No abstract available.
Carcinoma, Renal Cell*

Protrusion of coil loop(s) and subsequent occlusion of the parent artery is one of the dreadful complications during endovascular coil embolization of cerebral aneurysm. Although protrusion of one or two coil loops may not cause adverse events and can be ignored in many instances, it can also compromise the parent artery in some cases with or without thrombus formation. We report a case of rescue balloon reposition of the protruding coil mass back into the aneurysm and recanalization of parent artery during embolization of the anterior communicating artery aneurysm.
Aneurysm ; Arteries ; Embolization, Therapeutic ; Humans ; Intracranial Aneurysm* ; Parents ; Thrombosis

Purpose: Exogenous epidermal growth factor (EGF) causes apoptosis in EGF receptor (EGFR)–overexpressing cell lines. The apoptosis-inducing factors could be a therapeutic target. We aimed to determine the mechanism of EGF-induced apoptosis using a genome-wide clustered regularly interspaced short palindromic repeats (CRISPR)-based knockout screen. Materials and Methods: Two-vector system of the human genome-scale CRISPR knockout library v2 was used to target 19,050 genes using 123,411 single guide RNAs (sgRNAs). Recombinant human EGF (100 nM) or distilled water four times was administered to the experimental and control groups, respectively. The read counts of each sgRNA obtained from next-generation sequencing were analyzed using the edgeR algorithm. We used another EGFR-overexpressing cell line (A549) and short hairpin RNAs (shRNAs) targeting five EGF-resistance genes for validation. DUSP1 expression in A431, A549, and HEK293FT cells was calculated using reverse transcription–quantitative polymerase chain reaction. Results: We found 77 enriched and 189 depleted genes in the experimental group using the CRISPR-based knockout screen and identified the top five EGF-resistance genes: DDX20, LHFP, REPS1, DUSP1,<.i> and KRTAP10-12. Transfecting shRNAs targeting these genes into A549 cells significantly increased the surviving fractions after EGF treatment, compared with those observed in the control shRNA-transfected cells. The expression ratio of DUSP1 (inhibits ERK signaling) increased in A431 and A549 cells after EGF treatment. However, DUSP1 expression remained unchanged in HEK293FT cells after EGF treatment. Conclusion The CRISPR-based knockout screen revealed 266 genes possibly responsible for EGF-induced apoptosis. DUSP1 might be a critical component of EGF-induced apoptosis and a novel target for EGFR-overexpressing cancers.

PURPOSE: We wanted to determine and report on the outcome of combined gemcitabine/cisplatin chemotherapy for patients suffering with locally advanced or metastatic urothelial cancer. MATERIALS AND METHODS: Between July 1999 and December 2004, 43 selected patients were enrolled in this study. Group 1 (the adjuvant chemotherapy group) had undergone radical surgery with removal of evident tumor from the following primary sites: bladder (n=8), renal pelvis (n=7) and ureter (n=3). Group 2 (the salvage chemotherapy group) had undergone palliative surgery with a remnant tumor at the following primary sites; bladder (n=23) and renal pelvis (n=2). All the patients were given gemcitabine/ciplatin and they evaluated for the therapeutic effect and toxicity. The patients were initially treated with gemcitabine 1000 mg/m2 intravenously for 30 minutes on days 1, 8 and 15 of a 28-day cycle, and cisplatin 70 mg/m2 was administered intravenously on day 1 using prehydration measures. RESULTS: Group 1: The median follow-up period was 16.5 months. The mean age was 63 years (males: 15 cases, females: 3 cases), and eleven patients (61%) remained alive. The estimated median relapse-free survival period and 2-year survival rate were 24 months and 63%, respectively. Group 2: the median follow-up period was 20 months, the mean patient age was 63.8 years (males: 22 cases, females: 3 cases), and nine patients (36%) remained alive. The overall response and 2-year survival rates were 36% and 43%, respectively. Toxicities: Grade 3 toxicities developed in 14 cycles during the total 232 cycles. Grade 4 toxicity did not occur. CONCLUSIONS: The results of this study confirm that adjuvant and salvage chemotherapy with using gemcitabine and cisplatin is tolerable and safe.
Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Female ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Palliative Care ; Survival Rate ; Ureter ; Urinary Bladder ; Urologic Neoplasms

PURPOSE: No consistent histo-pathological characteristics of cystic renal cell carcinomas have previously been determined. In this study, attempts were made at our hospital to evaluate the histopathological characteristics of this cancer. MATERIALS AND METHODS: The medical records of 451 patients with renal cell carcinomas, having undergone a radical nephrectomy, between January 1995 and April 2002, were retrospectively reviewed. The renal cell carcinomas were classified, according to the criteria of the World Health Organization, as a cystic renal cell carcinoma in 31 of these patients (6.8%). The tumor size, nuclear grade and pathological stage were investigated. RESULTS: The mean age of the patients was 52 years, ranging from 35 to 75. Cancer stages were T1, T2 and T3 in 26 (84%), 3 (10%) and 2 (6%) patients, respectively. The nuclear grade and pathological stage were lower in patients with a cystic renal cell carcinoma. CONCLUSIONS: 81% of the cystic renal cell carcinoma cases were diagnosed incidentally. The cystic renal cell carcinomas were usually detected at lower stages and grades, and therefore were associated with a better prognosis than the renal cell carcinomas.
Carcinoma, Renal Cell* ; Humans ; Medical Records ; Nephrectomy ; Prognosis ; Retrospective Studies ; World Health Organization

