PURPOSE: We performed a retrospective study to determine the comparative characteristics of vesicoureteral reflux (VUR) between the infants less than 1 year and children more than 1 year old and whether early treatment in infantile VUR may be of benefit to preserve the renal function and to prevent the new renal scar. MATERIALS AND METHODS: All of 62 cases (infant group 19 and children group 43) with primary VUR were managed as the ureteral reimplantation from January 1991 to December 1996. RESULTS: The average age of patients was 7.1 months in infant group and 6.0 years in children group. The sex ratio of male to female showed no difference between infant and children group (1.7:1 Vs 1.5:1). The average follow up periods were 20.5 and 23.7 months in infant and children groups, respectively. The high grade reflux and renal scarring in infant group were significantly more frequent than those in children group (P<0.05), but the prevalence of urinary tract infection in children group was significantly higher than that in infant group (P<0.05). There was no significant difference in the rates of bilaterality and in the sex ratio between infant and children group. The success rate of operation was 100 percent in both groups. CONCLUSION: We suggest that the early surgical treatment in infants with bilateral and higher grade VUR may be of benefit to the preservation of renal function and the decrease of renal parenchymal change.
Child* ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Infant* ; Male ; Prevalence ; Replantation ; Retrospective Studies ; Sex Ratio ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSES: We performed a study to estimate the attitude of patients toward orchiectomy, and the factors impacting to choose treatment in real situation. MATERIALS AND METHODS: One thousand one hundred and eighteen patients were asked questionnaires at their first visit of outpatient clinic. Among them 775 patients completed the questionnaires which are composed with three items asking the degree of acceptance for orchiectomy, the acceptable cost to save the testes. The responses were analysed according to ages, educational levels, occupations and final diagnosis. In 38 patients diagnosed with prostate cancer, we analysed the factors impacting on their decision when they faced to choose a method of antiandrogen therapy. RESULTS: Among 775 patients who make the definite decisions for orchiectomy, 212 patients(27.4%) accepted the orchiectomy, 452 patients(58.3%) denied orchiectomy, 111 patients(14.3%) want to avoid orchiectomy as much as possible. The younger patients are, the more they want to save their testes. The accepting orchiectomy of patient is not impacted by occupation or educational levels. Among 45 patients who were finally diagnosed as metastatic prostate cancer, 13 patients changed thier choices that they selected at first visit. The most common causes to choose orchiectomy was economic conditions and to choose LH-RH analogue was fear to surgery. CONCLUSIONS: Around three forth of men over 50 years old have negative attitude for orchiectomy. But this can be changed easily by the factors such as economic status, fear to surgery and doctor`s advise. If the higher the house income is, the more LH-RH analogue will be used.
Ambulatory Care Facilities ; Diagnosis ; Gonadotropin-Releasing Hormone ; Humans ; Male ; Middle Aged ; Occupations ; Orchiectomy ; Prostate* ; Prostatic Neoplasms* ; Surveys and Questionnaires ; Testis

