Technical Refinement of 99mTc-RBC Scrotal Scan for Evaluating Varicocele / 대한남성과학회지

PURPOSE: The association of varicoceles and subfertility has been well documented. Although varicoceles remain the most common surgically correctable cause of male infertility the subjective diagnosis of varicocele, especially the small ones remains a challenge. MATERIALS AND METHODS: We evaluated 40 young men (16 volunteers, 24 varicocele patients) with scrotal blood pool scan using 99mTc RBC. RESULTS: Complete correlation between physical findings and the scrotal scan was found. The postoperative scans of 12 patients with surgically corrected high grade varicoceles demonstrated symmetrical photon accumulation in the scrotum. The technique which most accurately correlated the clinical grade was the varicocele index using total count at Valsalva maneuver. CONCLUSIONS: We believe that the 99mTc RBC scrotal scan with technical refinement is a useful procedure in the objective diagnosis and followup of varicoceles.

Intratumoral Injection of 166Holmium-chitosan Complex to SmallRenal Cell Carcinoma: Preliminary Results / 대한비뇨기과학회지

No abstract available.

Is There a Decrease in Semen Parameters among Korean Men? / 대한남성과학회지

A study was conducted in three large populations to determine whether sperm quality has changed in Korea between January 1995 to November 1999. We reviewed sperm concentration, motility and semen volume on two tertiary general hospitals in Korea, data of which collected since 1995 till 1999 according to the WHO guidelines(1987). The data were collected in healthy young Korean men in one center and those who visited urologic clinic in another center, There was no statistically significant difference at each year(p>0.05). Also semen volume and motility were not changed during that times. The data was collected in 1999 in both centers and monthly trends were also compared. No significant change was observed. No changes were observed in the semen parameters analysed in this two distinct populations, showing no evidence of deteriorating sperm quality in Korea over recent years. Furthermore, more data is required to draw any conclusion about the trend of semen qualities in Korea.

Clinical Characteristics in the 45XO/46XY Mosaicism and 45XO with SRY Gene Positive Patients / 대한비뇨기과학회지

PURPOSE: We investigated the clinical characteristics and relationship between chromosome and its phenotypic expression in patients with 45 XO/46XY mosaicism or 45 XO with SRY gene. MATERIALS AND METHODS: 11 patients with 45XO/46XY chromosomal abnormality and 4 patients with 45XO with SRY positive reaction admitted from 1990 to 1996 were evaluated. Patients were grouped according to chromosome and gonadal expression. Group A consisted of patients with 45XO/46XY chromosome and unilateral streak gonad, group B patients with 45XO chromosome, SRY positive reaction and unilateral streak gonad and group C patients with 45XO/46XY chromosome and bilateral streak gonads. RESULTS: Of the total 15 patients, the number of patients in group A, B, and C were 8, 4, and 3, respectively. SRY gene was positive in all group A and B patients but only one patient was positive in group C. Of the 8 patients in group A, 5 patients had a high XY mosaicism ratio compared to XO whereas an equal ratio was observed in the remaining 3 patients. Of the 4 male penotype patients only 1 patient had a high XY mosaicism ratio compared to XO while 3 patients displayed an equal ratio. There was no difference in associated anomaly and the degree of severity of ambiguity according to the mosaicism ratio in all patients. CONCLUSIONS: There was no definite correlation between the mosaicism ratio and phenotypic expression. Presence of SRY gene in 45XO patients may suggest MGD(mixed gonadal dysgenesis) and therefore, the evaluation SRY gene could be useful in the diagnosis of 45XO patients with ambiguous genitalia.

Urodynamic Studies of the Voiding Disorders in Patients with Idiopathic Parkinson`s Disease and Multiple System Atrophy / 대한비뇨기과학회지

PURPOSE: The onset and severity of voiding dysfunction in multiple system atrophy(MSA) is more early and severe than that of idiopathic Parkinson's disease(IPD). We compared the voiding symptoms and urodynamic findings in patients with MSA and IPD in order to elucidate the characteristics of their voiding dysfunction. MATERIALS AND METHODS: We reviewed urodynamic data from 19 men and 10 women with parkisonism. Of the 29 patients(mean age 66.5 years), 19 patients (mean age 68.7 years) had IPD and 10 patients(mean age 62.4 years) had MSA. The mean duration of the disease in all patients was 4 years and 10 months, and there was no significant difference between IPD and MSA. RESULTS: Detrusor hyperreflexia(DH) was seen in 8 patients, detrusor hypereflexia with impaired detrusor contractility(DHIC) in 3, detrusor hyperreflexia with bladder outlet obstruction(DHOB) in 4, impaired detrusor contractility(If) in 8, and normal findings in 6. In IPD, DH was noted in 5 patients, DHIC in 3, DHOB in 2, IC in 5 and normal in 4, and a similar distribution was seen in MSA. However, there was no significant difference in the prevalence of involuntary detrusor contraction between IPD and MSA. Irritative voiding symptoms were seen in 11 patients, obstructive symptoms in 10, and both in 8. Obstructive symptoms were dominate in IPD and irritative symptoms in MSA. Impaired relaxation of the voluntary sphincter was seen in 12(41%) patients with parkisonism,8 in IPD, and 4 in MSA. CONCLUSIONS: There was no difference between idiopathic Parkinson's disease and multiple system atrophy in mean age, sex, mean duration of disease, subjective voiding symptoms and urodynamic findings. Disease specific findings were not identified in patients with parkinsonism.

