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1.
ACS Appl Mater Interfaces ; 14(8): 10394-10406, 2022 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-35188737

RESUMO

Manufacturing an economically viable, efficient commercial thermoelectric (TE) module is essential for power generation and refrigeration. However, mediocre TE properties, lack of good mechanical stability of the material, and significant difficulties involved in the manufacturing of large-scale powder as well as bulk samples hinder the potential applications of the modules. Herein, an economically feasible single-step water atomization (WA) is employed to synthesize BST powder (2 kg) by Cu doping within a short time and consolidated into large-scale bulk samples (500 g) for the first time with a diameter of 50 mm and a thickness of about 40 mm using spark plasma sintering (SPS). The incorporation of Cu into BST greatly boosts the carrier concentration, leading to a significant increase in electrical conductivity, and inhibits the bipolar thermal conductivity by 73%. Synchronously, the lattice contribution (κL) is greatly reduced by the effective scattering of phonons by comprising fine-grain boundaries and point defects. Therefore, the peak ZT is shifted to the mid-temperature range and obtained a maximum of ∼1.31 at 425 K and a ZTave of 1.24 from 300 to 500 K for the BSTCu0.05 sample, which are considerably greater than those of the bare BST sample. Moreover, the maximum compressive mechanical strength of large-size samples manufactured by the WA-SPS process is measured as 102 MPa, which is significantly higher than commercial zone melting samples. The thermoelectric module assembled with WA-SPS-synthesized BSTCu0.05 and commercial n-type BTS material manifests an outstanding cooling performance (-19.4 °C), and a maximum output power of 6.91 W is generated at ΔT ∼ 200 K. These results prove that the BSTCux samples are eminently suitable for the fabrication of industrial thermoelectric modules.

2.
J Nanosci Nanotechnol ; 20(11): 7092-7095, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32604563

RESUMO

A polyacrylonitrile (PAN) nanofiber web was prepared by electrospinning PAN solutions with dimethyl sulfoxide (DMSO) or Dimethylformamide (DMF) as solvent. The PAN web was heated with sulfur to synthesize a sulfurized polyacrylonitrile (SPAN) nanofiber web. The shape of the SPAN web was found to depend on concentration of the PAN solution and properties of the solvent. The SPAN web synthesized using 8 wt% PAN solution in DMSO showed the highest capacity of 1053.3 mAh g-1sulfur under a current density of 526 mA g-1sulfur. Thus, we determined that DMSO could be a potential solvent for preparation of SPAN web electrodes.

3.
Kaohsiung J Med Sci ; 28(10): 526-30, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23089317

RESUMO

This study was performed in order to determine the value of plasma osteopontin (OPN) levels as a predictive factor of disease stage and recurrence in patients with bladder urothelial carcinoma (UC). Data from 50 patients diagnosed to have bladder UC after transurethral resection of bladder tumor (TURBT) from 2009 to 2010 were evaluated prospectively. Blood tests were performed before and after TURBT, and plasma OPN levels were measured using enzyme-linked immunosorbent assay. Differences in OPN levels according to clinicopathologic variables were analyzed statistically. Significant differences in plasma OPN levels were observed between groups with and without muscle invasion (89.16 vs. 67.08 ng/mL, p=0.041). Comparison according to tumor grade found no significant difference between high and low grade groups (p=0.115). Mean plasma OPN levels decreased after TURBT without statistical significance (p=0.571). Between groups with recurrence and those without recurrence, OPN levels of the group with recurrence were higher without statistical significance (p=0.161). Comparison of plasma OPN levels according to performance of radical cystectomy (RC) showed significant differences; patients who underwent RC showed higher levels of plasma OPN (95.58 vs. 70.37 ng/mL, p=0.030). Comparison according to T stage after RC showed significant differences in OPN levels (T1: 67.45, T2: 86.60 and T3: 95.23 ng/mL, respectively, p=0.006). The group with lymph node invasion showed significantly higher levels of OPN, compared to the group without invasion (153.24 vs. 68.03 ng/mL, p=0.017). Preoperative plasma OPN levels correlated to muscle invasion of bladder UC and pathological stage after RC.