PURPOSE: The objective of this study was to compare the complications and urodynamic parameters of the patients who underwent orthotopic bladder substitution with using ileocolic or ileal segments after radical cystectomy for treating invasive bladder cancer. MATERIALS AND METHODS: Between January 1990 and April 2006, 260 patients with invasive bladder cancer underwent radical cystectomy and construction of the urinary diversion; ileal conduit, indiana pouch, ileocolic neobladder, ileal neobladder were all done at St. Mary's Hospital. The mean age of the patient was 61.8 years (range: 46-86). The ratio of male and female was 88%/12%. Forty nine patients received an orthotopic ileocolic neobladder and 45 patients received an orthotopic ileal neobladder. The complications and urodynamic parameters were compared in both groups. RESULTS: The orthotopic ileocolic neobladder after radical cystectomy for treating invasive bladder cancer has been performed between 1990 and 1996 and the orthotopic ileal neobladder has been performed between 1996 and 2006. Ileocolic neobladder related complications developed in 10 patients; neobladder leakage in 1 (2%), neobladder rupture in 1 (2%), stricture of the ureteroenteric anastomosis site in 4 (8.2%), and stricture of the urethral anastomosis site in 4 (8.2%). Ileal neobladder related complications developed in 11 patients; ureteroenteric stricture in 7 (15.5%), stricture of the urethral anastomosis site in 3 (6.6%) and acute pyelonephritis in 1 (2.2%). The results of the mean maximal flow rate and mean postvoid residual volume were better in the ileal neobladder group than those in the ileocolic neobladder group. CONCLUSIONS: There were no significant differences in complications between ileocolic neobladder and ileal neobladder. The maximal uroflow and residual urine volume of the ileal neobladder were superior to those of the ileocolic neobladder on urodynamic study.
Colon ; Constriction, Pathologic ; Cystectomy* ; Female ; Humans ; Ileum ; Indiana ; Male ; Pyelonephritis ; Residual Volume ; Rupture ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion ; Urodynamics*

BACKGROUND: Germline mutations in the breast cancer-associated genes BRCA1 and BRCA2 confer susceptibility and a lifetime risk of breast. Several morphological and clinical features have been attributed to hereditary tumors. However, in sporadic breast cancer, the interrelationship between the loss of heterozygosity (LOH) of these loci and clinical features remains to be fully elucidated. METHODS: Microdissected paraffin-embedded tissue blocks of 48 cases of surgically resected breast carcinoma were investigated to identify the LOH of BRCA1 and BRCA2 using microsatellite markers. RESULTS: Of 48 cases, 22 (45.9%) exhibited LOH at BRCA1 locus while in 29 out of 48 (60.4%) cases LOH was observed for the BRCA2 region. There was no significant correlation between LOH at BRCA1/2 and the patient's age, tumor size, histologic grade or lymph node metastasis. When comparing the frequency of LOH with the expression of several prognostic factors, such as p53, c-erb B2 protein, estrogen and progesterone receptor using immunohistochemical stain, there was only correlation with LOH at BRCA2 and the progesterone receptor. CONCLUSIONS: Our results suggest that allelic deletion play a role to the development of sporadic breast cancers.
Breast Neoplasms* ; Breast* ; Estrogens ; Germ-Line Mutation ; Loss of Heterozygosity* ; Lymph Nodes ; Microsatellite Repeats ; Neoplasm Metastasis ; Paraffin* ; Receptors, Progesterone

PURPOSE: Chronic bacterial prostatitis (CBP) is the most common urological disease in adult males, with antibiotic therapy being the gold standard for its treatment. However, long-term therapy results in many side effects as well as bacterial resistance. For these reasons, there is a need for a new treatment modality to replace traditional antibiotic therapy. Lycopene, an extract of tomatoes, has antioxidant effects against various bacteria and synergistic effects with antibiotics. We evaluate the synergistic effects of lycopene on the treatment of CBP in an animal model. MATERIALS AND METHODS: Forty five rats demonstrating CBP were randomly divided into 4 groups; the control, lycopene, ciprofloxacin and lycopene with ciprofloxacin groups. All drug treatments were conducted over a period of 2 weeks. After treatment, the results were analyzed, with the microbiological cultures and histological findings of the prostate and urine samples compared with the control group and between each group. RESULTS: The uses of ciprofloxacin, and lycopene with ciprofloxacin showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (p<0.05). The lycopene with ciprofloxacin group showed a statistically significant decrease in bacterial growth and improvements in prostatic inflammation compared with the ciprofloxacin group (p<0.05). CONCLUSIONS: These results suggest that lycopene may be an effective material in the treatment of CBP. Especially, the combination treatment of lycopene and ciprofloxacin has synergistic effects. Therefore, it is suggest that the combination of lycopene and ciprofloxacin may be effective in the treatment of CBP, and with a higher success rate.
Adult ; Animals ; Anti-Bacterial Agents ; Antioxidants ; Bacteria ; Ciprofloxacin ; Humans ; Inflammation ; Lycopersicon esculentum ; Male ; Models, Animal* ; Prostate ; Prostatitis* ; Rats* ; Urologic Diseases

