PURPOSE: The diuretic renal scan has been considered to be a good tool for evaluating the postoperative renal function in the patients with ureteropelvic junction obstruction (UPJO). We evaluated the diagnostic accuracy of the renogram, the serial renal scan and the diuretic half time according to the differential renal function (DRF) on the diuretic renal scan. MATERIALS AND METHODS: We reviewed the diuretic renal scans of 27 pediatric patients (25 males and 2 females) who underwent pyeloplasty due to unilateral UPJO. Diuretic renal scanning was done using the 99mTc- DTPA (diethylenetriaminepentaacetic acid) standardized protocol. We compared the diagnostic accuracy of the renogram, the serial renal scan and the diuretic half time according to the DRF (group I: above 40%, group II: below 40%). RESULTS: The mean age of the patients was 48.0 59.2 months (range: 2-210 months). The diuretic half time, renogram, serial renal scan and each combination demonstrated statistical significance for the interpretation of ureteral obstruction (generalized estimation equation, p=0.003). The interpretation of the diuretic renal scan was not affected by the DRF (McNemar test, p=0.598). The false positive rate and specificity of the renogram, serial renal scan and diuretic half time were 22.2%, 29.6%, 59.3% and 77.8%, 70.4%, 40.7%, respectively. In addition, the false positive rate and specificity of a combination of the diuretic half time and renogram, the diuretic half time and serial renal scan, the renogram and serial renal scan, the diuretic half time and renogram, and serial renal scan were 22.2%, 25.9%, 14.8%, 14.8%, and 77.8%, 74.1%, 85.2%, 85.2%, respectively. CONCLUSIONS: The diuretic half time, renogram and serial renal scan were individually correlated with the postoperative status of the UPJO. However, a combination of various factors of the renal scan should be considered for evaluating the postoperative status of UPJO.
Follow-Up Studies ; Humans ; Male ; Pentetic Acid* ; Radionuclide Imaging ; Sensitivity and Specificity ; Ureteral Obstruction

No abstract available.

PURPOSE: To examine the centrally elicited erectile effects of alpha-MSH, oxytocin, prostagladin E1, and anabolic steroids after intracerebroventricular administration. MATERIALS AND METHODS: We used anesthetized male Sprague-Dawley rats. After intracerebroventricular administration of normal saline (NS), alpha-melanocyte stimulating hormone (alpha-MSH), oxytocin acetate (OT), prostaglandin E1 (PGE1), methylprednisolone (MP), testosterone enanthate (TE) or 17beta-estradiol (E2) under stereotaxis, the intracavernosal pressure (ICP), systolic femoral artery pressure (FAP), heart rate (HR), time to first response, duration, and number of erectile responses and adverse reactions were evaluated for 60 minutes. To show whether erections were centrally elicited, the above criteria were re-evaluated after a bilateral pelvic neurotomy and bilateral orchiectomy. RESULTS: A cerebral proerectile effect was elicited only by alpha-MSH and OT with no significant changes of FAP or HR. With PGE1, significant changes in FAP and HR were observed. The ICP/FAP ratio was highest (0.49 0.03) with alpha-MSH. The mean time latency was shortest with OT (20.6 5.6 min). The mean duration was longest in alpha-MSH (11.6 8.7 min). The number of responses was highest with OT (3.6 0.7). Adverse reactions, such as stretching, yawning and ejaculation, were simultaneously observed during increases in ICP. In the cases of a bilateral pelvic neurotomy or bilateral orchiectomy, these elicited erectile responses disappeared. CONCLUSIONS: alpha-MSH had the most potent proerectile effect compared to OT and PGE1 as assessed by highest intracavernosal pressure as well as duration of erectile response. The results suggest that testosterone and the pelvic nerve were essential for the central proerectile response.
alpha-MSH ; Alprostadil ; Animals ; Ejaculation ; Femoral Artery ; Heart Rate ; Humans ; Male ; Methylprednisolone ; Orchiectomy ; Oxytocin ; Penile Erection ; Rats* ; Rats, Sprague-Dawley ; Steroids ; Testosterone ; Yawning

A contralateral metachronous ureteropelvic junction obstruction (UPJO) following ipsilateral pyeloplasty for a UPJO is rarely reported. We report a case of 47-year-old woman who developed a contralateral metachronous UPJO following uneventful left-sided pyeloplasty for a UPJO. (Korean J Urol 2005;46:776-778)
Female ; Humans ; Kidney Pelvis ; Middle Aged ; Ureteral Obstruction

