Necrosis of the papilla and chronic interstitial nephritis of the renal cortex are the two renal 1esions most commonly. described in cases of analgesic nephropathy. Some authors believed that the necrosis of the papilla was secondary to the cortical changes by which fibrosis of the cortex produced ischemia of papilla and necrosis. However, other authors have suggested that the pathogenesis is, in fact, the reverse and that the cortical changes in analgesic nephropathy are caused by the medullary necrosis. An experimental study was therefore undertaken to clarify this problem and also to determine the influence of increased intrapelvic pressure on the postpapillectomy renal alterations. Followings are the results: 1. In 'the group having renal papillectomy, marked tubular dilatation and interstitial edema of the medulla are prominent changes upto two weeks after removal of the papilla. Tubules are usu. ally filled with various casts. After three weeks, there starts the tubular atrophy and interstitial fibrosis with mil infiltration of inflammatory cells. The tubular atrophy and renal scarring become much severe and diffuse six weeks after papillectomy. but glomeruli remain relatively intact. 2. The degree of tubular changes and parenchymal scarring are assumed influential to the size of removed papilla. The tubular atrophy is prominent in distal convoluted tubules and collecting tubules, and the interstitial changes extend from the medulla to the cortex in the late stage. 3. Focal or scattered depositions of amorphous calcium or calcium oxalate are found in about one fourth of cases. 4. In the group having partial ureteral ligation a week after renal papillectomy, the tubular and interstitial changes appear earlier and are more remarkable than those of papillectomy alone. The inflammatory reaction is also more prominent, and conglomeration of glomerulus is noted in some instances of the later stage. The form of the renal scarring found in this experimental study closely resembles that seen in analgesic nephropathy in man. This findings support the view that the cortical lesions in analgesic nephropathy develop as a direct consequence of papillary necrosis and additional ureteral ligation enhances interstitial nephritic process. It is possible that the tubular atrophy and interstitial edema that develop shortly after removal of the papilla may produce cortical changes.
Atrophy ; Calcium ; Calcium Oxalate ; Cicatrix ; Dilatation ; Edema ; Fibrosis ; Ischemia ; Kidney* ; Ligation* ; Necrosis ; Nephritis, Interstitial ; Ureter*

No abstract available.
Biopsy* ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms*

Two cases of primary carcinoma of the ureter were reported with review of the literatures.
Ureter*

BACKGROUND: Xerosis is a relatively common disorder, especially in the elderly. The condition is characterized by fine scaling and is associated with generalized pruritus. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy, safety and tolerability of Zalsming cream in patients with xerosis and pruritus. METHODS: Thirty patients were treated with Zalsming cream. Clinical efficacy, as measured by the score of subjective symptom and objective signs, transepidermal water loss(TEWL) and electron microscopic finding, were asessed at 2, 4, and 6 weeks after topical application of the cream. RESULTS: The scores of clinical signs and TEWL showed statistically significant improvements. No one developed any local or systemic side effects. CONCLUSION: Topical application of Zalsming cream was found to be effective and safe for patients suffering from xerosis and pruritus.
Aged ; Humans ; Pruritus*

PURPOSE: We evaluated the ability of endo-rectal coil MRI (ER-MRI) to predict the local pathological stage of prostate cancer prior to radical prostatectomy and compared the results with those of transrectal ultrasonography (TRUS). MATERIALS AND METHODS: ER-MRI using high field magnets (1.5 Tesla) were performed in 22 patients (mean age 62.8 years, range 51-73) with clinically localized prostate cancer before radical prostatectomy. Of the 22 patients, 17 patients were also assessed by TRUS. The results of the imaging techniques were compared with the post-operative histopathological findings. As one patient with pelvic lymph node metastasis, which was detected on frozen-section examination during surgery, was spared radical prostatectomy, the final evaluation included 21 patients. RESULTS: DSeven of the 21 patients (33%) were found to have extraprostatic extension (EPE), and 5 had seminal vesicle invasion (SVI). The sensitivity and specificity for diagnosing EPE using ER-MRI were 62.5% and 84.6%, respectively, and 16.7% and 100% with TRUS. The sensitivity and specificity for diagnosing SVI were 80.0% and 93.8%, respectively with ER-MRI, and 0% and 92.3% with TRUS. The accuracy of predicting SVI was 90.5% with ER-MRI compared to 70.6% with TRUS. CONCLUSIONS: ER-MRI was significantly better than TRUS for determining the local extent of prostatic cancer and for prediction of SVI in the preoperative staging of clinically localized prostate cancer.
Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Seminal Vesicles ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Abortion, Habitual* ; Cytogenetics* ; Family Characteristics* ; Female ; Pregnancy

