Although fibromas are the most common renal medullary tumor identified at autopsy. their small sized and benign course make clinical detection extremely difficult. Only 9 clinical cases of renal medullary fibromas have been reported. Many fibromas of the renal medulla, previously considered as bamahomas. seemed to be composed of tumerous transformation of renomedullary interstitial calls Herein we report on a patient with huge renal medullary fibroma treated by right radical nephrectomy.
Autopsy ; Brain Stem Neoplasms ; Fibroma ; Humans ; Nephrectomy

PURPOSE: We performed this study in order to evaluate the incidence and characteristics of urolithiasis in patients with malignant hematologic diseases. MATERIALS AND METHODS: Nine hundred one patients who underwent medical treatment for malignant hematologic disease and 40,543 patients who visited the emergency room and without malignant hematologic diseases were included in our study. The patients with malignant hematologic diseases were divided into two groups depending on their primary treatment. Group I included patients with acute and chronic leukemia (AML, ALL, CML, CLL) for which chemotherapy and steroid therapy was necessary, and group II included patients with anaplastic anemia and myelodysplastic syndrome and who had undergone repeated transfusion for treatment. Comparisons were made between the two groups in respect to the incidence of urolithiasis and the stones' radiopacity. RESULTS: Twenty nine patients (3.2%) of the 901 malignant hematologic patients were diagnosed with urolithiasis, compared to 575 patients (1.4%) of 40,543 emergency room patients. There was a significant increase of the incidence of urolithiasis in the malignant hematologic group. Compared to the general patients, the patients with malignant hematologic diseases had a higher rate of radiolucent stones (46.6% versus 16.3%, respectively), and the difference was significant. CONCLUSION: The incidence of urolithiasis for malignant hematologic patients was significantly higher than that for the control group.
Adult ; Aged ; Female ; Hematologic Diseases/*complications/epidemiology ; Humans ; Incidence ; Leukemia/complications/epidemiology ; Male ; Middle Aged ; Myelodysplastic Syndromes/complications/epidemiology ; Retrospective Studies ; Urolithiasis/*epidemiology/*etiology ; Young Adult

PURPOSE: We assessed sexual function by using a questionnaire in women who were diagnosed with stress urinary incontinence and underwent mid-urethral tape sling surgery. MATERIALS AND METHODS: A retrospective survey was conducted of 151 women without evidence of detrusor overactivity or concomitant prolapse who underwent surgery (tension-free vaginal tape or tension-free vaginal tape-obturator) for stress urinary incontinence. The participants filled out a questionnaire regarding their preoperative and 6-month postoperative sexual function. Paired t-tests were used to compare changes over time. The generalized McNemar test was used to compare individual preoperative and postoperative findings. We considered a p-value less than 0.05 as significant. RESULTS: Of the 303 women who fulfilled the inclusion criteria, 204 (67.3%) returned the questionnaire. Of those 204 women, 151 were sexually active before and after surgery. No significant differences were observed after surgery in the frequency or appreciation of intercourse or the extent of sexuality. A significant reduction in leakage symptoms was observed after surgery (p<0.01). Of the 151 women, 29 (19.2%) reported an improvement in satisfaction with intercourse and 23 (15.2%) reported a deterioration after the anti-incontinence procedure. Partner discomfort remained unchanged. Of the 151 patients, 26 (17.2%) patients were unsatisfied with the surgical outcome because of persistence or recurrence of stress urinary incontinence and deterioration in satisfaction with intercourse after surgery. CONCLUSIONS: These results suggest that mid-urethral tape sling operations for stress urinary incontinence improved the continence rate, but had little effect on preexisting sexual disturbances. Additional and larger retrospective studies are warranted to support these preliminary findings.
Female ; Humans ; Prolapse ; Recurrence ; Retrospective Studies ; Sexuality ; Suburethral Slings ; Urinary Incontinence

