A clinical observation was done 42 cases of bladder tumor admitted to the Department of Urology, Hanil Hospital during the period of 10 years from Jan 1. 1968 to December 31. 1977 and the following results were obtained. 1. The incidence of tumor of the bladder is 4.6 % to total number of in-patients. 2. The highest incidence of age distribution was between 40 and 69 year with 85.7 % 3. The sex ratio of male and female was 3.2: 1. 4. The most common symptom was hematuria which occurred in those case in 85.7 %. 5. 80.9 % of patients visited to our clinic within one year after initial symptom occurred 6. The I. V. P. findings showed 63.3 % of normal, 11.9 % of hydronephrosis and 4.8 % of unilateral nonvisualization 7. The tumors were located in lateral and posterior wall of the bladder ( 64.3 %) chiefly, and ""solitary"" cases were more than "" multiple "" cases. 8 The most common complication was cystitis in 33.3 %. 9. Among 42 cases, Pathologic diagnosis was as follows : Transitional cell carcinoma 38 cases, benign popilloma 1 case and undifferentiated 2. 10. The method of treatment, partial cystectomy was performed 14 cases, T. U. R. 12 chemotherapy 5, exploration 2 and no treatment 9.
Age Distribution ; Carcinoma, Transitional Cell ; Cystectomy ; Cystitis ; Diagnosis ; Drug Therapy ; Female ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Male ; Sex Ratio ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

A clinical observation was made on 78 cases of renal tuberculosis, admitted to the Department of Urology, Hanil Hospital during the period of 10 years from Jan 1, 1968 to December 31 1977. The results were summarized as follows. 1. During this period, the total number of in-patients were 907 among which 78 cases had renal tuberculosis, giving a rate of 8.6 % to total in-patients. 2. The most common age groups showed that 83.3 % of the cases in 11 to 40 years of age, and male to female ratio was 1.2: 1. 3. The site of the lesion showed right to left ratio of 48.7 % to 42.3 % and bilateral in 9.0 %. 4. Common symptoms were gross hematuria in 48.7 %, frequent urination in 46.2 %, painful urination in 35.9 %, flank pain in 34.6 % and scrotal swelling in 9.0 %. 5. 56.4 % of the cases admitted to in one month to one year period after onset of the symptoms. 6. The most common complication was pul tbc in 36 %. 7. Laboratory findings were as follows : acid urine in 83.3 %, proteinuria in 91.0 %, microscopic hematuria in 73.1 %, pyuria in 74.4 % and increased ESR in 67.9 %. 8. Urine AFB Positive findings were 25.7% in smear and 35% in culture. 9. Of blood nitrogen level of 30 patients, over 60% of cases showed normal level, and the highest level was shown by a bilateral renal tuberculosis case. 10. The excretory urographic changes in 50 cases of renal tuberculosis were nonvisualization in 44%, delayed visualization in 32%, caliectasis in 26%, narrowing or dilatation of ureter in 18% and contracted bladder in 4%. 11. Cystoscopic findings were active lesion of cystitis in 48.7% and fibrosis with trabeculation of bladder wall in 20.5%. 12. Method of treatment include chemotherapy only in 55.1%, nephrectomy in 38.5%, nephrostomy in 1.3%, cutaneous uretrostomy in 1.3% and untreated in 3.8%.
Cystitis ; Dilatation ; Drug Therapy ; Female ; Fibrosis ; Flank Pain ; Hematuria ; Humans ; Male ; Nephrectomy ; Nitrogen ; Proteinuria ; Pyuria ; Tuberculosis, Renal* ; Ureter ; Urinary Bladder ; Urination ; Urology

This study was conducted to investigate the effect of ascorbic acid on oxidative injury of cultured porcine retinal pigment epithelial (RPE) cells induced by t-butylhydroperoxide. The porcine RPE cells were cultured in Dulbecco's modified Eagle's medium and the culture medium was replaced with one containing 0.01 mM to 5 mM ascorbic acid and/or 0.2 mM t-butylhydroperoxide. After 2 hours incubation, the test medium was replaced with the control medium. The number of cells was counted with a Coulter counter after a 2-day incubation period. The medium was pretreated with 900 U/ml and the previous procedure was repeated to eliminate the toxic effects of hydrogen peroxide induced by ascorbic acid. Not only t-butylhydroperoxide (p < 0.01) but also ascorbic acid (p < 0.01) were found to have dose-dependent cytotoxicity on RPE cells. The cytotoxicity was more significant when both agents were added to the culture media. In the presence of catalase, the cytotoxicity of ascorbic acid became insignificant (p > 0.05). The cytotoxicity of t-butylhydroperoxide decreased when 1 mM and 5 mM of ascorbic acid was added to the culture media with catalase pretreatment (p = 0.0277). These results indicate that ascorbic acid was toxic to RPE cells in our culture model but this cytotoxicity was not detected in the presence of catalase. With catalase pretreatment, ascorbic acid in relatively high concentration provided protection against oxidative injury of t-butylhydroperoxide.
Animals ; Ascorbic Acid/*pharmacology ; Cell Count ; Cell Survival/drug effects ; Cells, Cultured ; Culture Media ; Dose-Response Relationship, Drug ; Free Radicals ; Oxidative Stress/*drug effects ; Peroxides/antagonists & inhibitors/toxicity ; Pigment Epithelium of Eye/cytology/*drug effects ; Reactive Oxygen Species/toxicity ; Swine ; tert-Butylhydroperoxide