PURPOSE: To investigate whether the preoperative prostatic biopsy values predict the tumor stage in radical retropubic prostatectomy (RRP) specimens. MATERIALS AND METHODS: We reviewed the prostatic needle biopsy findings in 69 patients, diagnosed with clinical organ confined prostate cancer, and who underwent a RRP between December 2003 and November 2004. The biopsy specimens were assessed for the number and maximal tumor length of positive cores and for the Gleason score. The preoperative serum prostate-specific antigen (PSA) level and prostate volume were measured using transrectal ultrasonography (TRUS). TRUS guided biopsies of 13.7 2.2 sites were performed. The preoperative values were compared with the pathological stage of the RRP specimens. RESULTS: Of the 69 patients, 53 (76.8%) had organ confined cancer and 16 (23.2%) had extraprostatic extension (pathologic T2 and T3 or greater, respectively), with mean ages of 65.6 and 65.1 years, respectively. The mean PSA levels were 8.0 and 13.0ng/ml and the prostate volumes were 38.3 and 33.8ml, respectively. The age, prostate volume, biopsy Gleason score and preoperative PSA level were not significant factors for predicting the pathological stage inform a multivariate analysis (p>0.05). The number (p=0.007) and maximal tumor length of positive cores (p=0.046) were significantly higher in those with an extraprostatic stage than in the organ confined cancer group. The optimal maximal tumor length and number of positive cores for the detection of extraprostatic cancer were 7.5mm and 6.5, respectively. CONCLUSIONS: The number and maximal tumor length of positive cores were strong predictors of the pathologic stage in the RRP specimens.
Biopsy* ; Biopsy, Needle ; Humans ; Multivariate Analysis ; Neoplasm Grading ; Pathology ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms ; Ultrasonography

PURPOSE: We identified preoperative factors and characteristics of prostate cancer with prostate-specific antigen (PSA) levels equal to or less than 4.0ng/ml, with an elevated PSA above age reference range, abnormal transrectal ultrasonography (TRUS) or digital rectal examination (DRE). MATERIALS AND METHODS: A total of 322 patients underwent 12 cores prostate biopsy guided TRUS between May 2003 and July 2004. Of these, 92 had a total PSA level of 4ng/ml or less. The indications for a biopsy were an elevated PSA above the age reference range, and an abnormal DRE and TRUS. The age, abnormalities of the DRE or TRUS, and the prostate volume, PSAD, International Prostate Symptom Score (IPSS) and maximal flow rate (Qmax) were measured, and the relationships of theses factors between the cancer and non-cancer groups evaluated. RESULTS: Of the 92 patients with a total PSA level of 4ng/ml or less, 19 were confirmed with prostate cancer; a cancer detection rate of 20.6%. The mean ages of patients in the cancer and non-cancer groups were 70.3 and 62.0 years, respectively. The mean prostate volumes, PSA levels, IPSS and Qmax were 31.4 and 48.9ml, 3.23 and 3.17ng/ml, 19.3 and 16.3 and 15.8 and 13.9ml/sec, respectively, in the cancer and non-cancer groups. The advanced age (p<0.05) and a decreased prostate volume (p<0.05) were associated with a positive prostate biopsy. The PSA level, abnormalities of DRE or TRUS, IPSS and Qmax were not associated with a positive biopsy. CONCLUSIONS: The detection rates of prostate and insignificant cancers rate were 20.6 and 36.8%, respectively. An advanced age and a decreased prostate volume were significant predictive factors of cancer in patients with PSA level equal to or less than 4.0ng/ml, with an elevated PSA above age reference range, abnormal TRUS or DRE. (Korean J Urol 2005; 46:565-568)
Biopsy ; Digital Rectal Examination ; Humans ; Prevalence ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Reference Values ; Ultrasonography

