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*

We performed original and modified technique of Mays' glanuloplasty in 6 and 12 cases respectively. The results were as follows: 1. 6 cases of mild from of hypospadias (2 cases of coronal, 4 cases of dist. penile) and 12 cases of severe form of hypospadias (5 cases of prox. penile, 6 cases of penoscrotal, 1 case of perineal) on pre-chordectomy but all cases became severe from of hypospadias (2 cases of prox. penile, 15 cases of penoscrotal, 1 case of perineal) on post-chordectomy. 2. The postoperative complications were 3 cases (50.0%) (1 case of meatal stenosis, 2 cases of meatal necrosis) in original technique of Mays' glanuloplasty and 2 cases of meatal stenosis (16.7%) in modified technique of Mays' glanuloplasty.
Constriction, Pathologic ; Female ; Hypospadias* ; Male ; Postoperative Complications

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: 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

It is well known that nitric oxide (NO) mediates smooth muscle relaxation via an increase in cyclic GMP (cGMP) 1evels. Acetylcholine (ACh) and nitroprusside (SNP) are known to mediate relaxation of cavernous smooth muscle via increasing the levels of NO. In recent years, the role of K+ channels in the hyperpolarization induced by nitrates and ACh in smooth muscle have been investigated. In this study, we attempted to characterize the role of K+ channel in rabbit cavernous smooth muscle relaxation by ACh and SNP under organ bath. Changes in isometric tension of corporal strips were monitored. The results were as follows; 1. The relaxant effects of ACh and SNP on contracted smooth muscle induced by 80 mM K' were less than those by phenylephrine. The ACh-induced relaxation was almost abolished in rabbit cavernous smooth muscle which endothelium was denuded, but the that of SNP was not affected by removal of endothelium. 2. Ng-nitro-L-arginine(L-NOARG) (3x0.00001M) and methylene blue (3x0.00001M) significantly inhibited the relaxant effect of ACh in cavernous smooth muscle, but that of SNP was not influenced by these drugs. The inhibition of L-NOARG on the relaxant effect of Ach was reversed by the addition of L-arginine(3x0.0001M). 3. Charybdotoxin (ChTx, 0.0000001M), significantly inhibited the relaxant effects of ACh,SNP and 8-Br-cGMP, but glibenclamide (0.00001M) and apamin (0.00001M) did not influence those of ACh and SNP 4. ACh (0.0001M} and SNP (0.0001M) increased the tissue content of cGMP The effect of ACh on the tissue content of cGMP was significantly affected by L-NOARG (3x0.00001M) and methylene blue (3x0.0000lM), but that of SNP was not influenced by these drugs. ChTx (0.000000lM) did not attenuate the accumulation of cGMP induced by ACh and SNP. Above results suggest that the relaxing effect of Ach and SNP on the isolated rabbit cavernous smooth muscle is associated with an increase in the tissue content of cGMP. Furthermore, ChTx sensitive-K+ channel-mediated hyperpolarization by increased cGMP may play a part in the relaxation of rabbit cavernous smooth muscle by ACh and SNP
Acetylcholine* ; Apamin ; Baths ; Charybdotoxin ; Cyclic GMP ; Endothelium ; Glyburide ; Methylene Blue ; Muscle, Smooth* ; Nitrates ; Nitric Oxide ; Nitroprusside* ; Phenylephrine ; Relaxation*

Xanthogranulomatous pyelonephritis (XGP) in childhood is not common and the characteristics of the disease are different from those in adults. A 14-year-old boy was admitted to Pusan National University Hospital complaining of fever and right flank pain. An excretory ungraphy shows compressed pelvocalyceal system by extraluminal space occupying lesion in right kidney CT and ultrasonogram of the kidney shows relatively well marinated localized bulging mass on right posterior aspect and invading to the right posterior Gerota's fascia, psoas muscle and quadratus lumborum muscle. Right nephrectomy was performed under the suspicion of Wilms` tumor. Pathologic findings revealed XGP postoperatively. We report a case of focal XGP in a child with review of the literature.
Adolescent ; Adult ; Busan ; Child ; Fascia ; Fever ; Flank Pain ; Humans ; Kidney ; Male ; Nephrectomy ; Psoas Muscles ; Pyelonephritis, Xanthogranulomatous* ; Ultrasonography

A concealed penis is a normally developed penis that becomes camouflaged by the suprapubic fat pad. This anomally can be congenital or iatrogenic following circumcision. A special variety of this disease is a retractile concealed penis with dysgenetic band of dartos fascia which produce recurrence not infrequently after operative correction by conventional method. We herein report 2 cases of concealed penis of which one case was a recurrent one and another was a case of severe degree with concomittent obesity where a new method for operative correction was applied.
Adipose Tissue ; Circumcision, Male ; Fascia ; Female ; Male ; Obesity ; Penis* ; Recurrence

