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

No abstract available.
Aged* ; Humans ; Korea*

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

To histologically compare benign prostatic hyperplasia with proslalic adenocarcinoma, a morphometric study was conducted on 20 cases of benign prostatic hyperplasia and 16 cases of prostatic adenocarcinoma. Adenocarcinoma group was divided into two subgroups. well differentiated (9 cases) and poorly differentiated (7 cases), based on the Gleason grading system. By means of computerized image analyzer, about 30 to 40 cells for each case were examined to evaluate mean nuclear area and perimeter, mean standard deviations and mean form factor. Mean form factor, the most prominent parameter in our study, was significantly different among BPH (1.063+/-0.008), well differentiated adenocarcinoma (1.089+/-0.018) and poorly differentiated adenocarcinoma (1.135 +/-0.057 ). Mean standard deviations of mean nuclear area and perimeter were significantly different between benign prostatic hyperplasia and well differentiated prostatic adenocarcinoma. .Morphometry. may provide the pathologists with a helpful technique, allowing them to analyze pathological material accurately. and in a more quantitative and reproducible fashion.
Adenocarcinoma* ; Neoplasm Grading ; Prostatic Hyperplasia*

No abstract available.
Animals ; Rats* ; Urinary Bladder*

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

It is known that the activity of tumor cells correlates with the malignant potential of tumors. Nucleolar organizer regions(NORs) are loops of DNA which occur in nucleoli and which possess 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 and indicator of the degree of malignancy in tumors. 0.05 % N-Butyl-N(4-hydroxybutyl) nitrosamine(BBN) in drinking water was given for 8 and 14 weeks to induce pre-neoplastic and neoplastic vesical epithelial lesions in female Wister rats. Ag-NORs were stained by the simple one-step silver colloid staining in routine processed, formalin-fixed paraffin sections of bladder lesions induced by N-butyl-N(4-hydroxybutyl) nitrosamine(BBN) in rat. The mean number of silver stained NORs(Ag-NORs) was as follows : normal transitional epithelium was 1.64+/-0.25(mean+/-SD; n=10), simple hyperplasia was 2.24+/-0.24(n=7). nodular hyperplasia was 2.63+/-0.12 (n=6), transitional cell papilloma was 3.24+/-0.28(n=6) and transitional cell carcinoma was 4.52+/-0.32(n=10). Based on the above results, we concluded that the mean number of Ag-NORs showed a stepwise increase from normal transitional epithelium through simple hyperplasia and nodular hyperplasia to papilloma and carcinoma of bladder epithelium induced by BBN in rat and may reflect proliferative activity of cells. Further investigations may be needed to confirm whether the number or quantification of Ag-NORs is a useful method for evaluating proliferative activity of neoplastic lesions or another indicator of prognosis in human bladder cancer.
Animals ; Butylhydroxybutylnitrosamine* ; Carcinoma, Transitional Cell ; Colloids ; DNA ; DNA, Ribosomal ; Drinking Water ; Epithelium ; Female ; Humans ; Hyperplasia ; Nucleolus Organizer Region* ; Papilloma ; Paraffin ; Prognosis ; Rats* ; RNA Polymerase I ; RNA, Ribosomal ; Silver ; Urinary Bladder Neoplasms ; Urinary Bladder*

Hypospadias can be repaired in the majority cases in 1-stage with a high success rate. We reviewed clinical experience of 50 patients who underwent primary hypospadias repair by 1 surgeon using 1-stage repairs except 3 cases in a 30-month period. The results were 1). The half of patients were younger than 5 years (48%). 2). A total of 34 cases (68.0%) had an associated ventral curvature. The dorsal tunica albuginea plication to correct intrinsic curvature was done in 21 cases (61.8%) and dividing the urethral plate in only 3 cases (8.8%). 3). Associated anomalies were cryptorchidism in 7, hydrocele in 3 and severe penoscrotal transposition in 8 cases. 4). 19 cases of anterior hypospadias were repaired by meatoplasty using Heineke-Mikulicz tissue rearrangement (9 cases), MAGPI (3 cases), pyramid procedure (4 cases), Mathieu urethroplasty (2 cases) and onlay island flap (1 case). Of the 31 cases of middle and posterior hypospadias onlay island flap repair was performed in 24 cases (77.4%). 5). The success rates in anterior, middle and posterior hypospadias were 94.7, 64.7 and 42.9%, respectively. The overall success rate was 70%. 6). The most commonly used procedure was onlay island flap urethroplasty. Only 14 of 25 cases (56.0%) were successful with this method but the last 8 cases were repaired with no complications. 7). The most common complications were urethrocutaneous fistula (11 cases) and meatal retraction (3 cases). The complications were managed by rotational advancement flap (11 cases), meatal based flap (2 cases) and urethral advancement (1 case) and the success rate was 73.3%. In conclusion, to achieve more satisfactory results the choice of operation depends on the configuration of either glans or meatus, presence or absence of chordee and status of ventral penile skin in anterior hypospadias. Although the 2-stage repair remains a safe and reliable alternatives for severe hypospadias 1-stage repair was more useful except severe hypospadias combined with penoscrotal transposition."
Cryptorchidism ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Skin