Jai Seong Cha

Myelolipomas of both adrenal glands.

Adrenal myelolipoma is a rare, nonfunctional benign tumor that is composed of mature adipose tissue and hematopoietic elements. In the past, these tumors were accidentally discovered at autopsy. Today, they are found much more frequently and incidentally, mainly because of the widespread use of noninvasive imaging with ultrasonography, computed tomography, and magnetic resonance imaging. Most lesions are asymptomatic, small, and unilateral, but a number of bilateral tumors have been reported. We report here on a case of a 48-year-old man with incidentally found myelolipomas of both adrenal glands. In particular, a giant myelolipoma of the left adrenal gland was treated by transperitoneal laparoscopic adrenalectomy.

Floating Hem-o-Lok Clips in the Bladder without Stone Formation after Robot-Assisted Laparoscopic Radical Prostatectomy

Hem-o-Lok clips (Weck Surgical Instruments, Teleflex Medical, Durham, NC, USA) are widely used in robot-assisted laparoscopic radical prostatectomy because of their easy application and secure clamping. To date, there have been some reports of intravesical migration of these clips causing urethral erosion, bladder neck contractures, and subsequent calculus formation. We report the first case of bladder migration of Hem-o-Lok clips without stone formation after robot-assisted laparoscopic radical prostatectomy. The Hem-o-Lok clips were found during urethral dilation with a guide wire for bladder neck contracture under cystourethroscopy. The Hem-o-Lok clips were floating in the bladder without stone formation and were removed by a cystoscopic procedure.

Clinical significance of immediate urine cytology after transurethral resection of bladder tumor in patients with non‐muscle invasive bladder cancer

Objectives:  To assess the clinical significance of immediate urine cytology (IUC) after transurethral resection of bladder tumor (TURBT) for non‐muscle invasive bladder cancer (NMIBC).

Dose-dependent effects of cisplatin on the severity of testicular injury in Sprague Dawley rats: reactive oxygen species and endoplasmic reticulum stress

Cisplatin (CIS) is used in the treatment of cancer, but its nonspecific systemic actions lead to toxic effects on other parts of the body. This study investigated the severity of CIS toxicity by increasing its dose over a constant time period. Sprague Dawley rats were divided into five treatment groups and control group with CIS (2, 4, 6, 8, and 10 mg/kg) administered intraperitoneally for 5 days. The body and organs were weighed, epididymal sperm was counted, and sperm motility and sperm apoptosis were evaluated. Blood samples were evaluated for complete blood count, reactive oxygen and nitrogen species, malondialdehyde levels, and total testosterone. The testicular tissue was examined for steroidogenic acute regulatory protein and endoplasmic reticulum stress protein. Epididymal sperm was collected for CatSper Western blot. The toxic effects of different doses of CIS on the testis and kidney were compared histologically. The weights of body, testis, epididymis, prostate, seminal vesicle, and kidney; sperm count; sperm motility; steroidogenic acute regulatory protein level; and epididymal sperm count were significantly lower in the CIS-treated groups than in the control group. In contrast, sperm apoptosis, plasma reactive oxygen and nitrogen species, and malondialdehyde, testosterone, red blood cell, hematocrit, hemoglobin, and endoplasmic reticulum stress protein levels all increased. Though CIS effectively treats cancer, at an increased dose it is toxic and life-threatening to the genitourinary system and other parts of the body.

Newly developed hypertension due to juxtaglomerular cell tumor in pregnancy.

An unusual case of juxtaglomerular cell tumor (JCT) is presented. A 29-year-old woman visited our hospital for the management of incidentally detected renal mass due to newly developed hypertension in the 20th week of pregnancy. Laboratory studies showed increased basal plasma renin activity and hypokalemia but serum aldosterone level was normal. Abdominal computed tomography scan showed about 2.4 cm sized multicystic mass in the right kidney. Nephron-sparing surgery was performed with excellent results. On histological examination, the tumor exhibited a structure typical feature of JCT. A few days later the patients blood pressure had been normalized.

