Biomedical subjects

Cheol Kwak

Publications and source records attributed to Cheol Kwak.

At least 19 recordsLinked to original sources

PubMed2007

Sarcomatoid differentiation as a prognostic factor for immunotherapy in metastatic renal cell carcinoma.

BACKGROUND: The objective of the current study was to determine the significance of sarcomatoid differentiation as a prognostic factor for immunotherapy in metastatic renal cell carcinoma (RCC). METHODS: Patients with metastatic RCC were included in this study and were categorized according to sarcomatoid differentiation. RESULTS: Patients with sarcomatoid differentiation had more aggressive tumor characteristics than those without sarcomatoid differentiation. After immunotherapy, the median progression-free survival was 9.0 months (95% confidence interval [CI] 1.4-52.7) for patient without sarcomatoid differentiation and 3.2 months (95% CI 0.4-42.9) for patients with sarcomatoid differentiation, respectively (P=0.0001). The median overall survival was 22.2 months (95% CI 3.2-75.4) and 10.0 months (95% CI 0.7-60.1) in both groups. When comparing patients with sarcomatoid differentiation, there was no significant difference of overall survival in the immunotherapy group and the no immunotherapy group. Multivariate Cox proportional hazards model analysis showed that T stage (Hazard ratio [HR] 1.71; 95% CI 1.07-2.74; P=0.024), sarcomatoid differentiation (HR 2.18; 95% CI 1.30-3.66; P = 0.003), and the number of metastasis sites (HR 1.81; 95% CI 1.14-2.88; P=0.012) were independent predictors of progression-free survival. Sarcomatoid differentiation and the number of metastasis sites were independent prognostic predictors of overall survival. The estimated relative risks of sarcomatoid differentiation and the number of metastasis sites were 2.83 (95% CI 1.49-5.40; P=0.002) and 2.31 (95% CI 1.29-4.16; P=0.005), respectively. CONCLUSIONS: Our findings suggest that sarcomatoid differentiation is an important prognostic factor for immunotherapy in metastatic RCC.

Adult↗

PubMed2006

Adjuvant systemic chemotherapy in the treatment of patients with invasive transitional cell carcinoma of the upper urinary tract.

OBJECTIVES: To evaluate the efficacy of adjuvant systemic chemotherapy in conjunction with surgery in patients with invasive transitional cell carcinoma of the upper urinary tract. METHODS: From January 1991 to May 2001, 36 men and 7 women had invasive (Stage pT2 or worse), but not metastatic, disease and were the subjects of this study. Their median age was 59 years (range 36 to 72). Of these 43 patients, 32 were scheduled to receive more than four courses of cisplatin-based chemotherapy. The median follow-up period of all the evaluated patients was 30.7 months (range 4.7 to 98.8). RESULTS: Recurrence was observed in 12 patients (37.5%) who underwent chemotherapy and 7 (63.6%) who did not (P = 0.170). The disease-free survival was lower in the nonchemotherapy group than in the chemotherapy group (P = 0.0439). During the follow-up period, 9 patients (28.1%) in the chemotherapy group died and 9 patients (81.8%) in the nonchemotherapy group died (P = 0.004). Multivariate Cox proportional hazard model analysis revealed that the use of adjuvant chemotherapy (P = 0.006, relative risk = 9.19) and node-positive status (P = 0.008, relative risk = 8.28) were strongly associated with overall survival. In the chemotherapy group, 24 (75%) had side effects due to the treatment; however, fever and gastrointestinal symptoms were the chief adverse effects and were well tolerated. CONCLUSIONS: Our results have indicated that adjuvant systemic chemotherapy may provide therapeutic benefit in patients with invasive transitional cell carcinoma of the upper urinary tract.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2006

Prevention of nephrolithiasis by Lactobacillus in stone-forming rats: a preliminary study.

