(Objective) The efficacy and safety of two types of phoshodiestrase type 5 (PDE 5) inhibitors (sildenafil (sil) and vardenafil (var)) were investigated for multi-centric study.
(Subjects and methods) One hundred and twenty five patients (55.9±10.9 years old) with erectile dysfunction (ED) were treated by both of sil and var. The patients were administered a pair of 25 mg of sil and 5 mg of var, or 50 mg of sil and 10 mg of var. The efficacy for ED and safety of these 2 drugs were evaluated after administration of each drugs at least 2 times.
(Results) The results showed that the score of international index of erectile function 5 (IIEF5) were elevated from 8.87±4.10 to 17.24±6.17 after treatments (p<0.0001, Student's t test). The efficacy rates for ED were 81.6% in sil and 81.6% in var, respectively. The adverse reactions rates such as headache, burning, palpitation, etc. were 13.6% in sil and 5.6% in var, which is significantly higher in sil (p=0.032; χ² test). These side effects were not serious at all, and there were no cases that gave up to use PDE5 inhibitors because of adverse reactions. According to individual patients experiences, 40.7% of patients preferred sil, 45.4% choose var. In addition, associated effects for quality of life (QOL) of ED patients treated by PDE5 inhibitors were analyzed. The results revealed that encouraging in life 46.5%, rejuvenation feeling 45.1%, self care for their health 28.2%, improvement of depression 12.7%, improvement of voiding dysfunction 5.6%, intimacy with partner 38.0%, good conversation with partner 18.3%, and so on.
(Conclusion) The treatments of ED by sil and var were very effective and safety. Furthermore, associated effects for QOL of ED patients were also improved with these treatments.

View full abstract

(Purpose) Mecobalamin has been reported to be useful for peripheral nerve disorder. There have been no previous reports of the effects of mecobalamin on urinary and sexual function after nerve sparing radical prostatectomy. We examined the effects of the use of mecobalamin on urinary and erectile functions after nerve sparing radical prostatectomy.
(Materials and methods) A total of 54 patients with localized prostatic cancer were prospectively randomized into 2 groups. The 27 patients in group A were treated with nerve sparing prostatectomy and mecobalamin 1,500 μg/day for 6 months. The 27 patients in group B were treated with nerve sparing prostatectomy alone. Urinary function (URF), urinary bother (URB), sexual function (SXF) and sexual bother (SXB) were evaluated using the University of California at Los Angeles Prostate Cancer Index (UCLA-PCI) before surgery, and 3, 6 and 12 months after surgery.
(Results) There were no significant differences in URF, URB, SXF or SXB between the two groups at any postoperative period. At 3 months after surgery, however, group A tended to have a better URF than group B (85.7±4.7 (mean±standard error) vs. 66.9±10.2) and URB (85.7±7.4 vs. 63.9±11.8) (p=0.121, p=0.168). At 12 months after surgery, both groups showed similar URF (86.4±7.4 vs. 81.8±4.2) and URB (86.5±8.3 vs. 84.5±4.7). Although the two groups had similar recovery phase of SXF, group A tended to report better SXB throughout the postoperative period.
(Conclusion) This study did not demonstrate any significant effect of the use of mecobalamin on the recovery of urinary or sexual function after nerve sparing prostatectomy, although an early recovery effect on urinary function was suggested. A randomized controlled study with a larger population is warranted to fully elucidate the role of mecobalamin in the improvement of functional outcome after radical prostatectomy.

View full abstract

A 31-year-old man presented with a 6-month history of right testicular enlargement. The patient underwent a right inguinal orchiectomy. Histopathological examination showed non-seminomatous germ cell tumor (choriocarcinoma> seminoma) which was confined to the tunica albuginea. The postoperative serum level of alpha-fetoprotein (AFP) and lactate dehydrogenase were normal. Serum level of human chorionic gonadotrophin (HCG), however, was 23,000 mIU/ml (normal, < 0.7 mIU/ml). A thoracic computed tomography (CT) at that time showed bilateral and multiple metastases to the lungs but the abdominal CT was normal. After the surgery, the patient was treated with conventional doses of cisplatin, etoposide, and bleomycin. On day 11 of the second chemotherapy course, the patient developed confusion and right sided weakness. Brain magnetic resonance imaging (MRI) showed an ischemic lesion in the left middle cerebral artery area. An echocardiogram showed normal left ventricular function and no valvular vegetations. Finally, the patient completed one additional course of chemotherapy with considerable measures to prevent side effects. A thoracic CT at the end of the third cycle showed no evidence of tumor. At 3 months follow-up after chemotherapy, he suffered from partial paralysis of right-sided upper and lower limbs but due to intensive rehabilitation he overcame the paralysis and is able to walk by himself. There was no evidence of tumor recurrence.

View full abstract

A 32-year-old man was admitted to our hospital with a complaint of right scrotal swelling. He had a past history of left testicular nonseminomatous germ cell tumor (NSGCT), stage IIB 14 years ago. He had undergone chemotherapy with 3 courses of PEP and retroperitoneal lymphnode dissection revealing pathological CR. He was diagnosed as having right testicular tumor. He underwent right high orchiectomy. Imaging studies and pathological studies revealed pure seminoma with spermatic cord invasion, stage I, pT3N0M0. He underwent chemotherapy with 3 courses of VIP. Herein we present a case of metachronous bilateral testicular germ cell tumor with a review of literatures.

View full abstract

A 37-year-old female was referred to our department for a renal mass which was incidentally found during a medical check-up. She had no history of tuberous sclerosis. Computed tomography and magnetic resonance imaging showed a 1.5-cm enhancing mass at the lower pole of the left kidney. An open partial nephrectomy was performed for a pre-operative diagnosis of renal cell carcinoma. Pathological examination revealed sheets of large polygonal epithelioid cells that showed positive immunostaining for HMB-45, which confirmed the diagnosis of an epithelioid angiomyolipoma. The patient remained free of recurrent or metastatic disease at 3 months of follow-up. Epithelioid angiomyolipoma is a recently identified variant of angiomyolipoma, which is sometimes associated with aggressive clinical behavior including local recurrence and metastasis. We present this case and review the literature concerning this unusual disorder.

View full abstract