45 cases of proved renal cell carcinoma which were operated on during last 10 years between March 1972 and February 1982 in the department of Urology of Yonsei University College of Medicine were clinically observed with the reference to the operative morbidity due to the surgical incisions of both anterior transperitoneal approach (25 cases or 55%) and modified thoracoabdominal approach which is 11th-rib resection with extrapleural and transperitoneal exposure (20 cases of 45%). According to the experience with modified thoracoabdominal incision for the 17 radical nephrectomies and 3 open biopsies and through the review of the literatures, some results were obtained and summarized as follows. 1. Modified Thoracoabdominal approach is superior to the anterior transperitoneal approach for the operation of renal malignancy because of better exposure for the renal pedicle and upper pole as well as low morbidity rate (1:1.6). 2.We could also be sure by our self experiences of a few advantages of Modified Thoracoabdominal approaches as others reported previously. (1) An undisturbed intrathoracic space avoids a source of complications. (2) Because of adequate exposure of renal pedicle and upper pole even in the large renal tumor, operativemanipulation is easier and safer. (3) As muscle layers to be cut are not heavy, postoperative pain is less complained. The incision is also relatively simple to make and close. (4) Modified Thoracoabdominal approach is worth to apply to any urologic operations for the kidney and upper ureter. 3. In case tumor thrombi were involved in the supradiaphragmatic vena cava and vena caval resection is inevitable, either midline abdominal incision with sternotomy or conventional thoracoabdominal incision should be chosen rather than Modified thoracoabdominal approach.
Biopsy ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Nephrectomy* ; Pain, Postoperative ; Sternotomy ; Ureter ; Urology

A group of 180 men who visited Urology Department of Severance hospital, including 115 patients with nongonococcal urethritis (N.G.U.), 27 patients with prostatitis, 13 patients with gonococcal urethritis (G.U.) and 25 healthy medical student controls were investigated for the isolation of Ureaplasma urealyticum (T-strain mycoplasma) from the specimen of urethral discharge, urine and semen. Taylor-Pobinson media of T-broth and T-agar was used for the isolation of Ureaplasma urealyticum. To the best of our knowledge, the study on the culture of Ureaplasma urealyticum was reported for the first time in Korea. The following results were obtained: 1. The isolation rate of Ureaplasma urealyticum in nongonococcal urethritis (53.0%) revealed highest of those in the other three groups of prostatitis, gonococcal urethritis and control (40.7%, 38.4% and 16.0% respectively). 2. As for the specimens, urethral discharge revealed higher isolation rate of Ureaplasma urealyticum (54.6%)than first voided urine (50.0%). 3. The more consorts patients had, the higher positive culture rate of Ureaplasma urealyticum were revealed. The isolation rate in case of more than one causal in nongonococcal urethritis (71.1%) revealed much higher than in case of marital only (42.8%), one regular (41.1%) and one causal (41.0%). 4. 18.7% of isolation rate of Ureaplasma urealyticum revealed in patients with nongonococcal urethritis who visited the clinic in later than 4 weeks after the symptoms developed. However, the isolation rate in patients who visited within 4 weeks revealed 58.9%. The lower isolation rate of Ureaplasma in the late treatment seekers might be probably due to the suppression effect against Ureaplasma urealyticum from the possible previous self antibiotic treatment. 5. Attachment of Ureaplasma urealyticum mostly to the neck and head portion of the spermatozoa seemed to play a role to affect the motility of sperms.
Head ; Humans ; Korea ; Male ; Neck ; Prostatitis ; Semen ; Spermatozoa ; Students, Medical ; Ureaplasma urealyticum* ; Ureaplasma* ; Urethritis* ; Urology