Hyperoxaluria is a risk factor for renal stones. It appears to be sustained by increased dietary load or increased intestinal absorption. The aim of this study was to evaluate whether oral administration of lactobacilli could prevent urolithiasis in stone-forming rats. Oxalate-degrading activities of lactobacilli were evaluated by measuring the oxalate level in a culture medium after inoculation with lactobacilli. Only the strains of Lactobacillus having oxalate-degrading activity were used. Sprague-Dawley rats were fed a powdered standard diet containing 3% sodium oxalate and/or received 100 mg/kg of celecoxib for the first 8 days by gavage, before or after the beginning of this experiment (groups with previous treatment or with co-treatment). Rats were sacrificed after 4 weeks and kidneys were harvested for the assay of crystal formation under a dissecting microscope. Twenty-four-hour urine collections were performed before kidney harvest. Only two strains, Lactobacillus casei HY2743 and L. casei HY7201 out of 31 strains of Lactobacillus were able to degrade oxalate. In both groups of co-treatment and previous treatment with L. casei HY2743 and L. casei HY7201, urine oxalate excretion decreased compared to the group without lactobacilli. The dissecting microscope examination of kidneys in the rats in two previous treatment groups and the co-treatment group with L. casei HY7201 showed less abundant crystals than control groups. Our results show that lactobacilli may be used as a potential therapeutic strategy in the prevention of urinary stones.

Animals↗

PubMed2006

Prognostic implication of capsular invasion without perinephric fat infiltration in localized renal cell carcinoma.

OBJECTIVES: To analyze the prognostic value of capsular invasion without perinephric fat infiltration in patients with localized renal cell carcinoma (RCC) Stage pT1-pT2N0M0. METHODS: A total of 288 patients with RCC (conventional type) confined to the kidney (pT1-pT2N0M0) who underwent radical nephrectomy from January 1993 to November 2004 at our institution were included in our study. The disease of all patients was staged according to the 2002 TNM classification system. Pathologic findings, including T stage, nuclear grade, and capsular invasion, were retrospectively reviewed. Disease-specific survival was compared according to the capsular invasion. RESULTS: Tumor invasion of the renal capsule was identified in 108 (37.5%) of the 288 patients. Of the 230 patients with Stage pT1, 78 (33.9%) had lesions invading the renal capsule and 30 (51.7%) of 58 patients with Stage pT2 had capsular invasion. Involvement of the renal capsule was associated with a worse pT stage (P = 0.015). The 5-year disease-specific survival rate for patients with no capsular invasion versus with capsular invasion was 91.8% versus 84.3%, respectively (P = 0.132). For patients with pT1 tumors, the 5-year disease-specific survival rate was 95.6% for patients without capsular invasion and 92.6% for those with capsular invasion (P = 0.299). For patients with pT2 tumors, the 5-year disease-specific survival rate was 90.5% for patients without capsular invasion and 73.8% for those with capsular invasion (P = 0.031). CONCLUSIONS: Renal capsular invasion is associated with a worse stage in localized RCC. Patients with Stage pT2 RCC and capsular invasion appear to have a worse prognosis than those with equivalently staged RCC without capsular invasion.

Adipose Tissue↗

PubMed2006

Metastatectomy prior to immunochemotherapy for metastatic renal cell carcinoma.

INTRODUCTION: We reviewed our experiences in performing cytoreductive metastatectomy before initiating systemic immunochemotherapy and tried to investigate potential prognostic factors for such an approach. PATIENTS AND METHODS: A retrospective analysis of 57 patients who received interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy for metastatic renal cell carcinoma was conducted. Before undergoing immunochemotherapy, 20 of the 57 patients had received metastatectomy along with nephrectomy (metastatectomy group) and the other 37 nephrectomy alone (non-metastatectomy group). RESULTS: The metastatectomy group demonstrated median disease-specific and progression-free survival of 23 and 13 months, respectively. The patients in the metastatectomy group were identified as having a better performance status and primarily demonstrating pulmonary metastasis compared with those in the non-metastatectomy group. As assessed in the metastatectomy group, factors such as the number of metastatic lesions, completeness of metastatectomy, and location of metastatic lesions (lung only vs. others) were observed to be significantly associated with overall survivals on univariate analysis. CONCLUSIONS: Metastatectomy may still play a significant therapeutic role for metastatic renal cell carcinoma even in the era of immunochemotherapy as part of a multidisciplinary treatment approach in a selected group of patients in adequate general condition who have pulmonary-limited metastasis that can be completely resected.

