1.Clinical Results of Transurethral Resection for the Benign Prostatic Hypertrophy -Significance of Suprapubic Cystostomy before Transurethral Resection-.
Korean Journal of Urology 1987;28(5):634-638
A clinical observation was made on 96 cases of transurethral resection for the benign prostatic hypertrophy, admitted during the period of 3 years from January 1984 to December 1986. Previous to the transurethral resection of prostate, the suprapubic cystostomy was accomplished in 38 cases among them and following advantageous results were obtained. 1. Suprapubic cystostomy before TURP provides better endoscopic vision by continuous flow of irrigating fluid to permit no interrupted resection. 2. By eliminating the time spent for evacuation of the bladder, eye accommodation and reestablishment of surgical land marks, it permits transurethral resection of larger gland, within recognized safety guidelines. 3. It tends to minimize and prevent absorptive complications by lessening intravesical pressure. 4. It decreases operative risk by lessening operative time and the volume of fluid absorbed. 5. It provides an alternative route of irrigation and drainage intraoperatively and postoperatively.
Cystostomy*
;
Drainage
;
Operative Time
;
Prostatic Hyperplasia*
;
Transurethral Resection of Prostate
;
Urinary Bladder
2.A Case of Fournier's Gangrene.
Ill Seuk CHOI ; Duck Ha KIM ; Bo Hyun HAN
Korean Journal of Dermatology 1988;26(2):212-216
Fournier's gangrene is a fulminating gangrene of the male genitalia. It is associated with severe systemic toxic effect and a high motality rate, and it requires early diagnosis and intensive care with surgical intervention. We report a case of Fournier's gangrene in 33-year-old man, who showed marked swelling and necrosis of the scrotum, and extending cellulitis on the right flank and chest. With prompt excision of all the gangrenous scrotal skin and drainage incisions made on the flank and chest, the healing was successful.
Adult
;
Cellulitis
;
Drainage
;
Early Diagnosis
;
Fournier Gangrene*
;
Gangrene
;
Genitalia, Male
;
Humans
;
Critical Care
;
Male
;
Necrosis
;
Scrotum
;
Skin
;
Thorax
3.Significance of Resistive index in Renal Transplantation.
Hyun Og SONG ; In Gi SEONG ; Bo Hyun HAN
Korean Journal of Urology 1995;36(8):843-848
The increasing use and availability of renal transplantation has resulted in a demand for noninvasive methods to study possible complications. One of the most serious adverse reactions is acute rejection, a possibly reversible cause of transplant failure if treated promptly. Sixty-six donors and recipients were evaluated by duplex Doppler examination of intrarenal arteries. A simplified formula, resistive index(RI) ([peak systolic frequency shift-lowest diastolic frequency shift]/[peak systolic frequency shift]), were used to diagnose rejection. All RI values of donors were within normal limit. RI values of recipients were not significantly different according to the number of renal artery and the ischemic time during operation. With a RI greater than 0.90, a 100% positive predictive value was obtained for the diagnosis of acute rejection. A 88% positive predictive value of acute rejection was obtained with a RI greater than 0.80. A value less than 0.70 was unlikely to be rejection(negative predictive value, 95%). The results suggest that the duplex Doppler examination and the resistive index obtained by simple analysis of the wave form would be used as a valuable noninvasive method for the detection of acute renal transplant rejection. The findings of Doppler examination are not necessarily pathognomonic for one specific process, but they can aid the clinician in deciding the kind of treatment necessary and the need for biopsy.
Arteries
;
Biopsy
;
Diagnosis
;
Graft Rejection
;
Humans
;
Kidney Transplantation*
;
Renal Artery
;
Tissue Donors
4.A study on the comparision of various imaging methods for the staging of renal cell carcinoma.
Korean Journal of Urology 1993;34(5):805-810
The diagnostic significance of ultrasonography, computed tomography and magnetic resonance imaging for predicting the stage of tumors was evaluated by comparing their results with preoperative and histopathologic findings. The 24 patients who were diagnosed as renal cell carcinoma by histopathologic finding have taken preoperative examination such as ultrasonography, computed tomography. Additionally, magnetic resonance imaging was performed in 15 patients among them. The T stage was determined correctly by magnetic resonance imaging in 87% of the cases, by computed tomography in 80%. We suggested that a computed tomography is reliable imaging method for evaluating the T,N category preoperatively, but magnetic resonance imaging is more sensitive than a computed tomography in predicting the stage of renal cell carcinoma and a magnetic resonance imaging can replace the computed tomography.