To estimate the cancer mortality rates among Koreans, a mortality survey was carried out in the province of Kyongsangnam-do. The study population are the beneficiaries of Korea Medical Insurance Corporation (KMIC), Kydngsangnam-do area, among which the 3,867 deaths occurred from January, 1989 to December, 1990, were reviewed to confirm the cancer deaths. These were based upon the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey was conducted along three steps. At first, the death certificates were examined, as a second step medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 990 deaths were found due to cancer. Using them, age and sex specific cancer(all sites and several sites) mortality rates were estimated. Overall cancer mortality rate in the area was estimated 138.7 per 100,000 person-years in males, and 65.7 in females, respectively. And the orders of site-specific cancer mortality rates were the cancers of stomach, liver, lung, esophagus, and cancers of the hematopoietic system among males, In females, followed by gastric cancer, cancers of lung and liver are the 2nd and 3rd in rank, respectively and cancers of breast and uterine cervix are the 4th and the 5th in rank.
Breast ; Cervix Uteri ; Death Certificates ; Esophagus ; Female ; Gyeongsangnam-do* ; Hematopoietic System ; Humans ; Insurance ; Korea ; Liver ; Lung ; Male ; Mortality* ; Stomach ; Stomach Neoplasms

Superficial bladder cancer is a disease with variable biologic potential. The behavior of the disease varies, depending upon the tumor characteristics evident on initial evaluation. A retrospective study of 178 patients with superficial transitional cell carcinoma and a follow up of at least 6 months is reported. Transurethral resection was done in all cases. Using Cox's proportional hazards model, the following results were obtained : 1. Grade was the most important factor followed by. in order of importance, the number of tumors, patient age, tumor size, shape of the tumor, and associated bladder mucosal changes. A previous history of a superficial bladder tumor was another independent prognostic factor. 2. Other variables such as sex the interval between transurethral resection and initial symptom or first recurred period were not prognostic factors. The high risk factors were grade 3, more than 2 tumors, more than 51 year old, tumor site more then 3cm, non-papillary shapes and associated bladder mucosal changes. More aggressive therapy should be considered for patients showing high risk factors.
Carcinoma, Transitional Cell ; Follow-Up Studies ; Humans ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder*

This report details the procedures used in the repair of refractory urethrovaginal fistula and a lower abdominal wall defect and extraction of a large vaginal stone. The stone was removed vaginally by extending Schuchardt`s incision. The urethrovaginal sublabial tunnel into the vagina and anchored to the bladder neck to seal the fistula sites. The lower abdominal wall defect was reconstructed with a left Tenosor Fascia Lata (TFL) myocutaneous flap transferred through the subinguinal tunnel. All problems were satisfactorily corrected.
Abdominal Wall* ; Fascia Lata* ; Fascia* ; Fistula* ; Humans ; Myocutaneous Flap* ; Neck ; Urinary Bladder ; Vagina

The use of a gracilis myocutaneous flap to overlay an extensively traumatized scrotoperineal soft tissue defect, through which both testes and the ruptured bulbous urethra were exposed, is discussed. The transplanted gracilis myocutaneous flap, which included vascularized and innervated tissue, was well taken and covered the perineal defect, exposed testes and urethral stricture both cosmetically and functionally.
Adult ; Case Report ; Human ; Male ; Muscles/surgery ; Perineum/*surgery ; Rupture ; Scrotum/*surgery ; Surgical Flaps/*methods ; Testis/*injuries/surgery ; Urethra/*injuries/surgery

To characterize the sympathetic nervous system response to congestive heart failure in infants and children, plasma norepinephrine levels were measured in 29 patients aged 4 months to 15 years undergoing routine cardiac catheterization at Dong San Hospital, Keimyung University during the period of 4 months from November 1990 to February 1991. Plasma norepinephrine levels were significantly higher in patients with heart disease and congestive heart failure than in those without congestive heart failure(P<0.001). A significant association was found between the level of plasma norepinephrine and severity of the symptoms of congestive heart failure. Plasma norepinephrine levels correlated well with size of the shunt (Qp/Qs)(gamma=0.75), degree of pulmonary arterial pressure (gamma=0.79) and degree of right ventricular pressure (gamma=0.82).
Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Estrogens, Conjugated (USP)* ; Heart ; Heart Diseases ; Heart Failure* ; Humans ; Infant* ; Norepinephrine* ; Plasma* ; Sympathetic Nervous System ; Ventricular Pressure

