No abstract available.

PURPOSE: We compared the biochemical and clinical presentation of gouty diathesis in patients with uric acid and calcium nephrolithiasis MATERIALS AND METHODS: We retrospectively reviewed biochemical and clinical data from 69 gouty diathesis patients(48 with uric acid stones and 21 with calcium stones) and 57 normal subjects were performed at our institution. RESULTS: Demographic similarity between two groups was a male predominance. Gouty diathesis patients in both groups showed abnormally low urinary pH(<5.5) and propensity for hyperuricemia and hypertriglyceridemia. Gouty arthritis and hyperuricemia was found in 31% and 44% of those with uric acid stones whereas 9.5% and 23.8% in those with calcium stone respectively. In control group, 1 case presented with hyperuricemia and urinary pH at 6.3. Both urinary pH and citrate increased after potassium citrate treatment in both groups. CONCLUSIONS: The two groups of gouty diathesis with either uric acid stone or calcium stones have similar biochemical and clinical features that are characteristic of primary gout. Calcium stone formation in patients with hyperuricemia or persistent acidic urine may represent a latent form of gout. Patients with calcium stones and biochemical feature of gouty diathesis may manifest primary gouty. Both groups are responsive to potassium citrate treatment.
Arthritis, Gouty ; Calcium* ; Citric Acid ; Disease Susceptibility* ; Gout ; Humans ; Hydrogen-Ion Concentration ; Hypertriglyceridemia ; Hyperuricemia ; Male ; Nephrolithiasis ; Potassium Citrate ; Retrospective Studies ; Uric Acid*

This experiment was performed to study the morphological responses of the thymic cortex of the mice after administration of BCG. Healthy adult mice weighing 25gm each were divided into normal and experimental groups. BCG[0.03X108-0.32X108 CFU] were injected subcutaneously to the animals every other day, and animals were sacrificed at 4 days, 1 week, 2 weeks and 8 weeks following the first injection. Thymus were removed immediately after sacrifice and transferred to cold phosphate buffered 2.5% glutaraldehyde-1.5% paraformaldehyde solution[pH 7.3], and cut into small pieces. Tissue samples were fixed for 2-3 hours in the same fixative, postfixed with phosphate buffered 1% osmium tetroxide solution[pH 7.3], dehydrated in a graded series of alcohol, and embedded in araldite mixture. Ultrathin sections stained with uranyl acetate and lead citrate were observed with a JEM 100CX-II electron microscope. The observed results were as follow : 1. In the early BCG treated groups, a few eosinophile leucocytes were observed, but more eosinophils were observed in later groups. Some elongated and bar-shaped lysosomes with eletron lucent gap were often obserced in the macrophages. 2. Cortical population of thymocytes in the thymus were reduced, whereas territoris of the epithelial reticular cells were expanded especially in 2 weeks and 8 weeks groups. Some portion of the thymic cortex exhibited large intercellular spaces, and a few nuclear bodies filled with materials of medium density were observed in the epithelial reticular cells. 3. In the 8 weeks groups, macrophages, plasma cells and eosinopile leucocytes and developing eosinophile leucocytes were often observed in the thymic cortex. Distended cisternae of granular endoplasmic reticula and newly forming prosecretory granulses in the Golgi complex were ovserved in som plasma cells. From the above results, it was suggested that repeated treatment with BCG could induce disturb the maturation and differentiation of the T lymphocytes. In turn, BCG, if repeatedly injected, may disturb the immunological medchanism.
Adult ; Animals ; Citric Acid ; Eosinophils ; Extracellular Space ; Golgi Apparatus ; Humans ; Lysosomes ; Macrophages ; Mice* ; Mycobacterium bovis* ; Osmium Tetroxide ; Plasma Cells ; T-Lymphocytes ; Thymocytes ; Thymus Gland

