Hemodialysis using Kiil type artificial kidney was performed on two cases of acute renal failure and a case of chronic renal failure and the following results were obtained: 1. A case of acute renal failure recovered from her deteriorated renal function following four consecutive hemodialyses and another following a single hemodialysis of six hours. 2. A case of chronic renal failure is now stabilized clinically and maintained on ambulatory intermittent long-term hemodialysis.
Acute Kidney Injury ; Kidney Failure, Chronic ; Kidneys, Artificial* ; Renal Dialysis* ; Renal Insufficiency*

The incidence of giant condyloma acuminata of the penis is extremely rare. Although they are considered clinically malignant, the real possibility of malignant changes from them are controversial even among the investigators but cannot be entirely overlooked. Therefore, attention must be focused on this fact, in our conclusion. Two cases of malignancy of the penis which have apparently been transformed from giant condyloma acuminata of the penis are herein presented with review of related literatures. Case I: Sixty nine year old male patient complained of a fungating mass on the sulcus coronaris of the penis with ulceration and bleeding from the mass. Biopsy confirmed giant condyloma acuminata and subsequently circumcision and electrocoagulation were performed. Pathological specimen taken after 4 months because of the recurrence of the mass on the same region showed squamous cell carcinoma of the penis and amputation of penis was performed. Case II: Sixty eight old male patient complained of a growing mass and pain on glans penis. This patient also underwent circumcision and electrocoagulation according to the biopsy finding of giant condyloma acuminata. But 1 year later with recurrence of the mass on the same region, the pathological finding revealed squamous cell carcinoma of penis.
Amputation ; Biopsy ; Carcinoma, Squamous Cell ; Circumcision, Male ; Electrocoagulation ; Female ; Hemorrhage ; Humans ; Incidence ; Male ; Penile Neoplasms ; Penis ; Recurrence ; Research Personnel ; Ulcer

No abstract available.
Animals ; DNA* ; LLC-PK1 Cells* ; Swine

A clinical evaluation has been undertaken of 41 patients with urethral stricture who have been treated with visual urethrotomy in the Department of Urology, Seoul National University Hospital during 3 years periods from 1983 to 1985. The over all success rate was 54%. The results were unrelated to the sites of the lesion, the causes of the stricture and the durations of the catheter drainage. However, the results of the obliterated strictures (12.5%) are more poor than the non-obliterated strictures (64%), and patients with nonobliterated stricture less than 2cm long had the best results (22%). The overall morbidity rate was 20%, six cases of false way, one case of incontinence, one case of penile hematoma. Twenty seven cases were followed up over 6 months and its success rate showed 44.4%.
Catheters ; Constriction, Pathologic ; Drainage ; Hematoma ; Humans ; Seoul ; Urethral Stricture ; Urology

Fourteen total cystectomy specimens with primary carcinoma of urinary bladder were investigated to illustrate the overall prevalence and nature of mucosal changes adjacent to the overt carcinoma and to clarify the distribution pattern and extent of carcinoma in situ in regard with multiplicity, histological type and depth of invasion of the macroscopically visible tumor mass. Of 14 cases subjected to this study were 12 cases of transitional cell carcinoma of varying degree of differentiation and invasion, one adenocarcinoma, and the another one with no grossly detectable tumor but history of previous cystoscopic removal of papillary transitional cell carcinoma. Each specimen was processed by a histotopographic technique developed by authors, an easy access to reconstruct the mucosal changes using reconstruction paper. For the histological grading and staging of the overt carcinomas, Ash's and Collins' classifications were applied, respectively. Carcinoma in situ (CIS) was found in 10 out of 11 cases with overt urothelial carcinoma of urinary bladder and one case with no grossly visible neoplasm, in which cystoscopic removal of papillary carcinoma was carried out previously. Distribution pattern of CIS was mostly circular (group I) or arborizing (group II) , located around the overt carcinoma within 0.5 to 2.0cm., but not beyond 3.0cm. from its margin. Correlation between multiplicity of overt carcinomas and presence of CIS was evident together with irregularity of its distribution, but no significance was found with gross appearance, histological grading or with staging.
Adenocarcinoma ; Carcinoma in Situ* ; Carcinoma, Papillary ; Carcinoma, Transitional Cell ; Classification ; Cystectomy ; Mucous Membrane* ; Prevalence ; Urinary Bladder*

Palliative open nephrostomy was done on 50 cases with advanced pelvic malignancy and benign conditions in the Department of Urology, Seoul National University Hospital during the period of March, 1979 to July, 1982. The results were as follows: 1. 20.5% (9/44) of our patients died without being discharged from the hospital after nephrostomy. 2. In advanced pelvic malignancy, only 52.6% of patients alive at 3 months and only 26.3% alive 6 months. 3. In advanced pelvic malignancy, the post-nephrostomy complication was 46.7% and the most common complication was various urinary problems. 4. The cause of death was multifactorical and impossible to define precisely. The nephrostomy complications were at least in part contributory to the deaths. 5. The terminal malignancy patients who might not expected to live six months and to lead a useful, relatively comfortable life outside the hospital after treatment could not have benefited from nephrostomy. Unavoidable cases, we recommended percutaneous nephrostomy and passage of ureteral catheters instead of open nephrostomy.
Cause of Death ; Humans ; Nephrostomy, Percutaneous ; Seoul ; Urinary Catheters ; Urology

We report a case of pseudosarcomatous variant of transitional cell carcinoma of the renal pelvis which showed grossly and microscopically the distinct biphasic growth patterns. Grossly, most part of the tumor showed solid growth protruding into the renal pelvic cavity as well as infiltrating into the parenchyma of lower pole. The overlying pelvic mucosa was replaced by a diffuse, papillary transitional cell carcinoma, and the solid mass was composed of pleomorphic spindle cell sarcomatoid component with frequent myxoid change and a few foci of osteoid deposit. Ultrastructural study of the spindle cells revealed epithelial differentiation featured with rich cytoplasmic organelles, basal lamina and basement membrane-like structures, although immunohistochemistry failed to detect epithelial differentiation.

