No abstract available.
Humans ; Laparotomy* ; Nephrectomy* ; Tissue Donors*

This study was designed to investigate the major factors affecting selection of delivery facilities by pregnant women. Five hundred women hospitalized at 23 Seoul-area delivery facilities, such as university hospitals, general hospitals, hospitals, and clinics were selected and given questionnaires from April 24 to May 7, 1990. A total of 350 questionnaires were collected and analysed for the study. The results are as follows; 1. In general, variables which significantly affected the choice of delivery facilities included the age of women, their educational level, the educational level of their husbands, monthly average incomes and residential areas. 2. In analyzing the obstetrical characteristics of the women, those variables significantly affecting the choice of delivery facilities were the gestational period, the facilities for prenatal care, the frequency of prenatal care, the type of delivery, the frequency of miscarriage, previous delivery experiences and the awareness on prenatal care. 3. In comparing the motivation factors for selecting the delivery facilities, all the factors except convenience and need for hospitalization differed significantly among delivery facilities. 4. The factor analysis was assessed for twenty possible factors motivating the choice of delivery facilities. Six factors including personal service, scale of the facility, reputation, urgency, convenience, and experience were noted explaining by 57.7%. 5. In the discriminant analysis used to clarify the major factors affecting the selection of delivery facilities, the 16 significant variables were regarded as independent variables, and the type of delivery facilities was considered a dependent variable. The stepwise method was applied to the analysis. Detected discriminant variables were the facilities for prenatal care, scale factor, personal service factor, urgency factor, convenience factor, reputation factor, experience factor, gestational period, types of delivery, frequency of miscarriage, age and income. These 12 discriminant variables were tested, with reference to discriminant prediction, on their importance in the choice of the delivery facility, by the discriminant functional formula. The test showed a hit-rate of 67.7%. The results suggest that general characteristics, obstetrical characteristics, and motivations for selecting the delivery facilities differ significantly according to the types of the delivery facilities. This study implies that all types of delivery facilities should attempt to acommodate characteristics and motivations of pregnant women. The facilities should be prepared to increase their patients satisfaction with required medical conditions by improving service and responding to the pregnant women's preferences.
Abortion, Spontaneous ; Discriminant Analysis ; Female ; Hospitalization ; Hospitals, General ; Hospitals, University ; Humans ; Motivation ; Pregnancy ; Pregnant Women* ; Prenatal Care ; Surveys and Questionnaires ; Spouses

No abstract available.
Aneurysm* ; Renal Artery*

A clinical observation was made on 201 cases of pediatric in-patients with urological diseases in the Department of Urology, Korea General Hospital, from September 1, 1972 to August 31, 1979. The results obtained were as follows. 1) Among 1009 cases of urological in-patients for the past 7 years, 201 cases belong patients giving 19.9%. 2) Yearly number of pediatric in-patients showed no increasing tendency. 3) The proportion of male to female pediatric urologic in-patients was 17: 1. The preschool children (1 to 6 years of age) were most frequently seen and giving a rate of 44.8% of the pediatric urologic in-patients. 4) The most frequently involved organ was scrotal contents, giving a rate of 57.7%. Urethral diseases was 14.9%, penile diseases l0.9%, renal diseases 8.5%. 5) The congenital anomaly was most frequent, showing l55 cases of total pediatric urologic in-patients (77.2%). The most common disease of the congenital anomaly was hydrocele in 60 cases (29.9%) and cryptorchism 47 cases (23.4%), hypospadia 24 cases (11.9%), phimosis 16 cases (8.0%) in order. 6) Of 201 cases, operation was performed in 179 cases (88.6%). The most common operation was hydrocelectomy 60 cases (33.5%), orchiopexy 47 cases (26.3%), circumcision 22 cases(12.3%), chordectomy 17 cases (9.5%), urethroplasty 7 cases (3.9%) in order.
Child, Preschool ; Circumcision, Male ; Cryptorchidism ; Female ; Hospitals, General ; Humans ; Hypospadias ; Korea ; Male ; Orchiopexy ; Pediatrics ; Penile Diseases ; Phimosis ; Urethral Diseases ; Urologic Diseases* ; Urology

Seventy-nine patients of bladder neck suspension using an extraperitoneal variation of laparoscopic surgery were performed for the treatment of stress urinary incontinence. Using a balloon dissector the anterior vesical pelvic space is secured. The bladder neck suspension similar to the Burch operation was performed through a laparoscopic procedure. Symptoms of patients were assessed preoperatively and at one and six months following surgery. Operative times and complications were also evaluated. Success rate was 89.8% at six months. Complications such as bladder perforations were observed. Laparoscopic extraperitoneal bladder neck suspension-(LEBNS) is a viable option to the conventional methods of suspension, it has definite cosmetic advantages, is devoid of intraperitoneal dissection and adhesion, and has a comparable success rate.
Adult ; Aged ; Bladder/anatomy & histology/*surgery ; Female ; Human ; Laparoscopy/methods ; Length of Stay ; Middle Age ; Postoperative Complications ; Quality of Life ; Retrospective Studies ; Urinary Incontinence, Stress/*surgery

This report deals with a case of malakoplakia of urinary bladder in a 68 year old female. The lesion of malakoplakia has been misdiagnosed as a neoplasm on several occasions in other institutes. This disease has been reported seldomly, and many urologists and pathologists alike have been unfamiliar to the lesion. An emphasis on the clinicopathologic features is made in order to prevent the serious misdiagnosis. The pertinent literatures are reviewed.
Academies and Institutes ; Aged ; Diagnostic Errors ; Female ; Humans ; Malacoplakia* ; Urinary Bladder*