Adult↗

PubMed2005

An animal model of calcium oxalate urolithiasis based on a cyclooxygenase 2 selective inhibitor.

Our aim was to develop a stone-forming animal model involving renal tubular injury using a cyclooxygenase 2 selective inhibitor. Male Sprague-Dawley rats fed chow containing 3% sodium oxalate with or without 100 mg/kg celecoxib were compared to animals fed normal chow. Rats were killed after 2 or 4 weeks and the kidneys were harvested for morphological examination. Collections of 24-h urine were made before kidney harvest. After 2 weeks only a few crystals were observed in rats that received oxalate and celecoxib, but after 4 weeks more crystals were observed at the renal papilla than in rats that received only oxalate. Few crystals were found in rats fed normal chow with or without celecoxib. The urinary activities of gamma-glutamyl transpeptidase (GGT) were increased by celecoxib administration whereas creatinine clearance rates were unchanged. In rats fed oxalate, urinary oxalate excretion increased, but calcium excretion decreased. This model using a cyclooxygenase 2 selective inhibitor is a useful stone forming animal model involving mild renal tubular injury together with mild hyperoxaluria.

Animals↗

PubMed2005

Effective local control of prostate cancer by intratumoral injection of (166)Ho-chitosan complex (DW-166HC) in rats.

PURPOSE: The aim of this study was to evaluate the therapeutic effect and morphological alterations resulting from (166)Ho-chitosan complex (DW-166HC) in an animal model of prostate cancer. METHODS: First, in a subcutaneous tumor model, 80 rats were randomly divided into four groups (n=20 in each group), and intratumoral injections of 0.05 ml (normal saline in group 1,( 165)Ho-chitosan complex solution in group 2, DW-166HC solution (10 mCi) in group 3, and DW-166HC solution (20 mCi) in group 4) were performed when the tumor measured approximately 1 cm along its long axis in each group. Further, in an orthotopic tumor model, 40 rats were similarly randomly divided into four groups (n=10 in each group), and intraprostatic injections of 0.05 ml [PBS in group 1,( 165)Ho-chitosan complex solution in group 2, DW-166HC solution (0.5 mCi) in group 3 and DW-166HC solution (1 mCi) in group 4] were performed at 1 week after implantation of the AIT cell line in the ventral prostate. RESULTS: In the subcutaneous tumor model, mean tumor weights of groups 3 and 4 were significantly lower than those of groups 1 and 2 at 2 and 4 weeks post injection (p<0.05). At 2 and 4 weeks after injection in the orthotopic tumor model, the mean weights of the prostate, including tumor, in groups 3 and 4 were also significantly lower than those in groups 1 and 2 (p<0.05). No adverse injury was seen in adjacent organs at histopathologic examination. CONCLUSION: Intratumoral injection of the beta-emitting radionuclide (166)Ho as a form of complex solution with chitosan appears to be a promising alternative therapeutic modality for the local control of prostate cancer.

Animals↗

PubMed2005

How painful are shockwave lithotripsy and endoscopic procedures performed at outpatient urology clinics?

Our aim was to investigate the subjective pain felt by patients during shockwave lithotripsy (SWL) and endoscopic procedures such as cystoscopy, retrograde ureteral stenting, retrograde pyelography (RGP), and ureteroscopic lithotripsy performed in an outpatient clinic, and to identify how severe pain during such procedures is. We estimated subjective pain in 984 patients after SWL (186), cystoscopy (489), retrograde ureteral stenting (127), RGP (97), and ureteroscopic lithotripsy (85) performed by a single expert in an outpatient clinic using a prospective questionnaire with a ten point visual analog scale between January 2001 and December 2003. There was no premedication in any procedure except ureteroscopic lithotripsy for which an intramuscular injection of analgesics (pethidine HCl 50 mg) was used. The pain scale score in SWL was 6.62+/-2.27, the highest among the procedures (P<0.05). Pain scores for endoscopies were 4.48+/-2.07 in retrograde ureteral stenting, 3.81+/-2.06 in ureteroscopic lithotripsy, 3.72+/-1.75 in RGP, and 3.08+/-1.95 in cystoscopy. In this study, we observed that patients feel most pain in SWL without anesthesia, and that pain during ureteroscopic lithotripsy under local anesthesia is not high, compared with other endoscopic procedures.

