Rigid transurethral ureteroscopy has been utilized on twenty-two occasions for the treatment of distal ureteral calculi. This resulted in successful stone removal and avoidance of an open operation in 77.3 percent of the cases. The advantages of this type of treatment are that it enables endoscopic access to a surgically difficult portion of the ureter and allows direct visualization during basket manipulation of ureteral calculi. It is concluded that the ureteroscopic stone manipulation could be the first choice of treatment in distalureteral calculi.
Calculi ; Ureter* ; Ureteral Calculi* ; Ureteroscopes ; Ureteroscopy ; Urinary Calculi

Calbindin-D28k, a vitamin D-dependent calcium binding protein, plays a cardinal role in transport of calcium in kidney. Previous studies have demonstrated calbindin-D28k immunoreactivity in the distal nephron of mammalian kidney. However, it is well known that in most species including rat and human, there is a gradual transition from the distal convoluted tubule to the cortical collecting duct, and that the connecting segment do no tclearly demarcated, because of intermingling of distal convoluted tubule cells, connecting tubule cells, principal cells and at least two configurations of intercalated cells. In this study, to identify the cell types of calbindin-D28k-positive cells in distal nephron of rat kidney, we used double immunostaining with an antibody against calbindin-D28k and antibodies against thiazide sensitive Na+/Cl- cotransporter for distal convoluted tubule or H+-ATPase for intercalated cells. In the distal convoluted tubule, most of the distal convoluted tuble cells were calbindin-D28k-positive, whereas the intercalated cells were calbindin-D28k-negative. In the connecting tubule, 68% of the cells were calbindin-D28k-positive, and about 97% of the positive cells were connecting tubule cells and only 3% of them were intercalated cells. In the cortical collecting duct, and outer medullary collecting duct of outer stripe and inner stripe, only 8.6%, 11.8% and 4.4% of cells were weak positive for calbindin-D28k respectively. These weak positive cells in the collecting duct are mainly identified as intercalated cells. These findings indicate that calbindin-D28k is involved in not only transcellular transport of calcium but also processes regulating intracellular calcium in rat kidney.
Animals ; Antibodies ; Calbindin 1 ; Calcium* ; Carrier Proteins* ; Humans ; Immunohistochemistry ; Kidney* ; Nephrons* ; Rats* ; Transcytosis ; Vitamins

Renal hypertension is found to be the cause in 5-15ft of patients with hypertension, and may be vascular or parenchymal in nature. Renal studies in diagnostic technique and vascular reconstructive techniques now enable successful management in many patients with renal hypertension. We experienced one case of renovascular hypertension due to renal vein hypoplasia. This rare renal venous hypertension has been diagnosed preoperatively and can be cured by nephrectomy, so we reported this case with brief review of the literature.
Humans ; Hypertension ; Hypertension, Renal ; Hypertension, Renovascular* ; Nephrectomy ; Renal Veins*

Since Memmalaar first reported the use of bladder mucosa graft technique in penoscrotal hypospadias in 1947, this technique has been used with reasonable success for the reconstruction of new urethra for the posterior hypospadias and hypospadias cripples. The a bladder mucosa is abundantly available, sterile and has good elasticity. This mucosa does not produce hair, does not excoriate, and does not desquamate from the exposure of the urin. Two new urethrae in patients with posterior hypospadias, aged 11 and 21, were successfully reconstructed with bladder mucosal graft technique. A minor meatal stricture developed in one patient. However, the over-all results of this technique appear to be satisfactory.
Constriction, Pathologic ; Elasticity ; Female ; Hair ; Humans ; Hypospadias* ; Male ; Mucous Membrane ; Transplants* ; Urethra ; Urinary Bladder*

PURPOSE: We divided the children diagnosed with intususception into three different age groups and compared the clinical symptoms and treatment outcomes in order to analysis diagnosis and treatment of Intusussception. METHODS: A retrospective chart review was established of 159 patients diagnosed with intussuception who had been admitted to Department of Pediatrics and General Surgery, Bundang CHA hospital from January, 2000 to May, 2004. We divided the patients into three groups, according to their age. Those who were under five months of age (group I; 21 patients), those between 5~11 months of age (group II; 61 patients), and those older than 11 months of age (group III; 77 patients). Then we compared the age, sex, seasonal distribution of occurrence, the cause, the clinical features, radiologic review, the type of intusussception, surgical methods, recurrence rate and treatment outcomes, among these three groups. RESULTS: On comparing the clinical symptoms and signs among the three groups, the most common major clinical symptom and sign was irritabiltity in all three groups. Vomiting with irritability was statistically more common in group I (p<0.05) and bloody stool was most frequent in group III. The average time taken until a diagnosis was made after the symptom onset was, 21 hours in group I, 20 hours in group II and 22 hours in group III. Which showed no significant difference. But there was a higher rate of delayed diagnosis in group I, which took over 48 hours until the diagnosis was made (group I; 23.8%, group II; 4.9%, group III; 7.8%). Simple abdominal X-rays showed more frequent instances of intestinal obstruction in group I (p<0.05). The primary treatment done was barium enema which showed a failure rate of 52.4% in group I, 26.2% in group II and 14.3% in group III. Showing the highest failure rate in group I. CONCLUSION: The youngest group had vague symptoms which lead to delayed diagnosis and more frequent surgical procedures. As so, we advocate the importance of further evaluation and close observation, considering intussusception in children with symptoms of irritability and vomiting, especially in the early infant group.
Age Distribution* ; Barium ; Child ; Delayed Diagnosis ; Diagnosis ; Enema ; Humans ; Infant ; Intestinal Obstruction ; Intussusception* ; Pediatrics ; Recurrence ; Retrospective Studies ; Seasons ; Vomiting

