PURPOSE: Extracorporeal shock wave lithotripsy (SWL) has been established as the treatment of choice for the urinary stones. But, for the treatment of staghorn calculi, the efficacy of this therapeutic procedure is controversal. We intended to study the therapeutic results and the usefulness of ureteral stent between 2 types of lithotriptor, EDAP LT-01 and Storz Modulith SLX. MATERIALS AND METHODS: Sixty cases were diagnosed as staghorn calculi from February 1990 to December 1998. Among them, 31 patients were treated with EDAP LT-01 SWL (group A) and 29 patients with Storz Modulith SLX SWL (group B). We inserted a double-J stent in 45 patients that consisted of 24 patients from group A and 21 patients from group B. The number of treatment sessions, complications and success rates were compared regarding each SWL and volume of the stone. RESULTS: The success rates of each SWL were 70.9% in group A and 75.9% in group B. The success rates, according to staghorn morphology, were 71.4% and 85.7% in partial staghorn of group A and B. The average shock wave sessions were 12.0 and 7.4 in partial staghorn of group A and B. The success rates, according to staghorn volume, were 67.8% and 88.9% in less than 60cm3 of group A and B. The average shock wave sessions were 12.6 and 9.6 in less than 60cm3 of group A and B. The findings were statistically significant between the two groups in less than 60cm3 or partial staghorn. After SWL, incidence of steinstrasse was 12.5% and 33.3% in the double-J stent inserted patients of group A and B. CONCLUSIONS: SWL could be a method of primary treatment for staghorn calculi. Storz Modulith SLX SWL was more effective than EDAP LT-01 SWL for staghorn calculi of which the volume was less than 60cm3. Placement of ureteral stents would be effective in the treatment of staghorn calculi by EDAP LT-01 SWL and not in Storz Modulith SLX.
Calculi* ; Humans ; Incidence ; Lithotripsy ; Shock ; Stents ; Ureter ; Urinary Calculi

PURPOSE: Although there is no favoring etiology and no definitive treatment modality for interstitial cystitis(IC), the search for the cause of IC continues in hope of identifying a target for treatment. Recently nitric oxide(NO) is speculated to be associated with the pathogenesis and the treatment of IC. But, the exact mechanisms are poorly known and the experimental and clinical data about NO in IC are conflicting. We attempted to determine that urine NO level evaluated in patients with interstitial cystitis(IC) and compared with those from control patients with bacterial cystitis. MATERIALS AND METHODS: Fifty six patients were involved in this study, including control 22, patients with IC 8, patients with bacterial cystitis 17, and recovery state from bacterial cystitis 8. Urine samples were collected by clean-catch midstream in men and from urethral catheterization in women. Urinary nitrite which was considered to be an urinary NO in this study was measured by Titerek Multiscan MCC/340 ELISA reader. RESULTS: Urinary NO levels were 6.16+/-1.09 pM/mg.creatinine in control, 5.15+/-0.87 pM/mg.creatinine in IC, 79.58+/-24.69 pM/mg. creatinine in bacterial cystitis, and 32.96+/-8.38 pM/mg.creatinine in recovery state from bacterial cystitis, respectively. Urinary NO levels in bacterial cystitis and recovery state from bacterial cystitis were significantly higher than those in control and IC(p<0.0001). CONCLUSION: Urinary NO in bacterial cystitis was higher than that in control and maintained for some period. Urinary NO in IC was lower than that in bacterial cystitis.
Creatinine ; Cystitis* ; Cystitis, Interstitial ; Enzyme-Linked Immunosorbent Assay ; Female ; Hope ; Humans ; Male ; Nitric Oxide ; Urinary Catheterization ; Urinary Catheters

