BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

We evaluated the role of retroperitoneal laparoscopic ureterolithotomy (RPLU) for upper ureter stones. Between February 1998 and July 2004, 12 patients (10 men and 2 women) underwent RPLU for upper ureter stones (mean size 18.1 mm, range 10-25). RPLU was carried out in 5 patients as a salvage treatment after failed shock wave lithotripsy (SWL) (3) and both of failed SWL and ureteroscopy (URS) (2), and in 7 patients as primary treatment for large impacted stones. Total 6 of 12 cases were converted to open surgery. The reason of open conversion was failure of locating ureter due to severe adhesion in 5 cases and vascular injury in 1 case. In 6 successful cases, mean operation time, mean estimated blood loss, and mean postoperative hospital stay were respectively 109 min (90-120 min), 50 mL (10-100 mL), 4.6 days (2-7 days). There was no serious postoperative complication except for one patient who showed delayed urinary leakage but was cured with conservative management. Our experience suggested that RPLU was not easy to perform simply because it was indicated mainly in ureter stones with severe adhesion or after failed SWL and/or URS. Nevertheless, it can be considered as a primary procedure before open ureterolithotomy.
Urologic Surgical Procedures/*methods ; Ureteral Calculi/*therapy ; Ureter/pathology ; Treatment Outcome ; Time Factors ; Sex Factors ; Retroperitoneal Space/pathology ; Peritoneum ; Middle Aged ; Male ; Lithotripsy/*methods ; Laparoscopy/*methods ; Humans ; Female ; Adult

PURPOSE: In the era of shock wave lithotripsy (SWL) and ureteroscopy, the majority of ureter stones are successfully managed with these less invasive treatment modalities. However, open ureterolithotomy still has a role in special situations. The efficacy of a laparoscopic retroperitoneal ureterolithotomy for large impacted ureter stones indicated for open ureterolithotomy is reported. MATERIALS AND MTHODS: Between February 1998 and December 1999, laparoscopic retroperitoneal ureterolithotomy for proximal ureter stones was performed in 5 patients who required an open ureterolithotomy. The mean size of the stones was 15mm, all of which were tightly impacted in the ureteral lumen and were associated with marked hydronephrosis. RESULTS: All but the initial operation was performed successfully via the retroperitoneal approach. Open conversion was needed in the first patient because of inexperience and the lack of anatomic perception. The mean operation time and estimated blood loss was 122 minutes and < or =50ml, respectively. A transfusion was not needed in any of the patients. Postoperative pain was well controlled with 175mg of Ketoprofen. The mean postoperative length of hospital stay was 6.3 days. There were no significant intraoperative or postoperative complications. CONCLUSIONS: A laparoscopic retroperitoneal ureterolithotomy can be considered as an alternative to conventional ureterolithotomy when open surgery is indicated.
Humans ; Hydronephrosis ; Ketoprofen ; Laparoscopy ; Length of Stay ; Lithotripsy ; Pain, Postoperative ; Postoperative Complications ; Shock ; Ureter ; Ureteroscopy

PURPOSE: In the era of shock wave lithotripsy (SWL) and ureteroscopy, the majority of ureter stones are successfully managed with these less invasive treatment modalities. However, open ureterolithotomy still has a role in special situations. The efficacy of a laparoscopic retroperitoneal ureterolithotomy for large impacted ureter stones indicated for open ureterolithotomy is reported. MATERIALS AND MTHODS: Between February 1998 and December 1999, laparoscopic retroperitoneal ureterolithotomy for proximal ureter stones was performed in 5 patients who required an open ureterolithotomy. The mean size of the stones was 15mm, all of which were tightly impacted in the ureteral lumen and were associated with marked hydronephrosis. RESULTS: All but the initial operation was performed successfully via the retroperitoneal approach. Open conversion was needed in the first patient because of inexperience and the lack of anatomic perception. The mean operation time and estimated blood loss was 122 minutes and < or =50ml, respectively. A transfusion was not needed in any of the patients. Postoperative pain was well controlled with 175mg of Ketoprofen. The mean postoperative length of hospital stay was 6.3 days. There were no significant intraoperative or postoperative complications. CONCLUSIONS: A laparoscopic retroperitoneal ureterolithotomy can be considered as an alternative to conventional ureterolithotomy when open surgery is indicated.
Humans ; Hydronephrosis ; Ketoprofen ; Laparoscopy ; Length of Stay ; Lithotripsy ; Pain, Postoperative ; Postoperative Complications ; Shock ; Ureter ; Ureteroscopy

No abstract available.
Breast Neoplasms* ; Breast* ; DNA* ; Oncogene Proteins* ; Oncogenes* ; Ploidies* ; Prognosis*