Assuntos
Recidiva Local de Neoplasia , Osteopontina/sangue , Neoplasias da Bexiga Urinária/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Neoplasias da Bexiga Urinária/sangue , Neoplasias da Bexiga Urinária/cirurgia
4.
J Nanosci Nanotechnol ; 12(2): 1453-6, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22629977

RESUMO

Silicon dioxide (SiO2) thin films have gained considerable attention because of their various industrial applications. For example, SiO2 thin films are used in superhydrophilic self-cleaning surface glass, UV protection films, anti-reflection coatings, and insulating materials. Recently, many processes such as vacuum evaporation, sputtering, chemical vapor deposition, and spin coating have been widely applied to prepare thin films of functionally graded materials. However, these processes suffer from several engineering problems. For example, a special apparatus is required for the deposition of films, and conventional wet processes are not suitable for coating the surfaces of substrates with a large surface area and complex morphology. In this study, we investigated the film morphology and optical properties of SiO2 films prepared by a novel technique, namely, liquid phase deposition (LPD). Images of the SiO2 films were obtained by scanning electron microscopy (SEM) and atomic force microscopy (AFM) in order to study the surface morphology of these films: these images indicate that films deposited with different reaction times were uniform and dense and were composed of pure silica. Optical properties such as refractive index and transmittance were estimated by UV-vis spectroscopy and ellipsometry. SiO2 films with porous structures at the nanometer scale (100-250 nm) were successfully produced by LPD. The deposited film had excellent transmittance in the visible wavelength region.

5.
Prostate ; 72(7): 721-9, 2012 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-21837777

RESUMO

BACKGROUND: We developed a korean prostate cancer risk calculator (KPCRC) for predicting the probability of a positive initial prostate biopsy using clinical and laboratory data from a Korean male population (http://pcrc.korea.ac.kr). We compared its performance to prostate-specific antigen (PSA) testing and the Prostate Risk Calculator 3 (PRC 3) based on data from the Dutch part of European Randomized Study of Screening for Prostate Cancer (ERSPC), which predicts biopsy results for previously unscreened men. METHODS: Data were collected from 602 Korean men who were previously unscreened and underwent initial ten-core prostate biopsies. Multiple logistic regression analysis was performed to determine the significant predictors. Area under the receiver operating characteristic curve (AUC) and calibration plots of both calculators were evaluated. RESULTS: Prostate cancer (PCa) was detected in 172 (28.6%) men. Independent predictors of a positive biopsy included advanced age, elevated PSA levels, reduced volume of the transition zone, and abnormal digital rectal examination findings. The AUC of the KPCRC was higher than the PRC 3 and PSA alone on internal and external validation. Calibration plots of the KPCRC showed better performance than the other models on internal and external validation. Applying a cut-off of 10% of KPCRC implied that 251 of the 602 men (42%) would not have been biopsied and that 12 of the 172 PCa cases (7%) would not have been diagnosed. CONCLUSIONS: The KPCRC improves the performance of the PRC 3 and PSA testing in predicting Korean population's risk of PCa. It implies that Asian populations need their own risk calculators for PCa.


Assuntos
Povo Asiático/estatística & dados numéricos , Neoplasias da Próstata/epidemiologia , População Branca/estatística & dados numéricos , Adulto , Idoso , Envelhecimento , Biópsia , Exame Retal Digital , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Curva ROC , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Risco
6.
Korean J Urol ; 52(8): 566-71, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21927705

RESUMO

PURPOSE: This study was conducted to investigate the effect of testosterone replacement treatment (TRT) in testosterone deficiency syndrome (TDS) patients with metabolic syndrome. MATERIALS AND METHODS: We reviewed the data of 200 men who were diagnosed with TDS and were undergoing TRT between August 2006 and August 2009. The 200 patients were divided into two groups (group 1: 71 patients with metabolic syndrome, group 2: 129 patients without metabolic syndrome) depending on metabolic syndrome, which was diagnosed according to the NCEP III criteria for Asians. Age, BMI (body mass index), waist circumference, serologic tests, AMS (the Aging Males' Symptoms scale), and IIEF (International Index of Erectile Function) were measured. RESULTS: In group 1, waist circumference and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the somatovegetative scale score of the AMS, the total AMS score, the erectile function score of the IIEF, the overall satisfaction score of the IIEF, and the total IIEF score were significantly improved after TRT. On the other hand, in group 2, waist circumference, BMI, total cholesterol, LDL, and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the 2 subscale scores of the AMS (psychologic and somatovegetative), the total AMS score, all subscale scores of the IIEF, and the total IIEF score were significantly improved after TRT. CONCLUSIONS: Overall, the patients who had TDS with metabolic syndrome showed less improvement in AMS, IIEF, and serum variables. Therefore, the correction of metabolic syndrome, such as diabetes, obesity, and hypertension, should be considered during TRT.

