Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

It may be that curettage should be considered as a primary treatment of choice for GCTs of the femoral head and neck.

BackgroundThere is a worldwide tendency of an increasing prevalence of obesity. Therefore, this study aimed at determining whether such a trend exists among cerebral palsy (CP) patients. We also tried to compare this trend with the trend in the general population. We also discuss the importance of obesity trends in CP patients.MethodsThis retrospective study was performed on 766 ambulatory patients who were diagnosed with CP since 1996 in our institution. The associations among the prevalence of obesity and the body mass index, age, gender, the type of CP, the gross motor function classification system and the time of survey were investigated.ResultsThe overall prevalence of obesity was 5.7%, and the overall prevalence of obesity together with being overweight was 14.6% for the ambulatory patients with CP. The prevalence of obesity and of obesity together with being overweight did not show a statistically significant temporal increase. On the other hand, age and gender were found to affect the body mass index of the ambulatory CP patients (p < 0.001 and 0.003, respectively).ConclusionsThe extent of obesity and being overweight in the ambulatory patients with CP in this study was far less than that reported in the United States (US). In addition, it appears that the differences of the prevalence of obesity in children and adolescents between those with and without CP are disappearing in the US, whereas the differences of the prevalence of obesity in children and adolescents between those with and without CP seem to be becoming more obvious in Korea. Accordingly, care should be taken when adopting the data originating from the US because this data might be affected by the greater prevalence of obesity and the generally higher body mass indices of the US.

PurposeAntagonists of α1-adrenergic receptors (α1ARs) relax prostate smooth muscle and relieve voiding and storage symptoms. Recently, increased expression of α1ARs with change of its subtype expression has been proved in bladder outlet obstruction (BOO). To search for the evidence of changes in α1ARs subtype expression and activity in the peripheral and spinal routes, the effects of spinal and peripheral administration of tamsulosin (an α1A/D-selective AR), naftopidil (an α1A/D-selective AR), and doxazosin (non-selective AR) on bladder activity were investigated in a rat model with or without BOO.MethodsA total of 65 female Sprague-Dawley rats were divided into the BOO surgery group (n=47) and the sham surgery group (n=18). After 6 weeks, cystometry was assessed before and after intrathecal and intra-arterial administrations of tamsulosin, naftopidil, and doxazosin.ResultsAfter intra-arterial administrations of all three drugs, bladder capacity (BC) was increased and maximal intravesical pressure (Pmax) was decreased in both BOO and the sham rat models (P<0.05). After intrathecal administration of all three drugs, BC was increased and Pmax was decreased in only the BOO group. The episodes of involuntary contraction in the BOO rat models were decreased by intra-arterial administration (P=0.031). The increase of BC after intrathercal and intra-arterial administrations of α1ARs was significantly greater in the BOO group than in the sham group (P=0.023, P=0.041). In the BOO group, the increase of BC and decrease in Pmax were greater by intra-arterial administration than by intrathecal administration (P=0.035). There were no significant differences of the degrees of changes in the cystometric parameters among the three different α1ARs.ConclusionsUp-regulations of the α1ARs in BOO were observed by the greater increases of BC after α1AR antagonist administrations in the BOO group than in the sham group. However, there were no subtype differences of the α1ARs in functional parameters of bladder activity. In addition, α1ARs also act on the lumbosacral cord which implies that the sensitivity of α1ARs is increased in pathologic models such as BOO. Further evaluation including differential expression of α1ARs in BOO models are need.

Purpose:We evaluated the feasibility of robot-assisted laparoscopic radical cystectomy (RARC) with pelvic lymph node dissection (PLND), especially extended PLND (ePLND), during our initial experience with this technique. Materials and Methods: From August 2007 to March 2009, prospective data were obtained from the 21 consecutive patients who underwent RARC with PLND at Korea University Hospital. Data included baseline characteristics, perioperative variables, pathological outcomes, and complications. Evidence of the lymph node yield curve was examined by using linear regression to compare the number of lymph nodes obtained. Results: Among 21 patients who underwent RARC, 13 had ileal conduit urinary diversion and 8 had orthotopic neobladder. Standard PLND (sPLND) was performed in the first 15 patients, and ePLND was performed in the more recent 6 patients. The mean total operative time was 515.5±145.1 minutes, and the mean estimated blood loss was 346.8±205.9 ml. The mean time for PLND was 106.7±25.2 minutes in patients with ePLND and 72.1±14.1 minutes in patients with sPLND (p=0.001). All patients had negative surgical margins. The mean number of retrieved nodes was 23. 5±12.8 (range, 8-50)