PURPOSE: The germ cell proliferation and apoptosis were investigated in testis and its effect to the spermatogenesis. MATERIALS AND METHODS: The biopsy specimens of testis were obtained from 58 infertile males with nonobstructive azoospermia due to primary testicular failure and from 13 prostate cancer cases with normal spermatogenesis. The infertility specimens were divided into 4 groups according to histopathologic findings- Sertoli cell only syndrome(A), maturation arrest(B), hypospermatogenesis(C) and disorganization with sloughing(D) and quantitatively evaluated with Johnsen score system. Germ cell proliferation and apoptosis were determined using immunohistochemical study with MIB-1, bcl-2 monclonal antibodies and TUNEL method, and evaluated the relationship between their results and histopathologic findings. RESULTS: MIB-1 expression was negative in all infertility group A. MIB-1 positivity was revealed no statistical significance among infertility groups B, C, D and control group(p>0.05 in each). Bcl-2 and apoptosis were not expressed in all infertilty group A and control group. Bcl-2 and apoptosis positivity were revealed no significant difference among group B, C and D (p>0.05). MIB-1 expression was shown no relationship with the apoptosis (p>0.05), and a high prevalence in bcl-2 positive group, but there was no significant correlation (p>0.05). In infertility group, the MIB-1 index and bcl-2 positivity were decreased according to high Johnsen score but no statistical difference (p>0.05), and apoptosis was shown no relationship with Johnsen score (p>0.05). CONCLUSIONS: MIB-1 expression did not represent the degree of spermatogenic failure in infertile patients. The apoptosis was detected in all infertility groups except Sertoli cell only syndrome. Apoptosis was suggested to be related somewhat with spermatogeneis.
Antibodies ; Apoptosis* ; Azoospermia ; Biopsy ; Cell Proliferation ; Germ Cells* ; Humans ; In Situ Nick-End Labeling ; Infertility ; Male ; Prevalence ; Prostatic Neoplasms ; Sertoli Cell-Only Syndrome ; Spermatogenesis* ; Testis*

Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes (3.45 +/- 0.43 g/dL) than in non-diabetic patients (3.64 +/- 0.36 g/dL) (p < 0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes (1.42 +/- 1.8 mg/dL) (p < 0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r = -0.553, p < 0.01) and non-diabetic (r = -0.579, p < 0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r = 0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) (153.1 +/- 80.1 mg/dL vs 101.6 +/- 62.4 mg/dL) and decreased serum HDL cholesterol (36.89 +/- 13.48mg/dL vs 47.00 +/- 14.02 mg/dL, P < 0.05). There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r = 0.438, p < 0.05) and non-diabetic (r = 0.527, p < 0.05) patients. Serum CRP level was negatively correlated with calorie (r = -0.468, p < 0.05), protein (r = -0.520, p < 0.01) and fat intakes (r = -0.403, p < 0.05) in diabetic patients and calorie (r = -0.534, p < 0.05) and protein intakes (r = -0.559, p < 0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.
C-Reactive Protein ; Cardiovascular Diseases ; Cholesterol, HDL ; Comorbidity ; Diabetes Mellitus ; Dialysis ; Hematocrit ; Humans ; Inflammation ; Kidney Failure, Chronic ; Malnutrition ; Mortality ; Nutritional Status* ; Prevalence ; Protein-Energy Malnutrition ; Renal Dialysis* ; Risk Factors ; Serum Albumin ; Triglycerides

A transurethral resection of bladder tumor (TURBT) is the primary treatment modality for bladder cancer. The common complications of TURBT include urinary tract infections, a hemorrhage requiring transfusion, and bladder perforation. Extravesical metastasis and intraperitoneal seeding of tumor cells following TURBT are very rarely reported. This report reviews a case of extravesical metastasis occurring after a repeated TURBT of non-invasive bladder cancer.