PURPOSE: The aim of this presentation is to analyze the factors influencing on retrograde insertion of double-J catheter in urethral obstruction due to malignancy and to predict the possibility of stunting with double-J catheter. MATERIALS AND METHODS: A retrospective analysis of 43 patients who had underwent retrograde double-J catheter insertion for urethral obstruction secondary to pelvic malignancy, from January 1993 to April 1997, was performed to evaluate the success rates of double-J ureteral stenting according to the factors such as age, sex, presence or absence of flank pain, degree of hydronephrosis, renal function, stage of tumor, laterality of ureter, past history of radiotherapy, operation and chemotherapy. RESULTS: According to the degree of hydronephrosis, the success rate was 100, 73.7 and 50% in grade I II and III, respectively(p<0.05). According to the renal function, the success rate was 81.3% in the group with normal renal function and 45.5% in the group with abnormal venal function(p<0.05) According to the stage of disease, the success rate was 100, 70.7 and 58.3% in stage I, II and III, respectively. According to the absence or presence of flank pain, the success rate was 56.3% in the group with flank pain and 81.5% in the group without flank pain. According to the past history of radiotherapy, the success rate was 65.6% in the group treated with radiotherapy and 90.9% in the group not treated with radiotherapy. The age, sex, laterality of ureter, past history of operation and chemotherapy were not significantly correlated to the success rates. CONCLUSIONS: The factors influencing on double-J ureteral slanting were the degree of hydronephrosis, renal function, absence or presence of flank pain, stage of disease and past history of radiotherapy Further study will be needed to demonstrate the accurate timing of urethral stenting with doublets ureteral catheter.
Catheters* ; Drug Therapy ; Flank Pain ; Humans ; Hydronephrosis ; Radiotherapy ; Retrospective Studies ; Stents ; Ureter* ; Ureteral Obstruction* ; Urethral Obstruction ; Urinary Catheters

No abstract available.
C-Reactive Protein* ; Chorioamnionitis* ; Female ; Humans ; Membranes* ; Pregnancy ; Rupture*

Peri-vater divertieula may interfere with the normal flow of biliary and pancreatic secretion, thus leading to pancreatobiliary diseasa and the very presence of juxtapapillary diverticulum makes cannulation technically difficult and contributes to the low success rate. In this present series, the relationship between duodenal diverticula and age, sex, and biliary-pancreatic pathology was stud.ied in 1400 patients examined with ERCP. The results are as follows. 1) Duodenal diverticula was demonstrated in 73 of 1400 patients(5, 2%). 2) The incidence of duodenal divertieular increased with age and they were more frequent in men. 3) The cannulation of one or both duct system was suecessful in 69 of the 73 patients, the success rate was 94. 5%. 4) The biliary pathology was found in 41 of the 73 patients and the pancreatic pathology in 6 of the 73 patients. The rnost common finding was biliary calculi which were demonstrated in 35 patients(47. 9%).
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Male ; Pathology

