BACKGROUND: Oxidation plays an important role in acute lung injury. This study was conducted in order to elucidate the effect of repetitive post-treatment of N-acetylcysteine (NAC) in lipopolysaccaride (LPS)-induced acute lung injury (ALI) of rats. METHODS: Six-week-old male Sprague-Dawley rats were divided into 4 groups. LPS (Escherichia coli 5 mg/kg) was administered intravenously via the tail vein. NAC (20 mg/kg) was injected intraperitoneally 3, 6, and 12 hours after LPS injection. Broncho-alveolar lavage fluid (BALF) and lung tissues were obtained to evaluate the ALI at 24 hours after LPS injection. The concentration of tumor necrosis factor alpha (TNF-alpha) and interleukin 1beta (IL-1beta) were measured in BALF. Nuclear factor kappaB (NF-kappaB), lipid peroxidation (LPO), and myeloperoxidase (MPO) were measured using lung tissues. Micro-computed tomography (micro-CT) images were examined in each group at 72 hours apart from the main experiments in order to observe the delayed effects of NAC. RESULTS: TNF-alpha and IL-1beta concentration in BALF were not different between LPS and NAC treatment groups. The concentration of LPO in NAC treatment group was significantly lower than that of LPS group (5.5+/-2.8 nmol/mL vs. 16.5+/-1.6 nmol/mL) (p=0.001). The activity of MPO in NAC treatment group was significantly lower than that of LPS group (6.4+/-1.8 unit/g vs. 11.2+/-6.3 unit/g, tissue) (p<0.048). The concentration of NF-kappaB in NAC treatment group was significantly lower than that of LPS group (0.3+/-0.1 ng/microL vs. 0.4+/-0.2 ng/microL) (p=0.0001). Micro-CT showed less extent of lung injury in NAC treatment than LPS group. CONCLUSION: After induction of ALI with lipopolysaccharide, the therapeutic administration of NAC partially attenuated the extent of ALI through the inhibition of NF-kappaB activation.
Acetylcysteine ; Acute Lung Injury ; Animals ; Antioxidants ; Humans ; Interleukin-1beta ; Lipid Peroxidation ; Lung ; Lung Injury ; Male ; NF-kappa B ; Peroxidase ; Rats ; Rats, Sprague-Dawley ; Therapeutic Irrigation ; Tumor Necrosis Factor-alpha ; Veins

BACKGROUND: Oxidation plays an important role in acute lung injury. This study was conducted in order to elucidate the effect of repetitive post-treatment of N-acetylcysteine (NAC) in lipopolysaccaride (LPS)-induced acute lung injury (ALI) of rats. METHODS: Six-week-old male Sprague-Dawley rats were divided into 4 groups. LPS (Escherichia coli 5 mg/kg) was administered intravenously via the tail vein. NAC (20 mg/kg) was injected intraperitoneally 3, 6, and 12 hours after LPS injection. Broncho-alveolar lavage fluid (BALF) and lung tissues were obtained to evaluate the ALI at 24 hours after LPS injection. The concentration of tumor necrosis factor alpha (TNF-alpha) and interleukin 1beta (IL-1beta) were measured in BALF. Nuclear factor kappaB (NF-kappaB), lipid peroxidation (LPO), and myeloperoxidase (MPO) were measured using lung tissues. Micro-computed tomography (micro-CT) images were examined in each group at 72 hours apart from the main experiments in order to observe the delayed effects of NAC. RESULTS: TNF-alpha and IL-1beta concentration in BALF were not different between LPS and NAC treatment groups. The concentration of LPO in NAC treatment group was significantly lower than that of LPS group (5.5+/-2.8 nmol/mL vs. 16.5+/-1.6 nmol/mL) (p=0.001). The activity of MPO in NAC treatment group was significantly lower than that of LPS group (6.4+/-1.8 unit/g vs. 11.2+/-6.3 unit/g, tissue) (p<0.048). The concentration of NF-kappaB in NAC treatment group was significantly lower than that of LPS group (0.3+/-0.1 ng/microL vs. 0.4+/-0.2 ng/microL) (p=0.0001). Micro-CT showed less extent of lung injury in NAC treatment than LPS group. CONCLUSION: After induction of ALI with lipopolysaccharide, the therapeutic administration of NAC partially attenuated the extent of ALI through the inhibition of NF-kappaB activation.
Acetylcysteine ; Acute Lung Injury ; Animals ; Antioxidants ; Humans ; Interleukin-1beta ; Lipid Peroxidation ; Lung ; Lung Injury ; Male ; NF-kappa B ; Peroxidase ; Rats ; Rats, Sprague-Dawley ; Therapeutic Irrigation ; Tumor Necrosis Factor-alpha ; Veins

