No abstract available.

Cancer of the gastric stump, first described by Balfour in 1922, is defined as the cancer detected more than 5 years after surgery for a benign disease. We experienced a case of cancer found at the gastric stump after gastrojejunostomy in a 53 years old male patients, proven pathologically as a early cancer. He visited to our hospital with the chief complaint of epigastric pain and indigestion for 1 Months. On past history, he has been received gastrojejunostomy due to duodenal ulcer obstruction, 23 years ago, Gastrofiberscopy was done, and we could find the early gastric cancer lesions at the anterior wall of gastric angle as type Ilc+III and antrum as type IIa. The microscopic finding of the multiple endoscopic biopsies at the gastic angle and antrum revealed the adenocarcinoma of signet ring cell type infiltrated to the level of submucosa. And so, we could diagnose these lesions as a early gastric cancer in the gastric stump after gastrojejunostomy. He was treated with subtotal gastrectomy and discharged with cured condition. Therefore, we report this case with a literature review.
Adenocarcinoma ; Biopsy ; Duodenal Ulcer* ; Dyspepsia ; Gastrectomy ; Gastric Bypass* ; Gastric Stump* ; Humans ; Male ; Middle Aged ; Stomach Neoplasms

We report on a patient with bilateral multiple renal stones after resection of the small intestine for the idiopathic necrotizing enteritis. She had no history of renal stone. Gross hematuria occurred 1 year after the operation and bilateral renal and ureteral stones with bilateral hydronephrosis were found. History and laboratory findings (low serum and 24 hour urine calcium levels) were suggestive of renal stones by hyperoxaluria. She was managed by oral hydration, low oxalate and low fat diet, urine alkalization with sodium bicarbonate and calcium supplement. Until now, there is no evidence of new stone formation and enlargement of stones.
Calcium ; Diet ; Enteritis ; Hematuria ; Humans ; Hydronephrosis ; Hyperoxaluria ; Intestine, Small* ; Sodium Bicarbonate ; Ureter

Herein we have analyzed retrospectively 24 patients with renal inflammatory mass lesions such as renal abscess, perirenal abscess, emphysematous pyelonephritis and xanthogranulomatous pyelonephritis managed at Seoul National University Hospital during 5-year period from January l980 to December l985. Major presentations were flank or abdominal pain (83%) and fever (79%) The most common organism was E. coli which was cultured in only 6 urine and 2 blood samples. The most common associated conditions were diabetes mellitus, renal and ureteral stone and recent abdominal operation. Ultrasonography of the kidney was the most available and accurate diagnostic method if combined with percutaneous aspiration which could be a therapeutic tool as well. Medical treatment was done in 9 patients and surgical treatment was done in l5 patients when there was no improvement with medical therapy, to remove the precipitating factor and to confirm the mass lesion. All patients were improved and discharged except one death due to upper gastointestinal bleeding and hepatic failure.
Abdominal Pain ; Abscess ; Diabetes Mellitus ; Fever ; Hemorrhage ; Humans ; Inflammation ; Kidney ; Liver Failure ; Precipitating Factors ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous ; Retrospective Studies ; Seoul ; Ultrasonography ; Ureter

No abstract available.
Recurrence*

PURPOSE: Urethral diverticulum in female can be easily detected by physical examination but sometimes the diagnosis can be difficult. Difficulty in prompt diagnosis and treatment arises from the constellation of nonspecific urinary symptoms. Furthermore, treatment may be unsuccessful and result in persistent or recurrent troublesome symptoms. We reviewed our experience with managing symptomatic diverticula for the prompt diagnosis and the definite cure. MATERIALS AND METHODS: We reviewed 33 cases of urethral diverticulectomy performed at our institution for the last 10 years. At presentation patient age ranged from 24 to 57 years (mean 39 years). Two women (6.0%) were nulliparious and average parity was 1.9 births (0-5). Investigations included voiding cystourethrogram, excretory urogram, cystourethroscopy, urodynamic studies and recently transvaginal ultrasound. Transvaginal diverticulectomy was performed using a 3-layer closure (urethral wall, periurethral fascia, vaginal wall) in all women. Concomitant bladder neck suspension was performed in 1 woman. RESULTS: Voiding cystourethrography adquately demonstrated the diverticulum in 11 of the 14 women (78.6%). Transvaginal ultrasound was performed in 21 women and identified the diverticulum in 19 women (90.5%). Of 33 women 32 were cured (97.0%) and secondary transvaginal diverticulectomy was performed for incomplete excision of diverticulumin in 1 woman. According to McGuire's classification 13 cases were classified as pseudodiverticulum which is a mucosal herniation through a periurethral fascial defect, and the rest 20 cases as true diverticulum. This classification had no influence on the surgical success rate. Complications of diverticulectomy included 2 cases of de novo stress urinary incontinence and 1 urethrovaginal fistula. CONCLUSIONS: Preoperative radiographic imaging helps to delineate diverticular anatomy and transvaginal ultrasound is useful test because of absence of ionizing radiation, reduced risk of infection, less invasiveness and higher detection rate than voiding cystourethrogram. With meticulous excision and 3-layer repair, definitive cure can be achieved with a single operation.
Classification ; Diagnosis ; Diverticulum* ; Fascia ; Female ; Fistula ; Humans ; Neck ; Parity ; Parturition ; Physical Examination ; Radiation, Ionizing ; Ultrasonography ; Urinary Bladder ; Urinary Incontinence ; Urodynamics

