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The use of bowel for bladder augmentation is associated with many complications. We have reported that acellular dermal biomatrix can be used successfully for directing the regeneration of each key bladder wall element in healthy domestic pigs. Before proposing that this material should be used in the human setting a final set of experiments using this scaffold to replace diseased bladder wall is necessary. We determined if acellular dermal biomatrix can be used to replace diseased bladder wall. We compared our findings to our previous results.Six domestic male pigs underwent urethral ligation and suprapubic tube placement. Five female pigs served as controls for bladder dynamics. Machined resistance valves of 5 and 10 cm H(2)O pressure were placed into the lumen of the cystostomy catheter for a mean of 3.3 weeks (range 3 to 4). Obstruction was then relieved and partial cystectomy was performed, followed by augmentation with a 4 x 4 cm segment of acellular dermal biomatrix of the markedly thickened and poorly compliant bladder. Animals were sacrificed 3 months following augmentation. Standard urodynamic studies were performed. Contractility and compliance were measured in freshly isolated regenerated and native bladder tissues. Histological evaluation was performed on hematoxylin and eosin, and Masson's trichrome stained sections.Bladder compliance was markedly decreased after 3.3 weeks of obstruction. Mean compliance +/- SEM before obstruction was 16.28 +/- 9.21 cm H(2)O. After 3.3 weeks of obstruction average compliance was 4.13 +/- 0.98 cm H(2)O. One pig died 2 weeks following augmentation due to graft separation and sepsis. Gross examination of augmented bladders revealed the complete replacement of acellular dermal biomatrix with bladder tissue. Histological evaluation revealed extensive fibrosis with small islands of poorly organized muscle in contrast to the complete regeneration of mucosa, smooth muscle and serosa seen in augmentations previously performed in healthy animal bladders. Maximum contractile tension of the patch tissue was not different than that in the native tissue from the obstructed hypertrophied bladder but it was only approximately 10% of the tension produced by healthy tissue from nonobstructed augmented bladders. The obstructed bladder patch and native tissue was approximately 14 times stiffer than healthy bladder tissue.While augmentation of healthy porcine bladder with acellular dermal biomatrix results in excellent functional bladder tissue regeneration, similar experiments in a porcine model of obstructed bladder disease failed to show favorable results. Therefore, acellular dermal biomatrix cannot be recommended at this time for human bladder dysfunction. Results support the contention that matrices designed for human bladder augmentation should be tested in a disease animal model before recommending them for human bladder dysfunction.

To our knowledge there is no multi-institutional report on prepubertal testicular tumors in Korea to date. We obtained demographic data for a better understanding of the biological behavior and optimal management of these tumors.The prepubertal testicular tumor registry form was mailed to all 87 hospitals registered in the Korean Urology Association. We retrospectively reviewed recent 5-year medical records.A total of 209 patients were enrolled in this registry. The incidence was 0.98/100,000 children. Age was 1 to 142 months (median 18). Most patients were diagnosed with a scrotal mass before age 4 years. Serum alpha-fetoprotein and beta-human chorionic gonadotropin increased in as many as 62.9% and 2.7% of patients, including 94.7% and 2.2% in those with yolk sac tumor and 30.4% and 2.7% in those with teratoma, respectively. While potentially malignant tumors accounted for 52.5% of patients, the remainder were benign. Germ cell tumors were the most common (89.4% of cases), mainly with yolk sac tumor (47.8%) or teratoma (39.7%). Management after surgery included surveillance in 71.8% of cases, chemotherapy in 9.1%, combination therapy in 1.4% and other in 17.7%. Of the total patients 10.5% (5.9% of stage I yolk sac tumors) had progression to metastasis. The final results of treatment were complete remission (64.6% of cases), incomplete remission (2.9%), no response or disease progression (1.4%) and unknown (31.1%). Outcomes at the last followup (average 23.5 months) were 76.1% of patients alive, 0.9% dead and 23.0% of unknown status.Demographic data on pediatric testicular tumors in Korea will lead to a better understanding of these rare tumors and to optimal therapy in these children.

