A sarcomatoid carcinoma of the urinary system is a rare malignant tumor, composed of both epithelial and stromal cells, is regarded as a similar disease entity to a carcinosarcoma. In Korea, only 1 case of primary sarcomatoid carcinoma and 4 cases of carcinosarcoma involving the bladder have been reported, but to date, no case of primary sarcomatoid carcinoma involving the renal pelvis has been reported. Recently, we experienced a case of sarcomatoid carcinoma involving the right renal pelvis in a 67-year-old male patient with intermittent gross hematuria. A CT scan demonstrated a 5x4cm sized mass in the right renal pelvis. Under the diagnosis of a right renal pelvic tumor, a right nephroureterectomy, with bladder cuff excision, was performed. The tumor was composed mostly of pleomorphic spindle cells, and in the peripheral part of the tumor and renal pelvis, a high grade transitional cell carcinoma and adenocarcinoma was also found. The tumor was pathologically confirmed as a primary sarcomatoid carcinoma of the renal pelvis.
Adenocarcinoma ; Aged ; Carcinoma, Transitional Cell ; Carcinosarcoma ; Diagnosis ; Hematuria ; Humans ; Kidney Pelvis* ; Korea ; Male ; Pelvis ; Stromal Cells ; Tomography, X-Ray Computed ; Urinary Bladder

Dermatofibrosarcoma protuberans is an unusual locally aggressive cutaneous neoplasm of low grade malignancy. We report the case of a 47 years- old male who presented with an asymptomatic erythematous firm protruding mass in the left peri-inguinal area. Histopathologically, the tumor showed spindle-shape cells, arranged in a storiform pattern. The tumor cells stained positively for Vimentin and CD34 on immunohistochemical staining. Herein, we report a case of dermatofibrosarcoma protuberans.
Dermatofibrosarcoma* ; Humans ; Male ; Vimentin

A primary sclerosing lipogranuloma of the scrotum is a rare disease, the cause and pathogenesis of which are still unknown. We experienced a 38-year-old man with a painless intrascrotal mass. The mass was firm, and rapidly increased in size in 3 weeks. The patient denied a history of injection of exogenous materials, or of trauma to the scrotum or penis. During the surgical operation, the mass was found to be partly fixed to the scrotal skin, but not to the corpus cavernosum, corpus spongiosum or bilateral spermatic cords. The mass extended deeply into the perineal region. The pathological findings were epithelioid granulomas, with multinucleated giant cells, lymphocytes and eosinophils. Herein, we report a case of a primary sclerosing lipogranuloma in the scrotum.
Adult ; Eosinophils ; Giant Cells ; Granuloma ; Humans ; Lymphocytes ; Male ; Penis ; Rare Diseases ; Sclerosis ; Scrotum* ; Skin ; Spermatic Cord

A 55-year-old woman, with a retroperitoneal cystic mass, incidentally found during evaluation for the cause of right upper quadrant pain, was referred to our hospital from a local clinic. Computed tomography, performed at our hospital, revealed a multilobulated cystic lesion in the right perinephric space, encasing the renal vessels, suggestive of a cystic lymphangioma. A cystic abdominal lymphangioma is a rare tumor in adults, which is difficult to diagnose preoperatively. Surgical excision is known as the treatment of choice; however, only three cases of laparoscopic excision have been reported. We report a case of a successful laparoscopic excision of a retroperitoneal cystic lymphangioma encasing the renal vessels of the renal hilum.
Adult ; Female ; Humans ; Laparoscopy ; Lymphangioma ; Lymphangioma, Cystic* ; Middle Aged ; Renal Artery ; Renal Veins

A hemangioma is a benign tumor arising in the vessels, but an intrascrotal hemangioma is rare, and a hemangioma of the epididymis is extremely rare. Ultrasound and MRI (magnetic resonance imaging) are mainly used for the diagnosis of an intrascrotal hemangioma, with surgical excision being the appropriate treatment. We report on the case of a 24 year- old-man with a mixed hemangioma of the epididymis.
Diagnosis ; Epididymis* ; Hemangioma* ; Magnetic Resonance Imaging ; Male ; Ultrasonography