No abstract available.
Bronchopulmonary Sequestration* ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Lung*

PURPOSE: A model and a program was developed for training surgeons in laparoscopic urethrovesical anastomosis in order to improve the laparoscopic suture technique for urologists with no previous experience. MATERIALS AND METHODS: The procedures were performed on a pelvic trainer using a videolaparoscopic unit. The program consisted of a simple suture, urethrovesical anastomosis with interrupted sutures, and urethrovesical anastomosis with continuous sutures. The trainees enrolled in this study were 5 residents from the urologic department who had little experiences in laparoscopic suturing. The trainees performed each procedure 10 times and the elapsed time was recorded. Univariate analysis of the general linear model was used to assess the significance of progression. RESULTS: In the first lesson of the simple suture, the mean elapsed time was 5.45+/-3.00 minutes (range 2.78-9.83minutes) and each trainee demonstrated a difference in the elapsed time for suturing. After the tenth lesson was complete, the mean elapsed time was 1.48+/-0.17 minutes (range 1.35- 1.70 minutes) and the time differences between each trainee decreased. In urethrovesical anastomosis with interrupted sutures, the mean elapsed time decreased from 24.07+/-3.97 minutes at the 1st lesson (range 16.13- 29.47 minutes) to 13.10+/-2.53 minutes (range 11.75-19.47 minutes) after 10 lessons. In urethrovesical anastomosis with continuous sutures, the mean time decreased from 39.61+/-3.60 minutes (range 34.41-45.71 minutes) after one lesson to 30.42+/-5.75 minutes (range 19.50-38.82 minutes) after 10 lessons. There were significant differences in the elapsed time up to the 2nd lesson compared with the 10th lesson in all procedures (p-value<0.05). CONCLUSIONS: The skills of the trainee can be improved by a model and a program for training laparoscopic urethrovesical anastomosis. In particular, urethrovesical anastomosis, in which many urologists find difficulty, may become more accessible using this model and program.
Anastomosis, Surgical ; Laparoscopy ; Linear Models ; Suture Techniques ; Sutures

OBJECTIVE: The purpose of this study was to evaluate the efficacy of PLIF using cages on the unstable level and additional instrumented posterolateral fusion in patients with multilevel lumbar degenerative disease with segmental instability. METHODS: Clinical and radiological outcomes including the rate of bony fusion and changes in disc height, translation, and angular displacement on PLIF level, and its complications were analyzed in 28 patients (male:female=8:20) who were observed for more than 2 years (mean 30.6 months) between 1998 and 2000. RESULTS: The rate of successful fusion was 93% (26 patients). Clinical outcomes according to Prolos's classification were revealed with excellent in 10 patients (36%), good in 14 patients (50%), fair in 3 patients (10%), and poor in 1 patient (4%). The mean disc height on the PLIF level (35 levels including 6 patients with 2 levels PLIF) was changed from 0.48+/-0.11, preoperatively to 0.66+/-0.08 at 2-year follow-up by Farfan method (P<0.05). Mean vertebral body translation was decreased from 7.52+/-2.74mm, to 1.07+/-1.33mm and mean angular displacement was corrected from 11.21+/-4.43 degree to 1.03+/-0.62 degree (P<0.05). Permanent complications were relatively minimal. CONCLUSION: Favorable outcomes were achieved in 86% with relatively low surgical morbidity rates. It can be concluded that PLIF using cages on unstable lumbar segment and additional instrumented posterolateral fusion method is an effective stabilizing method for the multilevel lumbar degenerative disease with segmental instability in spite of its technical demanding and long operation time.
Classification ; Follow-Up Studies ; Humans

A paraurethral cyst is a rare congenital or acquired abnormality in females that is characterized by a round, yellow or orange-colored cystic mass on either side of the urethral meatus. We report a patient who presented with frequent, postvoiding dribbling. The important differential diagnostic considerations in infants and adults are an ectopic ureterocele, urethral diverticulum, cystocele and paraurethral tumors. Intravenous pyelography, voiding cystourethrogram, cystourethroscopy are essential for differentiating these lesions. This case of a paraurethral cyst was treated with complete excision.
Adult ; Cystocele ; Diverticulum ; Female ; Humans ; Infant ; Ureterocele ; Urethra ; Urography

BACKGROUND: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et at retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. METHOD: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. RESULTS: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in nineteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), Poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to Inoculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(P<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. CONCLUSION: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement arid serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Chemistry ; Chest Tubes ; Diagnosis ; Drainage ; Empyema* ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Lung ; Pleural Effusion ; Retrospective Studies ; Staphylococcus aureus ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed* ; Ultrasonography