Adolescent↗

PubMed2005

Biodistribution and excretion of radioactivity after the administration of 166Ho-chitosan complex (DW-166HC) into the prostate of rat.

PURPOSE: The objective of this study was to determine the fate of the 166Ho-chitosan complex (DW-166HC) in rats by examining its absorption, distribution and excretion after administration into the prostate. METHODS: About 100 microCi of DW-166HC [containing 0.1875 mg of Ho(NO3)3.5H2O and 0.25 mg of chitosan] was administered intraprostatically. The level of radioactivity in blood, urinary and faecal excretion, and radioactivity distribution were examined. To determine the effect of chitosan in DW-166HC, 166Ho nitrate alone [0.1875 mg of Ho(NO3)3.5H2O] was administered into the prostate of male rats, and radioactivity distribution was examined using whole-body autoradiography. RESULTS: After administration of DW-166HC into the prostate, cumulative urinary and faecal excretion over the period 0-72 h was 0.35% and 0.11%, respectively. The radioactivity at the administration site was extremely high at all time points up to 144 h (>98% of injected dose). The small amount of radioactivity which did transfer from the administration site distributed mainly to the liver, spleen, kidney cortex and bone. Compared with the DW-166HC group, the group that received 166Ho nitrate alone displayed three- to fourfold higher levels of radioactivity in the main tissues, including liver, spleen, kidney cortex and bone, at 24 h after administration (P < 0.05). CONCLUSION: The results of this study show clearly that most of the administered DW-166HC remained at the administration site. It is concluded that the chitosan complex may be used to retain 166Ho within a limited area in cancer of the prostate.

Animals↗

PubMed2005

Apoptosis induced by oxalate in human renal tubular epithelial HK-2 cells.

Oxalate is not only considered to be one of the main constituents of urinary stones, but it also has toxic effects on renal tubular epithelial cells, affecting the pathogenesis of nephrolithiasis. We tried to elucidate the effects of oxalate on human renal tubular epithelial cells (HK-2 cells). In addition, we investigated whether the toxic effect of oxalate occurs by apoptosis, and determined the expression of Bcl-2 family and caspase 9 proteins known as apoptosis-related protein. HK-2 cells were incubated with different concentrations of oxalate, and the effect of oxalate on the growth of the cells was assessed by MTT assay. A caspase-3 activity assay and TUNEL assay were performed on HK-2 cells after oxalate exposure in order to evaluate apoptosis. Immunoblot analysis of Bax, Bcl-2, Bcl-xL, and caspase-9 were performed. Oxalate exposure resulted in significant growth inhibition of HK-2 cells as oxalate concentrations increased. The toxic effect of oxalate on HK-2 cells was considered to occur through apoptosis, as suggested by the increase of caspase-3 activity. The percentage of positive nuclei stained using the TUNEL method was 18+/-2.3 in oxalate-treated cells and 2.5+/-0.9 in untreated cells (P<0.05). Bax and caspase-9 protein expression increased significantly as oxalate concentrations increased, but Bcl-2 protein expression decreased. There was no difference in Bcl-xL protein expression among the various concentrations of oxalate. Our results show that oxalate has a toxic effect on HK-2 cells and that this effect is induced by apoptosis, which may be mediated by an intrinsic pathway.

Apoptosis↗

PubMed2005

Involvement of Rho-kinase in the contractile mechanism of human ureteral smooth muscle.