7.
Urol Res ; 39(5): 417-9, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21331772

RESUMO

Lesch-Nyhan syndrome is a rare sex-linked disorder of purine metabolism that is caused by a mutation in the hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene which causes marked hyperuricemia and hyperuricosuria, with signs of gouty arthritis and uric acid stone disease in early childhood. We report a case of renal pelvis calculi which was dissolved within 10 days of urine alkalinization and hydration.


Assuntos
Cálculos Renais/etiologia , Cálculos Renais/terapia , Síndrome de Lesch-Nyhan/complicações , Alopurinol/uso terapêutico , Criança , Hidratação , Humanos , Concentração de Íons de Hidrogênio , Hipoxantina Fosforribosiltransferase/genética , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/urina , Pelve Renal , Síndrome de Lesch-Nyhan/genética , Masculino , Mutação , Tomografia Computadorizada por Raios X , Urina/química
8.
J Korean Med Sci ; 26(1): 85-91, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21218035

RESUMO

We developed and validated a novel Korean prostate cancer risk calculator (KPCRC) for predicting the probability of a positive initial prostate biopsy in a Korean population. Data were collected from 602 Koreans who underwent initial prostate biopsies due to an increased level of prostate-specific antigen (PSA), a palpable nodule upon digital rectal examination (DRE), or a hypoechoic lesion upon transrectal ultrasound (TRUS). The clinical and laboratory variables were analyzed by simple and multiple logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was computed to compare its performance to PSA testing alone. Prostate cancer was detected in 172 (28.6%) men. Independent predictors included age, DRE findings, PSA level, and prostate transitional zone volume. We developed the KPCRC using these variables. The AUC for the selected model was 0.91, and that of PSA testing alone was 0.83 (P < 0.001). The AUC for the selected model with an additional dataset was 0.79, and that of PSA testing alone was 0.73 (P = 0.004). The calculator is available on the website: http://pcrc.korea.ac.kr. The KPCRC improved the performance of PSA testing alone in predicting the risk of prostate cancer in a Korean population. This calculator would be a practical tool for physicians and patients.


Assuntos
Exame Retal Digital , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Idoso , Área Sob a Curva , Biópsia por Agulha , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Próstata/patologia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Curva ROC , República da Coreia , Risco , Ultrassonografia
9.
Urology ; 77(4): 884-90, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20950844

RESUMO

OBJECTIVES: To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function and has different efficacy according to operative method used in patients with radical cystectomy. METHODS: From July 2007 to September 2009, we randomized open radical cystectomy (ORC) patients into Group AI (ORC without gum chewing) and Group AII (ORC with gum chewing). Robot-assisted radical cystectomy (RARC) patients were randomized into Group BI (RARC without gum chewing) and Group BII (RARC with gum chewing). RESULTS: A total of 32 ORC (17 Group AI and 15 Group AII) and 28 RARC (13 Group BI and 15 Group BII) patients were completed. The patient's perioperative data between the control (AI + BI) and chewing gum (AII + BII) group showed no differences. The median time to flatus and to bowel movement were significantly reduced in chewing gum group compared with the control patients: 57.1 vs. 69.5 hours 76.7 vs. 93.3 hours. In the ORC patients, decrease in time to flatus and bowel movement were observed in gum chewing (AII) group than control (AI) group: 64.3 vs. 80.3 hours 83.8 vs. 104.2 hours. In RARC patients, decrease in time to flatus and bowel movement were found in gum chewing (BII) group than control (BI) group: 48.8 vs. 60.3 hours 69.1 vs. 84.6 hours. No adverse effects were observed with chewing gum. CONCLUSIONS: Chewing gum had stimulatory effects on bowel motility after cystectomy and urinary diversion. Chewing gum was safe and could be used for postoperative ileus regardless of the operative method (ORC or RARC).


