In genitourinary trauma, the bladder is the second most common injury site. The majority of patients are injured by traffic accident. Injuries associated with bladder trauma are usually pelvic and rib fracture, but diaphragmatic rupture is rare. If bladder injury is suspected, diagnosis is made by a retrograde cystogram in most cases. However, if the patient complains of dyspnea, erect chest PA view or chest CT scan should be evaluated. We experienced a case of intraperitoneal bladder rupture combined with diaphragmatic rupture without other internal organ injury in a 68-year-old woman.
Accidents, Traffic ; Aged ; Diagnosis ; Diaphragm ; Dyspnea ; Female ; Humans ; Rib Fractures ; Rupture* ; Thorax ; Tomography, X-Ray Computed ; Urinary Bladder*

PURPOSE: Bacillus Calmette-Guerin(BCG) therapy for superficial bladders carcinoma and carcinoma in situ is believed to exert its antitumor effects through immune mechanisms when BCG is instilled into the bladder, but its detail mechanisms are poorly understood. Recently, intravesical BCG instillation is known to induce nitric oxide(NO) which is revealed to be tumoricidal . This experiment was performed to determine the intravesical localization and alteration of expression of inducible nitric oxide synthase(iNOS) after BCG instillation. MATERIALS AND METHODS: Normal saline(0.85m1/kg, control group) and BCG(6mg/kg, experimental group) were instilled intravesically in fifty four female mice. After 2 hours, each mouse urinated after removal of urethral ligature, and was sacrificed at 6th, 12th, 18th hour, 1st day, 1.5th, 2th, 3th, 7th and 14th day, respectively. Immunohistochemistry was performed on paraffin embedded bladder tissue using anti-inducible NOS antibody(Transduction Labaratories, USA.). RESULTS: Inflammatory cells were infiltrated in the bladder wall in the BCG-treated group, but not in the control group. Number of inflammatory cells among BCG-treated group, was the highest in the 18th hour group and was reduced gradually with time elapse thereafter In the control group, immunoreactivity of iNOS to be positive in the all intermediate cell layer and a few basal cell layer of bladder transitional epithelium, which did not change as time passed. In the BCG-treated group, immunoreactivity of iNOS increased from 6 hours after BCG instillation, and gradually decreased from 7 days to restore to the level of the control group. However, some cells of transitional epithelium showed reduced immunoreactivity, focally. CONCLUSIONS: These results suggest that iNOS is tonically expressed in transitional epithelium of mouse bladder which is further induced by BCG instillation. Also, NOS-mediated NO production is supposed to be one of factors to induce tumoricidal erect by BCG instillation.
Animals ; Bacillus ; Carcinoma in Situ ; Epithelium ; Female ; Humans ; Immunohistochemistry ; Ligation ; Mice* ; Mycobacterium bovis* ; Nitric Oxide ; Nitric Oxide Synthase Type II* ; Paraffin ; Urinary Bladder

Chlamydia trachomatis (C. trachomatis) is the most important pathogen of nongonococcal urethritis. C. trachomatis was detected by cell culture, enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) in 145 patients with nongonococcal urethritis. In 5 of 63 antibiotic-treated patients, C. trachomatis was identified by at least one method. C. trachomutid was identified in 34 (41.5%) of 82 nontreated patients. The most common symptom of the 34 patients was painful urination. C. trachomafir was identified in 6 cases (17.6%) of 34 patients by cell culture. And C. trachorrdtis was identified in 9 cases (26.5%) by ELISA, while in 33 cases(97.1%) by PCR. When PCR was performed with urines and urinary swabs collected from 38 patients with nongonococcal urethritis, 11(29%) cases showed positive with urine and 10(26%) cases with urinary swab. These results suggested that PCR with urine showed the higher positive detection rate of C. trachomatis in the patient with nongonococcal urethritis than other methods.
Cell Culture Techniques ; Chlamydia trachomatis* ; Chlamydia* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Polymerase Chain Reaction* ; Urethritis* ; Urination