AIM: Even though many agents have been implicated as modulators of ureteral contractile activity, the exact mechanisms that control human ureteral smooth muscle contractility have yet to be clearly defined. Recently, Rho-kinase has been reported to be involved in the contractile mechanism of smooth muscles in various organs. In the present study, we sought to investigate whether or not Rho-kinase is expressed in the human ureteral smooth muscle, and to study its role regarding human ureteral smooth muscle contractility. METHODS: Ureteral samples were obtained from human adult subjects undergoing radical nephrectomy. Immunohistochemistry and Western blotting were performed to determine the presence of Rho-kinase in human ureter. Functional studies were performed with human ureteral strips suspended in organ bath, and the effects of Y-27632, a specific inhibitor of Rho-kinase, on baseline tensions, spontaneous contractions, and electrical field stimulation (EFS)-induced contractions were analyzed. RESULTS: The results of immunohistochemistry and immunoblotting study indicated that Rho-kinase is present in human ureteral smooth muscle. In functional analysis, Y-27632 was shown to decrease the baseline tension. And, both spontaneous and EFS-induced contractile responses of human ureteral strips were attenuated by Y-27632 in dose-dependent manners. CONCLUSIONS: For the first time, the results of the present study indicate that Rho-kinase is present in human ureteral smooth muscle and may play an important role in the intricate mechanism of human ureteral contractility and tone.

Adult↗

PubMed2005

Do vascular, lymphatic, and perineural invasion have prognostic implications for bladder cancer after radical cystectomy?

OBJECTIVES: To elucidate the respective prognostic implications of vascular, lymphatic, and perineural invasion noted on the pathologic analyses of radical cystectomy specimens. Controversy still exists on whether the pathologic features of vascular, lymphatic, and perineural invasion have any role as prognostic indicators for bladder cancer. METHODS: A retrospective review of 125 patients with bladder cancer treated with radical cystectomy was conducted. Patients who received either preoperative or postoperative chemotherapy, those with lymph node metastasis confirmed on postoperative pathologic analysis, those who did not undergo standard bilateral pelvic lymph node dissection, and those receiving palliative treatment were excluded from the study. RESULTS: The mean patient age was 62.5 years (range 39 to 84), and the median follow-up duration was 41.0 months (range 1 to 146). Vascular, lymphatic, and perineural invasion was present in 8.8%, 20.8%, and 8.8% of specimens, respectively, and 28% of patients had at least one of the three pathologic features in the specimen. Univariate analysis revealed that vascular invasion, lymphatic invasion, and perineural invasion were significant prognostic predictors of overall survival. However, only the tumor stage and vascular invasion proved to be independent prognostic predictors of disease-specific survival on multivariate analysis. CONCLUSIONS: The results of the present study have shown that the pathologic tumor stage and the pathologic presence of vascular invasion are independent prognostic predictors for disease-specific survival in patients who have undergone radical cystectomy for bladder cancer. Additional study should be performed on the prognostic implications of lymphatic and perineural invasion.

Adult↗

PubMed2005

Early removal of nasogastric tube after cystectomy with urinary diversion: does postoperative ileus risk increase?

OBJECTIVES: To examine the risk factors of postoperative ileus and investigate whether the duration of postoperative nasogastric tube (NGT) use affects the rate of postoperative ileus in patients undergoing radical cystectomy with urinary diversion. METHODS: A total of 101 patients underwent radical cystectomy with urinary diversion from 1999 to 2003. We examined the demographic and perioperative variables of the patients who did and did not develop postoperative ileus. We divided the patients into two groups--those who had the NGT removed within 24 hours and those who had the NGT removed at first flatus. We compared the two groups for the incidence of ileus and clinical variables. RESULTS: Postoperative ileus was observed in 23 patients (23%). The demographic data of both groups were not different in terms of age or American Society of Anesthesiologists score. Also, the operative time, estimated blood loss, type of diversion, and postoperative complication rate were not significantly different between the two groups (P >0.05). However, the risk of postoperative ileus was significantly greater in those who took polyethylene glycol for bowel preparation than in those who took sodium phosphate (40% versus 18%, respectively, P = 0.02). No significant difference in the prevalence of ileus was found between the patients whose NGT was removed within 1 day and those in whom it was removed after 2 days (25% versus 22%, respectively, P >0.05). CONCLUSIONS: The results of our study suggest that the use of sodium phosphate for bowel preparation may reduce the incidence of postoperative ileus and that early NGT removal after cystectomy is not correlated with ileus.

