Urethral stricture usually follows the urethral rupture and periodical urethral soundation, which is an annoying procedure for. patients, is the usual method of treatment throughout their life. A case of urethral stricture who was successfully treated with modified Cecil's Operation, is presented.
Humans ; Rupture ; Urethral Stricture*

Neurocutaneous melanosis is a very rare congenital syndrome characterized by the presence of large or multiple congenital melanocytic nevi and benign or malignant melanotic tumors of the central nervous system. We report herein a case of neurocutaneous melanosis with leptomeningeal melanosis and a malignant melanoma of the right temporal lobe in a 46-year old man. The case is exceptional as regards the late onset of symptoms and death. Even without a malignant melanoma, the symptomatic neurocutaneous melanosis has a fatal course. The syndrome is rare but lethal, so the dermatologist should be aware of this syndrome when evaluating the patients with large or numerous congenital melanocytic nevi so as to watch for the usual signs of increased intracranial pressure and to take prompt palliative measures.
Central Nervous System ; Humans ; Intracranial Pressure ; Melanoma ; Melanosis* ; Nevus, Pigmented ; Temporal Lobe

Local contributing factors in penile erection are trabecular smooth muscle, endothelium, trabecular fibroelastic components, tunica albuginea and local neuro-control. There are three neuroeffector systems in local neuro-control for penile erection. One is adrenergic system causing contraction and the others are cholinergic and noncholinergic nonadrenergic system causing relaxation of corpus cavernosum under normoxia. The effect of these systems under hypoxic condition however is not fully understood. The aims of this study were to detect the pharmacophysiological changes of corporal smooth muscle about 3 local neuroeffector systems under hypoxia in the rabbit and to apply the results of study to the management of the priapism. The strips of rabbit corporal tissues were studied for isometric tension measurement under normoxia, hypoxia and cooling condition in the organ chambers. Influence of NL- monomethyl-L-arginine (L-NMMA) and L-arginine to acetylcholine under normoxia and effects of phenylephrine, norepinephrine, acetylcholine, VIP, endothelin 1, papaverine and KCI on the rabbit corpus cavernosal tissue were monitored under normoxia and hypoxia and changes under cooling condition were observed. Relaxing effect of acetylcholine under normoxia was suppressed with L-NMMA and this suppression was reversed with L-arginine. Relaxation with acetylcholine and contraction with endothelin 1 were suppressed under hypoxic condition. Contracting effect of norepinephrine and phenylephrine was stronger under hypoxia or cooling condition than normoxia or 37 degrees C condition respectively. Relaxing effect of VIP and papaverine on corpus cavernosa was similar under normoxia or hypoxia. These results suggest that endothelium-dependent relaxation by cholinergic and noncholinergic nonadrenergic system and endothelium-dependent contraction by endothelin 1 are suppressed under hypoxic condition. VIP related noncholinergic nonadrenergic relaxation and direct relaxation effect of papaverine to corporal smooth muscle are preserved under hypoxia. Application of adrenergics and local irrigation with cold saline would be effective in the management of priapism.
Acetylcholine ; Adrenergic Agents ; Anoxia* ; Arginine ; Endothelin-1 ; Endothelium ; Male ; Muscle, Smooth ; Norepinephrine ; omega-N-Methylarginine ; Papaverine ; Penile Erection ; Phenylephrine ; Priapism ; Relaxation

