PURPOSE: Visual internal urethrotomy is a standard therapy for incomplete urethral stricture, and may also be a reasonable initial treatment for a short complete urethral stricture. The success rate and final results of the repeated internal urethrotomy were retrospectively assessed to figure out the appropriate indication for visual internal urethrotomy as an initial treatment for incomplete pendulous and bulbous urethral stricture; according to the stricture free month. MATERIALS AND METHODS: Between January 1990 and December 1999, an internal urethrotomy was primarily performed on 166 patients with urethral strictures. The exclusion criteria were complete urethral and posterior urethral stricture. Retrograde urethrography was performed under fluoroscopic control. When the stricture recurred, the urethrotomy was repeated as the primary procedure. RESULTS: With regard to the time to recurrence, the success rate of the group of stricture recurrence at 6 months was significantly lower than that of the stricture free group at 6 months. CONCLUSIONS: With regard to the stricture site and length, the stricture free month might be considered as an important predictor of the outcome of a repeated internal urethrotomy, and visual internal urethrotomy might be considered as an initial treatment method for incomplete urethral stricture under the following conditions; a bulbous stricture, a stricture length under 20mm, and stricture free at 6 months.
Constriction, Pathologic ; Endoscopy ; Humans ; Recurrence ; Reoperation ; Retrospective Studies ; Urethral Stricture*

Hemifacial spasm consists of irregular, but repetitive clonic twitching of the muscles of one side of the face. Usually it is first involved around the eyes, the repetitive twitching spreads slowly to involve the whole face. It most commonly affects middle aged or elderly women, and usually appears with an aberrant vascular cross-compression near the root entry zone (REZ) of VII nerve. Among numerous approaches to treat facial spasm, only Jannetta's microvascular decompression has confirmed efficacy. However facial nerve block by needle insertion technique seems to be of benefit in patients with mild spasm, the elderly, poor risks and those who refuse the craniotomy. To treat our three patients with hemifacial spasm, we did physical facial nerve block by a direct puncture of the facial nerve trunk just at its exit from the stylomastoid foramen. Satisfactory results were obtained by the treatment employed. This technique is a valuable method in the treatment of hemifacial spasm.
Aged ; Craniotomy ; Facial Nerve* ; Female ; Hemifacial Spasm* ; Humans ; Microvascular Decompression Surgery ; Middle Aged ; Muscles ; Needles ; Punctures ; Spasm

PURPOSE: The mechanism of hypoxic damage is mainly intracellular influx of calcium ions through the glutamate ionotropic receptor. This study was performed to determine alterations in distribution and expression of kainate receptor subunits after 1 hour of moderate hypoxia in the newborn piglet brain, as in a condition of mild to moderate perinatal hypoxic-ischemic encephalopathy. METHODS: Ten newborn piglets were ventilated at PaO2 over 80mmHg for 30min. Thereafter, the control group(n=5) was ventilated with 21% oxygen, and hypoxic group(n=5) with 6% oxygen at PaO2 below 25mmHg for 1 hour. Concentrations of protein, ATP and phosphocreatine were determined. The proteins were immunostained with anti-rat GluR6/7 and anti-rat KA2 antibody. RESULTS: Hypoxia(PaO2 20+/-1mmHg) and acidosis(pH 7.06+/-0.09) developed significantly in the hypoxic group compared to the control group(PaO2 104+/-4mmHg, pH 7.44+/-0.03, respectively, P<0.01). The concentrations of ATP(2.84+/-1.28micromol/kg brain, P<0.05) and phosphocreatine(0.78+/-1.07micromol/kg brain, P<0.001) were reduced compared to the control group(5.04+/-0.25micromol/kg brain, 4.03+/-0.31micromol/kg brain, respectively). The protein contents of GluR6/7 subunits were ordered; cerebral cortex>hippocampus, thalamus, hypothalamus>basal ganglia, cerebellum>white matter, and KA2 subunits were ordered : hippocampus, basal ganglia>cerebral cortex>thalamus, cerebellum>hypothalamus, white matter. The distribution of the subunits between the hypoxic group and control group were similar. CONCLUSION: Cerebral cortex, hippocampus and basal ganglia may be the most vulnerable to excitotoxic injury. Kainate receptor subunits did not change after 1 hour of moderate hypoxia.
Adenosine Triphosphate ; Anoxia ; Basal Ganglia ; Brain* ; Calcium ; Cerebral Cortex ; Ganglia ; Glutamic Acid ; Hippocampus ; Humans ; Hydrogen-Ion Concentration ; Hypoxia-Ischemia, Brain ; Infant, Newborn* ; Ions ; Oxygen ; Phosphocreatine ; Receptors, Kainic Acid ; Thalamus

