No abstract available.
Biopsy* ; Prostate*

No abstract available.
Ureter*

PURPOSE: Recent studies report that up to 40 to 50% of patients who were thought to have clinically localized disease were found to be understaged subsequent to radical surgery. Clearly, development of more sensitive means to identify patients with micrometastatic, locally invasive disease is warranted. With the development of molecular biology, we can apply reverse transcriptase-polymerase chain reaction (RT-PCR) that allows us to identify PSA-synthesizing cells in peripheral blood even when they are highly diluted in a population of peripheral lymphocytes. In this study, we will evaluate the role of RT-PCR in molecular staging of prostate cancer to apply it to clinical situations. MATERIALS AND METHODS: Peripheral blood was obtained from a wide variety of patients with and without prostate cancer before radical prostatectomy. After ribonucleic acid isolation, complementary deoxyribonucleic acid was generated and amplified with a hot-start technique. RT-PCR results were compared with pathologic stage, Gleason score, serum PSA and tumor volume. RESULTS: The RT-PCR test was positive in 0 of 20 controls without suspicion of prostate cancer. Before radical prostatectomy a positive test was obtained in 2 of 9(22.2%) with pT2 disease versus 3 of 5(60%) with pT3 disease. A positive test was obtained in 5 of 6(83.3%) with overt lymph node or bone metastatic disease. We obtained intermittent RT-PCR positive results in serial procedures with two overt bone metastatic cancer patients. There was no significant difference in serum PSA, Gleason score or tumor volume between the men with positive or negative results. CONCLUSIONS: The PSA RT-PCR test in our laboratory cannot be used preoperatively to predict accurate pathological stage of prostate cancer who have undertaken radical prostatectomy. But there is a tendency that PSA mRNA was more frequently detected with higher stage. If the methodology of RT-PCR is refined and improved and sample size increased, RT-PCR for PSA mRNA will become a valuable tool for the evaluation of prostate cancer patients.
DNA ; Humans ; Lymph Nodes ; Lymphocytes ; Male ; Molecular Biology ; Neoplasm Grading ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms* ; RNA ; RNA, Messenger ; Sample Size ; Tumor Burden

Renal cell carcinoma may metastasize to various portions of the body but dissemination to the prostate is very rare. The presenting symptom of a 79 year old man was acute urinary retention which was clinically thought to be benign prostatic hyperplasia. Radical nephrectomy was performed 22 months ago due to renal cell carcinoma. The histologic examination of the transurethral resection specimen demonstrated metastatic renal cell carcinoma and there was no distant metastasis except the lymph node.
Aged ; Carcinoma, Renal Cell* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Nephrectomy ; Prostate* ; Prostatic Hyperplasia ; Urinary Retention

PURPOSE: Recently, many alternative forms of non-surgical treatment modalities were devised for the management of BPH and one of them is transurethral radiofrequency thermotherapy(TURT). In this study, we investigated the long term efficacy of TURT. MATERIALS AND METHOD: A total of 132 patients with symptomatic BPH were treated in a single session with TURT using Thermex-ll(47.5 degrees C, 150minutes) and 88 patients who were available to follow-up for more than 6 months after TURT were enrolled in this study. Among them, 65 patients were available to follow-up for more than 2 years. The baseline and post-treatment mean symptom score(Madson-Iversen), maximal flow rate(MFR), residual urine volume and prostate volume were compared. Improvement was defined as a reduction of more than 50% in at least one of two parameters(symptom score and maximal flow rate). We also investigated whether other treatment modalities were selected in 2 years after TURT. RESULTS: At 3 months follow-up, improvements were observed in 59.1%(52/88), and at 6 months 54.5%(48/88). However, improvements in both symptom score and maximal flow rate at 3 and 6 months after treatment were only 27.3% and 20.5%, respectively. Among 65 patients who were available to follow-up for more than 2 years, 27 patients(41.5%) had undergone transurethral resection of the prostate either with(19) or without medication(8). 28 patients (43.1%) received medical therapy such as alpha blocker during the last two years after TURT. The post-treatment values of the 10 patients who had not received adjuvant therapy were not significantly different from those at baseline. CONCLUSIONS: Although thermal treatment for BPH is an alternative option with minimal complication in selected symptomatic patients who are not clear candidates for surgery or high-risk patients, the long term effect of TURT is not sufficient to relieve the obstructive and irritative symptoms of BPH.
Follow-Up Studies ; Humans ; Hyperthermia, Induced* ; Prostate ; Prostatic Hyperplasia*

