Tissues obtained by transurethral prostatectomies were evaluated histologically and correlated with the clinical findings and the transrectal ultrasonographic pictures of 104 patients with benign prostatic hyperplasia (BPH). The patients were divided into 3 groups according to the following histology. predominantly glandular types (30 patients), predominantly stromal types (35 patients) and mixed types which have equal proportions of glandular and stromal hyperplasia (39 patients). The average age was highest in the glandular group. Postoperative obstructive symptom scores were significantly lower in the stromal type as compared to the glandular and the mixed type. The maximal flow rates at three months following the operations were highest in the stromal type. In comparison of the histologic findings with preoperative transrectal echographic pictures, the transverse and the longitudinal diameter of the transitional zone were significantly lower in the stromal type than in the glandular and the mixed type. The weight of transitional zone was significantly smaller in the stromal type than in the glandular and the mixed type. The echogenicity showed hyperechoic and isoechoic pattern in the stromal and the mixed type and hypoechoic and isoechoic pattern in the glandular type. The echographic homogeneity, the frequency of prostatic calculi and cyst formation, and the margination of the transitional zone did not show any significant difference among each group. In conclusion, the histologic types of BPH have correlations with the clinical findings and the transrectal ultrasonographic pictures. Furthermore precise interpretation of the histologic types of BPH by transrectal ultrasonography will be helpful in decision making about the treatment modality and in prediction of the clinical progress after some treatment for the patients with BPH.
Calculi ; Decision Making ; Humans ; Hyperplasia ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate ; Ultrasonography

Retroperitoneal lipoma probably constitute the group of the most massive solid abdominal tumors; their etiology is unknown; their symptoms insidious; and recurrence and sarcomatous change frequent. The clinical diagnosis was made by clinical symptoms, physical findings and radiologic evaluation such as intravenous urography, ultrasonography, computed tomography, angiography and so on. Abdominal CF scan provided clinically the most useful information regarding the state of tumors and also their effect on adjacent structures and shows homogenous appearing fat tissue with a low attenuation coefficient identical to that found in the subcutaneous fat. We present a case of treatment for a huge retroperitoneal lipoma in a 46-year-old man.
Angiography ; Diagnosis ; Humans ; Lipoma* ; Middle Aged ; Recurrence ; Subcutaneous Fat ; Ultrasonography ; Urography

Renal leiomyoma, a rare benign tumor, is a challenging diagnostic and therapeutic condition. The preoperative diagnosis of renal leiomyoma is very difficult, and the only definite method to distinguish between a leiomyoma and other renal tumor is postoperative microscopic evaluation. We report a case of leiomyoma of the kidney which was managed by radical nephrectomy under the impression of malignant renal mass which was incidentally found by ultrasonographic examination for health check in a 43-year-old woman.
Adult ; Diagnosis ; Female ; Humans ; Kidney* ; Leiomyoma* ; Nephrectomy

Primary squamous cell carcinoma of the endometrium is extremely rare malignancy. In 1928 Fluhmann proposed three criteria to establish the diagnosis: (1) no coexisting endometrial adenocarcinoma, (2) no connection between the endometrial tumor and the squamous epithelium of the cervix, and (3) no squamous cell carcinoma of the cervix present. Historically, this malignancy has been associated with short survival (<24 months) despite complete surgical extirpation, with or without pre- or postoperative external beam irradiation. In this report, a case of endometrial squamous cell carcinoma is presented with a review of related current knowledge.
Adenocarcinoma ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Diagnosis ; Endometrial Neoplasms ; Endometrium* ; Epithelium ; Female ; Myoma*