PURPOSE: The mechanism of hypoxic damage is mainly intracellular influx of calcium ions through the glutamate ionotropic receptor. This study was performed to determine alterations in distribution and expression of kainate receptor subunits after 1 hour of moderate hypoxia in the newborn piglet brain, as in a condition of mild to moderate perinatal hypoxic-ischemic encephalopathy. METHODS: Ten newborn piglets were ventilated at PaO2 over 80mmHg for 30min. Thereafter, the control group(n=5) was ventilated with 21% oxygen, and hypoxic group(n=5) with 6% oxygen at PaO2 below 25mmHg for 1 hour. Concentrations of protein, ATP and phosphocreatine were determined. The proteins were immunostained with anti-rat GluR6/7 and anti-rat KA2 antibody. RESULTS: Hypoxia(PaO2 20+/-1mmHg) and acidosis(pH 7.06+/-0.09) developed significantly in the hypoxic group compared to the control group(PaO2 104+/-4mmHg, pH 7.44+/-0.03, respectively, P<0.01). The concentrations of ATP(2.84+/-1.28micromol/kg brain, P<0.05) and phosphocreatine(0.78+/-1.07micromol/kg brain, P<0.001) were reduced compared to the control group(5.04+/-0.25micromol/kg brain, 4.03+/-0.31micromol/kg brain, respectively). The protein contents of GluR6/7 subunits were ordered; cerebral cortex>hippocampus, thalamus, hypothalamus>basal ganglia, cerebellum>white matter, and KA2 subunits were ordered : hippocampus, basal ganglia>cerebral cortex>thalamus, cerebellum>hypothalamus, white matter. The distribution of the subunits between the hypoxic group and control group were similar. CONCLUSION: Cerebral cortex, hippocampus and basal ganglia may be the most vulnerable to excitotoxic injury. Kainate receptor subunits did not change after 1 hour of moderate hypoxia.
Adenosine Triphosphate ; Anoxia ; Basal Ganglia ; Brain* ; Calcium ; Cerebral Cortex ; Ganglia ; Glutamic Acid ; Hippocampus ; Humans ; Hydrogen-Ion Concentration ; Hypoxia-Ischemia, Brain ; Infant, Newborn* ; Ions ; Oxygen ; Phosphocreatine ; Receptors, Kainic Acid ; Thalamus

PURPOSE: This study was conducted to evaluate the relationship between metabolic syndrome and the prostatic volume. MATERIALS AND METHODS: From January 1997 to December 2006, 555 male out-patients who visited our health care center were investigated and they underwent transrectal ultrasonogram of the prostate. The patients were divided into two groups; group A met the criteria for metabolic syndrome (128 patients) and group B did not meet the criteria (427 patients). The authors compared the age, the prostate-specific antigen (PSA) and the prostate volume between these two groups. RESULTS: There were no statistically significant differences in age and PSA between the two groups. The prostate volume was significantly larger in group A (39.5+/-17.3cc) than in group B (31.7+/-9.6cc). CONCLUSIONS: The results of this study proved that metabolic syndrome and the prostate volume are related. Therefore, proper clinical management of metabolic syndrome should accompany the treatment of benign prostatic hyperplasia (BPH).
Delivery of Health Care ; Humans ; Male ; Outpatients ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Ultrasonography

