Advances in laser technology have resulted in the creation of a new field of medical therapy. By virtue of the hyperdermic effects that can occur when intense energy of laser light is absorbed and transformed into heat, some lasers can be used to destroy tissue by vaporization or coagulation. The technology to allow extensive use in urology has only been recently perfected with the development of flexible light guides adaptable to standard urologic instruments. The Nd_YAG lasers can be attached to these urologic instruments and transmit through the water or the urine, so it has been prevailed in urologic disease, especially bladder tumor. We used the Nd_YAG lasers for the treatment of 25 patients with bladder tumor that admitted to the department of urology, Ewha Womans University Hospital during the period from October, l984 to July, 1986. The Nd_YAG lasers could be attached to the standard urologic instruments easily, so its use was very convenient and almost all portion of bladder wall could be irradiated. Intraoperative and postoperative bleeding was absent and indwelling of catheter wasn`t needed. During operation the obturator nerve reflex didn`t occur and the Jepth of coagulation could be controlled, so the risk of vesical perforation was almost nil. One year recurrence rate and progression rate to invasive tumor of 21 superficial bladder tumor patients was 28.6% and 4.8%, local recurrence didn`t occur in all patients. The main disadvantage of lasers was the incapability to get the pathologic specimen for staging and grading of tumor. Although laser therapy alone cannot obtain tissue specimen, it has various advantages and concomitant use with TUR increases the effectiveness of tumor therapy. So the lasers will act as an important role in the treatment of bladder tumor.
Catheters ; Female ; Hemorrhage ; Hot Temperature ; Humans ; Laser Therapy ; Lasers, Solid-State* ; Obturator Nerve ; Recurrence ; Reflex ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urologic Diseases ; Urology ; Virtues ; Volatilization ; Water

Acute scrotum is any pathologic condition of the scrotum or intrascrotal contents that requires emergency medical or surgical management. Management of each disease entity is different, but the differential diagnosis is very difficult. So many testes had been lost due to delay of the adequate surgery and unnecessary explorations had been taken under the misdiagnosis. Clinical observations were carried out on 59 patients with acute scrotum admitted to the department of urology, Ewha Womans University Hospital during 10 years from April, 1976 to March, 1986. There were 36 patients with acute epididymitis, 6 spermatic cord torsion and 17 scrotal trauma, the mean age was 32.6 year old in acute epididymitis, 12.8 spermatic cord torsion and 23.5 scrotal trauma. Symptoms and signs showed no significant difference from each disease entity, but Prehn`s sign was somewhat useful to differentiate each one. In half patients with spermatic cord torsion that had arrived to the hospital within 24 hours from onset of symptom, the testes could be saved. Testicular scan with 99mTc-perte- chnetate was performed in 14 patients and the diagnostic accuracy was 93%, 21 patients with acute epididymitis had urinary tract infection and spermatic cord torsion occurred in 2 patients with cryptorchidism.
Cryptorchidism ; Diagnosis, Differential ; Diagnostic Errors ; Emergencies ; Epididymitis ; Female ; Humans ; Male ; Scrotum* ; Spermatic Cord Torsion ; Testis ; Urinary Tract Infections ; Urology

Recently, the use of immunoperoxidase technique for the location of prostatic acid phosphatase is well established. We experienced 67 year-old male patient who taken TUR due to mass on bladder neck. Previously he had received Rt. radical nephrectomy due to renal cell carcinoma 6 years ago and TUR due to metastatic urethral adenocarcinoma from renal cell carcinoma origin 3 years ago. The Pathologic report represented that the mass was malignant adenocarcinoma. To confirm the origin of adenocarcinoma, we performed immunoperoxidase technique and the adenocarcinoma was originated from the prostate.
Acid Phosphatase ; Adenocarcinoma* ; Aged ; Carcinoma, Renal Cell ; Humans ; Immunoenzyme Techniques* ; Male ; Neck ; Nephrectomy ; Prostate ; Urinary Bladder

We report a case of leiomyosarcoma of the spermatic cord with the review of literatures. To our knowledge, this is the first case to be reported in Korea.
Korea ; Leiomyosarcoma* ; Spermatic Cord*

Echinococcal cyst is a rare disease in Korea. A 33 year old man who had lower abdominal discomfort for 4 months, and multiple cysts in intraperitoneal and retroperitoneal cavity on abdominal CT. scan. On abdominal exploration, the multiple were diagnosed for Echinococcal cyst. Thin case is the first documented case of multiple Echinococcal cysts among Koreans reported in the literature.
Adult ; Humans ; Korea ; Rare Diseases ; Tomography, X-Ray Computed

