Systematic Review of Recent Lipidomics Approaches Toward Inflammatory Bowel Disease

Researchers have endeavored to identify the etiology of inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis. Though the pathogenesis of inflammatory bowel diseases remains unknown, dysregulation of the immune system in the host gastrointestinal tract is believed to be the major causative factor. Omics is a powerful methodological tool that can reveal biochemical information stored in clinical samples. Lipidomics is a subset of omics that explores the lipid classes associated with inflammation. One objective of the present systematic review was to facilitate the identification of biochemical targets for use in future lipidomic studies on inflammatory bowel diseases. The use of high-resolution mass spectrometry to observe alterations in global lipidomics might help elucidate the immunoregulatory mechanisms involved in inflammatory bowel diseases and discover novel biomarkers for them. Assessment of the characteristics of previous clinical trials on inflammatory bowel diseases could help researchers design and establish patient selection and analytical method criteria for future studies on these conditions. In this study, we curated literature exclusively from four databases and extracted lipidomics-related data from literature, considering criteria. This paper suggests that the lipidomics approach toward research in inflammatory bowel diseases can clarify their pathogenesis and identify clinically valuable biomarkers to predict and monitor their progression.

Single-incision laparoscopic cholecystectomy using instrumental alignment in robotic single-site cholecystectomy

PURPOSE: There is no standardized single-incision laparoscopic cholecystectomy (SILC) technique in contrast to robot single-site cholecystectomy (RSSC). We tried to implement the array of instruments used in RSSC to SILC. METHODS: A series of 108 consecutive patients underwent SILC between September 2014 and July 2017 by 2 surgeons. The indication was benign disease of the gallbladder. The perioperative outcomes were reviewed. We used the 4-channel Glove port and conventional laparoscopic instruments. RESULTS: The study subjects consisted of 29 males and 79 females, and the mean age was 44.4 years (range, 16–70 years). Mean body mass index was 24.1 kg/m2. The mean working time was 25.0 ± 10.7 minutes and total operation time was 44.4 ± 12.4 minutes. There were 7 cases of conversion (additional 1 port in 4 patients, additional 2 ports in 2, and conventional 4 port technique in 1). Bile spillage from the gallbladder during the procedure occurred in 17 (15.7%). There were no postoperative complications. Postoperative hospital stay was 2.0 ± 0.6 days. CONCLUSION: The alignment of the instruments in a RSSC was successfully implemented into a SILC, so that an equally effective operation was possible.

The Correlation between Body Mass Index and Routine Parameters in Men Over Fifty

PURPOSE: This study aimed to investigate the relationships between body mass index (BMI) and prostate-specific antigen (PSA) levels, international prostate symptom score (IPSS), quality of life (QoL), and prostate volume (PV). MATERIALS AND METHODS: Height, weight, PSA levels, PV, and IPSS were analyzed in 15,435 patients who underwent a prostate examination between 2001 and 2014. Patients aged <50 years or with a PSA level ≥10 ng/mL were excluded. The relationships between BMI and PSA, IPSS, QoL, and PV were analyzed by a scatter plot, one-way analysis of variance, and the Pearson correlation coefficient. RESULTS: The mean age was 71.95±7.63 years, the mean BMI was 23.59±3.08 kg/m2, the mean PSA level was 1.45±1.45 ng/mL, the mean IPSS was 15.53±8.31, the mean QoL score was 3.48±1.25, and the mean PV was 29.72±14.02 mL. PSA, IPSS, and QoL showed a tendency to decrease with increasing BMI, and there were statistically significant differences for each parameter (p≤0.001). PV showed a significant tendency to increase with BMI (p < 0.001). In the correlation analysis, BMI showed a statistically significant correlation (p < 0.001) with PSA, IPSS, and QoL, although the correlations were very weak. In contrast, BMI showed a significant correlation with PV (p < 0.001), with a meaningful Pearson correlation coefficient of 0.124. CONCLUSIONS: Higher BMI was associated with lower PSA levels and higher IPSS and QoL scores. Meanwhile, PV increased with BMI. Although obese individuals had a greater PV, obesity did not aggravate lower urinary tract symptoms.

