with 10% fetal bovine serum and 0.1% bovine serum albumin were used. The invaded cancer cells were counted under high-power field microscope and the morphologic feature of invading cancer cells on reconstituted basement membrane was examined with scanning electron microscopy. The effects of the tissue inhibitor of metalloproteinase-2 (TIMP-2) and wild type tumor necrosis factor-alpha (wTNF-a) on invasiveness of three prostate cancer cell lines (hormone intermediate sensitive ALVA 101, and hormone refractory ALVA 41 and PPC-1) were investigated. The rate of movement of the cancer was reduced increasing thickness of the matrigel but increased in proportion to the incubation time (p0.05). TIMP-2 reduced the invasiveness of three kinds of cancer cell line at both the high and low concentration, indicating that this agent interferes the movement of the cells. Furthermore, this result suggests that TIMP-2 might repress metal-dependent enzymes, which are thought to elicit the invasiveness of the cancer cells. The wTNF-a did not show any effects on the invasiveness of three cell lines. The additive chemoattractant effect of 0.1% bovine serum albumin was not observed and serum free medium also did not induce the cancer cell invasion across the reconstituted basement membrane. The migration of the ALVA 41 and PPC-1 were more than the ALVA 101. The scanning electron microscopic examination showed the figures of migration of cancer cells through the pores on filter, supporting our experiments are performed in validness. The effect of protease inhibitor was distinct in different cancer cell lines studied. From this experiment, we conclude that the rate of movement of both ALVA 41 and PPC-1 cells with shorter doubling time and the hormone refractory was faster than that of ALVA 101 cells with longer doubling time and the hormone sensitive, suggesting biological characteristics of the cells are implicated in degree of cancer cell invasiveness and their malignancies.

Urethral Ultrasonographic Evaluation of the Urethral and Periurethral Tumor / 대한비뇨기과학회지

Tumors of the urethra and periurethra are rare lesions accounting for less than 1% of tumors arising from the genitourinary tract. Routine examinations of the urethra are X-ray study and endoscopic examination. X-ray and endoscopic examination have the risk of radiation exposure to the reproductive organs or pain at study and they have the limitation on outlining the periurethral environments. In the last few years, diagnosis of disease by ultrasound has made tremendous advances. Many investigations of ultrasound examinations on the male and female lower urinary tract using transrectal, transvaginal and transpubic approaches have been reported. But there has been no report of the ultrasound examination on the urethra and periurethral tumor. We report our experiences with sonourethrography of 6 cases of urethral and periurethral solid tumors. And we concluded that sonourethrography is less expensive, non-invasive and can accurately image the outline of the urethra and periurethral tumor.

Correlation between Age, Prostatic Volume and Voiding Symptoms in Randomly Selected Korean over Age 60 / 대한비뇨기과학회지

Until now, we do not have specific Korean data on the age related prostatic volume and voiding symptoms associated with prostatic volume among randomized aged population. Due to this problem, we studied the correlations on the age, prostatic volume and voiding symptom among random sampled 255 people over the age 60 from the 11 Myun in Chinyang Gun, Kyungsangnam-do from the July 12th to July 26th, 1993. The mean age of the examined people was 71.5 years. 244 people answered on questionaire for voiding symptom scoring and 224 people agreed on the transrectal ultrasonic measurement of the prostatic volume. The prolate spheroid method and elliptical method were used for the measurement of the prostatic volume with the major transverse diameter, major anteroposterior diameter and cephalocaudal diameter of each prostates as Terris. The volume of the prostate ranged from 6.2cc to 54.5cc ( Prolate spheroid method ) and 4.7cc to 44.1cc(Elliptical method ). The prostate volumes measured by the elliptical method were smaller than that measured by prolate spheroid method in each age group. The average prostatic volume measured by the elliptical volume and prolate spheroid method were 17.7/22.5cc(E/P) in age 61 to 65 group(n=17), 19.9/22.8cc in age 66 to 70 group(n= 88), 21.6/ 26.0cc in age 71 to 75 group(n=71), 24.4/27.7cc in age 76 to 80 group(n=34) and 18.1/23.7cc in age over 80 group(n =14) and the pattern of the changes in the prostatic volume related with aging was significant(p 0.05).