Assuntos
Goma de Mascar , Cistectomia/métodos , Motilidade Gastrointestinal , Recuperação de Função Fisiológica , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Feminino , Flatulência , Humanos , Íleus/prevenção & controle , Laparoscopia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Período Pós-Operatório , Estudos Prospectivos , Robótica
11.
Asian J Androl ; 12(6): 827-34, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20711215

RESUMO

To gain beneficial effects in the management of high-risk prostate cancer, an integrated approach that combines local therapy and androgen deprivation therapy (ADT) was used. We compared biochemical responses between primary cryosurgical ablation of the prostate (CSAP) combined with prolonged ADT and radiation combined with ADT, which is the established modality in high-risk disease. A total of 33 high-risk patients received CSAP combined with ADT for 3 months before and up to 24 months after treatment. This patient group was matched with another 33 patients who had undergone three-dimensional conformal radiation therapy (3D-CRT) with the same protocol for ADT. Biochemical recurrence (BCR) was assessed by the American Society for Therapeutic Radiation Oncology (ASTRO) definition, the Phoenix definition and a prostate-specific antigen (PSA) cutoff of 0.5 ng mL(-1). Median follow-up was 61.0 ± 11.9 months for the CSAP + ADT group and 86.0 ± 15.8 months for the 3D-CRT + ADT group. In the CSAP group, major complications including rectourethral fistula and incontinence were not noted. In the CSAP + ADT group, 57.0% had BCR using the ASTRO definition, 21.2% using the Phoenix definition and 54.5% using a PSA cutoff of 0.5 ng mL(-1). In the 3D-CRT + ADT group, 54.5%, 21.2% and 54.5% had BCR using the ASTRO, Phoenix and PSA definition, respectively. In the CSAP + ADT group, the BCR-free survival (BRFS) was 54 ± 10 months using the ASTRO definition, 65 ± 5 months using the Phoenix definition and 51 ± 4 months using a PSA cutoff of 0.5 ng mL(-1). In the 3D-CRT + ADT group, the BRFS was 68 ± 12, 93 ± 19 and 70 ± 18 months using the ASTRO, Phoenix and PSA definition, respectively. By the log-rank test, the BRFS values for each group were not statistically different. This intermediate-term result indicated that primary CSAP combined with prolonged ADT offers a parallel biochemical response compared with radiotherapy in high-risk prostate cancer.


Assuntos
Criocirurgia , Próstata/cirurgia , Neoplasias da Próstata/terapia , Idoso , Idoso de 80 Anos ou mais , Antagonistas de Androgênios/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Próstata/patologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/cirurgia
12.
Korean J Urol ; 51(8): 565-71, 2010 08.
Artigo em Inglês | MEDLINE | ID: mdl-20733964

RESUMO

PURPOSE: We investigated the influence of the location of the partial renal vein obstruction on the left kidney, the bilateral testes, and cauda epididymal sperm quality and determined whether this animal model is suitable for varicocele study. MATERIALS AND METHODS: A total of 25 adult male Sprague-Dawley rats were assigned to three groups: group 1 (experimental varicocele by partial ligation medial to the internal spermatic vein for 8 weeks, n=8), group 2 (partial ligation lateral to the internal spermatic vein for 8 weeks, n=10), and group 3 (sham operation for 8 weeks, n=7). Rats in groups 1, 2, and 3 underwent a left nephrectomy and bilateral orchiectomy at 8 weeks after the operation. Histological changes and Johnsen score in both testes were analyzed. Fibrotic changes in the left kidney were assessed by quantitative image analysis. Numbers of sperm and proportions of motile sperm in the cauda epididymides were determined. RESULTS: Significant histological abnormalities and Johnsen score changes were observed in the testes in group 1. Renal fibrosis did not differ significantly among the groups. The proportions of motile sperm were significantly lower bilaterally in group 1 than in groups 2 and 3. However, the mean bilateral epididymal sperm count in group 1 was not significantly lower than in groups 2 and 3. CONCLUSIONS: Our results showed that experimental varicocele in the rat, induced by partial ligation medial to the internal spermatic vein, influences epididymal sperm quality without harmful effects on the left kidney. The present study certifies that this traditional animal model is suitable for varicocele research.

13.
Korean J Urol ; 51(1): 8-14, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20414403

RESUMO

PURPOSE: We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method. MATERIALS AND METHODS: OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2). RESULTS: All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4+/-17.7 vs. 151.4+/-21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7+/-11.5 vs. 211.2+/-43.8 ml, p=0.06). Histologic examination revealed that over 80% of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group. CONCLUSIONS: OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications.