Impaired endothelium dependent relaxation occurs in diabetic rabbit corpus cavernosum and normal corpus cavernosum exposed to elevated glucose. Elevation of glucose can change the activities of two key enzymes, protein kinase C (PKC) and Na+-K+ ATPase. This study addresses the question of whether impaired endothelium dependent relaxation in isolated corpus cavernosum from normal rabbit exposed to elevated glucose is related to PKC and Na+-K+ ATPase activities and, if so, whether it is associated with altered ouabain sensitive 86-Rb uptake, an index of Na+-K+ ATPase activity, and contractile response of corpus cavernosum tissue to ouabain. Corpus cavernosal tissue suspended for measurement of isometric tension were incubated for 6 hours in control (5.5mM) or elevated glucose (44mM) to mimic euglycemic and hyperglycemic conditions. Relaxations of corpus cavernosum tissue in response to the endothelium-dependent vasodilator acetylcholine (ACh)were unaffected in control groups while significantly inhibited in the elevated glucose group. Relaxations of corporeal tissue to endothelium-independent vasodilators, sodium nitroprusside (SNP) were similar in the control and elevated glucose groups. Corporeal tissue treated with 4-phorbol 12-myristate 13-acetate (PMA), a PKC activator, showed decreased relaxations to ACh, similar to normal corporeal tissue exposed to elevated glucose. Relaxations in response to SNP were unaffected by treatment with PMA or exposure to elevated glucose. 1(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7), PKC inhibitor, restored the abnormal Ach-induced relaxation in corporeal tissue exposed to elevated glucose. The contractions caused by ouabain, Na+-K+ ATPase inhibitor, were smaller in elevated glucose groups than control and elevated glucose groups treated with H-7. Ouabain sensitive 86-Rb uptake of elevated glucose groups was significantly less than that of control groups but ouabain sensitive 86-Rb uptake of elevated glucose groups treated with H-7 was similar to those of control groups. These results suggest that activation in PKC activity and inhibition in Na+-K+ ATPase activity caused by elevated glucose contribute to impaired endothelium dependent relaxation in corpus cavernosum smooth muscle.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine ; Acetylcholine ; Adenosine Triphosphatases* ; Endothelium ; Glucose* ; Muscle, Smooth ; Nitroprusside ; Ouabain ; Protein Kinase C* ; Protein Kinases* ; Relaxation* ; Vasodilator Agents

No abstract available.
Aged* ; Humans ; Korea*

No abstract available.
Cervix Uteri* ; Conization* ; Female ; Pregnancy*

A retrospective study of 24 partial cystectomies done between April, 1978 and October, 1982 was undertaken to evaluate the proper role of the procedure in the treatment of bladder carcinoma. The following results were obtained:1. During this period, there were 84 cases of bladder tumor and partial cystectomy was performed in 24 cases(28.6%). 2. there were 20 males and 4 females with a ratio of 5:1 and 62.5 per cent of the patients were over 50 years old. 3. 54 per cent of the patients visited the hospital within 3 months after the occurrence of the initial symptom, 95.8 per cent within 1 year. 4. The most common presenting symptoms were hematuria (100%), frequent urination (45.8%), painful urination (29.1%) and voiding difficulty(25%). 5. The most common site of origin was lateral wall(58.3%) and 25% of the patients were located at the dome of bladder. 6. Of the entire group of 24 patients 15 cases were followed up. High stage(B2 or C) or high grade(III or IV)tumor recurred in all cases and recurred earlier than low stage or low grade tumor. In conclusion, partial cystectomy is adequate treatment for low stage and low grade bladder tumor.
Carcinoma, Transitional Cell* ; Cystectomy* ; Female ; Hematuria ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urination

Politano-Leadbetter method has been widely used in ureteroneocystostomy these days, we encounter some cases not suitable for this method, For example, in case the ureter was not properly long enough or in the process of making submucosal tunnel vesical mucosa happens to be irregulary dissected due to vesical inflammation, other useful method of vesicoureteral reimplantation is necessary. therefore, instead of making the submucosal tunnel, enough length of the intravesical ureter, which was the most important factor in preventing vesicoureteral reflux, was made protruded into the bladder lumen with free end method and modified Politano-Leadbetter method. these maneuvers well permit value-like flatting or closing of the distal ureteral segment during periods of increased intravesical pressure. We have performed experimental ureteroneocystostomy in 8 dogs, 16 ureters with simple free end method (group 1) and modified Politano-Leadbetter method(group 2)in two groups and two dogs were used as control. The procedure of free end method is a no-tunnel `drop-in` with a long segment protruding into the bladder lumen and that of modified Politano-Leadbetter method is as follows. The intravesical ureter is placed beneath the incised bladder mucosa without submucosal tunnelling and the spatulated distal end of the ureter is sutured with bladder mucosa. In control group ureteroneocystomy was performed by Politano-Leadbetter method. The roentgenographic findings and gross appearance of the kidney and ureter were observed in the 5 weeks after the operation. The anastomosis site was also observed histologically. The results obtained were as follows: 1. No vesicoureteral reflux was found cystographically in both group. 2. Hydronephrosis and obstruction at the anastomosis site were found in one out of 8 ureters in each group by intravenous urography. 3. Renal enlargement and chronic inflammation and fibrosis at the anastomosis site were noted in one out of 8 ureters in each group by gross and microscopical examination. 4. In group 2, modified Politano-Leadbetter method, it was found that the intravesical ureter was covered by regenerated vesical submucosal tissue microscopically. Through this study it is concluded that these two methods are useful to be performed for the ureteroneocystostomy when the submucosal tunnel technique is not suitable.
Animals ; Dogs* ; Fibrosis ; Hydronephrosis ; Inflammation ; Kidney ; Mucous Membrane ; Replantation ; Ureter ; Urinary Bladder ; Urography ; Vesico-Ureteral Reflux