Obesity as a Risk Factor for Prostatic Enlargement: A Retrospective Cohort Study in Korea / 대한배뇨장애요실금학회지

PURPOSE: We aimed to evaluate obesity, a risk factor of metabolic syndrome, and its association with prostatic enlargement in a retrospective cohort in Korea. METHODS: Baseline data were obtained from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population (KoGES-ARIRANG). Between March 2015 and November 2015, 2,127 male participants of KoGES-ARIRANG were invited to the Korean Prostate Health Council Screening Program, and 602 participants underwent urological examination, including serum prostate specific antigen measurement and transrectal ultrasonography, and completed the International Prostate Symptom Score questionnaire. The data for 571 participants were analyzed, after excluding 31 men who had a history of prostatic disease or testosterone replacement, or had undergone a prior prostatic surgery or procedure. RESULTS: Among components of metabolic syndrome, waist circumference had a statistically significant linear correlation with incremental increases in prostate volume (B=0.181, P=0.004). Abdominal obesity as determined by anthropometric measures including body mass index (odds ratio [OR], 1.205; 95% confidence interval [CI], 1.088–1.336), waist circumference (OR, 1.073; 95% CI, 1.032–1.115), body fat (OR, 1.126; 95% CI, 1.056–1.202), and visceral fat composition (OR, 1.667; 95% CI, 1.246–2.232) was significantly associated with the presence of high-volume benign prostatic hyperplasia (BPH) (prostate volume≥ 40 mL). Furthermore, the highest quartile of serum leptin (OR, 3.541; 95% CI, 1.103–11.365) and adiponectin levels (OR, 0.315; 95% CI, 0.102–0.971) were significantly correlated with high-volume BPH compared to the lowest quartile of levels. CONCLUSIONS: Abdominal obesity and serum leptin level are positively associated with prostate growth, whereas serum adiponectin level is inversely associated with the presence of prostatic enlargement.

Efficacy and safety of hyaluronate membrane in the rabbit cecum-abdominal wall adhesion model / 대한외과학회지

PURPOSE: Tissue adhesion is a well-known postsurgical phenomenon, causing pain, functional obstruction, and difficult reoperative surgery. To overcome these problems, various synthetic and natural polymer membranes have been developed as postoperative tissue adhesion barriers. However, limitation in their use has hindered its actual application. We prepared a hyaluronate membrane (HM) to evaluate its efficacy and safety as an adhesion barrier compared to a commercialized product (Interceed, Ethicon). METHODS: To evaluate the antiadhesion effect, a cecum-abdominal wall abrasion model was adopted in a rabbit. The denuded cecum was covered by Interceed or HM or neither and apposed to the abdominal wall (each, n = 10). Four weeks after surgery, the level of adhesion was graded. Acute and chronic toxicity of the three groups were also evaluated. RESULTS: Blood samples drawn to evaluate acute toxicity at postoperative day 3 and 7 showed no significant difference among the three groups. The grade and area of adhesion were significantly lower in the HM compared to those of the control and Interceed at four weeks after surgery. Histologic evaluations, which was carried out to estimate tissue reactions at the site of application, as well as to assess chronic toxicity for the major organs, were not significantly different in the three groups. CONCLUSION: This study showed that the antiadhesion efficacy of HM was superior to commercialized antiadhesion membrane, Interceed. Low inflammatory response and nontoxicity were also demonstrated. From these results, we suggest that the HM is a good candidate as a tissue adhesion barrier.

Hyperbilirubinemia Is a Significant Indicator for the Severity of Acute Appendicitis