14.
J Urol ; 183(2): 603-7, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20018323

RESUMO

PURPOSE: We prospectively evaluated magnetic resonance urethrography for depicting obliterative posterior urethral stricture. MATERIALS AND METHODS: A total of 25 men with a mean age of 48.7 years (range 21 to 72) with complete posterior urethral stricture were studied preoperatively with axial and sagittal turbo spin-echo T2, sagittal T1 and contrast enhanced sagittal T1-weighted images. Of the 25 patients 22 underwent conventional retrograde urethrography with voiding cystourethrography. For magnetic resonance urethrography aseptic lubricant was infused through the external urethral meatus to dilate the distal urethra up to the stricture. Each imaging result was compared with a surgical specimen or a description of the surgical findings. Measurement errors were analyzed using the Wilcoxon signed rank test. The relationship between true and measured stricture length was evaluated by linear regression analysis. RESULTS: Based on magnetic resonance urethrography findings 2 patients with a less than 1 cm stricture were treated with internal urethrotomy, 21 with a more than 1 cm stricture underwent open urethroplasty and 2 with prostatic displacement and a 4 cm stricture needed the combined perineal and transpubic approach. The mean +/- SD measurement error on magnetic resonance urethrography imaging was significantly lower than that on conventional retrograde urethrography combined with voiding cystourethrography (0.4 +/- 0.4 vs 1.4 +/- 1.1 cm, p <0.001). Linear regression analysis showed a stronger linear relationship between magnetic resonance urethrography and surgical measurement (r(2) = 0.62, p <0.01). CONCLUSIONS: Magnetic resonance urethrography is more effective for evaluating obliterative posterior urethral stricture than retrograde urethrography combined with voiding cystourethrography.


Assuntos
Imageamento por Ressonância Magnética , Estreitamento Uretral/diagnóstico , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estreitamento Uretral/diagnóstico por imagem , Urografia/métodos , Adulto Jovem
15.
Urology ; 73(4): 828-32, 832.e1, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19195693

RESUMO

OBJECTIVES: To evaluate the differences in tumor characteristics and prognosis according to age at presentation in patients with newly diagnosed Stage Ta, T1 urothelial carcinoma of the bladder. METHODS: From 1998 to 2002, 1587 patients with newly diagnosed nonmuscle-invasive bladder cancer treated with transurethral resection were enrolled in this study. The median age was 63 years (range 21-98), and the median follow-up duration was 44 months (range 12-97). The study cohort was subdivided into 3 age groups: age < 60 years (group 1, n = 614), age > or = 60 but < 70 years (group 2, n = 566), and age > or = 70 years (group 3, n = 398). RESULTS: Comparing the clinical and pathologic characteristics, the tumor size (chi(2)(trend) = 4.01, P = .045), multiplicity (chi(2)(trend) = 14.50, P < .001), T category (chi(2)(trend) = 17.11, P < .001), and tumor grade (chi(2)(trend) = 31.36, P < .001) tended to increase in the older age groups. The presence of carcinoma in situ and squamous differentiation, however, did not differ among the age groups (P > .05). The 5-year recurrence-free probability was 63.6%, 52.1%, and 43.9% for groups 1, 2, and 3, respectively (P < .001). The 5-year progression-free probability was 95.7%, 91.1%, and 84.2% for groups 1, 2, and 3, respectively (P < .001). CONCLUSIONS: Stage Ta, T1 bladder urothelial carcinoma in the younger patients tended to be smaller, have fewer lesions, be less invasive, and have a more favorable tumor grade at the initial presentation. Furthermore, younger patients appeared to have a more favorable prognosis than older patients.


Assuntos
Carcinoma de Células de Transição/patologia , Neoplasias da Bexiga Urinária/patologia , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico
16.
Asian J Androl ; 11(2): 167-75, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19151734