PURPOSE: Partial nephrectomy (PN) for patients with T1a renal cell carcinoma (RCC) has increasingly become accepted, although its role for patients with T1b RCC remains controversial. We retrospectively evaluated and then compared the oncologic and functional outcomes of patients with pT1b RCC who were treated with PN or radical nephrectomy (RN). MATERIALS AND METHODS: A total of 70 patients who were diagnosed with pT1bN0M0 RCC between January 1995 and December 2004 were included. The 5-year overall survival (OS), the 5-year recurrence-free survival (RFS), and the 5-year cancer-specific survival (CSS) were compared between the groups. Preoperative and postoperative serum creatinine and estimated glomerular filtration rate (GFR) levels were analyzed to assess renal function. RESULTS: The 5-year OS (92.3% vs. 87.8%, p=0.501), RFS (92.3% vs. 77.8%, p=0.175), and CSS (92.3% vs. 94.5%, p=0.936) of the PN and RN groups were not statistically different. The proportion of patients with decreased renal function was lower in the PN group than in the RN group (PN=0% vs. RN=11.5%). The postoperative change in serum creatinine and the GFR 1 year after nephrectomy was higher in the RN group than in the PN group (PN=0.2+/-0.2, 12.1+/-9.1 vs. RN=0.3+/-0.5, 18.1+/-12.5), but there was no statistical difference. CONCLUSIONS: There were no statistically significant differences in prognosis or renal function between patients treated with PN and those treated with RN for pT1b RCC. PN may be a useful treatment modality for patients with pT1b RCC.
Carcinoma, Renal Cell ; Creatinine ; Glomerular Filtration Rate ; Humans ; Nephrectomy ; Prognosis ; Retrospective Studies

PURPOSE: Although the prognosis of patients with pT1a stage renal cell carcinoma (RCC) is generally good, some of these patients show distant metastasis. In this study, we intended to identify the perioperative and pathologic prognostic factors for patients with pT1a stage RCC. MATERIALS AND METHODS: A total of 93 patients who were diagnosed with pT1aN0M0 RCC between January 1995 and December 2004 were included. All the patients underwent radical (n=63, 67.7%) or partial (n=30, 32.3%) nephrectomy by a single surgeon. Preoperative data [age, sex, body mass index (BMI), and the presence of symptoms], follow-up duration, surgical methods, and pathological parameters (tumor size, tumor location, histologic type, Fuhrman's nuclear grade and the presence of microvascular invasion, hemorrhage, necrosis, calcification, and a cystic component in the tumor) were retrospectively analyzed to identify which of these were prognostic factors for pT1a RCC. RESULTS: The patients' mean age was 55.0+/-11.4 years and the mean follow-up duration was 63.6+/-31.1 months. The 5-year cancer-specific survival rate and the 5-year recurrence- free survival rate were 100% and 88.1%, respectively. Nine patients (9.7%) showed distant metastasis, but local recurrence was not shown. Fuhrman's nuclear grade (p=0.040, OR=5.147), microvascular invasion (p=0.011, OR=13.500), and tumor necrosis (p<0.001, OR=26.000) had a significant impact on distant metastasis in the univariate analysis. The multivariate analysis subsequently showed that microvascular invasion (p=0.033, OR=17.947) and tumor necrosis (p=0.002, OR=15.922) were independent prognostic factors. CONCLUSIONS: Microvascular invasion and tumor necrosis are the prognostic factors for patients with pT1a RCC.
Body Mass Index ; Carcinoma, Renal Cell ; Follow-Up Studies ; Hemorrhage ; Humans ; Multivariate Analysis ; Necrosis ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

