The Psoas hitch procedure is a universal approach for ureteral reimplantation in all diseases of the distal ureter. Digital ureteral defect due to iatrogenic lesion and chronic inflammation such as tuberculosis, congenital ureteral anomalies including complicated reflux in child are the main indications for the Psoas hitch plasty. We performed ureteroneocystostomy with Psoas hitch procedure in l4 patients in recent 3 years. We evaluate the preoperative state. operative technique, postoperative course and follow-up of these cases and report with the review of the articles. The results were as follows: l. Fourteen cases included 7 ureteral injuries by 3 cases of transabdominal hysterectomy and 4 cases of ureterolithotomy, 3 chronic inflammatory stricture ie. tuberculosis, 2 traffic accidents, l bladder CA. in bladder diverticulum, 1 con genital megaureter. 2. Psoas hitch ureteroneocystostomy was done by submucosal tunnel with Psoas hitch in 9, end to side with Psoas hitch in 3, submucosal tunnel with Psoas hitch and Boari flap in 2 cases. 3. There were improvements in all l4 cases without ureterovesical stenosis or VUR. And functional capacity of the bladder has been well preserved. Postoperative complications were UTI in 3 cases.
Accidents, Traffic ; Child ; Constriction, Pathologic ; Diverticulum ; Follow-Up Studies ; Humans ; Hysterectomy ; Inflammation ; Postoperative Complications ; Replantation ; Tuberculosis ; Ureter ; Urinary Bladder

Even though prostatitis remains a complex, often puzzling disease, studies during the last decade have clarified many of its features. Much of the prevailing confusion concerning prostatitis is attributable is attributable to imprecise methods of diagnosis. We measured the immunologic response of the EPS using radial immunodiffusion method in 14 bacterial prostatitis cases, 39 nonbacterial prostatitis cases and 24 normal volunteer controls. The results obtained in this study are as follows: 1. Among the 14 cases of chronic bacterial prostatitis, gram negative bacterias were cultured from VB, and/or EPS specimens in 12 cases (85.8%) , and gram positive bacterias in 2 cases (14.2%). 2. In normal group, the mean+/-S.D. of IgG, IgA and IgM an serum was 1,235+/-203.78mg/dl, 192.0+/-50.16mg/dl, 172.0+/-32.11mg/dl respectively, in chronic bacterial prostatitis 1,171.5+/-241.O6 mg/dl, 163.1+/-67.61mg/dl, 137.1+/-51.88mg/dl, in nonbacterial prostatitis 1,258.3+/-313.47 mg/dl, 205.0+/-78.37 mg/dl, l35.0+/-48.78mg/dl. There was no significant difference among the normal control group, chronic bacterial and nonbacterial prostatitis patients. 3. In the normal group, the mean+/-S.D. of lgG, IgA and IgM was 1.5+/-0.74 mg/dl 0.82+/-0.06mg/dl, 2.7+/-1.37mg/dl, in chronic bacterial prostatitis 9.1+/-6.39mg/dl, 6.1+/-5.09mg/dl, 3.3+/-1.37mg/dl, in chronic nonbacterial prostatiti 2.8+/-1.99mg/dl, 2.7+/-3.05mg/dl, 2.2+/-1.56mg/dl. The levels of IgG. 4. The ratio of IgG and IgA in prostatic secretion to immunoglobulin in serum was increased in chronic bacterial prostatitis significantly more than the normal control group(P < 0.05). and IgA in prostatic secretion were more increased in chronic bacterial prostatitis than the normal control group(P< 0.05) but there was no significant elevation of EPS immunoglobulin in non-bacterial prostatitis.(P> 0.05) 5. After antimicrobial therapy the level of IgG and IgA in prostatic secretion was progressively decreased in chronic bacterial prostatitis but there was no definite change in chronic nonbacterial prostatitis.
Diagnosis ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Healthy Volunteers ; Humans ; Immunodiffusion ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Prostatitis*