RESUMO

To estimate the short-term results of robot-assisted laparoscopic radical prostatectomy (RALRP) during the learning curve, in terms of surgical, oncological and functional outcomes, we conducted a prospective survey on RALRP. From July 2007, a single surgeon performed 63 robotic prostatectomies using the same operative technique. Perioperative data, including pathological and early functional results of the patient, were collected prospectively and analyzed. Along with the accumulation of the cases, the total operative time, setup time, console time and blood loss were significantly decreased. No major complication was present in any patient. Transfusion was needed in six patients; all of them were within the initial 15 cases. The positive surgical margin rate was 9.8% (5/51) in pT2 disease. The most frequent location of positive margin in this stage was the lateral aspect (60%), but in pT3 disease multiple margins were the most frequent (41.7%). Overall, 53 (84.1%) patients had totally continent status and the median time to continence was 6.56 weeks. Among 17 patients who maintained preoperative sexual activity (Sexual Health Inventory for Men > or = 17), stage below pT2, followed up for > 6 months with minimally one side of neurovascular bundle preservation procedure, 12 (70.6%) were capable of intercourse postoperatively, and the mean time for sexual intercourse after operation was 5.7 months. In this series, robotic prostatectomy was a feasible and reproducible technique, with a short learning curve and low perioperative complication rate. Even during the initial phase of the learning curve, satisfactory results were obtained with regard to functional and oncological outcome.


Assuntos
Laparoscopia/métodos , Avaliação de Resultados em Cuidados de Saúde , Prostatectomia/educação , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Robótica , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Prostatectomia/efeitos adversos , Neoplasias da Próstata/patologia , Comportamento Sexual , Fatores de Tempo , Resultado do Tratamento , Incontinência Urinária
17.
Urol Oncol ; 26(6): 590-4, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18367106

RESUMO

OBJECTIVES: To investigate the presentation of germ cell tumors (GCT) in terms of histology and stage, to better clarify the epidemiology of this disease in eastern Asia. METHODS: Six hundred ninety-eight patients diagnosed with GCT between 1995 and 2004 were analyzed. Clinical parameters at the time of initial diagnosis were classified in terms of the American Joint Committee on Cancer (AJCC) tumor, nodes, metastasis staging (TNMS) system, the International Germ Cell Cancer Collaborative Classification (IGCCC), for high-risk stage I nonseminomatous GCT (NSGCT) of testis. RESULTS: The anatomic distributions for the primary sites of the observed tumors were as follows: testis 471 cases (67%); central nervous system (CNS) 137 cases (20%); mediastinum 78 cases (11%), and retroperitoneum 12 cases (2%); 239 (51%) of 471 tumors with testicular primary were seminoma. High risk vs. non-high risk stage I NSGCT cases were 62 vs. 58. Of NSGCT of testis, 129 (58%), 73 (33%), and 21 (9%) of tumors presented with good, intermediate, and poor prognosis, respectively, based on IGCCC, whereas 231 (99%) patients were classified with a good prognosis and 3 (1%) with an intermediate prognosis amongst seminomas of testis; 193 (82%) cases presented as stage I testicular seminoma whereas 120 (54%) cases presented as stage I NSGCT. CONCLUSIONS: Extragonadal primary GCTs are very common in Korean. Incidence of high risk NSGCT of testis with stage I disease was lower than in the Western report. NSGCT presents itself as a more aggressive form whereas seminoma is a very indolent tumor when compared with cases in Western countries.


Assuntos
Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Testiculares/patologia , Adulto , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Embrionárias de Células Germinativas/terapia , Prognóstico , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/terapia
18.
Cancer Res Treat ; 40(4): 184-9, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19688128

RESUMO

PURPOSE: To evaluate the feasibility and efficacy of performing laparoscopic renal cryoablation (LRC) for the treatment of RCC, as compared with open partial nephrectomy (OPN), which is the established NSS. MATERIALS AND METHODS: From April 2004, among the patients who underwent LRC with a 1.47 mm cryoprobe, we enrolled 20 patients who were pathologically confirmed as having RCC with a tumor size smaller than 4 cm. These patients were matched with a group of 20 patients, who were selected based on the pre-operative characteristics of the tumor and those of the patients, from a pre-existing database of the patients who underwent OPN during the same period. RESULTS: The mean age and tumor size were 56.3+/-11.5 years and 2.4+/-1.7 cm in the LRC group, and 57.6+/-10.9 years and 2.2+/-1.1 cm in the OPN group. The two groups were similar for their age, gender, BMI, ASA, the tumor characteristics and the indications for operation. While the pathologic results and the operation time showed similarity, the EBL (98+/-87 ml vs 351+/-147 ml, respectively, p=0.001), the transfusion rate (10% vs 40%, respectively, p=0.03) and the hospital stay (4.2+/-1.5 days vs 8.2+/-2.4 days, respectively, p=0.005) were significantly less in the LRC group. Major complications did not occur in the LRC group, but in the OPN group, one patient experienced urine leakage and one patient had a perirenal hematoma. During the mean follow up of 27.3+/-10.8 months and 28.7+/-14.9 months for each group, respectively, all the patients remained disease-free with no evidence of local recurrence or metastases. CONCLUSIONS: LRC using ultra-thin cryoprobes for the treatment of small RCC showed similar effective oncologic results with the merits of minimal invasiveness, as compared with OPN, during the intermediate term follow up.