Thirteen patients with contracted bladder due to tuberculosis who underwent surgical intervention were evaluated The most common agonizing symptom was frequency. Surgical management included augmentation cystoplasty in 8 patients and urinary diversion in 5 patients. In augmentation cystoplasty, the overall success rate of 87.5 % has been achieved in view of relief of symptom, improvement of bladder capacity and preservation of renal function. For the success of augmentation cystoplasty, creatinine clearance higher than 30 ml/min., no abnormality in selected intestinal segment, absence of uninhibited detrusor contraction or detrusor-sphincter-dyssynergia and no bladder outlet obstruction are inevitable. As an alternative, urinary diversion should be considered only in cases of severely deteriorated renal function, severely decreased bladder capacity, bladder outlet obstruction, neurogenic bladder and inapplicability of augmentation cystoplasty.
Creatinine ; Felodipine ; Humans ; Tuberculosis* ; Urinary Bladder Neck Obstruction ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Diversion

Ureteral reimplantation has been used widely for the correction of ureterovesical reflux, terminal ureteral stricture, ureteral obstruction, ectopic ureteral opening, megaureter, renal transplantation and ureteral injury, etc. The ultimate purpose of the ureteral reimplantation is for the preservation of renal function and upper urinary tract. since the concept of ureterovesical reflux reported by Sampson in 1903, many types of surgical procedure of ureteral eimplantation have been developed and performed for various ureteral obstructive problems. There is also increasing tendency of ureteral reimplantation in out country. To determine the efficacy of ureteral reimplantation, we reviewed and evaluated the records of 34 patients(40 ureters) who underwent ureteral reimplantation at the Department of Urology, Seoul National University Hospital during the period from March, 1979 to February, 1983. And following results were obtained: 1. Ureteral reimplantation was performed in cases of ureterovesical reflux, ureteral stricture, megaureter, bladder tumor, failed previous reimplantation and surgical injury. 2. Thirty two ureters were reimplanted with the method of Politano-Leadbetter, five ureters with Glenn Anderson, one ureter with Cohen and one ureter with transureteroureterostomy with Boari-flap method. 3. Mean duration of ureteral stenting was 6 days(3-10 days). 4. Complications had been observed in 11 cases which included persistent pyuria, persistent reflux, acute pyelonephritis, paralytic ileus, vesicocutaneous fistula and obstruction. 5. Postoperative pyelographic appearances were improved in 10/13(76.9%) cases. We made a conservative treatment in patients with persistent urinary tract infection.
Constriction, Pathologic ; Fistula ; Humans ; Intestinal Pseudo-Obstruction ; Intraoperative Complications ; Kidney Transplantation ; Pyelonephritis ; Pyuria ; Replantation* ; Seoul ; Stents ; Ureter* ; Ureteral Obstruction ; Urinary Bladder Neoplasms ; Urinary Tract ; Urinary Tract Infections ; Urology

A clinical observation was made on 175 of the 232 patients with bladder tumor seen in the Department of Urology, Seoul National University Hospital during the period from January, 1975 to December, 1979. The following results were obtained: 1. During the period, 2,801 patients were hospitalized, there were 232 cases of bladder tumor, giving the ratio of 8.3%. 2. There were 142 males and 34 female with a ratio of 4.2:1. 75.3% of the patients were over 50 years old. 3. The most common symptoms were hematuria (91%), frequency (83%), urinary retention(32%) and painful urination (28%). 4. Twenty-three percent of the patients visited the hospital within 3 months after the occurrence of the initial symptom, 82% within 1 year and 12% after 3 years from the appearance of initial symptom. 5. Among the 175 patients, 108 (61.7%) had multiple tumors, while 67 (38.3%) had single tumor. Regarding to the origin, 126 (72%) were located at the lateral wall, 110(63%) at the trigone area. 6. On IVP, 84 cases (48%) had normal upper tract and 62 cases (35%) had filling defect in the bladder. 7. On pathologic examination, 159 (91%) were transitional cell carcinoma, 9 cases (5%) were squamous cell carcinoma and 5 cases (3%) were adenocarcinoma and 1 cases (1%) was malignant melanoma. 8. Stage A, B, C, D were 48 cases (27%), 67 cases (38%), 28 cases (16%), 32 cases (18%) respectively by cystoscopic finding, bimannual examination, operation finding, pathological finding and clinical finding. 9. TUC was performed in 76 cases and partial cystectomy in 52 cases with low stage tumors and Bricker`s operation with or without total cystectomy in 47 cases with high stage or multiple low stage tumors that could not be performed TUC or partial cystectomy. 10. 3 years after treatment 27 cases (35.5%) were followed up and 18 cases (66.7%) were survived by TUC, 18 cases (34.6%) were followed up and 11 cases (61.1%) were survived by partial cystectomy and 14 cases (29.8%) were followed up and 6 cases (42.(%) were survived by Bricker`s operation: In conclusion, TUC and partial cystectomy are adequate treatment for low stage bladder cancer and give the patients good quality and length of life, revealed same survival rate as other authors by Bricker`s operation for high stage or multiple low stage bladder cancer.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Cystectomy ; Female ; Hematuria ; Humans ; Longevity ; Male ; Melanoma ; Middle Aged ; Seoul ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urination ; Urology