Primary aldosteronism, characterized by hypertension, hypokalemia and hyperaldosteronemia caused by chronic overproduction of aldosterone independent of normal renin-angiotensin system, due to aldosteronoma, or to bilateral cortical nodular hyperplasia, or to adrenal carcinoma rarely. We report a case of left adrenal adenoma which was diagnosed by classic clinical symptoms, laboratory data, adrenal venography and abdominal computerized tomography. We performed left adrenalectomy with subcostal transperitoneal approach, and then blood pressure and laboratory data were normalized postoperatively.
Adenoma ; Adrenalectomy ; Aldosterone ; Blood Pressure ; Hyperaldosteronism ; Hyperplasia ; Hypertension ; Hypokalemia ; Phlebography ; Renin-Angiotensin System

Background: Sedentary behavior is associated with increased cardiovascular disease (CVD) risk. We investigated this association of sedentary time and physical activity with increased 10-year CVD risk in Korean adults. Methods: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (2014–2017). In total, 14,551 participants aged 30–74 years (6,323 men, 8,228 women) were analyzed. The usual length of sedentary time per day was categorized into three groups (<6, 6–<9, or ≥9 h/d), and physical activity (metabolic equivalents [METs]∙min/wk) was categorized into two groups (low, <600 METs∙min/wk; moderate/high, ≥600 METs∙min/wk). Logistic regression analysis was performed to assess the association between sedentary time and increased CVD risk (predicted 10-year risk ≥10%). Adjusted variables were age, sex, body mass index, marital status, employment, household income, alcohol use, family history of CVD, and comorbidity (hypertension, diabetes, and dyslipidemia). Results: The average sedentary time for the 14,551 participants was 7.49 h/d, with an average 10-year CVD risk of 9.58%. There was no significant association between sedentary time and increased 10-year CVD risk in the moderate/ high physical activity group. In the low physical activity group, sedentary time ≥9 h/d had a significant association with increased CVD risk (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.04–1.62). However, when the sedentary time was <6 h/d, no significant associations were found (OR, 1.17; 95% CI, 0.92–1.49). Conclusion In the low physical activity group, reduction of sedentary time might be important for preventing increased CVD risk.

PURPOSE: The Gleason score is an important predictor of outcome that is used in conjunction with clinical stage and prostate-specific antigen to guide clinical decision making. The prostate biopsy Gleason grade frequently differs from the radical prostatectomy grade. The aim of this study was to determine the risk factors of Gleason upgrading in patients with low-risk prostate cancer after radical prostatectomy. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 146 patients who underwent radical prostatectomy between 1998 and 2008 in two hospitals of Jeonbuk province in Korea. Pathological Gleason score upgrading was defined as an increase in the Gleason score from < or =6 to > or =7 between the biopsy and radical prostatectomy specimen. Pretreatment clinical and pathological parameters were used to identify predictors of pathological upgrading. RESULTS: Of the total 146 patients, 51 (34.9%) were upgraded postoperatively. Small prostate volume (p=0.008), abnormality on the digital rectal examination, and positive surgical margin (p=0.001) were significantly and positively associated with upgrading after radical prostatectomy. A total of 17 of 65 patients with low-risk prostate cancer (26.2%) were upgraded postoperatively. Small prostate volume (<30 ml) was significantly (p=0.026) and positively associated with upgrading after radical prostatectomy in patients with low-risk prostate cancer. CONCLUSIONS: Overall, 26% of patients with low-risk disease were upgraded postoperatively. Small prostate volume was associated with an increased risk for pathological upgrading after radical prostatectomy. These conclusions should be kept in mind when making treatment decisions for men with low-risk prostate cancer.
Biopsy ; Decision Making ; Digital Rectal Examination ; Humans ; Korea ; Male ; Medical Records ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Retrospective Studies ; Risk Factors

