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*

A clinical observation of the prepuce was made on 3,302 men from examined in the Department of Urology, Capital Military Hospital and the following results were obtained. 1. Redundant prepuces were found in 2,789 cases with incidence of 84.5%. 2. Phimosis were found in 17 cases with incidence of 0.6%. Of 17 cases, 12 cases were congenital phimosis and 5 cases were found acquired phimosis. 3. Paraphimosis were found in 8 cases giving a rate of 0.3%. 4. Circumcised men were found in 166 cases, with incidence of 5.0% of all cases.
Animals ; Female ; Foreskin* ; Hospitals, Military ; Humans ; Incidence ; Male ; Paraphimosis ; Penis* ; Phimosis ; Urology

A paraffinoma is a type of inflammatory lipogranuloma that develops after the injection of an artificial mineral oil, such as paraffin or silicon, into the foreskin or the subcutaneous tissue of the penis for the purpose of penis enlargement, cosmetics, or prosthesis. The authors experienced a case of macro-paraffinoma associated with sexual dysfunction, voiding dysfunction, and pain caused by a buried glans penis after a paraffin injection for penis enlargement that had been performed 35 years previously. Herein, this case is presented with a literature review.
Foreskin ; Granuloma* ; Male ; Mineral Oil ; Oils ; Paraffin* ; Penis ; Prostheses and Implants ; Silicon ; Subcutaneous Tissue

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

PURPOSE: Penoscrotal transposition is found in cases with severe form of hypospadias. In those cases, severe chordee generally coexists and a long length of urethra may be necessary for its correction. We evaluated the clinical outcome of surgical repairs for 12 patients of proximal hypospadias with penoscrotal transposition. MATERIALS AND METHODS: Out of 12 cases, there were 2 with penoscrotal type, 7 with scrotal type and 3 with perineal type hypospadias. All cases had moderate to severe chordee. Five cases were treated with one-stage repair and seven cases with multi-stage repair. We analysed operative methods, postoperative complications and those managements between the cases of one-stage and multi-stage repairs. RESULTS: For one-stage repair, we used transverse preputial island flap method in 3 cases and urethroplasty using scrotal skin flap in 2 cases. For multi-stage repair, we performed Thiersh-Duplay urethroplasty in 2 cases, bladder mucosal graft in 2 cases and Belt-Fugua urethroplasty in 3 cases. Correction of penoscrotal transposition was performed successfully in all cases. In all cases, a paucity of skin was the most difficult problem. The overall complication rate was 50.0%. In cases treated with one-stage repair, there were two cases with urethrocutaneous fistulas. However, in cases treated with multi-stage repair, there were four cases with complications such as urethral strictures, urethrocutaneous fistulas with or without large skin defect. Overall the complications in cases with multi-stage repair were more severe than those in cases with one-stage repair. CONCLUSIONS: Our experience suggests that multi-stage operation may be not superior to one-stage operation in cases with proximal hypospadias associated with penoscrotal transposition. Thus we recommand one-stage repair in those cases despite a paucity of foreskin.
Female ; Fistula ; Foreskin ; Humans ; Hypospadias* ; Male ; Postoperative Complications ; Skin ; Transplants ; Urethra ; Urethral Stricture ; Urinary Bladder

BACKGROUND: Melanocytes synthesize melanin pigment by the action of specific enzyme tyrosinase. In normal skin, melanocytes maintain their constant population and steady melanogenic activity. But several stimuli to the skin such as UV irradiation and chemical irritation may accelerate the proliferation and differentiation of melanocytes and subsequently lead to hyperpigmentation of the skin. Endothelin-1(ET-1), produced by human keratinocyte acts as a strong mitogen on human melanocyte and has an effect on paracrine linkage between keratinocytes and melanocytes, and plays an important role in UVB induced hyperpigmentation as an intrinsic factor. OBJECTIVE: In this study, the role of ET-1 on melanocyte proliferation and melanogenesis was investigated, and the effects of ETRA(endothelin receptor antagonist) in cultured melanocyte was also evaluated. METHODS: Primary melanocytes from neonatal foreskins were cultured in complete MCDB 154 medium. To examine the effects of ET-1 on melanocytes, cultuled melanocytes were treated with ET-1 at various concentration(5nM, 10nM, 15nM, 20nM). Three days later, melanocyte proliferation and melanin content were measured. Also, we examined the effects of ETRA on ET-1 treated melanocytes. Five kinds of ETRA were added into 10nM of ET-1 treated melanocyte. After three days cultuviation, inhibitory effect of ETRA on ET-1 activity was measured. RESULTS: 1. The number of melanocytes increased in the groups of incubation with melanocyte medium of concentration in 10nM ET-1 than others. 2. The melanin contents increased most in the groups of incubation with melanocyte medium of concentration in 10nM ET-1 than others. 3. The number of melanocytes decreased in the groups of inhibited with ETRA I. 4. The melanin contents decreased in the groups of inhibited with ETRA II. CONCLUSION: This study provided an important confirmation of the proposal that ET-1 is intrinsic factor for proliferation and differentiation of human melanocytes, and ETRA has inhibitory effect on ET-1 induced melanogenesis and melanocyte proliferation. These findings suggest that ET-1 is an important mediator in epidermal pigmentation, and we will be able to use ETRA as a new whitening agent.
Endothelin-1 ; Foreskin ; Humans* ; Hyperpigmentation ; Intrinsic Factor ; Keratinocytes ; Melanins ; Melanocytes* ; Monophenol Monooxygenase ; Pigmentation ; Skin

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

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*