No abstract available.
Lithotripsy* ; Shock*

Ultrasound has been shown to be effective in the diagnosis of a variety of scrotal abnormalities. We performed ultrasound of the scrotum in 22 patients with conventional 3.75 MHz real time scanner. There were 6 intratesticular lesions-3 spermatic cord torsion, 1 malignant lymphoma,1 leukemic infiltration and l yolk sac tumor. Extratesticular abnormalities included acute epididymitis, chronic epididymitis, Tb epididymitis, epididymal cyst peritesticular abscess, spermatocele, hematocele and infected hydrocele. Sonography accurately distinguished between testicular and extratesticular masses in all cases and pathologic correlation were obtained for operated scrotal lesions. The results were as follows. l. Out of 22 patients, chief complaints of 9 were acute sctotum and 13 were scrotal mass. 2. Of 9 cases with acute scrotum, ultrasonography detected 5 cases with acute epididymitis, 3 cases with spermatic cord torsion and l case with hematocele. 3. Of 13 cases with scrotal mass, surgical exploration was done in 1O cases. 9 cases were confirmed same as post-operative finding (90% accuracy). One case with hematoma was confirmed to infected hydrocele after operation. 4. Ultrasound characteristics of 22 patients were classified as follows. 13 were hypoechoic, 4 were anechoic, 3 were mixed and 2 were hyperechoic.
Abscess ; Diagnosis ; Endodermal Sinus Tumor ; Epididymitis ; Hematocele ; Hematoma ; Humans ; Leukemic Infiltration ; Male ; Scrotum ; Spermatic Cord Torsion ; Spermatocele ; Ultrasonography

Cystic nephroma (CN) is a benign cystic neoplasm composed of mixed epithelial and stromal elements. Less than 200 cases have been reported. We had a patient, a 41-year-old woman, who had a huge typical CN. The patient was admitted for a right renal mass that was found incidentally. On laparaoscopic right nephrectomy, there was an encapsulated 7 cm multilocular cystic mass at the upper pole. Microscopically, the cystic wall was lined by a single layer of low cuboidal or hobnail epithelium without a solid area. The thin septa were composed of bland, ovarian type spindle cells. The main differential diagnoses were mixed epithelial and stromal tumor (MEST), low grade multilocular renal cell carcinoma, and tubulocystic carcinoma. The results of immunohistochemical staining were cytokeratin 7/19(+/+) and CD10(-) in lining epithelium, estrogen receptor/progesterone receptor(+/+) in stromal cells. After surgery, she was free of recurrence for 10 months. We report this rare case and compare it with other cystic renal tumors, especially MEST.
Adult ; Carcinoma, Renal Cell ; Diagnosis, Differential ; Epithelium ; Estrogens ; Female ; Humans ; Keratins ; Kidney ; Nephrectomy ; Receptors, Estrogen ; Recurrence ; Stromal Cells

PURPOSE: We analyzed the RESULTS of the GnRH stimulation test to assess its usefulness as a predictor for testicular dysfunction in adolescent varicocele. MATERIALS AND METHODS: We studied 20 adolescents with unilateral varicocele from January 1998 to January 2001. Eight patients were grade II and 12 were grade III. Testicular volume was measured using an orchidometer. The responses of the gonadotropins to GnRH stimulus were compared between grade II and III patients. All patients had varicocelectomy and 7 were followed up. RESULTS: After GnRH stimulus, all patients except one showed excessive response in LH and FSH. LH response(8-fold greater than the baseline) was more exaggerated than that of FSH(1.8-fold greater than the baseline). The 12 patients of grade III varicocele presented greater excessive responses in LH and FSH to GnRH stimulus than those of grade II(p>0.05). After surgical treatment, the exaggerated gonadotropin response to GnRH was not normalized. But the response was less exaggerated, suggesting an improvement of testicular dysfunction. CONCLUSIONS: In this study, the grade of the varicocele was correlated with the excessive responses of the gonadotropins to the GnRH stimulus. Nevertheless, we suggest that the deterioration of the testicular function in adolescents with varicocele was a progressive phenomenon. We think that the GnRH stimulation test could be useful in assessing the testicular dysfunction in adolescent varicocele patients.
Adolescent* ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Varicocele*