PURPOSE: Nephron-sparing surgery for renal tumors in solitary kidneys has several technical difficulties and complications, including renal failure. We evaluated operative outcome and feasibility in patients with renal cell carcinoma in a solitary kidney treated with laparoscopic partial nephrectomy. MATERIALS AND METHODS: Between September 2003 and September 2008, 59 patients with renal tumors underwent laparoscopic partial nephrectomy. Among them, 4 patients with a solitary kidney were enrolled in the study. The mean age of the 2 male and 2 female patients was 66.8 years old, and their mean body mass index was 24.7. The mean size of the tumor was 3.5 cm. RESULTS: The mean operative time was 138.5 minutes, and estimated blood loss was 163.8 ml. In 2 patients, warm ischemic times were 25 and 55 minutes. Initiation of postoperative oral intake and ambulation were at 1.0 and 1.5 days. The mean hospital stay was 15.0 days. One patient had a complication of urinary leakage. Pathologic examination revealed renal cell carcinomas with negative surgical margins in all patients. The mean serum creatinine level of preoperative and postoperative day 1 was 1.04 and 1.73 mg/dl, respectively. One patient required temporary hemodialysis. At the mean follow-up of 21.3 months, there was no recurrence of tumors. The mean serum creatinine level at the final visit was 1.36 mg/dl. CONCLUSIONS: Laparoscopic partial nephrectomy for renal tumors in solitary kidneys can be performed safely. Although it is a possible modality with excellent outcome, long-term follow-up for cancer control, along with advanced laparoscopic technique and experience, is necessary.
Body Mass Index ; Carcinoma, Renal Cell ; Creatinine ; Female ; Follow-Up Studies ; Humans ; Kidney ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Male ; Nephrectomy ; Operative Time ; Recurrence ; Renal Dialysis ; Renal Insufficiency ; Walking ; Warm Ischemia

Liposarcoma of spermatic cord is a rare malignant tumor. Because preoperative clinical diagnosis is very difficult, final diagnosis is made by postoperative pathologic examination. This tumor grows slowly and tends to recur locally. Therefore radical inguinal orchiectomy with wide local excision appears to be adequate treatment. We report a case of myxoid liposarcoma of right spermatic cord in 35 year-old male with a brief review of the literatures.
Adult ; Diagnosis ; Humans ; Liposarcoma ; Liposarcoma, Myxoid* ; Male ; Orchiectomy ; Spermatic Cord*

BACKGROUND: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. OBJECTIVE: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. METHODS: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. RESULTS: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. CONCLUSION: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis.
Anoxia ; Fibroblasts ; Humans ; Keloid ; Oxygen ; Shoulder ; Thorax ; Tissue Donors ; Vascular Endothelial Growth Factor A ; Wound Healing

No abstract available.
P-Glycoprotein* ; Stomach Neoplasms*

PURPOSE: Tumor invasion and metastasis are known to be extremely important factors in the prognosis of cancer patients. Although recent studies have demonstrated that cyclooxygenase-2 (COX-2) is overexpressed in various cancers including gastric cancer, the mechanisms underlying the contribution of COX-2 to tumorigenesis and tumor promotion remain unclear. METHODS: In order to determine the role of COX-2 in tumor growth and metastasis, we investigated COX-2 expression, apoptosis and the expression of E-cadherin, CD44v6, MMP-2 and TIMP-2 in gastric cancer xenografts treated with meloxicam (a selective COX-2 inhibitor). RESULTS: Cells from the MKN45 gastric cancer cell line that overexpress COX-2 were inoculated subcutaneously into athymic mice. Oral administration with meloxicam reduced the tumor volume (P<0.01), induced apoptosis of cancer cells (P<0.01), suppressed the proliferation rates (P<0.01), increased the expression of E-cadhrin (P<0.05) and reduced the expression of MMP-2 and TIMP-2. CONCLUSION: The above data showed that COX-2 inhibitors can inhibit tumor growth and suppress metastatic potential by expression of adhesion molecules and suppression of metalloproteinases, suggesting that this inhibitor can be used as an additive anti-cancer drug in cases of stomach cancer with radical resection, although further evaluation is required.
Administration, Oral ; Animals ; Apoptosis ; Cadherins ; Carcinogenesis ; Cell Line ; Cyclooxygenase 2 ; Cyclooxygenase 2 Inhibitors ; Heterografts* ; Humans ; Metalloproteases ; Mice ; Mice, Nude ; Neoplasm Metastasis* ; Prognosis ; Stomach Neoplasms* ; Tissue Inhibitor of Metalloproteinase-2 ; Tumor Burden