No abstract available.
Prostatectomy*

PURPOSE: It is agreed that tumor stage is the definitive prognostic indicator for patients with renal cell carcinoma. We investigated pathologic grade and cell subtype as another prognostic in each tumor stage. MATERIALS AND METHODS: We reviewed the medical records of 206 patients who underwent partial or radical nephrectomy for renal cell carcinoma between January 1991 and June 1998. Renal cell carcinoma grade, stage and cell subtype (conventional [clear cell], papillary, chromophobe, sarcomatoid type) were evaluated using the 1997 Union International Contre Ie cancer (UICC) and the American Joint Committee on Cancer (AJCC) grading, TNM staging criteria and renal cell carcinoma classification. Kaplan -Meier survival curves were used to determine 5-year survival for all patient groups. Univariate analysis using log rank test was performed to evaluate the prognostic significance of TNM stage, Fuhrman nuclear grade, cell subtype and tumor size. We investigated pathologic grade and cell subtype with log rank teat whether those were another significant prognostic factors in each tumor stage. Multivariate analysis was performed to determine which factors had an independent impact on survival of patients with renal cell carcinoma. RESULTS: Univariate analysis revealed that TNM stage (p<0.001), pathologic grad (p<0.001) were the important prognostic indicators for renal cell carcinoma. Survival was affected significantly by tumor size when cutoff diameter for localized T1 lesions was 7cm but not 2.5cm. Pathologic grade had a significant impact on patient survival (p<0.0001). In the cell subtype chromophobe type had the best survival and sarcomatoid type had the worst survival though cell subtype did not appear to affect survival significantly (p=0.0583). Multivariate analysis revealed that N classification (p=0.009) and M classification (p=0.018) were the most important prognostic indicators for cell subtype (p=0.841) were not shown to have any independent impact on patient survival. In the group of localized disease(TXN0M0 stage) at the diagnosis, cell subtype had a significant impact on survival in T1(p<0.001), T2(p=0.01) and T3(p=0.029) and grade in T1(p=0.0016) and T3(p=0.0054). CONCLUSIONS: Pathologic grade and cell subtype were significant predictors of survival in each T stage of localized disease though they didn't have independent impact on the patient survival.
Carcinoma, Renal Cell* ; Classification* ; Diagnosis ; Humans ; Joints ; Medical Records ; Multivariate Analysis ; Neoplasm Staging ; Nephrectomy

No abstract available.
Magnetic Resonance Imaging* ; Prostate* ; Prostatic Neoplasms*

Santonin-kainic acid complex was evaluated as a chemotherapeutic of the mass treatment of the Ascaris lumbricoides infection in Korea. The results could be summarized as follows: The negative conversion rate was 82.9% in average in 4 treated groups. Some variations of negative conversion rate among the treated groups were noticed. The egg reduciton rate was 97.7% in average and the results were rather uniform among the three evaluated groups. By the analysis of egg reduction, it seems that the lightly infected cases whose E.P.G. were under 5,000 were resistant to treatment with the less reduced egg output. After the treatment with this complex, the number of egg discharged cases were reduced to 1.84% and the average number of discharge eggs per incompletely treated or untreated cases were reduced to 12.5% compared with the level of before-treatment egg output. The successive observations of the pattern of worm expulsion after drug intake was made. The worms were mostly expelled in the stool within 3 days, and 58.9% of total expelled worms were collected within 24-hour stool. The minimum length of the immature worms expelled was 7.6cm. Among the 659 Ascaris collected in the first-day stool from 91 rural people, 8.5% were in the range of 7.6-12.2 cm-long, immature worms. The sex ratio, male: female= 0.69: 1.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; chemotherapy ; Santonin ; kainic acid

We report on a patient with spontaneous rupture of hemorrhagic renal cyst into the pyelocaliceal system. He had no history of trauma, bleeding disorders, urinary tract infection or urinary tract obstruction. Gross hematuria followed by left flank pain occurred 1 day prior to admission. Although radiologic findings were suggestive of rupture of renal cyst into the calyx or calyceal diverticulum. exclusion of malignant disease or renal carbuncle was difficult. He was managed by partial nephrectomy. Microscopic findings revealed ruptured cyst lined with low cuboidal epithelium without evidence of malignancy.
Carbuncle ; Diverticulum ; Epithelium ; Flank Pain ; Hematuria ; Hemorrhage* ; Humans ; Nephrectomy ; Rupture ; Rupture, Spontaneous* ; Urinary Tract ; Urinary Tract Infections