Acropustulosis of infancy is an uncommon, but not rare syndrome established as a new disease entity by Kahn and Rywlin(1976), which is characterized by recurrent, intensely pruritic vesicopustules on the distal extremities. We'd like to report a case of acropustulosis of infancy. Our patient was 19 month old girl who had been suffering from her skin disease since the age of 12 months. Intensely pruritic, 1 to 2 mm vesicopustules erupted on the palms, soles and the ventral aspects of the fingers. There were no bacteria, fungus and parasites(Sarcoptes scabiei) on the pustular lesions. Histopathologically, biopsy specimen of the left sole revealed large, well circumscribed intraepidermal pustule which was filled wth polymorphonuclear leukocytes. We confirmed our case as typical case of acropustulosis of infancy by it's characteristic clinical features and histopathologic findings. Severity of the skin lesions seems closely related to the dosage of dapsone. The eruptions were unresponsive to topical steroid, antibiotics and antihistaminics. But we observed that dapsone has dose dependent relationship with acropustulosis of infancy.
Anti-Bacterial Agents ; Bacteria ; Biopsy ; Dapsone ; Extremities ; Female ; Fingers ; Fungi ; Humans ; Infant ; Neutrophils ; Skin ; Skin Diseases

NORs are loops of DNA which occur in nucleoli and which posses ribosomal DNA genes. Ribosomal DNA genes transcribe to ribosomal RNA by RNA polymerase I and are of vital significance in the ultimate synthesis of protein. Proteins associated with the NORs are stained with silver nitrate (Ag-NORs). Ag-NORs were studied in various tumors and might reflect the activity of cells and might be an indicator of the degree of malignancy in tumors. Specimens of prostate obtained by transurethral resection or fine needle biopsy were examined with regard to the number and area of NORs in order to find out whether the above mentioned two parameters reflect proliferative activity in 23 cases of prostatic adenocarcinoma and 10 cases of benign prostatic hyperplasia as controls. The mean number of Ag-NORs in BPH, well, moderate and poorly differentiated adenocarcinoma was 1.24+/-0.10 (mean+/-SD; n=10), 1.87+/-0.23 (n=6). 2.08 J=0.28 (n=10). 4.02+/-0.22 (n=7). respectively. In each group, significant difference was found statistically (p<0.05) except between well and moderate differentiated adenocarcinoma. The mean area of Ag-NORs calculated by morphometry in BPH, well, moderate and poorly differentiated adenocarcinoma was 5.40+/-1.8 um2, 7.84+/-3.68 um2. 14.02+/-4.95 um2, 23.99+/-6.94 um2, respectively and significant difference was found statistically in each group (p<0.05). We concluded that the number and area of NORs increased with degree of malignancy and may reflect proliferative activity of cells in prostatic adenocarcinoma. Further investigations may be needed to confirm whether the number or area of Ag-NORs may be available as a prognostic factor for patient`s survival.
Adenocarcinoma* ; Biopsy, Fine-Needle ; DNA ; DNA, Ribosomal ; Nucleolus Organizer Region* ; Prostate ; Prostatic Hyperplasia ; RNA Polymerase I ; RNA, Ribosomal ; Silver Nitrate