Acute scrotum is defined as an acute painful swelling of the scrotum or its content. There are many conditions it may cause acute scrotum, but since a delay in the diagnosis and treatment may led to necrosis and its loss, the possibility of torsion of the spermatic cord should be ruled out in the first place. In a retrospective study of 32 childhood patients with acute scrotum presenting to Chungbuk National University Hospital from March 1992 to March 1995, we evaluated general aspects of acute scrotum including the result of follow up. The incidence of acute epididymitis, testicular torsion, mumps orchitis, and torsion of a testicular appendage were 66%, 19%, 9% and 6%, respectively. Of the eight scrotal explorations performed, 6 had testicular torsion, and 2 had torsion of appendages. With the exception of cases of far advanced necrotic testes, both color Doppler ultrasound and radioisotope imaging were highly specific diagnostic modalities. But, because of the potentially devastating outcome of a false-negative result of imaging studies, we continue to believe that physical exam is the best guide regarding the necessity of surgical exploration and all patients with unequivocal examinations are best served by prompt surgical therapy.
Acute Pain ; Child* ; Chungcheongbuk-do ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mumps ; Necrosis ; Orchitis ; Retrospective Studies ; Scrotum* ; Spermatic Cord ; Spermatic Cord Torsion ; Testis ; Ultrasonography ; Ultrasonography, Doppler, Color*

This study was carried out to observe the ultrastructure of tongue mast cells in frog, Bombina orientalis. In the light microscopy, mast cells were round, oval, spindle-like and irregular shape and occasionally had one or more tail-like long cytoplasmic processes. Mast cells had many red granules stained with toluidine blue in the cytoplasm. In the electron microscopy, mast cells had membrane-bounded granules and poorly developed organelles. The granules were composed of two parts, low and dense electron density. In high magnification the dense part in the middle region of granule had honey comb-like crystalline structure.
Anura* ; Crystallins ; Cytoplasm ; Honey ; Mast Cells* ; Microscopy ; Microscopy, Electron ; Organelles ; Tolonium Chloride ; Tongue*

It was well known that atrial myocytes systhesize atrial natriuretic peptide[ANP], and secrete it into the atrial lumen through the atrial endocardium. But the mechanism for regulation of ANP secretion has not been clearly elucidated, because there was little information of the atrial morphology concerning basal lamina. Basal lamina is surmised as one of barriers that control the movement of ANP, a large molecule. This study was attempted to elucidate the morphological characteristics of basal lamina and connective tissue fibers of atrial endocardial layer by scanning electron microscopy. Basal lamina was exposed by removal of the overlying endothelium. This was achieved by using OsO4 maceration, immersion in aqueous boric acid or EDTA treatment. After removal of the endothelial cell, the specimens were exposed to ultrasonic vibration in case of need. The external surface of basal lamina showed a fairly smooth appearance on the whole, although a few irregular folds are often encountered. Fenestrations, 0.1-1 micrometer in diameter, were randomly observed on the basal lamina, and they were circular to oval in shape. Margin of fenestrations was somewhat distinct and some was divided into two parts by linear structures. The structural differences of fenestrations between right and left atria were not found. The fibroreticular lamina under the basal lamina was revealed by removal of the endothelial cells and their basal lamina. This layer was consisted of interwoven fine fibers. These fine fibers were repeatedly divided and fused, forming reticular network. Some fine fibers connected with basal lamina. Some connective tissue fibers below fibroreticular layer were collected into thick bundles running parallel to myocytes. Above results may serve as a basis for the physiological and morphological studies of atrium.
Animals ; Atrial Natriuretic Factor ; Basement Membrane* ; Connective Tissue ; Edetic Acid ; Endocardium* ; Endothelial Cells ; Endothelium ; Immersion ; Microscopy, Electron, Scanning ; Muscle Cells ; Rats* ; Running ; Ultrasonics ; Vibration