Multicystic dysplastic kidney is the most frequent cause of abdominal mass in the neonate, but its presentation is variable depending on the size of cystic kidney, state of the opposite kidney and associated anomalies. multicystic dysplastic kidney also represents a spectrum of pathology from unilateral multicystic kidney through segmental and focal multicystic dysplasia to bilateral multicystic kidney. Herein we report 5 cases of MCK with different presentation and histology, a bilateral MCK associated with horseshoe kidney, a large MCK with uremia, a focal segmental MCK with contralateral UPJ obstruction, a small focal segmental MCK with contralateral megaureter and a small MCK detected by ultrasonogram for localization of impalpable testis.
Humans ; Infant, Newborn ; Kidney ; Kidney Diseases, Cystic ; Multicystic Dysplastic Kidney* ; Pathology ; Testis ; Ultrasonography ; Uremia

Chemotherapeutic agents were evaluated for their effect on the development of urinary bladder tumors, induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) in female Sprague-Dawley rats. For 16 weeks, 0.05% BBN was administered orally, and then chemotherapeutic agents (adriamycin and cisplatin) were injected intraperitoneally for 12 weeks. In our preliminary experimental series, an experimental bladder tumor model induced by BBN was useful in evaluating the effectiveness of chemotherapeutic agents. Cisplatin appears to be effective in inhibiting precancerous histologic changes and carcinoma in rat urinary bladder mucosa by BBN. However, the effectiveness of adriamycin was inconclusive.
Animals ; Carcinogenesis* ; Cisplatin ; Doxorubicin ; Female ; Humans ; Injections, Intraperitoneal* ; Mucous Membrane ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; Urinary Bladder*

Autonomic dysreflexia is a syndrome characterized by severe hypertension, headache, sweating that is seen in spinal cord injury population. It can be a life-threatening problem if not promptly recognized and treated. Since the most common cause is bladder distention, it is essential that the urologist sh6fild be familiar with this syndrome. Two hundred ninety four patients with spinal cord injury were reviewed for the prevalence rate and clinical manifestations of autonomic dysreflexia. The time of onset post-injury, precipitating causes, presenting symptoms and management were analyzed. 42 patients (34.4%) of 122 patients with lesion above T6 level exhibited autonomic dysreflexia. The majority of patients (61.9%) had manifested signs and symptoms of autonomic dysreflexia within the first year. The precipitating causes were bladder distention (69.0%), bowel distention (23.8%) and urinary tract infection (7.1%). The presenting symptoms of autonomic dysreflexia were headache (88.1%), sweating (88.1%), hot flushing (28.6%), chest discomfort, hyperpnea and spasm. The management of autonomic dysreflexia include prompt bladder erupting, bed rest and appropriate bowel preparation. In conclusion, prompt recognition and appropriate management of autonomic dysreflexia are essential to prevent life-threatening sequelae.
Autonomic Dysreflexia* ; Bed Rest ; Flushing ; Headache ; Humans ; Hypertension ; Prevalence ; Spasm ; Spinal Cord Injuries* ; Spinal Cord* ; Sweat ; Sweating ; Thorax ; Urinary Bladder ; Urinary Tract Infections

Sacral pressure sores have been treated by a variety of surgical methods. complete treatment needs wide excision and coverage with healthy tissue which has constant and sufficient blood supply. Use of gluteus maximus muscle flap with or without overlying skin is a revolutionary method because of the reliability of blood supply. However, it is technically a little bit complicated, and future reconstruction for recurrent decubitus is especially limited in paraplegic patients. The development of gluteal perforator-based flap with para-sacral perforator introduce a new treatment modality for the sacral pressure sores. Total 10 cases of sacral pressure sores were treated with gluteal perforator-based flap. There were minimal postoperative complications except wound dehiscence in one case. This flap has a many advantage of no transection or sacrifice of the gluteus maximus muscle, elevation time for the flap is short, reliable blood flow of the perforator, large rotation arc and no post-operative hindrance to walking in patients who are not paraplegic. The disadvantages of this perforator-based flaps are the anatomical variation in the location of perforators and the need for technically careful dissection.
Humans ; Postoperative Complications ; Pressure Ulcer* ; Skin ; Walking ; Wounds and Injuries

