55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients (36 male and 19 female) ranged in age from 3 to 72 years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases (9.4%), atelectasis in 4 (7.5%), transient urine leak in 2 (3.8%), delayed bleeding in 2 (3.8%) and urinary retention in 2 (3.8%). Postoperative residual stones were identified in 15 (27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases (87.3%) became stone free. The recurrence of stone was noted in 2 out of 48 patients during the short follow up period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.
Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Methods ; Postoperative Complications ; Pulmonary Atelectasis ; Recurrence ; Urinary Retention ; Urinary Tract Infections

No abstract available.

No abstract available.
Carcinoma, Renal Cell* ; Humans

No abstract available.
Hypertrophy*

Male urethral diverticulum is uncommon lesion, furthermore calculus formation within the male urethral diverticulum is very rare. Generally, urethral diverticula are classified as congenital and acquired. The majority of male urethral diverticula are acquired and approximately 10 to 20 per cent are congenital. Acquired urethral diverticula in the male may arise from many sources, including infection (prostatic abscess, infection of periurethral glands, hematoma or schistosomiasis), obstruction (stricture, impacted stone, Cunningham clamp or condom catheter) and trauma (instrumentation, external injury and pelvic fracture). Calculi formation is more common in the acquired diverticulum owing to stagnation of urine and infection. These calculi in the diverticulum usually are solitary and may attain considerable size with predisposing factors, 1) a ureteral or bladder calculus that is lodged in the urethra 2) urethral trauma or stricture, 3) calcification around a foreign body or hair. The treatment of urethral diverticulum combined with stone is excision of the diverticula with removal of stone. We treated two cases of urethral diverticulum combined with stone in the male, and report with review of literature.
Abscess ; Calculi ; Causality ; Condoms ; Constriction, Pathologic ; Diverticulum* ; Foreign Bodies ; Hair ; Hematoma ; Humans ; Male* ; Ureter ; Urethra ; Urinary Bladder Calculi

Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patients requesting vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy persist between the patency and pregnancy rate despite improvements in surgical techniques. A total of 200 patients undergoing vasovasostomy from May 1983 to April 1990 were reviewed. Of these 200 patients, only 130 patients (98 patients by two-layer, 32 patients by modified two-layer technique) could be followed up and analyzed as to pregnancy rate related to age, vasal obstructive interval, gross appearance and sperm quality of the vas fluid, operative method, and presence or absence of sperm granuloma. Success rates were 90.3% for patency and 65.4% for pregnancy. With regard to factors influencing to operation, it seemed that the results were better when there was a shorter vasal obstructive interval, watery vas fluid, presence of normal morphologic sperm quality, presence of sperm granuloma, and when the operation was done using the two-layer technique. However, no statistically significant difference was found, except between the bilateral presence and absence of sperm granuloma at the vasectomy site. Thus it is suggested that the most important single factor influencing the success rate of vasovasostomy is a meticulous and skillful operative technique itself, althought other factors may affect the outcome. More effort and research are needed to find the factors affecting the success rate of vasovasostomy.
Granuloma ; Humans ; Infertility* ; Korea ; Pregnancy Rate ; Pregnancy* ; Spermatozoa ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy*

Noncommunicating hydrocele in adult is the most frequently encountered mass of the scrotum. Traditionally surgery had been considered as the most effective method of treatment. Sclerotherapy, however, may provide an alternative means of treatment for patients who are poor surgical or anesthetic risks and those who refuse surgery. In recent years, a number of sclerosing agents including tetracycline have been introduced, but those were found to produce various kinds of complications or frequent recurrences. Alcohol was also proved to have sclerosing effect by Bean who used it in the treatment of simple renal cysts with good results. This study was designed to determine the feasibility of sclerotherapy with alcohol for noncommunicating hydroceles. 95% or 75% sterile alcohol and tetracycline were injected into the spaces of tunica vaginalis of male rats to produce fibrous adhesion. At second week after injection, There was no significant difference in successful adhesion rates between alcohol injection group (71.9%) and tetracycline injection group(75%). 95% alcohol seemed more effective than 75% alcohol. There was no specific change or damage in the testicular parenchyme or surrounding scrotal wall. This result suggests the clinical applicability of alcohol in the management of noncommunicatinghydroceles.
Adult ; Animals ; Ethanol* ; Humans ; Male ; Rats* ; Recurrence ; Sclerosing Solutions ; Sclerotherapy ; Scrotum ; Testis* ; Tetracycline