BACKGROUND/AIMS: To introduce and review the results of the different treatment modalities of infected pancreatic necrosis and abscess that have been used during a 1-year period. As well, to assess the technique and indications of retroperitoneal drainage that is selectively performed for the management of peripancreatic necrosis because of the problem of intraperitoneal drainage. METHODS: Five patients with infected pancreatic necrosis or abscess were operated on from July 1997 to June 1998. Two undrewent surgical necrosectomy and retroperitoneal drainage and 3 had a classical procedure of multiple intraperitoneal drainage after necrosectomy. RESULTS: Two of 5 patients that had retroperitoneal drainage performed were successful of wide ranging necrosectomy of retroperitoneal necrosis or abscess through one drainage site and the left flank, resulting in a decreased rate of intraperitoneal contamination, discomfort and disability. CONCLUSION: The advantages of retroperitoneal drainage for wide ranging retroperitoneal pancreatic necrosis are made possible by draining the retroperitoneal route from the retroperitoneal cavity to the same retroperitoneal external opening. The use of retroperitoneal drainage seemed to be a significant factor for improvement by providing a reliable drainage of retropancreatic areas and by avoiding the opening of the peritoneal cavity
Abscess ; Drainage* ; Humans ; Necrosis* ; Peritoneal Cavity

PURPOSE: This study was designed to determine the diagnostic availability of transperineal ultrasongraphy compared with chain cystourethrography for patients with stress urinary incontinence. MATERIALS AND METHOD: Twenty-seven outpatient women with stress urinary incontinence, who underwent both transperineal ultrasonography and chain cystourethrography for the last ten months, participated in this study. The mean age was 47 years(range 37 to 66 years). The posterior urethrovesical angle(PUVA) at lest and during strain, and both an increment of PUVA and bladder neck descent during strain were measured in the two methods, respectively. Wilcoxon Matched-Pairs Signed-Ranks test was used for the comparative analysis of the results. RESULTS: The mean of PUVAS at rest and during strain were 118.9 degrees and 142.3 degrees, respectively, and the mean of the increment of PUVAS during strain was 23.5 degreesin transperineal ultrasonography. The mean of PUVAS at rest and during strain were 130.7 degrees and 158,0 degrees, respectively, and the mean of the increment of PUVAS during strain was 27.3 in chain cystourethrography. There were statistically significant differences in PUVAS, but no significant differences in the increment of PUVAS during strain between the two methods. During strain condition, the mean descent of bladder neck was 11.8mm in transperineal ultrasonography and 13.7mm in chain cystourethrography, and there were no significant differences between the two methods. CONCLUSIONS: Compared with chain cystourethrography, the transperineal ultrasonography made no significant differences in the diagnosis of stress urinary incontinence using both the increment of PUVAS and the bladder neck descent caused by the increase of abdominal pressure during strain. In addition, the transperineal ultrasonography is considered to be replaceable for chain cystourethrography, as that is noninvasive, devoid of risks of irradiation, and removes the noticeable discomfort or embarrassment for the patient in the diagnosis of stress urinary incontinence.
Diagnosis ; Female ; Humans ; Neck ; Outpatients ; Ultrasonography* ; Urinary Bladder ; Urinary Incontinence

PURPOSE: Infection of the external urogenital system with human papillomavirus (HPV) has been implicated in the development of genital cancer. We evaluated the prevalence of HPV types 6/11, 16 and 18 deoxyribonucleic acid (DNA) by polymerase chain reaction (PCR) and the localization of HPV DNA by in situ hybridization. MATERIAL AND METHOD: A total of 22 formalin-fixed, paraffin-embedded specimens of invasive squamous cell carcinoma of the penis were analyzed. We used the PCR technique to evaluate type specific DNA sequences of unique E6 to E7 transforming regions of HPV. Also, we investigated the localization of HPV DNA by in situ hybridization in PCR positive cases. RESULTS: Overall, by PCR technique the detection rate for HPV DNA were 50% (11 of 22 cases). HPV DNA type 16 was detected in all positive specimen and type 6/11 in 5 cases, whereas type 18 could not be detected. All of HPV DNA type 6/11 positive specimens were also HPV DNA type 16 positive. Using in situ hybridization HPV DNA type 16 was detected in 2 (18.2%) from 11 specimens in which HPV DNA had already been detected by PCR, and HPV DNA type 16 was localized in the nuclei of scattered carcinoma cells. But, HPV DNA type 6/11 were not detected by in situ hybridization. CONCLUSIONS: These findings suggest that HPV DNA type 16 is the type most commonly associated with penile carcinoma. But the result of high detection rate for HPV DNA type 6/11 seems to require further investigations.
Base Sequence ; Carcinoma, Squamous Cell* ; DNA* ; Humans* ; In Situ Hybridization* ; Male ; Penis* ; Polymerase Chain Reaction* ; Prevalence ; Urogenital System