The idiopathic retroperitoneal fibrosis means that proliferation of fibrous tissue in the retroperitoneal cavity influences the aorta, inferior vena cava, psoas muscle and ureter, and its etiology is not found. Especially, when both ureters are compressed, hydronephrosis resulted in uremia are developed progressively, and it may be treated by urinary diversion. We report a case of idiopathic retroperitoneal fibrosis that treated by bilateral pyelo-ileo-neocystostomy and postoperative metabolic derangement that managed successfully with brief review of literature.
Aorta ; Hydronephrosis ; Psoas Muscles ; Retroperitoneal Fibrosis* ; Uremia ; Ureter ; Urinary Diversion ; Vena Cava, Inferior

PURPOSE: The increased incidence of urologic malignancy, especially transitional cell carcinoma in patient after renal allograft is well known. The aim of this study was to analyze the development of transitional cell carcinoma and its management. MATERIALS AND METHODS: Of 2,092 patients who underwent renal allograft at Severance hospital between April 1986 and August 2003, 10 (0.48%) had urologic malignancies. The clinical variables collected were patient age, age at renal allograft, cancer diagnosis time since renal allograft, cancer site, TNM stage, pathology and grade, treatment, recurrence and follow up tool. RESULTS: There were 6 men (median age at renal allograft 49.6, median age at cancer diagnosis 57.6) and 4 women (median age at renal allograft 54.5, median age at cancer diagnosis 62.8). There were two adenocarcinoma of prostate patients (0.10%), six transitional cell carcinoma patients (0.29%) and two squamous cell carcinoma of penis patients (0.10%). Sites of transitional cell carcinoma were bladder in five patients, renal pelvis in three patients, ureter in two patients, respectively. As a treatment, nephroureterectomy with bladder cuff resection for transitional cell carcinoma of renal pelvis or ureter, transurethral resection of bladder tumor with mitomycin C intravesical instillation for transitional cell carcinoma of bladder were done. No recurrence or metastasis was observed except transitional cell carcinoma of bladder. In four of five transitional cell carcinoma of bladder patients, multiple recurrences more than three times were observed. CONCLUSIONS: In patients after renal allograft, the transitional cell carcinoma always should be highly suspected. Aggressive follow up and management are indicated.
Adenocarcinoma ; Administration, Intravesical ; Allografts* ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney Pelvis ; Male ; Mitomycin ; Neoplasm Metastasis ; Pathology ; Pelvis ; Penis ; Prostate ; Recurrence ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms

OBJECTIVE: About 50% of patients undergoing radical cystectomy for muscle invasive bladder cancer have occult distant micrometastasis. Most of these patients have clinical manifestations of distant metastasis within 1 year of operation, and not likely to achieve 2-year survival. But in other words, the remaining half of patients can expect definite survival benefit from radical surgery. Therefore if those who have micrometastasis can be selected preoperatively, unnecessary cystectomies can be avoided, and bladder preservation by anticancer chemotherapy, radiotherapy, and partial cystectomy can be employedinstead. MATERIALS AND METHODS: From 1985 to 1993, 45 patients diagnosed with high grade muscle invasive transitional cell carcinoma at transurethral resection of bladder (TURB) who later confirmed to have stage T2, T3a, and T3b rumors after radical cystectomy were selected. Patients with double primary tumor, early death, follow up period under 2 years, and poor quality of paraffinized tissue presentation were excluded.Immunostaining of tumor suppressor gene p53 (DO7 and PAb1801; both wild and mutant type) and antimetastatic gene nm23-H1(NM301) were performed and the survival function was analysed. Stainings were interpreted as positive when more than heterogenous pattern for p53, and stronger than moderately stained for nm23-H1 were seen. RESULTS: Pathological nodal status (pN stage), combination of p53 and nm23-Hl expression, and p53 expression were correlated with survival. Pathological rumor stage (pT stage), nm23-H1 expression alone were not correlated with survival. Expression of p53 was 44.4% (20/45) and nm23-H1 expression was seen in 55.6% (25/45). Combinations of p53 negative plus nm23-H1 negative, p53 negative plus nm23-H1 positive, p53 positive plus nm23-H1 negative, and p53 positive plus nm23-H1 positive were 12, 13, 8, and 12 cases, respectively. Cases when both proteins were expressed poor survival was observed. Detection time elapsed from cystectomy to metastasis and duration from detection of metastasis to death was only related with N stage. CONCLUSION: 1. When cellular grade of TURB specimen is III, muscle invasive, and positive for both p53 and nm23-H1, the chance of surgical cure by radical cystectomy is significantly reduced. 2. In high grade tumors, the degree of muscle invasion does not affect survival, but might affect the detection time elapsed from cystectomy to metastasis and the duration from detection of metastasis to death. 3. Lymph node metastasis is related to survival, and especially p53 expression is related to survival.
Carcinoma, Transitional Cell* ; Cystectomy* ; Drug Therapy ; Follow-Up Studies ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Paraffin ; Radiotherapy ; Urinary Bladder Neoplasms ; Urinary Bladder*

With the recent advancement in the field of microvascular surgery, the demand for a microvascular prosthesis of 1-2 mm diameter has been increasing. The authors attempted to insert a Gore-tex graft of 1 mm inner diameter to the rat aorta and renal artery with different techniques and different suture materials. The telescoped technique was utilized for the anastomosis of the proximal part of the artery. They showed 80% patency of grafts up to 116 days with 10-0 ethilon and 83% patency up to 96 days with 7-0 silk in the rat aorta. In the rat renal artery, they showed 53.3% patency with 10-0 ethilon. These results showed that Gore-tex grafts of a 1 mm inner diameter could be used for microvascular reconstructions but further laboratory experimentation is needed before clinical application.
Angiography ; Animal ; Arteries/surgery* ; Polytetrafluoroethylene* ; Prostheses and Implants* ; Rats ; Rats, Inbred Strains