PURPOSE: The methods for vasovasostomy are varied, and many authors have reported various success rates. This study aimed to assess a new method for vasovasostomy with a Prolene stent. MATERIALS AND METHODS: Among 85 patients who underwent vasovasostomy with a Prolene stent, 69 patients were retrospectively reviewed at our hospital between October 2004 and December 2007. The average age at the time of vasovasostomy was 42.2 years (range: 24.0-52.0 years). The obstructive interval was 6.25 years (range: 0.7-20.0 years). The cases were divided into 2 groups according to obstructive interval: group A (above 8 years) and group B (8 years and less), with 18 (26.1%) and 51 (73.9%) cases, respectively. Patency was defined as a sperm concentration of more than 10x106/ml on semen analysis. RESULTS: The overall patency and pregnancy rates were 76.8% and 43.4%, respectively. The patency and pregnancy rates of group A were 61.1% and 33.3%. Those of group B were 82.3% and 47.0%. The mean duration to pregnancy was 10.9 months (range: 4-31 months). The mean operation time was 90.2 minutes (range: 50.0-165.0 minutes). CONCLUSIONS: The new method of vasovasostomy with the Prolene stent has good efficacy and safety. Its benefits are the maintenance of good patency, a good pregnancy rate, and a diminished operating time.
Humans ; Polypropylenes ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Semen Analysis ; Spermatozoa ; Stents ; Vasovasostomy

PURPOSE: To assess the long-term outcomes of tension-free vaginal tape (TVT) for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) and to identify influencing factors for failure in these cases. METHODS: A total of 136 women who underwent TVT procedures with minimum follow-up duration of 3 years were included in the study. Patients were divided into two groups (non-ISD and ISD groups) based on preoperative urodynamic studies. Patient outcomes were assessed from retrospective chart review and telephone research. Cure was defined as the subjective resolution of SUI in any circumstances. Improvement was defined as the subjective improvement of SUI without complete resolution. Failure was defined as the subjective lack of improvement of SUI. Patients in ISD group were subdivided into two subgroups (cure and non-cure groups) and were compared to identify influencing factors for TVT procedure failure. RESULTS: Eighty-nine patients were in non-ISD group, and 47 in ISD group. The mean follow-up durations were 50.3+/-9.2 and 49.7+/-9.7 months, respectively. Subjective cure rate was 75.3% for non-ISD group, and 76.7% for ISD group (P>0.05). Improvement rate was 6.7% for non-ISD group, and 2.1% for ISD group (P>0.05). Satisfaction scores was 3.8+/-1.2 points in the non-ISD group, and 3.5+/-1.2 points in ISD group (P>0.05). In ISD subgroups, VLPP was 41.9+/-12.0 cmH2O for non-cure group, and 50.5+/-8.6 cmH2O for cure group, and was the only factor that showed significant statistical difference between the two subgroups (P=0.011). CONCLUSIONS: With our long-term results, TVT is an effective treatment even in women with ISD. However, ISD patients with low VLPP should be counseled carefully about TVT outcome.
Female ; Follow-Up Studies ; Humans ; Retrospective Studies ; Suburethral Slings ; Telephone ; Urinary Incontinence ; Urodynamics

Primary lymphoma of the spleen is a relatively rare disease entity and is usually defined, although it is still controversial and hard to define, as the lymphoma which involved primarily the spleen and splenic hilar lymph nodes without involvement in any other site, particularly in the liver and in the mesenteric or para-aortic lymph nodes. In laparotomy of patients with non-Hodgkin's lymphoma, splenic involvements are found in 30 to 50% of patients as part of a diffuse pattern of the disease, but primary lymphoma of the spleen accounts for less than 1 % of all lymphoma cases. And it is often difficult to determine during laparotomy whether splenic involvement with lymphoma is primary or the result of a spread from another site. We herein report on a case of primary lymphoma of the spleen which was detected incidentally during evaluation of the cause of right upper quadrant abdominal pain. During the operation, a splenic tumor was found without the evidence of involvement in other sites, and it was confirmed pathologically to be a non-Hodgkin's lymphoma of the spleen. She lives well now without evidence of recurrence 14 months after the operation.
Abdominal Pain ; Humans ; Laparotomy ; Liver ; Lymph Nodes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Rare Diseases ; Recurrence ; Spleen*

PURPOSE: We administered doxazosin gastrointestinal therapeutic system (GITS) to women with non-neurogenic voiding dysfunction to evaluate its therapeutic effects. MATERIALS AND METHODS: Women who had voiding dysfunctions for at least 3 mo were included. Inclusion criteria were age > or =18yr, an International Prostate Symptom Score (IPSS) > or =15, and a maximum flow rate (Qmax) <15mL/sec and/or postvoid residual (PVR) > or =150mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram. After 4 weeks, treatment outcomes were evaluated. RESULTS: Sixty-two patients were evaluated of mean age 53.8 (32-78)yr. According to the Blaivas-Groutz nomogram, 24 patients had no or mild obstruction (group A) and 38 had moderate or severe obstruction (group B). After treatment, mean IPSS decreased significantly and by more than 5 points in 42 (67.7%). Mean bother scores, Qmax, and PVR also changed significantly. Thirty-seven (59.7%) showed Qmax increases of more than 50%. No significant difference were observed between the groups in terms of IPSS, bother score, Qmax, PVR, micturition frequencies, or functional bladder capacity changes. Adverse effects related to medication were de novo stress urinary incontinence (SUI) (1 case) and underlying SUI aggravation (1 case). By satisfaction assessments, 16 patients (25.8%) were 'mainly satisfied', 31 (50%) were 'slightly satisfied', and 15 (24.2%) were 'dissatisfied'. CONCLUSION: Doxazosin GITS was found to be effective in female patients with voiding dysfunction regardless of obstruction grade. The alpha-adrenoceptor antagonists should be viewed as initial treatment option for women with a non-neurogenic voiding dysfunction.
Doxazosin* ; Female ; Humans ; Nomograms ; Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urination