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

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

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

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*

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