PURPOSE: Biochemical confirmation of congenital hypothyroidism takes about 10 days, which may result in a delay in diagnosis. The delay could be reduced if a faster method of investigation such as knee radiograph is used. The aim of this study is to assess the value of plain radiography of the knee in providing supportive evidence for the diagnosis of congenital hypothyroidism. METHODS: Neonates with a screening TSH over 20microunit/mL or free T4 under 0.85ng/dL were referred for further investigation during period of 1992-1998. We included 116 patients whose results were all available. Diagnosis was confirmed by measuring serum TSH, T4, free T4 by radioimmunoassay, radioisotope scan and ultrasonography of the thyroid. Radiography of the knee was obtained and ossification center sizes were measured. RESULTS: Among 116 neonates, 31 were normal and congenital hypothyroisism was confirmed in 85 neonates. There was a statistically significant difference between the controls and the patients in regards to both biochemical data and knee epiphyseal ossification center size. In the congenital hypothyroidism group, there were a significant difference in biochemical data and knee epiphyseal ossification center size according to the diagnosis, and significant correlation between biochemical data and knee ossification center size, especially with serum T4 and combined mean epiphyseal diameter(r=0.56, P<0.01). In the patient group, simple regression equation was made between biochemical data and knee ossification center size. Combined mean epiphyseal diameter(mm) was 0.544 T4+4.161, combined epiphyseal surface area(mm2) was 2.940 T4+14.283. If T4 is below 7 microgram/dL, combined mean epiphyseal diameter is below 8mm and surface area is below 34mm2. CONCLUSION: In neonates with abnormal thyroid screening, knee radiograph showing a combined mean epiphyseal diameter of 8mm or less and surface area of 34mm2 or less suggests congenital hypothyroidism prior to biochemical confirmation, requiring thyroxine treatment.
Congenital Hypothyroidism* ; Diagnosis ; Epiphyses* ; Humans ; Infant, Newborn* ; Knee* ; Mass Screening ; Radiography ; Radioimmunoassay ; Thyroid Function Tests* ; Thyroid Gland* ; Thyroxine ; Ultrasonography

Ureteroscopy is the newer procedure for the treatment and diagnosis in the ureteral lesion.
Biopsy ; Diagnosis ; Hematuria ; Hemorrhage ; Humans ; Ureter* ; Ureteroscopy*

Ureteral stricture are not uncommon sequelae in renal tuberculosis. Oral steroid therapy has been tried as an alternative to surgery in some of these patient on several reports. Three ureteral stricture were effective in 5 patient by oral steroid therapy.
Constriction, Pathologic* ; Humans ; Tuberculosis ; Tuberculosis, Renal ; Ureter*

Malakoplakia of the bladder is an extremely rare condition in which there are multiple round or oval, plaque like or occasionally polypoid projections of the mucosa and submucosa which may be mistaken for cancer. It is believed to be infectious in origin, secondary to a deficiency of intracellular lysosomal digestion. There is often a clinical history of urinary tract infection, and the condition is considered to be an atypical form of granulomatous response to Gram negative coliform infection. We report a case of malakoplakia of the bladder clinically simulating malignant tumor, which was treated successfully with transurethral resection and antibiotics.
Anti-Bacterial Agents ; Digestion ; Malacoplakia* ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract Infections

No abstract available.
Muscle, Smooth* ; Relaxation*

The term endometriosis refers to ectopic endometriume. It most often involves the pelvic organs, including ovaries, broad and round ligaments, fallopian tubes, cervix, vagina and the pouch of Douglas. We report a case of vesical endometriosis in a 4- year old female patient and review literature. Segmental resection of this mass with involved bladder resulted in cure and this lesion was confirmed histologically as endometriosis of the bladder.
Cervix Uteri ; Endometriosis* ; Endometrium ; Fallopian Tubes ; Female ; Humans ; Ovary ; Round Ligament of Uterus ; Urinary Bladder ; Vagina

Developing the instruments in urological field, the urinary tract stones may be manipulated more easily and lesser invasively recently. The percutaneous nephrolithotripsy is one of the most widely using technique for the renal stone. But, the major portion of the failure through the manipulation of percutaneous nephrolithotripsy is the access to the correct, wanted calyx by puncture. So, we observed the 27 normal right kidneys and 26 left kidneys by abdominal computer tomogram scanning and excretory urography for the Korean caliceal anatomy. The following results were obtained 1. The average values of posterior renal rotation from the coronal plane of body were 31.0 degrees +/- 4.4 degrees in the right kidneys 32.4 degrees +/- 3.2 degrees in the left kidneys. 2. The average values of anterior and posterior caliceal angle were 58.8 degrees +/- 7.6 degrees and 20.7 degrees +/- 5.8 degrees in the right kidneys; 38.3 degrees +/- 6.2 degrees and 43.0 degrees +/- 5.2 degrees in the left kidneys. 3. The major type of classical system was Brodel type (74.l%) in the right kidney; Hodson type (53.8%) in the left kidney. 4. The anterior calyx is more laterally placed about 8l.8% in the excretory urography.
Kidney ; Punctures ; Urinary Calculi ; Urography