No abstract available.
Social Workers

No abstract available.
Female* ; Humans

Because there is difficulty in the suture of renal pelvis, extended pyelolithotomy for the renal or pelvic calculi gives often complication such as urine leakage or infection, which result in the fibrosis and stricture of the region. Seven cases of renal stones are treated with new method using 8F Trumpet-shaped Nelaton Catheter. The proximal portion of the Nelaton Catheter inserted into the renal pelvis through the incised opening is made to arrive the lumen of the urinary bladder and the Trumpet-shaped distal portion is made to fix with the suture of the renal pelvis and capsules. After five to seven days, the catheter is removed by cystoscopic manipulation. It seems that the method is easy and feasible to decrease the complication of the extended pyelolithotomy for renal calculi.
Calculi ; Capsules ; Catheters* ; Constriction, Pathologic ; Fibrosis ; Kidney Calculi ; Kidney Pelvis ; Stents* ; Sutures ; Ureter* ; Urinary Bladder

To determine the frequencies of the genotypes of NAT2 gene in healthy Korean populations and to identify the high-risk genotypes of NAT2 gene in colorectal cancer patients, 115 healthy controls and 109 cancer patients were analyzed using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). The distribution of NAT2 polymorphism in healthy Korean was found to be 7.8% of S/S genotype, 48.7% of S/F genotype, and 43.5% of F/F genotype. And the frequency of phenotypes was 8% of slow acetylator and 92% of rapid acetylator. S/S genotype of colorectal cancer patients was slightly more frequent than that of healthy controls(11.9% vs 7.8%). The relative risk of S/S genotype to colorectal cancer was estimated to be 1.41, taking the risk of F/F genotype as a baseline(1.00). These results suggest that the distribution of frequencies of NAT2 genotypes is very unique in Korean characterized by extremely low frequency of slow acetylator geno type(S/S) in comparison to the other ethnic groups. And the slow acetylator genotype(S/S) in Korean was found to be more susceptible to colon cancer. Therefore, S/S genotype may have a certain role an colonic carcinogenesis in Korean.
Carcinogenesis ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Ethnic Groups ; Genetic Predisposition to Disease* ; Genotype ; Humans ; Korea* ; Phenotype

Benign prostatic hyperplasia is one of the most common afflictions in an aged man, but the surgery has been the only therapeutic option in the treatment of benign prostatic hyperplasia. Recently, other alternative therapeutic modalities such as pharmacological, hormonal, less invasive treatment(laser, stents, thermotherapy, etc.) were developed. The prostatic laserthermia is one of the new therapeutic tool being evaluated for the treatment of BPH. The aim of this study is that the prostatic laserthermia will be an alternative therapeutic modality for BPH as transurethral resection of prostate(TURP). A total of 92 patients(ages 49 to 90 years) who were diagnosed as BPH were included in the study, underwent uroflowmetry, transrectal ultrasound and AUA symptom scoring. 34 of 92 patients were treated with TURP. And 58 of the 92 patients were treated with prostatic laserthermia. After the treatments, each patients were followed by uroflowmetry and AUA symptom score at post operative 1, 3 and 6 months. In TURP group, the preoperative peak flow rate was changed from 8.33+/-4.5ml/sec, to 14.65+/-4.74 ml/sec, 14.67+/-4.08 ml/sec and 14.60+/-4.63 ml/sec, at postoperative lst, 3rd and 6th month respectively. The amount of average residual urine was decreased from 158.l+/-121.6 ml, to 41.9+/-22.3 ml, 43.3+/-27.1 ml and 58.2+/-27.5 ml, at 1st, 3rd and 6 month respectively. Also the AUA symptom score was decreased from 22.5+/-7.0, to 9+/-4.7, 9.3+/-4.3 and 9.5+/-5.2, at postoperative 1st, 3rd and 6th month. In prostatic laserthermia group, the preoperative average peak flow was 9.33+/-6.30 ml/sec, changed to 11.46+/-5.20 ml/sec, 11.67+/-5.40 ml/sec and 11.72+/-5.27 ml/sec at postoperative lst. 3rd and 6th month. The preoperative average mean flow was 4.75+/-2.87 ml/sec, increased to 5.47+/-2.69 ml/sec, 5.l8+/-2.69 ml/sec and 5.28+/-3.06 ml/ sec at 1st, 3rd and 6th month. The preoperative average residual urine was 130.9+/-154.7 ml/sec, decreased to 59.9+/-66.6 ml/sec, 50.6+/-57.0 ml/sec and 31.3+/-45.7 ml/sec at postoperative lst, 3rd and 6th month. The preoperative average AUA symptom score was 27.0+/-5.9, decreased 19.1+/-8.1, 18.4+/-8.7 and 17.5+/-9.1 at 1st, 3rd and 6th month. When comparing the parameters between two treatment groups, improvement of peak flow rate was greater in TURP than in Prostatic laserthermia group(p<0.01). Decrease of AUA symptom score and amount of residual urine also were greater in TURP than in prostatic laserthermia group. As the result TURP is more effective than prostatic laserthermia in peak flow rate at 1st month and AUA symptom score at lst, 3rd and 6th month t < 0.05). But laserthermia also appears to be as effective as TURP in the decrease of postvoid residuals. It could be suggested that prostatic laserthermia is an alternative therapeutic modality of BPH, especially old man who has some risk factors for operation. Key Word : transurethral resection, laserthermia.
Humans ; Hyperthermia, Induced ; Prostatic Hyperplasia* ; Risk Factors ; Stents ; Transurethral Resection of Prostate* ; Ultrasonography

