The evaluation of urinary calculi was done in 84 patients of paraplegia and quadriplegia due to traumatic spinal cord injury. These patients were diagnosed by KUB and intravenous urography at National Veterans Hospital during 6 years from Jan. 1975 to Dec. 1980. The results were as follows; 1. Overall incidence of urinary calculi was 38.1 %; Incidence of renal calculi was 8.3%, ureteral calculi 4.8%, and urinary bladder claculi 32.1%. 2.Relation of neurological level and incidence of urinary calculi were as follows; Cervical injury in 34.8% upper thoracic injury in 40.0%, lower thoracic injury in 45.0%, and lumbar injury in 36.5%. 3. Laterality was not toplay a role information of urinary claculi. 4. The urinary calculi were developed 62.5% during the first 36 months following spinal cord injury. 5. The recurrence of urinary calculi was 40.6%; True recurrence was 15.6% and pseudo recurrence was 25.05.
Hospitals, Veterans ; Humans ; Incidence ; Kidney Calculi ; Paraplegia ; Quadriplegia ; Recurrence ; Spinal Cord Injuries ; Spinal Cord ; Thoracic Injuries ; Ureteral Calculi ; Urinary Bladder ; Urinary Calculi ; Urography

PURPOSE: Nitric oxide synthase(NOS) is an important enzyme in the production of nitric oxide(NO). The constitutive type(cNOS) is expressed in the normal physiologic state, and the inducible type(iNOS) in expressed in the active immune state. cNOS is divided into an endothelial type (eNOS) and a neuronal type(nNOS). eNOS affects blood vessels, while nNOS affects nerve fibers. In the present study, we evaluated the expression of eNOS and nNOS in rat bladders with short-term partial outlet obstructions. We presupposed that NO is responsible for prolonged micturition problems after partial outlet obstruction. MATERIALS AND METHODS: Specific pathogen-free Sprague-Dawley rats weighing 250-300g were used for the study. Individual bladders were obtained from sham-operated control rats(n=5) and from experimental rats at 12 hours and 1, 2, 3, and 7 days after partial urethral obstruction(n=25). eNOS and nNOS were detected using immunochemical staining and analyzed with confocal microscopy and an image analyzer. RESULTS: eNOS and nNOS expression were detected in both the control group and in the group with partial outlet obstruction. The expression of eNOS showed a sharp increase at 3 days after obstruction and returned to normal at 7 days. The expression of nNOS was not significantly different between the two groups. CONCLUSIONS: In this study, we showed that eNOS increases in the rat bladder after partial outlet obstruction. This finding suggests that overproduction of NO may be the result of ischemic injury sustained during partial bladder outlet obstruction.
Animals ; Blood Vessels ; Microscopy, Confocal ; Nerve Fibers ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; Urination

PURPOSE: Benign prostatic hyperplasia (BPH) with prostatitis is a common clinical problem. There have been no previous reports of the effect of pathologic prostatitis on the improvement of lower urinary tract symptoms (LUTS) preceded by transurethral resection of prostate (TURP). Therefore, the purpose of this study was to determine the effect of pathologic prostatitis on improvement of LUTS after TURP. MATERIALS AND METHODS: From March 1996 to December 2006, 237 patients who received TURP were divided into two groups of with mild or severe pathologic prostatitis according to the pathological results of prostate tissue evaluation, International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax) and the development of complications were recorded before and at 3 months follow up after surgery. RESULTS: No statistically significant differences were identified in the two groups with regard to Qmax, resection rate and complications (p>0.05). However, the IPSS and QoL were significantly different in comparisons between the two groups (p<0.05). CONCLUSIONS: Therefore, the results of this study show that BPH accompanied by pathologic prostatitis affects the improvement of LUTS, after TURP, and treatment of prostatitis may increase patients' satisfaction after surgery.
Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia* ; Prostatitis* ; Quality of Life ; Transurethral Resection of Prostate

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma with a long median survival time because of its low proliferation rate. A 75-year-old man was referred to the hospital for hematemesis. Upper endoscopy revealed a 30-mm subepithelial tumor (SET). Abdominal CT and EUS revealed a homogeneously hypoechoic lesion arising from the second layer of the stomach, without distant metastasis. Laparoscopic wedge resection was performed. On microscopic examination, the tumor showed diffuse aggregation of small lymphoid cells with abnormal architecture. Neoplastic cells showed positive reactivity for CD20 and prominent lymphoepithelial lesions were observed. The urease breath test was also conducted, with a negative result. Our final diagnosis was Helicobacter pylori-negative MALT lymphoma (Ann Arbor classification IE2), which is a rapidly growing SET pattern. This case highlights the importance of including gastric MALT lymphoma as a differential diagnosis for rapidly growing gastric SETs.