Aged↗

PubMed2005

Adjuvant interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy after radical nephrectomy for locally advanced renal cell carcinoma.

OBJECTIVES: To investigate the efficacy of interleukin-2 (IL-2), interferon-alpha, and 5-fluorouracil combination immunochemotherapy as adjuvant therapy after radical nephrectomy for nonmetastatic pathologic Stage T3 renal cell carcinoma. METHODS: Thirty patients who underwent radical nephrectomy for pT3N0M0 renal cell carcinoma at our department from June 1999 to December 2003 were studied retrospectively. Of the 30 patients, 9 (adjuvant group) also received adjuvant interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy after surgery; the other 21 (nonadjuvant group) did not. A comparative analysis of the two groups was performed with respect to disease-free and overall survival. Side effects from immunochemotherapy were also assessed. RESULTS: The adjuvant therapy and nonadjuvant therapy groups were not significantly different with respect to age, sex, Eastern Cooperative Oncology Group performance status, pathologic subtype, pathologic stage, tumor size, and Fuhrman's grade. The two groups demonstrated a significant difference in the time to progression (log-rank test, P = 0.011). Although 3 patients had died at a mean follow-up of 23.8 months (range 7.5 to 35) in the nonadjuvant group, apparent differences between the two groups in overall survival were not statistically significant (log-rank test, P = 0.2487). Combination immunochemotherapy was mostly well tolerated, and all side effects were limited to World Health Organization grades 1 and 2. CONCLUSIONS: Despite the ongoing controversy surrounding its effectiveness in the treatment of metastatic renal cell carcinoma, the results of our preliminary study suggest that interleukin-2, interferon-alpha, 5-fluorouracil combination immunochemotherapy may be effective as adjuvant therapy after complete resection of pT3N0M0 renal cell carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

Hand-assisted retroperitoneoscopic nephroureterectomy without hand-assisted device.

Various laparoscopic nephroureterectomy techniques for urothelial carcinoma of the upper urinary tract have been developed to minimize postoperative discomfort and the necessity for a lengthy convalescence. We performed hand-assisted retroperitoneoscopic nephroureterectomy without hand-assisted device in 3 male patients with urothelial carcinoma of the distal ureter. Average operative time and estimated blood loss were 251 min (range 235 to 280) and 250 mL (range 200 to 300), respectively. Complication did not occur and conversion to open surgery was not necessary in all cases. Postoperative analgesic requirements were moderate and the time to regular diet intake averaged 3 days (range 2 to 4). None of the patients had a positive margin on the final pathologic specimen. At the average follow-up of 8.1 months, no regional recurrence, port-site metastasis, bladder recurrence, or distant metastasis were noted in any patient. We described our initial experience with the described technique, which obviates the need for midprocedural patient repositioning.

Aged↗

PubMed2004

Enhanced chemosensitivity of bladder cancer cells to cisplatin by suppression of clusterin in vitro.

We examined the functional role of clusterin in chemotherapy-induced apoptosis and tested whether anti-sense transfection targeted against clusterin enhances the chemosensitivity in human bladder cancer cells in vitro. Clusterin mRNA and protein expression of 253J cells, a human bladder carcinoma cell line, after treatment with cisplatin were measured by RT-PCR and Western blot analysis. Clusterin expression and cell growth were compared between 253J cells transfected with constructed a clusterin anti-sense plasmid vector (pCR-CLU-AS) and controls. Tumor cell viability was measured with MTT assay after cisplatin treatment. DNA fragmentation and CPP32 assay were performed. Clusterin expression was increased after treatment with cisplatin and highest at 8 h in 253J cells. Clusterin anti-sense transfectants were highly sensitive to apoptotic cell death induced by cisplatin compared with parental 253J cells or control transfectants. Collectively, our results showed that expression of clusterin was increased in the acute phase of cell death caused by cisplatin and that suppressing the expression of clusterin enhanced the susceptibility of apoptosis caused by cisplatin in human bladder cancer cells. These results suggest that lowering the expression of clusterin might increase the sensitivity of bladder cancer cells to chemotherapeutic agents.