No abstract available.
Emergencies* ; Hematoma, Subdural, Acute* ; Trephining*

OBJECTIVE: Radiation injury includes radiation necrosis and apoptosis. The purpose of this study is whether steroids and calcium channel blockers are effective for the prevention of single high dose irradiation-induced apoptosis in the rat brain. METHODS: Eighty Sprague-Dawley rats were divided into four experimental groups: Control(nontreated, n=20), Dexamethasone-treated(0.1mg/kg, n=20), Prednisolone-treated(2mg/kg, n=20), Nimodipine-treated (0.5mg/kg, n=20). After drug was administered, the right hemisphere of rat's brain was exposed to a single 10Gy dose of gamma rays using Ir-192. All brains underwent histological examination at 1 week, 2 weeks, 4 weeks, and 8 weeks after irradiation to evaluate cortical thickness and number of apoptotic cells. Apoptotic cells were detected by TUNEL assay. RESULTS: In nimodipine-treated group, apoptotic cell count was reduced significantly, compared to that of control(non treated) group at 4 and 8 weeks after irradiation(p<0.05). The decrease of cortical thickness was reduced significantly in nimodipine-treated group, compared to that of control group(p<0.05). There was no significant changes in the number of apoptotic cells and cortical thickness in prednisolone and dexamethasone-treated groups compared with those of control. CONCLUSION: These results suggest that nimodipine treatment may have effects on the prevention of radiation-induced apoptosis. If it could be established that calcium channel blockers inhibit radiation injury, they might be useful in radiation therapy. Further investigation of calcium channel blockers including dosage effectiveness, intracellular calcium ion concentration and effects on tumor tissue are necessary to clarify the usefulness of nimodipine.
Animals ; Apoptosis* ; Brain* ; Calcium Channel Blockers ; Calcium Channels* ; Calcium* ; Cell Count ; Dexamethasone ; Gamma Rays ; In Situ Nick-End Labeling ; Necrosis ; Nimodipine ; Prednisolone ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley ; Steroids

PURPOSE: This study aimed to determine the exact characteristics of bacterial colonization after a ureteral stent indwelling. MATERIALS AND MTHODS: The natural history of bacterial colonization on the stent itself and urine samples after different periods of stent indwelling was examined. A total of 57 double-J stents from 52 patients (21 male; 31 female) with mean age of 52 (range 20-79) years were examined. In all patients, short-term (for 2-3 days) antimicrobial therapy was done at the time of stenting. Regular urinalysis and urine culture were performed until the stent was removed. The stents were removed under aseptic conditions and the proximal and distal tip segments were obtained. Three culture specimens were acquired from each stent segments (inner surface washing suspension, outer surface washing suspension and the stent tip itself). RESULTS: Bacterial colonies were found in 44% (25/57). Multiple pathogens were identified, and Enterococcus species (6/25) was the most common pathogen followed by E. coli (5/25). The bacteria did not colonize within the first 2 weeks of indwelling. However, the colonization rate increased, as the duration of the indwelling was further increased. Colonization in the stent was followed by the colonization in the urine. CONCLUSIONS: Bacterial colonization does not occur during the initial 2 weeks after stent indwelling. This suggests that antibiotics for short-term indwelling of ureteral stents are not necessary.
Anti-Bacterial Agents ; Bacteria ; Bacterial Adhesion ; Colon* ; Enterococcus ; Humans ; Male ; Natural History ; Stents* ; Ureter* ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: This study aimed to determine the exact characteristics of bacterial colonization after a ureteral stent indwelling. MATERIALS AND MTHODS: The natural history of bacterial colonization on the stent itself and urine samples after different periods of stent indwelling was examined. A total of 57 double-J stents from 52 patients (21 male; 31 female) with mean age of 52 (range 20-79) years were examined. In all patients, short-term (for 2-3 days) antimicrobial therapy was done at the time of stenting. Regular urinalysis and urine culture were performed until the stent was removed. The stents were removed under aseptic conditions and the proximal and distal tip segments were obtained. Three culture specimens were acquired from each stent segments (inner surface washing suspension, outer surface washing suspension and the stent tip itself). RESULTS: Bacterial colonies were found in 44% (25/57). Multiple pathogens were identified, and Enterococcus species (6/25) was the most common pathogen followed by E. coli (5/25). The bacteria did not colonize within the first 2 weeks of indwelling. However, the colonization rate increased, as the duration of the indwelling was further increased. Colonization in the stent was followed by the colonization in the urine. CONCLUSIONS: Bacterial colonization does not occur during the initial 2 weeks after stent indwelling. This suggests that antibiotics for short-term indwelling of ureteral stents are not necessary.
Anti-Bacterial Agents ; Bacteria ; Bacterial Adhesion ; Colon* ; Enterococcus ; Humans ; Male ; Natural History ; Stents* ; Ureter* ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract*

No abstract available.
Adult* ; Humans ; Korea* ; Prevalence* ; Seoul* ; Urolithiasis*