Desmoplastic small round cell tumor (DSRCT) is a rare and highly malignant mesenchymal tumor found in the abdominal cavity. It mainly affects young male patients. We report a case of DSRCT that occurred in the abdominal cavity of a 50-year-old man. The tumor was characterized by small round tumor cells with irregular nests in the prominent desmoplastic stroma. The tumor cells showed immunoreactivity for epithelial membrane antigen, desmin, vimentin, and neuron specific enolase.
Abdominal Cavity ; Desmin ; Desmoplastic Small Round Cell Tumor* ; Humans ; Male ; Middle Aged ; Mucin-1 ; Phosphopyruvate Hydratase ; Vimentin

PURPOSE: As the number of patients with localized renal cell carcinoma has increased, there are conflicting reports on the nuclear grade as a prognostic factor. The aim of this study was to evaluate the significance of the nuclear grade as a prognostic factor. MATERIALS AND METHODS: We retrospectively enrolled 172 patients with localized renal cell carcinoma and who underwent radical nephrectomy. The patients were staged according to the 1997 TNM stage and the Fuhrman grading. The survival rate was analyzed by the Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazard model. RESULTS: The overall 1- , 5- and 10-year survival rates were 98.1, 72.5 and 68.4%, respectively. The 5-year survival rates for grades I, II, III and IV were 100, 92.6, 85.0 and 60.9%, respectively (p<0.0001). According to the Fuhrman grade in each T stage, 1) for patients with pT1b, the 5-year survival rates were 100, 85.0, 85.71 and 33.3% for patients with grade I, II, III and IV, respectively (p=0.002). 2) for patients with pT2, the 5-year survival rates were 100, 92.3, 60.0 and 25.0% for patients with grade I, II, III and IV, respectively (p<0.0001). A comparison of the survival curves by the Fuhrman grade showed a statistically significant difference. CONCLUSIONS: The Fuhrman grade is an important prognostic factor for patients with localized renal cell carcinoma. A high nuclear grade tends to have metastatic potential and a poor prognosis. This group of patients with a high nuclear grade must be followed up more closely. Determining the pathologic stage along with using the Fuhrman grade-based surveillance protocols are a logical approach to follow-up.
Carcinoma, Renal Cell* ; Cell Nucleus Shape ; Follow-Up Studies ; Humans ; Logic ; Multivariate Analysis ; Nephrectomy ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

PURPOSE: The medical treatment for benign prostatic hyperplasia (BPH) had recently been directed at preventing the progression of BPH, which reduces the risk of acute urinary retention (AUR) and BPH-related surgery. This study compared the long-term effectiveness of administering alpha- adrenergic blocker (alpha-blocker) and finasteride, a 5-alpha reductase inhibitor (5ARI), for treating BPH to prevent AUR and BPH-related surgery in real-life clinical practice. MATERIALS AND METHODS: This retrospective study enrolled 166 BPH patients who were treated at our hospital with the alpha-blockers doxazosin, terazosin, prazosin and alfuzosin, or tamsulosin and 5ARI as their first BPH treatment between January 1997 and December 1997, and these treatments lasted at least 12 months. Using follow-up data that was obtained at up to 7 years after treatment, we calculated the AUR and BPH-related surgery percentages in the alpha-blocker only group and in the combination group. RESULTS: During the study period, 17 of 110 patients (15.5%) in the alpha- blocker only group and 4 of 56 patients (7.1%) in the combination group experienced AUR. BPH-related surgery was performed on 10 of 110 patients (9.1%) in the alpha-blocker only group and surgery was performed on 1 of 56 patients (1.8%) in the combination group. Among them, 5 patients in the alpha-blocker only group and 1 patient in the combination group received surgery for AUR, and another 5 patients in the alpha-blocker only group showed insufficient therapeutic response. CONCLUSIONS: Real-life clinical practice showed that long-term combination treatment with alpha-blockers and 5ARI reduced the risk of the progression of BPH, such as AUR or BPH-related surgery, as compared with alpha-blocker-only treatment.
Adrenergic alpha-Antagonists ; Adrenergic Antagonists ; Doxazosin ; Finasteride ; Follow-Up Studies ; Humans ; Oxidoreductases* ; Prazosin ; Prostatic Hyperplasia* ; Retrospective Studies ; Urinary Retention*