Pharmacologic treatment of the detrusor hypocontractility(hyporeflexia) remains controversial issues. Clean intermittent self catheterization(CIC) alone, or combination with bethanechol chloride has been generally accepted as treatment modality. Until presently, bethanechol chloride is the only pharmacologic agent commonly used for bladder emptying without significant complication. However, the effectiveness of bethanechol seem to be episodic. The present study compared the contractile response of various pharmacologic agents including bethanechol chloride, ATP, PG E1, E2, F2-alpha on the smooth muscle strips of male rabbit bladder. In addition, effect of the gastrointestinal motility agents such as cisapride and metoclopramide on the contraction of rabbit bladder were assessed. Each bladder was divided into bladder body and bladder base for comparison of pharmacologic effects. FS at basal tension elicited a frequency dependent contraction which was greater in bladder body strips than in bladder base strips. The contractile responses to bethanechol, ATP, PG E1, E2 and PG F2-alpha were greater in bladder body than in bladder base.In the bladder body,magnitude of the contractile responses by ATP and PG F2-alpha were approximately 1/3 of those by bethanechol or FS.PG F2-alpha was consistently more potent to produce contraction than PG E1, E2. ATP induced contraction only consisted of initial phasic rise of tension. The contraction induced by PG developed slower than those caused by bethanechol. Cisapride(10uM) induced weak contractile responses comparable to those by PG E1 Metoclopramide had no contractile effects in this studies. Conclusively, differences exist in the response of the bladder body and base to FS and various pharmacologic agents. ATP, PG E2 and PG F2-alpha exhibited some notable contractile responses to the bladder body that were approximately 1/3 of those by bethanechol. Gastrointestinal motility agents were not shown to be effective in the mediation of contraction of rabbit bladder.
Adenosine Triphosphate ; Bethanechol ; Cisapride ; Gastrointestinal Motility ; Humans ; Male ; Metoclopramide ; Muscle, Smooth* ; Negotiating ; Urinary Bladder*

Random biopsy of normal-looking mucosa of the bladder at the time of T.U.R.B. in the patients with bladder cancer have been used as a routine assessment of the tumor behavior. To investigate mucosal abnormalities of normal-looking mucosa in bladder cancer. we performed random mucosal biopsies during transurethral resection of the bladder cancer. The following results were obtained. 1. In Group 1 (Solitary, Stalk, Papillary ca). no CIS lesion was found in biopsy specimens. 2. In Group 2 (Solitary. Sessile. Papillary ca) and Group 3 (Solitary. Sessile. Non-papillary ca). some positive results were obtained. On the consideration of above results and the potentiality of implantation. we can raise an issue that the bladder cancer patients with a solitary, papillary shape do not necessarily undergo the mucosal biopsy during T.U.R.B. Instead, close follow up for the patients will be recommended.
Biopsy* ; Humans ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Incomplete bladder emptying even after prostatectomy were not uncommonly anticipated in patients with benign prostate hypertrophy (BPH) who had episodes of acute urinary retention. This may be related h impaired contractility of detrusor muscle secondary to decreased blood flow to the bladder and over-stretching of detrusor muscle caused by overdistension of bladder. We measured detrusor contractility in 41 patients with BPH who had episodes of urine retention (Group A) and 77 patients with BPH without urine retention. Also, follow up uroflowmetry were taken for 25 patients of group A and 40 patients of group B in 30-50 days after prostatectomy. Results were as follows; I. On filling cystometry. first sense of fill, urge sense to void, maximum cystometric capacity and compliance were not significantly different between 2 groups and detrusor instability were 23 cases (56%) in group A, 38 cases (49%) in group B. 2. On pressure-flow study, maximum detrusor voiding pressure was 32.5+/-4.13 cmH2O in group A and 50.27+/-2.4 cmH2O in group B (P<0.01). Peak flow rate (Qmax) and voided volume were 4.1 to 0.7 ml/sec, 76.1+/-12.7 ml in group A and 8.6+/-0.65 ml/sec, 176.1+/-16.7 ml in group B respectively (P<0.01, P<0.01). Residual urine was 256.5 1:24.3 ml in group A and 111.6 t 14.7 ml in group B (P<0.01). 3. On postoperative follow up uroflowmetry, voided volume and Qmax were increased compared to preoperative value in group A but still lower than those in group B (P<0.05, P<0.05). 4. The number of patients who didn't show any improvement of voiding symptoms after surgery were 17 on group A and 11 on group B. Impaired detrusor contractility was present in 25 of 41 cases (61%) of group A and 10 of 71 cases (13%) of group B on urodynamic diagnosis. Conclusively, in patients with BPH who had episodes of urine retention, preoperative pressure-flow study to recognize impaired detrusor contractility would be helpful in anticipating incomplete bladder emptying after prostate surgery and considering other forms of ancillary therapy.
Compliance ; Diagnosis ; Follow-Up Studies ; Humans ; Hypertrophy ; Prostate ; Prostatectomy ; Prostatic Hyperplasia* ; Urinary Bladder ; Urinary Retention ; Urodynamics