Morphologic changes of the urinary bladder epithelium of the Wistar rats induced by oral administration of 0.05% solution of N-buty1-N-(4-hydroxybutyl) nitrosamine (BBN) were studied by means of light and electron microscopes. Hyperplasia was constantly obsessed in the animals administered with BBN for 4 weeks or more, and the hyperplastic area increased proportionally with the duration of BBN administration, but decreased in the 4-& 8-week groups after cessation of BBN administration. Papilloma and carcinoma developed in 87.5% and 37.5% after 12 weeks of BBN administration, respectively, and the figure increased continuously without further administration of BBN. Ultrastructurally, the superficial cells in the normal and hyperplastic epithelia were composed of both light and dark cells and the luminal surface was characterized by the presence of asymmetric unit membrane with knob like protrusions. In the hyperplastic epithelium there was increase in the number of surface dark cells with occasional vesicles in hinge regions. A transitional lesion between hyperplasia and papilloma was observed, being characterized by dark cells with numerous microvilli on surface and lateral cell membranes. The cytoplasm of the cells contained round or ovoid vesicular structures, and intercellular edema was also seen. The surface dark cells of papilloma were frequently exfoliated and the immature intermediate cells were exposed to the luminal surface, the cell membranes showing pleomorphic microvilli at surface and lateral walls. The proliferation of the intermediate cells was also pronounced. The papillary carcinoma showed stromal invasion with interruption of basal lamina, and nuclear and cytoplasmic pleomorphism. The above ultrastructural features support that the transitional cell carcinoma develops from the preceding hyperplasia-papilloma process and the alterations in the intracytoplasmic vesicles and asymmetric unit membrane provide the sequential changes on the cell permeability to result in an easy access to the subsequent exposure to the intravesical accumulation of carcinogen.
Administration, Oral ; Animals ; Basement Membrane ; Carcinoma, Papillary ; Carcinoma, Transitional Cell ; Cell Membrane ; Cytoplasm ; Edema ; Epithelial Cells* ; Epithelium ; Hyperplasia ; Membranes ; Microvilli ; Papilloma ; Permeability ; Phenobarbital ; Rats* ; Rats, Wistar ; Urinary Bladder*

We reviewed 26 patients with staghorn calculi to determine whether extracorporeal shock wave lithotripsy (ESWL) monotherapy with Dornier MPL-9000X lithotriptor is a successful alternative to the classical approaches. Of the staghorn calculi 5 cases were complete and 21 cases were incomplete staghorn. Double-J ureteral stents were placed in 24 of 26 patients before the ESWL. Of 15 patients with stone volume less than 20ml, 12(80%) showed stone-free after 5.7 mean session of ESWL. Of 11 patients with stone volume more than 20 ml, 7 (64%) became stone-free after 7.1 mean session of ESWL. The post-ESWL complications were flank pain in 9 patients (35%), gross hematuria in 24 (92%), high fever in 3 (13%) and steinstrasse in 24 (92%). Frank pain and high fever were managed successfully with analgesics and antibiotics. Gross hematuria disappeared spontaneously within 2 days. For the steinstrasse, the stone fragments passed spontaneously in 15 cases (62.5%) and ESWL to the steinstrasse was needed in other 9 cases (37.5%). Though the treatment of choice for the staghorn stones is combination therapy (PNL and ESWL) at the present, we experienced good results by ESWL monotherapy in staghorn calculi with Dornier MPL-9000X.
Analgesics ; Anti-Bacterial Agents ; Calculi* ; Fever ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Shock* ; Stents ; Ureter