Langerhans cell histiocytosis (LCH) is a rare disorder, characterized by abnormal proliferation of Langerhans cells, which can affect various organ systems. The most common clinical findings are localized bone lesions, with eosinophilic granuloma, which occur at any age, although most patients present under the age of 15 years. We experienced a case of recurrent LCH, invading the bulbous urethra, in the perineal area of a 16-year-old boy. The primary tumor developed in the mastoid bone, and recurred in the ureter, maxillary sinus mucosa and perineum, in the order. The perineal lesion and part of bulbous urethra were surgically removed, through a perineal approach, and the urethra primarily reconstructed.
Adolescent ; Eosinophilic Granuloma ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Male ; Mastoid ; Maxillary Sinus ; Mucous Membrane ; Perineum ; Recurrence* ; Ureter ; Urethra

PURPOSE: The major pelvic ganglia (MPG) provide the majority of the innervations to the lower urinary tract. The pelvic ganglia are unique autonomic ganglia that contain both sympathetic and parasympathetic neurons. It has been known that the low-threshold voltage-gated (T-type) Ca2 channels are only expressed only in the sympathetic neurons, whereas these channels are absent in parasympathetic neurons. In the present study, we examined the effect of fluoxetine, a world-wide used antidepressant, on the voltage-dependent Ca2 and K currents in the adrenergic neurons of the MPG. MATERIALS AND METHODS: The effect of fluoxetine on the voltage-dependent Ca2 and K currents in the adrenergic neurons of the MPG were examined using the whole-cell patch-clamp technique. RESULTS: Fluoxetine inhibited the voltage-activated Ca2 currents in the adrenergic neurons of the MPG. Both high-threshold (HVA) and low- threshold (LVA, T-type) Ca2 currents were inhibited by fluoxetine with an IC50 of 5.3 and 10.8microM, respectively. Fluoxetine also decreased the both the peak amplitude and the plateau of the outward K currents. The inhibition of the peak K currents by fluoxetine was concentration- dependent with an IC50 of 3.2microM. The inhibitions of the Ca2 and K currents were quickly reversible upon washout of the fluoxetine. CONCLUSIONS: These results provide evidence for the direct inhibition of the voltage dependant Ca2 and K currents by fluoxetine and these inhibitory effects could modify the synaptic transmission in adrenergic neurons of the MPG.
Adrenergic Neurons ; Animals ; Calcium Channels ; Calcium* ; Fluoxetine* ; Ganglia* ; Ganglia, Autonomic ; Inhibitory Concentration 50 ; Neurons* ; Patch-Clamp Techniques ; Potassium Channels* ; Potassium* ; Rats* ; Synaptic Transmission ; Urinary Tract

PURPOSE: There have been a few reports investigating the measurement of penile lengths, but none that compare the results of circumcision with penile length. The aim of this study was to determine the correlation between penile length and circumcision, and the mean penile length of physically and sexually active young men in Korea. MATERIALS AND METHODS: The penile lengths in the flaccid and stretched states were measured, between November 2002 and April 2003, in a random group of 2,335 young men without endocrine disorders or an anomaly of the penis. Patients were classified as circumcised (group 1, n=1,767) or uncircumcised (group 2, n=568). The age, body height, body weight, and flaccid and stretched penile lengths were analyzed. RESULTS: The mean values of the flaccid and stretched penile lengths were 7.92+/-3.00 and 12.03+/-2.66cm, and 8.07+/-1.19 and 11.71+/-1.81cm in groups 1 and 2, respectively, with statistical significance according to the stretched length between the two groups (p<0.05). The flaccid and stretched lengths were correlated with height and weight in group 1 (p<0.05). CONCLUSIONS: In this study, we confirmed the normal range for penile length of young adults in Korea. The results of this study showed that a circumcision did not influence the penile length or increase the penile length postoperatively.
Body Height ; Body Weight ; Circumcision, Male* ; Female ; Humans ; Korea ; Male ; Penis ; Reference Values ; Young Adult*