Tuberculosis of the breast is a rare disease. Its diagnosis is difficult because clinical and radiological appearances are not specific and because isolation of the tubercle bacillus from the lesion is seldom possible. This disease is more common in women between 20 to 40 years of age, but is rare in male, elderly patients and prepubertal women. Difinite diagnosis rests on bacterilogical proof and histopathological findings -formation of a granuloma and usually caseous necrosis with or without demonstrable acid-fast bacilli. Treatment of the disease requires a combination of surgery and antitubercular drugs. We experienced 10 cases of tuberculosis of the breast and report with on them along a literature review.
Aged ; Antitubercular Agents ; Bacillus ; Breast* ; Diagnosis ; Female ; Granuloma ; Humans ; Male ; Necrosis ; Rare Diseases ; Tuberculosis*

BACKGROUND: Long-term administration of ethambutol (EMB) for Mycobacterium avium complex lung disease (MAC-LD) sometimes leads to permanent discontinuation of EMB due to various adverse events. This study aimed to investigate treatment outcomes after discontinuation of EMB.METHODS: Among patients diagnosed with MAC-LD between January 2001 and December 2014, 508 patients whose treatment was initiated with standard regimen until May 2018 were enrolled at a tertiary referral center in Korea. Of these 508 patients, 60 (11.8%) discontinued EMB due to various adverse effects. Among these 60 patients, treatment outcomes were analyzed for 44 patients by comparing their outcomes with those of matched subjects who received the standard treatment regimen without EMB discontinuation.RESULTS: The mean age of the 60 patients who discontinued EMB was 64.4 years. Ocular toxicity was the most common cause of discontinuation of EMB (75.0%, 45/60). The mean duration of EMB administration before its discontinuation was 7.0 ± 4.6 months. The treatment failure rate of the 44 patients with EMB discontinuation analyzed for treatment outcome was 29.6%, which was higher than that of the matched patients who received the standard regimen (18.3%), although the difference was not significant (P = 0.095). Of these 44 patients, EMB was substituted with later-generation fluoroquinolone in 23 patients, and the treatment failure rate of these 23 patients was significantly higher than that of the matched patients who received the standard regimen (39.1% vs. 19.3%, P = 0.045).CONCLUSION: These findings suggest that treatment outcomes are unsatisfactory in patients with MAC-LD who discontinue EMB owing to adverse events. Notably, there was a statistically significant high failure rate in patients who were prescribed fluoroquinolone to replace EMB.
Ethambutol ; Fluoroquinolones ; Humans ; Korea ; Lung Diseases ; Mycobacterium avium Complex ; Mycobacterium avium ; Mycobacterium ; Tertiary Care Centers ; Treatment Failure ; Treatment Outcome

BACKGROUND: Long-term administration of ethambutol (EMB) for Mycobacterium avium complex lung disease (MAC-LD) sometimes leads to permanent discontinuation of EMB due to various adverse events. This study aimed to investigate treatment outcomes after discontinuation of EMB. METHODS: Among patients diagnosed with MAC-LD between January 2001 and December 2014, 508 patients whose treatment was initiated with standard regimen until May 2018 were enrolled at a tertiary referral center in Korea. Of these 508 patients, 60 (11.8%) discontinued EMB due to various adverse effects. Among these 60 patients, treatment outcomes were analyzed for 44 patients by comparing their outcomes with those of matched subjects who received the standard treatment regimen without EMB discontinuation. RESULTS: The mean age of the 60 patients who discontinued EMB was 64.4 years. Ocular toxicity was the most common cause of discontinuation of EMB (75.0%, 45/60). The mean duration of EMB administration before its discontinuation was 7.0 ± 4.6 months. The treatment failure rate of the 44 patients with EMB discontinuation analyzed for treatment outcome was 29.6%, which was higher than that of the matched patients who received the standard regimen (18.3%), although the difference was not significant (P = 0.095). Of these 44 patients, EMB was substituted with later-generation fluoroquinolone in 23 patients, and the treatment failure rate of these 23 patients was significantly higher than that of the matched patients who received the standard regimen (39.1% vs. 19.3%, P = 0.045). CONCLUSION These findings suggest that treatment outcomes are unsatisfactory in patients with MAC-LD who discontinue EMB owing to adverse events. Notably, there was a statistically significant high failure rate in patients who were prescribed fluoroquinolone to replace EMB.

Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea.
Acute Disease ; Aged ; Aged, 80 and over ; *Angioplasty, Balloon ; Chronic Disease ; Female ; Humans ; Intestines/*blood supply ; Ischemia/surgery/*therapy ; Male ; Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion/surgery ; Middle Aged ; Tomography, X-Ray Computed

Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea.
Acute Disease ; Aged ; Aged, 80 and over ; *Angioplasty, Balloon ; Chronic Disease ; Female ; Humans ; Intestines/*blood supply ; Ischemia/surgery/*therapy ; Male ; Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion/surgery ; Middle Aged ; Tomography, X-Ray Computed