PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections

No abstract available.
Animals ; Mice*

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

Bone materials diggd up from the Haemi nameless martyrdom holy place burial sites were severely broken into fragments of various size, clay matrix filled the bone marrow cavities, grass roots were spreaded into the periosteum and the fragments were very soft enough to be flaken. To make permanent specimens, bony fragments impregnated within unsaturated polyester resin with catalyzer MEKP, promotor 8% cobalt octoate, and UV absorber. Permanent specimens were so very transparent that all the macroscopic structures can be observed, and they were hard enough not to be broken or cracked. This method of preserving bony fragments is considered to be used in archaeologic preservation and in making teaching materials of various human organs or tissues.
Bone Marrow ; Burial* ; Cobalt ; Humans ; Methods ; Periosteum ; Poaceae ; Polyesters ; Teaching Materials

Proliferating trichilemmal tumor is a rare benign tumor of skin appendage. It is usually solitary, more common in women after the fourth decade of life, and almost exclusively confined to the scalp and back of the neck. We report herein an unusual case of proliferating trchilemmal tumor which occurred on the knee.
Bursitis ; Female ; Humans ; Knee ; Neck ; Scalp ; Skin

Aortopulmonary fistula is an exceedingly rare vascular malformation. It is commonly derived after chest injuly or from complication of chest operation and aortic dissection and congenital aortopulmonary fistula is only several cases combined with Tetralogy of Fallot or aortic stenosis. But a congenital aortopulmonary fistula without any hemodynamic abnormalities was not reported. A 56-year old man with exertional dyspnea was admitted. In an examination on admission, there were no abnomalities. Aortography showed an aortopulmonary fistula that branches from the ascending aorta adjacent to the right coronary artery, running to the main pulmonary artery. Transcatheter coil embolization was performed and he was discharged 7 day after embolization without complication. Exertional dyspnea disappeared and careful follow up has be performed periodically.
Aorta ; Aortic Valve Stenosis ; Aortography ; Coronary Vessels ; Dyspnea* ; Embolization, Therapeutic ; Fistula* ; Follow-Up Studies ; Hemodynamics ; Humans ; Middle Aged ; Pulmonary Artery ; Running ; Tetralogy of Fallot ; Thorax ; Vascular Malformations

No abstract available.
Cicatrix, Hypertrophic* ; Skin*

Forty eight skin biopsies obtained from 24 patients were reviewed, and clinical, histological and immunohistochemical findings were analyzed. Results obtained are as follows: 1) Skin manifestation was plaque, erythroderma, scale and hyperpigmentation in mycosis fungoides, and subcutaneous nodule, mass and ulcerated patch in cutaneous lymphoma. The skin of lymphomatoid papulosis revealed hemorrhagic ulcerated and erythematous papules which healed spontaneously. 2) Histologically, mycosis fungoides showed epidermotropism in most cases. Pautrier's micro-abscesses were present in one-fourth of the cases. Malignant lymphoma was different in histology from mycosis fungoides. As compared with mycosis fungoides, it showed less frequent epidermotropism, more compact and diffuse infiltration of atypical lymphocytes, more often association with ulcer and necrosis, and more frequent mitotic figures. Lymphomatoid papulosis showed striking hemorrhage and edema of the papillary dermis. 3) Based on the results of immunohistochemical study, mycosis fungoides and lymphomatoid papulosis were considered as a T cell proliferative disorder of the skin. According to these findings, lymphoproliferative disorders of the skin occurred predominantly in the elderly and males. Clinical and histopathologic findings overlapped and were similar each other. It was difficult to make a definite diagnosis in early lesions, and a sequential follow up biopsy was required. It is concluded that strict criteria such as marked atypia and clustering of atypical cells are necessary for a histologic diagnosis of malignant lymphoproliferative disorder of the skin.
Biopsy

PURPOSE: To investigate the effects of glucose concentrations on formation of reactive oxygen products and cellular activity in human retinal pigment epithelial cells. METHODS: Human retinal pigment epithelial cells were cultured with high glucose (200 mg/100 ml, 300 mg/100 ml, 400 mg/100 ml) and normal glucose (100 mg/100 ml). The amounts of reactive oxygen products were assayed with dihydroethidium (DHE). Paraquat-induced cellular activity was determined by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) method. RESULTS: Reactive oxygen products of human retinal pigment epithelial cells were increased 120%, 250% and 390% in high glucose (200 mg/100 ml, 300 mg/100 ml, 400 mg/100 ml) media compared to those of normal glucose (100 mg/100 ml) media. Paraquat-induced cell toxicity was increased by high glucose concentrations. CONCLUSIONS: High glucose increased formation of reactive oxygen products in human retinal pigment epithelial cells. These results suggest that high glucose can make human retinal pigment epithelial cells more sensitive to oxidative cellular injury.
Epithelial Cells* ; Glucose* ; Humans ; Oxygen* ; Retinaldehyde*

No abstract available.
Genitalia* ; Humans ; Male*