The cause of radiolucent filling defects in the upper urinary tract are malignant tumor, radiolucent stones, blood clots, air bubbles, congenital deformities of renal parenchyme, and various specific and non-specific infection and their sequence. So the differential diagnosis between malignancy and radiolucent stones is very important, and the exact and fast diagnosis of radiolucent stones is useful in excluding the possibility of malignancy. 27 cases with radiolucent stones were evaluated retrospectively for exact diagnosis and appropriate treatment method. Intravenous urography was done in all cases, and retrograde pyelography, ultrasonography, computed tomography and/or ureterorenoscopy were performed for diagnosis, if needed. Size of stones were measured below 10mm by transverse length in 19 cases (70.4%) with a range of 3 to30mm. The locations of stones were pelvocalyceal system in 8 cases (29.6%) and ureter in 19 cases (70.4%). Among the diagnostic methods, computed tomography was used most frequently. ESWL with retrograde pyelography was most frequent used method of treatment, also simple hydration to small stone was effective.
Congenital Abnormalities ; Diagnosis ; Diagnosis, Differential ; Retrospective Studies ; Ultrasonography ; Ureter ; Urinary Tract ; Urography

No abstract available.
Animals ; Rats* ; Superoxides*

PURPOSE: We investigated the possible inhibitory effect of aspirin during the initiation and post initiating stages on N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) induced bladder carcinogenesis in female rats. MATERIALS AND METHODS: Forty-five female Sprague-Dawley rats were divided into three groups. Group A received 0.05% BBN in drinking water for 12 weeks. Group B re ceived 0.05% BBN in drinking water with 0.5% aspirin in the diet for 12 weeks. Group C received control diet without added chemicals. The rats were sacrificed after 12 weeks. For identification of chemopreventive effect of aspirin, apoptosis was detected by in situ cell death detection method. The apoptotic index (AI) was calculated from the ratio of typical apoptotic cells relative to the total cells from observation of at least 1000 cells in each preneoplastic lesion among the groups. RESULTS: All cases of group A showed multiple lesions of simple and focal hyperplasia. The incidence of papilloma was 80% in group A. All cases of group B also showed multiple lesions of simple and focal hyperplasia but the incidence of papilloma was decreased to 20%. The total numbers counted of focal hyperplasia and papilloma lesions were significantly reduced in group B than in group A (p<0.001 and p<0.001, respectively). The mean AI in group A and B sequentially increased in preneoplastic lesions, as compared to that in the normal epithelium of the rat bladder. Significant differences in AI in the lesions of simple and focal hyperplasia between group A and B were noted (p<0.001 and p<0.001, respectively). CONCLUSIONS: The result suggests that aspirin significantly decreases the incidence of precancerous lesions and it can act as a chemopreventive agent for precancerous lesions of urinary bladder.
Animals ; Apoptosis ; Aspirin* ; Carcinogenesis ; Cell Death ; Diet ; Drinking Water ; Epithelium ; Female ; Humans ; Hyperplasia ; Incidence ; Papilloma ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Animals ; Isoproterenol* ; Nitric Oxide* ; Rats* ; Urinary Bladder*

PURPOSE: To explore the effect of bilateral oophorectomy on the several proteins of female rat bladder via a proteomic approach. MATERIALS AND METHODS: A total of 20 female Sprague-Dawley rats were obtained at 8 weeks of age and were divided randomly into 3 groups: a control groups underwent sham operation and bladders were excised 4 weeks and 8 weeks after operation each. Other two groups underwent bilateral oophorectomy and bladders were excised 4 weeks (group 1) and 8 weeks (group 2) after operation each, too. Each group has 5 rats. Conventional proteomics was conducted via high resolution 2-D gel electrophoresis, followed by image analysis and protein identification through mass spectrometry. RESULTS: Bladder weights were reduced significantly in group 2 as compared with the 8-week control group. A comparison of the bladders of the oophorectomy group subjects with those of the control group subjects demonstrated that the expressions of 11 proteins were altered Eukaryotic translation initiation factor 5A (elF-5A), chaperone grp 75 precursor, actin-depolymerizing factor, contrapsin-like inhibitor 1 precursor, guanine deaminase, actin, peroxiredoxin 2, phosphatidylethanolamine, putative protein kinase, Keratin complex 2 and Enol protein. CONCLUSION: The roles of 11 proteins are variable. A part of these proteins have a role of cellular apoptosis, acute inflammation, and muscle contraction. It seems that these changes of proteins have an influence on bladder functions and LUTS.
Actins ; Animals ; Apoptosis ; Electrophoresis, Gel, Two-Dimensional ; Female ; Guanine Deaminase ; Humans ; Inflammation ; Mass Spectrometry ; Muscle Contraction ; Ovariectomy* ; Peptide Initiation Factors ; Peroxiredoxins ; Protein Kinases ; Proteomics ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder* ; Weights and Measures