Extracorporeal shock wave lithotripsy was performed in 231 patients for 13 months with Dornier MPL 9000 lithotriptor. The 231 patients had renal ( 48.9%) or ureteral (51.1%) stones varying from 0.6 to 4.4cm (mean 1.2cm) in size. Among 231 patients, 184 patients (79.7%) completed the treatment with 1 session and the number of treatment sessions increased in larger stones and in situ impacted ureteral stones, with an average of 1.3 sessions. The success rate (rate free of calculi plus that of clinically insignificant residual fragments) was 98.3 %. No general or regional anesthesia was required but parental analgesics were required in 22.9% of the treatment sessions. There were no significant complications in any patient. Therefore, extracorporeal shock wave lithotripsy with Dornier MPL 9000 lithotriptor is considered to be a safe and efficient procedure for initial treatment of urinary stones.
Analgesics ; Anesthesia, Conduction ; Calculi ; Humans ; Lithotripsy ; Parents ; Shock ; Ureter ; Urinary Calculi*

Ninety six patients with transitional cell carcinoma of the bladder treated by total cystectomy at Seoul National University Hospital during a 10 year period between 1978 and 1987 were analyzed retrospectively. Four patients were classified in stage pTA, 13 in stage pT1, 4 in stage pTIS, 26 in stage pT2, 19 in stage pT3A, 23 in stage pT3B, and 7 in stage pT4. Eight patients with stage pT3B tumors and 5 patients with stage pT4 tumors had positive pelvic nodes. actuarial 5 year survival rates were 93% for the patients with stage pTA, pT1, and pTIS tumors, 63% for the patients with stage pT2 tumors, 51% for the patients with stage pT3A tumors, 19% for the patients with stage pT3B tumors, and 0% for the patients with stage pT4 tumors. There was no significant difference of survival rate between stage pT2 and pT3A. In 74 patients with stage pT2 or higher tumors, the influence of the tumor grade, shape, size, and number on survival was examined. None of them appeared to be significant. Metastases were found in 45 patients following total cystectomy. Of these, 37 patients (82%) developed metastases within two years of total cystectomy. Thirty patients( 67%) had only distant metastases. 10 patients(22%) had only local recurrence and the remainder had both. The average survival length of the patients with metastases was 9 months. A total cystectomy provided benefit only in the patients with invasive but pathologically bladder confined tumor(pT2, pT3A).
Carcinoma, Transitional Cell* ; Cystectomy* ; Humans ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate* ; Urinary Bladder*

Five hundred forty three patients with transitional cell carcinoma managed at Seoul National University Hospital during a 20 year period between 1965 and 1984 art analyzed retrospectively. We selected 108 patients with stage A tumor for analysis of recurrence by excluding 95 patient with a prior history of bladder cancer, 14 patients whose initial treatment were a total cystectomy, 12 patients whose disease progressed in stage within 3 years following treatment, 58 patients followed up less than 3 years and 65 patients lost to follow up from 352 patients with stage A tumor. The over-all recurrent rate within the first 3 years following resection of stage A tumor was 70%. The influence of the tumor size, number and grade on recurrence was examined. Disease-free status by 36 months according to the tumor size 1cm or smaller, 1-2cm, 3-4cm, 5cm or larger was 57%, 31%, 17% and 7% respectively. All differences were statistically significant. There was no significant difference of recurrence rate between 1 tumor and 2 tumors, but 3 or more tumors showed significantly higher recurrence rate than 2 or less tumors. There was no significant difference of recurrent rate among grade I, Fade II , grade III tumors combined. Total cystectomies without pelvic lymphadenectomy or preoperative irradiation were performed in 110 patients and 77 patients were adequately followed up. Five-year survival rate of stage A, B, C, D was 87%, 26%, 11%, and 0% respectively. Operative mortality among patients undergoing total cystectomy was 4.5%. Metastases were found in the lymph node, adjacent organs and bone in the order of frequency. Only one patient with stage D tumor on initial presentation survived more than 5 years and the average survival length of stage D was 8 months.
Carcinoma, Transitional Cell ; Cystectomy ; Humans ; Lost to Follow-Up ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.
Carcinoma, Hepatocellular ; Diagnosis* ; Hemangioma ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.
Carcinoma, Hepatocellular ; Diagnosis* ; Hemangioma ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies