In the repair of hypospadia, the use of bladder mucosal grafts in cases in which previous adequate foreskin for urethral reconstruction is lacking or in which previous repairs have failed, is feasible. The bladder mucosal graft offers several theoretical advantages. It is of the same histologic character as the normal urethra, is not hair bearing, tends to re-epithelialize exposed surfaces and has great dispensability. We have experienced two cases of the perineal and penoscrotal hypospadias repaired successfully by the bladder mucosal graft technique.
Female ; Foreskin ; Hair ; Hypospadias* ; Male ; Transplants* ; Urethra ; Urinary Bladder*

PURPOSE: We evaluated the effect of a topical steroid(0.05% clobetasol propionate[Dermovate(R)]) on phimosis. MATERIALS AND METHODS: Between May 2005 and May 2007, 30 boys with phimosis were assigned to receive topical application of Dermovate(R). Of the 30 boys, 19 boys had concealed penises. The parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroid over the stenotic opening of the prepuce twice daily for 4 weeks then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 1-6. Response to treatment was arbitrarily defined as improvement in the retractibility score(complete response, score 5 and 6; partial response, score 3 and 4; no response, score 1 and 2). The effect of treatment was studied with respect to the duration of treatment, age, and an associated concealed penis. RESULTS: The pretreatment grade in all patients was a retractibility score of 1. The mean age of the patients was 48.5+/-27.6 months(range, 7-108 months). The complete response rates in boys treated for 4 and 8 weeks were 50% and 73.3%, respectively. In boys younger than 3 years of age (n=12) and older than 3 years of age(n=18), the complete response rates were 75% and 72.2%, respectively(p=0.866). In boys with or without an associated concealed penis(n=19 and n=11, respectively), the complete response rates were 63.1% and 90.9%, respectively(p=0.199). No adverse effect was encountered in all patients. CONCLUSIONS: Our data suggest that the application of topical steroids for 8 weeks as a first line treatment of phimosis may be effective, although further studies are needed to establish the definite efficacy and safety of this procedure.
Child ; Clobetasol ; Female ; Foreskin ; Humans ; Male ; Parents ; Penis ; Phimosis ; Steroids

Vitiligo is an acquired systemic disease of the skin characterized by circumscribed patches of complete pigment loss due to destruction of melanocytes. A 28-year old male patient presented with generalized depigmented patchs. We performed microscopic studies of cultured melanocytes from this patient and compared them with those of normal neonatal foreskin. Phase contrast microscopic findings revealed no difference between the two groups of melanocytes, but transmission electron microscopic findings showed dilated circular rough endoplasmic reticulum in cultured melanocytes from our vitiligo patient. We could observe the innate cellular structural aberration of melanocytes from the vitiligo subject.
Adult ; Endoplasmic Reticulum, Rough ; Foreskin ; Humans* ; Male ; Melanocytes* ; Skin ; Vitiligo*

BACKGROUND: The regulatory rnechanisrns of melanocytes underlying ultraviolet(UV) melanogenesis have been an interest tu many investigators. They have shown that several materials produced and secreted frorn norm il human keratinocytes play roles as mitogens of human melanocytes, and demonstrated that UVB exposure stirnulated highly the paracrine linkage of endothelin(ET) be tween keratinocytes and melanocytes. It suggest that ET is one of keratinocytes-derived intrinsic mitogens in UVB induced hyperpigmentation. OBJECTIVE: To evaluate whether ET secreted from keratinocytes under the UV irradiation works as paracrine effects such as melanocyte pro)iferation and function, the present, study was under taken. METHODS: Primary kevatinocytes and rnelanocytes cultures from neonatal foreskins were grown in complete MCDB 154 medium. Cultured human keratinocytes were irradiated with UVB 50mJ/ cm2. Twenty fours hour later, conditioned medium of keratinocytes was added into the growth medium of melanocytes of concentration in 10%, 20%, and 30%, respectively. Four days later, in order to detect of melanocytes proliferat.ion and function, number of melanocytes, melanin granules and tyrosinase activity v ere measured. RESULTS: J. The number of me anocytes were higher increase in groups of incubation with conditioned medium of irradiated keratinocytes than that of incubation with conditioned mediurn of irradiated keratinocytes and treatment of anti-ET-1(5ug/ml)(p>0.05). 2. The melanin contents were significantly higher increase in groups of incubation with conditioned medium(20%, 30%) of irradiated keratinocytes than that of incubation with conditioned medium of irradiated keiatinocytes and treatment of anti-ET-1(5ug/ml)(p<0.05). 3. The tyrosinase activity of melanocyte incubated with 30% COllcentration of conditioned medium from cultured keratinocyte irradiated with UVB was significantly higher increase than that of melanocyte incubated with 30% concentration of conditioned mediurn from cultured keratinocytes irradiated with UVB and treated with anti-ET-1(p<0.05). CONCLUSION: This stud provided an important confirmation of the proposal that ET-1 is intrin sic factor for proliferation and differentiation of human melanocytes. These findings suggest that keratinocyte derived ET-1 make a considerable effect on human melanocyte proliferation and function in UV melanog nesis.
Culture Media, Conditioned ; Endothelin-1* ; Foreskin ; Humans* ; Hyperpigmentation ; Keratinocytes* ; Melanins ; Melanocytes* ; Mitogens ; Monophenol Monooxygenase ; Research Personnel