Recurrent Priapism: 3 Cases Report / 대한비뇨기과학회지

Recurrent episodes of venoocclusive priapism have been described previously in patients who have had repeated exposure to a recognized stimulus such as intracavernosal injections of vasoactive agents, or pathologic conditions such as spinal stenosis or hematological disorders. Three patients were referred for evaluation of an unusual sequoia of an initial episode of idiopathic venoocclusive priapism, occurred with a frequency ranging from several times per month to once per year and were symptomatically disabling. We reviewed the characteristics and the possible pathophysiology of this syndrome and some therapeutic options in the management of these patients.

Clinical Significance of BTA Test in the Diagnosis and Follow-up of Bladder Cancer / 대한비뇨기과학회지

PURPOSE: The Bard Bladder Tumor Antigen(BTA) test is a latex agglutination assay that qualitatively detects the presence of basement membrane degradation complexes in the urine when the bladder tumor cells invade and destruct an extracellular matrix, called basement membrane. We evaluated the clinical significance of BTA test in the diagnosis and follow-up of patients with bladder cancer by comparing it with bladder washing cytology. MATERIALS AND METHODS: The Bard BTA test was compaired to bladder washing cytology in 26 patients with bladder cancer(group l), 18 undergoing surveillance cystoscopy for previous bladder cancer(group ll), and 10 suffering from other urologic diseases except bladder cancer(group lll). RESULTS: Of the group l patients, 84.6% were correctly diagnosed with the Bard BTA test compared to 69.2% with bladder washing cytology, which is statistically significant(p < 0.05). There was no difference in sensitivity according to tumor grade and stage. There was a high positive rate in group ll and lll patients probably due to the degeneration of basement membrane by other conditions such as intravesical BCG or mitomycin instillation, infection, or prostate cancer. CONCLUSIONS: The Bard BTA test is a non-invasive, simple, rapid, inexpensive adjunct to cystoscopy, and superior to bladder washing cytology in sensitivity, but many false positive results were observed. Further clinical evaluation is warranted to determine whether the false positive results are true or the result of inadequate number of patients studied.

SRY Gene Evaluation in Patients with the Disorders of Sexual Differentiation / 대한비뇨기과학회지

The disorders of sexual differentiation occurred due to the incompatibility of chromosomal sex, gonadal sex and phenotypic sex. A gene within Y chromosome such as SRY gene has been searched to explain this phenomenon. We report cases of defective sexual differentiation, where it is difficult to diagnose with Giemsa stain of Y chromosome alone but SRY gene evaluation was helpful in the diagnosis and treatment of these cases. Genomic DNA from WBC was extracted. XES 10 and XES 11 were used as primers in separately SRY gene by electrophoresis. A positive SRY gene facilitated in confirming the diagnosis of the following cases: Klinefelter`s syndrome with a positive SRY gene originally diagnosed as 46 XX male, Klinefelter`s syndrome with 46XX,a positive SRY gene that was thought to be chordee without hypospadias. Turner`s syndrome that was difficult to be diagnosed due to 46XY, a positive SRY gene, however, SRY gene detection was helpful to detect germ cell tumor development early. 46XX hermaphroditism without SRY gene was diagnosed as true intersex after pathologic examination. Two cases of 46XY hermaphroditism with SRY gene were diagnosed finally as 46 XY true intersex and mixed gonadal dysgenesis each other. Congenital adrenal hyperplasia and androgen receptor defect were confirmed by traditional methods such as hormonal tests and radiologic findings. SRY gene evaluation facilitated in identifying the pathophysiology of many defective sexual differentiations, however, this alone had a limit to explain all these cases. So future research into genes in the autosome, sex chromosome and Z protein will help in the diagnosis and treatment of patients with the disorders of sexual differentiation.