PURPOSE: To study the short term effects of hypercholesterolemia on corpus cavernosal tissue, we performed isometric tension studies and RT-PCR was used to identify mRNA expression of VEGF on isolated strips of corpus cavernosum, on rabbits which underwent partial ligation of the abdominal aorta and received a diet containing 2% cholesterol. MATERIALS AND METHODS: New Zealand White rabbits were divided into a control group(n=6) fed with a regular diet and a hypercholesterolemic group(n=10) which underwent partial ligation of the abdominal aorta and received a diet containing 2% cholesterol. After 3 weeks, the relationship between hypercholesterolemia and cavernosal smooth muscle pathophysiology was studied. To characterize the cavernosal smooth muscle reactivity in hypercholesterolemia, we performed isometric tension studies with phenylephrine(PE), acetylcholine(Ach), sodium nitroprusside(SNP) and electrical field stimulation(ES). RT-PCR was used to identify the mRNA expression of VEGF. RESULTS: PE-induced cavernous smooth muscle contraction in the hypercholesterolemic group was increased compared with the control group(p<0.05), while relaxation by Ach and ES in PE pretreated cavernosal smooth muscle in the hypercholesterolemic group was decreased(p<0.05). Relaxation by SNP in PE pretreated cavernosal smooth muscle was not different between any experimental groups. Expression of VEGF mRNA in cavernosal smooth muscle was significantly increased in the hypercholesterolemic group compared with the control group. CONCLUSIONS: Hypercholesterolemia caused a significant increase in PE-induced contraction of cavernosal tissue. Hypercholesterolemic cavernosal tissue retained the ability of relaxation induced by endothelium-independent, but relaxation induced by endothelium-dependant was impaired. Furthermore, expression of VEGF mRNA in cavernosal tissues was up regulated in the hypercholesterolemic group. This study showed that a short period of hypercholesterolemia could induce pathophysiologic change of cavernosal tissue.
Aorta, Abdominal ; Cholesterol ; Diet ; Erectile Dysfunction ; Hypercholesterolemia* ; Ligation ; Male ; Muscle, Smooth ; Rabbits* ; Relaxation ; RNA, Messenger ; Sodium ; Vascular Endothelial Growth Factor A

PURPOSE: Hand-assisted laparoscopic live donor nephrectomy (HALDN) are being performed at our institution in an attempt to make live donor more attractive to the potential donor. We review the results of HALD N retrospectively and compare them with those obtained using the standard open approach. MATERIALS AND METHODS: 9 consecutive HALDN were performed from February 2000 through June 2000. The control group consisted of the 22 open donor nephrectomy at the same institution from January 1999 through December 1999 immediately before the initiation of HALDN. Live donors were considered candidates for HALDN if they possessed left normal renal anatomy with single renal vessels and ureter. Among 9 HALDN patients, one patient had two main renal arteries and another one patient had a polar artery. We evaluated sex, age, body weight, BMI (Body Mass Index) basically. And we evaluated renal ischemic time, operation time, to normal activities, postoperative serum creatinine level, and postoperative complications. RESULTS: There was no significant difference in male-female ratio, age distribution and weight-height ratio between two groups. Warm ischemic time for HALDN group was 3 to 4 min and it was not different with open surgery. Operation time was prolonged in HALDN group (284.4+/-72.8 min) compared to open group (193.1+/-26.7 min) (p Age Distribution ; Arteries ; Body Weight ; Chylous Ascites ; Creatinine ; Humans ; Kidney Transplantation ; Length of Stay ; Nephrectomy* ; Pneumothorax ; Postoperative Complications ; Renal Artery ; Retrospective Studies ; Tissue Donors* ; Ureter ; Warm Ischemia

PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections

A total of 66 cases of thymoma(57 surgically resected cases and 9 incisional biopsy cases) were reviewed with an attempt to correlate pathomorphologic features and clinical presentations. Criteria of benign or invasive thymoma were primarily determined by operative clinical and pathologic findings. Of them, 21 cases were invasive thymomas. The mean age of patients at the time of surgery was 47 years and it occurred largely in the sixth decade. Myasthenia gravis was accompanied in 29 cases(43%). One patient died during folow-up period, and five of the remainder suffered from recurrence. Microscopically, mixed type was the most common one(33 cases), being followed by predominantly epithelial type(17 cases) and predominantly lymphocytic type(16 cases). Thirty four cases of thymomas were cortical type, 29 mixed type, and the remaining 3 medullary type. None of the histologic type were significantly correlated with tumor invasiveness, Myasthenia gravis was more frequently associated with mixed and cortical type, respectively.
Biopsy

No abstract available.
Animals ; Rats* ; Urinary Bladder*

No abstract available.
Intercellular Signaling Peptides and Proteins*

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

No abstract available.

PURPOSE: In this retrospective study, we attempted to evaluate the treatment outcome and the prognostic factors of thymoma treated with surgery, radiotherapy and chemotherapy. METHODS AND MATERIALS: Between 1979 and 1998, 55 patients with thymoma were treated at the Seoul National University Hospital. Of these, 11 patients underwent surgery only, 33 patients received postoperative radiotherapy and 11 patients received radiotherapy only. Twenty-three patients had gross total resection and 21 patients subtotal resection. For postoperative radiotherapy, the radiation dose consisted of 41.4-55.8 Gy. The average follow-up was 64 months, and ranged from 2 to 160 months. The sex ratio was 1:1 and the median age was 48 years (15-74 years). Overall survival and disease-free survival were determined via the Kaplan-Meier method, and the log-rank was employed to evaluate for differences in prognostic factor. RESULTS: The five- and 10-year survival rates were 87% and 65% respectively, and the median survival was 103 months. By univariate analysis, only stage ( p=0.0017) turned out to be significant prognostic factors of overall survival. Also, stage ( p=0.0007) was significantly predictive for overall survival in mutivariated analysis. CONCLUSION: This study showed the stage was found to be important prognostic factors, which influenced survival. Especially, as incomplete resection is related with poor results, complete resection is important to cure the invasive thymoma.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy ; Retrospective Studies ; Seoul ; Sex Ratio ; Survival Rate ; Thymoma* ; Treatment Outcome*

No abstract available.
Animals ; Intercellular Signaling Peptides and Proteins* ; Rats* ; Urinary Bladder Neck Obstruction* ; Urinary Bladder*