A retrospective analysis was done on 68 patients with primary superficial bladder cancer between September 1989 and December 1995. We evaluated the predictive value of urine cytology in the recurrence and the progression of superficial bladder cancer. Positive cytology was shown in 52.9% (36/68) and was significantly associated with tumor grade (p=0.001). The recurrence rate in patients with negative cytology was 28.1% (9/32) compared to 77.8% (28/36) in those with positive cytology (p=0;001). No patients of negative cytology had tumor progression while 4 out of 36 (11.1%) patients of positive cytology had progression to invasive or metastatic disease. In conclusion, urinary cytology appears to be a significant prognostic factor in superficial bladder cancer.
Humans ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: We compared prophylactic effects and complications of intravesical instillation of the Connaught and Tice strains bacillus Calmette-Guerin (BCG) in patients with stage pT1 bladder cancer. MATERIALS AND METHODS: A total of 98 patients with stage pT1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of the 98 patients, 51 received the Connaught strain BCG (81mg), 27 the Tice strain BCG (12.7mg) and 20 patients underwent TUR alone. The patients were followed-up for 18-78 months (mean 42.5months). The recurrence and progression rates, mean months to tumor recurrence, recurrence free survival rate, using Kaplan-Meier curve, and complications, were compared between the two BCG strain groups. RESULTS: The overall recurrence rate was 27.5% in the Connaught strain BCG group, 29.6% in Tice strain BCG group and 65% in TUR alone group. The mean months to tumor recurrence, and the recurrence free survival rate, showed that both BCG strain drugs were superior to TUR alone. Although the prophylactic efficacy of the Connaught strain BCG was a little higher than that of the Tice strain BCG, there were no significant differences in the recurrence rates and recurrence free survival rates between the two drugs. The incidences of complications were 94.1 and 85.2% in the Connaught strain BCG and Tice strain BCG groups, respectively. CONCLUSIONS: Both the Connaught and Tice BCG strains were superior to TUR alone in the prophylaxis of the recurrence in stage pT1 bladder cancer. There was no significant difference in the complication rates between the two groups. Therefore, both the Connaught and Tice BCG strains may be regarded as alternative treatments.
Administration, Intravesical ; Bacillus* ; BCG Vaccine ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Historically, digital rectal examination (DRE) had been the only method available to evaluate the prostate gland for malignant tumor. Recently, serum prostate specific antigen (PSA), transrectal ultrasonography (TRUS) and magnetic resonance imaging (MRI) using endorectal coil have been added to the methods used to detect prostate cancer. But the roles of these tests in detecting cancer are currently undefined. Because of its low specificity, some reports have suggested the routine use of TRUS be discouraged. The present study was undertaken to evaluate the value of TRUS in the detection of prostate cancer. In a retrospective study, 123 BPH patients were examined by TRUS and PSA measurement. All patients were planned for prostatectomy and they had no evidence for prostate cancer at DRE. Of 123 patients with pathologically proven diagnosis, 10 patients had prostate cancer and 113 patients had BPH. Among the patients with prostate cancer, 6 patients had elevated PSA level ( >10ng/mL), while a patient had normal PSA level. Of 66 patients whose PSA levels were between 4 and 10ng/mL, only 3 patients had prostate cancer. Among 10 patients with prostate cancer, one patient had positive finding in TRUS, while 9 patients had negative finding. Among 113 patients with BPH, 17 patients had positive findings in TRUS and 96 patients had negative findings. Over all TRUS sensitivity and specificity for prostate cancer detection was 10% and 84.9% respectively. From our data we conclude; 1. The use of TRUS in BPH patients with negative DRE and PSA less than 10ng/mL seems to be questionable. 2. For the patients with negative DRE and PSA higher than 10ng/mL, sono-guided biopsy should be done regardless of the result of TRUS.
Biopsy ; Diagnosis ; Digital Rectal Examination ; Humans ; Magnetic Resonance Imaging ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms* ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

Purpose: An acute ureteral obstruction during pregnancy presents both diagnostic and therapeutic challenges. When conservative therapy fails, temporary measures, such as ureteral stenting, are often chosen as a first- line intervention, which postpones definitive management until delivery. The usefulness of ureteral stenting was evaluated as an emerging strategy for the symptoms of an acute ureteral obstruction during pregnancy. Materials and Methods: Between 1996 and 2005, a retrospective analysis was performed on 53 pregnant patients with an acute ureteral obstruction. Eighteen of the patients were treated by ureteral stenting, as they failed to improve with conservative management. They were followed up until the removal of the ureteral stent. Results: Seventeen patients (95%) experienced significant pain relief within at least 2 days, but one patient (5%) did not. On ultrasound, 16 patients (88%) had resolution of hydronephrosis. Twelve patients (66%) continued to have problems with post-therapeutically irritative voiding symptoms, but 11 (61%) experienced relief of symptoms within 10 days. One patient (5%) had the ureteral stent removed due to the continuous complaint of irritative voiding symptoms. After delivery, all patients were taken intravenous pyelography (IVP). Fourteen patients showed normal findings, but 4 were diagnosed with a ureteral stone. Three patients were treated by extracorporeal shock wave lithotripsy (ESWL) for a stone in the upper and lower urinary tract. One patient, with a mid ureteral stone, was treated by ureteroscopic lithotripsy. Conclusions: Ureteral stents were usually placed without any major problems, and well tolerated, with only minor and short post-therapeutic discomfort. We concluded that ureteral stenting is a simple, safe and effective first-line therapeutic option in case of symptomatic and acute ureteral obstruction during pregnancy.
Humans ; Hydronephrosis ; Lithotripsy ; Pregnancy* ; Retrospective Studies ; Shock ; Stents* ; Ultrasonography ; Ureter* ; Ureteral Obstruction* ; Urinary Tract ; Urography