Carcinoma, Renal Cell*
;
Humans
;
Magnetic Resonance Imaging
;
Ultrasonography
5.Risk Factors Associated with Blood Loss During a Transurethral Resection of the Prostate.
Yang Hoo KIM ; In Gi SEUNG ; Bo Hyun HAN
Korean Journal of Urology 2002;43(10):831-836
PURPOSE: The purpose of this study was to find if any clinical or laboratory factors have significant correlations with blood loss caused by a transurethral resection of the prostate (TURP). MATERIALS AND METHODS: The medical records of 218 patients who had undergone a TURP were retrospectively reviewed. For each patient, the preoperative factors evaluated included age, type of presentation (patients who had been treated due to acute urinary retention; retention group, patients who had been treated due to lower urinary tract symptoms; symptomatic group), blood pressure, complete blood count, coagulation screening, prostate size on transrectal ultrasonography (TRUS), urine analysis, urine culture, ECG and drugs. Intraoperative and postoperative factors were also evaluated, including type of anesthesia, operator, operating time, weight of resected prostate tissue, blood transfusion and prostate histology. These factors were analyzed with respect to blood loss during the TURP using student's t, ANOVA and chi-square tests. RESULTS: The mean intraoperative blood loss and resected prostate weight were 415 ml and 15g, respectively. The factors which were found to significantly correlate with blood loss during a TURP were: resected prostate weight (r=0.44, p=0.0001), prostate size on TRUS (r=0.32, p=0.001), operating time (r=0.31, p=0.001), preoperative urine culture (p= 0.020), preoperative antimicrobials taken (p=0.020), and prostate histology (p=0.048). CONCLUSIONS: Of the factors found to correlate with blood loss during the TURP, the only reversible factor was a preoperative urinary tract infection. So, we expect that the prevention of preoperative urinary tract infection and its effective treatment in patients might be helpful in decreasing blood loss during a TURP.
Anesthesia
;
Blood Cell Count
;
Blood Loss, Surgical
;
Blood Pressure
;
Blood Transfusion
;
Electrocardiography
;
Humans
;
Lower Urinary Tract Symptoms
;
Mass Screening
;
Medical Records
;
Prostate*
;
Retrospective Studies
;
Risk Factors*
;
Transurethral Resection of Prostate
;
Ultrasonography
;
Urinary Retention
;
Urinary Tract Infections
6.PSAD and TZ-PSAD as Predictors of the Response to Alpha-adrenergic Blocker in Patients with Benign Prostatic Hyperplasia.
In Gon KIM ; Jeong Oh LEE ; Bo Hyun HAN
Korean Journal of Urology 2003;44(11):1103-1109
PURPOSE: To determine whether prostate-specific antigen density(PSAD) and transition zone prostate-specific antigen density(TZ-PSAD) can predict the clinical response of patients with benign prostatic hyperplasia(BPH) to alpha-adrenergic blocker(terazosin). MATERIALS AND METHODS: From January 2000 to June 2002, 202 patients with BPH who were treated with alpha-adrenergic blocker(terazosin) were enrolled in this study. The peak flow rate(Qmax) and the International Prostate Symptom Score(IPSS) were compared prior to and 3 months following medication. We analyzed total prostate volume(TPV), transition zone volume(TZV), transition zone index(transition zone volume/total prostate volume, TZI), PSAD(PSA/total prostate volume), and TZ-PSAD (PSA/transition zone volume) as predictors of the response to alpha-adrenergic blocker (terazosin). RESULTS: At 3 months following medication with terazosin, a statistically significant improvement was shown in the IPSS and Qmax. There was no significant correlation between pretreatment TPV, TZV, TZI and the percent change in the IPSS and Qmax. However, there was a significant negative correlation between pretreatment PSAD (r=-0.632, p<0.001), TZ-PSAD (r=-0.599, p<0.001) and the percentage change in Qmax, while there was a positive correlation between pretreatment PSAD (r=0.620, p<0.001), TZ-PSAD(r=0.604, p<0.001) and the percentage change in the IPSS. Using the receiver operating characteristic curves to compare PSAD and TZ-PSAD for IPSS, the areas under the respective curves were 0.867 and 0.874(cut-off values were 0.04 and 0.1), and for the Qmax, the areas under the respective curves were 0.876 and 0.873(cut-off values were 0.04 and 0.1). CONCLUSIONS: Patients with a lower pretreatment PSAD and TZ-PSAD responded better to alpha-adrenergic blocker than those with a higher pretreatment PSAD and TZ-PSAD. PSAD and TZ-PSAD were predictors of the response to alpha-adrenergic blocker (terazosin) in patients with BPH.