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma with a long median survival time because of its low proliferation rate. A 75-year-old man was referred to the hospital for hematemesis. Upper endoscopy revealed a 30-mm subepithelial tumor (SET). Abdominal CT and EUS revealed a homogeneously hypoechoic lesion arising from the second layer of the stomach, without distant metastasis. Laparoscopic wedge resection was performed. On microscopic examination, the tumor showed diffuse aggregation of small lymphoid cells with abnormal architecture. Neoplastic cells showed positive reactivity for CD20 and prominent lymphoepithelial lesions were observed. The urease breath test was also conducted, with a negative result. Our final diagnosis was Helicobacter pylori-negative MALT lymphoma (Ann Arbor classification IE2), which is a rapidly growing SET pattern. This case highlights the importance of including gastric MALT lymphoma as a differential diagnosis for rapidly growing gastric SETs.

Immunoglobulin G4-related sclerosing disease is a novel clinicopathological disease entity known to involve various organs including the pancreas, bile ducts, gall bladder, retroperitoneum, kidney, salivary gland, lung and prostate. The most common organ involved is the pancreas and cases without pancreatic involvement are uncommon. Positive response to steroids is an important characteristic of this disease and this enables early diagnosis, which is required for good prognosis. We demonstrate a case of immunoglobulin G4-related tubulointerstitial nephritis in a 59-year-old male accompanied by sclerosing cholangitis and sialadenitis without any evidence of pancreatic infiltration. The patient was treated with prednisolone and was fully recovered in 6 months.
Bile Ducts ; Cholangitis ; Cholangitis, Sclerosing ; Early Diagnosis ; Humans ; Immunoglobulins ; Kidney ; Lung ; Male ; Middle Aged ; Nephritis, Interstitial ; Pancreas ; Prednisolone ; Prognosis ; Prostate ; Salivary Glands ; Sialadenitis ; Steroids ; Urinary Bladder

BACKGROUND: Vascular endothelial growth factor (VEGF) is a potent enhancer of microvascular permeability and a selective endothelial cell growth factor. In human kidney, VEGF is expressed mainly in glomerular visceral epithelial cells. We investigated the relationship between serum levels of VEGF and factors reflecting the severity of disease including histological patterns in order to elucidate the relevance of VEGF in the pathogenesis of IgA nephropathy. METHODS: Serum VEGF was studied using a sandwich ELISA from 21 patients with IgA nephropathy. Histological patterns are classified to 5 grades by WHO classification and frequencies of crescent and glomerular sclerosis, degree of interstitial fibrosis were recorded. Serum concentrations of creatinine, albumin, IgA, amounts of 24 hour urine protein excretion, and creatinine clearances are also evaluated. RESULTS: Serum VEGF levels were significantly correlated with histological grade(r=0.471, p < 0.05), frequency of cellular crescent(r=0.485, p < 0.05), degree of interstitial fibrosis(r=0.562, p < 0.01), and 24 hour urine protein excretion(r=0.439, p < 0.05), and inversely with serum albumin concentration(r=-0.594, p < 0.01). Studies in 17 patients without crescent formation revealed that only serum albumin concentration showed significant correlation with serum VEGF level. CONCLUSION: Serum VEGF concentration is mainly correlated with cellular crescent formation reflecting activity of the disease rather than chronic structural changes such as glomerular sclerosis or interstitial fibrosis. Elevated serum VEGF concentration seems to be due to the release of relatively large amounts of stored VEGF from damaged visceral epithelial cells. Serum VEGF concentration may be a useful marker to evaluate the degree of acute renal injury, especially cellular crescent formation.
Acute Kidney Injury ; Capillary Permeability ; Classification ; Creatinine ; Endothelial Cells ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Fibrosis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Kidney ; Podocytes ; Sclerosis ; Serum Albumin ; Vascular Endothelial Growth Factor A*

