Under specific circumstances the appendix vermiformis may be an appropriate organ for replacement of a large ureteral defect or efferent loop in continent urinary diversion. Since 1995 we have applied the appendix in ureteral substitution (3 cases) and continent urinary diversion (3 cases). Primary diagnoses included complete lower ureteral stricture due to urinary tuberculosis (3 cases), invasive bladder tumor (1 case), areflexic neurogenic bladder (1 case), and contracted bladder (1 case). In all patients who have been replaced the ureter with appendix, clinical symptoms were markedly improved and degree of hydronephrosis decreased. Other patients with continent urinary diversion using appendix achieved dryness and low postoperative complications. we anticipate that the appendix will be used more commonly in the future as a ureteral substitute or continent urinary diversion as more urologists become more comfortable with it through its use in various reconstructive procedures.
Appendix* ; Constriction, Pathologic ; Diagnosis ; Humans ; Hydronephrosis ; Postoperative Complications ; Tuberculosis ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Diversion

We experienced a case of extensive urinary extravasation by rupture of renal pelvis in 61-year old male with no predisposing factors or any prior clues. He was managed by primary closure and followed up for 6 months without any problem.
Causality ; Humans ; Kidney Pelvis* ; Male ; Middle Aged ; Rupture ; Rupture, Spontaneous*

PURPOSE: To assess the quantitative accuracy and the clinical utility of 3D volumetric PET imaging with FDG in brain studies, 24 patients with various neurological disorders were studied. MATERIALS AND METHODS: Each patient was injected with 370 MBq of 2-[18F]fluoro-2-deoxy-D-glucose. After a 30 min uptake period, the patients were imaged for 30 min in 2 dimensional acquisition (2D) and subsequently for 10 min in 3 dimensional acquisition imaging (3D) using a GE AdvanceTM PET system. The scatter corrected 3D (3D SC) and non scatter-corrected 3D images were compared with 2D images by applying ROIs on gray and white matter, lesion and contralateral normal areas. Measured and calculated attenuation correction methods for emission images were compared to get the maximum advantage of high sensitivity of 3D acquisition. RESULTS: When normalized to the contrast of 2D images, the contrasts of gray to white matter were 0.75+/-0.13 (3D) and 0.95+/-0.12 (3D SC). The contrasts of normal area to lesion were 0.83+/-0.05 (3D) and 0.96+/-0.05 (3D SC). Three nuclear medicine physicians judged 3D SC images to be superior to the 2D with regards to resolution and noise. Regional counts of calculated attenuation correction was not significantly different to that of measured attenuation correction. CONCLUSION:: 3D PET images with the scatter correction in FDG brain studies provide quantitatively and qualitatively similar images to 2D and can be utilized in a routine clinical setting to reduce scanning time and patient motion artifacts.
Artifacts ; Brain* ; Humans ; Nervous System Diseases ; Noise ; Nuclear Medicine ; Positron-Emission Tomography

PURPOSE: This research was performed to determine which clinical signs and symptoms of brain injury are sensitive indicators of skull fracture (SF) and intracranial injury (ICI) in head injured children. METHODS: We conducted a prospective study of minor head trauma in children younger than 2 years of age for a 1-year period. Skull radiographs, brain computed tomography (CT), and data forms, including mechanism of injury, symptoms, physical findings, and hospital course, were completed for each child. RESULTS: Of 137 study subjects, 17 (12.4%) had SF/ICI. Falls were the most common mechanism of injury, and heights of fall above 1 meter were associated with incidence of SF/ICI (p<0.05). Scalp abnormalities were not associated with incidence of SF/ICI. As for clinical symptoms, lethargy and a grouping of features (irritability & vomiting) were associated with incidence of SF/ICI (p<0.05). The incidence of seizure, loss of consciousness, vomiting, irritability, and scalp abnormality did not differ significantly between those with normal radiologic findings and those with SF/ICI. Among asymptomatic patients, 11 (14.5%) patients had SF/ICI, and among patients with normal scalp findings, 9 (12.7%) patients had SF/ICI. CONCLUSION: Clinical signs and symptoms, except for lethargy and a grouping of features (irritability & vomiting), were not sensitive predictors of SF/ICI. Nevertheless, SF/ICI occurred among normal children. In such a case, a liberal policy of CT scanning is warranted.
Brain ; Brain Injuries ; Child ; Craniocerebral Trauma ; Head ; Humans ; Incidence ; Lethargy ; Prospective Studies ; Scalp ; Seizures ; Skull ; Skull Fractures ; Tomography, X-Ray Computed ; Unconsciousness ; Vomiting

Metastatic malignant tumors involving the thyroid gland are not as unusual as was once believed. They may in fact be more common than primary cancer of the thyroid, especially if careful screening is performed at autopsy. The origins of primary neoplasms that metasta size to the thyoid are myriad, but reports obviously indicate predminantly cancers of the kidney, breast, and lung and malignant melanoma. Occasienally, metastatic lesions from several gastrointestinal neoplasms such as colo-retal and esophageal carcinoma are seen, but metastasis from gastric cancer is very rare. We have seen one case of thyroid cancer metastasized from the stomach cancer. It simultaneously spread to the breast also and confirmed with gastrofiberscopic biopsy, fine needle aspiration cytology of the thyroid and excisonal biopsy of the breast. We report this case with reriew of literature.
Autopsy ; Biopsy ; Biopsy, Fine-Needle ; Breast* ; Gastrointestinal Neoplasms ; Kidney ; Lung ; Mass Screening ; Melanoma ; Neoplasm Metastasis* ; Stomach Neoplasms* ; Thyroid Gland* ; Thyroid Neoplasms