PURPOSE: To compare autonomic dysfunction in patients with urge urinary incontinence(UUI), patients with stress urinary incontinence(SUI) and normal group, we measured and analyzed heart rate variability to compare among the three groups. MATERIALS AND METHODS: We studied heart rate variability(HRV) in 30 patients with UUI(mean age, 47.7+/-10.0 years old), 40 patients with SUI(mean age, 47.6+/-8.7 years old), 120 healthy controls(mean age 45.2+/-6.9 years old). The parameters of HRV of the three groups were compared. RESULTS: There was no difference in uroflowmetry and heart rate among the three groups. In time domain, square root of the mean squared difference of successive N-N interval(RMSSD) in UUI was higher than that of the others, and standard deviation of N-N interval(SDNN) showed no difference. In frequency domain, low frequency(LF) in UUI, an indicator of cardiac sympathetic tone, was higher than thar of the others. Very low frequency(VLF), LF, low-frequency/high-frequency ratio(LF/HF ratio) didn't show difference. CONCLUSION: All parameters of HRV analysis in UUI were not same as those of SUI and controls. The increase in RMSSD and HF means that there could be imbalance in autonomic nervous system and it could be the cause of detrusor overactivity in UUI.
Autonomic Nervous System ; Heart Rate ; Humans ; Pilot Projects* ; Urinary Incontinence*

PURPOSE: This study was performed to investigate the effects of intravesical instillation of cyclooxygenase-2 (COX-2) inhibitors on the cyclophosphamide-induced overactive bladder. MATERIALS AND METHODS: The 40 Sprague-Dawley rats were divided into 3 groups; the control group, the overactive group, and the COX-2 inhibitor treated group. Cystometrograms (CMG) were performed and the contraction interval, inter-contraction interval, contraction time and contraction pressure were measured. After CMG, the bladders of each group were dissected out, and weighed. RESULTS: On CMG, the contraction interval and inter-contraction interval for the overactive group were significantly decreased compared with the control group. After treatment with COX-2 inhibitor, the contraction interval and inter-contraction interval were significantly increased compared with the overactive group (p<0.05). The contraction time in the overactive group was significantly increased compared with the control group, and it was also decreased in the COX-2 inhibitor treated group compared with the overactive group (p<0.05). The contraction pressure in the overactive group and the COX-2 inhibitor treated group were significantly increased compared with the control group. There were no significant differences between the overactive and COX-2 inhibitor treated groups. The bladder weights of the overactive and COX-2 inhibitor treated groups were significantly increased compared with the control group (p<0.05). CONCLUSIONS: Intravesical instillation of COX-2 inhibitor can suppress cyclophosphamide-induced detrusor overactivity. Therefore, intravesical instillation of COX-2 inhibitor may be considered as a possible treatment for the overactive bladder.
Administration, Intravesical* ; Cyclooxygenase 2 Inhibitors ; Cyclooxygenase 2* ; Cyclophosphamide ; Rats, Sprague-Dawley ; Urinary Bladder ; Urinary Bladder, Overactive* ; Weights and Measures

PURPOSE: This study was performed to investigate the effects of intravesical instillation of cyclooxygenase-2 (COX-2) inhibitors on the cyclophosphamide-induced overactive bladder. MATERIALS AND METHODS: The 40 Sprague-Dawley rats were divided into 3 groups; the control group, the overactive group, and the COX-2 inhibitor treated group. Cystometrograms (CMG) were performed and the contraction interval, inter-contraction interval, contraction time and contraction pressure were measured. After CMG, the bladders of each group were dissected out, and weighed. RESULTS: On CMG, the contraction interval and inter-contraction interval for the overactive group were significantly decreased compared with the control group. After treatment with COX-2 inhibitor, the contraction interval and inter-contraction interval were significantly increased compared with the overactive group (p<0.05). The contraction time in the overactive group was significantly increased compared with the control group, and it was also decreased in the COX-2 inhibitor treated group compared with the overactive group (p<0.05). The contraction pressure in the overactive group and the COX-2 inhibitor treated group were significantly increased compared with the control group. There were no significant differences between the overactive and COX-2 inhibitor treated groups. The bladder weights of the overactive and COX-2 inhibitor treated groups were significantly increased compared with the control group (p<0.05). CONCLUSIONS: Intravesical instillation of COX-2 inhibitor can suppress cyclophosphamide-induced detrusor overactivity. Therefore, intravesical instillation of COX-2 inhibitor may be considered as a possible treatment for the overactive bladder.
Administration, Intravesical* ; Cyclooxygenase 2 Inhibitors ; Cyclooxygenase 2* ; Cyclophosphamide ; Rats, Sprague-Dawley ; Urinary Bladder ; Urinary Bladder, Overactive* ; Weights and Measures

