No abstract available.
Prostatic Neoplasms* ; Receptors, Androgen*

BACKGROUND: Computerized topography(CT) is the method of choice for establishing patients with abdominal and/or pelvic trauma. However, the sensitivity of CT far detecting bladder rupture has been questioned. We investigated the roles of CT as the initial evaluation of abdominal and pelvic trauma in diagnosis of bladder rupture. METHODS: We reviewed the medical records and radiographs of 53 patients with bladder rupture for last 5 year. And among them, all radiographs of 30 patients who underwent both CT and retrograde cystography were evaluated independently by two urologists who had no knowledge of the patients' final diagnosis. RESULTS: Among 30 patients, all of patients were correctly diagnosed by retrograde cystography, but the CT diagnosis was correct in only 23 patients(76.7%), who were 17 patients(85.0%) with intraperitoneal rupture and 6 patients(60%) with extraperitoneal rupture. And of the 7 patients who were negative by the CT, all showed the sign of inadequate bladder distension. CONCLUSION: We suggest that CT, if properly performed with adequate bladder filling, is as sensitive for detection of bladder injuries as conventional cystography. Especially, in trauma patients with hematuria and suspected other organ injury, CT-cystography with retrograde filing may be as accurate as conventional cystography and obviate the need for an additional plain film cystography,
Diagnosis* ; Hematuria ; Humans ; Medical Records ; Rupture ; Urinary Bladder*

No abstract available.
Carbon Dioxide* ; Carbon* ; Respiratory Rate* ; Tidal Volume*

Pheochromocytoma originate from chromaffin cells and occur in the adrenal medulla in majority. About 10 per cent of pheochromocytomas can occur in the ectopic or extra-adrenal sites, anywhere along the fetal route of the chromaffin tissues. Pheochromocytoma of the bladder is a rare neoplasm that often occurs with the unique symptom complex of micturitional attacks, such as headache, palpitation, hypertension of sweating due to increased catecholamine secretion during detrusor activity. We report a very rare case of nonfunctioning pheochromocytoma of the bladder in a 67- year-old woman without typical symptoms. Preoperatively elevated urine catecholamines and their metabolites returned to normal after removal of the tumor.
Adrenal Medulla ; Catecholamines ; Chromaffin Cells ; Female ; Headache ; Humans ; Hypertension ; Pheochromocytoma* ; Sweat ; Sweating ; Urinary Bladder*

Transurethral laser induced thermotherapy by Prostalase is a new modality being evaluated for the treatment of BPH. We performed transurethral laser induced thermotherapies on 30 patients from April 1993 to December 1993. After treatment, 27 patients of them were followed up (urinary retention in 13 cases, non-urinary retention in 14 cases). Mean age of patients was 72 year-old. Prostalase in system was run for 40 minutes with single session without anesthesia. We evaluated patients with Boyarsky symptom score, urine flow rate. volume of residual urine, prostatic volume. Mean Boyarsky symptom score decreased from 16.5 to 7.8 for a 52.7% improvement on non-retention group, mean Boyarsky symptom score decreased from 16.7 to 6. 2 for a 62.8% improvement on retention group at 6 months after treatment. Mean peak flow rate increased 84.7% from a preoperative average of 7.2ml/s to 13.3ml/s at 6 months on non- retention group, mean peak flow rate increased 61.7 % from a postoperative 1-month average of 10.2ml/s to 16.5ml/s at 6 months on retention group. Prostatic volume decreased 22.4 % from a preoperative average of 37.5gm to 29.1 gm at 3 months on non-retention group, prostatic volume decreased 23.5% from a preoperative average of 42.0gm to 32.1gm at 3 months on retention group. There have been no urinary tract infection or retrograde ejaculation. Acute urinary retention occurred in 2 patients, gross hematuria in 1, urinary incontinence in 1. Our study number is small, but we think transurethral laser thermotherapy (Prostalase) to be a safe and less morbid alternative to transurethral resection of prostate.
Aged ; Anesthesia ; Ejaculation ; Hematuria ; Humans ; Hyperthermia, Induced* ; Male ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate ; Urinary Incontinence ; Urinary Retention ; Urinary Tract Infections