Antineoplastic Agents↗

PubMed2004

Histologic and molecular changes in the ipsilateral and contralateral epididymides of the rat in response to unilateral testicular torsion followed by detorsion.

OBJECTIVE: To investigate the histologic and molecular changes in the ipsilateral and contralateral epididymides in response to unilateral testicular torsion followed by detorsion. DESIGN: Controlled experimental study using rats. SETTING: Seoul National University College of Medicine, Seoul, Korea. ANIMAL(S): Thirty-five, 8-week-old Sprague-Dawley male rats: six experimental groups and a sham-operated control group. INTERVENTION(S): Testes of male rats were subjected to torsion for 10 minutes. At 0, 1, 4, 8, 24 hours and 1 week after detorsion, ipsilateral and contralateral epididymides were harvested. Microscopic examination and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) staining was performed. The percentage of apoptotic ducts in the epididymis was determined by counting 100 duct cross-sections of the head and the tail of the epididymis of each specimen. MAIN OUTCOME MEASURE(S): Morphologic change, including in situ apoptosis, of the ductal epithelium was evaluated. RESULT(S): There was no evidence of morphologic or apoptotic changes in the 0- or 1-hour detorsion groups. However, enlargement of the interstitial fibrous tissue was found 8 and 24 hours after detorsion and marked degeneration of ductal epithelium was observed at 1 week in both the ipsilateral and contralateral epididymides. Apoptosis was first observed at 4 hours after detorsion, and the percentage of apoptotic ducts was significantly increased at 8 hours, peaked at 24 hours, and slightly decreased at 1 week in both the ipsilateral and contralateral epididymides. CONCLUSION(S): Both morphologic changes and intracellular molecular alterations occur not only in the ipsilateral but also in the contralateral epididymis following unilateral testicular torsion/detorsion.

Animals↗

PubMed2004

Impact of transurethral resection of bladder tumor: analysis of cystectomy specimens to evaluate for residual tumor.

OBJECTIVES: To analyze the impact of transurethral resection of bladder tumor (TURBT) on the outcome of patients with bladder cancer who undergo subsequent cystectomy. METHODS: We reviewed the records of 90 patients with pathologic Stage T2 or less transitional cell carcinoma of the bladder at our institute. Before radical cystectomy, TURBT was performed for diagnostic and therapeutic purposes in all patients. We used the term "complete TURBT" in the following situations: no residual tumor endoscopically after TURBT, the presence of a muscle layer in the TURBT specimen, and no gross residual tumor in the cystectomy specimen as evaluated by a pathologist. RESULTS: No statistically significant differences in the completeness of TURBT were observed by age, sex, tumor multiplicity, shape, history of previous TURBT, tumor grade, or stage. Of 21 patients with superficial bladder tumors who had undergone incomplete resection, 14 (66.7%) had a higher stage on the cystectomy specimen; 3 (17.7%) of 17 patients had a higher stage in the complete TURBT group. Of 34 patients with an invasive tumor who underwent complete TURBT, 10 (29.4%) had an identical pathologic stage after cystectomy; the remaining patients had a lower stage. However, only 3 (16.7%) of 18 patients had a lower stage in the incomplete resection group. Of patients with Stage T2, those with pT0 stage had a better chance of survival than those with residual tumor (P = 0.04). CONCLUSIONS: Our findings indicate that the completeness of TURBT is an important aspect of patient outcome in cases of superficial or invasive bladder cancer.

Aged↗