PURPOSE: Because the preoperative diagnosis of xanthogranulomatous pyelonephritis (XGP) is difficult due to its similarities to other renal diseases, the diagnosis is made postoperatively in most patients. The aim of this study was to improve preoperative diagnosis of this disease. MATERIALS AND METHODS: We reviewed clinical characteristics, laboratory and radiological findings, preoperative diagnoses, and operative methods of 6 patients with XGP who underwent operation from March 1991 to July 1998. Mean age was 49.8 years (range 28 to 80) and male to female ratio was 1 to 2. RESULTS: All 6 patients had flank pain and urinary tract infection. Among 6 patients, there were 3 patients (50%) with renal staghorn stone and 1 (16.7%) with ureteropelvic junction stricture. No patient was diagnosed as XGP preoperatively. Three patients (50%) diagnosed as pyonephrosis with staghorn stone preopratively underwent simple nephrectomy and 2 patients diagnosed as renal mass preoperatively underwent radical nephrectomy. One patient diagnosed as renal abscess extended to retroperitoneum and psoas muscle preoperatively was diagnosed as XGP through intraoperative frozen section biopsy of renal tissue and underwent partial nephrectomy and drainage. CONCLUSIONS: Preoperative diagnosis of XGP will be raised through better understanding of the clinical characteristics and radiologic findings of this disease.
Abscess ; Biopsy ; Constriction, Pathologic ; Diagnosis ; Drainage ; Female ; Flank Pain ; Frozen Sections ; Humans ; Male ; Nephrectomy ; Psoas Muscles ; Pyelonephritis, Xanthogranulomatous* ; Pyonephrosis ; Urinary Tract Infections

No abstract available.

We used duplex and color Doppler sonography to assess the hemodynamic function of the penis in normal male and in patients with impotence to determine the competence of penile vascular system. The measured parameters are the diameter. peak-systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI) in each cavernosal artery before and after injection of 10ug of PGE, at 5, 10, 15 and 20 minutes. The results obtained are as follows: 1. In 20 normal control group after PGE, injection, the values of maximal and minimal mean PSV were 47.0+/-19.5 cm/sec and 35.7+/-20.9 cm/sec, the values of maximal and minimal mean EDV, 2.7+/-3.7 cm/sec and 0.6+/-1.6 cm/sec and the values of maximal and minimal mean RI, 1. 0+/-0.0 and 0.9+/-0.1, each respectively. 2. In 5 arteriogenic impotence patients after PGE. injection, the values of maximal and minima1 mean PSV were 16.2+/-7,8 cm/sec and 10.5+/-5.1 cm/sec. the values of maximal and minimal mean EDV, 2.4+/-1.7 cm/sec and 1.5+/-1.5 cm/sec and the values of maximal and minimal mean RI, 0.8+/-0.1 and 0.8+/-0.2, each respectively. 3. In 6 venogenic impotence patients after PGE. injection, the values of maximal and minimal mean PSV were 39.0+/-33.6 cm/sec and 33.8+/-26.1 cm/sec, the values of maximal and minimal mean EDV, 7.5+/-4.4 cm/sec and 4.7+/-2.9 cm/sec and the values of maximal and minimal mean RI, 0.8+/-0.1 and 0.8+/-0.1, each respectively. These findings suggest that PSV and EDV are important parameters for the diagnosis of arteriogenic and venogenic impotence, respectively. It is thought that duplex and color Doppler sonography with intracavernous PGE, injection is valuable screening test for vasculogenic impotence.
Arteries ; Diagnosis ; Erectile Dysfunction ; Female ; Hemodynamics ; Humans ; Impotence, Vasculogenic ; Male ; Mass Screening ; Mental Competency ; Penis ; Prostaglandins E

PURPOSE: We describe clinical assessment of visual internal urethrotomy (VIU) as primary treatment modality in 69 men who presented with complete or partial obstructed urethral stricture. MATERIALS AND METHODS: The 63 patients with partial obstructed urethral stricture were treated by typical VIU. The 6 men with complete obstructed urethral stricture were treated by VIU using sound passed through previously placed suprapubic tract as guide. RESULTS: The procedure was completed successfully in 57 of the 63 men with partial obstructed (90.5%) and 3 of 6 patients with complete obstructed urethral stricture (50%). CONCLUSIONS: VIU is a safe and effective as primary treatment plan when urethral stricture is partial obstructed and the impassable urethral segment is shorter than 1.0cm.
Humans ; Male ; Urethral Stricture*

