Because there is difficulty in the suture of renal pelvis, extended pyelolithotomy for the renal or pelvic calculi gives often complication such as urine leakage or infection, which result in the fibrosis and stricture of the region. Seven cases of renal stones are treated with new method using 8F Trumpet-shaped Nelaton Catheter. The proximal portion of the Nelaton Catheter inserted into the renal pelvis through the incised opening is made to arrive the lumen of the urinary bladder and the Trumpet-shaped distal portion is made to fix with the suture of the renal pelvis and capsules. After five to seven days, the catheter is removed by cystoscopic manipulation. It seems that the method is easy and feasible to decrease the complication of the extended pyelolithotomy for renal calculi.
Calculi ; Capsules ; Catheters* ; Constriction, Pathologic ; Fibrosis ; Kidney Calculi ; Kidney Pelvis ; Stents* ; Sutures ; Ureter* ; Urinary Bladder

PURPOSE: Recently, tension free vaginal tape (TVT) has been widely used in the management of stress urinary incontinence (SUI), and has been applied to SUI by intrinsic sphincter deficiency (ISD). This study was performed to identify the efficacy of the TVT procedure in SUI patients by ISD. MATERIALS AND METHODS: A total of 196 incontinent women, who underwent TVT procedures were enrolled in this study. The patients were divided into four groups according to their preoperative Valsalva leak point pressure (VLPP) and maximum urethral closure pressure (MUCP): Group I (anatomical incontinence, AI, n=78), Group II (mild ISD: 40cmH2O < or=VLPP<60cmH2O, n=54), Group III (moderate ISD: MUCP< or=20cmH2O or 30cmH2O< or=VLPP<40cmH2O, n=38) and Group IV (severe ISD: MUCP< or= 10cmH2O or VLPP< or=30cmH2O, n=26). One year after the TVT procedure, a symptom questionnaire and the urodynamic parameters were compared with the preoperative data. RESULTS: There were no significant differences in the Q-tip test, peak uroflow (Qmax) and post-voiding residual volume among the four groups preoperatively. There were no significant differences in success rates between ISD and AI. The postoperative cure rates were 82% (64/78) and 78% (92/118) for AI and ISD, respectively. In an urodynamic analysis, Groups III and IV the postoperative Q max were significantly decreased compared with Groups I and II, and the postoperative voiding difficulties were significantly higher in Groups III and IV (p<0.05). CONCLUSIONS: The TVT procedure showed high cure rates of SUI in the mild ISD and AI groups compared with those in the moderate and severe ISD groups. The rates of voiding difficulty were more frequent in moderate and severe ISD groups. According to our results, it can be suggested that TVT can be undertaken for stress incontinent women associated with ISD.
Female ; Humans ; Surveys and Questionnaires ; Residual Volume ; Suburethral Slings* ; Surgical Mesh ; Urinary Incontinence* ; Urodynamics

Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull

Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue ; Calcaneus ; Diagnosis ; Fat Necrosis ; Female ; Fibrosis ; Humans ; Ilium ; Lipoma* ; Male ; Middle Aged ; Osteogenesis ; Tibia ; X-Ray Film

PURPOSE: We investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency. MATERIALS AND METHODS: Eighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels. RESULTS: The subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels. CONCLUSIONS: Serum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.
Abdominal Fat ; Body Composition ; Electric Impedance ; Erectile Dysfunction* ; Exercise ; Exercise Test ; Humans ; Male ; Physical Fitness ; Testosterone*

Pharmacologic treatment of the detrusor hypocontractility(hyporeflexia) remains controversial issues. Clean intermittent self catheterization(CIC) alone, or combination with bethanechol chloride has been generally accepted as treatment modality. Until presently, bethanechol chloride is the only pharmacologic agent commonly used for bladder emptying without significant complication. However, the effectiveness of bethanechol seem to be episodic. The present study compared the contractile response of various pharmacologic agents including bethanechol chloride, ATP, PG E1, E2, F2-alpha on the smooth muscle strips of male rabbit bladder. In addition, effect of the gastrointestinal motility agents such as cisapride and metoclopramide on the contraction of rabbit bladder were assessed. Each bladder was divided into bladder body and bladder base for comparison of pharmacologic effects. FS at basal tension elicited a frequency dependent contraction which was greater in bladder body strips than in bladder base strips. The contractile responses to bethanechol, ATP, PG E1, E2 and PG F2-alpha were greater in bladder body than in bladder base.In the bladder body,magnitude of the contractile responses by ATP and PG F2-alpha were approximately 1/3 of those by bethanechol or FS.PG F2-alpha was consistently more potent to produce contraction than PG E1, E2. ATP induced contraction only consisted of initial phasic rise of tension. The contraction induced by PG developed slower than those caused by bethanechol. Cisapride(10uM) induced weak contractile responses comparable to those by PG E1 Metoclopramide had no contractile effects in this studies. Conclusively, differences exist in the response of the bladder body and base to FS and various pharmacologic agents. ATP, PG E2 and PG F2-alpha exhibited some notable contractile responses to the bladder body that were approximately 1/3 of those by bethanechol. Gastrointestinal motility agents were not shown to be effective in the mediation of contraction of rabbit bladder.
Adenosine Triphosphate ; Bethanechol ; Cisapride ; Gastrointestinal Motility ; Humans ; Male ; Metoclopramide ; Muscle, Smooth* ; Negotiating ; Urinary Bladder*