PURPOSE: In order to help identifying the subgroups of primary megaureter who neck operation, we retrospectively reviewed the clinical records of the patients who had primary megaureters without vesicoureteral reflux. MATERIALS AND METHODS: We analyzed the initial differential renal function, UTI rate and the incidence of breakthrough infection of each group. Every patient had abdominal renal ultrasonograms and diuretic renograms during his/her follow-up period and the calyceal changes and differential renal functions were assessed. RESULTS: Those who underwent operation in their neonatal period did not have considerable postoperative problems. Those with primary obstructive megaureters who underwent operation had severe calyceal dilatation at the initial evaluation. However, there were severe calyceal dilatation in the nonobstructive-nonrefluxing group, too. Those who had poor differential renal function at the initial evaluation had a greater chance to have surgical correction. Those who were classified as primary obstructive megaureter and underwent operation had a higher rate of urinary tract infection than the counterpart who had consevative care. CONCLUSIONS: In order to differentiate those who need operation, we think that the differential renal function, the calyceal morphology, The diuretic renogram curve and urinary tract infection all act as combined factors altogether and not a single factor acts as a contributing factor. That is, if the diuretic renogram cutie is obstructive and there is urinary tract infection in the initial evaluation or if there is severe calyceal dilatation and decline of the differential renal function, we think that surgical correction should be under consideration. In contrast, if the diuretic renogram cutie is not obstructive and there are other factors combined, we think that conservative treatment should be the choice only if there is no breakthrough infection.
Dilatation ; Follow-Up Studies ; Humans ; Incidence ; Neck ; Retrospective Studies ; Ultrasonography ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: The methods for vasovasostomy are varied, and many authors have reported various success rates. This study aimed to assess a new method for vasovasostomy with a Prolene stent. MATERIALS AND METHODS: Among 85 patients who underwent vasovasostomy with a Prolene stent, 69 patients were retrospectively reviewed at our hospital between October 2004 and December 2007. The average age at the time of vasovasostomy was 42.2 years (range: 24.0-52.0 years). The obstructive interval was 6.25 years (range: 0.7-20.0 years). The cases were divided into 2 groups according to obstructive interval: group A (above 8 years) and group B (8 years and less), with 18 (26.1%) and 51 (73.9%) cases, respectively. Patency was defined as a sperm concentration of more than 10x106/ml on semen analysis. RESULTS: The overall patency and pregnancy rates were 76.8% and 43.4%, respectively. The patency and pregnancy rates of group A were 61.1% and 33.3%. Those of group B were 82.3% and 47.0%. The mean duration to pregnancy was 10.9 months (range: 4-31 months). The mean operation time was 90.2 minutes (range: 50.0-165.0 minutes). CONCLUSIONS: The new method of vasovasostomy with the Prolene stent has good efficacy and safety. Its benefits are the maintenance of good patency, a good pregnancy rate, and a diminished operating time.
Humans ; Polypropylenes ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Semen Analysis ; Spermatozoa ; Stents ; Vasovasostomy

A primary malignant melanoma occurring within the male urethra is a very rare disease, which usually shows highly malignant potential. Due to the low incidence, the clinical features of this disease remain unclear, and the mode of treatment controversial. Herein, we report a case of a malignant melanoma of the male urethra in a 77 year old man, who was managed by transurethral resection, and has remained uneventful for a 6 month follow-up period.
Aged ; Follow-Up Studies ; Humans ; Incidence ; Male* ; Melanoma* ; Rare Diseases ; Urethra*