Ultrasonography is a very useul diagnostic modality for the evaluation of clinically suspicious abdominalmasses in infants and children, especially in assessing their existence, size,location, origin and internalconsistency. Authors analyzed and present ultrasonographic findings of 92 pathologically and/or clinically provenpediatric abdominal masses that were studied and treated in Chonnam University Hospital during recent 4 years. Theresults were as follows: 1. The most common originating site was kidney(26 cases: 28.3%), followed bygastrointestinal tract (21 cases: 22.8%), genital organ(17 cases: 18.5%), non-renal retroperitoneum (13cases:18.5%), hepatobilary tract (12 cases:13.0%), and anterior abdominal wall (3 cases: 3.3%) in ordre offrequency. 2. The most common mass was hydonephrosis(18 cases: 19.6%). Neuroblastoma(7 cases:7.6%),hepatoblastoma, ovarian teratoma, periappendiceal abscess and abdominal tuberculosis(6 cases: 6.5%, respectively),Wilms tumor(5 cases: 5.4%) were next in order of frequency. 3. The sex distribution is rather similar, that is ,male 42(45.7%) and female 50(54.3%), but characteristically choledochal cyst(2 cases) and genital mass(17 cases)were found only in females. Considering age distribution, 78 cases(84.8%) were found within the range of one to 15years of age. The rest, 14 cases(15.2%), were under the age of one year. 4. With ultrasonography, the diagnosis ofhydronephrosis could be made easily in every case and we could evaluate its severity and level of obstruction withhigh accuracy. 5. All Wilms tumor were large, round or oval, sharply marginated and relatively homogenous solidmasses. 6. All neuroblastomas were irregular shaped, poorly defined, heterogeneous solid masses. Tumorcalcification and extension across the midline were noted in 6 cases(85.7%) and 5 cases(71.4%), respectively. 7.All periappendiceal abscesses had irregular thickened wall and posterior acoustic enhancement: 4 cases (66.7%)among them were mixed echo pattern and 2 cases(33.3%) ehco free. 8. Among the 6 abdominal tuberculoses, 2 wereseen as irregularly defined solid masses, 1 as conglomeration of multiple hypoechoic nodulles and 3 as mixedpatterns. 9. All hepatoblastomas were seen to be poorly marginated solid masses with more echogenicity thanadjacent normal hepatic echo in 5 cases except one. 10. Among the 6 ovarian teraomas, 4 cases were cystic and 2cases solid. Acoutic shadowing was seen in 3 cases. 11. Choledochal cyst (2 cases), hydrops of gallbladder(1cases) and cyst of pancreas head(1 cases) had similar ultrasonic appearance as a large elliptical systic mass,but, it was important in differential diagnosis to ascertain the existence of gallblader and the connectionbetween the cyst and bile duct.
Abdominal Wall ; Abscess ; Acoustics ; Age Distribution ; Bile Ducts ; Child ; Choledochal Cyst ; Diagnosis ; Diagnosis, Differential ; Edema ; Female ; Hepatoblastoma ; Humans ; Infant ; Jeollanam-do ; Male ; Neuroblastoma ; Pancreas ; Sex Distribution ; Shadowing (Histology) ; Teratoma ; Tuberculosis ; Ultrasonics ; Ultrasonography ; Wilms Tumor

Pelvic kidney, an ectopic renal mass caused by developmental failure, is a rare condition. Here, we report a case of laparoscopic anterior resection in a patient with a solitary pelvic kidney. A 76-year-old man was diagnosed as having rectosigmoid colon cancer. Preoperative computed tomography revealed a left ectopic kidney in his pelvis. Computed tomographic angiography and retrograde pyelography were performed preoperatively to identify the renal vessels and the ureter. To keep the surgical plane intact for complete mesocolic excision, a complete laparoscopic anterior resection was safely performed without open conversion, and there was no injury to the pelvic kidney. The patient was discharged on postoperative day eight without any complication. No deterioration of renal function was observed after surgery. This report describes a case of laparoscopic anterior resection that was safely performed without conversion to open surgery in a patient with a pelvic ectopic kidney.