A total of 92 men with impotence underwent a trial of intracavernous injection of papaverine 30mg. Underlying causes of impotence were psychogenic (26 Pts.), posterior urethral injury (28 Pts.), spinal cord injury (15 Pts.), pelvic surgery (14 Pts.) and eldly (9 Pts.). The results were as follows 1. The underlying causes of impotence in papaverine responders were psychogenic 23 (88.5%), posterior urethral injury 19 (67.9%), spinal cord injury 13(86.7%), Pelvic surgery 5 (35.7%) and eldly 3 (33.3%). 2. Fourteen patients of the moderate papaverine responders underwent intracavernous injection of papaverine 30mg with phentolamine 1mg and 8 of them attained full erection. 3. After injection, the erection started in an average of 2.6 minutes, rigidity of penis attained in an average of 7.3 minutes, and erection status sustained for an average of 42.6 minutes in 60 patients. 4. Normal nocturnal penile tumescence monitoring (NPTM) or stamp test was found in 19 of 40 patient and 18 of them (94.7%) were papaverine responders, while 21 had an abnormal NPTM or stamp test and 11 of them were papaverine non-respoders. 5. A penile brachial index (PBI) of 0.6 or more was found in 62 of 73 patients and 53 of them(85.5 %) were papaverine responders, while 11 had an index of less then 0.6 and all of them were papaverine non-responders. 6. Thitry patients had sexual intercourse. Twenty-seven of them had a satisfactory result and 23 of them had ejaculation. 7. Papaverine induced prolonged erection occurred as major complicatiun in 4 patients after trial injection. Erection was subsided after intracavernous phenylepinephrine injection. There were minor complications such as ecchymosis at the injected site on the prepuce but subsided spontaneously in a few days. We conclude that intracavernous papaverine injectiun currently is a good screening technique for the differential diagnosis of severe vasculosenic impotence and is a useful chemical prosthesis of non-vasculogenic impotence.
Coitus ; Diagnosis, Differential ; Ecchymosis ; Ejaculation ; Erectile Dysfunction ; Humans ; Male ; Mass Screening ; Papaverine* ; Penile Erection ; Penis ; Phentolamine ; Prostheses and Implants ; Spinal Cord Injuries

The factors influencing upon stone fragmentation by extracorporeal shock wave lithotripsy (ESWL) of ureteral stones are considered to be stone size, location, component, and impaction. ESWL was performed in 322 cases with ureteral stones using the Modulith SL 20 electromagnetic lithqtripter between December 1990 and July 1992. The factors influencing upon stone fragmentation such as stone size, location, degree of hydronephrosis, shape, pain character and presence or absence of urinary tract infaction for the first and second session of ESWL were investigated. The failure rate of ESWL according to stone size was similar for stones smaller than 2.0cm(p>0.05) but was high for stones larger than 2.0cm(p<0.05). The failure rate of ESWL for upper ureteral stones was similar to midureteral stones(p>0.05) but was low for lower ureteral stones(p>0.05). The failure rate of SSWL according to degree of hydronephrosis was similar in cases without hydronephrosis and with mild hydronephrosis(p>0.05) but was high in cases with severe hydronephrosis(p<0.05). The failure rate of ESWL according to stone shape was not significantly different(p>0.05). The failure rate of ESWL in cases without pain was not significantly different from in cases with dull or colic pain(p>0.05). Urinary tract infection did not influence on the failure rate of ESWL(p>0.05). From this study it is believed that factors affecting fragmentation of ureteral stones were stone size, location, and degree of hydronephrosis, but stone shape, presence or absence of pre-ESWL pain or urinary tract infection did not influence on stone fragmentation rate.
Colic ; Hydronephrosis ; Lithotripsy* ; Magnets ; Shock* ; Ureter* ; Urinary Tract ; Urinary Tract Infections

Two hundred cases of surgically repaired hypospadias at Pusan University Hospital in the past sixteen half years were surveyed and analyzed. Of 200 patients, 99(49.5%) were corrected in their preschool age. The number of patients with the distal type and proximal type of hypospadias performed in 134(67%) of 200 and the success rate was 84.3 per cent(113 of 134). One stage repair was performed in 66(33.0%) of 200 and the success rate are as follows : King, 100%(7 of 7), MAGPI, 100.0% (4 of 4), Mathieu, 100.0%(5 of 5), Hodgson ( I , III), 75%(12 of 16), and preputial island flap including Duckett, Hodgson XX and double faced technique, 67.6% (23 of 34). The most common postoperative complication was fistula.
Busan ; Female ; Fistula ; Humans ; Hypospadias* ; Male ; Postoperative Complications