Purpose: To compare the recurrence pattern, disease-free survival (DFS), and overall survival (OS) after curative surgery for pancreatic ductal adenocarcinoma (PDAC) in patients who underwent preoperative evaluation with CT alone or in combination with MRI, and to compare the prognosis according to the first recurrence site. Materials and Methods: We retrospectively evaluated 152 patients who underwent R0 resection of PDAC. Preoperative CT or combined CT and MRI were performed for 103 and 49 patients, respectively. Two radiologists recorded the location and date of the first recurrence in consensus. The recurrence pattern, DFS, and OS were compared between the two groups. OS was analyzed according to the first recurrence site. Results: In both groups, liver metastasis was the most common recurrence pattern. DFS (p = 0.247) or OS (p = 0.067) showed no significant difference between the two groups. OS according to the first recurrence site was the lowest for liver metastasis, followed by locoregional recurrence (p < 0.001). Conclusion There were no significant differences in the recurrence pattern, DFS, or OS between patients evaluated with preoperative CT alone or with CT and MRI after curative resection of PDAC. Liver metastasis was the most common tumor recurrence pattern with the lowest OS.

Purpose: To compare the recurrence pattern, disease-free survival (DFS), and overall survival (OS) after curative surgery for pancreatic ductal adenocarcinoma (PDAC) in patients who underwent preoperative evaluation with CT alone or in combination with MRI, and to compare the prognosis according to the first recurrence site. Materials and Methods: We retrospectively evaluated 152 patients who underwent R0 resection of PDAC. Preoperative CT or combined CT and MRI were performed for 103 and 49 patients, respectively. Two radiologists recorded the location and date of the first recurrence in consensus. The recurrence pattern, DFS, and OS were compared between the two groups. OS was analyzed according to the first recurrence site. Results: In both groups, liver metastasis was the most common recurrence pattern. DFS (p = 0.247) or OS (p = 0.067) showed no significant difference between the two groups. OS according to the first recurrence site was the lowest for liver metastasis, followed by locoregional recurrence (p < 0.001). Conclusion There were no significant differences in the recurrence pattern, DFS, or OS between patients evaluated with preoperative CT alone or with CT and MRI after curative resection of PDAC. Liver metastasis was the most common tumor recurrence pattern with the lowest OS.

BACKGROUND: A paradoxical embolism through the patent foramen ovale has been suggested as a possible cause of ischemic cerebrovascular disease in young patients without other cardiovascular risk factors, however, the transesophageal contrast echocardiographic examination is proved to be sensitive and accurate to detect the patent foramen ovale in vivo by demonstration a right-to-left shunting of microbubbles at the interatrial septum. METHODS: Transesophageal contrast echocardiographic examinations were performed in 16 young patients(32+/-6 years, 19~39) with ischemic cerebrovascular diseases without other cardiovascular risk factors. Contrast agents were injected twice in each patients, one with Valsalva maneuver and the other with coughing and the presence of the patent foramen ovale was confirmed by demonstrating echogenic contrast crossing the interatrial septum. RESULTS: The patent foramen ovale was demonstrated in five of sixteen patients(31.2%) during transesophageal contrast echocardiographic examination. Although the prevalence of the patent foramen ovale in normal population has not been examined in this study, the prevalence in patient group appears to be significantly higher than that of normal population. CONCLUSIONS: Taken together, a paradoxical embolism through the patent foramen oval appears to be one of the causative factors and a transesophageal contrast echocardiography is recommended especially in young ischemic cerebrovascular disease patients who have normal transesophageal echocardiographic findings and no known risk factors.
Contrast Media ; Cough ; Echocardiography* ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Humans ; Microbubbles ; Prevalence* ; Risk Factors ; Valsalva Maneuver