No abstract available.
Lithotripsy* ; Shock*

PURPOSE: We analyzed the RESULTS of the GnRH stimulation test to assess its usefulness as a predictor for testicular dysfunction in adolescent varicocele. MATERIALS AND METHODS: We studied 20 adolescents with unilateral varicocele from January 1998 to January 2001. Eight patients were grade II and 12 were grade III. Testicular volume was measured using an orchidometer. The responses of the gonadotropins to GnRH stimulus were compared between grade II and III patients. All patients had varicocelectomy and 7 were followed up. RESULTS: After GnRH stimulus, all patients except one showed excessive response in LH and FSH. LH response(8-fold greater than the baseline) was more exaggerated than that of FSH(1.8-fold greater than the baseline). The 12 patients of grade III varicocele presented greater excessive responses in LH and FSH to GnRH stimulus than those of grade II(p>0.05). After surgical treatment, the exaggerated gonadotropin response to GnRH was not normalized. But the response was less exaggerated, suggesting an improvement of testicular dysfunction. CONCLUSIONS: In this study, the grade of the varicocele was correlated with the excessive responses of the gonadotropins to the GnRH stimulus. Nevertheless, we suggest that the deterioration of the testicular function in adolescents with varicocele was a progressive phenomenon. We think that the GnRH stimulation test could be useful in assessing the testicular dysfunction in adolescent varicocele patients.
Adolescent* ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Varicocele*

We reviewed 26 patients with staghorn calculi to determine whether extracorporeal shock wave lithotripsy (ESWL) monotherapy with Dornier MPL-9000X lithotriptor is a successful alternative to the classical approaches. Of the staghorn calculi 5 cases were complete and 21 cases were incomplete staghorn. Double-J ureteral stents were placed in 24 of 26 patients before the ESWL. Of 15 patients with stone volume less than 20ml, 12(80%) showed stone-free after 5.7 mean session of ESWL. Of 11 patients with stone volume more than 20 ml, 7 (64%) became stone-free after 7.1 mean session of ESWL. The post-ESWL complications were flank pain in 9 patients (35%), gross hematuria in 24 (92%), high fever in 3 (13%) and steinstrasse in 24 (92%). Frank pain and high fever were managed successfully with analgesics and antibiotics. Gross hematuria disappeared spontaneously within 2 days. For the steinstrasse, the stone fragments passed spontaneously in 15 cases (62.5%) and ESWL to the steinstrasse was needed in other 9 cases (37.5%). Though the treatment of choice for the staghorn stones is combination therapy (PNL and ESWL) at the present, we experienced good results by ESWL monotherapy in staghorn calculi with Dornier MPL-9000X.
Analgesics ; Anti-Bacterial Agents ; Calculi* ; Fever ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Shock* ; Stents ; Ureter

A retrospective analysis was done on 68 patients with primary superficial bladder cancer between September 1989 and December 1995. We evaluated the predictive value of urine cytology in the recurrence and the progression of superficial bladder cancer. Positive cytology was shown in 52.9% (36/68) and was significantly associated with tumor grade (p=0.001). The recurrence rate in patients with negative cytology was 28.1% (9/32) compared to 77.8% (28/36) in those with positive cytology (p=0;001). No patients of negative cytology had tumor progression while 4 out of 36 (11.1%) patients of positive cytology had progression to invasive or metastatic disease. In conclusion, urinary cytology appears to be a significant prognostic factor in superficial bladder cancer.
Humans ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Contrast arteriography and phlebography remain the standard diagnostic techniques for evaluation of peripheral arterial and venous diseases. However, invasive angiographic techniques involve expense, time, discomfort, and potential risks to the patient which preclude their use as routine screening and followup procedures. In order to obtain accurate, objective information to complement the clinical diagnosis of peripheral vascular diseases, many noninvasive diagnostic techniques have recently become available to the clinican. Among these techniques, photoplethysmograph (PPG), strain gauge plethysmograph (SPG), and doppler ultrasound were adopted for our study. Fourty young volunteers were studied as a control group, and twenty peripheral vascular disease patients were studied as a patient group. We obtained average values of PPGa, blood flow, maximum PRT venous reflux folw (MVRF), maximum venous outflow (MVOF), pulse reappearance time (PRT), PRT/2 and pulsatility idex(PI) for control group. Results for patient group were analysed and compared with those of control group. 1. Normal PPGa wave has a steep upslope, a relatively narrow peak, and a dicrotic wave on the downslope which is concave toward the baseline. PPGa reflected skin blood flow sensitively than any other technique. 2. Average forearm blood flow by means of SPG was 5.7±2.0, and that of calf was 3.7±1.4ml/min/100cc tissue. MVOF of forearm was 32.9±10.4, and that of calf was 18.0±7.0ml/min/100cc tissue. Blood flow measurement was not useful for detection of arterial occlusive disease, but MV OF was useful for diagnosis of deep vein thrombosis. 3. PRT, PRT/2, over shooting reaction time by means of SPG have low diagnostic value and PI by means of doppler ultrasound was useful for localization of arterial narrowing or obstruction. 4. Noninvasive diagnostic techniques including PPG, SPG and doppler ultrasound are useful for screening and follow-up procedures in diagnosis of peripheral vascular disease. They are also valuable to supplement angiographic or physical findings.
Angiography ; Arterial Occlusive Diseases ; Complement System Proteins ; Diagnosis ; Follow-Up Studies ; Forearm ; Humans ; Mass Screening ; Peripheral Vascular Diseases ; Phlebography ; Reaction Time ; Skin ; Ultrasonography ; Vascular Diseases ; Venous Thrombosis ; Volunteers