PURPOSE: This study aims to reveal more effective clinical or laboratory markers for the diagnosis of acute appendicitis and to score the severity based on a sufficiently large number of patients with acute appendicitis. METHODS: We identified 1,195 patients with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 1,271 patients that underwent a laparoscopic or an open appendectomy between 2009 and 2010. A retrospective chart review of the medical records, including laboratory and histologic results, was conducted. We then analyzed the data using univariate and multivariate analyses. RESULTS: Among the 1,195 patients, a laparoscopic appendectomy was performed in 685 cases (57.32%), and an open appendectomy was performed in 510 cases (42.68%). The univariate analysis demonstrated significant differences for white blood cell count (P < 0.0001), segmented neutrophils (P = 0.0035), total bilirubin (P < 0.0001), and systemic inflammatory response syndrome (SIRS) score between groups (P < 0.0001). The multivariate analysis demonstrated that total bilirubin (odds ratio, 1.772; 95% confidence interval, 1.320 to 2.379; P = 0.0001) and SIRS score (odds ratio, 1.583; 95% confidence interval, 1.313 to 1.908; P < 0.0001) have statistically significant diagnostic value for perforated appendicitis. CONCLUSION: Hyperbilirubinemia is a statistically significant diagnostic marker for acute appendicitis and the likelihood of perforation.

Risk factors for the clinical course of cholecystitisin patients who undergo cholecystectomy

BACKGROUNDS/AIMS: The aims of this study were to evaluate risk factors for acute cholecystitis that have been previously acknowledged and to evaluate several co-morbidities, such as hypertension, diabetes mellitus, cardiovascular disease, cerebrovascular accident and end-stage renal disease for which the prevalence rate has increased in the elderly. METHODS: We retrospectively reviewed 611 patients who underwent laparoscopic or open cholecystectomy for cholecystitis between January 2005 and January 2010. The relationships between the clinical outcomes and the clinico-demographic factors were analyzed by univariate and multivariate analyses. RESULTS: The diagnoses of the 611 patients who underwent laparoscopic cholecystectomy were acute cholecystitis (n=258; 42.2%) and chronic cholecystitis (n=353; 57.8%). Male gender (p50 (p<0.000), fever (p<0.000), leukocytosis (p<0.000), AST elevation (p=0.009), alkaline phosphatase elevation (p<0.000) and an elevation of total bilirubin (p<0.000) were identified as risk factors for acute cholecystitis. The presence of diabetes mellitus (p=0.002) and hypertension (p=0.019) may be risk factors for acute cholecystitis. CONCLUSIONS: For patients with risk factors for acute cholecystitis, early management, that is, early checkup and diagnosis following early cholecystectomy, is recommended before the disease progresses to an acute form of cholecystitis.

The Discriminating Ability of a Prognosis According to the TNM, Okuda, CLIP, JIS, and BCLC Staging Systems for Hepatocellular Carcinoma

PURPOSE: There is yet no ideal single staging system for hepatocellular carcinoma (HCC). The aim of this study was to analyze HCC survival times according to the TNM, Okuda, CLIP, JIS, and BCLC staging systems and their prognostic discrimination ability. METHODS: A retrospective analysis of medical records and statistical data from the Korean statistical information service was done for HCC patients diagnosed at Bundang CHA hospital between June, 1992 and February, 2009. RESULTS: During follow-up, 121 (72%) of 168 people died and 1, 3 and 5 year overall survival rates were, respectively, 58%, 35% and 25%. In the analysis of discriminative ability of each staging system, the CLIP staging system showed the highest LR chi-square value, and the lowest AIC value (p<0.05). Therefore, the CLIP staging system appears to be superior to the other systems. CONCLUSION: Of the 5 staging systems in this study, the CLIP staging system was superior to the other systems, but the results of many other studies from different countries have varied. It is necessary to establish the staging system suitable for each country's actual circumstances.

Efficacy and Safety of the Electrospun Nanofibrous Adhesion Barrier for Laparoscopic Surgery in a Rabbit Model