Heat Shock Protein (HSP) is a genetic product reacting on stress. HSP is increased by physiological or environmental stress and expressed at gastrointestinal tumors such as stomach cancer, pancreatic cancer and large intestinal cancer, and at other various tumors such as lymphoma and breast cancer. The role of HSP is to interrupt the process of apoptosis interfering with formation of tumors, and weaken function of tumor control beyond that of immune surveillance. In case of causing the normal p53 to be mutated, it leads to morphological change of p53 protein and combine with HSP. But, it has not been clarified yet. We intend to examine the meaning of HSP 70 in bladder tumor by investigating the relations among HSP expression and tumor stage, tumor grade, P-gp (glycoprotein) expression as a product of multi-drug resistant gene, and p53 expression in 59 cases of bladder tumor. 1) There were HSP expressions of 8 cases (22%) among 36 superficial bladder tumors and of 9 cases (39%) among 23 invasive bladder tumors. 2) HSP positive reactions were observed in 1 case (8%) of 13 Grade I, and 6 cases (29%) of 21 Grade II and 10 cases (40%) of 25 Grade III. 3) Positive reactions of HSP were showed in 10 cases (40%) among 25 P-gp expression, and in 7 cases (21%) among 34 P-gp non-expression. 4) The p53 proteins were expressed in 12 cases (29%) among 42 ones of HSP non-expression and in 8 cases (47%) among 17 ones of HSP expression. 5) Positive reactions of HSP were showed in 9 cases (23%) among 39 ones of p53 non-expression, and in 8 cases (40%) among 20 ones of p53 expression. 6) 5 patients of 6 with negative expression of HSP and strong positive expression of p53 had poorly differentiated transitional cells, in which one of the patients accompanied with lung metastasis. In view of above study, HSP expression has no correlation with P-gp and stage in bladder tumor, but it has probable pertaining to tumor grade and p53. As it were, tumor cellular differentiation and p53 expression have weak correlations with HSP 70 expression. Meanwhile, judging from poor differentiation, in most cases of HSP non-expressed but p53 strongly expressed, HSP is insufficient to be a prognostic factor of bladder tumor independently, however, in case of using it, as supplementary one, concurrently with p53, it would be valuable prognostic factor in bladder tumor.
Apoptosis ; Breast Neoplasms ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Humans ; Intestinal Neoplasms ; Lung ; Lymphoma ; Neoplasm Metastasis ; P-Glycoprotein ; Pancreatic Neoplasms ; Stomach Neoplasms ; Urinary Bladder Neoplasms* ; Urinary Bladder*

To evaluate the role of digital rectal examination(DRE), prostate specific antigen(PSA), transrectal ultrasound(TRUS) and prostate specific antigen density(PSAD) and the effectiveness of TRUS-guided perineal prostatic biopsy in the diagnosis of prostate cancer, the clinical data were reviewed from the 78 patients who were suggested to have prostate cancer with DRE, PSA or TRUS, and pathologically confirmed by TRUS-guided six systematic biopsy between May 1993 and February 1995. Of 78 patients, 15 patients(19.2%) had prostate cancer, 60 patients(76.9%) BPH, 2 patients (2.6%) chronic prostatitis and 1 patient(1.3%) prostatic metastasis from transitional cell carcinoma of the bladder. Only 2 of 15 cancers (13.3%) were localized cancer, while 10 of 15 cancers(66.7%) had distant metastasis. Although 35 patients received TURP among 60 patients with BPH, and their specimens were investigated pathologically whether prostate cancer was present, there was no prostate cancer. Of 34 patients whose PSA levels were below 10ng/ml, none had prostate cancer regardless of the results of DRE and TRUS. PSA had the highest sensitivity(100%) and DRE the highest specificity (79.4%) among the modalities. The positive predictive value of DRE, PSA and TRUS was 48.0%, 22.1% and 36.1% respectively. DRE and TRUS had 54.5% and 44.8% Positive predictive value in patients with elevated PSA level in contrast to 0% positive predictive value in patients with normal PSA level. Because 3 patients of prostate cancer with negative DRE and positive TRUS had elevated PSA level(>20ng/ml), the addition of TRUS to PSA and DRE was not helpful in early detection of prostate cancer. Although PSAD of prostate cancer group and non-prostate cancer group was 1.312+/-0.155(S.E.) and 0.279+/-0.036 respectively(p<0.05), we could not found any superiority of PSAD to PSA in early diagnosis of prostate cancer. In conclusion, these results suggest that PSA and DRE should be used as the first line modality in early diagnosis of prostate cancer, TRUS-guided prostatic biopsy may be considered as a confirmative modality in patients with elevated PSA level or abnormal DRE and the clinical.trials for standardization of the upper normal limit of PSA should be followed.
Biopsy* ; Carcinoma, Transitional Cell ; Diagnosis ; Early Diagnosis ; Humans ; Neoplasm Metastasis ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Prostatitis ; Sensitivity and Specificity ; Transurethral Resection of Prostate ; Ultrasonography* ; Urinary Bladder

Bilateral renal cell carcinoma is relatively rare and associated with dismal outlook. We experienced 2 cases of asynchronous bilateral renal cell carcinoma. Herein these cases are presented with review of literatures.
Carcinoma, Renal Cell*

The incomplete obliteration of the processus vaginalis leads to the development of inguinal hernia in pediatric age, and its management is principally surgical repair. This study was a review and analysis of the usefulness of herniography on the hydrocele in pediatric age. From January 1985 to June 1989, 117 patients with unilateral hydrocele were studied to evaluate incomplete obliteration of the processus vaginalis. The over-all incidence of open processus vaginalis on the opposite side was 6.9% (8 of 117 cases), but the rate of patients who had past history of a palpable or visualized mass on the opposite side was 5%(3 of 12 cases). This finding would suggest that the herniogram is needed for the patients whose history is suspicious for hydrocele testis.
Hernia, Inguinal ; Humans ; Incidence ; Testis

From July 1982 to February 1984, we performed 21 times of microsurgery for urethroplasty and pyeloplasty: 11 times in 11 cases of hypospadia, 4 times in 3 cases of urethrocutaneous fistula and 6 times in 5 cases of UPJ stricture. The results were as follows : 1. Success rate of urethroplasty was 81.8% (9/11) , but complication rate was 36.4% (4/11). 2. Success rate of urethrocutaneous fistular repair was 50% (2/4) . Fistula was recurred in two cases after first repair of urethrocutaneous fistula. 3. Success rate of pyeloplasty was 100%.
Constriction, Pathologic ; Female ; Fistula ; Hypospadias ; Male ; Microsurgery