Burns ; Humans ; Lactic Acid ; Plasma ; Prognosis ; Retrospective Studies

To compare the effects of atracurium, 0.75 mg/kg, on the mean arterial pressures, heart rates and plasma histamine levels under 2%-enflurane inhalation with mask, 24 patients were allocated randomly into two groups; one(Group I, n=12) which atracurium was administered with rapid bolus injection for 5 seconds and the other(Group II, n=12) with the slow injection for 75 seconds. In both groups, there are the most significant decreases and the recovery in mean arterial pressure 1~2 min and 5 min after atracurium, respectively, Group I showed a significant decrease of mean arterial pressure about 10% more than Group II. In heart rate, there are the significant decreases gradually to 87~88% of control 5 min after atracurium in both graups except the only significant increase(104%) 1 min after atracurium in Group I. And Group I showed a significant increase(200%) in plasma histamine concentration (p< 0.05) 2 min after injection than before, but Group II did no significant change. In conclusion, the slow injection of atracurium over 75s during induction of anesthesia can attenuate the histamine-induced cardiovascular response.
Anesthesia* ; Arterial Pressure ; Atracurium* ; Heart Rate ; Histamine Release* ; Histamine* ; Humans ; Inhalation ; Masks ; Plasma

This study was performed for the patients with benign prostatic hyperplasia who had underlying diseases which increase the risk of spinal or general anesthesia. Standard transurethral resections of prostate were done on patients with prostatic hyperplasia under local anesthesia. The selection criteria were urinary retention or below 10 ml/sec of maximum flow rate, coexist with medical problems which increase the risk of spinal and general anesthesia. Local infiltrations of 1% lidocaine were done at penoscrotal junction on each side of the corpus spongiosum, the lateral portion of the prostate and the bladder neck. This anesthesia was supplemented usually by modest dose of intravenous tranquilizers and analgesics under the continuous monitoring by an anesthesiologist. The Visual Pain Analogue Scale(VAS) was used for the evaluation of intraoperative and postoperative pain. The mean operating time, amount of the resected tissues and intraoperative and postoperative visual analogue scale were 50.2 min, 16 grams. 2.7 and 2.0. We thought that this type of anesthesia was a safe, simple and effective procedure.
Analgesics ; Anesthesia ; Anesthesia, General ; Anesthesia, Local* ; Humans ; Lidocaine ; Neck ; Pain, Postoperative ; Patient Selection ; Prostate ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate* ; Urinary Bladder ; Urinary Retention

PURPOSE: The presence of urge incontinence may affect the results of stress urinary incontinence (SUI) treatment. In this study, women with SUI were divided according to their accompaniment with urge incontinence or not. The aim was to define a group in whom a urodynamic assessment was unnecessary prior to offering surgery. In other words, we wished to define a group where the treatment plan could be determined only with the clinical opinions based on the symptoms and physical examinations. MATERIALS AND METHODS: Two hundred and fifty five women with SUI between January 1997 and February 2001 were enrolled in this study. The women with SUI symptoms were divided into a group of patients who had symptoms of pure SUI, and those who had SUI as well as urge incontinence. The clinical and urodynamic variables were analyzed to identify the sub-groups of women where a urodynamic study was unnecessary before initiating treatment for SUI. RESULTS: Of the 101 women with symptoms of pure SUI, only 5 had a detrusor instability (DI). Of the 154 women with coexisting urge incontinence symptoms, only 33.8% (52/154) had DI, suggesting the poor predictability of urge incontinence symptoms for a diagnosis of DI based on the urodynamic study. An identification of SUI by the urodynamics were noted in 77.6% (198/255), which almost corresponding to the rate (76.9%) of positive urine leakage confirmed at the provocative stress test. CONCLUSIONS: If a patient has symptoms of pure SUI associated with a positive stress test, the SUI can be treated without a urodynamic study. For women with symptoms of mixed urinary incontinence, it may be better to undergo a urodynamic study before launching a definitive treatment.
Diagnosis ; Exercise Test ; Female ; Humans ; Physical Examination ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urodynamics*