PURPOSE: To evaluated the effectiveness of abdominal ultrasonography as the initial diagnostic method in blunt renal trauma. MATERIALS AND METHODS: This study was undertaken to compare computerized tomography with abdominal ultrasonography in radiographic staging of blunt renal trauma(Renal Injury scale grade I-V by Moor) except vascular injury. During 3-years period(May 1994 to March 1997), emergency computerized tomography was performed in 66 patients with blunt renal trauma, simultaneously 34 patients among 66 patient were scanned by abdominal ultrasonography. RESULTS: Gross hematuria were present 48% of renal trauma cases. The degree of hematuria showed not correlation with the severity of renal injury(p-value=0.213, by Chi-square test). In diagnostic agreement of abdominal ultrasonography compared to computerized tomography, the diagnostic agreement of minor renal injury(x=0.544, by k2 statistics) was higher than that of major renal injury(r=0.375, by k2 statistics). The overall diagnostic agreement of abdominal ultrasonography in detecting adjacent organ injury was 0.321 (k value). CONCLUSIONS: In ultrasonography imaging, we concluded that minor blunt rectal trauma is not necessary other radiologic evaluation, but major blunt renal trauma should be evaluated by computerized tomography for proper diagnosis of combined injury and diagnostic staging of renal trauma. Renal trauma associated Intraabdominal injury should undergo with ultrasonography-guided paracentesis. Based under result of our study, we suggest the use of abdominal ultrasonography as the initial diagnostic method in blunt renal trauma compatible for prompt diagnosis and treatment.
Diagnosis ; Emergencies ; Hematuria ; Humans ; Paracentesis ; Ultrasonography* ; Vascular System Injuries

PURPOSE: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including urinary bladder tumor. The overexpression of the bcl-2 gene has been correlated with poor prognosis and chemotherapy resistance in other systems. We evaluated the significance of these gene expressions and correlation with prognostic factors in the urinary bladdder cancer. MATERIALS AND METHODS: The expression of bcl-2 and p53 oncoprotein were investigated serially in formalin-fixed and paraffin-embedded tissue specimens from 43 patients with primary transitioanl cell carcinoma in the urinary bladder. Thirty four were superficial bladder tumors and nine were invasive tumors. In histology grade according to WHO grading there were 9 grade I, 21 grade II and 13 grade III. RESULTS: Positive immunoreaction for bcl-2 was found in 3 out of 9 invasive bladder tumors, while 15 of 34 superficial tumors showed positive staining. Positive p53 immunostaining was found in 7 of 9 invasive tumors, while 18 of 34 superficial tumors showed positive staining. There was no significant correlation between bcl-2 or p53 expression and tumor stage(p=0.56, p=0.179). A higher incidence of bcl-2 staining was found in the grade I group than in the grade III group(p=0.041). There was no significant correlation between p53 expression and tumor grade (p=0.23). A significant inverse relationship was found between bcl-2 and p53 topographic expression(p=0.001). CONCLUSIONS: The results of this study indicated an inverse relationship between bcl-2 and p53 expression. These findings suggest bcl-2 expression may be associated with favorable prognosis in bladder tumor.
Drug Therapy ; Gene Expression ; Genes, bcl-2 ; Genes, Tumor Suppressor ; Humans ; Incidence ; Prognosis ; Urinary Bladder Neoplasms ; Urinary Bladder*

