Congenital bladder diverticulum usually occurs in areas where the muscle is inadequately formed, typically at the ureterovesical junction, or between bundles of hypertrophied muscle. Congenital bladder diverticulum might be missed in excretory urography, especially in case that primary symptom is not so severe to justify further invasive studies. Physicians should not neglect voiding symptoms in pediatric patients and should have high suspicion of congenital diseases. We report a case of rare congenital bladder diverticulum, misdiagosed as non-neurogenic neurogenic bladder, presenting as nocturnal enuresis, daytime frequency and post-voiding residual urine sensation without vesicoureteral reflux or outlet obstruction.
Diverticulum* ; Enuresis ; Humans ; Nocturnal Enuresis ; Sensation ; Urinary Bladder* ; Urinary Bladder, Neurogenic* ; Urography ; Vesico-Ureteral Reflux

PURPOSE: Treatment for malignant colonic obstruction consists of a multiple-staged emergency operation. In recent years, some authors have reported low morbidity and mortality rates using self-expandable metallic stents. This study is designed to evaluate the usefulness of self-expandable metallic stents in patients with malignant colonic obstruction. METHODS: The records of 38 patients who had undergone surgery for malignant colonic obstruction at our institution between January 2004 and August 2006 were reviewed retrospectively. Seventeen patients were treated with elective surgery after stent insertion, bowel decompression, and bowel preparation (stent group), and 21 patients were treated with emergency surgery without stent insertion (control group). RESULTS: There were no significant differences in age, sex, tumor node metastasis (TNM) stage, or cancer position between the two groups (elective operation after stent insertion vs. emergency operation). Of the 17 patients who underwent elective operation after stent insertion, primary anastomosis was possible in 15 (88.2 vs. 57.1% in the control group), with a lower need for a colostomy (11.8 vs. 42.9% in the control group, P=0.036). Also, the number of patients with severe complications (17.6 vs. 47.6% in the control group, P=0.048) and the hospital stay (10.82 vs. 13.43 days in the control group, P=0.032) were significantly lower in the study group. CONCLUSION: Placement of a self-expandable metallic stent for malignant colonic obstruction is a safe and effective procedure. It can reduce the colostomy, mortality, and morbidity rates and the hospital fee for treatment.
Colon ; Colostomy ; Decompression ; Emergencies ; Fees and Charges ; Humans ; Length of Stay ; Neoplasm Metastasis ; Retrospective Studies ; Stents

BACKGROUND AND OBJECTIVES: Cryoablation has been recognized as a potential tool in the treatment of cancer. Beside its ability to cause local destruction of the primary tumor, cryoablation has been claimed to induce a systemic anti-tumor immune response. We compared cryoimmunologic responses between cryoablation and surgical excision in a murine model of squamous cell carcinoma (SCC). MATERIALS AND METHOD: Six-to 8-weeks-old female mice (total n=30) were used for this study. Tumors were established at the flank of C3H mice with the SCCVII cell line, which is an immunogenic murine SCC of spontaneous origin in the C3H/HeJ mice. The mice underwent surgical excision or cryoablation, when the tumors were between 0.3 and 0.6 cm in the largest dimension. Successfully treated mice were re-challenged with the murine bladder cancer cells, namely, SCCVII cell line or MBT-2 cells at the contralateral flank. One week later, secondary tumor growth was estimated. Spleens were harvested from the mice that had no tumor after re-challenge. Effector splenocytes were added to the target SCCVII cells prelabeled with 3H thymidine. Cytotoxicity was investigated by measuring 3H thymidine releases from target cells. RESULTS: After re-challenging the SCCVII cell line, tumors were developed in 33% (1/3) of the mice treated by surgical excision, compared to 0% (0/4) of mice treated by cryoablation. In the cytotoxicity assay, there were no significant differences between the excision and cryoablation group. CONCLUSION: These results suggest that the anti-tumor immunologic effect of cryoablation in the murine SCC model is not better than that of surgical excision.
Animals ; Carcinoma, Squamous Cell ; Cell Line ; Cell Line, Tumor ; Cryosurgery ; Female ; Humans ; Mice ; Mice, Inbred C3H ; Spleen ; Thymidine ; Urinary Bladder Neoplasms

BACKGROUND: Angiotensin converting enzyme inhibitors (ACEIs) or Angiotensin II type 1 receptor blockers (ARBs) are compelling indication drugs for hypertensive patients with diabetes mellitus. But prescription rate in 2005 year study of Pohang . Gyeongju area was only 30.8%. Therefore, a study on the change of prescription rate in the same area after 3 years was done. METHODS: During three months from January 2008, 152 hypertensive patients with diabetes mellitus on their prescribed antihypertensive medications by 9 family physicians in visiting order were analyzed. After the analysis, the infl uencing factors for such prescriptions were ascertained by directly visiting each physicians who prescribed them. RESULTS: A regimen of 16 antihypertensive agents were prescribed by these family physicians. Prescription count of ACEIs or ARBs was 101 cases (66.4%). ACEIs single therapy was 19 cases (12.5%), ACEIs combination therapy was 7 cases (4.6%), ARBs single therapy was 31 cases (20.4%) and ARBs combination therapy was 44 cases (28.9%). The ACEIs or ARBs which were selected by physicians that followed "compelling indication" was 5 (55.6%), "excellent reduce pressure effect" was 3 (33.3%) and "public relations of new medicine" was 1 (11.1%). CONCLUSION: In prescribing antihypertensive agents for patients with diabetes mellitus, selection of ACEIs or ARBs was increased from 30.8% to 66.4%. Education of recommended standard by participating in such study and developing of excellent new medicines may increase such change.
Angiotensin II Type 1 Receptor Blockers ; Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Diabetes Mellitus ; Humans ; Hypertension ; Physicians, Family ; Prescriptions ; Primary Health Care

BACKGROUND: Angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker is usually recommended for hypertensive patients with diabetes mellitus. No reports have been made on antihypertensive agents prescribed for these patients in private practice. METHODS: During a one month period of December 2004, 169 hypertensive patients with diabetes mellitus on their prescribed antihypertensive agents by ten family physicians were analyzed. The influencing factors for such prescriptions were analyzed by directly visiting each physicians who prescribed them. RESULTS: A total of 21 antihypertensive agents were prescribed by these family physicians. Single calcium channel blocker therapy was the most common with 55 cases (32.5%), followed by 20 cases (11.8%) of single angiotensin converting enzyme inhibitor therapy and 16 cases of single therapy of Angiotensin II type 1 receptor blocker. The low frequency of prescribing the Angiotensin II type 1 receptor blocker was due to insufficient effect (7), lack of information (5), resistance from the patients from changing the medications (4) and expensive costs (4). CONCLUSION: In prescribing antihypertensive agents for patients with diabetes mellitus, angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker were chosen less. In order to decrease the incidence of complications in these patients, such agents should be prescribed more.
Antihypertensive Agents* ; Calcium Channels ; Diabetes Mellitus* ; Humans ; Hypertension ; Incidence ; Peptidyl-Dipeptidase A ; Physicians, Family ; Prescriptions ; Primary Health Care* ; Private Practice ; Receptor, Angiotensin, Type 1