Clinical significance of prostatic intraepithelial neoplasia / 대한비뇨기과학회지

To evaluate the clinical significance of the prostatic intraepithelial neoplasia (PIN) in prostatic tumors, we reviewed the clinical data of digital rectal examination (DRE), transrectal ultrasonography (TRUS) prostate specific antigen (PSA) and PIN from the patients of 50 benign prostatic hyperplasia (BPH) and 100 prostate cancers who were pathologically confirmed. The prostate nodules were palpated at DRE in 53% of prostate cancers. The 59% of the prostate cancer patients showed hypoechoic areas on TRUS and they were diagnosed with ultrasound guided directed prostate biopsy. Remaining 41% of the cancers were diagnosed at the directed or random biopsy or the hyperechoic or isoechoic area. Hypoechoic areas were detected from the 12 BPH patients and the PIN were detected at 7 of them at directed biopsies. The level of serum prostate specific antigen (PSA) less than 4ng/ml were 82% of BPH and 57% of prostate cancer. The major PIN grade in BPH patients were 62% for grade 1, 22% for grade 2 and 16% for grade 3 and in the prostate cancer, 9% for grade 1, 27% for grade 2 and 64% for grade 3. The distribution of PIN were even throughout the prostate in BPH but 17% of the prostate cancer showed PINs exclusively at peripheral zone. The remaining cancer patients were multifocal and 52% of total prostate cancers showed more than two thirds of the total PINs were located at peripheral zone. Among the 8 BPH patients who had the PIN grade 3, 3 were diagnosed as the prostate cancer at follow up. We assume that the nodules palpated at DRE and the hypoechoic areas TRUS are highly specific for the prostate cancer but the serum PSA values of 4ng/ml as the upper normal limit is not significantly reliable for the study for high risk group and early detection of prostate cancer. The combined application of DRE, TRUS, PSA and biopsy, including directed and random, would improve the results of prostate cancer diagnosis than single application. And the BPH patients with grade 3 PIN should be regarded as the high risk group for prostate cancer development and should be followed regularly.

Early experience of prostatic balloon catheter and urological spiral for benign prostatic hyperplasia / 대한비뇨기과학회지

Between January 1989 and July 1990, nonsurgical managements were tried in 9 patients with benign prostatic hyperplasia who were with a high surgical risk or didn`t want an operation. The prostatic balloon catheters were used in 3 patients and the urological spirals in 6 patients. They were followed with clinical evaluations, urine cultures and urine flow rates at 2 and 6 weeks. All procedures were done under the local anesthesia, except one spinal anesthesia. In the prostatic balloon catheter group, all three patients had recurrent voiding symptoms at 2, 3 and 9 months after prostatic balloon dilatation, respectively. In the urological spiral group, one procedure failed due to upward migration of the spiral into the bladder. In the remaining 5 patients, it has worked well up to 11 months after the procedure. Despite of some improvements in subjective voiding symptoms after procedure, there was no significant difference between before and after the procedure in maximum flow rate and total voided volume. Our results suggest that this modality, especially the urological spiral, can be a useful alternative to an operation in selected patients with an increased surgical risk.