BACKGROUND: Testicular rupture is a surgical emergency which command immediate repair. If surgery is delayed, a hematoma causes severe pain and loss of spermatogenesis as well as hormonal functions. Scrotal ultrasonography has been helpful in early diagnosis of testicular rupture. But disadvantage of ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Also the diagnostic accuracy, sensitivity or specificity of scrotal ultrasonography was variable in regard to authors. And so, a diagnostic accuracy of scrotal ultrasonography was evaluated in scrotal trauma. METHODS: We reviewed 38 patients of scrotal trauma from May, 1994 to March, 1998. 6 patients were treated conservatively following scrotal sonography and 10 patients treated only surgical exploration without ultrasonography. Surgical exploration was performed in 22 case, which were evaluated by ultrasound before surgical treatment. In a such 22 cases, diagnostic accuracy of scrotal ultrasonography was evaluated. RESULTS: We compared ultrasound before treatment with surgical exploration finding in a such 22 cases. The ultrasonographic features in 7(31.8%) out of 22 cases, which showed testicular ruptured, but surgical exploration revealed testicular rupture in 5 and epididymal rupture in 1, simple hematocele in 1. In 15(68.2%) out of 22 cases the simple hematocele was diagnosed by ultrasonography, but surgical finding feature in of the 7 cases revealed testicular rupture, epididymal rupture in 1, simple hematocele in 7. The sensitivity and specificity for the ultrasonography are 42.9% and 87.5%, and the positive and negative predictive values are 86.5% and 46.7%, respectively. Ultrasonography is low sensitive in identifying testicular rupture. CONCLUSION: Ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Therefore, early surgical exploration for saving the testis should be performed that sonographically by seeing hypoehoic peripheral lesions and disappearance of normal ovoid form of testis, hematocele in scrotal sac.
Contrast Media ; Early Diagnosis ; Emergencies ; Hematocele ; Hematoma ; Humans ; Male ; Rupture ; Sensitivity and Specificity ; Spermatogenesis ; Testis ; Ultrasonography*

PURPOSE: 5alpha reductase, dutasteride, has widely used to treat enlarged prostate (BPH). By suppressing the conversion of testosterone to dihydrotestosterone it decreases serum prostate-specific antigen (PSA) which is very important screening marker for prostate cancer. We evaluate the early serum PSA changes after dutasteride treatment to Korean BPH patients. MATERIALS AND METHODS: A total 159 men with a clinical diagnosis of BPH and no evidence of prostate cancer were enrolled. They were treated with dutasteride 0.5mg daily for 12 months. Serum PSA was evaluated at 2, 6, and 12 months after the medication. RESULT: Dutasteride statistically significantly reduced serum PSA to 0.70+/-0.52, 0.64+/-0.35, and 0.59+/-0.49 from baseline level at 2, 6, and 12 months after the medication, respectively. However, there was no statistical significance among the three groups in serum PSA changes after dutasteride. There were statistically significant correlations between a high pre-treatment serum PSA level and a large reduction of follow-up PSA levels at 2, 6, and 12 months after dutasteride treatment. CONCLUSIONS: The reduction of serum PSA is variable in patients to patients at 2, 6, and 12 months after dutasteride treatment. The patient with high initial serum PSA revealed a large reduction of serum PSA level after treatment. The traditional concept that follow-up serum PSA level should be doubled for prostate cancer screening may overestimate real serum PSA level within 12 months in Korean men receiving 5alpha reductase inhibitors.
Diagnosis ; Dihydrotestosterone ; Follow-Up Studies ; Humans ; Hypertrophy* ; Male ; Mass Screening ; Oxidoreductases ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Testosterone ; Dutasteride

PURPOSE: To verify the association between cigarette smoking and bladder cancer in the Korean population, as smoking is well known as a risk factor on bladder cancer. The risk of bladder cancer was compared among never-smokers, ex-smokers and current-smokers using a multivariate adjusted incidence rate and the mortality rate of bladder cancer of Koreans. MATERIALS AND METHODS: A total of 348,010 participants were enrolled in this prospective study between 1993 (to 1994) and 2002. All participants completed a self administered questionnaire on cancer risk factors, including smoking habit. Follow up for incident bladder cancer was established. We classified all participants into three categories: current-smoker, ex-smoker and never-smoker, on the basis of their smoking habits. We confirmed bladder cancer from the data of the Korea National Cancer Registry and National Health Insurance Corporation up to (December?) 2002. The multivariate adjusted incidence and the mortality due to bladder cancer were used for both genders for a statistical analysis using a Cox proportional hazards model. RESULTS: The incidence rate of bladder cancer per 100,000 persons in male never-smokers, ex-smokers and current-smokers were 27, 41 and 48, respectively, and the multivariate adjusted relative risks (RR) were 1.3 (95% confidence interval (CI), 0.9-2.0) and 1.7 (95% CI, 1.2-2.3) in ex- and current smokers, respectively. The incidence rate of bladder cancer in women was 4.7, 8.4 and 13, respectively. There was no significant association between the risk of bladder cancer and the amount and duration of smoking. CONCLUSIONS: We concluded that current smokers have an increased incidence and mortality rate of bladder cancer in both genders in the Korean population, but there was no significant difference in relation to the amount and duration of smoking.
Cohort Studies* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Male ; Mortality ; National Health Programs ; Proportional Hazards Models ; Prospective Studies* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking* ; Tobacco Products* ; Urinary Bladder Neoplasms* ; Urinary Bladder*