A consecutive series of 41 patients with renal cell carcinoma treated by nephrectomy from 1976 to 1986 is presented. The crude 2-year survival rate for all patients was 63% and for patients without distant metastases 84%. The importance of factors relating to prognosis was investigated with multivariate survival analysis(Cox's statistical regression models). Stage and metastases were strongly and independently associated with survival. The presence of regional lymph node and tumor cell type showed a statistically significant association with survival. But the invasion of renal vein, tumor size, the age and sex of the patients, grade, presence or absence of gross hematuria sedimentation rate and side or site of the tumors showed no prognostic significance.
Carcinoma, Renal Cell* ; Hematuria ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Renal Veins ; Survival Rate

Between January 1987 and February 1990, records of 5Z patients with 60 impalpable testes who had surgery were reviewed retrospectively regarding localization and management of the testes. Seven out of 60 testes turned out to be palpable by careful examination under anesthesia. Ultrasonogram detected 8 testes (5 intracanalicular and 3 preperitoneal) out of 25 testes. Laparoscopy provided and in planning the appropriate surgical approach in all 8 testes. Of the 47 testes found at surgery 19 were intraabdominal, 14 intracanalicular, 12 in preperitoneal and 1 located in superficial inguinal area. Also 13 vanished testes were confirmed during surgery examining blind end of spermatic vessels and vasa. Two patients with intersex ( true hermaphroditism and hernia uteri inguinalis) were presented as unilateral impalpable testes. 42 testes were brought down surgically utilizing regular orchiopexy in 26 testes, transabdominal orchiopexy in 8 testes, Fowler-Stephens orchiopexy in 7 testes and staged orchiopexy in 1 testis were done with acceptable results. transabdominal approach is recommended in cases of suspecting intraabdominal testis or intersex.
Anesthesia ; Hernia ; Humans ; Laparoscopy ; Orchiopexy ; Ovotesticular Disorders of Sex Development ; Retrospective Studies ; Testis* ; Ultrasonography ; Uterus

No abstract available.
Sensation* ; Zygote Intrafallopian Transfer*

From January 1980 to December 1989, 172 patients with transitional cell carcinoma of the bladder treated by transurethral resection (TUR) or total cystectomy with urinary diversion were analyzed retrospectively. Fifty-six patients underwent total cystectomy with urinary diversion and 116 underwent TUR. The 5-year survival rates in a total of 172 patients were noted in 96.6, 48.6, 32.7, 30.6 and 44.1% or those with stage Ta-1, T2, T3a, T3b and T4 disease, respectively and in 94.7, 87.9 and 52.1% of those with grade 1, 2 and 3 disease, respectively. The 5-year survival rates in 56 total cystectomy patients were noted in 94.1, 80.0. 31.0 and 28.6% of those with stage Tis-1, T2, T3a and T3b-4 disease, respectively and in 75.0, 80.0 and 45.3% or those with grades 1, 2 and 3 disease, respectively. The 3-year recurrence rates in 116 TUR patients were noted in 14.3, 43.1 and 55.9% of those with grade 1, 2 and 3 disease, respectively. Stage and grade were the most important prognostic factors in survival for cystectomy and tumor recurrence in TUR patients, respectively.
Carcinoma, Transitional Cell* ; Cystectomy ; Humans ; Recurrence ; Retrospective Studies ; Survival Rate* ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion

Urethrocutaneous fistula is the most common complication in hypospadias repair. De-epithelialized flap technique vas introduced to prevent fistula formation in hypospadias repair. Herein, we reviewed our recent experience of 26 hypospadias repairs using same principle and described the surgical technique of procedures using various skin flaps. Of 10 cases with hypospadias repair, 3 cases developed the fistula and of 16 cases with fistula repairs, 3 cases of fistula recurred respectively.
Female ; Fistula ; Hypospadias* ; Male ; Skin*