PURPOSE: The present study was performed to assess the risk factors for urolithiasis in patients receiving ileal conduit urinary diversion due to a certain underlying etiology. MATERIALS AND METHODS: This study included 43 patients (35 males and 8 females), who had undergone ileal conduit urinary diversion with a post-operative duration of at least 6 months, and 54 age-matched normal controls. Urine samples (24-hour) were collected on an outpatient basis without any dietary restriction when the patients were free of urinary tract infection or antibiotics medication. The urinary analytes, comprising of the urine volume, sodium, phosphorus, uric acid, creatinine, calcium, magnesium, oxalate and citrate, were investigated. These data were compared with the original values, and the values adjusted according to the creatinine level for both sexes. RESULTS: Not all the serum analytes significantly differed between the patients and controls. In the 35 male patients, the mean urinary excretion of oxalate was significantly greater than in the control group, which was converse to that of the citrate and uric acid (p=0.001, p<0.001 and p=0.001, respectively). Unexpectedly, the urinary excretion of calcium in the male patients was lower than in the controls (p<0.001), resulting in a significant decrease in the ratio of calcium to oxalate (p<0.001). Among the urinary analytes, the excretions of sodium, phosphorus, uric acid, citrate and oxalate were significantly correlated with that of urinary creatinine. The excretions of oxalate and citrate were different when adjusted according to the urinary creatinine excretion between the male patients and the controls. In the 8 female patients, decreases in the excretions of magnesium and citrate were observed compared to the controls (p=0.007, p=0.030). CONCLUSIONS: Our study indicated that ileal conduit urinary diversion causes increased excretion of urinary oxalate, leading to a decreased calcium to oxalate ratio and excretion of citrate as major metabolic alterations due to urolithiasis, although the excretions of urinary calcium and magnesium may play some role.
Anti-Bacterial Agents ; Calcium ; Citric Acid ; Creatinine ; Female ; Humans ; Magnesium ; Male ; Outpatients ; Phosphorus ; Risk Factors* ; Sodium ; Uric Acid ; Urinary Diversion* ; Urinary Tract Infections ; Urolithiasis

PURPOSE: It is thought that neurological disorders are one of the main causes of organic female sexual dysfunction. However, it is difficult to diagnose due to the lack of measuring tools for assessing genital neural function. Sensory nerve tests on external genitalia is a new challenge for diagnosing female sexual dysfunction. In this study, we aimed to evaluate the clinical significance of the quantitative measurement of the genital sensory threshold in female sexual dysfunction. MATERIALS AND METHODS: Forty women with complaints of sexual dysfunction were evaluated with physical and vagina examination, serum hormonal tests, routine urinalysis and a questionnaire (the brief index of sexual function for women). A genitosensory analyzer (GAS, Medoc, Israel) was used to quantitative measure the vaginal and clitoral warm, cold and vibratory sensory thresholds. RESULTS: Of the 40 women, an arousal disorder was reported in 40%, orgasmic disorder in 82.5%, sexual pain disorder in 17.5% and a decreased libido in 17.5%. Of the 40 women, 86.4 and 91.2% showed impairment of vaginal cold (A-delta fiber) and warm (unmyelinated C fiber) sensations, respectively. However, the touch and vibratory sensations (A-beta fiber) showed relatively lower impairments; vagina and clitoris in 20.0 and 89.2% of the patients, respectively. CONCLUSIONS: In this study, most of the patients with sexual problems had significant vaginal and clitoral sensory nerve fiber impairments. The results support the significance of organic origins in female sexual dysfunction and the usefulness of quantitative analysis of genital sensation in diagnosing the etiology. (Korean J Urol 2005;46:610-615)
Arousal ; Clitoris ; Diagnosis* ; Female* ; Genitalia* ; Humans ; Libido ; Nerve Fibers ; Nervous System Diseases ; Surveys and Questionnaires ; Sensation ; Sensation Disorders ; Sensory Thresholds ; Sexual Dysfunctions, Psychological ; Sexuality ; Somatoform Disorders ; Urinalysis ; Vagina