PURPOSE: Most recently developed anti-adhesive membranes are not suitable for laparoscopic surgery due to weak mechanical properties or adhesive characteristics. To overcome these problems, we prepared electrospun bioabsorbable nanofibrous poly (lactic-co-glycolic acid)-based membranes as an adhesion barrier. We evaluated the efficacy and safety of this material for laparoscopic surgery in a rabbit model. METHODS: A standardized laparoscopic surgical trauma was made on the rabbit's uterine horn and adjacent abdominal wall to induce adhesion formation. The injured uterus was covered by a nanofibrous barrier or it was left untreated (the negative control group) (each group: n=14). To evaluate acute toxicity of this material, blood sampling was made 3 and 7 days after laparoscopic surgery to check liver and renal function. Three weeks after laparoscopy, a second look laparoscopy was performed and the adhesions were scored according to Blauer's scoring system. Tissue between abdominal wall and uterus was obtained to examine microscopically. Liver, kidney and uterus were harvested to examine chronic toxicity. RESULTS: 36.4% of the nanofiber treatment group and 70% of the untreated control group showed severe adhesions (grade>3) after laparoscopic surgery but failed to get a statistical significance (P=0.198). Acute and chronic toxicity induced by this material were not noted in the blood and tissue exam. CONCLUSION: This study showed that nanofiber barrier seems to be a novel resorbable biomaterial for the reduction of postoperative adhesions. Easy placement and handling of this material make these membranes potentially successful candidates for laparoscopic surgery. But further study is needed to get a statistical significance.

The Relationship between Metabolic Syndrome and Prostate Volume in Men Over Sixties who Underwent Prostate Health Check-up / 대한비뇨기과학회지

PURPOSE: To evaluate the relationship between factors of metabolic syndrome(MS) to prostate volume and lower urinary tract symptom in men over sixties. MATERIALS AND METHODS: A total of 624 male subjects aged 60 to 90 years were enrolled. Prostate volume, urinary flow rate, voided volume, post void residual urine volume, voiding symptoms and MS-related parameters were investigated. Patients were divided into two groups; those with MS (n=223) and those without(n=401). Prostate volume, urodynamic factors and voiding symptoms were compared based upon MS categories. RESULTS: The MS and control group showed no significant differences with respect to age(74.8+/-5.6 vs. 74.0+/-5.4, respectively, p=0.083) and prostate specific antigen levels(1.8+/-1.5 vs. 1.7+/-1.5, respectively, p=0.248). However, the MS group had significantly greater waist circumference, blood pressure, fasting blood sugar level, hypertriglyceridemia and lower high density lipoprotein(HDL) cholesterol than the control group(p0.05). There was a significant relationship between prostate volume and obesity(p=0.016), however other MS factors such as low HDL, hypertension, non-insulin dependent diabetes mellitus and hypertriglyceridemia were not associated with prostate volume(p>0.05).CONCLUSIONS: Metabolic syndrome is associated with prostate volume related factors, but not to voiding dysfunction in Korean men over sixties. Among subcategories of MS, obesity is the most strongly related factor to prostate volume.

The Efficacy and Safety of HA/CMC Anti-adhesion Barrier Solution with Varying Viscosities

PURPOSE: Guardix-sol(TM) is solution type of anti-adhesion barrier, and it is composed of a mixture of hyaluronate (HA) and carboxymethylcellulose (CMC). The anti-adhesive effect was proved through several clinical trials with using this material, but the most efficient viscosity for this solution has not been shown by the previous research. The objective of this study was to evaluate the efficacy and safety of HA/CMC mixture solutions, with varying viscosities, in a rat model. METHODS: Three different viscosities (low=LV, mid=MV and high=HV) of the HA/CMC mixture solutions were prepared to evaluate their potential as a tissue adhesion barrier. The viscosity was measured by a Brookfield viscometer. To evaluate the anti-adhesion effect, a cecal-abdominal wall abrasion model was adopted. The denuded cecum was coated by a HA/CMC mixture of different viscosity or it was left uncoated (the negative control group) and then the denuded cecum was apposed to the abdominal wall (each group: n=10). All the rats underwent a second celiotomy after 14 days to evaluate the extent of their abdominal adhesions and tissue reactions (inflammatory response, granulation tissue formation and toxicity in organs). RESULTS: The viscosities of the HA/CMC mixture solutions were 248.+/-24.4 cps in the LV, 1,353.8+/-4.4 cps in the MV and 3,556.7+/-38.8 cps in the HV. The grade of adhesion and the adhesion area were significantly lower in the all HA/CMC mixture solution groups compared to the control regardless of their viscosity. The inflammatory responses were not remarkable at the application site and the major solid organs did not show histological change in the experimental groups. CONCLUSION: The difference of viscosity of HA/CMC mixture solutions did not affect the efficacy of the adhesion barrier. All the HA/CMC mixture solutions with varying viscosities showed a low inflammatory response and non-toxicity.