19.
Urology ; 70(3): 576-80, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17905120

RESUMO

OBJECTIVES: To evaluate the effect of extracorporeal magnetic innervation (ExMI) therapy in children with refractory monosymptomatic nocturnal enuresis (MNE). METHODS: A total of 55 children (34 boys and 21 girls, median age 8.0 years, range 5 to 13) who wetted the bed more than twice per week because of MNE that was refractory to treatment with desmopressin, anticholinergics, and enuretic alarm were assessed prospectively using a voiding diary before and after ExMI, administered once a week for at least 4 weeks with a size-adjusted magnetic chair (each session lasted 20 minutes). RESULTS: After all sessions of ExMI, the mean frequency of nocturnal enuresis decreased significantly to 2.09 +/- 2.47 in all patients (P = 0.04), and the mean functional bladder capacity increased 1.88 times in all patients (P = 0.00). In total, 63.6% of our patients had a nocturnal enuresis frequency of less than 50% after a mean of 6.62 +/- 4.26 ExMI sessions. CONCLUSIONS: From our results, reduced functional bladder capacity might be the main pathophysiologic cause in children with MNE refractory to established treatment. ExMI might have an acute inhibitory effect in these children with refractory MNE by increasing functional bladder capacity. However, long-term follow-up data and controlled study with a sham-stimulation group are necessary to determine the durability of this new therapy for refractory MNE.


Assuntos
Magnetismo/uso terapêutico , Enurese Noturna/terapia , Adolescente , Criança , Pré-Escolar , Antagonistas Colinérgicos/uso terapêutico , Desamino Arginina Vasopressina/uso terapêutico , Resistência a Medicamentos , Feminino , Humanos , Masculino , Enurese Noturna/tratamento farmacológico , Tamanho do Órgão , Estudos Prospectivos , Bexiga Urinária/patologia , Bexiga Urinária/fisiopatologia
20.
Int J Urol ; 14(2): 96-103, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17302563

RESUMO

AIM: Having better edge enhancement and penetrating power, refractive index radiology is suitable for the imaging of weakly absorbing objects such as tissue specimens. In this study the potential of refractive index radiology was evaluated for the imaging of renal cell carcinoma (RCC) and prostate cancer (PCA). METHODS: Specimens were cut in 3 mm and 4 microm thickness for X-ray radiology and hematoxylin and eosin (HE) staining, respectively. Radiographic images of RCC and PCA were obtained using the synchrotron hard X-rays from the 7B2 beam-line of the Pohang Light Source (PLS). The imaging technique applied was phase-contrast radiology based on the refraction enhancement mechanism. The resulting radiographic images were analyzed in correlation with those of optical microscopy. RESULTS: Using unmonochromatized hard X-rays, it was possible to obtain images with clear edge enhancement and relatively large field of view (6 cm x 6 cm). Even with overlapping signals from thick samples (more than 700-fold thicker than microscopic images), radiographic images clearly showed histological information of organelles in normal kidney such as glomeruli, tubules, and collecting ducts. Histological information of RCC including tumor subtypes and minute changes such as cystic degeneration could be identified without difficulty. The radiographic images of the prostate were comparable with those of low magnification optical microscopy, providing good visualization of normal microstructures such as adenoma, smooth muscle, and normal glands, or differentiation of tiny tumors from surrounding normal tissues. CONCLUSIONS: These results suggest the potential of refractive index radiology to provide a new way of imaging biological tissues with low absorption contrast such as RCC and PCA.


Assuntos
Adenocarcinoma/patologia , Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Neoplasias da Próstata/patologia , Adenocarcinoma/diagnóstico por imagem , Adulto , Idoso , Carcinoma de Células Renais/diagnóstico por imagem , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico por imagem , Radiografia
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