The authors report the case of a 25 year old woman with a chronic corticosteroid-refractory nephrotic syndrome complicated by myocardial infarction. The thromboembolism, especially acute myocardial infarction, is the most serious complication of nephrotic syndrome. Until now many mechanisms have been studied about thromboem bolism including coronary artery disease in nephrotic syndrome, but not clear. Hypercoagulability and prolonged hyperlipidemia are known as the principal contributing factors in this complication. In addition, use of steroid as therapeutic trial and hypovolemic state induced by vigorous diuretics will affect the thromboembolism, too. In this case, several coagulation abnormality and prolonged hyperlipidemia are observed. On admission day, this patient had deep vein thrombosis and then was complicated by pulmonary thromboembolism. Despite of anticoagulant and thrombolytic therapy, she experienced acute myocardial infarction on fourth day after admission. After onset of myocardial infarction, by thrombolytics and prolonged anticoagulant therapy, this nephrotic patient was relieved and discharged without other serious complication. We recommend anticoagulant and antiplatelet agent therpy in risky patient of nephrotic syndrome. We present this case with review of literature.
Adult ; Coronary Artery Disease ; Diuretics ; Female ; Humans ; Hyperlipidemias ; Hypovolemia ; Myocardial Infarction* ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Pulmonary Embolism ; Thromboembolism ; Thrombolytic Therapy ; Thrombophilia ; Venous Thrombosis

Membranoproliferative glomerulonephritis(MPGN) is a morphologic entity and characterized by several pathologic feature. MPGN is classified into a primary (or idiopathic) and secondary forms. We report a case of type I MPGN associated with cellulitis on pathologic feature. MPGN is classified into a primary (or idiopathic) and secondary forms. We report a case of type I MPGN associated with cellulitis on lower leg. He was admitted due to ingrowing nail complicated by surrounding cellulitis and edema. Chraracteristically, hematuria and proteinuria(3.2gm/ day) were noted. We couldn't find any secondary causes', ANA, cryoglobulin, HBs Ag and RA factor were negative. Renal pathologic findings showed double-contoured basement membrane, electron-dense material infiltration and mesangial proliferation. This findings were concordant with type I MPGN and we treated with antibiotics and supportive care. During follow-up, skin lesion, proteinuria and hematuria were resolved and he readmitted in purpose of control renal biopsy, We observed resolution of previous abnormal findings other than mesangial proliferation. This case was considered as type I MPGN associated with cellulitis on lower leg.
Anti-Bacterial Agents ; Basement Membrane ; Biopsy ; Cellulitis* ; Edema ; Follow-Up Studies ; Glomerulonephritis, Membranoproliferative* ; Hematuria ; Leg* ; Proteinuria ; Skin

Although the most of mushroom poisoning have a clinical menifestation of mild to moderate gastroenteritis, some mushroom may cause a serious illness; acute renal failure, hepatic necrosis. We experienced two cases of acute renal failure complicated by the poisoning of amanita virosa. Amanita virosa have a amatoxin. Amatoxin deteriorate hepatocytes, renal tubular cells, intestinal mucosal cells, and pancreas. They were transferred from local hospital for renal failure management. On admission, blood urea nitrogen and serum creatinine were highly elevated. We diagnosed acute renal failure complicated by poisoning of amanita virosa. In one case, renal function was further deteriorated compared with initial laboratory findings after creatinine was normalized at fifth day. Thus, we did a kidney biopsy. Light microscopy and EM showed interstitial inflammation and moderate tubular atrophy. They were recovered with the supportive management. We report two cases of mushroom poisoning-induced acute renal failure with review of literature.
Acute Kidney Injury* ; Agaricales ; Amanita* ; Atrophy ; Biopsy ; Blood Urea Nitrogen ; Creatinine ; Gastroenteritis ; Hepatocytes ; Inflammation ; Kidney ; Microscopy ; Mushroom Poisoning ; Necrosis ; Pancreas ; Poisoning* ; Renal Insufficiency