PURPOSE: The medical treatment for benign prostatic hyperplasia (BPH) had recently been directed at preventing the progression of BPH, which reduces the risk of acute urinary retention (AUR) and BPH-related surgery. This study compared the long-term effectiveness of administering alpha- adrenergic blocker (alpha-blocker) and finasteride, a 5-alpha reductase inhibitor (5ARI), for treating BPH to prevent AUR and BPH-related surgery in real-life clinical practice. MATERIALS AND METHODS: This retrospective study enrolled 166 BPH patients who were treated at our hospital with the alpha-blockers doxazosin, terazosin, prazosin and alfuzosin, or tamsulosin and 5ARI as their first BPH treatment between January 1997 and December 1997, and these treatments lasted at least 12 months. Using follow-up data that was obtained at up to 7 years after treatment, we calculated the AUR and BPH-related surgery percentages in the alpha-blocker only group and in the combination group. RESULTS: During the study period, 17 of 110 patients (15.5%) in the alpha- blocker only group and 4 of 56 patients (7.1%) in the combination group experienced AUR. BPH-related surgery was performed on 10 of 110 patients (9.1%) in the alpha-blocker only group and surgery was performed on 1 of 56 patients (1.8%) in the combination group. Among them, 5 patients in the alpha-blocker only group and 1 patient in the combination group received surgery for AUR, and another 5 patients in the alpha-blocker only group showed insufficient therapeutic response. CONCLUSIONS: Real-life clinical practice showed that long-term combination treatment with alpha-blockers and 5ARI reduced the risk of the progression of BPH, such as AUR or BPH-related surgery, as compared with alpha-blocker-only treatment.
Adrenergic alpha-Antagonists ; Adrenergic Antagonists ; Doxazosin ; Finasteride ; Follow-Up Studies ; Humans ; Oxidoreductases* ; Prazosin ; Prostatic Hyperplasia* ; Retrospective Studies ; Urinary Retention*

PURPOSE: We investigated the correlations between the expression of claudin-1 and claudin-7 in clear cell renal cell carcinoma (clear cell RCC) and clinical parameters. MATERIALS AND METHODS: The subjects of this study were 119 patients with confirmed clear cell RCC between January 2000 and December 2007. Their RCC tissues were immunohistochemically stained for claudin-1 and claudin-7. The correlations between the expression of claudin and parameters such as sex, age, body mass index (BMI), tumor size, TNM stage, Furhman nuclear grade, postoperative distant metastasis, and cancer-specific survival were analyzed. RESULTS: Among the total 119 subjects, claudin-1 was expressed in 18 (15.1%) and claudin- 7 in 31 (26.1%). Claudin-1 was expressed in patients who were older (p=0.007), who had a greater tumor size (p=0.001), who had a higher pathologic T stage (p=0.009), who had preoperative distant metastasis (p=0.035), and who had a higher Furhman nuclear grade (p=0.004). Claudin-7 was expressed only in patients who had a higher Furhman nuclear grade (p=0.031). The risk of postoperative distant metastasis was associated with the expression of claudin-1 (p<0.001) but not with the expression of claudin-7 (p=0.668). The expression of claudin-1 and -7 was not associated with cancer-specific survival (p>0.05). CONCLUSIONS: In clear cell RCC, claudin-1 was expressed in patients who were older and who had a greater tumor size, who had higher T or M stages, and who had a higher Furhman nuclear grade. The expression of claudin-1 was associated with a higher risk of postoperative distant metastasis.
Body Mass Index ; Carcinoma, Renal Cell ; Claudin-1 ; Humans ; Neoplasm Metastasis