PURPOSE: We compared the prophylatic effects and complications of intravesical instillation of the epirubicin and Bacillus Calmette-Guerin (BCG) in patients with stage T1 bladder cancer. MATERIALS AND METHODS: A total 87 patients with stage T1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of them, 51 patients received BCG (Connaught strain, 81mg), 16 patients received 50mg epirubicin and 20 patients underwent TUR alone. The patients were followed for 18-78 months (mean 40 months). Recurrence rates, progression rates, mean months to tumor recurrence, recurrence free survival rate using Kaplan-Meier curve and complications were compared among three groups. RESULTS: The overall recurrence rate was 27.5% in BCG group, 37.5% in epirubicin group and 65% in control group. Mean months to tumor recurrence and recurrence free survival rate showed that both drugs were superior to TUR alone. The incidence of complications was 94% in BCG group and 12.5% in epirubicin group. CONCLUSIONS: BCG and epirubicin were superior to TUR alone in the prophylaxis of recurrence in stage T1 bladder cancer. Although the prophylactic efficacy of BCG was a little higher than that of the epirubicin, the toxicity rate of epirubicin was much lower than that of BCG. Therefore, epirubicin may be regarded as an alternative treatment of the BCG, especially for the patients who cannot tolerate the side effects of BCG.
Administration, Intravesical ; Bacillus* ; Epirubicin* ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: High arousal threshold, nocturnal polyuria and small nocturnal functional bladder capacity have been implicated as causes of nocturnal enuresis. The two medications most widely used for the treatment of enuresis are imipramine and desmopressin. This study evaluated the effects of imipramine and desmopressin on sleep arousal. MATERIALS AND METHODS: A total of 50 enuretic patients who had responded to medications from Mar 1999 to Dec 2001 were evaluated. The mean age was 7 years old(range, 5-16), and there were 40 boys and 10 girls. They were classified into three groups according to their medication: imipramine group(22 patients), desmopressin group(7) and the combination group (imipramine+desmopressin, 21 patients). The parents were asked to record whether the patients woke up or not for 100 consecutive nights. RESULTS: The mean number of nights/100 nights that the patients woke up in each group was 3.2+/-7.2 in the imipramine group, 1.2+/-0.7 in the desmopressin group and 5.0+/-7.6 in the combination group. CONCLUSIONS: The main mechanism of imipramine and desmopressin for the treatment of enuresis does not seem to be associated with sleep arousal.
Arousal* ; Deamino Arginine Vasopressin* ; Enuresis ; Female ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Parents ; Polyuria ; Urinary Bladder

Neuroblastoma is a malignant neoplasm which arises from primitive sympathetic neuroblasts. It is the second most common solid tumor in young children, exceeded in incidence only by brain tumors. This tumor shows immunological features and spontaneous regression. But, in spite of recent advances in multimodality therapy survival rate has not been improved much. We reviewed 33 patients with neuroblastoma who had been diagnosed and treated between 1974 and 1980, and calculated survival rate by life table method
Brain Neoplasms ; Child ; Humans ; Incidence ; Life Tables ; Neuroblastoma* ; Survival Rate

PURPOSE: Transurethral resection of prostate(TURP) is the gold standard for the treatment of benign prostate hyperplasia(BPH) at the present. But many attempts have been made to develop minimally invasive method. We studied the efficacy of transurethral needle ablation(TUNA) of prostate for treatment of BPH. MATERIALS AND METHODS: We performed TUNA in 20 BPH patients including 13 patients with acute urinary retention. Preoperatively all patients were evaluated using urinary flow rates, International Prostate Symptom Score(1-PSS), Quality of life and cystoscopic examination. The urinary flow rates, 1-PSS and Quality of life were checked at 1, 3 and 6 months after TUNA in all patients. RESULTS: The average value of peak flow rate of the patients with urinary retention were 10ml/sec, 12ml/sec and 13ml/sec at 1, 3 and 6 months follow-up. The average value of Qmax of the patients without urinary retention were 9ml/sec preoperatively and increased to 13ml/sec, 13ml/sec and 14ml/sec at 1, 3 and 6 months postoperatively. 1-PSS of patients with urinary retention improved from average 26 at preoperation to 14, 13, 10 at 1, 3 and 6 months postoperatively. Quality of life of patients with urinary retention improved from average 5 at preoperation to 2, 2, 2 at 1, 3 and 6 months postoperatively. The average value of patients without urinary retention improved from average 26, 5 at preoperation to 14, 11, 11 and 2, 2, 2 at 1, 3 and 6 months follow-up. No patients complained of erectile dysfunction and retrograde ejaculation postoperatively. CONCLUSIONS: The result of our preliminary study suggest that TUNA can be considered to be a simple, safe and efficacious procedure for the treatment of BPH including urinary retention.
Ejaculation ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Needles* ; Prostate ; Quality of Life ; Tuna ; Urinary Retention

We have experienced an unusual case of hemorrhagic infarct in the right testis at the age of 59 years. The spermatic cord showed normal appearance and no torsion was noted. Orchiectomy was performed as frozen section revealed hemorrhagic infarction of the testis. Herein, hemorrhagic infarction of testis, a rare clinical entity, was reported with review of literatures.
Frozen Sections ; Infarction ; Orchiectomy ; Spermatic Cord ; Testis*