No abstract available.
Amyloidosis*

No abstract available.
Prostatectomy*

No abstract available.
Biopsy* ; Prostate*

The stone disease of urinary tract is common and familiar to urologist. But intrascrotal calculus is a rare disease. It is believed to originate either as a fibrinous deposit in tunica vaginalis testis or as a remnant of the appendix testis or appendix epididymis that has undergone torsion and become freely movable. Herein I report a case of intrascrotal calculi in the patient who complained scrotal mass.
Appendix ; Calculi* ; Epididymis ; Fibrin ; Humans ; Male ; Rare Diseases ; Scrotum ; Testis ; Urinary Tract

No abstract available.
Recurrence* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Although the advent of orthotopic bladder substitution in women was a major achievement in the evolution of urinary diversion, the mechanism of voiding dysfunction remains to be fully understood. This is a report on the voiding function of the ileal neobladder, based on a questionnaire survey of 6 female patients. MATERIALS AND METHODS: Between 1995 and 2002, 7 of 10 women(mean age 56.1) that underwent an orthotopic bladder substitution were evaluated using uroflowmetry, bladder diary and voiding cystourethrography. Six patients completed the questionnaire. The mean follow-up period was 24.6 months(range 1 to 72 months). RESULTS: From the uroflowmetry, the mean maximum flow rate was 12.2ml/sec, with a low average flow rate(mean 6.2ml/sec), and the voiding time was considerably prolonged(mean 68.5sec). According to the bladder diary and questionnaire responses, although the frequency and tidal volume of micturition were normal, the majority of patients were conscious of retarded, intermittent, prolonged and weak streams, with straining during voiding. Of the 7 patients, 5(71.4%) achieved excellent daytime continence, but 6(85.7%) had nighttime incontinence. One patient was unable to void and required regular intermittent catheterization. Two patients sometimes, or often, performed self-catheterization due to residual urine. According to the questionnaire responses, 4(66.7%) of the 6 patients stated that their micturition status was better or the same compared with their preoperative status, and 4(66.7%) of the patients felt satisfied. The degree of inconvenience was low for every item and the limitation on daily life was considered minimal. Cystograms revealed a descent of the pouch and urethral angulation in the 3 patients with difficulty in urination or hypercontinence. CONCLUSIONS: Orthotopic bladder substitution after a radical cystectomy in women provides relatively satisfactory functional outcomes.
Catheterization ; Catheters ; Cystectomy ; Female ; Follow-Up Studies ; Humans ; Surveys and Questionnaires* ; Rivers ; Tidal Volume ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion ; Urination

PURPOSE: Radical cystectomy has been a standard method in the treatment for invasive bladder cancer. Recently the orthotopic substitutions have been generally performed for urinary diversion. Ghoneim introduced a new method for orthotopic substitution which has used relatively short segment of ileum, and the method is regarded to have few complications. We performed this method for our study and analyzed the results and complications. MATERIALS AND METHODS: Among total 29 patients underwent ileal W-neobladder with serous-lined extramural tunnel, 27 patients had invasive bladder cancer and the remaining two patients had contracted bladder with vesicoureteral reflux. There were 25 male patients with the mean age of 59.2 years(45-70) and 4 female patients with 61.8 years(51-68). Mean follow-up period for the entire group was 8.4 months(3?17 month). History taking, physical examination, and complete laboratory tests were performed postoperatively and IVP or CT scan was taken at 3 month and 9 month after the operation for the evaluation of recurrence and upper tract change. RESULTS: The average operating time was 8 hours 35 minutes(420-670 min). Paralytic ileus developed in two patients and wound dehisced in 4. In all 29 patients, vesicoureteral reflux was not detected. Stricture of ureteroileal anastomosis was observed in 4 left renal units. We performed percutaneous nephrostomy and antegrade double J stenting on all the patients with stricture primarily, but one patient underwent neoureteroileostomy because of the failure of the primary management. Four patients complained enuresis, but no daytime incontinence was observed. There were no clinical symptoms of complications in all 29 patients and no metabolic acidosis was observed in laboratory tests. CONCLUSIONS: Serous-lined extramural tunnel method of orthotopic substitution showed an acceptable and safe reservoir with a large capacity at low pressure and absence of reflux with relatively short segment of ileum.
Acidosis ; Constriction, Pathologic ; Cystectomy ; Enuresis ; Female ; Follow-Up Studies ; Humans ; Ileum ; Intestinal Pseudo-Obstruction ; Male ; Nephrostomy, Percutaneous ; Physical Examination ; Recurrence ; Stents ; Tomography, X-Ray Computed ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion ; Vesico-Ureteral Reflux ; Wounds and Injuries