Adrenergic alpha-Antagonists
;
Humans
;
Prostate
;
Prostate-Specific Antigen
;
Prostatic Hyperplasia*
;
ROC Curve
7.Two Cases of Congenital Chylothorax Diagnosed by Prenatal Ultrasonography.
Kyung Hyun CHUNG ; Wan CHO ; Man Yong HAN ; Bo Kyung KIM ; Kyu Hyung LEE
Korean Journal of Perinatology 1999;10(4):512-517
Congenital chylothorax is a rare disorder and can be diagnosed by prenatal ultrasonography recently. Most cases of congenital chylothorax were characterized by different clinical courses of respiratory distress. We describe two female cases with congenital chylothorax observed by ultra- sonography prenatally. In the first case, left-sided pleural effusion was noted by prenatal ultrasonography taken at 34 weeks of gestation, and then pleural fluid was extracted by intrauterine thoracentesis under sonography guidance. After birth, this patient was managed by TPN(total parentral nutrition) and intermittent thoracentesis without surgical treatment. But, pleural fluid was accumulated recurrently and respiratory distress was aggravated. At 15th hospital day, shock state was developed and patient died. In the second case, bilateral pleural effusion and ascites were noted by prenatal ultrasonography, and then patient was delivered immediately without intrauterine thoracentesis. After birth, the second case received conservative therapy including mechanical ventilation, TPN, intermittent thoracentesis and paracentesis. The patient was discharged with complete regression of chylothorax. We report the two cases with brief review of related literatures.
Ascites
;
Chylothorax*
;
Female
;
Humans
;
Paracentesis
;
Parturition
;
Pleural Effusion
;
Pregnancy
;
Respiration, Artificial
;
Shock
;
Ultrasonography, Prenatal*
8.Clinical Experience of Upper Ureterolithotomy by Posterior Lumbotomy.
Korean Journal of Urology 1986;27(5):637-640
The posterior lumbotomy was a useful approached for removal of a small kidney, for bilateral nephrectomy in patients with chronic renal failure, for pyeloplasty, for pyelolithotomy when a stone was filled the pelvis and was not able to migrated, or for an upper ureterolithotomy when the stone was firmly impacted. During a 32 month interval 19 patients underwent upper ureterolithotomy through the posterior lumbotomy approach. The intraoperative course and postoperative performance were compared to the patients operated upon using the standard flank incision. Our analysis established the superiority of the posterior lumbotomy incision for all factors evaluated, especially postoperative drainage, analgesic use and postoperative hospitalization.
Drainage
;
Hospitalization
;
Humans
;
Kidney
;
Kidney Failure, Chronic
;
Nephrectomy
;
Pelvis
9.Simple Renal Cyst Treatment: Ultrasound-guided Aspiration Alone or with Instillation of 99% Ethanol into Renal Cyst.
Korean Journal of Urology 1990;31(6):915-920
Thirty-eight benign renal cysts in 35 patients were treated with or without 99% ethanol during diagnostic aspiration under ultrasonic guidance. All were followed by ultrasound from 3 to 59 months. There were twelve (80% ) recurrences in simple aspiration group. Two cases ( 6.25% ) were recurred in ethanol instillation group. All of the five symptomatic patients were relieved of subjective symptoms such as flank pain after alcohol instillation. Minor complications of local pain and temperature elevation were no more prevalent than with simple aspiration alone. There was no major complication. In conclusion, it is reasonable to treat and prevent of renal cyst by ablation of the cyst with alcohol at the same time as diagnostic procedure.
Ethanol*
;
Flank Pain
;
Humans
;
Recurrence
;
Ultrasonics
;
Ultrasonography
10.Treatment of Anterior Urethral Injury with Percutaneous Cystostomy.
Korean Journal of Urology 1980;21(6):632-636
A clinical observation was made on the anterior urethral injuries of the inpatients in the Department of Urology, Maryknoll HospitaI Juring the period from July 1, 1978 to December 3I. 1979. The following results were obtained. I. During the period the total number of patients with anterior urethral injury was 23 cases 2. Most favorable age was 20 to 40 years which was about 70%. 3. Fall from a height was the most common cause of anterior urethral injury. 4. Average duration of removal of suprapubic catheter was 18 days. 5. Average duration of first voiding after cystostomy was 8 days 6. Period of average admission was 25 days. 7. Partial urethral rupture showed better result than complete urethral rupture 8. Among 23 patients with anterior urethral injuries I8 cases were treated after cystostomy. with percutaneous cystostomy. Of these patients I3 cages recovered with good results.
Catheters
;
Cystostomy*
;
Humans
;
Inpatients
;
Rupture
;
Urology