The Efficacy and Safety of HA/CMC Anti-adhesion Barrier Solution with Varying Viscosities

PURPOSE: Guardix-sol(TM) is solution type of anti-adhesion barrier, and it is composed of a mixture of hyaluronate (HA) and carboxymethylcellulose (CMC). The anti-adhesive effect was proved through several clinical trials with using this material, but the most efficient viscosity for this solution has not been shown by the previous research. The objective of this study was to evaluate the efficacy and safety of HA/CMC mixture solutions, with varying viscosities, in a rat model. METHODS: Three different viscosities (low=LV, mid=MV and high=HV) of the HA/CMC mixture solutions were prepared to evaluate their potential as a tissue adhesion barrier. The viscosity was measured by a Brookfield viscometer. To evaluate the anti-adhesion effect, a cecal-abdominal wall abrasion model was adopted. The denuded cecum was coated by a HA/CMC mixture of different viscosity or it was left uncoated (the negative control group) and then the denuded cecum was apposed to the abdominal wall (each group: n=10). All the rats underwent a second celiotomy after 14 days to evaluate the extent of their abdominal adhesions and tissue reactions (inflammatory response, granulation tissue formation and toxicity in organs). RESULTS: The viscosities of the HA/CMC mixture solutions were 248.+/-24.4 cps in the LV, 1,353.8+/-4.4 cps in the MV and 3,556.7+/-38.8 cps in the HV. The grade of adhesion and the adhesion area were significantly lower in the all HA/CMC mixture solution groups compared to the control regardless of their viscosity. The inflammatory responses were not remarkable at the application site and the major solid organs did not show histological change in the experimental groups. CONCLUSION: The difference of viscosity of HA/CMC mixture solutions did not affect the efficacy of the adhesion barrier. All the HA/CMC mixture solutions with varying viscosities showed a low inflammatory response and non-toxicity.

The Prevalence and Risk Factors of Nocturia for Males Participating in a Prostate Examination Survey / 대한비뇨기과학회지

PURPOSE: Elderly men are often troubled by lower urinary tract symptoms (LUTS), including frequency, urgency, incontinence and nocturia. Especially, nocturia is one of the frequently complained about urologic symptoms and this can be combined with sleep disorders. We investigated the prevalence and risk factors for nocturia in males who participated in a prostate examination survey. MATERIALS AND METHODS: A total of 7,299 men participated in a prostate examination survey from March 2003 to December 2006; these men were given an International Prostate Symptom Score(IPSS) and they underwent transrectal ultrasonography of the prostate. The prevalence of nocturia and its associated factors, which included age, the IPSS severity, the prostate volume and the place of residence, were evaluated. RESULTS: Among the men who were evaluated, 23.4% reported voiding once per night and 68% reported voiding twice or more per night. The severe IPSS group revealed a significantly higher nocturia score compared to the mild and moderate IPSS group. While the nocturia score and the other LUTS score increased significantly with age, only the nocturia score increased significantly with age in each of the IPSS severity groups. The nocturia score increased significantly with a prostate volume >or=30g. Men living in Seoul showed a significantly lower nocturia score than that for men living in other areas. Multiple logistic regression analysis also indicated that an older age, a severe IPSS score, the country of residence were the independent risk factors. Multiple regression analysis revealed the nocturia score to have the highest correlation with the quality of life. CONCLUSIONS: For Korean males, the prevalence of nocturia >or=2 is 68% and the incidence of nocturia increased significantly according to age, the IPSS severity, the prostate volume and the place of residence.

