No abstract available.
Teratoma*

There was a development of the diagnostic aids such as electromyography, discography, epidural venography, myelography, and CT in lumbar disc herniation. In 1984, Edgardo et al. described that the diagnosis of unusual extreme lateral disc herniation might be suggested by CT, but the diagnosis was made more certain with CT done after discography. Also, in 1986, Michael et al. reported,that the addition of CT to lumbar discography could help the clinician to obtain an anatomically valid diagnosis in people who, in spite of prior negative diagnosis evaluation, continue with significant clinical symptoms of low back pain and sciatica. The authors have studied 25 cases of CT after discography from July 1984 to June 1987. The results were as follows;1) CT after discography, which was a diagnostic method of direct visualization of nucleus pulposus herniation, shown same finding as previous CT in 16 cases and more accurate finding of herniated site snd size in 2 cases. 2) In one csse, the diagnosis of extreme lateral disc herniation, which was suggested by previous CT, made more certain with CT after discography. 3) There was false negative in 6 cases.
Diagnosis ; Electromyography ; Low Back Pain ; Methods ; Myelography ; Phlebography ; Sciatica

No abstract available.

PURPOSE: We have endeavored to find the factors predicting the success of ureteral stenting before cystoscopic retrograde ureteral catheterization in the patients with malignant ureteral obstruction. MATERIALS AND METHODS: 38 patients(51 kidneys) were analyzed, who were treated by retrograde ureteral stenting or percutaneous nephrostomy due to ureteral obstruction in non-urologic malignancy during the past 3 years. The sorts of primary tumors were cervix cancer in 14 cases(18 kidneys), stomach cancer in 12 cases(18 kidneys), colo-rectal cancer in 7 cases(9 kidneys), ovary cancer in 4 cases(5 kidneys), and endometrial cancer in 1 case(1 kidney). The cause of the ureteral obstruction was direct tumor invasion in 26 kidneys, lymphadenopathy in 23 kidneys and post radiation therapy in 2 kidneys. Retrograde ureteral stenting had failed in 22 kidneys(ureteral orifice could not be found in 14 kidneys, guide wire could not be advanced in 8 kidneys). RESULTS: Among the 51 kidneys, 29 kidneys(57%) were succeeded, and 22 kidneys(43%) were failed in retrograde ureteral catheterization. In fourteen of 22 kidneys(64%) ureteral orifice could not identified due to hemorrhage and edema of mucosa of bladder, and in 8 kidneys(36%) ureteral catheter could not be advanced to the renal pelvis. The cause of failure of the retrograde ureteral catheterization were direct tumor invasion in 10/26 kidneys(39%), and lymphnode enlargement in 4 of 23 kidneys(17%)(p=0.0007). According to the presence of ureteral obstructive symptoms, 8/29 kidneys(28%) were with the presence of ureteral obstruction symptoms, whereas 14/22 kidneys(64%) were failed with the absence of ureteral obstructive symptoms(p=0.0051). Of the obstruction site, 4/21 kidneys(19%) of upper to mid ureteral obstruction and 18/30 kidneys(79%) of lower ureteral obstruction were failed(p=0.0056). Of the degree of hydronephrosis, 18/47 kidneys(38%) of mild to moderate degree of hydronephrosis and 4/4 kidneys(100%) of severe hydronephrosis were failed(p=0.0022). CONCLUSIONS: This study shows that direct tumor invasion to the ureter, asymptomatic ureteral obstruction, lower ureteral obstruction, and high grade hydronephrosis were regarded as a high failure factors for the retrograde ureteral catheterization. Thus, we should not hesitate to choose percutaneous nephrostomy, in such condition that makes difficult for retrograde ureteral catheterization in malignant ureteral obstruction patients.
Edema ; Endometrial Neoplasms ; Female ; Hemorrhage ; Humans ; Hydronephrosis ; Kidney ; Kidney Pelvis ; Lymphatic Diseases ; Mucous Membrane ; Nephrostomy, Percutaneous ; Ovarian Neoplasms ; Stents* ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction* ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters ; Uterine Cervical Neoplasms

No abstract available.
Carcinoma, Transitional Cell* ; Cytochrome P-450 CYP1A1* ; Genetic Predisposition to Disease* ; Urinary Bladder*

No abstract available.
Carcinoma, Transitional Cell* ; Cytochrome P-450 CYP1A1* ; Genetic Predisposition to Disease* ; Urinary Bladder*

