No abstract available.

PURPOSE: The relationship between pathological parameters, such as blood vessel, lymphatic and perineural invasions, and prognosis, are controversial. We retrospectively analyzed the charts of patients with bladder cancer to identify the prognostic significance of these parameters. MATERIALS AND METHODS: A retrospective review of 125 of 181 patients with bladder cancer treated with radical cystectomy was conducted. Patients treated with neoadjuvant or adjuvant chemotherapy and those who were found to have lymph node metastasis after cystectomy were excluded from the study. RESULTS: The mean patient age was 62.5 years(range 39-84) and the overall median follow-up was 40.1months(range 1 to 146). Blood vessel, lymphatic, and perineural invasions were present in 8.8%, 20.8%, 8.8% of the specimens, respectively, and 28% of the patients had at least one of three factors. Univariate analysis revealed that blood vessel lymphatic, and perineural invasions were prognostic predictors of survival. However, only tumor stage and blood vessel invasion were calculated to be independent factors of survival on multivariate analysis. CONCLUSIONS: In this series, the pathological stage and blood vessel invasion are significant parameters of tumor-free survival in patients who have undergone cystectomy for bladder cancer. Our findings suggest that blood vessel, lymphatic, and perineural invasions should be examined more carefully.
Blood Vessels* ; Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Cystectomy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis* ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Bladder*

The incidence of cancer is sharply increasing. Cancer is a leading cause of death as well as a significant burden on society. The incidence of urological cancer has shown a higher than average increase and will become an important concern in the future. Therefore, an overall and accurate understanding of the incidence of urological cancer is essential. In this study, which was based on the Korea National Cancer Incidence Database, annual incident cases, age-standardized incidence rates, annual percentage change (APC), and distribution by age group were examined in kidney, bladder, and prostate cancers, respectively. From 1999 to 2011, the total number of each type of urological cancer was as follows: kidney cancer (32,600 cases, 25.5%), bladder cancer (37,950 cases, 29.7%), and prostate cancer (57,332 cases, 44.8%). The age-standardized incidence rates of prostate cancer showed a significant increase with an APC of 12.3% in males. Kidney cancer gradually increased with an APC of 6.0% for both sexes and became the second most frequent urological cancer after 2008. Bladder cancer showed no significant change with an APC of -0.2% for both sexes and has decreased slightly since 2007. The distribution of kidney cancer according to age showed two peaks in the 50- to 54-year-old and 65- to 69-year-old age groups. Bladder and prostate cancers occurred mostly in the 70- to 74-year-old age group. The proportions of male to female were 2.5:1 in kidney cancer and 5.6:1 in bladder cancer. We have summarized the incidence trends of kidney, bladder, and prostate cancers and have provided useful information for screening and management of these cancers in the future.
Female ; Humans ; Incidence ; Kidney Neoplasms/epidemiology ; Male ; Prostatic Neoplasms/epidemiology ; Republic of Korea/epidemiology ; Urinary Bladder Neoplasms/epidemiology ; Urogenital Neoplasms/*epidemiology

PURPOSE: Survivin, a novel inhibitor of apoptosis(IAP), is expressed in many human cancers, but its potential role in prostate cancer is unknown. The expressions of survivin in benign prostate hyperplasia, localized prostate cancer and metastatic prostate cancer were investigated. MATERIALS AND METHODS: Immunohistochemical staining of paraffin sections by a monoclonal antibody for survivin using the standard avidin- biotin-peroxidase technique was performed in 19, 20 and 30 cases with benign prostate hyperplasia, localized prostate cancer and metastatic prostate cancer, respectively. The relationships between the expression of survivin and the clinicopathological characteristics were analyzed. RESULTS: No survivin expression was found in benign prostate hyperplasia, but not in prostate cancer. The expression of survivin was observed in the cytoplasm of the tumor cells, but not in the neighboring normal tissues. The immunoreactivity of survivin increased from localized prostate cancer (60.0%) to metastatic prostate cancer(76.7%), but did not differ significantly. A statistically significant association was observed between the expression of survivin and the Gleason score(p=0.001). CONCLUSIONS: Survivin is expressed in the majority of Prostate cancers and is related to the Gleason score. Survivin may be a potential target for apoptosis-based therapy.
Apoptosis ; Cytoplasm ; Humans ; Hyperplasia* ; Neoplasm Grading ; Paraffin ; Prostate* ; Prostatic Neoplasms*