No abstract available.
Vesicovaginal Fistula*

During the development of invasive tumor, tumor cells penetrate the basement membrane and enter the underlying interstitial stroma to gain access to lymphatics and blood vessel for further dissemination. Invasion of the basement membrane is one of the most important steps. The basement membrane of bladder is composed of laminin and type IV collagen primarily and plasminogen activator and cathepsin B are increased in bladder carcinoma. Retinoic acid which is vitamin A metabolite suppresses carcinogenesis and promotes the differentiation of several types of tumor cells. Membrane invasion culture system (MICS) is an in vitro invasion assay using artificial basement membrane, Matrigel. Using this in vitro chemoinvasion assay, we evaluated the invasion of human invasive bladder cancer cell J82 and the ability of retinoic acid to inhibit the invasion of J82 quantitatively. The invaded tumor cells were 38.1+/-9.0 cells/field, 24.4+/-13.3 cells/field, 20.6+/-6.5 cells/field and 16.0+/-8.2 cells/field after adding retinoic acid 0uM, 0.1uM, 1.0uM and 10.0uM respectively and the decrease was statistically significant(p <0.05). Thereafter, the possible mechanisms of action responsible for the anti-invasive effect were further investigated, comparing retinoic acid-treated cells with untreated cells. The survival fractions were 100%, 82.4%, 65.3% and 46% with retinoic acid concentration 0uM, 0.1uM, 1.0uM and 10.0uM respectively on MTT test. Type IV collagenolytic activities were measured by type IV collagenolysis assay using [3H] proline labeled collagen film. Type IV collagenolysis activities were significantly decreased to 100%, 82.4 %, 65.3 % and 46.0% after adding retinoic acid, 0 M, 0.1 M, 1.0 M and 10.0 M respectively. But retinoic acid could not inhibit either the activity of plasminogen activator nor activity of cathepsin B enzyme significantly. These results suggest that retinoic acid inhibit the invasion of human invasive bladder cancer cell J82 and the inhibitory effect of retinoic acid may be caused by suppression of type IVcollagenolysis and direct cytotoxicity.
Basement Membrane ; Blood Vessels ; Carcinogenesis ; Cathepsin B ; Collagen ; Collagen Type IV ; Humans* ; Laminin ; Membranes* ; Plasminogen Activators ; Proline ; Tretinoin* ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vitamin A

Purpose: To analyze various prognostic factors and surgical outcomes in patients who underwent radical nephrectomy and thrombectomy of a renal cell carcinoma with renal vein or inferior vena caval thrombosis. Materials and Methods: Among 44 patients with confirmed renal cell carcinomas and renal vein or inferior vena caval thrombosis, between December 1993 and June 2000, 42 having undergone radical nephrectomy and thrombectomy were retrospectively studied. 2 patients were excluded due to no operation performance. The 5-year disease-specific survival rates were analyzed according to various prognostic factors, including age, gender, clinical symptoms, tumor side (Rt. vs. Lt.), thrombus position (renal vein vs. IVC), histopathological cell type, lymph node involvement, pT stage irrespective of thrombus, Fuhrmann nuclear grade and invasion to perinephric fat, vessel, renal pelvis or adrenal gland. Results: The overall 5-year disease-specific survival rate of all the patients was 55%. A univariate analysis of the 42 patients showed that the position of the tumor thrombus, histopathological cell type and invasion to the adrenal gland had a significant impact on the survival. On multivariate analysis, the tumor thrombus location and histopathological cell type were independent prognostic factors for the survival. The 5-year disease-specific survival rates of the patients with a renal vein thrombus (n=23) and with IVC (inferior vena cava, n=20) were 75 and 20%, respectively. The 5-year disease-specific survival rate of the patients with a conventional cell type (n=32) was 68%, and patients with other pathologic cell types had no significant follow-up periods. Conclusions: The tumor thrombosis position, histopathological cell type and invasion to the adrenal gland are considered as clinically significant prognostic factors in patients with a renal cell carcinoma with vein thrombosis after radical nephrectomy with a thrombectomy. Meticulous radical nephrectomy with thrombectomy will be beneficial to the survival of patients with a renal cell carcinoma and vein thrombus.
Adrenal Glands ; Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Lymph Nodes ; Multivariate Analysis ; Nephrectomy ; Prognosis ; Renal Veins ; Retrospective Studies ; Survival Rate ; Thrombectomy ; Thrombosis* ; Veins