Recently, it is well established that nitric oxide synthase (NOS) produces nitric oxide (NO), which is known to act as an important neural mediator of smooth muscle relaxation in various organs. The present study was undertaken to investigate the role played by NO in relaxing bladder outlet by correlating its action with the existence, distribution and activity of NOS. The experiments consisted of nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining for the identification of NOS containing nerve fibers, NADPH diaphorase activity with spectrophotometric assay for NOS catalytic activity, Western blot analysis with polyclonal antibrain NOS antibody for the expression of neuronal NOS, and in vivo isovolumetric bladder contraction (IBC) and reflex urethral .relaxation (RUR) for the physiologic role of NO. On NADPH diaphorase histochemistry in the rat, NADPH positive staining was localized in neurons innervating the lower genitourinary tract including the urinary bladder and the proximal urethra. NADPH positive nerve fibers were mainly found in urethral area, whereas they were less common in detrusor. In assay of NADPH diaphorase activity on various organs of the rat, the NOS activity regionally predominated in the cerebellum, proximal urethra, and urinary bladder in the order of frequency, which were correlated with the RESULTS of Western blot. Subsequent investigations were focused on the physiologic role of NO in the reflex changes in bladder outlet activity during micturition in the rat. During IBC, the urethra exhibited reflex responses characterized by a decrease in RUR in conjunction with a rise in IBC. Administration of NOS inhibitor, Nw-nitro-L-arginine, reversibly decreased the magnitude and duration of RUR, and this effect was reversed by administration of L-arginine. From these RESULTS, it is suggested that the neuronal form of constitutive NOS in the bladder outlet synthesizes NO by its catalytic action, which mediates relaxation of bladder outlet during micturition.
Animals ; Arginine ; Blotting, Western ; Cerebellum ; Muscle, Smooth ; NADP ; NADPH Dehydrogenase ; Nerve Fibers ; Neurons ; Nitric Oxide Synthase ; Nitric Oxide* ; Rats* ; Reflex ; Relaxation* ; Urethra ; Urinary Bladder ; Urination

BACKGROUND: Matrix metalloproteinases (MMPs) are involved in the degradation of the extracellular matrix, which is an important step in tumor invasion and metastasis. A positive correlation between the expression of MMP-9 and aggressive behavior of renal cell carcinomas (RCCs) has been reported. MMP-9 expression in RCCs and adjacent normal kidney tissues were examined in this study. MATERILAS AND METHODS: Twenty-five patients pathologically diagnosed as clear cell RCCs, from specimens obtained at radical nephrectomy, between May 2003 and December 2004 were enrolled in this study. MMP-9 activity was estimated using gelatin zymography, and quantified using a laser densitometer. The results were compared with clinicopathological characteristics. RESULTS: The expression of MMP-9 was significantly elevated in the RCC compared with non-tumor kidney specimens (p<0.01). The levels of MMP-9 expression in the RCC patients with large tumors (>4 cm) or vascular invasion were significantly higher than in those without these clinical manifestations (p<0.01). There were also significant differences in the expression of MMP-9 among T stages (p<0.01). The tissue MMP-9 level was the highest in nuclear grade 4, but there was no statistical significance between the histological grades (p=0.17). CONCLUSIONS: These results suggest that enhanced MMP-9 expression contributes to carcinogenesis and tumor progression in the later stages of RCC.
Carcinogenesis ; Carcinoma, Renal Cell* ; Extracellular Matrix ; Gelatin ; Humans ; Kidney ; Matrix Metalloproteinase 9* ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Nephrectomy

PURPOSE: It has been suggested in our previous study that the serum level of xanthine oxidise(XO) activity, glutathione(GSH), malonyldialdehyde(MDA) could be used as marker of oxidant stress in association with renal ischemia/reperfusion(I/R) injury. The present study was undertaken to establish the early marker of renal 1/R injury and to investigate the effect of deferoxamine on renal 1/R injury. MATERIALS AND METHOD: In Sprague-Dawley rats(male, 200-250gm, n=60), bilateral renal arteries were clamped for 60mins after pretreatment with deferoxamine(group A) or saline(group B). After 30min of bilateral renal recirculation, left nephrectomy and blood sampling in inferior vena cava were performed for in-vitro spectrophotometric study. Control animals(group C) did not undergo I/R operation. In-vivo renal function studies were performed in both group A and B with measurement of creatinine clearance rate(Ccr) at 7th day of experiments a%or renal ischmia for 60min. RESULTS: The levels of XO activity and XO type conversion ratio in renal tissue (RT) and serum(5) were measured. These levels were significantly high in group B, but were lower in group A compared to those of control group. The values of GSH(micrometer/g tissue), a scavenger of OFR, were decreased in group A (RT:0.183+/-0.019,5:0.201+/-0.029) and greatly decreased in group B(RT:0.159+/-0.009,5:0.164+/-0.022) compared to control group(RT:0.201+/-0.006,5:0.224+/-0.031). The values of MDA(nM/g tissue), a stable end product of lipid peroxidation, were increased in group A(RT:0.149+/-0.003, 5:0.058+/-0.004) compared to control group(RT:0.128+/-0.013, 5;0.055+/-0.005), but the values were significantly lower in group A compared to group B(RT:0.171+/-0.005, 5:0.070+/-0.003). Subsequent investigation was focused on the established renal function study after 1/R, which was determined using Ccr(ml/min). The Ccr in group A(2.06+/-0.03) was significantly higher compared to that of group 8(1.48+/-0.18), although it was slightly lower than in control group(2.18+/-0.05). CONCLUSIONS: From these results, it is suggested that renal I/R injury is highly correlated with the production of OFR. The levels of GSH and MDA in renal tissue and serum seem to be probable markers of oxidant stress in association with renal I/R injury. Furthermore, deferoxamine could reduce the degree of renal damage resulting from ameliorating the production of OFR following renal I/R injury.
Animals ; Creatinine ; Deferoxamine* ; Lipid Peroxidation ; Nephrectomy ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Vena Cava, Inferior ; Xanthine