Emphysematous prostatitis is characterized by pockets of gas within the prostate due to gas-forming organisms. Although only one case of emphysematous prostatitis had been reported in the literature, it was incidental finding associated with emphysematous cystitis. We consider that it is the result of aerobic urinary tract infections or may be caused by gastrointestinal fistula or iatrogenic surgical and diagnostic instrumentation. We report a case of emphysematous prostatitis in a 66 years old male with diabetes mellitus.
Aged ; Cystitis ; Diabetes Mellitus ; Fistula ; Humans ; Incidental Findings ; Male ; Prostate ; Prostatitis* ; Urinary Tract Infections

Emphysematous prostatitis is characterized by pockets of gas within the prostate due to gas-forming organisms. Although only one case of emphysematous prostatitis had been reported in the literature, it was incidental finding associated with emphysematous cystitis. We consider that it is the result of aerobic urinary tract infections or may be caused by gastrointestinal fistula or iatrogenic surgical and diagnostic instrumentation. We report a case of emphysematous prostatitis in a 66 years old male with diabetes mellitus.
Aged ; Cystitis ; Diabetes Mellitus ; Fistula ; Humans ; Incidental Findings ; Male ; Prostate ; Prostatitis* ; Urinary Tract Infections

Xanthogranulomatous cystitis is a rare benign chronic inflammatory disease. To the best of our knowledge, only 16 cases have been reported in the literature. The etiology of xanthogranulomatous cystitis may include immunological disorders, abnormal lipid metabolism, a reduction of chemotactic activities, and metaplasia of the urothelium due to a chronic infection. Only one case has been reported in the Korean literature. Here we describe two cases of xanthogranulomatous cystitis with a review of the previous reports.
Cystitis* ; Inflammation ; Lipid Metabolism ; Metaplasia ; Urinary Bladder ; Urothelium

PURPOSE: The HedgehogGli(HHGli) signaling pathway controls many aspects of tissue patterning, cell proliferation, differentiation and regeneration, and regulates the number of cells in various organs. Inappropriate and uncontrolled activation of the HHGli signaling pathway has been demonstrated in a variety of human cancers. The Gli1, Gli2, and Gli3 genes encoding the Gli family transcription factors play a role as HH effectors. This study examined the significance in Gli2 and Gli3 expression in human bladder cancer. MATERIALS AND METHODS: The tumor tissues were obtained from 144 patients with a primary bladder cancer. The mRNA levels of Gli2, and Gli3 were examined using a real-time polymerase chain reaction(PCR) assay in 144 tumor specimens, and immunohistochemical staining was performed on 127 tumor paraffin blocks. The relationships between their expression and the pathological or clinical characteristics, such as tumor stage, grade, recurrence and progression were also analyzed. RESULTS: Gli2 mRNA expression was higher in the invasive bladder tumors than in the superficial bladder tumors(p<0.001) but, there was no difference in Gli3 mRNA expression according to the tumor stage and grade. The multivariate Cox regression model revealed that Gli2 mRNA expression(hazards ratio(HR): 2.329, 95% confidence interval(CI): 1.043- 5.202, p=0.039) was the only strong predictor of superficial bladder tumor recurrence. Kaplan-Meier analysis also showed identical results (log-rank test, p=0.043). CONCLUSIONS: The enhanced expression of Gli2 mRNA was strongly correlated with the recurrence of superficial bladder cancer. These results suggest that Gli2 may be a useful marker for assessing the recurrence of superficial bladder cancer in human bladder cancers.
Cell Proliferation ; Humans ; Kaplan-Meier Estimate ; Paraffin ; Recurrence ; Regeneration ; RNA, Messenger ; Transcription Factors ; Urinary Bladder ; Urinary Bladder Neoplasms

To examine the genetic background of avian pathogenic Escherichia coli (APEC) that affects virulence of this microorganism, we characterized the virulence genes of 101 APEC strains isolated from infected chickens between 1985~2005. Serotypes were determined with available anti-sera and median lethal doses were determined in subcutaneously inoculated chicks. The virulence genes we tested included ones encoding type 1 fimbriae (fimC), iron uptake-related (iroN, irp2, iucD, and fyuA), toxins (lt, st, stx1, stx2, and vat), and other factors (tsh, hlyF, ompT, and iss). Twenty-eight strains were found to be O1 (2.0%), O18 (3.0%), O20 (1.0%), O78 (19.8%), and O115 (2.0%) serotypes. The iroN (100%) gene was observed most frequently followed by ompT (94.1%), fimC (90.1%), hlyF (87.1%), iss (78.2%), iucD (73.3%), tsh (61.4%), fyuA (44.6%), and irp2 (43.6%). The strains were negative for all toxin genes except for vat (10.9%). All the strains were classified into 27 molecular pathotypes (MPs). The MP25, MP19, and MP10 pathotypes possessing iroN-fimC-ompT-hlyF-iucD-tsh-iss-irp2-fyuA (22.8%), iroN-fimC-ompT-hlyF-iucD-tsh-iss (21.8%), and iroN-fimC-ompT-hlyF-iss (11.9%) genotypes, respectively, were predominant. Redundancy of iron uptake-related genes was clearly observed and some strains were associated with higher mortality than others. Therefore, strains with the predominant genotypes can be used for diagnosis and vaccine.
Animals ; Bacterial Proteins/genetics/metabolism ; Chickens ; Escherichia coli/*classification/genetics/*pathogenicity ; Escherichia coli Infections/epidemiology/microbiology/*veterinary ; Gene Expression Regulation, Bacterial/physiology ; Phylogeny ; Poultry Diseases/epidemiology/*microbiology ; Republic of Korea/epidemiology ; Virulence