We developed nomograms to predict disease recurrence in patients with Ta, T1 transitional cell carcinoma of the bladder. Thirty-eight training hospitals participated in this retrospective multicenter study. Between 1998 and 2002, a total of 1,587 patients with newly diagnosed non-muscle invasive bladder cancer were enrolled in this study. Patients with prior histories of bladder cancer, non-transitional cell carcinoma, or a follow-up duration of less than 12 months were excluded. With univariate and multivariate logistic regression analyses, we constructed nomograms to predict disease recurrence, and internal validation was performed using statistical techniques. Three-year and five-year recurrence-free rates were 64.3% and 55.3%, respectively. Multivariate analysis revealed that age (hazard ratio [HR]=1.437, p<0.001), tumor size (HR=1.328, p=0.001), multiplicity (HR=1.505, p<0.001), tumor grade (HR=1.347, p=0.007), concomitant carcinoma in situ (HR=1.611, p=0.007), and intravesical therapy (HR=0.681, p<0.001) were independent predictors for disease recurrence. Based on these prognostic factors, nomograms for the prediction of disease recurrence were developed. These nomograms can be used to predict the probability of disease recurrence in patients with newly diagnosed Ta, T1 transitional cell carcinoma of the bladder. They may be useful for patient counseling, clinical trial design, and patient follow-up planning.
Aged ; Carcinoma in Situ/diagnosis/epidemiology ; Carcinoma, Transitional Cell/*diagnosis/*epidemiology ; Disease-Free Survival ; Female ; Humans ; Male ; Multivariate Analysis ; *Nomograms ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Recurrence ; Regression Analysis ; Reproducibility of Results ; Urinary Bladder Neoplasms/*diagnosis/*epidemiology

PURPOSE: We analyzed the long-term efficacy and safety of bipolar transurethral resection of the prostate (TURP) using the Gyrus(TM) PlasmaKinetic System compared with conventional monopolar TURP. MATERIALS AND METHODS: This study included 54 patients with benign prostatic hyperplasia (BPH) who underwent TURP between May 2003 and April 2004. In all, 28 consecutive patients had bipolar and 26 had monopolar TURP. All patients were assessed by preoperative and postoperative International Prostate Symptom Score (IPSS), uroflowmetry, transrectal ultrasonography, operative time, weight of resected tissue, length of hospital stay, duration of catheter use, change in hemoglobin and serum sodium, and complication rates. RESULTS: Significant improvement was seen postoperatively in both groups, and no difference was observed in the resection time, weight of resected tissue, change in hemoglobin and serum sodium, improvement of IPSS and maximum flow rate (Qmax) or complication rates over the 36-month follow up. However, there was a significant difference in duration of catheter use and hospital stay. Duration of catheter use (2.1 days vs. 3.5 days p=0.012) and hospital stay (2.9 days vs. 4.1 days p=0.024) were shorter in the bipolar group. CONCLUSIONS: Bipolar TURP using the Gyrus(TM) PlasmaKinetic System is as effective as conventional monopolar TURP with the advantages of reduced length of catheter use and shorter hospital stay. Both methods have low complication rates. In the long-term comparison, improvements in IPSS and Qmax after bipolar and monopolar TURP are similar. Thus bipolar TURP may be a good alternative to conventional TURP.
Catheters ; Follow-Up Studies* ; Humans ; Length of Stay ; Operative Time ; Prostate* ; Prostatic Hyperplasia* ; Sodium ; Transurethral Resection of Prostate ; Ultrasonography

Polyorchidism is a very rare anomaly of the genitourinary tract and about 100 cases have been reported in the literature. Although polyorchidism is associated with undescended testis, inguinal hernia, testicular torsion, hydrocele, epididymitis, varicocele and cancer, the majority of the patients are asymptomatic and present with painless groin or testicular masses. We describe a case of polyorchidism in a 19-year-old man with varicocele and review the literature and current management of polyorchidism.
Cryptorchidism ; Epididymitis ; Groin ; Hernia, Inguinal ; Humans ; Male ; Spermatic Cord Torsion ; Varicocele* ; Young Adult