We performed one-stage microsurgical phalloplasty on a 17-year-old male-pseudohermaphroditism patient after bilateral orchiopexy and urethroplasty, using the free radial forearm osteocutaneous sensory flap. The main advantages of this technique are not only the one-stage reconstruction and the satisfactory cosmetic and functional solution, but also the possibility of obtaining normal erogenous and tactile sensibility. One week after the operation, the urethrocutaneous fistula was developed between the native proximal urethra and the constructed neourethra, but seven weeks after the development, it spontaneously healed well. The results of our S-month follow-up are satisfactory in the following respects : 1) satisfactory cosmetic appearance 2) voluntary control of transurethral urination while standing 3) tactile and thermal sensibility. Further follow-up study is necessary for the confirmation of erogenous sensibility, successful sexual life and late complication.
Adolescent ; Fistula ; Follow-Up Studies ; Forearm* ; Humans ; Orchiopexy ; Urethra ; Urination

The management of post-thoracotomy pain is one of the difficult clinical problems. A variety of pain management methods have been used with variable efficacy. We compared the effect of acupuncture with the effect of analgesics for the post-thoracotomy pain control. From March 1995 to September 1995, 20 patients who underwent elective thoracotomy were randomized into two groups. The patients were treated with analgesics in control group(n=10) and acupuncture in the other group(n=10). Postoperative analgesic effects were evaluated by the scoring system which was made by the Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center. No significant difference was observed between two groups concerning the subjective pain and limitation of motion of operated side. Although the number of analgesic requirement was reduced significantly in the acupuncture group (P<0.05). We conclude that acupuncture is an effective method to control post-thoracotomy pain and it is safer than the analgesics bacause of its lower side effects.
Academic Medical Centers ; Acupuncture* ; Analgesics ; Humans ; Korea ; Pain Management ; Pain, Postoperative ; Thoracotomy

The management of post-thoracotomy pain is one of the difficult clinical problems. A variety of pain management methods have been used with variable efficacy. We compared the effect of acupuncture with the effect of analgesics for the post-thoracotomy pain control. From March 1995 to September 1995, 20 patients who underwent elective thoracotomy were randomized into two groups. The patients were treated with analgesics in control group(n=10) and acupuncture in the other group(n=10). Postoperative analgesic effects were evaluated by the scoring system which was made by the Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center. No significant difference was observed between two groups concerning the subjective pain and limitation of motion of operated side. Although the number of analgesic requirement was reduced significantly in the acupuncture group (P<0.05). We conclude that acupuncture is an effective method to control post-thoracotomy pain and it is safer than the analgesics bacause of its lower side effects.
Academic Medical Centers ; Acupuncture* ; Analgesics ; Humans ; Korea ; Pain Management ; Pain, Postoperative ; Thoracotomy

PURPOSE: Recurrence of upper urinary tract transitional cell carcinoma is common, and especially for bladder cancer. We evaluated the pathologic features, grade and recurrence rate of bladder tumors for patients who suffered with upper urinary tract transitional cell carcinoma and who were surgically treated at our hospital. MATERIALS AND METHODS: Between 2001 and 2006, a total of 68 patients without a history of bladder cancer underwent nephroureterectomy for upper urinary tract transitional cell carcinoma. We reviewed the pathologic features, the stage and the grade of the recurrent bladder cancer at a median follow up of 17.1 months. RESULTS: A total of 22 of 68 patients experienced recurred bladder tumors after nephroureterectomy for upper urinary tract transitional cell carcinoma at a mean interval of 17.1 months. Of the 22 patients with recurred bladder tumors, 21 of the patients(95%) had superficial tumor(Stage Ta, Tis, T1), 4(19%) of the patients had superficial tumors of a low grade (grades 1 and 2) and 17 patients(81%) had high grade tumor(grade 3). One patient had muscle invasive bladder tumor, so this was treated with radical cystectomy during the follow-up period. Regardless of the grade of the upper urinary tract transitional cell carcinoma, the pathologic grade of the bladder tumor was mostly high grade(82%). Regardless of the stage of upper urinary tract transitional cell carcinoma, the stage of the recurrent bladder tumors was almost superficial(95%). CONCLUSIONS: Bladder tumors recurred in 33%(22/68) of the patients after surgery for upper urinary tract transitional cell carcinoma. Of these bladder tumors, 95% were superficial and 81% were high grade. Therefore, conducting follow-up studies for bladder cancer is important after nephroureterectomy for upper urinary tract transitional cell carcinoma.
Carcinoma, Transitional Cell ; Cystectomy ; Follow-Up Studies ; Humans ; Muscles ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract

PURPOSE: To evaluate the relationship between F-18 FDG uptake of tumor in PET/CT scan and pathological or immunohistochemial parameters of colorectal cancer. MATERIALS AND METHODS: 147 colorectal cancer patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The pathologic results such as site, size, depth of invasion (T stage), growth pattern, differentiation of primary tumor, lymph node metastasis and Dukes-Astler & Coller stage and immunohistochemical markers such as expression of EGFR, MLH1, MSH2 and Ki-67 index were reviewed. RESULTS: 146 out of 147 PET/CT scans with colorectal cancer showed perceptible focal FDG uptake. SUVmax showed mild positive linear correlation with size of primary tumor (r=0.277, p=0.001) and Ki-67 index (r=0.226, p=0.019). No significant difference in F-18 FDG uptake was found according to site, depth of invasion (T stage), growth pattern, differentiation of primary tumor, presence of lymph node metastasis, Dukes-Astler & Coller stage and expression of EGFR. CONCLUSION: The degree of F-18 FDG uptake in colorectal cancer was associated with the size and the degree of Ki-67 index of primary tumor. It could be thought that FDG uptake of primary tumor has a correlation with macroscopic and microscopic tumor growth.
Colorectal Neoplasms ; Humans ; Lymph Nodes ; Neoplasm Metastasis

PURPOSE: Erectile dysfunction (ED) is a common comorbidity with diabetes mellitus (DM). The goal of this study was to evaluate the effect of cardiovascular risk factors (CVRF) on ED patients with DM and the response to phosphodiesterase type-5 (PDE5) inhibitors. MATERIALS AND METHODS: We performed a retrospective study on 32 patients with ED and type II DM. The CVRFs were defined as hypertension, coronary artery disease, hyperlipidemia, smoking and obesity. All the patients were checked for CVRFs and the erectile function was assessed with the International Index of Erectile Function (IIEF) score. Tadalafil (20mg) was taken for 3 months, and then the IIEF score was checked again. The scores of the IIEF-EF, Q3 and Q4 and the number of risk factors were analyzed. RESULTS: The scores of the IIEF-EF, Q3 and Q4 were higher in the non-risk factor group than that in the risk factor group. After Tadalafil treatment, the score of the group that had less than 1 risk factor was significantly improved, but the score of the group that had more than 2 risk factors showed little change. CONCLUSIONS: To treat ED patients with DM, their cardiovascular risk factors must be assessed.
Carbolines ; Comorbidity ; Coronary Artery Disease ; Diabetes Mellitus ; Erectile Dysfunction ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Obesity ; Phosphodiesterase 5 Inhibitors ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Tadalafil

PURPOSE: The cause of erectile dysfunction (ED) is mostly organic in nature and is associated with cardiovascular disease. Therefore, the presence of ED has been shown to be related to cardiovascular risk factors such as coronary artery disease, hypertension, diabetes mellitus (DM), and hyperlipidemia. This study evaluated the correlation between cardiovascular risk factors and penile hemodynamic parameters in men with ED. MATERIALS AND METHODS: The relationship between vascular risk factors and penile hemodynamic parameters were evaluated in a total of 149 men with ED. The patients were stratified according to the type and number of risk factors present. Each patient underwent a penile duplex Doppler ultrasound study after injections of intracavernous prostaglandin E1 to evaluate penile blood flow parameters. The rates of arterial insufficiency, venoocclusive dysfunction, and nonvascular etiologies were also evaluated. These results were statistically compared with those from patients with ED without vascular risk factors. RESULTS: The poorest blood flow was found in patients with ED with DM. Arterial insufficiency was most prevalent in patients with coronary artery disease and DM (p<0.05). Venoocclusive dysfunction was observed most often in hypertensive patients with ED. Abnormal penile blood flow parameters correlated with the number of vascular risk factors present. CONCLUSIONS: This study shows that cardiovascular risk factors are associated with abnormal penile blood flow. In addition, the number of risk factors is correlated with an increased probability of having abnormal blood flow parameters.
Alprostadil ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetes Mellitus ; Erectile Dysfunction ; Hemodynamics ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Risk Factors ; Ultrasonography, Doppler, Color