PURPOSE: To investigate whether the up-regulation of Bcl-2 gene expression may be associated with chemotherapy resistance and malignant progression in human renal cell carcinomas (HRCC). MATERIALS AND METHODS: The HRCC cell line, SN12C, was cultured in MEM medium, supplemented with 10% FBS. Full length of Bcl-2 cDNA was obtained using the sense primer (5'-ATGGCGCACGCTGGGAGAACGG-3') and the antisense primer (5'-TCACTTGTGGCTCAGATAGG-3') and inserted into SN12C cells to establish stable cells expressing the Bcl-2 gene (SN12C/smcb2). To investigate the response to doxorubicin in orthotropic organs, SN12C/smcb2 and parental cells were implanted into the subcapsular renal tissue of nude mice (n=5). The mice were treated with doxorubicin (8mg/kg) on days 8 and 15 following tumor cell implantation. Tumor tissues, obtained from the kidneys and lungs, were ex vivo cultured (SN12C/smcb2-kidney and SN12C/smcb2-lung, respectively). To compare the metastatic potential in these cell lines, the gelatinolytic activity was measured by zymogram and the expression of type IV collagenase (MMP-9) examined by western blot. RESULTS: In the in vitro study, the SN12C/smcb2 was more resistant to doxorubicin than the parental cells, and treatment and those cells produced a higher rate of tumor formation and metastasis. The SN12C/ smcb2-kidney showed higher gelatinolytic activity than the parental cells. Higher expression levels of type IV collagenase were detected in the SN12C/smcb2-lung and SN12C/smcb2-kidney, but barely detected in SN12C. CONCLUSIONS: The up-regulation of Bcl-2 gene expression in HRCC cells induces drug resistance to doxorubicin and increases the metastatic potential. Although the drug resistance induced by Bcl-2 over-expression enhances distant metastasis (lung), the up-regulation of Bcl-2 may enhance the malignant potential of tumor cells and produce distant metastasis.
Animals ; Blotting, Western ; Carcinoma, Renal Cell* ; Cell Line ; Collagenases ; DNA, Complementary ; Doxorubicin ; Drug Resistance* ; Drug Therapy ; Genes, bcl-2* ; Humans* ; Kidney ; Lung ; Mice ; Mice, Nude ; Neoplasm Metastasis ; Parents ; Up-Regulation

PURPOSE: We performed a prospective study to determine whether unenhanced helical computed tomography(UHCT) findings predict the spontaneous passage of ureteral calculi. MATERIALS AND METHODS: Between April 2006 and June 2007, 175 patients with a single ureteral calculus <1cm in diameter were enrolled in this study, and a UHCT was performed. All of the patients were managed conservatively for 2 weeks. Patients without spontaneous passage of ureteral calculi within 2 weeks were treated by ureteroscopy or extracorporeal shock wave lithotripsy(ESWL). The secondary signs (hydronephrosis, perinephric edema, and the tissue rim sign) were graded on a scale of 0-3. We evaluated whether spontaneous passage of ureteral calculi was associated with stone diameter, location, Hounsfield units(HU), and the degree of secondary signs. RESULTS: Ninety-two patients(52.6%) had spontaneous passage of ureteral calculi. The mean stone diameter was significantly smaller in the passage group than the non-passage group(4.28mm vs. 6.73mm, p=0.002). The rate of spontaneous passage was significantly higher involving distal ureteral calculi(66.1%) than proximal ureteral calculi(30.3%, p<0.001). The incidences of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(8.7% vs. 73.5% and 5.4% vs. 69.9%, respectively). The grades of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(p=0.001). Although there was a tendency toward increasing grades of hydronephrosis and perinephric edema with increasing stone size, the grades were more frequent and severe in the non-passage group in patients with similarly sized stones. CONCLUSIONS: The degree of hydronephrosis and perinephric edema are useful ancillary signs in predicting the likelihood of spontaneous passage of ureteral calculi.
Edema ; Humans ; Hydronephrosis ; Incidence ; Prospective Studies ; Shock ; Tomography, Spiral Computed ; Ureter ; Ureteral Calculi ; Ureteroscopy

Midurethral slings are increasingly popular for the surgical treatment of stress urinary incontinence. They are relatively simple to implant and shorten operating time, hospital stay, and recovery time. Tension free vaginal tape (TVT) and Intravaginal slingplasty (IVS) mesh are both polypropylene mesh. TVT is a type I totally macroporous mesh which, because of pores larger than 75 microns, admits bacteria, macrophages, and fibroblasts into the pores. IVS is a type III mesh with microporous components which admits bacteria but not macrophages. So anterior IVS appear to be more at risk of infection or vaginal erosion than other monofilament mesh. We report our experience with a patient who underwent anterior IVS and developed erosion of the mesh through vagina, creating pelvic abscess.
Abscess* ; Bacteria ; Fibroblasts ; Humans ; Length of Stay ; Macrophages ; Polypropylenes ; Suburethral Slings ; Surgical Mesh ; Urinary Incontinence* ; Vagina

PURPOSE: We report our experience to assess the effectiveness and safety of Holmium:YAG laser lithotripsy for managing ureteral calculi. MATERIALS AND METHODS: Ureteroscopic Holmium:YAG laser lithotripsy was performed in 116 cases from November 1999 to October 2003. Calculi were located at the upper ureter in 9%, mid ureter in 19% and lower ureter in 72%. The mean stone size was 1.2cm. A 8Fr semirigid ureterorenoscope, 7.5Fr flexible ureterorenoscope and holmium:YAG laser (Trimedyne, Irvine, USA) with 365mul laser fiber were used. RESULTS: Stones were completely cleared in 113 cases among 116 cases. Stone-free rates according to stone position were 97.6% in the lower ureter, 100% in the mid ureter and 90.9% in the upper ureter. Stone-free rates according to stone size were 100%, 100% and 85.7% in the cases of which diameter is below 10mm, between 10mm and 15mm and above 15mm respectively. Fragmentation was incomplete in 3 cases, so ESWL was performed in 2 cases and repeated procedure in on case. Ureteral perforation was developed in 1 case. CONCLUSIONS: The Holmium:YAG laser lithotripsy was highly effective and safe in managing ureteral calculi irrespective of their location.
Calculi ; Holmium ; Lithotripsy ; Lithotripsy, Laser ; Ureter* ; Ureteral Calculi*