PURPOSE: Our aim was to evaluate the effects of the centralized intensive education system (CIES) compared with an individualized ward education system (IWES) in the degree of acquisition of the proper clean intermittent catheterization (CIC) method as a treatment of patients with voiding dysfunction. MATERIALS AND METHODS: From March 2002 to March 2003, a prospective questionnaire study was performed on 122 patients (age 55.7+/-17.0 years; 52 males and 70 females). Patients were randomly divided into two groups (the CIES group versus the IWES group) at the time of the urologic consultation for voiding dysfunction. After the CIC education, the patients were asked to complete a self-administered questionnaire about the CIC education. Under the protocol of CIES or IWES for CIC, patients were instructed by doctors or nurses at their wards and performed self- catheterization under supervision. RESULTS: There were 122 patients with 72 patients in CIES, 50 patients in IWES, respectively. There were no differences between two groups in age, sex, education level, and socioeconomic status (p>0.05). CIES was superior to IWES in terms of the patient's understanding on the need for CIC, cause of their voiding dysfunction, help from pictures and the use of instruments related to CIC, sufficient explanation of questions about CIC, overall satisfaction of education, and confidence for CIC after education (p<0.05). There was a significant difference in the number of acquisitions of confidence for CIC between CIES and IWES, which were 3.1 (+/-2.0) times and 5.9 (+/-5.5) times, respectively (p<0.05). CONCLUSIONS: Our result shows that the CIES is superior to the IWES in CIC education. Further efforts are needed to enhance the understanding on the more detailed knowledge of the CIC and to increase the motivation of the patients.
Catheterization ; Catheters ; Education* ; Humans ; Intermittent Urethral Catheterization* ; Male ; Motivation ; Organization and Administration ; Prospective Studies ; Surveys and Questionnaires ; Social Class

Apoptosis ; Bone Regeneration ; Calcium ; Calcium Phosphates ; Cell Cycle ; Cell Proliferation ; Ceramics ; Durapatite ; Gene Expression ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Osteoblasts ; Osteogenesis ; Signal Transduction

PURPOSE: We report a new method of tumor exposure through a minilaparotomy window and cold ischemia using a LapSac(R) during partial nephrectomy by video-assisted minilaparotomy surgery (VAMS). MATERIALS AND METHODS: Partial nephrectomy was performed by VAMS in a total of 31 patients during a period ranging from January 2004 to June 2006, and tumor exposure and cold ischemia were achieved by using a LapSac(R). We investigated the tumor size and location, mean operative time, mean estimated blood loss, mean cold ischemic time, and pathologic outcomes retrospectively. We evaluated preoperative and postoperative renal function with the estimated creatinine clearance rate by the MDRD equation. RESULTS: The mean tumor size was 2.59+/-1.30 cm and mean surgical time was 182.5+/-44.5 minutes. Mean cold ischemic time was 31.84+/-8.43 minutes. Mean estimated blood loss was 445.65+/-202.77 ml (range, 100-800 ml), and 3 patients required transfusion. A histopathologic examination confirmed a diagnosis of renal cell carcinoma in 22 patients (71%). The surgical margin was positive in 1 patient. Twenty-one patients had a mean follow-up of 53+/-8.19 months. Nineteen patients survived without any disease recurrence, 1 patient survived with lung metastasis within 5 months, and 1 patient died of unrelated cause. There was no significant difference between the preoperative and postoperative estimated creatinine clearance rate by using the MDRD equation. CONCLUSIONS: Tumor exposure and cold ischemia were attempted in a partial resection of the kidney by VAMS with a LapSac(R). This technique for partial nephrectomy by VAMS might be an effective, safe modality.
Carcinoma, Renal Cell ; Cold Ischemia ; Cold Temperature ; Creatinine ; Follow-Up Studies ; Humans ; Kidney ; Laparotomy ; Lung ; Neoplasm Metastasis ; Nephrectomy ; Operative Time ; Recurrence ; Retrospective Studies ; Video-Assisted Surgery