outside report (n1⁄4152) was randomly matched with two Hospital A reports (n1⁄4304). The primary outcome was the percentage of checklist items described in the dictated VCUG report. Multivariate linear regression (using GEE for correlated data) was used to model the association between the outcome and the institution type and interpreting radiologist. RESULTS: Of the 456 studies, 66% were in females, 56% were in those

INTRODUCTION AND OBJECTIVES: We examined changes in the quality of life due to the effects on a postoperative recovery of physical function and the mental health following combined exercise intervention after radical prostatectomy in elderly patients with prostate cancer. METHODS: The current study was conducted in 49 patients who underwent radical prostatectomy for the management of localized prostate cancer. Of elderly patients ( 65 yrs), those who submitted a written informed consent were enrolled. Patients who presented adjuvant or neoadjuvant therapy, severe complications, or restrictions in exercise were excluded from the current analysis. Of patients of the exercise group, two patients were dropped out because of transferral of place of residence or new occupation. A total of 47 patients (exercise group; n 24, control group; n 23) were therefore enrolled in the current study. Types of exercise include resistance exercise, pelvic flexibility exercise and Kegel exercise. These exercises were mainly performed by sports experts with the use of a ball and an elastic band. In the control group, only Kegel exercise was performed. Following a 12-week exercise intervention, the physical functions were assessed based on functional fitness, flexibility and balance function. The body composition was measured using a body composition analyzer. Urinary incontinence and voiding symptoms were evaluated using a pad test and an ICIQ questionnaire. Besides, for the assessment of depression and quality of life, a Becki s depression inventory (BDI) and an SF-36 questionnaire were used. The measurement was performed preoperatively, on the first visit following exercise intervention on postoperative week 3 and on the final visit on postoperative week 15. RESULTS: Following a 12-week exercise intervention, except for grip strength, all the physical functions were more excellent in the exercise group as compared with the control group. However, there was no significant difference in the body composition between the two groups. On a questionnaire study using BDI and SF-36, the exercise group showed excellent outcomes. A pad test and an ICIQ questionnaire also showed that voiding symptoms were also recovered more promptly in the exercise group. CONCLUSIONS: A 12-week combined exercise intervention following radical prostatectomy was effective in making a recovery of the physical functions and mental health. This might also contribute to achieving a prompt recovery of daily lives.

Malignant giant cell tumor of osseous or extraosseous origin is extremely rare, and diagnosis is reserved for those lesions that display bizarre mitosis and cytological atypia or an association with sarcoma.1 Heller et al first reported malignant giant cell tumor of the kidney without accompanying sarcoma or carcinoma.2 Their case showed a high mitotic index, variable cytological atypia in mononuclear stromal cells and widespread metastasis of perirenal tissue. We report an unusual case of malignant giant cell tumor of the kidney with osteosarcomatous transformation. CASE REPORT

not associated with NSS use included age, race/ethnicity, insurance type, and hospital teaching status. Outcomes were similar between procedures, including length of stay (9.5 v. 8.6d, p=0.37), procedure count (2.2 v 1.9, 0.13), complication rate (12.5 v. 16.6%, 0.27), infection rate (10.8 v. 15.2%, 0.15) and total hospital costs ($68k v $55k, 0.06). However, costs were lower ($47k vs. $72k, p=0.0002) and hospital stay was shorter (6.7 vs. 9.9 days, p=0.0001) for patients treated by PU v. PGS, despite similar tumor severity levels (p=0.15). CONCLUSIONS: Although the majority of children with renal tumors undergo RN performed by PGS, children treated by PU are more likely to receive NSS, despite similar disease severity levels and outcomes between procedures. Surgery by PU was also associated with shorter hospital stays and lower treatment costs.