We reported a case of postoperative pulmonary embolism associated with pelvic lymphadenectomy for staging prostatic carcinoma. A 66-year-old man was admitted to our hospital complaining of dysuria. Transperineal prostatic biopsy under transrectal ultrasonographic guidance revealed evidence of malignancy. Abdominal CT and whole body scan demonstrated no abnormal findings. Staging pelvic lymphadenectomy was performed safely under general anesthesia. On the 6th postoperative day, the patient had sudden dyspnea and chest pain. EKG showed sinus tachycardia. Chest A-P showed some elevation of left diaphragm. Pulmonary perfusion scan revealed multiple cold area throughout both lung fields. A diagnosis of pulmonary embolism was made. Shock treatment and anticoagulant therapy were successfully performed. This case suggests that attention should be directed to pulmonary embolism as one of the postoperative complication of staging pelvic lymphadenectomy.
Aged ; Anesthesia, General ; Biopsy ; Chest Pain ; Diagnosis ; Diaphragm ; Dyspnea ; Dysuria ; Electrocardiography ; Humans ; Lung ; Lymph Node Excision* ; Perfusion ; Postoperative Complications ; Prostatic Neoplasms ; Pulmonary Embolism* ; Shock ; Tachycardia, Sinus ; Thorax ; Tomography, X-Ray Computed ; Whole Body Imaging

The pathogenesis of bladder and cloacal exstrophy is an abnormal development of the cloacal membrane. The incidence of each is one in l0,000-50,000 and 200,000-400,000 live births. Male is more commonly affected than female. We experienced two cases of bladder exstrophy and one cloacal. First case was one-day-old girl who was referred to our department because of urine leakage through defected abdominal wall. We performed primary bladder closure with paraexstrophy skin flap urethroplasty, approximation and traction of pubis without osteotomy and application of hip-spica cast. The second was seven-day-old boy visited our department because of urine and stool leakage. We performed primary bladder closure, bilateral orchiectomy and ileostomy. He recurred bladder exstrophy due to infection of operation site. The third was twenty-day-old boy visited our department because of urine leakage. We recommended admission and treatment, but his parents refused further evaluation.
Abdominal Wall ; Bladder Exstrophy* ; Cloaca ; Female ; Humans ; Ileostomy ; Incidence ; Live Birth ; Male ; Membranes ; Orchiectomy ; Osteotomy ; Parents ; Skin ; Traction ; Urinary Bladder*

Transvenous implantation of an implantable cardioverter defibrillator in patients with a prosthetic valve in the tricuspid position is difficult because a defibrillator lead cannot be implanted into the right ventricle through the prosthetic valve. Hence, there are three options: epicardial implantation, subcutaneous implantable cardioverter defibrillator implantation, and cardiac vein implantation. Here, we report the transvenous implantation of an implantable dual-chamber cardioverter defibrillator in a patient who had undergone tricuspid valve replacement with a prosthetic valve. The patient was a 70-year-old female with a prosthetic valve in the tricuspid position who had experienced two events of sudden cardiac arrest. We successfully performed the procedure by implanting the defibrillator lead into the middle cardiac vein.
Aged ; Death, Sudden, Cardiac ; Defibrillators* ; Defibrillators, Implantable ; Female ; Heart Ventricles ; Humans ; Tricuspid Valve* ; Veins

OBJECTIVE: The aim of our study was to evaluate the clinical, laboratory, and sonographic charac- teristics of struma ovarii. METHODS: Thirty three cases of struma ovarii were reviewed retrospectively over recent 5 years (1997- 2001). The presenting clinical, radiological, and pathological features of patients with consequent struma ovarii were compared, retrospectively. RESULTS: The mean age of the patients was 40.5 years (20-70). Eight women (24.2%) were postmenopausal. The mean tumor diameter was 7.6 cm (1.5-15) and occured more frequently (60.6%) in the right ovary. Ascites was present in 11 cases. The CA-125 level was normal in 30 cases and significantly increased in 3 cases. Fourteen patients had pelvic pressure symptoms such as lower abdominal discomfort or pain, lumbago, and some of these patients were examined because of irregualr vaginal bleeding. In asymptomatic 19 patients, the ovarian tumor was an incidental finding on routine examination. Although one of the patients had cervical thyroid nodule, preoperative and postoperative evidence of hyperthyroidism was not noted and any patients did not complained symptoms of hyperthyroidism. All of the tumors were diagnosed as benign on permanant pathology and only surgical excision was done as a definitive treatment. CONCLUSION: The presented clinical, laboratory and radiological features of patients with consquent struma ovarii were diverse. The diagnosis was only made later by strict pathological criteria and conservative treatment by tumor excision only may be sufficient.
Ascites ; Diagnosis ; Female ; Humans ; Hyperthyroidism ; Incidental Findings ; Low Back Pain ; Ovary ; Pathology ; Retrospective Studies ; Struma Ovarii* ; Thyroid Nodule ; Ultrasonography ; Uterine Hemorrhage