PURPOSE: PVP using a high-power potassium-titanly-phosphate(KTP) laser offers safe and efficacious surgical therapy for men with symptomatic BPH. To demonstrate its efficacy, safety and durability, we present the results of PVP for treatment of BPH with 12 month follow-up. MATERIALS AND METHODS: 104 consecutive men with symptomatic BPH underwent PVP with an 80 W KTP laser (Laserscope) between July 2003 and August 2004. All underwent preoperative and postoperative evaluation, including assessments of international prostate symptom score(IPSS), quality of life(QOL), peak urinary flow rate(Qmax), post-void residual volume(PVR), prostate specific antigen(PSA), and ultrasound prostate volume(PV). Secondary outcome parameters included surgical time, anesthesia, and length of catheterization. Follow-up assessment occurred at 1, 3, 6, and 12 months. Data were analyzed using the Wilcoxon signed rank test. RESULTS: Preoperative mean PV was 57.2+/-4.2 ml. PV decreased to 38.9, 35.4, 32.8 and 35.8 at 1, 3, 6 and 12 months (p <0.01 versus preoperative value). Mean improvements in IPSS, QOL, Qmax, and PVR at 12 months were 67%, 81%, 138% and 94%, respectively(p <0.001). Mean operative time was 26.3+/-15.0 minutes. Anesthesia included pudendal and prostatic block(n=102) and spinal anesthesia(n=2). Ninety-nine(95%) patients were treated as outpatients( <12 hrs) and the remaining 5 patients were admitted for 1 or 2 hospital days. Mean catheterization times were 9.8+/-3.1 hours(range 0~72), with 28(27%) patients not requiring a catheter post-operatively. Minor complications included mild hematuria lasting 3 weeks(3.8%), transient post-operative retention(2.9%), urge incontinence(1.9%), transient dysuria(25%), frequency(21.2%), urgency(17.3%) and retrograde ejaculation(41%). CONCLUSIONS: These results demonstrate that PVP is safe and efficacious for the treatment of symptomatic BPH. Long follow-up will further validate this new modality as the standard for surgical treatment of BPH.
Anesthesia ; Catheterization ; Catheters ; Follow-Up Studies ; Hematuria ; Humans ; Lasers, Solid-State* ; Male ; Operative Time ; Prostate ; Ultrasonography ; Volatilization*

Purpose: The ideal neurourophysiologic investigatory technique would objectively and quantitatively evaluate functional status of all parts of the neurologic network involved in obtaining and maintaining penile erection. We assessed electrical activity of the corpus cavernous smooth muscle in normal and neurogenic erectile dysfunction men using SPACE. Material and Methods: A total of 39 normal subjects and 40 neurogenic erectile dysfunction patients underwent single potential analysis of cavernous electricity(SPACE) with a 2-channel EMG amplifier and surface electrodes. The electrical potentials were processed with the cut off frequencies at 0.3 - 32 Hz, a paper speed of 0.5cm/sec, and a range of amplitude of 0.5mV. Results: In 35 of 39 normal subjects(89.7%) and 5 of 10 incomplete suprasacral spinal cord injury patients, similar single potentials of uniform shape were recorded. In patients with peripheral autonomic denervation, irregular shape potentials with higher frequency and lower amplitude were found. In 3 of 5 patients with long standing diabetes(over 15 years), SPACE shows electrical silence. Conclusion: These results suggest that SPACE test is a useful noninvasive and reproducible method for evaluating cavernous innervation in erectile dysfunction. Furthermore, the single potential means intact cavernous innervation.
Autonomic Denervation ; Electrodes ; Erectile Dysfunction ; Humans ; Male ; Muscle, Smooth* ; Penile Erection ; Spinal Cord Injuries

A male child of 9 months with bilateral Wilms tumor was admitted to our hospital. His chief complaint was abdominal mass. Clinical examination and IVP, USG and CT-scan disclosed bilateral Wilms tumor. Right nephrectomy and left partial nephrectomy were performed. Anuria was experienced to 24 hours and so exploratory-laparotomy was done. Renal autotranplantation was performed because of the thrombosis of renal artery. But six days after operation he died.
Anuria ; Child ; Humans ; Male ; Nephrectomy ; Renal Artery ; Thrombosis ; Wilms Tumor*