Ureteroscopic stone extraction is popular method for the management of ureteral stone after innovative development of rigid ureteroscope. A sequential analysis of the clinical study revealed that during the first 39 cases success rate was 56.4 %. Within the latter 39 cases success rate was 92.3%. Complication included ureteral perforation in 2 cases (2.7% ), fever more than 38 degrees C in 2 (2.7%). Although E.S.W.L. is the mainstream of method of management for ureteral stone, ureteroscopic stone extraction is choice for urologist where E.S.W.L. is not available or when patient refuses E.S.W.L.
Fever ; Humans ; Ureter ; Ureteroscopes

No abstract available.

The immature teratoma is extremely rare tumor consisting of mature tissues and immature embryonal tissues. The immature teratoma in children occurs more frequently at the sacrococcygeal bone, testis and ovary. Only 9.5 percent of immature teratomas occur in retroperitoneum. Often the presenting manifestation is asymptomatic with increasing abdominal distention or mass discovered during physical examination. We report a case of congenital retroperitoneal immature teratoma in 3-week-old boy who was treated by surgical excision.
Child ; Female ; Humans ; Male ; Ovary ; Physical Examination ; Teratoma* ; Testis

PURPOSE: We attempted to examine the correlation between metabolic syndrome and lower urinary tract symptoms (LUTS) in the aspect of gender-specific medicine. MATERIALS AND METHODS: A total of 922 patients participating in a health examination completed the International Prostate Symptom Score (IPSS) questionnaire and the Overactive Bladder Questionnaire Short Form (OABq-SF) symptom bother scale from March 2008 to July 2009. Metabolic syndrome was defined by using the National Cholesterol Education Program Adult Treatment Panel III criteria announced in 2001. We analyzed differences in lower urinary tract symptoms according to the presence of metabolic syndrome and the component elements of metabolic syndrome. RESULTS: The subjects were 538 males and 384 females with a mean age of 48.8+/-6.8 years. Among all patients, the number of patients with metabolic syndrome was 143 (15.5%); there were 110 males (20.4%) and 33 females (8.6%), showing a significant difference. There were no differences in scores on the IPSS or OABq-SF with respect to the presence or absence of metabolic syndrome in males. In females, however, there were significant differences in the IPSS and OABq-SF depending on the presence or absence of metabolic syndrome. In males and females, the IPSS total score was significantly correlated with age. Also, high-density lipoprotein (HDL) cholesterol in males and triglyceride in females was significantly correlated with the IPSS total score. CONCLUSIONS: There are sex differences in the morbidity rate of metabolic syndrome and its effect on lower urinary tract symptoms. Therefore, it is necessary to consider gender-specific medicine in the diagnosis and treatment of LUTS.
Adult ; Cholesterol ; Female ; Gender Identity ; Humans ; Lipoproteins ; Lower Urinary Tract Symptoms ; Male ; Metabolic Syndrome X ; Prostate ; Sex Characteristics ; Urinary Bladder, Overactive ; Urologic Diseases

BACKGROUND AND OBJECTIVES: Recent studies have shown that many kinds of K+ channels, including the muscarinic K+ channel (KACh), are activated in the ischemic heart. It is known that these channels can be modulated by phosphorylation. However, little is known about the function of the KACh in ischemic hearts. In this study, we examined whether the KACh channel is mediated by protein kinase C (PKC) activation in rat atrial myocytes under ischemic conditions. MATERIALS AND METHODS: Single atrial cells of adult rat heart were prepared by collagenase digestion. Channel activity of KACh was recorded by cell-attached configuration from single atrial cells under ischemic conditions, using a patch clamp technique. To simulate ischemia, adenosine or potassium cyanide (KCN) was applied to atrial myocytes, and Western blot was performed to specify PKC isoforms. RESULTS: Adenosine and KCN markedly increased KACh channel activity. The responses to adenosine and KCN were increased 3-fold at mean open time from that observed with control. Channel activity of KACh was blocked by pretreatment with PKC antagonists such as sphingosine, Go 6976, and rottlerin. PKC alpha and PKC betaI isoform levels were increased in the membrane fraction of ischemic heart, indicating that ischemic stress might trigger translocation of cytosolic PKC to the cell membrane. CONCLUSION: These results show that KACh channels are modulated by PKC activation under ischemic conditions induced by adenosine or KCN. Therefore, the channels can protect the heart from ischemic stress by increasing channel activity.
Adenosine ; Adult ; Animals ; Blotting, Western ; Cell Membrane ; Collagenases ; Cytosol ; Digestion ; Heart ; Humans ; Ischemia ; Membranes ; Muscle Cells* ; Phosphorylation ; Potassium Cyanide ; Protein Isoforms ; Protein Kinase C* ; Protein Kinases* ; Rats* ; Sphingosine