A 65 years old woman presented with indurative buccal swelling without ulceration. The result of the incisional biopsy disclosed as "plasmacytoma", and a series of radiographic and laboratory tests were rendered to find out if it involved multiorgan or not. Based on those studies, we finally diagnosed the disease as multiple myeloma and planned surgical excision followed by systemic chemotherapy.
Aged ; Biopsy ; Cheek* ; Drug Therapy ; Female ; Humans ; Mucous Membrane* ; Multiple Myeloma* ; Ulcer

Adult Wilms' tumor is rare unlike its pediatric counterpart. Because there is no specific radiologic findings of adult Wilms' tumor it is very difficult to diagnose the adult Wilms' tumor preoperatively and the final diagnosis is usually established with surgery. We report a case of Wilms' tumor in 26 years old postpartum woman with review of the literature.
Adult* ; Diagnosis ; Female ; Humans ; Postpartum Period ; Wilms Tumor*

PURPOSE: We evaluated the effect of tamsulosin on upper and lower ureteral stones that were smaller than 10mm to identify the patient groups for which tamsulosin was most applicable. MATERIALS AND METHODS: 85 patients who were diagnosed with ureteral stones smaller than 10mm in size were enrolled in this randomized prospective study. The patients were diagnosed via intravenous pyelography and then they were followed with weekly plain abdomen films for 4 weeks. The control group(Group 1) was given an nonsteroidal antiinflammatory drug(NSAID) for pain medication, and they were instructed to ingest at least 2l of fluids daily. For the treatment group(Group 2) once daily 0.2mg tamsulosin was added. Both groups were compared for the size of stone and the days to expulsion and pain control, based upon the number of emergency room(ER) visits. The proximal and distal ureteral stones were separately evaluated, and the patients' gender, age, stone size and stone position were analyzed to identify treatment efficacy. RESULTS: The average stone size was 5.2+/-2.6mm in group 1 and 4.7+/-1.5mm in group 2(p=0.344). The success rate was 42.9% in group 1 and 76.5% in group 2(p=0.005). Group 2 showed a significant reduction for the time to stone expulsion at 12.7+/-6.6 days compared to 18.5+/-6.9 days for group 1(p=0.008). Among the subset of patients, those with distal ureteral stones smaller than 5mm alone showed a significant increase in the expulsion rate(100%, p=0.047) and a decrease of the days to expulsion(12.1+/-5.1 days, p=0.018). CONCLUSIONS: Tamsulosin increases the spontaneous expulsion rate and reduces the time to expulse ureteral stones, and it was most effective for distal stones less than 5mm in size.
Abdomen ; Emergencies ; Humans ; Prospective Studies ; Treatment Outcome ; Ureter* ; Urinary Calculi ; Urography

Random biopsy of normal-looking mucosa of the bladder at the time of T.U.R.B. in the patients with bladder cancer have been used as a routine assessment of the tumor behavior. To investigate mucosal abnormalities of normal-looking mucosa in bladder cancer. we performed random mucosal biopsies during transurethral resection of the bladder cancer. The following results were obtained. 1. In Group 1 (Solitary, Stalk, Papillary ca). no CIS lesion was found in biopsy specimens. 2. In Group 2 (Solitary. Sessile. Papillary ca) and Group 3 (Solitary. Sessile. Non-papillary ca). some positive results were obtained. On the consideration of above results and the potentiality of implantation. we can raise an issue that the bladder cancer patients with a solitary, papillary shape do not necessarily undergo the mucosal biopsy during T.U.R.B. Instead, close follow up for the patients will be recommended.
Biopsy* ; Humans ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder*