Opacification of the gallbladder after parenteral administration of contrast material usually indicates diminished renal function but can occur with normal renal function. The authors recently experienced 13 cases of such vicarious excretion of contrast media. Among 13 patients. 9 patients had renal disease unilateral ureteral stone(n=3), staghorn calculi(n=2), acute renal failure from sepsis(n=1), renal contusion(n=2) and unilateral renal artery involvement by dissecting aortic aneurysm(n=1). Of these 9 patients, 3 patients showed abnormal serum creatinine levels at the time of presentation or shortly thereafter. In 6 patients, injection of a large amount of contrast media was possibly the additional cause of vicarius excretion. There was no detectable cause in the remaining 4 patients. Heterotopic excretion of contrast media is clearly a complex phenomenon, the reason for which it is difficult to establish with certainty in each individual case. Anyhow, vicarius excretion of contrast media occurs more frequently than previously thought, and it can occur not only with abnormal renal function but with normal function also.
Acute Kidney Injury ; Contrast Media ; Creatinine ; Gallbladder* ; Humans ; Renal Artery ; Ureter

To get the standard and marginal rigidity of physiologic erection in young Korean men with normal potency, nocturnal penile erection(NPE) and audio-visually stimulated erection(AVSE) were monitored using RigiScan in 30 young volunteers with normal potency aged from 21-35 years. Vibration induced erection was also assessed by bucking. The results were as follows. 1. Regarding to NPE, maximal rigidity lasting for more than 5 minutes was 40-70% in 4(10.3%) and more than 70% in 26 (89.7%) with mean+/-SD of 78.43+/-8.02 %. The maximal rigidity lasting for more than 10 minutes was 40-70% in 6(20%) and more than 70% in 24(80%), with mean+/-SD of 74.43+/-8.02%. 2. Regarding to AVSE, maximal rigidity lasting for more than 5 minutes was 40-70% in lt3.3 %) and more than 70% in 29(96.7%) with mean+/-SD of 81.30+/-7.18%. The maximal rigidity lasting for more than 10 minutes was 40-70% in 2(6.7%) and more than 70% in 28(93.3%), with mean+/-SD of 77.63 + 7.87%. Twenty seven men(90%) showed positive response to VIE test. but 3 with normal NPE and AVSE showed negative response to VIE test. Therefore, young potent men showed higher amplitude of maximal rigidity in AVSE than in NPE. and VIE test had the highest false negative response rate. The rigidity of 40% lasting 10 minutes was the lower limit of normal NPE and AVSE.
Erectile Dysfunction ; Humans ; Male ; Penile Erection* ; Vibration ; Volunteers ; Young Adult*

Prediction f chemical composition of gallstones is a prerequisite in contemplating the chemical dissolution or extracorporeal shock wave lithotripsy of gallstones. The author retrospectively analysed the correlation between quantitative chemical composition of gallstones and their ultrasonographic and computed tomographic findings. The ultrasonography(US) and computed tomography(CT) of 100 consecutive stones obtained from 100 patients were performed under the in vitro condition. Their US and CT fingings were grouped with certain patterns and each group was compared with the chemical composition of the stones. Stones with entirely discernible cirumsference and homogeneous internal echo on US had high bilirubin and low cholesterol content. Acoustic shadows were frequently absent with those stones. Stones with variable internal echo on US had relatively high cholesterol content but their distribution range were wide. There was no correlationship between the cholesterol content and the CT No. of the gallstones. There was positive correlationship between the calcium content and the CT No. of gallstones. The near totally calcified gallstones had very low cholesterol and high residue content. There was no relationship betweenthe calcification type and the ultrasonographic pattern. In conclusion, those stones with entirely discernible circumsference and homogeneous internal echo on US were pigment stones. On the contrary, stones with variable internal echo had relatively high cholesterol content. CT could predict the calcium content with CT No., but could not predict the cholesterol content.
Acoustics ; Bilirubin ; Calcium ; Cholesterol ; Gallstones* ; Humans ; In Vitro Techniques ; Lithotripsy ; Retrospective Studies ; Shock ; Ultrasonography*

PURPOSE: A nationwide survey was conducted of Korean urologists to illustrate physicians' perceptions and real practical patterns regarding Peyronie disease (PD). MATERIALS AND METHODS: A specially designed questionnaire exploring practice characteristics and attitudes regarding PD, as well as patient satisfaction with each treatment modality, was e-mailed to 2,421 randomly selected urologists. RESULTS: Responses were received from 385 practicing urologists (15.9%) with a median time after certification as an urologist of 12 years. Regarding the natural course, 87% of respondents believed that PD is a progressive disease, and 82% replied that spontaneous healing in PD occurred in fewer than 20% of patients. Regarding diagnosis of PD, the methods used were, in order, history taking with physical examination (98%), International Index of Erectile Function questionnaires (40%), intracavernous injection and stimulation (35%), and duplex sonography (28%). Vitamin E was most preferred as an initial medical management (80.2%), followed by phosphodiesterase-5 inhibitors (27.4%) and Potaba (aminobenzoate potassium, 20.1%). For urologists who administered intralesional injection, the injected agent was, in order, corticosteroid (72.2%), verapamil (45.1%), and interferon (3.2%). The most frequently performed surgical procedure was plication (84.1%), followed by excision and graft (42.9%) and penile prosthesis implantation (14.2%). Among the most popular treatments in each modality, the urologists' perceptions regarding the suitability of treatment and patient satisfaction were significantly different, favoring plication surgery. CONCLUSIONS: The practice pattern of urologists depicted in this survey is in line with currently available Western guidelines, which indicates the need for development of further local guidelines based on solid clinical data.
4-Aminobenzoic Acid ; Certification ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Data Collection ; Diagnosis ; Electronic Mail ; Humans ; Injections, Intralesional ; Interferons ; Male ; Patient Satisfaction* ; Penile Implantation ; Penile Induration* ; Physical Examination ; Potassium ; Questionnaires ; Transplants ; Verapamil ; Vitamin E ; Vitamins

PURPOSE: Chlormadinone acetate (CMA) therapy for benign prostatic hyperplasia (BPH) may lower the serum prostate specific antigen (PSA) level. However, little is known about the effect of CMA on the total or free serum PSA levels of PSA. Such information would be important since PSA testing is useful for prostate cancer screening. Thus, we prospectively studied the effect of CMA therapy on the total and free serum PSA levels. MATERIALS AND METHODS: The patients with lower urinary tract symptoms (LUTS) and BPH who were aged over 50 years were treated with 50mg CMA for 6 months. Men with a PSA level greater than 10ng/ml were excluded to reduce the likelihood of including cases of occult prostate cancer. Those with suspicious findings on the digital rectal examination and serum PSA testing were biopsied to rule out prostate cancer. alpha- blocking agents were permitted to treat the men with LUTS. Serum levels of the total and free PSA were measured at the study baseline and after approximately 3 and 6 months. The prostate volume (PV) was assessed by transrectal ultrasonography. RESULTS: The analysis included 170 patients with a mean age of 67.9 years, a baseline PV of 47.3ml and a baseline total PSA of 4.1ng/ml. The total PSA levels declined from 4.1ng/ml at baseline to 2.0ng/ml after 6 months of treatment (50.7% decrease, p<0.01). The mean percent free PSA (21% to 22% at baseline) was not significantly altered by CMA treatment. The PSA levels and PV at baseline did not affect the rate of decline of PSA. CONCLUSIONS: The total PSA serum levels decreased by an average of 50% during CMA therapy, but the percent free PSA did not change significantly. This information is potentially useful in the interpretation of the PSA data that's used for early detection of prostate cancer in the men receiving CMA.
Chlormadinone Acetate* ; Digital Rectal Examination ; Humans ; Lower Urinary Tract Symptoms ; Male ; Mass Screening ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Ultrasonography