PURPOSE: Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. METHODS: A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid (group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). RESULTS: The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. CONCLUSION: Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.
Child, Preschool ; Female ; Foreskin ; Humans ; Infant ; Male ; Penis ; Phimosis* ; Steroids ; Urinary Tract Infections

The cutaneous synthesis of vitamin D in response to ultraviolet radiation exposure is the most important factor in maintaining vitamin D balance in Man. The skin is not only the site of vitamin D synthesis, but also a target organ for calcitriol(1, 25-dihydroxy-vitamin D) which is naturally occuriag, hormonally active form of vitamin E. It is now known that calcitriol inhibits the proliferation of epidermal cells and induces her differentiation. In this study, epidermal keratinocytes and melanocytes were isilated from the neonatal foreskin, and were culturod using a MCDB 153 and modified TIC media, respectively. And then various concentratioris of calcipotriol(MC 903), a synthetic aralogue of calcitriol, were added to each culture. The effects of calcipotriol on the growth of human keratinocytes and melanocytes were investigated. The results were as follows : 1. The addition of calopotriol to human keratinocyte and melalocyte cultures inhibited their proliferation in a dosdependent manner. 2. Calcipotriol had no effects on the melanization process of the melanocyte. 3. Calcipotriol was found to inhibit the proliferation, however it induced the terminal differentiation of cultured keratinocytes, as judged by morphologicai changes. The decreased density of kerationcytes, The formation of cornified cells, and the cellular destruction in a concentration of 10 M of calcipotriol were observed. 4. By using the light atid the electron microscope, we observed that the epidermal thickness was decreased and terminal differentiation was facilitateir. Living Skin Equivalent (LSE) according to the increasing concentration of calcipotriol. A]i)parent cytotoxic effects were observed in 10 M, 10 M of calcipotriol. In summary, the above results indicate that the addition of calcipotriol to the in vitro culture system of human keratinocyte and melanocyte induces the biologic process of terminal differentiation of keratinocytes and inhibits proliferation of keratinoytes and melanocytes in a dose-dependent manner.
Calcitriol ; Cholecalciferol* ; Foreskin ; Humans* ; Keratinocytes* ; Melanocytes* ; Skin ; Tics ; Vitamin D ; Vitamin E ; Vitamins*

BACKGROUND: Trans-4-aminomethylcyclohexanecarboxylic acid (tranexamic acid) has recently been reported to inhibit prostaglandin synthesis and hinder the pigmentation caused after UV radiation. OBJECTIVE: we evaluated the influence of tranexamic acid on the viability, morphogenesis and melanization of cultured normal human melanocytes. METHOD: The cultured melanocytes from neonatal foreskin were exposed to UVB 20mJ/cm2, then treated with tranexamic acid [0.05microgram/ml, 0.05microgram/ml, and 0.5microgram/ml]. After 24 hours, the viability of melanocytes and the melanin concentration was measured. The number and length of the melanocytes' dendrites, and the expression level of tyrosinase, TRP-1 and TRP-2 were also evaluated. RESULTS: The viability of the melanocytes was decreased by tranexamic acid in a dose dependent manner (p<0.05). The increased melanin synthesis by UVB irradiation was decreased by tranexamic acid in a dose dependent manner (p<0.05). Also, the increased expressions of TRP-1, TRP-2 and tyrosinase after exposure to UV were statistically decreased by tranexamic acid in a dose dependent manner (p<0.05). CONCLUSION: tranexamic acid may prevents UVB induced pigmentation.
Dendrites ; Foreskin ; Humans* ; Melanins ; Melanocytes* ; Monophenol Monooxygenase ; Morphogenesis ; Pigmentation ; Tranexamic Acid