Eosinophilic cystitis is a baffling rarity impossible to distinguish grossly from bladder tumor. It is characterized by vesical irritability, hematuria and eosinophilia. The etiology is unknown. Authors have found only 7 cases in the literature and present one case which was mimicking papillary carcinoma. Patient 35 years-old married man, was admitted to Seoul National University Hospital on March 13. 1967. with a one-week history of hematuria, urgency, frequency and dysuria. Physical examination was negative. Hemograms showed normal except eosinophilia of 10% to 16%. Urinalysis showed one plus proteinuria, many red cells and 5 to 6 white cells per high power field. An excretory urogram displayed essentially normal. At cystoscopy marked bullous edema on entire bladder wall and large polypoid lesion in anterior wall were noted. Punch biopsy was done and it revealed mild degree transitional cell carcinoma of the bladder. He underwent bilateral cutaneoureteroetomy and cystectomy. The surgical specimen, however, showed no malignant lesion but diffuse eosinophilic cystitis.
Adult ; Biopsy ; Carcinoma, Papillary ; Carcinoma, Transitional Cell ; Cystectomy ; Cystitis* ; Cystoscopy ; Dysuria ; Edema ; Eosinophilia ; Eosinophils* ; Hematuria ; Humans ; Physical Examination ; Proteinuria ; Seoul ; Urinalysis ; Urinary Bladder ; Urinary Bladder Neoplasms

A clinical observation was made on 14 cases of transitional cell carcinoma of the renal pelvis and ureter whose diagnosis was confirmed pathologically at Kyung Hee University Hospital during the period tom November, 1971 to June, 1984. The results were as follows 1. The age of patient at the time of the diagnosis ranged from 42 to 75 years (mean 57.9 years), with highest incidence during the 6th decade. 11 tumors occurred in male patients and 3 in female patients, for a ratio of 3.7 : 1. 2. Common presenting symptoms were gross hematuria (92.8 %) and pain (28.5 %). 3. IVP was performed in all patients. A filling defect in the renal pelvis or ureter was found in 6 cases, and non-visualized kidney in 6 cases. RGP was performed in 9 patients and was useful to demonstrate a filling defect. 4. Urine cytology was positive in 6 of 13 patients. 5. Nephroureterectomy including a cuff of bladder was performed in 13 patients and simple nephrectomy was done in 1 patient who was misdiagnosed as hydronephrosis due to UPJ obstruction. 6. The tumors were staged into 4 Stages postoperatively. 5 patients had Stage A tumors, 2 Stage B, 5 Stage C and 2 Stage D. 1 patient had Grade I tumor, 6 Grade II, 4 Grade III and 3 Grade IV. In 3 patients, there were synchronous tumors in renal pelvis and ureter. Three patients subsequently developed bladder tumor. 7. 7 patients were died in 3 to 18 months (average 7.8 months) after initial treatment and all were categorized into Stage C and D.
Carcinoma, Transitional Cell ; Diagnosis ; Female ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Kidney Pelvis* ; Male ; Nephrectomy ; Ureter* ; Urinary Bladder ; Urinary Bladder Neoplasms

A case of multiple trichilemmal cysts (TC) is presented. TC is known to be a kind of keratinous cyst with lining cells showing trichilemmal keratiniration. A 63-year-old female patient presented with a 30 year duration of increasing in size and number of twenty five nodular lesions on the scalp. All twenty five TC on the scalp were totally excised and examined microscopically. However, the evidence of proliferation or malignant change like the previous case reports was not found in our case.
Female ; Humans ; Middle Aged ; Scalp

In this animal study, comedones were induced by topical application of oleic acid onto the rabbit ear canal and the histopathologic and ultrastructural changes in response to topical application of HO and hexane extracts of red ginseng, and saponin were measured. No microscopical difference was observed between treatment groups. Nucle ir remnants were observed in the horny cell layer as well as the thinning of the granular cell layer. Scattered and decreased keratohyaline granules were also noted. Six weeks after initiation of treatment, we observed the thinning of epidermis and veappearance of granular cell layer with normal keratohyaline granules. After treatment, scanning electron microscopy showed a decrease in the size of comedones, and loosened and desquamating horny cells in the comedones. From the above results, it could be concluded that Panax ginseng extracts might have effects on the keratinization process of the skin.
Animals ; Ear Canal ; Epidermis ; Microscopy, Electron, Scanning ; Oleic Acid ; Panax* ; Saponins ; Skin