Prostate cancer commonly manifests with bony metastases. Visceral metastasis can also occur in the lungs and liver. However, stomach metastasis related to prostate cancer is rare. Here, we report a case of prostate cancer metastatic to the stomach. A 66-year-old male was diagnosed with prostate adenocarcinoma. He was noted as having abdominal discomfort, nausea, and vomiting 18 months after the diagnosis. A histopathologic examination and an esophagogastroduodenoscopic gastric biopsy revealed stomach-metastatic adenocarcinoma. He was also noted as having cerebellar metastatic lesions, which were identified by using a brain magnetic resonance imaging (MRI) scan. The patient died of cardiovascular complications 5 months after the diagnosis of stomach metastasis.
Adenocarcinoma ; Aged ; Biopsy ; Brain ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Male ; Nausea ; Neoplasm Metastasis ; Prostate ; Prostatic Neoplasms ; Stomach ; Vomiting

Among several diagnostic tests, a Helicobacter pylori stool antigen (HpSA) test may offer a useful noninvasive method for diagnosing infection without sacrificing animals. In this study, male C57BL/6 mice (n=6) were infected with H. pylori ATCC 49503 (1x10(8) CFU/mouse) by intragastric inoculation three times at 2-day intervals, and H. pylori infected stool specimens were collected 1, 3, 5, 7, 14, 21 days after infection to assess reliability of the HpSA test. Five of six specimens were positive at 5-21 days after infection, and the sensitivity of the HpSA test was 83.33%. The presence of H. pylori infection was confirmed by the rapid urease test and genomic DNA polymerase chain reaction (PCR), and showed the same results as the HpSA. However, the rapid urease test and genomic DNA PCR are invasive tests and require animal sacrifice to detect H. pylori in gastric biopsy samples. We suggest that an HpSA test kit would be useful and effective for monitoring H. pylori in various laboratory animals, as H. pylori can be easily monitored without sacrificing animals.
Animals ; Animals, Laboratory ; Biopsy ; Diagnostic Tests, Routine ; DNA ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Mice ; Polymerase Chain Reaction ; Urease

BACKGROUND: The laparoscopic cholecystectomy (LC) has been accepted as the procedure of choice for chronic cholecystitis. However in cases of acute cholecystitis, the safety and the efficacy of LC has not been fully determined. Thus we performed this study to assess the clinical outcomes of a LC for acute cholecystitis to evaluate it's efficacy and safety. METHODS: The authors retrospectively analyzed 1,164 LCs performed in Yeungnam University Hospital from May 1991 to March 1996. Among the 1,164 LCs, 118 were performed for acute cholecystitis and 1,046 were performed for chronic cholecystitis. The authors compared the mean operation time, the conversion rate to an open cholecystectomy (OC), the reasons for conversion, the complication rate, the postoperative hospital stay, and the postoperative use of analgesics between the patients with acute cholecystitis and the patients with chronic cholecystitis. RESULTS: In the 1046 patients with chronic cholecystitis, the mean operation time was 55.9 minutes, the conversion rate to an OC was 2.7%, the complication rate was 4.0%, the mean postoperative hospital stay was 3.3 days, and analgesics were used in 48% of the patients. However in the 118 patients with acute cholecystitis, the mean operation time was 65 minutes, the conversion rate to an OC was 11.8%, the complication rate was 16.9%, the mean hospital stay was 4.4 days, and analgesics were used in the 60% of the patients. Also the authors found that the longer duration of preoperative symptoms and an advanced state of inflammation (e.g., GB empyema or gangrenous changes) were the two most common causes of conversion to an OC in the case of acute cholecystitis. Although all the analyzed parameters (especially, the conversion rate and the complication rate) were higher in the patients with acute cholecystitis than they were in the patients with chronic cholecystitis, a LC for acute cholecystitis seems to be acceptable because there were no mortalities and there were no life threatening complications. CONCLUSIONS: From, the aspects of safety and efficacy, a LC can be performed in most patients with acute cholecystitis. However, it should be remembered that the prolonged duration of symptoms prior to a LC increases the conversion rate to O.C. and if we confront the advanced cholecystitis (GB empyem or gangrenous change) with difficult Calot's triangle during a L.C., early conversion to an OC should be considered.
Analgesics ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Empyema ; Humans ; Inflammation ; Length of Stay ; Mortality ; Retrospective Studies