The purpose of the present study was to evaluate the efficacy and safety of bipolar transurethral prostatectomy (TURP) using the GyrusTM PlasmaKinetic System compared with conventional monopolar TURP. This study included 102 patients with benign prostatic hyperplasia (BPH) who underwent TURP from January 2003 to March 2005. In all, 49 consecutive patients had bipolar and 53 had monopolar TURP. All patients were assessed by preoperative and postoperative International Prostate Symptom Score (IPSS), uroflowmetry, transrectal ultrasonography, operative time, weight of resected tissue, change in serum sodium and hemoglobin, duration of catheter use, length of hospital stay, and complication rates. Significant improvement was seen postoperatively in both groups, and no difference was observed in the resection time, weight of resected tissue, change in serum sodium and hemoglobin, improvement of IPSS and peak flow rate (Qmax), or complication rates over the 12-month follow-up in both groups. There was, however, a significant difference in duration of catheter use and hospital stay. Duration of catheter use (2.28 days vs. 3.12 days) and hospital stay (3.52 days vs. 4.27 days) were shorter in the bipolar group (p = 0.012 vs. p = 0.034, respectively). Our results demonstrate that bipolar TURP using the Gyrus(TM) Plasma Kinetic System is as effective as conventional monopolar TURP with the additional advantage of reduced length of catheter use and hospital stay. Bipolar TURP is a promising new technique that may prove to be a good alternative to conventional TURP in the future.
Treatment Outcome ; Transurethral Resection of Prostate/adverse effects/*instrumentation/methods ; Prostatic Hyperplasia/*surgery ; Prostate/*surgery ; Middle Aged ; Male ; Humans ; Follow-Up Studies ; Equipment and Supplies/standards ; Aged

Idiopathic fibrosing mediastinitis is, an uncommon cause of pulmonary hypertension this is characterized by excessive fibrosis of the mediastinum with an unknown etiology. Steroid therapy has been suggested for individuals with progressive symptoms, bu there is littlet data demonstrating the efficacy of such therapy are lacking. We present a case of pulmonary hypertension secondary to a compression of a main pulmonary artery by fibrosing mediastinitis which was confirmed by a biopsy with a thoracotomy. The chest CT scan and 2D echocardiography performed before and after a trial of steroid therapy demonstrated improvement after steroid therapy.
Biopsy ; Echocardiography ; Fibrosis ; Hypertension, Pulmonary* ; Mediastinitis* ; Mediastinum ; Pulmonary Artery ; Thoracotomy ; Tomography, X-Ray Computed

PURPOSE: Transurethral resection of the prostate (TURP) using bipolar electrocautery and 0.9% saline is a new technology in the field of surgery for benign prostatic hyperplasia (BPH). This randomized prospective study was conducted to compare the efficacy and safety of the Gyrus(TM) Plasmasect loop bipolar TURP and the conventional monopolar TURP for the treatment of BPH. MATERIALS AND METHODS: This study included 50 patients who were randomized 1:1 to undergo bipolar or monopolar TURP from August 2003 to October 2004. Preoperatively, the patients were assessed by the symptom score, uroflow and transrectal ultrasonography, and the two groups were comparable with regards to these measures and the mean group age. The perioperative and postoperative parameters we studied included the operative time, the resected prostate volume and the change in serum Na and Hb. Postoperatively, the patients were assessed for the symptom score and uroflow at both 1 and 6 months. RESULTS: Postoperative improvements in the symptom score and the Qmax were significant for both groups and the improvements were similar for the two groups. There was no difference in the operative time and resected prostate volume. The serum Na dropped by 4.2mEq/l in the monopolar group, whereas it fell only 1.1mEq/l in the bipolar group (p<0.001). Significant smaller reduction in serum Hb, a shorter postoperative catheterization time and a shorter hospital stay were noted for the bipolar group. CONCLUSIONS: Bipolar TURP using the Gyrus(TM) system is as effective as conventional monopolar TURP and it has additional advantages too. Thus, bipolar TURP may be a good alternative to conventional TURP. However, more follow-up is necessary to assess its long-term efficacy.
Catheterization ; Catheters ; Electrocoagulation ; Follow-Up Studies ; Humans ; Length of Stay ; Operative Time ; Prospective Studies ; Prostate* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Ultrasonography