PURPOSE: Dendritic cells (DC) play a crucial role in the initiation of primary immune response and are known as an excellent adjuvant for anti-cancer immunity. In this study, we tried to obtain substantial numbers of DC from peripheral blood of normal volunteers. We also investigated the anti-tumor immune response of DC pulsed by renal cell carcinoma cell line A498 in vitro. MATERIALS AND METHODS: DC were generated by culturing plastic adherent mononuclear cells from the peripheral blood in the presence of granulocyte-macrophage colony- stimulating factor and interleukin-4. Immature DC were cocultured with T-cells and pulsed by A498. MTT analysis was performed using the medium in which A498 only was cultured as control. Our experiments were analyzed by means of a commercial IL-12 p70 ELISA (Quantikine; R & D Systems, Minneapolis, MN). The capture antibodies used in both tests specifically recognize the p70 heterodimer, but not the free p40 chains. Detection limits were 30pg/ml of IL-12. RESULTS: We could obtain 1.5-2.0x106 DC with phenotype typical of mature DC (CD14-, CD80+, and CD83+) from the normal peripheral blood. On T-cell proliferation assay, the number of T-cells increased in proportion to that of DC and when DC were pulsed by A498, the same phenomenon could be observed. DC and T-cell media with A498 tumor lysate showed more production of IL-12 on IL-12 p70 ELISA than the media without A498 tumor lysate. CONCLUSIONS: We could successfully obtain mature DC from the peripheral blood. The data revealed indirectly that DC treated with tumor lysate enhance immune activity and thereby increase the anti-cancer effect of T-cells. Further investigations including in-vivo study are necessary to realize the effect of immunotherapy using DC against metastatic renal cell carcinoma.
Antibodies ; Carcinoma, Renal Cell* ; Cell Line* ; Dendritic Cells* ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Immunotherapy ; Interleukin-12 ; Interleukin-4 ; Limit of Detection ; Monocytes* ; Phenotype ; Plastics ; T-Lymphocytes

PURPOSE: Asymptomatic microscopic hematuria is a difficult problem faced at the offices of many urologists. This study was aimed at evaluating the ability for the detection of significant lesions, according to the grade of microscopic hematuria and the comparison of various diagnostic modalities. MATERIALS AND METHODS: Between March 1999 and December 2003, 755 adult patients that visited our hospital due to asymptomatic microscopic hematuria were examined according to the diagnostic algorithm. The male-to-female ratio was approximately 1:1.1 (366:389). Microscopic hematuria was divided into five grades. Lesions found at evaluation were categorized as either highly or moderately significant or insignificant lesions. RESULTS: 221 (29.3%) out of 755 patients were found to have lesions during evaluation. Of these 221 patients, 33 with highly significant lesions, including 4 urologic malignancies, 127 with moderately significant lesions and 61 with insignificant lesions, were detected. Correlation was shown between the degree of microscopic hematuria and the likelihood of detecting significant urologic diseases. The sensitivity and specificity for the detection of significant lesions by urine cytology, ultrasonography (USG), intravenous pyelography (IVP), cystoscopy, computed tomography (CT) and the combination of USG and IVP were 2.5/96.3%, 35.6/96.5%, 34.7/ 96.0%, 7.4/97.7%, 100/98.2% and 44.8/94.8%, respectively. CONCLUSIONS: The combination of USG and IVP for the detection of significant lesions at the initial examination was more beneficial than USG or IVP. Cystoscopy and CT are necessary additional diagnostic modalities for patients with abnormal findings at the initial examination and for those patients with asymptomatic microscopic hematuria who are at high risk.
Adult* ; Cystoscopy ; Hematuria* ; Humans ; Sensitivity and Specificity ; Ultrasonography ; Urography ; Urologic Diseases