PURPOSE: We evaluated whether increased split renal function ratio (%) on the renal scan with Tc-99m diethylenetriamine pinta-acetic acid (DTPA) represent elevated renal function in the obstructed kidney. MATERIALS AND METHODS: From 1994 to 1995, we evaluated 36 patients with unilateral hydronephrosis due to ureteropelvic junction (UPJ) obstruction and split renal function ratios of the affected kidneys were calculated using Tc-99m DTPA renal scan. RESULTS: Of the 36 patients, 7 patients showed that split renal function ratios of the affected kidneys were all over 52%. To assess the significance of the split renal function ratio on the Tc-99m DTPA renal scan, we performed Tc-99m mercaptoacetyltriglycine (MAG3) renal scan with the time interval of 3 days and calculated the split renal function ratios of the affected kidneys on the MAG3 renal scan in all 7 patients. The split renal function ratios of the affected kidneys on the MAG3 renal scan were also higher than those of the normal kidney. And the split renal function ratios of the affected kidneys on the MAG3 renal scan were well correlated with those of DTPA renal scan (r=0.83). CONCLUSIONS: Our results suggest that the increased split renal function ratio in affected kidney due to UPJ obstruction is not an artifact of the DTPA renogram.
Artifacts ; Humans ; Hydronephrosis ; Kidney* ; Pentetic Acid

We report two cases of bilateral renal angiomyolipoma with tuberous sclerosis who had skin lesions like butterfly shaped adenoma sebaceum on face, shagreen patch on back, leaf-shaped hypopigmented spot on both extremities, mental retardation, and seizure, which they are treated unilateral simple nephrectomy and selective arterial embolization, each other.
Angiomyolipoma* ; Butterflies ; Extremities ; Intellectual Disability ; Nephrectomy ; Seizures ; Skin ; Tuberous Sclerosis*

PURPOSE: To determine whether seminal malondialdehyde and carbonyl group have any relation to sperm motility. MATERIALS AND METHODS: Human semen samples were obtained by masturbation after 3 days of abstinence from patients consulting an infertility clinic. Using conventional semen analysis, samples were divided into two groups according to sperm motility (group 1: motility > OR =50%, group 2: motility <50%). Malondialdehyde and carbonyl group were measured in whole semen. RESULTS: The amount of malondialdehyde and carbonyl group was slightly lower in group 1 than group 2. CONCLUSIONS: Although the difference between the groups was not statistically significant, it seems possible that malondialdehyde and carbonyl group, which are produced from reactive oxygen, are negatively correlated with sperm motility.
Humans* ; Infertility ; Malondialdehyde ; Masturbation ; Oxygen ; Reactive Oxygen Species* ; Semen ; Semen Analysis ; Sperm Motility ; Spermatozoa*

PURPOSE: The interest has been growing in the investigation and management of erectile dysfunction, but there is few report about prevalence of erectile dysfunction in Korea. The object of this study was to determine the prevalence of erectile dysfunction of men in rural region in Korea through a community based survey. Also, we investigated the relationship between risk factors and erectile dysfunction. MATERIALS AND METHODS: A total of 255 men aged 30 and over in chonnam province, Korea was randomly selected for determination of the prevalence of erectile dysfunction, and they participated in questionnaire survey including International Index of Erectile unction (IIEF), and clinical and laboratory examination that include blood pressure, ECG, blood glucose, urinalysis, serum level of lipid profiles, GOT, GPT and creatinine etc. Information on erectile dysfunction were collected by direct personal interview using IIEF. High risk factors of erectile dysfunction were divided according to estimated level and determined relationship with erectile dysfunction. RESULTS: Overall mean IIEF score was 20.6 7.3, and based on IIEF score, the prevalence of erectile dysfunction was 66.3% (169 of 255 men). The prevalence of erectile dysfunction of older aged men over 50 years was significantly higher than younger aged men. Also strong correlation was found between erectile dysfunction and diabetes mellitus, smoking. Although there was no statistical significance by multiple regression analysis, educational level, abnormal findings in ECG, history of chronic disease, hypertension, hypercholesterolemia and hyperlipidemia had relation to erectile dysfunction by ANOVA and Student t-test. And alcohol drinking, triglyceride and HDL-cholesterol were not statistically significant for development of erectile dysfunction. CONCLUSIONS: Our data showed that the prevalence and correlations with risk factors of erectile dysfunction in local community. We hope that this study will aid in larger epidemiologic study and prevention of erectile dysfunction in whole land.
Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Creatinine ; Diabetes Mellitus ; Electrocardiography ; Epidemiologic Studies* ; Erectile Dysfunction* ; Hope ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Hypertension ; Jeollanam-do ; Korea ; Male* ; Prevalence ; Surveys and Questionnaires ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Urinalysis