Efficacy and Safety of the TVT-SECUR® and Impact on Quality of Life in Women with Stress Urinary Incontinence: A 2-Year Follow-Up

Purpose As recently reported, the short-term results of the tension-free vaginal tape SECUR® (TVT-S) procedure seem to be similar to those of the conventional transobturator tape (TOT) procedure. However, results of efficacy and satisfaction with TVT-S are insufficient in patients with more than 1 year of follow-up. Therefore, we evaluated the results of the TVT-S procedure in women with stress urinary incontinence (SUI) during 2 years. Materials and Methods We evaluated 51 patients with clinical and urodynamic diagnoses of SUI who underwent the TVT-S procedure from March 2008 to February 2009. Preoperative evaluation included a history, cough stress test with full bladder, urodynamic study, and incontinence quality of life (I-QoL) questionnaire. Following the postoperative period, urinary incontinence status was examined through a physical examination and the I-QoL questionnaire was completed in an outpatient setting or by telephone. Results Data from 2 years of follow-up were available for 46 of 51 patients. The cure rate was 80.4% at 1 month after TVT-S and 76.0% at 2 years after TVT-S. The cure or improvement rate was 93.5% at 1 month after TVT-S and 86.8% at 2 years after TVT-S. The mean total I-QoL score increased by 42 points at 1 month after TVT-S (p<0.026) and by 32 points at 2 years after TVT-S (p<0.013). Most patients reported significant improvements in quality of life. At the 2-year follow-up, there were no significant complications related to TVT-S. Conclusions The results of this study suggest that TVT-S is an efficient and safe procedure for the improvement of both the quality of life of the patients and the SUI itself.

The relationship between serum total testosterone and free testosterone levels with serum hemoglobin and hematocrit levels: a study in 1221 men

Abstract Objective: To investigate the relationship between serum total testosterone (TT) and free testosterone (FT) levels in men with anemia. Methods: We reviewed the records of 1221 subjects between March 2009 and December 2014. All the subjects’ blood samples were drawn for TT and FT assays. Their serum hemoglobin (Hb) and serum hematocrit (Hct) levels were measured. The primary objective of our study was to investigate the association between TT and FT levels with Hb and Hct levels. Results: The mean age was 59.82 ± 12.71 years. The mean TT and FT levels were 4.54 ± 2.02 ng/mL and 10.63 ± 3.69 pg/mL, respectively. The mean Hb and Hct levels were 14.72 ± 1.34 g/dL and 43.11 ± 3.75%, respectively. Subjects with low TT (<2.35 ng/mL) had low Hb and Hct levels (p < 0.001, p < 0.001, respectively). TT was positively associated with FT, Hb, and Hct. TT and FT levels were significantly lower in older men. Conclusions: Subjects with low TT and FT levels had low Hb and Hct levels. This suggests that TT and FT play a significant role in erythropoiesis. Testosterone replacement therapy may be effective in men with hypogonadism to reduce the incidence of anemia.

Unusual Presentation of Bilateral Adrenocortical Carcinoma Mimicking Adrenal Metastasis

A 75-year-old female visited our hospital with bilateral adrenal masses that were detected incidentally during lumbar spine magnetic resonance imaging (MRI) for the evaluation of radiating flank pain. Consecutive computed tomography and MRI revealed bilateral adrenal masses with no evidence of lymph node enlargement or local invasion; 2[(18)F]fluoro-2-deoxyglucose (FDG)-positron emission tomography showed an intense FDG accumulation in both adrenal glands without abnormal FDG uptake in extra-adrenal regions. The laboratory test results were within normal ranges. We performed a bilateral adrenalectomy. The pathologic diagnosis of both adrenal masses was consistent with adrenocortical carcinoma. The patient recovered well with no complications.

Ureteropelvic junction obstruction and renal cell carcinoma in a patient with solitary functioning kidney

We present a case of ureteropelvic junction obstruction (UPJO) and renal cell carcinoma (RCC) in a solitary functioning kidney (SFK), managed by robot-assisted dismembered pyeloplasty with partial nephrectomy in a single stage. To our best knowledge, we report the first case of UPJO with RCC in a congenital SFK.

Huge Retroperitoneal Hemorrhage due to Adrenal Artery Injury without Visceral Organ Injury

We report a case of huge retroperitoneal hemorrhage with active contrast extravasation due to right adrenal artery injury without visceral organ injury. A 67-year-old woman was involved in an out car traffic accident. She sustained multiple traumatic injuries and right adrenal artery injury without visceral organ injury. Abdominal computed tomography scan showed huge retroperitoneal hemorrhage with active contrast extravasation. But, there is no evidence of renal injury. Renal angiography confirmed contrast media extravasation from right adrenal artery. Selective embolization of adrenal artery was attempted but, adrenal arterial lumen was spontaneously obstructed due to arterial spasm. To our knowledge, isolated adrenal artery injury occurring huge retroperitoneal hemorrhage have not been described previously. Awareness of this possible cause of retroperitoneal hemorrhage may assist in immediate diagnosis and appropriate treatment.