PURPOSE: A prospective study was performed to compare the efficacy and safety of intravesical mitomycin C (MMC) instillation for the prophylaxis of bladder cancer at different concentrations (30 mg or 40 mg). MATERIALS AND METHODS: Ninety-seven patients that received complete transurethral resection for superficial bladder cancer were divided into two-randomized groups. One group (n=53) received 30 mg and the other group (n=44) received 40 mg dose of MMC weekly for 8 weeks, which was followed monthly for 10 months as maintenance therapy. The recurrence rates and side effects in both groups were recorded. The mean follow-up period was 32.4 months in the 30 mg group, and 32.0 months in the 40 mg group. RESULTS: The overall one and two year recurrence rates were 19% and 24% in the 30 mg group, and 12% and 22% in the 40 mg group, which was not significantly different (p>0.05). Most of the side effects were mild and transient. Moreover, the rates of the individual side effects were not statistically different in the two groups. CONCLUSION: Our comparison of 30 mg and 40 mg intravesical MMC instillation showed no difference in either response or side effects. Thus, we tentatively conclude that we can use 30 mg instead of 40 mg as an intravesical MMC instillation dose.
Administration, Intravesical* ; Follow-Up Studies ; Humans ; Mitomycin* ; Prospective Studies* ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: While performing clean intermittent catheterization(CIC), atraumatic and non-infecting techniques are important in preventing long-term complications secondary to CIC. The aim of this study is to characterize several essential technical aspects of CIC in patients with neurologically stable spinal cord injury or diseases(SCI/D). MATERIALS AND METHODS: Between July 2002 and March 2003, a prospective questionnaire survey was undertaken in 106 neurologically stable SCI/D patients who were performing CIC as primary bladder emptying methods. Structured questionnaire was administered with the interview. Questionnaire items included key technical CIC steps and related questions. RESULTS: Mean age of the patients(74 males and 32 females) were 35.9(+/-1.3, SE) years and the duration of CIC was 17.3(+/-2.3) months. Levels of SCI/D were: cervical in 45 patients(42.4%), followed by thoracic in 43(40.6%), lumbar in 16(15.1%), and sacral in 2(1.9%). Omitting hand washing before CIC was found in 16 patients(15.1%), meatal cleansing before CIC in 13(12.3%), using lubricants in 12(11.3%), and performing CIC as a timed basis in 36(34.0%). The most preferred posture to perform CIC were: sitting(63.0%), followed by lying(19.1%) and standing(14.6%) in men, while sitting(45.6%), followed by the squatting(33.3%) and lying(15.8%) in women. Majority of the patients performed CIC five times a day with spending about ten minutes for each CIC. Omitting key elements were not significantly associated with the sex, age, level of SCI/D, duration of CIC, level of education, socioeconomic status. However, omitting meatal cleaning before CIC were significantly associated with the patients with shorter duration of performing CIC, lower educational level, and lower socioeconomic status(p<0.05). 57.6% of the patients were satisfied with the current CIC methods. CONCLUSION: Our results showed that some patients do omit key elements of the CIC steps. These elements should be emphasized during the initial CIC education and also must be screened during long-term followup in the SCI/D patients performing CIC.
Catheterization ; Education ; Female ; Follow-Up Studies ; Hand Disinfection ; Humans ; Intermittent Urethral Catheterization* ; Lubricants ; Male ; Posture ; Prospective Studies ; Surveys and Questionnaires ; Social Class ; Spinal Cord Diseases* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic

PURPOSE: In the treatment of large-sized renal stones, percutaneous nephrolithotomy (PNL) is regarded as a minimally invasive surgery with an easy postoperative recovery. In previous procedures, which were done with the patient in a prone position, appropriate measures could not be taken in cases in which a cardiopulmonary emergency appeared. Given this background, we performed PNL in a manner to which the department of urology was accustomed. Then, we attempted to assess the treatment effect and safety of PNL on the basis of our clinical experiences. MATERIALS AND METHODS: This study was conducted in 14 patients who underwent PNL in a semi-lateral position at our medical institution between April and October of 2008. The complete removal of renal stones, blood transfusion, the period of use of a catheter for nephrostomy, complications, and the need for additional procedures after the surgery were examined. RESULTS: Six patients had stones in the pelvis, three had stones in the lower calyx, and five had multiple stones or pelvocalyceal stones. The mean stone size was 2.66 cm (range, 1.56-6.37 cm). In all patients, the renal stone was completely removed and post-procedure complications were minimal except for blood transfusion in one patient. No additional procedures were required in any of the patients. CONCLUSIONS: PNL was performed in a semi-lateral position, which is a position to which the department of urology is accustomed. By use of this position, surgeons and anesthesiologists can reduce the surgical burden due to posture. Based on our clinical experiences, PNL in a semi-lateral position is an effective, safe modality.
Blood Transfusion ; Catheters ; Emergencies ; Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Pelvis ; Posture ; Prone Position ; Urology