Ectopic Endometriosis of the Extra-pelvic Cavity

PURPOSE: Endometriosis is the heterotropic occurrence of island of endometrial glands and stroma outside of uterus. It common occurs in pelvic cavity, but rarely at the ectopic area of extra-pelvic cavity. The aim of this study was to evaluate the clinical characteristics of extrapelvic endometriosis in order to help diagnosis and treatment. METHODS: Between January 2001 and June 2007, 22 patients who underwent surgery and was diagnosed as ectopic endometriosis of extra-pelvic cavity at Bundang CHA hospital were retrospectively reviewed with medical records and a telephone interview. RESULTS: All cases were women in their reproductive age, with a median age of 33 years (range 24~49 years). 17 of 22 cases were endometriosis in the scarring tissue of prior caesarean section wound on abdomen. 1 case in vaginal orifice on episiotomy wound of perineum, 1 case in femoral ring area and 3 cases in appendix. All patients except endometriosis of appendix, were presented with mass, pain and symptoms almost associated with menstruation. 18 of 22 cases were suspected of having extra-pelvic endometriosis due to their specific clinical features, 4 cases were suspected of hernia and acute appendicitis. All patients were treated with surgery. None has revisited to clinics due to recurrence. CONCLUSION: Women who have mass or lump in surgical scar and symptoms associated with menstruation period should be suspected of having endometriosis. Endometriosis of surgical scaring tissue should be treated by wide local excision to prevent local recurrence.

Mass spectrometry based proteomic analysis of human stem cells: a brief review

Stem cells can give rise to various cell types and are capable of regenerating themselves over multiple cell divisions. Pluripotency and self-renewal potential of stem cells have drawn vast interest from different disciplines, with studies on the molecular properties of stem cells being one example. Current investigations on the molecular basis of stem cells pluripotency and self-renewal entail traditional techniques from chemistry and molecular biology. In this mini review, we discuss progress in stem cell research that employs proteomics approaches. Specifically, we focus on studies on human stem cells from proteomics perspective. To our best knowledge, only the following types of human stem cells have been examined via proteomics analysis: human neuronal stem cells, human mesenchymal stem cells, and human embryonic stem cells. Protein expression serves as biomarkers of stem cells and identification and expression level of such biomarkers are usually determined using two-dimensional electrophoresis coupled mass spectrometry or non-gel based mass spectrometry.

A Case of Gastric Duplication Cyst / 대한소화기내시경학회지

Duplicated cyst is a rare congenital disease that makes up 4% of all gastrointestinal duplications. It is two times more prevalent in women than in men. The majority of cases are detected by such symptoms as an abdominal mass, nausea, abdominal pain and anemia in infants, but these symptoms are uncommon in adults. Obstruction, hemorrhage and perforation are possible complications and malignancy can develop on rare occasions. Most cases are controlled by surgical resection. We report here on a case of gastric duplication cyst in a 20-year-old woman who presented with severe nausea and vomiting. She was managed by surgical resection after evaluation was done via endoscopic ultrasonography.

Anti-adhesive Effect of Poloxamer/Alginate/CaCl2 Mixture in the Rat Model

PURPOSE: The occurrence of post-surgical adhesion is still a major cause of postoperative morbidity due to the lack of satisfactory treatment or prophylaxis. Several adhesion barriers have been developed in the form of solutions or membrane in an attempt to solve these problems. However both types of tissue barriers have some limitations in their practical applications. In order to overcome these problems, a temperature-sensitive Poloxamer/Alginate/CaCl2 mixture was prepared as an adhesion barrier. With this material, toxicity, inflammation and the adhesion prevention effect was evaluated in an animal model. METHODS: The sol-gel transition behavior was measured using a viscometer. An in vitro gel stability test and an in vivo degradation test was performed. The anti-adhesion effect was evaluated using a cecal-abdominal wall abrasion model. The denuded cecum was coated with Poloxamer/ Alginate/CaCl2 mixture, GUARDIX-SL (positive control group) or neither (negative control group) and apposed to the abdominal wall (each n=14). One week after surgery, the level of adhesion was graded from zero to three using a whole-number system. RESULTS: The LCST of the poloxamer/sodium alginate mixture was 25 degrees C. The gel stability of Poloxamer was improved by adding mild cross-linked sodium Alginate/CaCl2 mixture. The adhesion grade and area were significantly lower in the experimental group than in the control. CONCLUSION: The anti-adhesive effect of the Poloxamer/Alginate/CaCl2 mixture was comparable to the previously- developed solution type barrier and all the materials had degraded within 21 days. From these results, Poloxamer/ Alginate/CaCl2 mixture is a good candidate for use as a coatable or injectable tissue adhesion barrier.