BACKGROUND: The development of new drugs or alternative therapies effective against methicillin-resistant Staphylococcus aureus (MRSA) is of great importance, and various natural anti-MRSA products are good candidates for combination therapies. We evaluated the antibacterial activities of a Phellinus baumii ethyl acetate extract (PBEAE) and its synergistic effects with beta-lactams against MRSA. METHODS: The broth microdilution method was used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of the PBEAE. The PBEAE synergistic effects were determined by evaluating the MICs of anti-staphylococcal antibiotic mixtures, with or without PBEAE. Anti-MRSA synergistic bactericidal effects of the PBEAE and beta-lactams were assessed by time-killing assay. An ELISA was used to determine the effect of the PBEAE on penicillin binding protein (PBP)2a production. RESULTS: The MICs and MBCs of PBEAE against MRSA were 256-512 and 1,024-2,048 microg/mL, respectively. The PBEAE significantly reduced MICs of all beta-lactams tested, including oxacillin, cefazolin, cefepime, and penicillin. However, the PBEAE had little or no effect on the activity of non-beta-lactams. Time-killing assays showed that the synergistic effects of two beta-lactams (oxacillin and cefazolin) with the PBEAE were bactericidal in nature (Deltalog10 colony forming unit/mL at 24 hr: 2.34-2.87 and 2.10-3.04, respectively). The PBEAE induced a dose-dependent decrease in PBP2a production by MRSA, suggesting that the inhibition of PBP2a production was a major synergistic mechanism between the beta-lactams and the PBEAE. CONCLUSIONS: PBEAE can enhance the efficacy of beta-lactams for combined therapy in patients infected with MRSA.
Acetates/chemistry ; Agaricales/*chemistry/metabolism ; Anti-Infective Agents/chemistry/*pharmacology ; Drug Synergism ; Enzyme-Linked Immunosorbent Assay ; Methicillin-Resistant Staphylococcus aureus/*drug effects/metabolism ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins/analysis/metabolism ; Plant Extracts/chemistry/*pharmacology ; beta-Lactams/*pharmacology

In 38 of 70 patients who underwent lumbar spinal surgery, we performed a randomized, prospective double-blind study of the effect of caudal block with morphine sulfate on postoperative pain levels. Age, sex, clinical features, postoperative analgesic consumption, pain score, adverse effects and patient satisfaction on discharge were recorded. The consumption of parenteral analgesics on the 1st, 2nd and 3rd days was significantly lower in the morphine sulfate group(p<0.05), than in the control group. Caudal block with morphine sulfate also led to marked reductions in pain levels and thus increases patients satisfaction during the postoperative period(p<0.05). Transient respiratory depression occurred in three of 38 patients(7.9%), but further treatment was not needed. Seventeen patients(44.7%) developed urinary retention, but this recovered spontaneously. The present study demonstrates that caudal block with morphine sulfate leads to a highly significant reduction in pain during postoperative periods and a corresponding reduction in the need for additional postoperative analgesics, in addition, patients are more satisfied.
Analgesics ; Double-Blind Method ; Humans ; Morphine* ; Pain, Postoperative* ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Respiratory Insufficiency ; Urinary Retention