Recently, some forms of non-surgical treatment modalities for BPH such as microwave or laser induced hyperthermia have been available and its demand by patient is increasing. The advantage of these treatment is its out-patient basis of treatment(no admission & no anesthesia). However, it leaves no surgical specimens for the pathological examination and detection of stage A prostate cancer may be impossible. Therefore, early detection of prostatic cancer prior to the non-surgical treatment of BPH is considered important if there are any suspicious signs of prostate cancer from the results of prostate specific antigen (PSA), digital rectal examination (DRE), or transrectal ultrasound(TRUS). The aims of our study is to compare the predictability of the DRE, PSA, and TRUS in the detection of prostate cancer before planning to take non- surgical treatment of BPH. One hundred thirty three patients between 50 to 85 years old (mean age 67.9) with symptoms of prostatism were examined serum PSA, DRE and TRUS prior to the treatment of BPH and predictability for the detection of prostatic cancer by each test were analyzed. Of the 133 cases, 3 were diagnosed as inflammations, 1 as tuberculosis, 1 as infarct, 110 as nodular hyperplasia, 18 as prostate cancers. Positive predictability of each test were as followed: 59.3% of the patients with abnormal DRE, 57.7% of the patients with abnormal TRUS and, 34% of the patients with abnormal PSA level( > 10 ng/ml). For the 44 patients with abnormal PSA level( > l0 ng/ml) and, coexisting abnormalities on either TRUS or DRE, positive predictability was 72%. However, in the 26 patients with abnormal PSA( >10ng/ml) with normal findings at DRE and TRUS, only 2 patients have prostate cancer. Of the 17 patients showing abnormal findings at DRE and TRUS irrespective of PSA level, 15 patients(positive predictability of 90%) have prostate cancer. Of the 12 patients having abnormal DRE and TRUS with elevated PSA level(more than 10.0 ng/ml), all patients had cancer. Conclusively, cancer predictability of single application of these screening test was low. Positive predictability of the elevated PSA level above 10 ng/ml was low if there were no abnormalities at DRE and TRUS. However, if there were abnormalities at DRE and TRUS, predictability of cancer became high. It is suggested that, if there were no abnormalities found at DRE and TRUS, prostate needle biopsy seem to be necessary despite the normal level of PSA( < 4 ng/ml). For the gray zone of the PSA level( 4-10 ng/ml) with no suspicious findings at DRE and TRUS, careful observation with follow up PSA measurement could be suggested.
Aged, 80 and over ; Biopsy, Needle ; Digital Rectal Examination ; Humans ; Hyperplasia ; Hyperthermia, Induced ; Inflammation ; Mass Screening ; Microwaves ; Outpatients ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Prostatism ; Tuberculosis

Granulocytic sarcoma is an uncommon extramedullary tumor composed of granulocytic precursor cells such as myeloblasts or monoblasts. These tumor were originally called chloroman because of the green color imparted by the heavy concentration of the myeloperoxidase present in myelogenous leukemic cells. The tumor usually develops during the course of myelogenous leukemia or myeloproliferative disorders and may represent the initial manifestation of leukemia. Rarely, granulocytic sarcoma is recognized as an isolated tumor without any evidence of leukemia. We report a case of a 21-year-old man who was diagnosed as granulocytic sarcoma of right kidney after complete remission of acute myelocytic leukemia.
Granulocyte Precursor Cells ; Humans ; Kidney* ; Leukemia ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute* ; Monocyte-Macrophage Precursor Cells ; Myeloproliferative Disorders ; Peroxidase ; Sarcoma, Myeloid* ; Young Adult