PURPOSE: Although a radical nephrectomy is the mainstay in the surgical management of renal cell carcinomas, a partial nephrectomy is indicated in certain situations where a radical nephrectomy would render the patients in a state of renal insufficiency. Furthermore, the indications are being expanded to include incidentally found small unilateral renal cell carcinomas with a normal contralateral kidney. Therefore, the outcomes between patients treated with partial and radical nephrectomies for renal cell carcinomas were compared. MATERIALS AND METHODS: Between January 1997 and March 2004, 171 nephrectomy operations were performed as curative treatments for renal masses at the urooncology department of our hospital. The study group was composed of 93 and 32 cases of radical and partial nephrectomies, respectively, with a final pathologic diagnosis of a renal cell carcinoma. The operations for renal cell carcinomas were performed by the same surgeon. The survival rate, time of local recurrence, complication and outcomes were compared and the records of 125 patients who underwent a nephrectomy for a renal cell carcinoma were retrospectively reviewed. RESULTS: The overall mean postoperative follow-up was 25.9, ranging from 2 to 72 months. All the long-term outcomes of a partial nephrectomy for renal cell carcinoma were comparable to those of a radical nephrectomy, especially for localized renal cell carcinomas. CONCLUSIONS: A partial nephrectomy could be a better treatment option for localized renal cell carcinomas in appropriately selected cases with normal contralateral kidneys as well as in the absolute indication, with comparable outcomes to a radical nephrectomy, but the more groups and a long-term follow up are required if a partial nephrectomy is to become the standard operation for localized renal cell carcinoma treatment.
Carcinoma, Renal Cell* ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney ; Nephrectomy* ; Recurrence ; Renal Insufficiency ; Retrospective Studies ; Survival Rate

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

Purpose: To understand the process of hemodynamic change and compensatory hypertrophy of the contralateral kidney in an acute ureteral obstruction (UO), the inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1alpha (HIF-1alpha) expressions in the contralateral kidney were evaluated during the acute stage of unilateral UO in the rat. Materials and Methods: Specimens (kidneys) were aseptically removed from 35 Sprague-Dawley rats (8 weeks old, weight 250-300gm) of the control (0 hours), sham (6, 12 and 24 hours) and experimental groups (UO 6, 12 and 24 hours). The iNOS, VEGF and HIF-1alpha expressions in the contralateral kidney (total renal tissue, medulla and cortex) were evaluated by immunohistochemical staining. The HIF-1alpha expression was also evaluated by a Western blot assay. Results: Contrary to the control and sham groups, the iNOS, VEGF and HIF-1alpha expressions in the contralateral kidney from the immunohistochemical staining increased with time of obstruction, especially in the medulla. The HIF-1alpha expression in the contralateral kidney by the Western blot assay was increased in all the renal tissue, medulla and cortex compared to those in the control and sham groups. Conclusions: In the contralateral kidneys of rats with UO increased expressions of iNOS, VEGF and HIF-1alpha may facilitate trophic changes and a compensatory increase in the blood flow.
Animals ; Blotting, Western ; Hemodynamics ; Hypertrophy ; Kidney* ; Models, Animal* ; Nitric Oxide Synthase Type II ; Rats* ; Rats, Sprague-Dawley ; Ureter* ; Ureteral Obstruction* ; Vascular Endothelial Growth Factor A*

PURPOSE: Radical cystectomy with pelvic lymphadenectomy is an effective therapeutic modality in invasive bladder cancer. The development of another technique for a radical cystectomy for the early recovery and reduction of complications was attempted. MATERIALS AND METHODS: Between March 1997 and June 2003, an extraperitoneal radical cystectomy was attempted in 18 patients with invasive bladder cancer (pT1-pT4). Not only standard or extended pelvic lymphadenectomy, but also re-positioning of the ureter to the opposite side, could be performed extraperitoneally. An intestinal segment could be taken out through a small window within the peritoneum and manipulated as desired. The clinical safety and complications of other surgical approaches for radical cystectomy were also investigated. RESULTS: The procedure was successful in 15 of the 18 patients (4 studer pouches, 3 ileal conduits and 8 ureterocutaneostomies). Failure to peel out the peritoneum occurred in 3 cases, 1 each due to technical difficulties, tumor invasion at the bladder dome and adhesion due to a previous radical prostatectomy. Complications occurred in 8 cases (53.1%). The intestinal obstruction progressed in 1 case (12.5%) due to a high positioned mesentery of the Studer pouch. There were no significant gastrointestinal complications in any of the 8 patients that underwent the extraperitoneal radical cystectomy with ureterocutaneostomy. CONCLUSIONS: An extraperitoneal radical cystectomy seems to reduce the gastrointestinal complications and be worthwhile in certain cases with advanced bladder cancer. Despite the visual limitation, it is an acceptable surgical technique compared to the conventional transperitoneal methods.
Cystectomy* ; Humans ; Intestinal Obstruction ; Lymph Node Excision ; Mesentery ; Peritoneum ; Prostatectomy ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion

Most foreign bodies in the lower genitourinary tract are self-inserted through the urethra. A diagnosis is made by clinical history, physical examinations, and imaging studies of the patient. The best method of removing a urethral foreign bodydepends on the size and mobility of the object. When possible, endoscopic and minimallyinvasive techniques of removal should be used. However, surgical retrieval of a foreign body may be required. We report 4 cases of foreign bodies in the urethra with a brief literature review.
Diagnosis ; Foreign Bodies* ; Humans ; Physical Examination ; Urethra*