Primary gastric actinomycosis is an extremely rare disease and less than 20 cases are reported in literature. We experienced a case of gastric actinomycosis in the 63-year-old woman who had subtotal gastrectomy for early gastric cancer(type IIc) 7 month ago. Endoscopic biopsy from elevated lesion on stoma was found to show the neutrophilic infiltration and sulfur granule. She placed on tetracycline for 30 days. Follow up endoscopy showed no abnormality. We report this case with literature review. (Koresn J Gastrointest Endosc 18: 757~ 760, 1996)
Actinomycosis ; Biopsy ; Endoscopy ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Middle Aged ; Neutrophils ; Rare Diseases ; Stomach Neoplasms* ; Sulfur ; Tetracycline

PURPOSE: Asymmetrical dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS) and the major metabolic pathway of ADMA is enzymatic degradation via dimethylarginine dimethylaminohydrolasease (DDAH). In this study, we hypothesized that an elevated cavernosal ADMA level might result from poor DDAH activity in the corpus cavernosum. We examined whether ADMA was accumulated in our atherosclerotic rat model of vasculogenic erectile dysfunction (VED). MATERIALS AND METHODS: Twelve 12-wk-old Sprague-Dawley rats were grouped in either the atherosclerosis group (AS, n=6) or the control (n=6) group. The AS group received a 1% cholesterol diet for 6 weeks and the rats were also treated with NG-nitro-L-arginine methyl ester (3mg/ml) for the initial 2 weeks. The control group received a normal diet. Six weeks later, all the rats were anesthetized with urethane (1.6g/kg) and cavernous electrostimulation was done under continuous arterial and cavernosal pressure monitoring (6V, 0.5ms, 20Hz, 50sec). The methylarginine level in both the AS group and the control group was measured respectively. Also, the NOS activity and DDAH activity in the corpus cavernosum were evaluated. RESULTS: Upon cavernous electostimulation, the peak intracavernosal pressure (ICP) of the control group was 88.5+/-5.5mmHg (n=6). In contrast, the peak ICP level was markedly reduced in the atherosclerotic group to 54.2+/-4.8mmHg (n=6, p<0.001). The cavernosal level of ADMA in the control group was 320.5+/-23.6micrometer and it was 860.7+/-34.7micrometer in the AS group. The constitutive NOS activity in the rat corpus cavernosum of the AS group was markedly reduced compared to the control group. Also, the cavernosal DDAH activity was reduced in the AS rats and the activity showed significant negative correlation with the cavernosal ADMA level. CONCLUSIONS: In this study, we have demonstrated that the dysregulation of DDAH activity may be one of the causes of decreased NOS activity in atherosclerotic erectile dysfunction.
Animals ; Atherosclerosis ; Cholesterol ; Diet ; Erectile Dysfunction* ; Male ; Metabolic Networks and Pathways ; Models, Animal* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Rats* ; Rats, Sprague-Dawley ; Urethane

Malignant Mixed Mullerian tumors(MMMTs) are unusual neoplasms occumng mostly in the uterus and, ralely, they arise in the ovary. The clinical features of malignant mixed mullerian tumor of the ovary are similiar to other ovarian malignancies. The clinical course is rapidly progressive and fatal. The optimal treatment modalities has remained elusive. The most reliable prognostic criterion is the initial tumor stage and the overall survival was poor. We experienced two cases of malignant mixed miillerian tumor of the ovary, so we report these cases with a brief review of the concerned literatures.
Female ; Ovary* ; Respiratory Sounds ; Uterus

No abstract available.
Bacteremia* ; Female ; Humans ; Pregnant Women*