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소아 요관류의 다양한 수술적 치료에 대한 임상 결과 고찰
송채린,박영서,김건석 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.8
Purpose: We reviewed our experience in the management of ureteroceles in children as we selected the surgical method according to the patients' age and the differential function of the affected renal unit. Materials and Methods: Thirty-six children(10 boys, 26 girls) with ureteroceles who received surgical management between 1991 and 2003 and were followed up for at least 12 months postoperatively were the subjects of this study. Age at operation ranged from 1 month to 10 years(median 6.5 months) and patients were followed up for an average of 43 months postoperatively(12-103 months). Results: Twenty patients had functioning renal units, 16 including 4 infants, of which received transurethral incision(TUI), 3 ureteroureterostomy and 1 ureteroneocystostomy after ureterocelectomy. Eight of the 16 patients(50%) who received TUI developed de novo vesicoureteral reflux (VUR), 5 of whom requiring secondary open procedure. Of the 16 patients with nonfunctioning renal units who received either heminephrectomy or nephrectomy, 6 required secondary open procedures for persistent ureteral obstruction or bladder outlet obstruction. On follow-up, of the 20 patients with initially functioning renal units, 19 maintained preoperative level of renal function and all remained free of urinary tract infection(UTI). Conclusions: In surgical approach to the ureteroceles, individualization with respect to the function of the affected unit and the age of the patient appears to be effective in controlling UTI and preserving the renal function. TUI, despite the high rate of de novo VUR, may be a useful option in immediate decompression of the obstructed urinary tract in the face of acute UTI especially in younger children.
cis-Diamminedichloroplatinum (Ⅱ) 내성 방광암 세포주에서 Bcl-2와 Bax 단백의 발현
송채린,강태진,유달산,홍준혁,안한종 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.5
Purpose: Development of drug resistance has been the major obstacle in cis-Diamminedichloroplatinum (II) (cisplatin)-based combination chemotherapy in the treatment of advanced bladder cancer for which a variety of mechanisms has been suggested. We investigated to determine the changes of expression of apoptotic regulator proteins Bcl-2 and Bax in cisplatin-resistant bladder cancer cell lines and the reversibility of chemoresistance with antisense oligonucleotide against Bcl-2. Materials and Methods: In T24, J82, 253J, 253J-BV and HT-1376 bladder cancer cell lines, we established cisplatin-resistance using stepwise exposure to cisplatin. The changes of Bcl-2 and Bax proteins in the resistant cell lines were determined by Western blot. Then, after administration of antisense oligonucleotide targeting the Bcl-2 coding sequence to the T24, T24-R1, and T24-R2 cell lines with lipofectamine, changes of Bcl-2 expression were determined along with cisplatin cytotoxicity before and after transfection. Results: We confirmed the acquisition of cisplatin resistance in all 5 cell lines as the percent increase of IC50 in each cell lines were 210%, 175%, 181%, 280% and 153%, respectively. The expression of Bcl-2 protein increased in all 5 cisplatin-resistant cell lines, while the expressions of Bax decreased in 4 of 5 cisplatin-resistant cell lines. Treatment with antisense oligonucleotide significantly enhanced the cytotoxicity of cisplatin in T24, T24-R1 and T24-R2 cell lines. Conclusions: These results suggest that the up-regulation of Bcl-2 expression as well as down-regulation of Bax expression may be one of the mechanisms of cisplatin resistance in bladder cancer cells, and antisense Bcl-2 oligonucleotide may be helpful in chemotherapy of bladder cancer by reversing cisplatin resistance. (Korean J Urol 2004;45:472-477)