The distribution of pemphigus subclass autoantibodies in a patient with pemphigus vulgaris (PV) has been investigated by semiquantitative indirect immunofluorescence (IIF), using the HP series monoclonal antibodies specific for four human IgG subclasses on human foreskins. IgG1 and IgG4 intercellular substance-specific autoantibodies were detected in the serum of the patient, whereas IgG2 and IgG3 autoantibodies were absent. In addition to foreskins, human tonsillar epithelia were used as substrates of IIF for detecting the PV autoantibodies and it was one of satisfactory substitutes for monkey esophagus.
Antibodies, Monoclonal ; Autoantibodies* ; Esophagus ; Fluorescent Antibody Technique, Indirect ; Foreskin ; Haplorhini ; Humans ; Immunoglobulin G* ; Pemphigus*

BACKGROUND: Superoxide dismutases (SOD) are important metallo-enzymes which scavenge and dismutase the superoxide free radical. They are thought to be the main enzymes in the antioxidant defense system. In the several cell ines the induction of Mn-SOD expression by tumor necrosis factor (TNF)-alpha which is a known inflammatory cytokine, suggests that Mn-SOD may play a role in the inflammatory process. However, this effect is occurred. OBJECTIVE: The present study was undertakento determine whether the induction of SOD expression by TNF-alpha, in the keratinocytes is occurred. METHODS: Primary keratinocyte cultures from neonatal foreskins were grown in complete MCDB 153 medium. Measurement of superoxide radical and SOD activity were performed according to Babior and Fridovich methods, respectively. RESULTS: 1. The release of superoxide radical were measured after 30, 60, 90 minutes exposure to 10ng/ms TNF-alpha, THE RESULTS SHOWS 2.94+/-0.30 NMOL/2x105, 3.55+/-0.52 NMOL/2x105, 4.13+/-0.70 nmol/2x105 respectivelyl The increase of superoxide radical release was detectable in a time dependent manner. 2. Total SOD activity without treatment of TNF-alpha at 24 hours was 18.46+/-2.85, Total SOD activities after treatment of 1, 10, 100 ng/ml TNF-alpha at 24hours were 36.47+/-6.80, 88.01+/-7.79, 94.50+/-8.97 respectively, which suggested that TNF-alpha induced increase of total SOD significantly (p<0.050. TNF-alpha stimulate total SOD induction in a dose and time dependent manner, although the effects were not outstanding. Mn-SOD activity after treatment of 100 ng/ml TNF-alpha at 48 hours was 84.12+/-14.83, which was approxdimately 10.5 fold of that of the untredated case. TNF-alpha also induced the Cu, Zn-SOD activity, but the effect was not so much as in the case of Mn -SOD. CONCLUSION: TNF-alpha induces production of total SODD activities, especially Mn-SOD in the human kerati ocytes, which may be to protect cells from inflammation mediated oxidative damage, namely production of total SOD protein, especially Mn-SOD in response to TNF-alpha induced and scavenged overproduced superoxide radical which in turn may result in protection of the keratinocytes.
Foreskin ; Humans* ; Inflammation ; Keratinocytes* ; Superoxide Dismutase* ; Superoxides* ; Tumor Necrosis Factor-alpha*

We present a 40-year-old woman who had a well circumscribed, pea sized red-brown glistening erosive papule on the foreskin of clitoris for four months which had been resistant to various forms of treatment. Histopathologic examination revealed flattened epidermis with lozenge keratinocytes and watery spongiosis, In the upper dermis, dense bandlike infiltration of plasma cells, endothelial proliferation, and capillary dilatation were noted. Peroxidase-antiperoxidase stain showed polyclonal pattern of reaction in the cytoplasm of plasma cells.
Adult ; Capillaries ; Clitoris ; Cytoplasm ; Dermis ; Dilatation ; Epidermis ; Female ; Foreskin ; Humans ; Keratinocytes ; Peas ; Plasma Cells ; Vulvitis*