PURPOSE: The presence of urge incontinence may affect the results of stress urinary incontinence (SUI) treatment. In this study, women with SUI were divided according to their accompaniment with urge incontinence or not. The aim was to define a group in whom a urodynamic assessment was unnecessary prior to offering surgery. In other words, we wished to define a group where the treatment plan could be determined only with the clinical opinions based on the symptoms and physical examinations. MATERIALS AND METHODS: Two hundred and fifty five women with SUI between January 1997 and February 2001 were enrolled in this study. The women with SUI symptoms were divided into a group of patients who had symptoms of pure SUI, and those who had SUI as well as urge incontinence. The clinical and urodynamic variables were analyzed to identify the sub-groups of women where a urodynamic study was unnecessary before initiating treatment for SUI. RESULTS: Of the 101 women with symptoms of pure SUI, only 5 had a detrusor instability (DI). Of the 154 women with coexisting urge incontinence symptoms, only 33.8% (52/154) had DI, suggesting the poor predictability of urge incontinence symptoms for a diagnosis of DI based on the urodynamic study. An identification of SUI by the urodynamics were noted in 77.6% (198/255), which almost corresponding to the rate (76.9%) of positive urine leakage confirmed at the provocative stress test. CONCLUSIONS: If a patient has symptoms of pure SUI associated with a positive stress test, the SUI can be treated without a urodynamic study. For women with symptoms of mixed urinary incontinence, it may be better to undergo a urodynamic study before launching a definitive treatment.
Diagnosis ; Exercise Test ; Female ; Humans ; Physical Examination ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urodynamics*

Fluid resuscitation is a basic treatment in hemorrhagic shock. We compared the circulatory responses to fluid resuscitation of 10% pentastarch with those of fresh whole blood and plasmanate in hemorrhagic shock. Eighteen mongrel dogs were bled 24 ml/kg and replaced by equivalent amounts of fresh whole blood(n=6, group B), pentastarch(n=6, group P) and plasmanate(n=6, group PL). Hemodynamic measurements and calculations were performed before and after bleeding and after volume therapy. The decrease of hematocrit and platelet count after volume replacement indicate that hemodilutional effect was maximum 30 min after volume therapy and significantly greater in group P than PL(p<0.05). Central venous pressure(CVP), pulmonary capillary wedge pressure(PCWP) and cardiac index(CI) were increased to 146-189%, 146-172% and 146-175% in group P, respectively during 60 min. These changes were significantly greater than group B and PL(p<0.05). There was delayed recovery of mean arterial pressure in group PL(92% 30 min after volume therapy) compared with group B and P(92% and 93% 5 min). Also group P and PL showed significant prolongation in prothrombin time and partial thromboplastin time during experiment(120 min) and these were significantly more prolonged in group P than PL(P<0.05). And group P showed similar O transport and O extraction ratio to those of group B. The increases in plasma catecholamine were observed after hemorrhage, but no significant changes 5 and 30 min after volume therapy. This suggests that the neurohumoral response to hemodilution was not marked. Mixed venous O2 saturation(SvO2) was directly proportional to CI during experiment(r=0.69, p<0.01), indicating that SvO2 can represent CI during shock and volume therapy. In conclusion, l0% pentastarch is useful as a substitute for fresh whole blood or plasmanate.
Animals ; Arterial Pressure ; Blood Transfusion, Autologous* ; Capillaries ; Dogs* ; Hematocrit ; Hemodilution ; Hemodynamics ; Hemorrhage ; Hydroxyethyl Starch Derivatives ; Partial Thromboplastin Time ; Plasma ; Platelet Count ; Prothrombin Time ; Resuscitation* ; Shock ; Shock, Hemorrhagic*

PURPOSE: During the night time decision making on patients suspicious of appendicitis is often difficult because diagnosis and timing for operation are frequently delayed. Therefore, we analyzed above cases and solution is suggested. METHODS: This retrospective study included 360 patients who underwent laparotomies for suspected appendicitis at Hanil Hospital during one year, from March 1998 to Feb. 1999. They were divided into two groups according to presenting time to physician (Day time: 6 a.m. to 6 p.m., Night time: 6 p.m. to 6 a.m.). Sex & age distribution, time of presentation to physician, duration of symptoms, symptoms & physical findings, white blood cell counts, interval from presentation to operation, hospital stay, and pathologic diagnosis were compared. RESULTS: There were no significant differences in sex & age distribution, duration of symptoms, symptoms & physical findings, white blood cell counts, pathologic diagnosis between the two groups. However, during the night time, the interval from presentation to operation was longer than that of the day time (9.15 hours versus 4.83 hours, p<0.001), the rate of delayed appendectomy during the night was 58.0%, the rate of negative laparotomy increased when appendectomy was delayed for more than 12 hours compared with less than 12 hours (28.1% vs 11.7%, p<0.01), and in the cases with perforated appendicitis, delayed appendectomy for more than 12 hours had longer hospital stay compared with less than 12 hours (12 days vs 9.44 days, p<0.01). Factors causing delayed appendectomy were related to the physician (42.5%), lack of anesthetic & nursing supports (19.5%), failure to structure the operation team (20.7%), and patient itself (17.3%). When white blood cell counts were rechecked in the next morning, levels above 10,000 cells/mm3 were highly associated with appendicitis in contrast to that below 10,000 cells/mm3 (91.7% vs 43.5%, p<0.002).
Age Distribution ; Appendectomy ; Appendicitis* ; Decision Making ; Diagnosis ; Humans ; Laparotomy ; Length of Stay ; Leukocyte Count ; Nursing ; Retrospective Studies