Studies on the Functions of the Graft Kidney Immediately After the Transplantation / 대한비뇨기과학회지

As an attempt to elucidate the functional changes of the transplanted kidney with particular emphasis on the immediate postoperative periods, various renal functions of the graft kidney were compared with that of the remaining normal kidney after auto and homotransplantation in the dog. The results are summarized briefly as follows: 1. Glomerular filtration rate(GFR) and renal plasma flow (RPF) of the graft kidney was approximately 50 to 60 per cent of the normal kidney immediately following operation both in auto and homotransplantation. 2. Fraction of filtered water and electrolytes excreted was significantly greater in graft kidney and seemed to be caused by transient tubular damage. 3. The maximum concentration ability of urine in the graft kidney was significantly reduced. 4. Transfer maxima for PAH secretion of the graft kidney was reduced proportionately as the reduction of renal plasma flow, thus not affecting the tubular perfusion ratio. 5. The magnitude of splay in the PAH titration curve was identical between control and graft kidney. These findings suggest that intrarenal distribution of the blood flow is not altered in the graft kidney immediately following operation.

Primary Vesicoureteral Reflux - Extravesical Antireflux Plasty - / 대한비뇨기과학회지

The vesicoureteral reflux is closely related to urinary tract infection in children and persistent vesicoureteral reflux with recurrent urinary tract infection is the common indication for antireflux plasty But it has been known that the vesicoureteral reflux was rare in Korea. From March 1979 to June 1984, author observed 13 patients with vesicoureteral reflux in the absence of any lower urinary tract obstruction, neuropathic disorder, inflammatory lesion at the base of the bladder, which were confirmed with IVP, VCUG and cystoscopy. The results were as follows 1. Age distribution was from 1 yr to 10 yr 2. Sex ratio of male to female was 1.1:1 3. Chief complaints at admission were fever 7 cases (53.9 %), flank pain 3 cases (23%), abdominal mass 2 cases (15.3%), incontinence 1 cases (7.6%). 4. Urinary culture at abmission revealed E. Coli in 9 patients (69%) and both E. Coli and Staphylococci in a patient. 5. 9 of 13 patients showed normal findings in IVP before treatment 6. 13 of 19 ureters showed one more than grade III in VCUG; before treatment. 7. In cystoscopy, shapes of 19 ureteral orifices with vesicoureteral reflux were golf-hole type 9 cases (47.4 %), horse-shoe type 2 cases (10.5 %), stadium type 1 case (5.2%), cone type 6 cases (31.6%) and in one case, it couldn`t be detected due to severe trabeculation. 8. Gregoir-Lich extravesical antireflux plasty were obtained in 13 of 19 ureters with vesicoureteral reflux without failure during four to seven follow-up months.

A Clinical Investigation for Effect of Chlormadinone acetate(Prostal / 대한비뇨기과학회지

The hypertrophied prostate is the most common cause of infravesical obstrcutions, in the male patients with 50 years old or above. Though the cause of benign prostatic. hypertrophy has not clearly identified yet, recently it has been clarified that androgen, especially dihydrotestosterone, may play a great role in the benign prostatic hypertrophy. The author carried out to investigate the effect of Chlormadinone acetate-potent oral synthetic anti-androgen agent on prostatic volume and obstructive urinary symptoms induced by hypertrophied pro. static gland. The following results were obtained; 1. 23 patients were studied :19 patients with benign prostatic hypertrophy and 4 patients with benign prostatic hypertrophy and 4 patients with prostatic cancer. The mean age of patients was 72 years old. 2. The mean prostatic volume was markedly decreased from 58.7+/-2.94cc before treatment to 23.6+/-1.06cc 16 weeks after treatment. 3. Obstructive urinary symptoms, residual urine and nocturnal frequency were improved after treatment. 4. Judging from the fracts mentioned above, it may be believed that Chlormadinone acetate increase the effect of transurethral resection and prevent the rehypertrophied prostate after transurethral resection of prostate.