The study on the histopathologic changes in chorioallantoic membrane of the fertilized chicken eggs where the MBT-2 mice bladder cancer and the human bladder cancer tissue were implanted and chemosensitivity test for anticancert drugs / 대한비뇨기과학회지

The MBT-2 mice bladder cancer tissues and the human bladder cancer tissues were implanted on the chorioallantoic membrance(CAM) of the immune deficient fertilized chicken eggs and the histopathologic changes of the CAM and gross morphologic changes of the implanted cancer tissues on CAM ere studied. The chemosensitivity tests using chicken CAM were performed for the 4 human bladder cancer tissues to mitomycin C, thiotepa and adriamycin. With this study, the following results were obtained: 1. The observation of the blood vessel on the chorioallantoic membrane was possible from the post-incubation 6th day group, but for the implantation of the cancer tissues, the blood vessels from the post-incubation 8th day group was appropriate. 2. The budding oif the host capillary vessel to the implanted cancer tissue were observed from the post-implantation second day. 3. The size of the post-implantation 7th day cancer tissues were varied from 2.3 to 9.2 folds to the size of the implantation day. 4. The total failure rate in experiment within post-operative 3rd day were 71.3 percent and the total failure rates in group who had the damage on the chorioallantoic membrance during operation was 82.5 percent. The failure rate of the experiment was declined acutely after post-operative 4th day. 5. The salvage of the eggs could be maintained until post-operative 7th day in 28.1 percent among chemosensitivity test group. 6. The 4 bladder cencer tissues which had the chemosensitivity test showed 1.6 to 7.1 fold growth to the inital implanted size and this meant resistance to the test drugs and these results were corresponded with clinical course.

Study on the Histopathological Changes of the Subrenal Capsular Implantation of the Human Urologic Cancers / 대한비뇨기과학회지

The selection of the chemotherapeutic agents for the treatment of the urologic malignancy was one of the difficult problem in urologic practice. After the development of the in vivo sensitivity test using subrenal capsular implantation of the cancer tissue, a lot of the application of this assay were performed in various field of the advanced malignancies. We examined the histopathological changes of the implanted urologic cancer tissues under the renal capsule of the mice. The specimens, implanted under the renal capsule, were 14 cases of the bladder cancer, 2 cases of the renal cell carcinoma and one case of the prostatic carcinoma. In experiment, we used 472 immunocompetent normal mice and divide them into two groups, non-immunosuppressed normal mice and immunosuppressed group with intravenous infusion of the cyclophosphamide 200mg/kg 24 hours prior to assay. As the control group, we used athymic nude mice for human urologic cancer and C3H/He strain for MBT-2 bladder cancer. The results we found were as follow ; 1. The growth of the implanted cancer tissues was noticed in 270 mice among 291 which were sacrificed until the 6th postoperative day and the take rate was 92.8%. 2. The growth of the implanted cancer tissues was continuous until the 6th postoperative day progressively but reduced thereafter in immunocompetent group. But in immunosuppressed group, it showed progressive growth of the implanted tissue until the 8th postoperative day. The growth of the control group was similar to the immunosuppressed group, until the 6th postoperative day. 3. Calculation of the proportion of the host cellular infiltration in total dimension of the grafted tissue was done and in immunocompetent group, the 4th postoperative day group was 27.3%, the 6th postoperative group was 89.4% and the 8th postoperative group was 100%. But in contrast in immunosuppressed group, at the 4th postoperative day group was less than 10%, the 6th postoperative day was 29.4% and at the 8th postoperative day group was 91.7%. With above histopathological study, we conclude that the most easy and reasonable subrenal capsular assay(SRCA) in the in vivo chemosensitivity test for the selection of the anticancer chemotherapeutic agent for the treatment of the malignancy is the test performed under the immunosuppressed state with cyclophosphamide, 24 hours prior to SRCA, and the results is the most proper at the examination at postoperative 6th day after implantation.

The Study on the Ultrasonographic Urethrogram of the Urethral Stricture / 대한비뇨기과학회지

The study of the ultrasonographic urethrogram on the male urethral stricture in 9 patients were performed. We could get the excellent three dimensional figures, which were demonstrating the nature of the urethral strictures in compared to the retrograde urethrogram. The ultrasonographic urethrography was useful in the diagnosis of the anterior urethral stricture, especially, but the delineation of the posterior urethra was difficult.